Gentile v. Turkoly , 2017 Ohio 1018 ( 2017 )


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  • [Cite as Gentile v. Turkoly, 
    2017-Ohio-1018
    .]
    STATE OF OHIO, MAHONING COUNTY
    IN THE COURT OF APPEALS
    SEVENTH DISTRICT
    RICHARD D. GENTILE, M.D.,                       )   CASE NO. 16 MA 0071
    )
    PLAINTIFF-APPELLANT,                    )
    )
    VS.                                             )   OPINION
    )
    KELLY TURKOLY,                                  )
    )
    DEFENDANT-APPELLEE.                     )
    CHARACTER OF PROCEEDINGS:                           Civil Appeal from the Court of Common
    Pleas of Mahoning County, Ohio
    Case No. 2015 CV 606
    JUDGMENT:                                           Affirmed.
    APPEARANCES:
    For Plaintiff-Appellant:                            Atty. Christopher P. Lacich
    Roth, Blair, Roberts, Strasfeld & Lodge
    100 East Federal Street
    Suite 600
    Youngstown, Ohio 44503
    For Defendant-Appellee:                             Atty. Christopher J. Regan
    Atty. J. Zachary Zatezalo
    Bordas and Bordas, LLC
    1358 National Road
    Wheeling, West Virginia 26003
    JUDGES:
    Hon. Carol Ann Robb
    Hon. Cheryl L. Waite
    Hon. Mary DeGenaro
    Dated: March 20, 2017
    [Cite as Gentile v. Turkoly, 
    2017-Ohio-1018
    .]
    ROBB, P.J.
    {¶1}     Plaintiff-Appellant Richard D. Gentile, M.D., appeals the decision of
    Mahoning County Common Pleas Court granting a directed verdict for Defendant-
    Appellee Kelly Turkoly. Two arguments are presented in this appeal. The first is
    whether the trial court is permitted to direct a verdict sua sponte. The second is
    whether the trial court erred and/or abused its discretion in granting the directed
    verdict. For the reasons expressed below, the trial court’s decision is affirmed. Trial
    courts have inherent authority to sua sponte direct verdicts. The trial court did not err
    when it granted a directed verdict in Appellee’s favor.
    Statement of the Case
    {¶2}     In 2010, Appellee hired Appellant to perform facial plastic surgery. In
    2011, Appellee sued Appellant for medical malpractice and medical battery. The
    case proceeded to a jury trial, and the jury returned a verdict in Appellee’s favor. The
    jury found Appellant failed to obtain Appellee’s informed consent and committed a
    medical battery; however, the jury found Appellant did not act with actual malice. The
    jury awarded damages in the amount of $5,100,000. That verdict, however, was
    reduced to $600,000, which was satisfied in September 2013. Tr. 401-402. Appellee
    appealed the verdict, but later voluntarily dismissed the appeal. 8/27/14 Notice of
    Appeal 13MA135; 9/24/13 Voluntary Dismissal J.E.
    {¶3}     In early September 2013, Appellee posted a review of Appellant on
    vitals.com. Plaintiff’s Exhibit 1. The review stated, among other things, Appellant was
    not “Board Certified as a PLASTIC SURGEON” and warned others to “stay away
    from this Unscrupulous Dr.” Plaintiff’s Exhibit 1.
    {¶4}     In late 2014, after doing some research, Victoria Oliver Dos Santos
    contacted Appellant about having a procedure on her thighs. Tr. 249. After the
    consultation she paid for the surgery, but continued to research Appellant. This
    additional research led her to cancel her surgery and ask for a refund.
    {¶5}     According to Dos Santos the additional research unearthed some
    negative reviews and newspaper articles about the aforementioned medical
    malpractice lawsuit. Tr. 256-257.               When she called to cancel the surgery, she
    referenced negative reviews and the malpractice verdict.
