Desert Palm Surgical Group, P.L.C. v. Petta , 236 Ariz. 568 ( 2015 )


Menu:
  •                                 IN THE
    ARIZONA COURT OF APPEALS
    DIVISION ONE
    DESERT PALM SURGICAL GROUP, P.L.C., an Arizona professional
    limited liability company; and ALBERT E. CARLOTTI and MICHELLE L.
    CABRET-CARLOTTI, husband and wife, Plaintiffs/Appellees,
    v.
    SHERRY PETTA, an individual, Defendant/Appellant.
    No. 1 CA-CV 13-0376
    FILED 1-15-2015
    Appeal from the Superior Court in Maricopa County
    No. CV2008-010464
    The Honorable Mark H. Brain, Judge
    AFFIRMED IN PART; REVERSED IN PART; VACATED AND
    REMANDED
    COUNSEL
    Kelly McCoy, P.L.C., Phoenix
    By Matthew J. Kelly, Kevin C. McCoy
    Counsel for Plaintiffs/Appellees
    Clark Hill P.L.C., Scottsdale
    By Ryan J. Lorenz, Sean M. Caroll
    Counsel for Defendant/Appellant
    OPINION
    Presiding Judge Lawrence F. Winthrop delivered the opinion of the Court,
    in which Judge John C. Gemmill and Chief Judge Diane M. Johnsen joined.
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    W I N T H R O P, Associate Presiding Judge:
    ¶1             Sherry Petta appeals the superior court’s judgment in the
    amount of $12,009,489.96 in favor of Desert Palm Surgical Group, P.L.C.
    (“DPSG”), Dr. Albert E. Carlotti, and Dr. Michelle L. Cabret-Carlotti
    (collectively, “Plaintiffs”) on claims for defamation and false light invasion
    of privacy. In this opinion, we affirm the superior court’s denial of Petta’s
    motions for judgment as a matter of law, but vacate the judgment and
    remand for a new trial because the judgment cannot be supported by the
    damages evidence presented and shocks the conscience of this court. We
    also reverse the superior court’s summary judgment on Petta’s
    counterclaim for medical battery, a claim that may be tried on remand.
    FACTS AND PROCEDURAL HISTORY1
    ¶2             Drs. Carlotti and Cabret-Carlotti (collectively, “the Doctors”)
    are husband and wife with dental and medical degrees who operate DPSG,
    an Arizona professional limited liability company formed in 2002.
    Plaintiffs’ practice offers a wide range of services, including maxillofacial
    surgery, cosmetic surgery, dental procedures, and various skin procedures
    and treatments.
    ¶3            In January 2007, Dr. Carlotti performed cosmetic surgery on
    Petta’s nose and eyelids, and Dr. Cabret-Carlotti performed laser
    resurfacing treatments on Petta’s face. Petta was dissatisfied with the
    results, and aggressively voiced her dissatisfaction to the Doctors and their
    staff on numerous occasions. In Petta’s view, the laser procedure had
    burned and scarred her face. Without question, healing was delayed,
    persistent post-operative infection occurred, and Petta’s nose developed
    residual thickening due to scar tissue. Throughout 2007, the Doctors
    attempted to improve Petta’s healing and appearance with various
    treatments, but the doctor-patient relationship deteriorated.
    ¶4            Petta eventually consulted physicians not associated with
    DPSG and underwent other treatment on her face; the parties disputed
    whether the Doctors had authorized her to do so. By September 2007, Dr.
    Carlotti refused to continue Petta’s care for a period of time, ostensibly due
    to Petta’s “screaming and using profanity” and her reliance on
    1     We view the facts and inferences in the light most favorable to
    sustaining the verdict and judgment. Hyatt Regency Phoenix Hotel Co. v.
    Winston & Strawn, 
    184 Ariz. 120
    , 123, 
    907 P.2d 506
    , 509 (App. 1995).
    2
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    “unauthorized care.” On September 25, 2007, Dr. Carlotti presented Petta
    with the following agreement, which both he and Petta signed:
    Desert Palm Surgical Group agrees to perform 3 IPL [intense
    pulse light] treatments of the forehead and periorbital areas,
    provided that there is absolutely no intervention by any
    unauthorized doctor, nurse or esthetician of any type during
    the course of treatment. This includes medications, products
    and treatments. In addition, treatment intervals will be
    clearly defined to which the patient must comply completely.
    Lastly, if there is any profanity, screaming or threats made
    now or in the future, to either Drs. Carlotti or any staff
    member, you will be dismissed as a patient from Desert Palm
    Surgical Group.
    In the fall of 2007, the IPL treatments proceeded as planned, and Petta’s face
    improved.
    ¶5             On January 3, 2008, Dr. Carlotti performed at cost a second
    surgery (a “revision nasal tip surgery”) to remove the scar tissue on Petta’s
    nose. Petta remained dissatisfied, in part because, as she alleged, the doctor
    had now shortened and curved her nose upward, without her permission
    and against her express wishes. On February 1, 2008, Petta consulted a
    different physician, Dr. Ronald J. Caniglia, who opined that Petta’s nose
    had “been shortened quite a bit” and that it appeared there was “collapse
    in the left middle vault with a stepoff deformity there.”
    ¶6            Petta eventually contacted the Arizona Medical Board
    (“AMB”), the Arizona State Board of Dental Examiners (“the Dental
    Board”), the Arizona Radiation Regulatory Agency (“ARRA”), and former
    DPSG employees and patients, and discovered the Doctors were not
    certified in plastic or cosmetic surgery, or maxillofacial surgery, by a
    certifying professional board recognized by the American Board of Medical
    Specialties (“ABMS”).2 In early March 2008, Petta submitted a formal
    2      The AMB does not itself issue board certification, but allows its
    licensees to report on its consumer website if they are certified as a specialist
    by a member of the ABMS. The Doctors are not board certified by any of
    the member boards of the ABMS, but are instead certified by the American
    Board of Oral & Maxillofacial Surgery (“ABOMS”), a separate organization
    not so recognized by the AMB or the ABMS.
    3
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    complaint against the Doctors to the AMB, alleging they had operated on
    her nose beyond the scope of her consent.3
    ¶7            At about the same time, Petta requested copies of her medical
    records, and although she paid for a copy of those documents, a
    disagreement arose over Plaintiffs’ delivery of those records. On March 24,
    2008, Petta called DPSG to inquire about the status of her request, and she
    was informed her records were ready to be picked up. When she arrived
    at DPSG, however, she was informed the records were not available. A
    heated verbal exchange followed, with Petta purportedly shouting
    profanity-laced warnings to other patients present not to allow the Doctors
    to practice on them, and Scottsdale police were called. Dr. Carlotti refused
    to provide Petta with her records because she had filed a complaint with
    the AMB.        A police officer spoke telephonically with an AMB
    representative, who informed the officer that DPSG could not withhold
    Petta’s records on that basis. The officer relayed the information to Dr.
    Carlotti, who agreed to provide the records to Petta by the end of the day.4
    Later that day, with the assistance of law enforcement, Petta received her
    medical records, which she later maintained had been altered.5 Also on
    March 24, at Dr. Carlotti’s behest, the police issued Petta a trespass warning.
    On March 26, 2008, Dr. Carlotti sought an injunction against harassment
    against Petta, which was issued after an evidentiary hearing.
    ¶8            In the next few weeks, Petta began posting statements on
    various consumer review websites, complaining of her experiences as the
    Doctors’ patient, including alleging the Doctors were not “board certified.”
    She also created her own website complaining she had been Plaintiffs’
    “victim” and warning the public of the Doctors’ alleged incompetence and
    3      That complaint was ultimately dismissed by the AMB.
    4      At trial, Dr. Carlotti denied Petta’s complaint with the AMB was the
    basis for his refusal to provide Petta with her records, but he acknowledged
    a representative of the AMB advised him telephonically to “just give her
    her records.”
    5     Petta contacted a former DPSG employee, who replied with an e-
    mail that appeared to confirm Petta’s suspicion that some chart
    documentation the former employee had authored had been altered.
    4
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    unethical, unprofessional behavior.6 In late April and early May 2008,
    Plaintiffs sent two letters through counsel to Petta demanding she “remove
    all defamatory and baseless statements from any and all websites” and
    advising her that if she did not, Plaintiffs would sue her.
    ¶9              On May 7, 2008, Plaintiffs filed a complaint against Petta,
    alleging she had posted false and defamatory statements about Plaintiffs in
    her internet postings, omitted facts, and disparaged Plaintiffs while
    painting them in a false light. Through their complaint, Plaintiffs asserted
    claims for (1) defamation/libel per se, (2) tortious interference with medical
    practice, (3) injurious falsehood/business disparagement, and (4) false light
    invasion of privacy. That same day, Plaintiffs also requested an application
    for a temporary restraining order (“TRO”) and preliminary injunction to
    compel Petta to remove any postings from websites in which Petta had
    complained about the Doctors’ surgical work and other matters and to
    enjoin her from continuing to post allegedly false statements on those
    websites. On May 22, 2008, Petta through counsel stipulated to the relief
    sought in the TRO, and the superior court entered the TRO. Petta removed
    her comments approximately one month after they had been posted.7
    ¶10           Petta filed an answer and asserted a counterclaim for medical
    battery, claiming she had not consented to the scope of the January 2008
    alteration to her nose.8 On January 8, 2010, Plaintiffs filed an amended
    6      After the hearing on the injunction against harassment, Petta
    modified her online comments to clarify she was “not disputing” Dr.
    Carlotti was certified by the ABOMS, but continued to maintain that
    “neither doctor is state Board Certified” based on information she received
    directly from the AMB staff and its website. She also provided a link
    directing viewers to the AMB website.
    7      On November 17, 2008, however, a different judge of the superior
    court, addressing a flurry of motions filed by the parties, issued a follow-
    up minute entry denying Plaintiffs’ application for a TRO. Apparently
    relying on this ruling, Petta resumed posting complaints about Plaintiffs to
    “doctor rating” websites in December 2008, and Plaintiffs filed a motion for
    contempt and sanctions for violation of the TRO. On February 11, 2009, the
    court reaffirmed the TRO, and Petta again removed the comments.
    8     In the meantime, the parties’ respective antagonism escalated. Petta
    continued to file numerous complaints about the Doctors with the AMB,
    contending in part they had falsified records, Dr. Carlotti was “messed up
    5
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    complaint, adding several of their former employees and the mother of a
    former employee as defendants.9 The additional defendants were all
    eventually dismissed with prejudice, ostensibly as the result of negotiated
    settlements containing confidentiality clauses.
    ¶11            Before trial, Petta moved for summary judgment on each of
    Plaintiffs’ claims. Plaintiffs moved for summary judgment on Petta’s
    counterclaim, arguing Petta had consented to the January 2008 procedure
    on her nose (the revision nasal tip surgery) and, in any event, Petta could
    not prove which of the Doctors had performed the surgery. The superior
    court granted Petta’s motions for summary judgment as to Plaintiffs’ claims
    for injurious falsehood/business disparagement and wrongful interference
    with business relations, and Plaintiffs’ motion for summary judgment as to
    Petta’s counterclaim for medical battery.
    ¶12           Plaintiffs’ remaining claims for defamation and false light
    invasion of privacy were tried. After a ten-day trial, the jury returned a
    verdict in favor of Plaintiffs and against Petta in the amount of eleven
    million dollars in actual or compensatory damages and one million dollars
    in punitive damages on Plaintiffs’ claims for defamation and false light
    invasion of privacy.10 The superior court entered a final judgment on the
    verdict.
    on narcotics,” and the Doctors were using a laser not in compliance with
    ARRA regulations. (Plaintiffs were in fact assessed civil fines for non-
    compliance with the ARRA.) Also, Petta complained about Dr. Cabret-
    Carlottii to the Dental Board. Meanwhile, in August 2008, after Petta
    presented evidence to the AMB regarding Plaintiffs’ alleged lack of proper
    licensing and lack of proof of maintenance of the laser equipment, Dr.
    Cabret-Carlotti sent Petta a series of personally insulting text messages,
    accusing Petta of being psychotic and blaming Petta for her post-operative
    complications.
    9       During discovery, Petta became aware of numerous individuals,
    including Plaintiffs’ former patients, employees, and business associates,
    who indicated a willingness to testify as to their poor results and/or
    Plaintiffs’ lack of competence, unprofessional conduct, and bad reputation
    in the Scottsdale community. Some or all of these individuals, assisted by
    Petta, also filed complaints about Plaintiffs with the AMB.
    10   The jury was not asked to break out the amounts awarded for
    compensatory damages.
    6
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    ¶13            Petta moved for a new trial, for judgment as a matter of law,
    for remittitur, and for relief from judgment. The superior court denied
    Petta’s motions and denied Plaintiffs’ request to impose a permanent
    injunction against Petta, but amended its judgment to correct an accrual of
    interest calculation. In the amended final judgment, the court found in
    favor of Plaintiffs in the amount of $12,009,489.96 (an amount that included
    costs), plus interest. Petta filed a timely notice of appeal.
    ANALYSIS
    I.     Jurisdiction
    ¶14           As an initial matter, Plaintiffs argue this court lacks
    jurisdiction because Petta failed to designate the amended final judgment
    in her notice of appeal. We disagree.
    ¶15           “The timely filing of a valid notice of appeal is a prerequisite
    to the exercise of appellate jurisdiction.” Santee v. Mesa Airlines, Inc., 
    229 Ariz. 88
    , 89, ¶ 3, 
    270 P.3d 915
    , 916 (App. 2012) (citations omitted). As a
    general rule, our review is limited to matters designated in the notice of
    appeal or cross-appeal. See Flory v. Silvercrest Indus., Inc., 
    129 Ariz. 574
    , 581-
    82, 
    633 P.2d 383
    , 390-91 (1981); ARCAP 8(c) (“The notice of appeal . . .
    shall designate the judgment or part thereof appealed from . . . .”). We
    have an independent duty to determine whether we have jurisdiction over
    an appeal and must dismiss an appeal over which we lack jurisdiction.
    Baker v. Bradley, 
    231 Ariz. 475
    , 478-79, ¶ 8, 
    296 P.3d 1011
    , 1014-15 (App.
    2013).
    ¶16            Nevertheless, “where the record discloses an appellant’s
    intent to appeal from a judgment, such as sending copies of a defective
    notice of appeal to all defendants, or where a notice of appeal
    substantially complies with the Rules of Civil Appellate Procedure, the
    notice of appeal should be construed as sufficient so long as the defect has
    neither misled nor prejudiced an opposing party.” Hill v. City of Phoenix,
    
