Marchell v. Whelchel

785 A.2d 253, 66 Conn. App. 574, 2001 Conn. App. LEXIS 520
CourtConnecticut Appellate Court
DecidedOctober 30, 2001
DocketAC 20604
StatusPublished
Cited by20 cases

This text of 785 A.2d 253 (Marchell v. Whelchel) is published on Counsel Stack Legal Research, covering Connecticut Appellate Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Marchell v. Whelchel, 785 A.2d 253, 66 Conn. App. 574, 2001 Conn. App. LEXIS 520 (Colo. Ct. App. 2001).

Opinion

Opinion

SCHALLER, J.

The plaintiff, Andrew H. Marchell,1 appeals from the judgment of the trial court, rendered following a jury trial, in favor of the defendant, Lynn W. Whelchel, Jr., in this medical malpractice action. The plaintiff claims on appeal that the court improperly (1) denied his motion to set aside the verdict, (2) admitted into evidence irrelevant and prejudicial testimony of the defendant’s medical expert, (3) limited his closing argument, (4) refused to allow him to amend his complaint and (5) instructed the jury. We affirm the judgment of the trial court.

The following facts and procedural history are relevant to the disposition of the plaintiffs appeal. On December 12, 1995, the plaintiff consulted a podiatrist, Andrew E. Schwartz, regarding the removal of a bunion on his left foot. Schwartz examined the plaintiff to deter[576]*576mine if he was fit to undergo a bunionectomy.2 His examination revealed that the plaintiff had a weaker pulse in his foot. That concerned Schwartz because he thought that the weaker pulse might indicate a lack of circulation and blood flow in that area, which might impair the plaintiffs ability to heal after the bunion removal. Schwartz referred the plaintiff to the defendant, a vascular surgeon, to determine whether the plaintiff had adequate circulation to recover from the proposed procedure.3

On December 15, 1995, the defendant examined the plaintiff. He reviewed the plaintiffs medical history, physically examined him and performed two diagnostic tests. The initial physical examination indicated to the defendant that the plaintiff had adequate circulation in his foot. Despite those findings, the plaintiffs prior physical health and age prompted the defendant to conduct two additional tests.

The first test was a Doppler study, which is performed to assess the blood flow through a patient’s arteries and into his extremities. That test requires the administering physician to hold an instrument against the patient’s body at various points, listen for blood flow as it is reproduced and amplified by certain machinery, and determine at what rate, if any, blood is pumping through the patient’s extremities. According to the defendant, the results of that test on the plaintiff indicated that he had an adequate amount of blood flowing through the foot.

The defendant next conducted a segmental blood pressure test, which also is called an ankle brachial [577]*577index (test). That test requires the administering physician to take the patient’s regular blood pressure at the arm and then take another blood pressure reading at the ankle. Those readings are then compared and scaled on an index to indicate the amount of blood flow that the patient has in the extremity. The defendant conducted that test but measured the patient’s blood pressure at the thigh as opposed to the ankle. Though the defendant actually performed a thigh brachial index test, he reported the results as an ankle brachial index reading. The defendant concluded that this test revealed no vascular insufficiency.

On the basis of his total examination of the plaintiff, the defendant determined that the plaintiff did not have a vascular insufficiency. He also concluded that the lack of pulse in the plaintiff’s foot that Schwartz described was the result of arteriosclerosis, which is a hardening of the artery walls. That condition had made it impossible to get a pulse in the patient’s foot because the affected arteries could not be compressed sufficiently to feel blood flow. Because a hardening of the arterial wall is not the equivalent of a blockage or obstruction within the artery itself, however, the defendant did not believe that condition necessarily indicated a blood flow problem.

The defendant subsequently advised Schwartz of his findings and determination of vascular sufficiency in a written report. On December 29, 1995, Schwartz performed the bunionectomy on the plaintiffs left foot. Following the procedure, the plaintiff began to experience complications. A follow-up visit to Schwartz on January 11, 1996, revealed signs of infection and that some of the tissue on the plaintiff’s left foot had become necrotic.

Schwartz transferred the plaintiff on that day to the care of Dennis D. D’Onofrio, another podiatrist, at [578]*578which time the plaintiff was admitted to Charlotte Hungerford Hospital in Torrington for treatment of the infection and removal of the necrotic tissue. While at the hospital, the plaintiff underwent a Duplex study, which is similar to the Doppler examination that the defendant had earlier performed. Those test results indicated that the plaintiff had significant vascular compromise. Another ankle brachial index test was attempted at that time, but was unsuccessful because the plaintiffs arteries could not be constricted with the blood pressure cuff. On January 19, 1996, the plaintiff underwent an angiogram at the hospital, which indicated a vascular insufficiency.

