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Bradley v. Bishop

Court of Appeals of Tennessee, Jackson

March 30, 2017

CHRISTY L. BRADLEY, ET AL.
v.
LAURA BISHOP M.D., ET AL.

         Session February 14, 2017

         Appeal from the Circuit Court for Shelby County No. CT-002977-13 Rhynette N. Hurd, Judge.

         This is a health care liability action wherein a trial by jury resulted in judgment for the defendants. Plaintiffs filed a motion for a new trial, asserting that: (1) the trial court erred in granting defendants' motions in limine, which restricted plaintiffs' ability to adequately cross-examine defendants' expert witnesses regarding the "best possible care"; (2) the trial court erred in granting defendants' motions in limine, which restricted plaintiffs' ability to present evidence relating to medical expenses; (3) the trial court failed to give a curative instruction after defendants' opening statement; and (4) the weight of the evidence was against the jury verdict. The trial court denied the post-trial motion and affirmed the jury verdict as the thirteenth juror. Plaintiffs appealed. We affirm.

         Tenn. R. App. P. 3 Appeal as of Right; Judgment of the Circuit Court Affirmed

          Richard Glassman and Lauran G. Stimac, Memphis, Tennessee, for the appellants, Christy L. Bradley and J. Anthony Bradley.

          William H. Haltom, Jr., Margaret F. Cooper, and Laura L. Deakins, Memphis, Tennessee, for the appellees, Laura Bishop, M.D. and Women's Care Center of Memphis, MPLLC dba Ruch Clinic.

          J. Steven Stafford, P.J., W.S., delivered the opinion of the court, in which D. Michael Swiney, C.J., and Kenny Armstrong, J., joined.

          OPINION

          J. STEVEN STAFFORD, JUDGE.

         Background

         Prior to the events at issue in this case, in 2002, Plaintiff/Appellant Christy Bradley ("Ms. Bradley") had a blood clot in her portal vein, [1] which blood clot impaired her liver function. This condition required approximately three abdominal surgeries between 2002 and 2003, wherein a shunt was eventually inserted from Ms. Bradley's sternum to two inches below her navel. Although the injuries healed, scars developed. Thereafter, Ms. Bradley became a patient at Defendant/Appellee Ruch Clinic in 2004 for treatment of abnormal uterine bleeding.

         From 2004 to 2012, transvaginal ultrasounds performed on Ms. Bradley at the Ruch Clinic revealed that she had a fibroid[2] in her uterus. The treating physician performed a conservative surgery called a hysteroscopic myomectomy[3] on Ms. Bradley on two separate occasions to remove the fibroid. Each time, this procedure would temporarily alleviate the bleeding. However, Ms. Bradley's heavy bleeding would eventually resume, and the fibroid would return. Ms. Bradley was also prescribed medication to treat the heavy bleeding issue, but this treatment was also unsuccessful. During these years, Ms. Bradley would either experience no period at all or, if she did experience a period, would bleed abnormally. Because of these bleeding issues, Ms. Bradley had difficulty conceiving a child and was referred to a fertility clinic.[4]

         On August 24, 2006, the fertility specialist performed a laparoscopy[5] on Ms. Bradley to address the various disorders related to her ovaries. The report noted findings of "extensive adhesions of the bowel and omentum[6] to her abdomen with the pelvis noticed to be 'relatively free of adhesions. [7]'"

         From early to mid-2012, Ms. Bradley's bleeding issues worsened. On or around October 2012, another physician at the Ruch Clinic performed a transvaginal ultrasound and diagnosed Ms. Bradley with another large fibroid. The physician at the Ruch Clinic referred Ms. Bradley to Defendant/Appellee Laura Bishop, M.D. ("Dr. Bishop, " or, together with the Ruch Clinic, "Appellees"), a surgeon specializing in obstetrics and gynecology ("OB/GYN surgeon"), who recommended several options, including a hysterectomy. Ms. Bradley chose instead to attempt yet another hysteroscopic myomectomy to remove the fibroid conservatively; Dr. Bishop performed this procedure at the end of October 2012.

