FL: anesthesiologist fails to intubate reflux pt.: was death forty-two days later a triable issue?

CASE FACTS: Clay Harris, as personal representative of the estate of Charlotte Harris appealed a final judgment entered upon a directed verdict in favor of Dr. Steven Gandy and Panhandle Anesthesiologists, Inc. (Panhandle), in a medical malpractice suit. Clay had filed suit for wrongful death against Dr. Gandy and Panhandle. The plaintiff alleged that even though the patient presented with a history of gastroesophageal reflux disease, Dr. Gandy provided mask anesthesia without protection of the patient's airway, by endotracheal intubation. He alleged that as a result of Dr. Gandy's negligence, the decedent aspirated contents from her stomach into her lungs during surgery which ultimately caused her death forty-eight days later. Dr. Gandy defended on two grounds. First, in his judgment, the risk of bronchospasm posed by intubating an asthmatic patient such as Charlotte outweighed the risks of aspiration since the patient was not having symptomatic reflux. Second, Dr. Gandy contended that there was no causal connection between his choice of anesthesia (use of the mask) and the patient's death. At the conclusion of the plaintiff's case the trial court granted Dr. Gandy's motion for a directed verdict, finding that the plaintiff failed to introduce sufficient evidence that Dr. Gandy breached the standard of care or that his action caused the patient's death. The plaintiff appealed.

COURT'S OPINION: The District Court of Appeal of Florida reversed the judgement entered on Dr. Gandy's motion for a directed verdict and remanded the case back to the court for trial. The court held, inter alia, that when considering a motion for a directed verdict, courts must evaluate the facts and inference drawn from the evidence in a light most favorable to the non-moving party. A directed verdict is not proper where there is any evidence to support a verdict for the non-moving party. If there are any conflicts in the evidence or different reasonable inferences to be drawn from the evidence, a motion for a directed verdict should not be granted. Concerning the standard of care, the critical issue was whether Dr. Gandy should have administered anesthesia by endotracheal intubation rather than by mask. The decisive issue in determining whether Dr. Gandy breached the standard of care was whether the patient was having symptoms of active reflux that were not controlled by medication at the time of the procedure. The trial court noted that there was testimony by Dr. Gandy and a nurse anesthetist that, "at the time of the procedure," the patient was not having any reflux problems. However, they both failed to address that the facts showed that the patient had a long standing history of recurring reflux problems. Harris v. Gandy, 2009-FL-0202.115 (1/30/2009)--FL

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