Cromer v. Children's Hosp. Med. Ctr. of Akron (Slip Opinion)
142 Ohio St. 3d 257
| Ohio | 2015Background
- Five-year-old Seth Cromer was treated in an ER and then PICU for shock; physicians provided fluids, epinephrine, central/arterial lines, and ultimately intubation but Seth died after cardiac arrest.
- Disputed issue at trial: timing of intubation — plaintiffs’ expert said delay breached standard of care; defense experts said risks of immediate intubation justified delay and physicians performed risk-benefit analysis.
- Trial court gave standard medical-negligence instructions plus an additional general foreseeability instruction (from OJI general negligence language); plaintiffs objected.
- Jury found no negligence and no proximate cause; plaintiffs moved for new trial arguing erroneous jury instructions; trial court denied; appellate court reversed, holding foreseeability is irrelevant to medical-duty questions and that inclusion required reversal.
- Ohio Supreme Court granted discretionary review to decide whether foreseeability is part of medical-negligence standards and whether the foreseeability instruction here required reversal.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether foreseeability is part of the duty/standard-of-care inquiry in medical malpractice | Foreseeability is irrelevant to physician duty once physician-patient relationship exists; instruction misstates law and should not be given | Foreseeability is relevant to whether physicians recognized and weighed risks; instruction is permissible when supported by evidence | Foreseeability is relevant to scope of physician’s standard of care but often unnecessary when physicians admit they knew the risk; court reversed appellate court and held instruction was not prejudicial here |
| Whether giving a general foreseeability instruction (ordinary-person formulation) in a medical-malpractice trial was legally correct | Instruction improperly framed foreseeability in lay terms/probability and misstated medical standard | Instruction was drawn from OJI and not misleading in context because other instructions defined standard in medical terms | General foreseeability instruction is not manifestly incorrect but preferable to tailor foreseeability to the reasonable-medical-professional standard; here other instructions referenced medical standard so jury was not misled |
| Whether the unnecessary foreseeability instruction required reversal per se | Inclusion of foreseeability was prejudicial and led to reversal by appellate court | An unnecessary instruction is harmless absent affirmative showing of material prejudice on the record | An unnecessary instruction alone is not reversible error; prejudice must be shown; record here failed to show material prejudice, so reversal was improper |
| Whether the jury’s completion of proximate-cause interrogatory showed confusion from the instruction | Completion of causation interrogatory proves the foreseeability instruction confused jury and prejudiced plaintiffs | No causal link between surplus foreseeability instruction and jury answering a mooted interrogatory; jury answers were consistent | No connection shown on record between instruction and jury behavior; interrogatories and general verdict were consistent, so no prejudice shown |
Key Cases Cited
- Menifee v. Ohio Welding Products, Inc., 15 Ohio St.3d 75 (recognizing foreseeability as central to existence of duty in negligence)
- Gedeon v. E. Ohio Gas Co., 128 Ohio St. 335 (foreseeability tests scope of legal duty; reasonable person standard)
- Bruni v. Tatsumi, 46 Ohio St.2d 127 (medical standard of care measured by physicians of ordinary skill, care, and diligence)
- Berdyck v. Shinde, 66 Ohio St.3d 573 (physicians’ augmented duty to recognize symptoms and associated risks)
- Hayward v. Summa Health Sys./Akron City Hosp., 139 Ohio St.3d 238 (erroneous jury instruction reversible only if it probably misled jury and resulted in erroneous verdict)