    -2-
    {¶6}   Appellant’s receptionist, Tammy Steele, received the call from Dos
    Santos. Tr. 320. Steele testified Dos Santos told her she wanted to cancel the
    surgery based on remarks she had seen on vitals.com and having read Appellant
    was not board certified. Tr. 321, 327. Steele avowed she followed office procedures;
    she accurately and immediately wrote the message down and forwarded the
    message to the Office Manager Rose Weese. Tr. 324; Plaintiff’s Exhibit 2.
    {¶7}   Weese testified upon receiving the message, she went directly to
    Appellant. Tr. 350. Both Weese and Appellant were surprised by the note, and
    Appellant directed Weese to suggest a couple of other, more legitimate, websites.
    Tr. 351. Allegedly vitals.com is not as accurate as other review websites because
    the patient/reviewer on vitals.com is not required to register. Tr. 351. Weese then
    composed an email to Dos Santos indicating why vitals.com was unreliable and
    suggested other websites to investigate. Tr. 352, Plaintiff’s Exhibit 3. The email also
    addressed Appellant’s board certifications. Plaintiff’s Exhibit 3. Weese indicated Dos
    Santos could confirm that Appellant is a certified facial plastic surgeon by looking on
    the American Board of Facial Plastic and Reconstructive Surgery website. Plaintiff’s
    Exhibit 3.
    {¶8}   Dos Santos testified when she called to cancel the appointment she did
    not state she read reviews on vitals.com, and she did not state she read that
    Appellant was not certified. Tr. 264, 266, 269, 271. She testified she had never been
    on the vitals.com review site. Tr. 251, 304. She averred she never read he was not
    board certified; her testimony indicated she was confused by that statement because
    she always believed he was board certified. Tr. 271-272, 302-303. Dos Santos was
    given Appellee’s review to read; after reading it she avowed she never saw the
    review. Tr. 275. She testified if she had seen it she would have remembered it
    because it referenced MRSA and her grandfather died from MRSA. Tr. 276-277.
    She further testified she does not know Appellee and has never corresponded with
    Appellee. Tr. 278, 297. All she knew was what she read about the lawsuit in the
    newspaper article. Tr. 278.
    {¶9}   Dos Santos responded to Weese’s email. Tr. 305-307; Defendant’s
    Exhibit A. She once again cancelled the surgery and requested a refund. The email
    -3-
    stated that she could not forget “the extremely negative reviews and the lawsuit for
    $5.1 million.” Defendant’s Exhibit A; Tr. 306-307.
    {¶10} Dos Santos surgery was cancelled and she received a refund.
    {¶11} As a result of her cancellation and Appellee’s vitals.com review,
    Appellant sued Appellee for tortious interference with business relations and tortious
    interference with a contract. Appellant sought monetary and injunctive relief. 3/4/15
    Verified Complaint. Appellant asserted two of the statements in the vitals.com review
    were actionable – the statement about him not being board certified and the
    statement he was unscrupulous. Appellee answered the complaint and following
    discovery filed a motion for summary judgment. 6/1/15 Answer; 12/17/15 Summary
    Judgment Motion.      In the motion for summary judgment, Appellee asserted the
    statement about Appellant not being a board certified plastic surgeon was true and
    calling him unscrupulous was an opinion.         Appellant filed a response.     1/28/16
    Response to Motion for Summary Judgment. Appellant filed a reply. 2/5/16 Reply.
    The motion for summary judgment was denied.
    {¶12} A jury trial began on March 23, 2016. After Appellant’s case-in-chief,
    the trial court directed the parties to “argue the motion for directed verdict.” Tr. 453.
    Neither party objected to this order. After lengthy discussions, the trial court directed
    a verdict in Appellee’s favor.    Tr. 476.   Although the trial court found there was
    sufficient evidence of the existence of a contract between Appellant and Dos Santos,
    the trial court found there was insufficient evidence on the Appellee’s knowledge of
    this contract and any other business relationship, and insufficient evidence there was
    tortious interference causing a party to breach the business relationship. 3/31/16 J.E.
