Thursday, September 22, 2011

Shugart v. Regents of Univ. of Calif. (Cal. Ct. App. - Sept. 22, 2011)

I'm glad Justice Grimes published this one.

It's concise.  It's too the point.  It's correct.

The trial court was an overly sticky proceduralist.  It was fine for plaintiff's medical expert to attach the plaintiff's medical records as support for his opinion.  You don't need to submit independently authenticated documents.  If there's a problem with those records (which, of course, there's not), I'd expect defendant to say so.

Moreover, on the merits, the expert declaration raised a genuine issue of material fact.  Sure, it's short.  But it says why the one defendant allegedly fell below the standard of care.  That's good enough.

Ditto for the Court of Appeal's ruling with respect to the other defendant.  With respect to that one, the expert's wholly conclusionary opinion -- essentially, a half-sentence -- didn't create a genuine issue.  Seems right to me.

The only downside of publishing the opinion is that it's not exactly family reading.  A snippet:

"Christine Shugart . . . advised Dr. Warren she suffered from urinary incontinence and had to manually manipulate her perineum in order to defecate, symptoms she had had for a couple of years. Christine had previously had a hysterectomy. . . . Christine was admitted to Mercy Southwest Hospital in Bakersfield, and Dr. Warren performed a transvaginal tape placement and a posterior vaginal repair. . . . As Christine started to wake from the anesthesia, a nurse noted heavy vaginal bleeding. Christine was returned to the operating room to determine the source of the bleeding. Dr. Warren located some "oozing" in one incision and placed additional sutures.

The first postoperative visit was on September 5, 2007. Christine was experiencing a brownish discharge. . . . On September 14, Christine told Dr. Warren she was experiencing pain, more so than immediately after the surgery. Dr. Warren examined Christine, noticed a protruding suture, which she deemed the likely cause of irritation, and removed it. Christine returned again for an examination on September 27. Dr. Warren noted a portion of the tape was 'palpated lateral to the urethra.' Dr. Warren cut the tape slightly to release the 'pinching' and nicked the vaginal mucosa, causing some bleeding. Christine was advised her infection was resistant to the antibiotics, so she was prescribed a different antibiotic. She was told again to return in two weeks.

On October 3, 2007, Christine went to Dr. Warren’s office, complaining of continuing problems, although she was continent. During the vaginal examination, Dr. Warren noted some of the blue mesh/tape was protruding from the incision site. She prescribed a vaginal cream to assist in the healing process and told Christine to return in four weeks. Christine returned to Dr. Warren in early November, complaining that her symptoms were getting worse. During the pelvic examination, Dr. Warren noted there was 'mesh protruding from the vaginal mucosa on the right and midline.'"

It goes on like that for a while.  In language that only reaffirms the prescience of my decision to become a lawyer rather than a doctor.