Searching over 5,500,000 cases.

Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Collins v. St. Vincent Hospital, Inc.

Court of Appeals of New Mexico

December 20, 2017

WANDA COLLINS, as Personal Representative of the ESTATE OF WILLIAM "MACK" VAUGHAN, Plaintiff-Appellant,
ST. VINCENT HOSPITAL, INC., Defendant-Appellee.

         APPEAL FROM THE DISTRICT COURT OF SANTA FE COUNTY Sarah M. Singleton, District Judge

          Stephen Durkovich Santa Fe, NM Hunt& Marshall Lee R.Hunt Santa Fe, NM Cohen and Zedalis, LLC Seth T.Cohen Santa Fe, NM for Appellant

          Modrall, Sperling, Roehl, Harris & Sisk, P.A. Ernil J. Kiehne Elizabeth A. Martinez Albuquerque, NM for Appellee


          JONATHAN B. SUTIN, Judge

         {1} The simple question in this unnecessarily complicated and convoluted direct liability action is whether the jury's determination that a hospital's negligence was not i a cause of the death in question must be reversed based on district court instruction-related error. We hold that the court did not err, and we uphold the jury's verdict and the court's judgment dismissing Plaintiffs claim.


         Pertinent Medical History

         {2} William "Mack" Vaughan presented at the emergency department of Defendant St. Vincent Hospital, Inc. (the Hospital) in Santa Fe, New Mexico in August 2002 with complaints of abdominal pain. He was seen in the emergency department by Dr. Martin Wilt, who was a subcontractor/partner of Northern New Mexico Emergency Medical Services, and who ordered a CT scan. The scan was reviewed by Dr. J.R, Damron, a radiologist and employee of Santa Fe Radiology, who concluded that the most likely [ diagnosis was a diverticular abscess in the colon, but it was also possible that Vaughan had a neoplasm, which is cancer. Dr, Wilt consulted with Dr. Anna Voltura, a surgeon, to evaluate Vaughan. Dr. Voltura5s working diagnosis was diverticular abscess. She recommended that Vaughan be admitted and placed on IV antibiotics. Vaughan refused, saying that he wanted to go home, and upon discharge, he was prescribed antibiotics. Vaughan was instructed to follow up with Dr. Voltura in one week for any problems, Vaughan was advised that he would need surgery in the future, and Dr. Voltura warned Vaughan that his condition was serious and that he could potentially die if it were left untreated.

         {3} Dr. Darnron dictated a CT scan report, and the report was transcribed the next day. The written report contained Dr, Darnron's findings that "[m]ultiple diverticula in the sigmoid colon are present, .., An abscess associated with a diverticulitis would be a first consideration with neoplasm as the etiology being the second consideration." Drs, Voltura and Wilt testified that they did not recall seeing or receiving copies of Dr. Darnron's written report. Vaughan left the Hospital without being told that he had a possible neoplasm in his colon.

         {4} Despite Dr, Voltura's instructions, Vaughan did not follow up with Dr. Voltura, In September 2002, he visited the Veterans Administration hospital in Albuquerque, New Mexico, complaining of foul-smelling, cloudy, burning urination, but he declined an x-ray. He visited the Veterans Administration hospital again in November 2002 to establish a primary care provider, on which visit a colonoscopy was recommended but apparently not performed.

          {5} In April 2003, Vaughan presented at the Hospital's emergency department with I complaints of brown, foul-smelling, gritty material in his urine and with symptoms I similar to those he had in October 2002, including burning with urination. While at the I emergency room in April 2003, he was advised to follow up with a urologist, but he did not do so. In May 2003, the Veterans Administration sent Vaughan a letter advising him that additional tests were recommended for his continuing urinary tract infections, including a cystoscopy. No evidence indicates that Vaughan went in for those tests at that time.

