DiGeronimo v. Fuchs

33 Misc. 3d 206
CourtNew York Supreme Court
DecidedAugust 4, 2011
StatusPublished

This text of 33 Misc. 3d 206 (DiGeronimo v. Fuchs) is published on Counsel Stack Legal Research, covering New York Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
DiGeronimo v. Fuchs, 33 Misc. 3d 206 (N.Y. Super. Ct. 2011).

Opinion

OPINION OF THE COURT

Joseph J. Maltese, J.

Facts

The plaintiff was 34 years old when she sought prenatal care from Dr. Fuchs on September 25, 2003 after becoming pregnant [208]*208by in vitro fertilization. The plaintiff is a Jehovah’s Witness, and is firmly opposed to receiving “allogenic” blood products derived from other persons. The plaintiff alleges she chose providers of obstetrical care who she believed would honor her desire not to receive allogenic blood products. The plaintiff claims that she would have accepted an “autologous” blood transfusion derived from her own blood for any necessary transfusion, but not the blood of others. A health care proxy signed in 1995, nine years before this hospital admission, explicitly directed that no allogenic blood transfusions should be administered to her.

The plaintiff states she chose Staten Island University Hospital (SIUH) as a medical care provider because SIUH offered “cell salvage technology” and advertised a “bloodless” medicine and surgery program. Cell salvage technology, also known as “cell saver” technology, collects blood cells from a patient that would otherwise have been lost during a surgical procedure, processes those blood cells, and reinfuses the cells into the same patient. By seeking out cell salvage technology, the plaintiff implied she was not opposed to autologous blood transfusions, i.e., the reinfusion of her own blood. The plaintiff alleges she advised Dr. Fuchs of her beliefs. She believed he would create a treatment plan that would use, when necessary and possible, autologous blood transfusions and other medications and procedures acceptable to her and concordant with her beliefs as a Jehovah’s Witness.

The plaintiff never provided the hospital with any of her own blood nor was she advised to deposit any blood for possible future use. During this pregnancy, the plaintiff saw Dr. Fuchs as an outpatient from September 2003 through March 31, 2004. Because the plaintiff was already pregnant when she first saw Dr. Fuchs, she was not a candidate to donate her own blood for storage. On December 5, 2003, a sonogram performed at SIUH showed total placenta previa, a condition where the placenta sits over the birth canal. On February 17, 2004, a second sonogram showed only marginal placenta previa, which is a partial covering of the birth canal. On March 26, 2004, a third sonogram showed a low lying placenta situated two centimeters from the cervical opening and not actually in or over any part of the birth canal.

One week later, on April 3, 2004, the plaintiff entered SIUH because she had vaginal bleeding and early onset labor. Upon admission to the labor and delivery area, the plaintiff was hav[209]*209ing irregular contractions, and her cervix was dilated to between four and five centimeters. Because a previous test showed the plaintiff was colonized with Group B Streptococcus, the plaintiff received two doses of intravenous ampicillin, which is an antibiotic. This prophylactic antibiotic therapy was followed by augmentation of labor with Pitocin, a synthetic oxytocin that enhances cervical contractions to assist giving birth. The next day, on April 4, 2004, Dr. Fuchs performed a median episiotomy (a cervical incision of the vaginal opening that facilitates vaginal delivery). A healthy male infant was delivered at 11:40 a.m., and at 11:44 a.m. the placenta was delivered. However, bleeding continued despite further treatment with Pitocin and uterine massage.

A manual exploration of the uterus extracted fragments of retained placental tissue. Because of persistent bleeding, the patient was brought to an operating room. Uterine curettage was performed, and additional placental tissue was extracted. However, bleeding continued despite the administration of Methergine and Hemabate (medications to staunch the flow of blood), and despite uterine packing. Although other modalities of treatment were considered, Dr. Fuchs performed a supra-cervical hysterectomy without cell saving technology.

Because of her total blood loss, the plaintiff was advised that she would die without an allogenic blood transfusion. Dr. Fuchs asserts that the plaintiff indicated her husband should decide whether she should be transfused. In extremis, the plaintiff finally nodded consent, but due to her weakened condition, she could not sign the consent forms herself. The plaintiffs husband had authority as a health care proxy for his wife. He signed the forms to indicate the plaintiff’s consent to receive allogenic blood transfusions. The plaintiff now states she has no recollection of these events.

The plaintiff was transfused with two units of allogenic packed red blood cells, two units of allogenic fresh frozen plasma and one unit of cryoprecipitate. The plaintiff was stabilized and she was given Procrit to stimulate the bone marrow to produce red blood cells. Following the plaintiffs surgery, she was first taken to the recovery room, and then to an intensive care unit.

SIUH and Dr. Fuchs state that pathological examination of the uterus later showed placenta increta, a penetration of the placenta into the uterine musculature associated with increased risk of uterine hemorrhage. Five days later, on April 9, 2004 the patient had improved adequately and she was discharged from the hospital.

[210]*210Discussion

“[Mjedical malpractice is a breach of a doctor’s duty to provide his or her patient with medical care meeting a certain standard.”1 “The requisite elements of proof in a medical malpractice action are a deviation or departure from accepted community standards of practice and evidence that such departure was a proximate cause of injury or damage.”2

“On a motion for summary judgment, a defendant doctor has the burden of establishing the absence of any departure from good and accepted medical practice or that the plaintiff was not injured thereby.”3 “In opposition, a plaintiff must submit evidentiary facts or materials to rebut the defendant’s prima facie showing, so as to demonstrate the existence of a triable issue of fact.”4 In actions founded upon medical malpractice, where there are conflicting medical opinions, any issue of credibility must be resolved by a trier of fact.5 To succeed in a defendant’s motion for summary judgment, the defendant must prove every critical element of the defense.6 Similarly, the plaintiffs motion must show proof of each material element of the cause of action.7 Where the plaintiffs claim fails to state each essential element of a claim, the claim must be dismissed.8 The Plaintiff Has Failed to Make a Prima Facie Case for Medical Malpractice

The plaintiff provided an expert affidavit from Dr. Jeffrey Soffer, M.D., who alleged deviations from the standard of care that resulted in the plaintiff receiving transfusions. According to Dr. Soffer, the plaintiff had arrested dilation during delivery, which by itself showed the need for a caesarean section. Dr. Soffer reasoned that a caesarean section would have obviated the need for the blood transfusion. He further stated that notwithstanding the ultrasonic imaging, placenta previa should have been anticipated and a caesarean section should have been done as an early option. Further, Dr. Soffer stated that, although he [211]

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Cite This Page — Counsel Stack

Bluebook (online)
33 Misc. 3d 206, Counsel Stack Legal Research, https://law.counselstack.com/opinion/digeronimo-v-fuchs-nysupct-2011.