George & Tina Vaughan v. Sanders Vision Center

STATE OF LOUISIANA
COURT OF APPEAL, THIRD CIRCUIT

06-651

GEORGE & TINA VAUGHAN, INDIVIDUALLY AND ON BEHALF OF
THEIR MINOR SON, AUSTIN VAUGHAN

VERSUS

SANDERS VISION CENTER AND CHILDREN’S EYE CLINIC,
DR. CRAIG M. SANDERS

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APPEAL FROM THE
FIFTEENTH JUDICIAL DISTRICT COURT
PARISH OF LAFAYETTE, NO. 2003-5414
HONORABLE PATRICK L. MICHOT, DISTRICT JUDGE

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ELIZABETH A. PICKETT
JUDGE

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Court composed of Michael G. Sullivan, Elizabeth A. Pickett, and Billy Howard
Ezell, Judges.

AFFIRMED.

Michael J. Remondet Jr.
Scott F. Higgins
Jeansonne & Remondet
P.O Box 91530
Lafayette, LA 70509
(337) 237-4370
Counsel for Plaintiffs/Appellants:
George & Tina Vaughan
Austin Vaughan

Joseph B. Morton III

Lawrence J. Duplass
Nicole M. Bowen
Duplass, Zwain, Bourgeois, Morton, Pfister & Weinstock, PLC
3838 N.Causeway Blvd., #2900
Metairie, LA 70002
Counsel for Defendants/Appellees:
Chicago Ins. Co.
Dr. Craig M. Sanders
Children's Eye Clinic
Sanders Vision Center

PICKETT, Judge.

The plaintiffs, George and Tina Vaughan, individually, and on behalf of their

minor son, Austin Vaughan, appeal a judgment of the trial court granting judgment

in favor of the defendants, Dr. Craig M. Sanders, Sanders Vision Clinic, Children’s

Eye Care Center, and Chicago Insurance Company, dismissing their suit with

prejudice and at their expense. We affirm the judgment of the trial court.

FACTS

The minor plaintiff in this case, Austin Vaughan, failed a vision screening at

his school in St. Martin Parish. A letter was sent home with the child informing the

parents of this. Austin’s mother, Tina Vaughan, took her son to Kids Med, a

screening clinic for children on Medicaid. Kids Med referred Austin to the

defendant, Dr. Craig M. Sanders, O.D. Dr. Sanders first saw Austin on February 3,

2000, when Austin was five years old. Dr. Sanders’ records from that initial visit

show that he determined Austin had 20/30 vision in his right eye and 20/400 vision

in the left eye, for which he prescribed glasses. Dr. Sanders also diagnosed Austin

with hyperopia, astigmatism, and amblyopia. He referred Austin to Dr. Rhonda

Moser for vision therapy for the amblyopia as he did not offer that treatment. He did

not see the child again until October 18, 2001, when he returned for new glasses.

This was Austin’s last visit. After consulting with a pediatric ophthalmologist, Dr.

Richard J. Piccione, and learning that Austin would never have “normal” vision, the

Vaughans filed suit against Dr. Sanders on October 9, 2003, alleging that because of

Dr. Sanders’ “mistreatment and misdiagnosis of Austin, [the child] now has

diminished and/or incurable farsightedness, astigmatism, and amblyopia in his eyes.”

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The case was tried to a judge who ruled in favor of the defendant and this

appeal followed.

