Winschel v. Jain

925 A.2d 782, 2007 Pa. Super. 121, 2007 Pa. Super. LEXIS 823
CourtSuperior Court of Pennsylvania
DecidedMay 1, 2007
StatusPublished
Cited by58 cases

This text of 925 A.2d 782 (Winschel v. Jain) is published on Counsel Stack Legal Research, covering Superior Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Winschel v. Jain, 925 A.2d 782, 2007 Pa. Super. 121, 2007 Pa. Super. LEXIS 823 (Pa. Ct. App. 2007).

Opinions

OPINION BY

McCAFFERY, J.:

¶ 1 Appellant, James J. Winschel, administrator of the estate of Appellant’s decedent, Robert J. Winschel, Jr. (hereinafter “Decedent”), appeals from the judgment entered against him after the trial court denied his motion for a new trial in a medical malpractice action brought against Appellee and Cross-Appellant, Ajay Jain, M.D. (hereinafter “Dr. Jain”). Specifically, Appellant contends that the verdict was against the weight of the evidence because, even though the jury found Dr. Jain negligent, it ignored undisputed evidence that Dr. Jain’s negligence was the cause of Decedent’s death. After careful review, we reverse and grant a new trial.

¶2 The relevant facts and procedural history of this case are as follows. In February 2002, after an episode of chest pain, Decedent was referred by Dr. Hrin-da, his family physician, to Dr. Jain, a cardiologist, for a stress test. During the office visit, Dr. Jain obtained a medical history from Decedent, which revealed multiple risk factors for coronary artery disease, including diabetes, cigarette smoking, elevated cholesterol, hypertension, and a family history of premature heart disease. Dr. Jain began to administer a treadmill stress test, but had to halt the test prior to completion because of Decedent’s complaints of fatigue. Dr. Jain then performed another diagnostic test, known as a persantine SPECT scan test,1 on Decadent. No abnormalities were detected by these diagnostic tests, and no further testing was recommended. However, on May 14, 2002, approximately three months after the tests were conducted, Decedent suffered a cardiac event and died at age forty-five. Dr. Mary Ellen Reitz conduct[786]*786ed an autopsy and concluded that the cause of death was acute myocardial infarction, secondary to complete obstruction of the left coronary artery.

¶ 3 On August 6, 2003, Appellant filed suit against Dr. Jain, alleging negligence in Dr. Jain’s failure to diagnose the obstruction in Decedent’s left coronary artery. At trial, Appellant specifically alleged that the treatment of Decedent fell below the standard of care for a cardiologist because Dr. Jain had failed to recommend that Decedent, who had virtually every risk factor for coronary artery disease and who had suffered chest pain, undergo cardiac catheterization in order to rule out a life-threatening arterial obstruction.

¶4 To support this theory, Appellant offered the testimony of two board-certified cardiologists, Dr. Robert Stgrk and Dr. Halbert Feinberg, both of whom testified that Dr. Jain’s treatment of Decedent fell below the standard of care for a cardiologist because Dr. Jain had failed to recommend a catheterization. In turn, the defense presented the testimony of two other board-certified cardiologists, Dr. Jeffrey Garret and Dr. George Beller. They opined that Dr. Jain’s treatment of Decedent had not deviated from the appropriate standard of care because, although Decedent had multiple risk factors for coronary artery disease, his stress test and SPECT test were normal and thus cardiac catheterization was not indicated.

¶ 5 On the issue of causation, Appellant again relied on the testimony of Drs. Stark and Feinberg. These two expert witnesses opined, based on Decedent’s medical history and Dr. Reitz’s autopsy report, that Decedent’s death had resulted from a total or nearly total occlusion of his left coronary artery. They further noted, based on the autopsy report, that Decedent had suffered several mini heart attacks prior to his fatal cardiac event, as revealed by multiple regions of scarring in his heart. Therefore, in the opinion of Appellant’s cardiology experts, when Dr. Jain tested Decedent less than three months before his death, his left coronary artery was already substantially occluded and the occlusion would have been detected by catheterization. Appellant also offered the testimony of Dr. Eric Vey, a board-certified forensic pathologist for the Erie County Coroner’s Office. In agreement with Drs. Stark and Feinberg, Dr. Vey testified that the near total occlusion of Decedent’s left coronary artery was a factual cause of his death, had developed over a long period of time, and would have been clinically significant three months before his death, i.e., at the time that Dr. Jain administered the stress test. Drs. Stark, Feinberg, and Vey all agreed that lesions in the proximal region of the left anterior descending coronary artery (“LAD artery”), such as the lesion detected upon autopsy of Decedent, are typically referred to as “widow makers” because they frequently result in sudden death. (Notes of Testimony (“N.T.”) Trial, 2/15/06, at 52,121-22,163).

[787]*787¶ 6 Defense expert Dr. Beller conceded that Decedent had died because of an almost totally occluded LAD artery and that the artery would not have been normal three months before his death, ie., at the time he was seen by Dr. Jain. Although Dr. Beller testified that he was unable to estimate the extent of the occlusion of Decedent’s LAD artery three months before the fatal cardiac event, he also acknowledged that, had catheterization been performed, it would have detected whatever occlusion was there, even if the occlusion had been only 40-50 percent.2

¶ 7 The jury returned a verdict in favor of Dr. Jain. Specifically, the jury indicated that although it found the conduct of Dr. Jain to be below the applicable standard of care, it also found that Dr. Jain’s negligence was not a factual cause of Decedent’s death. Appellant filed a motion for post-trial relief seeking a new trial. Appellant argued that the jury’s conclusion as to causation was against the weight of the evidence and indeed was inconsistent with all the medical testimony as to causation that had been proffered at trial. In response, Dr. Jain then also filed a motion for post-trial relief, contending that the trial court had erred in excluding the deposition testimony of pathologist Dr. Reitz, who had performed the autopsy on Decedent. Dr. Jain had sought at trial to introduce portions of Dr. Reitz’s deposition in which she had suggested the possibility of an alternate cause of death; however, the trial court had excluded the testimony as too speculative and inconsistent with findings in her autopsy report. Dr. Jain also contended in his post-trial motion that the trial court had erred by precluding the testimony of other expert witnesses regarding possible alternate causes of death and regarding the standard of care for a cardiologist.

¶ 8 The trial court denied Appellant’s post-trial motion, thus rendering Dr. Jain’s motion moot. Appellant filed a motion for reconsideration, which was also denied. Judgment was entered on the verdict in favor of Dr. Jain on June 1, 2006.3 Appellant appealed to this Court and Dr. Jain cross-appealed.

¶ 9 Appellant raises one issue for our review which he articulates as follows:

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Cite This Page — Counsel Stack

Bluebook (online)
925 A.2d 782, 2007 Pa. Super. 121, 2007 Pa. Super. LEXIS 823, Counsel Stack Legal Research, https://law.counselstack.com/opinion/winschel-v-jain-pasuperct-2007.