2023 Ohio 3362
Ohio Ct. App.2023Background:
- Plaintiff Nathan Santamaria (≈67) treated for BPH and other urologic conditions; preexisting scrotal bladder herniation was repaired before prostate surgery.
- Dr. Brian Canterbury performed a "button" TURP in late 2018 and intentionally resected a limited amount of tissue at the bladder neck to reduce incontinence risk.
- Postoperatively Santamaria had UTIs, blood clots, and kidney stones (none alleged to be caused by the TURP) and continued voiding problems requiring self-catheterization.
- About nine months later a second urologist performed a more extensive TURP that resolved Santamaria’s symptoms.
- The operative note inaccurately overstated the amount resected (template error); Santamaria alleged this amounted to fraud but showed no damages from the documentation error.
- At trial defense experts (Drs. Wright and Babayan) testified Canterbury met the standard of care; plaintiff’s expert (Dr. Steinberg) testified Canterbury breached it by not removing adequate obstructing tissue. Trial court denied directed verdict; jury returned verdict for defendants. Appeal affirmed.
Issues:
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the trial court erred in denying Santamaria's motion for directed verdict on medical negligence (insufficient resection) | Santamaria: the TURP was ineffective — not enough tissue was removed — so Canterbury breached the standard of care and liability is established | Clinic/Canterbury: there was conflicting expert testimony that a limited bladder‑neck resection was a reasonable, conservative approach; efficacy alone does not prove negligence | Affirmed — reasonable minds could differ given competing expert opinions; jury properly resolved credibility and factual dispute |
| Whether cross‑examination of defense experts required directed verdict because it defeated their opinions | Santamaria: cross‑examination showed no disputed issues and undermined defense experts | Defendants: cross‑examination affects credibility/weight but does not nullify properly elicited expert opinions unless an expert recants | Affirmed — no recantation occurred; cross‑examination went to weight/credibility, not legal sufficiency of expert testimony |
Key Cases Cited
- Goodyear Tire & Rubber Co. v. Aetna Cas. & Sur. Co., 95 Ohio St.3d 512 (Ohio 2002) (standard of review for motions for directed verdict/Civ.R. 50)
- Ruta v. Breckenridge-Remy Co., 69 Ohio St.2d 66 (Ohio 1982) (directed verdict appropriate only when reasonable minds could come to but one conclusion)
- Hamden Lodge v. Ohio Fuel Gas Co., 127 Ohio St. 469 (Ohio 1934) (early Ohio authority on directed verdict standard)
- Bruni v. Tatsumi, 46 Ohio St.2d 127 (Ohio 1976) (elements of medical malpractice: standard of care, breach, causation)
- Grieser v. Janis, 100 N.E.3d 1176 (10th Dist. 2017) (properly stated expert opinion on probability establishes prima facie case; cross‑examination goes to weight, not admissibility)
- Galletti v. Burns Internatl., 74 Ohio App.3d 680 (Ohio Ct. App. 1991) (discussing when expert testimony establishes prima facie case)