Background
Heather Micek received prenatal care from Dr. James Walker during a monochorionic-diamniotic twin pregnancy, which carried a known risk of twin-to-twin transfusion syndrome (TTTS). An ultrasound on July 7, 2011, did not show obvious signs of TTTS. After Micek reported fluid discharge on July 18 and lower-back pain on July 20, Walker did not order an ultrasound. An August 3 ultrasound showed abnormalities, and Walker immediately referred her to a maternal-fetal-medicine specialist.
The next day, the twins were diagnosed with TTTS and delivered by urgent cesarean section. One child, identified as Kayla, suffered permanent injuries. The Miceks alleged that Walker negligently failed to refer Heather to a specialist earlier and failed to adequately monitor the pregnancy. A Dunn County jury found Walker was not negligent between July 18 and August 3, 2011.
The Court’s Holding
The Wisconsin Court of Appeals affirmed the defense judgment. It held that the circuit court properly limited the evidence, argument, and special-verdict question to July 18 through August 3 because the Miceks lacked expert testimony establishing, to a reasonable degree of medical certainty, that any allegedly negligent conduct before July 18 caused Kayla’s injury.
The plaintiffs’ expert testified that the July 7 ultrasound appeared normal and could say only that it was possible TTTS had been developing longer than one or two weeks before its August diagnosis. That possibility was insufficient to prove medical causation without speculation. The court also upheld the denial of a post-empanelment venue-change motion, finding no publicity about the case, a careful voir dire process, and no reasonable likelihood that community prejudice deprived the Miceks of a fair trial.
Key Takeaways
- Medical-malpractice plaintiffs need expert evidence connecting the alleged negligence to the injury; possibilities alone do not establish causation.
- A trial court may exclude alleged negligence from a verdict question when proof of causation fails for that period.
- A doctor’s community prominence and jurors’ connections to the doctor did not require a venue change on this record.
Why It Matters
The decision underscores that expert testimony must support not just a claimed breach of care, but a non-speculative causal link to the injury. It also confirms trial courts’ broad discretion to frame special verdicts around claims supported by the evidence.