Branham v. Rock
2014 Ky. LEXIS 606
| Ky. | 2014Background
- Peggy Branham, unrestrained passenger in a crash, was treated at University of Kentucky Medical Center ER; chest x‑ray flagged concerning findings but she was discharged and died ~36 hours later of a ruptured aorta from blunt chest trauma.
- Estate sued four physicians (two attendings, two residents) for wrongful death/medical negligence and asserted vicarious liability against the Medical Center and Hospital Corporation.
- Trial court dismissed claims against the Medical Center and Hospital Corporation on sovereign‑immunity grounds; jury found for the individual Physicians; judgment entered for defendants.
- Estate appealed, challenging exclusion of evidence about Dr. Rock’s licensing discipline and Dr. Britt’s prior failed licensing attempts, limitation on expert witnesses, and the substance of jury interrogatory/instructions; also urged revisiting immunity holding.
- Kentucky Supreme Court affirmed: exclusion of the collateral licensing evidence and of Dr. Britt’s exam failures was not an abuse of discretion; permitting multiple retained experts was within the trial court’s control; the given jury instruction was appropriate; immunity issues were moot given affirmance of physician verdicts.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Admissibility of Dr. Rock’s Board discipline and agreed order | Discipline shows lack of medical knowledge/credibility and is admissible because Dr. Rock was identified as an expert | Discipline was collateral, unrelated to ER trauma care, and unduly prejudicial/propensity evidence | Exclusion affirmed — collateral and not relevant to treatment at issue; Dr. Rock testified mainly as fact witness, not on standard of care |
| Admission of Dr. Rock’s alleged inconsistent deposition statements | KRE 608 impeachment for untruthfulness was proper and probative | Would provoke a trial‑within‑a‑trial, confuse jury, and was not material to whether care met standard | Exclusion affirmed — evidence had little relevance to whether treatment complied with standard and risked confusion/prejudice |
| Admission of Dr. Britt’s prior failures on licensing exam | Shows lack of competence/knowledge and credibility because Physicians labeled him an expert | Irrelevant; he didn’t testify primarily as an expert nor give standard‑of‑care opinions; later passed and completed residency | Exclusion affirmed — not probative of compliance with standard of care in this case |
| Number of retained expert witnesses allowed | Multiple retained experts were cumulative and wasteful; court should limit to one per specialty | Each defendant may present expert testimony reflecting resident vs attending perspectives; trial court controls cumulative evidence | Denial of Estate’s motion affirmed — trial court did not abuse discretion in permitting multiple experts |
| Jury interrogatory framing (event vs injury) | Jury should decide whether negligence was substantial factor in failure to diagnose the aortic injury (event), not merely in death (injury) | Court’s standard instruction focusing on death was adequate absent claim of a superseding intervening cause; counsel can clarify during argument | Instruction affirmed — Deutsch event instruction required only when a superseding intervening cause is claimed; here none was found |
| Challenge to sovereign immunity of Medical Center/Hospital Corporation | Withers should be revisited; entities derive funds from non‑state sources and operate distinctly from the university | Existing precedents uphold immunity; vicarious liability depends on agent negligence | Moot — because physician verdicts stand, vicarious liability never attaches; court declined to revisit Withers |
Key Cases Cited
- Trover v. Estate of Burton, 423 S.W.3d 165 (Ky. 2014) (framework for admissibility of collateral misconduct and propensity evidence)
- Miller ex rel. Monticello Baking Co. v. Marymount Medical Center, 125 S.W.3d 274 (Ky. 2004) (Deutsch/event instruction required only when superseding intervening cause is contested)
- Deutsch v. Shein, 597 S.W.2d 141 (Ky. 1980) (uses substantial‑factor test and discusses event‑focused instruction)
- Withers v. University of Kentucky, 939 S.W.2d 340 (Ky. 1997) (addressing sovereign immunity of university medical center)
- Kentucky Ctr. For the Arts Corp. v. Berns, 801 S.W.2d 327 (Ky. 1991) (establishes test for governmental immunity analysis)
- Goodyear Tire & Rubber Co. v. Thompson, 11 S.W.3d 575 (Ky. 2000) (abuse of discretion standard for trial court evidentiary rulings)
- Baptist Healthcare Sys., Inc. v. Miller, 177 S.W.3d 676 (Ky. 2005) (trial judge’s wide discretion to admit or exclude evidence)
- Cohen v. Alliant Enterprises, Inc., 60 S.W.3d 536 (Ky. 2001) (no vicarious liability if agent not negligent)
- Olfice, Inc. v. Wilkey, 173 S.W.3d 226 (Ky. 2005) (Kentucky is a "bare bones" instruction jurisdiction; counsel must flesh issues in argument)