Keans v. Bottiarelli

Brief Fact Summary. The Superior Court in the judicial district of Hartford-New Britain at New Britain (Connecticut) awarded damages to the patient in her dental malpractice action but reduced the award after finding that the patient failed to mitigate her damages, denied the dentist’s motion to set aside the judgment, and denied the patient’s motion for a bill of costs. Both Plaintiff patient and Defendant dentist appealed the decision.
Synopses of Rules of Law. In order to prevail in a medical malpractice action the plaintiff must prove (1) the requisite standard of care for treatment, (2) a deviation from that standard of care, and (3) a causal connection between the deviation and the claimed injury. To prove that a physician has breached the legally required standard of care, the plaintiff must offer some evidence that the conduct of the physician was negligent. Testimony of an expert witness is necessary to establish both the standard of proper professional skill or care on the part of a physician and that the defendant failed to conform to that standard of care.
One who is injured by the negligence of another must use reasonable care to promote recovery and prevent any aggravation or increase of the injuries. When there are facts in evidence that indicate that a plaintiff may have failed to promote his recovery and do what a reasonably prudent person would be expected to do under the same circumstances, the court, when requested to do so, is obliged to charge on the duty to mitigate damages.

Facts. Plaintiff patient visited Defendant, an oral surgeon, for extraction of a tooth. She told the dentist that she suffered from a rare blood disorder, myelofibrosis, which inhibited production of red blood cells and platelets. The dentist extracted the tooth without first consulting the patient’s hematologist. The patient suffered postoperative complications and contacted the dentist. The patient made no further effort to contact the dentist despite worsening of her condition. The patient then contacted her hematologist, who recommended that she be admitted to the hospital where she was treated and released after three days, suffering no permanent injuries. She brought suit against the dentist.

Issue.
* Did the trial court correctly finds that plaintiff had met her burden with respect to the elements of medical malpractice?
* Was the trial court correct in reducing damages because plaintiff failed to mitigate her injuries in accordance with the avoidable consequences rule?

Held. The trial court’s judgment was affirmed.
* Yes. The court ruled that the trial court’s finding that the patient had established the elements necessary to prove dental malpractice by the dentist was correct.
* Yes. The court agreed with the reduction in damages because the patient’s conduct exacerbated her initial injury.

Discussion. The trial court found in favor of the patient but concluded that her failure to follow the dentist’s postoperative instructions led to the hospitalization, and reduced damages to the extent of the patient’s hospitalization expense. This is an example of a court’s applying the avoidable consequences rule.
Concerning the underlying claim for medical malpractice, the court first iterates the elements of a prima facie case: (1) the requisite standard of care for treatment, (2) a deviation from that standard of care, and (3) a causal connection between the deviation and the claimed injury. In applying this standard, and in assessing the weight of expert testimony, the trial court correctly found for plaintiff. The trial court found that the dentist deviated from the standard of prudent practice in failing to consult with plaintiff’s hematologist. Thus, its ruling was proper.
With regard to mitigation, a general rule (the “avoidable consequences” rule) a plaintiff is required to exercise reasonable care to minimize damages; if a plaintiff fails to mitigate injuries, the defendant will not be held liable for incremental losses that otherwise could have been avoided. If, for example, one has an eye injury and a doctor tells her to avoid swimming, but she goes swimming anyway and her condition is exacerbated by exposure to chlorine, the avoidable consequences rule would deny recovery for medical expenses related to chlorine expo.