On January 20, 1996, the plaintiff was transferred to the John Dempsey Hospital in Farmington, where Steven Ruby, another vascular surgeon, took charge of the plaintiffs care and continued to treat the plaintiff’s infection. The infection subsequently healed despite the failure of bypass surgery to increase blood flow in the plaintiffs foot. Although that infection healed, another infection settled in the plaintiffs left great toe. The toe subsequently became gangrenous and had to be amputated on January 26,1996. After being hospitalized again in June, 1996, the plaintiff also successfully fought off another infection in his left foot.

The plaintiff filed a medical malpractice complaint against the defendant on March 13, 1998, alleging that the defendant breached the professional standard of care for physicians in the defendant’s profession. Specifically, the complaint alleged that the postbunionectomy complications were caused by the defendant’s negligent failure to diagnose his peripheral vascular insufficiency and his negligent failure to perform adequate and accurate tests to assess that condition, and that the defendant improperly cleared the plaintiff to undergo the bunionectomy.

[579]*579In support of his malpractice claims against the defendant, the plaintiff elicited expert testimony that, in the circumstances faced by the defendant, a vascular surgeon has a duty to perform a Doppler study and an ankle brachial index test. The plaintiffs experts further testified that those tests had to be performed to assess the plaintiffs condition adequately. They also testified that the defendant’s performance of those two tests, as well as his conclusions and reporting, were below the acceptable standard of care because they were inaccurate, incorrect or both.

The defendant rebutted the testimony of the plaintiffs experts with his own testimony as an expert. As an expert on the standard of care, the defendant testified that the applicable standard does not require that an ankle brachial index test be performed to assess vascular insufficiency. He offered the opinion that no single test is a conclusive indicator of vascular condition. Rather, the standard requires a broader approach when reaching a diagnosis. A physician assessing a patient’s vascular sufficiency must consider all of the elements of his evaluation in the patient’s case when reaching his conclusion precisely because no single test can be relied on as conclusive.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cockayne v. Bristol Hospital, Inc.
210 Conn. App. 450 (Connecticut Appellate Court, 2022)
Gois v. Asaro
Connecticut Appellate Court, 2014
Rawls v. Progressive Northern Ins. Co.
Supreme Court of Connecticut, 2014
O'Briskie v. Berry
897 A.2d 605 (Connecticut Appellate Court, 2006)
Juchniewicz v. Bridgeport Hospital
860 A.2d 1275 (Connecticut Appellate Court, 2004)
Message Center Management, Inc. v. Shell Oil Products Co.
857 A.2d 936 (Connecticut Appellate Court, 2004)
Carusillo v. Associated Women's Health Specialists, P.C.
831 A.2d 255 (Connecticut Appellate Court, 2003)
Grondin v. Curi
817 A.2d 61 (Supreme Court of Connecticut, 2003)
Harlan v. Norwalk Anesthesiology, P.C.
816 A.2d 719 (Connecticut Appellate Court, 2003)
Newman v. Lee, No. Cv98 35 72 92 S (Jan. 8, 2003)
2003 Conn. Super. Ct. 382 (Connecticut Superior Court, 2003)
Colon v. Padro, No. Cv00 037 26 30 (Dec. 18, 2002)
2002 Conn. Super. Ct. 16216 (Connecticut Superior Court, 2002)
Marella v. Vazzano, No. Cv35 74 70 S (Oct. 9, 2002)
2002 Conn. Super. Ct. 12786 (Connecticut Superior Court, 2002)
Rizzitelli v. Caggianello, No. Cv 99 036 04 15 (Sep. 20, 2002)
2002 Conn. Super. Ct. 11928 (Connecticut Superior Court, 2002)
Loughrey v. Rizzetta, No. Cv00 0372507 (Sep. 17, 2002)
2002 Conn. Super. Ct. 11848 (Connecticut Superior Court, 2002)
Raybeck v. Danbury Orthopedic Associates, P.C.
805 A.2d 130 (Connecticut Appellate Court, 2002)
L'Homme v. Department of Transportation
805 A.2d 728 (Connecticut Appellate Court, 2002)
Patterson v. Meyer, No. Cv98 035 70 52 (Jul. 17, 2002)
2002 Conn. Super. Ct. 8934 (Connecticut Superior Court, 2002)
Santa Maria v. Klevecz
800 A.2d 1186 (Connecticut Appellate Court, 2002)
Bonan v. Goldring Home Inspections, Inc.
794 A.2d 997 (Connecticut Appellate Court, 2002)

Cite This Page — Counsel Stack

Bluebook (online)
785 A.2d 253, 66 Conn. App. 574, 2001 Conn. App. LEXIS 520, Counsel Stack Legal Research, https://law.counselstack.com/opinion/marchell-v-whelchel-connappct-2001.