    The court stated Appellee had the right to write her opinion on Appellant and as to
    board certification, there was no sufficient evidence indicating her statement was
    untrue. Tr. 478.
    {¶13} Appellant timely appealed the decision raising six assignments of error.
    The first two assignments of error address the trial court’s decision to sua sponte
    grant a directed verdict. The third through six assignments of error address the
    merits of the directed verdict ruling, i.e., whether Appellant presented sufficient
    evidence for the cause of action to go to the jury.
    -4-
    First and Second Assignments of Error
    “The trial court erred by sua sponte granting directed verdict in favor of
    Defendant-Appellee and not upon motion of a party, contrary to Civil Rule 50(A)(1)
    and/or (A)(3) and/or (A)(4).”
    “The trial court abused its discretion by sua sponte granting directed verdict in
    favor of Defendant-Appellee and not upon motion of a party, contrary to Civil Rule
    50(A)(1) and/or (A)(3) and/or (A)(4).”
    {¶14} The first and second assignments of error procedurally attack the trial
    court’s decision to sua sponte direct a verdict in Appellee’s favor. Appellant is of the
    position the language of Civ.R. 50(A) does not permit a trial court to sua sponte grant
    a directed verdict. Rather, a directed verdict can only be granted if a party has
    moved for a directed verdict.
    {¶15} Appellee disagrees and argues this court and numerous other Ohio
    Appellate Courts have held a trial court has inherent authority to sua sponte direct a
    verdict.
    {¶16} The rule for a motion for directed verdict states:
    (A) Motion for directed verdict
    (1) When made. A motion for a directed verdict may be made on the
    opening statement of the opponent, at the close of the opponent's
    evidence or at the close of all the evidence.
    (2) When not granted. A party who moves for a directed verdict at the
    close of the evidence offered by an opponent may offer evidence in the
    event that the motion is not granted, without having reserved the right
    so to do and to the same extent as if the motion had not been made. A
    motion for a directed verdict which is not granted is not a waiver of trial
    by jury even though all parties to the action have moved for directed
    verdicts.
    (3) Grounds. A motion for a directed verdict shall state the specific grounds
    therefor.
    -5-
    (4) When granted on the evidence. When a motion for a directed verdict
    has been properly made, and the trial court, after construing the evidence
    most strongly in favor of the party against whom the motion is directed,
    finds that upon any determinative issue reasonable minds could come to
    but one conclusion upon the evidence submitted and that conclusion is
    adverse to such party, the court shall sustain the motion and direct a
    verdict for the moving party as to that issue.
    (5) Jury assent unnecessary. The order of the court granting a motion for a
    directed verdict is effective without any assent of the jury.
    Civ.R. 50(A).
    {¶17} Appellant contends the language of this rule clearly indicates a party
    must move for a directed verdict before a trial court is permitted to grant the motion.
    Or in other words, trial courts have no authority to sua sponte direct a verdict.
    {¶18} Our district and our sister districts disagree with that argument.        In
    2002, we reviewed a trial court’s decision to sua sponte grant a directed verdict. City
    of Steubenville v. Schmidt, 7th Dist. No. 01 JE 13, 
    2002-Ohio-6894
    , ¶ 31. We held
    the trial court has authority to sua sponte direct a verdict and supported that
    conclusion by citing to the Sixth Appellate District. 
