Browne v. Portland Adventist Medical Center
Browne v. Portland Adventist Medical Center
Opinion of the Court
In this medical negligence action, defendant Portland Adventist Medical Center appeals from a judgment awarding plaintiff damages on her claim that defendant failed to timely diagnose, and properly treat, a heart attack that she suffered on July 19, 2007.
We set out the evidence in the light most favorable to plaintiff, who prevailed at trial. Rathgeber v. James Hemenway, Inc., 176 Or App 135, 137, 30 P3d 1200 (2001), aff'd, 335 Or 404, 69 P3d 710 (2003). On July 19, 2007, plaintiff went to the emergency room at the Portland Adventist Medical Center after experiencing severe chest pains and pain in her left and right arms, her neck, and her jaw. Plaintiff’s symptoms had begun earlier that morning. Plaintiff had suffered a heart attack two days earlier and, on the same day, a stent had been implanted in her heart to clear an occluded artery. On July 19, plaintiff was treated at defendant’s emergency department by Dr. Douglass, a physician who was employed by defendant. Douglass ordered a battery of tests including an (EKG) and a test to determine the possible presence of troponin, an enzyme that, when present in the blood, is an indicator that the patient has suffered a heart attack. The troponin test was administered around 11:30 a.m. on July 19 and produced a negative result. Douglass did not conduct a follow-up troponin test.
Between 11:30 a.m. and 12:20 p.m. on July 19, Douglass consulted with Dr. Hart, a cardiologist employed by Northwest Cardiovascular Institute, regarding plaintiff’s condition. Hart was the “on call” cardiologist for defendant’s emergency department on July 19. Douglass recounted plaintiff’s medical history and her various test results to Hart. After reviewing the information provided by Douglass, Hart did not believe that plaintiff was suffering a heart attack. In particular, Hart opined that the results of plaintiff’s EKG test did not suggest that she had suffered a
The next day, plaintiff was examined by her cardiologist, Dr. Strelich, who administered a second troponin test. That test indicated that plaintiff had experienced a heart attack on July 19. Strelich concluded that the heart attack most likely was caused by stent thrombosis resulting from the development of a blood clot behind the stent that had been implanted in plaintiff’s heart on July 17. Strelich recommended that plaintiff return to the hospital that day for treatment in a “cath lab.”
Plaintiff filed this action, alleging, as pertinent here, that defendant had been negligent in (1) failing to diagnose the heart attack that she suffered on July 19; (2) failing to refer her to its cath lab for treatment; (3) failing to perform repeat EKG and troponin tests; and (4) failing to adequately communicate with Hart concerning plaintiff’s treatment, including the determination of who would treat plaintiff.
The case was tried to a jury. After plaintiff rested, defendant moved for a directed verdict on all four specifications of negligence. Defendant conceded that there
The trial court granted defendant’s motion for a directed verdict regarding the specification alleging that defendant had been negligent in failing to send plaintiff to the cath lab, but the court denied the motion with respect to the remaining three specifications of negligence. The jury returned a general verdict that did not distinguish among the three remaining specifications, finding that defendant had been negligent, that its negligence had caused plaintiff’s injuries, and apportioning fault between defendant and Northwest Cardiovascular Institute. Defendant appeals from the ensuing judgment.
When reviewing the denial of a motion for directed verdict, we view the evidence, including any inferences, in the light most favorable to the nonmoving party. Brown v. J.C. Penney Co., 297 Or 695, 705, 688 P2d 811 (1984); DeNucci v. Henningsen, 248 Or App 59, 65, 273 P3d 148 (2012). If, after viewing the facts in that light, the moving party is entitled to judgment as a matter of law, then a directed verdict is appropriate. Wild Rose Ranch Enterprises v. Benton County, 210 Or App 166, 168, 149 P3d 1281 (2006), rev den, 342 Or 504 (2007). However, the verdict cannot be set aside “unless we can affirmatively say that there is no evidence from which the jury could have found the facts necessary to establish the of plaintiff’s cause of action.” Brown, 297 Or at 705 (emphasis added).
Because it is sufficient to do so, we focus only on plaintiff’s second specification that defendant’s negligent failure to conduct a second troponin enzyme test caused plaintiff’s injuries. One of plaintiff’s expert witnesses, Dr. Nelson, testified that the longer the delay before a heart patient receives interventional treatment, the more heart tissue is likely to be lost. Nelson opined that, if Douglass had conducted a second troponin enzyme test six hours after plaintiff began experiencing heart pain, that test would have shown that she was experiencing a heart attack. According to Nelson, the applicable standard of care for an emergency room physician required Douglass to conduct such a repeat test, because it would mitigate the extent of any permanent injury to plaintiff’s heart. That evidence was sufficient for the jury to find that Douglass’s failure to conduct a second troponin test resulted in a delay in diagnosing plaintiff’s heart attack that caused her injuries and related damages.
Defendant remonstrates that Hart testified that, even if “Douglass had correctly diagnosed plaintiff’s condition as a heart attack, he would not have performed coronary angioplasty,” a treatment, defendant asserts, that “[plaintiffl claimed was the only potentially curative treatment.” For two reasons, that argument is not persuasive. First, plaintiff’s evidence did not show that coronary angioplasty was the only potentially curative treatment for her condition. In particular, Nelson testified that, in addition to coronary angioplasty, plaintiff’s occluded stent could have been treated with “lytic drugs” or a “coronary artery bypass graft.”
In sum, there was evidence in the record from which the jury could have found that Douglass’s failure to conduct a second troponin enzyme test caused plaintiff to suffer greater injury to her heart than would have occurred if he had conducted that test. It follows that the trial court properly denied defendant’s motion for a directed verdict.
Affirmed.
A second defendant, Northwest Cardiovascular Institute, DLLP, has not appealed from the verdict and judgment in plaintiff’s favor.
The term “cath lab” refers to a laboratory wherein cardiac catheterizations are performed. Catheterizations are used to remove blockages, such as blood clots, within the heart and its surrounding blood vessels.
At trial, plaintiff withdrew a fifth specification of negligence.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.