Atkins v. Louisiana Mutual Medical Insurance Co.
105 So. 3d 781
| La. Ct. App. | 2012Background
- Emergency room physician treated decedent for chest pain; death from myocardial infarction nine hours later after transfer to Monroe hospital.
- Atkins presented with chest pain, risk factors, and prior GI testing the day before; initial evaluation occurred at Jackson Parish Emergency Room (JPER).
- EKG at 3:21 p.m. showed ST elevations in multiple leads; troponin rose from 0.23 to 0.78, then 1.46 by 11:20 p.m. after transfer.
- Dr. Rainwater interpreted the EKG as not showing a STEMI and delayed transfer to a cardiologist; ASA and GI cocktail given; no beta blocker or thrombolytic administered.
- Panel and expert testimony diverged on whether EKG findings constituted STEMI and whether Rainwater’s conduct met the standard of care; trial court denied JNOV and new trial, which the appellate court affirmed.
- The case proceeded to jury verdict in favor of Rainwater; plaintiffs argued for JNOV or new trial due to new defense theory and belated testimony; appeal followed.
- The medical review panel initially found no breach of standard of care by Rainwater for the other defendants; this opinion addresses Rainwater’s conduct and communications.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether JNOV was proper given the evidence on standard of care | Atkins’ STEMI diagnosis was clear; delay in transfer breached standard of care | Reasonable interpretation of EKG and ACS presentation; transfer timely after Troponin rise not clearly negligent | JNOV denied; reasonable jurors could differ on care standard |
| Whether Rainwater’s post-Troponin treatment violated standard of care | Beta blockers/plavix/anticoagulants should have been given; delay harmed prognosis | Biopsy risk and pain status justified withholding certain meds | No reversible error; jury could find conduct within standard of care |
| Whether Rainwater’s failure to inform Mouhaffel of ST elevations breached duties | Informing cardiologist of EKG abnormalities was essential | Communication adequacy when considering overall clinical picture | No manifest error; not enough to overturn verdict |
| Whether trial court abused discretion denying continuance/new trial | Needed rebuttal witness for new male-ST elevation defense | No due diligence to obtain witness; issue cumulative | Denial affirmed; no abuse of discretion |
Key Cases Cited
- Peterson v. Gibraltar Savings & Loan, 98-1601 (La. 5/18/1999) (JNOV standard; weigh evidence for manifest error)
- Anderson v. New Orleans Public Service, Inc., 583 So.2d 829 (La. 1991) (precedent on JNOV review and manifest error)
- Horton v. Mayeaux, 931 So.2d 338 (La. 2006) (new trial discretion based on miscarriage of justice)
- Lamb v. Lamb, 430 So.2d 51 (La. 1983) (permissible grounds for new trial continuance)
- Jackson v. A.L. & W. Moore Trucking, 609 So.2d 1064 (La. App. 2d Cir. 1992) (examination of appellate review standards for verdicts)