Milano ex rel. Milano v. Freed

64 F.3d 91
CourtCourt of Appeals for the Second Circuit
DecidedAugust 25, 1995
DocketNo. 1886, Docket 95-7048
StatusPublished
Cited by2 cases

This text of 64 F.3d 91 (Milano ex rel. Milano v. Freed) is published on Counsel Stack Legal Research, covering Court of Appeals for the Second Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Milano ex rel. Milano v. Freed, 64 F.3d 91 (2d Cir. 1995).

Opinion

CALABRESI, Circuit Judge:

Michael Milano and his parents, Christopher and Jeanne Milano, appeal from a judgment entered by the United States District Court for the Eastern District of New York (Nicholas Tsoucalas, Judge1), which dismissed their medical malpractice action against various doctors who treated Michael before it was discovered that he suffered from a malignant tumor.2 The Milanos brought suit claiming that the doctors’ failure to refer Michael to a pediatric neurologist constituted malpractice, which, by delaying the diagnosis of Michael’s tumor, aggravated the harms Michael suffered. Upon the defendants’ motion at the close of the Milanos’ presentation of evidence at trial, the District Court ruled as a matter of law that the Milanos had failed to establish a prima, facie case of medical malpractice against any of the defendants, and ordered dismissal of all the Milanos’ claims. We find, instead, that the Milanos presented enough evidence to support a jury finding of malpractice against three of the defendant doctors. We therefore reverse the judgment dismissing the Milanos’ action with respect to these doctors and their partners, affirm with respect to the other defendants, and remand for further proceedings.

BACKGROUND

Michael Milano’s Medical History. Michael Milano was born to Jeanne and Christopher Milano on March 1, 1988. Though Michael appeared healthy at birth, when he was 4]é-months old it was discovered that he had developed a neuroblastoma, a malignant tumor on his spine. The tumor was apparently eradicated as a result of a long course of chemotherapy, but Michael was left a paraplegic with various additional permanent injuries.

Prior to the discovery of the tumor, Michael had been seen principally by doctors at the “Freed Group.” Jeanne Milano had met defendant Dr. Jay A. Freed during her pregnancy. Based on his description of his pediatric partnership and its practices, the Mila-nos decided to have Dr. Freed’s medical group serve as Michael’s pediatricians.

On March 15, 1988, two weeks following his birth, Michael had his first appointment with the Freed Group and was examined by defendant Dr. Stephanie Citerman. The initial visit was uneventful, except for some minor concerns about jaundice.

According to the trial testimony, during the two weeks after this appointment Michael first began to manifest a number of unusual symptoms. Michael’s parents, Christopher and Jeanne, as well as Jeanne’s parents noticed that Michael had abnormal stomach movements when he breathed; that he had limited leg movement even though his legs would shake strangely when touched; that he often vomited after feedings; that he had a weak cry; that he had a tendency to lean to the right; and that he had only a limited ability to lift his head.

[93]*93At Michael’s next scheduled appointment with the Freed Group on March 30, 1995, these symptoms were reported to defendant Dr. Mitchell Kleinberg. Both Jeanne and her mother, who made a special effort to accompany her daughter and grandson on this visit, testified that they told Dr. Klein-berg about all of Michael’s unusual ailments. After conducting a quick exam, however, Dr. Kleinberg expressed no concern about Michael’s condition and suggested that Jeanne was overfeeding her son.

Over the next few weeks, Michael’s parents observed that his symptoms were becoming more pronounced. Worried about her son’s worsening condition, Jeanne moved up Michael’s scheduled visit to the Freed Group. And on April 19, 1988, Jeanne and her mother told Dr. Freed about all the symptoms that they had seen over the previous month. After a five-minute examination, Dr. Freed, like Dr. Kleinberg before him, expressed no significant concerns about the infant’s health. Dr. Freed explained that any problems with Michael’s legs could be attributed to an underdeveloped circulatory or nervous system, which the pediatrician said was common in babies. And, still according to Jeanne’s trial testimony, Dr. Freed accounted for Michael’s other ailments by declaring that he was a “slow starter” and “lazy.” Jeanne was again told that she was overfeeding Michael, and Dr. Freed added that she “was just being a very nervous, first-time mother.”

Dr. Freed’s diagnosis notwithstanding, Michael continued to manifest the same distressing symptoms over the next month. He regularly vomited after feeding, his stomach moved abnormally when he breathed, his legs continued to shake to an unusual degree, he leaned to the right, his extremities on the right side were cold to the touch, and his cry grew even weaker.

Troubled by his son’s condition, Christopher took time off from work to accompany his wife at Michael’s next scheduled visit with the Freed Group on May 19, 1988. At this appointment, Jeanne and Christopher reported to Dr. Kleinberg that Michael’s symptoms seemed to be getting progressively worse. Dr. Kleinberg looked at Michael’s head and told the Milanos that he suspected Michael had craniosynostosis, a condition in which the bones in an infant’s head grow together prematurely. Dr. Kleinberg suggested that Michael’s symptoms could be attributed to this problem, which was correctable through surgery, and he referred the Milanos to defendant Dr. Alan D. Rosenthal, a pediatric neurosurgeon.

The Milanos saw Dr. Rosenthal just over a week later, on May 31, 1988. According to the trial testimony, all of Michael’s symptoms were described to Dr. Rosenthal. Dr. Ro-senthal conducted a brief examination of Michael’s head. He then explained to the Mila-nos what craniosynostosis is and how it can be corrected surgically. Dr. Rosenthal said he wanted Michael to undergo a set of diagnostic tests — a CAT scan and a 3-D reconstruction of his head — and made an appointment for the next day with defendant Dr. Richard Silvergleid, a radiologist.

On June 1,1988, Dr. Silvergleid performed a CAT sean and a 3-D reconstruction of Michael’s head at the offices of defendant Manhasset Diagnostic Imaging, P.C. In a letter to Dr. Rosenthal dated that same day, Dr. Silvergleid wrote that the CAT scan indicated that Michael did suffer from craniosy-nostosis.

After a couple of phone calls, Jeanne was able to contact Dr. Rosenthal about the results of her son’s tests. On June 14, 1988, Dr. Rosenthal explained to Jeanne that the CAT scan and 3-D reconstruction had confirmed his diagnosis of craniosynostosis. During their conversation, Dr. Rosenthal reassured Jeanne that Michael would be fine following corrective surgery. In a telephone conversation the following week, Dr. Rosen-thal reported to Jeanne that a meeting had been arranged for early July to discuss the details of Michael’s surgery.

Concerned about Michael’s still worsening condition, and perhaps troubled by the prospect of an operation, the Milanos and Jeanne’s parents decided to seek a second opinion. An appointment was made for July 1, 1988 with Dr. Peter Carmel, a pediatric neurosurgeon not associated with the Freed Group. After hearing Michael’s medical his[94]*94tory, examining the child’s head, and reviewing the CAT scan and 3-D reconstruction, Dr. Carmel conjectured that Michael’s problems were not related to his skull, but to his brain. Accordingly, Dr. Carmel referred the Milanos to two pediatric neurologists and urged them to go to whichever one could see them first. The Milanos were able to schedule a visit with Dr. Steven Pavlakis for July 15, 1988.

Meanwhile, during the first week of July, Michael developed a high fever.

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Related

In re Cay Clubs
2014 NV 92 (Nevada Supreme Court, 2014)
Milano v. Freed
64 F.3d 91 (Second Circuit, 1995)

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64 F.3d 91, Counsel Stack Legal Research, https://law.counselstack.com/opinion/milano-ex-rel-milano-v-freed-ca2-1995.