Legal Analysis of Meena v. Wilburn Case

Legal Analysis of Meena v. Wilburn Case

• The complete title and citation for the case

Meena V. Wilburn, 603 So. 2d 866 (Miss. 1992).

• Explain which court decided this case.

The Supreme Court of Mississippi tried this appeal case and delivered judgment on June 17, 1992. The lawsuit had first been filed for trial in Hinds County Circuit in 1988.

• Procedural History

The case was first tried in Hinds County Circuit in 1988. As per the facts mentioned herein, the plaintiff, Flora B. Wilburn initiated a negligence suit against the first defendant, Albert L. Meena, M.D and his nurse, the second defendant, Miss Juleigh Greer, for the infection, pain, suffering, and loss of wages arising due to performance of surgery on the wrong patient. The jury in Hinds County Circuit absolved the 2^nd defendant of any liability but found the 1^st defendant liable, charging him 125000 dollars. The decision was highly unsatisfactory to the 1^st defendant, and thus this appeal.

• What laws, statutes, cases, etc. that were used

Statutes

The notable statutes used was the Mississippi Rules of Evidence Act 1986.  Specifically, Rule 702 of the act applied in the determination by the court of the admissibility of an expert witness for the plaintiff, whose testimony was in contention

Case laws

It is not alien for the heavy application of case laws in the determination of a matter. The first caselaw applied in the Meena v Wilburn was the rule in the Beaman v. Helton case (1990) that necessitated the existence of a physician-patient relationship in any medical negligence suit. The case law is followed closely by that of CIG Contractors, Inc. v. Mississippi State Bldg. Common (1987) and Branch v. State, (1977) that guided the court in the determination of the second issue. In determining the problem of assigning company to the misery, the court relied on the case laws of Golden Flake Snack Foods v. Thornton (1989) and Capital Transport Co. v. McDuff (1975).

The merits of West Cash & Carry Bldg. Materials v. Palumbo (1979) were pitted with those of Anchor Coatings v. Marine Industrial Residential, Inc. (1986) in addressing the long-standing conflict on the prejudicial effect upon mention of insurance before a jury. The latter prevailed, in that there was no prejudice impact. Lastly, the rule in Bolam v Friern Hospital Management Committee (1957) was applied in the assessment of the liability of a physician during practice in medical negligence cases.

• What were the Legal Issues discussed?

The first issue was whether the trial court erred in not dismissing Wilburn’s action due to her failure to prove the existence of a physician-patient relationship between herself and Dr Meena. Proof of the existence of such a relationship was a fundamental prerequisite during the institution of claims for medical negligence suits.

The second issue that arose was whether the trial court erred in denying the defendant a new trial due to the plaintiff’s inability to link the injuries successfully she complained of to the medical bills and costs incurred.

The third issue arising was whether the trial court erred by allowing the jury to return a verdict only against Dr Meena, instead of both defendants. Understandably, Dr Meena in this issue was soliciting for company in his misery.

The fourth issue was whether the lower trial court erred in not granting a mistrial as a result of the plaintiff’s expert witness testimony concerning medical malpractice insurance before the jury. The long-standing principle was that a court would declare a mistrial if the witness of a plaintiff brought to the attention of the court the issue of insurance as it was deemed prejudicial.

Lastly, whether the lower court erred in not excluding the testimony of Russell Samson, M.D., one of the plaintiff’s experts, the purported expert witness had failed to qualify as an expert witness under the existing applicable law regarding admission of such evidence.

• Discuss the Facts of the case

Significant portions of the facts of this case are not under contention. In 1987, the plaintiff, a 36-year-old custodian at the Russell C. Davis Planetarium in Jackson, Mississippi, bumped her leg while cleaning and suffered a minor abrasion. The cut worsened due to poor blood circulation and her diabetic condition. She was referred her to Dr. Maples. The good doctor admitted her to the Mississippi Baptist Medical Center, and did surgery that entailed an incision from her groin downward, to inches above her knee. Dr.  Maples regarded the operation as a success and noted his patient was doing remarkably well.

Forty-eight hours after the surgery, the appellant, Dr. Albert L. Meena, was standing in for his colleague, Dr. Petro, with instructions to remove the staples from his patient, Dora Slaughter, who shared a room with Wilburn.

In his testimony, the appellant alleges that he was led to believe by one of the nurses that Dora Slaughter’s bed was next to the window. The appellant, together with his nurse, Madam Juleigh Greer, went to the patient’s room to carry out the instructions given. Upon entering, the appellant called out the intended patient’s name, with no response forthcoming. The appellant indicates that the patient whose bed was next to the window was fully covered and did not respond. However, the patient seated in a chair next to the window looked up to him in acknowledgement that she was Dora Slaughter.

