Dierl v. Birkin

2023 UT App 6, 525 P.3d 127
CourtCourt of Appeals of Utah
DecidedJanuary 20, 2023
Docket20210756-CA
StatusPublished
Cited by9 cases

This text of 2023 UT App 6 (Dierl v. Birkin) is published on Counsel Stack Legal Research, covering Court of Appeals of Utah primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Dierl v. Birkin, 2023 UT App 6, 525 P.3d 127 (Utah Ct. App. 2023).

Opinion

2023 UT App 6

THE UTAH COURT OF APPEALS

MARTIN J. DIERL, Appellant, v. BARRY M. BIRKIN, Appellee.

Opinion No. 20210756-CA Filed January 20, 2023

Third District Court, Silver Summit Department The Honorable Richard E. Mrazik No. 170500532

David E. Ross II, Attorney for Appellant George T. Naegle, Cortney Kochevar, Kristina H. Ruedas, and Aaron T. Cunningham, Attorneys for Appellee

JUDGE DAVID N. MORTENSEN authored this Opinion, in which JUDGES MICHELE M. CHRISTIANSEN FORSTER and RYAN M. HARRIS concurred.

MORTENSEN, Judge:

¶1 After being injured at a ski resort, Martin J. Dierl underwent a CT scan, which was interpreted by Dr. Barry M. Birkin as being normal. In reality, the scan showed a tumor in Dierl’s brain. Some nine months later, after the tumor became symptomatic, Dierl learned of the tumor and had surgery to remove it. He suffered complications associated with the surgery, including permanent partial loss of vision and pituitary gland damage. Dierl sued Birkin for malpractice.

¶2 The district court granted summary judgment to Birkin because Dierl offered no admissible expert testimony establishing Dierl v. Birkin

that Birkin’s failure to diagnose Dierl’s brain tumor nine months earlier proximately caused Dierl’s injuries. Dierl appeals, arguing that two expert witness affidavits should have been admitted to establish that Dierl sustained worse complications from surgery than he would have sustained if he had undergone surgery earlier. Because we conclude that the trial court appropriately exercised its discretion in excluding both affidavits, we affirm.

BACKGROUND 1

¶3 Dierl was injured at a ski resort in Park City in February 2015 and was taken by ambulance to an emergency room. The attending physician ordered a CT scan of Dierl’s brain. Birkin, a radiologist, interpreted Dierl’s CT brain scan and reported it as a “[n]egative CT,” stating that “[t]here are no intracranial masses.”

¶4 Beginning in November 2015, Dierl began experiencing “severe headaches, loss of balance, dizziness, speech impediment, memory loss[,] and loss of vision.” Dierl saw another doctor, who requested another CT brain scan, along with the records from the earlier brain scan. This doctor “informed Dierl that he had a large tumor in his brain and that was the reason for his suffering and loss of vision.” The doctor “also informed Dierl that the tumor was visible in the [earlier scan] and inquired whether [anyone had] informed him of this large brain tumor.” “Dierl stated that no one had told him” about the tumor after the earlier scan. In

1. “In reviewing the district court’s grant of summary judgment, we view the facts in the light most favorable to [Dierl], as the nonmoving party.” Nelson v. 15 White Barn Drive LLC, 2022 UT App 106, n.3, 517 P.3d 1062 (cleaned up).

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December 2015, “Dierl underwent a right pterional craniotomy[2] for resection of the tumor.”

¶5 Dierl later filed a complaint for medical negligence against Birkin. Dierl alleged that Birkin “breached the standard of care in failing to diagnose Dierl’s brain tumor,” which “grew and placed pressure against his optic nerves and pituitary [gland].” Dierl further asserted that Birkin’s “breach of the standard of care [was] the proximate cause of Dierl’s injuries.”

¶6 Dierl timely disclosed a neurosurgeon (Neurosurgeon 1) as an expert witness. Birkin elected to take Neurosurgeon 1’s deposition, wherein Neurosurgeon 1 testified that the tumor grew by four millimeters—from twenty to twenty-four millimeters— over the course of the nine months following the February 2015 CT scan. Neurosurgeon 1 also testified that had the tumor been detected in February 2015, it was “most likely that surgical treatment, direct craniotomy, would have been carried out,” as it had been in December 2015. Neurosurgeon 1 agreed that— regardless of the size of the tumor—this type of surgery carries certain risks, including “pituitary dysfunction, visual impairment, fluid leak, incomplete resection, [and] damage to the hypothalamus.” And Neurosurgeon 1 testified that following Dierl’s surgery, Dierl did in fact experience “an increase in his

2. A craniotomy is “[a]n operation in which a small hole is made in the skull or a piece of bone from the skull is removed to show part of the brain. A craniotomy may be done to remove a brain tumor or a sample of brain tissue. . . . The piece of bone that is removed from the skull is usually put back in place after the surgery has been done.” Craniotomy, Nat’l Cancer Inst., https://www.cancer.gov/publications/dictionaries/cancer-terms/ def/craniotomy [https://perma.cc/HCF9-2H9C].

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visual loss and panhypopituitarism.” 3 After this, the following exchange occurred:

Q. Can you say, to a reasonable degree of medical probability, that . . . Dierl would not have experienced an increase in his visual loss or panhypopituitarism if the surgery had been performed in February 2015?

A. Well, my opinion is that his risk of those [complications] would be less, had he had surgery in or around February 2015, as compared to December of 2015.

Q. That’s fair. And my question is a little bit different, though. I understand that you—it’s your opinion that there is an increased risk there, but can you say, to a reasonable degree of medical probability, that had . . . Dierl undergone surgery in February of 2015, that he would not have had an increased visual loss?

A. No.

Q. And can you say, to a reasonable degree of medical probability, that had . . . Dierl undergone surgery in February of 2015, that he would not have experienced complications related to panhypopituitarism?

3. Panhypopituitarism is “[a] rare condition in which the pituitary gland stops making most or all hormones.” Panhypopituitarism, Nat’l Cancer Inst., https://www.cancer.gov/publications/dictiona ries/cancer-terms/def/panhypopituitarism [https://perma.cc/HH Q7-XS88].

20210756-CA 4 2023 UT App 6 Dierl v. Birkin

....

Q. My question is, can you say, to a reasonable degree of medical probability, that had . . . Dierl undergone surgery in February of 2015, that he would not have the exact same injury to his vision today?

A. No, because I would be—I would be speculating.

Q. Okay. Same question in regards to his panhypopituitarism. . . . [H]ad the surgery been completed in February of 2015, can you say, to a reasonable degree of medical probability, that . . . Dierl would not have experienced the exact same injury to his pituitary gland that he experienced following his surgery in December of 2015?

¶7 Later, Birkin filed a motion for summary judgment, arguing that Dierl had “failed to establish a prima facie case of medical negligence against Birkin with expert testimony” because “Dierl’s only causation expert failed to establish that any delay in diagnosis of . . . Dierl’s tumor caused . . . Dierl actual damages.” Birkin further argued that Dierl’s “reliance upon merely an increased risk of surgical complication, but nothing more, does not amount to actual damages and cannot sustain a cause of action for medical negligence.”

¶8 Dierl opposed the motion and provided a new affidavit by Neurosurgeon 1 stating, “Affiant opines that due to the significant enlargement of the tumor from February 2015 to December 2015[,] . . . Dierl’s vision loss was greater than it would have been if the

20210756-CA 5 2023 UT App 6 Dierl v. Birkin

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Bluebook (online)
2023 UT App 6, 525 P.3d 127, Counsel Stack Legal Research, https://law.counselstack.com/opinion/dierl-v-birkin-utahctapp-2023.