Pasti v. Darakjian CA2/8

CourtCalifornia Court of Appeal
DecidedJune 1, 2015
DocketB253259
StatusUnpublished

This text of Pasti v. Darakjian CA2/8 (Pasti v. Darakjian CA2/8) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pasti v. Darakjian CA2/8, (Cal. Ct. App. 2015).

Opinion

Filed 6/1/15 Pasti v. Darakjian CA2/8 NOT TO BE PUBLISHED IN THE OFFICIAL REPORTS California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

SECOND APPELLATE DISTRICT

DIVISION EIGHT

ROSE SUSAN PASTI, B253259

Plaintiff and Appellant, (Los Angeles County Super. Ct. No. PC053260) v.

HRAIR E. DARAKJIAN et al.,

Defendants and Respondents.

APPEAL from a judgment of the Superior Court of Los Angeles County, Elia Weinbach, Judge. Affirmed.

Law Offices of Gabor Szabo and Gabor Szabo for Plaintiff and Appellant.

La Follette, Johnson, De Haas, Fesler & Ames, Christopher P. Wend, Thien Nguyen and David J. Ozeran for Defendants and Respondents.

_______________________________ Summary judgment was entered in favor of defendants and respondents Hrair E. Darakjian, M.D., and Mid-Valley Orthopedic Specialists, Inc. (hereafter collectively Darakjian) in a medical malpractice action. Plaintiff Rose Pasti appealed. We affirm the summary judgment and an order denying section Code of Civil Procedure section 4731 relief. FACTS Background On April 1, 2011, then 83-year-old Pasti fell and injured her wrist. The same day, Pasti received emergency medical treatment for her wrist injury at Providence Tarzana Hospital. Upon being discharged, she was referred to Darakjian, an orthopedic surgeon. On April 5, 2011, Pasti went to Darakjian’s office. In a typed “Orthopedic Evaluation” report prepared contemporaneously with the visit, Darakjian recorded the following information and impressions: “Surgery can restore better alignment, although normal function is not anticipated, even with surgery. Restriction in the range of motion can be present with or without surgery. Surgery has the additional risk of vascular injury, nerve injury to the median nerve and tendon injury that can affect movement of the fingers. Additional surgery may become necessary if there is a tendon injury or for hardware removal. Due to her age, the bones are soft and the risks of complications and failure of the surgery are much higher. A lengthy discussion was held with the patient about the risks and complications. The patient is adamant about not having any surgery. She understands that the fracture will heal, however, a deformity will persist in the wrist without surgery. She agrees to have the cast treatment.”2

1 All further undesignated section references are to the Code of Civil Procedure. 2 There is conflicting evidence in the record as to how much of the information recorded in Darakjian’s Orthopedic Evaluation report was actually relayed to Pasti by

2 All of the following facts are undisputed: Darakjian put a cast on Pasti’s wrist during the visit on April 5, 2011. Pasti returned to Darakjian on April 13, April 21, and May 9, 2011. On the May 9 visit, Darakjian removed the cast from Pasti’s wrist, applied a splint, and referred Pasti to physical therapy. Pasti never returned to Darakjian. On February 6, 2012, Eli T. Ziv, M.D., performed surgery on Pasti’s wrist. The Litigation In June 2012, Pasti filed a complaint for medical malpractice against Darakjian. Pasti’s complaint alleged that Darakjian acted below the standard of care in that he (1) “failed to properly diagnose the seriousness of [Pasti’s] injuries;” (2) “failed to realize that only surgery could repair the fractures;” (3) “failed to perform the surgery;” and (4) “failed to properly align the fractured bones before he applied the cast.” Pasti alleged that Darakjian’s errors and omissions caused her to suffer “one year of extreme pain . . . until another surgeon performed the needed surgery, which should have been performed by [Darakjian].” Pasti did not allege a cause of action for lack of informed consent, nor did her complaint allege any facts regarding a lack of informed consent. Darakjian filed a motion for summary judgment (MSJ). The MSJ was supported by the declaration of a medical expert, George Macer, M.D., who opined that the medical treatment provided by Darakjian to Pasti complied with the standard of care. Dr. Macer stated that Darakjian “acted appropriately” by treating Pasti “conservatively,” explaining that “placing a cast is standard with fractures of the radius, especially in older patients who do not want surgery.” As summarized by Dr. Mercer: “It is my medical opinion that to a reasonable degree of medical probability, nothing [Darakjian] did or did not do caused [Pasti’s] malunion, or the need to undergo surgery.”

Darakjian. At her deposition, Pasti testified that Darakjian told her little more during their initial visit than that a cast was “just as good as” surgery for her. Further, Pasti denied she told Darakjian that she was opposed to having surgery.

3 Pasti filed an opposition to Darakjian’s MSJ supported by a declaration from a medical expert, Bernard Diamond, M.D., who faulted Pasti’s medical treatment. As summarized by Dr. Diamond: “[A] closed reduction to . . . Pasti’s comminuted displaced fracture was not carried out prior to placing a cast on her wrist, which resulted in the malunion of the fraction of the distal radius and ulna.”3 In reply papers, Darakjian objected to Dr. Diamond’s declaration, asserting his opinions lacked foundation because his declaration did not show that the doctor had reviewed any of Pasti’s medical records, including any records from Tarzana Hospital, Dr. Ziv, or Darakjian’s office. The parties argued the merits of the MSJ to the trial court. The court’s written tentative ruling was to grant the MSJ because the declaration of Pasti’s expert, Dr. Diamond, lacked a proper foundation as argued in Darakjian’s reply papers. During argument, a lawyer appearing on behalf of the law office representing Pasti responded to the issue as follows: “It’s no secret that experts’ declarations are at least in part drafted by counsel for the parties. And in this case we have drafted the declaration of our expert, Dr. Diamond, and, admittedly, we did not do a very good job in conveying to the court exactly what information Dr. Diamond relied on in forming his opinion. “For that, counsel is prepared to file a 473 motion because it would be unjust to deny plaintiff’s day in court because of the shortness of Dr. Diamond’s declaration. It was only two pages, and I think it didn’t clearly convey exactly what he did rely on. “Dr. Diamond’s declaration does state that he relied on the x-rays. There is really nothing else in her medical record other than her x-rays and

3 Further, as noted above Pasti, disputed the extent to which Darakjian explained her surgery versus cast treatment options. This evidence, of course, had no relevance inasmuch as Pasti’s complaint did not allege any claim based on a theory of a lack of informed consent for the cast.

4 defendant doctor’s self-serving orthopedic evaluation reports. . . . [T]hose reports, the authenticity of those reports, are hotly contested and there is a direct factual issue as to their correctness or actually what was said to the patient, plaintiff, by the defendant doctor. “She denies that he explained to her the surgery options. She claims that he talked her out of surgery. And for defendant’s expert to rely on those reports I think it’s really for the jury to decide the believability of defendant’s experts. “But Dr. Diamond’s very short declaration does refer to the numerous x-rays and from those x-rays it was obvious that something was not done. “This is a case of omission. This is a case where defendant doctor failed to operate when he should have. There is [sic] no detailed operative reports with which to review for our expert.

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Bluebook (online)
Pasti v. Darakjian CA2/8, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pasti-v-darakjian-ca28-calctapp-2015.