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PRESIDING JUSTICE GOLDENHERSH delivered the opinion of the court:

Marc Reardon (plaintiff) appeals the February 27, 1998, judgment entered by theEffingham County circuit court. The trial court entered the judgment following a juryverdict against plaintiff and for Bonutti Orthopaedic Services, Ltd., and Timothy Gray, M.D. On appeal, plaintiff claims that the trial court erred in refusing to grant plaintiff a new trialwhere the jury's verdict was contrary to the manifest weight of the evidence. For the reasonsthat follow, the judgment is vacated and the cause is remanded for a new trial.

On July 26, 1995, plaintiff filed a four-count complaint against Bonutti OrthopaedicServices, Ltd., St. Anthony's Memorial Hospital in Effingham (St. Anthony's), PeterBonutti, M.D., and Timothy Gray, M.D. (defendant). St. Anthony's filed an answer onAugust 21, 1995, and the remaining defendants filed their answers on September 22, 1995. On November 12, 1996, plaintiff filed a voluntary motion to dismiss the claim against Dr.Bonutti, and the trial court granted the motion on December 6, 1996. Plaintiff filed anamended four-count complaint. Drs. Bonutti and Gray and Bonutti Orthopaedic Servicesfiled their answers on January 2, 1997, and St. Anthony's filed its answer on January 9,1997. On April 11, 1997, St. Anthony's filed a motion for summary judgment as to countsII and III. Plaintiff responded by filing a motion to voluntarily dismiss, without prejudice,counts II and III on May 1, 1997, which the trial court granted. On February 24 through 26,1998, a trial was held against Dr. Gray and Bonutti Orthopaedic Services, Ltd. The juryreturned a verdict in favor of those defendants and against plaintiff. The trial court enteredthe judgment on February 27, 1998. After the trial, plaintiff obtained new counsel, and onMarch 27, 1998, the trial court granted plaintiff an extension of time to file his posttrialmotion so his new counsel could review the proceedings. On May 18, 1998, the partiesagreed to grant plaintiff an additional two-week extension to file his posttrial motion. Anextension was again granted on May 29, 1998, until June 30, 1998, because plaintiff madea motion to interview the jurors. On July 1, 1998, the trial court granted plaintiff's motionto interview the jurors and gave an additional 30-day extension. On July 30, 1998, the trialcourt granted one last extension to plaintiff until August 6, 1998. Plaintiff filed his posttrialmotion on August 6, 1998, requesting a judgment notwithstanding the verdict, or in thealternative, to grant a new trial because the jury verdict was against the manifest weight ofthe evidence. The defendants responded on August 24, 1998. A hearing was held onOctober 2, 1998, and the trial court denied plaintiff's posttrial motion on the same day. Plaintiff filed a timely notice of appeal.

On January 10, 1995, plaintiff suffered multiple fractures to his right foot. Plaintiff'smost severe fracture was of the calcaneus (heel) bone. The fracture was described by all thephysicians and nurses who examined plaintiff as highly comminuted, or broken into multiplepieces. The calcaneus does not break along lines as other bones; rather, it shatters whensuffering a trauma. In this case, the heel bone was shattered and smashed up into the foot. Testimony from all parties indicated that even if the doctors could fuse the pieces backtogether, plaintiff would suffer stiffness and a lack of ability to engage in high-intensityactivities at the level that he had before the trauma.

At the trial, plaintiff called the nurses who attended to him at St. Anthony's. The twonurses whose testimony was of note were Deborah Niemerg and Julie Werner. NurseNiemerg worked the 7 a.m.-to-3 p.m. shift on January 12, 1995, and attended to plaintiff. She stated that on January 12, 1995, plaintiff's toes were swollen but that they did blanchwell. (Blanching occurs when one applies pressure to the skin and the skin whitens andupon the release of the pressure, the skin returns to its normal color. How swiftly the skinresponds to this indicates the level of circulation in that part of the body.) Nurse Niemergbelieved that plaintiff could wiggle his toes on January 12, 1995.

