Broughton v. Wong ( 2018 )


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  • I,N THE SUPERIOR COURT OF THE STATE ()F DELAWARE
    MGNICA BROUGHTON, individually, )
    and as Parent and Natural Guardian of )
    AMARI M. BROUGHTON-FLEMING, )
    a Minor )
    )
    Plaintiffs, ) C.A. NO. Nl4C-Ol-185 VLM
    )
    v. )
    )
    PETER J. WONG, M.D., and )
    DEDICATED TO WOMEN, OB~GY`N, )
    P.A., )
    )
    Defendants. )
    MEMORANDUM ()PINION
    Submitted: November 30, 2017
    Decided: February 15, 2017
    Upon Consideration OfDefena’ants’ Renewed MOtl'on for Judgment as a Mczz‘ter 0f
    Law or, in the alternative, Motz`onfor a New Trial, or in the alternative, Remittitur,
    DENIED.
    Ben T. Castle, Esquire, and Bruce L. HudSOn, Esquire, Of Hudson & Castle, LLC,
    Of Wihnington, Delaware. Az‘lorneysfor Plaz'ntg`/YS.
    Richard Galperin, Esquire, and JOShua H. Meyeroff, Esquire, Of MOI‘riS James LLP,
    of Wilrnington, Delaware. Az‘tomeysfor the Defendants.
    MEI)INILLA, J.
    INTRODUCTI()N
    On Septernber 26, 2017, after a seven-day medical negligence trial, a jury
    returned a $3 million verdict in favor of l\/lonica Broughton (l\/Iother), individually
    and as parent and natural guardian of nine-year~old Amari Broughton-Fleming
    (Amari) (“Plaintiffs”). Defendants, Dr. Peter Wong and Dedicated to Women ()B-
    GYN, P.A. (“Defendants”), seek judgment as a matter of laW, a new trial, or
    remittitur After consideration of the parties’ briefings and oral arguments, for the
    reasons stated beloW, Defendants’ Renewed Motion for Judgrnent as a l\/Iatter of
    Law, or in the alternative, Motion for a NeW Trial, or Rernittitur is DENIED.
    FACTUAL AND PROCEDURAL HISTORY
    Plaintiffs brought this medical negligence claim against Defendants, alleging
    that Dr. Wong negligently applied excessive lateral traction during childbirth With
    such force that the stretching of Amari’s head during delivery caused a permanent
    right brachial plexus injury. In response, Defendants maintained that, in the
    presence of a shoulder dystocia, Dr. Wong used What he considered to be a “unique”
    method of delivery and noted in his records that he had “not applied any traction” to
    Amari.‘ To explain the cause of injury, Defendants relied heavily upon the
    American Congress of ()bstetricians and Gynecologists (“ACOG”) Monograph as
    scientific evidence that Amari’s injury Was the result of maternal endogenous forces
    l Defs.’ l\/lot. at il 2.
    during labor, not attributable to the physician’s actions. In other words, l\/Iother’s
    pushing during the delivery caused the permanent injury.
    During the seven days of trial, the undisputed facts included that during
    delivery, the force that occurred during labor was sufficient to cause both transient
    and permanent nerve damage to Amari’s right arm. As a result, both as an infant
    and a young child, he underwent two major surgeries to repair the damaged nerves,
    but his injury has left him permanently impaired When Amari took the stand, the
    jury noted that his arm was visibly shorter than the other. Even at such a young age,
    he was able to articulate how the injury has affected him throughout his life. He
    explained why he has never been able to ride a bicycle, and described how his injury
    prevents him from being able to play his favorite sports such as football, soccer, or
    baseball. Through medical testimony, the jury also heard that these physical deficits
    will carry into his adult life.
    Both sides presented inconsistent accounts from eyewitnesses who were
    present in the delivery room. Amari’s father and maternal grandmother both
    testified that they observed Dr. Wong pull on Amari’s head when he was emerging
    during delivery. ln contradiction, Defendants’ medical witnesses, also present
    during the delivery, testified that they did not make similar observations, and Dr.
    Wong, of course, denied that he ever pulled on Amari’s head. Against this factually
    inconsistent backdrop, the parties’ medical experts offered conflicting opinions on
    the critical issues of standard of care and causation.
