Jacob Becker, et al., Appellants,

This opinion is nonprecedential except as provided by
Minn. R. Civ. App. P. 136.01, subd. 1(c).

STATE OF MINNESOTA
IN COURT OF APPEALS
A24-1315

Jacob Becker, et al.,
Appellants,

vs.

Mark A. Steinhauser, et al.,
Respondents.

Filed March 31, 2025
Affirmed
Larkin, Judge

Ramsey County District Court
File No. 62-CV-21-891

Teresa Fariss McClain, Elizabeth Fors, Robins Kaplan LLP, Minneapolis, Minnesota (for
appellants)

Mark R. Bradford, Elizabeth Euller, Bradford Andresen Norrie & Camarotto,
Bloomington, Minnesota (for respondents)

Considered and decided by Johnson, Presiding Judge; Larkin, Judge; and Schmidt,
Judge.
NONPRECEDENTIAL OPINION
LARKIN, Judge
In this appeal from judgment following a jury trial on appellants’
medical-malpractice claims, appellants assert that the district court abused its discretion by
denying their motion to amend the ir pleadings to allege a negligent-nondisclosure claim
and their motion for a new trial. We affirm.
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FACTS
Appellants Jacob Becker, et al. (the Beckers) sued respondents Mark A. Steinhauser,
et al, for medical malpractice. The Beckers’ claims were based on care that Dr. Steinhauser
provided on May 7, 2018, at Entira Family Clinic (Entira).
Evidence at trial showed that J acob Becker was injured at work and underwent a
medical evaluation on April 27, 2018. His blood pressure was very high, 206/109, and he
was told to follow up with a primary-care doctor as soon as possible. Becker had a history
of elevated blood -pressure readings dating back to at least 2015. He also had a family
history of cardiovascular disease and diabetes.
On May 7, 2018, Becker met with Dr. Steinhauser—a family-medicine physician—
for the first time. Becker was 39 years old. His chief complaint was swelling (edema) in
his feet and ankles, which started on May 3, 2018. He also complained of frequent
urination and weight gain. He denied other symptoms.
Dr. Steinhauser noted that Becker had significant weight gain over the preceding
few years. Dr. Steinhauser noted that Becker snor ed and may have had “apneic periods,”
meaning his breathing temporarily stopped . Dr. Steinhauser recorded Becker’s blood
pressure twice during the visit.1 The first reading was 184/97; the second was 178/90. The
average of those readings reflected a severely high blood pressure. Severely high blood
pressure can be life -threatening, and as Dr. Steinhauser acknowledged during his

