Appeal from the Circuit Court of Cook County Honorable Jennifer Duncan-Brice Judge Presiding.
The opinion of the court was delivered by: Justice Gallagher
Plaintiff Natalie Buckholtz brought this medical malpractice action against several defendants, including MacNeal Hospital (MacNeal), Yousuf Sayeed, M.D., and Janyce Blatt, C.R.N.A., after her father, Frank Stajszczyk, died at MacNeal following surgery. A jury returned a verdict in favor of plaintiff and the court entered judgment. Defendants *fn1 filed post-trial motions for judgment notwithstanding the verdict (judgment n.o.v.), a new trial or, in the alternative, for remittitur. The trial court denied their motions. Defendants now appeal. For the reasons that follow, we affirm in part and reverse in part.
On May 4, 1995, Mr. Stajszczyk was admitted to MacNeal for femoral-popliteal bypass surgery to restore circulation to his left leg to help heal an ulcer on his left heel that had been present for several months. Due to his medical history, he was at an increased risk for a coronary event during surgery and was assigned a cardiologist to monitor him before and after surgery. On May 7, 1995, Dr. Joan Briller, a cardiologist at MacNeal, examined Mr. Stajszczyk and cleared him for surgery. The surgery took place on May 8, 1995.
Prior to the surgery, between 12:55 p.m. and 1:30 p.m., Dr. Sayeed, the attending anesthesiologist, attempted to place a central venous catheter ("central line") in the left internal jugular vein to assist in monitoring Mr. Stajszczyk during the procedure. Dr. Sayeed made two unsuccessful attempts to place the catheter in the right internal jugular vein, and three or four unsuccessful attempts in the left internal jugular vein. Dr. Sayeed enlisted the help of Dr. Hodgett, a surgical resident, who made two or three unsuccessful attempts in the left internal jugular vein. Dr. Sayeed decided to forgo the placement of the central line, and the surgery commenced.
Mr. Stajszczyk was administered 7,500 units of Heparin, a blood anticoagulant, at 1:57 p.m. and 2:57 p.m. The Heparin administration was routine and necessary to ensure the prevention of clot formations during surgery. Dr. Sayeed knew that Mr. Stajszczyk had received the Heparin.
At 3 p.m., in order to raise Mr. Stajszczyk's blood pressure, Dr. Sayeed administered Neosynephrine in three 100-microgram boluses between 3 p.m. and 3:15 p.m. The drug was then continued by intravenous drip from 3:25 to 4:05 p.m, at which time Dr. Sayeed stopped it. At 3:45 p.m., Protamine was administered to reverse the effects of the Heparin. The surgery ended at approximately 4:30 p.m.
Shortly after 4:30 p.m., immediately after the procedure, there was a drop in Mr. Stajszczyk's blood pressure. Chest X rays and a blood test were ordered. Mr. Stajszczyk's hemoglobin level was between 3.6 to 4.2, representing a 60% loss of the oxygen-carrying capacity of his blood. The chest X ray revealed a whiteout. Dr. Stengle, the surgical resident, placed a chest tube in Mr. Stajszczyk, out of which a minimum of 1 to 1½ liters of blood was expelled. In Dr. Stengle's opinion, that blood came from a hole in the left internal jugular vein that was made by one or more of the attempts to pass the central line. Dr. Stengle testified that the lost blood must be replaced immediately. Dr. Stengle admitted that it is the duty of the anesthesiology team to replace blood when it is lost. Mr. Stajszczyk was given albumin at 5 p.m. and received his first unit of packed red blood cells at 5:10 p.m. Mr. Stajszczyk died 5½ hours later at 10:07 p.m.
Plaintiff filed her initial complaint on May 6, 1997. Plaintiff's third amended complaint contained two counts *fn2 against five defendants. In count I, plaintiff alleged that the anesthesia defendants, Sayeed and Blatt (the nurse anesthetist), were negligent in failing to timely perceive that the attempts to place a central line caused a large hemorrhage in Mr. Stajszczyk's chest that was likely to cause harm, or failing to timely appreciate and treat the resulting hemorrhage caused by the perforation of his left internal jugular vein. Count II made identical allegations against the attending surgeon, Jorge Pollitt, M.D., *fn3 and the surgical resident, John Stengle, M.D. Counts I and II also alleged that MacNeal was vicariously liable under an agency theory for the acts or omissions of each of the doctors and the nurse anesthetist.
During trial, conflicting testimony was given regarding Mr. Stajszczyk's cause of death. Defendants' theory was that the cause of death was not due to the hemorrhage but, rather, from a myocardial infarction (heart attack) resulting from a blood clot. Plaintiff's expert, Dr. Katz, however, opined that the drop in blood pressure from the hemorrhage led to a myocardial infarction. At the close of plaintiff's case, the trial court entered directed verdicts in favor of defendants Pollitt and Stengle. At the close of all the evidence, the court entered a directed verdict in favor of MacNeal on plaintiff's apparent agency allegations, but did not direct a verdict on plaintiff's implied (actual) agency theory. The case was submitted to the jury, which returned a general verdict in favor of plaintiff and against defendants Sayeed, Blatt, and MacNeal in the amount of $801,642.57. The jury also answered a special interrogatory finding that Sayeed and Blatt were agents of the hospital.
Defendants now appeal from the judgment entered against them. Plaintiff has filed no cross-appeal from the directed verdicts entered against her. Defendants contend that the trial court erred in denying defendants' motions for judgment n.o.v., a new trial or, in the alternative, for remittitur. MacNeal further contends that the trial court should have directed a verdict in its favor as to the actual agency issue.
We first address the standards of review that are applicable in this appeal for a directed verdict, judgment n.o.v., a new trial and remittitur. We apply the de novo standard of review to the trial court's denial of a motion for directed verdict as well as its denial of a motion for judgment n.o.v. Donaldson v. Central Illinois Public Service Co., 199 Ill. 2d 63, 89, 767 N.E.2d 314, 330 (2002); Gathings v. Muscadin, 318 Ill. App. 3d 1091, 1093, 743 N.E.2d 659, 660 (2001). "[V]erdicts ought to be directed and judgments n.o.v. entered only in those cases in which all of the evidence, when viewed in its aspect most favorable to the opponent, so overwhelmingly favors movant that no contrary verdict based on that evidence could ever stand." Pedrick v. Peoria & Eastern R.R. Co., 37 Ill. 2d 494, 510, 229 N.E.2d 504, 513-14 (1967). "In making this assessment, a reviewing court must not substitute its judgment for the jury's, nor may a reviewing court reweigh the evidence or determine the credibility of the witnesses." Donaldson v. Central Illinois Public Service Co., 199 Ill. 2d 63, 89, 767 N.E.2d 314, 331 (2002). The standard to be used in determining whether to grant a new trial is whether the jury's verdict was against the manifest weight of the evidence. Maple v. Gustafson, 151 Ill. 2d 445, 455, 603 N.E.2d 508, 513 (1992). " 'A verdict is against the manifest weight of the evidence where the opposite conclusion is clearly evident or where the findings of the jury are unreasonable, arbitrary and not based upon any of the evidence.' " Maple, 151 Ill. 2d at 454, 603 N.E.2d at 512-13, quoting Villa v. Crown Cork & Seal Co., 202 Ill. App. 3d 1082, 1089, 560 N.E.2d 969, 973 (1990). This court will not reverse a trial court's ruling on a motion for a new trial except in those instances where it is affirmatively shown that the trial court clearly abused its discretion. Maple, 151 Ill. 2d at 455, 603 N.E.2d at 513. In determining whether the trial ...