Engleman v. McCullough
2017 Ark. App. 613
Ark. Ct. App.2017Background
- On March 3, 2011, Natasha Engleman received an intramuscular steroid injection from LPN Cindye McCullough at St. John’s Clinic and shortly thereafter developed severe leg pain, progressive weakness, and foot drop.
- Treating and consulting physicians, neurogram by Dr. Aaron Filler, and subsequent surgeries supported a diagnosis of sciatic-nerve injury and CRPS; appellees disputed a needle injury causation.
- Central factual dispute at trial: the anatomic site of the injection — McCullough testified it was the gluteus medius (upper outer quadrant); Engleman testified it was the gluteus maximus (inner buttock, overlying the sciatic nerve).
- Both sides presented nursing and medical experts; parties agreed the correct site is the gluteus medius and that injection into the gluteus maximus would breach the standard of care.
- At charge conference the court gave AMI 1501 (medical-malpractice instruction) including its second paragraph limiting consideration of professional-skill evidence to the nurses’ expert testimony; Engleman objected and proffered a modified second paragraph, which the court rejected.
- Jury returned a defense verdict after brief deliberation; Engleman appealed arguing the AMI 1501 instruction (and refusal to give her modification) effectively prevented the jury from considering her testimony about injection location.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether giving standard AMI 1501 (including paragraph that confines consideration of skill/learning to expert nurses) was error | AMI 1501’s second paragraph directed jury to ignore Engleman’s firsthand testimony about injection location and thus deprived her of a credibility determination | AMI 1501 accurately states law for medical-malpractice claims and was required because the issues relied on expert testimony | Court held no error: AMI 1501 must be given in such cases unless court finds common-knowledge exception; here parties used experts and court made no such finding |
| Whether the trial court should have found the case fell within the jury’s common knowledge (and thus omitted AMI 1501’s second paragraph) | Engleman: location of a needle stick is within lay common knowledge and did not require expert testimony | Defendants: medical issues were complex and both sides presented experts, so the common-knowledge exception does not apply | Held: appellant never requested a court finding that expert testimony was unnecessary; record shows experts were relied on, so AMI 1501 was proper |
| Whether trial court abused discretion by refusing appellant’s proposed modified AMI 1501 (stating only the nurses who testified may opine on care and on ultimate negligence) | Proposed modification would allow jurors to consider lay testimony about location while limiting expert testimony to nurses | Defendants: modification misstates law because it would permit experts to opine on the ultimate issue of negligence and is not a correct statement of law | Held: trial court did not err in refusing the modification because it was not a correct statement of law and would improperly permit experts to answer the ultimate negligence question |
| Whether Duke v. Lovell and similar authority required a different instruction here | Engleman: Duke shows AMI 1501 can mislead when the critical issue is a simple fact within juror competence; modification (or AMI 104) should have been given | Defendants: Duke supports giving AMI 1501 with the common-knowledge language; AMI 1501 was revised post-Duke to address concerns and was properly used here | Held: Court distinguished Duke — AMI 1501 was updated to allow jurors to use common knowledge where appropriate, and here no court finding excused the model instruction |
Key Cases Cited
- Duke v. Lovell, 262 Ark. 290 (1977) (reversed where AMI 1501 misled jury on a critical, nonexpert fact)
- Chrestman v. Kendall, 247 Ark. 802 (1969) (requires giving AMI 1501 in medical-malpractice claims)
- Barnes v. Everett, 351 Ark. 479 (2003) (non-AMI instructions allowed only if AMI fails to contain an essential instruction or accurately state law)
- Gramling v. Jennings, 274 Ark. 346 (1987) (expert testimony may not directly instruct the jury on the ultimate issue of negligence)
- Nelson v. Stubblefield, 2009 Ark. 256 (2009) (trial court’s decision to submit jury instructions reviewed for abuse of discretion)
- Mitchell v. Lincoln, 366 Ark. 592 (2006) (limited common-knowledge exception in medical-negligence cases)