1 Dr. Steinhauser testified that Becker’s blood pressure was checked throughout the visit,
but those values were not recorded.
3
testimony, accepted standards of care require a doctor to “look for signs of target organ
injury.”
While examining Becker, Dr. Steinhauser observed “two to three plus pitting edema
in both lower extremities,” meaning that Becker’s swollen feet and legs showed a pitted
depression after the doctor pressed on them with his fingers. Dr. Steinhauser agreed that
this is “moderate pitting edema” and can be a sign of heart or kidney dysfunction. Becker’s
liver “was three to four centimeters below the right costal margin,” which could indicate
enlargement. But Becker’s liver was not tender or causing pain. Be cker had anemia,
meaning low hemoglobin in the blood ; asymptomatic microscopic hematuria, meaning
blood in the urine; and proteinuria, meaning protein in the urine. Blood and protein in the
urine can be a sign of kidney damage.
Dr. Steinhauser did not send Becker to the hospital or prescribe medication. Dr.
Steinhauser acknowledged at trial that there were signs of organ injury, but he testified that
Becker “was relatively stable” and “there wasn’t an acute symptom to cause [ Dr.
Steinhauser] to diagnose hypertensive emergency.” Dr. Steinhauser testified, “I told
[Becker] he had hypertension, but I wanted the laboratory study before starting treatment.”
The morning after his appointment with Dr. Steinhauser, Becker fell to the floor of
his home. He had suffered a hemorrhagic stroke. He underwent multiple surgeries but
continues to suffer from cognitive issues.
The Beckers sued Dr. Steinhauser and Entira. They alleged that Dr. Steinhauser
failed to appreciate the significance of Becker’s elevated blood pressure and fail ed to
properly evaluate and treat the hypertensive emergency that Becker presented. They also
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alleged that Entira was vicariously liable for Dr. Steinhauser’s medical malpractice as his
employer.
The case was tried to a jury . The Beckers called Dr. Steinhauser to testify during
the presentation of their case. Later, the Beckers moved the district court to amend their
pleadings to include a claim of negligent nondisclosure based on Dr. Steinhauser’s
testimony. The district court denied that motion.
The central issue at trial was whether Dr. Steinhauser failed to meet the accepted
standard of care. Evidence showed that a hypertensive emergency is severe blood pressure
elevation in the presence of “acute target organ injury,” also referred to as “acute end-organ
damage.” And evidence showed that the standard of ca re for a patient presenting a
hypertensive emergency is to refer the patient for an emergency evaluation. The Beckers’
theory was that Becker presented a hypertensive emergency during his visit with Dr.
Steinhauser and that Dr. Steinhauser therefore had a duty to refer him for emergency care.
Because there was no dispute over whether Becker had severe blood pressure elevation ,
the issue of breach turned on w hether Becker was suffering acute target organ injury or
acute end-organ damage when Dr. Steinhauser examined him.
The Beckers’ expert, Dr. Brian Smith, a family -medicine physician, testified that
Becker showed signs of acute end-organ damage primarily based on his edema. Dr. Smith
also noted concern over the protein and blood in Becker’s urine, which indicated that there
could be something wrong with his kidneys, but he conceded that it was unclear at the time
whether this issue was acute or chronic. Dr. Smith testified, “It’s clear he had severely
elevated blood pressure. He had at least two signs of end -organ dama ge potentially
5
affecting three organs,” yet Dr. Steinhauser did not send Becker “to the emergency room
for acute treatment.”
Respondents’ expert, Dr. Steven Zeiler, a stroke neurologist, testified that
hemorrhagic strokes are primarily caused by chronic hypertension . He opined that
Becker’s stroke was caused by chronic hypertension , and he stated that there was no data
to suggest that treatment to lower Becker’s blood pressure would have prevented a
hemorrhagic stroke. Dr. Zeiler also opined that the blood and protein in Becker’s urine
indicated a chronic issue, not an acute issue, and that Becker’s edema was the result of liver
disfunction, which is not caused by hypertension. Dr. Zeiler did not believe that Becker
presented a hypertensive emergency during his appointment with Dr. Steinhauser . Dr.
Zeiler testified that Becker “had no symptoms of target organ injury” and that Dr.
Steinhauser could not have prevented Becker’s hemorrhagic stroke.
Dr. Ruth Bolton, a family-medicine physician, also testified as an expert witness for
respondents, opining that Dr. Steinhauser followed accepted standards of care in his
evaluation and treatment of Becker. Dr. Bolton testified that Becker did not have any
symptoms of acute target organ injury during his appointment with Dr. Steinhauser.
The day after testifying during the Beckers’ case -in-chief, Dr. Steinhauser did not
appear for trial. Defense counsel informed the court that Dr. Steinhauser was ill. After
discussion with counsel, the district court informed the jury that Dr. Steinhauser was ill
and that the Beckers’ case would “proceed .” Later, defense counsel informed the district
court that the defense would forgo the opportunity to question Dr. Steinhauser as a witness.
6
During final instructions, the district court instructed the jury to treat Dr. Steinhauser’s
testimony no differently than any other evidence provided at trial.
During closing arguments, defense counsel argued that a demonstrative exhibit that
the Beckers had introduced was fraudulent. The B eckers objected, and the district court
overruled the objection.
The jury returned a unanimous special verdict, finding that Dr. Steinhauser was not
negligent in his care of Becker. The district court entered judgment in favor of respondents.
The Beckers moved for a new trial, and the district court denied that motion.
The Beckers appeal.
DECISION
I.

