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IN THE SUPREME COURT OF MISSISSIPPI NO. 94-CA-00578-SCT MARY LOU BROWN v. DENNIS ADAMS, M.D., THE ESTATE OF LLOYD G. BERRONG, M.D. AND SIMPSON GENERAL HOSPITAL THIS OPINION IS NOT DESIGNATED FOR PUBLICATION AND MAY NOT BE CITED, PURSUANT TO M.R.A.P. 35-A DATE OF JUDGMENT: TRIAL JUDGE: COURT FROM WHICH APPEALED: ATTORNEY FOR APPELLANT: ATTORNEYS FOR APPELLEES: 3/30/94 HON. ROBERT G. EVANS SIMPSON COUNTY CIRCUIT COURT VINCENT CARACCI MARK P. CARRAWAY WHITMAN B. JOHNSON III STEVE KRUGER CIVIL - MEDICAL MALPRACTICE AFFIRMED - 4/10/97 8/29/97

NATURE OF THE CASE: DISPOSITION: MOTION FOR REHEARING FILED: MANDATE ISSUED:

EN BANC. SMITH, JUSTICE, FOR THE COURT:

On March 15, 1988, Mary Lou Brown felt two small lumps on the inner portion of the underside of her left breast. Later that day, she went to the offices of Dr. Dennis Adams, a family practitioner. Although she told the nurse/receptionist that the chief complaint was lumps in her breast, the nurse/receptionist wrote down that Mary Lou was complaining of pain in her left breast. The lumps were not then, nor had they ever been painful, and Dr. Adams' actions were contrary to the minimal standard of care in his treatment of the lumps because he acted in a manner inconsistent with the accepted treatment of a complaint of breast lumps which is sufficient to present a symptom of breast cancer. He did so by sending Mary Lou to Simpson General Hospital, a facility which was only equipped to do screening mammograms, when the proper treatment would have been to send her to a

facility which was capable of doing diagnostic mammograms to locate the source of her complaint. Simpson General Hospital only performed screening mammograms, not diagnostic mammograms. Dr. Adams knew as much at the time that he sent her to Simpson General Hospital for the mammogram. Dr. Adams also admitted that if Mary Lou complained to anyone in his office of lumps, then the level of care that he administered was inadequate because he acted in a manner inconsistent with a complaint of breast lumps. When Mary Lou arrived at the hospital, she was x-rayed by an x-ray technician. Dr. Berrong, the radiologist, then took the x-rays, read them and sent a report to Dr. Adams in which he stated that there was no cause for alarm from anything that he could read in this x-ray. Dr. Adams informed Mary Lou not to worry and recommended no follow-up visitation. In the summer of 1991, Dr. Sherry Meadows examined a lump that had developed in Mary Lou's left breast over the course of the past year. That lump was apparently nine centimeters, or about three to four inches, in diameter, and was located in the upper outer portion of the breast. The mass was diagnosed as a malignant stage III tumor and Mary Lou started a regimen of seven chemotherapy treatments to reduce the tumor to an operable size. As a stage III cancer patient, she has approximately a fifty percent prospect of surviving through 1997. STANDARD OF REVIEW At the conclusion of the plaintiff's proof in a medical malpractice case, upon motion of the defendant for a directed verdict, the trial court is required to consider the evidence in a light most favorable to the plaintiff, considering the testimony in behalf of the plaintiff to be true along with all favorable inferences that may be drawn therefrom, and evidence of contradiction thereof must not be considered. Ladner v. Campbell, 515 So. 2d 882, 887 (Miss. 1987). DISCUSSION OF LAW Hall v. Hilbun, 466 So. 2d 856, 873 (Miss. 1985), defined a physician's nondelegable duty of care as follows: Given the circumstances of each patient, each physician has a duty to use his or her knowledge and therewith treat through maximum reasonable medical recovery, each patient, with such reasonable diligence, skill, competence, and prudence as are practiced by minimally competent physicians in the same specialty or general field of practice throughout the United States, who have available to them the same general facilities, services, equipment, and options. To present a prima facie case of medical malpractice, a plaintiff, after establishing a doctor-patient relationship and its attendant duty, is generally required to present expert testimony identifying and articulating the requisite standard of care and establishing that the defendant physician failed to live up to that standard of care in some causally significant respect. Boyd v. Lynch, 493 So. 2d 1315, 1318 (Miss.1986). In addition, the plaintiff must prove the extent of her damages. Ladner v. Campbell, 515 So. 2d at 887-88. Mary Lou Brown alleges several points of error which all boil down to one thing: should the trial judge have disallowed the testimony of Dr. Elliott. The trial court articulated four reasons to the to

the jury to explain why he was taking the case from them. Most significant, and the reason which we uphold as sufficient to affirm as to all defendants is: DR. ELLIOTT WAS NOT ABLE TO STATE WITHIN A REASONABLE DEGREE OF MEDICAL CERTAINTY OR PROBABILITY THAT THE ALLEGED NEGLIGENCE ON THE PARTS OF DOCTORS ADAMS AND BERRONG PROXIMATELY CAUSED OR CONTRIBUTED TO THE PLAINTIFF'S DAMAGES. Ladner v. Campbell states: In cases of this nature . . . proof of causation does not require that it be shown that the patient was certain to have recovered or improved with sound medical care, . . . [T]he plaintiff may sustain the burden of establishing proximate causation with evidence that it was probable, or more likely than not, that the patient would have been helped by proper treatment. . . . Ladner v. Campbell at 515 So. 2d 888, quoting 54 A.L.R.4th 10

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