Georgia Supreme Court Uphold $8.3M Verdict In MedMal Case

The Georgia Supreme Court has declined to review a medical malpractice verdict totaling $8.3 million arising from complications following a knee replacement surgery, leaving intact both the damages award and a significant attorney fee ruling. The court unanimously denied a petition for certiorari filed by Georgia Bone & Joint Surgeons PC, effectively affirming lower court decisions that found the practice liable for injuries suffered by patient Margaret Keel.

The verdict consists of $6.5 million in compensatory damages and an additional $1.8 million in attorney fees. While the justices did not issue a full opinion, a concurring statement by Justice Charles Bethel provided guidance on the interpretation of prior precedent governing jury instructions in medical malpractice trials. The concurrence addressed the limits of required jury charges when testimony involves a medical expert’s personal clinical practices.

Background of the Medical Malpractice Claims

The underlying case stems from a knee replacement surgery Keel underwent in 2018. Court records show that the procedure itself was successful and without immediate complication. Following surgery, Keel was transferred to a post-anesthesia care unit, where she was administered narcotic medications to manage pain.

Because narcotics can suppress respiratory function, Keel was placed on a CPAP machine to assist breathing and ensure adequate oxygenation. During the night, however, she was discovered unresponsive with the CPAP mask removed. Nurses were unable to detect a pulse, prompting the use of a defibrillator and an emergency transfer to a hospital.

Keel was placed into a medically induced coma in an effort to protect neurological function. Despite these measures, she alleged that the cardiac arrest and resulting oxygen deprivation caused permanent brain damage, significantly impairing her independence and requiring her to move into assisted living. She later filed suit against Georgia Bone & Joint, the surgeon who performed the operation, and a nurse involved in her postoperative care.

Trial Verdict and Allocation of Liability

A jury ultimately found Georgia Bone & Joint liable for Keel’s injuries, concluding that the practice’s staffing levels and postoperative monitoring were inadequate to ensure patient safety. The jury awarded $6.5 million in damages to compensate for medical costs, long-term care needs, and diminished quality of life.

Notably, the jury declined to impose liability on the individual physician and nurse named in the lawsuit. This outcome reflected a distinction between individual clinical judgment and institutional responsibility, with jurors concluding that systemic shortcomings at the practice level contributed to the harm. In addition to compensatory damages, the trial court awarded Keel $1.8 million in attorney fees.

Georgia Bone & Joint appealed the verdict, arguing that legal errors during the trial warranted reversal or a new proceeding. Among its central arguments was a challenge to the jury instructions given by the trial court.

Dispute Over Jury Instructions and Expert Testimony

On appeal, Georgia Bone & Joint asserted that the trial court erred by failing to instruct jurors on how to evaluate testimony concerning a medical expert’s personal practices. According to the provider, such an instruction was required under the Georgia Supreme Court’s 2009 decision in Condra v. Atlanta Orthopaedic Group.

The practice contended that when expert witnesses testify about how they personally perform procedures or manage postoperative care, jurors must be instructed that differences in professional opinion alone do not establish malpractice. Without such guidance, Georgia Bone & Joint argued, jurors could improperly equate disagreement among physicians with a breach of the standard of care.

The Supreme Court declined to adopt that interpretation. In his concurrence, Justice Bethel explained that Condra addressed only the admissibility of personal-practices testimony, not a mandatory requirement for a specific jury charge whenever such testimony is introduced.

“As Condra addressed only the narrow question of the admissibility of personal practices testimony in the medical malpractice context, its discussion about using jury instructions to head off potential juror confusion is not necessary to its result,” Justice Bethel wrote, adding that “our reflection on jury instructions thus was not a holding.”

Guidance on Trial Court Discretion

While rejecting Georgia Bone & Joint’s argument, the concurrence offered broader guidance to trial courts handling complex medical malpractice cases. Justice Bethel emphasized that pattern jury instructions are not binding law and should not be treated as inflexible mandates. Instead, trial judges retain discretion to modify or depart from standard instructions when necessary to reflect the evidence and legal issues presented.

“It is black-letter law that jury instructions must be adjusted to the evidence in the particular case before the jury,” the justice stated. “And trial courts should not hesitate to do so.”

The concurrence clarified that evidence about an expert’s personal practices can be admitted both as substantive evidence and for impeachment purposes, so long as it is otherwise admissible. The credibility of expert witnesses, and how their testimony aligns with or diverges from accepted medical standards, remains a central issue for juries to evaluate without rigid instructional requirements.

Implications for Medical Malpractice Litigation

The Supreme Court’s decision reinforces the durability of jury verdicts in medical malpractice cases where appellate challenges focus on nuanced instructional issues rather than clear legal error. For healthcare providers and defense counsel, the ruling highlights the difficulty of overturning verdicts based on alleged omissions in jury charges, particularly when precedent does not mandate a specific instruction.

For plaintiffs, the decision affirms the ability to rely on expert testimony concerning institutional practices and staffing conditions to establish liability. The concurrence also signals that trial courts may exercise flexibility in crafting jury instructions tailored to the facts of each case, rather than relying exclusively on pattern charges.

By declining review, the Georgia Supreme Court has left in place a substantial verdict that underscores the potential exposure healthcare practices face when postoperative monitoring and staffing are alleged to fall short of patient safety standards.

Case Details

Case Name: Georgia Bone & Joint Surgeons PC v. Keel

Court Name: (Georgia Supreme Court)

Case Number: S25C1409

Plaintiff Attorney(s): Slappey & Sadd LLC

Defense Attorney(s): Huff Powell & Bailey LLC; Peters & Monyak LLP