    Prior to trial, Defendants filed motions in limine seeking to exclude the
    testimony of Plaintiffs’ experts, Drs. Marc Engelbert and Scott Kozin, offered to
    opine on standard of care and causation2 Defendants objected that both failed to
    meet the requirements of D.R.E. 702 and under Daubert,3 arguing, in part, that they
    were relying upon impermissible res ipsa loquitur or ipse dixit-type reasoning»~that
    the presence of the injury alone meant that Dr. Wong breached the standard of care
    and caused the injury.4 The Court accepted Plaintiffs’ responses to the motions and
    agreed that both experts satisfied the requirements under D.R.E. 702 and Daubert
    sufficient to testify at trial.
    After both the close of Plaintiffs’ case and again when all the evidence was
    in, Defendants made their application forjudgment as a matter of law under Superior
    Court Civil Rule 50(a). Defendants reiterated their objections concerning Dr.
    Engelbert’s “res ipsa” reasoning underlying his opinion and raised an additional
    argument that excessive traction could be appropriate as a lifesaving alternative in a
    2 Defendants do not ask this Court to revisit arguments regarding Dr. KoZin, and renew this motion
    only with respect to the opinion of Dr. Engelbert.
    3 Dauberl v. Merrell Dow Pharm. Inc., 
    509 U.S. 579
    (l993).
    4 ln addition to the arguments raised regarding the experts’ methodologies, Defendants’ motions
    in limine also asserted that each expert’s opinion lacked an adequate factual basis.
    4
    medical emergency sufficient to warrant judgment in their favor. This Court
    determined that there was a sufficient basis from which a reasonable jury could find
    in favor of Plaintiffs and denied Defendants’ motions.
    On October 9, 2017, Defendants renew their l\/Iotion for Judgment as a l\/latter
    of Law under Superior Court Civil Rule 50(b), or alternatively seek a new trial under
    Rule 59, or remittitur Plaintiffs responded in opposition on October 20, 2017. Oral
    arguments were heard on November 21, 2017, wherein Defendants presented
    additional authority to support their position. This Court granted leave so that the
    parties could address the applicability of the newly presented case law. Plaintiffs
    submitted their positions on November 22, 2017 and Defendants filed a response on
    November 30, 2017. Having considered all submissions, the matter is now ripe for
    review.
    RENEWED JUDGMENT AS A MATTER OF LAW
    Standard of Review
    Superior Court Civil Rule 50(a) that reads as follows:
    lf during a trial by jury a party has been fully heard on an issue and there is
    no legally sufficient evidentiary basis for a reasonable jury to find for that
    party on that issue, the Court may determine the issue against the party and
    may grant a motion for judgment as a matter of law . . . . 5
    5 DEL. SUPER. CT. Clv. R. 50(a).
    As occurred in this case, if such a motion is denied or is not granted, the motion may
    be renewed following trial pursuant to Superior Court Civil Rule 50(b)." Viewing
    all the evidence in the light most favorable to the non-moving party, the Court must
    determine whether the evidence and all reasonable inferences that can be drawn
    therefrom could justify a jury verdict in favor of the plaintiff(s).7 “Thus, ‘the factual
    findings of a jury will not be disturbed if there is any competent evidence upon which
    the verdict could reasonably be based.”’8
    Discussion
    The Court agrees with Defendants that the jury cannot presume negligence
    from the mere presence of an injury.9 The jury was instructed accordingly. ln their
    renewed motion, Defendants maintain that Plaintiffs offered no legally sufficient
    evidentiary basis for a reasonable jury to find in their favor because Dr. Engelbert’s
    standard of care opinion advanced an impermissible res ipsa loquitur theory. In
    support, Defendants extract select lines from Dr. Engelbert’s expert testimony to
    reiterate that his opinion is fatally flawed because he testified during trial that had
    6 DEL. SUPER. CT. Clv. R. 50(b).
    7 Aiwell v. RHIS, Inc., 
    2007 WL 914648
    , at *l (Del. Super. Feb. 26, 2007) (citing Mu)n_/`ord v.
    Paris, 
    2004 WL 231611
    , at *2 (Del. Super. Jan. 31, 2003)).
