Atlanta Obstetrics & Gynecology Group, P. A. v. Coleman

Ms. Coleman brought this medical malpractice action to recover for injuries she suffered from a stroke following an abortion. The jury returned a verdict against two of Ms. Coleman’s doctors. The trial court granted a judgment notwithstanding the verdict in favor of one of the doctors, Dr. Hutchinson, finding the record devoid of evidence that his conduct was the proximate cause of Ms. Coleman’s injuries. The Court of Appeals reversed, finding that Dr. Hutchinson’s negligence initiated the chain of events that resulted in the injury. Coleman v. Atlanta Obstetrics &c. Group, 194 Ga. App. 508 (390 SE2d 856) (1990). We granted certiorari to consider the Court of Appeals opinion in light of McAuley v. Wills, 251 Ga. 3 (303 SE2d 258) (1983), where we held that a specified act of negligence was too remote as a matter of law to constitute proximate cause.

To recover damages in a tort action, a plaintiff must prove that the defendant’s negligence was both the “cause in fact” and the “proximate cause” of the injury. The requirement of proximate cause constitutes a limit on legal liability; it is a “policy decision . . . that, for a variety of reasons, e.g., intervening act, the defendant’s conduct and the plaintiff’s injury are too remote for the law to countenance recovery.” McAuley, supra at 7. Although many legal scholars have attempted to lay down a single standard to determine proximate causation, see generally Prosser & Keeton on Torts, 5th ed., § 42 at pp. 276-279 (1984), no satisfactory universal formula has emerged. Instead, proximate cause

“. . . is always to be determined on the facts of each case upon mixed considerations of logic, common sense, justice, policy and precedent. . . . The best use that can be made of the authorities on proximate cause is merely to furnish illustrations of situations which judicious men upon careful consideration have adjudged to be on one side of the line or the other.” Foundations of Legal Liability, Vol. 1, p. 110 (1906). McAuley, supra at p. 9 (Weltner, J., dissenting).

Thus, whether proximate cause exists in a given case is a mixed question of law and fact. It requires both factfinding in the “what happened” sense, and an evaluation of whether the facts measure up to the legal standard set by precedent. Ordinarily, both determinations are most appropriately made by a jury upon appropriate instructions from the judge. McAuley, supra. The decision may be made by the trial judge or appellate court only if reasonable persons could not differ as to both the relevant facts and the evaluative application of legal standards (such as the legal concept of “foreseeability”) to the facts. In other words, “[although what amounts to proximate cause is undeniably a jury question, it will be determined by the court as a matter of law in plain and undisputed cases. [Cits.]” McAuley, supra at 7.

The case presently before the court is simply not a “plain and undisputed” case. The record is replete with factual disputes regarding both the cause in fact and the legal inferences to be drawn from those facts. There is a great deal of evidence in the record that might suggest that Dr. Hutchinson’s treatment was not a cause in fact or that other causes preponderated to cause Ms. Coleman’s injuries. However, in reviewing a judgment notwithstanding the verdict, an appellate court must view the evidence in the light most favorable to the party who secured the jury verdict. Pendley v. Pendley, 251 Ga. 30 (302 SE2d 554) (1983). A judgment notwithstanding the verdict may not be granted because the strength or weight of the evidence is on one side. Findley v. McDaniel, 158 Ga. App. 445 (280 SE2d 858) (1981).

After reviewing the record, we conclude that the jury in this case was authorized to conclude that Dr. Hutchinson should reasonably have known that a woman who was trying to become pregnant might already be pregnant. He was negligent in administering a hormone shot to a pregnant woman. This negligence directly caused Ms. Coleman to undergo an abortion procedure that would otherwise have been unnecessary. Further, the evidence authorized the jury to conclude that the events that followed the first abortion procedure were unusual, but entirely foreseeable complications that are attendant to that medical procedure.

This case, in its simplest terms, involves foreseeable complications relating to abortion procedures that would not have been necessary if not for Dr. Hutchinson’s negligent administration of a hormone shot. The record is not devoid of evidence that Dr. Hutchinson’s negligence was the proximate cause of Ms. Coleman’s injuries. The jury’s verdict must be restored.

Judgment affirmed.

All the Justices concur, except Smith, P. J., Weltner and Bell, JJ., who concur specially.

A summary of the facts can be found in Coleman v. Atlanta Obstetrics &c. Group, supra.