MORUS v. KAPUSTA (2003)

Following a jury trial,¹ the trial court entered judgment on the jury's general verdict in favor of plaintiff Joan Morus (plaintiff) as against defendant Dr. George Kapusta (defendant) in the amount of $1.5 million, with respect to the death of decedent Frank Morus (Morus) upon elective gall bladder surgery performed by defendant.²  Defendant filed a posttrial motion seeking judgment notwithstanding the verdict or, in the alternative, a new trial.   The trial court denied this motion.   Defendant now appeals, asking that we reverse the judgment of the trial court and enter judgment in his favor or, in the alternative, that we remand the cause for a new trial.   For the following reasons, we affirm.

BACKGROUND

Decedent Morus, who had a history of congestive heart failure (CHF), was admitted to Christ Hospital in Oak Lawn, Illinois, on June 8, 1995.   Initially, he was suffering from swollen legs, a breakdown in his skin and infection.   While in the hospital, Morus developed gastric problems, including nausea.   It was determined that he was suffering from cholecystitis (diseased gall bladder), and elective cholecystectomy surgery (gall bladder removal) was recommended and scheduled for June 30, 1995.   Defendant, a surgeon, was asked to give a surgical consultation, and he agreed with this recommendation.

Upon Morus' admission on June 8, 1995, he was diagnosed by several doctors as being in continued CHF. Four portable chest X rays were taken between June 8 and 13, 1995, and each revealed that Morus had the major symptoms of CHF, including an enlarged heart, pulmonary congestion and bilateral pleural effusions (fluid accumulation in the spaces between the lungs and the chest walls).   A full chest X ray was never taken of Morus, nor was any other portable chest X ray taken between June 13 and 30, 1995, prior to the scheduled surgery.

While in the hospital, Morus was taking a daily dose of aspirin in response to concerns regarding his medical history with respect to strokes.   Morus continued taking aspirin every day until the day before the scheduled surgery.   Also, upon his admission to the hospital, Morus weighed 221 pounds.   He was placed on a diuretic, and his weight dropped to 215 pounds.   In the 8 days before the scheduled surgery, Morus gained 11 pounds.

Defendant performed surgery on Morus on the scheduled date of June 30, 1995.   Defendant did not use a Swan-Ganz catheter or an arterial line during surgery to monitor Morus' heart and lung pressure.   The surgery was completed that afternoon, and Morus was taken to the general recovery room.   Defendant left the hospital.   While in the recovery room, Morus' blood pressure dropped and he began experiencing respiratory problems.   Morus was placed on a ventilator and was transferred to the surgical intensive care unit.   Morus then went into shock.   By 1 a.m. the next day (July 1, 1995), his pupils were dilated and he was nonresponsive in a comatose state. Defendant received four telephone calls at several points throughout the night of June 30, 1995, from the on-call surgical resident describing Morus' condition and deterioration.   Defendant did not return to the hospital until some time later in the morning of July 1, 1995, between 6 a.m. and 7 a.m. At 9 a.m., defendant and other doctors involved in Morus' care, as well as Morus' family, decided to remove Morus from the ventilator pursuant to his living will, and Morus died.   An autopsy revealed that Morus had an enlarged heart and pleural effusions consistent with CHF, and that he had bled internally.   The autopsy also showed that Morus had been suffering from renal failure.

Plaintiff, Morus' wife, filed a complaint at law against defendant containing a survival count and a wrongful death count.   Plaintiff alleged that defendant violated preoperative, surgical and postoperative medical standards of care in treating Morus, and that defendant's negligence in one or more of these respects was a contributing and proximate cause of Morus' death.   The case proceeded through discovery, and during a pretrial conference, plaintiff filed several motions in limine.   One included a motion to preclude defendant from submitting any opinions concerning Morus' life expectancy other than that he would not have been expected to live “more than an additional five years.”   After discussing this with the parties, the trial court granted plaintiff's motion in limine, and stated that the experts' opinions as to Morus' life expectancy would be subject to cross-examination during trial.   Later, during a jury instruction conference prior to trial, the court and the parties again discussed Morus' life expectancy.   Plaintiff presented an instruction utilizing life expectancy tables, but the court and the parties agreed that the information contained in the tables was not applicable to the instant case based on the evidence that would be presented with respect to Morus' particular life expectancy.   A discussion then ensued as to whether the language of the instruction to be presented to the jury should be that Morus would have lived “no longer than five more years” or, rather, that he would have lived “approximately five more years.” The trial court concluded that the instruction on Morus' life expectancy should read that he would have lived approximately five years, and stated that this instruction would be revisited later during the trial, “when it comes to [a] more specific [time] [sic].”   Before trial had begun, the court read this instruction to the jury.   The cause then proceeded to trial.

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In her case-in-chief, plaintiff presented the expert testimony of Dr. Lawrence Hollander, a general surgeon who had reviewed the evidence in this cause.   Dr. Hollander testified that in his opinion, defendant had breached the standard of care in his treatment of Morus in four ways:  preoperatively in conducting his evaluation of Morus and finding him suitable for surgery on June 30, 1995;  in failing to discontinue Morus' aspirin 7 to 10 days prior to surgery;  during surgery in performing the operation;  and postoperatively in failing to return to the hospital and administer or manage Morus' post-surgical care.

As to defendant's preoperative conduct, Dr. Hollander averred that defendant had not conducted a proper pre-surgical evaluation of Morus and that had defendant done so, the operation would have been cancelled and Morus would not have died on July 1, 1995.   Dr. Hollander's testimony with respect to this preoperative care focused on Morus' chest X rays and untreated CHF, his weight gain, his use of aspirin, and the fact that this was an elective procedure.   Dr. Hollander testified that medical records showed Morus was in CHF when he was admitted to the hospital.   Dr. Hollander stated that, because of this, defendant could not rely, prior to surgery, simply on the four portable chest X rays taken early on during Morus' admission, since these X rays provided scans of only half of Morus' chest.   Rather, in view of Morus' symptoms, the standard of care required defendant to order a full chest X ray before surgery rather than a portable one, because the full X ray includes scans of both the postero-anterior and lateral views of the body.   Defendant never ordered a full chest X ray;  Dr. Hollander averred that a CT scan and ultrasound defendant did conduct were “useless” because they are not adequate substitutes for such an X ray.   Dr. Hollander testified that even with the less-complete portable X rays, Morus' signs of CHF, including his enlarged heart, pulmonary congestion and pleural effusions, were obvious prior to the scheduled surgery.

In addition to the inadequate chest X rays, Dr. Hollander stated that defendant further breached the preoperative standard of care in failing to consider Morus' 11-pound weight gain in the 8 days before surgery.   Dr. Hollander testified that although the surgery may have been necessary, it was “not permissible to perform an elective operation” such as this one on Morus once he had gained this amount of weight in the week prior to surgery.   Dr. Hollander stated that, since medical records showed that Morus had no appetite and was not eating regularly while in the hospital, the weight gain could only be the result of water retention due to Morus' CHF. The weight gain further signaled that Morus had an enlarged heart, engorged pulmonary vessels and pleural effusions, and was another reason that the standard of care required defendant to order a full chest X ray before clearing Morus for surgery.

Dr. Hollander further opined that defendant breached the standard of care by failing to consider the effects of Morus' daily use of aspirin on his blood and that the failure to do so contributed to Morus' death.   Dr. Hollander stated that aspirin has irreversible abnormal effects on platelets, which aid the body in clotting its blood.   Dr. Hollander averred that the standard of care required defendant to stop the administration of aspirin to Morus at least 7 to 10 prior to surgery in order to prevent bleeding.   Dr. Hollander stated that because defendant did not do this, Morus suffered from “platelet poisoning” which caused post-surgical bleeding and contributed to his death.

As to his conduct during surgery, Dr. Hollander opined that defendant breached the standard of care in monitoring Morus while conducting the gall bladder removal procedure.   Dr. Hollander testified that because of Morus' “critically ill” status in the days prior to surgery, the standard of care required defendant to use a Swan-Ganz catheter or an arterial line during surgery in order to monitor the pressure in Morus' heart and lungs.   Dr. Hollander stated that defendant's failure to use these devices during the operation caused and contributed to Morus' death.

Dr. Hollander further testified as to defendant's conduct after the surgery.   Dr. Hollander opined that defendant breached the standard of care postoperatively in several respects.   Dr. Hollander testified that, upon defendant's discovery through telephone calls with the on-call surgical resident during the night of June 30, 1995 that Morus was being transferred to the surgical intensive care unit, the standard of care required defendant to inquire about the status of Morus' blood pressure.   Dr. Hollander stated that the failure to do so would constitute a breach of the standard of care.   Dr. Hollander also stated that if defendant did inquire and was told about Morus' low blood pressure, the standard of care required him to return to the hospital and resume management of Morus' care.   Dr. Hollander explained that a postoperative drop in a patient's blood pressure, as occurred with Morus, creates the presumption that the patient is bleeding internally.   Dr. Hollander stated that when this happens, it is “the surgeon's responsibility” to stop the bleeding. Dr. Hollander averred that in Morus' case, the standard of care required defendant to return to the hospital to stop the bleeding in two ways:  re-operate on Morus to find the cause of the bleeding and, knowing that Morus had been taking aspirin until the morning of surgery, “replace the platelets” to “reverse the platelet poisoning.”   Dr. Hollander concluded that because defendant did not return to the hospital after surgery to perform any of these requirements, he breached the standard of care, thereby causing Morus' death.

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Plaintiff presented the expert testimony of Dr. Patrick Sullivan, an internist.   Dr. Sullivan opined that defendant breached the standard of care in clearing Morus for surgery, in performing the surgery and in his conduct after the surgery was completed.   Dr. Sullivan stated that these breaches were a “contributing and proximate cause” of Morus' death the day after surgery.

