252 A.3d 271
R.I.2021Background
- Patricia Kinney presented in 2011 with a left adnexal mass on CT/ultrasound; she had prior endometriosis and prior pelvic surgery.
- Gynecologist Kathleen Cassin performed exploratory surgery July 13, 2011; a portion of the mass adhered to the ureter and a segment was left in situ to avoid ureteral injury; frozen sections suggested an endometrioma but malignancy could not be excluded.
- Postoperatively cytology and final pathology (received July 21, 2011) showed clear cell ovarian adenocarcinoma; Kinney developed a postoperative fistula and later metastatic disease, dying in 2014.
- Plaintiff (Joplin, executrix) alleged Cassin was negligent for failing to refer a high-risk patient to a gynecologic oncologist preoperatively, for surgical mismanagement, and for failing to refer postoperatively; plaintiff’s expert said a gynecologic oncologist would have removed the entire mass and likely cured Kinney.
- A jury found Cassin negligent but concluded that the negligence was not the proximate cause of Kinney’s death; the trial justice granted plaintiff’s motion for a new trial (finding that liability necessarily entailed causation).
- The Supreme Court vacated the new-trial order, holding the trial justice overlooked material evidence and that reasonable minds could differ on proximate causation; it remanded with instructions to reinstate the jury verdict.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the trial justice properly granted a new trial by concluding liability and proximate cause were "completely interwoven" | Joplin: negligence (pre-, intra-, and post-op failures to refer/perform) necessarily caused Kinney's death; but-for oncologist involvement, Kinney would have been cured | Cassin: reasonable minds could conclude breach occurred but was not the proximate cause; jury reasonably rejected causation | Court: trial justice erred by substituting her judgment for jury's; vacated new-trial order and reinstated verdict (reasonable minds could differ on causation) |
| Whether the trial justice referenced sufficient evidence and addressed all liability theories when ruling on the new-trial motion | Joplin: trial justice’s finding was supported by experts who said oncologic surgery would have cured Kinney | Cassin: trial justice ignored defense evidence (Dr. Schilling) and multiple plausible bases for jury's causation finding | Court: trial justice failed to consider material defense evidence and alternative breach theories; thus did not apply correct standard |
Key Cases Cited
- Manning v. Bellafiore, 991 A.2d 399 (R.I. 2010) (trial-justice new-trial rulings afforded great weight; justice acts as superjuror)
- Aptt v. Cedarz Medical and Cosmedics, Inc., 175 A.3d 484 (R.I. 2018) (uphold jury verdict if evidence is evenly balanced or reasonable minds could differ)
- Marcotte v. Harrison, 443 A.2d 1225 (R.I. 1982) (review evidence in light most favorable to prevailing party when trial justice overlooks material evidence)
- Schenck v. Roger Williams General Hospital, 382 A.2d 514 (R.I. 1977) (plaintiff bears burden to prove causal relation between defendant's act/omission and injury)
- King v. Huntress, Inc., 94 A.3d 467 (R.I. 2014) (trial justice must reference enough evidence to show correct standard was applied)
- Tennant v. Peoria & P.U. Ry. Co., 321 U.S. 29 (1944) (jury is primary factfinder; courts cannot simply reweigh evidence and override reasonable jury conclusions)