Nurse Niemerg worked the 7 a.m.-to-3 p.m. shift on January 13, 1995, also. Hernursing notes were not in the chart obtained from St. Anthony's, so her testimony as to theevents on January 13, 1995, was from her independent recollection. She testified thatplaintiff's morphine intake during her shift on January 13, 1995, was nearly double hisintake on January 12, 1995. (Plaintiff controlled his own narcotic painkiller intake becauseof the pain associated with such a severely comminuted calcaneus.) She stated thatplaintiff's foot still blanched but that she did not believe the response was as good as onJanuary 12, 1995. Plaintiff developed blisters on the top, sides, and bottom of his foot. Nurse Werner relieved Nurse Niemerg at 3:30 p.m. Nurse Niemerg communicated herconcerns to Nurse Werner. She then called defendant's office sometime between 3:30 p.m.and 3:45 p.m. and talked to office personnel. Nurse Niemerg saw defendant one time on themorning of January 13, 1995. She testified that she listed plaintiff's pain as a five on a scaleof one to ten. She noted that she became more and more concerned about plaintiff'scondition as her shift progressed on January 13, 1995, because the foot was turning a deeperpurple color and the blanching was not as responsive.

Nurse Werner worked the 3 p.m.-to-11 p.m. shift on January 13, 1995. As withNurse Niemerg's notes, Nurse Werner's notes disappeared from St. Anthony's chart, and shetestified from her independent recollection. Upon relieving Nurse Niemerg, Nurse Wernerreceived a report on plaintiff's condition, and the two went in to examine plaintiff's foottogether. There was now a whitish-gray patch of skin on the top of plaintiff's foot. Afterher examination, Nurse Werner asked Nurse Niemerg to call and inform defendant ofplaintiff's condition. Nurse Niemerg informed Nurse Werner that she had been told thatdefendant would see plaintiff the following morning. Nurse Werner continued to monitorplaintiff because his circulation worsened.

At 5:10 p.m. on January 13, 1995, Nurse Werner called defendant and personallyinformed him of the poor blanching of plaintiff's toes, the poor circulation, and the whitish-gray patch on his foot. Defendant told her to keep plaintiff's foot elevated and iced and thathe would see plaintiff in the morning. Nurse Werner claims that she called defendant threemore times before she and Nurse Mix, another nurse on duty, called defendant at 6:20 p.m. Defendant denies receiving five calls from the nurses between 5:10 p.m. and 6:20 p.m. onJanuary 13, 1995, and only acknowledges two phone calls. During the 6:20 p.m. call, NurseWerner asked defendant to come and examine plaintiff in person after Nurse Mix, aregistered nurse on another floor that had at least seen plaintiff's foot beginning on themorning on January 13, 1995, told defendant about the perceived change in the conditionof plaintiff's foot.

At this point, defendant requested a Doppler study, a test that checks the circulationof the arteries and veins, and he also requested that Dr. Inder Khokha, a vascular surgeon,see plaintiff. Nurse Werner informed defendant that the Doppler technician was not presentat the hospital and that Dr. Khokha was in his car en route to Chicago. Defendant thenrequested that plaintiff be transferred to a hospital with a vascular surgeon; however, beforethe transfer order went through, a technician arrived, and the Doppler study was conducted. Defendant asked for the technician to call him when the results of the Doppler study wereknown. On cross-examination Nurse Werner stated that she listed plaintiff's pain as a sixon a one-to-ten scale and that plaintiff could move his toes. On redirect examination, NurseWerner stated that plaintiff could wiggle his toes; however, she stated that he did not wantto do so because the pain was too intense.

Dr. Khokha was contacted by a nurse at 6:42 p.m. on January 13, 1995, at the requestof defendant regarding his seeing plaintiff. Dr. Khokha informed the nurse that he wasunavailable because he was en route to Chicago. Later, defendant contacted Dr. Khokha anddiscussed plaintiff's poor circulation. Dr. Khokha agreed with defendant's decision toconduct vascular tests and to transfer plaintiff to a hospital with a vascular surgeon. Afterhaving the lab technician discuss the results of the tests conducted on plaintiff's foot, Dr.Khokha explained the circulation of the foot. The foot has two main arteries, doralis pedisand tibial posterior. These main arteries branch out into digital arteries and then tocapillaries that deliver oxygen to the muscle cells. Dr. Khokha testified that the results ofthe test demonstrated that plaintiff had adequate profusion (blood flow) at the ankle but thatthe profusion was poor at the toes. Therefore, Dr. Khokha surmised that plaintiff's problemwas at the digital artery or capillary level between the ankle and the toes. Dr. Khokhaopined that defendant took the appropriate step of transferring plaintiff to a facility with avascular surgeon. At approximately 9 p.m. on January 13, 1995, plaintiff was transferredfrom St. Anthony's to St. John's Hospital in Springfield (St. John's).

