Costaras v. Gilson

Citation: 2022 Ohio 4011Docket: 111225

Court: Ohio Court of Appeals; November 9, 2022; Ohio; State Appellate Court

Original Court Document: View Document

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In Costaras v. Gilson, 2022-Ohio-4011, Janice Costaras, both individually and as executor of her late husband Dr. George Costaras's estate, challenged the Cuyahoga County Medical Examiner's ruling that her husband's death was a suicide due to blunt force injuries. Following Dr. Costaras's death on January 14, 2020, the Medical Examiner conducted an autopsy, concluding that he had jumped from a bridge, listing the death as a suicide. Janice sought a judicial order to amend the cause of death on the death certificate from "suicide" to "undetermined." 

During a bench trial on October 5, 2021, the Medical Examiner moved to dismiss the case after Janice presented her evidence. The court granted this motion, concluding that the Medical Examiner's determination was supported by substantial evidence and that Janice failed to provide credible evidence to support an alternative ruling on the manner of death. On January 20, 2022, the court issued findings affirming the Medical Examiner's verdict. Janice appealed the dismissal, but the appellate court upheld the lower court's decision, affirming the Medical Examiner's ruling based on the evidence presented. 

Key testimonies included that of Dr. Othman A. Shemisa, Dr. Costaras’s primary care physician, who noted a history of anxiety but did not believe Dr. Costaras exhibited severe depression leading to suicide, contrary to the Medical Examiner's findings.

Dr. James Thomas Kelly, Jr., a primary care provider, noted in his November 18, 2019, appointment with George that he was treating him for hypertension, depression with anxiety, high cholesterol, and hyperglycemia. Dr. Kelly prescribed Wellbutrin and renewed George's Alprazolam prescription, acknowledging George's significant stress but confirming he was neither suicidal nor homicidal. A follow-up was recommended in four to six weeks to assess George's response to Wellbutrin.

Dr. Sandra Lynn Darling from the Cleveland Clinic Wellness and Preventative Medicine Department met George on January 7, 2020, with Janice present. George's primary concern was stress, which he attributed to financial issues and business pressures, leading to sleep disturbances and a weight loss of 10-15 pounds over six weeks. Dr. Darling noted George had a history of anxiety and prior use of Alprazolam, and he had been prescribed Wellbutrin about six weeks before this appointment. George expressed reluctance to pursue treatment for mental health due to fears of losing his medical license. Dr. Darling diagnosed him with uncontrolled hypertension related to stress, sleep difficulties, anxiety, and depression, prescribing Trazodone and recommending various non-pharmaceutical therapies. She found no indications of suicidal thoughts during their meeting.

Janice, George’s wife of over 41 years, described George's previously healthy lifestyle and recent weight loss, attributing it to a lack of appetite. She indicated that they did not recognize depression as part of their lives, despite George's medical consultations for high blood pressure and sleep apnea.

Janice testified about her surprise at Dr. Shemisa's 2016 diagnosis of situational anxiety for her husband, George, who was prescribed Alprazolam. She noted that George's podiatry business had been struggling financially, but this issue predated their marriage. While he appeared "nervous" and "worried" about the business, Janice did not characterize him as stressed. At the time of George's death, their financial situation was stable, with no mortgage and a net worth of approximately $2.5 million. They had recently acquired a new car, which represented their largest debt.

On January 14, 2020, Janice had plans to spend the day with George, who had been working late the previous night to complete paperwork. After speaking with him at 11:00 p.m. on January 13, he left the office, telling her he would be home shortly. When George did not return by midnight, Janice became concerned, searched for him, and ultimately called the police. At around 2:00 a.m., officers informed her that George had committed suicide by jumping off a bridge.

Janice noted that George had been worried about retirement but did not seem depressed. Their son, Nicholas, testified about his close relationship with George, stating that they often exercised and discussed family matters. Nicholas recalled conversations regarding George’s retirement plans, emphasizing that the business was performing well despite some declines in insurance reimbursements. After receiving a call from his mother in the early hours of January 14, Nicholas felt that something was wrong and learned of his father’s death upon arriving home, where police were investigating the incident.

Nicholas testified that he did not notice any significant changes in his father’s behavior prior to his death and was unaware of his father's diagnoses of anxiety and depression or that he was taking antidepressant and anti-anxiety medications. He confirmed that his father had sought wellness counseling a week before passing. Margaret Costaras, his sister, similarly reported no alarming behavior from their father before his death, noting only that he seemed tired during family gatherings. She was also unaware of his mental health issues and medication. On January 14, 2020, she received a call from her mother about their father's death, which was reported as a suicide by jumping from a bridge. Margaret expressed confusion and disbelief, stating her father never indicated any suicidal thoughts. Following the incident, she and her family raised concerns about the area where it occurred, but were told by a detective that the case was closed. Paul Baeppler, a private investigator hired by the Costaras family, reviewed various reports and indicated additional investigative steps, such as searching for surveillance footage, should have been taken. He has extensive experience in suicide investigations and noted potential oversights in the current inquiry.

