Lanzone v. Zart, 2007-L-073 (3-28-2008)

2008 Ohio 1496
CourtOhio Court of Appeals
DecidedMarch 28, 2008
DocketNo. 2007-L-073.
StatusPublished
Cited by4 cases

This text of 2008 Ohio 1496 (Lanzone v. Zart, 2007-L-073 (3-28-2008)) 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
Lanzone v. Zart, 2007-L-073 (3-28-2008), 2008 Ohio 1496 (Ohio Ct. App. 2008).

Opinion

OPINION
{¶ 1} Appellants, Suzanne Lanzone ("Ms. Lanzone"), individually and on behalf of her minor daughter, Gina, appeal the Lake County Court of Common Pleas judgment entered against her. For the reasons that follow, we affirm.

{¶ 2} Statement of Facts and Procedural History

{¶ 3} On May 26, 2006, Ms. Lanzone filed a medical malpractice action against appellees/cross-appellants, Janie M. Zart, M.D. ("Dr. Zart") and her employer, Prime Health, Inc. ("Prime Health"), and defendants, Liese Vito, M.D., Lake Hospital System, Inc. and Lake West Hospital.1 The complaint alleged, inter alia, that the defendants failed to manage Ms. Lanzone's prenatal care and negligently and/or recklessly failed to offer Ms. Lanzone a Cesarean section ("C-section") delivery, which resulted in Gina being born with a left brachial plexus injury. Following extensive discovery and just prior to trial, Ms. Lanzone voluntarily dismissed defendants Liese Vito, M.D., Lake Hospital System, Inc. and Lake West Hospital.

{¶ 4} Beginning on November 9, 2006, a four-day trial was held. In addition to testifying about her prenatal care, delivery, and the subsequent care and treatment for Gina, Ms. Lanzone presented the following witnesses: 1) Nancie Arsham, occupational therapist from Therapy Specialists, who testified regarding her treatment of Gina for her brachial plexus injuries; 2) Dorene A. Spak, president of Life Care Technologies, who conducted a vocational assessment of Gina; 3) Geraldine Zampini, maternal grandmother of Gina; 4) Geriann Bagdonis, Ms. Lanzone's sister; 5) Christine Gielink, Ms. Lanzone's friend who was present during the delivery; 6) economist, Dr. Harvey Rosen, who testified regarding Gina's diminished earning capacity; and 7) expert witness, Dr. Stuart Edelberg, who testified that appellee, Dr. Zart, had breached the *Page 3 standard of care regarding informed consent. Dr. Edelberg opined that the standard of care was breached by Dr. Zart's failure to provide Ms. Lazone with informed consent regarding risks and dangers present in her pregnancy, and for failing to discuss with Ms. Lanzone the option of having a C-section delivery.

{¶ 5} Defense counsel presented the testimony of 1) Dr. Zart, and the videotaped testimony of expert witnesses, 2) Dr. Michael Belfort, and 3) Dr. James Nocon. In essence, Dr. Zart and these expert witnesses testified that Dr. Zart did not breach the standard of care in this case.

{¶ 6} Evidence Regarding Prenatal Care and Delivery

{¶ 7} Ms. Lanzone began treating with Dr. Zart beginning in February of 2000. Her estimated due date was October 10, 2000. Toward the end of her pregnancy, on September 13, 2000, at 36 weeks, an ultrasound examination revealed an unusually large baby, weighing 3590 grams, placing her in the 90th percentile of weight. Because the expected growth of a baby in the final weeks of pregnancy is between 200-250 grams a week, Dr. Zart estimated that Ms. Lanzone's baby would weigh 4500 grams (approximately 10 pounds) if the pregnancy went to term.

{¶ 8} According to the American College of Obstetrics and Gynecologists (ACOG) standards in place in 2000, a birth weight of 4500 grams for a nondiabetic mother is defined as "macrosomia," or large for gestational age, and carries with it certain inherent risks, including the risk of shoulder dystocia, which is a complication of labor and delivery in which one or both of the baby's shoulders becomes lodged behind the mother's pubic bone. More recently, the ACOG increased the birth weight to 5000 grams to be deemed macrosomia. *Page 4

{¶ 9} Due to the expected high birth weight, Dr. Zart decided to induce Ms. Lanzone two weeks early. On September 27, 2000, Ms. Lanzone was admitted to Lake West Hospital for induction. On the hospital admission chart, Dr. Zart noted that the estimated fetal weight was nine pounds. She also noted in three places on the hospital chart "suspected macrosomia." Dr. Zart had Ms. Lanzone sign a general informed consent form, which indicated that a C-section would be required in the event of certain serious complications. However, at no time did Dr. Zart inform Ms. Lanzone the risk of shoulder dystocia with a large birth weight baby and a vaginal delivery, nor was she offered the option of a C-section given the estimated high birth weight. Ms. Lanzone testified that had she been fully informed of the risks, she would have opted for a C-section delivery.

{¶ 10} Subsequent to the induction of labor, Ms. Lanzone endured a long labor that included between two and one-half to three hours of pushing. During the delivery, Ms. Lanzone's baby encountered shoulder dystocia. Dr. Zart utlilized two maneuvers to free the baby's shoulders. Gina was later diagnosed with a left brachial plexus injury, and as a result, she has limited strength and function in her left arm. Gina's birth weight was 4,044 grams, or 8 pounds and 14 ounces.

{¶ 11} Expert Testimony Regarding Liability and Informed Consent

{¶ 12} The expert witnesses agree that when there is macrosomia, the standard of care requires the physician to discuss the risks or offer the mother the option of a C-section delivery. Thus, if the birth weight is estimated to be below 4500 grams in a non-diabetic mother, the option of a C-section need not be offered. The experts also agreed that the risk for shoulder dystocia increases with the increase in the baby's birth weight. *Page 5

{¶ 13} Ms. Lanzone's expert witness, Dr. Edelberg, opined that Dr. Zart breached the standard of care regarding informed consent. Dr. Edelberg interpreted Dr. Zart's notations of "suspected macrosomia" in the hospital records to mean that Dr. Zart suspected at the time of Ms. Lanzone's admission that the baby was macrosomic. Thus, according to Dr. Edelberg, Dr. Zart was required to fully inform Ms. Lanzone of all risks associated with the macrosomia so that she could make an informed decision of whether to accept the risks and proceed with a vaginal delivery or to opt for a C-section delivery.

{¶ 14} Defense experts, Dr. Belfort and Dr. Nocon, disagreed with this interpretation and emphasized that in their opinions Dr. Zart did not breach the standard of care by failing to offer Ms. Lanzone a C-section. They based their opinions on the fact that the estimated birth weight, as recorded in the chart, was nine pounds, less than that of a macrosomic baby. In their opinions, there was no reason to offer Ms. Lanzone a C-section delivery where the estimated weight was nine pounds.

{¶ 15} At the close of the trial, following deliberations, the jury returned a defense verdict. Ms. Lanzone filed a motion notwithstanding the verdict and a motion for a new trial, which the trial court overruled. The court found there was competent, credible evidence to support the defense verdict.

{¶ 16} Ms. Lanzone filed the instant appeal, raising two assignments of error:

{¶ 17} "[1.] The trial court erred to the prejudice of Plaintiffs-Appellants in denying their Motion For Judgment Notwithstanding the Verdict and/or Motion for a New Trial.

{¶ 18}

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Bluebook (online)
2008 Ohio 1496, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lanzone-v-zart-2007-l-073-3-28-2008-ohioctapp-2008.