Williams v. Dimensions Health Corp.

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TERENCE WILLIAMS v. DIMENSIONS HEALTH CORPORATION

No. 0036-2020

Court of Special Appeals of Maryland

August 28, 2023

UNREPORTED ^[*]

IN THE APPELLATE COURT OF MARYLAND ^[**]

Circuit Court for Prince George's County Case No CAL17-35481

Berger, Beachley, Zic, JJ.

OPINION

ZIC J.

Appellant/cross-appellee Terence Williams brought suit against Dr. Montague Blundon and appellee/cross-appellant Dimensions Health Corporation, Inc., d/b/a Prince George's Hospital Center ("Hospital") in the Circuit Court for Prince George's County, alleging that Dr. Blundon was negligent in treating Mr. Williams' right leg, which had been injured in a motor vehicle accident. Mr. Williams sued Dr. Blundon for medical negligence and the Hospital under a theory of apparent agency.

The Hospital moved for summary judgment at the close of Mr. Williams' case, arguing Mr. Williams did not establish sufficient evidence of apparent agency, and the court reserved ruling on the motion. At the conclusion of all evidence, the Hospital renewed its motion for summary judgment on apparent agency, and both the Hospital and Dr. Blundon moved for summary judgment based on insufficient evidence of economic damages. The circuit court again reserved ruling on both motions. The jury found in favor of Mr. Williams, and that Dr. Blundon was an agent of the Hospital. Dr. Blundon and the Hospital both filed motions for judgment notwithstanding the verdict on the issue of economic damages, and the Hospital also filed a motion for judgment notwithstanding the verdict on the issue of apparent agency. The court denied the motions on economic damages and granted the Hospital's motion based on apparent agency.

Mr. Williams appealed the court's grant of the motion for judgment notwithstanding the verdict on apparent agency, and the Hospital filed a cross-appeal on the denial of the motion on the issue of economic damages. We affirmed the circuit court's decision to grant the motion on apparent agency and declined to consider the Hospital's cross-appeal. The Supreme Court^[1] granted certiorari and reversed, holding that Dr. Blundon was an apparent agent of the Hospital. This case now returns to us to consider the Hospital's cross-appeal regarding economic damages.

QUESTIONS PRESENTED

On cross-appeal, the Hospital presents one question for our review, which we have rephrased as follows:^[2]

Did the circuit court err in concluding that there was sufficient evidence to support the jury's economic damages award?

For the reasons that follow, we answer the question in the negative and affirm the circuit court's decision to deny the motion for judgment notwithstanding the verdict, upholding the jury's damages award of $6,285,549.

BACKGROUND

Early in the morning of May 3, 2014, Mr. Williams was involved in a single-car accident^[3] when he lost control of his vehicle while driving on the Capital Beltway and crashed. Mr. Williams hit the guardrail and flipped several times, resulting in severe injuries to his left arm and both of his legs. Emergency personnel arrived shortly after and took Mr. Williams to the Hospital, where he was treated by multiple physicians including Dr. Blundon, an undisputed independent contractor. There, Dr. Blundon performed a fasciotomy on Mr. Williams' right leg, resulting in an above-the-knee amputation of the leg. Due to the severity of the injuries to Mr. Williams' left leg, the left leg was also amputated. It is undisputed that Dr. Blundon and the Hospital are not responsible for the above-the-knee amputation of Mr. Williams' left leg and the severe and permanent damage to his left arm.

On November 14, 2017, Mr. Williams filed this medical malpractice case against Dr. Blundon, alleging that Dr. Blundon negligently performed a fasciotomy to address compartment syndrome in Mr. Williams' right leg, which ultimately resulted in its amputation. Further, Mr. Williams asserted liability on the part of the Hospital based on apparent agency. The matter proceeded to trial on October 7, 2019.

Expert Testimony

At trial, Mr. Williams, Dr. Blundon, and the Hospital offered extensive expert witness testimony regarding the cause of Mr Williams' right leg injuries and the care he would need as a result. While objections were made to certain statements by each of the experts, no objection was made to the admission or testimony of any of the expert witnesses.

