Pesek v. Univ. Neurologists Assn., Inc.

2000 Ohio 483, 87 Ohio St. 3d 495
CourtOhio Supreme Court
DecidedJanuary 18, 2000
Docket1998-0238
StatusPublished
Cited by31 cases

This text of 2000 Ohio 483 (Pesek v. Univ. Neurologists Assn., Inc.) is published on Counsel Stack Legal Research, covering Ohio Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pesek v. Univ. Neurologists Assn., Inc., 2000 Ohio 483, 87 Ohio St. 3d 495 (Ohio 2000).

Opinion

[This opinion has been published in Ohio Official Reports at 87 Ohio St.3d 495.]

PESEK, APPELLANT, ET AL. v. UNIVERSITY NEUROLOGISTS ASSOCIATION, INC. ET AL.; KLEIN ET AL., APPELLEES.

[Cite as Pesek v. Univ. Neurologists Assn., Inc., 2000-Ohio-483.] Physicians—Torts—Medical malpractice—Jury instructions—“Different methods” charge to jury appropriate, when. In medical malpractice cases, the “different methods” charge to the jury is appropriate only if there is evidence that more than one method of diagnosis or treatment is acceptable for a particular medical condition. (No. 98-238—Submitted September 21, 1999—Decided January 19, 2000.) APPEAL from the Court of Appeals for Cuyahoga County, No. 71637. __________________ {¶ 1} In November 1990, Caitlin Marie Pesek was born at Meridia Hillcrest Hospital. Shortly after her birth, Caitlin became tremulous, which indicated a possible seizure disorder. She was given phenobarbital and transferred to Rainbow Babies’ and Children’s Hospital (“Rainbow”). In the admission report, a resident of Rainbow suggested pyridoxine (vitamin B-6) dependency as a possible cause for neonatal seizures. Following her admission, Caitlin underwent electroencephalogram (“EEG”) and ultrasound examinations of her head. The results of the ultrasound were normal; the EEG showed abnormalities. A CT scan was also performed, and it “raised the question of a possible midline problem of the corpus callosum.” The corpus callosum is a band of fibers connecting the left and right cerebral hemispheres. Appellee Dr. Samuel J. Horwitz, a pediatric neurologist at Rainbow, concluded that Caitlin had suffered a seizure. On November 18, 1990, Caitlin was discharged from the hospital. {¶ 2} Thereafter, Caitlin appeared to be developing normally until February 1991, when her seizures returned. She was again taken to Rainbow. During this SUPREME COURT OF OHIO

stay, Caitlin experienced multiple seizures and underwent a magnetic resonance image scan (“MRI”). Dr. Charles F. Lanzieri, a pediatric neuroradiologist, examined Caitlin’s MRI results and concluded that Caitlin had agenesis (absence or incomplete development) of the corpus callosum. A hospital report noted that the MRI “showed definite agenesis of the corpus callosum with some evidence of cortical atrophy especially anteriorly.” Caitlin responded to phenobarbital, and she was discharged from the hospital to continue on the phenobarbital. The final diagnosis was “Seizure disorder” and “Agenesis corpus callosum.” {¶ 3} In March 1991, Caitlin began to suffer again from seizures, and she was again admitted to Rainbow. This time her seizures occurred more frequently and were longer. Caitlin was given phenobarbital, Dilantin, Tegretol, and Valium. However, she did not respond to the drugs. At one point, Caitlin stopped breathing, her heart rate accelerated to a high level, and a “code” was called. She went into “status epilepticus” and was transferred to the hospital’s pediatric intensive care unit. Appellee Dr. Susan Klein, a pediatric neurologist, and one of Caitlin’s treating physicians at Rainbow, described status epilepticus as continuous seizures lasting twenty or thirty minutes. Caitlin was placed into pentobarbital comas to control the seizures. She was also given Solu-Medrol and valproic acid in an attempt to control her condition. {¶ 4} On March 20, 1991, at the request of Caitlin’s parents, a second opinion regarding Caitlin’s condition was rendered by Dr. A. David Rothner, a pediatric neurologist from the Cleveland Clinic. He examined Caitlin at Rainbow, reviewed her medical history and a prior scan of her head, and questioned the diagnosis of agenesis of the corpus callosum. Rothner suggested that Caitlin be given, among other things, vitamin B-6. Thereafter, Caitlin had another MRI, which revealed a corpus callosum. The MRI confirmed that Lanzieri’s previous diagnosis of agenesis of the corpus callosum had been wrong. {¶ 5} In early April 1991, still in the hospital, Caitlin again experienced

