*1
[Cite as
Fehrenbach v. O'Malley
,
IN THE COURT OF APPEALS FIRST APPELLATE DISTRICT OF OHIO
HAMILTON COUNTY, OHIO APPEAL NO. C-100730 :
TARA N. FEHRENBACH,
TRIAL NO. A-9701756 : GINA D. FEHRENBACH,
O P I N I O N. : and : THOMAS J. FEHRENBACH, : Plaintiffs-Appellants, : vs. : KATHRYN O’MALLEY, M.D., : and : SUBURBAN PEDIATRIC ASSOCIATES, INC., :
Defendants-Appellees. Civil Appeal From: Hamilton County Court of Common Pleas Judgment Appealed From Is: Affirmed
Date of Judgment Entry on Appeal: October 28, 2011
John H. Metz , for Plaintiffs-Appellants, Lindhorst & Dreidame , Michael F. Lyon , and Bradley D. McPeek , for Defendants- Appellees.
Please note: This case has been removed from the accelerated calendar . *2 D INKELACKER , Presiding Judge.
{¶1} Plaintiffs-appellants Tara, Gina, and Thomas Fehrenbach, filed a medical malpractice action against defendants-appellees Kathryn O’Malley, M.D., and her employer, Suburban Pediatric Associates, Inc., (collectively, where appropriate, “Dr. O’Malley”). A jury returned a verdict in favor of Dr. O’Malley. The Fehrenbachs have filed a timely appeal. We find no merit in their six assignments of error, and we affirm the trial court’s judgment.
I. Facts and Procedure On October 1, 1990, 14-month-old Tara woke with a temperature of
105.2 degrees. She vomited, and her mother, Gina, found her to be “lethargic.” Gina made an appointment to take Tara to see her pediatrician, Dr. O’Malley, at Suburban Pediatric Associates, that afternoon. Tara had had a history of ear infections and her parents had
scheduled surgery to correct her ear problems. Dr. O’Malley examined Tara and concluded that she had a severe double ear infection. She prescribed an oral antibiotic and Tylenol. That night, Tara was cranky and slept poorly. Gina noticed that she
would not lie on her back. Gina took Tara back to Dr. O’Malley’s office the following morning. She told the doctor that Tara’s fever had not been lower than 104 degrees, that she was still vomiting, and that she was “very lethargic.” Dr. O’Malley examined her and found that Tara was still suffering from ear infections. She told Gina to continue with the antibiotic and Tylenol, and to give Tara fluids to prevent dehydration. On the morning of October 3, Tara showed some improvement. Her
temperature was lower, and she was able to sit up for a short time and eat a little. *3 Gina felt encouraged and left Tara with her mother-in-law while she went to work for a short time.
{¶6} Tara took a turn for the worse that afternoon. Her fever spiked and her grandmother had difficulty arousing her from sleep. Gina came home and found Tara to be extremely lethargic. She held Tara most of the afternoon and Tara pressed her head into Gina’s arm. That night, Thomas returned from an out-of-town trip. He thought
that Tara looked worse than she had when he had left on October 1. He insisted that they call the doctor’s office. The on-call physician at Suburban Pediatrics told them to take Tara to the hospital immediately. They took her to the emergency room at Children’s Hospital Medical Center. A lumbar puncture revealed that Tara had bacterial meningitis. Her
spinal fluid revealed over 1 million colonies of a particularly virulent, antibiotic- resistant bacterium that was virtually unknown in Cincinnati at the time. Tara was given intravenous antibiotics and remained hospitalized for over a month. While she was hospitalized, Tara suffered numerous complications.
