Howland v. Wadsworth
324 Ga. App. 175
| Ga. Ct. App. | 2013Background
- Wadsworth went to Houston Medical Center ER complaining of worsening bilateral foot pain, coldness, and inability to walk; she was triaged as non-urgent (level 4) and placed in a fast-track pod.
- PA Gregory Howland examined her, gave morphine, ordered a venous ultrasound (DVT negative), found palpable/diminished pulses, diagnosed cellulitis, and discharged her with antibiotics after about three hours; supervising physician Dr. Paustian agreed without personally examining her.
- Approximately 12 hours after discharge Wadsworth returned in near cardiac arrest; imaging revealed complete arterial occlusions behind both knees and both lower legs were later amputated below the knees.
- Wadsworth sued for ordinary and gross negligence; defendants moved for directed verdict invoking OCGA § 51-1-29.5 (ER emergency-care gross-negligence standard) and arguing plaintiff failed to prove gross negligence by clear and convincing evidence.
- Trial court refused directed verdict, submitted both ordinary- and gross-negligence theories and burdens to the jury, instructed on the statute’s definition of "emergency medical care," and the jury returned a $5,000,000 verdict applying the ordinary negligence standard.
- Defendants appealed, raising: (1) jury should not decide whether care was "emergency medical care" under OCGA § 51-1-29.5; (2) as a matter of law the care was emergency medical care; (3) insufficient proof of gross negligence; (4) jury instructions were confusing/unduly emphasized ordinary negligence.
Issues
| Issue | Wadsworth's Argument | Howland/Paustian's Argument | Held |
|---|---|---|---|
| Whether whether a claim involves "emergency medical care" is for jury or court | Jury may decide whether care falls within statutory "emergency medical care" (stabilization exception factual) | Statutory interpretation is a question of law for the court; jury should not decide scope | Jury question allowed; statute contemplates factual questions (affirmed) |
| Whether, on these facts, care was emergency medical care as matter of law | Her condition was stabilized and capable of nonemergency treatment, so ordinary negligence applies | Care arose from ER emergency care, so § 51-1-29.5 gross-negligence standard applies as matter of law | Not decided as matter of law; factual dispute existed about stabilization so jury must decide (affirmed) |
| Whether Wadsworth failed to prove gross negligence by clear and convincing evidence (directed verdict) | N/A (plaintiff argued ordinary negligence exception applied) | Directed verdict should have been granted because plaintiff failed to prove gross negligence by clear and convincing evidence | Court did not reach merits because jury applied ordinary negligence standard (affirmed) |
| Whether charging both standards/burdens confused jury or unduly emphasized ordinary negligence | Charging both was proper because applicability depended on jury’s factual finding; verdict form resolved any confusion | Charging both confused jury and unduly emphasized ordinary negligence, warranting reversal | Instructions and verdict form, viewed as a whole, were legally correct and not harmful (affirmed) |
Key Cases Cited
- Bonds v. Nesbitt, 322 Ga. App. 852 (2013) (whether patient was stabilized under OCGA § 51-1-29.5 can be a jury question)
- Pottinger v. Smith, 293 Ga. App. 626 (2008) (applied gross-negligence standard in ER-misdiagnosis/discharge context where § 51-1-29.5 was assumed applicable)
- Johnson v. Omondi, 318 Ga. App. 787 (2012) (addressed sufficiency of clear-and-convincing proof of gross negligence under § 51-1-29.5)
- West v. Breast Care Specialists, LLC, 290 Ga. App. 521 (2008) (jury instructions must be read as a whole in assessing error)
- Jackson v. Rodriquez, 173 Ga. App. 211 (1984) (undue repetition of a charge favorable to one party can be reversible error)