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Dr. Sullivan testified that the basis of his opinions originated from his review of the following information.   Dr. Sullivan stated that the chest X rays taken of Morus early in June 1995 when he was admitted to the hospital indicated CHF, as exhibited by Morus' enlarged heart, engorged pulmonary vessels and pleural effusions.   Dr. Sullivan also noted that Morus' 11-pound weight gain in the 8 days before the scheduled surgery was due to the accumulation of fluid in Morus' body caused by a progressive increase in the failure of Morus' heart.   Dr. Sullivan stated that this weight gain was enough of a change to alert defendant that the preoperative standard of care required him to order a chest X ray to check for CHF before surgery.   Dr. Sullivan testified that had defendant complied with this standard of care, Morus' CHF would have been obvious and no surgical operation would have occurred on June 30, 1995.

Dr. Sullivan then testified to the general effects of aspirin on a patient waiting to undergo surgery.   Dr. Sullivan testified that aspirin causes platelets to function improperly, impairing the body's ability to clot its own blood.   As a result, the blood of a patient undergoing surgery while having taken aspirin becomes thin and does not clot properly, causing a risk for serious problems such as bleeding and hemorrhaging.   The following exchange then took place between plaintiff's counsel and Dr. Sullivan:

“Q. * * * How, if at all, can the effects of aspirin be reversed through the use of platelet transfusions?

A. Well, you can do that.   You can give platelet transfusions to somebody.”

Defense counsel objected, claiming a violation of Rule 213 in that plaintiff never disclosed in discovery that Dr. Sullivan would give an opinion with respect to “platelet transfusions.”   The trial court overruled the objection, finding that this was merely a basis for Dr. Sullivan's previously disclosed opinion during discovery that the failure to stop the administration of aspirin to Morus was a violation of the standard of care.   Dr. Sullivan then reiterated his opinion, stating “[y]ou can reverse the effect of aspirin by giving platelet transfusions to a patient or just waiting until the effect of the aspirin wears off.”

Dr. Sullivan then testified with respect to the particular effects of aspirin as they related specifically to Morus' situation.   Dr. Sullivan opined that, because Morus' gall bladder surgery was an elective procedure, there was “no benefit to having [him] on aspirin, only risk.”   Dr. Sullivan stated that the daily doses of aspirin Morus was taking prior to surgery compromised his clotting abilities and increased his likelihood of bleeding after surgery.   This post-surgical bleeding caused Morus' blood loss and, in turn, perpetuated Morus' continued CHF, resulting in Morus' death on the morning after surgery.

As to his conduct after surgery, Dr. Sullivan opined that defendant breached the post-surgical standard of care in failing to return to the hospital.   Dr. Sullivan testified that defendant should have returned Morus to surgery to stop the intra-abdominal bleeding, which defendant should have recognized due to the reports he received that evening that Morus' blood count and blood pressure were falling to very low levels.   Dr. Sullivan stated that if defendant had returned to the hospital prior to Morus' development of brain damage, which did not occur until the next morning, there was a chance that Morus would have survived.

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Dr. Sullivan testified as to his opinion with respect to Morus' life expectancy.   When asked how long Morus would have lived had the surgery not been performed on June 30, 1995, Dr. Sullivan responded “I believe probably five years.”   Dr. Sullivan stated that the basis for his opinion was “[j]ust a general survival of patients like [Morus] with the diseases he had.”   Dr. Sullivan was also asked whether the fact that Morus had a living will indicating he had no desire to be put on dialysis or other life-saving treatments impacted his opinion.   Dr. Sullivan stated that this fact “didn't really enter into it.”

At the close of plaintiff's case in chief, defendant moved for a directed verdict, asserting that plaintiff did not present sufficient evidence to show that any one of her four theories of negligence was the proximate cause of Morus' death.   The trial court denied defendant's motion.

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Defendant testified that on June 22, 1995, he was asked to provide a surgical consultation with respect to whether removal of Morus' gall bladder would ease his nausea.   Defendant ordered a CT scan and ultrasound of Morus' abdomen at that time, concerned that Morus may have been suffering from a more serious illness, such as pancreatic or gall bladder cancer.   The tests were negative for those illnesses, showing only that Morus had gall bladder disease.   Defendant concluded that Morus would require removal of his gall bladder through a surgical procedure which, though major, was elective and not an emergency.

Defendant also testified that he reviewed Morus' chest X rays taken in the days after his admission to the hospital between June 8 and June 13, 1995, before defendant was assigned to the case.   Defendant stated that these X rays showed that Morus had an enlarged heart, pulmonary congestion and bilateral pleural effusions.   Defendant averred that the CT scan and ultrasound he ordered later in June confirmed that Morus had pleural effusions, and that the recorded impressions of other doctors involved in Morus' treatment concluded that Morus was in CHF. Defendant stated that because of this condition, Morus was a high surgical risk patient.   Defendant did not order any other chest X rays of Morus prior to surgery.

Defendant further testified that Morus' weight fluctuated while he was in the hospital, and that Morus gained 11 pounds in the 8 to 10 days prior to surgery.   Defendant acknowledged that this weight was not due to food consumption, but rather, to a retention of fluid in Morus' body.   Defendant also testified that he was aware that Morus had been taking aspirin every day since the first day of his admission to the hospital to guard against blood clots and stroke, and that Morus continued to take aspirin until June 29, 1995, the day before surgery.   Defendant stated that aspirin impairs platelet function by adversely affecting an enzyme in the platelets which allows the platelets to clump together and aid the body's blood to clot.   Defendant testified he knew that, because of Morus' continued aspirin ingestion, his platelet function was impaired and that this was irreversible for the life of the platelets, which is 7 to 10 days.   Defendant stated that he did not know of any patient who had a stroke while discontinuing aspirin for 7 to 10 days prior to undergoing major surgery, and that, if this was a concern, there were other anticoagulant drugs that could be administered and then stopped hours before surgery to guard against stroke.

Defendant further testified that on June 28 and 29, 1995, the two days prior to the scheduled gall bladder surgery, Morus was not symptomatic of CHF or other heart problems, displaying clear lungs and no shortness of breath.   Because of this, defendant did not order a chest X ray and concluded that Morus was in the best possible condition for surgery at that time.   Defendant stated that while he would have been “taking chances” in delaying the surgery, the surgery did not need to be performed on June 30, 1995.   Defendant testified that during surgery, he discovered that Morus suffered from gall stones, porcelain gall bladder, morbid obesity, diabetes and renal failure.   While Morus lost blood during surgery, defendant stated that Morus was not bleeding when the surgery was concluded.

Defendant testified that after the operation, he left the hospital and Morus was transferred from the operating room to the general recovery room and placed under the care of Dr. Eric Swenson, the on-call surgical resident.   Dr. Swenson telephoned defendant four times throughout the night of June 30, 1995, about Morus' condition.   Defendant averred that during one of those calls, Dr. Swenson informed defendant that Morus had to be moved to the surgical intensive care unit because his blood pressure had dropped to very low levels and he was experiencing respiratory problems, requiring the use of a ventilator.   Defendant testified that this was “unexpected.”   Defendant also averred that during another call, Dr. Swenson informed him that Morus was having heart problems, his blood count was dropping requiring a transfusion, and he was leaking urine. Defendant testified this indicated that Morus was bleeding postoperatively inside his abdomen.   Defendant stated that he did not feel it necessary to return to the hospital because Morus' heart problems were cardiac-related, and that he could do nothing because this was beyond his training.   When defendant returned to the hospital later the next morning (July 1, 1995), he concluded that Morus had been without brain function from 1:00 a.m. to 9:00 a.m. leading to brain damage, and agreed with other doctors present as well as Morus' family that Morus should be removed from his ventilator.   Defendant acknowledged that his performance of the gall bladder surgery caused Morus' bleeding which resulted in low blood pressure and blood counts, and that, if he had not performed the surgery, Morus would not have died the next day.

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Dr. Robert Caplan was called by codefendant Dr. Ann Brennan as an expert witness and his evidence deposition was entered into the record at trial.   Dr. Caplan reviewed the depositions of several doctors in this cause, as well as Morus' autopsy report and his medical records.   Dr. Caplan provided opinion testimony with respect to Morus' medical condition, the effects of aspirin, and Morus' life expectancy.

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Dr. Caplan testified that when Morus was admitted on June 8, 1995, a chest X ray showed that he was in CHF, exhibiting an enlarged heart, pulmonary congestion and bilateral pleural effusions. Subsequent chest X rays taken on June 9 and 10, 1995, showed slight improvement, but continued CHF. This was corroborated in Morus' final chest X ray before surgery, taken on June 13, 1995.   Dr. Caplan further testified that, as the date of surgery approached, Morus' medical records showed that he was no longer symptomatic of CHF, but rather, that he was in stable condition with normal heart sounds and clear lungs, and thus, was an appropriate candidate for the scheduled surgery.   Dr. Caplan opined that, because of this, no chest X ray was required before surgery, there was no need to delay the surgery and the standard of care did not warrant the use of a Swan-Ganz catheter or arterial line to monitor Morus during surgery.   Dr. Caplan also determined that Morus' postoperative problems had been successfully addressed and he was transferred to the intensive care unit in a stable condition.

With respect to aspirin, Dr. Caplan testified that medical records showed Morus was given aspirin every day from June 9, 1995, to the day before his surgery on June 29, 1995.   Dr. Caplan stated that aspirin has a negative effect on platelets, impairing their function for 7 to 10 days.   The following colloquy took place:

“[Plaintiff's counsel] Q. Aspirin irreversibly impairs the function of platelets once aspirin is given, correct?

[Dr. Caplan] A. Yes.

Q. And the only way you can reverse that is to wait until those platelets have lived their life span, which is seven to ten days, correct?

A. Outside of giving a platelet transfusion, the answer is yes.”

Dr. Caplan further opined that “the final and important event” in Morus' case was inter-abdominal bleeding occurring after surgery, which in turn affected Morus' heart.   Dr. Caplan testified that the continued administration of aspirin to Morus contributed to this bleeding.

