Debra C. Gunn, MD, Obstetrical and Gynecological Associates, P.A. and Obstetrical and Gynecological Associates, PLLC v. Andre McCoy, as Permanent Guardian of Shannon Miles McCoy, an Incapacitated Person
14-14-00112-CV
| Tex. | Dec 22, 2015Background
- At 37 weeks in 2004, Shannon McCoy presented with placental abruption and developed DIC; fetus was stillborn and Shannon suffered massive bleeding, uterine atony, cardiac arrest in OR, and permanent anoxic brain injury requiring 24-hour care.
- Dr. Debra Gunn (OGA) was Shannon’s obstetrician when the critical events unfolded; dispute centers on whether Gunn timely ordered/administered fresh frozen plasma (FFP) and other blood products to manage DIC and blood loss.
- Plaintiff (Andre McCoy, permanent guardian) tried Gunn and OGA for healthcare liability; jury found Gunn negligent and awarded over $10.6M (including past medical $703,985.98 and future medical $7,242,403.00); trial court entered judgment and found OGA vicariously liable and entitled to indemnity from Gunn.
- Pretrial, plaintiff obtained no-evidence summary judgment on defendants’ comparative-responsibility defense (as to hospital nurses), which Gunn and OGA challenge on appeal.
- On appeal defendants raised multiple challenges: no-evidence summary judgment on comparative responsibility; legal sufficiency of causation and damages (past and future medical expenses); exclusion of defense life-care expert; and several requested jury instructions.
- The court affirmed liability and past-medical damages but found $159,854 of the future-medical award unsupported and suggested remittitur; otherwise reversed and remanded unless remittitur accepted, in which case judgment is modified and affirmed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Legally sufficient causation (Gunn’s negligence → Shannon’s brain injury) | McCoy: expert Brewer linked Gunn’s failure to order/administer FFP and to keep up with blood loss to progressive hypovolemia → cardiac arrest → anoxic brain injury. | Gunn/OGA: Brewer’s blood-loss estimates and causal chain are speculative, inconclusive, and contain analytical gaps; alternative causes exist. | Held: Evidence (including lab trends, documented external blood loss, and expert testimony) was legally sufficient for jury to find proximate cause; causation affirmed. |
| No‑evidence summary judgment on comparative responsibility (blaming hospital nurses) | McCoy: no evidence the nurses breached standard of care or proximately caused Shannon’s injuries. | Gunn/OGA: nurses failed to document/implement verbal orders for FFP; their conduct should be submitted to jury. | Held: Granting no‑evidence SJ was proper—Gunn/OGA failed to produce non‑speculative evidence tying nurses’ conduct to orders or causation. |
| Past medical expenses admissibility / sufficiency ($703,985.98) | McCoy: presented subrogation summaries and expert linkage; no counteraffidavits filed. | Gunn/OGA: affidavits not proper under §18.001, Haygood limits recoverable amounts; lack of expert on reasonableness/causation/segregation. | Held: Evidence admitted at trial supported jury finding as presented in the charge; award for past medical expenses was legally sufficient. |
| Future medical expenses—admission of defense life‑care expert & scope of recoverable costs ($7,242,403) | McCoy: offered life‑care plan and economist; counsel said "potential" but asked jury for probable needs. | Gunn/OGA: trial court excluded defense life‑care expert (Schilling); jury award included impermissible "potential" costs ($159,854) not within reasonable medical probability. | Held: Exclusion of Schilling was not reversible error (her critiques were before jury via plaintiff’s expert); evidence legally insufficient for $159,854 of "potential" items—remittitur suggested; otherwise future‑care award reduced to $7,082,549 if accepted. |
| Jury instructions (unavoidable accident; not consider nurses; new and independent cause) | Gunn/OGA: requested instructions to avoid liability where events were inevitable, caused by others (nurses, anesthesiologist, later embolus/stroke). | McCoy: contested need for such instructions; evidence supported jury considering Gunn’s management. | Held: Trial court did not abuse discretion in refusing these instructions; charge was adequate and not reversible error. |
| Indemnity ripeness (OGA v. Gunn) | Gunn: OGA’s indemnity claim is not ripe until final, non‑appealable judgment. | OGA: indemnity claim accrues when indemnitee’s liability becomes fixed by judgment. | Held: Indemnity claim was ripe when trial court entered judgment; indemnity determination stands. |
Key Cases Cited
- City of Keller v. Wilson, 168 S.W.3d 802 (Tex. 2005) (legal‑sufficiency standard and crediting evidence for jury verdict)
- Columbia Rio Grande Healthcare, L.P. v. Hawley, 284 S.W.3d 851 (Tex. 2009) (medical‑malpractice proximate‑cause standard)
- Jelinek v. Casas, 328 S.W.3d 526 (Tex. 2010) (expert must explain how and why negligence caused injury)
- Haygood v. De Escabedo, 356 S.W.3d 390 (Tex. 2011) (limits on admissible medical expenses; recoverable amounts are those actually paid or incurred)
- Gammill v. Jack Williams Chevrolet, Inc., 972 S.W.2d 713 (Tex. 1998) (analytical‑gap principle for expert reliability)