She developed hydrocephalus, a condition in which her body’s ability to drain cerebral fluid was compromised. The doctors placed a shunt into her head to drain the fluid down to her abdomen. Tara will have to have a shunt for the rest of her life. The doctors agreed that Tara had survived the meningitis against the odds. She did not develop any cognitive impairment, and she was a college student with a high grade-point average at the time of the trial. Nevertheless, she has had multiple brain surgeries to remedy complications from the shunt and other issues that resulted from the meningitis. She also had to have surgery to remedy chronic back pain. She will have to be monitored for the rest of her life to make sure that the shunt does not malfunction. If it does, and she becomes lethargic and/or suffers a *4 severe headache, she must be able to get to a medical facility capable of conducting brain surgery within four hours or she could die. Seven years after Tara’s illness, Tara, through her parents, sued Dr.
O’Malley and her employer, Suburban Pediatrics, for medical malpractice. Her parents also filed a loss-of-consortium claim. Following a trial, a jury returned a verdict in favor of O’Malley. The trial court denied the Fehrenbachs’ motion for a new trial or for judgment notwithstanding the verdict. The Fehrenbachs filed a timely appeal from the trial court’s judgment. We reversed the trial court’s judgment on several grounds, most
notably, pervasive misconduct by Dr. O’Malley’s counsel.
Fehrenbach v. O’Malley
,
164 Ohio App.3d 80,
testimony that Dr. O’Malley had deviated from the standard of care by failing to diagnose and treat for meningitis, and that earlier treatment would have prevented the bacteria in Tara’s blood from infecting her brain or would have attacked the meningitis in time to prevent hydrocephalus and the other complications that Tara had suffered. O’Malley presented expert testimony showing that Tara had a rare,
aggressive strain of bacteria that did not emerge as meningitis until the afternoon of October 3, when she took a turn for the worse. O’Malley’s experts testified that Tara did not have meningitis when she saw Dr. O’Malley on October 1 and 2, and that given the non-specific symptoms that Tara had presented with on October 1 and 2, a diagnosis of ear infections was reasonable.
*5 After the jury returned a verdict in favor of Dr. O’Malley, the Fehrenbachs filed motions for judgment notwithstanding the verdict (“JNOV”) and for a new trial. The trial court denied both motions. This appeal followed.
II. Conduct of Defense Counsel In their first assignment of error, the Fehrenbachs contend that the
trial court erred in overruling their motions for JNOV and for a new trial. They argue that defense counsel made numerous improper remarks in front of the jury designed to arouse passion or prejudice and that defense counsel’s misconduct again required a new trial. This assignment of error is not well taken. We review a decision to grant or deny a motion for JNOV de novo. A
JNOV is proper if, upon viewing the evidence in a light most favorable to the
nonmoving party, reasonable minds could come to but one conclusion in favor of the
moving party.
Goodyear Tire & Rubber Co. v. Aetna Cas. & Sur. Co.
, 95 Ohio St.3d
512,
proper limits and to prohibit counsel from creating an atmosphere of passion and
prejudice.
Roetenberger
, supra, at ¶9;
Furnier
, supra, at ¶10. It should not permit
abusive conduct, and it has a duty to intervene sua sponte to correct the prejudicial
effect of misconduct.
Pesak v. Univ. Neurologists Assn., Inc.
, 87 Ohio St.3d 495,
offensive and prejudicial to the plaintiffs and to the integrity of the judicial system.”
We went on to state that defense counsel’s comments “went far beyond the wide
latitude provided to counsel in opening statement and closing argument.” Id. at ¶26.
In fact, we decided a series of cases involving the same defense counsel and ordered
new trials based on that counsel’s misconduct. See, e.g,
Thamann v. Bartish
, 167
Ohio App.3d 620,
occurred in this trial rose to the level of the misconduct that had occurred in the previous one. On the contrary, defense counsel was restrained and took a new approach to the trial. Instead of attacking the Fehrenbachs, their attorney and their experts, counsel stated that “the bad guy” in this case was meningitis and that no one else, particularly Dr. O’Malley, had done anything wrong. The incidents that the *7 Fehrenbachs cite as evidence of misconduct are simply not that egregious, and the record shows that counsel’s arguments were generally based upon the evidence. We find no misconduct by defense counsel that was prejudicial in the context of the overall trial. Further, contrary to the Fehrenbachs’ assertions otherwise, the trial
judge kept a tight rein on the trial. In overruling the Fehrenbachs’ motions for JNOV and for a new trial on the basis of misconduct by defense counsel, the court stated that “[t]his Court’s recollection of the conduct of defense counsel is totally inconsistent with that set forth in the memorandum supporting plaintiff’s motion. Defense counsel’s conduct was well within the appropriate parameters of representing his client.” Where the record supports a trial court’s finding that counsel’s
conduct did not affect the outcome of the trial, an order denying a new trial is not an
abuse of discretion.
