EVELYN D. BUTLER, INDIVIDUALLY, AS ADMINISTRATRIX FOR THE ESTATE OF ALICE JEAN BUTLER, AND ON BEHALF OF THE WRONGFUL DEATH BENEFICIARIES OF ALICE JEAN BUTLER APPELLANT
CHADWICK NURSING & REHABILITATION CENTER, CHADWICK NURSING AND REHABILITATION CENTER, LLC, JOHN C. FARMER, M.D., AND FARMER AND ASSOCIATES INTERNAL MEDICINE, INC. APPELLEES
OF JUDGMENT: 11/18/2015
COUNTY CIRCUIT COURT, FIRST JUDICIAL DISTRICT HON. WILLIAM A.
GOWAN JR., Judge
ATTORNEY FOR APPELLANT: WILLIAM W. FULGHAM
ATTORNEYS FOR APPELLEES: W. DAVIS FRYE MILDRED M. MORRIS
TIMOTHY LEE SENSING ANDREA LA'VERNE FORD EDNEY JEAN
COOPER BERTAS JOHN BURLEY HOWELL III
GRIFFIS, P.J., BARNES AND WILSON, JJ.
Alice Butler was admitted to Central Mississippi Medical
Center (CMMC) on October 28, 2009, with severe hip pain.
Alice's doctor at CMMC believed that she needed a hip
replacement, but he recommended that she undergo a course of
rehabilitation to improve her strength prior to surgery. On
November 5, 2009, Alice was transferred to Chadwick Nursing
and Rehabilitation Center LLC (Chadwick) for rehabilitation.
At the time of her admission, Chadwick's staff documented
multiple areas of skin breakdown on Alice's body,
including two bed sores (pressure ulcers) on her buttock.
While Alice was at Chadwick, these sores deteriorated and
became infected. On November 27, 2009, Alice was transferred
to the emergency room at CMMC, where she was diagnosed with
sepsis and other illnesses. On December 27, 2009, Alice died
of acute respiratory failure caused by sepsis.
Alice's daughter, Evelyn, subsequently filed a medical
malpractice complaint against Chadwick and Alice's
primary physician at Chadwick, Dr. John Farmer. Evelyn
alleges that Chadwick failed to notify Alice's doctors of
changes in her condition in a timely fashion. She also
alleges that Dr. Farmer's treatment of Alice did not meet
the standard of care. She further alleges that these failures
by Chadwick and Dr. Farmer more likely than not caused
Alice's death. The case eventually proceeded to a jury
trial. However, at the conclusion of Evelyn's
case-in-chief, the circuit judge granted the defendants'
motions for directed verdicts because the judge concluded (1)
that there was insufficient evidence that any alleged breach
of care by Chadwick caused Alice's death and (2) that as
a matter of law Evelyn failed to establish any breach of care
by Dr. Farmer. We agree with the circuit court that both
defendants were entitled to judgment as a matter of law.
Therefore, we affirm.
AND PROCEDURAL HISTORY
In October 2009, Alice Butler was sixty-eight years of age.
She had been diagnosed with diabetes, hypertension,
arthritis, and gout. She was morbidly obese, and her medical
history also included a diabetic coma, a stroke, and heart
bypass surgery. However, Alice lived in her own home and was
able to care for herself.
Alice also suffered from degenerative joint disease. On
October 28, 2009, she went to see her doctor, Dr. Hursie
Davis Sullivan, because she had been unable to walk for three
days due to severe pain in her left hip. At Dr.
Sullivan's recommendation, Alice was admitted to CMMC the
same day for her hip pain.
One of the doctors at CMMC, Dr. Temple, felt that Alice
needed a hip replacement, but he recommended Alice should go
somewhere for a period of rehabilitation prior to surgery.
Alice's family placed her at Chadwick for rehabilitation.
Alice was transferred from CMMC to Chadwick on November 5,
2009. Alice's family testified that for about the first
week she was at Chadwick, she seemed to be normal and in good
Dr. Farmer was Alice's admitting physician at Chadwick.
Upon her admission on November 5, Chadwick's staff
evaluated Alice and noted two bed sores (i.e., pressure
ulcers) on her buttock that were described as
"open" and "red in color" but without any
"drainage or odor." One sore measured three and a
half centimeters by one centimeter, and the other measured
two centimeters by one centimeter. On November 10,
Chadwick's staff noted that one of Alice's sores was
eight centimeters long and four centimeters wide. Records
indicate that there was no odor from the sores, but there was
On November 13, Chadwick's staff noted in Alice's
records that she had not walked in the previous seven days
and needed "extensive assistance" to bathe or use
the restroom. Alice got around Chadwick primarily by using a
wheelchair. Alice's records also reflect that she
experienced hip and joint pain daily that at times was
"horrible or excruciating."
Alice's family testified that they noticed a change in
her condition during her second week at Chadwick. They
testified that Alice was almost always asleep when they went
to visit her, but Chadwick's staff told them that Alice
was just tired from her rehabilitation.
On November 17, Alice's sores developed slough.
Chadwick's staff notified Dr. Farmer of this change in
Alice's condition, and he ordered that the wound be
treated with Santyl, a chemical debriding agent, to remove
the slough. Alice's records reflect that on November 18
the wound was still eight centimeters long by eight
centimeters without odor or drainage; however, the wound had
turned yellow in color and slough was present.
Alice's family testified that Alice continued to sleep a
lot during her third week at Chadwick, and Evelyn testified
that she stopped receiving daily phone calls from Alice.
Alice's family testified that they were concerned about
Alice and continued to question staff about her condition.
At some point during Alice's third week at Chadwick,
Evelyn learned about Alice's wound for the first time.
Evelyn testified that she asked to see the wound on more than
one occasion, but Chadwick's staff told her that she
could not because the wound had just been treated with
ointment or bandaged or because Alice was asleep. Evelyn