The Massachusetts Supreme Judicial Court has upheld a $20 million jury verdict in a medical malpractice case involving the above-the-knee amputation of a patient’s leg due to negligence by three medical professionals.
Jury Finds Negligence in Treatment
In 2023, a jury determined that a registered nurse, a physician assistant, and a nurse practitioner at Lowell General Hospital were negligent in their treatment of Steven Luppold, a 38-year-old man. Luppold had visited the hospital multiple times in 2015, complaining of foot, leg, and back pain. The jury concluded that the medical staff failed to diagnose and treat his blood clots properly, which ultimately led to his amputation.
Appeal by Registered Nurse
Among the three defendants found liable, only the registered nurse appealed the verdict. She contended that the trial judge made several errors during the trial. One significant point in her appeal was the trial judge’s decision to exclude cross-examination regarding a “high-low” settlement agreement entered into by the other two defendants. Leg Amputation Case
A “high-low” agreement caps a defendant’s liability while guaranteeing the plaintiff a minimum payment, irrespective of the trial’s outcome. The nurse argued that this agreement influenced one defendant to alter his testimony to align more with the plaintiff’s claims and to criticize her actions.
Court’s Rationale and Decision
The high court emphasized that settlement agreements are generally inadmissible to avoid discouraging settlements and skewing jurors’ perceptions. The justices found no evidence that the other defendant’s testimony was influenced by the high-low agreement.
Additionally, the registered nurse challenged parts of the jury instruction, the denial of her motion for judgment notwithstanding the verdict, and the assessment of prejudgment interest on future pain and suffering damages. However, the Supreme Judicial Court found no errors by the trial judge.
Jury Instruction Clarification
The court, while affirming the trial judge’s instructions, noted a minor adjustment to the model jury instructions on “but-for” causation for future cases. The revised language aims to clarify the meaning of causation for jurors more explicitly.
The updated instruction reads: “If [defendant’s] negligence had an impact on [plaintiff’s] injuries (by causing them or worsening them), then it caused those injuries. But if the negligence had no impact on [plaintiff’s] injuries, meaning that the same harm would have happened anyway, then [defendant] did not cause the injuries.”
This minor revision ensures jurors have a clearer understanding of the legal standard for causation in medical malpractice cases.
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