JOSHUA GRAY, by His Parents and Next Friends, MICHAEL and JOLENE GRAY, and MICHAEL GRAY and JOLENE GRAY, Individually, Plaintiff-Appellant s/Cross-Appellees, vs. COUNCIL BLUFFS COMMUNITY SCHOOL DISTRICT and ROSE SCHLEMMER, Defendant-Appellees/Cross-Appellants.
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IN THE COURT OF APPEALS OF IOWA
No. 6-738 / 05-1830
Filed November 16, 2006
JOSHUA GRAY, by His Parents
and Next Friends, MICHAEL and
JOLENE GRAY, and MICHAEL GRAY
and JOLENE GRAY, Individually,
Plaintiff-Appellants/Cross-Appellees,
vs.
COUNCIL BLUFFS COMMUNITY
SCHOOL DISTRICT and ROSE SCHLEMMER,
Defendant-Appellees/Cross-Appellants.
________________________________________________________________
Appeal from the Iowa District Court for Pottawattamie County, Charles
Smith, Judge.
Joshua Gray, by his parents and next friends, Michael and Jolene Gray,
appeals following an adverse jury verdict in a nursing malpractice action brought
against a school district and its nurse. AFFIRMED.
Patrick O'Bryan and Robert Tucker, Des Moines, for appellants/crossappellees.
Gregory Barntsen and Nathan Watson of Smith Peterson Law Firm, LLP,
Council Bluffs, for appellees/cross-appellants.
Heard by Sackett, C.J., and Zimmer and Eisenhauer, JJ.
2
ZIMMER, J.
Joshua Gray, by his parents and next friends, Michael and Jolene Gray,
appeals following an adverse jury verdict in a nursing malpractice action brought
against a school district and its nurse. The Grays contend: (1) the district court
erred in allowing defense counsel to read from a report during his opening
statement, (2) the court erred in failing to give an adverse inference instruction
based on the school district’s alleged failure to turn over some documents, and
(3) the court erred in admitting the allegedly unreliable testimony of an expert
witness. The school district cross-appeals, claiming the court erred in denying its
motion for summary judgment. We affirm.
I.
Background Facts & Proceedings
On January 8, 2002, the Grays filed a petition in which they alleged their
son, Joshua Gray, suffered a prolonged hypoglycemic episode (hereinafter
seizure) at school on January 10, 2000, caused by his diabetes. 1 The Grays
alleged the school district’s resident nurse failed to properly diagnose and treat
the seizure, leading to a permanent decrease in Joshua’s cognitive function. The
Grays claim Joshua became aggressive, suffered severe behavioral and
attitudinal difficulties, regressed in his social skills, and suffered from depression
following the alleged seizure on January 10.
The school district filed an answer to the petition denying all the
allegations of negligence. The district filed a motion for summary judgment on
January 14, 2003, because the Grays had not certified to the district court
1
A hypoglycemic episode is caused by low blood sugar.
3
information regarding any expert witnesses within 180 days of the defendants’
answer in violation of Iowa Code section 668.11(1) (1999). 2
The Grays made a motion to extend the expert designation deadline, and
they eventually designated their experts on April 1, 2003.
The district court
granted the Grays’ motion and denied the school district’s motion for summary
judgment in an order filed April 2, 2003.
Jury trial commenced on August 2, 2005, and lasted for approximately
four weeks. The Grays presented evidence and expert witness testimony in an
attempt to convince the jury the alleged negligence of the school district’s nurse,
Rose Schlemmer, in responding to a seizure experienced by Joshua on
January 10, 2000, was the proximate cause of his alleged subsequent decline in
cognitive function. The school district presented evidence Joshua has suffered
from a variety of diseases and disorders throughout his life, many since his birth.
Joshua has been diagnosed with pariventricular leukomalacia, type-1 diabetes
mellitus, a right-hemispheric brain disorder, attention deficit hyperactivity
disorder, and asthma.
The district offered evidence these diseases and
disorders are the likely cause of his current medical condition.
The parties presented conflicting evidence regarding what happened to
Joshua on January 10. All the school personnel present at school the day of
2
Iowa Code section 668.11(1) states:
1.
A party in a professional liability case brought against a licensed
professional pursuant to this chapter who intends to call an expert
witness of their own selection, shall certify to the court and all other
parties the expert’s name, qualifications and the purpose for calling
the expert within the following time period:
a.
The plaintiff within one hundred eighty days of the defendant’s
answer unless the court for good cause not ex parte extends
the time of disclosure.
