Stecker v. First Commercial Trust Co.
962 S.W.2d 792, 331 Ark. 452 (1998)
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Rule of Law:
A physician's failure to report suspected child abuse can be the proximate cause of a child's subsequent death in a medical malpractice action if expert testimony and circumstantial evidence establish that a report would, more likely than not, have prevented the fatal injury.
Facts:
- Dr. Rheeta Stecker, a family practitioner, treated sixteen-month-old Laura Fullbright.
- On June 12, 1992, Dr. Stecker discovered two fractured bones in Laura's forearm, causing her to suspect neglect or abuse by the child's mother, Mary Ellen Robbins, and her boyfriend, Joseph Rank.
- Despite her suspicions, Dr. Stecker did not report the injury to authorities.
- On July 9, 1992, Laura presented with symptoms of being 'wobbly' and running into things, which Dr. Stecker noted were consistent with head trauma.
- On July 22, 1992, Dr. Stecker saw Laura for swollen eyelids, which the mother attributed to a fall. Dr. Stecker again considered and consciously decided against reporting her suspicions of child abuse.
- During August 1992, an adult guest stayed in the home, and Laura suffered no injuries during this period.
- On September 12, 1992, after being left in the care of Joseph Rank, Laura was found unconscious and later died. The cause of death was ruled a homicide, for which Rank was convicted.
Procedural Posture:
- First Commercial Trust Company, as administrator of Laura Fullbright's estate, sued Dr. Rheeta Stecker, Mary Ellen Robbins, and Joseph Rank in an Arkansas state trial court for medical malpractice and other claims.
- In the first trial, the trial court granted a directed verdict for Dr. Stecker on the medical malpractice claim, finding the plaintiff's expert witness was not qualified to testify.
- The estate (appellant) appealed the directed verdict to the Supreme Court of Arkansas.
- The Supreme Court of Arkansas reversed the trial court's decision and remanded the medical malpractice claim against Dr. Stecker for a new trial.
- At the second trial, a jury returned a verdict against Dr. Stecker for medical malpractice, and the court entered a judgment against her.
- Dr. Stecker (appellant) now appeals that judgment to the Supreme Court of Arkansas, with First Commercial Trust Company (appellee) responding.
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Issue:
Does sufficient evidence of proximate cause exist to hold a physician liable for medical malpractice when the physician fails to report suspected child abuse, and expert testimony suggests that reporting would, more likely than not, have prevented the child's subsequent death at the hands of an abuser?
Opinions:
Majority - Justice David Newbern
Yes. Sufficient evidence of proximate cause exists to support the jury's verdict. A plaintiff can establish proximate cause in a medical malpractice action for failure to report suspected child abuse through expert testimony and circumstantial evidence that demonstrate a reasonable probability the harm would not have occurred if a report had been made. Here, the expert testimony from both the plaintiff's and the defendant's witnesses suggested that reporting the suspected abuse would likely have initiated an investigation that would have deterred the abuser. Dr. Stecker's own witness, Dr. Smith, conceded on cross-examination that an investigation would likely make an abuser 'back off' and 'might save a child's life.' This testimony, combined with the circumstantial evidence that the abuse ceased when another adult was present in the home, provided a sufficient, non-speculative basis for the jury to conclude that it was more probable than not that Dr. Stecker's failure to report was a proximate cause of Laura Fullbright's death.
Analysis:
This decision is significant because it affirms that a physician's breach of the statutory duty to report child abuse can satisfy the proximate cause element in a medical malpractice claim for subsequent fatal abuse. It establishes that plaintiffs can meet their burden of proof through a combination of expert opinion on the likely deterrent effect of an investigation and corroborating circumstantial evidence. This lowers the evidentiary hurdle in 'failure to act' cases, which often pose challenges in proving causation, by focusing on 'reasonable probability' rather than demanding certainty that the intervention would have prevented the harm. The case reinforces the legal weight of a physician's role as a mandatory reporter and its direct link to patient safety and legal liability.
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