SUSAN KULA and ANDREW KULA, Plaintiffs-Appellants, vs. BOONE COUNTY HOSPITAL, Defendant-Appellee.
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IN THE COURT OF APPEALS OF IOWA
No. 7-369 / 06-1781
Filed June 27, 2007
SUSAN KULA and ANDREW KULA,
Plaintiffs-Appellants,
vs.
BOONE COUNTY HOSPITAL,
Defendant-Appellee.
________________________________________________________________
Appeal from the Iowa District Court for Boone County, William J.
Pattinson, Judge.
Plaintiffs appeal following the denial of their motion for new trial after the
jury returned a defendant’s verdict in their medical malpractice action against
Boone County Hospital. AFFIRMED.
Guy R. Cook and Nicholas Mauro, Des Moines, for appellants.
Joseph Fitzgibbons, Estherville, for appellee.
Considered by Sackett, C.J., and Vogel and Miller, JJ.
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SACKETT, C.J.
Plaintiffs Susan and Andrew Kula appeal following the denial of their
motion for new trial after the jury returned a defendant’s verdict in their medical
malpractice action against Boone County Hospital. Plaintiffs contend the district
court abused its discretion in admitting certain medical and mental health records
of Susan. The defendant contends the district court did not err in overruling
plaintiffs’ motion as (1) the court did not abuse its discretion in admitting the
evidence and (2) plaintiff’s substantial rights were not affected because there
was insufficient evidence to support a finding that defendant’s negligence was a
proximate cause of plaintiff’s injuries. We affirm.
Scope of Review. In ruling on motions for new trial, the trial court has
broad, but not unlimited, discretion in determining whether the verdict effectuates
substantial justice between the parties. Gorden v. Carey, 603 N.W.2d 588, 590
(Iowa 1999); Jackson v. Roger, 507 N.W.2d 585, 589 (Iowa Ct. App. 1993). Our
review of rulings on motions for a new trial depends on the grounds asserted in
the motion and ruled upon by the district court. Ladeburg v. Ray, 508 N.W.2d
694, 696 (Iowa 1993). If the motion and the ruling are based on a discretionary
ground, we review the ruling for abuse of discretion. Id. If the motion and ruling
are based on a legal issue, our review is for correction of errors at law. Id. at
696-97. Rulings on evidentiary issues are based on a discretionary ground. See
Iowa R. Civ. P. 1.1004(1). Our review on this issue is therefore for abuse of
discretion.
Hansen v. Cent. Iowa Hosp. Corp., 686 N.W.2d 476, 480 (Iowa
2004). We review the question of whether there was evidence to support a
finding of proximate cause for error. See Iowa Mut. Ins. Co. v. McCarthy, 572
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N.W.2d 537, 541 (Iowa 1997). The question there is whether the evidence, when
viewed in the light most favorable to the plaintiffs, was sufficient to generate a
jury question. Roling v. Daily, 596 N.W.2d 72, 74 (Iowa 1999); Nesler v. Fisher &
Co., 452 N.W.2d 191, 193 (Iowa 1990).
Background and Proceedings. Susan was admitted to the hospital on
February 2, 2002, for gallbladder surgery. Susan and her husband, Andrew,
subsequently sued contending Susan sustained ulnar nerve injuries in her left
wrist and elbow from problems with I.V. therapy during her hospitalization.
Susan claimed she sustained damages including past and future physical and
mental pain and suffering, and loss of past and future full mind and body.
Andrew claimed the loss of spousal consortium. The jury found the defendant
negligent but found the negligence was not a proximate cause of the plaintiffs’
damages.
Plaintiffs filed a post-trial motion contending they should have a new trial
because prejudicial evidence was admitted, including Susan’s mental health
records and medical records addressing an incident when Susan was struck by
lightening. They contended these records were prejudicial as they caused the
jury confusion in addressing the issue of proximate cause.
They further
contended the admission of plaintiff’s mental health records were prejudicial and
not relevant.
Alternatively, they claim that if the records were relevant, the
relevance was outweighed by unfair prejudice.
Prior to trial, plaintiffs filed a motion in limine seeking to exclude Susan’s
psychiatric records as well as records concerning a lightening strike Susan
sustained in 1993. The records were offered by the defendant at the close of the
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evidence at which time plaintiffs told the court they had no objections other than
those previously made. Prior to closing arguments and outside the presence of
the jury, plaintiffs again requested the counseling records be redacted from the
defendant’s exhibits.
The district court denied the motion for new trial relying on two grounds.
First, the district court noted that defendant had moved for a directed verdict at
the close of the plaintiffs’ case contending there was insufficient evidence for the
question of proximate cause to be submitted to the jury. The district court denied
the motion. He related that the Iowa Supreme Court encourages district court
judges to deny motions for directed verdicts in most cases even if the district
court judge believes the motion should be sustained.
