DANIEL L. DYSART, Judge.
Defendant, Ochsner Medical Center-Kenner ("Ochsner"), and Intervenor, Louisiana Patient's Compensation Fund/ Louisiana Compensation Patient's Compensation Fund Oversight Board (collectively, "LPCF"), appeal the judgment notwithstanding the verdict ("JNOV") and conditional new trial rendered in favor of the plaintiff, Gina Corona. For the reasons that follow, we reverse the trial court's JNOV and reinstate the judgment it rendered in accordance with the jury's verdict.
This lawsuit has a rather complex history and raises several procedural issues; however, based on our finding that the trial court improperly granted a JNOV, warranting a reversal, we need not address all of those issues. The following is a brief summary of the procedural history of this case.
Plaintiff, Gina Corona, filed the instant medical malpractice lawsuit against her medical providers, Dr. Thaddeus L. Teaford and Ochsner.
Plaintiff timely filed a motion for JNOV, and alternatively, for new trial and alternatively, for mistrial. On June 29, 2012, the trial court denied Ms. Corona's motion as to Dr. Teaford but granted a JNOV as to Ochsner, awarding $500,000.00 in damages. The trial court also granted a conditional new trial if the JNOV were to be reversed on appeal.
On September 19, 2012, the trial court issued another judgment, sua sponte, by which it vacated the July 17, 2012 order of appeal and granted Ochsner an appeal of the September 6, 2012 judgment. This appeal was consolidated with the June 29, 2012 appeal.
The LPCF intervened in this matter on September 24, 2012, and appealed the September 6, 2012 judgment. The LPCF filed a second Petition for Intervention in this Court, seeking to appeal the trial court's June 29, 2012 judgment, in the event that the September 6, 2012 judgment is without effect. Ochsner, too, filed another motion for suspensive appeal (out of an abundance of caution) on September 25, 2012. Plaintiff then filed another answer to Ochsner's motion for appeal, along with a cross-appeal on October 4, 2012, raising the same issues noted in footnote 4, above.
As noted, this case has a complicated procedural history, with numerous motions for appeal and answers to the various motions for appeal. While we find that the trial court's JNOV was erroneously entered, we must address whether Ochsner's initial appeal of the JNOV divested the trial court of jurisdiction so that all subsequent pleadings and judgments are without effect. We do so only because a resolution of this issue determines whether we address the merits of plaintiff's argument concerning the trial court's failure to grant a JNOV or motion for new trial as to Dr. Teaford. This issue turns on whether plaintiff's cross-appeal, filed only after Ochsner filed its September 25, 2012 motion for appeal, is timely. We conclude that it was not, as plaintiff's motion for new trial on the JNOV was not a procedurally recognized pleading.
Under La. C.C. Pr. art. 1811(D), the only party who may move for a new trial after a JNOV has been granted is "[t]he party whose verdict has been set aside." There is no procedure by which
The judgment under consideration in this appeal, therefore, is the June 29, 2012 judgment. While plaintiff answered Ochsner's motions for appeal (see footnotes 4 and 5), plaintiff did not file a separate appeal of the trial court's denial of the motion for JNOV and/or new trial as to Dr. Teaford. Under La. C.C. Pr. art. 2133(A), an answer to an appeal is "equivalent to an appeal on his part from any portion of the judgment rendered against him in favor of the appellant and of which he complains in his answer." (Emphasis added). Plaintiff's answer "does not have the effect of an appeal as to any portion of the judgment rendered either in favor of, or against, a party who has not appealed." Francois v. Ybarzabal, 483 So.2d 602, 605 (La.1986). As Dr. Teaford is not an appellant in this case, an answer to Ochsner's appeal is ineffective in preserving for appeal any issue concerning the trial court's denial of the motion for JNOV and/or new trial as to Dr. Teaford. Accordingly, those issues are not properly before us.
Certain facts are clearly not in dispute by any of the parties. On December 27, 2006, Gina Corona underwent a mammogram at Ochsner Medical Center-Kenner. She had a medical history which included numerous screening mammograms, starting as early as 1994. In 2003, she had a mammogram at Kenner Regional Medical Center ("Kenner Regional," the predecessor to Ochsner-Kenner). Her referring physician was her gynecologist, Dr. Louise Collins. The reviewing radiologist noted extremely dense breasts "which can mask underlying lesions." There was no sign of malignancy and a repeat study was recommended in one year.
In November 2004, Ms. Corona underwent a routine screening mammogram again ordered by Dr. Collins. The mammogram was reviewed by a radiologist who noted that there were no suspicious masses; however, the study was significantly reduced due to the density of Ms. Corona's breasts. Another routine screening
Ms. Corona's next mammogram was on October 24, 2005, and was again performed at Kenner Regional. The radiologist noted an area of concern and two days later, on October 26, 2005, a bilateral ultrasound was performed which detected cysts in both breasts, which the reviewing radiologist felt were benign. However, the radiologist recommended further testing on a particular nodule in the left breast. A needle aspiration biopsy was performed which was negative for malignancy.
