Griffin v. Subram

606 N.E.2d 560, 238 Ill. App. 3d 712, 179 Ill. Dec. 728, 1992 Ill. App. LEXIS 1900
CourtAppellate Court of Illinois
DecidedNovember 24, 1992
Docket1-91-2104
StatusPublished
Cited by4 cases

This text of 606 N.E.2d 560 (Griffin v. Subram) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Griffin v. Subram, 606 N.E.2d 560, 238 Ill. App. 3d 712, 179 Ill. Dec. 728, 1992 Ill. App. LEXIS 1900 (Ill. Ct. App. 1992).

Opinion

PRESIDING JUSTICE HARTMAN

delivered the opinion of the court:

This is an appeal from the jury verdict and judgment for defendant, Dr. Aswath Subram, and against plaintiff, Gene Griffin, administrator of the estate of his deceased wife, Annie Griffin (Griffin). Plaintiff’s post-trial motion, seeking a new trial on all issues, was denied. Plaintiff appeals. Although plaintiff raises several issues for review, we need address only two: namely, whether the circuit court erred by permitting the jury, during its deliberation, to examine an exhibit which was not in evidence, and whether the court erred in allowing defense counsel excessive leeway in questioning defendant after his adverse witness testimony.

On March 3, 1984, Griffin, age 37, was admitted to South Suburban Hospital, where she was examined by Dr. R. Singh, a neurosurgeon, who advised a laminectomy. This surgical procedure was performed by Dr. Singh on March 14, 1984, assisted by Dr. S. Kumar, a general surgeon, and Dr. R. Palaniappan, an anesthesiologist.

During the surgery, Griffin sustained a sudden and dramatic loss of blood pressure, frequently a symptom of massive internal bleeding. During the post-operative period, Griffin remained in shock, requiring transfusions of blood and other fluids. On March 15, 1984, the day after surgery, Dr. Kumar discovered a “murmur,” a noise in the abdomen, which was further evidence of a vascular injury in that area. Dr. Subram was called in as a vascular specialist, to consult on Griffin’s condition at 10:30 a.m., March 16, 1984. Dr. Subram found the patient in serious condition, in shock, with evidence that her liver and kidneys were failing.

Dr. Subram considered, among other possibilities, that the patient’s deteriorating condition was the result of a vascular injury, suffered during surgery. He heard the murmur previously recorded by Dr. Kumar. He noted the findings of a hematologist indicating the “possibility” of internal bleeding, but did not order the recommended CAT scan to confirm the findings. He did not attempt or dictate surgical intervention to repair the injury at that time or at any time during the next 17 hours, until Griffin’s death at 3:20 a.m., March 17,1984.

Dr. Subram was of the opinion that Griffin could not withstand an operation until and if her coagulopathy, the ability of her blood to clot, was improved through further transfusions of blood and platelets. The level of platelets can be accelerated by using “packs,” a concentration of platelets, but Dr. Subram did not administer such “packs” to Griffin until 9 p.m., nearly 12 hours after he first examined her.

Griffin arrested at 9:50 p.m. and was revived. Dr. Subram did not then consider taking her to surgery. Although he admitted that there are many instances in which a doctor would operate on a patient in less than optimal conditions in order to correct the source of the instability, Dr. Subram did not believe that was necessary in Griffin’s case. He was of the opinion that, following the vascular injury, an arteriovenous fistula had formed. An “AV fistula,” according to him, is a temporary connection between an injured artery and vein which closes the circulatory system and prevents further massive bleeding. He admitted he never had performed surgery to correct an AV fistula. He did not consult with any other vascular surgeon.

Before trial, a settlement was reached between plaintiff and all parties named in the complaint, except for Dr. Subram.

Plaintiff moved in limine to preclude any testimony regarding the alleged negligence or medical malpractice of any other physician, person or institution, and sought to confine the issue at trial to what Dr. Subram did, or did not do, during the period of 10:30 a.m., March 16, 1984, to 3:20 a.m., March 17, 1984. The motion was denied. Plaintiff thereafter moved to reconsider, arguing that: (1) Dr. Subram could not rely on a defense that a third party previously or concurrently may have committed negligence; (2) allowing testimony that other physicians were also negligent invited the jury to improperly apportion loss and render a compromise verdict, contrary to Illinois law; and (3) any defense must rest on proof that Dr. Subram was free of negligence. The motion was denied.

The trial began March 6, 1991. During his opening statement, defense counsel introduced the theory of his case that Griffin’s prior treating physicians, alone, violated the standard of care by failing immediately to detect, diagnose and repair the vascular injury which apparently occurred during the surgical procedure. Plaintiff’s objections to a conclusion not based upon expert opinion and defendant’s further speculation that the other doctors “didn’t want to acknowledge” the presence of bleeding were overruled.

Dr. Subram was called by plaintiff as an adverse witness. Plaintiff questioned defendant with the frequent use of leading questions. When defense counsel questioned him, counsel continued the use of leading questions, as upon cross-examination. Plaintiff objected to the continued use of leading questions by the defense. Plaintiff was overruled, the court explaining that, in This view, since plaintiff had been permitted to lead the witness, defense counsel could do so as well.

Plaintiff also objected to defense counsel improperly eliciting from defendant opinions concerning areas of medicine in which he had no expertise; that were based upon previously undisclosed literature; and that were beyond the scope of the adverse examination. Plaintiff’s request for a sidebar hearing, to consider the correctness of the court’s ruling, was denied.

Dr. Philip Haid testified as plaintiff’s expert. In his opinion, defendant violated the standard of care in the specialty of vascular surgery by failing to operate on Griffin in a timely manner to correct the vascular injury which occurred during surgery. He believed the patient had a 60% chance of recovery with corrective surgery, but had no chance of survival without such a procedure. It was Dr. Haiti’s opinion that Griffin would have had a normal life expectancy had she survived the suggested corrective surgery.

During cross-examination of Dr. Haiti, defense counsel introduced a compilation of figures, selected by counsel from Griffin’s hospital records, in the form of a large chart. The chart was marked as defendant’s exhibit No. 4, for identification. The figures on the chart represented the measure of patient’s hemoglobin, hematocrit and platelets before, during and after surgery. Dr. Haiti agreed that such figures were indicators of whether or not a patient is bleeding, but disagreed with the contention that the apparent stabilization of hemoglobin and hematocrit, following transfusions, meant that Griffin was not actively bleeding, or that an AV fistula had formed. Dr. Haiti testified that the autopsy report showed no evidence of an AV fistula.

Dr. James Schuler testified as defendant’s expert. He agreed with defendant’s conclusion that an AV fistula had formed and was not, of itself, a major risk for the patient. Dr. Schuler based his opinion on the history of hematocrit values which had returned to a near-normal level, following transfusions of plasma and platelets. Dr. Schuler concurred with defendant’s decision to postpone surgery because of the apparent bleeding disorder.

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Bluebook (online)
606 N.E.2d 560, 238 Ill. App. 3d 712, 179 Ill. Dec. 728, 1992 Ill. App. LEXIS 1900, Counsel Stack Legal Research, https://law.counselstack.com/opinion/griffin-v-subram-illappct-1992.