    8 Muln]’ord, 
    2003 WL 231611
    , at *2 (quoting Delaware Elec. Co-Op, Inc. v. Pitls, 
    633 A.2d 369
    ,
    
    1993 WL 445474
    , at *l (Del. Oct. 22, 1993) (TABLE) (emphasis added)).
    9 Cir)ci()la v. Del. COCa-Cola Br)llling Cr)., 
    172 A.2d 252
    , 257 (Del. 1961).
    6
    there been no permanent injury, then Dr. Wong would have met the standard of care.
    For the following reasons, this Court finds that Defendants fail to establish why they
    are entitled to relief as a matter of law under Rule 50(b).
    First, this Court notes that although Dr. Engelbert was offered as an expert on
    the issue of whether Dr. Wong breached the standard of care, the Defendants elicited
    testimony on cross-examination concerning issues of causation in order to further
    develop their res ipsa loquitur argument10 Since the legal doctrine of res ipsa
    loquitur relates to causation--versus standard of care_it stands to reason that
    Defendants had to engage in a thorough cross-examination on the issue of causation
    if they were to successfully argue that Dr. Engelbert employed a “res ipsa ” approach
    in reaching his opinion. Therefore, the Court notes that references from Dr.
    Engelbert’s testimony necessarily went beyond a “standard of care” opinion and
    touched upon issues of causation when he was challenged to defend his opinion.
    A dispute for the jury to decide was whether the permanent damage suffered
    by Amari was caused by the excessive force applied by Dr. Wong or l\/Iother. To
    refute Dr. Engelbert’s opinion that Dr. Wong was negligent, Defendants questioned
    him extensively regarding conclusions from the ACOG l\/lonograph, which they
    10 Res ipsa loquitur is a legal doctrine concerning causation; it is a “doctrine providing that, in
    some circumstances, the mere fact of an accident’s occurrence raises an inference of negligence
    that establishes a prima facie case.” BLACK’S LAW DICTIONARY (10th ed. 2014).
    7
    maintained established scientific evidence that Amari’s injury was the result of
    maternal endogenous forces during labor. Plaintiffs’ experts, including Dr.
    Engelbert, criticized many of the conclusions reached in the ACOG l\/lonograph, in
    large part because the study did not fully differentiate between a permanent versus
    transient injury.
    These medical_versus legal-references to the critical distinctions between
    a permanent and transient brachial plexus injury were highlighted throughout the
    trial and vital to Dr. Engelbert’s ability to both defend his opinion as more than
    merely a “res ipsa ” conclusion, and to refute Defendants’ theory that it was l\/lother’s
    force that caused the injury as challenged on cross-examination Equally as
    important to Dr. Engelbert’s opinion was that the determination of whether the injury
    was permanent or transient was not readily apparent at the time of delivery.
    Therefore, while some nerves that suffered a transient injury were able to be
    repaired, the diagnosis and cause of the permanent brachial plexus injury could not
    be made until it was known that some nerves were permanently damaged To the
    extent that the ACOG Monograph identified instances of injury caused by maternal
    forces, Plaintiffs established that these injuries were transient, not permanent in
    nature. Therefore, Plaintiffs argued that the conclusions from the ACOG
    l\/lonograph could not be applied to Plaintiff Amari’s case.
    Dr. Engelbert testified that there were no undisputed cases of permanent
    brachial plexus injury that resulted from endogenous (or maternal) forces. His
    testimony centered on the difference between a permanent or temporary nerve injury
    and the known, undisputed causes of permanent brachial plexus inj uries. in fact, Dr.
    Engelbert ruled out other causes, including l\/lother’s force. His opinion on standard
    of care is perhaps best summed up in the following portion:
    Understanding that to get that extent of an injury in the face of a shoulder
    dystocia, in his situation there is no other possible cause other than excessive
    traction. There are rare causes of permanent brachial plexus injury that don’t
    apply to Amari. You rarely see this: Cancer in the brachial plexus, or an
    infection in the brachial plexus. These are rare causes which didn’t apply to
    Amari. Sometimes the mother -- the mother, l\/lonica, could have had
    something wrong with her uterus, where Amari’s shoulder could have been
    stuck in a bad position because of the uterus. ln those situations, the babies
    that get affected that way, they have muscle atrophy, which Amari didn’t
    have. So when you look at the other causes of permanent injury, none of them
    applied to Amari. ll
    Dr. Engelbert rejected the opinion of Defendants’ experts that a permanent injury
    could be caused by Mother and he explained his rationale to the jury. These included
    excessive downward lateral traction, as was alleged in this case, and ruling out a few
    rare causes, such as cancer, infection, or the shape of the mother’s uterus, not present
    here.
    ll Trial Testimony ofl\/larc Engelbert, M.D., hereinafter referred to as “'I`EW,” 46:13-47:03.
