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Advisacare Healthcare Solutions, Inc. v. Auto-Owners Insurance Company (COA – UNP 10/15/2020; RB #4160)


Michigan Court of Appeals; Docket # 349756; 350221; Unpublished
Judges Murray, Cavanagh, and Cameron; Per Curiam
Official Michigan Reporter Citation: Not Applicable; Link to Opinion

Entitlement to PIP Benefits: Arising Out of / Causation Requirement [§3105(1)]

Not Applicable

In this unanimous unpublished per curiam decision, the Court of Appeals reversed the trial court’s denials of defendant Auto-Owners Insurance Company’s motions for summary disposition and directed verdict, and remanded for entry of judgment in favor of Auto-Owners.  The plaintiff’s patient, Vivian Mazade, suffered a severe leg injury in a motor vehicle crash and developed a walking disability as a result.  Her walking disability caused her to fall down and further injure her leg approximately one month after the collision, and as a result of her fall, her leg became infected with cellulitis and sepsis.  Ultimately, Mazade had her leg amputated, and thereafter sought PIP benefits from Auto-Owners for the attendant care she received during her recovery.  The Court of Appeals held that Mazade was not entitled to such benefits related to the amputation, however, because Mazade failed to present sufficient evidence that the wounds that became infected and led to the amputation were the same wounds she received as a result of the crash.

Mazade lost control of her vehicle in November 2016 and hit a tree, causing her to sustain injuries to numerous parts of her body, including her legs.  As a result of the crash, Mazade developed a walking disability, and approximately one month after the collision, while visiting family, Mazade fell as a result of her walking disability and further injured her leg.  As a result of the injuries she sustained in the fall, Mazade’s leg became infected with cellulitis and sepsis, and she was forced to have her leg amputated.  While her treating physician and the doctor who performed the amputation both attributed the infection and subsequent amputation to the crash, Auto-Owners’ physician opined that the cellulitis and sepsis were not related to the accident.  Accordingly, Auto-Owners denied Mazade’s claim for attendant care services after the amputation, and Mazade’s attendant care provider, Advisacare Healthcare Solutions, Inc., filed the underlying first-party action against Auto-Owners.  Throughout the course of litigation, the trial court denied both Auto-Owners’ motion for summary disposition and Auto-Owners’ motion for a directed verdict, and, ultimately, the jury found for Advisacare.

The Court of Appeals held that the trial court erred in denying Auto-Owners’ motions, however, and analogized this case to McPherson.  The Court of Appeals noted that, as in McPherson, the connection between the infection and the crash was too attenuated to prove that the connection between the infection and the crash was “more than incidental, fortuitous, or ‘but for.’”  Moreover, there was inconclusive evidence regarding whether the wounds and the injuries Mazade sustained in the crash were the same wounds that ultimately became infected and led to her amputation.

Similar to McPherson, the record reflects that “the first injury directly caused the second accident, which in turn caused the second injury.” Id. at 298-299. Mazade did not contract an infection from the accident. Rather, she contracted the infection during one of her falls, which was caused by her decreased mobility, which was caused by her instability, which was caused by her use of a motor vehicle as a motor vehicle in 2016. See id. at 297. This type of causation was explicitly rejected, meaning that the falls that Mazade suffered were too remote and too attenuated from the automobile accident to permit a finding that the causal connection between the accident and infection/amputation were “more than incidental, fortuitous, or ‘but for.’ ” Id. at 298, quoting Thornton, 425 Mich at 659 (quotation marks omitted).

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