         {6} In August 2003, Vaughan returned to the Hospital's emergency room, complaining again of painful urination and also complaining of abdominal pain at which time he underwent a cystoscopy that revealed a colovesical fistula. Vaughan was ultimately diagnosed in October 2003 with colon cancer in the sigmoid colon at the location of the abscess, Vaughan died in 2010 of a metastatic lesion, with colon cancer listed as the "[d]isease or injury that initiated events resulting in death[.]"

         The Lawsuit

         {7} Years before his death, in January 2006, Vaughan sued the Hospital pursuant to a complaint for medical negligence, averring the Hospital's negligent failure "through an administrative inadequacy to forward [a] radiology report[, ]" indicating the existence of a neoplasm, on to his physician.

         {8} The case was first before this Court in Vaughan v. Si. Vincent Hospital Inc., No, A-l-CA-30395, 2012 WL 1720346, mem. op. (N.M. Ct. App. Apr, 16, 2012) (non-precedential). In Vaughan, we affirmed the district court's summary judgment dismissal of Vaughan's complaint on the ground that he failed to give sufficient notice under Rule 1 -008 NMRA of assertion of a claim of apparent agency giving rise to vicarious liability of the Hospital Id. at *1, *8. After Vaughan passed away in 2010, Diego Zarnora, as personal representative of Vaughan's estate, was substituted as the plaintiff Our Supreme Court: reversed the Vaughan decision in Zamora v. St Vincent Hospital, 2014-NMSC-035, ¶ 1, 335 P.3d 1243, holding that "Vaughan's complaint adequately notified [the Hospital] that one or more of its employees or agents was negligent[.]"

         {9} More specifically, in Zamora, our Supreme Court stated that "Vaughan's pleading was sufficiently detailed to put [the Hospital] on notice of a claim of apparent agency or vicarious liability related to the failure to communicate his cancer diagnosis, “ id. ¶ 8, and that nothing in our rules or statutes "require[d] a civil complaint to specifically recite reliance on theories of vicarious liability or apparent agency in order to provide fair notice of a cause of action.” Id. ¶ 14, Our Supreme Court concluded its opinion stating that the "complaint adequately notified [the Hospital] that it was liable for the negligence of one or more of its agents" and that disputed issues of fact existed "concerning the negligence of [the Hospital's] agents in felling to communicate [a] cancer diagnosis to Vaughan or his treating doctor." Id. ¶ 34. Our Supreme Court remanded for trial on the merits. Id.

         The District Court Proceedings on Remand

         {10} On remand, and re-captioned with a substituted personal representative, Wanda Collins, Plaintiff changed course as to the nature of the claim-she was no longer claiming or asserting any negligence on the part of any of the physician providers involved, Drs. Wilt, Darnron, and Voltura, Plaintiff chose not to pursue vicarious liability against the Hospital, but chose instead to pursue a direct liability claim based solely on negligence of the Hospital stemming from alleged communication, operational, and systemic failures.

         {11} Plaintiffs direct liability theory was expressed in different ways at different intervals. But as stated in the district court's pretrial order, Plaintiff did not contend that Drs. Voltura, Wilt, or Damron were negligent, but only the Hospital was negligent by its failure to deliver the report: of Vaughan's CT scan results to Vaughan, Dr. Wilt, and Dr. Voltura. At trial, Plaintiff contended that she did not allege "that any of the physicians did anything wrong" but that the Hospital was liable based on a number of systemic and communication failures. The Hospital's defense to Plaintiffs contention was that Vaughan's cancer did not progress from August 2002 to October 2003, and any delay in treatment was caused by Vaughan's repeated failures to heed medical advice.