Baeppler indicated he lacked subpoena power to investigate the operational status, angles, or zoom capabilities of cameras potentially capturing events on the bridge the night of Dr. Costaras's death. He identified various cameras in the vicinity that might have recorded relevant activity. Baeppler suggested that following up with the motorist who reported an inoperable vehicle on the bridge could have provided valuable leads for the police investigation. He expressed the need for forensic investigation of Dr. Costaras's electronic devices to uncover any communications or internet searches indicating distress or personal issues. Baeppler critiqued the investigation, suggesting steps were missed and that police might have prematurely assumed suicide. On cross-examination, he acknowledged he did not perform a forensic analysis of Dr. Costaras's devices and that the family declined such investigations. Baeppler also confirmed he had no evidence supporting foul play, accident, or natural causes regarding Dr. Costaras's death, stating an investigator should rule out other possibilities beyond suicide. After Janice's case concluded, the state moved for dismissal under Civ. R. 41(B)(2), asserting she failed to present sufficient evidence to challenge the coroner's ruling. The court agreed, determining that speculation about law enforcement's actions did not meet the burden of proof necessary to dispute the coroner's report. R.C. 313.19 establishes that the coroner's verdict regarding the cause of death is legally accepted unless a court directs otherwise after a hearing.

In Vargo v. Travelers Ins. Co., the Ohio Supreme Court established that a coroner's report and death certificate create a non-binding, rebuttable presumption regarding the manner and cause of death unless credible evidence contradicts it. Under Civil Rule 41(B)(2), a defendant may move for dismissal after the plaintiff has presented their case if the plaintiff has not demonstrated a right to relief. The trial court's role in such motions is to assess the evidence without favoring the plaintiff and to decide if the plaintiff has met the burden of proof by a preponderance of the evidence. A reviewing court can overturn the trial court's decision only if it is legally erroneous or against the manifest weight of the evidence. 

In Janice's first assignment of error, she contended that the trial court incorrectly determined that the presumption against suicide did not apply. Ohio law presumes a person has not committed suicide in the absence of sufficient counter-evidence. The courts have ruled this presumption is rebuttable but may be extinguished by substantial evidence. However, the Medical Examiner concluded the death was a suicide, which is legally binding under R.C. 313.19. Janice failed to produce credible evidence to counter this finding, as all indications pointed to suicide, including the lack of foul play and the circumstances surrounding the decedent's death. Consequently, the court upheld its ruling against Janice's assignment of error.

Janice contested the trial court's requirement for a medical expert to challenge the coroner's report, arguing it erred in this finding. The court indicated that Janice did not need a medical expert but noted her failure to provide credible evidence to counter the Medical Examiner’s report. The court emphasized that a coroner's verdict is accorded significant weight and that competent, credible evidence is necessary to dispute it. Consequently, Janice's third assignment of error was overruled.

In her second and fourth assignments of error, Janice claimed the trial court incorrectly sustained the Medical Examiner's motion for dismissal, asserting sufficient evidence existed for reasonable minds to reach differing conclusions regarding the cause of death. She also argued against the trial court's refusal to change the cause of death from suicide to undetermined, contending it contradicted the manifest weight of the evidence. The court clarified that there was no directed verdict, as the Medical Examiner's motion was a Civ.R. 41(B)(2) dismissal based on evidence weighing. The appellate standard for manifest weight applies in both civil and criminal cases, and Janice failed to provide evidence that effectively countered the Medical Examiner's determinations.

Janice failed to meet her burden of proof by merely suggesting that the Medical Examiner should have explored further investigative avenues regarding the manner of Dr. Costaras's death. Both circumstantial and direct evidence are equally probative, with circumstantial evidence sometimes being more compelling. Although no direct evidence of suicide, such as a note or witnesses, was presented, circumstantial evidence indicated that Dr. Costaras's death was likely a suicide. Indicators included his documented mental health issues, weight loss, lack of interest in exercise, and sleep disturbances. His vehicle was located at the top of a bridge, while his body was found below, with no signs of foul play. Consequently, the evidence did not strongly contradict the trial court's findings, leading to the overruling of Janice's second and fourth assignments of error and the affirmation of the judgment. Appellees are awarded costs, and the court recognizes reasonable grounds for the appeal, issuing a special mandate for execution of the judgment. A certified copy of this entry will serve as the mandate as per Rule 27 of the Rules of Appellate Procedure. Judges LISA B. FORBES, ANITA LASTER MAYS, and EMANUELLA D. GROVES concur.