    9
    Yet Defendants maintain that Dr. _Engelbert’s testimony was speculative and
    cite an unrelated District Court of Massachusetts case of McGovern v. Brigham &
    Women’s Hospz`tal.'2 This Court finds that McGovern is distinguishable ln
    McGovern, the District Court found that Dr. Engelbert’s opinions were “mere
    speculation, not supported by reliable scientific knowledge,” unsupported by “even
    one peer reviewed publication” then available13 That is not the record here.
    Plaintiffs established that Dr. Engelbert’s opinion was supported by multiple,
    reliable medical sources, including Williams Obstetrics (24th ed.),‘“`* Gabbe
    Obstetrics.' Normal ana' Prol)lem Pregnancies (7th ed.),‘5 O’Leary Shouloler
    Dystocia ana’ Birth Injurj/ (3d ed.),‘6 a peer-reviewed study by l\/lollberg
    “Comparison in Obstetric Management on Infants with Transient and Persistent
    Brachial Plexus Palsy,”17 and Creasy and Resnik, Maternal-Fetal Meclicine (7th
    ed.).18 Dr. Engelbert went beyond merely asserting that a causal link was “well-
    12 See McGovern v. Brigham & Women 's Hosp., 
    584 F. Supp. 2d 418
    , 425~26 (D. l\/Iass. 2008).
    13 lar
    |4 TE 24223~28223.
    15 TE 29201-3l113.
    16 TE 31214~36107.
    17 TE 36:08 - 38:23.
    18 TE 39: 03~40:19.
    10
    established,” as was problematic in McGovern. 19 Additionally, distinguishable from
    McGovern, with respect to Dr. Engelbert’s overall methodology, here Dr. Engelbert
    0 Furthermore,
    did not “fail[] to eliminate other possible causes” of the injury.2
    Defendants had an opportunity to cross-examine Dr. Engelbert when he ruled out
    the mother’s endogenous forces as another possible cause when they questioned him
    extensively regarding the ACOG l\/Ionograph.
    Defendants’ further reliance on our court’s decision in Norman v. All About
    Women2l is also unpersuasive There, the court granted a motion in limine to
    exclude the plaintiff expert’s standard of care testimony because “no evidence has
    been presented that [the expert]’s opinion [was] ‘based on information reasonably
    relied upon by experts’ in his field.”22 Unlike the expert in Norman, for the reasons
    previously stated, this Court finds that the jury had evidence before them to consider
    and accept Dr. Engelbert’s opinion that the permanent injury could only be the result
    of excessive lateral traction. ln doing so, there was evidence in this case that his
    opinion was based upon medical records, eyewitnesses’ accounts of the delivery,
    19 
    McGovern, 584 F. Supp. 2d at 425
    .
    20 
    Id. at 426.
    21 Norman v. AllAbout Women P.A., 
    2017 WL 5624303
    (Del. Super. Ct. Nov. 16, 2017).
    22 Ia’. at *2.
    ll
    and all other information an expert would ordinarily rely upon in his field, including
    ruling out other causes-not an uncommon exercise used in the medical field, and
    previously accepted as admissible in other cases in similar medical negligence
    actions.23
    While perhaps Dr. Engelbert could have stated his opinion differently, the line
    between medical and legal language is often blurred and this Court is often asked
    use its discretion regarding the admissibility of expert opinion. The Supreme Court
    has previously recognized in Mammarella v. Evantash24 and Moses v. Drake25 that
    there is not a set script medical experts must follow when they render opinions.26
    Rather, this Court may “exercise some discretion to determine whether the opinion
    offered by an expert, when considered in light of all the evidence, meets [the] legal
    standard.”27
    23 See Lewis v. McCracken, 
    2016 WL 6651417
    , at *4 (Del. Super. Ct. Nov. 7, 2016) (expert met
    the requirements of D.R.E. 702 and Daul)ert where the expert reviewed medical records,
    deposition transcripts and medical literature, and, in rendering a differential diagnosis, determined
    the only possible cause of permanent brachial plexus injury was excessive traction during
    childbirth).