4
Joshua’s alleged seizure testified Joshua returned to class after a routine and
successful treatment of his hypoglycemia. The Grays presented testimony that
Joshua suffered a prolonged, inappropriately treated seizure at school on
January 10, leading to his loss of cognitive function.
Pursuant to his Individual Health Plan (IHP), Joshua had his first blood
sugar test of the day at approximately 10:00 a.m. on January 10. Joshua’s IHP
states a normal blood sugar reading is 80 to 100 mg/dl. Joshua’s blood sugar
reading at 10:00 a.m. was 40 mg/dl. In compliance with the IHP, the school
nurse, Rose Schlemmer, was notified, and Joshua was given a glucose gel tube
orally. Although the Grays claim Joshua gagged on the gel tube, Schlemmer
testified Joshua never gagged or exhibited an inability to ingest the gel.
Schlemmer called Jolene Gray and notified her of the blood sugar reading. 3
Schlemmer observed Joshua’s right hand “shaking a little,” which she said
indicated low blood sugar; Schlemmer testified she saw no symptoms of a
seizure.
Joshua was given a snack, one-half cup of milk and thirty goldfish
crackers, as an additional measure to raise his blood sugar level. Schlemmer
informed Jolene of the measures taken to raise Joshua’s blood sugar.
By
10:30 a.m., Joshua’s blood sugar was 56 mg/dl, and by 10:55, it had risen to 149
mg/dl. According to Schlemmer, Joshua returned to class at 10:55, and she told
Jolene about Joshua’s successful return to class.
Jolene testified she told
Schlemmer to call 911, but the school never called 911.
3
Jolene had previously instructed the school to notify her regarding any blood sugar
readings below 80 mg/dl.
5
Joshua’s one-on-one assistant, Karen Anderson, testified Joshua
attended school lunch and afternoon classes without incident, and school records
reflect Jolene signed Joshua out of school at 2:55 p.m. 4 The Grays contend they
picked Joshua up from school around 12:45 p.m., and when they arrived Joshua
was being carried with his head down and his arms limp. The Grays maintain
Joshua seemed unable to recognize them, was confused, and had urinated and
defecated in his pants.
Jolene claimed before she picked Joshua up from school on January 10,
she stopped by her husband’s workplace to bring him along. However, Michael
Gray’s timecard for January 10 shows he punched out for lunch at 11:01 a.m.,
punched back in from lunch at 11:31 a.m., and punched out for the day at
2:32 p.m. Dave Kliegl, Michael’s work supervisor, testified he would not have
allowed Michael to work off the clock, and he had been instructed to always
punch out when leaving a shift.
The Grays also offered testimony that Joshua saw Dr. Peter Daher on
January 10 after they picked him up from school. Dr. Daher testified he saw
Joshua on January 10; however, he admitted that during a prior deposition, he
stated Jolene came to his office alone that day. Dr. Daher’s office notes indicate
Jolene said Joshua had two seizures at school that day, but his medical records
and billing records do not show he saw Joshua on January 10. Furthermore,
Dr. Daher testified if he had seen Joshua in a condition where he had urinated
and defecated in his pants, that is something he would have written down, which
he did not do.
4
The Grays contend the school district forged Jolene’s signature on the sign-out form.
6
On January 11, the Grays took Joshua to see Dr. Daher, and the doctor
rated Joshua’s physical condition as normal. According to Jolene, Joshua had
experienced multiple seizures before and after January 10, but she has been the
only individual to witness those seizures. Johanna Tietsort, a licensed practical
nurse who provided full-time in-home nursing services for Joshua from May to
August 2001, testified she never saw Joshua have a seizure.
The Grays presented expert medical testimony regarding the disabilities
allegedly caused by the seizure on January 10. The Grays claim Joshua is
unable to take care of himself and cannot even fasten buttons, use a zipper, or
tie his shoes. However, Tietsort testified Joshua is capable of buttoning his shirts
and using a zipper. Dr. John Meyers conducted a neuropsychological evaluation
of Joshua on December 11, 2001, and he concluded Joshua reported no
problems fastening buttons, using a zipper, or tying his shoes. Furthermore,
Dr. Meyers observed Joshua “was able to demonstrate adequate fine motor
control consistent with being able to perform buttoning.” Dr. Meyers concluded
the results of his testing were “not consistent with an acquired brain injury.”
Dr. Michelle Marsh, a child psychiatrist, testified Joshua’s psychological
state before and after January 10, 2000, based on records provided by various
mental health providers, was unchanged. In addition, Dr. Waldman, a witness for
the plaintiffs, testified Jolene kept medical logbooks documenting recurring
seizure activity prior to January 10, 2000. Dr. Waldman testified she could not
exclude the prior seizures as the cause of Joshua’s problems.