    Id.,
     citing Graham v. Cedar Point,
    Inc., 
    124 Ohio App.3d 730
    , 
    707 N.E.2d 554
     (6th Dist.1997). In addition to the Sixth
    District, many of our other sister districts have reached the same conclusion. Frazier
    v. Rodgers Builders, 8th Dist. No. 91987, 
    2010-Ohio-3058
    , ¶ 69 (inherent authority to
    direct a verdict); Hardmon v. CCC Van Wert Credit Union, 3d Dist. No. 15-09-07,
    
    2009-Ohio-6721
    , ¶ 21 (same); Mynes v. Brooks, 4th Dist. No. 08CA3211, 2009-Ohio-
    5017, ¶ 52 (same); Ray v. Plaza Mini Storage, Inc., 9th Dist. No. 00CA007734, 
    2001 WL 542320
     (inherent authority to sua sponte grant a directed verdict on any ground
    that is appropriate); Miller v. Miller & Miller Accountants, Inc., 5th Dist. No.99CA18-2,
    
    2000 WL 329814
     (Mar. 6, 2000) (“While Civ.R. 50(A) is silent as to the power of the
    court to grant a directed verdict sua sponte, several courts of appeals have held if a
    court determines reasonable minds could come to but one conclusion, on the
    evidence submitted, the court should be able to remove [that] issue from the jury
    -6-
    upon its own motion.”); English v. Halishak, 11th Dist. No. 1136, 
    1984 WL 6432
    (inherent authority to direct a verdict).
    {¶19} Given the case law, we maintain our position; a trial court can sua
    sponte direct a verdict, if that decision is supported by the record.             Factual
    distinctions between cases have not deterred appellate courts from consistently
    holding a trial court has inherent authority to sua sponte direct a verdict. The first and
    second assignments of error are meritless.
    Third, Fourth, Fifth and Sixth Assignments of Error
    “The trial court erred as a matter of law by determining at the conclusion of the
    Plaintiff’s case-in-chief that even looking at the evidence in plaintiff’s favor, said
    evidence was not sufficient evidence on one or more essential elements of Plaintiff’s
    claim, contrary to Civil Rule 50(A)(4).”
    “The trial court abused its discretion by determining at the conclusion of the
    Plaintiff’s case-in-chief that even looking at the evidence in plaintiff’s favor, said
    evidence was not sufficient evidence on one or more essential elements of Plaintiff’s
    claim, contrary to Civil Rule 50(A)(4).”
    “The trial court erred as a matter of law by determining at the conclusion of the
    Plaintiff’s case-in-chief that even looking at the evidence in plaintiff’s favor,
    reasonable minds could come to but one conclusion adverse to plaintiff, contrary to
    Civil Rule 50(A)(4).”
    “The trial court abused its discretion by determining at the conclusion of the
    Plaintiff’s case-in-chief that even looking at the evidence in plaintiff’s favor,
    reasonable minds could come to but one conclusion adverse to plaintiff, contrary to
    Civil Rule 50(A)(4).”
    {¶20} A trial court's decision granting a motion for directed verdict presents a
    question of law, which an appellate court reviews de novo. Carter v. R & B Pizza
    Co., Inc., 7th Dist. No. 09JE34, 
    2010-Ohio-5937
    , 
    2010 WL 4926742
    , ¶ 15. The
    applicable standard of review for a directed verdict is set forth in Civ.R. 50(A)(4):
    When granted on the evidence. When a motion for a directed verdict
    has been properly made, and the trial court, after construing the
    evidence most strongly in favor of the party against whom the motion is
    -7-
    directed, finds that upon any determinative issue reasonable minds
    could come to but one conclusion upon the evidence submitted and that
    conclusion is adverse to such party, the court shall sustain the motion
    and direct a verdict for the moving party as to that issue.
    Civ.R. 50.
    {¶21} A motion for directed verdict tests the sufficiency of the evidence at trial,
    not the weight of such evidence or the credibility of witnesses. Sayavich v. Creatore,
    7th Dist. No. 07-MA-217, 
    2009-Ohio-5270
    , ¶ 44. “[T]he court is confronted solely
    with a question of law: Was there sufficient material evidence presented at trial on
    this issue to create a factual question for the jury?”      One Step Further Physical
    Therapy, Inc. v. CTW Dev. Corp., 7th Dist. No. 11 MA 66, 
    2012-Ohio-6137
    , ¶ 35.