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With respect to Morus' life expectancy, Dr. Caplan opined that the surgery Morus underwent was not an emergency procedure, and it was “more likely than not [Morus] would not have died the next day” if the surgery had not been performed.   Dr. Caplan testified that “[g]iven the severity of his underlying disease states, [Morus'] life expectancy would be reduced, below that of an individual who did not have these disease states, and, as a rough estimate, another five years might be a reasonable projection.”

In addition to these expert witnesses, several members of Morus' family testified at trial, including plaintiff and Morus' children.   They stated that in accordance with his living will, Morus had expressed to them that he did not want to be connected to machines necessary to keep him alive, such as a ventilator.   They also testified that Morus had expressed that he did not want to undergo dialysis, even if this was necessary to his survival.

At the close of the testimony in this cause, the trial court again read the jury instructions to the jury, including the following with respect to Morus' life expectancy:

“If you find for the Plaintiff, Joan Morus[,] * * * under the Wrongful Death Count, then in assessing damages, you may consider how long Frank Morus was likely to have lived.   The evidence shows that Frank Morus was likely to have lived approximately five years from the date of his death.”

The jury returned a general verdict in favor of plaintiff and against defendant in the total amount of $1.5 million.   Defendant did not present the jury with any special interrogatories to determine on which of the four bases of negligence asserted by plaintiff the jury found defendant to have been negligent.   The jury's award was itemized as follows:  $250,000 on the survival count ($250,000 for pain and suffering Morus experienced as a result of the injury, $0 for the reasonable expense of necessary medical care, and $0 for the reasonable expense of the funeral and burial);  and $1,250,000 on the wrongful death count.

ANALYSIS

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As set forth above, defendant presents four issues for review.   We address each separately.

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A. Breaches of the Standard of Care and Proximate Cause

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Defendant's first contention on appeal is that the trial court erred in not directing a verdict in his favor or awarding him judgment notwithstanding the verdict and ordering a new trial based on plaintiff's failure to present evidence that defendant's alleged breaches of the standard of care were the proximate cause of Morus' death.   Defendant asserts two principle errors.   First, he claims that plaintiff failed to present expert testimony on causation with respect to three of the four theories of negligence pursued at trial:  defendant's failure to discontinue aspirin as a proximate cause of Morus' death, defendant's failure to use a Swan-Ganz catheter during surgery as a proximate cause of Morus' death, and defendant's failure to return to the hospital after surgery as a proximate cause of Morus' death.   Second, defendant claims that without this corresponding causation testimony, he was prejudiced by the trial court's admission of that testimony describing the standards of care.

A judgment notwithstanding the verdict, as well as a directed verdict, is to be entered only when the evidence, viewed in the light most favorable to the non-movant, so overwhelmingly favors the movant that no contrary verdict could stand based on the evidence.   See McClure v. Owens Corning Fiberglas Corp., 188 Ill.2d 102, 132, 241 Ill.Dec. 787, 720 N.E.2d 242 (1999) (reviewing motions for judgments notwithstanding the verdict);  Dunlap v. Alcuin Montessori School, 298 Ill.App.3d 329, 339, 232 Ill.Dec. 483, 698 N.E.2d 574 (1998) (reviewing motions for directed verdict).   Just as the trial court in a jury trial cannot reweigh the evidence and set aside a verdict merely because it feels that other results are more reasonable, we likewise cannot substitute our judgment on questions of fact and witness credibility submitted to and tried by the jury.   See McClure, 188 Ill.2d at 132, 241 Ill.Dec. 787, 720 N.E.2d 242;  Dunlap, 298 Ill.App.3d at 339, 232 Ill.Dec. 483, 698 N.E.2d 574.   Therefore, we apply a de novo standard to our review of decisions on motions for judgments notwithstanding the verdict and those for directed verdict.   See McClure, 188 Ill.2d at 132, 241 Ill.Dec. 787, 720 N.E.2d 242;  Dunlap, 298 Ill.App.3d at 339, 232 Ill.Dec. 483, 698 N.E.2d 574.

In addressing defendant's first claim, namely, plaintiff's alleged failure to present expert testimony on proximate causation with respect to three of her four theories of negligence, we note as a threshold matter that defendant has waived his right to contest the sufficiency of the evidence presented against him because he failed to request the submission of special interrogatories to the jury.   See Goad v. Evans, 191 Ill.App.3d 283, 293, 138 Ill.Dec. 523, 547 N.E.2d 690 (1989).   The purpose of submitting special interrogatories to a jury in a cause which is based on several theories of liability is to elicit on which of the legal theories presented the jury relied for its verdict.   See Goad, 191 Ill.App.3d at 293, 138 Ill.Dec. 523, 547 N.E.2d 690.   Our case and statutory law is clear that when a plaintiff presents more than one theory in support of her claim and a jury returns a general verdict in the plaintiff's favor, the verdict will be upheld if there was sufficient evidence to sustain any one of the theories presented “and the defendant, having failed to request special interrogatories, cannot complain.”  Witherell v. Weimer, 118 Ill.2d 321, 329, 113 Ill.Dec. 259, 515 N.E.2d 68 (1987);  accord Dillon v. Evanston Hospital, 199 Ill.2d 483, 492, 264 Ill.Dec. 653, 771 N.E.2d 357 (2002);  see also 735 ILCS 5/2-1201(d) (West 2000) (“[i]f several grounds of recovery are pleaded in support of the same claim * * *, an entire verdict rendered for that claim shall not be set aside or reversed for the reason that any ground is defective, if one or more of the grounds is sufficient to sustain the verdict”).

In the instant case, plaintiff's complaint, as well as the instructions given to the jury at the close of trial, show that plaintiff alleged four theories of negligence:  (1) that defendant was negligent in clearing Morus for surgery without first completing a proper pre-surgical evaluation as required by the preoperative standard of care;  (2) that defendant was negligent in failing to discontinue Morus' aspirin 7 to 10 days prior to surgery as required by the preoperative standard of care;  (3) that defendant was negligent in performing the surgical operation without using proper monitoring devices as required by the surgical standard of care;  and (4) that defendant was negligent in failing to provide the necessary care after surgery as required by the postoperative standard of care. On appeal, defendant challenges the sufficiency of the evidence with respect to three of these theories:  the discontinuation of aspirin, the monitoring during surgery, and his conduct after surgery.   However, defendant does not dispute the sufficiency of the evidence presented at trial in support of the first of these theories, namely, his evaluation of Morus for surgery in violation of the preoperative standard of care.   Defendant presented no argument on this theory in his appellate brief, in his reply brief or before this court during oral argument in this cause.   Applying the principles of general verdicts as discussed above, with defendant's failure to submit special interrogatories to the jury, there is no way to know on which of the four theories, alone or in combination, the jury relied to make its decision.   The jury could well have relied on the first theory, which remains unchallenged by defendant on appeal.   Therefore, because defendant's failure to submit special interrogatories leaves us with only speculation as to the basis for the jury's general verdict, and because defendant does not challenge on appeal the sufficiency of the evidence presented with respect to plaintiff's first theory of negligence, we cannot entertain defendant's contention here that we must set aside the verdict due to insufficient evidence.  See Dillon, 199 Ill.2d at 491-92, 264 Ill.Dec. 653, 771 N.E.2d 357 (reviewing court could not set aside jury's general verdict in medical malpractice action on the defendant's contention that evidence was insufficient where the plaintiff alleged several theories of negligence, the defendant failed to submit special interrogatories to the jury to elicit which theory was the basis for their general verdict, and the defendant challenged the sufficiency of the evidence with respect to only one theory on appeal).

Even were we to review defendant's contentions as to each of plaintiff's theories, we could not agree with his contention that plaintiff did not present sufficient medical expert evidence of proximate causation with respect to each of the three negligence theories he challenges and that, therefore, a judgment notwithstanding the verdict or a directed verdict was proper.   To the contrary, the record is clear that not only did plaintiff present such evidence, but also that this evidence, with respect to each of the three theories challenged by defendant, does not so overwhelmingly favor him that a verdict for plaintiff cannot stand.

The elements of a medical malpractice action plaintiff was required to prove in the instant case are (1) the standard of care by which to measure defendant's conduct, (2) that defendant negligently breached the standard of care, and (3) that defendant's breach was the proximate cause of Morus' death.  See Seef v. Ingalls Memorial Hospital, 311 Ill.App.3d 7, 15, 243 Ill.Dec. 806, 724 N.E.2d 115 (1999).   The proof needed to sustain each of these three elements must come via medial expert testimony, or else the cause of action fails.  See Seef, 311 Ill.App.3d at 15, 243 Ill.Dec. 806, 724 N.E.2d 115;  accord Mengelson v. Ingalls Health Ventures, 323 Ill.App.3d 69, 74-75, 256 Ill.Dec. 38, 751 N.E.2d 91 (2001) (in the absence of expert testimony presented by the plaintiff that the defendant's acts caused the injuries within a reasonable degree of medical certainty, a verdict in the plaintiff's favor cannot stand).   We note, as defendant does, that with respect to proximate cause, that element is not established where the medical expert testimony of causal connection is “ ‘contingent, speculative or merely possible.’ ”   Mengelson, 323 Ill.App.3d at 75, 256 Ill.Dec. 38, 751 N.E.2d 91, quoting Newell v. Corres, 125 Ill.App.3d 1087, 1092, 81 Ill.Dec. 283, 466 N.E.2d 1085 (1984).   However, plaintiff will sustain her burden in proving proximate cause as long as the medical expert testimony she presents demonstrates within a reasonable degree of medical certainty that defendant's breach in the standard of care is more probably than not the cause of the injury suffered.   See Mengelson, 323 Ill.App.3d at 74-75, 256 Ill.Dec. 38, 751 N.E.2d 91;  accord Borowski v. Von Solbrig, 60 Ill.2d 418, 424, 328 N.E.2d 301 (1975).   Further, we note that issues of negligence, due care and proximate cause are questions of fact for a jury to decide, along with the weight to be given the medical expert testimony plaintiff presents and the determination of the credibility of these experts.   See Mengelson, 323 Ill.App.3d at 75, 256 Ill.Dec. 38, 751 N.E.2d 91 (“[i]t is well established that issues involving proximate cause are fact specific and therefore uniquely for the jury's determination”);  Wojcik v. City of Chicago, 299 Ill.App.3d 964, 971, 234 Ill.Dec. 137, 702 N.E.2d 303 (1998);  Kaplan v. Berger, 184 Ill.App.3d 224, 233, 132 Ill.Dec. 461, 539 N.E.2d 1267 (1989);  accord Borowski, 60 Ill.2d at 423, 328 N.E.2d 301 (“the question of whether the doctor deviated from the standard of care and whether his conduct was a proximate cause of the plaintiff's injury are questions of fact for the jury”).

