303 So.3d 798
Miss. Ct. App.2020Background
- Della Sumrall, a 68-year-old with significant pulmonary comorbidities, underwent open cholecystectomy and had a central venous catheter placed; on February 29, 2012 a nurse (Chequita Steele) removed the catheter while Della was reclined ~30–45°.
- Shortly after removal Della became unresponsive and suffered respiratory arrest and anoxic brain injury; a second central line was later placed and removed without complication on March 19, 2012 (Trendelenburg position used).
- The Sumralls sued Singing River under the MTCA alleging Nurse Steele breached the standard of care by not placing Della in the Trendelenburg (supine, feet up) position during removal, causing an air embolus and injury.
- First bench trial resulted in judgment for defendant but this Court (Sumrall I) reversed and remanded, holding the trial court improperly allowed the defense expert (Dr. Corder) to testify outside his designation and that the trial court had erred in finding no standard of care as to positioning.
- On remand a second bench trial was held with Dr. Corder re‑testifying; the trial court found the Trendelenburg method is the standard but allows deviation if the patient cannot tolerate it, and concluded Della could not tolerate Trendelenburg on Feb. 29 and Nurse Steele did not breach the standard.
- On appeal the Sumralls challenged (inter alia) Dr. Corder’s qualifications/disclosure compliance, the weight of evidence on tolerance of Trendelenburg, compliance with the remand directive, and cumulative error; the Court of Appeals affirmed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Qualification of defense expert to opine on standard of care | Dr. Corder (anesthesiologist/internist) lacked familiarity with the nursing standard and thus was unqualified | A physician who routinely places/removes central lines can testify; no evidence standard differs between nurses and physicians | Court: No abuse of discretion; Dr. Corder showed satisfactory familiarity and standard is not specialty‑dependent |
| Consistency of expert testimony with pretrial designation | Dr. Corder testified beyond/disagreed with his disclosed opinions and thus violated M.R.C.P. 26 | Disclosure identified that he would contradict plaintiffs’ causation/standard opinions based on records, literature, experience | Court: Testimony stayed within designated subject matter; trial court did not abuse discretion |
| Weight of evidence re: whether patient could tolerate Trendelenburg (breach/causation) | Sumralls: Della later tolerated Trendelenburg (Mar. 19), so failure to use it on Feb. 29 breached standard causing injury | Singing River: Della had acute pulmonary compromise and could not tolerate supine/Trendelenburg on Feb. 29; deviation justified | Court: Bench findings not manifestly wrong; substantial credible evidence supports finding Della could not tolerate Trendelenburg and no breach |
| Compliance with remand and cumulative error | Trial court failed to follow remand directives and cumulative pretrial errors denied fair trial | Trial court redacted/disallowed undisclosed opinions, re‑tried per remand, and errors claimed were moot or unsupported | Court: Remand directives were followed; alleged cumulative errors did not produce unfair trial |
Key Cases Cited
- Sumrall v. Singing River Health Sys., 189 So. 3d 661 (Miss. Ct. App. 2015) (prior appellate opinion reversing for undisclosed expert testimony and addressing standard of care)
- Hubbard v. Wansley, 954 So. 2d 951 (Miss. 2007) (expert must show satisfactory familiarity with specialty to testify to standard of care)
- Buskirk v. Elliott, 856 So. 2d 255 (Miss. 2003) (compare expert discovery disclosure to trial testimony when assessing sanctions/exclusion)
- King v. Singing River Health Sys., 158 So. 3d 318 (Miss. Ct. App. 2014) (expert opinions conflicting with medical literature require supporting basis beyond mere experience)
- Colthrap v. Canesale, 733 So. 2d 780 (Miss. 1999) (excluding expert testimony for unanticipated new theory disclosed at trial)
- Greenwood Leflore Hosp. v. Bennett, 276 So. 3d 1174 (Miss. Ct. App. 2018) (standard of review and deference to bench‑trial factfinder)
- G.B. Boots Smith Corp. v. Cobb, 911 So. 2d 421 (Miss. 2005) (mandate of appellate court is binding on trial court on remand)
- Lacoste v. Lacoste, 197 So. 3d 897 (Miss. Ct. App. 2016) (cumulative‑error doctrine: combined harmless errors may require reversal if they result in unfair trial)