Díaz-Casillas v. Doctors' Ctr. Hosp. San Juan

342 F. Supp. 3d 218
CourtUnited States District Court
DecidedOctober 23, 2018
DocketCivil No. 17-1152 (FAB)
StatusPublished
Cited by11 cases

This text of 342 F. Supp. 3d 218 (Díaz-Casillas v. Doctors' Ctr. Hosp. San Juan) is published on Counsel Stack Legal Research, covering United States District Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Díaz-Casillas v. Doctors' Ctr. Hosp. San Juan, 342 F. Supp. 3d 218 (usdistct 2018).

Opinion

BESOSA, District Judge.

*222On September 12, 2018, the Court continued the trial pending the disposition of four motions in limine. (Docket No. 95.) Plaintiffs José Díaz-Casillas ("José Díaz"), Olga Díaz-Casillas ("Olga Díaz") and Rosa Luz Ramos ("Ramos") (collectively, "plaintiffs") move to exclude the deposition transcripts of Katia Dávila-Díaz ("Dávila") and Kenneth Miller ("Miller"). (Docket Nos. 66 and 67.) The plaintiffs also move to preclude defendants Doctors' Center Hospital San Juan, Inc. ("Doctors' Center Hospital") and José Pesquera-García ("Pesquera") (collectively, "defendants") from calling expert witnesses at trial. (Docket No. 65.) The defendants move to exclude expert testimony by José Díaz and Boris Rojas ("Rojas"), testimony by Dávila and Iris González ("González"), and a "Day in the Life" video of Zoraida Díaz-Casillas ("Zoraida Díaz"). (Docket No. 53.)

For the reasons set forth below, the plaintiffs' motion to preclude the defendants from calling expert witnesses at trial is MOOT. (Docket No. 65.) The plaintiffs' motions to preclude Miller and Dávila's deposition transcripts are DENIED. (Docket No. 66 and 67.) The defendants' motion in limine is GRANTED IN PART and DENIED IN PART. (Docket No. 53.)

I. Background1

This medical malpractice litigation stems from a purported misdiagnosis. (Docket No. 1.) On February 12, 2016, Zoraida Díaz became ill with jaundice and developed a skin condition. Id. at p. 4. González drove Zoraida Díaz to the Centro de Diagnóstico y Tratamiento in Carolina, Puerto Rico. Id. at p. 4. A complete blood count exam revealed that Zoraida Díaz possessed a "critical[ly] low value of platelets at 13," in addition to low levels of red bloods cells, hemoglobin, and hematocrits. Id. at p. 5. Zoraida Díaz sent text messages with photos of her skin condition to her brother José Díaz, who is a neurologist in Houston, Texas. Id. José Díaz urged Zoraida Díaz to be "evaluated by a hematologist emergently." Id.

The Centro de Diagnóstico y Tratamiento transferred Zoraida Díaz to the Doctors' Center Hospital. Id. Her transfer sheet indicated that she had "petequiae in her mouth and lips and petequiae and hematomas on her extremities." Id. González accompanied Zoraida Díaz in an ambulance to Doctors' Center Hospital. Id. at p. 6.

Doctors' Center Hospital triaged Zoraida Díaz an hour after her arrival, classifying her as "urgent" rather than "emergency." Id. The triage nurse noted that Zoraida Díaz's skin condition was "normal." Id. The emergency room physician, Toru Hashida-Kurihara ("Hashida"), evaluated Zoraida Díaz. Id. She informed Hashida that José Díaz "believed her petechiae, hematomas and laboratory values presented an emergency medical condition." Id. at p. 7. Hashida consulted with Pesquera, a hematologist. Id. Pesquera prescribed one unit of platelets and a corticosteroid. Id. According to the plaintiffs, Pesquera did so without obtaining results from diagnostic tests, including "a peripheral *223blood smear, an LDH test, and an ADAMTS 13 test." Id. at p. 8. The plaintiffs maintain that these tests are necessary to distinguish between "TTP and ITP," both of which are blood-related diseases. Id. Pesquera diagnosed Zoraida Díaz with ITP. Id.