Merkl v. Siebert
, 1st Dist. Nos. C-080973 and C-081033, 2009-
Ohio-5473, ¶26. “[A]ppellate courts should defer to trial judges, who witnessed the
trial firsthand and relied upon more than a cold record to justify a decision.”
Harris
v. Mt. Sinai Med. Ctr.
,
product of passion and prejudice due to counsel’s misconduct. Therefore, the trial
court did not err in overruling the Fehrenbachs’ motion for JNOV. Further, the
court’s decision to overrule the motion for a new trial was not so arbitrary,
unreasonable or unconscionable as to connote an abuse of discretion. See
Blakemore v. Blakemore
(1983),
III. Alteration of Medical Records In their second assignment of error, the Fehrenbachs contend that the
trial court erred in granting Dr. O’Malley’s motion for a directed verdict and in denying their motion for a directed verdict on their claims for alteration of medical records. They argue that the evidence was undisputed that Dr. O’Malley had altered Tara’s medical records, and that the question of whether the doctor had altered the records to avoid liability was, at least, a question of fact for the jury. This assignment of error is not well taken. The standard for granting a directed verdict is the same as for
granting JNOV.
Mantua Mfg. Co. v. Commerce Exchange Bank
,
medical records regarding her temperature, the diagnosis, the medicine prescribed
and an instruction to call if Tara’s symptoms worsened. Dr. O’Malley contended that
she added the information because her partner had brought the incomplete chart to
her attention. She also gave other, inconsistent explanations at various times.
In
Moskovitz v. Mt. Sinai Med. Ctr.
, 69 Ohio St.3d 638, 1994-Ohio-
324, 635 N.E.2d 331, the Ohio Supreme Court stated that “[a]n intentional
*9
alteration, falsification or destruction of medical records by a doctor, to avoid
liability for his or her medical negligence, is sufficient to show actual malice, and
punitive damages may be awarded whether or not the act of altering, falsifying or
destroying records directly causes compensable harm.” Id., paragraph one of the
syllabus. Thus, a plaintiff can bring a
Moskovitz
claim for a presumption of malice.
In
Moskovitz
, the doctor had “whited-out” incriminating portions of
his original office chart, added exculpatory language, made copies of the new chart,
and destroyed the original chart.
Fisher v. Von Loveren
, 1st Dist. No. C-070228,
evidence. See
Smith v. Howard Johnson Co.
,
by the defendant designed to disrupt the plaintiff’s case.
Smith
, supra, at 29;
Hope v.
Lake Cty. Bd. of Commrs.
, 11th Dist. No. 2008-L-173,
IV. Expert Testimony/Discovery In their third assignment of error, the Fehrenbachs contend that the
trial court erred in allowing defense experts to give new, undisclosed opinions at trial. They argue that their testimony went well beyond the topics that Dr. O’Malley had originally stated in discovery and beyond their deposition testimony. This assignment of error is not well taken. Civ.R. 26(E) requires each party to seasonably supplement the subject
matter of its experts’ expected testimony. But this rule does not require a party to
give notice as to every nuance of an expert’s opinion.
Hofmeier v. Cincinnati Inst. of
Plastic & Reconstructive Surgery, Inc.
