Aragon v. Issa
103 So. 3d 887
| Fla. Dist. Ct. App. | 2012Background
- Estate sued Internist, hospital, Initial Cardiologist, and others for Aragon's death after an anaphylactic reaction during catheterization; Interventional Cardiologist settled and hospital settled before trial; jury found multiple defendants negligent; Internist moved for directed verdict; trial court granted judgment consistent with directed verdict against Estate; appellate reversal sought.
- Aragon presented chest pain and positive troponin tests; shellfish allergy noted; internist admitted Aragon, ordered monitoring, but did not see him personally or relay full information to the cardiology team; a lack of pre-treatment planning and communication occurred.
- Cardiologist team proceeded with catheterization based on incomplete information; interventional cardiologist administered contrast dye with a single steroid pre-treatment, leading to fatal anaphylaxis; experts opined a proper pre-treatment plan would have prevented death.
- Experts Bakken and Alton testified breach of care and failure to communicate information were proximate causes; causation evidence was disputed but sufficient to submit to jury; trial court cannot resolve causation on summary or directed verdict given conflicting evidence.
- Remand to consider a new trial; if denied, enter judgment consistent with the jury verdict.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Causation standard sufficiency | Estate—causation proven by expert testimony | Internist—causation not proven or speculative | Jurors may resolve causation; evidence could support liability |
| Directed verdict appropriateness | Evidence supports more likely than not causation | Conflicting evidence requires judge to decide | Directed verdict improper; issue for jury |
| Application of Hancock/Cox standards | Evidence aligns with Hancock/Cox allowances for inference | Misapplication; testimony speculative | Causation should be for jury; not law to resolve at summary stage |
| Ewing v. Sellinger distinction | Ewing-like inference acceptable here | Ewing distinguishable; outcome not affected by initial omissions | Ewing inapplicable; issue reserved for jury |
Key Cases Cited
- Hancock v. Schorr, 941 So.2d 409 (Fla. 4th DCA 2006) (causation evidence reviewed for jury determination when not purely speculative)
- Cox v. St. Josephs Hosp., 71 So.3d 795 (Fla.2011) (experts may rely on experience and literature; conflict resolved by jury)
- Gooding v. Univ. Hosp. Bldg., Inc., 445 So.2d 1015 (Fla.1984) (elements of medical malpractice and causation standard)
- Ewing v. Sellinger, 758 So.2d 1196 (Fla. 4th DCA 2000) (distinguishes when initial faults do not affect outcome; jury guidance on causation)
- Hancock v. Hancock, 941 So.2d 412 (Fla. 4th DCA 2006) (prima facie causation evidence admissible to submit to jury)
- Fabre v. Marin, 623 So.2d 1182 (Fla. 1993) (verbatim jury submission standards for negligence verdicts)