Medical malpractice; Kalaj v. Khan; Necessity of expert testimony to establish “causation” & breach of the standard of care (SOC); Teal v. Prasad; Recovery for “the loss of an opportunity to survive or an opportunity to achieve a better result”; Dykes v. William Beaumont Hosp.; MCL 600.2912a(2); Carotid endarterectomy (CEA) (procedure to remove build up from the carotid artery walls)

[Unpublished opinion.] The court concluded that the trial court on remand did not err in determining that the Supreme Court’s order covered more than testimony relating to the decedent’s (Peetz) “‘chronic’ subdural hematoma.” It also did not err in concluding that “hypertension was not a separate causal theory, but was instead a component of the same causal theory rejected by the Supreme Court.” However, the court held that the trial court erred in granting the defendants summary disposition as to plaintiff’s CT scan causal theory. Thus, it affirmed in part, reversed in part, and remanded. Peetz died after undergoing a CEA. Defendant-Hans was the vascular surgeon. After prior appellate proceedings, the trial court granted defendants’ summary disposition motion. The court noted that in reversing its prior decision in the case, the Supreme Court “rejected plaintiff’s theory that Peetz’s subdural brain bleed (whether acute or chronic) occurred as a result of lack of blood flow to Peetz’s brain during the CEA, causing the brain to retract from the skull, tearing blood vessels, and creating a pathway for blood to accumulate in the subdural space.” However, plaintiff’s experts (A and F) also “opined that Peetz would have survived if she had received a CT scan immediately after her second surgery.” Plaintiff asserted that “this theory of causation was independent of the theory rejected by the Supreme Court.” F testified that Hans breached the SOC “by failing to obtain a CT scan immediately after Peetz’s second surgery when he could not independently determine the cause of her serious neurological symptoms.” Both experts “explained that the failure to obtain a CT scan immediately after the second surgery caused Peetz’s death because, without the CT scan, her physicians were unable to identify the subdural hematoma in time to perform intracranial surgery to evacuate the excess blood and relieve the pressure on her brain.” The Supreme Court’s order did not address their testimony on “the CT scan causal theory,” and the trial court did not dismiss it “on the basis that the expert testimony addressing it was inadmissible under MRE 702.” Rather, it concluded that “Peetz did not have a greater than 50% chance at survival even if she had received a CT scan immediately after the second surgery. This determination was improper at the summary disposition stage” given the experts’ testimony.