The Beckers contend that the district court abused its discretion by refusing to
submit a negligent-nondisclosure claim to the jury , arguing that they established a prima
facie case of negligent nondisclosure. See Minn. R. Civ. P. 15.02 (governing amendments
to the pleadings to conform to the evidence).
After a responsive pleading has been served, “[a] plaintiff may not amend the
complaint if the proposed amendment would be futile because it would serve no useful
purpose.” U.S. Bank Nat’l Ass’n v. RBP Realty, LLC, 888 N.W.2d 699, 705 (Minn. App.
2016), rev. denied (Minn. Apr. 18, 2017). We normally apply an abuse -of-discretion
standard of review to a district court’s denial of a motion to amend the complaint. Id. But
“[i]f a district court denies a motion to amend on the ground of futility, our review of the
7
district court’s ruling may turn on whether it was correct in an underlying legal ruling.” Id.
(quotation omitted).
In Minnesota, the doctrine of negligent nondisclosure was first outlined in Cornfeldt
v. Tongen, 262 N.W.2d 684 (Minn. 1977), in which t he supreme court “held that when
there is a particular risk inherent in a treatment or procedure the doctor may have a duty to
disclose it.” Pratt by Pratt v. Univ. of Minn. Affiliated Hosps. & Clinics, 414 N.W.2d 399,
401 (Minn. 1987). The duty to disclose has been applied “when the patient must decide
between the recommended treatment and no treatment at all” and “when a patient must
choose between two or more medically accepted alternative treatments.” Id. “The
existence of the duty depends on an objective standard . . . .” Kinikin v. Heupel , 305
N.W.2d 589, 594 (Minn. 1981). “A duty to disclose arises if the doctor knows or should
know of the risk.” Id. A doctor must disclose “risks of death or serious bodily harm which
are of significant probability,” as well as “[r]isks which a skilled practitioner of good
standing in the community would reveal.” Id. at 595.
The B eckers argue that the proposed amendment was appropriate because Dr.
Steinhauser never told Becker “that his severely high blood pressure and abnormal findings
of pitting edema in his lower extremities and microscopic hematuria and proteinuria were
signs of target organ damage that constituted a [h]ypertensive [e]mergency necessitating
immediate treatment to avoid irreversible and life -threatening organ damage. ”
Respondents counter that “Minnesota law is perfectly clear that there can be no claim for
negligent nondisclosure where the doctor doesn’t tell the patient of other, alternative
courses of treatment in the event the doctor’s diagnosis is wrong .” That is, “a physician
8
does not have to inform the patient of all alternative courses of treatment in the event the
physician’s diagnosis is incorrect.”
Respondents rely on Pratt, in which the supreme court stated that the doctrine of
negligent nondisclosure does not “require disclosure of conditions not diagnosed after a
diagnosis has been non -negligently made.” 414 N.W.2d at 401. The supreme court
reasoned in Pratt:
[T]he [d]octors used all available tests and gathered all
pertinent information in making their diagnosis. Thereafter
they informed the Pratts of their conclusions and proceeded in
a manner consistent with that diagnosis. Under the
circumstances of this case, there was nothing more that could
be done.
To say that the [d]octors had a duty to disclose
something more would, in effect, require them to inform the
Pratts that their diagnosis might be incorrect. There is no
logical stopping point to such a requirement. Such a rule could
conceivably force physicians to inform patients of all risks
associated with all conditions that were not diagnosed. To
require physicians to list such a parade of horribles under these
circumstances is not countenanced under either law or policy.

Id. at 402.

Here, it is undisputed that Dr. Steinhauser did not diagnose a hypertensive
emergency. Indeed, Dr. Steinhauser’s decision to not diagnose a hypertensive emergency
was the basis of the negligence claim. And as explained in section II .C. of this opinion,
the evidence supports the jury’s finding that Dr. Steinhauser’s diagnosis was not
negligently made.
In denying the Beckers’ motion to amend, the district court reasoned:

I don’t think . . . the law supports a claim for a duty to warn
under the facts of this case. . . . [E]ither Dr. Steinhauser has a
9
duty to tell [Becker] to go to the hospital, or he . . . had a duty
to instruct him that this would be treated as an outpatient, and
he would perform tests and call him in the morning. And so
with that, I don’t believe that it would be appropriate for the
negligent failure to disclose claim to proceed.

