*1 and Kevin Mark M. ARBOGAST Rebecca Below, Appellees,

Arbogast, Plaintiffs CORP., MEDICAL

MID-OHIO VALLEY Valley Corporation, d/b/a Care, Below, Appel-

Urgent Defendant

lant.

No. 31314. Appeals

Supreme Court of Virginia.

West 8,Oct. 2003.

Submitted

Decided Oct. Dissenting

Concurring part Opinion Albright

part Justice 4, 2003.

Nov.

Dissenting Opinion of Justice 3, 2003.

McGraw Dec. J., part

Albright, and dis- concurred separate opinion. part

sented

MeGraw, J., separate opin- dissented

ion. *2 April returned

On bruise, pain, complaining hand. Mrs. Arbo- and numbness in her left Figueroa, who gast by Dr. was seen Allen *3 provided diagnosis of the left “hematoma Marunich, Brooks, Ann Stephen R. Carol for Figueroa prescribed Dr. Advil arm.”1 Bonasso, Sensabaugh Morgan- Flaherty, & Arbogast Mrs. to pain. instructed He town, Appellant. elevated, arm, for keep it and apply heat to the sling. awear DiCuccio, Davis, Butler, Nicole A. William OH, DiCuccio, Columbus, Theo- to on Arbogast Mrs. returned Mid-Ohio Cincione & Davitian, Davitian, 8, 1996, pain Davitian & Parkers- as a result of continued April dore and burg, Appellees. for in her left arm hand. She and numbness by Dr. noted again Figueroa. He was seen presence on the continued of hematoma PER CURIAM: to Mrs. Figueroa left Dr. decided refer arm. Valley Corp., Medical Mid- Mid-Ohio d/b/a Conley, Arbogast to Yale D. a vascular Dr. (hereinafter Valley re- Urgent Care Ohio that she surgeon, because he “was concerned “Mid-Ohio”), appellant/defen- to as ferred injury.” significant vascular could have some below, ruling by from a appeals dant 9,1996, April Arbogast Mrs. visited the On County granting Re- Circuit Court Wood Conley. In of Dr. his medical medical office Arbogast Arbogast and Kevin becca M. Mark visit, Conley concerning the Dr. wrote notes (hereinafter Arbogasts”) as to “the referred “experiencing pain Arbogast that Mrs. was below, appellees/plaintiffs judgment as a maybe a stick and small th[e] from needle of law on the issue of matter pressure on with some the nerve.” hematoma Here, damages. on issue of new trial Conley arranged Arbogast Dr. for Mrs. circuit contends Mid-Ohio on EMGs and nerve conduction studies have jury’s by setting committed error aside follow-up In his notes left hand. medical her which verdict found Mid-Ohio 24,1996, Conley April Dr. wrote: dated alleged by was not liable harm the Arbo- for for gasts. Arbogast] of the “I have referred [Mrs. After careful review briefs record, considering as oral well as nerve conduction studies and EMG’s which very arguments by parties, questionable mild car- counsel documented tunnel I is a coincidental pal reverse. which feel finding. Obviously the needle stick could however, problem, this have exacerbated I. pain.... I present time less at the there’s problem there’s no here and feel AND FACTUAL PROCEDURAL permanent dys- in any should result BACKGROUND pres- function and the inflammation that is 26, 1996, Arbogast March Rebecca On resolving completely is ent should for an went evaluation Mid-Ohio w[ee]ks.” in the next resolved several During respiratory problems. treatment evaluation, pain, July on a result of continued blood was drawn from Mrs. As Dunn, Arbogast Mrs. went the medical Arbogast’s left arm Tina labora- Gregg O’Malley, orthope- Dr. M. tory employed by Mid-Ohio. The office technician O’Malley’s surgeon. Dr. medical notes purpose per- dic blood was extracted early signs out or late forming complete blood from the visit ruled count. When (hereinafter regional pain syndrome completed complex evaluation was “CRPS”).2 The *4 on damages. Syllabus point the issue of 3 Arbogast experience Mrs. continued to of Riffle, Brannon v. W.Va. 197 475 pain and numbness in her left arm and hand (1996), 97 S.E.2d we stated: surgery. During after a follow-up visit appellate The of for standard review 7, 1997, O’Malley with Dr. on March he granting [judgment of a a motion for as a Arbogast’s observed that Mrs. left arm was pursuant matter of to law] Rule 50 of the purplish O’Malley and cold. Dr. indicated Virginia West Rules of Civil Procedure is early might sign this an of be CRPS. Dr. court, appeal, de novo. this On after con- O’Malley pain recommended treatment at a sidering light in the evidence most clinic. party, favorable to will the nonmovant sus- 29,1997, July Arbogast On Mrs. visited the granting [judgment tain the of a as a mat- medical office of Dr. James Powers. Mrs. ter of only law] when one con- reasonable Arbogast was to Dr. referred Powers her clusion as to can the verdict be reached. counsel, in order “to come to some conclu- But if minds could reasonable differ as to problem, suggestions sions as to to her make importance sufficiency and of the evi- treatment, as far as and also to look at dence, ruling a circuit court’s a prognosis.” diagnosed Dr. Ar- Powers Mrs. [judgment will law] as a matter be re- bogast suffering as from CRPS. versed. 20, 1998, Arbogast On March Mrs. and her explained sylla in We this standard spouse, Arbogast, Kevin Mark filed in- point Bank, bus 3 of v. First National Mid-Ohio, Alkire against stant alleging negli- action (1996), 122 part, 197 W.Va. in gence in drawing of her blood which by holding that “[w]hile review this negligence was the cause of her plenary, is motion it is circumscribed developing eventually CRPS.3 case The went because we must review the evidence in April trial in returned a light nonmoving party.” most favorable to the verdict for Arbogasts the defendant. The Moreover, in 5 of post-verdict syllabus point Orr v. judgment filed motions for Crow as a der, (1983), 173 593 matter of law W.Va. 315 we or new trial. The circuit court S.E.2d indicated, granted part, in in our Arbogasts’ motion for review we must liability. as a “[1] matter law on the issue of assume that all conflicts the evidence granted The circuit court also in favor new trial were resolved of the Now, circuit, will, you Q. you. reverberating you explain Thank would for It sets off a discomfort, complex regional syn- pain changes pain what is in the drome, you entity as best can? limb. And it whose name is has because, syndrome actually changed years A. Yeah. This over as time has war, on, hospital gone opinions was first the civil described in we have different as to what medicine, Philadelphia. physician group many things A had this caused it. Like we them, patients complex problems, set of can we can treat who had this describe some things: things, always triggers and it has as a number been known but we don’t know what syndrome, causalgia, atrophy. certainly them to And one of start. shoulder/hand It deals with very inju- problems who has someone had some those to deal with. difficult ry. may may It be a blunt trauma. It be a defendants, injury injuries complaint nerve heal as most 3. The other doesn't listed several body prior appear to the do. all of whom settled to have trial. 360 Negligence A. proved as all