         However, the hysteroscopic myomectomy did not stop the bleeding because it was found that the fibroid had grown into Ms. Bradley's uterine wall. Dr. Bishop thereafter recommended a laparoscopic robotic hysterectomy, which she described as the least invasive option with the fastest recovery time. It is undisputed that Dr. Bishop also informed Ms. Bradley of the possibility of converting to an open procedure during the surgery. After Ms. Bradley was given some time to consider her options, Ms. Bradley informed Dr. Bishop that she wished to proceed with the recommended procedure.

         The hysterectomy occurred on December 26, 2012, at Baptist Memorial Hospital for Women. Although the surgery initially began as a laparoscopic hysterectomy, Dr. Bishop converted to an open hysterectomy rather than continue with the planned robotic procedure. Prior to the conversion, Dr. Bishop noticed a superficial cut on Ms. Bradley's colon.[8] At some point during the transition from the laparoscopic surgery to open surgery Dr. Bishop sought assistance from two different surgical teams. Dr. Bishop, however, made the decision to finish the open procedure herself by suturing the colon and removing the uterus without help from another surgeon once she determined that help was not readily available and that she was confident she could finish the procedure herself. In the days following the hysterectomy, Ms. Bradley's condition deteriorated. On December 29, 2012, Ms. Bradley was transferred to the ICU at Baptist East, and another surgeon, Stephen Behrman, M.D. performed an operation that revealed contamination of the abdominal cavity and a "through-and-through injury" of the small bowel, necessitating an "enterectomy[9] with primary anastomosis.[10]" Ms. Bradley stayed at the hospital for approximately three weeks. Ms. Bradley's medical records reveal that it took Dr. Behrman approximately three hours to "completely free up and delineate the small bowel" because of the "tremendous adhesions from the patient's prior surgery." Ms. Bradley was able to return to work in April 2013. According to Ms. Bradley, the injury and surgery resulted in three years of additional procedures, therapy, and disfigurement.

         Ms. Bradley and her husband, Plaintiff/Appellant J. Anthony Bradley (together with Ms. Bradley, "Appellants") filed a health care liability action on July 13, 2013 against Appellees in the Shelby County Circuit Court.[11] The complaint alleged, inter alia, that Dr. Bishop negligently caused injury to Ms. Bradley's small bowel. The complaint also alleged that the Ruch Clinic was vicariously liable for Dr. Bishop's negligence. On August 12, 2013, Appellees filed an answer generally denying all material allegations.

         During discovery, on August 20, 2015, counsel for Appellants deposed one of Appellees' expert witnesses, Thomas Stovall, M.D. The portion of Dr. Stovall's testimony relevant to this appeal is as follows:

Q: What is the standard of care for Dr. Bishop on the day in question?
A: What a reasonable and prudent doctor with the same training and background would have in this locale, in Memphis.
Q: Under similar circumstances?
A: Yes.
Q: And is that to do the best she can-
A: Oh, I think-
Q: -for the patient?
A: I think we always try to do the best we can for the patient.
Q: So then the standard of care requires that a physician like Dr. Bishop, under the circumstances in his case, do the best she can for the patient?
A: I don't believe the best she can is in the statute, no.
Q: What statute?
A: In the definition of what standard of care is legally.
Q: Well, let's talk about all doctors in Memphis doing what Dr. Bishop was doing on the day of this event. Are all doctors required to do the best they can for their patients?
A: I believe so, but I don't believe that that's part of a standard of care definition.
Q: Well, how do you apply the standard of care to all doctors?
A: Well, because that's what a reasonable and prudent doctor, under similar circumstances, would do in that situation.
Q: . . . [D]o you agree with me that all doctors, on the day that these services were rendered to [Ms.] Bradley by Dr. Bishop, should attempt as best they can to do no harm to the patient?
A: Yes. As best they can, yes.
Q: And that's every doctor?
A: Yes.
Q: And you agree with me that every doctor should do his or her best for the patient under the circumstances presented?
A: Yes.
Q: There's no exception to that, is there?
A: Not that I'm aware of.
Q: And there's no exception to do the best you can to do no harm to the patient, is there?
A: Not that I'm aware of.
Q: And you believe that Dr. Bishop did the best that she could to do no harm in this case?
A: Yes.
Q: And you believe that she, Dr. Bishop, gave the best possible care and services she could to [Ms.] Bradley ...

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