Sirias Carias, Etc. v. Laura Dalton, D.O.

CourtNew Jersey Superior Court Appellate Division
DecidedJune 8, 2026
DocketA-2484-24
StatusUnpublished

This text of Sirias Carias, Etc. v. Laura Dalton, D.O. (Sirias Carias, Etc. v. Laura Dalton, D.O.) is published on Counsel Stack Legal Research, covering New Jersey Superior Court Appellate Division primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sirias Carias, Etc. v. Laura Dalton, D.O., (N.J. Ct. App. 2026).

Opinion

NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION This opinion shall not "constitute precedent or be binding upon any court ." Although it is posted on the internet, this opinion is binding only on the parties in the case and its use in other cases is limited . R. 1:36-3.

SUPERIOR COURT OF NEW JERSEY APPELLATE DIVISION DOCKET NO. A-2484-24

SIRIA CARIAS, as mother and Natural Guardian of M.M., an infant,

Plaintiff-Appellant,

v.

LAURA DALTON, D.O., VIRTUA HEALTH, INC., VIRTUA WEST JERSEY HEALTH SYSYTEMS, INC., and VIRTUA MEDICAL GROUP, PA,

Defendants,

and

CHIDINMA AROLE, M.D.,

Defendant-Respondent. ______________________________

Argued April 22, 2026 – Decided June 8, 2026

Before Judges Mayer, Paganelli and Jacobs.

On appeal from the Superior Court of New Jersey, Law Division, Burlington County, Docket No. L-1192-20. Sherry L. Foley argued the cause for appellant (Foley & Foley, and Joseph Monaco, PC, attorneys; Sherry L. Foley, Timothy J. Foley and Joseph D. Monaco, of counsel and on the briefs).

Christopher M. Wolk argued the cause for respondent (Blumberg & Wolk, LLC, attorneys; Christopher M. Wolk and Dylan T. Stracke, on the briefs).

Abbott S. Brown argued the cause for amicus curiae New Jersey Association for Justice (Lomurro Munson LLC, attorneys; Christina Vassiliou Harvey, Abbott S. Brown, and Jonathan H. Lomurro, of counsel and on the brief).

PER CURIAM

In this medical malpractice matter, plaintiff as mother and natural

guardian of M.M.,1 an infant, appeals from trial court orders of April 26, 2024,

barring the testimony of her expert and March 6, 2025, denying reconsideration

of the April order and granting summary judgment to defendant Chidinma Arole,

M.D. We conclude the trial court erred in barring the expert's opinion without

conducting a N.J.R.E. 104 hearing. Because the decision to bar the expert's

testimony provided the basis for the grant of summary judgment, we vacate the

1 We use initials to preserve the minor's privacy. R. 1:38-3(f)(2).

A-2484-24 2 April and March orders and remand for further proceedings consistent with this

opinion.2

I.

On June 18, 2020, plaintiff filed a complaint alleging medical malpractice

negligence and lack of informed consent regarding the December 2015 delivery

of M.M. Plaintiff alleged M.M. sustained physical injuries and pain and

suffering. This appeal concerns the medical malpractice aspect of the litigation.

After completion of discovery, defendant moved to bar the testimony of

plaintiff's expert, Richard L. Luciani, M.D., and for summary judgment.

In his report, Dr. Luciani noted his "[o]pinions are stated within a

reasonable degree of medical probability/certainty." Further, his "[o]pinions are

based upon a review of all documents and a thorough understanding of the

standards of care applicable in this case at the time the treatment was rendered."

He stated his "[k]nowledge regarding standard of care has been learned as a

result of residency training, [continuing medical education (CME)], review of

gynecological journals[,] textbooks[,] and bulletins, interaction[s] with

2 Plaintiff's complaint regarding defendants Laura Dalton, D.O., Virtua Health, Inc., Virtua West Jersey Health Systems, Inc., and Virtua Medical Group, PA was dismissed with prejudice on June 7, 2023. These defendants are not participating in the appeal. A-2484-24 3 colleagues as well as the continuous active practice of OB[/]GYN for over 43

years." He noted he has "been board certified in OB/GYN since 1982 . . . and

voluntarily recertified in 2013."

