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Shortino v. Buna

Citations: 427 N.J. Super. 285; 48 A.3d 401; 2012 WL 3046240; 2012 N.J. Super. LEXIS 131

Court: New Jersey Superior Court Appellate Division; July 27, 2012; New Jersey; State Appellate Court

Narrative Opinion Summary

The case involves plaintiffs appealing a jury verdict that found a physician negligent but not the proximate cause of the plaintiff's injuries. Central to the appeal is the trial court's failure to submit the informed consent claim to the jury, despite evidence suggesting the physician did not adequately inform the plaintiff of treatment options for an equivocal pregnancy diagnosis. The court also addressed issues regarding proximate cause, alleging record alteration, and the consolidation of negligence claims into a single jury question. Expert testimony criticized the physician's reliance on inconclusive ultrasound results and subsequent initiation of methotrexate treatment. The appellate court reversed and remanded for a new trial on the informed consent claim, affirming other findings. The ruling underscores the importance of informed consent when presenting treatment options and associated risks, distinguishing it from deviations in the standard of care. The decision highlights procedural nuances in medical malpractice cases, particularly around jury instructions and claim presentation, ultimately focusing on the patient's right to a fully informed decision-making process.

Legal Issues Addressed

Allegations of Record Alteration in Medical Malpractice

Application: The trial court declined to charge the jury on record alteration due to insufficient direct proof, though circumstantial evidence was presented by the plaintiffs.

Reasoning: The plaintiffs claimed that the trial court erred by not instructing the jury on the alteration of medical records, asserting that sufficient evidence indicated Dr. Buna fabricated and inserted notes into Laurie’s medical charts.

Combining Negligence Claims in Jury Interrogatories

Application: The court found no error in the trial court's decision to present a single negligence question to the jury, emphasizing that interrogatories should focus attention on case details.

Reasoning: The plaintiffs argued that combining their negligence claims into a single interrogatory was confusing. However, the court found no error in this approach.

Deviation from Standard of Care in Medical Malpractice

Application: Expert testimony established that Dr. Buna's actions, such as initiating methotrexate treatment based on inconclusive ultrasound results, constituted a deviation from the standard of care.

Reasoning: Dr. Richard Luciani testified that the first two ultrasounds could not definitively confirm an ectopic pregnancy, suggesting a conservative approach of observation and blood tests.

Informed Consent in Medical Malpractice

Application: The court ruled that the trial court erred by not allowing the informed consent claim to go to the jury, as the plaintiffs should have been informed about treatment options and associated risks.

Reasoning: The trial court erred in not allowing the informed consent issue to be presented to the jury, misapplying precedent concerning misdiagnosis and failing to recognize that Laurie raised the lack of information on treatment options.

Judgment Notwithstanding the Verdict

Application: The court rejected the plaintiffs' motion for judgment notwithstanding the verdict, as there was sufficient evidence to support the jury's findings.

Reasoning: The inquiry for j.n.o.v. focuses on whether sufficient evidence supported the jury's findings, with all evidence favoring the opposing party being accepted as true.

Jury Instructions on Proximate Cause

Application: The appellate court found no error in the submission of the proximate cause question to the jury, as evidence suggested Dr. Buna communicated the equivocal nature of the ultrasound results.

Reasoning: The appellate court disagreed, stating that the harmless error standard applies when a plaintiff objects to the proximate cause charge.