Duran v. Mad River Medical Center

Vermont Superior Court·Decided May 13, 2021·No. 465-8-16 Wncv·Published

Opinion

VERMONT SUPERIOR CIVIL DIVISION COURT Washington Unit Case No. 465-8-16 Wncv 65 State Street Montpelier VT 05602 802-828-2091 www.vermontjudiciary.org

Duran vs. Mad River Medical Center et al

Opinion and Order on Defendants’ Motion for Summary Judgment and Plaintiff’s Motion to Compel

Ms. Patricia Duran 1 (age 63) was found dead in her condominium the day after she was treated for tooth pain by Defendant Deborah Van Dyke, a nurse practitioner at the Mad River Family Practice (MRFP), which is owned by Defendant Central Vermont Medical Center, Inc. (CVMC). Patricia’s brother and the administrator of her estate, Plaintiff Michael Duran, brought this action against Ms. Van Dyke, CVMC, and Defendant Francis Cook, M.D., Ms. Van Dyke’s collaborating physician, asserting several claims of medical malpractice and several other claims of or arising out of alleged misrepresentations to the effect that Ms. Van Dyke was a “doctor” rather than a “nurse.” Defendants have filed a motion for summary judgment addressing the misrepresentation-related claims only.

Generally, Plaintiff alleges that Ms. Van Dyke, in treating Patricia for reported tooth pain, failed to recognize that Patricia, who has suffered her entire life from “salt-losing adrenal hyperplasia (21-hydroxylase deficient type)” also was

1 Ms. Patricia Duran and Ms. Linda Duran are key figures in this decision. For ease of reference, the Court will refer to them by their first names and means no disrespect by using that approach.

experiencing adrenal insufficiency and urgently needed “stress doses” of steroids and immediate hospitalization. Ms. Van Dyke treated the tooth pain with a prescription for antibiotics and instruction to see a dentist and did not recognize or treat adrenal insufficiency. Plaintiff alleges that Ms. Van Dyke’s failure to treat adrenal insufficiency was negligent and caused Patricia’s death the following day. These are the basic allegations of the medical negligence claims not directly at issue at this time (Counts 1, 2, 3, 4, 12, and 13).

Plaintiff separately alleges that Patricia would have “solely” consented to treatment with a “doctor,” as opposed to a nurse practitioner; she actually sought treatment with a doctor; and due to several misrepresentations to the effect that Ms. Van Dyke in fact was a doctor, Patricia in fact believed that she was seeing a doctor. Had she known the truth, Plaintiff alleges, she instead would have sought treatment elsewhere with a doctor. Plaintiff alleges that, had she been seen by a doctor, her adrenal insufficiency would have been properly recognized and treated, implying that the circumstances were such that a competent nurse practitioner would not reasonably have been capable of recognizing Patricia’s adrenal insufficiency but a competent doctor would have. 2 These basic allegations of misrepresentation form the basis of those counts currently at issue: Count 5 (negligent misrepresentation); Count 6 (negligence per se); Count 7 (violation of the Consumer Protection Act (CPA), 9 V.S.A. §§ 2451–2481x); Count 8 (intentional

2 This last step is “implied” to the extent that it is crucial to establishing causation

but nowhere addressed in the evidence in the record. Because the parties do not address it in the context of Defendants’ motion, neither will the court.

misrepresentation); Count 9 (breach of contract and the duty of good faith and fair dealing); Count 10 (violation of the federal Lanham Act, 15 U.S.C. § 1125(a)); Count 11 (respondeat superior of CVMC regarding misrepresentation); Count 14 (civil conspiracy to misrepresent); and Count 15 (punitive damages for misrepresentation). Defendants also seek summary judgment on Counts 2, 3, and 4 (medical malpractice) but only to the extent that those counts include misrepresentation framed as an item of medical malpractice.

