Lindsay D. Sightler v. Ashley Lubecki, D.O.

Court of Appeals of Virginia·Decided May 27, 2025·No. 0535241·Unpublished

Opinion

COURT OF APPEALS OF VIRGINIA UNPUBLISHED

Present: Chief Judge Decker, Judges Malveaux and Callins Argued by videoconference

LINDSAY D. SIGHTLER

MEMORANDUM OPINION* BY

v. Record No. 0535-24-1 JUDGE MARY BENNETT MALVEAUX MAY 27, 2025

ASHLEY LUBECKI, D.O., ET AL.

FROM THE CIRCUIT COURT OF THE CITY OF NORFOLK Everett A. Martin, Jr., Judge

Randy D. Singer (Rosalyn K. Singer; Maryam M. Atty; Singer Hoffman, LLC, on briefs), for appellant.

Rodney S. Dillman (Julie Mayer; Michael E. Olszewski; Edward W.

Bailey; Hancock, Daniel & Johnson, P.C., on brief), for appellees.

Lindsay Sightler filed a medical malpractice suit against Ashley Lubecki, D.O., Lubecki’s employer, Bayview Physicians Services, P.C., and others, alleging that they failed to properly diagnose and treat her breast cancer. A jury returned a partial verdict in Sightler’s favor and awarded her $98,000. On appeal, Sightler argues that the circuit court erred by denying her post-

trial motion for an investigative hearing and a new trial based on juror misconduct, denying her motion for additur, and permitting a defense expert to testify to certain opinions. For the following reasons, we affirm the judgment of the circuit court.

I. BACKGROUND

On appeal, we “view the facts in the light most favorable to the prevailing party below.”

Friedman v. Smith, 68 Va. App. 529, 543 (2018) (quoting Blackson v. Blackson, 40 Va. App.

507, 517 (2003)).

*

This opinion is not designated for publication. See Code § 17.1-413(A).

A. Complaint

Sightler filed a medical malpractice suit against Ashley Lubecki and Bayview Physician Services, P.C., alleging that the defendants were negligent in failing to properly diagnose and treat her breast cancer.1 Sightler first mentioned a lump in her breast to Lubecki in September 2018. Sightler reported continuing issues over the following year, including two lumps in her breast that were also noted on an ultrasound in September 2019. But it was not until she saw a different doctor in January 2020 that she was diagnosed with “invasive ductal carcinoma,” a type of breast cancer. Her treatment plan involved a “modified radical mastectomy” and “surgical exploration of her left axilla,” as well as “aggressive chemotherapy and radiation therapy, followed by ten years of hormonal deprivation.” Sightler alleged that the damages she suffered as a result of her treatment were caused by the defendants’ “failure to diagnose [the cancer] in a timely manner and the prescribing of contraceptives containing estrogen and progesterone.” Sightler prayed for judgment against the defendants jointly and severally, in the amount of $2,400,000 plus pre-judgment interest and costs.

B. Expert Designation

In preparation for trial, Lubecki designated Maggie DiNome, M.D., a board-certified surgical oncologist specializing in breast oncology, as an expert witness. DiNome was expected to testify that Lubecki’s treatment of Sightler “did not cause or contribute to” the cancer’s presence in Sightler’s lymph nodes, because “she would have still required mastectomy, axillary node dissection, radiation, chemotherapy, and hormone suppressant medications” even if she had been diagnosed prior to January 2020. DiNome would explain that

1 Sightler also filed suit against Andrew Zasada, M.D., Stafford Brown, M.D., Bayview Medical Center, Inc., and Hampton Roads Radiology Associates, P.C. The circuit court ultimately dismissed Zasada from the case. On Sightler’s motion, the action was partially nonsuited as against Bayview Medical Center. The jury returned a verdict against Sightler for Brown and Hampton Roads Radiology Associates.

[t]he fact that Ms. Sightler had two palpable masses in two separate quadrants of the breast indicate[s] that the “burden” of the cancer was heavy, and more likely than not she had additional areas of cancer in her breast that were not yet detectable on the imaging or via palpation . . . . [O]nce a malignant mass is palpable, the cancer has already invaded one or more of the axillary nodes.

DiNome was further expected to testify that “more likely than not at least two masses were in Ms. Sightler’s breast in September of 2018, and she had axillary nodal invasion” and that “because there were multiple locations of the cancer in 2020, it is more likely than not that the same was true in 2018, whether or not they were detected on imaging.”

In her deposition, DiNome was asked about the relationship of a palpable mass in the breast to the cancer’s presence in the lymph nodes. She answered that “if it’s a multifocal palpable mass, then more likely than not there’ll be lymph node disease.” She agreed this was a “pretty major distinction” from her designated opinion that “if the patient has a palpable mass, the cancer has already invaded one of the axillary nodes.” She clarified that “it doesn’t even have to be palpable,” but a patient has “a more likely than not chance of having lymph node disease” if “multifocal multicentric masses, or cancers” are present in the breast.

Sightler filed a motion in limine to exclude those certain portions of DiNome’s deposition opinions that differed from those that were designated. Specifically, Sightler highlighted that whereas DiNome’s designated opinion was that “a single palpable mass ‘almost always’ means lymph node involvement,” she testified in her deposition “that a multi-focal palpable mass (at least two masses) more likely than not meant lymph node involvement (perhaps 60% of the time).” Sightler argued that DiNome should not be permitted to testify to the opinion “that when you can palpate more than one mass it means that the cancer has probably invaded the lymph nodes,” because this opinion “r[a]n contrary” to the designation requirements of Rule

4:1(b)(4)(A)(i), as interpreted in John Crane, Inc. v. Jones, 274 Va. 581 (2007). The circuit court took the motion under advisement.

C. Trial Proceedings

At trial, Sightler renewed her objection to the portion of DiNome’s testimony concerning the relationship of the number of palpable masses to the cancer’s presence in the lymph nodes, because “she changed . . . the number of masses required” to discern whether cancer has invaded the nodes from “a malignant mass” to “more than one mass,” and she also “went from [a] certainty standard to a more likely than not standard.” The circuit court overruled the objection, and Sightler noted a continuing objection to DiNome’s expected testimony on that specific topic.

On direct examination, DiNome opined that “had [Sightler] been diagnosed when she first presented in 2018, she would have still required the mastectomy, the lymph node dissection, the chemotherapy, the radiation and the hormone blocking therapy,” because Sightler “had presented . . . with the palpable finding” and “had extensive evidence of lymph node disease already.” DiNome testified that Sightler incurred “[n]o additional bills” because of Lubecki’s care, as the treatment options “would have been the same.” DiNome further testified that “when women present with palpable lumps, the amount of tumor is larger than if they presented with a cancer that was found on regular screening mammogram,” and noted that “whether or not [Sightler] felt one or two lumps, . . . on the final pathology she did have very extensive disease.” DiNome also explained that “multicentric multifocal disease means there’s more than one focus of breast cancer . . . multifocal means there’s more than one in the same quadrant. And multicentric means there’s more than one but in different quadrants of the breast.” She then noted that Sightler’s “ultrasound in September of 2019 showed two abnormalities . . . [in] two separate quadrants of the same breast.”

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Lindsay D. Sightler v. Ashley Lubecki, D.O., (Va. Ct. App. 2025).

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