Ms. Corona then underwent the mammogram at issue in this lawsuit on December 27, 2006, again with Dr. Collins as her referring physician. In attendance was Sandy Wells, who performed the mammogram, and Deanna Nettles, the supervisor of breast imaging at Tansey Breast Center at Ochsner. Ms. Nettles was present at the request of her supervisor who asked that she observe the mammography procedures at the Kenner facility, which Ochsner had recently acquired. Two sets of films were taken that date; one was determined to be of inferior quality, and a second set was taken.
The mammogram study was reviewed by Dr. Teaford who issued a report noting that he had compared it with prior imaging studies. His evaluated the mammogram films to reflect heterogeneously dense breast tissue, with benign-negative findings. As with prior reports, Dr. Teaford felt that the density of Ms. Corona's breast tissue lowered the sensitivity of the study and he recommended a repeat mammogram in one year. Dr. Teaford issued a standard letter to Ms. Corona regarding his findings, recommending that she maintain monthly self-examinations, advising that she should not ignore lumps and further advising that she should contact her physician if she discovered a lump or other change.
On May 9, 2007, Ms. Corona, away on a business trip, contacted Dr. Collins' office and reported that she felt a solid mass in her left breast. Dr. Collins examined Ms. Corona on May 18, 2007, at which time Dr. Collins recommended that she see a surgeon. Ms. Corona underwent a biopsy on May 21, 2007, which was positive for infiltrating ductal cell carcinoma, an aggressive form of breast cancer. She underwent a left modified radical mastectomy on May 24, 2007, and then began a course of chemotherapy. Despite treatment over the years, including chemotherapy, radiation, a preventive hysterectomy and the removal of Ms. Corona's right breast, her cancer recurred after several years of remission and caused Ms. Corona's ultimate demise.
There is no real dispute that, had Ms. Corona undergone a diagnostic mammogram, rather than a screening mammogram, at her December 26, 2006 appointment at Ochsner, the cancer would have been discovered at that time. Thus, the salient issue in this case is whether, during the December 26, 2006 examination, a diagnostic mammogram should have been performed. The jury, finding no fault on either Ochsner or Dr. Teaford's part, clearly considered all of the evidence presented and concluded that, at the time of the mammogram, there was no indication for a diagnostic mammogram.
While La. C.C. Pr. art. 1811 governs JNOVs, it sets forth no grounds for or criteria by which a JNOV may be granted. Our jurisprudence, though, clearly establishes the guidelines for when a trial court may properly grant a JNOV. Our Supreme Court reiterated that criteria in Lawson v. Mitsubishi Motor Sales of America, Inc., 05-0257, pp. 24-25
In reviewing a JNOV, an appellate court must determine "whether the trial judge erred in granting the JNOV by using the aforementioned criteria in the same way as the trial judge in deciding whether to grant the motion." VaSalle v. Wal-Mart Stores, Inc., 01-0462, pp. 11-12 (La.11/28/01), 801 So.2d 331, 339. (Citations omitted). That is, "the appellate court must determine whether the `facts and inferences point so strongly and overwhelmingly in favor of the moving party that reasonable persons could not arrive at a contrary verdict.'" Id., p. 12, 801 So.2d at 339. If the appellate court determines that reasonable persons might reach a different conclusion, then the district judge erred in granting the motion and the jury verdict should be reinstated. Id.
Our jurisprudence limits the application of the JNOV doctrine to those cases where the jury's verdict is absolutely unsupported by any competent evidence. Cattles v. Allstate Ins. Co., 09-1576, pp. 6-7 (La.App. 4 Cir. 8/4/10), 45 So.3d 627, 631, writ denied, 10-2353 (La.12/10/10), 51 So.3d 733, citing Sciambra v. Jerome Imports, Inc., 05-0260, p. 5 (La.App. 4 Cir. 12/14/05), 921 So.2d 145, 149; Boudreaux v. Schwegmann Giant Supermarkets, 585 So.2d 583, 586 (La.App. 4th Cir.1991). Likewise, "a trial court may not weigh the evidence, pass on credibility of witnesses or substitute its own judgment for that of the jury" when deciding a motion for JNOV. Boudreaux supra at 585, citing Hutchinson v. Wal-Mart, 573 So.2d 1148, 1151 (La.App. 1st Cir.1990).