The first physician to see plaintiff at St. John's was Dr. Ashraf Mansour, a vascularsurgeon. Dr. Mansour received a history from plaintiff and conducted a physicalexamination of plaintiff's foot. Dr. Mansour stated that plaintiff's ankle was receivingcirculation but that his toes were not. He ordered a Doppler study, which confirmed hisassessment that plaintiff had good circulation at the ankle level but no circulation at the toes. Dr. Mansour testified that at this time his impression was that plaintiff was suffering fromcompartment syndrome. Compartment syndrome is an increase in pressure within thecompartments in which muscles are contained. Muscles are surrounded by tissue that keepsthem in compartments, and when the pressure inside these compartments increases to acertain level, the expansion begins to pinch the arteries. When the pressure is great enough,the arteries can close, causing blood flow to stop. Eventually, if not relieved, compartmentsyndrome leads to muscle necrosis or death.

Because Dr. Mansour opined that the compartment syndrome was a result of ashattered calcaneus, he believed that an orthopaedic physician would be better able to treatthe compartment syndrome, and he contacted Dr. Timothy Lang, a resident orthopaedicsurgeon at St. John's. Dr. Lang agreed with Dr. Mansour's diagnosis. They decided tocontact Dr. John Fisk, resident supervisor and orthopaedic surgeon at St. John's. Dr.Mansour conceded on cross-examination that no compartment pressures were taken. (Allthe physicians in this case testified as to an instrument that can definitively inform thephysicians if there is increased pressure in a compartment.) However, Dr. Mansour statedthat when a patient suffers from the clear clinical signs of compartment syndrome, the deviceis not necessary. The clinical signs entail the "five Ps." Physicians check for: (1) pain outof proportion, (2) pulselessness, (3) pallor, (4) parathesia, and (5) pain with passivemovement. Dr. Mansour's notes indicated that he did not detect arterial damage upon hisphysical exam. Also, he noted that the blood flow in the foot was decreased, not absent. Although his notes indicated that plaintiff could not move his great toe, his personalrecollection was that plaintiff could not move any of his toes. At 12:10 a.m. on January 14,1995, Dr. Mansour wrote his notes but did not recommend procedures for surgery, such asthat no food be taken. Dr. Mansour admitted that these orders were inconsistent with arecommendation of fasciotomy, the surgical procedure to relieve the compartment pressures,but that the diagnosis was a working one and subject to modifications upon consultationwith an orthopaedic surgeon. Dr. Mansour testified that plaintiff suffered from compartmentsyndrome and that the proper procedure was a fasciotomy.

Dr. Lang was paged by Dr. Mansour shortly after midnight on January 14, 1995. Dr.Mansour talked to Dr. Lang over the phone and told him that plaintiff needed an orthopaedicevaluation and that he suspected a compartment syndrome that might require surgery. Dr.Lang examined plaintiff's x rays and noted that plaintiff had a severe calcaneus fracture. Hetook plaintiff's history, during which plaintiff informed him that he was worried about hisfoot because he suffered increased pain during the morning of January 13, 1995. Dr. Lang'sexamination revealed swelling, hemorrhagic fracture blisters, and branching necrosis of theskin on the top of the foot. Dr. Lang noted that the bottom surface of plaintiff's foot wasswollen and that a palpation of the calcaneus and an extension of the toes caused plaintiffsevere pain. Dr. Lang believed that plaintiff was able to actively (by himself) move his toesby using the muscles in his calf and not those in his foot. Dr. Lang also stated that when hepassively moved plaintiff's toes, plaintiff had significant pain. He testified that heconducted his examination of plaintiff from 12:15 a.m. to 12:25 a.m. but that the timereflected in his notes was 1:10 a.m. Dr. Lang explained that the time on the notes is later,as he does not write his notes until after the examination.

