Jamison ex rel. Estate of Jamison-Barber v. Hilton

Citations: 413 S.C. 133; 775 S.E.2d 58; 2015 S.C. App. LEXIS 140Docket: Appellate Case No. 2013-001711; No. 5330

Court: Court of Appeals of South Carolina; July 15, 2015; South Carolina; State Appellate Court

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In the medical malpractice case involving Rock Hill Gynological and Obstetrical Associates, PA, the court upheld the denial of the Practice's motion for judgment notwithstanding the verdict related to Samantha Jamison’s negligence claims concerning her son Jayden's death. The Practice took over Jamison's prenatal care in July 2008, during which she presented with chronic hypertension. On August 9, 2008, Jamison visited the emergency room with abdominal pain, where Dr. Gregory Miller conducted tests that ruled out preterm labor, leading to her discharge with instructions for follow-up visits.

On August 25, 2008, during a checkup, Jamison reported swelling in her ankle but had no severe complications noted by Dr. Miller, who did not conduct a non-stress test despite Jamison's lack of complaints regarding fetal movement. On September 5, 2008, concerned about decreased fetal movement, Jamison visited the Practice and was examined by nurse practitioner Robin Pruitt, who ordered a non-stress test. After the test, a biophysical profile indicated the fetus was in a breech position with reduced movement, prompting Dr. Ansley Hilton to refer Jamison to the hospital for potential emergency treatment.

Dr. Hilton ensured Jamison had transportation and communicated with Dr. Christopher Benson, who prepared for an emergency cesarean section at the hospital. Upon arrival, Jamison underwent an admissions process that took approximately thirty minutes before hospital staff confirmed the absence of a fetal heartbeat.

Dr. Benson arrived within two minutes of a call and performed an ultrasound, finding no fetal heartbeat, and informed Jamison that her baby, Jayden, was deceased. A C-section was conducted later that day, but the cause of death remains undetermined. In 2011, Jamison filed a complaint against Dr. Hilton, Dr. Benson, and their Practice, alleging malpractice leading to Jayden's pre-delivery death. All defendants denied the allegations. At trial, which began on April 8, 2013, expert testimonies were presented, including that of Dr. Edward Karotkin, who stated Jayden died between 11 and 11:48 a.m. on September 5, 2008, and that his death was foreseeable. He claimed that an earlier C-section could have saved Jayden. Dr. Douglas Phillips testified that both Dr. Hilton and Dr. Benson breached the standard of care, with Dr. Hilton failing to advise immediate hospital admission and Dr. Benson not ensuring timely transport for Jamison. Dr. Miller was also cited for negligence for not ordering necessary tests during an earlier visit. 

The defendants moved for a directed verdict, arguing a lack of evidence linking their actions to Jayden’s death, but the court denied this motion. Both Drs. Hilton and Benson could not determine a cause of death, and expert opinions for the defendants maintained they did not breach the standard of care. The jury, after deliberation, found no negligence by Dr. Hilton or Dr. Benson but did find the Practice negligent, awarding Jamison $90,000 in damages. Subsequent motions for a new trial or judgment as a matter of law by the defendants were denied. The Practice later filed a motion under Rule 59(e), SCRCP, which was also denied. The Practice subsequently appealed. The standard for reviewing the trial court’s rulings on directed verdicts or judgments notwithstanding the verdict (JNOV) is to view evidence favorably to the non-moving party, allowing for denial if multiple reasonable inferences exist. A JNOV can only be granted if no reasonable jury could have reached the verdict.

In motions for judgment notwithstanding the verdict (JNOV), trial and appellate courts cannot resolve issues of witness credibility or conflicts in testimony (Welch v. Epstein). The Practice claims the trial court incorrectly denied its JNOV motion, arguing there was no legal basis for liability against it, especially since defense verdicts for Drs. Hilton and Benson negate vicarious liability. The Practice asserts that no evidence supports a verdict against it based on actions of employees other than Drs. Hilton and Benson. In contrast, Jamison argues that this claim is unpreserved and points to expert Dr. Phillips' testimony regarding negligence by other Practice employees. 

To establish medical malpractice, a plaintiff must demonstrate: 1) a doctor-patient relationship, 2) adherence to recognized medical standards, 3) deviation from those standards by the defendant, 4) that this deviation caused the plaintiff's injury, and 5) actual injury occurred (Brouwer v. Sisters of Charity Providence Hospitals). Expert testimony is essential to establish the standard of care and the defendant’s failure to meet it unless the issue is within common knowledge (Carver v. Med. Soc. of S.C.). When relying solely on expert opinions to demonstrate causation, experts must assert with reasonable certainty that the injuries likely resulted from the defendant’s negligence, providing a significant causal link rather than a hypothetical one (Hoard ex rel. Hoard v. Roper Hosp. Inc.).

During the trial, while much focus was on Drs. Hilton and Benson, some testimony addressed the actions of other Practice employees, particularly regarding an office visit on August 25, 2008. Jamison's only complaint was swelling in her left ankle, with no mention of decreased fetal movement. Dr. Miller found no complications and determined that a non-stress test was unnecessary based on medical standards.

Jamison did not return to the medical Practice until September 5, 2008, following an office visit on August 25. Expert testimony from Dr. Phillips indicated that Dr. Miller failed to meet the standard of care by not ordering a non-stress test and biophysical profile during or shortly after the August visit, particularly due to Jamison's chronic hypertension. However, Dr. Phillips could not definitively state what the tests would have revealed or that Dr. Miller’s actions directly caused Jayden’s death, maintaining that Dr. Miller was not "directly" responsible.

On September 5, Jamison, concerned about decreased fetal movement, arrived at the Practice without an appointment. She signed in as the twentieth patient but did not request immediate attention or indicate acute distress. After approximately an hour wait, a nurse practitioner conducted a non-stress test, which showed a normal fetal heartbeat, and subsequently initiated a biophysical profile. Medical experts agreed that Jayden was alive when the biophysical profile was halted, and Jamison was instructed to go to the hospital.

Dr. Phillips criticized the Practice for not prioritizing Jamison's case, asserting that the delay in treatment constituted a breach of care. Dr. Karotkin further testified that Jayden's death was preventable and attributed it to inadequate monitoring and timely intervention, indicating signs of fetal distress leading up to and including the morning of September 5. 

The trial court's denial of the Practice's motion for judgment notwithstanding the verdict (JNOV) was upheld, with evidence of negligence by the Practice's employees noted, particularly concerning the delays in testing and hospital transfer, leading to the conclusion that Jayden's survival could have been possible with timely care.

Delays in testing and the time taken for the patient to arrive at labor and delivery resulted in the loss of a previously detected normal heartbeat of 158 beats per minute, leading to the demise of the infant, Jayden. The trial court's denial of the Practice's motion for Judgment Notwithstanding the Verdict (JNOV) regarding allegations of negligence by Samantha Jamison was affirmed. Jamison contended that the Practice’s argument on proximate cause was not preserved for appellate review since it was not included in the directed verdict motion. However, it was noted that an issue must be raised and ruled upon by the trial judge to be preserved. The Practice's counsel had motioned for a directed verdict, arguing that the plaintiff failed to prove her case, citing that Dr. Phillips, under cross-examination, did not affirm that the defendants caused the baby's death. The motion adequately highlighted the lack of expert testimony on causation. It was also pointed out that Jamison's other expert, Dr. Karotkin, did not provide opinions on Dr. Miller’s treatment of Jamison.