Pugh v. Advocate Health & Hospitals Corp.

2019 IL App (2d) 180118-U
Appellate Court of Illinois·Decided October 22, 2019·No. 2-18-0118·Unpublished

Opinion

No. 2-18-0118

Order filed October 22, 2019

NOTICE: This order was filed under Supreme Court Rule 23 and may not be cited as precedent by any party except in the limited circumstances allowed under Rule 23(e)(1).

IN THE

APPELLATE COURT OF ILLINOIS

SECOND DISTRICT

TONY AND ELZENA PUGH, ) Appeal from the Circuit Court ) of Lake County.

Plaintiffs-Appellants, )

)

v. ) No. 13-L-928 )

ADVOCATE HEALTH AND HOSPITALS ) CORPORATION d/b/a ADVOCATE GOOD ) SHEPHERD HOSPITAL, MEDICAL GROUP ) LAKE COOK ORTHOPEDIC ASSOCIATES, ) Honorable and JACK PERLMUTTER, M.D., ) Margaret M. Mullen and ) Michael J. Fusz,

Defendants-Appellees. ) Judges, Presiding.

JUSTICE BURKE delivered the judgment of the court.

Justices Hutchinson and Schostok concurred in the judgment.

ORDER

¶1 Held: Plaintiffs’ posttrial motion failed to properly preserve with specificity their argument that the trial court erred by permitting undisclosed expert testimony in violation of Supreme Court Rule 213; the trial court’s refusal to grant a jury instruction on res ipsa locquitur was not an abuse of discretion and because plaintiffs’ summary judgment argument merged into the judgment regarding res ipsa entered at trial, the issue whether the trial court erred by not granting partial summary judgment on res ipsa is not reviewable on appeal; and, similar to their first issue, plaintiffs’ posttrial motion failed to properly preserve with specificity their argument that they are entitled to a new trial based on defense counsel’s conduct during questioning and closing argument. Affirmed.

¶2 Plaintiffs, Tony and Elzena Pugh, brought a medical malpractice suit against defendants, Jack Perlmutter M.D., and Medical Group Lake Cook Orthopedic Associates (defendant Advocate Health and Hospitals Corporation d/b/a Advocate Good Shepherd Hospital was dismissed with prejudice pursuant to the terms of a settlement agreement with plaintiffs), alleging Perlmutter breached the standard of care he owed to Tony during spinal surgery. Tony underwent a spinal fusion and discectomy to lumbar regions L3-L4 and L4-L5 on September 28, 2012. It was undisputed that during this surgical procedure, Perlmutter misread a radiological film and performed a spinal fusion on L2-L3. Four days later, Tony underwent a second surgery. Plaintiffs alleged that Tony became incapacitated and claimed total disability from work. Elzena, Tony’s wife, claimed that she sustained damages as a result of injuries suffered by Tony. Plaintiffs alleged res ipsa locquitur in count II of their first amended complaint.

¶3 After the jury returned a verdict for defendants, plaintiffs filed a posttrial motion, which was denied. On appeal, plaintiffs contend: (1) the trial court erred by permitting undisclosed expert testimony pursuant to Illinois Supreme Court Rule 213 (eff. Jan. 1 2007); (2) the trial court erred by not granting plaintiffs partial summary judgment on res ipsa locquitur and refusing their jury instruction on the same; and (3) they are entitled to a new trial based on defense counsel’s conduct during questioning and closing argument. We affirm.

¶4 I. FACTS

¶5 At trial, plaintiffs presented the following witnesses: Dr. Stanley Gertzbein and Dr. Richard Jackson (plaintiffs’ expert witnesses), Dr. Seng Leong (Tony’s internist), Michael Blankenship, an expert vocational rehabilitation specialist who performed an assessment and found Tony disabled with an earning capacity impacted by his injuries related to the wrong site

surgery in the amount of $926,887, and defendant, Dr. Jack Perlmutter, as an adverse witness. Plaintiffs also called Tony, Elzena, and Roderick Stringwell (Tony’s co-worker).

¶6 Defendants presented the following expert witnesses in support of their case: Dr. Perlmutter and Dr. Terrance Lichtor, who both testified as to the standard of care; and Dr. Andrew Zelby, an expert on causation and damages.

¶7 The following relevant testimony was presented at trial. Tony had significant back pain starting in the late 1990’s. Tony had abnormal lumbar anatomy or what was sometimes referred to as an anatomical variance or abnormality. His lumbar spinous process curved downward, as opposed to going straight up. Leong, his primary care physician, treated him for this condition. When the problem became more severe, Tony saw Perlmutter in 2003 for an assessment, who believed that Tony had serious issues with his spine, but was too young for surgery at that time. Perlmutter found that Tony had pathological changes in his back but recommended that he try conservative treatment. Tony did this, but his pain continued until 2009.

¶8 In 2009, Tony returned to the spinal surgeon because of worsening pain, numbness, and disability. He was evaluated by an orthopedic surgeon, Dr. Brebach, Perlmutter’s colleague, who recommended surgery at that point. However, Tony did not follow up on his recommendation.

¶9 In the spring of 2012, Tony injured his back while he was moving heavy furniture. He visited Leong, who recommended therapy, which did not help. Tony went to pain management and had an epidural steroid injection, which did not help either. Tony had pain in his legs and his whole lower extremity. He could not even lie down, stand erect, or bend over. His gait was off, and he could not feel his feet. He could not engage in any real activity. Gertzbein stated that Tony had pain complaints of 8-9-10 from the left buttocks into the legs. Tony had trouble walking any distance, even to the car. He had trouble sitting for 30 minutes and could not stand.

Gertzbein agreed that Tony had failed conservative therapy and it was correct to offer a surgical option.

¶ 10 Leong referred Tony to Perlmutter. He told Tony that spinal surgery with the fusion would take 1½ to 2 years to make him feel better.

¶ 11 Tony filled out a pain diagram for Perlmutter, which showed extensive pain. Perlmutter testified that Tony’s symptoms were consistent with cauda equina syndrome. Tony had a flattened lordotic curve. He had bones sliding off each other. He had disease at the L5-S1 level and was in danger of further breakdown at that level. There was no increased danger at that level if the operation was extended up to L2-L3. There was no greater chance of breakdown at the L1-L2 level, with a 3 level fusion as opposed to a 2 level fusion.

¶ 12 Perlmutter performed the operation on September 28, 2012, when Tony was approximately 54 years’ old. Perlmutter placed a marker after he made the incision to identify the anatomy of the spine. An x-ray was then taken. Gertzbein testified that one could not see anything from the x-ray marker which could tell Perlmutter that he was at the wrong level of the spine. When he operated at the wrong site, he found the pathology he expected to find.

¶ 13 Perlmutter ordered a CT scan when Tony expressed some symptomatology that he did not expect. The scan revealed that the procedure took place from L2-L3 to L3-L4 when it had been planned to go from L3-4 to L4-L5. Perlmutter planned a new operation to extend down to the L4-L5 space.

¶ 14 Perlmutter encountered a lot of scar tissue at the second operation, which took place four days later on October 2, 2012. The dura was adhered and he encountered a dural tear. Gertzbein testified that, if Perlmutter had operated at the appropriate level the first time, there would have been a good chance of the dural tear.

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