Background
Cree Erwin-Sheppard, age 24, underwent an elective abortion and placement of an intrauterine contraceptive device at Planned Parenthood. Experts later opined that her uterus was perforated during the procedure. Two days later, she went to Bronson Battle Creek Hospital with constant, severe abdominal pain, nausea, and vomiting. An emergency physician ordered an ultrasound, but only a transabdominal study was performed. The radiologist reported possible clot or retained products of conception, and she was discharged with a diagnosis of incomplete miscarriage and pelvic pain.
Erwin-Sheppard was found unconscious the following day and died. The medical examiner attributed her death to complications of pregnancy, including pulmonary emboli related to uterine vein thrombosis and uterine perforation following the abortion and contraceptive placement. Her estate sued the medical providers, alleging that compliance with the applicable standards of care would have led to timely diagnosis and treatment and prevented her death. The circuit court granted summary disposition to the defendants because the experts could not definitively identify whether the fatal emboli originated in the uterine veins or lower extremities.
The Court’s Holding
The Court of Appeals reversed. It held that the estate presented sufficient expert testimony to create a genuine issue of material fact as to whether the defendants’ alleged negligence more probably than not caused Erwin-Sheppard’s death. The estate did not have to identify a particular clot and trace its movement through her body.
Viewed in the estate’s favor, the experts’ testimony permitted a reasonable jury to find that timely recognition of the uterine perforation, surgical or specialist intervention, and anticoagulation would more probably than not have prevented the fatal pulmonary embolism, regardless of the thrombi’s precise origin. Because the evidence supported a reasonable inference of causation rather than mere possibility, the circuit court improperly resolved a factual issue at the summary-disposition stage.
Key Takeaways
- A medical-malpractice plaintiff need not trace the exact physical progression of a fatal clot when expert evidence otherwise supports a reasonable probability of causation.
- Expert testimony that timely diagnosis, treatment, surgery, or anticoagulation more probably than not would have prevented death can create a triable causation issue.
- A court deciding summary disposition may not weigh competing expert evidence or resolve material factual disputes.
Why It Matters
The decision clarifies that uncertainty about the precise biological mechanism of injury does not automatically defeat medical-malpractice causation. The relevant question is whether the evidence, considered collectively and in the plaintiff’s favor, supports a reasonable likelihood that proper care would have produced a different outcome.
The ruling returns the estate’s claims against the defendant medical providers to the circuit court for further proceedings; it does not determine that any defendant was negligent or ultimately liable.