Consequently, the appellant approached her, introduced himself as a colleague of Dr.  Petro, and informed her of his intentions to remove the staples in her leg. The appellant further alleges that the appellee did not utter a word in response to his statements. He then got a call summoning him to St Dominical hospital to attend to an emergency. The appellant notes that he instructed his nurse, Madam Greer, to remove the staples from the patient’s legs.

In her testimony, the appellee, Flora B. Wilburn, attests that she tried, without success, to dissuade the nurse from removing her surgery staples.  She begged with them that they were mistaken and informed them that she had just had surgery. Deaf to her pleas, the nurse continued with the procedure, ignoring her undeniable pain and discomfort. The appellee further alleges that the nurse did not bother to confirm her name or examine her wound, a fact to which the appellant concedes.

In her defense, Miss Greer, the second defendant in the civil action, states that she did not compare the details of the patient in the chart with the armband, as she had no cause for doubt whatsoever as the patient had been adequately identified by the doctor, who had left her with the instructions herein.

The second defendant concedes that indeed she did remove the staples of the said patient, disregarding her discomfort. However, she stopped the procedure at the 8^th staple when the patient’s skin bursts open, exposing the layer of fat underneath. She came to the unfortunate realization that she was operating on the wrong patient after cross-checking the patient’s details with the charts.  She immediately alerted the patient’s doctor, Dr. Maples, who restapled Wilburn’s skin with 12 staples.

Days later, after being discharged, the appellee reported being unwell to her physician, who prescribed medication for her high fever, ranging at 101 degrees. This, however, did not help with her condition as she later complained of chills, fever, and other symptoms of a worsening infection. Consequently, she was readmitted to the hospital for 22 days where she had more surgery and placed in intensive care for the infection.

To negate any fault on the part of the appellee, she testified that she followed all her doctors’ instructions, which were inter alia, use of crutches, getting enough rest, and changing the dressing of the infected area. Due to her impeccable care, her wound gradually healed, and she fully recovered, except for scars and indention, a constant reminder of her terrible plight.

• What was the Verdict?

Upon consideration of the facts, issues, evidence, testimonies and the parties’ submissions, the Supreme Court, in its wisdom, affirmed the decision of the trial court that the appellant, Dr. Meena, was 100% liable for the injuries occasioned on the plaintiff as a result of his negligence as a healthcare administrator. The Supreme Court further held that the trial court judge errored in neither ordering a new trial or a mistrial. Furthermore, the Supreme Court upheld the jury’s decision in exonerating Nurse Greer, the second defendant.

• Rationale for Decision

In the first issue, the appellant sought to rely on the rule in Beaman case that “no medical malpractice or negligence action may be instituted in the absence of a physician-patient relationship” (Beaman v Helton, 1990). The court adopted a contrary view that upon careful reevaluation, the rule translates that a physician may be deemed liable upon satisfaction of the core elements of negligence, that is, duty, breach of duty, causation, and injury. As such, the absence of a physician-patient relationship does not affect this case.  The existence of a physician-patient relationship only assists in the determination of the nature of the duty owed, as per Justice Sullivan in his dissent in the Beaman case. Furthermore, the appellant had already admitted breaches of duty and negligence in his admissions. This warranted the affirmation of the trial court verdict.

In the second issue, the court noted that the trial judge had already allowed the admission of the said medical bills as evidence, upon consent by both parties.  The appellant is also precluded from the privilege of questioning the reasonableness and necessity of the documents, as he did not do so at the trial court, as required in the CIG Contractors case (CIG Contractors, Inc. v. Mississippi State Bldg. Common, 1987). Furthermore, the court acknowledged its inability to address the issue of causal connection. This is because the appellant did not follow the rule in Branch v State case that commands the production of the medical bills in contention in court (Branch v. State, 1977). The rationale above places the burden on the appellant to ensure the inclusion of exhibits. As such, the court cannot delve into and decide on what is not before it. Therefore, the preceding substantiates the affirmation of the trial court’s decision to deny the appellant a retrial.

In the third issue, the appellant claims that as per the judge’s peremptory instructions, the jury ought to have returned a verdict against both defendants, as they were joint tortfeasors. The appellee argued that the appellant had no right to cause a fuss over an error that does not adversely affect him, and noted that the courts rarely reversed a case in case of an exoneration of one tortfeasor (Golden Flake Snack Foods v. Thornton, 1989).In the latter, a court will not reverse a verdict simply because the master was doomed, while the servant was exonerated. Concerning the aforementioned guiding cases, the court rejected Meena’s affirmations as it was not the duty of the court to assign company to those in misery.

