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Thomas v. Meadors

Court of Appeals of Arkansas, Division I

September 6, 2017

CAROLYN THOMAS, ADMINISTRATRIX OF THE ESTATE OF ALFRED THOMAS, SR., DECEASED APPELLANT
v.
CAROL C. MEADORS, M.D., AND LITTLE ROCK ANESTHESIA SERVICES, PLLC APPELLEES

         APPEAL FROM THE PULASKI COUNTY CIRCUIT COURT, SIXTH DIVISION [NO. 60CV-13-3438] HONORABLE TIMOTHY DAVIS FOX, JUDGE

          McKissic & Associates, PLLC, by: Gene E. McKissic, Sr., and Jackie B. Harris, for appellant.

          Mitchell, Williams, Selig, Gates & Woodyard, P.L.L.C., by: Michelle L. Browning, Jason Browning, and Graham Talley; and Anderson, Murphy & Hopkins, L.L.P., by: Mark D. Wankum, for appellees Carol Crittenden Meadors, M.D., and Little Rock Anesthesia Services, P.L.L.C.

          BRANDON J. HARRISON, Judge

         Carolyn Thomas, administratrix of the estate of Alfred Thomas, Sr., appeals the grant of summary judgment in favor of Dr. Carol Meadors and Little Rock Anesthesia Services, PLLC. Thomas argues that she met her burden of meeting proof with proof and demonstrated a genuine issue of material fact as to causation. We disagree and affirm.

         Alfred Thomas, Sr., underwent a revascularization procedure on 29 August 2011. After the surgery, Mr. Thomas exhibited cardiac instability and was admitted to the intensive care unit. He died three days later; the cause of death was listed as cardiogenic shock.[1]

         In a complaint filed in August 2013 and an amended complaint filed in January 2016, Carolyn Thomas, as administratrix of the estate of Alfred Thomas, alleged that the medical negligence of Dr. Carol Meadors and Little Rock Anesthesia Services, PLLC (collectively "Meadors"), was the proximate cause of Mr. Thomas's death.[2] Thomas alleged that Meadors (1) failed to properly and adequately perform a presurgical history and physical examination of Mr. Thomas, and (2) failed to fully acquaint herself with Mr. Thomas's medical history or to appreciate the seriousness of Mr. Thomas's ongoing heart conditions. According to the complaint, Mr. Thomas had multiple known comorbidities, including a history of ischemic heart disease, a history of congestive heart failure, decompensated heart failure, severe vascular disease, diabetes, atrial fibrillation, and a history of stroke. Thomas alleged that Meadors "knew or should have known that subjecting a patient with multiple sever[e] systemic diseases that were a constant threat to his life to prolonged anesthesia induced unconsciousness during a high risk invasive peripheral vascular surgery would pose an eminent threat to Thomas'[s] life." The complaint also alleged that Mr. Thomas experienced a blood pressure "crash" immediately after the general anesthesia had been administered, that a discussion on whether to proceed with the surgery lasted twenty-five mintues, and that this failure to act in a timely manner was negligence.

         In April 2016, Meadors moved for summary judgment and identified the following undisputed facts: (1) Meadors induced Mr. Thomas's anesthesia on 29 August 2011; (2) immediately following induction, Mr. Thomas experienced an acute decompensation (drop in blood pressure); (3) the doctors inserted a Swan-Ganz catheter and began treating Mr. Thomas with vasopressors to increase his blood pressure; (4) Mr. Thomas's blood pressure eventually stabilized, and the doctors chose to proceed with the planned procedure. Meadors explained that in the complaint and amended complaint, Thomas had two primary criticisms of Mr. Thomas's medical care: (1) that Meadors failed to conduct an adequate physical examination of Mr. Thomas prior to the August 29 procedure and (2) that Meadors negligently failed to terminate the revascularization procedure after Mr. Thomas had experienced the acute drop in blood pressure immediately following the induction of anesthesia. However, Meadors asserted, neither of Thomas's identified experts, Dr. Timothy Beacham, a board-certified anesthesiologist, and Dr. Morton Rinder, a cardiologist, could state to a reasonable degree of medical certainty that this alleged negligence proximately caused Mr. Thomas's death. And without a qualified causation opinion, Meadors argued, Thomas could not maintain a prima facie claim for medical negligence, and Meadors was entitled to summary judgment as a matter of law. In support, Meadors cited the following excerpts from the doctors' depositions.

         During Dr. Beacham's deposition on 5 April 2016, the following exchanges occurred:

Q: [A]re you going to testify that had any kind of different physical assessment or different preoperative course been taken, that it would have changed the outcome in this case in any way?
A: No, I will not do that.
. . . .
Q: But you can't say, to a reasonable degree of medical certainty, that any of-doing these things that you say she failed to do would have changed anything?
A: Correct.
. . . .
Q: Both Plaintiff's cardiologist and cardiovascular surgeon have testified that they can't say, to a reasonable degree of medical certainty, that after induction, if Mr. Thomas had not undergone the remainder of the procedure, whether or not he would have still suffered the same injury.
A: Sure.
Q: Is that your testimony, as well, that you can't say, to a reasonable degree of medical certainty, whether or not he would have sustained the same injury after induction?
A: Right. . . . [T]here's a degree of medical certainty that this patient would have woken up. Now, what condition the patient would have been in, I cannot say any further than that.
. . . .
Q: You have mentioned several times this evening that upon the placement of the Swan-Ganz catheter and the recognition of the pulmonary artery pressure, you believe that Mr. Thomas would have woken up, correct?
A: If the case had been stopped at that point?
Q: Yes, sir.
A: Based on information compared to previous records, yes.
Q: Now, can you testify, to a reasonable degree of medical certainty, that Mr. Thomas would have been able to come ...

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