In Dr. Luciani's report, he stated that at M.M.'s "delivery[,] a shoulder

dystocia was noted with the anterior left arm stuck under [plaintiff's] pubic

bone." Under this circumstance, the doctor opined the standard of care requires

"maneuver[s ] such as McRoberts, suprapubic pressure, rotational maneuvers,

or delivery of the posterior arm" be implemented to "dislodge the impacted

shoulder."

Further, plaintiff's expert explained "[g]entle axial traction . . . should only

be used once it is believed that" such maneuvers "dislodged the impacted

shoulder." "[A] reasonably prudent OB/GYN in 2015" must use "no more than

gentle axial traction . . . on the fetal head in attempting to d eliver the shoulder."

The doctor opined "[g]entle traction is what is used in a normal delivery. An

obstetrician should not use greater force than used in a normal delivery in the

face of shoulder dystocia." Further, "[i]f the obstetrician determines that the

impact has not been relieved by the maneuvers, traction should be ceased and

the obstetrician should then proceed to try another maneuver." (Footnotes

omitted).

A-2484-24 4 At his deposition, Dr. Luciani agreed the delivery record, and Dr. Arole's

deposition testimony, established that Dr. Arole "used three different methods

to try to release the shoulder, the McRoberts maneuver, suprapubic pressure[,]

and a Woods' screw maneuver." In his report, Dr. Luciani noted Dr. Arole stated

in her deposition testimony "that continued McRoberts and suprapubic pressure

allowed the left anterior shoulder to disimpact." Dr. Luciani testified that the

three maneuvers performed by Dr. Arole, alone and without other contributing

factors, "would not be a cause of a permanent injury in this case."

Nevertheless, Dr. Luciani opined "[i]f the traction on the baby's head by

the obstetrician is more than gentle and/or bends the baby's neck, then it is

deemed excessive and below the standard of care." (Footnote omitted). Further,

excessive traction "is a known cause of brachial plexus injuries," which are

"caused when the nerves are stretched beyond the elastic limit and they rupture

or avulse." The doctor opined "[p]ermanent injuries to the brachial plexus

nerves are caused by excessive traction, torque, or force on the baby's head away

from the fixed shoulder." Moreover, according to Dr. Luciani, "[p]ermanent

brachial plexus injuries are not caused by gentle traction."

Dr. Luciani opined "it is clear that Dr. Arole deviated from the standard

of care during the delivery . . . by utilizing excessive traction on [M.M.]'s head

A-2484-24 5 and neck." Dr. Luciani stated that at delivery, M.M. "was noted to have

significant left arm weakness documented to be a brachial plexus injury." The

doctor stated a "[s]ubsequent evaluation by Dr. Scott Kozin . . . on

[October 23, 2022] noted a C5-C6 brachial plexus injury noted to be permanent

in nature after having undergone tendon transfer on [October 1, 2018] with

incomplete recovery."

Dr. Luciani considered other causes: "muscle atrophy or other markers

consistent with in utero positioning"; "infection or cancer"; predisposition;

"biological variance to her anatomy"; and abnormal "maternal contractions

and/or pushing." However, the doctor concluded "[t]here are no facts

surrounding this delivery that indicate [these] cause[s] exist[ed]."

Regarding "maternal contractions and/or pushing," Dr. Luciani opined

that "[u]terine contractions spread . . . gradually creating an expulsive force.

The uterine muscle generates no traction force which has clearly been implicated

in causing brachial plexus injuries." Moreover, "[a]lthough th[e] magnitude of

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Sirias Carias, Etc. v. Laura Dalton, D.O., Counsel Stack Legal Research, https://law.counselstack.com/opinion/sirias-carias-etc-v-laura-dalton-do-njsuperctappdiv-2026.