LAW.coLAW.co

ARRA v. KUMAR (2021)

Supreme Court, Appellate Division, Second Department, New York.2021-12-22No. 2018–00192, 2018–00199

Summary

Holding. The judgment dismissing the complaint against the defendants is affirmed. The appeal from the order granting summary judgment is dismissed because the right to directly appeal the order terminated upon entry of the judgment, and the issues raised have been considered on appeal from the judgment itself.

The plaintiff, as administrator of his deceased spouse's estate, brought a medical malpractice and lack of informed consent action against a physician who performed a splenectomy and incidental cholecystectomy in 2009. The patient subsequently developed a postoperative E. coli wound infection but recovered, and died of natural causes nearly two years later in 2011. The trial court granted summary judgment in favor of the defendants, finding no departure from accepted medical standards and no causal connection to the patient's injuries.

On appeal, the court rejected the plaintiff's challenge to the trial court's decision. The defendants had submitted medical records and expert testimony establishing that the physician adhered to accepted standards of care and that any alleged departures did not cause the patient's injuries. The plaintiff's opposing expert affidavit was deemed speculative and conclusory because it failed to meaningfully address the defendants' expert's specific assertions and relied on facts unsupported by the record. Accordingly, the plaintiff did not create a genuine dispute of material fact sufficient to defeat summary judgment.

Summary generated by law.co from the public-domain opinion. The opinion text itself is public domain.

Key issues

  • Whether the physician deviated from accepted community standards in performing the splenectomy and incidental cholecystectomy
  • Whether any alleged deviation was a proximate cause of the patient's injuries
  • Whether the plaintiff's expert testimony was sufficiently specific and record-supported to raise a triable issue of fact
  • Whether lack of informed consent for the cholecystectomy proximately caused the patient's injuries

Procedural posture

The plaintiff appealed from a trial court order granting defendants' motion for summary judgment and the resulting judgment of dismissal.

Authorities cited

No cited authorities resolved to law.co cases yet.

Opinion

DECISION & ORDER

In an action, inter alia, to recover damages for medical malpractice, etc., the plaintiff appeals from (1) an order of the Supreme Court, Kings County (Ellen M. Spodek, J.), dated September 20, 2017, and (2) a judgment of the same court entered November 3, 2017.  The order, insofar as appealed from, granted that branch of the motion of the defendants Sampath R. Kumar and Sampath R. Kumar, Physician, P.C., which was for summary judgment dismissing the complaint insofar as asserted against them.  The judgment, insofar as appealed from, upon the order, is in favor of those defendants and against the plaintiff dismissing the complaint insofar as asserted against those defendants.

ORDERED that the appeal from the order is dismissed;  and it is further,

ORDERED that the judgment is affirmed insofar as appealed from;  and it is further,

ORDERED that one bill of costs is awarded to the defendants Sampath R. Kumar and Sampath R. Kumar, Physician, P.C.

The appeal from the order must be dismissed because the right of direct appeal therefrom terminated with the entry of the judgment in this action (see Matter of Aho, 39 N.Y.2d 241, 248, 383 N.Y.S.2d 285, 347 N.E.2d 647).  The issues raised on the appeal from the order are brought up for review and have been considered on the appeal from the judgment (see CPLR 5501[a][1]).

The plaintiff is the surviving spouse and administrator of the estate of the decedent, Ellen Lopez–Arra (hereinafter the decedent).  In 2008, the decedents hematologist referred her to the defendant Sampath R. Kumar for a splenectomy to treat the low platelet count in her blood.  On March 24, 2009, Kumar performed the splenectomy at the defendant Lutheran Medical Center in Brooklyn (hereinafter Lutheran).  While the decedent was on the operating table, Kumar noticed the presence of “a large stone in the gallbladder and evidence of ․ chronic cholecystitis” and he performed a cholecystectomy, removing the decedents gallbladder.

The decedent did not exhibit any signs of infection during her postoperative recovery, and she was discharged from Lutheran on March 29, 2009.  On June 3, 2009, the decedent was again admitted to Lutheran because of a pulmonary embolism.  During this period of hospitalization, the decedent was running a high fever and was assessed as having an infection in her surgical wound, which was subsequently diagnosed as an E.coli infection.  On June 16, 2009, the decedent was transferred to New York University Medical Center (hereinafter NYUMC), from which she was discharged on June 27, 2009.  According to the plaintiff, the E.coli infection was resolved at NYUMC, and approximately six weeks after the decedent was discharged, she resumed her normal activities.  In April 2011, the decedent died of natural causes.

The plaintiff, in his capacity as administrator of the decedents estate, and individually, commenced this action against Kumar and his medical practice, the defendant Sampath R. Kumar, Physician, P.C. (hereinafter together the defendants), among others, to recover damages, inter alia, for medical malpractice and lack of informed consent.  The defendants moved, inter alia, for summary judgment dismissing the complaint insofar as asserted against them.  The Supreme Court granted that branch of the defendants motion and subsequently entered judgment dismissing the complaint against the defendants.  The plaintiff appeals.

