Wilkerson v. County of Cook

884 N.E.2d 808, 379 Ill. App. 3d 838, 318 Ill. Dec. 840, 2008 Ill. App. LEXIS 135
CourtAppellate Court of Illinois
DecidedFebruary 25, 2008
Docket1-07-0294
StatusPublished
Cited by7 cases

This text of 884 N.E.2d 808 (Wilkerson v. County of Cook) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Wilkerson v. County of Cook, 884 N.E.2d 808, 379 Ill. App. 3d 838, 318 Ill. Dec. 840, 2008 Ill. App. LEXIS 135 (Ill. Ct. App. 2008).

Opinion

JUSTICE GARCIA

delivered the opinion of the court:

In this medical malpractice case, the plaintiff, Jacqueline Wilkerson, successor special administrator of the estate of Beverly Newsome, deceased, appeals from an order granting summary judgment in favor of the defendants, County of Cook, d/b/a Cook County Hospital, Jaya Ahuja, M.D., and Henry Ching. On appeal, the plaintiff contends that summary judgment was improper because (1) a question of fact exists as to whether the defendants were negligent in their treatment of the decedent and (2) Dr. Ahuja’s contradictory testimony created a credibility issue, appropriately resolved only by the trier of fact. We affirm.

BACKGROUND

The controversy before us concerns whether Cook County Hospital and its employees, Henry Ching, a cytotechnician, and Dr. Jaya Ahuja, a pathologist, were negligent in the treatment of Ms. Newsome following an abnormal Pap smear that revealed the presence of “Inflammatory and degenerative changes. Reactive changes. Anucleated squames,” by failing to conduct a follow-up Pap smear and, potentially, a cervical biopsy. According to the plaintiff, the failure to conduct such a follow-up constituted negligent treatment from which liability may occur under the Local Governmental and Governmental Employees Tort Immunity Act (Tort Immunity Act) (745 ILCS 10/6 — 106(d) (West 2004)).

On November 18, 1996, Ms. Newsome went to Cook County Hospital complaining of lower abdominal pain and vaginal discharge. The results of a Pap smear taken during her initial examination yielded the following: “Inflammatory and degenerative changes. Reactive changes. Anucleated squames.” Dr. Ahuja and Ching reviewed the Pap smear and made nonspecific findings. Ms. Newsome’s diagnosis was pregnancy and a vaginal infection, bacterial vaginosis. Dr. Ahuja did not diagnose cancer or a precancerous condition. Ching, as a technician, did not make a diagnosis.

Ms. Newsome was treated for the vaginal infection. Ms. Newsome underwent additional prenatal visits at Cook County Hospital, but ultimately delivered her child at West Suburban Medical Center in April 1997. She was later diagnosed by West Suburban Medical Center staff with cervical cancer. Ms. Newsome sought treatment for cervical cancer until her death on June 24, 1997.

On May 16, 2005, the plaintiff filed the present form of her complaint, the first amended complaint at law. In counts I and II of her complaint, the plaintiff alleges that the defendants were negligent in one or more of the following respects.

“a. Failing to properly or adequately administer pap smears during Plaintiffs Decedent’s treatment; or
b. Failing to properly or adequately interpret the laboratory tests done during Plaintiffs Decedent’s treatment; or
c. Failing to properly or adequately follow-up or treat the abnormal pathology reports made during Plaintiff’s Decedent’s treatment; or
d. Failing to obtain adequate or proper consults with specialists.”

The defendants filed a motion for summary judgment based on the Tort Immunity Act. 745 ILCS 10/1 — 101 et seq. (West 2004). In their motion, the defendants argued they were entitled to the protections of the Tort Immunity Act because they, never diagnosed Ms. Newsome as having cancer or a precancerous condition and, thus, no follow-up testing or treatment was required. See 745 ILCS 10/6 — 105, 6 — 106(a) (West 2004). The only treatment Ms. Newsome received from the defendants was for a vaginal infection and the plaintiff does not contend that the treatment of the infection was negligent.

In her reply, the plaintiff argued that the evidence established that Ms. Newsome was diagnosed with pregnancy and an abnormal Pap smear. She was then treated with prenatal visits and monitoring. The plaintiff argues that as part of the treatment plan, the defendants were required to conduct a repeat Pap smear or cervical biopsy and that their failure to do so proximately led to Ms. Newsome’s death. The plaintiff contends that because the defendants’ negligence related to their treatment of Ms. Newsome, not her diagnosis, they are not entitled to immunity under the Tort Immunity Act.

In reviewing the defendants’ motion for summary judgment, the trial court considered the depositions of Henry Ching, Dr. Jaya Ahuja, and Dr. Ronald S. Leuchter.

During his deposition, Ching testified that he was the cytotechnologist who analyzed Ms. Newsome’s Pap smear slides at Cook County Hospital in November 1996. Ching explained that his job as a cytotechnologist requires him to screen slides and then mark his impressions, whether normal or abnormal. He does not make any recommendation or opinion as to why a reading could have resulted in an abnormal impression as he is not trained to do so. Ching explained that the procedure at Cook County Hospital requires him to fill out a “requisition form” noting his impressions after review of a Pap smear slide. If the slide results appear abnormal, he notes that on the back of the requisition form and sends his impressions, along with the slides, to the pathologist for a diagnosis.

Ching testified to the presence of several abnormalities on Ms. Newsome’s Pap smear slides. Thus, consistent with procedure, he noted his impressions on the requisition form and forwarded it, with the slides, to Dr. Ahuja. In response to questions concerning results of Pap smears generally, Ching explained that the presence of anucleated cells must be reported by a cytotechnologist to a pathologist because, at times, these cells may hide malignant cells. He further explained that an “inflammatory degenerative” finding is generally considered a normal finding, and thus, not required to be brought to the attention of a pathologist, but a “reactive changes” finding needs to be brought to the attention of a pathologist. He explained that when he observes something unusual, whether benign or malignant, he always forwards the slides to the pathologist “for them to judge if it’s malignant or not,” as he is not trained to make that determination.

In her deposition, Dr. Jaya Ahuja testified that she was the surgical pathologist who reviewed Ms. Newsome’s Pap smear slides after the cytotechnologist forwarded them to her with his impressions. She explained that the procedure of Cook County Hospital requires her to review all slides cytotechnologists read as abnormal. Dr. Ahuja reviewed Ms. Newsome’s Pap smear slides and reported “Inflammatory and degenerative changes. Reactive changes. Anucleated squames.” Dr. Ahuja generated a summary report based on her findings that was made available to the patient’s attending physician. Dr. Ahuja attributed the inflammation of the cervix to a bacterial infection. She explained that inflammation “is not consistent with malignancy.” Dr. Ahuja further explained that “reactive changes” and “anucleated squames” can be seen when the cells are benign, “dysplastic” or malignant. She explained that dysplastic is a condition between benign and malignant.

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Bluebook (online)
884 N.E.2d 808, 379 Ill. App. 3d 838, 318 Ill. Dec. 840, 2008 Ill. App. LEXIS 135, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wilkerson-v-county-of-cook-illappct-2008.