The Grays contend Joshua’s treating psychiatrist, Dr. James Severa,
indicated Joshua should not be in school, so the Grays have home-schooled
7
Joshua for the past six years with workbooks Jolene purchased at Sam’s Club.
Tietsort indicated Joshua watched television approximately eighty-five percent of
the time when he was at home, and he also played videogames. Dr. Meyers
testified Joshua’s IQ scores appeared to drop over the years because his peer
group was improving, but he was not. He noted there was even a thirteen-point
drop in his IQ score between 1997 and 1999 before the seizure the Grays allege
resulted in his decreased cognitive function.
The jury returned a verdict on August 29, 2005, finding no negligence on
the part of the school district or its nurse. The Grays now appeal, and the school
district cross-appeals.
II.
Opening Statement
The Grays first contend the district court should have granted their motion
for new trial because defense counsel read a statement from a report during his
opening statement that was never admitted into evidence. For the reasons which
follow, we reject this assignment of error.
During his opening statement, defense counsel briefly mentioned a report
prepared by one of the plaintiffs’ witnesses, Dr. Joseph Evans.
The report
indicated Joshua was born prematurely, had a number of severe diabetic
reactions throughout his life, and has intellectual deficits. Defense counsel said
Dr. Evans concluded it was not possible “to single out any one episode as a
cause of his limited intellectual functioning.” The report from Dr. Evans was
never admitted into evidence, and the plaintiffs contend defense counsel
8
improperly provided the jury with information regarding causation that the jurors
should not have heard. 5
We review the district court’s ruling on allegedly improper comments made
by legal counsel during opening statements for abuse of discretion. Moore v.
Vanderloo, 386 N.W.2d 108, 116 (Iowa 1986). Before we will grant a new trial for
misconduct in argument, it must appear that prejudice resulted or a different
result would have been probable but for the misconduct. Id. at 116-17.
The defendants contend the Grays failed to preserve error regarding this
issue. They note that Dr. Evans’s report was exchanged by the parties during
discovery and was referred to in the doctor’s pretrial deposition. They also note
the report was listed as a trial exhibit for which foundation was waived, and no
objections to the report were made prior to trial. Even if we assume without
deciding that the reference to Dr. Evans’s report in opening statement was an
error which was properly preserved, we conclude the plaintiffs failed to
demonstrate any prejudice.
The trial court informed the jury that the statements of the attorneys were
not to be considered as evidence. Dr. Evans’s report was mentioned briefly at
the very beginning of a four-week trial. The report did not come into evidence as
an exhibit, so the jury never saw the language of which the plaintiffs complain. In
addition, both sides presented several other witnesses in support of their
respective positions regarding medical causation. Because the jury found neither
defendant was negligent, it did not have to address the issues of causation and
5
Neither party called Dr. Evans to testify at trial.
9
damages. Therefore, the mention of Dr. Evans’s statement regarding “causation”
was irrelevant to the jury’s verdict.
III.
Jury Instruction
The Grays next argue the court should have given the jury an adverse
inference instruction because the school district “failed to turn over requested
documents.”
We review the failure to give a requested jury instruction for the correction
of errors at law. Stover v. Lakeland Square Owners Ass'n, 434 N.W.2d 866, 867
(Iowa 1989). When a party requests an instruction stating a correct rule of law
having application to the facts of the case, and the concept is not otherwise
embodied in the court's instructions, that party is entitled to have his or her
requested instruction or its substance given. Adam v. T. I. P. Rural Elec. Co-op.
271 N.W.2d 896, 901 (Iowa 1978).
Error in giving or refusing to give an
instruction does not require reversal unless the error is prejudicial. Stover, 434
N.W.2d at 868.
An adverse inference instruction based on the spoliation of
evidence is only appropriate when the destruction of relevant evidence was
intentional, as opposed to destruction as the result of routine procedure. Lynch
v. Saddler, 656 N.W.2d 104, 111 (Iowa 2003). A spoliation inference should be
utilized prudently and sparingly. Id.
One contested issue at trial was the exact timeline of the events on
January 10, 2000.
The Grays contend they picked Joshua up from school
around 12:45 p.m. and discovered he was unable to recognize them, was
confused, and had urinated and defecated in his pants.
The school district
10
maintains Joshua returned to lunch and afternoon classes without incident and
was signed out of school by Jolene at 2:55 p.m.
