Filed September 10, 2002.
Appeal from the District Court, St. Louis County, File No. C300602145.
Robert E. Mathias, (for appellant)
Steven E. Tomsche, Chandelle L. Heyer, (for respondent)
Considered and decided by Anderson, Presiding Judge, Lansing, Judge, and Kalitowski, Judge.
This opinion will be unpublished and may not be cited except as provided by Minn. Stat. § 480A.08, subd. 3 (2000).
The district court granted summary judgment in favor of a liquor licensee in this civil-damages action. The court concluded, as a matter of law, that the sale of alcohol to the allegedly intoxicated driver who injured Jeremy Brockman did not proximately cause Brockman's death, which occurred during administration of anesthesia preceding surgery necessitated by the accident injuries. Because the evidence is sufficient to create a triable issue on proximate cause, we reverse and remand.
Jeremy Brockman sustained severe injuries on December 22, 1999, when he was pinned between a retaining wall and a car driven by Terry Price. Brockman, Price, and Brockman's cousin were at the Beacon Sports Bar Grill in Duluth where Price consumed beer and one Windsor coke. They left the bar at closing time in a car driven by Price. Price drove erratically, went through a stop sign, and then backed into a ditch. As Brockman and his cousin tried to push Price's car out of the ditch, the car moved backward and pinned Brockman against a retaining wall, causing a severe crush-type injury to his left thigh and perineum.
As a result of this injury, Brockman was hospitalized for about a month. During the hospitalization, the wound in his thigh area required several surgical excisions of dead or contaminated tissue. When the hospital discharged Brockman on January 21, 2000, he still had a small, open, perineal wound.
Brockman contacted his treating physician on February 17, 2000, to report increasing tenderness and pain in his left leg. The treating physician located a large, fluid-filled mass in Brockman's lateral left thigh and recommended immediate surgery to drain the infected fluid. During endotracheal intubation, in the administration of general anesthesia, Brockman went into unexpected, sudden cardiovascular collapse. Cardiovascular resuscitation failed, and Brockman died. The surgeon identified the most likely cause of the sudden cardiovascular collapse as a massive blood clot in the lungs.
Following an autopsy, the medical examiner listed the cause of death as sudden circulatory arrest. The examiner found no definite anatomic cause of the circulatory arrest, but presumed it was physiological and found it was temporally associated with induction of anesthesia before the surgery. No further medical evidence on the cause of death was submitted to the district court.
Brockman's father obtained appointment as the special administrator of Brockman's estate and filed a civil-damages complaint against Beacon Sports Bar. Beacon Sports Bar moved for summary judgment on the grounds that the evidence was insufficient to establish a prima facie case of Price's obvious intoxication or that Price's intoxication caused Brockman's death. The district court denied summary judgment on the first ground but granted it on the second, the issue of causation. The court concluded that Brockman's death resulted from "complications" in surgery necessitated by the injuries sustained in the accident but held, as a matter of law, that the accident was too remote in the chain of events leading to Brockman's death to satisfy the requirements for proximate cause.
On appeal from summary judgment, the reviewing court must determine whether the case raises genuine issues of material fact and whether the district court erred in its application of the law. Offerdahl v. University of Minn. Hosps. Clinic, 426 N.W.2d 425, 427 (Minn. 1988). Generally, proximate cause is a fact question for the jury. Canada by Landy v. McCarthy, 567 N.W.2d 496, 506 (Minn. 1997).
The Civil Damages Act creates a right of action by a person injured by the intoxication of another against the person who caused the intoxication by illegally selling alcoholic beverages. Minn. Stat. § 340A.801, subd. 1 (2000). The person bringing the action must show that the illegal sale caused the intoxication, and that the intoxication was the "proximate cause" of the injuries sustained. Kryzer v. Champlin Am. Legion No. 600, 494 N.W.2d 35, 36 (Minn. 1992) (quotation and citation omitted).
Minnesota law defining proximate cause is well settled. See Dellwo v. Pearson, 259 Minn. 452, 455, 107 N.W.2d 859, 861 (1961) (citing Christianson v. Chicago, St. Paul, M. O. Ry. Co., 67 Minn. 94, 97, 69 N.W. 640, 641 (1896)). Consequences that follow in an unbroken sequence from the original wrongful act, without an intervening efficient cause, are natural and proximate, and the original wrongdoer is responsible for these consequences even when the particular result is not foreseeable. Dellwo, 259 Minn. at 454-55, 107 N.W.2d at 861-62 (1961). The existence of proximate cause does not depend on the foreseeability of the final result. Id. "It is enough to say that negligence is tested by foresight but proximate cause is determined by hindsight." Id., 259 Minn. at 456, 107 N.W.2d at 862.