    193 Ariz. 570
    , 572-73, ¶ 10, 
    975 P.2d 700
    , 702-03 (1999) (citing Hanen v. Willis,
    
    102 Ariz. 6
    , 9-10, 
    423 P.2d 95
    , 98-99 (1967) (“[W]e believe that distinction
    is not material, and that the better rule is that if a valid judgment has been
    entered in the case, a notice of appeal timely filed in relation to such
    judgment will not be found insufficient merely because the date given as
    that of the order or judgment appealed from is the date of an earlier
    rendering of the same judgment by minute entry order . . . .“)).
    ¶17         In this case, the superior court entered a signed final
    judgment resolving all claims and counterclaims on February 8, 2012.
    7
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    Plaintiffs filed their motion to alter or amend the judgment, and Petta filed
    a timely motion for new trial, for judgment as a matter of law, and for
    remittitur. On May 1, 2013, the superior court’s amended final judgment
    was filed, and the court’s signed minute entry denying Petta’s post-trial
    motions was filed the next day – on May 2, 2013. On May 16, 2013, Petta
    filed a timely notice of appeal “from the Judgment entered in this matter
    on February 8, 2012, and the order denying post-trial motions entered on
    or about May 1 or 2, 2013, and all parts of each.”
    ¶18             Plaintiffs note that Petta’s notice of appeal failed to designate
    the amended final judgment as the judgment from which she was
    appealing. Citing Ball v. Chandler Improvement District No. 48, 
    150 Ariz. 559
    ,
    
    724 P.2d 1228
     (App. 1986), for the proposition that failure to identify the
    amended judgment results in a waiver, Plaintiffs argue we should dismiss
    for lack of jurisdiction. See generally Swichtenberg v. Brimer, 
    171 Ariz. 77
    , 82,
    