2 January Term, 2000

seizures. She was given vitamin B-6, and her seizures stopped. She was eventually discharged from Rainbow with treatment with vitamin B-6 to continue. The medical discharge summary report noted that Caitlin had suffered from “Grand mal status epilepticus,” “Pyridoxine dependent seizures,” “Gastrointestinal hemorrhage secondary to ulcerative esophagitis and gastritis,” “Pneumonia,” and “Anemia secondary to gastrointestinal hemorrhage requiring blood transfusion.” {¶ 6} Caitlin suffered severe brain damage. She temporarily became cortically blind. At trial, Caitlin was approximately six years old. She could not talk, she had difficulty walking, and she had to wear diapers. Caitlin will never be able to live independently. {¶ 7} On March 26, 1993, appellant, Renee Pesek, Caitlin’s mother, individually and on behalf of Caitlin, and Caitlin’s father, James Pesek, filed a medical malpractice complaint in the Cuyahoga County Court of Common Pleas. In the complaint, the plaintiffs named as defendants Drs. Lanzieri, Horwitz, and Klein, University Neurologists Association, Inc. (“University Neurologists”), University Hospitals of Cleveland (“University Hospitals”), and other doctors and organizations. {¶ 8} Before trial, plaintiffs dismissed or settled their claims against some of the defendants. The case eventually proceeded to trial against Horwitz, Klein, and University Neurologists. {¶ 9} At trial, plaintiffs attempted to demonstrate that Horwitz and Klein had been negligent in failing to administer vitamin B-6 to Caitlin. According to plaintiffs’ expert witness, Dr. Arthur L. Prensky, if Caitlin had received vitamin B- 6 at critical times during the March 1991 stay at Rainbow, the vitamin would have prevented most or all of Caitlin’s irreversible brain damage. The defendants, on the other hand, contended that their care and treatment of Caitlin was proper, given Lanzieri’s misdiagnosis of agenesis of the corpus callosum. {¶ 10} At the close of plaintiffs’ case-in-chief, the trial court granted a

3 SUPREME COURT OF OHIO

motion for directed verdict in favor of University Neurologists, which was not appealed. At the conclusion of the trial, the jury found in favor of appellees Horwitz and Klein. In response to interrogatories, the jury concluded that the “cognizable event” occurred before August 28, 1991, indicating that the individual claims of Renee and James Pesek against appellees were barred by the applicable statute of limitations. The jury also returned a verdict in favor of appellees with respect to the claims brought by appellant Renee Pesek on behalf of Caitlin. {¶ 11} The trial court entered judgment in accordance with the jury’s verdict. Upon appeal, the court of appeals affirmed the judgment of the trial court. {¶ 12} The cause is now before this court upon the allowance of a discretionary appeal. __________________ James G. Corrigan, for appellant Renee Pesek. Weston, Hurd, Fallon, Paisley & Howley, L.L.P., and Stephen D. Walters, for appellees. __________________ DOUGLAS, J. {¶ 13} Appellant challenges the judgment of the court of appeals on two grounds. Appellant contends that the case should be reversed and remanded for a new trial because the trial court erred in its charge to the jury and because of the misconduct of appellees’ counsel during his closing argument. For the reasons that follow, we reverse the judgment of the court of appeals and remand the cause for a new trial.

4 January Term, 2000

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2000 Ohio 483, 87 Ohio St. 3d 495, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pesek-v-univ-neurologists-assn-inc-ohio-2000.