The district court’s reasoning is consistent with Pratt: because Dr. Steinhauser ’s
diagnosis was not negligently made and did not include hypertensive emergency, Dr.
Steinhauser had no duty to advise Becker of the risk of a hypertensive emergency. See id.
at 401. Under Pratt, Dr. Steinhauser had no duty to recommend the alternative option of
emergency care just in case he was wrong in his diagnosis. See id.
In sum, precedent indicates that the B eckers did not have a cognizable claim for
negligent nondisclosure, and the district court did not abuse its discretion by rejecting their
motion to amend.
II.

The Beckers contend that the district court abused its discretion by denying their
motion for a new trial. A district court’s ruling on a motion for a new trial is reviewed for
an abuse of discretion. TC/Am. Monorail, Inc. v. Custom Conveyor Corp. , 840 N.W.2d
414, 417 (Minn. 2013). “The district court abuses its discretion if it bases its ruling on an
improper application of the law to the facts.” Id. However, we review questions of law de
novo. See id. at 417-18. The Beckers argue that they were entitled to a n ew trial because
the district court erroneously instructed the jury regarding Dr. Steinhauser’s absence from
trial, because defense counsel accused the Beckers of fraud during closing argument, and
because the jury’s special verdict was not supported by the evidence. We address each
argument in turn.
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Jury Instructions

