## Facts

- Sylvester Franklin, Jr., a high-risk patient with multiple serious medical conditions, was scheduled for carpal tunnel surgery at Church Hospital on July 17, 1981.
- Dr. Shanker L. Gupta was the surgeon; Dr. Herbert S. T. Lee was the anesthesiologist; Gary J. Sergott was a certified registered nurse anesthetist.
- Dr. Lee was assigned to another operating room concurrently and left the administration and monitoring of anesthesia to Sergott.
- Lee and Sergott preferred regional anesthesia due to Franklin’s risk profile; the regional block was only partially effective.
- When the block did not provide adequate anesthesia, Gupta insisted on general anesthesia; Sergott believed general anesthesia was unsafe and left to consult Lee.
- During Sergott’s absence, Franklin developed cardiopulmonary distress (including cyanosis), required emergency intervention, and the surgery was cancelled.
- Franklin alleged the event worsened his preexisting conditions and caused permanent injury.

## Issues

1. Whether the trial court properly granted judgment notwithstanding the verdict (JNOV) for Lee, Sergott, and the hospital based on insufficient evidence of breach of the applicable standard of care and proximate causation.
2. Whether Gupta could be held vicariously liable for anesthesia-related acts or omissions under a “captain of the ship” or similar control-based theory.
3. Whether Franklin was entitled to a jury instruction imposing overarching operating-room responsibility on Gupta.

## Decision

- The appellate court affirmed the JNOV for Lee, Sergott, and Church Hospital.
- The court held the evidence was legally insufficient for a reasonable jury to find negligence and causation against the anesthesia providers and the hospital.
- The court affirmed judgment for Gupta and rejected “captain of the ship” liability on this record.
- The court upheld the refusal to give the requested instruction that would have imposed automatic surgeon responsibility for operating-room personnel.

## Legal Principles

- In Maryland medical malpractice cases, expert testimony is ordinarily required to establish the applicable professional standard of care and to prove that any breach proximately caused the claimed injury.
- JNOV is proper when, viewing the evidence most favorably to the nonmoving party, there is insufficient evidence for a reasonable jury to find for the plaintiff.
- A surgeon is not automatically vicariously liable for the negligence of an anesthesiologist or nurse anesthetist; liability depends on ordinary agency and control principles (e.g., an employment/agency relationship and actual supervisory control).
- A “captain of the ship” instruction is improper without evidence supporting the surgeon’s right to control the other professionals’ work in the area at issue.

## Conclusion

The court affirmed judgment for all defendants because Franklin’s proof did not supply the expert foundation needed to establish anesthesia-related standards of care and causation, and because Maryland law does not impose automatic surgeon liability for independent anesthesia professionals absent evidence of agency and control.


Franklin v. Gupta, 567 A.2d 524 (Md. Ct. Spec. App. 1990)