Court: Appellate Court of Illinois; June 17, 1992; Illinois; State Appellate Court
In the medical malpractice case involving plaintiff Kathleen Ciolino, administratrix of Beatrice Lynch's estate, the court affirmed a judgment in favor of defendants Drs. Morris Bernstein and Thomas Marvelli following a jury verdict. Ciolino raised two main issues regarding Dr. Bernstein: (1) whether the trial court erred in excluding evidence that Dr. Bernstein could have arranged for an ICU bed by displacing another patient, and (2) whether the trial judge improperly pressured the jury to continue deliberating after they reported being deadlocked four times concerning Dr. Bernstein. Additionally, the plaintiff contended that the jury’s verdict was against the manifest weight of the evidence for both doctors.
The case details revealed that at 4:05 a.m. on May 3, 1981, Beatrice Lynch presented to Northwest Hospital’s emergency room with chest pain. Dr. Marvelli, the attending emergency physician, conducted assessments and decided Lynch should be admitted to the ICU. However, he was informed that no ICU beds were available. Dr. Bernstein, consulted by Dr. Marvelli, ordered admission to a monitored bed, but again, this was unavailable. Consequently, Dr. Bernstein prescribed frequent monitoring and pain management. Lynch's condition deteriorated rapidly, leading to a code blue situation at 6:02 a.m., and she sustained severe brain damage before being transferred to the ICU at 6:55 a.m.
During the trial, experts testified regarding the standard of care, with Dr. Rosen asserting that admitting Lynch to an unmonitored bed constituted a deviation from acceptable practices, while Dr. Gordon criticized Dr. Marvelli for inadequate patient management. Ultimately, both doctors were found not liable for the circumstances leading to Lynch's myocardial infarction, which they could not have prevented.
Dr. Gordon testified that Dr. Bernstein deviated from the standard of care by ordering rhythm strips every four hours without a cardiac monitor. He acknowledged, however, that a monitor would not have prevented the decedent's cardiac arrest and that monitors can often yield missed or misread readings. The plaintiff sought to introduce evidence from Sue Garber's medical records to argue that Dr. Bernstein could have moved her from the ICU to accommodate the decedent, but the trial court excluded this evidence. The court ruled that the plaintiff did not establish a foundation for the evidence or provide expert testimony linking the failure to move Garber to a breach of the standard of care.
Dr. Gerald Menaker, an expert for Dr. Bernstein, testified that the standard of care did not require the decedent to be admitted to the ICU or remain in the emergency room, especially given the stable condition of the decedent at 5:30 a.m. and the unavailability of a monitored bed. He opined that Dr. Bernstein's orders were appropriate and provided adequate monitoring. Dr. Terrence Carden, testifying for Dr. Marvelli, stated that Dr. Marvelli's management met the standard of care and noted he lacked the authority to transfer patients to hospital floors. He also indicated that the decedent's myocardial infarction was neither preventable nor predictable.
Both Drs. Bernstein and Marvelli maintained that their treatments complied with the standard of care during trial. The jury deliberated over the course of several days, sending notes indicating difficulty reaching a decision regarding Dr. Bernstein, but ultimately returned not guilty verdicts for both doctors. The plaintiff contended that the trial court abused its discretion in excluding evidence related to Sue Garber, arguing its relevance to Dr. Bernstein's alleged breach of care.
Dr. Bernstein contends that evidence concerning Sue Garber was appropriately excluded due to its irrelevance and the plaintiff's failure to establish a foundational basis for its admission. The trial court has discretion in ruling on motions in limine, and the primary consideration is whether the evidence should be excluded under the rules of evidence. In medical malpractice cases, plaintiffs must provide expert testimony to establish the standard of care, demonstrate how the defendant deviated from that standard, and show that such deviation caused injury. The only exception to this rule is the 'common knowledge' exception, applicable when negligence is apparent or treatment is common knowledge among laypersons.
In this instance, the plaintiff did not present expert testimony to support the claim that Dr. Bernstein breached the standard of care by not transferring Sue Garber from the ICU. The plaintiff acknowledged the lack of evidence regarding this breach and conceded that attempts to establish this through Dr. Bernstein would not succeed, as he would not testify to that issue. Consequently, the trial court did not abuse its discretion in excluding the evidence related to Sue Garber.
Additionally, the plaintiff argues that the trial judge improperly coerced the jury into reaching a verdict by not accepting their statements of deadlock. After the jury's initial deliberation failed to produce a consensus, they were sent home and returned later. Upon receiving a note indicating a deadlock on Dr. Bernstein's charges, the trial judge engaged the jury and provided a cautionary instruction regarding deadlock, reminding them of the lengthy trial and deliberation period. The plaintiff did not contest this instruction as coercive. Later, when the jury again reported an inability to reach a unanimous decision, the judge instructed them to continue deliberations.
At 3:05 p.m., the trial judge received a note from the jury indicating they had concluded deliberations. The judge instructed them to continue deliberating to reach a unanimous verdict. By 4:50 p.m., the jury reported being deadlocked with a vote of eight to three. The judge, after consulting with counsel, decided to adjourn deliberations for the night, resuming the next day at 9:30 a.m. The jury reached a unanimous verdict shortly before 11 a.m. the following day.
The discretion regarding the length of jury deliberations lies with the trial judge. Previous cases establish that a jury may only be discharged if it appears they will never reach an agreement, considering the duration of deliberations. Even after declaring a deadlock, a trial judge can direct further deliberation, which is not typically seen as coercive. Factors influencing the reasonableness of deliberation include trial length, case complexity, and evidence volume.
In this case, the trial involved two defendants, lasted seven days, and included testimony from 19 witnesses. The judge's handling of the jury's notes, received within a five-hour timeframe, was deemed appropriate given the trial's complexity. The court found no abuse of discretion in instructing continued deliberation.
The plaintiff argued that the jury's verdict was unsupported by evidence regarding the defendants' adherence to the standard of care in a medical malpractice claim. The plaintiff contended that Dr. Bernstein sent the decedent to an unmonitored bed and that Dr. Marvelli failed to provide adequate information about the decedent's care. The standard for reviewing a jury verdict focuses on whether it is reasonable based on the evidence presented, not on alternative conclusions.
Ultimately, it was determined that the jury's verdict was not against the manifest weight of the evidence, and the judgment was affirmed. Judges Rizzi and Cerda concurred with this decision.
