Spadaccini v. Dolan

63 A.D.2d 110, 407 N.Y.S.2d 840, 1978 N.Y. App. Div. LEXIS 11322
CourtAppellate Division of the Supreme Court of the State of New York
DecidedJuly 13, 1978
StatusPublished
Cited by40 cases

This text of 63 A.D.2d 110 (Spadaccini v. Dolan) 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
Spadaccini v. Dolan, 63 A.D.2d 110, 407 N.Y.S.2d 840, 1978 N.Y. App. Div. LEXIS 11322 (N.Y. Ct. App. 1978).

Opinions

[113]*113OPINION OF THE COURT

Fein, J.

Defendants Westchester Square Hospital and Doctors Sherman, Di Salvo and Nisi appeal from a judgment entered after trial on a jury verdict in favor of plaintiff in this action to recover damages for the wrongful death of Santo Spadaccini and for the conscious pain and suffering allegedly endured by him during the period he lingered in the hospital prior to his death on April 19, 1970. The jury returned a verdict in favor of plaintiff on the cause of action for wrongful death in the sum of $350,000, apportioned 80% against the doctors and 20% against the hospital and, on the cause of action for conscious pain and suffering, in the sum of $25,000 against the doctors and $25,000 against the hospital.

On this appeal, defendant doctors assign as error the failure of the Trial Justice to instruct the jury that mere error of judgment is not malpractice particularly after having advised counsel, at the conference held prior to closing statements pursuant to CPLR 4110-b, that the court would charge the jury in substance that defendant doctors were required to exercise reasonable care in the care and treatment of decedent, but could not be held liable for mere error of judgment. It is undisputed that no instruction was given to the effect that the doctors could not be held liable for mere error of judgment. The doctors contend they were entitled to such a charge on the facts of this case. They assert that in any event reversal is required because the court deviated in this respect from the commitment made to counsel prior to closing statements.

Defendant hospital contends that (1) the proof against it was insufficient for submission to the jury; and (2) plaintiff failed to make out a prima facie case. All defendants further claim that (1) the verdict in both the death action and the survival action for conscious pain and suffering was excessive; (2) the jury’s apportionment was improper; and (3) the judgment entered in the sum of $50,000 on the cause of action for conscious pain and suffering, 50% against the doctors and 50% against the hospital was improper in view of the jury’s 80%-20% apportionment on the wrongful death cause. Defendants also claim that the verdict for pain and suffering was in the total sum of $25,000 and that even in that amount, it was excessive.

Essentially this is a case where the decedent received sue[114]*114cessful surgical treatment, but allegedly died as a result of improper attention and treatment following surgery. For several days decedent complained of a swelling of the tongue and pain in the mouth. He was referred to Westchester Square Hospital by Dr. Procario, a general practitioner, who called in Dr. Sherman, a head, neck and plastic surgery specialist. Dr. Sherman diagnosed the condition as Ludwig’s Angina and advised that immediate surgery was required. In diagnosing the condition as Ludwig’s Angina, Dr. Sherman noted a severe infection, evidenced by marked swelling under the chin and marked edema of the floor of the mouth. The condition is usually caused by a dental infection which can spread from the bottom front of the mouth in toward the back of the tongue and, if not treated, can cause swelling on the outside of the neck. Primary treatment is administration of anitbiotics and/or surgery.

Subsequent to decedent’s admission, Dr. Sherman performed the operation on March 27, 1970, consisting of an incision and drainage through the neck to the floor of the mouth. Following the operation, decedent was placed in a private room to insure necessary isolation precautions because of the severe infection. Dr. Sherman had ordered that a tracheotomy set be placed in the room in the event of any upper respiratory difficulty. Decedent was not placed in an intensive care unit, nor does it appear that there was an intensive care unit in the hospital, other than a coronary care unit for treatment of coronary patients. Although certain precautions were taken, the private room in which decedent was confined was admittedly not made the equivalent of an intensive care unit (ICU). It did not have the equipment normally found in such a unit. Nor did it have an ICU nurse or doctor constantly present in the event of an emergency. Although decedent did have a private room with a private duty nurse, this was not the equivalent of ICU confinement.

Subsequent to the operation, decedent developed pneumonia in the left lung, at which point Dr. Procario called in Dr. Nisi and his partner, Dr. Di Salvo, internists. They rendered medical treatment to decedent during the postoperative period. None of the doctors ordered a tracheotomy either during the operation or during the postoperative period, a procedure which even defendants’ expert, Dr. Cohen, testified "should always be considered in a case of Ludwig’s Angina in order to prevent respiratory distress.” Plaintiffs expert, Dr. Greene, [115]*115also testified to the necessity of a tracheotomy to assure the protection of the patient’s airway where there is a threat of respiratory obstruction. Indeed the presence of a tracheotomy set in decedent’s room indicated some awareness by all of the treating physicians as to the possible or potential need to administer a tracheotomy.

Plaintiff’s primary claim of negligence against the doctors was their failure to order an elective prophylactic tracheotomy or a tracheotomy during the postoperative period and their failure to insure that decedent was placed in an intensive care unit or the equivalent. The sufficiency and the adequacy of the medical treatment accorded decedent was clearly a question for resolution by the jury.

As to defendant hospital, plaintiff’s allegation of negligence concerned the manner in which the hospital reacted when decedent went into respiratory arrest and a code 54 was announced throughout the hospital. Code 54 is an emergency code indicating that a patient is in immediate danger of death. It indicates that the patient is in distress and needs immediate resuscitation and emergency treatment. The evidence was sufficient for a finding that there was a delay of some 15 minutes between the time the code 54 was issued and the time a doctor responded thereto.

The evidence was adequate to present a jury question as to whether defendant hospital and its staff timely responded to the emergency code. According to the proof, decedent began choking and turning blue at 7:55 p.m. The code 54 was not called until 8:00 p.m. and a tracheotomy was not begun until at least 8:15 p.m. We find the evidence sufficient to present a question for the jury whether the delay in responding after the code 54 call was turned in conformed to proper and accepted medical practice and was a proximate cause of the death. The hospital entries leave much to be desired. Even assuming the accuracy of the hospital record, there appears to have been at least a 15-minute delay during which Mr. Spadaccini went into cardiac arrest and sustained the irreversible brain damage which led to his death some 21 days later on April 19, 1970. The proof was sufficient for a jury to find that the hospital did not timely respond to the code 54. On the basis of the evidence, it cannot be ruled as a matter of law, as the hospital apparently contends on this appeal, that by the time the code 54 was sounded or within a minute thereafter irreversible brain damage already existed, which [116]*116the hospital was powerless to prevent. These were questions for the jury, which by its verdict resolved them against the hospital.

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Bluebook (online)
63 A.D.2d 110, 407 N.Y.S.2d 840, 1978 N.Y. App. Div. LEXIS 11322, Counsel Stack Legal Research, https://law.counselstack.com/opinion/spadaccini-v-dolan-nyappdiv-1978.