With respect to the first theory of negligence challenged by defendant, namely the failure to discontinue Morus' aspirin consumption, we disagree with his contention that plaintiff presented “no expert testimony” that this was a proximate cause of Morus' death and find, conversely, that there was sufficient evidence in this regard to support the jury's verdict.   Defendant concedes in his brief that Dr. Hollander testified that defendant deviated from the standard of care by continuing the administration of aspirin to Morus every day of his hospital stay until the day of the scheduled surgery.   Defendant also concedes that Dr. Hollander testified that this deviation was a breach of the standard of care because defendant should have discontinued the aspirin for 7 to 10 days prior to the surgery, and that Dr. Hollander testified that this breach contributed to Morus' death.   Defendant argues, however, that Dr. Hollander's testimony failed to satisfy the element of proximate cause because his testimony did not describe “how” defendant's failure to discontinue aspirin led to Morus' death.   Yet, the record shows that Dr. Hollander did in fact describe how this led to Morus' death:  Dr. Hollander explained that because Morus was taking aspirin for so long, and because aspirin abnormally affects the platelets' ability to clot the body's blood, Morus suffered from “platelet poisoning” which caused his post-surgical bleeding.   Dr. Hollander further elaborated that this blood flow to Morus' abdomen deprived his heart of the oxygen carried by the blood, causing his heart to strain and work less effectively.   Dr. Hollander concluded that it was this bleeding, which resulted from the affects of the aspirin, that contributed to and caused Morus' death.

Moreover, we note that defendant attacks the sufficiency of only Dr. Hollander's medical expert testimony, and ignores the fact that several other witnesses also provided similar medical expert testimony about defendant's failure to stop Morus' aspirin consumption.   For example, when discussing the particular effect aspirin had on Morus, Dr. Sullivan testified that Morus' daily doses of aspirin compromised his clotting abilities, increasing his chance of post-surgical bleeding.   Dr. Sullivan also stated that Morus experienced this bleeding, which perpetuated his CHF and, in turn, resulted in his death.   Similarly, Dr. Caplan stated in his evidence deposition that aspirin impairs the clotting function of platelets for 7 to 10 days.   Dr. Caplan explained that the continued administration of aspirin to Morus until the surgery contributed to his inter-abdominal bleeding after surgery, which was “the final and important event” leading to his death.   Even defendant himself testified that he knew that aspirin destroys platelet function by prohibiting the platelets from clumping together, that this effect is irreversible for 7 to 10 days, that Morus had been taking aspirin since his admission to the hospital until the day before surgery, and that, because of this, Morus' blood-clotting abilities were impaired when he underwent this major surgery.   From this evidence in the record, we find that plaintiff presented sufficient medical expert testimony detailing how defendant's breach of the standard of care in failing to discontinue Morus' aspirin intake before surgery was a proximate cause of Morus' death.

Defendant next challenges the plaintiff's theory of negligence that he breached the standard of care during surgery by failing to use a Swan-Ganz catheter.   Defendant again claims that plaintiff presented “no expert testimony” that this breach was a proximate cause of Morus' death.   To the contrary, however, plaintiff did present expert testimony in this regard, namely, again, that of Dr. Hollander.   Dr. Hollander specifically testified that the surgical standard of care in this case required defendant to use the catheter during surgery because of Morus' “critically ill” status.   Dr. Hollander explained that the catheter was necessary because Morus required monitoring of the pressure in his heart and lungs due to his continued CHF. Dr. Hollander further testified that defendant's failure to use the catheter to monitor Morus during surgery caused and contributed to Morus' death.   Thus, based on the record, we find no merit in defendant's contention that plaintiff did not provide any medical expert testimony that defendant's failure to use a Swan-Ganz catheter was a proximate cause of Morus' death.

The last theory of negligence defendant challenges is that with respect to his conduct after surgery.   Defendant contends that plaintiff did not present any expert testimony that defendant's failure to return to the hospital was either a breach of the standard of care or a proximate cause of Morus' death.   However, based on the record before us, we disagree with both contentions.   First, plaintiff presented ample medical expert testimony that defendant's failure to return was a breach of the standard of care.   We note that defendant's assertion in his brief that there was “uncontroverted evidence” that he was not told of Morus' post-surgical bleeding is incorrect.   The record shows that defendant admitted at trial that he received a call from Dr. Swenson on the night of June 30, 1995, informing him that Morus had to be moved to the surgical intensive care unit because his blood pressure had dropped to very low levels.   Defendant testified that this was “unexpected.”   Defendant further testified that he received a second call from Dr. Swenson informing him that Morus' blood count had again dropped and that he need a blood transfusion.   Defendant admitted that this indicated to him that Morus was bleeding postoperatively inside his abdomen, but that he chose not to return to the hospital.

Based on these admissions, plaintiff's medical experts concluded that defendant breached the standard of care in failing to return to the hospital.   Dr. Hollander testified that upon defendant's discovery that Morus had been transferred from recovery to the surgical intensive care unit, the standard of care required him to inquire about Morus' blood pressure:  if he did not, this was a breach;  if he did and was told it was low, the standard of care at that time then required him to return to the hospital because it is “the surgeon's responsibility” to find the cause of the bleeding and stop it.   Likewise, Dr. Sullivan testified that the standard of care required defendant to return to the hospital and that his failure to do so was a breach.   Dr. Sullivan based his opinion on defendant's own admission that he received reports throughout the night after the surgery that Morus' blood count and pressure were falling.   Based on this information known to defendant, Dr. Sullivan testified that he should have recognized that Morus was bleeding internally, was required to stop it, and his failure to return to the hospital to attempt this was a breach.

As for the second part of defendant's contention that plaintiff did not present any testimony that this breach of the standard of care was a proximate cause of Morus' death, we note that plaintiff presented sufficient medical expert testimony that this was indeed the case.   Dr. Hollander specifically testified that defendant's breach in failing to return to the hospital to stop the bleeding caused Morus' death.   In addition, Dr. Sullivan stated that if defendant had not committed this breach, Morus would not have developed brain damage and would have survived.   Thus, we find, again contrary to defendant's contentions, that plaintiff presented sufficient medical expert testimony that defendant breached the standard of care in failing to return to the hospital after surgery and that this breach was a proximate cause of Morus' death.

Defendant relies principally on the case of Snelson v. Kamm, 319 Ill.App.3d 116, 253 Ill.Dec. 354, 745 N.E.2d 128 (2001), aff'd in part, rev'd in part on other grounds, and remanded 204 Ill.2d 1, 272 Ill.Dec. 610, 787 N.E.2d 796 (2003), for his contentions on each of the three negligence theories he challenges that plaintiff did not present any expert testimony that his breaches were proximate causes of Morus' death.   However, defendant mischaracterizes the rationale of Snelson, and his reliance on that case is misplaced.   In Snelson, the plaintiff brought a medical malpractice action against, among others, a hospital, alleging that the actions of its nursing staff in failing to properly monitor him proximately caused his injuries.   At trial, the plaintiff presented the testimony of a nursing expert who generally stated that a nurse's failure to follow certain steps in the nursing process “increases the likelihood” of an unfavorable outcome in a patient's treatment.  Snelson, 319 Ill.App.3d at 130, 253 Ill.Dec. 354, 745 N.E.2d 128.   The plaintiff also presented the medical expert testimony of a doctor, but the doctor testified as to other defendants involved in the case and gave no opinion concerning the nursing staff's conduct.   The jury returned a verdict in favor of the plaintiff and against, in part, the hospital.   The trial court granted the hospital's motion for judgment notwithstanding the verdict, and the reviewing court agreed.   See Snelson, 319 Ill.App.3d at 131, 253 Ill.Dec. 354, 745 N.E.2d 128.

Defendant here claims that the Snelson court's rationale in upholding the trial court's decision was that the nursing expert's testimony, which discussed an increase in the likelihood of an unfavorable outcome, had been vague and conclusory in proving proximate cause.   In so characterizing the court's rationale, defendant asserts that the expert testimony presented in the instant case was even more vague and conclusory than that of the nursing expert in Snelson, and thus, we must follow the result in that case and find in his favor.   This argument is incorrect.   It is true that the Snelson court acknowledged that the nursing expert's testimony was vague.   However, the court made the reasoning for its decision clear:  the plaintiff did not provide the requisite proximate causation testimony not because the nursing expert's testimony was vague, but rather, because the nursing expert was not a medical expert, and thus, was not a proper witness to testify regarding the element of proximate cause in a medical malpractice action.   See Snelson, 319 Ill.App.3d at 130, 253 Ill.Dec. 354, 745 N.E.2d 128, citing Seef, 311 Ill.App.3d at 20-21, 243 Ill.Dec. 806, 724 N.E.2d 115.   The Snelson court further noted that while the plaintiff did present the testimony of a medical expert (i.e., the doctor), this expert admitted that he had no opinion concerning the conduct of the nursing staff.   See Snelson, 319 Ill.App.3d at 131, 253 Ill.Dec. 354, 745 N.E.2d 128.   Therefore, the court reasoned, there was no proximate causation evidence presented to link the nursing staff's alleged deviations from the standard of care to the plaintiff's injuries, and judgment notwithstanding the verdict in the hospital's favor was proper because a verdict for the plaintiff could never stand under these circumstances.   See Snelson, 319 Ill.App.3d at 131, 253 Ill.Dec. 354, 745 N.E.2d 128.

