Estiverne ex rel. Estiverne v. Esernio-Jenssen

910 F. Supp. 2d 434, 2012 WL 6721079, 2012 U.S. Dist. LEXIS 183059
CourtDistrict Court, E.D. New York
DecidedDecember 14, 2012
DocketNo. 06 CV 6617(NG)(RLM)
StatusPublished
Cited by7 cases

This text of 910 F. Supp. 2d 434 (Estiverne ex rel. Estiverne v. Esernio-Jenssen) is published on Counsel Stack Legal Research, covering District Court, E.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Estiverne ex rel. Estiverne v. Esernio-Jenssen, 910 F. Supp. 2d 434, 2012 WL 6721079, 2012 U.S. Dist. LEXIS 183059 (E.D.N.Y. 2012).

Opinion

OPINION AND ORDER

GERSHON, District Judge.

Plaintiffs Mario Estiverne and Nativida Antoine (the “Adult Plaintiffs”), individually and on behalf of their infant children, Andrew Estiverne, Dyan Estiverne, and Mario Estiverne, Jr. (collectively, the “Infant Plaintiffs”), bring this action, under 42 U.S.C. § 1983, alleging that defendant Debra Esernio-Jenssen, M.D., and her employers, defendants Long Island Jewish Medical Center (“LIJ”) and its parent corporation, North Shore — Long Island Jewish Health Systems, Inc. (“Hospital Defendants”), violated Adult Plaintiffs’ Fourteenth Amendment rights, as well as Infant Plaintiffs’ Fourth and Fourteenth Amendment rights, by improperly detaining and testing Andrew, as well as working with the State to petition for the removal of Infant Plaintiffs from Adult Plaintiffs’ custody. Plaintiffs also bring, under New York state common law, claims for medical malpractice and gross negligence.1 The case was tried by the court without a jury.

[437]*437Findings of Fact and Conclusions of Law

A trial on liability and damages was held on various dates between October 22, 2012 and November 19, 2012.2 Twelve witnesses testified: (1) Dr. Martin Wolpin, plaintiffs’ medical expert; (2) Mario Estivferne; (3) Nativida Antoine; (4) Mario Estiverne, Jr.; (5) Dyan Estiverne; (6) Andrew Estiverne; (7) Dr. Dan Bariev, then-LIJ Chief of Pediatric Radiology; (8) Dr. David Godfried, then-LIJ Pediatric Orthopedic Surgeon; (9) Dr. Jenssen, then-LIJ Pediatrician; (10) Dr. Timothy Radomisli, Hospital Defendants’ medical expert; (11) Rasheda Goodwine, child protective caseworker for the Administration for Children’s Services (“ACS”); and Reginald Bartholemy, plaintiffs’ pastor. In addition, the parties submitted the deposition transcripts of several additional witnesses, including some who testified at trial. Based on the preponderance of the credible evidence, as well as the parties’ post-trial memoranda, the following are my findings of fact and conclusions of law, pursuant to Rule 52(a) of the Federal Rules of Civil Procedure.

Findings of Fact

Prior to trial, the parties stipulated that LIJ is a privately owned and operated hospital and that Schneider Children’s Hospital (“Schneider”) is also a private hospital which was.owned and operated by LIJ.

The Testing and Diagnosis of Andrew

On Saturday, November 27, 2004, Adult Plaintiffs took Andrew, then nine months old, to the emergency room at Schneider, reporting to the emergency room doctor that Andrew had been favoring his right wrist, which was slightly swollen. Ms. Antoine reported that Andrew had on and off fevers over the prior week, up to 101 degrees, and that he had had two infections in the previous month, both of which had resolved. She also informed the doctor that Andrew was learning to stand and would fall at times. An x-ray showed that Andrew had buckle fractures of the right distal radius and ulna, with periosteal elevation. Andrew’s arm was therefore put in a splint.

