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09/04/91 JAMES G. KANE v. JANET RYAN

September 4, 1991

JAMES G. KANE, M.D., APPELLANT
v.
JANET RYAN, ET AL., APPELLEES



Appeal from the Superior Court of the District of Columbia; Hon. Harriett R. Taylor, Trial Judge

Ferren and Schwelb, Associate Judges, and Mack, Senior Judge.

The opinion of the court was delivered by: Ferren

A jury awarded appellee Janet Ryan $1,150,000 and her husband, appellee George Ryan, $150,000 for Dr. James G. Kane's failure to diagnose and treat Ms. Ryan's Systemic Lupus Erythematosus, which resulted in an hemorrhagic stroke. Appellant, Dr. Kane, contends that the Ryans (1) failed to produce sufficient evidence of proximate cause, and that the trial court erred (2) in allowing certain expert economic testimony about Ms. Ryan's future lost income, (3) in limiting Dr. Kane's cross-examination for bias of one of the Ryans' experts, and (4) in refusing to grant a pro rata, rather than pro tan to, credit for pretrial settlement with the co-defendant, Dr. Robert M. Adrian. We affirm.

In September 1985, Ms. Ryan's gynecologist asked Dr. Kane to examine Ms. Ryan's swelling leg while she was at Sibley Hospital. Dr. Kane found blood clots and prescribed Coumadin, a blood thinner. Dr. Kane also asked a dermatologist, Dr. Adrian, to examine a pink rash covering parts of Ms. Ryan's body. Dr. Adrian examined Ms. Ryan and concluded that the rash was caused either by a drug allergy or by the sun. Dr. Kane treated Ms. Ryan seven times between September 1985 and February 1986, including treatment during a rehospitalization at Sibley beginning November 7, 1985.

In March 1986, Dr. Kane received a biopsy report showing symptoms from which he concluded that Ms. Ryan had Cutaneous Lupus, although he suspected she might have Systemic Lupus Erythematosus (S.L.E.). *fn1 Dr. Kane, however, did not consult with a lupus specialist about Ms. Ryan's condition. Dr. Kane discussed Ms. Ryan's symptoms with Dr. Adrian in mid-March, when Dr. Adrian assured him that Ms. Ryan's problems were strictly dermatologic. Dr. Kane checked Ms. Ryan again on April 16 and May 14, 1986. On July 9, 1986, Dr. Kane advised her over the telephone to stop taking Coumadin. On September 4, 1986, Ms. Ryan returned to Dr. Adrian complaining of red lumps on her legs and arms. Dr. Adrian said he would check her blood and call her (the record does not reveal whether Dr. Adrian called Ms. Ryan about the test). On October 9, 1986, Ms. Ryan was admitted to Georgetown University Hospital after suffering a stroke. After several months in the hospital, she returned home where she remains brain impaired, having lost 40 IQ points.

The Ryans brought this jury action claiming that Dr. Kane and Dr. Adrian negligently failed to diagnose and treat Ms. Ryan's pre-stroke symptoms. Dr. Kane filed a cross-claim against Dr. Adrian alleging that, as the last doctor to see Ms. Ryan, Dr. Adrian should have diagnosed her S.L.E. The cross-claim was tried before the trial court. On the first day of trial, the Ryans settled with Dr. Adrian for $300,000. After trial, the jury awarded Ms. Ryan $1,150,000 against Dr. Kane for negligence and awarded Mr. Ryan $150,000 for loss of consortium. Thereafter, the trial court ruled in Dr. Adrian's favor on the cross-claim. The court then applied a pro tanto credit of $300,000 (representing the amount of the settlement with Dr. Adrian) to the overall verdict and granted judgment against Dr. Kane for $1,000,000. On May 7, 1990, the trial court denied Dr. Kane's motions for judgment notwithstanding the verdict, a new trial, a remittitur, or a pro-rata credit. This appeal followed.

I.

Dr. Kane argues that the evidence of proximate cause was insufficient to sustain the jury verdict. We review the appeal of a denial of a motion for judgment notwithstanding the verdict by viewing the evidence in the light most favorable to the non-moving party. We reverse only if no reasonable juror could have reached the verdict. See Jackson v. Condor Mgmt. Group, Inc., 587 A.2d 222, 224 (D.C. 1991); District of Columbia v. Cassidy, 465 A.2d 395, 397 (D.C. 1983) (per curiam).

A.

Dr. Kane contends that because the trial court found insufficient evidence of proximate cause on the cross-claim, the court erred in denying his motion for judgment notwithstanding the verdict. The trial court, in ruling for Dr. Adrian, found:

The credible evidence was that the stroke could not have been prevented. I simply disagree with what must have been the jury's verdict in this respect.

I find that the credible evidence is also that had Coumadin been resumed and continued until the time that Mrs. Ryan had the stroke, it would have harmed her. And I further find that had low dose steroids been given, they would not have been effective to prevent the stroke.

Dr. Kane argues that because of the inconsistent verdicts, he is left with the worst possible result: owing the entire amount himself (minus the pro tanto credit for Dr. Adrian's settlement) because the jury found him liable and the trial court found Dr. Adrian not liable. Had the jury's reasoning on proximate cause prevailed on the cross-claim, Dr. Adrian and Dr. Kane would have been jointly and severally liable, and thus Dr. Kane presumably would have been liable for only $650,000. If, on the other hand, the trial court's reasoning on proximate cause had prevailed in both instances, then Dr. Kane would not have been liable at all. Dr. Kane contends that, because the trial court repudiated the jury verdict, the court erred in sustaining that verdict against his motion for a judgment n.o.v.

Dr. Kane's argument is not persuasive. The trial court listened to additional evidence in evaluating the cross-claim and made its ruling in a different factual context. The question addressed in the cross-claim was whether, in September 1986, Dr. Adrian, as a consultant to Dr. Kane for dermatological complications, was negligent in failing to diagnose Ms. Ryan's lupus and to treat it with steroids and Coumadin. The jury, on the other hand, evaluated whether, over a period of at least eight months -- including the four months immediately before the stroke -- Dr. Kane, as Ms. Ryan's treating physician, should have diagnosed and treated her condition. Dr. Gale McCarty, the Ryans' medical expert, testified that as a consultant Dr. Adrian would not have been responsible for prescribing medicine, a task the primary caretaker would fulfill. The alleged proximate cause in this case was the failure to ...


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