After his examination of plaintiff, Dr. Lang contacted Dr. Fisk to discuss the case. Dr. Lang relayed the results of the physical exam and stated his diagnosis of compartmentsyndrome. He told Dr. Fisk that the diagnosis was from the physical evaluation. Dr. Fiskagreed with Dr. Lang's diagnosis, and he agreed that surgery was needed to relieve thepressure. Dr. Fisk believed that plaintiff's foot would benefit from increased oxygenimmediately after surgery, and he recommended that plaintiff be put in a hyperbaric oxygenchamber. St. John's did not have such a facility, and so Dr. Fisk recommended that plaintiffbe transferred to Memorial Medical Center (Memorial), also in Springfield, which possessesa hyperbaric chamber. After talking with Dr. Fisk, Dr. Lang contacted Dr. Konrad, who isinvolved with hyperbaric oxygen at Memorial, Dr. Crickard, an orthopaedic resident on callat Memorial, and Dr. Chris Wottowa, chief resident on call at Memorial.

Dr. Lang testified that he was confident of his clinical diagnosis and that time wasof the essence. He stated that measuring the compartment pressures would definitivelydefine a diagnosis of compartment syndrome but that the device was on another floor. Oncross-examination, the defense questioned Dr. Lang as to why he had time to transferplaintiff but did not have time to check plaintiff's compartment pressures. Dr. Langexplained that the time it takes to prepare an operating room at either hospital is the sameand that a transfer by an ambulance would not affect the swiftness with which a patient andfacility could be ready for surgery.

Dr. Lang opined that defendant deviated from the standard of care due plaintiff byfailing to personally examine plaintiff after being contacted by the nurses from St.Anthony's on the evening of January 13, 1995. Dr. Lang did concede that arterial orvascular trauma could eventually develop into compartment syndrome but stated that he didnot believe that to be the case here. He testified that the fact that plaintiff had circulation tohis toes immediately following the initial trauma on January 10, 1995, indicates that bloodflow was compromised only after the compartment syndrome worsened and not vice-versa. Dr. Lang testified that from the onset of compartment syndrome, a patient has a six- to eight-hour window for a realistic chance of saving the muscles. In this case, that window hadpassed by the time surgery was performed. From a review of St. Anthony's records, as wellas the testimony of the nurses at St. Anthony's, Dr. Lang opined that only defendant, asplaintiff's physician during the crucial time period, could have diagnosed the compartmentsyndrome and saved the muscles in plaintiff's foot. Therefore, defendant deviated from thestandard of care owed to plaintiff.

Dr. Fisk first saw plaintiff in the operating room at Memorial, where Dr. Wottowaand Dr. Crickard were present to assist in the procedure. Multiple incisions were made onthe compartments in plaintiff's foot. Dr. Fisk testified that upon incising the compartments,the muscles bulged out and appeared grayish-red in color. He testified that no bleedingoccurred upon the incision. He stated that all of these are signs of muscle death. Dr. Fiskapplied an electronic stimulant to the muscles with no success. The muscles were in factdead. Dr. Fisk testified that the lack of bleeding indicated that the artery had thrombosedor clotted. He continued to state that the artery had, in his medical opinion, clotted becauseof compartment syndrome.

Dr. Fisk testified that the clinical signs before surgery indicated compartmentsyndrome and that, upon operating on the foot, he made the diagnosis of compartmentsyndrome. He stated that the bulging of the muscle out of the compartment after cutting thetissue is indicative of the pressure that existed in the compartments of the foot and, therefore,indicated that plaintiff's foot suffered from compartment syndrome. He continued to explainthat compartment syndrome is a condition whose seriousness is determined by time. Ifcompartment syndrome is diagnosed and the pressure is relieved, via a fasciotomy, thecondition can be reversed. In this case, Dr. Fisk opined that plaintiff developed thecondition during the afternoon of January 13, 1995. He bases this upon the time it takesfrom the onset of compartment syndrome until muscle death (six to eight hours), as well asthe testimony of the nurses at St. Anthony's and the records from St. Anthony's.

The defense questioned Dr. Fisk as to how he could definitively know that plaintiff'sfoot did not have arterial damage that slowly clotted the arteries of the foot and developedinto compartment syndrome. Dr. Fisk refuted this thinking based upon the records from St.Anthony's. While conceding that vascular damage may coexist and even cause compartmentsyndrome, he stated that the records indicate that plaintiff had adequate circulation to histoes immediately following the initial trauma. Only over a period of days did circulation toplaintiff's toes show signs of decreasing. In fact, Dr. Fisk notes that plaintiff could movehis toes when leaving St. Anthony's, could not move his great toe when Dr. Mansourexamined him upon arriving at St. John's, and could not move any toes before surgery atMemorial. Dr. Fisk opined that this demonstrates that the pressures were increasing in thefoot compartments and slowly cutting off circulation. Dr. Fisk also conceded that the deadskin on the top of plaintiff's foot is usually indicative of vascular injuries but that whencompartment syndrome advances to a certain point, this can occur because the pressure hascut off all circulation.

