Ritchey v. Medical Center of Beaver

1 Pa. D. & C.5th 500
CourtPennsylvania Court of Common Pleas, Beaver County
DecidedNovember 16, 2007
Docketno. 10601-2002
StatusPublished

This text of 1 Pa. D. & C.5th 500 (Ritchey v. Medical Center of Beaver) is published on Counsel Stack Legal Research, covering Pennsylvania Court of Common Pleas, Beaver County primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ritchey v. Medical Center of Beaver, 1 Pa. D. & C.5th 500 (Pa. Super. Ct. 2007).

Opinion

KWIDIS, J,

FACTS

This is a medical malpractice case wherein the plaintiff, Joseph E. Ritchey, suffered a permanent brain injury as the result of a cardiopulmonary arrest that occurred at the conclusion of a surgical procedure performed by Dr. David Rafalko on April 13,2000, at The Medical Center of Beaver County.

[501]*501On April 8, 2002, a complaint was filed by the plaintiff’s sister, Suzanne F. Woodson, as guardian ad litem, against The Medical Center of Beaver, an operating division of Valley Medical Facilities Inc. (Medical Center) and against the attending anesthesiologist, Michael C. Brody M.D., alleging the following facts.

Plaintiff underwent an elective uvulopalatopharyngoplasty (UP3) for treatment of obstructive sleep apnea on April 13, 2000 at the Medical Center, with the general anesthesia being provided and overseen by Brody.1 After the surgery was completed, the patient was in a period of opioid induced depression as the result of Fentanyl administration, causing Ritchey to be sedated and in respiratory depression.2 Narcan was given by a certified registered nurse anesthetist (CRNA) in an attempt to reverse the post-operative opioid depression induced by F entanyl. The patient remained in a period of known risk for opioid-induced respiratory depression and sedation, due to his underlying conditions and body structure.3 A CRNA, Sharon Spratt, attempted to page Brody and when Brody did not respond, caused Ritchey to be prematurely extubated prior to the time it was reasonably safe to do so, causing the patient to suffer a sudden respiratory arrest resulting in cardiac arrest, an anoxic brain injury, permanent injuries and damages.4 The complaint pleads that the negligent premature extubation occurred as the result of the direct acts of Brody, his medical as[502]*502sociates and a CRNA, who was an employee of the Medical Center.5

After the premature extubation and administration of drugs, Ritchey suffered a sudden respiratory arrest resulting in cardiac arrest as the direct result of the premature extubation.6 As the direct result of the cardiopulmonary arrest, Ritchey suffered permanent brain damage in the form of anoxic encephalopathy, resulting in impairment of his ability to think, speak, ambulate, control his bodily functions and/or otherwise live the life he did prior to suffering the injury.7 Plaintiff’s damages included increased medical, nursing and life care expenses, pain, suffering and inconvenience, loss or limitation of enjoyment of life and permanent surgical scarring.8

The Medical Center filed an answer and new matter on April 26, 2002 that did not aver that Brody was an independent contractor, nor did it admit that Brody was an agent of the Medical Center. The Medical Center did not file a cross-claim against Brody. The Medical Center did not admit that the CRNA, Sharon Spratt, was an employee of the Medical Center.

Brody filed an answer on August 28,2002, that generally denied all of the allegations of the plaintiff’s complaint. The answer did not aver any new matter. It is important to note at this point, due to the subsequent argument of counsel for Brody concerning the effect of the joint tort-feasor release (JTR) tendered by the Med[503]*503ical Center, that there was no averment that Brody was an agent of the Medical Center, nor that the attending CRNAs were agents of Brody. There was no cross-claim filed against the co-defendant, Medical Center.

The plaintiff’s testifying expert, an anesthesiologist, Miles Dinner M.D., prepared a report, dated March 2, 2005, outlining his opinions as to the deviations from the standard of care as follows:

“(1) Failure to appreciate the history and severity of the plaintiff’s sleep apnea;
“(2) Failure to understand the nature of the surgical intervention;
“(3) Failure to appreciate the patient’s history of bronchospasm;
“(4) Failing to supervise the CRNA during the critical portions of a procedure;
“(5) Over-narcotization of the patient;
“(6) Administering multiple beta-blockers to the plaintiff with known wheezing problems;
“(7) Failing to note the impending signs of hypoxia;
“(8) Failing to timely intervene to restore oxygenation.”

