Alberts v. All About Women, P.A.

Superior Court of Delaware·Decided November 24, 2020·No. N18C-07-212 JRJ·Published

Opinion

IN THE SUPERIOR COURT OF THE STATE OF DELAWARE

JETTA ALBERTS, )

)

Plaintiff, )

)

v. ) C.A. No. N18C-07-212 JRJ )

ALL ABOUT WOMEN, P.A. a Delaware ) corporation, REGINA SMITH, D.O., ) and CHRISTIANA CARE HEALTH ) SERVICES, INC, )

)

Defendants. )

OPINION

Date Submitted: July 21, 2020 Date Decided: November 10, 2020 Corrected: November 24, 2020*

Upon Plaintiff’s Motion to Strike Errata Corrections: GRANTED

Randall E. Robbins, Esquire, Randall J. Teti, Esquire, Ashby & Geddes, Wilmington, Delaware, Attorneys for Plaintiff.

Gregory S. McKee, Esquire, Lauren C. McConnell, Esquire, Wharton, Levin, Ehrmantraut & Klein, P.A., Wilmington, Delaware, John D. Balaguer, Esquire, Lindsay E. Imbrogno, Esquire, White and Williams LLP, Wilmington, Delaware, Attorneys for Defendants.

Jurden, P.J.

* The Court’s decision was originally issued with a cover page stating “Memorandum Opinion.” This has been corrected to read “Opinion.”

I. INTRODUCTION

This is a medical negligence action arising from a myomectomy performed

on Plaintiff Jetta Alberts (“Plaintiff”) at Christiana Hospital on September 6, 2017

that ultimately resulted in the loss of her uterus at the age of twenty-five.1 On June

3, 2020, Plaintiff deposed Diane McCracken, M.D., an owner of Defendant All

About Women, P.A., (collectively, with Dr. Regina Smith, D.O., “Defendants”) and

the supervising attending physician who was responsible for Plaintiff’s post-

operative care.2 Following that deposition, and as a result of Dr. McCracken’s

testimony, the Plaintiff’s OB/GYN expert supplemented his expert opinions,

opining, among other things, that Dr. McCracken breached the standard of care with

respect to the clinical assessment of the Plaintiff.3 Almost a month later, Dr.

McCracken submitted an errata sheet setting forth multiple “desired corrections”

(“corrections”) to her deposition testimony (collectively, the “Errata sheet”).

Plaintiff moves to strike a number of these corrections, arguing they significantly

“manipulate, supplement, or change” Dr. McCracken’s deposition answers.4

For the following reasons, Plaintiff’s Motion to Strike Errata Corrections is

GRANTED.

1 D.I. 107 ¶ 1. A myomectomy is a surgical procedure to remove uterine fibroids. D.I. 1 ¶ 13. 2 Id. ¶ 3. 3 D.I. 107, Ex. B at 3. 4 D.I. 107 ¶ 4. Dr. McCracken reserved the right to review and read her deposition transcript. D.I. 120 ¶ 1.

II. FACTS AND PROCEDURAL HISTORY

A. Plaintiff’s Medical Negligence Claims

Plaintiff alleges Defendants breached the standard of care by failing to

timely recognize Plaintiff experienced post-operative internal bleeding in the two

days following her myomectomy.5 By the time Defendants discovered the

bleeding, Plaintiff had lost almost two-thirds of her blood volume and had to

undergo an emergency hysterectomy.6 According to Plaintiff, the standard of care

required Defendants to be cognizant of her full clinical picture and immediately

recognize the signs and symptoms of internal bleeding throughout post-operation

day one (“POD1”) and the morning of post-operation day two (“POD2”).7

Plaintiff claims that had the Defendants met the standard of care, Plaintiff would