Dr. Fisk opined that defendant deviated from the standard of care owed to plaintiffby failing to personally examine plaintiff on the evening of January 13, 1995. Dr. Fiskbelieves that the reports that the nurses were giving defendant should have alerted him thatsomething was happening and that a physical examination by a physician was necessary. Dr. Fisk did not have a problem with anything else that defendant did or did not do. Heagreed that consulting a vascular surgeon was appropriate and the prudent thing to do. However, Dr. Fisk opined that the failure to personally examine plaintiff's foot on theevening of January 13, 1995, resulted in lost time and caused plaintiff to lose his right foot.

Dr. Wottowa was one of the orthopedic resident surgeons who operated on plaintiff'sfoot. Dr. Wottowa physically examined plaintiff before surgery at Memorial. Based uponhis examination and the history of the plaintiff's condition, Dr. Wottowa testified that hebelieved that plaintiff suffered from compartment syndrome of the right foot. He testifiedthat this diagnosis was confirmed by the condition of the foot he observed during surgery. He opined that pain is the best clinical sign of compartment syndrome, although it can besomewhat controlled with narcotics. He opined that compartment syndrome could havebeen diagnosed between 8 a.m. and 6:30 p.m. on January 13, 1995. He stated that thecondition of the muscles during surgery indicated that plaintiff had suffered fromcompartment syndrome for more than eight hours. He also testified that the thrombosis ofthe tibial artery was caused by the compartment syndrome.

Plaintiff's expert witness was Dr. Michael Grear. Dr. Grear reviewed all the recordsand depositions in this case and arrived at the medical opinion that defendant deviated fromthe appropriate standard of care owed to plaintiff. Dr. Grear testified that plaintiff clearlysuffered from compartment syndrome. He stated that the condition began around 2 p.m. or3 p.m. on January 13, 1995. He denoted this time because he expected that the amount ofmorphine taken by plaintiff to control his pain would have subsided by this point. He statedthat the pain associated with a calcaneus fracture should begin to dissipate in a couple ofdays; however, in this case the pain medication taken by plaintiff increased over time. Hestated that plaintiff's condition, at the very least, showed clinical signs of compartmentsyndrome and that if defendant had doubts as to whether plaintiff had compartmentsyndrome, he could have measured the compartment pressures and verified the condition oneway or the other. Dr. Grear testified that he had no problem with defendant ordering avascular study in evening of January 13, 1995, following the nurses' phone calls as to thecondition of plaintiff's foot. However, he testified that defendant deviated from the standardof care by neglecting to personally examine plaintiff that evening. Dr. Grear stated that ifdefendant had visited and properly diagnosed plaintiff with compartment syndrome, then thechances of saving plaintiff's foot would have been considerably higher, because thedeterminant of whether compartment syndrome results in muscle death is the swiftness withwhich a physician can relieve the pressure in the compartments.

Next, defendant was called as an adverse witness. Defendant admitted that heassumed the care for plaintiff when Dr. Bonutti left on the evening of January 12, 1995. Hestated that he saw plaintiff's foot on January 11, 1995, and saw plaintiff on his rounds at 8a.m. on January 13, 1995, and that plaintiff's foot was the same as when he saw it onJanuary 11, 1995. He also visited plaintiff at noon on January 13, 1995, but did not examinehis foot. Defendant testified differently as to the number of phone calls received by thenurses between 5 p.m. and 6:30 p.m. on January 13, 1995, but does not deny that two callsoccurred or that the nurses were concerned and asked for him to come see plaintiff's foot. Defendant states that he was most concerned with the change of the color of the skin on thetop of the foot, which indicates a vascular problem. The time line of events is the same fromhere on as the other witnesses testified to; however, defendant disagrees with plaintiff'sexperts' medical opinions as to the clinical signs. He refutes that the pain was out ofproportion, that plaintiff's heel bone was shattered, and that large amounts of narcotics arenot unusual to control the pain associated with such an injury. He disagreed that pain withpassive movement of the toes is the best clinical technique to diagnose compartmentsyndrome. He believes, contrary to most other testimony, that active movement of the toesindicates that the muscles in the foot are not in trauma and compartment syndrome is notpresent. The other experts stated that one must check for pain with passive movement(movement induced by someone else) because even if compartment syndrome exists,patients may still be able to wiggle their toes using the muscles in the calf. Only passivemovement guarantees that the muscles in the foot are being stretched, and if one is sufferingfrom compartment syndrome, the amount of pain is enormous. Defendant disagreed withhis expert, Dr. Mark Myerson, that compartment syndrome is diagnosable only by usingcompartment pressure measurements. He also stated that any testimony diagnosing plaintiffwith compartment syndrome is wrong.