    {¶22} The claims raised to the trial court were tortious interference with a
    contract and tortious interference with a business relationship.
    {¶23} Tortious interference with a contract occurs “when a person, without a
    privilege to do so, induces or otherwise purposely causes a third person * * * not to
    perform a contract with another.” A & B–Abell Elevator Co. v. Columbus/Cent. Ohio
    Bldg. & Constr. Trades Council, 
    73 Ohio St.3d 1
    , 14, 
    651 N.E.2d 1283
     (1995). The
    elements of the tort are: 1) the existence of a contract, 2) the defendant's knowledge
    of a contract, 3) the defendant's intentional procurement of the contract's breach, 4)
    the lack of justification, and 5) the resulting damages from that breach. Fred Siegel
    Co., L.P.A. v. Arter & Hadden, 
    85 Ohio St.3d 171
    , 
    707 N.E.2d 853
     (1999), paragraph
    1 of the syllabus. In order to prevail, a party must demonstrate that the wrongdoer
    intentionally and improperly interfered with its contractual relations with another.
    Dryden v. Cincinnati Bell Tel. Co., 
    135 Ohio App.3d 394
    , 400, 
    734 N.E.2d 409
     (1st
    Dist.1999).
    {¶24} Tortious interference with a business relationship is similar to tortious
    interference with a contract. “The tort of interference with a business relationship
    occurs when a person, without privilege to do so, induces or otherwise purposefully
    causes a third person not to enter into or continue a business relationship with
    another.” DK Prods., Inc. v. Miller, 12th Dist. No. CA2008–05–060, 2009–Ohio–436,
    ¶ 9, citing Diamond Wine & Spirits, Inc. v. Dayton Heidelberg Dist. Co., 148 Ohio
    -8-
    App.3d 596, 
    774 N.E.2d 775
    , 2002–Ohio–3932, ¶ 23 (3rd Dist.). The elements of
    tortious interference with a business relationship are: (1) the existence of a
    prospective business relationship; (2) the wrongdoer's knowledge thereof; (3) an
    intentional interference causing a breach or termination of the relationship; and (4)
    damages resulting therefrom. First-Knox Natl. Bank v. MSD Properties, Ltd., 2015-
    Ohio-4574, 
    47 N.E.3d 490
    , ¶ 19 (5th Dist.). Tortious interference with a business
    relationship does not require the breach of contract, rather it is sufficient to prove that
    a third party does not enter into or continue a business relationship with the plaintiff.
    See Magnum Steel & Trading, LLC v. Mink, 9th Dist. Nos. 26127 and 26231, 2013-
    Ohio-2431, ¶ 10.
    {¶25} Both causes of action require proof of actual malice to defeat a claim of
    qualified privilege. A & B-Abell Elevator Co. v. Columbus/Cent. Ohio Bldg. & Constr.
    Trades Council, 
    73 Ohio St.3d 1
    , 14, 
    651 N.E.2d 1283
     (1995). Thus, Appellant was
    required to prove Appellee “knew [the statements] were false or acted with reckless
    disregard of whether they were true or false.” Id. at 15. Merely communicating a
    good faith opinion to another person does not rise to the level of tortious interference.
    Altier v. Valentic, 11th Dist. No. 2003-G-2521, 
    2004-Ohio-5641
    , ¶ 18. The Ohio
    Supreme Court has recognized that expressions of opinion are generally protected
    under Section 11, Article I of the Ohio Constitution.         Vail v. The Plain Dealer
    Publishing Co., 
    72 Ohio St.3d 279
    , 281, 
    649 N.E.2d 182
     (1995), citing Scott v. News–
    Herald, 
    25 Ohio St.3d 243
    , 
    496 N.E.2d 699
     (1986). In determining whether speech is
    a protected opinion, a court must consider the totality of the circumstances. Vail at
    syllabus.   The court must consider “the specific language at issue, whether the
    statement is verifiable must be considered, the general context of the statement, and
    the broader context in which the statement appeared.” 