prevailing party; [2] assume Alkire With due issues raised. which facts standards, that: party the benefit facts tends was such facts reviewing it is not the have ruled task might have reached the decision below. motion proved.” which the reasonably is to determine whether the evidence reviewing a trial court’s v. First National prove; S.E.2d we consideration for the that a on the [judgment now Further, task of prevailing party’s evidence of all may consider the substantive reasonable evidence ^[3] determine give favorable as matter syllabus point 2 Bank, 197 drawn from to the appellate presented. held, how it granting of trier of fact inferences prevailing *5 foregoing W.Va. would part, law], Its fied that the standard Maricopa Med. blood patient’s whether blood from her left arm. Hosp., recognized that a of Dr. standard standard 1180, 1183(Ct.App.1988)). acted duct is to be measured.’ medical standard of care negligently until it from a Beverly Inc., Arbogast sought a medical (2000) arm of care During against which the defendant’s contended patient through Kovanda. (per Ctr., the trial of malpractice “ ‘jury that Mid-Ohio curiam) extracting was established in the 101, 108, 529 of care for ” has Ariz. Dr. expert testimony Reynolds City cannot consider This Court has (quoting determined the Kovanda testi- defendant has establish blood from a case, extracting breached 755 P.2d drawing v. Bell Mrs. con Laboratory National for Committee Clinical

