RICHMOND, Va. (Legal Newsline) - A woman who blamed her fall on an emergency physician’s failure to treat low blood sodium will have to go back to trial, after the Virginia Supreme Court reversed her $1.6 million jury verdict based on improper jury instructions.
Emergency Physicians of Tidewater argued that when presented with two or more potential causes of an injury, the jury must decide whether the defendant was responsible for at least one of them in order to award damages, the high court ruled. An appeals court compounded the error by ruling Emergency Physicians had forfeited the argument by failing to specify an alternate cause of Hanger’s fall, the high court ruled.
Patricia Hanger sued Emergency Physicians and Dr. Allison L. Raines after she was admitted to Sentara Leigh Hospital in 2017. Dr. Raines found Hanger suffered from low sodium, or hyponatremia, noted it in her chart and testified she told Hanger and her husband to follow up on the condition with her primary care physician.
Hanger and her husband denied they were told about the hyponatremia. A physician assistant in a later visit noted “all workup” during her ER visit “was negative,” although the diagnosis was in her chart. The PA prescribed Hanger an antidepressant and didn’t discuss her low blood sodium.
Hanger fell a couple of months later and suffered traumatic brain injury. A photo taken right after her fall showed a plastic floor vent was awry, although the vent was in its proper place in a later, staged photo. Defense experts testified Hanger’s blood sodium level wasn’t low enough to cause a seizure at the time and her fall might have been due to the antidepressant or another cause.
The defense argued for jury instructions requiring them to let Emergency Physicians off the hook if they can’t determine which of the competing causes was responsible for Hanger’s fall. Plaintiff lawyers argued the instruction wasn’t the law. The trial judge responded it “may be the law, but it’s not the law applicable in this context.”
An appeals court agreed the proposed instruction followed the law, but held the defense waived their rights because they only raised the prospect of a trip-and-fall on appeal.
The Virginia Supreme Court reversed that decision in an April 4 opinion by Justice Thomas P. Mann. It was enough for the defense to argue before the trial judge that the proposed instructions followed the law, the court ruled, since there was ample evidence there were other potential causes for Hanger’s fall.
The case will be returned to the trial court, the Supreme Court observed, but on the second time around “the approach and strategy to the litigation may change, and unexpected factors inherent to any case might emerge.” Based on the evidence presented, the jury may or may not receive the proposed instructions.