I. Summary Judgment Standard Summary judgment is appropriate if the evidence in the record, referred to in the statements required by Vt. R. Civ. P. 56(c)(1), shows that there is no genuine issue as to any material fact and that the movant is entitled to a judgment as a matter of law. Vt. R. Civ. P. 56(a); Gallipo v. City of Rutland, 163 Vt. 83, 86 (1994) (summary judgment will be granted if, after adequate time for discovery, a party fails to make a showing sufficient to establish an essential element of the case on which the party will bear the burden of proof at trial). The Court derives the undisputed facts from the parties’ statements of fact and the supporting documents. Boulton v. CLD Consulting Engineers, Inc., 2003 VT 72, ¶ 29, 175 Vt. 413, 427. A party opposing summary judgment may not simply rely on allegations in the pleadings to establish a genuine issue of material fact. Instead, it must come forward with deposition excerpts, affidavits, or other evidence to establish such a dispute. Murray v. White, 155 Vt. 621, 628 (1991). Speculation is insufficient. Palmer v. Furlan, 2019 VT 42, ¶ 10, 210 Vt. 375, 380.

II. Narrowing the Claims As a preliminary matter, Plaintiff’s negligence per se (Count 6) and Lanham Act (Count 10) claims may be dispensed with summarily, and Plaintiff’s core medical malpractice claims can be limited.

For Count 6, Plaintiff cites several statutes and claims “negligence per se,”

evidently intending to assert liability based on the violation of “safety statutes.” Defendants argued that there is no negligence per se in Vermont, prompting Plaintiff to recharacterize this claim as “prima facie negligence.” There is no tort of prima facie negligence in Vermont, however. A legitimate safety statute provides evidence of a standard of care, the breach of which may give rise to a bursting bubble, rebuttable presumption of negligence. See Sheldon v. Ruggiero, 2018 VT 125, ¶ 24, 209 Vt. 33, 43 (Violation of safety statute “may serve as rebuttable evidence that the defendant breached the applicable standard of care, thereby shifting the burden of production to the defendant.”); see also Marzec-Gerrior v. D.C.P. Industries, Inc., 164 Vt. 569, 572–77 (1995) (Dooley, J., concurring) (criticizing bursting bubble presumption in safety statute context). Nonetheless, there must be an underlying duty to which that standard attaches. Sheldon, 2018 VT 125, ¶¶ 24–25, 209 Vt. at 43–44. In other words, the prima facie negligence rule is not its own independent claim. To the extent that Plaintiff intended Count 6 to assert a claim of negligence predicated on misrepresentation, he already has done

so exhaustively with his other misrepresentation claims. Count 6 is duplicative at most and may be dismissed without any prejudice to Plaintiff. 3 Plaintiff has assented to dismissal of Count 10 (violation of the Lanham Act).

Plaintiff’s three core medical malpractice claims, Counts 2, 3, and 4, address both the alleged misdiagnosis and the alleged misrepresentation. The parties spar as to whether a misrepresentation can ever be properly characterized as medical malpractice, but it is unnecessary to resolve that matter. Even if a misrepresentation as to a provider’s credentials can be characterized as medical malpractice, doing so in this case is entirely duplicative of Plaintiff’s negligent and intentional misrepresentation claims and thus need not be separately considered.

III. Detrimental Reliance Reliance is an element of each of Plaintiff’s core misrepresentation claims:

negligent misrepresentation (Count 5), consumer fraud (Count 7), intentional misrepresentation (Count 8), and civil conspiracy to misrepresent (Count 14). See Union Bank v. Jones, 138 Vt. 115, 121 (1980) (“An action for fraud and deceit will lie upon an intentional misrepresentation of existing fact, affecting the essence of the transaction, so long as the misrepresentation was false when made and known to be false by the maker, was not open to the defrauded party’s knowledge, and was

3 Plaintiff cites as safety statutes the CPA, the Lanham Act, and 26 V.S.A. §§ 129a,

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