STORM COLLETON VS. MARK BIEBEL (L-5125-12, MONMOUTH COUNTY AND STATEWIDE)

New Jersey Superior Court Appellate Division·Decided May 15, 2019·No. A-5469-16T1·Unpublished

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NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION This opinion shall not "constitute precedent or be binding upon any court."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-5469-16T1

STORM COLLETON and MELINDA COLLETON,

Plaintiffs-Appellants,

v.

MARK BIEBEL, DPM, MARK DECOTIIS, DPM, BIEBEL & DECOTIIS PODIATRY ASSOCIATES, SHREWSBURY SURGICAL CENTER, THEODORE KUTZIN, MD, and ATLANTIC AMBULATORY ANESTHESIA ASSOCIATES, LLC,

Defendants-Respondents.

Argued April 29, 2019 – Decided May 15, 2019 Before Judges Fasciale and Gooden Brown.

On appeal from Superior Court of New Jersey, Law Division, Monmouth County, Docket No. L-5125-12.

Michael B. Zerres argued the cause for appellants (Blume Forte Fried Zerres, & Molinari, attorneys;

Michael B. Zerres, of counsel and on the briefs; Robert C. Sanfilippo, on the briefs).

Charles C. Koernig argued the cause for respondents Mark Biebel, Mark DeCotiis, and Biebel & DeCotiis Podiatry Associates (Kaufman Borgeest & Ryan, LLP, attorneys; Charles C. Koernig, of counsel; Jonathan D.

Hallett, on the brief).

James M. Ronan, Jr. argued the cause for respondents Theodore Kutzin and Atlantic Ambulatory Anesthesia Associates (Ronan, Tuzzio & Giannone, PA, attorneys;

James M. Ronan, Jr., of counsel and on the brief; Nicole M. Scillia, on the brief).

Judith A. Wahrenberger argued the cause for respondent Shrewsbury Surgical Center (Ruprecht Hart Ricciardulli & Sherman, LLP, attorneys; Judith A.

Wahrenberger, of counsel; Lindsay B. Beaumont, on the brief).

PER CURIAM This is a medical malpractice case primarily against two podiatrists (Dr.

Mark Biebel, DPM; and Dr. Mark DeCotiis, DPM), an anesthesiologist (Dr. Theodore Kutzin), and a nurse (Janice Jones) (collectively defendants).1 Plaintiff Storm Colleton suffered permanent nerve damage following surgery to repair a torn Achilles tendon. The case came down to a battle of the experts on the standard of care applicable to the correct amount of tourniquet pressure

1 Plaintiff, and his wife Melinda Storm, who filed a per quod claim, (collectively plaintiffs), had also sued Biebel and DeCotiis Podiatry Associates; Shrewsbury Surgical Center as respondeat superior for nurse Janice Jones; and Atlantic Ambulatory Anesthesia Associates (the other defendants).

A-5469-16T1

applied to plaintiff's right thigh. Dr. Biebel, who performed the surgery, used 350mm/Hg of mercury as tourniquet pressure, which plaintiff contended was too great.

The jury found that plaintiffs failed to prove defendants deviated from the accepted medical standards of care. After the judge denied plaintiffs' motion for a new trial, she entered a judgment of no cause of action. Plaintiffs argue primarily that the judge made erroneous evidentiary rulings and failed to address juror misconduct. We agree, reverse the judgment, and remand for a new trial on all issues.

I.

Plaintiff was an avid martial arts participant. While fighting in a Kapap2 match, he kicked an opponent and felt a pop in his right leg. The next day plaintiff consulted Dr. Biebel, who ordered an ultrasound and MRI of plaintiff's right leg. Those tests revealed that plaintiff severely ruptured his Achilles tendon. Dr. Biebel told plaintiff that corrective surgery was the best option, it was a simple procedure, and he would be back to work as a State Trooper in four to six weeks.

2 Kapap is an Israeli self-defense form focusing on hand-to-hand combat and physical endurance. See https://en.wikipedia.org/wiki/Kapap.

