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Patient Coffee Spill During Seizure; Burn Treatment Negligence


A man sought treatment in the emergency room (ER) at a hospital. The man complained of a history of recurrent seizures. After he was placed on an examination table, his father brought him a cup of coffee. The man experienced another seizure and the hot coffee spilled into his lap, burning him. Later that day, the man was admitted to the hospital.

 

Three days after he was admitted, the man was examined by a physician and diagnosed as suffering from second degree burns. A plastic surgery consultation was requested. Upon examining the man the following day, the plastic surgeon diagnosed his injuries as second and third degree burns.

 

The man was discharged the following day, with instructions to see further treatment from a physician within one week and from a plastic surgeon within two weeks. Upon learning that the man had been discharged, the plastic surgeon who had examined him directed his staff to contact him to arrange an office visit so the man could be seen more promptly.

 

The visit occurred several days following his discharge. The plastic surgeon recommended a referral to a burn center. The man subsequently underwent debridement and skin grafting surgery. As a result of his burn injuries, the man allegedly suffered permanent scarring, lost function, and continuing pain.

 

The man sued the hospital for negligence and medical malpractice. The complaint alleged that, given his history of frequent seizures, the hospital was negligent in permitting him to have coffee in the ER. The complaint contended that the hospital’s employees exacerbated his injuries and failed to comply with accepted standards of care by failing to remove his clothes and cool his skin immediately after the coffee spill and by discharging him prematurely.

 

At trial the man’s expert in emergency medicine testified that the man was improperly discharged without an appropriate assessment and treatment plan, and that the hospital should have transferred him to a burn center. The expert opined that the man’s pain would have been handled more effectively at a burn center and that its duration and severity were prolonged by the premature discharge. The man’s treating plastic surgeon testified that the risk of infection is generally increased when a burn patient’s admission to a burn center is delayed.

 

A plastic surgeon testified as an expert on the hospital’s behalf that an earlier transfer to a burn center would not have affected the man’s ultimate outcome.

 

The man testified that he continued to experience pain after he was admitted to the burn center, throughout his treatment there, and following his release.

 

After the trial, the jury was instructed that, if it determined that the hospital was negligent in causing the man’s injuries, then it must also determine whether any negligence on the man’s part contributed to causing the coffee spill.

 

The jury returned a verdict finding the hospital was not negligent for allowing the man to have coffee in the ER, but that the hospital deviated from accepted standards of care in treating the man’s burns. The jury found that the hospital’s deviation from the standard of care was a substantial factor in causing the man’s injuries. The jury found that the hospital deviated from accepted standards of care in discharging the man prematurely, but that it was not a substantial factor in causing the man’s injuries. The jury found that the man was comparatively negligent in causing the coffee spill, and that his percentage of fault was 90%, while the hospital’s percentage of fault was 10%. The jury rendered an award of damages in the sum of $25,000 to the plaintiff for pain, suffering, and loss of enjoyment of life, to the date of the verdict, with no award for future damages.

 

The Saratoga County Supreme Court denied the man’s motion to set aside the part of the verdict in favor of the hospital.

 

The Appellate Division of the New York Supreme Court, Third Department, affirmed in part and reversed in part. The court held that the trial court did not err in denying the man’s motion to set aside the verdict because the jury’s finding that his premature discharge was not a substantial factor in causing him harm was not against the weight of the evidence and contrary to law, but the trial court erred in denying the man’s motion to set aside the verdict because the jury’s finding that he was comparatively negligent was against the weight of the evidence and contrary to law.

 

The trial court did not err in denying the man’s motion to set aside the verdict because the jury’s finding that his premature discharge was not a substantial factor in causing him harm was not against the weight of the evidence and contrary to law. The jury’s determination that the man was prematurely discharged was supported by the testimony of the man’s expert in emergency medicine. However, the court found that there was ample other evidence from which the jury could reasonably have found that the severity of the man’s pain was caused by the initial injury rather than the premature discharge, and that his pain was not increased by the timing of his admission to the burn center a week after his discharge. Although there was testimony that the man was in pain during the period that he was at home following his discharge, there was no evidence that his pain diminished following his arrival at the burn center, or that his treatment there was less painful than the previous treatments. Although the man’s treating plastic surgeon testified that the risk of infection is generally increased when a burn patient’s admission to a burn center is delayed, there was no evidence that the man suffered an infection. Additionally, there was some evidence that the timing of his admission to the burn center after his plastic surgeon’s referral was affected, in part, by his own hesitation; he was initially unsure that he wanted to go to the burn center, and did not immediately take the necessary actions to bring about his admission following the referral. The court concluded that, granting the hospital the benefit of every favorable inference that can reasonably be drawn from the trial evidence as required, the court could not say that the evidence was so much in favor of the man that the verdict could not have been reached on any fair interpretation of the evidence.

 

The trial court erred in denying the man’s motion to set aside the verdict because the jury’s finding that he was comparatively negligent was against the weight of the evidence and contrary to law. No comparative negligence instruction should be given when a plaintiff’s alleged negligence preceded the alleged medical malpractice and is not otherwise alleged to have contributed to the harm resulting from the malpractice. A plaintiff’s prior conduct is not relevant, since the defendant’s liability extends only to that portion of the plaintiff’s injuries attributable to the defendant’s malpractice. Here, although there was evidence from which the jury could have found that the man shared responsibility for the initial coffee spill, the hospital made no claim at trial that he had any such shared responsibility for the hospital’s subsequent deviations from the accepted standard of care in treating his injuries, nor was there any evidence adduced at trial from which the jury could have found that he shared such responsibility. The court found that the jury was neither instructed to limit its consideration of the man’s comparative negligence, nor that the hospital’s liability extended only to that portion of his injuries attributable to its malpractice. The jury was thus prevented from fairly considering the central issue of damages. The errors were further compounded by the failure to instruct the jury to determine the total amount of damages sustained by the man, undiminished by any percentage of fault to avoid juror confusion and the risk of a double reduction of the man’s recovery. The court found it impossible to determine whether the jury intended the amount that it awarded to represent the total damage award or the man’s 10% share following the erroneous apportionment of fault. Accordingly, the court held that the combined errors in the charge were fundamental, and that a new trial on the issue of the man’s damages was warranted in the interest of justice

 

The Appellate Division of the New York Supreme Court, Third Department, affirmed the trial court’s denial of the man’s motion to set aside the jury’s finding that his premature discharge was not a substantial factor in causing him harm and reversed the trial court’s denial of the man’s motion to set aside the jury’s finding that he was comparatively negligent.

 

See: Vallone v. Saratoga Hosp., 2016 WL 3748555 (N.Y.A.D. 3 Dept., July 14, 2016) (not designated for publication).

 

See also Medical Law Perspectives, June 2016 Report: How Risky Is Going to the Hospital? The Dangers and Liabilities of Healthcare-Associated Infections 

 

 

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