Fairrow v. OhioHealth Corp.
2020 Ohio 5595
Ohio Ct. App.2020Background
- Ronald Fairrow underwent laparoscopic appendectomy; circulating nurse Megan Conrad and resident Alon Geva attempted Foley catheter placement but multiple attempts failed and were not documented.
- Urologist Dr. Jason Jankowski was consulted intraoperatively, performed cystoscopy, and observed "multiple false passages" in the urethra; he ultimately placed an 18-French catheter and the appendectomy was completed.
- Postoperatively Fairrow experienced penile bleeding, urethral strictures, required a suprapubic catheter and multiple procedures, and eventually a urethroplasty that removed several centimeters of urethra.
- Fairrow sued OhioHealth, Conrad, and Geva for medical negligence; trial evidence included competing urology experts (plaintiff's Dr. Vapnek; defendants' Dr. Donovan) and operative notes from Drs. Jankowski and Taylor.
- Trial rulings: court excluded jury apportionment to Jankowski (no expert saying Jankowski breached), permitted testimony that lack of documentation could demonstrate a deviation from the standard of care, and allowed an interrogatory on whether the injury was a "permanent and substantial physical deformity." Jury found for plaintiffs; noneconomic damages reduced to statutory cap; defendants appealed.
Issues
| Issue | Plaintiff's Argument (Fairrow) | Defendant's Argument (OhioHealth, Conrad, Geva) | Held |
|---|---|---|---|
| Sufficiency of evidence of deviation from standard of care | Conrad and Geva applied excessive force during catheter attempts causing false passages; expert testimony (Vapnek) supports breach | Evidence was insufficient; injuries seen by Jankowski might be "trivial" or caused later by Jankowski/Amplatz dilators | Trial court properly denied directed verdict/JNOV; expert testimony created factual question for jury and supported breach finding |
| Causation between defendants' attempts and later injuries | Vapnek testified, to reasonable medical probability, defendants caused the false passages and later complications (same lesions observed later) | Defendants argue causation uncertain: could be Jankowski or Amplatz dilators that caused or worsened injuries; timeline ambiguous | Enough evidence of causation existed to submit to jury; credibility disputes for jury to resolve |
| Request to apportion liability to non-party Dr. Jankowski (R.C. 2307.23) | Defendants sought an interrogatory to apportion fault to Jankowski as a non-party who also attempted catheterization | No expert at trial testified Jankowski breached the standard of care; thus no evidentiary basis for apportionment to non-party | Trial court did not abuse discretion in refusing apportionment interrogatory because lack of expert evidence that Jankowski was negligent |
| Admissibility of testimony that Conrad's failure to document constituted deviation | Fairrow: lack of documentation is relevant to habit/credibility and standard of care; excluding it would incentivize non-documentation | Defendants: proof of deviation must be tied to proximate cause; documentation alone prejudicial without causation | Court did not abuse discretion in admitting testimony; later granted directed verdict as to documentation-based negligence (no causation shown) and instructed jury on limited relevance |
| Submission of interrogatory on higher noneconomic damages cap (permanent and substantial deformity) | Fairrow: objective and testimonial evidence (multiple procedures, urethroplasty, scarring, penile shortening, sexual dysfunction) meets threshold for jury consideration | Defendants: insufficient objective proof (e.g., photos, measuring) to warrant higher-cap question | Court acted within discretion allowing jury to decide; evidence met threshold to reach jury on permanent and substantial deformity; jury consideration proper |
Key Cases Cited
- Bruni v. Tatsumi, 46 Ohio St.2d 127 (Ohio 1976) (sets Ohio standard for medical negligence proof)
- Texler v. D.O. Summers Cleaners & Shirt Laundry Co., 81 Ohio St.3d 677 (Ohio 1998) (directed verdict legal-sufficiency standard)
- Posin v. A.B.C. Motor Court Hotel, Inc., 45 Ohio St.2d 271 (Ohio 1976) (standard for JNOV/directed verdict review)
- Ramage v. Central Ohio Emergency Servs., Inc., 64 Ohio St.3d 97 (Ohio 1992) (expert testimony required to establish medical standard of care)
- Arbino v. Johnson & Johnson, 116 Ohio St.3d 468 (Ohio 2007) (discusses "permanent and substantial physical deformity" and role of jury on noneconomic damage caps)
- Blakemore v. Blakemore, 5 Ohio St.3d 217 (Ohio 1983) (defines abuse-of-discretion standard on evidentiary rulings)