Paulk v. Central Laboratory Associates, P.C.

636 N.W.2d 170, 262 Neb. 838, 2001 Neb. LEXIS 181
CourtNebraska Supreme Court
DecidedNovember 30, 2001
DocketS-00-109
StatusPublished
Cited by72 cases

This text of 636 N.W.2d 170 (Paulk v. Central Laboratory Associates, P.C.) is published on Counsel Stack Legal Research, covering Nebraska Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Paulk v. Central Laboratory Associates, P.C., 636 N.W.2d 170, 262 Neb. 838, 2001 Neb. LEXIS 181 (Neb. 2001).

Opinion

Stephan, J.

This is a professional liability action in which Lynda F. Paulk, as the personal representative of the estate of Greg W. Anderson, seeks damages for personal injury and wrongful death. Defendants named in the action include G.L. Morris, M.D.; A.F. Kielhom, M.D.; and Central Laboratory Associates, P.C. (CLA), a professional corporation with which Morris and Kielhom were affiliated at all pertinent times (collectively the defendants). Following a trial in the district court for Buffalo County, the jury returned a verdict in favor of the defendants and the district court entered judgment thereon. Paulk appeals from an order overruling her motion for new trial.

BACKGROUND

On April 17, 1991, Anderson had a mole surgically removed from his back. The surgeon submitted a specimen of the excised tissue to a pathology laboratory operated by CLA, where it was first examined by Morris, a board-certified pathologist. Morris diagnosed the specimen as an “[i]rritated junctional nevus,” a type of benign lesion. Kielhom, who is also a board-certified *840 pathologist, then independently examined the specimen and concurred with Morris’ diagnosis. On April 18, CLA reported the diagnosis reached by Morris and Kielhom to the surgeon, who, in reliance thereon, notified Anderson that the surgically removed tissue was benign.

On June 17, 1995, Anderson was admitted to St. Francis Medical Center in Grand Island, Nebraska, with complaints of severe back pain, dizziness, vomiting, slurred speech, and headaches. He was thereafter diagnosed as suffering from a metastatic cancerous lesion in his brain, caused by metastatic malignant melanoma. On June 23, in an attempt to determine the primary source of the malignancy, pathologists at St. Francis Medical Center reexamined the specimen slide from the 1991 surgery. They concluded that the specimen was not a benign lesion, as Morris and Kielhom had concluded, but, rather, a primary nodular malignant melanoma. Anderson’s health deteriorated rapidly, and he died as a result of the malignancy on September 11, 1995.

In her operative petition, Paulk alleged that Morris and Kielhom were negligent in failing to correctly diagnose and report the malignancy in 1991 and that such negligence was attributable to CLA under the doctrine of respondeat superior. She further alleged that

[a]s a direct and proximate result of the negligence of the Defendants, [Anderson] died on September 11, 1995, and his surviving next of kin have been deprived of his care, comfort, companionship, services, earnings, contributions, and consortium, and all other pleasures and rights, having a pecuniary value, which attend inter-family relationships.

In their answer, the defendants admitted that the 1991 diagnosis was incorrect, but specifically denied that they were negligent in any manner and further alleged that “there was no causal relationship between any action or inaction on the part of these defendants in the death of [Anderson], the same being an unavoidable medical sequela of his pathological condition as it there and then existed ...”

Prior to trial, the defendants responded to written interrogatories propounded by Paulk. One of the interrogatories directed to each defendant stated:

*841 Identify each person whom defendant expects to call as an expert witness, stating the subject matter on which the expert is expected to testify, the substance of the facts and opinions to which the expert is expected to testify, and a summary of the grounds for each such opinion.

Each defendant identified David Bouda, M.D.; Jerry Jones, M.D.; and David Howe, M.D., as experts whom they had consulted, and responded to the aforementioned interrogatory as follows: “Dr. David Bouda and Dr. David Howe will testify as to causation. Dr. Jones will testify as to causation and standard of care.” In supplemental responses, each defendant identified George Bascom, M.D., as an additional defense expert who would testify as to “causation.”

After the first of these responses was served, Paulk made a written request by letter for a curriculum vitae for each expert identified and further requested by letter the “facts and opinions upon which each expert is expected to testify.” In response, defense counsel wrote:

[Ejach of the ... expert witnesses ... will testify, based on a review of the materials in the case ... that the actions of the defendants were not the proximate cause of [Anderson]’s death. The experts will testify as to the nature of this type of cancer, its curability rate, and the treatments available at the time the decedent suffered from the disease. The experts will further opine regarding the pathology of metastatic melanoma, the disease process itself, and the manner and shape in which the disease manifests itself. Dr. Jones will specifically testify regarding the standard of care regarding the defendants and the difficulty in diagnosing metastatic melanoma. Dr. Jones will testify in detail regarding the process of examining and diagnosing this disease versus other processes of skin samples.

Paulk deposed Jones prior to trial. Jones, a pathologist who practices in Omaha, testified that he reviewed the specimen slide containing tissue from Anderson’s 1991 surgery and concluded that it reflected a malignant melanoma. Jones also identified a series of seven photomicrographic slides which he had prepared from the specimen slide, depicting the tissue excised in 1991. When asked why he prepared these slides, Jones stated: “Well, I *842 may — I would like to offer a caveat that I may have additional things to say about these slides.” Paulk’s counsel then stated, “I would like to know everything you are going to say about those slides, Doctor[.]” Jones was then questioned and commented upon what was depicted in each of the seven photomicrographic slides. He did not disclose that any of the slides depicted melanoma cells in the blood. After expressing his opinions regarding the applicable standard of care, Jones stated his opinion that the melanoma had already metastasized at the time of Anderson’s 1991 surgery. Paulk’s counsel then stated, “Tell me all the reasons why you are of that view[.]” Jones discussed “several reasons” but did not mention any detection of melanoma cells in the blood in the 1991 tissue specimen.

At trial, Kris Mleczko, M.D., a board-certified pathologist, was called as an expert witness on behalf of Paulk. Mleczko testified he reviewed a specimen from a scalp lesion biopsy performed during Anderson’s 1995 hospitalization and reached a diagnosis of metastatic malignant melanoma, indicating that the malignancy had spread from a distant primary site. In an effort to ascertain the primary site, Mleczko reviewed the tissue specimen from Anderson’s 1991 surgery and concluded that it reflected a primary lesion from which the metastatic tumor had originated. He opined that the failure of Morris and Kielhom to diagnose and report the malignancy in 1991 fell below the applicable standard of care.

Donald Bell, M.D., a board-certified surgeon, also testified as an expert witness on behalf of Paulk.

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Bluebook (online)
636 N.W.2d 170, 262 Neb. 838, 2001 Neb. LEXIS 181, Counsel Stack Legal Research, https://law.counselstack.com/opinion/paulk-v-central-laboratory-associates-pc-neb-2001.