Defendant's first expert was Dr. Robert Pierron, an orthopaedic surgeon and associateprofessor of orthopaedics at St. Louis University. Dr. Pierron opined that plaintiff sufferedan arterial or vascular injury. He based this conclusion on a CT scan of plaintiff's foot,which had been taken in the emergency room at St. Anthony's. He testified that the recordsdid not indicate pain out of proportion with a calcaneus fracture on the level of severity asthat suffered by plaintiff. He testified that defendant did not deviate from the standard ofcare by not personally examining plaintiff on the evening of January 13, 1995. He statedthat it is not inappropriate for a physician to rely on the physical examination conducted bya nurse and that a physical examination would not have resulted in a different report of thefindings of the foot. He testified that compartment syndrome probably did develop inplaintiff's foot but was a result of the arterial injury suffered during the initial trauma. Whenan arterial trauma causes circulation to decrease or even stop, the muscles do not receivesufficient oxygen and begin to die. This death of muscle causes swelling, which canincrease the pressure in a compartment and result in compartment syndrome. Dr. Pierrontestified that both passive and active movement may be helpful in clinically diagnosingcompartment syndrome. However, in this case, he believes that plaintiff suffered a vascularinjury that may have resulted in compartment syndrome. He stated that both can existconcurrently and that he had no criticism for any physician in the case.

The final expert to testify was Dr. Mark Myerson, a board-certified surgeon. Dr.Myerson opined that plaintiff never suffered from compartment syndrome and that all thephysicians who testified that he did were incorrect. Dr. Myerson noted a "spike" of boneprotruding into plaintiff's neurovascular bundle of the right foot. Dr. Myerson explainedthat the foot has a bundle consisting of nerves, arteries, and veins and that the severe fractureof the calcaneus bone caused a fragment of bone to jut into the bundle. He further testifiedthat the Doppler study conducted on January 13, 1995, illustrates that the tibial artery wasnot open. He opined that the bone fragment in the neurovascular bundle either cut the arteryor pinched it so that the blood flow to the muscles in the foot was decreased. Either way,the problem was a vascular problem suffered from the initial trauma to the calcaneus bone.

Reliance on the "five Ps"-pain out of proportion, pallor, pulselessness, parathesia,and pain with passive motion-is useless according to Dr. Myerson. While conceding thatpain would be excruciating and while using the lack of pain as a basis for believing thatplaintiff did not have compartment syndrome, Dr. Myerson testified that the only manner todiagnose a patient with compartment syndrome is by taking the compartment pressures. Dr.Meyerson stated that even Dr. Fisk was wrong when he definitively stated that, based on hisobservations during surgery, plaintiff suffered from compartment syndrome.

Dr. Myerson testified that he believed that defendant followed the applicable standardof care in ordering vascular studies for plaintiff on January 13, 1995. He also agreed withdefendant's decision to transfer plaintiff to a hospital with a vascular surgeon. He did notbelieve that defendant's care for plaintiff contributed to the amputation of plaintiff's rightfoot. However, Dr. Myerson did criticize the sending of plaintiff to a vascular surgeon,because the injury was at a level of the circulatory system where a microvascular surgeonwas required.II. ANALYSIS

Plaintiff contends that the jury verdict and the following judgment were against themanifest weight of the evidence. Therefore, this court must determine whether the oppositeconclusion is apparent or whether the judgment is arbitrary, unreasonable, or not based uponthe evidence. See Leonardi v. Loyola University, 168 Ill. 2d 83, 106, 658 N.E.2d 450, 461(1995); Wodziak v. Kash, 278 Ill. App. 3d 901, 913, 663 N.E.2d 138, 147 (1996); Boey v.Quaas, 139 Ill. App. 3d 1066, 1071, 487 N.E.2d 1222, 1224 (1986). The proper inquiry iswhether the result reached is reasonable based upon the facts and evidence, not whetherother conclusions are possible. See Boey, 139 Ill. App. 3d at 1071, 487 N.E.2d at 1224.