Two doctors who examined Andrew in the emergency room — an orthopedic and a pediatric resident — concluded that tests should be run in order to rule out osteomyelitis.3 Blood tests and blood cultures4 were taken in order to further investigate this potential diagnosis. An MRI was also recommended; an MRI potentially could reflect whether osteomyelitis was present. Andrew was admitted to Schneider for further testing and to await the outcome of the laboratory tests. At the time of Andrew’s admission, the doctors who had examined Andrew believed'that there was a low suspicion of abuse, although the pediatric resident did contact another doctor at Schneider to discuss the potential of abuse. That doctor, Dr. Clifford Nerwin, was a pediatric attending physician who is consulted on potential abuse cases when Dr. Jenssen, who is the head of the Schneider Child Protection Consultation Team, is off duty. Dr. Nerwin directed that a skeletal [438]*438survey and ophthalmologic exam be scheduled.

On the morning of November 28, 2004, Dr. Dan Bariev, Schneider’s Chief of Pediatric Radiology, reviewed Andrew’s x-rays. Dr. Bariev determined that the two fractures were 7-10 days old and were of an unusual nature in a child under the age of one. Generally speaking, traumatic buckle fractures occurred only in older, larger children who could walk and whose body mass was significant enough to cause sufficient force, should the child trip and fall, to break the child’s bone. In addition, Dr. Bariev noted that there was not an appropriate clinical history of Andrew’s injuries. Because Andrew was non-verbal, he could indicate neither the cause of the injury nor any additional injuries that he may have had, and Andrew’s parents could not identify how the injury occurred. Dr. Bariev therefore agreed that the previously recommended skeletal survey and ophthalmologic exam should be performed to determine whether any other fractures or unidentified injuries were present. Ordering such tests was standard in cases of unexplained fractures in children of this age because, if there were additional fractures or injuries of which the parents were unaware, they would require treatment. In addition, the results of such testing could reflect whether abuse or neglect was occurring. Dr. Bariev also observed that there was no indication of osteomyelitis. He did note, however, that osteomyelitis could not be ruled out and that, if a clinical concern for such a diagnosis was identified by Andrew’s treating doctors, follow up testing would be required.

On the morning of November 29, 2004, Andrew’s case was referred to Dr. David Godfried, an attending orthopedic surgeon with a specialty in pediatric orthopedics. After reviewing Andrew’s chart and the results of the blood test, Dr. Godfried agreed that there was no evidence of osteomyelitis. Despite a slight initial elevation of Andrew’s white blood cell count (an indicator of infection), a closer look at the levels of specific white blood cells most frequently associated with a bacterial infection — namely, mature and immature neutrophils — reflected normal to below normal levels, a result that did not indicate osteomyelitis. In addition, although Andrew’s sedimentation rate was elevated (another possible indication of infection), Dr. Godfried believed this to be the result of a recent ear infection for which Andrew had been treated. Because Dr. Godfried, who had many times treated children for osteomyelitis, believed that there was no likelihood that Andrew had such an infection, he indicated that an MRI was unnecessary.5 Also, an MRI would require anesthesia and a team of hospital staff who specialized in infant MRIs, which was not justified in light of the lack of evidence of osteomyelitis. Like Dr. Bariev and Dr. Nerwin, however, Dr. Godfried was of the opinion that Andrew needed additional testing to determine whether there were other undetected fractures. Dr. Godfried also found a moderate to low suspicion of abuse.

Later in the day on November 29, 2004, defendant Jenssen examined Andrew for the first time. As noted above, in addition to being a Schneider pediatrician, Dr. Jenssen was the coordinator of Schneider’s Child Protective Consultation Team.

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910 F. Supp. 2d 434, 2012 WL 6721079, 2012 U.S. Dist. LEXIS 183059, Counsel Stack Legal Research, https://law.counselstack.com/opinion/estiverne-ex-rel-estiverne-v-esernio-jenssen-nyed-2012.