K.R. ex rel. Perez v. United States

843 F. Supp. 2d 343, 2012 WL 512947, 2012 U.S. Dist. LEXIS 19909
CourtDistrict Court, E.D. New York
DecidedFebruary 16, 2012
DocketNo. 08-CV-2192
StatusPublished

This text of 843 F. Supp. 2d 343 (K.R. ex rel. Perez v. United States) is published on Counsel Stack Legal Research, covering District Court, E.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
K.R. ex rel. Perez v. United States, 843 F. Supp. 2d 343, 2012 WL 512947, 2012 U.S. Dist. LEXIS 19909 (E.D.N.Y. 2012).

Opinion

FINDINGS OF FACT AND CONCLUSIONS OF LAW

KUNTZ, District Judge.

Plaintiff K.R. (“Plaintiff’ or “K.R.”) is a minor who brings this medical malpractice action against Defendant United States of America through her mother and natural guardian Daria Perez (“Ms. Perez”) pursuant to the Federal Torts Claims Act, 28 U.S.C. §§ 1346(b), 2671 et seq. (“FTCA”). Plaintiff alleges she wrongfully was subjected to a visual vaginal inspection by employees of the Lutheran Medical Center School Health Program (“Lutheran Program”) while attending Public School 10 (“P.S. 10”) in Brooklyn, New York. Specifically, Plaintiff claims deemed employees of the United States, Patricia Silverman (“Nurse Silverman”), a licensed nurse practitioner, and Nancy Rodriguez (“Ms. Rodriguez”), a licensed medical assistant, departed from the applicable standard of medical care by conducting a visual vaginal inspection on January 13, 2006. Plaintiff argues the medical consent and enrollment form signed by her mother, Ms. Perez, did not provide Nurse Silverman and Ms. Rodriguez consent to perform the visual vaginal inspection.

This Court conducted a four-day bench trial in accordance with 28 U.S.C. § 2402 solely on the issue of liability. Having reviewed the testimony and exhibits, as well as the parties’ post-trial submissions, this Court, pursuant to Rule 52 of the Federal Rules of Civil Procedure, makes the following Findings of Fact and Conclusions of Law. For the reasons set forth below, this Court finds the United States not liable for medical malpractice.

I. Findings Of Fact

A. Background

Plaintiff K.R. is a thirteen-year-old female born on June 13, 1998. At all times relevant to this action, K.R. was a seven-year-old student at P.S. 10 in Brooklyn, New York and was living in the home of her maternal grandparents with her mother and two brothers. Nurse Silverman and Ms. Rodriguez were employees of the Lutheran Program and provided medical care to K.R. on January 13, 2006.

Nurse Silverman has been a licensed adult and family nurse practitioner for approximately fifteen years. Tr. 472:11-20. She began working for the Lutheran Program in September 1997 as a family nurse practitioner. Tr. 479:21-23. She worked full-time at P.S. 10 from September 2005 to January 2009 and treated approximately twenty to twenty-five students per day. Tr. 480:19-481:3; 781:6-16. During her career in the Lutheran Program, Nurse Silverman conducted thousands of visual vaginal inspections. Tr. 758:9-13. She testified she most often conducted these inspections during routine well exams of female students. Otherwise, she performed them to check for trauma, injury, and foreign objects, or to investigate patient complaints about the vaginal area. Tr. 758:14-18. Nurse Silverman has conducted the majority of visual vaginal inspections in the presence of the parent(s) of the student. However, she has conducted at least thirty percent of these inspections without a parent or guardian present. Tr. 758:21-759:9. Each time the parent had been absent, he or she was informed of the inspection afterward. Other than this case, no parent had ever complained about the inspection being conducted by Nurse Silverman outside of a parental presence. Tr. 780:16-781:5.

[346]*346Ms. Rodriguez has been a licensed medical assistant for approximately eleven years. She has been employed by the Lutheran Program since 2002 as a floater medical assistant. Tr. 395:6-396:18. Ms. Rodriguez had observed multiple visual vaginal inspections where the parent was not present. Tr. 437:13-25.

B. The Relevant Medical History Of Plaintiff Prior To January 13, 2006

The pediatrician of Plaintiff is Dr. Vasudev Gabbur. According to the medical records of Dr. Gabbur, K.R. has been a patient since at least July 5, 2005 when she was seen for a well exam. Ex. H. During a subsequent visit on August 20, 2005, K.R. complained of vaginal discharge. According to the medical records of Dr. Gab-bur, Ms. Perez stated K.R. received a bubble bath with dishwashing liquid while at her grandmother’s house the week before and had vaginal discharge for five days. Dr. Gabbur conducted a vaginal exam and diagnosed K.R. with vaginitis.

C. The Enrollment Of Plaintiff In The Lutheran Program

The Lutheran Program is a federally funded healthcare program designed to offer primary medical care to participating students at school and at no cost to their parents. Tr. 482-484. The Lutheran Program utilizes nurse practitioners who can diagnose and treat illness and injury, as well as prescribe medication. Schools participating in the Lutheran Program agree to provide appropriate facilities, equipment, and supplies necessary to render the medical services. Enrollment of a student in the Lutheran Program is entirely optional.

The Lutheran Program operates a school-based clinic at P.S. 10 pursuant to a Memorandum of Understanding dated February 2001. Ex. D; Tr. 710:5-16. Parents voluntarily enroll their child in the Lutheran Program by completing and submitting a Medical Consent and Enrollment form (“General Consent Form”). Ex. A, Tr. 486-^488. The General Consent Form provides two levels of care from which parents can choose to enroll their child. The first option offers “Complete Medical Care” and includes “complete physical examinations, immunizations, routine laboratory tests, treatment for both acute and chronic illnesses, psychological and nutritional counseling, dental, vision and hearing screening, health education and first aid.” Ex. A. The Complete Medical Care option permits a nurse practitioner to conduct a complete physical examination of a child and provide treatment even when a child’s parent is absent. Tr. 489:20-25. The second option offers “First Aid and Health Screening” and includes “only first aid treatment for minor bumps, bruises, cuts or minor complaints, and dental, vision, hearing screening. This level does not include physical examinants [sic] and treatment for illness.” Ex. A. The First Aid and Health Screening, option allows a medical assistant to render first aid, but it does not permit a nurse practitioner to treat and examine a child. Tr. 488:9-24. Therefore, a child requiring immediate medical attention or physical examination would not be able to receive it at the school-based clinic.

Parents wishing to enroll their child in the Lutheran Program select one of the two levels of care on the General Consent Form, sign the form, and indicate their relationship to the child. Parents must provide their home address and telephone, work telephone, and any insurance information. Ex. A; Tr. 486:16-24. In 2006, approximately ninety to ninety-five percent of P.S. 10 students were enrolled in the Lutheran Program. Of those stu[347]*347dents, approximately ninety percent of the parents selected the Complete Medical Care option. Tr. 397:16-18.

Ms. Perez enrolled K.R. in P.S. 10 on March 1, 2005. Tr. 142:22-25. On the same day, Ms. Perez enrolled K.R. in the Lutheran Program by signing and submitting a General Consent Form. Ex. A; Tr. 141:16-142:3. During the time K.R. attended P.S. 10, Ms.

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Bluebook (online)
843 F. Supp. 2d 343, 2012 WL 512947, 2012 U.S. Dist. LEXIS 19909, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kr-ex-rel-perez-v-united-states-nyed-2012.