Plaintiff sued for medical malpractice for failure to diagnose an inspissated barium bolus and failure to diagnose the existence of a tumor, cancer of the rectal-sigmoid and for failure to diagnose the perforation of the deceased’s bowel, lower intestine, and colon. At the conclusion of plaintiff’s evidence, the Court sustained a directed verdict from which plaintiff appeals.
Plaintiff’s motion for new trial contained several allegations of error, including evi-dentiary questions. Plaintiff claims he made a submissible case in regаrd to the only point he briefed and argued, which was
“That the defendant failed to discover and treat a massive impaction of barium in the colon of the deceased and that defendant’s failure contributed to cause her death.”
The Court will review only that point preserved and briefed by plaintiff.
We must review the evidence giving plaintiff the benefit of every inferenсe and consider it in a light most favorable to the plaintiff. Steele v. Woods, Mo.,
Within days of her admission and after the first barium, the evidence shows that she began passing rectally, white rocks. Several days after her release, the deceasеd pulled chunks of white hardened rock from her rectum, one of which was the size of a silver dollar. On October 15, 1965, the deceased returned to Dr. Ber-wald’s office where he felt a mass аfter having palpated the abdomen of deceased. She was transferred to the care of a Dr. Samuel Soule who was a gynecologist. Three days after her consultatiоn with Dr. Soule, she was seen by Dr. Murray Chin-sky, an internist, and was admitted to Jewish Hospital on an emergency basis. The hospital records indicate that three large scybala of hardened barium were manually removed from her rectum. They were smaller than a lemon, about the size of a silver dollar.
Exploratory surgery was performed October 29, 1965, at which time a large 7x5 centimeter bolus of barium was found in the colon which had caused necrosis of the bowel wall and had perforated the bowel. The fecal bolus completely obstructed the lumen of the сolon. The area was inflamed with peritonitis present. Twelve centimeters from the location of the barium bolus, the surgeon found cancer of the sigmoid colon. The cancеr of the colon completely encircled the interior of the colon and obstructed the passage. The surgeon *709 performed a colostomy, removed apprоximately ten inches of the colon, as well as the barium bolus, removed that area which was cancerous and that area which was perforated and necrotic where thе barium bolus was located. The patient did not respond satisfactorily and a second operation was performed, at which time the surgeon discovered that the colostоmy operation had failed, that the patient had gangrene, and he removed the gangrenous segment of the colon and performed another colostomy of the colоn. Shortly after, on November 11, 1965, the patient died.
The death certificate listed the immediate cause of death as peritonitis due to bowel resection due to perforation of the bowel by fecalith due to cancer of the rectal sigmoid. A postmortem was performed in which the pathologist listed a total of fifteen primary causes of death. The final anatomical diagnosis (the pathologist’s report) listed in numerical order the following findings:
1. Infiltrating adenocarcinoma;
2. Obstructing fecal barium bolus;
3. Gangrene of the colon;
4. Peritonitis;
and thereafter, the remaining eleven other findings. Dr. Murray Chinsky, when asked to comment on this anatomical diagnosis and pathology report, was asked the following question and made the following answer:
“Q. Now, doctor, under the word ‘primary’ in the final anatomical diagnosis report, why are they listed there in that fashion? What is the reason for that?
“A. Because the pathologist believes these are the major factors leading to her death.”
The only evidence thаt would remotely bear on the causal connection between the negligent act or omission is the answer given by Dr. Chinsky “because the pathologist believes these are the majоr factors leading to her death.” Dr. Chinsky himself was not asked what the cause of death was. No other questions were asked of Dr. Chinsky in regard to the fourteen other findings in the pathologist’s report nor was Dr. Soule, who testified by deposition, asked what the cause of death was nor was he asked to comment at all upon the final anatomical report.
The defendant was required to use and exercise that degree of skill and proficiency which is commonly experienced by the ordinary, skillful, careful and prudent physician and surgeon engaged in the рractice of medicine. This duty required that he give heed to symptoms subsequent to an operation or treatment, and give or prescribe such method of treatment which the situation demanded and as would commend itself to the ordinary, prudent, careful and skillful physician and surgeon. We also stated it is sufficient if there is substantial evidence which shows that the injury (death) is a natural and prоbable consequence of the negligent act or omission. Steele v. Woods, Mo., 327 S.W.2d 187, supra.
In Herke v. St. Louis & S. F. Ry. Co.,
“Q. And it' wouldn’t make any difference where that оbstruction occurred, that is, where it was, and when it was there, whether there *710 was a cancer or a polyp or anything else, it would occur and could occur independent of the obstruction itself, isn’t that correct?
“A. Well, if I understand that question, this would not have occurred (the inspissated barium bolus) without the cancer, it makes a lot of difference when there is a cancer, if the cancer isn’t there the bolus would have been washed out, if the cancer wasn’t there.”
Dr. Sachar, while not being questioned specifically about the fifteen findings in the pathоlogy report and final anatomical diagnosis, made these responses to the following questions:
“Q. Doctor, when you referred yesterday to a fatal cancer, you referred to this woman dying of cancer?
“A. Yes.
“O. Now you said the woman died of the cancer and not the bolus ?
“A. Yes.
“Q. Did an obstruction of fecalith with inspissated barium bolus kill this woman ?
“A.' No.”
Dr. Sachar, on redirect examination was questioned concerning the second item of the pathology and final anatomical report. The question was propounded by plaintiff’s counsel in the following fashion:
“Q. So the obstructing filler material, the barium bolus, that was at least the cause, if not the entire cause of this woman’s death, and that’s a fair medical statement is it not?
“A. Well, it really isn’t, because that would be what they (the pathologists) find and that doesn’t mean cause, that means just what’s present, not what caused death but what was present at the time of death.”
Dr. Sachar, on cross-examination, then testified:
“Q. And she died of the surgery?
“A. Yes.
“Q. And she died because yоu operated on her and she got gangrene from this peritonitis from the gangrene?
“A. Yes, and a pulmonary emboli.”
The rule is well settled that a party is bound by the uncontradicted testimony of his own witness. Reece v. Reed, Mo.,
The judgment of the trial court is therefore affirmed.