Conner v. Ofreneo

628 N.E.2d 1150, 257 Ill. App. 3d 427, 195 Ill. Dec. 686
CourtAppellate Court of Illinois
DecidedDecember 30, 1993
Docket1-91-2255
StatusPublished
Cited by9 cases

This text of 628 N.E.2d 1150 (Conner v. Ofreneo) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Conner v. Ofreneo, 628 N.E.2d 1150, 257 Ill. App. 3d 427, 195 Ill. Dec. 686 (Ill. Ct. App. 1993).

Opinion

PRESIDING JUSTICE MANNING

delivered the opinion of the court:

Plaintiff Deborah Conner brought a medical malpractice action against defendants Children’s Memorial Hospital and Dr. Danilo Ofreneo to recover damages for the death of her daughter, Karla Conner, which plaintiff alleged was caused by the negligence of defendants. Defendant Children’s Memorial Hospital settled with plaintiff before a verdict was entered, and plaintiff proceeded to trial against Dr. Ofreneo. Following a jury trial, a general verdict was returned against plaintiff and in favor of defendant.

On appeal plaintiff argues that the trial court: (1) erred in admitting into evidence the testimony of an expert defense witness who provided testimony and opinions that were not produced during discovery; (2) erred in permitting defendant to cross-examine plaintiff’s expert witness, Dr. Barkin, regarding the standard of care and treatment rendered at Children’s Memorial Hospital; and (3) the jury’s verdict was against the manifest weight of the evidence. For the following reasons, we affirm.

According to the record, on February 5, 1980, Deborah Conner (plaintiff) took her daughter, Karla Conner, to the Uptown Clinic in Chicago. Karla had experienced excessive thirst, slurred speech, weight loss, and excessive bladder movement. While at the clinic, Karla eventually was examined by defendant Dr. Ofreneo, a general surgeon and general practitioner. Plaintiff testified that Ofreneo spent about 15 to 20 minutes with Karla asking specific questions and that Karla was not responsive to his questions. Dr. Ofreneo had X rays taken of Karla and requested a blood sample. Plaintiff testified that Dr. Ofreneo advised her to call him back to obtain the results of the blood tests, but he failed to advise her when Karla should return for a check-up.

After leaving the clinic, plaintiff took Karla home, where she continued to experience frequent bladder movement, stomach and head pains, hoarseness of the voice and general weakness. Later that evening, plaintiff took Karla to Children’s Memorial Hospital (Children’s) in Chicago.

Karla was treated at Children’s by Dr. Tomasi. He performed blood and urine tests on Karla to determine her glucose level. Karla’s glucose level was 1,126, and Tomasi concluded that a normal range for a child Karla’s age was less than 120, assuming the child had not eaten a large carbohydrate meal. Tomasi concluded that Karla should be admitted to the hospital. Karla’s primary problem was dehydration, poor circulation of blood to her brain, severe metabolic acidosis, and complications of diabetic ketoacidosis. The staff at the hospital attempted to increase Karla’s blood pressure and correct her hydration by starting an IV.

Tomasi testified that it took an hour to hydrate Karla to a point where she could make urine. He stated that with a newly diagnosed diabetic it takes two or three days to correct the ketoacidosis. Tomasi testified that in the treatment of Karla it was necessary for the persons involved to take a history to discover the problems she was experiencing. Tomasi testified that Karla’s history showed that she had slept and drunk more water than usual on the day she came to the hospital. He also noted that, according to plaintiff, Karla had lost 15 pounds within a two-day period. Tomasi stated that the results of the blood tests revealed that Karla had a large amount of ketones in her urine. He tried to correct Karla’s hydration and to correct the acidosis by giving her bicarbonate. He also tried to correct the diabetic problem by giving her insulin in high doses in hopes that it would stop the production of the ketoacids.

Tomasi stated that it was necessary to correct the problem slowly enough to allow Karla to equilibrate within her body, but to correct the condition rapidly enough so that she did not die in the process, of being treated. Karla later suffered heart failure, a physician was called and Karla was moved to intensive care. She later died. Tomasi testified that Karla’s death was due to cardiorespiratory arrest which caused brain damage. Tomasi stated that he believed had Karla not been critically ill when she arrived at the hospital, the volume of fluid she received would not have resulted in her death.

On cross-examination Tomasi testified that the hospital records indicated that Karla was lethargic and had slurred speech when she arrived at the hospital. He stated that in comparison to what is described in the authoritative texts for treatment of a patient in diabetic ketoacidosis, Karla received excessive fluids. He agreed that excessive fluids can lead to pulmonary edema, to hypoxia, to cardiac arrest and ultimately to death.

Dr. Barkin testified as an expert on behalf of plaintiff. He stated that, in his opinion, Dr. Ofreneo deviated from the standard of care when he failed to perform and/or record an adequate medical history of Karla and failed to recognize the significance of her illness. He also opined that Ofreneo failed to perform adequate and timely laboratory tests and failed to intervene in a timely fashion. Barkin testified that each of these deviations caused or contributed to Karla’s death. He further testified that the amount of fluid Karla received at the hospital contributed to Karla’s death and that he did not believe the excess fluid was the sole cause of her death.

On cross-examination Dr. Barkin agreed that the fluid overload led to pulmonary edema, which led to hypoxia, causing cardiac pulmonary edema and, ultimately, Karla’s death.

Dr. Kessel testified on behalf of defendant. He stated that on February 5, 1980, he examined Karla for an acute illness which was relatively mild at that time. He testified that Karla was diabetic and mild to moderately dehydrated at 10 a.m. Based upon the variance in the physical findings between 10 a.m. and midnight, Karla rapidly progressed from mild to severe ketoacidosis.

Kessel testified that the standard of care did not require Dr. Ofreneo to consider the possibility of diabetes based upon the information available to him at 10 a.m. that morning. Kessel stated that Ofreneo’s failure to diagnose diabetic ketoacidosis did not cause or contribute to Karla’s death. In his opinion, defendant’s examination was within the applicable standard of care. He testified that he believed the sole cause of death was the fluid overload which occurred while Karla was at the hospital.

Dr. Ofreneo testified on his own behalf that when Karla came to the clinic on September 5, 1980, she was fragile and skinny. Plaintiff came into the office with Karla and told him that Karla was having abdominal pain, had not been eating well, and had experienced weight loss. Dr. Ofreneo examined Karla’s head, eyes, nose, throat, heart, lungs and abdomen. He found nothing significant, although her throat was slightly red, indicating that it was congested. Ofreneo also stated that Karla’s history was within normal limits, although he did testify that he did not write down her prior immunizations, illnesses or allergies. Her previous medical conditions and illnesses were not recorded.

Under the assessment portion of his report, Ofreneo indicated that Karla possibly suffered from anorexia. He ruled out appendicitis or other acute abdominal problems. He was concerned about the possibility of a chronic infection or a malignancy.

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Bluebook (online)
628 N.E.2d 1150, 257 Ill. App. 3d 427, 195 Ill. Dec. 686, Counsel Stack Legal Research, https://law.counselstack.com/opinion/conner-v-ofreneo-illappct-1993.