South Carolina hospital wins reversal of $12.3 million award in bedsore suit

South Carolina’s highest court has reversed a $12.3 million jury verdict in a bedsore lawsuit on the ground that the trial court allowed an erroneous and prejudicial jury instruction about a rehabilitation hospital’s duty of care.

A charge that wrongly heightened defendant HealthSouth Corp.’s duty of care to its patient likely influenced the jurors’ decision to award $8 million in punitive damages, the Supreme Court said.

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The panel of five justices unanimously ordered a new trial on negligence and loss-of-consortium claims brought by the late Vernon Sulton and his wife, Willie M. Scott, in the Richland County Court of Common Pleas.

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According to the complaint, Sulton became a paraplegic from gunshot wounds he sustained as a bystander during an armed robbery in December 2005.

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After initial treatment at a hospital, he transferred to HealthSouth Rehabilitation Hospital in February 2006 and was noted to have a “stage two” pressure ulcer on his sacrum, the suit said.  A stage-two ulcer appears as a shallow open wound, according to the National Pressure Ulcer Advisory Panel’s website.

The plaintiffs claimed that after 11 days at HealthSouth, Sulton’s ulcer, or bedsore, progressed to an infected, foul-smelling “stage four” wound, which entails full-thickness tissue loss with exposed bone, tendon or muscle.

The complaint said HealthSouth failed to provide adequate nursing care to Sulton, including frequent turning, repositioning and dressing changes.

The suit also named as defendants six individual nurses who allegedly cared for Sulton at HealthSouth.

Sulton, whose ulcer eventually healed after a colostomy, surgery and skin graft, died of unrelated causes before trial, according to the Supreme Court’s opinion.

At trial, the plaintiffs’ counsel told jurors that HealthSouth’s net operating revenue in 2009 was $1.9 billion, though the hospital operator contended it had no net worth, the opinion says.

The trial court instructed the jury over HealthSouth’s objection that health care providers have a greater duty of care to patients whose symptoms indicate a “risk of substantial danger,” according to the opinion.

The jury found against all defendants on the negligence claim and awarded nearly $307,000 in economic damages.

In addition, the jury found HealthSouth alone was liable for $4 million in noneconomic damages on the loss-of-consortium claim and awarded $8 million in punitive damages.

HealthSouth argued on direct appeal to the Supreme Court that the jury instruction erroneously heightened the duty of care applicable in a medical malpractice action, according to the opinion.

The hospital operator also claimed the trial court improperly permitted the plaintiffs to tell jurors that HealthSouth’s net operating revenue in 2009 was $1.9 billion, though the hospital operator contended it had no net worth, the opinion says.

The Supreme Court agreed that the jury instruction warranted reversal of the verdict.

Under case law in the state, the proper duty of care in a medical malpractice action is that of an average, competent practitioner acting in the same or similar circumstances, Justice Costa M. Pleicones wrote for the panel.

Moreover, if jurors believed the law imposed a heightened duty on HealthSouth due to Sulton’s vulnerability, they may have been more likely to perceive the breach of that duty as egregious as demonstrated by their award of substantial punitive damages, Justice Pleicones said.

The Supreme Court also found the trial court had prejudiced HealthSouth by allowing information about its net operating revenue without supporting evidence.

The information was “almost certainly misleading” and likely stirred any jury bias against big businesses, Justice Pleicones said.

 Sulton et al. v. HealthSouth Corp. et al., No. 27192, 2012 WL 5870807 (S.C. Nov. 21, 2012).