Hyams v. Cleveland Clinic Found.

2012 Ohio 3945
CourtOhio Court of Appeals
DecidedAugust 30, 2012
Docket97439
StatusPublished
Cited by4 cases

This text of 2012 Ohio 3945 (Hyams v. Cleveland Clinic Found.) is published on Counsel Stack Legal Research, covering Ohio Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hyams v. Cleveland Clinic Found., 2012 Ohio 3945 (Ohio Ct. App. 2012).

Opinion

[Cite as Hyams v. Cleveland Clinic Found., 2012-Ohio-3945.]

Court of Appeals of Ohio EIGHTH APPELLATE DISTRICT COUNTY OF CUYAHOGA

JOURNAL ENTRY AND OPINION No. 97439

JARED HYAMS, ET AL. PLAINTIFFS-APPELLEES

vs.

CLEVELAND CLINIC FOUNDATION, ET AL.

DEFENDANTS-APPELLANTS

JUDGMENT: AFFIRMED

Civil Appeal from the Cuyahoga County Common Pleas Court Case No. CV-636016

BEFORE: Boyle, P.J., Cooney, J., and Kilbane, J.

RELEASED AND JOURNALIZED: August 30, 2012 ATTORNEYS FOR APPELLANTS

Anna M. Carulas Ingrid Kinkopf-Zajac Douglas G. Leak Roetzel & Andress, LPA One Cleveland Center, 9th Floor 1375 East Ninth Street Cleveland, Ohio 44114

ATTORNEYS FOR APPELLEES

Christopher M. Mellino Thomas D. Robenalt Allen C. Tittle Mellino Robenalt LLC 19704 Center Ridge Road Rocky River, Ohio 44116 MARY J. BOYLE, P.J.:

{¶1} Defendants-appellants, the Cleveland Clinic Foundation and Barbara

Wechsler (collectively “the Clinic”), appeal a jury verdict for plaintiffs-appellees, Jared

Hyams and his parents, Douglas and Linda Hyams (collectively “the Hyamses”), on their

medical malpractice action. The gravamen of their appeal is that the Hyamses’ expert

witness, Dr. Robert Granacher, was not competent to testify at trial, and therefore the trial

court should have granted a directed verdict in their favor. They further challenge

several evidentiary rulings. Finding no merit to the appeal, we affirm.

Procedural History and Facts

{¶2} In April of 2005, Linda and Douglas Hyams took their son, Jared, who was

nine years old at the time, to the Cleveland Clinic after Jared had developed an

unexplained limp and unsteady gait. Jared was evaluated by pediatric neurologist Neil

Friedman, who thought that Jared presented with signs of a “conversion disorder.” A

conversion disorder is “a neuropsychiatric condition and that the symptom or deficit

cannot after appropriate investigation be fully explained by a general medical condition.”

Swaiman, Ashwal, and Ferriero, Swaiman’s Pediatric Neurology: Principles and

Practice (4th Ed.2007). It is a psychological condition that is believed to be caused by

some traumatic experience or other difficulty in the person’s life. {¶3} Following outpatient physical therapy, Dr. Friedman ultimately referred

Jared to the day hospital program at the Cleveland Clinic Children’s Hospital for

Rehabilitation (“day hospital”) for treatment of conversion disorder and inability to walk.

At the day hospital, Dr. Wechsler, a pediatric rehabilitation specialist, oversaw Jared’s

treatment.

{¶4} Jared’s day hospital program included physical and occupational therapy

daily, multiple counseling sessions with a clinical social worker or psychologist, and

attendance at school and social interaction programs. According to Dr. Wechsler’s

discharge summary, any efforts to “normalize [Jared’s] left foot posture” were

abandoned, however, when “the factitious nature of Jared’s ambulatory problems became

apparent.” The day hospital staff was committed to enforcing a consistent behavioral

plan, such that, according to Dr. Wechsler, “Jared is beginning to recognize that his

behaviors have consequences.” Jared’s behavior plan at the day hospital included

certain reinforcement measures, such as “[i]f he falls during walking he owes 5 sit ups per

fall; [i]f he touches the wall/chair/person while walking he owes 5 push ups.”

{¶5} Jared was in the day hospital program from May 3, 2005 until May 31,

2005. Upon his discharge, staff members of the day hospital program visited Jared’s

school for his school re-entry meeting. Their recommendations focused on the belief

that Jared “is seeking attention by manipulating the adults around him and falling into the

sick role and enjoying the attention he is receiving from this.” Consequently, the school

re-entry recommendations included, among others, the following: Jared should be treated as any other child and should receive the natural

consequences of any other child for being tardy to class or uncooperative to

perform his work. His gait is currently atypical and no focus should be

placed on how he is walking in the school environment. He should not be

assisted during walking with any hand holding. * * * It is important to treat

him as a healthy young boy and not allow him to manipulate adults.

{¶6} The Hyamses were also instructed to follow the same behavior plan used at

the day hospital for Jared, focusing on the importance of not rewarding Jared with

attention or help when he failed to walk properly. Likewise, the Hyamses were

instructed to specifically withhold privileges from Jared, such as eating at the table with

the family, if he did not walk properly.

{¶7} Jared’s condition however continued to deteriorate. Finally, while being

seen by a psychiatrist unaffiliated with the Cleveland Clinic, a dystonia gene panel was

ordered and taken in April 2006. Through this blood test, it was discovered that Jared

does not have a conversion disorder, but instead, a rare genetic disorder — dystonia.

According to the Dystonia Foundation, dystonia is defined as a movement disorder that

causes muscles to contract and spasm involuntarily. The dystonia is what caused Jared’s

inability to walk and his steady physical deterioration.

{¶8} The Hyamses subsequently filed the underlying medical malpractice suit

against the Clinic, Dr. Friedman, and Dr. Wechsler, alleging that Dr. Friedman was

negligent by failing to properly diagnose the dystonia and that, assuming Jared even had a conversion disorder, Dr. Wechsler’s treatment plan was a “substandard treatment plan.”

They alleged that the treatment plan “psychologically traumatized, humiliated, and

isolated Jared.” According to the Hyamses’ medical expert, Dr. Granacher, the

behavioral plan for Jared was punitive and not acceptable for a nine-year-old boy. Dr.

Granacher further testified that the treatment plan caused “significant psychological

injuries” to Jared. Conversely, the Clinic’s expert testified that Jared’s treatment plan

was a reasonable and acceptable approach to the treatment of a conversion disorder.

The Clinic’s expert maintained that it was not a punitive plan and that Jared did not suffer

emotional or psychological injuries as a result of the plan.

{¶9} The case proceeded to trial where the jury ultimately found that Dr. Friedman

was not negligent but that Dr. Wechsler was negligent in the following two areas: (1)

“negligent in creation and implementation of the behavior plan at the day hospital and

into the Hyams[es’] household”; and (2) “negligent in the creation and implementation of

the behavior plan into the school reentry recommendation.” The jury then awarded

Jared $590,000 in past and future non-economic loss, the mother $200,000 in damages,

and the father $100,000 in damages. The trial court subsequently reduced the total

award to the statutory cap of $500,000.

{¶10} The Clinic appeals, raising the following five assignments of error:

“[I.] The trial court abused its discretion in failing to strike the trial testimony of

plaintiffs-appellees’ expert Robert Granacher, M.D. “[II.] The trial court erred in failing to grant defendants-appellants’ motion for a

directed verdict.

“[III.] The trial court abused its discretion in allowing plaintiffs-appellees to play

misleading bits and pieces of videotaped depositions.

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