It is considered more
prudent for a district court judge to submit a weak case to the jury and avoid a
second trial in case there was error in sustaining the motion for directed verdict.
It is preferable to give the jury an opportunity to consider the evidence and
potentially reach the same conclusion as the district court so that unnecessary
re-trials and additional appeals may be avoided.
See State v Kading, 552
N.W.2d 305, 308 (Iowa 1996); Reed v. Chrysler Corp., 494 N.W.2d 224, 228-29
(Iowa 1992).
The district court found no substantial evidence to support a finding of
proximate causation noting there was no expert testimony on this necessary
element and the issue of causation was not within the common experience of lay
persons.
The court noted it would have sustained a motion for judgment
notwithstanding the verdict if the jury had found proximate cause. Having found
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no evidence of proximate cause, the district court found error, if any, on the issue
of admission of records was of little import.
The plaintiffs have not challenged this finding on appeal nor do they argue
there was sufficient evidence in the record to support a finding of proximate
cause. Consequently, we agree with the defendant’s argument that even if the
district court abused its discretion in admitting the challenged records, there is
not reversible error.
Secondly, the district court addressed the issue of the admission of
records. He discussed the fact that Susan sought compensation for past and
future pain and suffering, and for past and future lost body and mental functions.
The court found Susan’s mental and emotional state before and after the claimed
injuries were probative of her ability to enjoy life and the extent to which her
mental discomfort could be attributed to the injury. The court also found her
mental and emotional condition before the alleged injury was relevant to the
issue of causation and whether she was in fact injured. He noted the evidence
that Susan feared she was becoming a hypochondriac tended to disprove the
element of causation.
Medical records offered in evidence by the plaintiffs
indicated that in early June of 2002, Susan’s physician wondered whether her
complaints were more psychologically rooted than physiologic. The district court
further found that the admitted records were relevant to Andrew’s claim for lost
spousal consortium; for the records indicated that other things may have
damaged Susan’s body and mental functions. The court believed the challenged
evidence did not mislead the jury nor did it unfairly prejudice the plaintiffs.
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A trial court has wide discretion in determining the relevancy of proffered
evidence. Spahr v. Kriegel, 617 N.W.2d 914, 916 (Iowa 2000). Evidence is
relevant if it has any tendency to make the existence of a fact in controversy
more or less probable than it would be without the evidence. Iowa R. Evid.
5.401. Evidence is relevant when it has “any tendency to make the existence of
any fact that is of consequence to the determination of the action more probable
or less probable than it would be without the evidence.” Id. The test is whether a
reasonable person might believe the probability of the truth of the consequential
fact to be different if the person knew of the proffered evidence. McClure v.
Walgreen Co., 613 N.W.2d 225, 235 (Iowa 2000); State v. Plaster, 424 N.W.2d
226, 229 (Iowa 1988).
Even relevant evidence is not admissible “if its probative value is
substantially outweighed by the danger of unfair prejudice, confusion of the
issues, or misleading the jury, or by considerations of undue delay, waste of time,
or needless presentation of cumulative evidence.” Iowa R. Evid. 5.403. Unfair
prejudice arises when the evidence prompts the jury to make a decision on an
improper basis, often an emotional one. Pexa v. Auto Owners Ins. Co., 686
N.W.2d 150, 158 (Iowa 2004).
The plaintiffs’ pleading put both the physical and mental condition of
Susan in the case. She complained of pain and emotional distress. Andrew
claimed a loss of consortium.
One factor the jury considers in determining
damages for pain and suffering is loss of enjoyment of life.
See Poyzer v.
McGraw, 360 N.W.2d 748, 753 (Iowa 1985). Evidence concerning other medical
conditions that have and will impact Susan’s physical and mental well-being and
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her ability to enjoy life are clearly relevant to her damage claims. See Pexa, 686
N.W.2d at 158 (affirming trial court’s decision to include plaintiff’s pre- and postaccident history of cancer and treatment in his underinsured motorist claim
against his insurer).
Furthermore, there was medical evidence showing that there was no
explanation for plaintiff’s injury.
The questioned records indicate Susan
constantly and consistently sought medical help for a variety of pains in various
parts of her body.
For the majority of these consultations, there was no
underlying physical cause.
psychologically based.
Rather, there was an indication they were
The evidence was probative and did not unfairly
prejudice the jury’s consideration of plaintiffs’ claims.
The adverse effect of
relevant evidence due to its probative value is not unfair prejudice. Id. at 158-59.
We affirm the district court’s denial of a new trial.
AFFIRMED.
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