State Appeals Court Upholds Verdict in Drug Overdose Case

In a medical malpractice action not unlike some Massachusetts medical malpractice cases, the defendant Emergency Medicine Physicians of New London County, LLC, appealed from the judgment of the trial court after a jury verdict was rendered in favor of the plaintiff. On appeal, the defendant claimed that there was insufficient evidence supporting the jury’s verdict and award of noneconomic damages. Specifically, it claimed that the plaintiff failed to present sufficient evidence for the jury (1) to find that the defendant’s negligence caused the death of the decedent, and (2) to award $150,000 in damages for the destruction of the decedent’s capacity to carry on and enjoy life’s activities. The Connecticut Court of Appeals affirmed the judgment of the trial court.

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On November 29, 2008, the decedent was found unresponsive and was brought to a hospital emergency department, where she was treated for a suspected drug overdose by the attending emergency department physician. After the decedent’s vital signs improved and stabilized, she was discharged and returned to the home of a friend, where she was found unresponsive the next morning and was pronounced deceased.

The plaintiff alleged that the hospital was vicariously liable for the medical malpractice of the doctor in treating the decedent for a suspected drug overdose. The plaintiff claimed that the doctor’s discharge of the decedent after only four and one-half hours of observation was premature in that the doctor should have kept the decedent under medical monitoring for 24 hours, which is the period of time during which the fatal side effects of methadone toxicity may occur. If the decedent had remained under medical monitoring for the full 24 hours, the fatal overdose side effects she experienced after her discharge would have been treated, and her eventual death from methadone toxicity would have been averted.

The jury returned a verdict for the plaintiff, and the trial court rendered judgment in accordance with the verdict, from which the doctor appealed. The hospital claimed that there was no direct evidence as to when the decedent consumed the fatal dose of methadone, and the undisputed scientific evidence established that if she had actually overdosed on methadone on November 29, 2008, she would have had a recurrence of overdose symptoms before she was discharged from the hospital’s emergency department.

The Connecticut Court of Appeals first held that there was sufficient evidence to support the jury’s finding that the hospital’s negligence caused the decedent’s death. The court reasoned that the the jury had before it sufficient evidence from which it could have inferred, without resorting to speculation, that the decedent had consumed the fatal dose of methadone before she was brought to the emergency department on November 29, 2008. Although the jury was presented with conflicting expert testimony as to how soon a methadone overdose patient would experience recurring overdose symptoms after receiving a certain medication that is used as an antidote for opiate and opioid overdoses, the jury was free to believe the opinion of the plaintiff’s expert witness on the standard of care:  that delayed, recurring respiratory depression can occur in methadone overdoses, even if such a phenomenon defied certain undisputed and settled toxicology principles.

The jury could also disbelieve, the appeals court reasoned, those portions of the testimony of the hospital’s expert witness on causation that attempted to refute that phenomenon. Moreover, the court reasoned that the hospital’s claim that it was improper for the jury to consider the expert’s testimony concerning the concept of delayed, recurring respiratory depression as it related to causation was unavailing because even if the expert’s testimony was offered strictly for standard of care purposes, the hospital failed to pursue any preemptive or remedial measures that would have precluded or limited the expert’s testimony on the issue of delayed, recurring respiratory depression. Since the lower  court never instructed the jury that it should disregard the expert’s testimony thereon or that it should consider such testimony only for standard of care purposes, the evidence regarding delayed, recurring respiratory depression was before the jury to use for any purpose, including causation.

Furthermore, the appeals court reasoned that the fact that the decedent did not immediately experience recurring overdose symptoms one hour after the overdose medication was administered did not require the jury to conclude that the decedent’s overdose on November 29, 2008 was caused by a narcotic other than methadone. The jury could have concluded, instead, that the delayed, recurring respiratory depression that the decedent eventually experienced was consistent with her ingestion of a toxic dose of methadone before her visit to the emergency department on November 29, 2008.

Next, the appeals court held that the defendant could not prevail on the claim that since the plaintiff failed to present evidence demonstrating that the decedent would have been admitted to the hospital had the doctor not discharged her from the emergency department, the jury could not reasonably have found that the hospital caused the decedent’s death. Although the plaintiff’s expert initially testified that the standard of care applicable to possible methadone overdoses required the doctor to admit the decedent to the hospital for continuous monitoring, the expert subsequently clarified that the applicable standard of care required only that the doctor monitor the decedent for 24 hours for signs of recurrent opiate overdose. Thus, the jury reasonably could have accepted that portion of the expert’s testimony indicating that monitoring was required and rejected that portion of his testimony suggesting that admittance was required. Accordingly, the appeals court reasoned, to prove causation, the plaintiff needed to show only that the decedent could have been monitored sufficiently for 24 hours, and the jury reasonably could have inferred that from the evidence presented.

Finally, the appeals court held the trial court did not abuse its discretion in denying the hospital’s motion to set aside the jury’s award of $150,000 in damages for the destruction of the decedent’s capacity to carry on and enjoy life’s activities. The jury reasonably could have forecast, the court reasoned, the decedent’s life expectancy from its own knowledge and from the substantial evidence presented by the plaintiff of the decedent’s age, health, physical condition, and habits, all of which were relevant to determine life expectancy. Therefore, the jury’s award of damages for the destruction of the decedent’s capacity to carry on and enjoy life’s activities was not unreasonable or speculative.

For these reasons, the lower court’s judgment was affirmed.

If you or a loved one was unlawfully harmed by another party’s negligence, you may need the assistance of a medical malpractice lawyer to seek compensation. At the Neumann Law Group, our Massachusetts attorneys provide trustworthy legal representation to victims all over the state. Contact us toll-free at 800-525-NEUMANN or use our online form to set up a free consultation.

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