422 S.W.3d 343
Mo. Ct. App.2013Background
- Snellen, a fourteen-year-old with cerebral palsy, was born by Cesarean section after induction of labor on April 3–4, 1998 at Capital Region.
- Plaintiff contends Snellen’s cerebral palsy resulted from hypoxic-ischemic encephalopathy due to fetal distress and lack of oxygen during labor; Capital Region contends there was no oxygen deprivation and CP was not caused by HIE.
- Lydia Keisler, the treating physician, was questioned about peer-review board investigations; Snellen sought mistrial due to references to Board vindication, which the court denied.
- At trial, Capital Region relied on a literature-based ACOG document to support its experts’ opinions; Snellen challenged admissibility and reliance on that literature.
- Salafia and Reznik, placental pathologists allied with Capital Region, testified about placental damage; Salafia suggested a correlation between placental vascular damage and neurological impairment but did not tie it to this case with certainty.
- The jury unanimously found for Capital Region; Snellen appeals on four issues, all of which were affirmatively resolved by the appellate court.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Mistrial for Board-peer review reference | Snellen argues the Board reference was prejudicial and grounds for mistrial under section 537.03. | Capital Region contends the objection was sustained and the court gave a withdrawal instruction; no manifest abuse. | Mistrial denial affirmed; no manifest abuse of discretion. |
| Admission of ACOG document through Yeast | Yeast’s reliance on the ACOG document at trial was improper and prejudicial because deposition indicated he would not rely on it. | Document was disclosed and other experts used it; Yeast’s use was proper as a corroborating reference. | Admission not an abuse of discretion; no prejudice established. |
| Withdrawal instruction regarding Salafia | Salafia’s placental evidence lacked basis in medical certainty and should have been withdrawn. | Salafia’s testimony regarding placental pathology and literature correlation was admissible foundation. | Denial of withdrawal instruction affirmed; no plain error. |
| Voir dire and juror excusal remarks | Judge’s voir dire comments and excusing a juror for a breastfeeding need were prejudicial. | No reversible error given no objection and the record shows no bias in decision. | Denied; no reversible error. |
Key Cases Cited
- State ex rel. Kemper v. Vincent, 191 S.W.3d 45 (Mo. banc 2006) (mistrial discretion; drastic remedy standard)
- In re Brasch, 332 S.W.3d 115 (Mo. banc 2011) (trial court's ruling on mistrial within discretion)
- Pierce v. Platte-Clay Elec. Coop., Inc., 769 S.W.2d 769 (Mo. banc 1989) (mistrial standard; discretion)
- Linzenni v. Hoffman, 937 S.W.2d 723 (Mo. banc 1997) (record on appeal presumed correct; standard of review)
- McFadden v. State, 369 S.W.3d 727 (Mo. banc 2012) (jury instruction and plain error review framework)