Cole v. Champlain Valley Physicians' Hospital Medical Center

Citations: 116 A.D.3d 1283; 984 N.Y.S.2d 225

Court: Appellate Division of the Supreme Court of the State of New York; April 17, 2014; New York; State Appellate Court

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An appeal was filed against a Supreme Court order that denied summary judgment motions by several defendants in a medical malpractice and wrongful death case involving Edwin E. Cole Sr. (decedent). He was admitted to Champlain Valley Physicians’ Hospital Medical Center (CVPH) with a chronic cough and bloody sputum. A CT scan revealed fluid in his left lung, which led to a collapsed lung during an unsuccessful drainage attempt. Consulting thoracic surgeon Craig Nachbauer placed a chest tube to reinflate the lung, and after further complications, he and pulmonologist William Bruce Bunn scheduled a thoracoscopy but postponed it due to the decedent’s unstable condition. Ultimately, after two weeks, Bunn deemed the decedent stable for surgery. The day before the procedure, Bunn performed a thoracentesis, removing significant fluid. During the subsequent surgery by Nachbauer, a large amount of blood obstructed the decedent's airway during an intubation attempt by anesthesiologist Madeline Waid, resulting in cardiac arrest and death.

The plaintiff, the decedent's widow, initiated legal action against multiple defendants. The remaining defendants sought summary judgment, asserting they met the standard of care and did not cause harm. The Supreme Court found that they did not meet the criteria for summary judgment, leading to the appeal. Defendants provided medical records, testimonies, and expert affidavits to demonstrate compliance with the standard of care. Nachbauer, Waid, Bunn, and their respective practices successfully established their entitlement to summary judgment based on the evidence submitted, which included detailed affidavits and expert opinions.

Waid, an employee of CVPH, was found not culpable during the fatal surgery, but the court noted that the care provided by CVPH employees in the two weeks prior was not addressed in the submissions. This omission meant CVPH was not entitled to summary judgment, as it failed to meet its initial burden, despite the plaintiff's opposing papers. The burden then shifted to the plaintiff to demonstrate triable questions of fact regarding deviations from accepted standards of care by Waid, Bunn, and Nachbauer, which could have contributed to the decedent's injuries and death.

A detailed expert affidavit from the plaintiff indicated that Waid's actions, specifically related to the endotracheal tube, likely caused a hemorrhage leading to the decedent's death. While the source of the bleeding was unclear, the expert asserted that such bleeding typically indicates negligence. Given Waid's exclusive control over the decedent’s medical situation, questions of fact remained, allowing the plaintiff to invoke the doctrine of res ipsa loquitur to support claims of Waid’s negligence.

The expert also critiqued Bunn and Nachbauer’s care in the weeks leading up to the surgery, suggesting that inadequate treatment left the decedent in a weakened condition that contributed to his inability to survive. Specifically, Bunn was criticized for failing to perform timely procedures like bronchoscopy and thoracotomy, while Bunn's expert defended his decisions based on the decedent's deteriorating condition. The plaintiff's expert argued that the decedent's organ failure and respiratory distress stemmed from delays in addressing fluid around the lungs, creating factual disputes regarding whether Bunn and CVPA breached their duty of care, which may have proximately caused the decedent's injuries.

Nachbauer maintained that his role as a surgical consultant limited his duty, suggesting he was only responsible for the medical functions he undertook and that the plaintiff relied upon.

Nachbauer's responsibilities were confined to inserting and monitoring chest tubes after the decedent's lung collapsed and consulting with attending physicians regarding potential thoracic surgery, without addressing the decedent's infections, pneumonia, or renal failure. However, when considering the evidence favorably for the plaintiff, it appears Nachbauer consulted with Bunn about the decedent's condition and surgical scheduling, establishing a duty to adhere to the standard of care during these consultations. There are factual disputes regarding whether Nachbauer deviated from this standard and the impact of any such deviation on the decedent's health and subsequent death, leading the Supreme Court to deny the defendants' motions for summary judgment. Although there is no evidence that the decedent experienced conscious pain during the final surgery, potential pain and suffering resulting from alleged malpractice in the preceding two weeks could be pursued at trial. The case also notes that some original defendants have been removed through stipulations or successful summary judgments. The claims against CVPA are based on vicarious liability linked to Bunn’s treatment. Nachbauer’s challenge to the admissibility of the plaintiff's expert affidavit, due to presumed employment by the plaintiff's counsel, was rejected. While bias may affect credibility, it does not undermine the expert's competency, and courts do not evaluate credibility in summary judgment motions. The order was affirmed with costs.