    24 93 A.zd 629 (Dei. 2014).
    25 
    109 A.3d 562
    (Del. 2015).
    26 Moses, 109 A.Bd at 568; 
    Mammarella, 93 A.3d at 636-37
    .
    27 
    Moses, 109 A.3d at 568
    .
    12
    Accordingly, Dr. Engelbert’s opinion, when considered in light of all the
    evidence, meets the requirements under D.R.E 702 and Daubert. Given the issues
    in this case, it was proper for the jury to understand the distinctions about the severity
    of the injury through his explanation, and to be given an opportunity to refute the
    conclusions in the AC()G l\/lonograph. On cross-examination, it was appropriate for
    him to defend his conclusions, rule out other causes, and explain why the
    permanency of the injury was germane to his opinion that Dr. Wong’s unique
    method of delivery breached the standard of care. The jury was free to accept or
    reject Dr. Engelbert’s opinion as presented in the same manner as they were free to
    accept the versions from Dr. Wong or Defendants’ experts. For these reasons, this
    Court finds that Dr. Engelbert’s opinion went beyond a res ipsa loquitur conclusion
    and the testimony challenged by Defendants goes to the weight of the evidence, not
    its admissibility.
    Defendants next argue that they are entitled to judgment as a matter of law
    because Dr. Engelbert testified on cross-examination that excessive traction could,
    in some cases, be an appropriate alternative medical treatment.28 Defendants
    28 lt is unclear ifDefendants are arguing there was an alleged deficiency in Dr. Engelbert’s
    testimony or that the Court failed to give an alternative medical treatment jury instruction,
    particularly as they cite to Corbilt v. Tatagari, 
    804 A.2d 1057
    (Del. 2002). The Court will
    address both arguments, although not expressly raised.
    13
    maintain that judgment in their favor is mandated because his testimony suggested
    a medical event could qualify as a “lifesaving situation,” such that the testimony
    unequivocally locks Dr. Engelbert into a position where he could not properly opine
    that Dr. Wong breached the standard of care. Defendants reliance on Corl)itt v.
    TataCorbitt, 804 A.2d at 1063-64
    .
    14
    Dr. Engelbert’s limited testimony on this subject did not suggest that excessive
    lateral traction could ever be considered “an appropriate alternative medical
    treatment” at the moment it was allegedly used in this case.
    Burgos stands for the proposition that “the entry of a verdict in favor of the
    defendant is appropriate only when, under the evidence presented by the plaintiff,
    reasonable minds could draw but one inference and that inference is that a verdict
    favorable to the plaintiff is not justified.”32 Here, Dr. Wong said there was no
    alternative available to him. In contrast, Dr. Engelbert testified that Dr. Wong’s
    unique method of delivery was not appropriate, and he would have waited additional
    time before employing any traction efforts as a lifesaving maneuver33 The jury was
    free to weigh the differing medical opinions, and the timeframes that they offered.
    They were also free to consider and draw inferences from the eyewitnesses who
    testified about what they saw during the delivery and decide what version to accept
    about how and when the traction, if any, was used. Dr. Engelbert did not accept
    excessive traction as a lifesaving alternative within the same timeframe that Dr.
    Wong did. Reasonable minds can draw more than just one inference from the
    32 
    Burgos, 695 A.2d at 1144
    .
    33 'l`E 52111453:04; 53:13-15; 54:01-03.
    15
    available testimony. As such the entry of a verdict in favor of Defendants is not
    appropriate in these circumstances
    Viewing all the evidence in the light most favorable to the non-moving party,
    the Court determines that the evidence and all reasonable inferences that can be
    drawn justified ajury verdict in favor of _Plaintiffs. Defendants have not shown that
    there is no competent evidence upon which the verdict could reasonably be based.
    As such, Defendant’s motion under Rule 50 must be denied.
