CARROLL L. WITTEN, JR., M.D., AND WITTEN, SHERMAN & CATALANO, PLLC V. BONNIE PACK, ADMINISTRATRIX FOR THE ESTATE OF JAMES PACK
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RENDERED : NOVEMBER 1, 2007
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Courf of
2005-SC-000414-DG
CARROLL L. WITTEN, JR., M.D ., AND
WITTEN, SHERMAN & CATALANO, PLLC
V.
APPELLANTS
ON REVIEW FROM COURT OF APPEALS
CASE NUMBER 2003-CA-000551
JEFFERSON CIRCUIT COURT NO . 02-CI-002802
BONNIE PACK, ADMINISTRATRIX FOR
THE ESTATE OF JAMES PACK
APPELLEE
OPINION OF THE COURT BY JUSTICE SCOTT
REVERSING
Appellants, Carroll L. Witten, Jr., M .D . and Witten, Sherman & Catalano,
PLLC, appeal from a decision of the Court of Appeals overturning a jury verdict in
their favor in this medical malpractice action . The Court of Appeals held that Dr .
Witten, an orthopedic surgeon, was negligent as a matter of law for slipping in
the operating room while holding a patient's leg. This matter is before us on
discretionary review.
On appeal to this Court, Appellants argue that setting aside the verdict
was improper because Dr. Witten was not negligent as a matter of law. For the
reasons set forth herein, we reverse the Court of Appeals and reinstate the
judgment of the Jefferson Circuit Court.
1 . FACTS
James Pack underwent hip replacement surgery performed by Dr. Witten
on July 25, 2001 . After completing the surgery, Dr. Witten slipped on liquid on
the operating room floor while holding Mr. Pack's leg . Shortly after the fall, Dr.
Witten moved the hip through a range of motion and determined that it was not
dislocated. However, while Mr. Pack was in the recovery room, an x-ray
revealed that the hip was indeed dislocated . Dr. Witten then put the hip back into
place. Mr. Pack was subsequently released from the hospital on July 29, 2001 .
Mr. Pack returned for a follow-up visit on August 13, 2001 . At the
appointment, Dr. Witten discovered that the hip was again dislocated and
performed a second surgery . Mr. Pack's hip unfortunately became dislocated
again prior to his release from the hospital, but a third surgery was successful in
stabilizing it.
A few months later, a physician at a pain management clinic prescribed
methadone to Mr. Pack. Mr. Pack died on November 30, 2001, the day he
started taking methadone .
Appellee, Bonnie Pack, brought a medical malpractice action, in her
capacity as administratrix of her deceased husband's estate, against Dr. Witten
and his practice . The matter was tried before a jury. At trial, Appellee moved for
a directed verdict on the issue of liability, which was denied . The jury returned a
verdict in favor of Appellants . Appellee then moved for judgment notwithstanding
the verdict or, in the alternative, for a new trial, arguing that Dr. Witten's
statement that he had dropped Mr. Pack's leg constituted a judicial admission
entitling her to a directed verdict on the issue of breach of the standard of care.
The circuit court denied the motion.
On appeal, the Court of Appeals vacated the judgment of the circuit court
and remanded for a new trial. Specifically, the Court of Appeals concluded that
the circuit court erred in failing to direct a verdict in Appellee's favor with respect
to the initial accident of the jerking of Mr. Pack's leg in the operating room . In so
doing, it held that Dr. Witten was negligent as a matter of law for slipping . This
appeal followed .
11. ANALYSIS
The Court of Appeals held that :
[T]he jury should have been instructed that the doctor was
negligent as a matter of law with respect to the initial
accident of the jerking of his patient's leg in the operating
room . Because we are unable to determine the possible
impact on the jury caused by the trial court's failure to direct
a verdict on this issue, the entire verdict is tainted .
Pack v. Witten , No. 2004-CA-000551-MR, slip op. at 9 (Ky. App . Mar. 4, 2005).
Appellants contend that the Court of Appeals incorrectly determined Dr. Witten
was negligent as a matter of law and, therefore, setting aside the verdict was
error.
The applicable standard of review for a directed verdict is as follows :
[W]hen an appellate court is reviewing evidence supporting a
judgment entered upon a jury verdict, the role of an appellate court
is limited to determining whether the trial court erred in failing to
grant the motion for a directed verdict. All evidence which favors
the prevailing party must be taken as true and the reviewing court is
not at liberty to determine credibility or the weight which should be
given to the evidence, these being functions reserved to the trier of
fact. The prevailing party is entitled to all reasonable inferences
which may be drawn from the evidence .
Bierman v. Klapheke, 967 S.W.2d 16, 18 (Ky. 1998) . A verdict is not to be
disturbed unless the appellate court finds that it is "palpably or flagrantly against
the evidence so as to indicate that it was reached as the result of passion or
prejudice ." Id.
In support of their argument that Dr. Witten was not negligent as
a matter
of law, Appellants cite to a number of slip and fall cases where the issue of
negligence was for the jury to decide .' However, we do not find the slip and fall
cases to be controlling with respect to medical malpractice actions .
