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

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Michigan Court of Appeals; Docket # 349756; 350221; Unpublished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


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

TOPICAL INDEXING:
Not Applicable


SUMMARY:
In this unanimous unpublished per curiam decision, the Court of Appeals reversed the trial court’s denials of defendant Auto-Owners Insurance Company’s motions for summary disposition and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.

In this case, the trial court should have applied McPherson and granted either defendant’s motion for summary disposition or motion for directed verdict. There was evidence presented that Mazade sustained a serious left-leg injury as a result of the car accident. Notably, it was Mazade’s left leg that ultimately became infected and was amputated. However, there was no evidence to suggest that the injuries that Mazade sustained to her left legfrom the car accidentcaused the infection and subsequent amputation. In other words, the infection and subsequent amputation did not “arise out of” the injuries sustained in the November 2016 automobile accident. See MCL 500.3105(1). While the causal connection that a plaintiff must establish does not rise to the level of proximate causation, there must be “something more than a showing that the causal connection between the injury and the use of the motor vehicle was merely incidental, fortuitous, or ‘but for.’ ”Kochoian v Allstate Ins Co, 168 Mich App 1, 8; 423 NW2d 913 (1988), citing Thornton, 425 Mich at659-660.Contrary to plaintiff’s bare assertions that Mazade opened the wounds that she suffered from the car accidentduring one of her numerous falls, there is no evidence in the record to suggest that those wounds were what became infected or that her falls in Alabama resulted in reinjuring her wounds from the car accident at issue.


Lansing car accident lawyer Stephen Sinas is the lead editor of the appellate case summaries published on this site regarding the Michigan auto insurance law. To learn more about how Stephen Sinas and how the Sinas Dramis Law Firm can help you if you have been injured in a Michigan auto accident, visit SinasDramis.com.

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