LAW AND DISCUSSION

On appeal the plaintiffs argue that the trial court erred in believing the

defendant’s testimony and in finding that the defendant had not breached his standard

of care in treating Austin. The trial court’s conclusions on these arguments required

it to weigh testimony and evidence, i.e., to make factual determinations. The “gold

standard” of appellate review in cases involving factual determinations was set out

by the Louisiana Supreme Court in Rosell v. ESCO, 549 So.2d 840,

844(La.1989)(citations and footnote omitted):

It is well settled that a court of appeal may not set aside a trial
court’s or a jury’s finding of fact in the absence of “manifest error” or
unless it is “clearly wrong,” and where there is conflict in the testimony,
reasonable evaluations of credibility and reasonable inferences of fact
should not be disturbed upon review, even though the appellate court
may feel that its own evaluations and inferences are as reasonable. The
appellate review of fact is not completed by reading only so much of the
record as will reveal a reasonable factual basis for the finding in the trial
court, but if the trial court or jury findings are reasonable in light of the
record reviewed in its entirety, the court of appeal may not reverse even
though convinced that had it been sitting as the trier of fact, it would
have weighed the evidence differently. Where there are two permissible
views of the evidence, the factfinder’s choice between them cannot be
manifestly erroneous or clearly wrong. In applying the manifestly
erroneous--clearly wrong standard to the findings below, appellate
courts must constantly have in mind that their initial review function is
not to decide factual issues de novo.

When findings are based on determinations regarding the
credibility of witnesses, the manifest error--clearly wrong standard
demands great deference to the trier of fact’s findings; for only the
factfinder can be aware of the variations in demeanor and tone of voice
that bear so heavily on the listener’s understanding and belief in what is
said.

Louisiana Revised Statutes 37:1041, et seq., governs the practice of optometry

in this state. Louisiana Revised Statutes 37:1041(C)(5) states:

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“Optometry” means that practice in which a person employs
primary eyecare procedures or applies any means other than ophthalmic
surgery, for the measurement of the powers and testing the range of
vision of the human eye, and determines its accommodative and
refractive state, general scope of function, and the adaptation of frames
and lenses, including contact lenses in all their phases, to overcome
errors of refraction and restore as near as possible, normal human vision.
Optometry also includes the examination, diagnosis, and treatment,
other than by ophthalmic surgery of abnormal conditions and pathology
of the human eye and its adnexa, including the use and prescription of
diagnostic and therapeutic pharmaceutical agents.

The terms “diagnostic and therapeutic pharmaceutical agents” are defined as follows:

“Diagnostic and therapeutic pharmaceutical agent” means any
chemical in solution, suspension, emulsion, or ointment base, that when
applied topically has the property of assisting in the diagnosis,
prevention, treatment, or mitigation of abnormal conditions and
pathology of the human eye and its adnexa, or those which may be used
for such purposes, and oral antibiotics, and oral antihistamines, and
certain approved narcotics, when used in treatment of disorders or
diseases of the eye and its adnexa.

La.R.S. 37:1041(C)(2)(a).

An optometrist (O.D.) is not a medical doctor (M.D.) and an O.D.’s scope of

treatment is limited when compared to that of an ophthalmologist, an M.D. who treats

diseases and/or abnormalities of the eye. However, in any medical malpractice action

the scope of the burden of proof is the same and is set forth in La.R.S. 9:2794:

A. In a malpractice action based on the negligence of a physician
licensed under R.S. 37:1261 et seq., a dentist licensed under R.S. 37:751
et seq., an optometrist licensed under R.S. 37:1041 et seq., or a
chiropractic physician licensed under R.S. 37:2801 et seq., the plaintiff
shall have the burden of proving:

(1) The degree of knowledge or skill possessed or the degree of
care ordinarily exercised by physicians, dentists, optometrists, or
chiropractic physicians licensed to practice in the state of Louisiana and
actively practicing in a similar community or locale and under similar
circumstances; and where the defendant practices in a particular
specialty and where the alleged acts of medical negligence raise issues
peculiar to the particular medical specialty involved, then the plaintiff
has the burden of proving the degree of care ordinarily practiced by

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physicians, dentists, optometrists, or chiropractic physicians within the
involved medical specialty.

(2) That the defendant either lacked this degree of knowledge or
skill or failed to use reasonable care and diligence, along with his best
judgment in the application of that skill.

