Anderson v. House of Good Samaritan Hospital

44 A.D.3d 135, 840 N.Y.S.2d 508
Appellate Division of the Supreme Court of the State of New York·Decided July 18, 2007·No. Appeal No. 1·Published·Cited by 19 cases

Opinion

OPINION OF THE COURT

Hurlbutt, J.

[137]*137In appeal No. 1, plaintiff, as limited by her brief, appeals from an order and judgment insofar as it dismissed the complaint in this medical malpractice action against House of Good Samaritan Hospital (Samaritan), Mercy Hospital of Watertown, doing business as Mercy Center for Health Services, doing business as Community Mental Health Center (Mercy), and Maritza Santana, M.D. (collectively, defendants). In appeal No. 2, plaintiff appeals from an order denying her motion to set aside the verdict pursuant to CPLR 4404. The appeal from the order must be dismissed because that order is subsumed in the final order and judgment (see Woodhouse v Bombardier Motor Corp. of Am., 5 AD3d 1029 [2004]; see also CPLR 5501 [a] [1], [2]). Of the 18 instances of reversible error asserted by plaintiff to have occurred in the lengthy and complex trial, we conclude that only one requires reversal of the order and judgment insofar as appealed from. We agree with plaintiff that Supreme Court committed reversible error in giving an “error in judgment” charge to the jury, and we thus conclude that plaintiff is entitled to a new trial.

I

Plaintiff, the wife of an army officer stationed at Fort Drum in Jefferson County, presented herself at Fort Drum’s Guthrie Clinic on October 5 and 7, 1993 with complaints of a headache, nausea, vomiting, numbness and tingling in her hands and feet, and dizziness. After conducting a physical examination and various laboratory tests, the examining physician concluded that plaintiff was suffering from, inter alia, an inflammation of the ear known as labyrinthitis, which the physician concluded was probably viral in origin. On October 11, 1993, plaintiff sought treatment for the same complaints in the emergency department at Samaritan. After an examination and various tests, including a CT scan of plaintiff’s head, the emergency department physician concluded that the most likely cause of plaintiffs symptoms was a middle ear problem. When plaintiff returned to the Samaritan emergency department the next day, a second emergency department physician reviewed the records and test results from the previous day’s visit, took a history, and performed an examination. That physician believed that plaintiff may have been suffering from depression and consulted with and referred plaintiff to a family practitioner at the Guthrie Clinic.

Plaintiff was next seen by a Fort Drum psychiatrist two days later, on October 14, 1993. Based on plaintiffs presentation and [138]*138history, that psychiatrist made a provisional diagnosis of major depression or depression with psychotic features, based on his assessment of plaintiff’s appearance and recent history of numerous “stressors,” including relocation to Fort Drum, an ectopic pregnancy requiring surgery, a miscarriage, and a recent dilatation and curettage procedure. That same day, plaintiff was brought to Mercy’s outpatient clinic, where she was seen by a second psychiatrist, who was acting as the designee of the Director of Community Services for Jefferson County. The second psychiatrist determined, upon his examination of plaintiff, that she was unable “to safely survive in the community” due to her mental status, and applied for her involuntary admission to the psychiatric ward at Mercy, pursuant to Mental Hygiene Law § 9.37.

That application brought plaintiff under the care of defendant Maritza Santana, M.D., a psychiatrist employed by Mercy in the mental health unit operated by Samaritan but located in Mercy’s facilities. Dr. Santana reviewed plaintiffs history and medical records, examined plaintiff’s mental status, and approved plaintiff’s involuntary admission pursuant to Mental Hygiene Law § 9.37. Believing plaintiff to be depressed, Dr. Santana formulated a differential diagnosis of “organic dementia, organic delusions, rule out major depression with psychotic symptoms, [and] rule out atypical psychosis.” Plaintiff was admitted to the mental health unit on October 15, 1993 and remained there until she was transferred to Walter Reed Army Medical Center (Walter Reed) on October 23, 1993. The course of continued assessment and treatment included discontinuing plaintiffs medications to rule those out as a cause of plaintiffs physical symptoms, performing an upper GI series to rule out peptic ulcer disease, and prescribing Haldol, an antipsychotic medication. By the time plaintiff was transferred to Walter Reed, her condition had deteriorated to such a degree that she was catatonic.

At Walter Reed, after staff physicians performed a lumbar puncture, an MRI, and other neurological tests, plaintiff was diagnosed with acute disseminated encephalomyelitis, an inflammatory process in the brain secondary to a viral infection, and treatment was immediately commenced. Plaintiff presented evidence at trial that, as a result of the delay in making a diagnosis of her neurological disorder, she sustained various cognitive and other neurological deficits, and defendants controverted that evidence.

[139]*139Over the objection of plaintiff, the court included the “error in judgment” charge in its jury instructions on medical malpractice (see PJI 2:150), stating: “A doctor is not liable for an error in judgment if he or she does what he or she decides is best, after careful examination, if it is a judgment that a reasonably prudent doctor would have made under the circumstances.”

The jury returned a verdict finding that none of the defendants was negligent. This appeal, however, concerns only Samaritan, Mercy and Dr. Santana and, as previously noted, we agree with plaintiff that the court erred in giving the “error in judgment” charge. Because we cannot conclude that the error is harmless, we conclude that plaintiff is entitled to a new trial.

II

The “error in judgment” charge emanates from the 1898 decision of the Court of Appeals in Pike v Honsinger (155 NY 201 [1898]). There, in reversing a judgment in a malpractice action that directed a verdict in favor of the defendant, the Court wrote that physicians are bound to possess that degree of learning and skill ordinarily possessed by those practitioners in the same locality, and that they must use both “reasonable care and diligence” and their “best judgment” in rendering care to patients (id. at 209). Further, the Court wrote that “[t]he rule requiring [doctors] to use [their] best judgment does not hold [them] liable for a mere error of judgment, provided [they do] what [they] think[ ] is best after careful examination” (id. at 210).

In Spadaccini v Dolan (63 AD2d 110 [1978]), the First Department explained that “[a]n error [in] judgment charge is appropriate in a case where a doctor is confronted with several alternatives and, in determining appropriate treatment to be rendered, exercises his [or her] judgment by following one course of action in lieu of another” (id. at 120). We cited and followed Spadaccini in Martin v Lattimore Rd. Surgicenter (281 AD2d 866 [2001]). In that part of the Martin decision that is particularly analogous here, involving the allegation that the defendant physician had failed to obtain an X ray after the plaintiff patient had “exhibited classic symptoms of a bowel obstruction,” we noted that the defendant physician testified that he would have ordered an X ray had he suspected a bowel obstruction and that the defendant physician’s expert testified that the defendant physician’s “assessment . . . was reasonable” (id. at 867).

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Anderson v. House of Good Samaritan Hospital, 44 A.D.3d 135, 840 N.Y.S.2d 508 (N.Y. Ct. App. 2007).

44 A.D.3d 135 (Anderson v. House of Good Samaritan Hospital) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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