## Facts

- Michelle Esquivel received prenatal care from Aaron T. Watters, M.D., at Ark City Clinic beginning in August 2001.
- On November 15, 2001, Michelle obtained a free “gender determination” sonogram at South Central Kansas Regional Medical Center (SCKRMC) using a clinic gift certificate.
- The consent/release for the sonogram stated it was only to determine fetal sex, not to diagnose abnormalities, and included a liability release.
- During the sonogram, a technician observed a serious fetal abnormality consistent with gastroschisis and documented images contrary to the “gender only” purpose.
- A radiologist declined to interpret the images as diagnostic and directed the technician to contact Dr. Watters.
- The technician called Dr. Watters and reported the suspected abnormality, but no note of the call was made in Michelle’s chart.
- Dr. Watters directed staff to contact Michelle to have her come in promptly; staff attempts culminated in a message relayed through a person believed to be her husband, without disclosing the abnormality.
- Michelle missed a November 26 prenatal appointment and did not return until January 4, 2002; by then Dr. Watters had forgotten the reported abnormality and took no further steps regarding it.
- Michelle later required an emergency cesarean delivery; the infant, Jadon David Esquivel, was born with bowel outside his body, underwent transfer and surgery, was deemed terminal, and died about one month after birth.
- The parents, as heirs and estate representatives, sued Dr. Watters, Ark City Clinic, and SCKRMC for negligence and wrongful death.
- The district court granted summary judgment to defendants; the Court of Appeals affirmed; the Kansas Supreme Court granted review.

## Issues

1. Whether genuine issues of material fact precluded summary judgment on claims that Dr. Watters breached the standard of care and caused injury/death.
2. Whether SCKRMC was entitled to summary judgment based on (a) lack of a patient–health care provider relationship/duty arising from a “gender only” sonogram and (b) the sonogram release as a bar to liability.
3. Whether disputed inferences, expert conflicts, and credibility questions required resolution by a factfinder rather than on summary judgment.

## Decision

- The Kansas Supreme Court reversed the summary judgments for Dr. Watters and SCKRMC and remanded for further proceedings.
- As to Dr. Watters, the court held the record presented triable fact disputes regarding breach (including follow-up, documentation, and failure to act after learning of a suspected abnormality) and causation.
- As to SCKRMC, the court held the hospital’s conduct during and after the sonogram and the scope/enforceability of the release presented factual and legal questions not suitable for summary disposition.
- The court rejected using summary judgment to resolve competing inferences and credibility-dependent disputes in this negligence/medical-malpractice record.

## Legal Principles

- On summary judgment, courts must resolve all reasonable factual inferences in favor of the nonmoving party and may not weigh evidence or assess witness credibility.
- Summary judgment is seldom appropriate in negligence cases, including medical malpractice, when material facts or reasonable inferences are disputed.
- Negligence is not presumed from a bad outcome; malpractice plaintiffs generally must prove breach and causation, ordinarily through expert testimony.
- Where the evidentiary record allows competing inferences on breach, causation, duty, or the effect of a liability release, those questions are for the factfinder rather than disposition as a matter of law.

## Conclusion

The Kansas Supreme Court held that the malpractice and wrongful-death claims could not be dismissed on summary judgment because the record raised genuine disputes about the physician’s follow-up and causation, and about the hospital’s duty and the reach of a “gender-only” sonogram release, requiring trial resolution.


Esquivel v. Watters, 286 Kan. 292, 183 P.3d 847 (Kan. 2008)