Fellin v. Sahgal

296 A.D.2d 526, 745 N.Y.S.2d 565, 2002 N.Y. App. Div. LEXIS 7540
CourtAppellate Division of the Supreme Court of the State of New York
DecidedJuly 22, 2002
StatusPublished
Cited by4 cases

This text of 296 A.D.2d 526 (Fellin v. Sahgal) is published on Counsel Stack Legal Research, covering Appellate Division of the Supreme Court of the State of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Fellin v. Sahgal, 296 A.D.2d 526, 745 N.Y.S.2d 565, 2002 N.Y. App. Div. LEXIS 7540 (N.Y. Ct. App. 2002).

Opinion

In an action to recover damages for medical malpractice, etc., the plaintiffs appeal, as limited by their brief, from so much of an order of the Supreme Court, Kings County (Spodek, J.), dated February 13, 2001, as granted those branches of the defendants’ motion which were to set aside the verdict, to dismiss the cause of action relating to the giving of medications, and for a new trial on the cause of action relating to delayed diagnosis and treatment, and the defendants cross-appeal from so much of the same order as denied that branch of their motion which was to dismiss the cause of action relating to delayed diagnosis and treatment.

Ordered that the order is modified by deleting the provision [527]*527thereof granting that branch of the defendants’ motion which was to dismiss the cause of action relating to the giving of medications; as so modified, the order is affirmed insofar as appealed and cross-appealed from, without costs or disbursements, and the matter is remitted to the Supreme Court, Kings County, for a new trial.

This medical malpractice action arose on January 31, 1991, when David Fellin (hereinafter the plaintiff), who worked as an elevator repairman for Long Island College Hospital (hereinafter LICH), suddenly experienced pain in his back. At 11:40 a.m. that day, the plaintiff walked into LICH’s emergency room and complained that he felt pressure on his back. The plaintiff, then age 23, was otherwise a healthy man who had no prior medical history. At 12:30 p.m., the plaintiffs vital signs were taken and were normal, including a blood pressure reading of 130/90. At about 1:00 p.m., the plaintiff reported that the back pain had subsided, but he felt “a lot of headache” and he had vomited. At 1:30 p.m., the plaintiffs vital signs and blood pressure were still essentially normal. Nevertheless, he continued to experience a lot of pain in his head and the vomiting had not ceased. At approximately 2:00 p.m., the defendant Dr. Vivek Sahgal conducted a gross neurological exam of the plaintiff. This exam revealed that the plaintiff was alert and oriented, that both pupils were equally reactive, and that he had normal movement in his extremities. At this time the plaintiffs blood pressure remained within normal limits, but he continued to complain of back pain radiating up to his head. As a result, Sahgal ordered a CAT scan to be performed on the plaintiff.

At approximately 2:45 to 3:00 p.m., before the CAT scan test could be done, the plaintiffs blood pressure spiked to an unacceptably high level, and he suddenly deteriorated into a comatose state. Ultimately, brain surgery was performed to save the plaintiffs life. He survived, but remains in a chronic debilitated state. It was thereafter determined that prior to 11:40 a.m. the plaintiff suffered an initial bleed (subarachnoid hemorrhage) from an aneurysm located in his right middle cerebral artery, and at 3:00 p.m. the aneurysm ruptured completely, thereby discharging a massive amount of blood into the brain. The blood and resulting pressure caused a shift and herniation of the plaintiffs brain stem.

Following a trial, the jury was asked to consider two theories of liability: (1) whether LICH committed malpractice by failing to obtain a timely CAT scan and operate immediately without obtaining further testing, and (2) whether Sahgal and/or LICH committed malpractice by not giving any medications to reduce [528]*528the plaintiffs blood pressure prior to 3:00 p.m. The jury returned a verdict in favor of the plaintiffs on both issues, and awarded substantial damages.

Upon the defendants’ post-verdict motion, inter alia, to set aside the verdict, the Supreme Court determined that there was legally sufficient evidence to support the jury verdict on the issue of delayed treatment, but that it was against the weight of the evidence. Thus, the court set aside the verdict on that cause of action and ordered a new trial. As for the issue of giving medications to lower the plaintiffs blood pressure, the Supreme Court granted that branch of the defendants’ motion which was to dismiss that cause of action, finding that there was legally insufficient evidence to support the jury’s determination.

We disagree with the Supreme Court to the extent that it concluded there was legally insufficient evidence to support the conclusion that the defendants were liable for their failure to administer medication (specifically, the drug “mannitol”) at some point before the plaintiff experienced a catastrophic brain aneurysm. To conclude as a matter of law that a jury verdict is not supported by sufficient evidence, there must be “no valid line of reasoning and permissible inferences which could possibly lead rational men to the conclusion reached by the jury on the basis of the evidence presented at trial” (Nicastro v Park, 113 AD2d 129, 132; see Cohen v Hallmark Cards, 45 NY2d 493, 499). In this case, there was a valid line of reasoning by which one could conclude that the defendants’ failure to administer Mannitol during the relevant period constituted a departure from good and accepted medical practice. The plaintiffs’ expert, Dr. Lawrence Shields, specifically testified that Mannitol should have been administered to the plaintiff at an early stage to reduce intracranical pressure. In Shields’ opinion, this medication, along with certain other non-medicinal efforts, would have “bought some additional time.” It is this additional time or “window of opportunity” which was crucial since it could have allowed the pre-operative procedures to have been completed without concomitantly running an inordinate risk of severe neurological impairment.

On the other hand, the defendants’ expert opined that Mannitol was contraindicated because during the relevant time period, the plaintiff was awake, not confused, and his pupils were equal in size, all of which indicated that he did not have a “mass inside [his] head that’s on the verge of ruining [him] or taking [his] life.” Most significantly, the defense maintained that Mannitol should not be given where, as here, the patient’s [529]*529blood, pressure readings were within normal parameters. In any event, the fact that there was disagreement between Shields and the defense experts regarding the propriety and/or efficacy of administering Mannitol is not a basis upon which to conclude that the evidence on this issue was legally insufficient (see generally Gonzalez v Lok K. Cheng, 287 AD2d 595, lv denied 97 NY2d 613; Halkias v Otolaryngology-Facial Plastic Surgery Assoc., 282 AD2d 650).

However, the determination that the defendants committed malpractice by not administering Mannitol was against the weight of the evidence. A jury verdict should be set aside as against the weight of the evidence where “the jury could not have reached the verdict on any fair interpretation of the evidence” (Nicastro v Park, 113 AD2d 129, 134; Delgado v Board of Educ., 65 AD2d 547, affd 48 NY2d 643). Setting aside a jury verdict as against the weight of the evidence “requires a discretionary balancing of many factors” (Nicastro v Park, supra at 133). Moreover, as we noted in Nicastro (at 136): “[t]hat discretion is at its broadest when it appears that the unsuccessful litigant’s evidentiary position was particularly strong compared to that of the victor. At that point, the question is whether the result the jury reached is so contrary to the conclusion that might fairly have been reached on the basis of the evidence that the court should exercise its power to overturn the jury’s determination.”

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Cite This Page — Counsel Stack

Bluebook (online)
296 A.D.2d 526, 745 N.Y.S.2d 565, 2002 N.Y. App. Div. LEXIS 7540, Counsel Stack Legal Research, https://law.counselstack.com/opinion/fellin-v-sahgal-nyappdiv-2002.