Background
Herschel Crawford lived at The Willows Health and Rehab Center from 2012 until his death in June 2020. He fell in his room on May 28, 2020, but no one besides his roommate witnessed the fall, and the record did not establish what caused it. Two days later, after reporting hip pain, Crawford was taken to a hospital, underwent hip surgery, and later died. His death certificate listed failure to thrive with a recent hip fracture as the cause of death.
His estate sued the facility for ordinary negligence, a medical claim, wrongful death, and punitive damages. At trial, the estate’s expert, Dr. Timothy Klein, identified several fall-prevention measures he believed the facility should have used. But he did not know where, when, or how Crawford fell, and acknowledged that the proposed measures would not have prevented a fall occurring while Crawford was simply walking in his room. The trial court excluded federal and state regulations and directed a verdict for The Willows after the estate rested.
The Court’s Holding
The Eighth District affirmed. It held that the trial court properly granted a directed verdict because the expert’s causation opinion was speculative. Although Dr. Klein used probability language, the evidence did not support a conclusion that it was more likely than not that any breach by The Willows caused Crawford’s fall. Without evidence of how the fall happened, a jury could only speculate whether any proposed precaution would have prevented it.
The court also upheld the pretrial exclusion of federal and state regulations. The estate preserved the issue for appeal because the written ruling on the motion in limine was definitive under Evid.R. 103(A)(2). But the court found no abuse of discretion: regulations do not establish negligence per se or the standard of care, R.C. 2317.45(B) bars specified Medicaid and CMS regulations in medical-claim actions, and their limited probative value was outweighed by the risk of confusing or misleading the jury.
Key Takeaways
- An expert’s use of “reasonable medical probability” language does not save an opinion unsupported by facts showing probable causation.
- In a fall case, unknown circumstances surrounding the fall may make proposed preventive measures too speculative to establish proximate cause.
- A definitive written ruling on a motion in limine preserves an evidentiary issue for appeal under Evid.R. 103(A)(2).
Why It Matters
The decision underscores the evidentiary burden in nursing-home fall litigation. A plaintiff need not eliminate every possible cause, but must offer evidence connecting the alleged lapse in care to the particular fall with more than conjecture. General testimony about available fall precautions is insufficient when the record does not show how the resident fell or why a particular intervention would probably have prevented it.