    828 P.2d 1218
    , 1223 (App. 1991) (“Subject matter jurisdiction cannot be
    waived, and can be raised at any stage of the proceedings.” (citation
    omitted)).
    ¶19           Plaintiffs’ reliance on Ball is unavailing. In Ball, this court
    simply held that, because the City of Chandler had failed to appeal the
    underlying merits of a judgment and had only appealed from the award of
    attorneys’ fees, the City could not launch a collateral attack on the judgment
    in the appeal. 150 Ariz. at 562-63, 
    828 P.2d at 1231-32
    . Here, the final
    judgment, the amended final judgment, and the superior court’s order
    denying the post-trial motions (with the exception of Plaintiffs’ motion to
    amend the award of interest) were all part of the same determination on the
    same claims. Further, Plaintiffs cannot argue they have been misled or
    prejudiced by Petta’s notice of appeal. Accordingly, we have jurisdiction
    to decide the merits of Petta’s appeal pursuant to Arizona Revised Statutes
    (“A.R.S.”) section 12-2101(A)(1) and (5)(a) (West 2015).11
    II.    The Superior Court’s Denial of Summary Judgment
    ¶20            Petta argues the superior court erred in denying her motions
    for summary judgment as to Plaintiffs’ claims for defamation and false light
    invasion of privacy because insufficient evidence of causation and damages
    existed to create a genuine issue of material fact. She premises her claim on
    the fact the superior court granted her motion for summary judgment on
    Plaintiffs’ injurious falsehood/business disparagement claim for lack of
    11    We cite the current version of all statutes unless changes material to
    our decision have occurred since the relevant dates.
    8
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    provable damages, concluding that in the absence of such evidence, the jury
    “would be left to speculate regarding damages.” The court also granted
    summary judgment on Plaintiffs’ tortious interference with medical
    practice claim on the basis that Plaintiffs failed to “identify specific damages
    resulting from that interference.” Petta argues the court’s reasoning in
    dismissing those two claims must be applied to the defamation and false
    light invasion of privacy claims; otherwise, she submits, the court’s
    conclusions are “contradictory.” Plaintiffs argue Petta did not raise the
    sufficiency of causation or damages in her summary judgment motion and
    we should not review the superior court’s denial of summary judgment on
    appeal.
    ¶21             “Generally, the denial of a summary judgment motion is
    not  reviewable   on appeal from a final judgment entered after a trial on
    the merits.” John C. Lincoln Hosp. & Health Corp. v. Maricopa Cnty., 
    208 Ariz. 532
    , 539, ¶ 19, 
    96 P.3d 530
    , 537 (App. 2004) (citing Navajo Freight Lines,
    Inc. v. Liberty Mut. Ins. Co., 
    12 Ariz. App. 424
    , 428, 
    471 P.2d 309
    , 313 (1970)).
    That is because allowing appellate review of the superior court’s denial of
    a summary judgment motion after a trial on the merits “could lead to the
    absurd result that one who has sustained his position after a full trial and
    a more complete presentation of the evidence might nevertheless be
    reversed on appeal because he had failed to prove his case more fully
    at the time of the hearing of the motion for summary judgment.” Navajo
    Freight Lines, 12 Ariz. App. a t 428, 
    471 P.2d at 313
     (citations omitted).
    ¶22           An appellate court may, however, review a trial court’s denial
    of summary judgment in a case that has gone to trial if the denial is based
    on a purely legal issue or if the proponent reasserts the issue in a Rule 50,
    Ariz. R. Civ. P., motion for judgment as a matter of law or other post-trial
    motion. John C. Lincoln Hosp., 
    208 Ariz. at 539, ¶ 19
    , 
    96 P.3d at 537
    ; Hauskins
    v. McGillicuddy, 
    175 Ariz. 42
    , 49, 
    852 P.2d 1226
    , 1233 (App. 1992). “A purely
    legal issue or question is one that does not require the determination of
    any predicate facts, namely, ‘the facts are not merely undisputed but
    immaterial.’” John C. Lincoln Hosp., 
    208 Ariz. at
    539 n.5, ¶ 19, 
    96 P.3d at
    537 n.5 (quoting Seidel v. Times Ins. Co., 
    970 P.2d 255
    , 257 (Or. Ct. App.
    1998)). We review de novo whether a pure question of law precluded the
    denial of summary judgment. See Hourani v. Benson Hosp., 
    211 Ariz. 427
    ,
    430, ¶ 4, 
    122 P.3d 6
    , 9 (App. 2005).
    ¶23            In this case, the issue raised by Petta is not a purely legal issue.
    Rather, it requires this court to review and assess predicate facts. See Barrett
    v. Harris, 
    207 Ariz. 374
    , 378, ¶ 12, 
    86 P.3d 954
    , 958 (App. 2004) (“Causation
    is generally a question of fact for the jury unless reasonable persons could
    9
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    not conclude that a plaintiff had proved this element.” (citation omitted)).
    Moreover, Petta’s motions for summary judgment regarding defamation
    and false light invasion of privacy were based primarily on her defense of
    truth; she did not argue lack of causation or damages. Further, although
    Petta also moved during trial for judgment as a matter of law pursuant
    to Rule 50, she again did not raise the issue of causation or damages;
    instead, she once more focused her argument on her contention that her
    statements were true or simply a matter of opinion. 12 It was not the
    superior court’s obligation to search the record for facts that might
    support Petta’s motion for summary judgment. See, e.g., Mast v. Standard
    Oil Co. of Cal., 
    140 Ariz. 1
    , 2, 
    680 P.2d 137
    , 138 (1984). Additionally, no
    inherent contradiction exists in the superior court’s rulings. Petta did not put
    the issue of causation and damages before the court in her motions for
    summary judgment, and even if she had done so, the court could have
    concluded Plaintiffs’ defamation and false light invasion of privacy claims
    could be supported by their evidence of general damages.13 We see no reason
    to further examine the superior court’s rulings denying Petta’s motions for
    summary judgment on the defamation and false light invasion of privacy
    claims.
    III.   The Claims for Defamation and False Light Invasion of Privacy
    ¶24           Petta contends Plaintiffs’ claims for defamation and false light
    invasion of privacy were not supported by the evidence at trial because her
    12     Petta did, however, raise the issues of insufficient causation and
    damages in her post-judgment motions for new trial, judgment as a matter
    of law, and remittitur.
    13      Actual or compensatory damages may consist of general and/or
    special damages. “General damages are such as the law implies and
    presumes to have occurred from the wrong complained of, while special
    damages are those which are the natural but not the necessary consequence
    of the act complained of and usually stem from the particular circumstances
    of the case.” S. Ariz. Sch. For Boys, Inc. v. Chery, 
    119 Ariz. 277
    , 280, 
    580 P.2d 738
    , 741 (App. 1978) (citations omitted). In tort cases, such as those
    involving defamation and false light invasion of privacy, general
    damages cover a plaintiff’s loss of reputation, shame, mortification,
    injury to the feelings, and the like, whereas special damages are limited to
    the plaintiff’s actual pecuniary loss, which must be specially pleaded and
    proved. F.A.A. v. Cooper, 
    132 S. Ct. 1441
    , 1451 (2012) (citation omitted).
    10
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    statements about Plaintiffs either were truthful or constituted matters of
    opinion, and insufficient evidence of causation and damages existed. She
    maintains the superior court therefore erred in denying her motions for
    judgment as a matter of law.14
    ¶25            We review de novo the denial of a motion for judgment as a
    matter of law. Goodman v. Physical Res. Eng’g, Inc., 
    229 Ariz. 25
    , 27-28, ¶ 6,
    