In a medical malpractice case, the plaintiff bears the burden of proving: (1) thestandard of care that the defendant physician owed to patients in the plaintiff's position, (2)that the defendant physician violated that standard of care, and (3) that the defendantphysician's deviation was the proximate cause of the plaintiff's injuries at issue in the suit. See Pumala v. Sipos, 163 Ill. App. 3d 1093, 1098, 517 N.E.2d 295, 298 (1987); Boey, 139Ill. App. 3d at 1071-72, 487 N.E.2d at 1224-25. The plaintiff must prove by apreponderance of the evidence that defendant was the proximate cause. See Pumala, 163Ill. App. 3d at 1098, 517 N.E.2d at 298; Boey, 139 Ill. App. 3d at 1071-72, 487 N.E.2d at1224-25. In this case, the central issue is whether plaintiff suffered from compartmentsyndrome that resulted in the amputation of plaintiff's right foot, for which defendant wouldbe liable for failing to diagnose, or a vascular problem, for which defendant would be liablefor not diagnosing.

The evidence at the trial indicates that it was compartment syndrome. Everyphysician, save two, testified within a reasonable degree of medical certainty that plaintiffsuffered from compartment syndrome. The two physicians who disagreed were defendant,whose motives must be questioned as self-serving, and Dr. Myerson, who stated that onecannot diagnose compartment syndrome unless one uses an instrument that actuallymeasures the pressure inside the compartments. Dr. Meyerson testified that plaintiff sufferedfrom a microvascular injury; however, he never personally examined plaintiff, but rather hereviewed depositions and medical records in making his diagnosis. On plaintiff's side, everyphysician stated that plaintiff suffered from compartment syndrome. Even Dr. Pierron,another of defendant's experts, testified that he believed that plaintiff suffered an initialvascular injury, but that such an injury can lead to compartment syndrome. The only savinggrace for defendant was that if the compartment syndrome developed from a vascular injury,it could adjust the time frame so that defendant would not be held responsible.

All other physicians testified that plaintiff had compartment syndrome, including Dr.Fisk, who performed the fasciotomy on plaintiff in the hopes of relieving the compartmentpressures before muscle necrosis set in. Dr. Fisk testified that plaintiff suffered fromcompartment syndrome. He based this diagnosis on the state of the muscles within the footthat he observed during surgery. This diagnosis was supported by Dr. Mansour, whoclinically diagnosed plaintiff with compartment syndrome, and Drs. Lang and Wottowa, whonot only clinically diagnosed plaintiff with compartment syndrome but also observed themuscles during the fasciotomy. Plaintiff also presented an expert, Dr. Grear, who, basedupon a review of depositions and medical records, testified that he believed that plaintiffsuffered from compartment syndrome.

Even with this evidence, the jury returned a verdict in favor of defendants. Thedefense correctly asserts that assessing the weight and credibility of testimony is exclusivelyin the province of the jury. See Wodziak, 278 Ill. App. 3d at 913-14, 663 N.E.2d at 147. When conflicting testimony exists, it is for the jury to resolve the conflict. See Wodziak, 278Ill. App. 3d at 913-14, 663 N.E.2d at 147. However, the jury cannot accept expert testimonyarbitrarily. The jury must consider the facts and the evidence upon which the experts basetheir opinions. In this case, all the physicians had access to the same records. Defendant'sexpert, Dr. Myerson, had less personal knowledge to base his opinion than Drs. Fisk, Lang,and Wottowa, who had the same records as Dr. Myerson and also personally examinedplaintiff, as well as performed or assisted in the fasciotomy.

The jury may have concluded that Dr. Pierron was correct, which would reconcile allthe physician testimony. If plaintiff suffered a vascular injury that developed intocompartment syndrome, then the testimony of Dr. Lang and Dr. Myerson could bereconciled. Dr. Lang encountered plaintiff after he developed compartment syndrome. Dr.Myerson based his diagnosis on the initial trauma. Thus, defendant could not havediagnosed compartment syndrome until after defendant properly transferred plaintiff to ahospital with a vascular surgeon. However, plaintiff had good circulation immediatelyfollowing the accident on January 10, 1995, and only developed decreased circulation onJanuary 13, 1995. The evidence shows that plaintiff suffered from compartment syndromethat could have been diagnosed in the late afternoon or early evening on January 13, 1995.