The plaintiffs allege that blood smears are "ordered on a regular basis when a person is being treated or monitored for a blood cell-related disease." Id. Zoraida Díaz received a blood smear four days after arriving at Doctors' Center Hospital. Id. at p. 9. The blood smear "yielded a value of 5805 when the hospital's reported accepted range is between [ ] 313-618." Id. Subsequently, Zoraida Díaz's sight diminished, she became incoherent and lost control of her extremities. Id. Pesquera ordered a Head CT scan, which "indicated that the images were deteriorated by the patient's motion, aggressiveness and disorientation." Id. at p. 11.

Pesquera subsequently altered his diagnosis. Id. at p. 11. He concluded that Zoraida Díaz suffered from TTP. Id. The plaintiffs aver that the "administration of platelets to a patient with TTP is contraindicated because it causes thrombi or blood clots, which can be life threatening." Id. at p. 8. The standard TTP treatment includes a "plasmapheresis or, in the alternative, a plasma transfusion." Id. at p. 11. The Doctors' Center Hospital did not administer a plasmapheresis or a plasma transfusion. Id. If left untreated, TTP "can be fatal or cause lasting damage, such as brain damage or stroke." Id. Zoraida Díaz transferred to another hospital in Puerto Rico, where she received a plasmapheresis. Id. at p. 12.

The plaintiffs allege that Zoraida Díaz sustained "permanent ischemic damage," after which point her family transported her to Texas for additional medical treatment. Id. José Díaz visited Zoraida Díaz in Texas daily, at times as her attending physician. Id. at p. 16. She remains in a "permanent vegetative state, completely incapacitated and unable to do anything for herself, even speak." Id. at pp. 12-13. At the time of her alleged misdiagnosis, Zoraida Díaz was 60 years old and "had no physical limitations." Id. at p. 14.

On February 7, 2017, José Díaz, Olga Díaz and Ramos commenced this civil action. (Docket No. 1.)2 The plaintiffs are Zoraida Díaz's siblings. Id. at p. 2.3 The complaint sets forth a medical malpractice cause of action pursuant to the Puerto Rico General Torts Statute, Articles 1802 and 1803 of the Civil Code ("Articles 1802 and 1803"). Id. at pp. 16-31; see Laws of P.R. Ann. tit. 31 §§ 5141, 5142.4

*224The complaint names five defendants: Doctors' Center Hospital, Pesquera, Hashida, Guardian Insurance Company, Inc. ("Guardian Insurance"), and Sindicato de Aseguradores para la Suscripción Conjunta de Seguro de Responsibilidad Profesoinal Médico-Hospitalaria ("SIMED"). Id. The Court granted the plaintiffs' motions to dismiss the complaint without prejudice as to Guardian Insurance and SIMED. (Docket Nos. 15 and 30.) Hashida failed to answer the complaint, despite several attempts to serve process on him personally and by publication. See Docket Nos. 18, 20, 26-28. On June 5, 2017, the Clerk entered default against Hashida. (Docket Nos. 33 and 34.) Accordingly, Doctors' Center Hospital and Pesquera are the only remaining defendants in this litigation. The parties filed four motions in limine. (Docket Nos. 53, 65, 66 and 67.) The Court continued trial to adjudicate these motions. (Docket Nos. 82 and 95.)

II. The Plaintiffs' Motions in Limine

The plaintiffs filed three motions in limine. (Docket Nos. 65, 66 and 67.) José Díaz, Olga Díaz and Ramos seek to preclude the Doctors' Center Hospital and Pesquera from presenting expert testimony at trial, and from using the transcripts from Dávila and Miller's depositions. Id.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cite This Page — Counsel Stack

Bluebook (online)
342 F. Supp. 3d 218, Counsel Stack Legal Research, https://law.counselstack.com/opinion/diaz-casillas-v-doctors-ctr-hosp-san-juan-usdistct-2018.