JEFFERSON CITY, Mo. (Legal Newsline) - The children of a man who died after what may have been unnecessary prostate surgery were entitled to punitive damages, the Missouri Supreme Court ruled, even though a subsequent change in the law has put them out of reach in such cases.
Meanwhile, a dissenting judge said the $300,000 in punitive damages weren’t merited even under then-existing law since the plaintiffs proved only negligence, not intentional wrongdoing.
Roosevelt Rhoden was in his late seventies and suffering from a variety of chronic conditions including obesity, diabetes and hypertension as well as mild prostate disease when Dr. Linza Killion allegedly told him he needed prostate surgery or he would have to self-administer catheters for the rest of his life. He reported severe abdominal pain after surgery, grew gradually sicker and eventually died.
A jury ordered Missouri Delta Medical Center to pay his two children about $270,000 in compensatory damages, $300,000 for pain and suffering and $300,000 in punitives.
The medical center appealed, arguing there wasn’t enough evidence to prove “but-for” causation, or that without the actions of the doctors, Rhoden wouldn’t have died. MDMC also objected to punitive damages and said the jury was improperly instructed on when they can be awarded.
In a Feb. 18 decision penned by Judge David A. Dolan, a majority of justices on the Missouri Supreme Court rejected MDMC’s arguments. Viewing the evidence in the light most favorable to the plaintiffs, the court ruled, it was clear that Rhoden died because of the negligence of his physicians.
Plaintiff experts testified that Dr. Killion had improperly recommended prostate surgery when non-invasive alternatives were available and the surgeon had removed too much tissue and inserted a catheter improperly outside the patient’s bladder, the court ruled.
The court rejected MDMC’s argument experts couldn’t identify how long Rhoden would have lived but for the actions of the physicians, saying there’s no need to go into that level of detail. The court also rejected MDMC’s argument the jury instructions on punitive damages should have included the statutory definition “willful, wanton or malicious” instead of “complete indifference” to the safety of the patient, saying they were synonymous.
In a footnote, the court observed that Missouri tightened the law governing punitive damages in medical malpractice cases last year, requiring proof the defendant “intentionally caused damage to the plaintiff or demonstrated malicious misconduct that caused damage to the plaintiff” and explicitly removing conscious disregard as sufficient evidence. The fact the legislature made the change demonstrates lawmakers recognized the lower standard was in force in 2018 when Rhoden’s case was ongoing, the court ruled.
Justice W. Brent Powell, in a concurrence, agreed with the result but said “litigants should proceed cautiously” in seeking punitive damages going forward and “reserve such submissions for the truly extraordinary cases.” As the judge in the Rhoden case told lawyers, Judge Powell noted, “pigs get fat and the hogs are going to get slaughtered.”
“Future litigants should heed the circuit court’s warning,” Judge Powell wrote.
In a dissent, Judge Paul Wilson said punitive damages weren’t justified even under existing Missouri law since the plaintiffs never proved anything more than negligence.
“Dr. Killion’s decision to recommend surgery and his performance of that surgery were negligent, perhaps even grossly so, but it cannot be said they were `tantamount to intentional wrongdoing,’” the dissenter wrote. “Plaintiffs cannot credibly suggest that the `natural and probable consequence’ of the decision to proceed to surgery was death or that this decision presented such a high risk of Mr. Rhoden’s death so as to justify the law treating Dr. Killion as though he intended that outcome.”