Frances Parker, Etc. v. John W. Poole, M.D.

111 A.3d 101, 440 N.J. Super. 7
CourtNew Jersey Superior Court Appellate Division
DecidedMarch 17, 2015
DocketA-1874-12
StatusPublished
Cited by33 cases

This text of 111 A.3d 101 (Frances Parker, Etc. v. John W. Poole, M.D.) is published on Counsel Stack Legal Research, covering New Jersey Superior Court Appellate Division primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Frances Parker, Etc. v. John W. Poole, M.D., 111 A.3d 101, 440 N.J. Super. 7 (N.J. Ct. App. 2015).

Opinion

NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION

SUPERIOR COURT OF NEW JERSEY APPELLATE DIVISION DOCKET NO. A-1874-12T4

FRANCES PARKER, Individually and as General Administratrix of the ESTATE OF DALE S. APPROVED FOR PUBLICATION PARKER, March 17, 2015 Plaintiff-Appellant, APPELLATE DIVISION v.

JOHN W. POOLE, M.D.,

Defendant-Respondent,

and

HOLY NAME HOSPITAL and DOUGLAS BENSON, M.D.,

Defendants. ————————————————————————————————————————

Argued October 7, 2014 – Decided March 2, 2015

Before Judges Yannotti, Hoffman and Whipple.

On appeal from Superior Court of New Jersey, Law Division, Bergen County, Docket No. L- 7098-09.

Dennis T. Smith argued the cause for appellant (Pashman Stein, attorneys; Mr. Smith and David G. White, on the briefs).

Philip F. Mattia argued the cause for respondent (Mattia & McBride, P.C., attorneys; Mr. Mattia, on the brief). The opinion of the court was delivered by

HOFFMAN, J.A.D.

Plaintiff Frances Parker, individually and as administrator

of the estate of her late husband, Dale Parker ("Mr. Parker"),

appeals from the no cause jury verdict returned in the medical

malpractice case against her husband's surgeon, defendant John

W. Poole, M.D., and from the order denying plaintiff's motion

for a new trial. Plaintiff contends that the trial court erred

in excluding certain evidence. For the reasons that follow, we

reverse and remand for a new trial.

I.

We begin by summarizing the most pertinent trial evidence.

Mr. Parker was diagnosed with colon cancer when a tumor was

discovered during a colonoscopy. A biopsy had revealed that Mr.

Parker had an invasive adenocarcinoma of the colon,1 and he was

referred to defendant to immediately undergo surgery to remove

the tumor. Defendant, a board-certified general surgeon, saw

decedent for a surgical consult on February 13, 2009. Defendant

performed the surgery, a transverse colon resection, to remove

the tumor on February 19, 2009. After removing the tumor,

1 According to defendant, invasive adenocarcinoma of the colon is a "pathologic diagnosis," which "means the tumor has spread beyond the basic membrane of the lining of the intestine," creating "a risk for it to . . . further spread."

2 A-1874-12T4 defendant performed an open anastomosis, sewing the colon back

together, to close the opening. Defendant reported no

difficulties during the surgery.

After the surgery, Mr. Parker remained in the hospital. At

some point between February 22 and 23, he developed

complications. On February 23, nurses observed blood-tinged

fluid coming from the surgical site. Examination by defendant

revealed that Mr. Parker had developed a dehiscence.2 Based on

the risk of the incision re-opening, defendant decided to

perform a second operation to repair the dehiscence.

On February 24, defendant performed the second surgery.

During the procedure, defendant noticed some "murky fluid in the

abdominal wound." As a result, he investigated to determine if

there was an anastomotic leak, a hole or perforation in the

intestine that allows intestinal contents to leak into the

abdomen. While defendant testified, "We never saw a hole[,]

[w]e never saw a perforation," he nevertheless decided to resect

or remove the anastomosis. He explained, "I felt the

anastomosis was not perfect[;] . . . my job as a surgeon was to

make the anastomosis perfect." Defendant continued to follow

Mr. Parker after the surgery on the 24th; however, "he had a

2 According to plaintiff's surgical expert, David Befeler, M.D., "dehiscence is a failure of the abdomen wall closure," meaning "the abdominal wall comes apart."

3 A-1874-12T4 cataclysmic rapid demise and ultimately expired early on the

26th."

Plaintiff's theory in the case was that defendant

negligently performed the first anastomosis, creating a leak,

which led to sepsis, and that defendant then negligently failed

to address the sepsis. Specifically, plaintiff contended that,

because defendant encountered evidence of infection in the

second surgery, he should have performed an ileostomy, a

procedure where a loop of small bowel would have been

externalized to stop feces from coming into the abdomen, and

then drained the abdomen to remove the purulent fluids, and

allowed Mr. Parker to heal. Once healed, Mr. Parker could have

undergone a re-anastomosis. Defendant indicated that he

performs such "ostomy" procedures "all the time."3

The defense disputed the source of the sepsis which caused

Mr. Parker's death, as well as the timing of the onset of the

sepsis. At trial, plaintiff sought to introduce defendant's

deposition testimony, specifically, an exchange in which

defendant responded to a question about the cause of Mr.

Parker's death:

Q: Why did Mr. Parker die?

3 Defendant explained, "when we externalize the colon, it's a colostomy, when we externalize the small bowel, it's an ileostomy."

4 A-1874-12T4 A: It appears that he got septic, though I'm not sure why he had such a rapid demise.

Q: To what did you attribute the sepsis?

[Defendant's Counsel]: Objection, but you can answer.

A: I have to assume that it was related to the anastomotic leak.

When plaintiff sought to read this deposition excerpt into

the record as part of her case, defendant objected, arguing that

the language he used in response ("I would have to assume") was

speculative. Plaintiff argued that it was an admission by a

party-opponent and thus admissible under N.J.R.E. 803(b)(1),

regardless of any claimed speculative nature.

The trial court sustained the objection, finding the

testimony speculative. The court also appeared to question the

propriety of plaintiff attempting to elicit expert testimony

from defendant.

Essentially, what plaintiff urges — it converts [defendant] into an expert witness. It's asking him to render an opinion when, in fact, he's being called as a fact witness. Now we have a number of expert witnesses who have opined as to Mr. Parker's cause of death. [I]t's not really a [N.J.R.E.] 701 [issue], where we're asking for opinion testimony of a lay witness because it's not [an] opinion as to . . . how fast was he going in your common experience.

5 A-1874-12T4 It's an opinion that requires expertise. The reality, it seems, is that the . . . cause of death isn’t so much the ultimate question here. . . . [T]he ultimate question is, whether or not [defendant] departed from the standard of care required of him. And I do think that it is asking for, again over the objection of [defendant's] attorney, for him to become an expert witness against himself.

And in addition to that, it is cumulative and it is calling for speculation on his part. And therefore, I'm going to uphold [defendant's] objection and I'm not going to allow it to be read into evidence[.]

On direct examination, defendant testified that "Mr. Parker

had no evidence of sepsis at the time leading up to the [second]

surgery, at the time of the surgery, and immediately in the

recovering room after the surgery."4 Nevertheless, in the

operative report defendant dictated immediately after the second

surgery, he wrote, "I did not want to take the chance the

anastomosis was leaking and would cause further sepsis."

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Bluebook (online)
111 A.3d 101, 440 N.J. Super. 7, Counsel Stack Legal Research, https://law.counselstack.com/opinion/frances-parker-etc-v-john-w-poole-md-njsuperctappdiv-2015.