, 1st Dist. No. C-000274,
which they now complain, and they, therefore, waived any error. See
Stores Realty
Co. v. Cleveland
(1975),
V. Basis of Expert Testimony In their fourth assignment of error, the Fehrenbachs contend that the
trial court erred in allowing the defense expert witnesses to use undisclosed medical literature to support their opinions. Specifically, they argue that Dr. Elias Chalhub referred to “several large studies” that supported his opinion. They argue that that testimony was improper under the rules of evidence, and that those studies were not disclosed in discovery as required by Civ.R. 26(E). This assignment of error is not well taken. Previously, Evid.R. 706 had provided that learned treatises could only
be used on cross-examination to impeach a witness. In 2006, that rule was repealed and Evid.R. 803(18) was enacted. The new rule allows for a learned-treatise exception to the hearsay rule. State v. Henry , 11th Dist. No. 2007-L-142, 2009- Ohio-1138, ¶88-89. Even before those amendments, courts had allowed general
references to literature in the expert’s field. The Ohio Supreme Court has stated,
“There is a difference between a witness’s referring to specific statements in
professional literature as substantive evidence and an
expert
witness’s referring to
the literature as being part of the basis for that expert’s opinion. While the former
reference would be inadmissible hearsay, numerous courts in Ohio have held that the
latter reference is admissible. We agree with the decisions in those cases.”
Beard v.
Meridia Huron Hosp.
, 106 Ohio St.3d 237,
*12
Further, this court has stated, “References to studies by other experts
in a particular field, however, do not automatically make the expert’s testimony
tainted by a learned treatise. It is well established that experts derive much of their
expertise from reading or studying the written works of others in their field;
therefore, the mere acknowledgement of those studies does not necessarily bring into
play the learned-treatise barrier.”
Suida v. Howard
, 1st Dist. Nos. C-000656 and C-
000687,
basis for her expert’s testimony, the record shows that Chalhub had referred to those
studies in his deposition. Further, the reference to the studies was tangential to the
main point of his testimony. Finally, other experts had testified regarding the same
subject matter, although they didn’t refer to the studies. The trial court has broad
discretion in the admission of evidence, including expert testimony.
Terry v.
Caputo
, 115 Ohio St.3d 351,
VI. Jury Misconduct In their fifth assignment of error, the Fehrenbachs contend that the
trial court erred in denying their motion for a new trial on the basis of jury misconduct. They argue that a juror conducted outside research and ignored the trial court’s instructions. This assignment of error is not well taken. Under the aliunde rule, a jury’s verdict may not be impeached by
evidence from a member of the jury unless a foundation is laid by evidence aliunde.
Evidence aliunde is extraneous, independent evidence of alleged misconduct based
*13
on the firsthand knowledge of someone who is not a juror. Evid.R. 606(B);
State v.
Schiebel
(1990),
treatment of Tara “was appropriate” and the court had instructed the jury to accept that stipulation. The court had also given standard instructions that the jury should not consider outside evidence. The Fehrenbachs presented the affidavit of juror number one, in
which he expressed a number of concerns regarding juror number five. He stated, “During the time we, the jury, were together in this trial, Juror #5 raised issues that the court instructed us were not to be considered. For example, whether Children’s Hospital was liable, whether Children’s should have tapped Tara’s head sooner, whether certain medications should not have been given. He voiced his opinion even after the verdict that he did not know why the parties did not go after Children’s since in his opinion they were at fault. “Juror #5 also made a number of very specific statements about the
medications, particularly, ‘Dexameth[a]sone.’ He made comments that the drug was not appropriate and referenced the * * * [Material Safety Data Sheet] as to Dexamethasone. None of this was offered in evidence before us the jury during trial. These comments clearly originated from some source other than the evidence presented during trial.
{¶45} “Based upon my observations and comments of Juror #5, I can only reasonably conclude that he probably did research about this case outside of the courtroom.