III. (hereinafter referred to as Standards “NCCLS”). by standards Under set DISCUSSION NCCLS, person extracting blood the should verdict, jury its had To reach the patient phlebotomy have the sit in a or veni- that Mid-Ohio did not breach determine the puncture pro- chair has “armrests [to] which applicable standard of and therefore was care support backbending of preventing vide while Alternatively, to reach its not liable. subsequent flattening the elbow and of the jury had determine that Mid-Ohio the Further, requires vein.” the NCCLS the care; applicable the of breached standard pa- person extracting “[h]ave the blood the but, proximate breach the that such was not position straight to form tient arm his/her Arbogast’s injury.4 of Mrs. The circuit cause from the to the wrist. arm line shoulder The jury’s rejected verdict. The circuit firmly by supported should be armrest that court concluded the evidence established and should not at the elbow.” be bent negligently did fact breach Mid-Ohio and that applicable standard of care such contrast, presented In the ex- proximate negligence was the cause of Mrs. testimony pert of Dr. Bruce Newman to ad- injury. Arbogast’s Syllabus point 5 of issue standard of dress the of the care Co., Realty v. Mason 148 W.Va. Hatten extracting blood. Dr. Newman testified that (1964), made clear that we by standard “is established NCCLS negligence proximate of “[questions [and] conditions, what should done under ideal present jury ... fact for cause issues of being practiced. what is but not What pertaining when the evidence determination being practiced standard of care.” Dr.. is the conflicting or where such issues provided support no data to his Newman facts, though undisputed, are such that even opinion from that standard different [persons] may different con reasonable draw being was followed. established NCCLS proceed them.” In instant clusions from Arbogast Dr. propriety address Mrs. contends that ing we will ruling proxi testimony “locality rule” negligence circuit court’s Newman’s created standard; yet, requires separately. law our case mate cause However, proximate separate was verdict form did not cause. negligent properly instructed on these issues. issues of breach of the standard care conclusion, a national agree. However, standard medical care be stan- different we agree. single syllabus inquiry juncture. dard. We In the of our does not end at this City Parkersburg, 176 W.Va. Paintiff succinctly 345 S.E.2d 564 B. Proximate Cause held ‘locality malprac- “[t]he rule’ in medical Merely finding that the evidence tice cases is Dr. abolished.” Whether New- established that Mid-Ohio violated stan testimony establishing man’s was a local or extracting dard of care for blood does not national standard of care was unclear at best. impose liability alone Arbogast’s for Mrs. fact, testimony open Dr. Newman’s left injury. malprac We have held that “[i]n for the to determine whether he was case, plaintiff tice only prove must not referring national standard or a local negligence but must also show that such Notwithstanding standard. Dr. Newman’s negligence proximate was the cause of the unsupported testimony on the standard injury.” Syl. pt. Appalachian Short v. care, opinion we are that Dr. Kovanda OH-9, Inc., 203 W.Va. 507 S.E.2d 124 clearly established the standard of care (1998). Further, “[t]he burden is on the extracting patient, blood from a being as plaintiff prove by preponderance of the which was outlined the NCCLS. evidence that negligent the defendant was following proce- The evidence revealed the and that negligence such was the extracting dure was used in blood from Mrs. injury.” Syl. pt. cause Walton v. Arbogast’s Arbogast arm. Given, left Mrs. was 215 S.E.2d 647 edge examining seated on the of an table that, contended be arm, instructed to hold out her left with the cause Mid-Ohio did not follow the standard lying knuckles of hand her on the inside arm, in extracting care blood from her support her left No knee. was used to stabi- damaged arm, needle median vein her *6 lize her A left arm. needle was thereafter developing which resulted in her In CRPS. inserted into her arm. Dr. Kovanda was words, negligence other Mid-Ohio’s was the opinion asked render an as to whether the proximate injury. parties cause of her Both manner in which blood was extracted from presented hotly contested evidence on this Arbogast complied Mrs. with the national issue. standard of care: Arbogast Mrs. testified that when the nee- my opinion, A. In it did not meet placed dle was in her arm she felt excruciat- appropriate standard care. ing pain body. in her did not She scream out Q. Why not? or pain. During inform Ms. Dunn of the supported. A. The arm was not It was Powers, testimony of Dr. a witness for Mrs. just in extended the air. Arbogast, although he stated that the EMG’s Q. purpose having And what is the damage, did not reveal median nerve by supported something? arm they EMG’s were conclusive because thing, A. For one it is much easier purpose examining were taken for the deep goes, control how the needle control left wrist opin- area. Dr. Powers was of the goes. anatomy up where it The in lined thorough ion that a examination of the area very specific way sup- when the arm is may where the needle was inserted have ported just versus when it is extended. damage. revealed nerve Dr. Powers also opined that the CRPS resulted from nerve Dr. Newman testified that in manner damage by caused the insertion of the needle which blood was extracted from Mrs. Arbo- Arbogast’s Arbogast’s Mi's. arm. Mrs. gast met the standard of care. Shramowait, treating physician, Dr. Michael hesitancy determining We have little fact, Arbogast, testified that Mrs. had conclusively that the evidence established damage in median nerve her left arm. extracting the standard of care for blood, NCCLS, by that, as set out position was not took if Mrs. CRPS, followed. To the by extent the trial court had it was caused surgery found that the could not performed by O’Malley. have reached a Dr. Mid- 362 more con- found evidence to be videotaped deposition of Mid-Ohio’s presented the Ohio Therefore, improper- opined vincing. judge trial Dr. Brown Mark Brown.

