Background
In August 2009, Donna Anglin underwent surgery performed by Dr. Kevin Cline to repair a bladder prolapse and treat urinary incontinence. The procedure involved placement of a Pinnacle mesh kit with sacrospinous ligament suspension and an Obtryx sling. Donna had a long-standing diagnosis of fibromyalgia. Immediately after surgery she experienced severe left leg pain, and multiple physicians subsequently evaluated her for possible sciatic nerve injury. The Medical Review Panel (“MRP”) convened under Louisiana’s Medical Malpractice Act found that Dr. Cline failed to obtain adequate informed consent because the consent forms did not reference the sacrospinous suspension or the Pinnacle mesh kit — a known risk factor for sciatic nerve injury — but noted a factual dispute over whether that failure caused the resulting damages. Dr. Cline settled the claim against him for the statutory cap of $100,000.
The Anglins then sought excess damages from the Louisiana Patient’s Compensation Fund, requiring them to prove at trial that Dr. Cline’s breach caused injury exceeding $100,000 that would not have otherwise occurred. A five-day jury trial was held in July 2024. Expert testimony was sharply divided: the plaintiffs’ neurological and urology experts attributed Donna’s permanent sciatic nerve injury to surgical traction on the sacrospinous ligament, while the defense’s electrodiagnostic expert, Dr. Bicknell, testified that his EMG studies showed no axonal sciatic nerve injury and that observed amplitude reductions were attributable to leg edema. Defense expert Dr. Hart further opined that Dr. Cline’s conduct did not cause damages exceeding $100,000, noting the near-universal occurrence of transient buttocks pain with sacrospinous fixation and the difficulty of injuring the sciatic nerve in that anatomical region.
The jury answered “No” to whether Dr. Cline’s breach caused injury over $100,000 that would not have otherwise occurred, and judgment was entered accordingly on July 31, 2024. On appeal, the Anglins argued the trial court erred by refusing to have a designated reader present Dr. Marchetti’s life-care-plan expert deposition orally to the jury — rather than providing the written deposition for jurors to review during deliberations — after this court had previously granted a writ compelling the trial court to allow the deposition at trial.
The Court’s Holding
The court of appeal affirmed the judgment. On the deposition issue, the court held that its earlier writ granted the Anglins the right to use Dr. Marchetti’s discovery deposition at trial, but did not mandate that it be read aloud into the record — those are distinct forms of relief, and the trial court’s prior writ ruling said nothing about the manner of presentation. Because a trial court retains broad discretion in conducting trial proceedings and determining how testimony is received, the trial court did not abuse that discretion by allowing the deposition to be provided to the jury in written form rather than read aloud.
The court found this assignment of error without merit and affirmed the jury verdict in its entirety, sustaining the finding that the plaintiffs failed to establish causation of damages beyond the $100,000 already paid by Dr. Cline.
Key Takeaways
- An appellate writ order permitting use of a discovery deposition “at trial” does not dictate the specific manner of presentation; trial courts retain discretion over whether the deposition is read aloud or submitted in written form to the jury.
- In Louisiana medical malpractice claims against the Patient’s Compensation Fund, plaintiffs bear the burden of proving that the physician’s breach of the standard of care — here, failure to obtain adequate informed consent — caused damages in excess of the $100,000 statutory settlement threshold that would not have otherwise occurred.
- Competing expert testimony on causation (particularly where a plaintiff has significant pre-existing conditions such as fibromyalgia and electrodiagnostic findings are disputed) creates a credibility question for the jury, and an adverse verdict will be affirmed when supported by the record.
- Consent forms that omit specific reference to a named surgical technique (e.g., sacrospinous suspension) or a specific device (e.g., Pinnacle mesh kit) may establish a breach of the informed-consent standard, but breach alone is insufficient — plaintiffs must still prove the undisclosed risk materialized and caused quantifiable harm.
Why It Matters
This decision illustrates the high causation burden plaintiffs face when pursuing excess damages from the Louisiana Patient’s Compensation Fund after a physician settlement. Even where a Medical Review Panel has found a breach of the standard of care and acknowledged a material factual question on causation, a jury may still find that the breach did not produce compensable harm beyond the settlement amount — particularly when pre-existing conditions complicate the causation picture and defense experts credibly contest the nature of the alleged injury.
For practitioners, the case also offers a practical reminder about the limits of appellate writ relief: an order broadly permitting a party to “use” evidence at trial does not micromanage the trial court’s conduct of proceedings. Counsel seeking a specific mode of presentation — such as live oral reading of a deposition — should obtain explicit language to that effect in any writ order, or risk the trial court exercising its discretion to present the evidence in a different, equally permissible form.