    270 P.3d 852
    , 854-55 (App. 2011); A Tumbling-T Ranches v. Flood Control
    Dist. of Maricopa Cnty., 
    222 Ariz. 515
    , 524, ¶ 14, 
    217 P.3d 1220
    , 1229 (App.
    2009). Such a motion should be granted “if the facts produced in support
    of the claim or defense have so little probative value, given the quantum of
    evidence required, that reasonable people could not agree with the
    conclusion advanced by the proponent of the claim or defense.” A
    Tumbling-T Ranches, 222 Ariz. at 524, ¶ 14, 
    217 P.3d at 1229
     (quoting Orme
    Sch. v. Reeves, 
    166 Ariz. 301
    , 309, 
    802 P.2d 1000
    , 1008 (1990)). “In making
    this determination, we view ‘the evidence in a light most favorable to
    upholding the jury verdict,’ and will affirm ‘if any substantial evidence
    exists permitting reasonable persons to reach such a result.’” 
    Id.
     (quoting
    Hutcherson v. City of Phoenix, 
    192 Ariz. 51
    , 53, ¶ 13, 
    961 P.2d 449
    , 451
    (1998)).
    ¶26                “Defamation is a common law action based upon a tortious
    invasion of one’s interest in his or her reputation.” Boswell v. Phoenix
    Newspapers, Inc., 
    152 Ariz. 1
    , 5, 
    730 P.2d 178
    , 182 (App. 1985) (citations
    omitted). Arizona follows the Restatement ( S e c o n d ) o f T o r t s ( 1 9 7 7 )
    ( “ R e s t a t e m e n t ” ) on claims relating to defamation of a private person.
    Peagler v. Phoenix Newspapers, Inc., 
    114 Ariz. 309
    , 315, 
    560 P.2d 1216
    , 1222
    (1977). “ One who publishes a false and defamatory communication
    concerning a private person, or concerning a public official or public figure
    14        Plaintiffs argue that, because Petta failed to move for judgment as a
    matter of law pursuant to Rule 50 on the grounds that Plaintiffs did not
    present any evidence of causation and damages prior to the case being
    submitted to the jury, Petta has waived any entitlement to judgment as a
    matter of law on those bases. See Cnty. of La Paz v. Yakima Compost Co.,
    
    224 Ariz. 590
    , 607, ¶ 51, 
    233 P.3d 1169
    , 1186 (App. 2010). Nevertheless, “the
    rule that issues not objected to at trial are waived is procedural, not
    jurisdictional, and we may suspend it at our discretion.” Standard
    Chartered PLC v. Price Waterhouse, 
    190 Ariz. 6
    , 39, 
    945 P.2d 317
    , 350 (App.
    1996) (citations omitted); see also Stokes v. Stokes, 
    143 Ariz. 590
    , 592, 
    694 P.2d 1204
    , 1206 (App. 1984) (recognizing that “[the rule] an appealing party may
    not urge as grounds for reversal a theory which he failed to present below
    . . . is procedural and not jurisdictional”) (citations omitted).
    11
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    in relation to a purely private matter . . . , is subject to liability, if, but only
    if, he (a) knows that the statement is false and that it defames the other, (b)
    acts in reckless disregard of these matters, or (c) acts negligently in failing
    to ascertain them.” Restatement § 580B. Negligence is conduct that creates
    an unreasonable risk of harm and the failure to use that amount of care a
    reasonably prudent person would use under similar circumstances. Peagler,
    
    114 Ariz. at 315
    , 
    560 P.2d at 1222
    .
    ¶27            Substantial truth of an allegedly defamatory statement may
    provide an absolute defense to an action for defamation. See Fendler v.
    Phoenix Newspapers, Inc., 
    130 Ariz. 475
    , 479-80, 
    636 P.2d 1257
    , 1261-62 (App.
    1981). If the underlying facts are undisputed, the court may determine the
    question of substantial truth as a matter of law. 
    Id. at 480
    , 
    636 P.2d at 1262
    .
    A slight inaccuracy of expression is immaterial if the alleged defamatory
    statement is true in substance. Heuisler v. Phoenix Newspapers, Inc., 
    168 Ariz. 278
    , 285 n.4, 
    812 P.2d 1096
    , 1103 n.4 (App. 1991). Also, a technically false
    statement may nonetheless be considered substantially true if, viewed
    “through the eyes of the average reader,” the statement differs from the
    truth “only in insignificant details.” Currier v. W. Newspapers, Inc., 
    175 Ariz. 290
    , 293, 
    855 P.2d 1351
    , 1354 (1993) (quoting Zerangue v. TSP
    Newspapers, Inc., 
    814 F.2d 1066
    , 1073 (5th Cir. 1987)).
    ¶28           In Yetman v. English, 
    168 Ariz. 71
    , 
    811 P.2d 323
     (1991), our
    supreme court set forth the test to determine when statements are
    actionable as defamation. That test may be summarized as follows:
    Statements that can be interpreted as nothing more than
    rhetorical political invective, opinion, or hyperbole are
    protected speech, but false assertions that state or imply a
    factual accusation may be actionable. The trial court first
    decides whether, under all the circumstances, a statement is
    even capable of a defamatory meaning. If so found, the jury
    then determines whether the defamatory meaning was
    actually conveyed. In most instances, it is for the jury to
    determine whether an ordinary reader or listener would
    believe the statement to be a factual assertion, mere opinion
    or hyperbole. The meaning of words and statements should
    not be construed in isolation; rather, consideration should be
    given to the context and all surrounding circumstances,
    including the impression created by the words used and the
    expression’s general tenor. If the jury finds that a defamatory
    statement of objective fact (beyond mere hyperbole) exists, it
    should then consider actual damage to [the plaintiff’s]
    12
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    reputation in the real world by measuring the defamatory
    aspect of [the statement] by its natural and probable effect on
    the mind of the average recipient.
    Burns v. Davis, 
    196 Ariz. 155
    , 165, ¶ 39, 
    993 P.2d 1119
    , 1129 (App. 1999)
    (internal citations and quotations omitted) (citing Yetman, 
    168 Ariz. at
    76-
    79, 
    811 P.2d at 328-31
    ).15
    ¶29            False light invasion of privacy is recognized in Arizona as a
    tort separate from defamation. See Godbehere v. Phoenix Newspapers, Inc., 
    162 Ariz. 335
    , 340, 
    783 P.2d 781
    , 786 (1989). The distinction between defamation
    and false light invasion of privacy is, however, subtle. 
    Id.
     To establish a
    claim for false light invasion of privacy, a plaintiff must show (1) the
    defendant, with knowledge of falsity or reckless disregard for the truth,
    gave publicity to information placing the plaintiff in a false light, and (2)
    the false light in which the plaintiff was placed would be highly offensive
    to a reasonable person in the plaintiff’s position. 
    Id. at 338, 340
    , 
    783 P.2d at 784, 786
     (quoting Restatement § 652E). Although a cause of action for false
    light invasion of privacy may arise when someone publishes something
    untrue about a person, in some instances, even a true statement may form
    the basis for false light liability if it creates a false implication about the
    person. See id. at 341, 
    783 P.2d at 787
     (“[T]he false innuendo created by the
    highly offensive presentation of a true fact constitutes the injury.” (citing
    Restatement § 652E)).
    ¶30            In this case, the superior court did not err in denying Petta’s
    motions for judgment as a matter of law. Legitimate questions of fact
    existed as to both the defamation and false light invasion of privacy claims.
    The parties hotly contested whether Petta’s statements were true, and
    15      The United States Supreme Court has determined that “in cases
    raising First Amendment issues . . . an appellate court has an obligation to
    ‘make an independent examination of the whole record’ in order to make
    sure that ‘the judgment does not constitute a forbidden intrusion on the
    field of free expression.’” Milkovich v. Lorain Journal Co., 
    497 U.S. 1
    , 17 (1990)
    (quoting Bose Corp. v. Consumers Union of United States, Inc., 
    466 U.S. 485
    ,
    499 (1984) (quoting New York Times Co. v. Sullivan, 
    376 U.S. 254
    , 284–286
    (1964))). “The question whether the evidence in the record in a defamation
    case is sufficient to support a finding of actual malice is a question of law.”
    