The instant case is distinguishable because plaintiff here presented more than ample medical expert testimony regarding proximate causation on each of the negligence theories.   In contrast to the nursing expert in Snelson, Dr. Hollander and Dr. Sullivan were qualified medical experts who were able to testify as to proximate cause.   Further, not only was their testimony not couched in vague “increases [in] the likelihood of an unfavorable outcome” as in Snelson, but they gave specific opinions of how defendant's conduct before, during and after surgery violated the standards of care and proximately caused Morus' death.   Thus, unlike in Snelson where there was no such testimony, we cannot say here that all of the proximate causation evidence presented, when viewed in plaintiff's favor, so overwhelmingly favored defendant that we must grant his request for a directed verdict or for judgment notwithstanding the verdict.

Having so determined plaintiff presented sufficient medical expert testimony to show a proximate causal connection between defendant's breaches of the standards of care and Morus' death, we need not entertain defendant's secondary claim with respect to this issue, namely that the trial court erred in admitting standard-of-care testimony without corresponding causation testimony. However, even were we to address this claim, we find that it is without merit.

Defendant argues that the evidence presented that he breached the standards of care “unfairly prejudiced” him, requiring a new trial, because there was no evidence that the breaches “had any bearing on” Morus' death, and thus, the trial court erred in admitting the standard-of-care evidence.   With this assertion, defendant is simply re-challenging plaintiff's alleged failure to present medical expert testimony of proximate cause.   As just analyzed, this is incorrect, since plaintiff presented sufficient evidence in this vein through the testimony of Dr. Hollander and Dr. Sullivan.   Based on our review of the record above and our analysis of the medical expert testimony presented by plaintiff at trial with respect to each of the three theories of negligence defendant challenges on appeal, we conclude that there was no such abuse of discretion or prejudice here.

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B. Expert Testimony and Rule 213

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Defendant's second contention on appeal is that the trial court erred in allowing plaintiff's expert witness, Dr. Sullivan, to give an opinion during his testimony that was not disclosed before trial pursuant to Rule 213.   The challenged opinion testimony is as follows:

“[Plaintiff's counsel] Q. * * * How, if at all, can the effects of aspirin be reversed through the use of platelet transfusions?

[Dr. Sullivan] A. Well, you can do that.   You can give platelet transfusions to somebody.”

The parties here agree that plaintiff never disclosed in response to any written interrogatories that Dr. Sullivan would testify as to “platelet transfusions” or would give the opinion at trial that this is a way to reverse the impairing effects aspirin has on platelet function.   The parties also agree that Dr. Sullivan did not mention platelet transfusions any time prior to trial, for example, in his deposition.   Based on this, defendant argues that his theory on the case, namely that the risk of operating on Morus immediately was less than the risk of waiting for his platelets to be replenished, was unfairly jeopardized by plaintiff's failure to disclose Dr. Sullivan's opinion that giving Morus a platelet transfusion was a viable third option to either delaying the surgery or performing the surgery with impaired platelets.   Defendant asserts that this portion of Dr. Sullivan's testimony was either a new expert witness opinion that was required to be disclosed under Rule 213, or, at the very least, that this testimony comprised a new basis for Dr. Sullivan's prior opinion that there should have been no surgery until Morus' aspirin intake was stopped, also requiring disclosure under the auspices of Rule 213.   Based on the record and the strict requirements of Rule 213, we agree with defendant that a Rule 213 violation occurred here.

Rule 213 mandates that upon written interrogatory, a party must disclose the subject matter and conclusions of any witness who will offer opinion testimony at trial.   See 177 Ill.2d R. 213(g);  Seef, 311 Ill.App.3d at 22, 243 Ill.Dec. 806, 724 N.E.2d 115;  accord Copeland v. Stebco Products Corp., 316 Ill.App.3d 932, 937, 250 Ill.Dec. 235, 738 N.E.2d 199 (2000).   This includes the witnesses' opinions and the bases which form the foundation of those opinions.   See 177 Ill.2d R. 213(g);  Seef, 311 Ill.App.3d at 24, 243 Ill.Dec. 806, 724 N.E.2d 115 (“if an opinion is important to the theory of one's case, it is essential that it and the bases therefor be disclosed”).   In addition, Rule 213 requires a party to seasonably supplement any information that becomes known to him with respect to the opinion witnesses he plans to present and the bases of those opinions to which they will testify at trial.   See 177 Ill.2d R. 213(i);  Copeland, 316 Ill.App.3d at 937, 250 Ill.Dec. 235, 738 N.E.2d 199.   The express purpose of Rule 213 is to discourage tactical gamesmanship and prevent surprise.   See Scassifero v. Glaser, 333 Ill.App.3d 846, 854-55, 267 Ill.Dec. 487, 776 N.E.2d 859 (2002);  Copeland, 316 Ill.App.3d at 937, 250 Ill.Dec. 235, 738 N.E.2d 199.   Our courts have consistently noted that the provisions of Rule 213 are mandatory and must be strictly followed by both the trial court that must impose them and counsel who must operate pursuant to them during discovery.   See Scassifero, 333 Ill.App.3d at 854, 267 Ill.Dec. 487, 776 N.E.2d 859;  Copeland, 316 Ill.App.3d at 937, 250 Ill.Dec. 235, 738 N.E.2d 199;  Seef, 311 Ill.App.3d at 22, 243 Ill.Dec. 806, 724 N.E.2d 115;  accord Regala v. Rush North Shore Medical Center, 323 Ill.App.3d 579, 584, 256 Ill.Dec. 563, 752 N.E.2d 443 (2001) (“Rule 213 is mandatory and strict compliance is required”).   Therefore, when an opponent objects to the opinion testimony offered, the party-proponent of that testimony must show that the opinion at issue was expressed by that witness prior to trial, for example in interrogatories or in a deposition.   See Boehm v. Ramey, 329 Ill.App.3d 357, 365, 264 Ill.Dec. 789, 771 N.E.2d 493 (2002).   Any disagreement as to whether the testimony was previously disclosed is to be construed against the proponent of the evidence.  See Seef, 311 Ill.App.3d at 22, 243 Ill.Dec. 806, 724 N.E.2d 115.   While the trial court has discretion in admitting evidence, we will not hesitate to reverse the court's ruling under Rule 213 if there was an abuse of that discretion.  See Seef, 311 Ill.App.3d at 22, 243 Ill.Dec. 806, 724 N.E.2d 115;  see also Department of Transportation v. Crull, 294 Ill.App.3d 531, 538-39, 228 Ill.Dec. 834, 690 N.E.2d 143 (1998) (Rule 213 has “more exacting standards” than its predecessor former Rule 220 and courts “should be more reluctant” to permit parties to deviate from the strict disclosure requirements of Rule 213).

In the instant case, defendant objected immediately after Dr. Sullivan mentioned platelet transfusions, claiming a violation of Rule 213.   The trial court overruled the objection, finding that this was merely a basis for Dr. Sullivan's previously disclosed opinion during discovery that the failure to stop the administration of aspirin to Morus was a violation of the standard of care.   However, the trial court's characterization of Dr. Sullivan's testimony was incorrect.   Dr. Sullivan's statement that a platelet transfusion can be given to a patient awaiting surgery to reverse the effects of aspirin was indeed a new opinion in this cause.   Plaintiff concedes that Dr. Sullivan did not mention platelet transfusions anytime prior to his trial testimony.   From our review of the record, the principle dispute in medical opinions at trial with respect to the aspirin theory of negligence was between two options that had been available to defendant while treating Morus:  wait 7 to 10 days prior to surgery and risk a delay, or perform the surgery and risk Morus' bleeding.   Dr. Sullivan's testimony that defendant could have performed a platelet transfusion and soon thereafter operated on Morus described a third option, thereby presenting a new opinion that had not been disclosed before to dispute the other two.

Even if the trial were correct that Dr. Sullivan's testimony did not comprise a new opinion, but rather, merely a basis for a previously disclosed opinion, its action in overruling defendant's objection to the testimony on Rule 213 grounds was still erroneous.   As noted above, Rule 213 and the case law enforcing its provisions are clear:  “[t]he express language of Rule 213 plainly provides that each party is required to disclose an opinion witness' proposed testimony, including conclusions and the basis of those conclusions.”  Crull, 294 Ill.App.3d at 536, 228 Ill.Dec. 834, 690 N.E.2d 143 (emphasis in original) (the defendant's contention that expert's new information at trial only sought to explain basis for his previously disclosed opinion, and thus, was not a violation of Rule 213 could not stand because “Rule 213 expressly requires a party to disclose all opinions and ‘the bases therefor’ ”).   Thus, plaintiff's failure to disclose this basis for Dr. Sullivan's opinion was a violation of Rule 213.

Plaintiff argues that there was no Rule 213 violation here because Dr. Sullivan's testimony at trial was consistent with his deposition testimony, since Dr. Sullivan never stated in his deposition that stopping aspirin was the “only alternative” available to counter its effects prior to surgery.   Plaintiff cites Conners v. Poticha, 293 Ill.App.3d 944, 228 Ill.Dec. 441, 689 N.E.2d 313 (1997), and asserts that had Dr. Sullivan testified in his deposition that stopping aspirin was the only alternative, then and only then would his revelation of the possibility of a platelet transfusion at trial have been a violation of Rule 213 because an inconsistency between the two statements would have resulted.   Plaintiff's argument is incorrect.   First, we note that Conners provides no support for plaintiff's claim because the court in that case evaluated the opinion testimony at issue pursuant to an analysis under former Rule 220, which has undisputably been supplanted by the stricter requirements of Rule 213.   See generally Conners, 293 Ill.App.3d 944, 228 Ill.Dec. 441, 689 N.E.2d 313;  Crull, 294 Ill.App.3d at 538-39, 228 Ill.Dec. 834, 690 N.E.2d 143.   Furthermore, no exceptions for Rule 213's disclosure requirements have been recognized.   See Boehm, 329 Ill.App.3d at 363, 264 Ill.Dec. 789, 771 N.E.2d 493;  Regala, 323 Ill.App.3d at 585, 256 Ill.Dec. 563, 752 N.E.2d 443.   Thus, whether an expert's opinion testimony at trial is consistent with his deposition testimony given before trial is not a determinating factor in reviewing whether a Rule 213 violation occurred.   See Sinclair v. Berlin, 325 Ill.App.3d 458, 470, 259 Ill.Dec. 319, 758 N.E.2d 442 (2001) (expert's opinion was consistent with his deposition testimony;  however, his testimony was still barred pursuant to Rule 213 because opinion had not been disclosed before trial).   Rather, we look only to whether the testimony given at trial was encompassed by the original opinion given before trial.   See Scassifero, 333 Ill.App.3d at 860, 267 Ill.Dec. 487, 776 N.E.2d 859 (expert can elaborate on disclosed opinion, but this testimony must be correlated to that opinion and cannot be a new reason for it).   In the instant case, as previously discussed, Dr. Sullivan's opinion before trial regarding aspirin consumption and its negative effects on platelets never encompassed his testimony at trial about the existence of platelet transfusions.