Dr. J. damage hotly disput- to the did no on this ly opinion insertion its the needle substituted During Arbogast’s arm. cross Hager, nerve Mrs. 205 factual issue. Toler v. ed examination, that the Dr. conceded 468, Powers 519 166 we address W.Va. S.E.2d by Dr. surgery performed carpal tunnel point as follows: Dur- O’Malley caused the CRPS. could have testimony If is a conflict there Shramowait, of Dr. he ing cross examination may point, or if reasonable men a material surgery performed acknowledged that the of fact to be in their conclusions differ contributed to the O’Malley Dr. could have evidence, or if the conclu- drawn from the Further, during cross development of CRPS. weight given dependent on the sion is Kovanda, Dr. she testified examination testimony, judge trial cannot sub- expect patient to voice that she would conclusion for that of the stitute his damaged complaint if a median nerve was for a merely he would have voted because type pain experienced caused the had been on the different verdict he Arbogast. Dr. Brown also testified Mrs. jury. weight jury’s of a when struck, Arbo- nerve had a median been upon which it is credible evidence there screamed, jumped, called it gast “would have based, by the trial can be is not overborne attention.” to someone’s judge’s disapproval. of the evidence we our review Toler, at 519 at 174 S.E.2d conclusion that both with the definite are left McNeely, 204 Va. (quoting Commonwealth conflicting presented strong and evi parties (1963)). 218, 222, 129 690 S.E.2d “The issue of cause. dence on the positions involves the[ir] conflict two between IV. determinations, credibility and other factual jury.” province of a Gaith issues within CONCLUSION Inc., n. City Hosp., 199 710 er v. W.Va. trial court’s order We reverse the 4 905 n. See law Arbogasts judgment as a matter of Carvill, 605, 611, Brown v. W.Va. trial on and a new on the issue of (1998) (“If per reasonable 5.E.2d in- damages. with This case remanded issue, question is could differ on the sons jury’s verdict structions reinstate jury[.]”). has one for the Indeed Court *7 favor of Mid-Ohio. long negligence of “[w]hether held that the Reversed. charged in declaration the defendant as the inju proximate plaintiffs cause of the is the concurs, part; in injury ry, of the Justice ALBRIGHT or whether the sole cause dissents, part; separate a independent person, third and files was act of the jury opinion. for questions are of fact determination.” 1, Syl. Blankenship City William pt. v. of and flies a McGRAW dissents Justice (1926).