The Beckers argue that “[t]he district court’s comments and instructions to the jury
regarding Dr. Steinhauser’s health constituted a prejudicial irregularity in the proceedings”
under Minn. R. Civ. P. 59.01(a) “and an error of law” under Minn. R. Civ. P. 59.01(f).
To obtain a new trial based on irregularity, the moving party must show that an
irregularity occurred and that the party was deprived of a fair trial as a result. Boschee v.
Duevel, 530 N.W.2d 834, 840 (Minn. App. 1995), rev. denied (Minn. June 14, 1995). “An
irregularity is a failure to adhere to a prescribed rule or method of procedure not amounting
to an error in a ruling on a matter of law.” Id. (quotation omitted). We will not reverse a
district court’s decision on whether to grant a new trial based on irregularity absent a clear
abuse of discretion. Id.
District courts have “considerable latitude” in choosing jury instructions.
Youngquist v. W. Nat’l Mut. Ins. Co., 716 N.W.2d 383, 385 (Minn. App. 2006) (quotation
omitted). A new trial is warranted if “an erroneous instruction destroys the substantial
correctness of the charge as a whole, causes a miscarriage of justice, or results in substantial
prejudice.” Larson v. Gannett Co. , 940 N.W.2d 120, 140 (Minn. 2020) (quotation
omitted). An error is prejudicial if there is a reasonable likelihood the instruction had “a
significant effect” on the jury’s verdict. Youngquist, 716 N.W.2d at 386.
The Beckers called Dr. Steinhauser to testify in their case -in-chief and completed
that testimony. The next day, Dr. Steinhauser did not appear for trial. Defense counsel
informed the district court: “[M]y client will not be here today; he is not well, and he is
going to be seen medically. I do not know what the outcome of that will be.” Defense
11
counsel asked the court to tell the jury that Dr. Steinhauser would be absent for medical
reasons. The Beckers’ counsel expressed concern that a reference to Dr. Steinhauser being
ill would produce sympathy for him.
The district court voiced concern that the jury would expect Dr. Steinhauser to
return to be “questioned by the other side,” as “will happen for all of the other witnesses in
this case.” The Beckers’ counsel asked the court to tell the jury that Dr. Steinhauser was
out due to “unforeseen circumstances.” The district court expressed concern that such a
statement might prejudice Dr. Steinhauser by causing the jury to “think that he had
something else that he thought was more important going on today, that he just decided he
was not going to show up.”
After discussing the issue with counsel and considering their input, the district court
advised the jury: “Dr. Steinhauser has fallen ill. And so we are going to proceed with the
[Beckers’] case this morning.” The next day, Dr. Steinhauser was still ill. The district
court did not address the issue with the jury, reasoning: “I don’t see the need to address
that with the jury; we told them yesterday.” However, the district court told the parties that
it would not allow defense counsel to use Dr. Steinhauser’s deposition as a substitute for
live testimony without a showing that he was unavailable.
Defense counsel ultimately informed the district court that, because Dr. Steinhauser
remained ill, the defense was willing to submit the case to the jury on the existing
evidentiary record, without calling Dr. Steinhauser to testify. Defense counsel asked the
district court to instruct the jury that Dr. Steinhauser remained out due to illness. The
Beckers’ counsel responded: “Your Honor, we don’t have any objection to that.”
12
The district court proposed a final instruction regarding Dr. Steinhauser ’s partial
absence from trial, which was based on the district court’s concern that a juror might
question the weight to be afforded Dr. Steinhauser’s testimony because it had been
presented in a different process (i.e., without both direct and cross -examination). The
district court indicated that in its view, instructing the jury was the “fairest thing to do.”
The court told the jury : “You heard the testimony of Dr. Steinhauser, wh o fell ill. You
should consider his testimony just as you heard the other evidence.”
The Beckers do not cite any rule or authority indicating that the district court’s
instructions regarding Dr. Steinhauser’s absence were improper. A district court has broad
discretion in instructing a jury. State Farm Fire & Cas. Co. v. Short, 459 N.W.2d 111, 113
(Minn. 1990). A district court also has broad discretion in controlling courtroom
proceedings. See Rice Park Props. v. Robins, Kaplan, Miller & Ciresi, 532 N.W.2d 556,
556 (Minn. 1995). The record shows that the district court carefully considered its options
and received input from the parties before exercising its discretion, both when the issue
first arose and when crafting its final instructions.
The Beckers argue that the district court abused its discretion because the
instructions regarding Dr. Steinhauser’s absence were “irrelevant to any material issue.”
Although the instructions were not relevant to the elements of the Beckers’ medical -
malpractice claims, the instructions were within the district court’s broad authority to
control courtroom proceedings. See id.
The Beckers also argue that the district court’s instructions “relied on facts not
supported by the record.” But defense counsel’s representations regarding Dr.
13
Steinhauser’s illness were made as an officer of the court. The district court could rely on
counsel’s representation. See Findling v. Grp. Health Plan, Inc. , 998 N.W.2d 1, 12 n.10
(Minn. 2023) (“We assume lawyers in Minnesota are acting ethically.”).
Finally, the Beckers argue that the district court’s instructions unfairly prejudiced
them. But the district court instructed the jury to treat Dr. Steinhauser’s testimony just as
it would “other evidence ” and to “not allow sympathy, prejudice, . . . or emotion to
influence [its] verdict.” We assume that the jury followed the court ’s instructions and
properly considered Dr. Steinhauser’s testimony. See State v. Ferguson, 581 N.W.2d 824,
833 (Minn. 1998) (“We assume that the jury follows a court’s instructions.”). And even if
the instruction was erroneous, an erroneous jury instruction may not be prejudicial if there
is ample evidence to support the jury’s findings. Lewis v. Equitable Life Assurance Soc’y.
of the U.S. , 389 N.W.2d 876, 885 (Minn. 1986). As discussed in section II.C of this
opinion, the evidence amply supported the jury’s finding that Dr. Steinhau ser was not
negligent in his care of Becker.
In sum, the district court did not abuse its discretion by declining to grant a new trial
based on its instructions regarding Dr. Steinhauser’s absence from trial.
Fraud Accusation
The Beckers argue that they are entitled to a new trial because defense counsel
engaged in misconduct during closing argument by accusing them of fraud.
Minn. R. Civ. P. 59.01(b) permits the grant of a new trial based on “[m]isconduct
of the . . . prevailing party.” The decision to grant a new trial based on attorney misconduct
“rests almost wholly in the discretion of the [district] court,” and we will not reverse absent
14
a “clear abuse” of that discretion. Wild v. Rarig, 234 N.W.2d 775, 785 (Minn. 1975). “The
primary consideration in determining whether to grant a new trial is prejudice.” Id. at 786.
“[A] new trial for prejudicial argument is granted only to prevent a miscarriage of
justice.” Connolly v. Nicollet Hotel , 104 N.W.2d 721, 731 ( Minn. 1960). Statements of
counsel during closing argument “which are borne out by the record cannot be deemed
prejudicial.” Id. at 732. “Counsel have the right to present to the jury all legitimate
arguments on the evidence, to analyze and explain the evidence, and to present all proper
inferences to be drawn therefrom.” Id.
The Beckers introduced exhibit 45G, a diagram depicting, among other things, the
organs that can be damaged from s everely high blood pressure. Text on the lower left -
hand side of exhibit 45G says: “Can damage kidneys, liver, brain, and heart.” A box on
the bottom of exhibit 45G contains the insignia of the American Heart Association (AHA)
accompanied by a small copyright symbol.

