Lecroy v. Miller

651 N.E.2d 617, 272 Ill. App. 3d 925, 209 Ill. Dec. 439
CourtAppellate Court of Illinois
DecidedMay 30, 1995
Docket1-93-2292
StatusPublished
Cited by38 cases

This text of 651 N.E.2d 617 (Lecroy v. Miller) 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
Lecroy v. Miller, 651 N.E.2d 617, 272 Ill. App. 3d 925, 209 Ill. Dec. 439 (Ill. Ct. App. 1995).

Opinion

JUSTICE McCORMICK

delivered the opinion of the court:

Plaintiff, Diane Govis Lecroy, individually and as special administrator of the estate of her deceased husband, Peter Govis, appeals a jury verdict finding defendant, Robert P. Miller, M.D., 1 not guilty of medical negligence.

On July 20, 1988, Peter Govis died of complications due to lung and liver cancer. Previously, in October 1986, he had been diagnosed with cancer of the larynx and had received a laryngectomy. This litigation arises out of Diane Govis Lecroy’s allegations that in January 1986 Dr. Miller negligently failed to biopsy abnormal tissue he had observed in Peter’s throat and to develop a follow-up examination plan, thereby delaying the diagnosis of his laryngeal cancer until it had the opportunity to begin metastasizing to his lungs and liver.

In August 1985, Peter Govis was 30 years old. He had begun experiencing hoarseness in his throat. A neighbor referred him to Dr. Stephen Yeh, an otolaryngologist (ENT). Dr. Yeh attempted to examine Peter’s throat and vocal cords by mirror, but Peter had a hyperactive gag reflex, which made the exam difficult. Peter gagged and vomited and Dr. Yeh discontinued the exam. Ten days later, on August 24, Dr. Yeh had a follow-up appointment with Peter at Evanston Hospital, where he performed an indirect laryngoscopy, which involves the feeding of a fiber-optic device through the patient’s nose down into his throat. Dr. Yeh performed this procedure to give himself the view of Peter’s vocal cords that he desired, which he had been prevented from seeing through a mirror exam because of Peter’s hyperactive gag reflex. Dr. Yeh saw nothing that appeared to be a tumor; however, he noted that Peter had diffuse redness of the larynx. Dr. Yeh attributed this redness to voice abuse — Peter was a truck driver who had to yell in the course of his work — and possibly to exposure to toxic fumes. Dr. Yeh did not take a biopsy of Peter’s larynx. He would not have biopsied a diffuse process, such as he viewed in Peter’s throat, because he would not have known where to direct the biopsy. According to Dr. Yeh, to biopsy diffuse redness "would be considered frivolous.” Dr. Yeh instructed Peter to rest his voice and avoid diesel fumes for about a week.

Peter followed Dr. Yeh’s instructions and returned to work; however, the hoarseness persisted. Peter never returned to see Dr. Yeh after the Evanston Hospital visit. Later in the fall, as Peter continued to experience hoarseness and began to experience pain while swallowing hard foods, he visited Dr. Dale, an ENT practicing in Park Ridge, Illinois. Peter saw Dr. Dale on two occasions. Peter reported to Dr. Dale that he had been suffering from hoarseness and that he had also experienced some difficulty swallowing. Dr. Dale attempted a mirror examination during both visits, but Peter experienced his gagging problem. Dr. Dale was not equipped to further examine Peter, so he referred Peter to Dr. Robert Miller, who is also an ENT.

Peter first visited Dr. Miller on December 14, 1985, at his office in Park Ridge. Peter related his hoarseness and swallowing problems to Dr. Miller. Dr. Miller’s records for Peter do not indicate that Peter told him that he had seen Dr. Yeh prior to seeing him. Dr. Miller attempted a mirror exam and an indirect laryngoscopy on December 14, but Peter experienced his gagging problem, and Dr. Miller discontinued the exam immediately, noting the hyperactive gag reflex. Dr. Miller determined that he would need to perform a direct laryngoscopy on Peter, which required hospitalization and anesthesia.

Dr. Miller performed the direct laryngoscopy on Peter on January 8, 1986, at Lutheran General Hospital. Diane accompanied Peter to Lutheran General for this procedure. After the procedure, according to Peter’s evidence deposition, Dr. Miller told Peter that he had chronic laryngitis and that he did not have cancer. In his exam report, Dr. Miller recorded that "the supraglottic structures (those above the vocal cords) were noted to have a slightly granular appearance with mild inflammation,” a condition Dr. Yeh had not noted in his exam. Dr. Miller also noted mild inflammation of the vocal cords, though "slightly more on the left than on the right.” According to Dr. Miller, a granular appearance is not normal and the granular appearance of the supraglottic structures would not account for hoarseness, but the inflamed vocal cords would. Dr. Miller diagnosed chronic laryngitis of unknown etiology. Dr. Miller further stated that laryngitis can be caused by numerous things, including voice abuse, exposure to toxic chemicals and fumes, as well as reflux of stomach acid. Dr. Miller also concluded that there was not a cancerous process in the supraglottic structures.

The primary reason that Dr. Miller performed the direct laryngoscopy was to determine if there was anything he needed to biopsy. Dr. Miller did not biopsy the granular area because there was no specific point that appeared different from the rest, which is the general indicator for biopsy. Without such an area, he would have to guess where to biopsy. According to Dr. Miller, doctors need to focus on some kind of visible lesion for biopsy rather than a general area. The standard of care does not include the performing of random biopsies on the voice box.

Dr. Miller told Peter to rest his voice for a week and to go on a two-week vacation. Dr. Miller directed that a discharge sheet be written. That sheet included a notation that Peter was to return to see Dr. Miller in three weeks. Before he left the hospital, Peter read and signed this form. Peter did not return to see Dr. Miller after January 8, 1986.

Peter followed Dr. Miller’s instructions as to voice rest and then resumed his daily routine. Peter saw no doctors regarding his throat between January and August 1986. During that time, his voice progressively worsened, although for a period of between a few weeks, according to Peter’s evidence deposition, to almost two months, according to the medical records of Dr. Joyce Schild who subsequently treated Peter, his hoarseness abated. Peter’s swallowing problem progressively worsened to the point where Peter had difficulty swallowing soft foods, as well as hard. Peter also developed an earache.

According to Peter’s evidence deposition, in September 1986 Peter decided that his problems had persisted too long and he consulted Dr. Schild, an ENT at the University of Illinois in Chicago. Dr. Schild’s notes revealed that Peter had experienced hoarseness and right throat and ear pain for a number of months which had abated for l1!2 months and then reappeared. Dr. Schild scheduled Peter for a computerized tomography examination (CT scan). On September 29, 1986, Dr. Schild informed Peter that the CT scan had revealed a mass in Peter’s throat, which prompted Dr. Schild to schedule a direct laryngoscopy and biopsy of the mass. As a result of the biopsy, Dr. Schild diagnosed squamous cell carcinoma of the larynx. She scheduled Peter for a laryngectomy, which she performed around October 23, 1986.

Dr. Schild testified that absent the mass revealed by the CT scan, she would not have biopsied Peter’s throat because random biopsies of the larynx are not generally done. Rather, a doctor looks for a specific area of abnormality. Dr.

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Cite This Page — Counsel Stack

Bluebook (online)
651 N.E.2d 617, 272 Ill. App. 3d 925, 209 Ill. Dec. 439, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lecroy-v-miller-illappct-1995.