This section contains the nature of the case and procedural background.

P was burdened with a host of physical and emotional problems. He also developed carpal tunnel syndrome. P had a history of syncope (temporary blackouts), asthma, emphysema, bronchitis, hyperthyroidism, chronic depression, and a nervous condition (he was also a heavy smoker). He was also excessively -- 'morbidly' -- obese; five feet, five inches tall, he weighed 295 pounds. He was permanently and totally disabled from employment and subsisted on Social Security disability benefits. Surgery was scheduled. Dr. Shanker L. Gupta (D), a general surgeon, was going to perform the surgery. Dr. Lee (D), an anesthesiologist, and Sergott (D), a certified registered nurse anesthetist, were assigned by the hospital to administer and monitor the anesthesia. Because of P's asthma, obesity, and hyperthyroidism, Dr. Lee (D) recognized that P was a 'high risk patient for anesthesia'; he therefore decided against general anesthesia and opted instead for an axillary or brachial block. Dr. Lee (D) was also scheduled to administer and monitor anesthesia to another patient in another operating room at the same time. The job then fell to Nurse Sergott (D). Without any advice, direction, or notes on the medical record from Dr. Lee (D) Nurse Sergott (D) examined P on the morning of the 17th, just before the surgery. Nurse Sergott (D) independently decided to use a brachial block; he decided, by himself, which drug to use for that purpose; and he also decided, by himself, what analgesic to use and how it was to be administered. At some point shortly after administering the third dose of the drug Sublimaze, Nurse Sergott (D) noticed that the block was 'patchy.' At some point shortly after administering the third dose of the drug Sublimaze, Nurse Sergott (D) noticed that the block was 'patchy.' -- i.e., '[t]he media flesh was not completely blocked on his hand.' He wanted to give P another block, but Dr. Gupta insisted that he put P to sleep. Believing that general anesthesia was inappropriate and that, 'being a surgeon, [Dr. Gupta] is not aware of anesthesia,' Nurse Sergott (D) decided to consult Dr. Lee (D) who, of course, was in another operating room. Sergott (D) summoned another nurse anesthetist -- Ms. Belvay -- went over P's vital signs with her, and then left to consult with Dr. Lee (D). Dr. Lee, then busy with another patient under anesthesia and unable to leave, agreed that P should be given another brachial block and not put to sleep. He returned to the operating room and found Nurse Belvay ventilating P with oxygen. It appears that, about 10 minutes after administration of the third dose of Sublimaze and while Nurse Sergott (D) was conferring with Dr. Lee (D), P's breathing became shallow. P became cyanotic and then became bradycardic (slow heartbeat) and had a period of asystole (his heart stopped beating entirely). There was evidence that it lasted from 10 seconds to two minutes. P was promptly intubated and given Atropine and cardiopulmonary resuscitation, and his heartbeat returned to normal. Dr. Lee (D) appeared and instructed Dr. Gupta (D) to cancel the surgery. P was discharged on July 21 and never had the surgery. P filed a claim with the Health Claims Arbitration Office against Dr. Gupta (D) and Ds. The arbitration panel found no liability on the part of any Ds and entered an award in their favor. P rejected the award and filed suit. P did not present any evidence showing that Gupta (D) was negligent or that he supervised or controlled Ds. At the close of the evidence, P submitted jury instruction 11, 'Responsibility and Liability of Surgeon -- the Captain of the Ship Doctrine.' The court declined the instruction related to Gupta (D). The jury held that there was no liability on the part of Dr. Gupta (D), but it concluded that Ds were culpable and returned a $375,000 verdict. The court granted motions for judgment NOV. It further declared its judicial conscience shocked by what it regarded as 'grossly excessive' damages. It conditionally granted a new trial unless P agreed to accept a remittitur of all but $50,000. P appealed.

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