Schwabach v. Center

72 A.D.2d 308, 424 N.Y.S.2d 208, 1980 N.Y. App. Div. LEXIS 9685
CourtAppellate Division of the Supreme Court of the State of New York
DecidedJanuary 29, 1980
StatusPublished
Cited by8 cases

This text of 72 A.D.2d 308 (Schwabach v. Center) is published on Counsel Stack Legal Research, covering Appellate Division of the Supreme Court of the State of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Schwabach v. Center, 72 A.D.2d 308, 424 N.Y.S.2d 208, 1980 N.Y. App. Div. LEXIS 9685 (N.Y. Ct. App. 1980).

Opinions

OPINION OF THE COURT

Bloom, J.

Plaintiff, then 86 years old, was admitted to Beth Israel Hospital on April 19, 1976 at the direction of her private physician. She was found to be suffering from cardiac arrythmia and a pacemaker was successfully implanted on April 29, 1976. Following the operation, which was uneventful, she was taken to the hospital’s intensive care unit where she remained until May 1, 1976. On that day she was transferred, by wheelchair, to another floor.

During her stay in the intensive care unit, plaintiff became confused and extremely agitated. This condition, we are informed, is not unusual in patients, particularly elderly ones, introduced into the environment of an intensive care unit. Plaintiff screamed, flailed her arms about, tried to pull out her intravenous tubes and cardiac monitors, bit a nurse and struck a doctor who was endeavoring to assist her. Sedation was ineffective for more than brief periods. Because of the danger of dislodging the pacemaker, thus causing cardiac arrest, it became necessary to place restraints upon her wrists.

The restraints used in this case were known as the Kerlix and consisted of four by nine padding in the Kerlix roll. The padding was placed around the plaintiff’s wrists, the Kerlix [310]*310put around the padding and the Kerlix was then tied to the side of the bed. While there is a commercial restraint in use at the hospital known as the Posey restraint, none was then available in the intensive care unit, although they may have been available in other parts of the hospital.

In accordance with the hospital’s procedures, plaintiff was examined upon her transfer from the intensive care unit to her room. The hospital records indicate that upon that examination, it was first noted that plaintiff was suffering from a left wrist drop. Some two days later, her surgeon recommended a neurological consultation which established damage to the radial nerve at or above elbow level. As a result, plaintiff was not able to extend her wrist. It hung limply. At the time of her discharge from the hospital, there was no evidence of the recovery of new function and the prognosis for further recovery remained guarded.

Thereafter, this action was commenced. It resulted in a verdict in favor of plaintiff and against the hospital in the total sum of $82,432, $10,000 of which was allocated to pain and suffering, $5,432 to hospital care and the balance of $67,000 to past and future full-time nursing care which, it is asserted, plaintiff will require for the balance of her life.

The question of negligence was a strongly contested one. The plaintiff’s medical expert, Dr. Davidson, had neither treated nor examined the plaintiff. Moreover, he was a surgeon and not a neurologist. He acknowledged that, in the circumstances indicated by the hospital records, the use of restraints was probably necessary. While he was of the opinion that Posey restraints were preferable to Kerlix restraints, he stated that the use of the latter was medically sanctioned and their use for short periods would constitute good judgment if the Posey restraints were not immediately available. The entries in the hospital record indicated the application of the Kerlix restraints on six occasions on April 30 and May 1, 1976. They do not indicate when they were removed. Sedatives were given during this two-day period and the records reflect that during much of the time plaintiff slept or rested peacefully.

Dr. Davidson expressed the opinion that the records were incomplete based upon plaintiff’s condition as reflected in those records. He concluded that the direct cause of damage to plaintiff’s left radial nerve was the extended use of the Kerlix restraint. Based upon hypotheses presented to him and with[311]*311out ever having examined the plaintiff’s left wrist he further concluded that the damage to it was total and permanent.

While the issue of negligence was a close one, we hold that, on balance, it was properly a matter for the jury. The attack on the opinions voiced by Dr. Davidson went to the credibility of those opinions. That was a question within the purview of the jury and was properly left to it.

The trial court’s charge presents a more serious problem. A number of requests similar to those normally included in the charge in a case of this sort were refused. Standing alone, this refusal may not have been sufficient to warrant reversal. However, when coupled with other errors connected with the charge, a retrial is mandated.

At the request of counsel for the hospital the report of the Medical Malpractice Mediation Panel was received in evidence and read to the jury. In pertinent part it read: "With respect to the medical malpractice claim of the plaintiff against the defendant Beth Israel Medical Center, we find there is no liability on the part of said defendant”.

The court, in charging the jury on the effect of that recommendation, noted that:

"[i]f it [the Medical Malpractice Mediation Panel] agrees upon a recommendation of liability, which it did in this case, then, under the law, that recommendation is admissible in evidence *• * *
"You may accept or reject the recommendation of the panel”.

While the report itself was in evidence we cannot determine what the effect of this clearly accidental misstatement that the Medical Malpractice Mediation Panel had agreed that the hospital was liable had upon the jury.

Subsequent to the submission of the case to it, the jury sent a note to the court which read as follows: "Is a hospital liable for any injury to the patient while in its intensive care unit”?

It is apparent from the question that the jury’s thinking centered about the need for proof of causal relationship or whether, in light of the charge on res ipsa loquitur such proof was necessary. The somewhat obscure response by the court was: "All right, the only injury that is claimed in this case is the injury to the left radial nerve and none other”.

He then sent the jury back to continue its deliberations.

That the court’s supplemental charge did little to clarify the [312]*312issue for the jury is manifest from its second note which followed shortly more than an hour thereafter. The question there propounded was:

"We are in agreement that an injury to the radial nerve occurred to this plaintiff while in the intensive care unit.
"For the hospital to be liable, is it necessary to agree that this wrist restraint caused this injury?
"Are we limited to consider the wrist restraint only as the causative agent of the injury to the plaintiff’s radial nerve”?

In response to the question the court reread somewhat more than five and one-half pages of its original charge covering negligence and standard of care, the doctrine of respondeat superior, res ipsa loquitur and other matters. Included in this supplemental charge was a five-line paragraph defining generally the doctrine of proximate cause. Nowhere was there a speciñc answer to the jury’s inquiry.

Here, the jury, after the initial charge had been read to it, made clear its confusion and requested enlightenment on a specific matter.

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Bluebook (online)
72 A.D.2d 308, 424 N.Y.S.2d 208, 1980 N.Y. App. Div. LEXIS 9685, Counsel Stack Legal Research, https://law.counselstack.com/opinion/schwabach-v-center-nyappdiv-1980.