15

The Beckers introduced exhibit 45G through their expert, Dr. Smith. On cross-
examination, Dr. Smith testified that the Beckers’ counsel prepared exhibit 45G and that
he reviewed it. Dr. Smith agreed exhibit 45G was being represented as something from
the AHA. Dr. Smith was then shown a n image obtained from the website
iStockPhoto.com. The figure in the image was identical to the one in exhibit 45G, but the
iStockPhoto.com image did not contain an AHA insignia—suggesting the Beckers’ image
was not obtained from or approved by the AHA. Dr. Smith agreed that the AHA’s website
did not list any health threat to the liver from high blood pressure.
The defense discussed exhibit 45G in closing arguments as follows:
I don’t think this is from the [AHA]. The [AHA] doesn’t say
that the liver is . . . an end organ subject to damage from
hypertension. Whether it’s chronic or acute. And so I see this
insignia, and I ask him -- you know, Dr. Smith, do you see that?
That’s the [AHA] insignia. There’s a C with a circle around it.
I think that means -- I am no copyright lawyer, but I think that
means it’s been copyrighted. You have to have their
permission to . . . use their insignia. Did you check it? Did
you check to see if this is on the . . . [AHA] website? No. Did
you ask them if they checked if it’s on the [AHA] website? No,
he did not ask that. Well, I did. We did check. And it’s from
iStockPhoto.com. It’s the exact same figure -- this has been
marked as Exhibit 239. It’s the exact same figure, and it talks
about hypertension, and included in it is not the liver.
Hypertension can cause stroke, blindness, heart attack and
failure, kidney failure, arterial sclerosis, blood pressure
damage. That Exhibit 45G is not the truth. And we are here to
find the truth. . . . [W]e are here because an allegation, an
accusation is being made against my client, and we are here to
ask you, as finders of the truth, as the finders of fact, whether
there was negligence. And if they have to doctor an exhibit in
order to prove their case, that ’s not a search for the truth.
That’s the search for a case. Isn’t it?

16
. . . .

And, by the way, when we talk about the truth, there’s actually
a definition of what the truth is. Or means. The truth is a fact
that can be verified. So if you can’t verify something that has
been said by a witness or a lawyer, well, you have to question
whether it’s actually based on something scientific or factual
in the medical record. And here we know from Dr. Smith that
an actual fraudulent exhibit was put forth in an attempt for the
[Beckers] to meet their burden of proof.

