In its decision dated July 2, 2021, the Court of Appeals of Georgia (“Georgia Appellate Court”) reversed the Directed Verdict entered in favor of the defendant emergency room doctor and his employer in a Georgia medical malpractice case where the plaintiff had to have her leg amputated after the defendant placed a catheter in her femoral artery instead of her femoral vein, stating: “Here, there is not an absence of testimony on the essential element of the standard of care; but instead, conflicts in an expert’s testimony that “go solely to the expert’s credibility, and are to be assessed by the jury when weighing the expert’s testimony … The record still contains evidence regarding the standard of care for the placement of a femoral catheter, and Dr. Gluck’s opinions as to how Dr. Bloom breached that standard … [T]he trial court may not on motion for directed verdict . . . eliminate evidence on the ground that it was improperly received at the trial and then dispose of the case on the basis of the diminished record.””

Standard For Directed Verdict

A directed verdict is authorized only when there is no conflict in the evidence as to any material issue and the evidence introduced, with all reasonable deductions therefrom, shall demand a particular verdict. A grant of directed verdict is a ruling that the evidence and all reasonable deductions there from demand a particular verdict. It is illogical to say such a finding will be upheld if there is any evidence to support it. A grant of directed verdict can be upheld only where the appellate court determines that all the evidence demands that verdict. This requires a de novo review. It is correct to say that a directed verdict cannot be granted if there is any evidence to support a contrary verdict, but there cannot be “some evidence” that all the evidence demands a particular verdict.

The Georgia Appellate Court stated in the present case: “There is little dispute about the salient facts of this case. While Lockhart was a patient at Northside Hospital-Cherokee, she was treated by Dr. Bloom; the physician mistakenly placed a catheter in Lockhart’s femoral artery instead of her femoral vein. Lockhart was transferred to the ICU and by the time the mistake had been detected, the medications that were administered though the catheter accumulated in her leg and destroyed tissue; ultimately resulting in an amputation of her leg. The case proceeded to trial at which Lockhart introduced the testimony of Eric Gluck, M.D. to establish the standard of care for inserting a femoral catheter, the procedure conducted by Dr. Bloom. Without objection, Dr. Gluck was tendered as an expert in critical care medicine. Dr. Gluck is not an emergency room physician, but testified that he had been board certified in critical care medicine for 27 years and had experience placing central venous catheters in the femoral region, where Lockhart’s catheter was placed. Dr. Gluck testified that, at the time of trial, he “runs” the ICU at the hospital where he worked in Chicago and was chairperson of the critical care committee which sets policies and procedures for critical care departments at the hospital, which includes the emergency department. Dr. Gluck trained in New York and Utah, has practiced medicine in Connecticut and Illinois, and he testified at trial that he was familiar with the standard of care in placing a femoral catheter, which, he said, is the same whether the procedure is completed by an ER physician, general practitioner, or critical care physician. According to Dr. Gluck, the standard of care for inserting a femoral catheter requires the physician to confirm that the catheter was placed into its intended location, which can be done in four different ways: (1) by drawing blood from the catheter and observing the color or sending the blood sample to the lab to identify the sample as arterial blood or venous blood; (2) transduction which, involves specialized equipment to measure pressure; (3) evaluating for pulsatility, which involves differentiating between the higher pressure blood flow of arteries compared to the low pressure. non-pulsating flow of veins; and (4) using ultrasound to visually confirm placement. Dr. Gluck further detailed how a femoral catheter is placed and how a physician can identify when it has not been placed in its intended location. Dr. Gluck opined that Dr. Bloom violated the standard of care when he did not confirm that the femoral catheter was placed in Lockhart’s femoral vein rather than her femoral artery.”

The Georgia Court of Appeals held: “It is clear from the trial court’s order that the court entirely dismissed Dr. Gluck’s testimony in ruling on the motion for directed verdict. A trial court is afforded wide discretion to determine the competency of expert witnesses … But neither the trial court nor Appellees cite any authority in support of the proposition that a trial court can selectively disregard unobjected to evidence when considering a motion for directed verdict, and we are aware of none. Accordingly, we conclude that the trial court erred in directing a verdict in favor of Appellees.”

Source Lockhart v. Bloom, A21A0412.

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