203 So. 3d 41
Miss. Ct. App.2016Background
- Bonita Henson was admitted to Grenada Lake Medical Center (GLMC) and was identified as a fall risk; she fell on June 30 while being weighed, fracturing and dislocating her left ankle.
- GLMC staff applied a splint/cast; Henson was transferred for orthopedics and underwent surgery; later records showed fecal matter on the cast and, ultimately, a staphylococcal wound infection.
- Henson was treated at multiple facilities; on August 8 her left leg was amputated below the knee. She died July 28, 2014; her husband and estate continued the suit.
- Henson sued GLMC (and initially UMMC) for medical negligence, alleging nurses failed to prevent the fall and provide proper wound care, resulting in infection and amputation.
- GLMC moved for summary judgment arguing Henson’s only expert—Rita Wray, RN—was not competent to prove medical causation and offered conclusory opinions; the trial court granted summary judgment.
- The Court of Appeals affirmed: the nurse-expert could not opine on medical causation (infection/amputation) and her affidavit failed to articulate the applicable nursing standard of care or explain how it was breached.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether plaintiff produced competent evidence of medical causation linking GLMC care to infection/amputation | Wray’s opinions show nursing negligence caused the fall and led to subsequent infection and amputation | Nurse experts are not competent to testify to medical causation; no competent evidence ties infection/amputation to GLMC | Held for defendant: nurse cannot testify to medical causation; no proof GLMC care caused infection or amputation |
| Whether a nurse-expert may establish causation for complications (staph infection/amputation) | Wray was offered to show causation from negligent nursing care | Vaughn and precedent bar nurses from testifying to medical causation/diagnosis | Held: nurses cannot testify as to medical causation; Wray incompetent on that issue |
| Whether Wray’s affidavit adequately articulated the applicable standard of care | Wray’s affidavit asserts breach of "recognized national standards" and failure to provide adequate safety measures | Wray’s affidavit is conclusory and fails to identify standards or explain how they were breached | Held: affidavit insufficient—fails to articulate objective standard or specific breaches to create genuine fact issue |
| Whether Henson could survive summary judgment on lesser injury (fracture/pain) without expert causation linking breach to infection/amputation | Plaintiff suggests expert unnecessary to link fall to fracture | Defendant argues plaintiff still lacks required expert proof on any consequential injuries and Wray’s opinions are conclusory | Held: court did not rely on resolving fracture-only theory; even assuming fracture claim arguable, Wray’s conclusory affidavit fails to defeat summary judgment |
Key Cases Cited
- Vaughn v. Miss. Baptist Med. Ctr., 20 So. 3d 645 (Miss. 2009) (nurses cannot testify as to medical causation or diagnoses)
- McDonald v. Mem'l Hosp. at Gulfport, 8 So. 3d 175 (Miss. 2009) (elements of prima facie medical negligence case)
- Hubbard v. Wansley, 954 So. 2d 951 (Miss. 2007) (expert must identify standard of care and causation)
- Barner v. Gorman, 605 So. 2d 805 (Miss. 1992) (expert proof required for standard and proximate causation)
- Coleman v. Rice, 706 So. 2d 696 (Miss. 1997) (medical negligence generally requires expert testimony unless issue is within common knowledge)
- McGee v. River Region Med. Ctr., 59 So. 3d 575 (Miss. 2011) (plaintiff’s success depends on adequacy of chosen medical expert)
- Maxwell v. Baptist Mem'l Hosp.-DeSoto Inc., 958 So. 2d 284 (Miss. Ct. App. 2007) (expert must articulate objective standard of care)