2023 Ohio 934
Ohio Ct. App.2023Background
- Plaintiff Deborah Geletka had a palpable "marble"-like mass on her upper left thigh; Dr. Kevin Grimes diagnosed a femoral hernia and on Oct. 18, 2018 inserted a 4"×1" polypropylene mesh plug.
- After surgery the original lump persisted; an ultrasound later identified a saphena varix (venous) distinct from the alleged hernia.
- Geletka sued for medical malpractice, alleging the mesh insertion was unnecessary, caused pain, and that Dr. Grimes falsified records; she sought damages for pain and suffering.
- At trial Geletka’s sole expert, Dr. Mark Liberman, testified generally that mesh placement was unnecessary and can cause problems, but did not opine to a reasonable degree of medical probability that the mesh caused Geletka’s specific pain.
- The trial court granted a directed verdict for Dr. Grimes for failure to prove causation; the court also denied Geletka’s Civ.R. 59 motion for a new trial (and sanctions) alleging defense counsel refused to stipulate to medical-record authenticity.
- The Eighth District affirmed: expert testimony failed to establish causation by the requisite standard and the record did not show counsel misconduct or a trial irregularity warranting a new trial.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Sufficiency of evidence on causation (directed verdict) | Liberman established mesh placement was negligent and would cause post‑op pain at the implant site, which was the cause of Geletka’s suffering. | Liberman never opined, to a reasonable degree of medical probability, that the mesh caused Geletka’s pain; plaintiff herself cannot supply expert causation. | Directed verdict proper; expert testimony did not establish causation. |
| Authentication / admissibility of medical records (stipulation) | Trial briefs anticipated stipulation; defense refusal obstructed admission of Cleveland Clinic records plaintiff intended to use. | No pretrial stipulation existed; defense willing to stipulate only after seeing identical records; plaintiff failed to provide exhibit list or call a records custodian. | No error; records required authentication and plaintiff did not follow available procedures. |
| Motion for new trial under Civ.R.59(A)(1),(2) (irregularity/misconduct) | Defense counsel’s refusal to stipulate created an irregularity and deprived Geletka of a fair trial. | Any alleged obstruction was remedial by plaintiff (custodian, pretrial exchange); no intentional misconduct and no prejudice shown. | Denial of new trial affirmed; trial court did not abuse discretion. |
| Standard for expert causation testimony | Plaintiff contends Liberman’s statements about mesh reaction and site pain were sufficient to establish causation. | Ohio law requires expert causation expressed as probability (more likely than not); general or speculative testimony is insufficient. | Court applied probability standard; Liberman’s testimony was too general and speculative to satisfy causation. |
Key Cases Cited
- Wagner v. Midwestern Indemn. Co., 83 Ohio St.3d 287 (Ohio 1998) (directed verdict legal-sufficiency principles)
- Ltd. Stores v. Pan Am., 65 Ohio St.3d 66 (Ohio 1992) (standard for granting directed verdicts)
- Crawford v. Halkovics, 1 Ohio St.3d 184 (Ohio 1982) (directed verdict jurisprudence)
- Goodyear Tire & Rubber Co. v. Aetna Cas. & Sur. Co., 95 Ohio St.3d 512 (Ohio 2002) (de novo review for legal questions)
- Stinson v. England, 69 Ohio St.3d 451 (Ohio 1994) (expert causation must be expressed as probability)
- Shepherd v. Midland Mut. Life Ins. Co., 152 Ohio St. 6 (Ohio 1949) (probability standard in causation)
- Cooper v. Sisters of Charity, Inc., 27 Ohio St.2d 242 (Ohio 1971) (causation/expert opinion standard)
- White v. Leimbach, 131 Ohio St.3d 21 (Ohio 2011) (expert opinion that a procedure was "most likely" cause insufficient for medical-probability standard)
- Bruni v. Tatsumi, 46 Ohio St.2d 127 (Ohio 1976) (elements of medical-malpractice claim)