    MOTION FOR NEW TRIAL
    Standard ofReview
    A motion for a new trial under Delaware Superior Court Civil Rule 59 may
    be granted where the jury verdict “shocks the Court’s conscience and sense of
    justice.”34 The jury’s verdict is entitled to “enormous deference.”35 The Court will
    not upset the verdict “unless ‘the evidence preponderates so heavily against the jury
    verdict that a reasonable jury could not have reached the result’ or the Court is
    24 Young v. Frase, 
    702 A.2d 1234
    , 1237 (Del. 1997) (quoting Mills v. Telenczak, 
    345 A.2d 424
    ,
    426 (D€l. 1975)). S€e’ alS() DEL. SUPER. CT. Cl\/. R. 59.
    35 See, e.g., Gallo v. Buccini/Pollin Group, 
    2008 WL 836020
    , at *6 (Del. Super. l\/Iar. 28, 2008)
    (quoting 
    Frase, 702 A.2d at 1236
    ; Storey v. Castner, 
    314 A.2d 187
    , 193 (Del. 1973)).
    16
    convinced that the jury disregarded applicable rules of law, or where the jury’s
    verdict is tainted by legal error committed by the Court during the trial.”%
    Discussion
    Defendants argue that the use of what they consider “improper statistical
    evidence”37 entitles them to a new trial under Timl)lin v. Kent General Hospital
    (Inc.,).38 Specifically, Defendants claim that portions of Dr. Engelbert’s trial
    testimony and the repetitive questioning of all medical experts regarding
    complications associated with a shoulder dystocia qualify as improper statistical
    evidence under Timl)lin. This Court finds that the merits and the timeliness of this
    argument do not fall under Timblin.
    In Timl)lin, a hospital allegedly failed to properly ventilate a heart attack
    patient after he went in to cardiac arrest, resulting in a neurological deficit. During
    the direct examination of one of the emergency room physicians, the doctor testified
    that “published studies cite a short-term hospital mortality without thrombolytic
    therapy within the range of ten to fifteen percent.”39 Later, a defense expert opined
    36 Mitchell v. Halalar, 
    2004 WL 1790121
    , at *3 (Del. Super. Ct. Mar. 20, 2008) (quoting Storey v.
    Cumper, 
    401 A.2d 458
    , 465 (Del. 1977)).
    37 Defs.’s l\/lot. at 11 5.
    38 640 A.Zd 1021 (D€l. 1994).
    39 
    Id. 17 that
    very few patients who suffer cardiopulmonary arrest survive. Defendant
    attempted to tie these statistics with standard of care, asking the expert whether
    anything about plaintiffs condition was properly performed The defense expert
    responded:
    The fact that he was resuscitated . . . . Statistically we know less than twenty-
    five percent of patients whose heart [sic] goes into asystole [cessation of
    electrical activity] can be resuscitated; l think it’s one out of twenty. l think it
    was remarkable that they were able to bring his heart back under those
    circumstances40
    Our Supreme Court held that the admission of this “statistical evidence was
    erroneous because its probative value was substantially outweighed by its prejudicial
    effect.”‘" Such information was not germane to whether the hospital acted in
    conformity with the applicable standard of care, which was the only issue before the
    trial court. ln that case, there was no dispute that the damage to the plaintiff s brain
    was caused by a long period of oxygen deprivation and that the long period was
    because plaintiff was not intubated.42 Therefore, the causation issue was solely
    whether the inability to intubate was caused by the hospital’s alleged negligence,
    “not whether [plaintiff’s] brain damage was an inevitable result.”43 The Timblin
    40 Ia’. at 1022-23 (alterations in original).
    4'1¢1. ar1023_
    42 
    Id. at 1024-25.
    43 la'. at 1025.
    18
    Court found that the probative value of the statistical evidence was therefore
    minimal, if not of no value. The statistical evidence that was presented in that case
    was also deemed to be misleading since “[t]he statistics invited an inference that,
    because the majority of patients who suffer a cardiac arrest die or suffer brain
    damage, [plaintiff] was expected to suffer brain damage.”44
    Here, Defendants do not specifically identify what language from Dr.
    Engelbert is objectionable, only citing generally to two pages of his trial testimony.45
    Page one includes the following testimony: “Everybody, millions of us, we all were
    delivered, and millions of babies every day go through maternal forces, contractions,
    pushing If that could cause permanent brachial plexus injuries, logically there
    would be lots more babies, lots more people, affected with permanent brachial
    plexus injuries.”46 This testimony makes no statistical references Also, there is no
    particular study identified If anything, it is an appeal to the common sense of the
    jury and directly rebutting Defendants’ trial theory that mother’s endogenous forces
    caused the injury.
    44 1a 311026.
    45 Defs.’ l\/lot. at 11 5.
    46 TE 48:17-23.
    19
    The second page cited by the Defendants includes the following question by
    Plaintiffs’ counsel and the response by Dr. Engelbert:
    Q: Permanent neurological injuries rarely occurred in one or two of every
    10,000 births. Does that conform with that [sic] understanding is in terms of
    frequency‘?
    A: lt’s an approximation, yes.47
    Here, without objection, Plaintiffs’ counsel is questioning Dr. Engelbert about a
    particular study, Creasy and Resnik, Maternal-Fetal Mea’icine (7th ed.). While
    including a statistic_one or two out of every 10,000 births_this testimony only
    generally speaks to how rare brachial plexus injuries are. Such testimony is
    distinguished from the statistical evidence in Timblin because such testimony does
    not “invade[] the province of the trier of fact.”48 lt was agreed to by all experts that
    these injuries are rare. The background information was relevant to the Plaintiff’s
    particular injury and did nothing to confuse the jury or obscure issues of fact.
    Finally, Defendants object to the recurring questioning of all experts and
    Defendant Dr. Wong with the following questions: ln their professional career (1)
    How many births had the physician perfonned?; (2) How many shoulder dystocias
    47 TE 39:12~16.
    45 
    Timblin, 640 A.2d at 1025
    (citing Wheat v. Slate, 
    527 A.2d 269
    , 275 (Del. 1987)).
    20
    had the physician encountered‘?; and (3) How many permanent brachial plexus
    injuries had the physician encountered‘? Plaintiffs respond that these questions go to
    the experience of each physician, to the relative rarity of these types of injuries, and
    generally provide background information Plaintiffs further argue that the
    probative value of the information is not substantially outweighed by its potential
    for prejudice The Court agrees.
    Plaintiffs asked the same laundry list of questions to all medical witnesses
    about their own individual and professional experiences The responses do not
    constitute statistical evidence of the kind deemed fatal in Timblin. Here, the jury
    heard from the medical witnesses about their individual experiences when faced with
    these medical events during their professional careers. lt was abundantly clear from
    the testimony of all experts that a shoulder dystocia is a rare obstetrical complication
    and that brachial plexus injuries are extremely uncommon Such testimony was even
    elicited by Defendants in their discussion of the ACOG l\/Ionograph with all of the
    experts, especially in their questioning of the experts as to whether a shoulder
    dystocia could constitute an emergency situation Unlike Timl)lin, the responses
    from the experts were not based on studies.
    Even assuming, arguendo, that any of this testimony was statistical evidence
    under Timl)lin, a new trial is not appropriate where Defendants failed to object.
    Parties must make contemporaneous objections at trial. Our Court has recently
    21
    opined concerning the perverse incentives that arise from granting a new trial under
    such circumstances:
    Despite their failure to object at trial, [the party] now comes[s] before the
    Court urging that a legal error occurred . . . . Were the Court to grant this
    l\/Iotion, the practical effect of [the party’s] conduct is that [the party] could
    make a strategic decision not to object at trial with the hope of receiving a
    favorable verdict, but if [the party] received an unfavorable jury verdict, they
    would be assured of a new trial before a new jury with the possibility of a
    different outcome The Court will not retroactively cure any perceived
    mistake created by trial counsel’s failure to object at trial.49
    Defendants made a strategic decision and the Court is reluctant to provide a
    retroactive cure that could encourage gamesmanship. Unlike Timblin, Defendants
    did not preserve their objection.50 The Court was also unable to undertake a Rule
    403 analysis Even if it had been asked to do so, the responses to the questions
    simply reiterated what the jury knew about the rarity of these injuries.
    Finally, this Court briefly addresses Defendants’ argument that the verdict is
    against the “great weight of the evidence.”5] F or the reasons stated, the Court does
    not agree. The seven-day trial allowed both sides to present their respective
    452 Cohen-Thomas v. Lewullis, 
    2016 WL 721009
    , at *4 (Del. Super. Ct. Jan. 29, 2016).
    50 Timbltn, 640 A.2d ar 1022
    51 Defs.’ l\/lot. at 11 6 (citing Slorey v. Camper, 
    401 A.2d 458
    , 465 (Del. 1979)).
    22
    positions through lay and expert witnesses The evidence does not weigh so heavily
    against the jury verdict that a reasonable jury could not have reached the result.52
    REMITTITUR
    Stana'ard of Review
    On Defendants’ l\/lotion for Remittitur, the Court must evaluate the evidence
    and decide whether the jury award falls within a range supportable by the evidence.53
    An award will not be set aside unless it is so excessive as to shock the court’s
    conscience and sense of justice or the jury manifestly disregarded the applicable
    rules of law.54 The Court should defer to the jury and reduce the jury award to the
    absolute maximum amount that the record can support.55 “lt is well-settled that jury
    verdicts be given great weight. lf a trial has been conducted properly, a jury is the
    best way to determine an injured plaintiffs damages.”56
    52 
    Camper, 401 A.2d at 465
    .
    55 Reia' v. Hina’l, 
    976 A.2d 125
    , 131 (Del. 2009).
    54 Storey v. Castner, 314 A,2d 187, 193 (Del. 1973); Riegel v. Aastaa’, 
    272 A.2d 715
    , 718 (Del.
    1970).
    55 
    Reial, 976 A.2d at 131
    .
    56 West v. Maxwell, 
    2001 WL 789654
    , at *6 (Del. Super Ct. .lune 29, 2001) (citing Mea’ical Ctr. of
    Del., Inc. v. Lougheea’, 
    661 A.2d 1055
    , 1061 (Del. 1995).
    23
    Discussion
    Defendants argue that the $3 million verdict is excessive and only the result
    of the impermissible motive of “passion.”57 The Court finds that the 333 million
    verdict is supported by the evidence.
    In reaching its award, the jury heard testimony from experts, Amari’s family
    and Amari himself about the painful medical treatment that Amari underwent, and
    the physical and mental impact that the injury has had, and will continue to have on
    his life. This included, but was not limited to, considerations that Amari cannot
    engage in activities that other children take for granted, such as playing sports or
    riding a bicycle. The jury heard testimony that the physical deficits and mental
    consequences will remain with him throughout his adult life.
    The jury was instructed that their verdict must be based solely on the evidence
    in this case and that they could not be influenced by sympathy, prejudice, or public
    opinion There is no evidence that the jury “manifestly disregarded the applicable
    rules oflaw.”58
    57 Defs.’ l\/Iot. atjl 6 (citing Mea'. Clr. ofDel., Inc. v. Lougheea’_, 
    661 A.2d 1055
    . 1061 (Del. 1995);
    Rieg€l, 272 A.2Cl 715, 717-18 (D€l. 1970)).
    58 See Storey v. Castner, 
    314 A.2d 187
    , 193 (Del. 1973); Riegel v. Aastacl, 
    272 A.2d 715
    , 718 (Del.
    1970).
    24
    Jury verdicts should receive great weight. lt has been cautioned that “[i]t is
    difficult, if not potentially dangerous, to refer to other kinds of cases to argue a
    particular verdict is too high or too low. There are too many variables . . . .”59 The
    Court will therefore not engage in such comparison This Court’s conscience is not
    shocked by the verdict.
    CONCLUSION
    Viewing all the evidence in the light most favorable to the non-moving party,
    the Court determines that the evidence and all reasonable inferences that can be
    drawn justified a jury verdict in favor of Plaintiffs Under Rule 50, Defendants have
    not shown that there is no competent evidence upon which the verdict could
    reasonably be based Defendants further fail to establish why a new trial is warranted
    under Rule 59. Remittitur is inappropriate because the jury verdict is supported by
    the evidence Therefore, Defendants’ Renewed l\/lotion for Judgment as a l\/latter of
    Law, or in the alternative, Motion for a New Trial, or in the alternative, Remittitur
    is DENIED.
    rr ls so oRDERED. y
    59 Bissel v. Taylor, 
    1994 WL 555340
    , at *7 (Del. Super. Ct. Sept. 14, 1994).
    25
    oc: Prothonotary
    cc: All Counsel on Record (via e-fling)
    26