Boyles v. Dougherty, No. CV-11-900633, 2013 Ala. LEXIS 133 (Ala. Sept. 27, 2013)
The Plaintiff filed suit on behalf of her minor son, alleging that negligent care by a nurse at University of Alabama Hospital caused her son to lose all of his fingers on his right hand. At the order of the treating physician, the Defendant nurse took a blood culture from the son’s right arm. Shortly after the culture, the Plaintiff observed discoloration of her son’s finger tips and alerted the Defendant. The Defendant responded by applying a warm compress to Plaintiff’s son’s hand. Plaintiff offered admissible expert testimony that this action breached the standard of care. The discoloration in the fingertips continued and began to spread up the arm until the fingertips ultimately “autoamputated.” Defendant moved for summary judgment, arguing that although the Plaintiff had offered expert testimony that the Defendant’s application of the compress was a breach of the standard of care, there was no expert testimony that the breach of the standard of care specifically caused the injury. The trial court agreed and granted summary judgment.
In a plurality opinion, with Justice Murdock concurring in the result and Justices Stuart, Bolin, Shaw, and Bryan dissenting, the Alabama Supreme Court reversed the summary judgment and remanded the case for further proceedings. The Court found that despite the absence of specific expert testimony that the breach of the standard of care caused the injury, the Plaintiff could sufficiently established causation through the totality of the evidence presented. The Court found that the limited expert testimony offered by the Plaintiff combined with the certified medical records from the hospital which attributed the autoamputation to “poor perfusion and thrombatic fingertips” supported a “logical sequence of cause and effect based on the time line and the absence of any other explanation in the record.” The Court held that the totality of the evidence “would support a reasonable inference that the negligent conduct of [the Defendant] probably caused the auto-amputation of [Plaintiff’s son’s] fingertips.”
In her dissent, Justice Stuart emphasized the lack of expert testimony as to causation: “I agree with the trial court that [Plaintiff] failed to identify an expert capable of testifying that [Defendant’s] alleged breach of the standard of care probably caused the identified injury… and that summary judgment was accordingly proper on that basis.”
The Defendant nurse has filed an application for rehearing.
Prepared by Oscar M. Price