Stone v. Sobol

171 A.D.2d 235, 575 N.Y.S.2d 939, 1991 N.Y. App. Div. LEXIS 13737
CourtAppellate Division of the Supreme Court of the State of New York
DecidedOctober 31, 1991
StatusPublished
Cited by3 cases

This text of 171 A.D.2d 235 (Stone v. Sobol) 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
Stone v. Sobol, 171 A.D.2d 235, 575 N.Y.S.2d 939, 1991 N.Y. App. Div. LEXIS 13737 (N.Y. Ct. App. 1991).

Opinion

[237]*237OPINION OF THE COURT

Mahoney, P. J.

These combined CPLR article 78 proceedings were initiated by petitioners to review respondent’s determinations disciplining them for professional misconduct in their care and treatment of patient A at New York Hospital (hereinafter the hospital) in March 1984. At that time, petitioner Gregg W. Stone, a physician, was a first-year resident at the hospital and the immediate supervisor of petitioner Luise L. Weinstein, an intern. The evidence adduced at consolidated hearings conducted by a Hearing Committee of the Department of Health’s Board for Professional Medical Conduct reveals that patient A arrived at the hospital’s emergency room as directed by her family physician, Raymond Sherman, at approximately 11:45 p.m. on March 4, 1984 and was initially examined by Maurice Leonard. Patient A informed Leonard that she had a tooth extracted five days earlier and thereafter developed an earache and fever. During the examination, Leonard noted that patient A was "moving her arms and legs in a sort of random fashion”. Leonard observed that these movements were "of a volitional nature”, prompting consideration that they may be psychological in origin. After Leonard consulted with Sherman and reviewed several laboratory tests, patient A was admitted to the hospital. Leonard then contacted Weinstein and assigned her to patient A’s case, and Weinstein, in turn, notified Stone.

Stone then examined patient A, obtaining her medical history and questioning her regarding her use of Nardil, an antidepressant prescribed by her psychiatrist. Stone also spoke with Weinstein, Sherman and patient A’s mother. In view of patient A’s agitation, Stone twice questioned her, and spoke with her parents, regarding use of narcotics, including marihuana, cocaine and heroin. Although patient A and her parents denied that she had ever used illegal drugs, it was later discovered that patient A did have traces of cocaine in her system.

After the examination, Stone recorded his working diagnosis as "a [suspected] viral syndrome [with] hysterical symptoms, but [the differential diagnosis] should include [several other ailments]”. As the Hearing Committee later noted in its findings of fact: "Because the patient could control [her thrashing] when told to do so and also because such seemingly volitional conduct is often associated with the psychological [238]*238disorder of hysteria * * * Stone appended to his working diagnosis of 'viral syndrome’, the words 'with hysterical symptoms’ as a possible explanation for the patient’s motor activity.” Stone then ordered several additional tests and after consulting with Sherman began treating patient A’s symptoms. Stone also suggested a psychological evaluation if all the medical tests proved negative. After completing his treatment plan and concluding that patient A’s condition was stable, Stone turned the care and treatment of patient A over to Weinstein at approximately 3:00 a.m. and attended to other patients. At 5:00 a.m. Stone left the hospital and went home, where he was available by remote page.

Weinstein first saw patient A on her way to the emergency room to discuss the case with Leonard. Weinstein then proceeded to patient A’s room and reviewed the emergency room records while Stone completed his examination. Stone and Weinstein then discussed treatment plans and the possibility that patient A had ingested illegal substances. Drug testing was planned and a psychiatric evaluation considered because of the volitional component to patient A’s agitation.

Weinstein began her own evaluation by taking patient A’s history and conducting a physical examination. According to the Hearing Committee’s findings, "patient [A] was vague and had a lot of nonspecific complaints”. Weinstein questioned patient A more than once on her use of illegal narcotics, which patient A essentially denied despite Weinstein’s assurances of confidentiality. After completing her physical evaluation of patient A at approximately 3:00 A.M., Weinstein spent the next hour writing the admission orders and note, ordering tests and setting up a treatment plan essentially the same as that being previously followed for patient A. During this time patient A continued her intermittent "agitation” and Weinstein spent 15 to 20 minutes periodically tending to her, once to replace the intravenous line that patient A had removed. Shortly after 4:00 a.m., Weinstein made a final check on patient A and returned to her assigned floor to care for her other patients.

Between 4:15 a.m. and 4:30 a.m., Weinstein received calls from the nursing staff regarding patient A’s agitation and restlessness. Weinstein inquired as to any changes in patient A’s medical condition. The attending nurse indicated none but voiced concern that patient A might injure herself. Weinstein directed the use of a bed jacket which restrained only patient A’s torso. When this proved ineffective, the attending nurses [239]*239restrained patient A’s arms and ankles without informing Weinstein, as permitted by hospital regulations. When patient A still failed to calm down, Weinstein was again contacted and asked to return to patient A and sedate her. In response, Weinstein again inquired as to patient A’s condition, particularly patient A’s appearance and ability to breathe comfortably. Although no changes were noted by the nurse, Weinstein ordered the administration of Haldol to calm patient A and aid her sleep. Patient A was subsequently monitored by the nursing staff three times between 5:00 a.m. and 6:00 a.m., during which she exhibited no distress and was sleeping comfortably.

Weinstein was next contacted regarding patient A at 6:30 a.m. when she was informed that patient A’s temperature had risen. Weinstein directed the nurse to arrange for a cooling blanket and to apply cold compresses to patient A. The Hearing Committee found that Weinstein then "proceeded to a conference room on the other end of the floor to collect her medical instruments [and], [a]s she was getting her instruments * * * Weinstein heard the arrest code called and immediately proceeded to patient A’s room”. The "arrest code” was activated because patient A was in cardiac arrest. Despite resuscitation attempts by hospital staff, including Weinstein, patient A was pronounced dead at 7:30 a.m. While the autopsy report listed bilateral bronchopneumonia as the cause of death, various experts at the hearing testified that the exact cause of death was unknown.

Stone was subsequently charged by the Office of Professional Medical Conduct (hereinafter OPMC) with eight specifications of gross negligence and, based on the same facts, eight specifications of negligence on more than one occasion and failing to maintain a proper hospital record. Weinstein was separately charged with 10 specifications of gross negligence and again, based on the same facts, 10 specifications of negligence on more than one occasion and failure to maintain proper records. At the conclusion of the hearing, the Hearing Committee issued an extensive report setting forth its findings and conclusions and unanimously recommended that all charges against petitioners be dismissed. The Commissioner of Health subsequently reviewed the record and, stating that "both individual [petitioners] exercised their best judgment given the circumstances”, adopted the Hearing Committee’s findings, conclusions and recommendations in full.

The Regents Review Committee, after reviewing the record [240]

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Bluebook (online)
171 A.D.2d 235, 575 N.Y.S.2d 939, 1991 N.Y. App. Div. LEXIS 13737, Counsel Stack Legal Research, https://law.counselstack.com/opinion/stone-v-sobol-nyappdiv-1991.