son, 199, 132 101 492 See W.Va. S.E. dissenting opinion. Farmer, 2, Syl. Evans v. 148 W.Va. pt. (1963) (“The 142, questions of 133 710 S.E.2d ALBRIGHT, J., concurring part, intervening proximate cause cause [and] ... dissenting part. jury questions of fact for where ... are the 2003) (Filed 4, Nov. facts, conflicting or the the evidence is when majority I of the concur with the decision undisputed, though are such reasonable of law on reversing judgment as a matter may conclusions the [persons] draw different them.”). by liability of the lower jury conflicting the issue entered heard the from jury.1 contrary of the court to the verdict issue of cause and evidence on the designa- Virginia, In the of matter of law.” West to Rule 50 of the Federal Rules 1. Amendments judg- a tion of a Rule 50 motion as "motion discontinued the terms "directed Civil Procedure notwithstanding changed notwithstanding "judgment ment the verdict” also the ver- verdict” and dict,” "judgment in the amend- phrase "judgment to a as a matter of law” the as a in favor of

363 performing analysis, The reason for trial court’s action does credibility the this the satisfactorily not appear considered, on the record. the witnesses will be con resolved, in testimony flicts will not be majority I from the decision dissent weight of the will evidence not be require the lower court reinstate the Nursing evaluated.” v. Sundale offering verdict without trial court an Barefoot Home, 475, 482, 193 W.Va. 457 S.E.2d opportunity to amend its order a trial new 159 See also Alkire v. Na First of liability include the issue and state with Parsons, tional Bank 197 W.Va. particularity reasons, any, trial court’s 122, 128(1996).... awarding a such new on all trial issues. This Court’s celeritous reinstatement Conversely, judge a when trial vacates a jury affording oppor- verdict without such an trial, grants verdict and a new he or is, view, tunity my shortsighted judgment. she does not a enter final precedents meticulously violation of fash- Thus, trial judge granting a a new trial has years. ioned over the Court in determining more discretion whether

