Talbert v. Evans

Citations: 88 So. 3d 673; 2011 La.App. 4 Cir. 1096; 2012 La. App. LEXIS 288; 2012 WL 746364Docket: No. 2011-CA-1096

Court: Louisiana Court of Appeal; March 6, 2012; Louisiana; State Appellate Court

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In the medical malpractice case, the Louisiana Patient’s Compensation Fund Oversight Board appeals a trial court ruling that found it liable for malpractice by Dr. Henry M. Evans, Jr. Plaintiffs John Lee Talbert Jr. and Cynthia Talbert challenge the trial court's allocation of fault and damages. On December 21, 1999, John Lee Talbert, Sr., 72, visited the Louisiana Avenue Medical Center (LAMC) for headaches. He was treated by physician’s assistant Miriam Wilbon, who failed to document test results and did not perform an ordered EKG due to a lack of supplies. Wilbon diagnosed him with migraines and prescribed Zomig, despite being informed by his daughter that he had memory issues. After taking the medication, Mr. Talbert experienced severe adverse effects and was subsequently hospitalized. He died the following morning from an acute myocardial infarction related to coronary artery disease. A medical review panel later determined Dr. Evans did not meet the standard of care and was responsible for the actions of the physician assistant and the medication prescribed, noting that Zomig posed an increased risk for a patient with coronary artery disease. The appellate court affirmed the trial court's decision, with amendments.

On August 1, 2007, the Talberts initiated a post-panel petition against Dr. Evans and LAMC for damages. The Patient’s Compensation Fund (PCF) intervened on April 1, 2008, filing a motion for summary judgment, asserting that it was not liable for Ms. Wilbon's actions. The trial court ruled in favor of the PCF, determining that Ms. Wilbon did not qualify under the PCF, and granted the motion. The trial proceeded to trial on April 7, 2010, resulting in a judgment for the plaintiffs, awarding $175,000 to John Lee Talbert, Jr. and $200,000 to Cynthia Talbert for wrongful death. The court found Dr. Evans breached the standard of care by failing to supervise his employee, leading to Mr. Talbert's death.

Post-trial motions were filed by all parties. The trial court granted the plaintiffs' motion for judgment notwithstanding the verdict (JNOV) and awarded an additional $75,000 for survival damages and $1,120 for past medical expenses. It partially granted the defendants’ motion for a new trial, reducing the damage awards per the Louisiana Medical Malpractice Act and assigning comparative fault: Dr. Evans (30%), LAMC (30%), and Ms. Wilbon (40%). However, the court maintained that Dr. Evans was fully responsible for Mr. Talbert’s wrongful death.

The defendants appealed, arguing the trial court did not clarify the PCF's non-liability and failed to categorize the defendants' acts as medical malpractice. The plaintiffs responded to the appeal, contending that the trial court incorrectly apportioned fault, suggesting Dr. Evans should be found 100% liable, and deemed the awarded damages insufficient, proposing increases for both wrongful death and survival damages. The Louisiana Medical Malpractice Act defines medical malpractice broadly, encompassing a range of unintentional torts and breaches of contract related to healthcare services.

In 2001, the Louisiana Legislature expanded the definition of malpractice in the Act to encompass the training and supervision of health care providers. The updated definition includes unintentional torts or breach of contract related to health care services, emphasizing responsibilities arising from acts or omissions in the training or supervision of healthcare personnel, as well as from defects in medical products. The Patient Compensation Fund (PCF) contends it is not liable for Dr. Evans's supervision of Ms. Wilbon, arguing that the prior version of the Act did not cover such supervision. Citing three First Circuit cases, the PCF asserts that negligent supervision claims do not amount to medical malpractice as "supervision" was not explicitly included in the definition at the time of the incident.

However, the Louisiana Supreme Court in Coleman v. Deno acknowledged that the medical malpractice statute could not address all potential malpractice scenarios. The Court proposed six factors to help determine if a claim qualifies as malpractice, including whether the wrong was treatment-related, if expert medical evidence was needed, and if the incident occurred within a physician-patient relationship.

In the current case, Ms. Wilbon inadequately assessed Mr. Talbert, notably failing to perform an EKG due to lack of supplies, and administered a potentially harmful medication considering his coronary artery disease. Dr. Evans, as the supervising physician, also committed breaches of care, such as providing pre-signed prescription forms and leaving his medication sample closet unsecured. Expert Dr. Robert Ryan testified that Ms. Wilbon's history-taking was insufficient and that not performing an EKG constituted a breach of the standard of care, which could have confirmed Mr. Talbert’s coronary condition. Dr. Ryan further criticized Dr. Evans's practices regarding medication accessibility and prescription management.

Dr. Ryan concluded that Zomig caused a coronary spasm leading to Mr. Talbert's myocardial infarction and subsequent death. Despite certain situations not being explicitly mentioned in the Medical Malpractice Act, the conduct in this case was treatment-related, as determined by applying the factors from Coleman v. Deno. Medical experts indicated a breach of the appropriate standard of care, particularly highlighting inadequate assessment of Mr. Talbert's condition. A physician-patient relationship existed between Dr. Evans and Mr. Talbert, supported by Dr. Evans’s management of the clinic and his signature on the prescription. The trial court found that the actions constituted medical malpractice, holding the Patient Compensation Fund (PCF) liable. Initially, Dr. Evans was found 100% liable, but this was amended to assign 30% liability to Dr. Evans, 30% to LAMC, and 40% to Ms. Wilbon. However, it was implied that Dr. Evans remained ultimately responsible for all events at the clinic, as LAMC could not operate without him. The judgment was amended to clarify Dr. Evans's 100% liability for damages. The plaintiffs argued that the damage awards of $75,000 for survival and $175,000 and $200,000 for wrongful death were insufficient. However, the appellate court upheld the trial court's discretion in assessing these damages, affirming that the awards did not constitute an abuse of discretion. The judgment of the trial court was affirmed, with the amendment reflecting Dr. Evans's full liability.