Concerning the fourth issue, it had been long-standing that there should be no mention of insurance before a jury as it was prejudicial as per the general rule in the Palumbo case (West Cash & Carry Bldg. Materials v. Palumbo, 1979).  However, this rule watered down due to the recognition of the need for liability insurance. Therefore, a mention of insurance was no longer presented a proclamation for mistrial (Anchor Coatings v. Marine Industrial Residential, Inc., 1986). Furthermore, the appellant did raise the issue in due time to allow the trial judge to assess its prejudicial effect under the Palumbo rule.  Consequently, the appellant’s argument is, therefore dismissed.

 In the fifth issue, the judges of the Supreme Court noted that Meena objected after Wilburn’s expert witness had all transpired. Therefore, his allegation that Samson’s expertise regarding vascular infections did not pertain to anyway about how surgeons normally carried out their conduct in accordance with the Bolam rule on the assessment of medical negligence was stale (Bolam v Friern Hospital Management Committee, 1957). Further, the Supreme Court judges held that Samson’s testimony assisted the jury in a fact-finding mission in determining whether Wilburn’s vascular infection could have been caused by erroneous removal of the staples. It was, therefore, properly admitted under Rule 702 of the Mississippi Rules of Evidence 1986. Such admission, indeed, did not amount to a miscarriage of justice. In light of the above, the issue warranted dismissal.

Was the Decision Unanimous?

Yes, the decision was unanimous. All the judges concurred. The judges of the case were Robertson, Pittman, McRae, Hawkins and Noble. In his concurring judgement, McRae, Justice, notes that the court had overruled their general rule in Beaman, that a doctor-patient relationship is a prerequisite in a claim for medical malpractice (Beaman v Helton, 1990). He notes that the judges had modified the rule, in as much as that a physician-patient relationship was only a factor of consideration in determining the nature of the action, and a physician who undertakes the responsibility of providing healthcare, subject himself to potential liability for a cause of action in medical negligence or malpractice. The rule in Beaman is rendered unviable, hence bad law.

• Why is this case important for health care administrators?

This case is essential as it expounds on the liability of healthcare providers, even in the absence of a physician-patient relationship. Therefore, physicians and other healthcare personnel who undertake to provide their services to persons should be aware of potential liable in case of any mishaps owing to their negligence, as it is already established law.

Furthermore, the case sheds light on the doctrine of vicarious liability. Though it may seem improper, the jury, in its profound wisdom, may deem it wise to place all the liability on the master, rather than the servant, who was simply carrying out the instructions of his master.

The case is also crucial as it sensitizes the importance of practical observance of medical rules and policy governing their profession. A minor ignorant action like an assumption on the identity of a patient may occasion disastrous repercussions, as observed in the facts of the case. Furthermore, medical providers should seek to take out insurance policies for liability in case of disasters such as these.

• What do you think about the decision?

I think the decision is a fair one. The jury was justified in finding the 1^st defendant liable and awarding damages to the complainant, as affirmed by the Supreme Court. The satisfaction of the legal rules pertaining to duty, breach of duty, causation, injury negligence was satisfactorily proved. In particular, I also noted the application of the Bolam test in the assessment of negligence by expert witnesses (Bolam v Friern Hospital Management Committee, 1957). I hereby concur with the court’s decision that the admission of Wilburn’s expert witness Dr. Samson, was done according to the law.

Furthermore, I consider the amount ordered as compensation reasonable enough to adequately cater to the plaintiff’s injuries and suffering as a result of the doctor’s negligent actions. Healthcare providers should be of impeccable conduct at all times humanly possible.

However, I find it is improper that the jury decided to exonerate Nurse Greer of all liability and the subsequent affirmation by the Supreme Court. Even though she rationalized her actions, I deem it careless of her to have ignored the apparent protestations, pain, and discomfort of the patient to carry out her master’s instructions. The nurse should have taken note of the protestations of the complainant and assessed the veracity of her claims. The jury should have also held her 30% liable for the negligence. Were it not for her ignorance; perhaps, the accident would have never occurred.

References

Anchor Coatings v. Marine Industrial Residential, Inc., 490 So.2d 1210, 1219 (Miss. 1986).

Beaman v. Helton, 573 So.2d 776 (Miss. 1990).

Bolam v Friern Hospital Management Committee, 1 WLR 582 (1952)

Branch v. State, 347 So.2d 957, 958-59 (Miss. 1977).

Capital Transport Co. v. McDuff, 319 So.2d 658, 660-61 (Miss. 1975).

CIG Contractors, Inc. v. Mississippi State Bldg. Common, 510 So.2d 510, 514 (Miss. 1987)

Golden Flake Snack Foods v. Thornton, 548 So.2d 382 (Miss. 1989)

Mississippi Rules of Evidence Act 1986. (2017), 1-135. Retrieved February 18 2020, from https://courts.ms.gov/research/rules/msrulesofcourt/Restyled%20Rules%20of%20Evidence.pdf

West Cash & Carry Bldg. Materials v. Palumbo, 371 So.2d 873, 876 (Miss. 1979).