However, our finding that a violation of Rule 213 occurred here as to the admission of Dr. Sullivan's testimony does not end our inquiry with respect to this issue on appeal.   Rather, defendant, as the party challenging the admission of the testimony, must show that the violation caused substantial prejudice and denied him of a fair trial.   See Copeland, 316 Ill.App.3d at 946, 250 Ill.Dec. 235, 738 N.E.2d 199;  Hendrix v. Stepanek, 331 Ill.App.3d 206, 214, 264 Ill.Dec. 855, 771 N.E.2d 559 (2002) (party opponent must show prejudice arising from the Rule 213 violation).   Based on our review of the particular circumstances of the instant case, we conclude that although a Rule 213 violation occurred, any error from the admission of that portion of Dr. Sullivan's testimony now challenged did not prejudice defendant, but rather, was only harmless and does not require a new trial.   See Nassar v. County of Cook, 333 Ill.App.3d 289, 303, 266 Ill.Dec. 592, 775 N.E.2d 154 (2002) (Rule 213 violations may be reviewed pursuant to a harmless error analysis).

First, we note that defendant did not suffer prejudice from the Rule 213 violation because the challenged testimony of Dr. Sullivan was cumulative within the context of this case.   Prior to Dr. Sullivan's testimony, Dr. Caplan's evidence deposition was read into evidence at trial.   With respect to aspirin, Dr. Caplan testified that Morus' platelet function had been negatively impacted by his aspirin intake and that, in addition to waiting 7 to 10 days for the platelets to replenish themselves, another way to reverse the negative effect is to perform a “platelet transfusion.”   Defendant did not object to this testimony, and this opinion was admitted into evidence.   Thus, the existence of a platelet transfusion was a concept already presented to the jury even before Dr. Sullivan testified, without any contest by defendant.   Moreover, the record shows that Dr. Sullivan commented on platelet transfusions only when he was testifying in general terms as to the effects of aspirin on patients who are about to undergo surgery, not during the separate portion of his testimony when he explained the particular effects aspirin had on Morus in specific relation to his condition and those medical factors unique to his case.   Also, Dr. Sullivan's comment on platelet transfusions was not linked in any way to that portion of his testimony discussing Morus' aspirin intake or to his opinion that defendant breached the standard of care in failing to discontinue the aspirin.   In addition, Dr. Sullivan's general comment involved only six lines of trial testimony in a record of approximately 350 pages, making his reference to platelet transfusions negligible in relation to his lengthy testimony.   Finally, the record demonstrates that plaintiff did not rely on Dr. Sullivan's testimony about platelet transfusions in support of her claims at trial.   Counsel did not refer in closing argument to that term or to the concept that a platelet transfusion could have been performed on Morus.   Nor was the jury instructed in any way that defendant's failure to consider or give a platelet transfusion to Morus was a breach in the standard of care or was related to any of the four negligence theories at issue.   The only instruction given regarding aspirin asked the jury to determine simply whether defendant breached the standard of care in performing the operation without discontinuing Morus' aspirin intake for 7 to 10 days prior to the date of the scheduled surgery.

Therefore, we find that, although there was a Rule 213 violation committed by plaintiff in failing to disclose Dr. Sullivan's opinion about platelet transfusions and that the trial court erred in admitting this testimony, this violation, based on the record before us, was harmless and does not entitle defendant to a new trial.

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C. Jury Instruction on Life Expectancy

Defendant's third contention on appeal is that the trial court erred in instructing the jury with respect to Morus' life expectancy. The instruction given by the trial court now at issue in this cause was a modified version of Illinois Pattern Jury Instruction (IPI) 31.13 (IPI Civil (2000) No. 31.13), and stated the following:

“If you find for the Plaintiff, Joan Morus[,] * * * under the Wrongful Death Count, then in assessing damages, you may consider how long Frank Morus was likely to have lived.   The evidence shows that Frank Morus was likely to have lived approximately five years from the date of his death.”

Defendant claims that the evidence presented at trial was in conflict as to what Morus' life expectancy was likely to be and, therefore, did not support the instruction given by the trial court which, in essence, directed a verdict for plaintiff.   In response, plaintiff asserts that defendant waived this argument because he did not object to the instruction when it was first read to the jury by the court before trial began.   Plaintiff also argues that, even if the issue were not waived, the instruction was proper because the evidence regarding life expectancy was “undisputed.”   Based on the record before us, we agree with plaintiff and find that the instruction as given by the trial court regarding Morus' life expectancy was warranted.

 First, with respect to plaintiff's contention of waiver, we conclude that defendant did not waive this issue for review.   A party waives its right to challenge a jury instruction that was given at trial when it fails to make a specific objection to the instruction during the jury instruction conference and fails to tender a remedial instruction to the trial court.   See Deal v. Byford, 127 Ill.2d 192, 202-03, 130 Ill.Dec. 200, 537 N.E.2d 267 (1989) (party challenging instruction must specify defect and submit instruction that states the law for which he argues on appeal);  accord Branum v. Slezak Construction Co., 289 Ill.App.3d 948, 956-57, 225 Ill.Dec. 88, 682 N.E.2d 1165 (1997).   This timely objection and submission are to assist the trial court by affording it the opportunity to correct the defective instruction, and to prohibit the challenging party from gaining an advantage by obtaining a reversal based on his own failure to act.   See Dean v. Keith's & Ralph's Tavern, Inc., 25 Ill.App.3d 970, 972, 324 N.E.2d 7 (1975).

The record in the instant case demonstrates that defendant did not waive his right to challenge the life expectancy instruction given by the trial court.   It is clear that this instruction was a central topic of debate among the parties and the trial court at several junctures throughout the trial process.   The first time life expectancy was discussed was during a hearing on plaintiff's motion in limine, during which plaintiff asked the court to preclude any opinions concerning Morus' life expectancy other than the opinion that he would not have been expected to live more than an additional five years from the date of his death.   The court granted plaintiff's motion, but only upon two caveats:  (1) that an opinion that Morus would have lived a shorter time, for example, 4 years and 11 months, was close enough to “not more than 5 years” and would be allowed into evidence;  and (2) that defendant would be allowed to cross-examine Dr. Sullivan, the only witness present at trial who would be testifying as to life expectancy, with respect to his previously disclosed opinion that Morus would have lived approximately five more years.   Then, after this hearing, the first of two jury instruction conferences in the instant case took place, before trial had even begun.   As the parties discussed what instruction should be given as to Morus' life expectancy, the trial court stated that it should read that Morus was “likely to have lived approximately five years from the date of his death.”   Noting that there was a dispute, codefendant Debre's counsel responded “[m]aybe we should just not say anything about the years until the end of the case.”   The court then stated, “[p]ut down approximately five years.   I don't know how that hurts.   We'll change it when it comes to [a] more specific [time] [sic].”   With this statement, the court informed the parties that the life expectancy instruction would be revisited before it would be given at the close of evidence.   The court then gave this instruction to the jury before opening statements.

At the end of trial but before the jury was charged, a second instruction conference was held.   Defendant specifically objected to the life expectancy instruction, noting that the evidence elicited at trial that Morus would have lived approximately five years was now in conflict, since testimony revealed that Morus was suffering from renal failure and had declared that he would not undergo dialysis.   Defendant also submitted an instruction to the court on this issue, retaining the first sentence of the instruction the trial court fashioned during the first conference, but omitting the second sentence that stated that Morus was likely to have lived approximately five years.   The trial court refused defendant's instruction and acknowledged that it would be instructing the jury with respect to a life expectancy of five years over defendant's objection.

Based on these circumstances as found in the record, we conclude that defendant preserved this issue for review.   Defendant both specifically objected to the jury instruction at the second jury instruction conference and tendered a replacement instruction to the trial court.   See Deal, 127 Ill.2d at 202-03, 130 Ill.Dec. 200, 537 N.E.2d 267;  Branum, 289 Ill.App.3d at 956-57, 225 Ill.Dec. 88, 682 N.E.2d 1165.   The trial court was not deprived of an opportunity to correct the instruction, nor did defendant fail to act, thereby resulting in an advantage to him.   See Dean, 25 Ill.App.3d at 972, 324 N.E.2d 7.

Plaintiff's argument that defendant was required to object to the instruction during the first jury conference before trial had begun, rather than the second conference which occurred after all the evidence was admitted, is unconvincing based on the circumstances of the instant case.   Plaintiff does not present any law to the effect that there is a requirement to object at such a preliminary stage in the trial process.   The trial court stated during plaintiff's motion in limine that the experts' opinion that Morus would have lived five years would be subject to cross-examination during trial.   Later, at the first conference, codefendant's attorney, though perhaps not officially objecting, did raise a reservation as to the instruction with the trial court.   It was at this juncture that the court told the parties that the issue would be revisited later, when it became “more specific” to the cause at hand and after Dr. Sullivan had been cross-examined as to his opinion on life expectancy.   Thus, the court acknowledged that a new life expectancy instruction may be necessary and would be dealt with later, at the close of evidence.   It could reasonably be concluded, then, that the court lulled defendant into believing that another conference would be held at the close of evidence which would afford the parties a chance to again debate the life expectancy instruction.   This is in fact what occurred, and upon defendant's objection and tender of a substitute instruction, we find no reason to conclude that the issue is waived on appeal simply because defendant waited to officially raise his objection until the promised second jury conference.