During the trial, Joshua’s teacher, Susan King, testified about Joshua’s
recess times. In response to a question from plaintiffs’ counsel, King asked
counsel if he had a copy of her lesson plans. She stated her schedule would
indicate the time Joshua had his two recesses.
Principal Joy Stein testified that all student records, including the lesson
plans in question, were destroyed following the end of the school year. However,
a secretary at the school testified she believed Stein collected grade books and
class lessons and placed them in a storage room in the school’s basement for
five years.
At the conclusion of trial, the Grays’ attorneys requested an adverse
inference instruction based on their belief that “there is testimony that certain
documents had been turned over to the school system and not seen again.” 6
Their proposed jury instruction stated, “When relevant evidence is within the
control of a party whose interest is affected, a court may infer that the evidence, if
not produced, would be unfavorable to that party.”
The court declined to give the requested jury instruction. The court found
“especially as to the adverse inference proposal, there is no evidence that would
get beyond speculation as to whether or not the defendant does have within their
control the evidence alluded to.”
The court also found that the spoliation of
evidence would have to be something outside of the ordinary course of the
6
The record we have been provided with for purposes of our appellate review does not
make clear the district court was referred to specific documents.
11
school district’s business, and the principal indicated it was in the ordinary course
of business to destroy some documents.
On appeal, the Grays appear to contend they were entitled to an adverse
inference instruction because King’s lesson plans or grade books as well
Principal Joy Stein’s personal calendar should have been produced prior to trial.
There are several problems with this argument. First, these documents were
never requested by the Grays during the discovery process. Second, nothing in
the record suggests the school district intentionally destroyed evidence with
knowledge it was relevant to this litigation. Third, the Grays only speculate that
Joshua’s teacher’s lesson plans and grade book and the school principal’s day
planner contained information relevant to issues of negligence, causation, and
damages. We find the district court did not err in refusing to give the Grays’
proposed jury instruction under these circumstances.
IV.
Expert Testimony
The final argument raised by the Grays is that the court erred in permitting
allegedly unreliable testimony by Dr. John Meyers to become part of the record. 7
Dr. Meyers is a board certified neurologist who specializes in diagnosing and
treating individuals with brain injury. At trial, the school district elicited testimony
from Dr. Meyers about his developmental curve theory. Dr. Meyers attributed all
of Joshua’s intellectual deficits to injuries he sustained at birth due to the injury to
his right brain hemisphere. Dr. Meyers testified Joshua’s decline in IQ scores
was due to his injury at birth and his slow intellectual development compared to
his peers. The Grays contend Dr. Evans discredited Dr. Meyers’s report.
7
The plaintiffs filed a motion in limine prior to trial challenging Dr. Meyers’s testimony.
12
We review the district court’s decision regarding the admissibility of expert
testimony for the correction of errors of law. Wheeler v. Dental East, P.C., 494
N.W.2d 248, 250 (Iowa Ct. App. 1992). We will not interfere with the court’s
decision to permit expert testimony unless a manifest abuse of discretion has
resulted in prejudice to the complaining party. Id. Abuse of discretion is shown
only when the party objecting to the ruling proves that such discretion was
exercised on grounds or for reasons clearly untenable or to an extent clearly
unreasonable. State v. Blackwell, 238 N.W.2d 131, 138 (Iowa 1976).
We find no abuse of discretion in the trial court’s decision to admit this
expert’s testimony. Moreover, the Grays were not prejudiced by the admission of
Dr. Meyers’s testimony regarding his developmental curve theory.
The jury
found no negligence on the part of the school district or its nurse, and the Grays
have not appealed this finding. For that reason, it did not have to decide the
issues of causation or damages.
The portion of Dr. Meyers’s testimony the
Grays now find objectionable directly relates to the causation of Joshua’s injuries.
Causation and damages are irrelevant if the jury fails to find no underlying breach
of duty. Novak Heating & Air Conditioning v. Carrier Corp., 622 N.W.2d 495, 497
(Iowa 2001). We reject this assignment of error.
V.
Cross-Appeal
The school district filed a motion for summary judgment because the
Grays had not certified to the district court information regarding any expert
witnesses within 180 days of the defendants’ answer in violation of Iowa Code
section 668.11(1). The school district now cross-appeals, contending the district
court erred in granting the Grays’ motion for extension of time to designate
13
experts and in denying its motion for summary judgment. Our resolution of the
issues raised by the Grays makes it unnecessary for us to address the remaining
issues presented by this cross-appeal.
VI.
Conclusion
Because we find no merit in any of the plaintiffs’ appellate claims, we
affirm the district court’s rulings and the jury’s verdict.
AFFIRMED.
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