(Emphasis added.) At this point, the Beckers’ counsel objected to the characterization of
the exhibit as fraudulent , and the district court overruled the objection. Defense counsel
then reiterated that the exhibit was “[f]raudulent” and again implied that the exhibit had
been “doctor[ed]” by the Beckers’ counsel.
In denying the Beckers’ motion for a new trial based on the alleged misconduct of
defense counsel, the district court reasoned that the arguments “enjoyed support in the
record.” That is a fair characterization of the record. The record shows that exhibit 45G
was deceptive in two ways. First, the AHA insignia suggested the diagram was an image
prepared by the AHA, as opposed to a stock diagram from an internet site . Second, the
AHA insignia suggested that the AHA endorsed the information in the diagram. The
testimony of the Beckers’ own witness largely established that the exhibit misrepresented
that the AHA treats the liver as an organ that is at risk of acute damage from hypertension.
Although defense counsel struck “hard blows” in closing argument, the record provided
adequate support for counsel’s argument. See Connolly, 104 N.W.2d at 732.
17
Thus, the precedential cases on which the Beckers rely are factually distinguishable
because in those cases the record did not support the challenged arguments.2 See Wild, 234
N.W.2d at 786 (noting a duty to grant a new trial where the misconduct “appears to be
inexcusable and of such serious and prejudicial consequence as to deny the litigants a fair
trial” and where the trial was so “permeated by such personality conflicts, such obvious
appeals to passion and prejudice, and such rude, abusive, and unlawyer-like trial antics and
tactics that no jury could arrive at an impartial verdict” (emphasis added)) ; Krenik v.
Westerman, 275 N.W. 849, 85 0-51 (Minn. 1937) ( concerning a closing argument by
plaintiff’s counsel that was “permeated with the contention that there was somethi ng
reprehensible on defendant ’s part about the taking of [certain] statements from the
plaintiff,” despite the fact that there was nothing in the record showing that the taking of
the statements was fraudulent or done in a reprehensible manner); Ferraro v. Taylor, 265
N.W. 829, 832-33 (Minn. 1936) (granting a new trial because counsel “made statements of
fact not justified by the record”).
And we reject the Beckers’ argument that the AHA insignia was a “citation” for all
the organs listed on the exhibit 45G except the “liver.” Nothing on the face of the exhibit