not have experienced such significant blood loss and would not have had to

undergo the hysterectomy.8

5 D.I. 107 ¶ 1 6 Id. ¶ 2. 7 Id. 8 Id. According to Plaintiff, a significant issue in this case is whether Defendants failed to recognize the signs and symptoms of internal bleeding throughout POD1 (9/7/17) and the morning of POD2 (9/8/17). The signs and symptoms included POD1 bloodwork showing a 6- point hemoglobin drop to 7.1 from Plaintiff’s pre-op hemoglobin of 13.2, representing a loss of nearly 50% of her blood volume, together with persistent pain, persistent nausea and vomiting, fluid imbalance, and elevated heartrate, all consistent with internal bleeding. Plaintiff contends Defendants never checked the POD1 bloodwork results on POD1 that were posted to Plaintiff’s chart at 9:07 a.m. according to CCHS’s audit trail. It was not until POD2, when Plaintiff’s hemoglobin level dropped to 4.7, that Defendants recognized Plaintiff was bleeding internally and had lost nearly 2/3 of her blood volume. She underwent the hysterectomy shortly thereafter. Plaintiff maintains that the standard of care required Defendants to, among other things, check

B. Plaintiff’s Motion to Strike the McCracken Errata Sheet Corrections

On June 3, 2020, Plaintiff took Dr. McCracken’s deposition.9 After

receiving a copy of Dr. McCracken’s deposition transcript, Plaintiff’s OB/GYN

expert, Dr. Daniel Small, M.D., supplemented his expert disclosure

(“Supplemental Disclosure”) to add that, in his expert opinion, (1) Dr. McCracken

breached the standard of care owed to Plaintiff when she failed to recognize the

“obvious signs, symptoms and labs consistent with internal bleeding” until

POD2,10 (2) Dr. McCracken’s testimony that “potentially any of us or potentially

none of us” responsible for Plaintiff’s care would know the elements of the clinical

information necessary to diagnose Plaintiff’s condition, falls below the standard of

care,11 and (3) Dr. McCracken’s testimony regarding what a “clinical picture”

means is a “grossly inaccurate representation of the meaning of clinical picture,

and falls far below the knowledge and skill ordinarily employed by an attending

the bloodwork results they ordered and to be aware of Plaintiff’s total clinical picture. D.I. 107 ¶ 2. 9 Id. ¶ 3. Plaintiff originally sought to take Dr. McCracken’s deposition in November 2019, but the parties were unable to agree to a common date until April, when COVID-19 struck. The parties agreed to a date in June in order to safely conduct the deposition. Hr’g: 3:23-6:4. 10 D.I. 107, Ex. B at 3. In his first expert disclosure, Dr. Small opined that the hospital’s doctors, residents, and nurses, including Dr. Regina Smith, breached the standard of care by failing to timely respond to Plaintiff’s internal bleeding until her risk level was dangerously high and failing to investigate and be aware of Plaintiff’s whole clinical picture. Id. at 3, 5. 11 Id. at 6, citing McCracken Dep. at 127-28 (internal quotations omitted).

OB/GYN and the use of reasonable care and diligence in the postoperative care of

a myomectomy patient[.]”12

Two weeks after Plaintiff produced Dr. Small’s Supplemental Disclosure,

and almost one month after her deposition, Dr. McCracken submitted an Errata

sheet substantively supplementing and changing her deposition testimony.13 In

response, Plaintiff filed the instant motion.

The corrections on the Errata sheet Plaintiff moves to strike are as follows:14

Dep. Question Asked Testimony Desired Corrections Tr. 38:12- Q: Does [Ashley A: She typically would – if we A: She typically would – if 19 August, P.A.] have the list in front of us I we have the list in front of us communicate to would say are there any issues? I would say are there any you about all And she would say yes, you issues? And she would say patients or just know, this person’s blood yes, you know, this person’s ones where she pressure is elevated and this blood pressure is elevated 1. perceives there’s person wants to go home early and this person wants to go an issue? or something like that. home early or something So we wouldn’t necessarily go like that. through details of every single So we wouldn’t necessarily patient if the patients are stable. go through all the details of every single patient if the patients are stable.

12 Id. 13 D.I. 107 ¶ 4. Defense counsel received the transcript of Dr. McCracken’s deposition on June 5, 2020. D.I. 120 ¶ 3. Plaintiff produced Dr. Small’s Supplemental Disclosure on June 17, 2020. D.I. 99. 14 Desired corrections are in bold and underlined. For ease of reference, the Court has numbered the corrections. The actual Errata sheet with the corrections and reasons for the corrections can be found at D.I. 107, Ex. C.

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