We do find persuasive the cited medical malpractice cases where the
physician was not held to be negligent as a matter of law. For example, it was
not negligence as a matter of law when a dentist slipped while drilling on a
patient's tooth, Neal v. Wilmoth, 342 S.W .2d 701 (Ky. 1961), or when a dentist
left a broken fragment of a tooth embedded in a patient's jaw, which could have
been easily discovered, Butts v. Watts , 290 S .W.2d 777 (Ky. 1956) .
On the other hand, Appellee contends that the present case is analogous
to medical malpractice actions where a foreign object is left in a patient's body
during surgery. With respect to retained foreign bodies, this Court held that a
surgeon who closed an incision after an inaccurate sponge count had failed to
show that a sponge was missing was negligent as a matter of law. Laws v.
' See Wal-Mart Stores, Inc. v. Lawson , 984 S.W.2d 485 (Ky. App. 1998)
(holding that negligence of a store customer in failing to perceive a strip of black
substance was a questio n for the jury) ; Jones v. Winn-Dixie of Louisville, Inc. ,
458 S .W.2d 767 (Ky. 1970) (holding that negligence of a pedestrian in tripping
over a concrete abatement on the premises of a grocery store was a question to
be resolved by the jury) ; Hornbeck v. Food Basket No. 1, 494 S .W .2d 87 (Ky.
1973) (holding that whether a customer was negligent in failing to observe a
bundle of grocery sacks on the floor before stepping toward it is a jury question) ;
Downing v. Drybrough , 249 S .W.2d 711 (Ky. 1952) (holding that a patron was not
guilty of contributory negligence as a matter of law for slipping while leaving a
parking lot via the wrong aisle) ; Kroger Grocery & Baking Co. v. Monroe, 34
S.W .2d 929 (Ky. 1931) (holding that a customer was not guilty of contributory
negligence as a matter of law even though she knew the oil was on the floor
before her slip and fall).
4
Harter , 534 S .W.2d 449 (1975). However, we decline to extend the rationale of
Laws to the present case . In Laws , there was no legitimate explanation for the
sponge being left in the patient's abdomen other than an act or omission by the
physician . In this matter, however, we do not know who or what caused the
slippery condition on the operating room floor. Moreover, we do not know
whether the accidental slip caused the hip dislocation because, as pointed out by
Appellants, dislocation is a risk of hip replacement surgery. We therefore hold
that the question of whether or not Dr. Witten was negligent was appropriately
submitted to the jury.
The Court of Appeals additionally determined that Dr. Witten's testimony
that he slipped in the operating room constituted a judicial admission of
negligence . "A judicial admission . . . is a formal act of a party (committed during
the course of a judicial proceeding) that has the effect of removing a fact or. issue
from the field of dispute ; it is conclusive against the party and may be the
underlying basis for a summary judgment, directed verdict, or judgment
notwithstanding the verdict ." Robert G . Lawson, The Kentucky Evidence Law
Handbook ยง 8 .15[4], at 590 (4th ed. LexisNexis 2003) (emphasis omitted) .
Testimony of a party may constitute a judicial admission if "deliberate and
unequivocal and unexplained or uncontradicted ." Bell v. Harmon , 284 S .W.2d
812, 815 (Ky. 1955) . However, judicial admissions should be "narrowly
construed." Lewis v. Kenady , 894 S.W.2d 619, 622 (Ky. 1994). Whether a
statement is a judicial admission is a question of law that we review de novo.
Reece v. Dixie Warehouse and Cartage Co., 188 S.W.3d 440, 448 (Ky. App.
2006) .
We disagree with the Court of Appeals that Dr. Witten's testimony
constituted a judicial admission of negligence. Although Dr. Witten admitted to
slipping, he denies that it caused Mr. Pack's hip to become dislocated . Dr.
Witten testified that, soon after he slipped, he put Mr. Pack's hip through a range
of motion to confirm that he had not dislocated it. In fact, there was a disputed
issue of fact among the witnesses as to whether the slip caused the dislocation .
In particular, Appellants presented expert testimony that dislocation is a known
risk of hip replacement surgery. Moreover, there was no expert testimony
indicating that the slip constituted a breach of the standard of care .
Thus, it was for the jury to decide whether Dr. Witten was negligent when
he slipped on liquid in the operating room while holding Mr. Pack's leg.
Therefore, we conclude that the Court of Appeals erred in holding that Dr. Witten
was negligent as a matter of law, and that the circuit court correctly denied
Appellee's directed verdict motion. See Bierman , 967 S.W.2d at 18 .
111. CONCLUSION
For the foregoing reasons, we reverse the decision of the Court of
Appeals and reinstate the judgment of the circuit court.
All sitting . All concur.
COUNSEL FOR APPELLANT
James P . Grohmann
O'Bryan, Brown & Toner, Suite 1500
Starks Building, 455 South Fourth Ave.
Louisville, KY. 40202
COUNSEL FOR APPELLEE
Gary R . Hillerich
1800 Kentucky Home Life Building
239 S . Fifth Street
Louisville, KY. 40202-3213
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