It abundantly clear court that the trial such action is [weighing warranted.... In perceived something in the evidence and its considering evidence and credibility], the generated consideration judge trial does not invade the function of judge’s lack of confidence in the verdict. In judge the fact finder because the trial confidence, reacting to that lack of the trial granting a simply sending new trial is judgment awarded as matter law issue back to fact Though finder. this on the issue of and a new trial on the Court has power clear made that the damages, issues of both of which are the grant a new sparingly, trial should used be subject Having appeal. of this found will judge’s Court not review trial judgment justified, as a matter of is not law grant decision to a new trial unless the majority fairly has failed to consider judge tidal abuses his or her discretion. remedy whether the lesser of new trial on 291-92, 199 at 484 W.Va. at 174-75 S.E.2d liability might In- issue order. (internal omitted). citations stead, majority has substituted its own This previously Court has judgment vested substan input soliciting without further tial so, judges discretion in trial doing from trial consider court. I believe trial, granting observing majority judge a new has failed to consider essen- may tial set aside a provide differences reasons between the standard re- determination, view for for that as a matter of and order new trial. law syllabus point In' Young Duffield, standard of review for the three of (1968), Conley, new trial. 152 162 Gonzalez v. W.Va. S.E.2d 285 over (1997), grounds, ruled on other Court identi- Tennant v. Marion significant Found., fied this explained distinction and Health Care W.Va. as follows: S.E.2d 374 this Court held: “The *8 judgment setting of a court trial aside a The distinction the of between effect awarding verdict and a is entering judgment notwithstanding a new trial entitled the peculiar weight to and its in this opposed as action re granting verdict to a trial new thus, spect appeal will not be disturbed is substantial on unless and warrants a differ- plainly Syllabus point ent standard of review.... a trial unwarranted.” four of When Young judge by explained: appellate “An entering vacates the verdict court is judgment notwithstanding disposed the more to affirm of trial the the action a judge entering judgment setting trial is final a a court aside verdict and litigation upon which ends than the issue a new trial such action results a when which has judgment denying Sylla- been entered. “In final a new trial.” 6, not, however, April ment to Rule 50 effective See "[t]he 1998. amendment did either affect 351, 8, Triplett, by Miller v. 203 W.Va. 356 n. 507 the a standard which trial court reviews mo- 714, (1998). by S.E.2d 719 n. 8 In v. tions under the rule or the appellate which an standard Barefoot Home, 475, Nursing ruling.” Sundale 193 W.Va. 457 court a reviews trial court’s (1995), 7, S.E.2d 152 this Court 193 at observed W.Va. 482 n. 457 S.E.2d at n. 7. 159 364 is This much exercise of discretion. continued: “Courts are point five

bus contrary which is to settled. required to believe if the verdict of the is physical facts and Miller, § supra at 2818 at Wright & contrary testimony is to upon which based 124, 193 at 454 at 418. S.E.2d W.Va. facts, a it be set aside and new physical will Harris, syllabus In of v. the Cook trial awarded.” (1976), explained 225 S.E.2d 676 W.Va. Health Care Foun- In Tennant v. Manon conclusions, such as follows: the rationale for dation, Inc., 97, 459 S.E.2d 374 194 W.Va. judge merely but A trial is not a referee (1995), of explained the standard this Court supervising is vested with discretion grant a trial follows: for the of new as review preventing miscarriages of and verdicts challenges findings reviewing to [I]n duty justice, power and to set with the court, apply a rulings a circuit made if new aside and award a trial verdict two-pronged deferential standard re- plainly wrong supported is it even it is circuit rulings the view. We review evidence, judge trial and when a some concerning new trial and its conclu- court acts, decision, being discharge of so his as to the existence of reversible error sion pass upon power duty to his standard, and under an abuse of discretion weight of to that ex- the evidence limited underlying the circuit court’s we review tent, weight peculiar to and will entitled clearly findings under a factual erroneous clearly appeal unless not be disturbed on subject Questions of are law standard. unwarranted. a de novo review. recognized This that “[t]he Court has 104, 459 at 381. at W.Va. many opportunities trial has observe things in course of trial which Virginia Public re State West presented appellate printed record Building Litigation, 193 Asbestos W.Va. ” Browning .... court does not disclose nom., (1994), cert. denied sub 454 S.E.2d Co., Transp. Monongahela Virginia, 515 Grace & Co. v. West U.S. W.R 1160, 115 132 L.Ed.2d 857 S.Ct. explained as this Court follows: majority judice in the sub While the case upon premises regard- its conclusions error Although judge rarely should trial ing judgment as a granting of matter trial, judge, grant new the trial neverthe- law, preferred matter resolution less, has broad discretion determine judge’s entry would entail a reversal of grant- not a new trial should be whether or plaintiff favor verdict in grant “Courts do not new trials unless ed: and a remand further consideration reasonably prejudicial error it is clear that grounds new trial. On articulation crept into record or that substan- has remand, any regard- the rationale for action justice has not done- Ulti- tial been ing grant trial could ex- new mately motion the sound dis- invokes plained specificity. with court, appellate cretion of trial ruling quite limited.” of its review By simply reversing the court’s de- lower Wright R.] Mil- Alan] [Arthur & [Charles termination, majority ignored the has ler, § supra at 2803 at 32-33 [§ 2801] judge likely reality that some observed omitted). (footnotes However, it has been inconsistency view discrepancy or his pointed out: majority trial. The chose merited new *9 subjects upon its attention the error are the entire focus entire There few subject granting of law on that the as matter procedure field have been liability controversy ignored the broader change so the issue and to much and verdict, By years proper scope reinstating recent as the re- issue. majority spirit, has granting denying or violated the not view of an order letter, of this own that we shall motion for a trial. The trial court Court’s rule new appel- give judge’s deference to determinations very has broad discretion on issue trials. More great will his new late courts defer a deal stated, Therefore, importantly, judg- our I we have substituted the reasons re- trial on spectfully ment for issues dissent. likely