         {12} Although many of the jury instructions were settled prior to trial at a mid-trial jury instruction conference, the district court considered whether to give an apparent agency instruction based on UJI 13-1120B NMRA and Houghland v. Grant, 1995-NMCA-005, 119 N.M. 422, 891 P.2d 563, that "[a] hospital is responsible for the actions of health care providers who are not hospital employees[.]" According to Plaintiff, it was a "general proposition" that a hospital is "on the hook" because the physician providers are apparent agents, and that the hospital is on the hook for their actions. The court rejected Plaintiffs position because Plaintiff was not claiming that the providers made "any bad medical decisions.”Plaintiff disagreed, stating that the Hospital was "broadly" responsible for the failures of the apparent agent providers who are part of the failed system, including bad medical decisions not constituting negligence. The district court ultimately determined that it was going to give the apparent agency instruction only if it was limited for the purposes of considering whether to award punitive damages and limited to "consideration of the cumulative conduct of its employees or apparent agent[, ]"[1]

         {14} In closing arguments, Plaintiff again focused on her theory that the Hospital I negligently failed to deliver Dr. Darnron's final report to Vaughan's treating physicians land to Vaughan. In its closing argument, the Hospital argued that it was not negligent I because its system for delivering reports complied with the industry standards, was sufficient, and worked in practice. The Hospital noted the stipulation that Dr. Darnron I was not negligent, but indicated nevertheless that Dr. Darnron was the cause of Vaughan. not getting the information about a possible neoplasm. In Plaintiffs closing rebuttal, Plaintiff again stressed the failure to deliver the report and argued, "[i]t wasn't Dr. Damron's job to take that report and walk it down the hall [The] Hospital set up the system.”

         {15} After closing arguments, the jury was given the following relevant instructions, beginning with Instruction No. 2:

In this case, [Plaintiff] . . . seeks damages from the [Hospital] for I damages that [P]laintiff says were caused by the negligence of [the] Hospital.
To establish [the Hospital's] negligence, [Plaintiff] has the burden of proving that [the Hospital] negligently did not deliver Dr... Damron's final written report of the August 8 CT examination of . . Vaughan identifying a pelvic abscess the result of either diverticulosis or a neoplasm to at least one of the following:
To . . . Vaughan's ER physician Dr. . . . Wilt for Dr. Wilt's use in diagnosing and treating Vaughan, or I To . . . Vaughan's surgeon Dr. . . . Voltura for use in diagnosing and treating . . . Vaughan, or
Alternatively, [Plaintiff] has the burden to prove that because of [the Hospital's] negligence there was a failure to I communicate the information contained in Dr. Damron's final written report about a possible neoplasm to . . . Vaughan for his own use in deciding what kind of care he should obtain to address the possibility that his abscess was the result of a neoplasm or cancer,
[Plaintiff] has the burden of proving [the Hospital's] negligence was a cause of his death, his injuries [, ] and damages.
The [Hospital] denies . . . [P]laintiff's allegations regarding negligence. [The Hospital] asserts that it exercised the knowledge, skill, and care of a reasonably well[-]qualified hospital in its care and treatment of. .. Vaughan. [The Hospital] denies that it failed to deliver the August 8, 2002 CT report to Dr. Wilt and further denies that it failed to deliver a copy of the August 8, 2002 CT report to Dr. Voltura. [The Hospital] denies that it was obligated to deliver a copy of the report to Dr. Voltura without express indication from Dr, Damron, [The Hospital] denies that it failed to deliver a copy of the report to . .. Vaughan and states that Vaughan would have received a copy of his records if he had asked for them. [The Hospital] also denies that it created the appearance that Drs. Wilt or Damron were its employees or apparent agents and denies that [it] is responsible for their conduct, [The Hospital] denies, . . [P]laintiff's claims that it caused or contributed to... Vaughan's death, injuries[J and damages.
[The Hospital] affirmatively states that... Vaughan was negligent and that his negligence was a cause of his death, injuries[J and damages. The [Hospital] has the burden of proving that . . . Vaughan failed to exercise a duty of ordinary care and that his negligence caused his injuries and damages. To establish that., . Vaughan was negligent, [the Hospital] has the burden of proving at least one of the following:
a. Vaughan unreasonably declined admission to [the Hospital] for further work-up and treatment on August 8, 2002;
b . . Vaughan unreasonably failed to follow the discharge instructions provided to him by [the] Hospital and Dr. Voltura on August 8, 2002;
c. . . . Vaughan unreasonably failed to obtain recommended medical care by his health care providers at the ...

Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.