Mr. Williams called the following expert witnesses to testify regarding the extent of his injuries: John Michael, Michael Sirkin, Michael April, Cathryn Winslow, and Thomas Borzilleri. He first presented an expert in prosthetics and orthotics, John Michael, to testify as to the prostheses Mr. Williams would need due to the amputation of his right leg. Mr. Michael opined that Mr. Williams required three separate sets of prostheses: the power knee prostheses, shortened prostheses, and water aerobic prostheses. For the power knee, Mr. Michael testified that each prosthesis had an initial cost of $94,174, requires yearly maintenance of $9,400, and needs periodic socket replacement at $22,738 each. Next, he testified that the shortened prostheses cost $27,336 each, require yearly maintenance of $2,700, and the same socket replacement of $22,738. Finally, the water aerobic prostheses each cost $27,660, require $2,766 of yearly maintenance, and the same $22,738 socket replacement. Each prosthesis had a projected lifespan of four to six years. For comparison, Mr. Michael then testified as to the prostheses he would have recommended if Mr. Williams had retained his right leg. Assuming Mr. Williams would have "sufficient strength to use his surviving knee to stand up and down," instead of the power knees, Mr. Michael would recommend a sophisticated walking prosthesis that would cost $209,227, require yearly maintenance of $20,923, and a socket replacement of $16,923.^[4] Mr. Michael would also recommend a fitness prothesis so that Mr. Williams could exercise more regularly, which would cost $33,166, require annual maintenance of $3,317, and a socket replacement of $16,923. Finally, Mr. Michael testified he would again recommend a water aerobic prothesis, which costs $29,075, requires maintenance of $2,907 each year, and the same socket replacement of $16,923. Each prosthesis again has a projected lifespan of four to six years. Mr. Michael provided this information to the life care planner, Cathryn Winslow, so that she could use the assessment to determine what care Mr. Williams would need and the overall cost when creating his life care plan.^[5] On cross-examination, Mr. Michael acknowledged that Mr. Williams has chronic full-body pain and noted that without proper pain management, he would have a difficult time utilizing any of the prostheses consistently.

Dr. Michael Sirkin, an expert in orthopedic surgery and trauma surgery, testified that if Mr. Williams' compartment syndrome had been treated timely, Mr. Williams would have a right leg that he could "probably walk on," although he would have trouble with recreational activities like sports and would likely have occasional pain. On cross-examination, however, he conceded that even with proper treatment, Mr. Williams "[a]bsolutely 100 percent was not going to have a normal right leg."

Dr. Michael April, a physical medicine and rehabilitation expert, testified that he assessed Mr. Williams' current and future needs and compared them to what he determined Mr. Williams' needs would be if his right leg had been saved. Dr. April shared his determination of Mr. Williams' needs with Ms. Winslow and assisted in the formulation of the life care plan for Mr. Williams. Dr. April also opined that Mr. Williams' life expectancy was 23 additional years when adjusted for smoking. Although Dr. April testified that he had "adjust[ed] his recommendations for assistance in the event [Mr. Williams] had one extremity amputated with a limited function left upper extremity, prosthetic leg on the left side and chronic pain medication," he agreed that even if he had kept his right leg, Mr. Williams "would still need care because of his chronic pain, his [] non-functional left upper extremity, and his above-the-knee amputation on the left."

Another expert witness, Cathryn Winslow, testified that she created a life care plan for Mr. Williams. A life care plan explains what support an individual will need as a result of a catastrophic injury or illness, examines the short- and long-term goals of the individual, and emphasizes maximum wellness and independence. Ms. Winslow prepared a life care plan for Mr. Williams, which required her to meet with Mr Williams, read his medical records, and read reports from Dr. April and Mr. Michael. The life care plan included the expenses for Mr. Williams' needs that she attributed to the loss of his right leg. To determine this number, Ms. Winslow calculated the total cost of care that Mr. Williams would need if he had retained his right leg and subtracted this amount from the total cost of care that he now requires. In doing this, Ms. Winslow testified that if he still had his right leg, Mr. Williams would only require a total of 12 hours of attendant care each week, however, due to the loss of his right leg, Mr. Williams now needs 24/7 attendant care. Based on an hourly rate of $22 an hour for a home health aide, the difference between 12 hours per week and 24/7 care amounted to about $178,992 per year for life. Ms. Winslow also allocated $54,000 for a wheelchair van to be driven by a caretaker, claiming that Mr. Williams would not require a wheelchair van if he had not lost his right leg because he would otherwise be able to drive. Finally, Ms. Winslow testified that she relied on Mr. Michael's recommendations regarding prostheses to...