The thrust of Dr. Dinner’s report was the period of emergence and the immediate phase of recovery after extubation, which is the critical time in the anesthetic management of a patient. This was described as a “takeoff’ and “landing.”

The testifying expert of Brody, Dr. Christopher A. Troianos, whose report of January 24, 2006 responded [504]*504in item by item form to the report of Dr. Dinner, opined that the care provided by Brody was within the standard of care for an unexpected cardiac event.

At a second pretrial conference conducted on April 11, 2007, Brody, filed a motion in limine that attempted to limit the plaintiff’s expert’s testimony so that Dr. Dinner would not be able to testify about any of the reasons why he determined that the extubation was premature based on the contention that it was beyond the scope of the complaint. This court denied Brody’s motion.9

Plaintiff’s counsel verbally moved for leave to amend the complaint at that conference. The motion was granted by the court.10 Since the court had already denied the motion in limine to preclude such testimony, determining that it merely amplified the complaint’s theory, the court granted the motion for leave to amend.11 The court also offered defendants a continuance of the trial if they contended they were unable to prepare for trial as the result of the court’s rulings, which they declined.12 Plaintiff’s counsel also offered, and Brody’s counsel accepted, an agreement that the defendant did not have to file an answer to the amended complaint’s averments, as deemed to be denied. This agreement was approved by the court.13

[505]*505Plaintiff filed an amended complaint on April 24,2007, which contended that the negligently premature extubation was the result of:

“(a) the negligently inadequate preoperative evaluation by Brody’s agent, Loffredo-Mancinelli;
“(b) Brody’s failure to form an anesthetic plan appropriate for the patient’s history;
“(c) Brody’s failure to consider the effects of the surgery upon the patient’s airway;
“(d) Brody’s failure to consider the effects of the patient’s overnarcotization and/or the temporary masking effect of Narcan administration;
“(e) Brody’s failure to consider the impact of the administration of beta blockers on a patient with a history of bronchospasm; and,

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Commonwealth v. Ellison
902 A.2d 419 (Supreme Court of Pennsylvania, 2006)
Chicchi v. Southeastern Pennsylvania Transportation Authority
727 A.2d 604 (Commonwealth Court of Pennsylvania, 1999)
A. G. Cullen Construction, Inc. v. State System of Higher Education
898 A.2d 1145 (Commonwealth Court of Pennsylvania, 2006)
Johnson v. City of Philadelphia
808 A.2d 978 (Commonwealth Court of Pennsylvania, 2002)
McHugh v. Proctor Gamble Paper Products Co.
776 A.2d 266 (Superior Court of Pennsylvania, 2001)
Gaylord v. Morris Township Fire Department
853 A.2d 1112 (Commonwealth Court of Pennsylvania, 2004)
Stewart v. Motts
654 A.2d 535 (Supreme Court of Pennsylvania, 1995)
Capoferri Ex Rel. Capoferri v. Children's Hospital of Philadelphia
893 A.2d 133 (Superior Court of Pennsylvania, 2006)
Dawson v. Fowler
558 A.2d 565 (Supreme Court of Pennsylvania, 1989)
ALEXANDER v. Knight
177 A.2d 142 (Superior Court of Pennsylvania, 1962)
Commonwealth v. Colon
299 A.2d 326 (Superior Court of Pennsylvania, 1972)
Chaney v. Meadville Medical Center
912 A.2d 300 (Superior Court of Pennsylvania, 2006)
Commonwealth, Department of General Services v. United States Mineral Products Co.
927 A.2d 717 (Commonwealth Court of Pennsylvania, 2007)

Cite This Page — Counsel Stack

Bluebook (online)
1 Pa. D. & C.5th 500, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ritchey-v-medical-center-of-beaver-pactcomplbeaver-2007.