David Jernigan, As Next Of Kin and Surviving Husband To Jane Ann Jernigan v. Robert Evan Paasche, M.D., M2020-00673-COA-R3-CV

Background:

Decedent presented to an ED on Aug. 11, 2012; CT showed a "large paraesophageal hernia;" she was discharged with meds and told to follow up.
She returned to a different hospital ED on Aug. 12, 2012, was seen and discharged again; later presented with perforation and underwent surgery but died postoperatively.
Plaintiff (Jernigan, surviving spouse) sued the two ED physicians for health-care liability/wrongful death, alleging failure to diagnose, to obtain a surgical consult, and discharge in unstable condition.
First jury trial (Dec. 2017) resulted in a defense verdict, which the trial court set aside and granted a new trial; case transferred and numerous pretrial evidentiary disputes followed.
Trial court bifurcated the retrial into (1) standard of care/liability and (2) causation/damages; during the standard-of-care phase plaintiff’s surgical and radiology experts were excluded and plaintiff presented two emergency-medicine experts; the jury found no deviation from the standard of care.
Trial court denied plaintiff’s post-trial motion for new trial; plaintiff appealed, challenging bifurcation, expert exclusions/rebuttal, and alleged blame‑shifting.

Issues:

Issue	Plaintiff's Argument	Defendant's Argument	Held
Bifurcation of standard of care and causation	Bifurcation improperly separates intertwined issues (differential diagnosis and causation) and prejudices plaintiff	Bifurcation was within discretion given prior trial problems and need to control evidentiary scope	Affirmed — trial court did not abuse discretion; exceptional circumstances supported severance
Exclusion of surgical & radiology experts from SOC phase	Excluded experts were relevant to what ED physicians should have done; Ledford permits experts from other specialties	Their testimony would be cumulative to plaintiff's ED experts and Rule 403 justified exclusion	Affirmed — exclusion was within discretion as cumulative and not outcome‑determinative
Denial to call excluded experts as rebuttal witnesses	Rebuttal needed to controvert defendants' experts and explain CT findings (volvulus/obstruction)	Proffered rebuttal did not contradict the points it purported to rebut and largely agreed with defendants on report accuracy	Affirmed — proffered rebuttal would not have altered outcome and did not controvert defendants' testimony
Alleged blame‑shifting to radiologist / waiver	Allowing testimony that ED physicians may rely on the radiologist shifted blame to nonparty radiologist and was unfairly prejudicial	Plaintiff failed to contemporaneously object; plaintiff's own experts testified similarly; defendants did not accuse radiologist of negligence	Affirmed — issue waived for lack of objection and testimony was not improper blame‑shifting

Key Cases Cited

Ennix v. Clay, 703 S.W.2d 137 (Tenn. 1986) (standards for bifurcation of issues for jury)
Lee Med., Inc. v. Beecher, 312 S.W.3d 515 (Tenn. 2010) (abuse‑of‑discretion review for discretionary rulings)
Davis v. McGuigan, 325 S.W.3d 149 (Tenn. 2010) (trial court as gatekeeper on expert admissibility; abuse‑of‑discretion standard)
Draper v. Westerfield, 181 S.W.3d 283 (Tenn. 2005) (elements of medical malpractice/health‑care liability)
Cotten v. Wilson, 576 S.W.3d 626 (Tenn. 2019) (cause‑in‑fact and legal causation distinctions)
Hampton v. Braddy, 270 S.W.3d 61 (Tenn. Ct. App. 2007) (offer of proof requirement to preserve exclusion claims)
Goss v. Hutchins, 751 S.W.2d 821 (Tenn. 1988) (contemporaneous objection required to preserve evidentiary issues)