    Id.
     (quoting Harte–Hanks Commc’ns, Inc. v. Connaughton, 
    491 U.S. 657
    , 685
    (1989)).
    13
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    although the jury could have found that some of Petta’s statements about
    Plaintiffs were either true or substantially true, or constituted matters of
    opinion or hyperbole, it also could have found (and obviously did find) that
    at least some of Petta’s statements conveyed a defamatory meaning and/or
    painted Plaintiffs in a false light.16 See Burns, 
    196 Ariz. at 165, ¶ 39
    , 
    993 P.2d at 1129
    ; Godbehere, 
    162 Ariz. at 338
    , 
    783 P.2d at 784
    . The jury was in the best
    position to resolve these material questions of fact. Further, once the jury
    found Petta’s statements were defamatory or constituted a false light tort,
    it was within the jury’s province to consider any actual damage to
    Plaintiffs’ reputations and/or any emotional damage or damage to
    sensibility. See Burns, 
    196 Ariz. at 165, ¶ 39
    , 
    993 P.2d at 1129
    ; Godbehere, 
    162 Ariz. at 340
    , 
    783 P.2d at 786
    .
    IV.    Petta’s Statements to Government Agencies and Officials
    ¶31           Petta argues her statements to government administrative
    agencies, such as the AMB, and her statements to government officials, such
    as the Arizona Ombudsman - Citizens’ Aide, were privileged and therefore
    could not be actionable. We find no error.
    ¶32            At common law, an absolute privilege existed for those
    reporting professional misconduct to administrative agencies.                See
    Advanced Cardiac Specialists, Chartered v. Tri-City Cardiology Consultants, P.C.,
    
    222 Ariz. 383
    , 386, ¶ 7, 
    214 P.3d 1024
    , 1027 (App. 2009); Drummond v. Stahl,
    
    127 Ariz. 122
    , 125-26, 
    618 P.2d 616
    , 619-20 (App. 1980). By statute, “[a]ny
    person or entity that reports or provides information to the [AMB] in good
    faith is not subject to an action for civil damages.” A.R.S. § 32-1451(A).
    Under § 32-1451(A), regarding complaints to the AMB, “the common-law
    absolute privilege has been fully abrogated in favor of a qualified privilege
    for those acting ‘in good faith.’” Advanced Cardiac Specialists, 222 Ariz. at
    387, ¶ 11, 
    214 P.3d at 1028
    . “A conditional privilege is abused and forfeited
    when a defendant acts with malice in fact.” Hirsch v. Cooper, 
    153 Ariz. 454
    ,
    458, 
    737 P.2d 1092
    , 1096 (App. 1986) (citation omitted), disapproved on other
    grounds by Godbehere, 
    162 Ariz. at
    339 n.1, 
    783 P.2d at
    785 n.1. “An abuse
    16     The superior court recognized this fact before trial when, in denying
    Petta’s motion for summary judgment as to Plaintiffs’ defamation claim, the
    court noted that “many of [the Doctors’] claimed defamatory statements
    appear questionable (and probably not actionable). The record supports,
    however, at least the notion that Petta published a statement that Dr.
    Carlotti was ‘messed up on narcotics treating patients.’” (Emphasis in
    original.) Moreover, even if truthful, some of Petta’s statements might have
    painted Plaintiffs in a false light.
    14
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    through ‘actual malice’ occurs when the defendant makes a statement
    knowing its falsity or actually entertaining doubts about its truth.”
    Advanced Cardiac Specialists, 222 Ariz. at 388, ¶ 14, 
    214 P.3d at 1029
    . To take
    a matter outside the scope of this qualified privilege, a plaintiff must prove
    by clear and convincing evidence the speaker abused the privilege.
    Id. at 387, ¶ 13, 
    214 P.3d at 1028
    .
    ¶33            No question exists that Petta’s statements to the AMB and
    other agencies were made within the ambit of a qualified privilege. See
    A.R.S. § 32-1451; Advanced Cardiac Specialists, 222 Ariz. at 387, ¶¶ 11-12, 
    214 P.3d at 1028
    . Further, Petta claimed, and the jury was instructed without
    objection on, both qualified privilege with regard to her reports to the AMB
    and Dental Board and absolute privilege with regard to her statements to
    government officials.17 Nevertheless, the question whether Petta abused
    her qualified privilege for filing complaints with the AMB involved a
    factual determination about her motivations, especially in light of her
    persistent serial complaints against Plaintiffs. Petta contended she did not
    act out of spite or to ruin Plaintiffs’ reputations or to injure their business.
    Plaintiffs, however, offered evidence Petta abused her qualified privilege,
    and the jury could have concluded Plaintiffs met their burden of
    proving Petta’s statements to the AMB and other agencies were made
    with malice – that is, were knowingly false or made while entertaining
    doubts of their truth. Advanced Cardiac Specialists, 222 Ariz. at 388, ¶ 14,
    
    214 P.3d at 1029
    . We presume the jury followed the superior court’s
    instructions. See Wendland v. AdobeAir, Inc., 
    223 Ariz. 199
    , 207, ¶ 28, 
    221 P.3d 390
    , 398 (App. 2009).
    ¶34            Furthermore, because the jury was not provided special
    interrogatories or special verdict forms for each damage component, we
    cannot determine whether the jury held Petta liable for defamation and/or
    false light invasion of privacy in connection with her statements to the
    AMB, other agencies, and/or government officials. See Murcott v. Best W.
    Int’l, Inc., 
    198 Ariz. 349
    , 361, ¶¶ 64, 66, 
    9 P.3d 1088
    , 1100 (App. 2000)
    17     With regard to other government officials, the court instructed the
    jury without objection that, although Petta could not be held liable for
    complaining to government officials, the jury could “consider the
    underlying substance of the statements made as evidence of [Petta’s]
    motive and intent regarding actionable acts under these instructions,
    including whether [Petta] acted with an evil mind, intended to cause injury,
    or was motivated by spite or ill will, as set forth in the instruction on
    punitive damages.”
    15
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    (recognizing this court will “uphold a general verdict if evidence on any
    one count, issue, or theory sustains the verdict” (citations omitted)).
    V.     Denial of Petta’s Motion for New Trial or Remittitur
    ¶35           Compensatory or actual damages in tort cases provide
    compensation for a plaintiff’s injury caused by a defendant’s wrongful
    conduct. See State v. Griswold, 
    8 Ariz. App. 361
    , 364, 
    446 P.2d 467
    , 470 (1968);
    U.S. Fid. & Guar. Co. v. Davis, 
    3 Ariz. App. 259
    , 262-63, 
    413 P.2d 590
    , 593-94
    (1966).
    ¶36           Petta argues the superior court erred in denying her motion
    for new trial or remittitur because the actual damages awarded were
    excessive. In considering Petta’s motion, the superior court agreed with
    Petta that the verdict “was on the high side, bigger than I expected,” and
    noted “[t]he real question in my mind is to go back again and look and see
    whether we ought to do something because the numbers are that high.”
    After finding Petta had raised a “colorable issue” whether the actual
    damages awarded were excessive and unsupported by the evidence, the
    court nonetheless denied Petta’s motion. We agree with Petta that, on this
    record, the damages awarded were wholly excessive and unsupported by
    the evidence.
    ¶37            We review for an abuse of discretion the superior court’s
    denial of a motion for new trial or remittitur. Monaco v. HealthPartners of
    S. Ariz., 
    196 Ariz. 299
    , 304, ¶ 13, 
    995 P.2d 735
    , 740 (App. 1999); Mammo v.
    State, 
    138 Ariz. 528
    , 532, 
    675 P.2d 1347
    , 1351 (App. 1983).
    ¶38            “A remittitur is a device for reducing an excessive verdict to
    the realm of reason.” Muccilli v. Huff’s Boys’ Store, Inc., 
    12 Ariz. App. 584
    ,
    590, 
    473 P.2d 786
    , 792 (1970). Remittitur should be ordered only for the
    most cogent reasons, such as a lack of evidence supporting the damages
    awarded. Yakima Compost Co., 224 Ariz. at 607, ¶ 52, 
    233 P.3d at 1186
    (citations omitted). Nevertheless, if a verdict is so unfair, unreasonable, and
    outrageous as to shock the conscience of the court, or is plainly the product
    of passion, prejudice, mistake, or disregard of the evidence, a court may
    grant a remittitur or a new trial. See Haralson v. Fisher Surveying, Inc., 
    201 Ariz. 1
    , 6, ¶ 21, 
    31 P.3d 114
    , 119 (2001); Acheson v. Shafter, 
    107 Ariz. 576
    ,
    579, 
    490 P.2d 832
    , 835 (1971); Meyer v. Ricklick, 
    99 Ariz. 355
    , 357, 
    409 P.2d 280
    , 281 (1965); Young Candy & Tobacco Co. v. Montoya, 
    91 Ariz. 363
    , 370, 
    372 P.2d 703
    , 707 (1962); Sheppard v. Crow-Barker-Paul No. 1 Ltd. P’ship, 
    192 Ariz. 539
    , 549, ¶ 53, 
    968 P.2d 612
    , 622 (App. 1998). If it is clear the jury’s
    verdict is a result of passion or prejudice, a court cannot merely offer a
    16
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    remittitur on account of excessive damages, or grant a new trial limited to
    the question of damages, but must grant a new trial on all issues. See Mayo
    v. Ephrom, 
    84 Ariz. 169
    , 173-74, 
    325 P.2d 814
    , 817 (1958) (citations omitted).
    ¶39           In 1972, the Arizona Supreme Court examined representative
    Arizona case law concerning appellate review of the size of jury verdicts
    and the granting or refusing of a trial court’s adjustment of a verdict. In
    Creamer v. Troiano, 
    108 Ariz. 573
    , 575, 
    503 P.2d 794
    , 796 (1972), Chief Justice
    Hays explained the test for reviewing a trial court’s ruling on additur,
    remittitur, and new trial because of an inadequate or excessive verdict as
    follows:
    From what we have written, it is obvious that the test
    for reviewing the granting or refusing of a trial judge’s
    adjustment of a verdict is complex and can only be solved by
    an ad hoc approach. Almost always when there is a conflict
    in the evidence, the trial judge should not interfere with what
    is peculiarly the jury’s function, and if he does not, we will
    nearly always uphold him. If there is no conflict in the
    evidence on items that obviously were omitted from the
    verdict, the trial judge must adjust, and we will uphold him if
    he does. Behind all of these tests still stands the original
    doctrine - that if the verdict is supported by adequate
    evidence, it will not be disturbed, and the greatest possible
    discretion is in the hands of the trial judge. In this court, the
    ultimate test will always be justice, and any case before us which
    shows an unjust result because of the granting or denial of either
    additur or remittitur, will be reversed. Each case will be
    considered upon its own facts.
    