{¶46} “I recall that the court had specifically instructed each member of the jury to refrain from doing any personal research outside of the courtroom during the pendency of the trial.” In overruling the Fehrenbachs’ motion for a new trial, the court
indicated that the statement in the affidavit concluding that juror number five “probably did research about this case outside the courtroom is conjecture at best.” We agree. It went on to state the rule that “some competent evidence extraneous and independent and from another source is an absolute requirement.” It held that the aliunde rule applied, and said that it would not “invade the sanctity of the jury process in this case even though it was short of perfect.” We agree with the trial court’s reasoning. The Fehrenbachs
presented no evidence aliunde of juror misconduct. Their argument rests entirely on the affidavit of another juror, which cannot be used to impeach the verdict. We note that we do not consider counsel’s arguments about what he heard from jurors because those arguments were not evidence. The Fehrenbachs’ reliance on Doan v. Brigano (C.A.6, 2001), 237
F.3d 722 is misplaced. In that case, the United States Court of Appeals for the Sixth Circuit held that the application of the aliunde rule in Evid.R. 606(B) violated the defendant’s Sixth Amendment right to a fair trial, which includes the fundamental rights of confrontation and cross-examination. Id. at 730-731. We believe that this case is a narrow one, and we do not find it to be
dispositive. First, it not binding on this court. Second, it is a criminal case in which the court relied on separate constitutional grounds for its decision. Finally, it *15 involved an out-of-court juror experiment. The juror reported her findings like an expert witness, yet she had not been subject to cross-examination or the rules of evidence. Id. at 733. In Doan , the Sixth Circuit Court of Appeals acknowledged the
important policy considerations underlying Evid.R. 606(B). Id. at 733, quoting
Tanner v. United States
(1987),
an instruction on “subsequent harm” somehow contributed to the misconduct. They had requested that the court instruct the jury, “If one who has suffered personal injuries by reason of another’s negligence exercises reasonable care in obtaining the services of a competent physician or surgeon, and such injuries are thereafter aggravated by the negligence, mistake or lack of skill of such physician or surgeon, such aggravation is a proximate result of the negligence of the original tortfeasor, and he is liable therefore.” But the record shows that the court and the parties discussed the
instructions as a whole and agreed to the instructions that were given to the jury,
which did not include the “subsequent harm” instruction. The Fehrenbachs did not
object to the instructions as given, and later acknowledged that they had agreed to
the instruction telling the jury about the stipulation regarding Children’s Hospital.
Consequently, the Fehrenbachs waived any objection. Civ.R. 51(A);
Joiner v. Simon
,
1st Dist. No. C-050718,
{¶54} Under the circumstances, we cannot hold that the trial court abused its discretion in overruling the Fehrenbachs’ motion for a new trial on the basis of juror misconduct. See Bentley , supra, at ¶7. Therefore, we overrule the Fehrenbachs’ fifth assignment of error.
VII. Motion for Costs and Expenses Finally, in their sixth assignment of error, the Fehrenbachs contend
that the trial court erred in overruling their motion for costs and expenses related to the first trial. They argue that R.C. 2323.51 empowered the court to sanction defense counsel. This assignment of error is not well taken. We find some appeal to this argument given defense counsel’s
misconduct in the previous trial. Nevertheless, the trial court correctly denied the
motion because it was not timely filed. The applicable version of R.C. 2323.51(B)(1)
provides that “at any time prior to the commencement of a trial in a civil action or
within twenty-one days after the entry of judgment in a civil action * * *, the court
may award court costs, reasonable attorney fees, and other reasonable expenses
incurred in connection with the civil action or appeal to any party to the civil action
or appeal who was adversely affected by frivolous conduct.”
The Ohio Supreme Court has construed the word “judgment” as used
in the statute to mean a final appealable order.
Soler v. Evans
,
VIII. Summary In sum, we hold that the trial court did not err in overruling the
Fehrenbachs’ motions for JNOV and for a new trial. They received a fair trial, and we find no reason to overturn the jury’s verdict. We overrule all six of the Fehrenbachs’ assignments of error, and we affirm the trial court’s judgment.
Judgment affirmed. H ILDEBRANDT and S UNDERMANN , JJ., concur.
Please Note:
The court has recorded its own entry this date.