about which the trial court is better

informed. express opinion I cannot on

While knowing without

ultimate issue

judge’s setting reasons aside disagree vehemently I with ma-

jority’s decision that the trial court’s action

justifies reinstatement verdict. A remand with instructions would have been a In re JOSEPH G. appropriate more resolution and would have purpose served the acclaimed Justice No. 31221. Cleekley concurring opinion in his in In re Supreme Appeals Court of Bldg. Litigation,

State Public Asbestos Virginia. West “[b]y broadening authority of trial courts grant limiting [to trials] new that of the Sept. Submitted 2003. same], appellate court [to review the Decided 2003. Nov. judicial strike decent note for restraint judicial economy.” 193 W.Va. at

S.E.2d at 426.

McGRAW, Justice, dissenting.

(Filed 3, 2003) Dec. majority correctly holds that Mid- negligently

Ohio breached the standard of employed

care medical technician when Appellee

there extracted blood from Rebecca

Arbogast’s left arm on March As a negligence,

direct result the technician’s

Appellee Arbogast immediately Rebecca de- arm,

veloped large left hematoma her

along pain with and numbness in her left Following surgery per-

hand arm. attempt

formed in an alleviate some

pain negligent- and numbness caused draw,

ly-performed Appellee blood Rebecca complex developed regional pain

syndrome.

Experts Appellees for both and Mid-Ohio

agreed surgery would not have been

necessary had blood draw have injury Appellee

caused Rebecca Arbo-

gast’s It arm. is horn book law that there

may be more than of an one cause ease,

injury. judge In the instant the trial Appellee Arbogast’s

saw clearly Rebecca regional syndrome

complex pain sprang from and, negligence viewing

Mid-Ohio’s even light in the most

evidence favorable Mid-

Ohio, that no fact reasonable trier of could

have concluded otherwise. as notes went home. referred blood, by damage to a nerve. CRPS collection 2. CRPS caused Hematoma is “a localized clotted, tissue, usually organ, space, sympathetic dystrophy. due in an or Dur- also called reflex trial, wall of a vessel.” Rich- to a break blood gave ing follow- tire Dr. James Powers Sloane, Annotated Medi- ard The Sloane-Dorland description ing CRPS: Dictionary, cal-Legal Thereafter, her of damages. “[a]ll indicated muscles the issue normally.” appeal. forearm and hand function Dr. filed this O’Malley definitively diagnose was unable Arbogast’s pain. of Mrs. the cause He be- II. might carpal lieved it be attributed to tunnel 9, 1996, syndrome. August On Mrs. Arbo- STANDARD OF REVIEW gast O’Malley’s again went to Dr. Dr. office. proceeding, we are asked to O’Malley surgery recommended for nerve re- review the circuit order court’s carpal lease at the left forearm level and post-verdict motion for as a matter wrist. surgery tunnel release on the left of law liability, on and a the issue of new trial 21,1996. performed August was