    Id. at 576-77
    , 
    503 P.2d at 797-98
     (emphasis added).
    ¶40           We are fully aware that, previously in that opinion, the Chief
    Justice pointed out that in each of the cases examined, the appellate court
    had affirmed the trial court, and noted, “That in itself should carry a strong
    inference that one of the key factors in our decisions is to give the trial judge
    the benefit of the doubt. Like the jury, he has had the opportunity to
    observe the witnesses’ demeanor on the stand, and his ruling on additur,
    remittitur, and new trial, because of an inadequate or excessive verdict, will
    generally be affirmed, because it will nearly always be more soundly based
    than ours can be.” 
    Id. at 575
    , 
    503 P.2d at 796
    . Nevertheless, as the Chief
    Justice further explained:
    17
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    The difficulty is that each case is slightly different, and
    we have to adjust to them as they come before us. Hence, in
    the later cases, the reasons for our opinions have not always
    been stated in the same words. It is also true that emotions
    such as passion and prejudice are rarely seen from the
    reporter’s transcript, and must be sought - in this court - in
    the size of the verdict compared to damages actually proved,
    and tempered by how much of the damages are effectively
    contradicted, the prestige of the doctors who testify,
    undercover investigators, etc.
    
    Id. at 575-76
    , 
    503 P.2d at 796-97
    . Accordingly, each case involving a request
    for remittitur must stand or fall on its own peculiar facts, and the ultimate
    test will always be justice. Any case which shows an unjust result because
    of the grant or denial of remittitur must be reversed. See Sequoia Mfg. Co. v.
    Halec Constr. Co., 
    117 Ariz. 11
    , 25, 
    570 P.2d 782
    , 796 (App. 1977) (citing
    Creamer, 
    108 Ariz. at 576-77
    , 
    503 P.2d at 797-98
    ).
    ¶41            We have thoroughly reviewed the entire record in the instant
    case. The jury was instructed it could award actual damages stemming
    from four different aspects of Plaintiffs’ alleged injury: (1) impairment
    of Plaintiffs’ reputation and standing in the community; (2) personal
    humiliation, mental anguish, and emotional distress; (3) financial damages
    to Plaintiffs’ business, trade, profession, or occupation; and (4) financial
    losses actually caused by any false and defamatory statement. The
    evidence on damages was noticeably thin, entirely subjective, and based
    solely on Plaintiffs’ non-specific, vague, and conclusory testimony.
    Accordingly, the record plainly does not objectively support the
    compensatory damages awarded. Plaintiffs offered no evidence of any net
    loss to their income related to Petta’s statements. They called no
    independent witnesses to support their contention that their respective
    professional reputations had been damaged; no physician testified that he
    or she declined to refer surgical candidates to Plaintiffs or that members of
    the public otherwise declined to seek Plaintiffs’ services as a result of seeing
    Petta’s web posts or learning of any professional board complaints.18
    18     We also note Petta’s website statements were only available for
    viewing for a very short time, and as Petta notes in her opening brief,
    Plaintiffs provided no evidence of the number of visitors or “hits” to the
    websites on which she posted her criticisms of Plaintiffs.
    18
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    ¶42            Before trial, the superior court noted its concern with
    Plaintiffs’ lack of proof of causation and specific damages when the court
    entered summary judgment against them on their injurious
    falsehood/business disparagement and wrongful interference with
    business relations claims,19 and Plaintiffs’ testimony at trial failed to further
    illuminate their assertion that Petta’s statements caused them special
    damages. Plaintiffs’ testimony about special damages was unsupported by
    any documentary evidence, including any business operations analysis, tax
    returns or similar exhibits, or expert testimony, and Plaintiffs’ own
    conclusory statements provided little quantifiable evidence of their claimed
    damages, leaving the jury to speculate regarding special damages. 20 See
    Gilmore v. Cohen, 
    95 Ariz. 34
    , 36-37, 
    386 P.2d 81
    , 82-83 (1963) (recognizing in
    a breach of contract case that “the plaintiff in every case should supply
    some reasonable basis for computing the amount of damage and must do
    so with such precision as, from the nature of his claim and the available
    evidence, is possible” (citations omitted)).
    ¶43          Furthermore, the evidence presented does not support such
    an excessive award of general damages. We are aware that Plaintiffs
    19     In part, the court found Plaintiffs’ causation and damages evidence
    suffered from vagueness and “a jury would be left to speculate regarding
    damages.”
    20     Dr. Carlotti testified, without documentary support, that the Doctors
    spent “a fortune, like $100,000” in defending against Petta’s claims they had
    altered her medical records, and incurred “a fortune” in legal fees
    defending against the professional board complaints. Dr. Cabret-Carlotti
    also testified that they lost their home to foreclosure; however, there were
    no exhibits admitted to support such an assertion, let alone any business
    analysis demonstrating any legitimate causal connection between Petta’s
    web posts and the financial health of the Doctors’ practice or personal
    finances. Dr. Cabret-Carlotti did testify in summary fashion that, in the
    twelve months after Petta initiated her website, the Doctors’ “production”
    dropped 36 percent, and “collections” for Dr. Carlotti dropped 70.6 percent,
    from approximately $1.52 million in 2007 to approximately $444,000 by
    2010, before he was “vindicated by the medical board.” However, as
    counsel for Plaintiffs conceded at oral argument, Plaintiffs at trial provided
    no evidence of any changes in their net income or how any such changes
    were caused by Petta during the relevant time periods, which coincided
    with a severe economic recession.
    19
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    testified as to their own emotional distress, and Dr. Carlotti testified he had
    lost weight and even contemplated suicide. However, the evidence also
    indicates that, although some of Petta’s comments were actionable, much
    of what Plaintiffs complained of was either true or substantially true, or
    could be characterized as mere opinion (even if laced with spite), and did
    not necessarily cast Plaintiffs in a false light.21
    ¶44            Moreover, the verdict rendered in this case was
    approximately equivalent to the largest civil jury verdict in Arizona in 2013,
    and is the thirtieth largest civil verdict in Arizona in the past ten years. See
    Kelly Wilkins MacHenry, Arizona’s Civil Verdicts 2013, Ariz. Att’ny, June
    2014, at 40, 50. The next largest reported civil jury verdict for a defamation
    case in the last decade was $3,071,668, which ranks ninety-eighth in the top
    one hundred Arizona verdicts. 
    Id. at 54
    . Thus, the verdict in this case is
    nearly four times the verdict entered in the next largest defamation case,
    and it simply cannot be reconciled with other Arizona civil jury verdicts,
    especially given the record before us.
    ¶45            Consequently, we are of the opinion that, by denying Petta’s
    motion for new trial or remittitur, the superior court allowed Plaintiffs to
    obtain an award of damages not supported by adequate evidence, and
    allowed a verdict to stand that not only shocks the conscience of this court,
    but was so extreme “as to manifestly indicate passion, prejudice, mistake or
    a complete disregard of the evidence.” Tryon v. Naegle, 
    20 Ariz. App. 138
    ,
    141, 
    510 P.2d 768
    , 771 (1973) (citations omitted). Because the ultimate test
    of a jury verdict is justice, and the judgment here cannot meet that test, we
    must vacate the judgment. See Sequoia Mfg., 
    117 Ariz. at 25
    , 
    570 P.2d at
    796
    (citing Creamer, 
    108 Ariz. at 576-77
    , 
    503 P.2d at 797-98
    ). Further, in this case
    the issue of liability was vigorously contested by the parties, and the issues
    of liability and damages are so inextricably intertwined that it is impossible
    to determine the degree to which the quality of the evidence submitted on
    one may have influenced the jury’s verdict on the other; accordingly, a new
    trial on both liability and damages is mandated. See Tovrea Equip. Co. v.
    21     Furthermore, from our review of the entire record, it is obvious
    neither side was a model of propriety. The parties at times engaged in
    petty, unprofessional, and vengeful behavior. Petta’s behavior and
    language toward Plaintiffs, their staff, and other patients were wholly
    inappropriate, and it is clear she ultimately attempted to engage Plaintiffs
    in what amounted to a war of attrition, but substantial evidence indicates
    the Doctors engaged in retaliatory behavior designed to further provoke
    Petta, perhaps contributing to her outbursts and contested statements, and
    thereby arguably provoked some of her improper behavior.
    20
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    Gobby, 
    72 Ariz. 38
    , 42, 
    230 P.2d 512
    , 515 (1951); Styles v. Ceranski, 
    185 Ariz. 448
    , 451, 
    916 P.2d 1164
    , 1167 (App. 1996) (“Partial new trials are not
    recommended because they create much opportunity for confusion and
    injustice.” (citations omitted)); see also Englert v. Carondelet Health Network,
    
