Phinney v. Paulshock

181 F.R.D. 185, 42 Fed. R. Serv. 3d 244, 1998 U.S. Dist. LEXIS 10682, 1998 WL 396831
CourtDistrict Court, D. New Hampshire
DecidedJune 4, 1998
DocketCivil No. 97-45-JD
StatusPublished
Cited by16 cases

This text of 181 F.R.D. 185 (Phinney v. Paulshock) is published on Counsel Stack Legal Research, covering District Court, D. New Hampshire primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Phinney v. Paulshock, 181 F.R.D. 185, 42 Fed. R. Serv. 3d 244, 1998 U.S. Dist. LEXIS 10682, 1998 WL 396831 (D.N.H. 1998).

Opinion

[187]*187 ORDER

MUIRHEAD, United States Magistrate Judge.

Plaintiffs’ motion for sanctions (document no. 51) and defendants’ motion to strike (document no. 59) arise out of a medical malpractice action concerning the death of Kenneth J. Phinney on March 19,1996 during surgery for a brain aneurism. Plaintiffs assert that Kenneth Bouchard, who is the attorney for [188]*188both Atlantic Anesthesia (“AA”) and Dr. Craig Paulshoek (collectively “defendants”1), impermissibly coached a deponent during her deposition. Plaintiffs also assert that defendants and/or their attorney wrongly failed to comply with legitimate discovery requests, and that defendants and/or their attorney fabricated evidence. Defendants seek to strike these allegations from the record and seek Rule 11 sanctions. The court conducted a hearing into the matter on March 20, and from March 31 to April 3,1998.

I. Background

A. Undisputed Facts in the Underlying Case

Kenneth Phinney was a 38 year old married father of two minor children. He and his family lived in Eliot, Maine. He worked at the Portsmouth Naval Shipyard.

On the evening of Saturday, March 16, 1996, Mr. Phinney complained of a very severe headache. Feeling no better the next day, he went to the emergency room of Wentworth-Douglass Hospital in Dover, N.H. He was admitted and a brain aneurism was diagnosed.

Mr. Phinney went into surgery for a cra-niotomy to repair the aneurism at approximately 11:00 a.m. on Tuesday, March 19, 1996. The lead neurosurgeon was Dr. Clinton Miller, assisted by Dr. Carlos Palacio. The anesthesiologist was Dr. Craig Paul-shock, an employee and shareholder of AA. He was assisted by nurse anesthetist Elise Jackson, an employee of AA. After the operation was underway, Dr. Paulshoek left the operating room (“OR”) leaving Nurse Jackson responsible for the anesthesia. Shortly before 1:50 p.m., nurse anesthetist Patricia Daley, another AA employee, entered the OR to assist with the procedure. At 1:50 p.m., Nurse Jackson intravenously administered Nimodipine, an oral medication, in a dosage suitable for oral administration.2 At 2:03 p.m. Mr. Phinney experienced a precipitous drop in blood pressure accompanied by elec-tro-mechanical disassociation. At 2:10 p.m. a “code” was called, indicating that the patient was in cardiac arrest and setting into motion a concerted resuscitation effort.

Dr. Paulshoek returned to the OR as the crisis ensued.3 Upon his entry into the OR, Nurse Jackson informed him that she had administered Nimodipine to the patient.4 Dr. Paulshock’s partners, Dr. Nathan Jor-gensen and Dr. James Tobin, responding to the code, entered the OR shortly thereafter. Dr. Jorgensen inserted a subclavian triple lumen central venous pressure (“CVP”) catheter into the patient, in part to search for an air embolism that could be causing the arrest.5 He subsequently inserted a “Swan-Gantz” catheter for the same purpose. Mr. Phinney was pronounced dead at 2:40 PM.