    Id.
    {¶26} In this case, the trial court found the evidence was sufficient to show
    Appellant had a contract with Dos Santos. The court, however, found there was
    insufficient evidence to show Appellee knew of that contract, and there was
    insufficient evidence she knew of any other business relationship between any other
    person. The trial court found there was insufficient evidence of any actual malice on
    -9-
    the part of Appellee. It also found Appellant offered insufficient evidence on the issue
    of damages. 3/31/16 J.E.
    {¶27} Further reasoning for the decision to direct the verdict was stated at the
    trial:
    If I then go on and follow your argument to the business relationship,
    there’s no evidence in front of me, there’s not one piece of evidence,
    other than a belief by the doctor, that this one posting affected his
    business relationship.
    I have comments made by nameless people and nameless localities. I
    have nothing in front of me to show any loss of business. I have no
    other individuals that have come in. There’s nothing in front of me to
    show that this was at all an interference with a business relationship.
    That she had to, with purpose and intent to procure the contract’s
    breach. Well, if I find that she didn’t know about the contract, she can’t
    do that. There’s no proof that there was any interference with business
    relations. There’s no evidence that she did it with that purpose. She
    has a right to write her opinions, and if the effect of that opinion is that
    other people don’t go there, then there should be a cause of action for
    everybody who goes online and writes an opinion that’s negative about
    a doctor or lawyer or anybody. And that’s not what the law is.
    And while there is some great disagreement as to board certification, it
    is not sufficient enough for me to find that it’s untrue. Unscrupulous
    may have been a bad word, but there’s worse words than
    unscrupulous. She has a right to give her opinion. There’s no evidence
    as to the D. And I don’t find – because I don’t find any injury. The only
    testimony in front of me is he spent money on attorney fees.           And
    there’s nothing to show a loss of income, there’s nothing to show any of
    that. So there’s no damages here.
    Tr. 477-478.
    -10-
    {¶28} Considering the trial court’s reasoning and the evidence presented, the
    trial court did not err in directing the verdict. As set forth below, the evidence at trial
    was not sufficient to create a factual issue for the jury on the elements of tortious
    interference with a contract and/or tortious interference with a business relationship.
    {¶29} The first two elements are the existence of a contract or prospective
    business relationship and defendant’s knowledge thereof. The knowledge required is
    actual knowledge; constructive knowledge is not sufficient to sustain a cause of
    action for tortious interference with contract, actual knowledge is required. Norris v.
    Philander Chase Co., 5th Dist. No. 10-CA-04, 
    2010-Ohio-5297
    , ¶ 26, citing Crown
    Equip. Corp. v. Toyota Material Handling, U.S.A., Inc., 
    202 Fed.Appx. 108
    , 2006
    Fed.App. 0798N (C.A.6, 2006).
    {¶30} Admittedly, the evidence undisputedly establishes there was a contract
    between Dos Santos and Appellant. The contract was canceled and the evidence
    shows Dos Santos was refunded approximately $8,000. The reason the contract
    was canceled is disputed. Appellant’s office receptionist testified Dos Santos told her
    she wanted to cancel the surgery based on reviews she had seen on vitals.com and
    having read Appellant was not board certified. Tr. 321, 327. Dos Santos stated the
    reason she canceled was negative reviews from other websites and newspaper
    articles about the million dollar medical malpractice lawsuit. Tr. 256-257, 278. Dos
    Santos testified she has never been on the website vitals.com, she did not read
    Appellee’s review prior to her testimony, and she never told the staff person at
    Appellant’s office that she was canceling the surgery based on a review she read on
    vitals.com claiming Appellant was not board certified. Tr. 251, 264, 266, 269, 271,
    275, 278, 304.     This information creates a genuine issue of material fact as to
    whether Appellee’s review was the cause of her canceling her surgery. However,
    that does not mean the directed verdict was inappropriate on the interference with a
    contract claim. The issue is still the element of whether she had actual knowledge of
    the contract. The evidence undisputedly demonstrates Dos Santos and Appellee did
    not know each other and Appellee did not know of the contract between Dos Santos
    and Appellant. Tr. 297-298.
