Background
Brooks Davison, who had maintained sobriety while taking Suboxone for opioid-use disorder, underwent spinal fusion surgery at Ohio State University Wexner Medical Center in February 2016. After his Suboxone was stopped, the hospital increased his oxycodone regimen to 30 to 45 milligrams every three hours and, at discharge, prescribed that dose along with diazepam. Earlier on the day of discharge, Davison had experienced low oxygen saturation, shortness of breath, and chest pain.
Davison died at home two days later. The coroner attributed his death to multiple-drug intoxication involving oxycodone and benzodiazepines. His estate administrator brought medical-negligence and wrongful-death claims. The Court of Claims dismissed the medical-negligence claim as untimely but, after a bench trial, found the medical center liable for wrongful death and awarded $4,531,700.50 in damages. The medical center appealed, challenging the admission of rebuttal expert testimony and the trial court’s causation finding.
The Court’s Holding
The Tenth District affirmed. Although the estate did not dispute that an addiction psychiatrist’s rebuttal testimony concerning post-mortem redistribution was inadmissible because it had not been disclosed in his expert report, the appellate court held that the medical center had not affirmatively shown the trial judge relied on that testimony. In a bench trial, courts presume the judge considered only competent, admissible evidence absent a contrary showing. The liability decision instead relied on concessions made by the medical center’s pharmacology expert during cross-examination.
The court also held that the wrongful-death judgment was not against the manifest weight of the evidence. The trial court could credit evidence that the prescribed high-dose oxycodone and diazepam regimen caused Davison’s death and discount defense expert opinions that his toxicology results proved he took more oxycodone than prescribed. Even assuming Davison overconsumed oxycodone, the trial court permissibly found that risk foreseeable given his susceptibility to opioid misuse, so it would not break the causal connection to the hospital’s prescribing decisions. The court declined to review the new-trial argument because the medical center merely incorporated arguments from its trial-court motion rather than developing an appellate argument.
Key Takeaways
- In a bench trial, an appellant must affirmatively show that the trial court relied on inadmissible evidence to overcome the presumption that the judge disregarded it.
- Cross-examination may use possibility evidence to undermine an opposing causation expert’s opinion, even though affirmative causation proof must be stated in terms of probability.
- A patient’s alleged medication misuse did not sever causation where misuse was foreseeable in light of the patient’s opioid-use history and the hospital supplied the dangerous prescriptions.
Why It Matters
The decision illustrates the latitude trial courts have to weigh competing medical and toxicology testimony in wrongful-death cases. It also reinforces that post-discharge prescribing decisions, including opioid dosage, benzodiazepine co-prescribing, and follow-up planning, may support proximate-cause findings where an overdose risk is foreseeable.
For appellate practitioners, the opinion underscores that alleged evidentiary error in a bench trial requires a record-based showing of actual reliance, and that arguments incorporated by reference from trial-court filings do not satisfy an appellant’s obligation to develop an argument in its brief.