 Even if technically defendant did not properly preserve this issue for review, we nonetheless choose to address it here.   The circumstances and sequence of events surrounding the fashioning of the jury instruction in this case are unique, especially since the trial court decided to give the instruction before any evidence was presented and then held a second instruction conference after the close of evidence.   This warrants our review of this issue despite any technical waiver that may have occurred.  See Dillon v. Evanston Hospital, 199 Ill.2d 483, 504-05, 264 Ill.Dec. 653, 771 N.E.2d 357 (2002) (waiver rule is concept of administrative convenience only and does not limit jurisdiction of reviewing court, which may deem its responsibility to address certain issues to override such technical requirements).   However, while we address this issue on its merits, we nonetheless find that it does not compel reversal for the reasons discussed below.

 The determination of whether to give a specific jury instruction is within the trial court's discretion, and we will not disturb that determination unless there was an abuse of that discretion.   See Trimble v. Olympic Tavern, Inc., 239 Ill.App.3d 393, 401, 180 Ill.Dec. 199, 606 N.E.2d 1276 (1993);  Thompson v. MCA Distributing, Music Corp. of America, 257 Ill.App.3d 988, 991, 195 Ill.Dec. 898, 629 N.E.2d 206 (1994).   The standard for determining whether such abuse occurred is whether the instructions given fairly stated the law without having prejudiced a party and depriving him of a fair trial.  See Dillon, 199 Ill.2d at 505, 507, 264 Ill.Dec. 653, 771 N.E.2d 357.   We will not order a reversal on the basis of an error in instructing the jury unless that error was of such magnitude as to mislead the jury.   See Solich v. George & Anna Portes Cancer Prevention Center of Chicago, Inc., 273 Ill.App.3d 977, 988, 210 Ill.Dec. 235, 652 N.E.2d 1211 (1995).

 It is true that testimony offered by expert witnesses is to be judged by the same rules of weight and credibility applied to other witnesses, which are questions of fact for a jury.   See Cannell v. State Farm Fire & Casualty Co., 25 Ill.App.3d 907, 912, 323 N.E.2d 418 (1975).   However, while a jury is free to disregard an expert's opinion or conclusion of fact on the basis of credibility considerations, it cannot disregard expert testimony when this testimony pertains to medical issues “beyond the understanding of a layperson.”  Piano v. Davison, 157 Ill.App.3d 649, 675, 110 Ill.Dec. 35, 510 N.E.2d 1066 (1987) (jury is generally “not bound” to accept expert opinion on issue, but must do so when issue requires expert testimony, such as in medical malpractice cases);  see Turney v. Ford Motor Co., 94 Ill.App.3d 678, 685, 50 Ill.Dec. 85, 418 N.E.2d 1079 (1981).   Thus, when an issue is presented in a cause of action for which the jury is not equipped to draw any conclusion without the assistance of expert testimony, the jury cannot “reasonably come to a conclusion different than that” of the expert, thereby ignoring the expert's conclusion and instead employing its own independent interpretation of the evidence to reach an ultimate conclusion on this issue.  O'Keefe v. Greenwald, 214 Ill.App.3d 926, 936, 158 Ill.Dec. 342, 574 N.E.2d 136 (1991) (issue of causation of the plaintiff's injuries required expert testimony as it was beyond understanding of jury;  thus, jury could not disregard concurring expert opinions of seven doctors who testified on medical causation issue nor could jury “reasonably come to a conclusion different than” this expert testimony);  accord Piano, 157 Ill.App.3d at 675, 110 Ill.Dec. 35, 510 N.E.2d 1066 (jury could not disregard expert witness's conclusion because medical issue in cause, which involved interpretation of X ray and CT scan, was beyond jury's understanding);  see, e.g., Gauthier v. Westfall, 266 Ill.App.3d 213, 220-21, 203 Ill.Dec. 435, 639 N.E.2d 994 (1994) (patient's prognosis requires need for expert testimony and is outside realm of lay witness's competency);  Mazzone v. Holmes, 197 Ill.App.3d 886, 899, 145 Ill.Dec. 416, 557 N.E.2d 186 (1990) (issues involving patient post-operative care requires expert testimony);  Weekly v. Solomon, 156 Ill.App.3d 1011, 1017, 109 Ill.Dec. 531, 510 N.E.2d 152 (1987) (expert testimony, and consideration by jury thereof, is required with respect to issues of pre-operative care).

Here, the trial court's instruction with respect to life expectancy was warranted and not in error.   It would not have been reasonable for the jury in the instant case to have refused to consider the medical expert testimony that Morus would probably live five more years in light of the unique circumstances presented.   See O'Keefe, 214 Ill.App.3d at 936, 158 Ill.Dec. 342, 574 N.E.2d 136.   Two witnesses provided a specific prognosis for Morus' life expectancy, an issue which required expert testimony because it was beyond the jury's understanding to determine how long Morus would have lived.   These witnesses were Dr. Sullivan, who was plaintiff's expert, and Dr. Caplan, who was an expert for the defense.   Although testifying for opposing parties, these experts came to the same conclusion, namely, that Morus was likely to have lived five years.   Because these experts provided necessary testimony on an issue for which the jury was not equipped to use its own interpretation, and because the experts' testimony converged to reach the same conclusion, we fail to see how the jury could reasonably have disregarded or abandoned the expert opinion that Morus was likely to have lived five years.   See O'Keefe, 214 Ill.App.3d at 936, 158 Ill.Dec. 342, 574 N.E.2d 136.   Therefore, the trial court's instruction to the jury reiterating this expert testimony was not an abuse of discretion but, rather, was warranted under the circumstances of the instant case.

Defendant cites Northern Trust Co. v. County of Cook, 135 Ill.App.3d 329, 90 Ill.Dec. 157, 481 N.E.2d 957 (1985), and Goodman v. Terminal R.R. Ass'n of St. Louis, 68 Ill.App.2d 80, 215 N.E.2d 457 (1966), along with IPI 31.13, for the proposition that jury instructions on life expectancy that are conclusive are improper and erroneous because they do not permit the jury to exercise their own “experience in the affairs of life” as the law requires.   Northern Trust Co., 135 Ill.App.3d at 333, 90 Ill.Dec. 157, 481 N.E.2d 957;  Goodman, 68 Ill.App.2d at 95, 215 N.E.2d 457 (“[t]o require a jury to accept and be bound by a doctor's prediction of expectancy would deprive them of consideration of their own observation and experience with reference to such predictions”);  IPI, Civil (2000) No. 31.13.   However, each of those cases, as well as the pattern instruction, involves life expectancy evidence given in the form of mortality tables, which provide only general statistical averages without focusing on the individual subject to whom that table is alleged to apply.   Neither case, nor the pattern instruction, includes a situation where, as here, the medical expert testimony converged and provided a specific prognosis based on the particular circumstances of the person whose life expectancy was at issue.   On this basis, the cases cited by defendant are inapplicable, and we find no error on the part of the trial court in giving the life expectancy instruction now challenged on appeal.

 Alternatively, even were we to conclude that the trial court did err in giving the challenged instruction to the jury, a conclusion to which we do not subscribe, we find, based on the record, that such error would have been harmless.   See Nilsson v. NBD Bank of Illinois, 313 Ill.App.3d 751, 762, 247 Ill.Dec. 1, 731 N.E.2d 774 (1999) (court's decision whether to give jury instruction is subject to harmless error analysis).   The instruction stating that the evidence showed that Morus was likely to have lived approximately five years after his death which the court gave at the end of trial had already been read to the jury earlier, at the beginning of this cause before opening argument.   Also, defendant never submitted a proposed instruction to counter this five-year life expectancy estimate.   It is true that defendant tendered a different instruction during the second jury conference, along with his objection.   However, that proposed instruction merely reiterated the first sentence of the instruction given, stating only that the jury “could consider how long Frank Morus was likely to have lived,” and omitted the second sentence referring to the converging medical expert testimony that was presented.   This proposed instruction would not have been appropriate because it omitted the five-year basis as agreed by the expert testimony at trial without providing any other definite number which was grounded in presented evidence.   As previously discussed, Morus' life expectancy was an issue beyond the understanding of the jury and required a medical basis couched in expert testimony.   Thus, it would not have been proper to leave the jury with nothing but its own interpretation to decide this issue.   See O'Keefe, 214 Ill.App.3d at 936, 158 Ill.Dec. 342, 574 N.E.2d 136.

Moreover, we further note that, contrary to defendant's contention, the instruction as given by the trial court did not preclude defendant from arguing that Morus may have lived less than the five-year estimate established by the expert testimony.   In fact, defendant specifically argued in his closing argument to the jury that there were other factors in evidence which indicated that Morus would have lived less than five years.   For example, defendant stated:  “[b]ut ladies and gentlemen, no matter what happened on June 30, 1995 based on the best of all possible prognosis of the five years, Frank Morus wouldn't be here with us today regardless, and you can decide whether he would have passed * * * earlier.”   Therefore, defendant was actually permitted to, and indeed, challenged this the five-year estimate without objection from plaintiff or interference from the trial court.

D. Compromised Verdict

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Defendant's final contention on appeal is that he is entitled to a new trial, or alternatively, a new trial as to damages alone, because the trial court erred in entering judgment on a compromise verdict.   Defendant claims that the jury's damages award “illustrates a compromise” in that it assessed damages against defendant based on his liability but awarded nothing with respect to Morus' medical bills or funeral expenses.   Defendant argues that this signifies an inconsistency between the jury's award and its apparent conclusion that defendant was responsible for Morus' death, and thus, calls into doubt the verdict and the award because it holds defendant liable for his actions but at the same time excuses him from the consequences of these actions.   We disagree.