    -11-
    {¶31} Other than the contract with Dos Santos, Appellant did not offer any
    testimony or evidence that the vitals.com review prevented third parties from entering
    into business relationships with him. Admittedly, the review was found “helpful” by
    six unnamed individuals. Plaintiff’s Exhibit 9. Given the facts, that evidence was not
    sufficient to prevent a directed verdict. The “helpful” designations were made by
    unnamed people and merely clicking on the “helpful” icon does not evince these
    “users” intended to have surgery performed and this one review is the reason that
    user did not use Appellant to perform the surgery.
    {¶32} Also, as to the third element for each cause of action, there was no
    evidence of an intentional interference causing a breach or termination of a business
    relationship.   Appellant complains of the language in the vitals.com review and
    contends two of the statements made in the review are actionable.          The review
    written by Appellee states:
    I chose Dr. Gentile because all the research I did on him before paying
    him to do my surgery said he was an expert plastic surgeon with years
    of experience on the head and neck. Little did I realize that meant he
    was Board Certified as an ENT., and NOT Board Certified as a
    PLASTIC SURGEON.          There is a BIG difference in those two
    Certifications, but how is the common patient to know this? He mislead
    me in the consultation, saying I needed many more procedures than
    just the Upper eyelid surgery Which I consulted with him in the first
    place. I TRUSTED him and paid him to do the procedures he said I
    would need to make me look fabulous in 2 weeks! The morning of
    surgery, after taking sedatives that he prescribed, I showed up at the
    Boardman office. They were running late and I sat in the waiting room
    for almost 90 minutes. A nurse came out and had me sign papers
    telling me they were for anesthesia. Minutes later I was taken in the
    back, I.V. put in my arm, and seconds before I blacked out, Dr. Gentile
    walked in, said “Lets get started” . . . when I woke up, I was very
    disoriented and have very little memory for days after surgery.       He
    never told me that he didn’t do the procedures I paid him to do, and that
    -12-
    he did procedures I knew nothing about. I had to discover this all on my
    own, each day as bandages and stitiches were removed. I broke out
    with huge boils on my face just days after surgery. I called, begging for
    an appt., but was told “it’s a normal healing process and they’d see me
    at my next appt, which was days later. I asked for an antibiotic and was
    told, “No”. When I would show up for my appt., the Dr. avoided me,
    would not address my problems and then I was told that “he was in
    surgery” and couldn’t see me. The staff always told me how I [sic] great
    I looked, which was a joke, because I looked like a Monster, with huge
    boils, bruises and a tremendous amount of swelling. Finally, I had to
    resort to seeing my “Family Dr.” and after culturing my boils, he
    determined that I had MRSA. I tried making appts., so that I could talk
    to Dr. Gentile about my Dr.’s diagnosis, but they kept cancelling them.
    This went on for 2 months. I am left now with permanent scarring that I
    shouldn’t have. Nerve Damage and MRSA infections. Stay away for
    this Unscrupulous Dr.
    Plaintiff’s Exhibit 1.
    {¶33} Appellant contends the statement that he is not board certified and the
    statement he is unscrupulous are actionable. We disagree.
    {¶34} The unscrupulous statement is the Appellee’s opinion based on her
    factual situation with Appellant. In the prior lawsuit, Appellee was able to prove
    Appellant performed surgery on her without her informed consent.            Her review
    indicates she did not give her consent for the procedures and that led her to conclude
    Appellant was unscrupulous. The parties agree the word unscrupulous has many
    definitions. When used in the manner it was used in this review, it invokes the
    thought that this is the writer’s opinion given the facts as she laid them out. Opinions
    generally are not actionable. Vail, 72 Ohio St.3d at 281.