A-5469-16T1

Plaintiff underwent the surgery at the Shrewsbury Surgery Center on March 30, 2011. Dr. DeCotiis, who was Dr. Biebel's partner, assisted during the surgery. Plaintiff returned home with a "pain pump" attached to the back of his right leg. The pump intravenously fed pain medication into his leg through a catheter that Dr. Kutzin had inserted into the soft tissue behind the knee, an area known as the popliteal fossa. After a couple of days, the medicine was exhausted and plaintiff removed the pump and catheter as directed by the discharge instructions. Initially, he felt no pain when he removed the catheter, nor did he notice any bleeding or swelling, but shortly after removing the pump, plaintiff felt intense pain in his leg. Plaintiff took Percocet, which did not relieve the pain.

Dr. Biebel then met plaintiff at the emergency room, where he received morphine. The doctor was unsure what was causing the pain, but noted swelling in the upper part of plaintiff's right foot. There was no sign of swelling or bleeding in the leg itself. He instructed plaintiff to come to his office if the pain did not subside.

Thereafter, plaintiff followed up with Dr. Biebel, who was still unsure of the source of the pain, so he sent plaintiff to a pain management doctor who prescribed several pain control medications, none of which worked. Dr. Biebel

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referred plaintiff to a physiatrist for nerve conduction studies, which showed Dr. Biebel that plaintiff had no nerve function from his right knee downward.

Plaintiff then sought second opinions from numerous medical specialists.

He underwent physical therapy and consulted with an orthopedic surgeon, both to no avail. A neurologist performed a second nerve conduction study, which again revealed significant nerve damage in plaintiff's right leg. During this period, plaintiff's right foot and leg pain persisted. He experienced "electric shocks" that awakened him in the middle of the night, and he suffered from substantial muscle atrophy.

In March 2012, plaintiff consulted Dr. Lee Dellon, a peripheral nerve surgeon from Maryland. Dellon performed two separate surgical procedures that restored some feeling to plaintiff's leg and foot but did not alleviate the toe contractures. The surgery resulted in pain abatement, but sporadic electric shocks continued.

In January 2014, Dr. Martin O'Malley, who is a foot and ankle specialist, surgically removed the tendons in plaintiff's toes, which helped plaintiff walk. Dr. O'Malley inserted metal screws to straighten plaintiff's toes, and plaintiff's right foot had increased from a size nine to an eleven doublewide, which required special shoes.

A-5469-16T1

Plaintiff's theory at trial was that his nerve injuries were caused by compression from over-pressurization of the mid-thigh pneumatic tourniquet used during the Achilles repair surgery. He blamed Dr. Biebel for setting the tourniquet pressure too high. As to Dr. DeCotiis, Dr. Kutzin, and the nurse, his theory was that they failed to intercede and insist that Dr. Biebel lower the pressure.

Plaintiff presented expert testimony from Dr. Arup De, an anesthesiologist. He noted that plaintiff's tourniquet was in place for forty-eight minutes at a pressure of 350mm/Hg of mercury. Dr. De concluded that Dr. Kutzin deviated from the accepted standard of care by not questioning t he use of such a high tourniquet pressure.

Plaintiff also presented expert testimony from Erica Leach, a licensed registered nurse. Ms. Leach identified guidelines for perioperative practice published in 2007 by the Association of periOperative Registered Nurses (AORN).3 The guidelines cautioned to use a minimum amount of pressure for pneumatic tourniquets. She stated that Jones departed from accepted standards

3 AORN is a professional association for perioperative nurses that publishes guidelines to "define standardized practice for perioperative professionals." https://www.aorn.org/about-aorn (last visited Apr. 29, 2019).

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of nursing care by failing to advocate for her patient, and that Jones should have been aware of the AORN guidelines and spoken to Dr. Biebel about the over- pressurization.

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STORM COLLETON VS. MARK BIEBEL (L-5125-12, MONMOUTH COUNTY AND STATEWIDE), (N.J. Ct. App. 2019).

STORM COLLETON VS. MARK BIEBEL (L-5125-12, MONMOUTH COUNTY AND STATEWIDE) (STORM COLLETON VS. MARK BIEBEL (L-5125-12, MONMOUTH COUNTY AND STATEWIDE)) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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