The district court determined that the illegal sale of alcohol could not be the proximate cause of Brockman's death because the chain of events leading to his death was too remote. We conclude that Minnesota caselaw does not support this determination.
First, the concept of proximate cause has always encompassed unforeseen medical complications that develop from the original injury. See Keegan v. Mpls. St. Louis R.R. Co., 76 Minn. 90, 91-95, 78 N.W. 965, 965-67 (1899). In Keegan the supreme court upheld a jury's determination that a hole in a railroad station platform that caused a passenger's sprained ankle proximately caused the passenger's death five months later from endocarditis. Id. The court, relying on medical evidence, reasoned that the sprained ankle resulted in the articular rheumatism that caused the endocarditis. Justice Mitchell stated that the evidence was legally sufficient to justify the jury's finding that the inflammation of the heart membrane was directly and proximately caused by the sprained ankle. Id. The causation chain in Brockman's death is comparable. Brockman sustained injuries that required extended hospitalization, necessitated surgery that required a general anesthetic, and the administration of anesthesia triggered the circulatory arrest that resulted in Brockman's death. The fact that Beacon Sports Bar could not have foreseen that the injuries would cause death does not change this analysis.
Second, proximate cause also encompasses the aggravation of the original injury caused by the administration of necessary medical care. See Couillard v. Charles T. Miller Hosp., 253 Minn. 418, 422, 92 N.W.2d 96, 99 (1958) (recognizing that original tortfeasor remains responsible for proximate results of act even though injury is more serious as result of medical care). The rationale underlying this rule is that the original tortfeasor has put the injured plaintiff in a position to require the medical treatment. See Restatement (Second) of Torts § 457 cmt. a, b (1965). Most jurisdictions faced with this issue have agreed that an original injury that is aggravated, or a subsequent additional injury, sustained through medical care for the original injury, is a natural and probable consequence of the original wrongdoing. See Simmons v. Lollar, 304 F.2d 774, 777-79 (10th Cir. 1962) (holding evidence sufficient to establish proximate cause when plaintiff died of cardiac arrest during accident-related surgery); Hastie v. Handeland, 79 Cal.Rptr. 268, 272 (Cal.Ct.App. 1969) (holding chain of causation sufficient to find original tortfeasor responsible for blood infection contracted while plaintiff was hospitalized for accident-related surgery); Weems v. Hy-Vee Food Stores, Inc., 526 N.W.2d 571, 574 (Iowa App. 1994) (holding that district court did not err in refusing to instruct on intervening cause when epidural block administered for back pain caused rare complication of spinal meningitis).
We recognize that evidence of an intervening, superseding act will break the chain of causation, insulating a defendant's negligence as a direct cause of the plaintiff's injury. Lennon v. Pieper, 411 N.W.2d 225, 228 (Minn.App. 1987). An intervening cause may be considered superseding if: (1) its harmful effects occurred after the original negligence; (2) it was not brought about by the original negligence; (3) it actively worked to bring about a result which would not otherwise have followed from the original negligence; and (4) it was not reasonably foreseeable by the original wrongdoer. Canada, 567 N.W.2d at 507. See, e.g., Oltmans v. Orthopaedic and Fracture Clinic, P.A., 278 N.W.2d 538, 541 (Minn. 1979) (holding that it was not error to submit jury instruction on superseding cause when plaintiff, after undergoing surgery, left hospital with no signs of infection and was later readmitted with staphylococcus infection, and x-rays showed osteomyelitis). The issue of an intervening, superseding cause has not been raised in this case.
Finally, we note that the district court primarily relied on Lewellin v. Huber, 465 N.W.2d 62 (Minn. 1991), to grant summary judgment for the liquor licensee. But Lewellin's requirement of a more direct and immediate proximate cause involved an interpretation of the dog-bite statute that imposes absolute liability on the dog owner. 465 N.W.2d at 65-66. Courts have not imposed a similar limitation on proximate cause in connection with civil-damage actions. See, e.g., Kryzer, 494 N.W.2d at 36.
The evidence in this case is sufficient to create a jury issue on proximate cause. The evidence establishes that, at the time of the surgery, Brockman was an otherwise healthy, 25-year-old man. It is undisputed that the surgery was a reasonable and necessary procedure to treat injuries sustained in the car accident. The medical evidence supports a claim that the administration of anesthesia was responsible for triggering the circulatory arrest. On these facts, the evidence is sufficient to create a triable issue on proximate cause, it was therefore error to grant summary judgment on that issue.
In connection with this appeal, Beacon Sports Bar also moved to strike two medical records contained in appellant's appendix on the grounds that these medical records were never submitted to the trial court. With respect to the first medical record, we deny the motion because this medical record was indeed contained in the trial court file, having been submitted by Beacon Sports Bar in connection with an earlier motion to compel discovery. The second medical record has not been considered in reaching this decision.