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Allen v. State4/2/2002
ping blood clots in the leg rises with each decade of life). Inherited factors such as hypercoagulability might also contribute to developing blood clots, but testing must be done while a person is still alive, and the medical history obtained by Dr. Thorpen did not indicate the presence of hypercoagulability.
[ ] Dr. Thorpen reviewed the "operative" reports regarding Mary Fink's ankle surgery, which "appeared to go well," but he did not know why the surgery was not performed immediately. When asked, based on Mary Fink's age and the presence of obesity, recent trauma or injury, and immobilization, whether it was "foreseeable that something like this could happen when surgery is slated," Dr. Thorpen replied, "[n]ot in this c ase" and reiterated that "the blood clot was present, you know, prior to the surgery."
[ ] Dr. Thorpen opined that, from a medical standpoint, Mary Fink's ankle fracture "was the beginning of" the process which led to her blood clots, and once that process began, it led directly to her death. He testified that it was "possible but not likely" that Mary Fink could have "had the pulmonary thromboembolism without this accident ever occurring," but saw no evidence to suggest it in this case, characterizing the proposition as speculative. Dr. Thorpen felt the ankle fracture was clearly the "most significant" risk factor--it causes damage to a vein or veins, slows blood flow, implicates immobilization, and enhanced the other pre-existing risk factors (age, obesity). Dr. Thorpen testified:
Q: But in your medical opinion, would she have suffered this embolism without the fractured ankle?
A: I would have to say it's possible.
Q: Do you see any evidence to suggest that that is what occurred?
A: No, sir, I don't.
Q: And when we look solely at evidence and not speculation and possibilities, is there any other cause for that clot?
A: In my opinion, no.
[ ] We find that, based on Dr. Thorpen's testimony, which is uncontradicted in the record, and its inferences when viewed in a light most favorable to the State, a rational jury could conclude beyond a reasonable doubt that appellant's conduct was the proximate cause of Mary Fink's death. Dr. Thorpen's testimony, when viewed in this fashion, established that, based on the evidence (including the autopsy, scientific evidence, and a complete review of Mary Fink's medical records and medical history), as opposed to other speculative "possibilities," the ankle fracture Mary Fink suffered in the collision with appellant's vehicle resulted in trauma to a vein or veins in her lower extremity. Due to this injury, blood flow slowed in the damaged area, Mary Fink was immobilized, and a clot developed within five days to one or two weeks prior to her ankle surgery, but nevertheless after the collision with appellant's vehicle. The fracture was the "most significant" factor in the clot's development, enhancing Mary Fink's pre-existing risk factors for developing clots. Sometime on May 7, 1999, the clot broke away and caused Mary Fink's death. The record is insufficient, in this context, to establish an intervening cause based on the conduct of Mary Fink's treating physicians (the only basis relied upon in appellant's argument). Dr. Thorpen rendered his opinion (again uncontradicted in the record) based on his review of Mary Fink's medical records, medical history, and operative reports relating to her ankle surgery; he did not know why the ankle surgery was not performed immediately and stated that it was not foreseeable in this case that something "like this could happen when surgery is slated."
[ ] In light of this finding, the district court similarly did not err in denying ap
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