A trial court may set aside a jury verdict and order a new trial where the amount of damages is palpably inadequate, where the damage award is against the manifest weight of the evidence, where the jury has clearly disregarded a proved element of damages, or where it is apparent that the jury made a compromise between the defendant's guilt and the plaintiff's damages.   See Healy v. Bearco Management, Inc., 216 Ill.App.3d 945, 954, 160 Ill.Dec. 241, 576 N.E.2d 1195 (1991);  accord Duncan v. Peoria Yellow Checker Cab Corp., 45 Ill.App.3d 653, 654, 4 Ill.Dec. 290, 359 N.E.2d 1242 (1977).   For similar reasons, the trial court may order a new trial on the issue of damages alone, but only if the jury's verdict on liability is amply supported by the evidence, the question of damages is distinct, and the record does not suggest that the jury reached a compromise verdict.   See Vacala v. Village of LaGrange Park, 260 Ill.App.3d 599, 616, 201 Ill.Dec. 380, 636 N.E.2d 812 (1994).   However, because the issue of damages is one of fact for the jury to determine (see Duncan, 45 Ill.App.3d at 655, 4 Ill.Dec. 290, 359 N.E.2d 1242), the amount of a jury verdict is within the jury's discretion (see Vacala, 260 Ill.App.3d at 616, 201 Ill.Dec. 380, 636 N.E.2d 812).   Our courts cannot reweigh the evidence considered by the jury in reaching its verdict (see Wilkinson v. Mullen, 27 Ill.App.3d 804, 809, 327 N.E.2d 433 (1975)), and thus, are “reluctant to interfere with the jury's exercise of its discretion” (Duncan, 45 Ill.App.3d at 655, 4 Ill.Dec. 290, 359 N.E.2d 1242).   Therefore, the trial court's determination whether to grant a new trial, or a new trial with respect to damages only, is within the court's discretion and we will not reverse its decision absent an abuse of this discretion.   See Healy, 216 Ill.App.3d at 954, 160 Ill.Dec. 241, 576 N.E.2d 1195;  Vacala, 260 Ill.App.3d at 616, 201 Ill.Dec. 380, 636 N.E.2d 812.

We find that the trial court did not abuse its discretion in refusing to grant a new trial or a new trial on the issue of damages. As will be discussed below, the verdict issued by the jury cannot be considered a comprise verdict simply because it failed to award damages for Morus' medical bills and funeral expenses.   Rather, the jury's award was rational and reasonable when viewed in accordance with the circumstances that occurred as presented in the record.

With respect to Morus' medical bills, the record supports the jury's award of zero damages.   Plaintiff's theory on the case was not that Morus did not need the gall bladder surgery performed by defendant, but rather, that it should not have been performed on June 30, 1995, while Morus was in CHF and taking aspirin.   Thus, plaintiff did not dispute that she would have to pay for the surgery at some point, and did not attribute the medical bills incurred for the surgery to defendant's negligence.   The record shows that the only medical expenses plaintiff sought to recover were those that were incurred when Morus was unexpectedly sent to the surgical intensive care unit after the effects of defendant's negligence began to reveal themselves.   Plaintiff testified that these medical bills amounted to $6,665.70.   However, plaintiff testified that she did not know whether these bills had already been paid, and accordingly, defendant moved that these medical bills not be admitted into evidence.   The trial court agreed, and the jury never received a copy of the medical bills.   From this, we find that it was reasonable for the jury to conclude that either the medical bills were not sufficiently proven as part of the damages suffered by plaintiff, or that they had already been paid and that plaintiff was not entitled to recover on this point.   See Raithel v. Dustcutter, Inc., 261 Ill.App.3d 904, 907, 199 Ill.Dec. 809, 634 N.E.2d 1163 (1994) (no compromise verdict was found where jury's verdict with respect to award on medical expenses is amply supported by the evidence present).

Similarly, with respect to the jury's award of zero damages for Morus' funeral expenses, the record shows that the jury could have reasonably concluded that Morus would have died sometime soon, absent defendant's negligence, and thus, plaintiff was not entitled to recover these expenses.   Unlike the medical bills, plaintiff testified that the funeral expenses had been paid, and the trial court admitted these expenses into evidence.   However, both plaintiff and defendant agreed that absent any negligence, Morus would have died, at the latest, five years from the date of the surgery.   His death, then, would have occurred even without any negligence on defendant's part before trial had begun in this cause.   It was reasonable for the jury to conclude without any inconsistency in its verdict that even were defendant negligent, that negligence did not cause the need for a funeral, but rather, simply hastened its occurrence, and that therefore, plaintiff should not be entitled to these expenses.   Indeed, defendant argued this point in his closing argument, plaintiff did not dispute that this was the case, and the jury apparently agreed.   Defendant should not now be allowed to claim that this resulted in an inconsistent verdict.

Defendant relies on Svetanoff v. Kramer, 80 Ill.App.3d 575, 35 Ill.Dec. 864, 400 N.E.2d 1 (1979), and Duncan, 45 Ill.App.3d 653, 4 Ill.Dec. 290, 359 N.E.2d 1242, in support of his argument here that the jury rendered a compromise verdict that cannot stand.   Those cases, however, are factually distinguishable from the instant case.   In Svetanoff, the jury awarded zero damages to an injured driver although the evidence presented to the jury at trial with respect to the amount of medical bills she incurred was definite and undisputed by the parties.   The reviewing court declared this to be a compromise verdict.   See Svetanoff, 80 Ill.App.3d at 579, 35 Ill.Dec. 864, 400 N.E.2d 1.   The court stated that an award of zero damages was only proper if no damages were suffered.   See Svetanoff, 80 Ill.App.3d at 578, 35 Ill.Dec. 864, 400 N.E.2d 1.   Because the parties in Svetanoff agreed as to the dollar-amount of damages suffered by the driver, the jury's award of zero dollars bore no reasonable relationship to this amount in evidence, and thus, could not stand.   See Svetanoff, 80 Ill.App.3d at 578-79, 35 Ill.Dec. 864, 400 N.E.2d 1 (where amount of damages is stipulated or undisputed, jury's award of a substantially lesser amount indicates a compromise verdict).   Similarly, in Duncan, evidence was presented as to the full amount of medical expenses incurred by the injured plaintiff.   This evidence and the amount it reflected were not contested by the opposing party.   The jury, however, awarded only one-fourth of this established amount, a figure the reviewing court declared was “drawn out of the air.”  Duncan, 45 Ill.App.3d at 655, 4 Ill.Dec. 290, 359 N.E.2d 1242.   The court concluded that because an established amount, the legitimacy of which was not challenged, had been presented to the jury, the jury's verdict of a considerably lesser amount bore no relationship to the plaintiff's damages and could not stand.   See Duncan, 45 Ill.App.3d at 655, 4 Ill.Dec. 290, 359 N.E.2d 1242.

In the instant case, unlike in Svetanoff and Duncan, there was no established amount of medical bills or funeral expenses that was stipulated to by the parties or remained unchallenged and undisputed.   Here, Morus' medical bills were never submitted to the jury, and it was unclear whether they had been paid or whether plaintiff could recover on them.   Morus' funeral expenses were submitted to the jury, but defendant challenged the validity of imposing the expenses on him since medical expert testimony presented by both parties indicated that, in the best case scenario even without negligence, Morus would have died anyway before trial.   Therefore, because there is no indication in the record signaling a compromise between the jury's finding of liability on the part of defendant and the damages sustained by plaintiff attributable to this liability, we find that the trial court did not abuse its discretion in refusing to grant a new trial, or a new trial solely on the issue of damages, on the basis of defendant's claim of a compromise verdict.

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Accordingly, we affirm the decision below.   The record shows that plaintiff presented ample medical expert testimony and evidence with respect to her four theories of negligence to support the jury's finding that one or more of defendant's breaches in the applicable standards of care involved in this case were a proximate cause of Morus' death.   While the trial court erroneously admitted Dr. Sullivan's opinion testimony about platelet transfusions in violation of Rule 213 (177 Ill.2d R. 213), this error was harmless in view of the particular circumstances of this case and did not substantially prejudice defendant.   Moreover, the instruction given by the trial court with respect to Morus' life expectancy was based on the undisputed medical evaluations of both plaintiff's and defendants' experts as presented at trial, and thus, was warranted.   Finally, we find, based on the record, that the jury's failure to award damages for Morus' medical bills and funeral expenses did not constitute a compromise verdict.

CONCLUSION

For the foregoing reasons, we affirm the holding of the trial court.

Affirmed.

FOOTNOTES

1.   Defendant presents four issues on appeal, dealing with proximate cause, expert testimony, jury instructions on life expectancy and compromise verdict.   Because our court is bound by administrative order of the Illinois Supreme Court limiting the length of our opinions to 20 pages, we have chosen to publish only that portion of our original 47-page Rule 23 decision discussing jury instructions on life expectancy and the pertinent facts involved therein.   See 166 Ill.2d R. 23.   We do so because of the dearth of published opinions that compare, as we do, instructions as to life expectancy premised upon general mortality tables and instructions premised not upon mortality tables but on the specific medical prognosis of the life expectancy of a specific individual based upon his or her medical condition.   The complete Rule 23 decision can be found in the office of the clerk of this court.

2.   We note that this verdict was also entered against codefendant Dr. Michael Debre.   Dr. Debre appealed this decision to our court and that appeal was consolidated with the present appeal.   See Morus v. Kapusta, No. 1-01-1207 (April 17, 2002).   However, Dr. Debre and plaintiff entered into a settlement, and that appeal was dismissed.   We also note that the jury found no liability as to codefendant Dr. Ann Brennan.   Accordingly, our decision here pertains only to defendant Dr. Kapusta, as his case remains pending as a single appeal before our court.

Presiding Justice GORDON delivered the opinion of the court: