The Impact of Gooding on actions for malpractice in the treatment of malignant disease.

• Author: Toker, Cyril
• Position: Gooding v. University Hospital Building, Inc. - Florida

The holding in Gooding v. University Hospital Building, Inc., 445 So. 2d 1015 (Fla. 1984), has profoundly influenced, and continues to influence, malpractice suits involving the treatment of malignant disease in Florida. This article analyzes Gooding and evaluates its impact.

On October 4, 1976, Mr. Gooding developed abdominal pain at home and fainted. His wife contacted his gastroenterologist, Dr. Borland, and informed him of what had happened. Mr. Gooding was then transported to the emergency room of the Memorial Hospital in Jacksonville. The emergency room staff did not take a history or examine Mr. Gooding. Their belief was that Dr. Borland, who was in the hospital, would be coming to the emergency room shortly. However, Dr. Borland did not respond to repeated paging. In the interim, Mr. Gooding complained of increasing abdominal pain and shortness of breath. Dr. Borland arrived in the emergency room as Mr. Gooding died. Mr. Gooding had been in the hospital some 45 minutes. Death was due to a ruptured aortic aneurysm.

Mrs. Gooding brought suit for wrongful death against the hospital, alleging negligence by the emergency room staff for their failure to take any action during her husband's stay in the hospital. The trial court instructed the jury that they could find for Gooding if the hospital had destroyed his chance of survival. The jury awarded $300,000 in compensatory damages to Gooding's estate. On appeal the First District Court of Appeal reversed, reasoning that the trial court should have directed a verdict in favor of the hospital because Gooding's chances of survival would have been no more than even with proper treatment.(1) The Supreme Court of Florida affirmed the district court's ruling.

Supreme Court's Holding

The Supreme Court reiterated the district court's belief that Mr. Gooding did not have any more than an even chance of survival. The Supreme Court rejected a mere decrease in any chance of survival as a basis for awarding damages. Instead, it cited Cooper v. Sisters of Charity of Cincinnati, Inc., 27 Ohio St.2d 242, 253-254, 272 N.E.2d 97, 104 (1971), and established two requirements for awarding damages in a medical malpractice action. First, there must be evidence of a greater-than-even chance of survival in the absence of negligence. Second, if this requirement is met, proximate causation demands the additional showing that it is more likely than not that the decreased survival has resulted from the defendant's negligence. It must be established that the negligence probably reduced survival. A mere possibility that it may have reduced survival will not suffice.

Survival Versus Cure

"Cure" signifies eradication of the disease process. "Survival" denotes continued existence in the presence of disease, which may or may not be clinically detectable. The medical situation in Gooding is sharply delimited. The issue is not one of survival, even though it is couched in this language. The issue is one of cure. For Mr. Gooding to have survived, the aneurysm would have to have been eradicated. It is not possible to exist with a ruptured aortic aneurysm. The aneurysm is either successfully resected, and the patient cured, or the patient will face imminent death.

The facts of Gooding, therefore, refer to cure. The question is whether...