B. Evidence Relevant to the Allegations of Sanctionable Conduct6

1. The Presence or Absence of a Finding of Aerated Blood

One allegation of defendants’ sanctionable conduct concerns a written statement by Dr. [189]*189Jorgensen that he aspirated six or seven syringes of frothy blood from Mr. Phinney via the CVP catheter. A finding of true aerated blood could indicate the existence of a venous air embolism, which could explain Mr. Phinney’s cardiac arrest.7 Plaintiffs allege that Jorgensen’s statement that he withdrew aerated blood consistent with a venous air embolism was fabricated by defendants either with or without the assistance of Attorney Bouchard.

Attorney Bouchard testified that he was engaged to defend AA within days of Mr. Phinney’s death. He learned from Dr. Paul-shoek soon after his engagement about the potential defense of an air embolism. He asked Dr. Paulshoek to record his recollections of the circumstances surrounding Mr. Phinney’s death, and asked him to relay that request to his partners as well. Dr. Paul-shock testified that he made that request by note to his partner, Dr. Jorgensen.

In a memorandum dated April 1, 1996, Dr. Jorgensen purported to record his role in the events surrounding Mr. Phinney’s death (“Jorgensen memorandum”). The memorandum states that: . Plaintiffs Exhibit No. 1 (hereinafter “Notebook”) 8, tab 1.

[b]ecause venous air embolism is a potential cause of arrest in a patient undergoing a craniotomy, I placed a subclavian triple lumen CVP into the right superior vena cava/ atrium. I began to aspirate from the port to the distal lumen using a 20 ec syringe. I was able to aspirate frothy blood. There was air noted in the clear portion of the distal port lumen continuously as I aspirated. This seemed to confirm the likely diagnosis of venous air embolism. The central line was aspirated until no more air returned — six to seven 20cc syringes with a 50 /50 blood air mix.

At the top of the memorandum, written in a manner to suggest that Jorgensen’s memorandum was responsive, is a handwritten note stating “Nathan — please report your observations involving the events in the case of K. Phinney on 3-19-96. Your statement will be filed in anticipation of litigation involving me, Atlantic Anesthesia, etc. Thanks. CP.” Id. At the hearing, Dr. Paulshoek admitted that he wrote this note onto the Jorgensen memorandum after Jorgensen prepared it but claimed that it was the same as the note he had previously written to Dr. Jorgensen.

Plaintiffs became aware of the contents of the Jorgensen memorandum during the deposition of Dr. Paulshoek on September 30, 1997 and requested its production at that time. The Jorgensen memorandum had been listed on defendants’ privilege log provided to plaintiffs on June 23, 1997. See Notebook, tab 3. Defendants decided to waive the previously asserted privilege and produced the memorandum to plaintiffs on October 3,1997.

Prior to Dr. Paulshock’s September 30 deposition, and the production of the Jorgensen memorandum, there had been no evidence advanced to support the theory that an air embolism contributed to the death of Kenneth Phinney. None of the documents produced or deposition testimony taken prior to September 30, 1997 mentioned a finding of aerated blood. None of the medical records indicated that air was aspirated from the patient.9

[190]*190Dr. Miller, the neurosurgeon, testified that Dr. Jorgensen did not withdraw aerated blood of the type indicative of a venous air embolism from Mr. Phinney. Every effort by Dr. Jorgensen to aspirate air from Mr. Phinney was observed by Dr. Miller. Dr. Miller stood no more than eighteen inches from Dr. Jorgensen as the latter inserted the catheter into Mr. Phinney’s neck, had an unobstructed view of what Dr. Jorgensen was doing, and was watching Dr. Jorgensen intently throughout the entire attempt to aspirate air. Dr. Miller stated that Dr. Jor-gensen had great difficulty inserting the CVP line due to a lack of blood in the vein.

Eventually Dr.

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Bluebook (online)
181 F.R.D. 185, 42 Fed. R. Serv. 3d 244, 1998 U.S. Dist. LEXIS 10682, 1998 WL 396831, Counsel Stack Legal Research, https://law.counselstack.com/opinion/phinney-v-paulshock-nhd-1998.