A three-month-old child was brought to the emergency room (ER) with symptoms including decreased appetite, coughing, and a fever that had lingered for several days. The attending ER physician diagnosed the child with a viral upper respiratory infection. The child was discharged with instructions to continue fluids and to seek further treatment if the symptoms continued.
The child’s condition worsened. The child began vomiting, became dehydrated, decreased activity, and became irritable whenever the child’s neck was touched.
The following day, the child was brought back to the ER. The child was admitted to the hospital. A pediatrician diagnosed the child with a viral infection and possible acetaminophen toxicity. The child’s fever resolved. The child ate consistently without vomiting and with normal urine output. Following a satisfactory physical examination and laboratory tests, the pediatrician discharged the child two days after the child was admitted. The pediatrician did not prescribe the child any medication. The child was scheduled for a follow-up appointment one week later.
After the child was discharged, the child did not sleep well and continued to have a fever and exhibit irritability. The child’s parents took him to see a different pediatrician the day after the child was discharged from the hospital. The other pediatrician performed a lumbar puncture, also known as a spinal tap, a procedure in which spinal fluid is removed from the spinal canal for the purpose of diagnostic testing. Testing the spinal fluid revealed the presence of bacterial meningitis. The child was immediately transported to the ER.
Subsequently, the child was transferred to a children’s hospital, where the child was treated with an antibiotic regimen. The child suffered from meningococcal meningitis, hydrocephalus, seizure disorder, blindness, and deafness as a result of bacterial meningitis. The child was discharged one month later.
The child filed a medical malpractice claim against the hospital. The complaint alleged that the pediatrician breached acceptable standards of care in providing treatment to the child during the child’s stay at the hospital by failing to timely diagnose and treat the child’s bacterial meningitis. The complaint alleged that the hospital was vicariously liable for the conduct of the pediatrician.
The case proceeded to a jury trial. During cross-examination, the hospital’s counsel asked the corporate representative of the hospital whether the corporate representative had ever heard of a hospital controlling or supervising the actions of independent physicians on staff. The corporate representative had not.
Citing the curative admissibility doctrine, counsel for the child sought to submit evidence to the jury that while the corporate representative had worked in that role, the hospital had been sued in relation to its control or supervision of the actions of independent physicians on staff.
Over the hospital’s objections, the Walker Circuit Court admitted evidence of prior medical malpractice lawsuits filed against the hospital. The trial court explained that the answer the hospital solicited from the corporate representative suggested that the theory of liability advanced by the child was an absurd proposition that had never been raised before and that this was a frivolous lawsuit. Based on the trial court’s application of the doctrine of curative admissibility, the question and the corporate representative’s answer opened the door to the child’s introduction of other lawsuits involving claims asserted against the hospital based on allegations that the hospital was liable for the conduct of a physician working at the hospital based upon the theory of vicarious liability or agency. The trial court prohibited evidence from both parties related to the ultimate disposition or merits of any such claim. The child’s counsel presented the alleged prior malpractice by the hospital and injuries in each of the cases to the jury.
The jury returned a verdict finding that the pediatrician’s actions did not meet the applicable standard of care and the hospital was liable for the conduct of pediatrician. The jury awarded the child $10 million in damages.
The Supreme Court of Alabama reversed. The court held that the trial court exceeded its discretion in allowing the jury to hear testimony about prior medical malpractice lawsuits filed against the hospital.
The trial court exceeded its discretion in allowing the jury to hear testimony about prior medical malpractice lawsuits filed against the hospital. The court reasoned that the question and the corporate representative’s answer opened the door only to the extent of knowledge of the existence of prior lawsuits against the hospital where agency was at issue, not any additional facts from which any prior claims of vicarious liability stemmed. The child’s counsel did not limit the presentation of curative evidence solely to demonstrate the hospital’s knowledge of the mere existence of claims where agency was at issue. The court found that the child’s counsel used the presentation of curative evidence to introduce the damning, inflammatory facts and horrific injuries from each of the prior cases. The court held that those factual recitations were undeniably prejudicial and lacked any probative value as to the hospital’s or corporate representative’s knowledge of lawsuits against the hospital based on a theory of vicarious liability. The court concluded that the facts related to the jury regarding prior acts and omissions by the hospital were entirely irrelevant for the purpose of curative admissibility, were highly prejudicial to the hospital, and warranted reversal of the judgment against the hospital.
The Supreme Court of Alabama reversed the trial court’s entry of judgment on a jury verdict in favor of the child.
See: Baptist Health System, Inc. v. Cantu, 2018 WL 2276599 (Ala., May 18, 2018) (not designated for publication).
See also Medical Risk Law Report: Pediatrician Liability Involving Diseases and Conditions of Childhood