Howard v. Kowalski

823 N.W.2d 302, 296 Mich. App. 664
CourtMichigan Court of Appeals
DecidedMay 29, 2012
DocketDocket No. 297066
StatusPublished
Cited by4 cases

This text of 823 N.W.2d 302 (Howard v. Kowalski) is published on Counsel Stack Legal Research, covering Michigan Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Howard v. Kowalski, 823 N.W.2d 302, 296 Mich. App. 664 (Mich. Ct. App. 2012).

Opinion

Per Curiam.

Plaintiff appeals by right a judgment of no cause of action in this medical malpractice case, asserting that certain evidentiary rulings resulted in the denial of a fair trial. Specifically, plaintiff contends that the trial court abused its discretion by not admitting as an exhibit for impeachment purposes an affidavit of a nonparty doctor-witness and by excluding presuit correspondence concerning the affidavit between plaintiffs attorney and a representative of the witness’s insurer. We conclude the trial court abused its discretion and that the error was not harmless. We reverse and remand.

I. FACTUAL BACKGROUND

Plaintiffs decedent, Barbara Johnson, a horse owner, was severely bitten in the face by one of her mares while assisting in the birth of a foal. Although the bite resulted in deep gashes below her right eye and along her jaw that caused heavy bleeding, Mrs. Johnson managed to call for an ambulance and also called her daughter. The decedent was transported to the emergency room (ER) of the defendant hospital, arriving at about 2:38 p.m., according to the emergency medical services report. Defendant, Robert E Kowalski, M.D., the physician on duty in the ER at the time, assessed Mrs. Johnson at about 2:45 p.m., finding that she was alert and oriented. There was bleeding into her mouth, but her airway was open and being maintained by the suctioning of blood as needed.

Dr. Kowalski testified that between 2:50 and 2:52 p.m., he requested the assistance of an ENT1 and [668]*668ananesthesiologist “STAT” to help manage Mrs. Johnson’s airway and that a medical helicopter be summoned to transport her to a larger hospital with better trauma treatment capability. Dr. Charles Urse, an anesthesiologist, responded, and shortly thereafter Dr. Lisa Jacobson, an ENT specialist, also responded to the “STAT” call for assistance. Both Drs. Kowalski and Urse testified in their pretrial depositions and at trial that Mrs. Johnson had been relatively stable when they were at her bedside discussing the best medical procedure to maintain the patency of her airway. About 3:00 p.m., Dr. Kowalski was called away to another emergency room patient who had gone into cardiac arrest. Thereafter, at about 3:05 p.m., Mrs. Johnson began having more serious difficulty breathing, crying out that she could not breathe. Dr. Urse administered medications and attempted to orally intubate Mrs. Johnson, but the amount of blood in her mouth and throat made it impossible. Dr. Urse, with Dr. Jacobson’s assistance, performed a cricothyroidotomy to ventilate the patient’s lungs by inserting breathing tubes directly through her throat. The procedure was only partially successful, and Mrs. Johnson suffered a cardiac arrest. She was resuscitated and placed on life support, but she had sustained permanent brain damage. Five days later, she was removed from life support and died.

Plaintiffs theory of the case was that when Dr. Kowalski left Mrs. Johnson to attend the other patient, Dr. Urse was not present and assistance was not summoned until after Mrs. Johnson’s condition suddenly deteriorated. Plaintiff contended that Dr. Kowalski was negligent by failing to immediately intubate Mrs. Johnson before being called away to the other patient and leaving Mrs. Johnson unattended. According to plaintiffs theory, Dr. Urse had not arrived until after the patient’s fatal deterioration began at about 3:05 [669]*669p.m. Dr. Urse then took steps to intubate Mrs. Johnson, but blood in her mouth and throat prevented him from completing the procedure. Dr. Urse then performed a cricothyroidotomy with Dr. Jacobson’s assistance. This too was not completely successful because Mrs. Johnson went into cardiac arrest and suffered loss of oxygen to the brain. Plaintiffs counsel formed this theory of the case during the presuit notice-of-intent period, MCL 600.2912b, apparently on the basis of his review of the medical records.

Plaintiffs counsel named Dr. Urse as a potential defendant in plaintiffs notice of intent, MCL 600.2912b, but did not name him in the complaint. On July 26,2007, counsel wrote to Nancy A. Croze, a claims representative for Dr. Urse’s liability insurer, American Physicians Assurance Corporation, advising her that on the basis of his understanding of the facts, Dr. Kowalski bore sole responsibility for the medical accident. After setting forth his understanding of the facts of the case, plaintiff s counsel indicated that he was planning to file a lawsuit only against Dr. Kowalski, assuming that his information was accurate. Counsel stated in his letter that he needed “some kind of verification perhaps in the form of an affidavit by Dr. Urse” that would confirm his understanding of the facts and that counsel “could draft such an affidavit.”

Following the July 26, 2007, letter and other communications with plaintiffs counsel, which included e-mails, Croze wrote to counsel on August 15, 2007, enclosing Dr. Urse’s August 9, 2007, affidavit. Croze stated in her letter: “I am confident that this document will meet your needs as you assess your intentions for pursuit of the case.”

In pertinent part, two paragraphs of the affidavit stated:

[670]*6704. I was contacted, by beeper or through the [operating room] front desk staff (I can’t recall completely which one) in regards to a STAT ER page on patient Barbara Johnson on the afternoon of April 4, 2005. Then I immediately proceeded to the [post anesthesia care unit] to obtain the anesthesia department airway box, and then immediately proceeded to the Emergency Room, arriving within approximately two to three minutes after I was notified.
5. That my findings and treatment are summarized in my hand-written progress note contained in the medical record.

At trial and in his deposition 18 months earlier, Dr. Urse testified contrary to plaintiffs theory of the case that he was, in fact, at Mrs. Johnson’s bedside discussing treatment options with Dr. Kowalski while the patient was stable and before Dr. Kowalski was called away. Dr. Urse further testified that his one-page progress note did not include the events preceding the patient’s acute deterioration and that he signed his affidavit believing that the information desired was the time frame it took for him to arrive at the ER after receiving the stat page. He testified that he never saw the correspondence between plaintiffs counsel and Croze.

Two weeks before trial, the trial court heard and granted defendants’ motion for a protective order regarding plaintiffs effort to subpoena Croze and her file. During the hearing, the court suggested, without deciding, that the Urse affidavit could arguably be used at trial as a prior inconsistent statement to impeach Dr. Urse’s testimony.

On the first day of trial, after a jury had been selected and sworn, plaintiffs counsel sought a ruling from the court on the admissibility and use of Dr. Urse’s affidavit and the correspondence between plaintiffs counsel and Croze. Counsel argued that plaintiffs “whole case [671]*671rest[ed] upon the medical records which contradict the testimony” of Drs. Urse and Kowalski that they were both present with Mrs. Johnson before the onset of fatal respiratory distress. Plaintiffs counsel agreed that use of the affidavit would be limited to impeaching the anticipated trial testimony of Dr. Urse and that the letters were intended only to provide context for the affidavit.

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Cite This Page — Counsel Stack

Bluebook (online)
823 N.W.2d 302, 296 Mich. App. 664, Counsel Stack Legal Research, https://law.counselstack.com/opinion/howard-v-kowalski-michctapp-2012.