208 A.3d 792
Me.2019Background
- On Aug. 14, 2012 Michael Holmes had a noncancerous colon polyp removed and was discharged Aug. 18.
- On Aug. 20 Holmes returned to EMMC ED with abdominal pain; Dr. St. Jean ordered an abdominal CT to evaluate for bleeding or an anastomotic leak.
- A radiologist initially read the CT that night finding ascites; Dr. Guillermo Olivos reviewed the CT the next morning (Aug. 21) and reported pelvic ascites, some air near the liver, but "no findings to suggest an anastomotic leak."
- Later on Aug. 21 a surgeon performed exploratory surgery and discovered a small anastomotic leak and infected abdominal fluid; Holmes thereafter suffered prolonged hospitalization, intubation/tracheostomy, DVT, and a stroke.
- The Holmeses sued for medical malpractice against St. Jean and Olivos (and affiliated providers). After prelitigation screening and discovery, the court granted summary judgment for Olivos and a jury returned verdict for St. Jean; the Supreme Judicial Court affirmed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Olivos’s delayed/erroneous CT read was a proximate cause of Holmes’s injuries | Holmes: Olivos’s negligent reading delayed necessary treatment and that delay more likely than not caused or worsened injuries | Olivos: He reviewed the scan well after the critical window; plaintiffs lack expert evidence linking his conduct to the injuries (causation speculative) | Court: Affirmed summary judgment for Olivos; plaintiffs failed to present sufficient expert evidence of proximate causation |
| Whether summary judgment was appropriate given experts’ general testimony that "earlier is better" | Holmes: Expert testimony that earlier surgery likely would have reduced complications supports causation | Olivos: General statements that earlier treatment helps are conclusory and do not tie his specific conduct to the outcome | Court: General/conclusory opinions insufficient; causation requires evidence linking defendant’s act to injury, not mere foreseeability |
Key Cases Cited
- Grant v. Foster Wheeler, LLC, 140 A.3d 1242 (Me. 2016) (summary judgment review and standards for viewing evidence)
- Merriam v. Wanger, 757 A.2d 778 (Me. 2000) (proximate cause in malpractice requires evidence that defendant’s conduct played substantial part and is more likely than not causal)
- Phillips v. E. Me. Med. Ctr., 565 A.2d 306 (Me. 1989) (plaintiff must show departure from standard of care was proximate cause)
- Estate of Cabatit v. Canders, 105 A.3d 439 (Me. 2014) (summary judgment burdens when defendant is moving party)
- Budge v. Town of Millinocket, 55 A.3d 484 (Me. 2012) (summary judgment: defendant bears initial burden when moving)
- McAfee ex rel. McAfee v. Baptist Med. Ctr., 641 So. 2d 265 (Ala. 1994) (expert statements that "time is of the essence" insufficient alone to prove causation)