    199 Ariz. 21
    , 27, ¶ 15, 
    13 P.3d 763
    , 769 (App. 2000) (“Any doubt should be
    resolved in favor of a trial on all the issues.” (citations omitted)).
    VI.    Punitive Damages
    ¶46            Petta argues the superior court erred by submitting Plaintiffs’
    claim for punitive damages to the jury and by refusing to grant judgment
    as a matter of law on punitive damages. Because we have determined that
    Petta is entitled to a new trial on both liability and damages, we vacate the
    punitive damages award in this matter; however, as the legal sufficiency of
    Plaintiffs’ punitive damages claim may arise on remand, we briefly address
    Petta’s arguments on appeal.
    ¶47            Assuming an adequate evidentiary predicate, a jury may
    award punitive damages to punish a defendant for willful or malicious
    conduct and to deter others from similar behavior. Memphis Cmty. Sch. Dist.
    v. Stachura, 
    477 U.S. 299
    , 306 n.9 (1986) (citation omitted); accord State Farm
    Mut. Auto. Ins. Co. v. Campbell, 
    538 U.S. 408
    , 419 (2003) (“It should be
    presumed that a plaintiff has been made whole for his injuries by
    compensatory damages, so punitive damages should only be awarded if
    the defendant’s culpability, after having paid compensatory damages, is so
    reprehensible as to warrant the imposition of further sanctions to achieve
    punishment or deterrence.” (citation omitted)); Hudgins v. Sw. Airlines, Co.,
    
    221 Ariz. 472
    , 486, 489, ¶¶ 38, 50, 
    212 P.3d 810
    , 824, 827 (App. 2009)
    (recognizing that punitive damages should be awarded only in the most
    egregious cases and are not intended to compensate plaintiffs but to punish
    the wrongdoer and deter both the wrongdoer and others from future
    harmful conduct).
    ¶48            To obtain an award of punitive damages, a plaintiff must
    prove by clear and convincing evidence that the defendant engaged in
    “reprehensible conduct combined with an evil mind over and above that
    required for commission of a tort.” Linthicum v. Nationwide Life Ins. Co.,
    
    150 Ariz. 326
    , 332, 
    723 P.2d 675
    , 681 (1986). “The key is the wrongdoer’s
    intent to injure the plaintiff or his deliberate interference with the rights of
    others, consciously disregarding the unjustifiably substantial risk of
    significant harm to them.” 
    Id. at 331
    , 
    723 P.2d at
    680 (citing Rawlings v.
    Apodaca, 
    151 Ariz. 149
    , 160, 
    726 P.2d 565
    , 576 (1986)); see also Volz v. Coleman
    Co., 
    155 Ariz. 567
    , 570, 
    748 P.2d 1191
    , 1194 (1987) (recognizing that
    21
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    recklessness or even gross negligence is insufficient to support punitive
    damages).
    ¶49            We are mindful that “[a] grossly excessive punitive damage
    award violates the Due Process Clause of the Fourteenth Amendment to the
    United States Constitution because the defendant did not have ‘fair notice’ of
    [her] exposure to the extent of punishment that could be imposed.” Hudgins,
    221 Ariz. at 489, ¶ 50, 
    212 P.3d at
    827 (citing BMW of N. Am., Inc. v. Gore, 
    517 U.S. 559
    , 574-75 (1996); State Farm, 
    538 U.S. at 417
    ). In determining whether
    a punitive damages award is so excessive as to be unconstitutional, a
    reviewing court examines de novo three guideposts: (1) the degree of
    reprehensibility of the defendant’s misconduct, (2) the ratio between
    compensatory and punitive damages, and (3) how the award compares
    with other penalties. 
    Id. at 490, ¶ 51
    , 
    212 P.3d at
    828 (citing Gore, 
    517 U.S. at 575
    ; State Farm, 
    538 U.S. at 418
    ).
    ¶50            Petta argues Plaintiffs failed to demonstrate by clear and
    convincing evidence that her actions were reprehensible and guided by evil
    motives. See Linthicum, 
    150 Ariz. at 332
    , 
    723 P.2d at 681
    ; Rawlings, 
    151 Ariz. at 162
    , 
    726 P.2d at 578
    ; see also Medasys Acquisition Corp. v. SDMS, P.C., 
    203 Ariz. 420
    , 424, ¶ 18, 
    55 P.3d 763
    , 767 (2002) (“The critical inquiry should be
    whether such an award is appropriate to penalize a party for ‘outwardly
    aggravated, outrageous, malicious, or fraudulent conduct’ that is coupled
    with an ‘evil mind.’” (quoting Linthicum, 
    150 Ariz. at 331
    , 
    723 P.2d at 680
    )).
    Petta maintains her conduct did not rise to the level of “conduct involving
    some element of outrage similar to that usually found in crime,” Rawlings,
    