    {¶35} As to board certification as a plastic surgeon, there was testimony
    about this issue. There is an American Board of Medical Specialties (ABMS) and it
    has certain boards of specialties.         One board is the American Board of
    Otolaryngology and another one is the American Board of Plastic Surgery. Tr. 434-
    -13-
    435; Plaintiff’s Exhibit 10.     Appellant is certified by the American Board of
    Otolaryngology.   Plaintiff’s Exhibit 10; Tr. 411.   The language of the certification
    states, “has pursued an accepted course of graduate study, clinical work and has
    successfully   passed   an     examination    in   Otolaryngology   including   General
    Otolaryngology, Otology, Facial Plastic Surgery, Head and Neck Surgery and
    Pediatric Otolaryngology.” Plaintiff’s Exhibit 10. However, Appellant is not certified
    by the ABMS American Board of Plastic Surgery. Tr. 435. He testified he is certified
    by a non-ABMS board for facial plastic and reconstructive surgery. Tr. 435.
    {¶36} Technically, Appellee’s statement is correct. Appellant is not an ABMS
    board certified plastic surgeon.      However, he is certified by the ABMS for
    Otolaryngology. Otolaryngology is defined as “the branch of medicine that combines
    treatment of the ear, nose and throat.”       Webster’s II New Riverside University
    Dictionary 833 (1984). To an ordinary person this definition means an ENT. Thus, it
    is a fact Appellant is not certified by the ABMS American Board of Plastic Surgery.
    Therefore, the statement is not actionable.
    {¶37} That said, we acknowledge the review does not use ABMS board
    certified references. Appellant’s certification by the ABMS Otolaryngology specialty
    board, which includes facial plastic surgery, is not referenced in the review nor is
    Appellant’s certification by a non-ABMS board for Facial Plastic and Reconstructive
    Surgery.   However, when the review is read in its context, Appellee is correctly
    asserting Appellant is not an ABMS board certified plastic surgeon. Her reference to
    Appellant being a board certified ENT demonstrates she is aware of his board
    certification by the Otolaryngology specialty board and he is not certified by the
    ABMS Plastic Surgery specialty board.
    {¶38} The conclusion her statements are true further supports the conclusion
    the claims are not actionable; Appellant cannot show actual malice. Appellant admits
    he must show actual malice, which is the statements are false or Appellee acted with
    reckless disregard as to whether the statements were false. The vitals.com review
    does not demonstrate actual malice; the review was based on her experience and
    opinion. It shows a knowledge of board certifications, but does not create an issue
    as to whether she recklessly disregarded and omitted that Appellant was a non-
    -14-
    ABMS certified facial plastic and reconstruction surgeon. Furthermore, Appellee’s
    testimony on cross-examination supports the position that she was not acting with
    actual malice; she indicates she was not angry, but was telling her experience. Tr.
    213, 216, 225.
    {¶39} Lastly, Appellant failed to present evidence of damages, the final
    element of both causes of action.    Appellant presented the damages from Dos
    Santos rescinding her contract. However, as stated above, there was no evidence
    Appellee had actual knowledge of that contract. Other than the cancellation of the
    Dos Santos contract, there was no evidence of lost revenue. In fact, there was no
    evidence on revenue prior to the review as compared to revenue after the review was
    published. Appellant’s own witnesses testified the office was always busy and was
    busy when Dos Santos canceled her surgery.
    {¶40} For the above stated reasons, these assignments of error lack merit.
    There was no evidence Appellee had actual knowledge of the contract or business
    relationship between Dos Santos and Appellant, or the statements in the vitals.com
    review were facts and opinion. There was no showing of actual malice, and no
    evidence of damages.
    Conclusion
    {¶41} All assignments of error lack merit.     The trial court’s decision is
    affirmed.
    Waite, J., concurs.
    DeGenaro, J., concurs.