Sampson v. Surgery Ctr. of Peoria, LLC (7/30/2021)

August 9, 2021

Arizona Supreme Court holds that a jury in a medical malpractice case may not be left to infer causation without the guidance of expert testimony where the cause of death is disputed and not obvious to an ordinary person.

A young child underwent surgery.  After surgery, the child began waking up from anesthesia and could sit up, cry, drink, and speak.  However, the child’s mother observed that he was sleepy and uncomfortable.  After sixty-one minutes, the child was released from the surgery center and the mother took him home.  At home, the mother put the child in bed.  Approximately two hours after his discharge, the mother found that the child was not breathing.  Emergency personnel could not revive him.

Mother sued the surgery center and the providing doctor for wrongful death and identified an expert witness to establish cause of death, proximate cause, and standard of care.  The expert testified that the defendants had fallen below the standard of care and that a longer observation time at the surgery center could have prevented the child’s death.  In addition, the expert testified that the child had died from an inability to breath from the after-effects of surgery and anesthesia.  But the autopsy report stated that the child had died from an infection. 

The defendants moved for partial summary judgment and contended that the expert’s testimony did not establish proximate cause of the child’s death.  Mother countered that cause could be inferred and expert testimony was not necessary.  The trial court granted the motion and found that the causal connection between defendants’ failure to observe the child for a longer period and the child’s death was a matter for the expertise of medical practitioners and was beyond the ken of the average juror.  The Court of Appeals reversed, finding that a reasonable jury could properly infer that early discharge was the probable cause of the child’s death.

The Supreme Court held the expert had failed to connect the dots between the premature discharge and the child’s death.  Furthermore, although causation in medical malpractice cases can be inferred when readily apparent in a narrow set of cases, expert testimony establishing causation is essential in most cases, including this one.  The Court reasoned that even the medical experts did not agree on the cause of death, and therefore it is unrealistic to conclude that the jury could properly infer without speculation that the child’s early discharge caused his death.

Justice Bolick authored the unanimous opinion.