2 We are not bound by, and do not discuss, the nonprecedential cases of this court , federal
cases, and cases from other states on which the Beckers rely. See Minn. R. Civ. App. P.
136.01, subd. 1(c) (“Nonprecedential opinions and order opinions are not binding authority
except as law of the case, res judicata or collateral estoppel, but nonprecedential opinions
may be cited as persuasive authority.”); TCI Bus. Cap., Inc. v. Five Star Am. Die Casting,
LLC, 890 N.W.2d 423, 431 (Minn. App. 2017) (stating that “[a] federal court ’s
interpretation of Minnesota law is not binding on this court”); see also Mahowald v. Minn.
Gas Co., 344 N.W.2d 856, 861 (Minn. 1984) (indicating that c ases from other states are
not binding but may have persuasive value).
18
indicates that the AHA insignia was a “citation” or that the purported citation did not apply
to the “liver.” Moreover, the Beckers ’ witness did not describe the exhibit in that way.
Instead, the witness acknowledge d the disconnect between the plain appearance of the
exhibit and the AHA’s actual position during cross-examination. The insignia reasonably
suggested AHA approval of all the information in exhibit 45G.
Finally, we reject the Beckers’ assertion that the “fraud” references in defense
counsel’s closing argument were improper because respondents never pleaded a fraud
claim or offered evidence to satisfy the five elements of a fraud claim. Although defense
counsel used the term “fraudulent” as a descriptive term when analyzing and explaining
the Beckers’ exhibit, counsel was not attempting to present a legally cognizable claim of
fraud.
In sum, the district court did not abuse its discretion in declining to grant a new trial
based on defense counsel’s statements during closing argument.
Weight of the Evidence
The Beckers argue that the district court erred by denying their motion for a new
trial because the jury’s verdict was not justified by the evidence.
Under Minn. R. Civ. P. 59.01(g), a new trial may be granted if the verdict is not
justified by the evidence. In determining whether a verdict is justified by the evidence, a
district court is vested with “the broadest possible discretionary power.” Clifford v.
Geritom Med. Inc., 681 N.W.2d 680, 687 (Minn. 2004) (quotation omitted). “Whether the
verdict is justified by the evidence presents a factual question[,] and the district court may
properly weigh the evidence.” Id. “The applicable test for granting a new trial on the basis
19
that the evidence does not justify the verdict is whether the verdict is so contrary to the
preponderance of the evidence as to imply that the jury failed to consider all the evidence,
or acted under some mistake .” Id. (quotation omitted). “[W]e will not set aside a jury
verdict on an appeal from a district court ’s denial of a motion for a new trial unless it is
manifestly and palpably contrary to the evidence viewed as a whole and in the light most
favorable to the verdict.” Navarre v. S. Wash. Cnty. Schs., 652 N.W.2d 9, 21 (Minn. 2002)
(quotations omitted).
The jury was presented with conflicting expert testimony regarding whether Becker
presented an acute target organ injury during his single visit with Dr. Steinhauser . Two
experts testified that Becker had symptoms of acute end -organ damage. First, Dr. Smith
testified that the edema in Becker’s lower extremities was a sign of acute end-organ
damage. But Dr. Smith could not identify lower-extremity edema listed as a symptom of
acute end-organ damage in literature admitted into evidence on the topic of hypertensive
emergencies. And he could not say which organ was causing the edema. Dr. Smith also
testified that the presence of blood and protein in Becker’s urine could be evidence of acute
end-organ damage.
Second, Dr. Scott Lipson testified by deposition that Becker had an enlarged liver,
which could indicate acute end -organ damage. But the Beckers’ other expert, Dr. Smith,
disagreed that hypertension could affect the liver. And Dr. Smith agreed that an AHA
exhibit did not recognize the liver as an organ that is affected by hypertension. In sum, the
Beckers’ own experts provided conflicting testimony regarding whether Becker ’s liver
indicated acute target organ injury caused by hypertension.
20
The Beckers assert that Dr. Steinhauser admitted at trial that Becker had acute target
organ injury because Dr. Steinhauser acknowledged that pitting edema and abnormal
kidney labs were “potential indicators of target organ damage.” Although Dr. Steinhauser
acknowledged that pitting edema and anormal kidney labs could be “potential indicators”
of target-organ damage, he also testified that Becker “was relatively stable” and that “there
wasn’t an acute symptom to cause [him] to diagnose hypertensive emergency.”
A defense expert witness, stroke neurologist Dr. Zeiler, testified that the swelling in
Becker’s lower legs was a product of liver disfunction—a chronic condition. Dr. Zeiler
explained in detail why Becker’s edema was “almost certainly” coming from his poorly
functioning liver. Dr. Zeiler also testified that “the patho physiology that led up to [the
edema] had to have been going on for a prolonged period of time.” Dr. Zeiler opined that
a prolonged condition is “the only way that that type of edema would build up” and that
Becker’s hematuria and proteinuria were “more likely than not signs of a chronic problem
in the kidney.”
Another defense expert witness, Dr. Ruth Bolton, agreed that Becker’s hematuria
and proteinuria were related to chronic issues . As to Becker’s liver, Dr. Bolton testified ,
“I’ve never seen [the liver] affected” by high blood pressure . Dr. Bolton testified that
nothing indicat ed Becker had acute target organ injury and that if she had been in Dr.
Steinhauser’s shoes, she “wouldn’t hospitalize [Becker] at that point. You wouldn’t even
know which part of the hospital to put him in.”
In sum, on the one hand, one of the Beckers’ experts opined that Becker’s edema,
hematuria, and proteinuria could indicate acute end -organ damage and therefore a
21
hypertensive emergency. That expert rejected the opinion of the Beckers’ second expert
that an enlarged liver indicated acute end-organ damage. On the other hand, Dr.
Steinhauser and the defense experts testified that Becker’s edema, hematuria, and
proteinuria were not indicative of acute target organ injury. The jury resolved the
conflicting testimony with a determination that Dr. Steinhauser was not negligent.
Again, “[t]he applicable test for granting a new trial on the basis that the evidence
does not justify the verdict is whether the verdict is so contrary to the preponderance of the
evidence as to imply that the jury failed to consider all the evidence, or acted under some
mistake.” Clifford, 681 N.W.2d at 687 (quotation omitted). When viewed in the light most
favorable to the verdict, the jury’s finding that Dr. Steinhauser was not negligent in his
treatment of Becker is not “manifestly and palpably contrary to the evidence viewed as a
whole.” Navarre, 652 N.W.2d at 21 (quotations omitted). Thus, the district court did not
abuse its discretion in declining to grant a new trial based on inadequate evidence.
In conclusion, the record demonstrates that the district court thoughtfully exercised
its discretion throughout the trial and ensured that the case was fairly tried under the
circumstances. We discern no basis to reverse.
Affirmed.