Krznaric v. Summa Rehab Hosp., L.L.C.

2024 Ohio 4776, 253 N.E.3d 838
Ohio Court of Appeals·Decided October 2, 2024·No. 30318·Published

Opinion

STATE OF OHIO ) IN THE COURT OF APPEALS )ss: NINTH JUDICIAL DISTRICT COUNTY OF SUMMIT )

STEPHEN J. KRZNARIC, as the Personal C.A. No. 30318 Representative of the Estate of Frances M. Krznarich, (deceased)

Appellant APPEAL FROM JUDGMENT ENTERED IN THE

v. COURT OF COMMON PLEAS COUNTY OF SUMMIT, OHIO

SUMMA REHAB HOSPITAL, LLC et al. CASE No. CV-2019-09-3536

Appellees

DECISION AND JOURNAL ENTRY Dated: October 2, 2024

PER CURIAM.

{¶1} Plaintiff-Appellant Stephen J. Krznaric, as the Personal Representative of the Estate of Frances M. Krznarich, appeals the judgment of the Summit County Court of Common Pleas. This Court reverses and remands the matter for proceedings consistent with this decision.

I.

{¶2} Mr. Krznaric is the son of Ms. Krznarich. In September 2018, Ms. Krznarich was admitted to Defendant-Appellee Summa Rehab Hospital, LLC, a short-term, acute rehabilitation hospital. At the time of Ms. Krznarich’s admission to Summa Rehab Hospital, LLC she was under the care of Defendant-Appellee Dane Donich, M.D. for acute, chronic subdural hematoma. She was to follow up with Dr. Donich at a separate appointment. Dr. Donich’s practice is Defendant- Appellee Donich Neurosurgery and Spine, LLC.

{¶3} The staff at Summa Rehab Hospital, LLC observed that Ms. Krznarich was sometimes confused and experienced both hallucinations and agitation. This was aggravated by the fact that she could not speak English fluently. She was designated as a fall risk as she had previously fallen. Due to her extreme fall risk, she was ordered to have 24/7 supervision, which consisted of a bed alarm, video monitoring, and an in person full-time sitter at her bedside to monitor her. Summa Rehab Hospital, LLC employee Tammy Kimmel, a licensed practical nurse, was assigned as Ms. Krznarich’s primary sitter.

{¶4} Summa Rehab Hospital, LLC’s records reflected that Ms. Krznarich was scheduled for a follow-up outpatient appointment with Dr. Donich on September 17, 2018. Kristen Grund, a registered nurse and case manager at Summa Rehab Hospital, LLC, was responsible for assessing and arranging the appropriate transport needs. Ms. Grund, through a secretary, arranged transport by ambulette through American Medical Response (“AMR”), which could accommodate Ms. Krznarich in her wheelchair.

{¶5} Ms. Kimmel was responsible for Ms. Krznarich’s transfer to the AMR driver. In her deposition, Ms. Kimmel testified that she “went over the stuff: [Ms. Krznarich] was confused. She had the Foley. She was a high fall risk.” Ms. Kimmel also handed the driver “the transport form[,]” but was not the person that filled it out. Ms. Grund completed the form. The form that was given to the driver is also described as the ambulette form in the transcript.

{¶6} When asked about more hypothetical situations involving patients similar to Ms.

Krznarich, Ms. Kimmel stated that she would tell the transport driver that “she’s confused; that she will get up; that * * * she had a Foley bag. That’s it.” Ms. Kimmel was then asked if she would make sure to tell the transport driver that the driver had to stay with Ms. Krznarich, Ms. Kimmel responded, that “[t]hat was on the form.” When Ms. Kimmel was asked again if she would tell a

transport driver of a patient who was at a high fall risk to stay with the patient, Ms. Kimmel indicated that she did not say those exact words. Instead, she “told him about the Foley [bag]; that she gets up, that she’s a high fall risk. That’s, that’s pretty much it.” Ms. Kimmel was then asked if she would verbally tell the transport driver that the driver had to stay with the patient. Ms. Kimmel responded, “Yes. I mean, go over the …” However, the remainder of her answer was cut off by the next question. Nevertheless, Ms. Kimmel indicated it was her understanding that the driver would stay with Ms. Krznarich and return to Summa Rehab Hospital, LLC.

{¶7} Within this Court’s record is a three-page document which is authenticated by an attorney from Summa Rehab Hospital, LLC as being a true and accurate copy of AMR records produced by Mr. Krznaric. There is no indication within the affidavit that that document is the same one utilized in Ms. Kimmel’s deposition, which was not marked as an exhibit. In fact, there were no exhibits accompanying Ms. Kimmel’s deposition. One of the three pages related to the transport in the record is the AMR Ohio Jobs and Family Services Ambulette Certification of Medical Necessity Form. That form was signed by Ms. Grund and contained the handwritten notation “wait and return[.]” That notation is off to the side and is not labeled as a note or instruction to the transport driver. Ms. Grund testified at her deposition that, she did not make the handwritten notes, a secretary did. Ms. Kimmel did not use the phrase “wait and return” at all during her deposition.

{¶8} Upon arrival at Dr. Donich’s office, the AMR transport driver handed the paperwork to Tia Cruise, the front desk receptionist, and then left the office. Ms. Cruise called Summa Rehab Hospital, LLC to inquire if a family member or nurse was coming to the appointment and explained that patients are not typically brought to appointments without accompaniment. She did not recall Summa Rehab Hospital, LLC’s response.

{¶9} After being advised that Ms. Krznarich was unattended, in a wheelchair with an alarm, on a Foley catheter, and appearing confused, Jessica Herraiz, a nurse practitioner at Dr. Donich’s office, also contacted Summa Rehab Hospital, LLC. Amber Lally, a registered nurse and as-needed supervisor at Summa Rehab Hospital, LLC took the call from Ms. Herraiz. Ms. Herraiz advised Ms. Lally that Ms. Krznarich’s appointment had been previously cancelled. Ms. Herraiz also asked why no one was with Ms. Krznarich and indicated that she was confused. Ms. Herraiz informed Ms. Lally that Dr. Donich would see Ms. Krznaric but, in the future, someone needed to accompany her.

{¶10} According to Dr. Donich’s deposition testimony, he became aware at some point during the appointment that Ms. Krznarich was unaccompanied. Dr. Donich stated that the failure of the AMR driver to remain with the patient was unusual and that medical transport drivers routinely stay during the entirety of the office visit, including while in the exam room. He advised that neurology visits do not typically have modesty concerns because they involve only the head and neck areas. Dr. Donich indicated that someone should have been present with her for the duration of her time at the office and that his practice did not have the staffing to provide that care.

{¶11} Following the exam, Ms. Krznarich was placed in the lobby to wait for the AMR driver. Ms. Cruise witnessed Ms. Krznarich attempt to stand from her wheelchair. Ms. Cruise went to the lobby to help Ms. Krznarich sit back down, then returned to her desk. Ms. Cruise witnessed Ms. Krznarich stand again, catch her right foot on her left foot, and fall to the ground. Ms. Cruise went to Ms. Krznarich’s aid and remained with her until EMS arrived.

{¶12} Ms. Krznarich was transported to Akron City Hospital. Mr. Krznaric was not notified that Ms. Krznarich had an appointment, and, when he stopped to see her, he was notified that she had fallen at the appointment and was enroute to the hospital.

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Krznaric v. Summa Rehab Hosp., L.L.C., 2024 Ohio 4776, 253 N.E.3d 838 (Ohio Ct. App. 2024).

2024 Ohio 4776 (Krznaric v. Summa Rehab Hosp., L.L.C.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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