    151 Ariz. at 162
    , 
    726 P.2d at 578
     (quoting Restatement § 908 cmt. b), and
    without clear and convincing evidence of an “evil mind” that caused
    Plaintiffs injury, the punitive damage award should be vacated. See
    Saucedo ex rel. Sinaloa v. Salvation Army, 
    200 Ariz. 179
    , 184, ¶ 19, 
    24 P.3d 1274
    , 1279 (App. 2001) (recognizing “the conduct giving rise to punitive
    damages must be a proximate cause of the harm inflicted”); see also Shaner
    v. Tucson Airport Auth., Inc., 
    117 Ariz. 444
    , 448, 
    573 P.2d 518
    , 522 (App.
    1977) (stating that the evidence must establish a “reasonable probability”
    that a defendant’s conduct caused the plaintiff’s alleged harm).
    ¶51            As we have noted, the evidence in this case was hotly
    contested, and Plaintiffs presented substantial evidence from which the
    jury could have found Petta engaged in reprehensible conduct intended to
    injure Plaintiffs’ business and professional reputations and was motivated
    by an “evil mind.” Evidence was presented that Petta’s conduct involved
    repeated actions (by posting her comments to several websites and making
    or assisting in the filing of numerous board complaints) and the jury could
    22
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    have found any resulting harm was the result of intentional malice. See
    Hudgins, 221 Ariz. at 490, ¶ 52, 
    212 P.3d at
    828 (citing State Farm, 
    538 U.S. at 419
    ). Although substantial evidence was also presented that militated
    against finding Petta acted in a highly reprehensible manner, we find no
    error in the superior court’s decision to allow the jury to consider Plaintiffs’
    claim for punitive damages.
    VII.   Petta’s Counterclaim for Medical Battery
    ¶52          Petta also argues the superior court erred in granting
    summary judgment on her counterclaim for medical battery. Petta
    acknowledges she consented to surgery on her nose in January 2008, but
    maintains she did not consent to the particular procedure (allegedly
    shortening and turning up her nose) performed by the Doctors at that time.
    ¶53           Plaintiffs maintain Petta lacks standing because, once she
    filed for bankruptcy, her claim for medical battery became property of her
    bankruptcy estate, subject to the sole direction and control of the
    Chapter 7 trustee. See In re Bailey, 
    306 B.R. 391
    , 392 (Bankr. D.D.C. 2004)
    (“In a chapter 7 bankruptcy case, any unliquidated lawsuits initiated by a
    debtor prepetition (or that could have been initiated by the debtor
    prepetition) become part of the bankruptcy estate subject to the sole
    direction and control of the trustee, unless exempted or abandoned or
    otherwise revested in the debtor.”); accord DCFS USA, LLC v. Dist. of
    Columbia, 
    820 F. Supp. 2d 1
    , 3-4 (D.D.C. 2011) (“As soon as a debtor files a
    bankruptcy case all legal or equitable interests, including causes of action
    on behalf of the debtor, are transferred from the debtor to the bankruptcy
    estate. In a Chapter 7 case, after a trustee is appointed, only the trustee can
    bring actions on behalf of the estate. Thus a debtor has no standing to
    prosecute estate actions once a trustee has been appointed.” (internal
    quotations and citations omitted)).
    ¶54            Plaintiffs are correct that a Chapter 7 debtor’s claim in a
    lawsuit is property of the bankruptcy estate. See 
    11 U.S.C. § 541
    . Petta
    contends, however, that she “litigated the issue of ownership of her
    appeal rights against the bankruptcy trustee and prevailed.” In support of
    her contention, she has provided this court with a minute entry order
    from the bankruptcy court indicating that, on November 28, 2012, the
    court denied the trustee’s motion to sell Petta’s “interest in state court
    litigation case CV2008-010464.” Although at oral argument Plaintiffs
    disputed Petta’s contention, we conclude on this record Petta has the right
    to assert her challenge to the superior court’s grant of summary judgment
    regarding her claim for medical battery.
    23
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    ¶55           Plaintiffs next argue they were entitled to summary judgment
    on Petta’s claim for medical battery because Petta consented to a “revision
    nasal tip surgery” and acknowledged before the surgery that her results
    were not guaranteed, and is now simply complaining about the results
    rather than the scope of the surgery. We disagree with Plaintiffs’
    conclusion.
    ¶56            We review de novo the superior court’s grant of summary
    judgment and its application of the law. Andrews v. Blake, 
    205 Ariz. 236
    , 240,
    ¶ 12, 
    69 P.3d 7
    , 11 (2003); State Comp. Fund v. Yellow Cab Co., 
    197 Ariz. 120
    ,
    122, ¶ 5, 
    3 P.3d 1040
    , 1042 (App. 1999). In our review, we construe the facts
    and reasonable inferences in the light most favorable to the party opposing
    summary judgment. Wells Fargo Bank v. Ariz. Laborers, Teamsters & Cement
    Masons Local No. 395 Pension Trust Fund, 
    201 Ariz. 474
    , 482, ¶ 13, 
    38 P.3d 12
    ,
    20 (2002); Strojnik v. Gen. Ins. Co. of Am., 
    201 Ariz. 430
    , 433, ¶ 10, 
    36 P.3d 1200
    , 1203 (App. 2001). Summary judgment is proper if no genuine issues
    of material fact exist and the moving party is entitled to judgment as a
    matter of law. Orme Sch., 
    166 Ariz. at 309
    , 
    802 P.2d at 1008
    ; Ariz. R. Civ. P.
    56(c)(1).
    ¶57           “A medical malpractice action brought against a licensed
    health care provider shall not be based upon assault and battery.” A.R.S.
    § 12-562(B). Nevertheless, “claims involving lack of consent, i.e., the
    doctor’s failure to operate within the limits of the patient’s consent, may
    be brought as battery actions.” Duncan v. Scottsdale Med. Imaging, Ltd., 
    205 Ariz. 306
    , 310, ¶ 13, 
    70 P.3d 435
    , 439 (2003). For consent to be effective, it
    must be “to the particular conduct, or substantially the same conduct.” 
    Id. at 311, ¶ 16
    , 
    70 P.3d at
    440 (citing Restatement § 892A(2)(b)). As our
    supreme court further observed in Duncan:
    The terms and reasonable implications of the consent given
    determine the scope of the particular conduct covered.
    Restatement § 892A cmt. d. The “scope” of consent is an issue
    for the trier of fact to determine. Id.; see also Cathemer v.
    Hunter, 27 Ariz. App. [780,] 785, 558 P.2d [975,] 980 [(1976)]
    (holding a jury question existed as to whether a patient
    consented to an operation and whether the operation received
    was “substantially similar” to the operation to which the
    patient consented so as to be within the scope of the consent).
    “[A]nything greater or different than the procedure
    consented to becomes a battery.” Hales [v. Pittman], 118 Ariz.
    [305,] 310, 576 P.2d [493,] 498 [(1978)].
    24
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    Duncan, 
    205 Ariz. at 311, ¶ 16
    , 
    70 P.3d at 440
    .
    ¶58           “[W]hen a patient gives limited or conditional consent, a
    health care provider has committed a battery if the evidence shows the
    provider acted with willful disregard of the consent given.” Id. at ¶ 18; see
    also Meretsky v. Ellenby, 
    370 So. 2d 1222
    , 1224 (Fla. Dist. Ct. App. 1979)
    (holding that, when a physician allegedly ignored the instructions of a
    patient and operated on the tip of the patient’s nose, causing a “turned up”
    nose, the patient’s general consent to rhinoplasty was not conclusive proof
    the patient had consented to the additional work, and an action for battery
    could be brought).
    ¶59            Plaintiffs argue and the superior court found that Petta’s
    battery claim should fail because she consented to the surgery. However,
    Petta’s general authorization of a surgery on her nose does not defeat her
    battery claim because her consent was allegedly limited. According to Petta,
    she explicitly conditioned her consent to removal of the scar tissue on the
    dorsal aspect of her nose, and expressly rejected the suggestion of any
    further surgical shortening or alteration of her nose. Thus, there was
    admissible evidence that any surgery beyond removal of the dorsal scar
    tissue was not consensual. See Duncan, 
    205 Ariz. at 310-11, ¶ 15
    , 
    70 P.3d at 439-40
    . Further, given the photographic evidence and Dr. Caniglia’s report,
    a reasonable jury could find Petta’s nose had been shortened and “turned
    up” by the surgery, and the limited information provided on the signed
    consent and release forms leaves open to interpretation whether the surgery
    exceeded the scope of Petta’s authorized consent. The parties characterize
    differently the surgery to which Petta consented, and the relevant inquiry is
    not whether Petta consented to surgery; rather, whether she consented to
    the particular procedure Plaintiffs performed. See id. at ¶ 18. On this record,
    the superior court erred in granting Plaintiffs’ motion for summary
    judgment as to Petta’s counterclaim for medical battery. Accordingly, we
    remand that claim for trial as well.22
    22    Plaintiffs do not argue, and we do not address, Plaintiffs’ argument
    made in support of their motion for summary judgment that Petta’s
    counterclaim fails because Petta cannot identify which of the Doctors
    performed the surgery.
    25
    DESERT PALM et al. v. PETTA
    Opinion of the Court
    CONCLUSION
    ¶60            We affirm the superior court’s denial of Petta’s motions for
    judgment as a matter of law. We vacate the judgment in favor of Plaintiffs
    and remand for a new trial, however, because the jury verdict cannot be
    supported by the damages evidence presented and shocks the conscience
    of this court. We also reverse the superior court’s summary judgment on
    Petta’s counterclaim for medical battery.
    :ama
    26