(3) That as a proximate result of this lack of knowledge or skill or
the failure to exercise this degree of care the plaintiff suffered injuries
that would not otherwise have been incurred.

....

C. In medical malpractice actions the jury shall be instructed that
the plaintiff has the burden of proving, by a preponderance of the
evidence, the negligence of the physician, dentist, optometrist, or
chiropractic physician. The jury shall be further instructed that injury
alone does not raise a presumption of the physician’s, dentist’s,
optometrist’s, or chiropractic physician’s negligence.

The “degree of knowledge or skill possessed or the degree of care ordinarily

exercised” is commonly referred to as the “standard of care.” In Young v. Mobley,

05-547, p. 5 (La.App. 3 Cir. 3/1/06), 923 So.2d 917, 920-21, this court explained as

follows:

Louisiana Revised Statute 9:2794 provides the applicable burden
of proof for a plaintiff in a medical malpractice case. That article
provides that a plaintiff must establish the following elements by a
preponderance of the evidence: (1) the standard of care applicable to the
defendant; (2) that the defendant breached that standard of care; and
(3) that there was a causal connection between the breach and the
resulting injury. Generally, expert testimony is required to establish the
applicable standard of care and whether or not that standard of care was
breached. Butler [v. DePuy, 04-101 (La.App. 3 Cir. 6/9/04)], 876 So.2d
259 (citing Davis v. Atchison, 37,832 (La.App. 2 Cir. 10/29/03), 859
So.2d 931). There is an exception to this general rule for cases where
the negligence is so obvious that a lay person can infer negligence
without the guidance of expert testimony. Thomas v. Southwest La.
Hosp. Ass’n., 02-0645 (La.App. 3 Cir. 12/11/02), 833 So.2d 548, writ
denied, 03-0476 (La.4/25/03), 842 So.2d 401 (citing Pfiffner v. Correa,
94-0924, 94-0963, 94-0992 (La.10/17/94), 643 So.2d 1228). We do not
find that this is such a case[. . . .]. Accordingly, we find that Plaintiffs
would be required to produce expert testimony to establish the
applicable standard of care and a breach thereof. We note that it has

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been recognized that a plaintiff can establish these things through the
testimony of the defendant’s expert witness.

The plaintiffs attempted to establish the standard of care Dr. Sanders owed to

Austin and his parents through the deposition of Dr. Stephen O. Sessums (a defense

witness) and the testimony of Dr. James Piccione, both pediatric ophthalmologists.

Dr. Sessums stated that he had no opinion as to the standard of care for optometrists.

Further, he opined that since Dr. Sanders did not treat amblyopia, it was appropriate

for him to refer Austin to another optometrist who did. Dr. Piccione stated that he

had never practiced optometry, but in the medical profession it was a common

practice to refer patients to one’s colleagues. He stated that if he didn’t treat a

particular condition, he would refer a patient to another physician who did. He

admitted that Austin was not wearing his glasses when he arrived for his initial

examination and that Mrs. Vaughan told him the glasses were “broken.”

In sum, the record shows that Dr. Sanders made the appropriate diagnosis, that

he prescribed glasses and that he referred Austin to a colleague for the treatment of

amblyopia. Austin’s parents did not follow up on the referral and did not ensure that

Austin wore his glasses as prescribed. Even after consulting Dr. Piccione, Austin’s

parents failed to ensure he complied with Dr. Piccione’s course of

treatment—copious “patching” and the constant wearing of his glasses.

The trial judge found “that the plaintiffs failed to establish the standard of care

for optometrists [and] [e]ven assuming that plaintiffs established the standard of care,

. . . plaintiffs did not meet their burden of proofing [sic] that Dr. Craig M. Sanders

was negligent or breached the standard of care for an optometrist.” We find no clear

error in the trial court’s conclusions.

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Accordingly, for the reasons stated above, we affirm the judgment of the trial

court. All costs of this appeal are assessed against the plaintiffs, George and Tina

Vaughan.

AFFIRMED.

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