Time is a key component in compartment syndrome. From the onset, or the pointwhere it is reasonable to diagnosis compartment syndrome, a patient has six to eight hoursto have the pressure relieved, or the muscles will die. Thus, if surgery was performedshortly after 2 a.m. on January 14, 1995, then 6 p.m. to 8 p.m. would have been the latestpossible time, with mid- to late afternoon being better, to diagnose plaintiff withcompartment syndrome and save the muscles in the foot. During this period of time,plaintiff was under defendant's watch, and the nurses at St. Anthony's were informingdefendant of a change in plaintiff's condition. It was a violation of defendant's duty of careto fail to come to the hospital and physically examine a patient whose condition waschanging, especially when nurses are requesting that defendant do so.

Plaintiff did not need to prove that if defendant had come to the hospital andexamined plaintiff, that would have prevented plaintiff's foot from being amputated. TheIllinois Supreme Court settled the question of whether to use the "loss of chance" doctrineor the "better result" test, in Holton v. Memorial Hospital, 176 Ill. 2d 95, 679 N.E.2d 1202(1997). The supreme court held that it was not necessary for a plaintiff in a medicalmalpractice case to have to prove beyond that of a normal negligence case by being requiredto prove that a better result would have been achieved absent the alleged negligence of thedoctor. Rather, the plaintiff must prove, by a preponderance of the evidence, that thedoctor's negligence costs him a chance for a better result. See Holton, 176 Ill. 2d 95, 679N.E.2d 1202; Borowski v. Von Solbrig, 60 Ill. 2d 418, 328 N.E.2d 301 (1975); Hajian v.Holy Family Hospital, 273 Ill. App. 3d 932, 940, 652 N.E.2d 1132, 1136 (1995). In thiscase, the negligent delay of defendant in failing to examine plaintiff on January 13, 1995,resulted in a decreased chance of saving the muscles in plaintiff's foot. Negligent delay ortreatment that lessens the effectiveness of treatment is sufficient to prove proximate causeunder the "loss of chance" doctrine. Hajian, 273 Ill. App. 3d at 937, 652 N.E.2d at 1136-37;Chambers v. Rush-Presbyterian-St. Luke's Medical Center, 155 Ill. App. 3d 458, 508N.E.2d 426 (1987).

In this case, the weight of expert testimony would lead a reasonable person to theconclusion that plaintiff suffered from compartment syndrome at some point in time. Plaintiff established the time period in which defendant was responsible for the care ofplaintiff and that during that period of time defendant could have diagnosed plaintiff'scondition. The evidence demonstrates that defendant did not personally come to the hospitalto examine plaintiff, even after being requested to by plaintiff's nurses. Plaintiff has proven,at the very least, that the chances of saving his foot would have been greater had defendantphysically examined his foot. Therefore, we conclude that the jury's verdict was against themanifest weight of the evidence.

For the foregoing reasons, the judgment of the circuit court of Effingham County isvacated, and the cause is remanded for a new trial.

Vacated; cause remanded.

WELCH and CHAPMAN, JJ., concur.

___________________________________________________________________________

MARC REARDON, ) Appeal from the

) Circuit Court of

Plaintiff-Appellant, ) Effingham County.

)

v. ) No. 95-L-55

)

BONUTTI ORTHOPAEDIC SERVICES, )

LTD., and TIMOTHY GRAY, M.D., ) Honorable

) John P. Coady,

Defendants-Appellees. ) Judge, presiding.

___________________________________________________________________________

Opinion Filed:

___________________________________________________________________________

Justices: Honorable Richard P. Goldenhersh, P.J.

Honorable Thomas M. Welch, J., and

Honorable Charles W. Chapman, J.,

Concur

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Attorney M. Keith Smith, Law Offices of M. Keith Smith, 123 South 10th

for Street, Suite 407, Mercantile Building, P. O. Box 745, Mt. Vernon,

Appellant IL 62864

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Attorney Richard C. Hayden, 201 East Richmond Avenue, P. O. Box 1216,

for Mattoon, IL 61938

Appellees

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