Sbarboro v. Vollala

911 N.E.2d 553, 392 Ill. App. 3d 1040
CourtAppellate Court of Illinois
DecidedJune 30, 2009
Docket1-07-3236
StatusPublished
Cited by11 cases

This text of 911 N.E.2d 553 (Sbarboro v. Vollala) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sbarboro v. Vollala, 911 N.E.2d 553, 392 Ill. App. 3d 1040 (Ill. Ct. App. 2009).

Opinion

JUSTICE QUINN

delivered the opinion of the court:

Plaintiff, surviving brother of John Sbarboro and independent administrator of the estate of John Sbarboro, filed a lawsuit alleging medical negligence against defendants, Dr. Raghu Vollala, Dr. Alan B. Spacone, Dr. Alan B. Spacone, Ltd., a Corporation, VHS of Illinois, Inc., d/b/a MacNeal Health Network, MacNeal Hospital, MacNeal Home Care, and MacNeal Hospice (MacNeal Hospital), claiming that Dr. Vollala failed to diagnose and treat the decedent’s aortic dissection. Following a trial, the jury returned a verdict in favor of defendants and against plaintiff. Plaintiff filed a posttrial motion requesting a new trial, which the circuit court denied. On appeal, plaintiff contends that the circuit court abused its discretion in denying his posttrial motion for a new trial where: (1) the circuit court allowed evidence of Dr. Vollala’s discharge summary pertaining to the decedent to be presented to the jury despite the fact that the document was not produced to plaintiff until at trial; (2) plaintiff was not allowed to introduce evidence that Dr. Vollala had failed his board-certification examination; and (3) the substantial errors in this case were not harmless because it was a close case on the facts. For the following reasons, we affirm.

I. BACKGROUND

On April 21, 2001, John Sbarboro (the decedent) began experiencing chest pain sometime between 9 p.m. and 11 p.m. On April 22, 2001, at about 4:30 a.m., John took a taxi from his home to the emergency room at MacNeal Hospital in Berwyn, Illinois. Dr. Alan Spacone treated John in the emergency room. Defendant Dr. Vollala was the attending physician on call to accept patients who did not have a primary care physician and needed to be admitted to the hospital.

At about 10:10 a.m., after several hours in the emergency room, Dr. Vollala admitted John to MacNeal Hospital. At 10:55 a.m., Dr. Vollala had John transferred to the telemetry unit for heart monitoring. John continued to experience chest pain and two successive tests for cardiac enzymes were ordered to rule out a myocardial infarction (MI). Both tests came back negative. At about noon, the telemetry nurse telephoned Dr. Vollala and Dr. Vollala examined John at about 1 p.m. At 1:30 p.m., Dr. Kelly Choi, an intensive care unit (ICU) fellow, evaluated John and ordered a third test for cardiac enzymes. At 3:56 p.m., John died at MacNeal Hospital from an aortic dissection, which is a tear in the lining of the aorta.

At trial, plaintiff called Dr. Vollala as an adverse witness. Dr. Vollala testified that at about 10:10 a.m., on April 22, 2001, he spoke on the telephone with Dr. Spacone from the emergency room. Dr. Spacone informed Dr. Vollala that John was complaining of chest pain, but all of his tests were negative. Dr. Spacone advised Dr. Vollala that he was going to admit John to rule out an MI and have a cardiac fellow see him. At about noon, Dr. Vollala testified that he gave telephone orders to Nurse Karen Manyak on the telemetry floor to give John an injection of 50 milligrams of Demerol every six hours or as needed for back pain. At about 1 p.m., Dr. Vollala saw John, took a history, then transferred John to the ICU and ordered a nitroglycerin drip. Dr. Vollala noted in John’s history that he had experienced chest pain for more than five hours prior to admission and complained of retrosternal pain that sometimes radiated into his left back.

Dr. Vollala testified that the policy at MacNeal Hospital at that time required that when a patient was transferred to the ICU, that patient would be examined by an ICU fellow. Pursuant to this policy, after John was transferred to the ICU, Dr. Kelly Choi was called for a consult. At about 2 p.m., Dr. Choi called Dr. Vollala and told him that an MI had been ruled out and that she had countermanded the ICU transfer order and suggested that John remain in the telemetry unit. Dr. Vollala testified that he agreed that John should be monitored in the telemetry unit and that another set of tests for cardiac enzymes had been ordered by the ICU team.

Dr. Vollala testified that he took John’s history and physical examination but did not chart them at the time. Dr. Vollala agreed that aortic dissection is a potentially life-threatening disease that should be ruled out, but Dr. Vollala testified that he had no reason to suspect that John was suffering from that ailment. Dr. Vollala did not consider ordering a CT or CAT scan which, depending on when it is taken, would have shown evidence of an aortic dissection. The decedent also had an allergy to iodine, which is used during a CAT scan. Dr. Vollala testified that MacNeal Hospital had a policy that required an attending physician to place a discharge summary in the patient’s chart within 24 hours, but he did not remember if he prepared a discharge summary for John. Plaintiffs counsel asked Dr. Vollala, “Nowhere in this record is there a discharge summary prepared by you, correct?” Dr. Vollala answered that he could not remember.

Following Dr. Vollala’s adverse examination by plaintiff, counsel for defendant MacNeal Hospital asked for a recess and, outside the presence of the jury, advised the parties and the circuit court to the existence of a discharge summary that was dictated and transcribed in July 2001. Plaintiffs counsel stated that this was the first time that he was shown the discharge summary despite defendant’s counsel receiving notice to produce a complete set of John’s hospital chart. Counsel for defendant MacNeal Hospital indicated that the discharge summary had come to her with the file when her law firm had substituted in as counsel and she had assumed that the discharge summary had been previously produced through discovery. Plaintiffs counsel then requested that the circuit court bar evidence of the discharge summary. At the suggestion of Dr. Vollala’s counsel, the circuit court provisionally barred the use of the discharge summary and decided to revisit the matter the following day after the parties had more time to consider the matter.

During cross-examination by his own attorney, Dr. Vollala testified that he did not see any indication that John had an aortic dissection and the emergency room records did not show any description of pain that was suggestive of an aortic dissection. Dr. Vollala testified that the emergency room records also did not show a history of hypertension or tachycardia. Dr. Vollala testified that a complaint of back pain is not necessarily consistent with an aortic dissection. Dr. Vollala testified that the protocol to rule out an MI is to monitor the patient’s vitals, give the patient a nitroglycerin drip and provide the patient with morphine for pain and beta blockers for a fast heartbeat. A set of cardiac enzymes is performed to rule out myocardiac damage at timed intervals, a second set after six hours, and a third set after nine hours, and two EKGs are then done to rule out damage to the heart.

Dr. Vollala testified that when he saw John, his blood pressure was normal, there was no tachycardia, hemodynamic instability or neurological symptoms and his heart had no murmur. Dr. Vollala testified that John had retrosternal pain, which is a symptom of unstable angina, heart attack or coronary insufficiency, not aortic dissection. Dr. Vollala testified that John’s back pain also responded to Demerol, which is inconsistent with an aortic dissection. Dr.

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Cite This Page — Counsel Stack

Bluebook (online)
911 N.E.2d 553, 392 Ill. App. 3d 1040, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sbarboro-v-vollala-illappct-2009.