In the instant matter, the trial court granted a JNOV, finding in its Reasons for Judgment that the "jury was clearly wrong in its verdict in favor of [Ochsner]." It further "deliberately [put] aside any judgment of credibility, and simply [found] that the jury failed to ascertain the one reasonable conclusion as to what actually transpired on that fateful morning of December 27, 2006." In making these conclusions, the trial court made factual findings based solely on the testimony favorable to plaintiff and disregarding any contradictory testimony. For example, the trial court made the factual finding that plaintiff complained of discomfort in her left breast at the examination, which "would have triggered a request by the attendant to convert to a diagnostic mammogram,
While the trial court's factual conclusions are one view of the evidence adduced at trial, they are not the only view of the evidence, as the trial court suggests. The record does not demonstrate that the jury's verdict was absolutely unsupported by any competent evidence. See: Sciambra, supra. The jury, hearing the same evidence as the trial court, simply reached different factual conclusions which are also supported by the record.
Again, the case turns on what occurred at plaintiff's December 27, 2006 appointment, as those events determined whether plaintiff underwent a screening mammogram or a diagnostic mammogram. There is no dispute that plaintiff's ob/gyn, Dr. Collins, referred her for a screening mammogram as Dr. Teaford's December 28, 2006 report notes the "Reason" for the mammogram to be "Screening." Plaintiff's own expert, Dr. Robert Hurwitz, agreed that, absent complaints of hardness or discomfort at the time of the mammogram, a screening mammogram would have been appropriate.
The jury heard testimony about the December 27, 2006 mammogram from three witnesses: plaintiff, Sandy Wells and Deanna Nettles. Plaintiff testified that, on the morning of her mammogram, she told the technician that her breast felt uncomfortable and hard. When asked whether she repeated her complaint, she indicated that she "just said it one time." She "[couldn't] recall" if they were "in a position to listen to [her] or to hear [her] when she said that." Rather, she "assumed" that they did.
Neither Ms. Wells nor Ms. Nettles had specific recollections of plaintiff, given that they testified more than five years after the mammogram. However, they both testified that, had plaintiff voiced complaints about her left breast, they would have recorded those complaints and requested that plaintiff's screening mammogram be converted to a diagnostic mammogram.
Ms. Nettles testified that, while she had no independent recollection of plaintiff, on that date, her purpose was to "observe how [the Kenner facility] did their mammogram so that we would have consistency across." When asked if she was in a position to hear the discussion between Ms. Wells and plaintiff, she testified that she "made sure that [she] positioned herself to where [she] could follow what she was saying." In her experience, having performed "approximately 20,000" mammograms, Ms. Nettles has never "proceeded with a screening mammogram after a patient reported a complaint in [her] breast." Likewise, she agreed that, "on a daily basis[, she] received complaints from patients and convert[ed] [the mammogram] to a diagnostic [mammogram]." She had no reason "that that would not have been done for plaintiff."
Ms. Wells, too, testified that, had plaintiff reported any complaints on the morning of her mammogram, she would have taken steps to ensure that her screening
At the time of plaintiff's mammogram, Ms. Wells' general practice was to verify the type of mammogram ordered (in this case, a screening mammogram) and then go through the patient's history, noting any complaints or problems. She typically asked patients if they had any lumps. When she went over a patient's questionnaire and history, she was "face-to-face" at a counter and "about a foot way from" the patient. Ms. Wells testified that she had been in a position to hear anything plaintiff would have told her.
After our thorough review of the record, we do not find that the facts and inferences point so strongly and overwhelmingly in favor of plaintiff or that reasonable jurors could have arrived at only one verdict, as the trial court found. We further find that the trial court improperly substituted its own judgment for that of the jury. We therefore conclude that the trial court erred in granting a JNOV.
As noted, the trial court denied plaintiff's motion for new trial; however, it conditionally granted a new trial as to Ochsner under La. C.C. Pr. art 1811(C)(1), which provides as follows:
In accordance with this Article, the trial court specified the following reasons as to conditionally granting a new trial to Ochsner:
In Lawson, supra, pp. 28-29, 938 So.2d at 54-55 (Emphasis in original; citations omitted), the Louisiana Supreme Court discussed the trial court's role in ruling on a motion new trial:
Our jurisprudence reflects that, where a jury's verdict is "reasonable in light of the evidence presented," the moving party is not entitled to a new trial. Trunk v. Medical Center of Louisiana at New Orleans, 04-0181, p. 11 (La.10/19/04), 885 So.2d 534, 540. See also: In re Gramercy Plant Explosion at Kaiser, 04-1151
In this matter, we have already determined that the jury's verdict was reasonable in light of the evidence presented. Accordingly, we find that plaintiff is not entitled to a conditional new trial and the trial court abused its discretion in granting plaintiff's motion for new trial.
For the reasons set forth herein, the judgment of the trial court is reversed and the jury's verdict is reinstated.