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Rockdale Hospital, LLC v. Evans
Supreme Court of Georgia
October 7, 2019
ROCKDALE HOSPITAL, LLC
EVANS et al.; and vice versa.
granted certiorari in Case Number S18G1189 to consider (1)
the standard that appellate courts should apply when
reviewing a trial court's ruling on a claim under OCGA
§ 51-12-12, and (2) whether the Court of Appeals
properly applied that standard in this case. In Case Number
S18G1190, we asked whether it was error for the Court of
Appeals to remand the case for a retrial on both liability
and damages, assuming the proper standard of review had been
applied. We conclude that the Court of Appeals applied the
wrong standard in reviewing the trial court's decision,
and so we vacate the judgment and remand the case with
direction to apply the standard set forth in this opinion.
We, therefore, do not reach the question posed in S18G1190.
Viewed in the light most favorable to the plaintiffs, who
prevailed at trial, the underlying facts, as the Court of
Appeals presented them, are as follows:
[O]n the night of Saturday, January 14, 2012, [Janice K.]
Evans, who was 60 years old, woke up with the worst headache
that she had ever experienced, jumped out of bed, and vomited
on herself. She then had episodes of vomiting and diarrhea
throughout the night. Mrs. Evans believed that she was
suffering from food poisoning and had become dehydrated.
However, a severe "thunderclap" headache, commonly
described by patients as the worst headache in their life,
followed by vomiting and nausea, are common symptoms
associated with bleeding in the brain.
Mrs. Evans's symptoms did not subside over the next two
days, and around 8:00 p.m. on Monday, January 16, 2012,
[Shaun G.] Evans, her husband, drove her to the [defendant
Rockdale Hospital ("Rockdale")] emergency room.
After arriving there, Mrs. Evans complained of dehydration,
headache, diarrhea, and nausea, and she told the nursing
staff that she might have food poisoning from a local
restaurant. The triage nurse failed to document Mrs.
Evans's initial complaint of headache in the medical
chart and chose the charting template on the computer for
digestive system illness, which remained the template used by
the nursing staff throughout Mrs. Evans' stay in the
The triage nurse documented Mrs. Evans's initial blood
pressure as 213/105, a blood pressure within the American
Heart Association's guidelines for hypertensive crisis.
All of the blood pressure readings subsequently taken by the
emergency room nursing staff reflected that Mrs. Evans had a
continued systolic blood pressure of over 200, which is
"extremely high" and also can be a sign of bleeding
in the brain. Additionally, Mrs. Evans requested medication
for a severe throbbing headache, which she described as an 8
out of 10 on the hospital pain scale. Despite her complaint
of a severe headache and high blood pressure, the nursing
staff did not ask Mrs. Evans focused questions about her
headache and thus did not learn from her and document in the
medical chart that her initial onset of symptoms had involved
her waking up with the most severe headache of her life.
Mrs. Evans was diagnosed with high blood pressure, nausea,
and vomiting, with no specific cause identified. The
emergency room physician told Mrs. Evans that he was
concerned about her high blood pressure and that she needed
to see her primary care physician that week. Mrs. Evans was
discharged from the emergency room in the early morning hours
of January 17, 2012, and was instructed to return if her
After Mrs. Evans was discharged, Mr. Evans called a local
primary care practice and made Mrs. Evans an appointment for
the following Monday, the first available appointment. Mrs.
Evans's severe headache and vomiting returned after she
was discharged, and she continued to have those symptoms
throughout the week. She fell several times during the week
and had to crawl back to bed on at least one occasion. On
January 22, 2012, Mr. Evans called 911 after Mrs. Evans began
moving her mouth unnaturally while eating and was unable to
get up from the couch.
Mrs. Evans was transported by ambulance to the Rockdale
emergency room, where a CT scan showed a blood clot in her
brain. She was transferred to Emory Hospital, and further
testing revealed that she had suffered several strokes as a
result of a ruptured brain aneurysm. Mrs. Evans underwent
multiple surgeries and spent months in the hospital and a
rehabilitation facility. She is permanently and totally
disabled, is incontinent, requires a feeding tube, cannot
speak, has severe cognitive and other impairments, has a
seizure disorder, and requires 24-hour care.
In August 2013, Mr. Evans, individually and as guardian of
Mrs. Evans, sued Rockdale for medical malpractice and loss of
consortium. During the trial, the parties disputed whether
Mrs. Evans suffered from a ruptured brain aneurysm when she
presented at the emergency room on January 16, 2012, whether
a diagnosis of a ruptured aneurysm on that date would have
led to a better outcome, and whether the Rockdale emergency
room nurses violated the standard of care. Rockdale also
argued that Mrs. Evans's fault exceeded that of Rockdale
because, among other things, she had not obtained treatment
for her longstanding, uncontrolled hypertension despite being
aware of that condition.
As to damages, the plaintiffs presented medical billing
records reflecting that Mrs. Evans's total past medical
expenses were $1, 196, 288.97, as well as testimony regarding
the procedures and rehabilitation that she had to undergo
after the ruptured aneurysm up to the point of trial. The
plaintiffs also presented evidence of future medical
expenses, past and future lost wages, and of Mrs. Evans's
current impaired condition requiring 24-hour care. Mr. Evans
and a certified nurse's aide testified to the care that
had to be provided to Mrs. Evans, and the jury was shown a
day-in-the-life video reflecting the care provided by Mr.
Evans and the nurse's aide.
Rockdale did not contest that Mrs. Evans was catastrophically
injured and did not address the issue of damages during
closing argument. During the cross-examination of the
plaintiffs' damages experts who opined on Mrs.
Evans's lost wages and future medical expenses, Rockdale
did challenge the experts' credibility and the extent of
the damages sought for future medical expenses.
Following its deliberation, the jury returned its verdict on
a special verdict form. In Section 1 of the verdict form, the
jury awarded Mrs. Evans the amount she had requested in
damages for past medical expenses ($1, 196, 288.97), but
awarded her zero damages for future medical expenses, zero
damages for past and future lost wages, and zero damages for
past and future pain and suffering. The jury awarded Mr.
Evans $67, 555 in damages for loss of consortium. In Section
2 of the verdict form, the jury apportioned fault among the
parties, finding that Rockdale was 51 percent at fault and
that Mrs. Evans was 49 percent at fault. The trial court
reduced the amount of damages awarded by the jury in
proportion to the percentages of fault and entered judgment
in favor of the plaintiffs and against Rockdale in the amount
of $586, 191.60 for past medical expenses and $33,
101.95 for loss of consortium.
The plaintiffs filed a motion for additur or for a new trial
on the ground that the jury's award of damages against
Rockdale was so clearly inadequate as to be inconsistent with
the preponderance of the evidence. The plaintiffs contended
that any new trial ordered by the trial court should be
limited to the issue of damages. Rockdale opposed the motion,
contending that the jury's damages award should not be
disturbed and that any retrial could not be limited to the
issue of damages because the case involved ...
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