Kniceley v. Migala

603 N.E.2d 843, 237 Ill. App. 3d 72, 177 Ill. Dec. 773, 1992 Ill. App. LEXIS 1797
CourtAppellate Court of Illinois
DecidedNovember 6, 1992
Docket2-91-1192
StatusPublished
Cited by9 cases

This text of 603 N.E.2d 843 (Kniceley v. Migala) 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
Kniceley v. Migala, 603 N.E.2d 843, 237 Ill. App. 3d 72, 177 Ill. Dec. 773, 1992 Ill. App. LEXIS 1797 (Ill. Ct. App. 1992).

Opinions

JUSTICE DUNN

delivered the opinion of the court:

Plaintiff, Roger Kniceley, filed a medical malpractice action against defendant, James Mígala, M.D. Following a jury trial, the circuit court of Du Page County entered judgment in defendant’s favor, and plaintiff now appeals. The issues are as follows: (1) whether two physicians who examined plaintiff for the purpose of determining whether he was disabled for worker’s compensation purposes should have been allowed to provide opinion testimony as to the cause of plaintiff’s injury and the standard of care applicable to defendant when neither was disclosed within the deadlines set forth in Supreme Court Rule 220 (134 Ill. 2d R. 220); (2) whether it was error to permit defendant, a physician, to testify about the standard of care applicable to surgical technologists; (3) whether testimony by defendant that he had never experienced a breakage problem with a certain surgical device was relevant; and (4) whether certain references by the defense to collateral source payments were prejudicial and require a new trial. We reverse and remand.

Plaintiff was a police officer for the Village of Villa Park. On July 10, 1985, he twisted his left knee while walking up a steep incline. After seeing one physician, he was referred to defendant, an orthopedic specialist.

Plaintiff first saw defendant on July 30, 1985. Defendant believed that plaintiff had suffered a torn medial meniscus. During a subsequent visit, plaintiff informed defendant that the pain had not subsided. Plaintiff agreed to undergo arthroscopic surgery, which was scheduled for September 5, 1985.

The initial arthroscopy revealed that plaintiff’s medial meniscus was not damaged. Instead, he had suffered a lateral subluxating patella, which means that his kneecap was not properly aligned. Defendant performed a procedure called a retinacular release in order to realign the kneecap.

A few weeks after the surgery, plaintiff noticed that he would sometimes feel a small hard object about the size of a jelly bean toward the surface of his left knee. The object would cause a great deal of pain. Plaintiff, however, was always able to push it back inside the knee, and the pain would subside.

Plaintiff saw defendant again on October 11, 1985. Defendant felt that plaintiff may have had a loose body in his knee. A loose body is an item such as a piece of bone or cartilage that somehow breaks off. Defendant scheduled plaintiff for a second arthroscopy on October 31, 1985.

Defendant did not discover a loose body during the second arthroscopy. He did, however, remove a synovial plica from the knee. Synovial plica is a fold consisting of tissue. By early December, plaintiff was improving and only experiencing a little pain. His knee locked on January 30, 1986, and plaintiff reported this when he saw defendant the next day. Defendant believed that a loose body was present, and he scheduled plaintiff for a third arthroscopy on February 18,1986.

During the third arthroscopy, defendant found a one-inch piece of plastic in plaintiff’s left knee. He removed the object and discovered that it was the tip from a cannula, a device used in arthroscopies. After the cannula is placed inside the knee during an arthroscopy, water tubing is hooked up to the cannula so that a saline solution can be circulated through the knee during the operation. Defendant admitted that the piece from the cannula must have broken off during one of the prior arthroscopies, most likely the first.

Plaintiff underwent physical and occupational therapy, but was unable to return to work as a police officer because of recurrent difficulties with his left knee which resulted from damage to the articular cartilage. Dr. Gerald Kane, an orthopedic surgeon who testified as an expert witness on plaintiff’s behalf, stated that he believed the damage to the articular cartilage resulted from the cannula tip that was left in plaintiff’s knee. Dr. Kane further testified that defendant deviated from the applicable standard of care by failing to inspect the cannula after the operation. Kane stated that all surgical instruments placed inside the patient’s body should be inspected following surgery because instruments can break while inside the patient.

Frank Cassara, a certified surgical technologist, assisted defendant in all three arthroscopies. Cassara testified that he performed the duties of what is commonly referred to as a scrub nurse. He was not a registered nurse, however. Nancy Germany, a licensed registered nurse who had assisted as a scrub nurse during hundreds of arthroscopies, testified that, in her opinion, Cassara had deviated from the applicable standard of care by failing to inspect the cannula at the end of the operation. Plaintiff did not sue Cassara, but did allege in his complaint that defendant was vicariously liable for the negligence of Cassara, who was defendant’s employee.

Defendant testified that, in his opinion, the applicable standard of care did not require him to inspect a plastic cannula after it was removed from a patient during an arthroscopy. He explained that a cannula is not like surgical instruments that are used to probe or cut into a patient’s knee. Instead, the cannula is merely a device that is placed in the patient’s knee during the operation. Defendant stated, over plaintiff’s objection, that, as of the time of the initial arthroscopy performed on plaintiff, he had never heard that plastic cannulas have any tendency to break and that none had ever broken during arthroscopies in which he had used them.

Defendant further testified as follows. In his opinion, Frank Cassara did not deviate from the standard of care applicable to surgical technicians by failing to inspect the plastic cannula after the operation. Furthermore, in his opinion, the damage to plaintiff’s articular cartilage resulted from the original injury rather than the presence of the cannula tip inside plaintiff’s knee.

Dr. Robert Stone, an orthopedic physician, testified as follows. Plaintiff visited his office once a year between 1987 and 1989 for the purpose of having his left knee examined. Dr. Stone diagnosed plaintiff as suffering from complications relating to a subluxated patella. After each visit he prepared and signed a letter stating that plaintiff was unable to return to work as a result of the trouble with his knee. Dr. Stone did not know at the time of these examinations that a cannula tip had been left in plaintiff’s knee for several months. He was not sure if this caused any of the damage to plaintiff’s knee. He stated that the damage was consistent with the original injury that plaintiff suffered.

Dr. Satya Kaushal, an orthopedic physician who examined plaintiff’s knee on April 28, 1987, testified as follows by means of an evidence deposition. In his opinion, the damage to plaintiff’s left knee resulted from the original injury rather than the cannula tip that had been left in the knee. Originally, Dr. Kaushal stated that he was not sure if he had Dr. Mígala’s office records at the time he examined plaintiff. After having his recollection refreshed, Dr. Kaushal stated that he did have those records at the time and would have therefore been aware that the cannula tip had been in plaintiff’s knee for several months.

Dr.

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Bluebook (online)
603 N.E.2d 843, 237 Ill. App. 3d 72, 177 Ill. Dec. 773, 1992 Ill. App. LEXIS 1797, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kniceley-v-migala-illappct-1992.