While the medical records submitted by the defendants in support of their motion were uncertified, the plaintiff does not argue that he was prejudiced by the admission of such records.  Importantly, the plaintiff does not challenge the accuracy or veracity of the uncertified records and, in fact, he and his expert relied upon those records in opposing the defendants motion (see Benedetto v. Tannenbaum, 186 A.D.3d 1596, 1598, 131 N.Y.S.3d 673;  Tomeo v. Beccia, 127 A.D.3d 1071, 1073, 7 N.Y.S.3d 472).  Thus, the Supreme Court did not err in considering those medical records in determining the defendants motion.

“In order to establish the liability of a physician for medical malpractice, a plaintiff must prove that the physician deviated or departed from accepted community standards of practice, and that such departure was a proximate cause of the plaintiffs injuries” (Stukas v. Streiter, 83 A.D.3d 18, 23, 918 N.Y.S.2d 176;  see Benedetto v. Tannenbaum, 186 A.D.3d at 1597, 131 N.Y.S.3d 673).  In moving for summary judgment, a defendant physician must establish, prima facie, “either that there was no departure or that any departure was not a proximate cause of the plaintiffs injuries” (see Benedetto v. Tannenbaum, 186 A.D.3d at 1597, 131 N.Y.S.3d 673, quoting Lesniak v. Stockholm Obstetrics & Gynecological Servs., P.C., 132 A.D.3d 959, 960, 18 N.Y.S.3d 689).  Once a defendant has made such a showing, the burden shifts to the plaintiff to “submit evidentiary facts or materials to rebut the prima facie showing by the defendant physician” (Alvarez v. Prospect Hosp., 68 N.Y.2d 320, 324, 508 N.Y.S.2d 923, 501 N.E.2d 572;  see Stukas v. Streiter, 83 A.D.3d at 30, 918 N.Y.S.2d 176).  Where a defendant physician makes a prima facie showing on both elements, “the burden shifts to the plaintiff to rebut the defendants showing by raising a triable issue of fact as to both the departure element and the causation element” (Stukas v. Streiter, 83 A.D.3d at 25, 918 N.Y.S.2d 176).

Here, the defendants submissions in support of their motion included, among other things, the decedents medical records and the affirmation of their expert, who opined with a reasonable degree of medical certainty that Kumar did not depart from the accepted standard of care, and that, in any event, any alleged departures were not a proximate cause of the decedents injuries as set forth in the plaintiffs bills of particulars.  Through their submissions, as the plaintiff acknowledges, the defendants established their prima facie entitlement to judgment as a matter of law dismissing the medical malpractice cause of action insofar as asserted against them (see Benedetto v. Tannenbaum, 186 A.D.3d at 1598, 131 N.Y.S.3d 673).  Further, the defendants demonstrated, prima facie, that the alleged lack of informed consent to the removal of the decedents gallbladder did not proximately cause the decedents injuries (see Gilmore v. Mihail, 174 A.D.3d 686, 688–689, 105 N.Y.S.3d 504;  Tsimbler v. Fell, 123 A.D.3d 1009, 1010–1011, 999 N.Y.S.2d 863).

“Although conflicting expert opinions may raise credibility issues which can only be resolved by a jury (see Feinberg v. Feit, 23 A.D.3d 517, 519, 806 N.Y.S.2d 661), expert opinions that are conclusory, speculative, or unsupported by the record are insufficient to raise triable issues of fact” (Wagner v. Parker, 172 A.D.3d 954, 955, 100 N.Y.S.3d 280).  “In order not to be considered speculative or conclusory, expert opinions in opposition should address specific assertions made by the movants experts, setting forth an explanation of the reasoning and relying on specifically cited evidence in the record” (id. at 955, 100 N.Y.S.3d 280 [internal quotation marks omitted]).  “An expert opinion that is contradicted by the record cannot defeat summary judgment” (id., quoting Bartolacci–Meir v. Sassoon, 149 A.D.3d 567, 572, 50 N.Y.S.3d 395).

Here, in opposition to the defendants motion, the plaintiff failed to raise a triable issue of fact with regard to either the medical malpractice or the lack of informed consent cause of action.  The plaintiffs experts affirmation failed to address the defendants experts contentions and relied on facts that were not supported by the record.  Thus, the plaintiffs experts affirmation was speculative, conclusory, and insufficient to defeat that branch of the defendants motion which was for summary judgment dismissing the complaint insofar as asserted against them (see Wagner v. Parker, 172 A.D.3d at 955, 100 N.Y.S.3d 280;  Tsimbler v. Fell, 123 A.D.3d at 1010–1011, 999 N.Y.S.2d 863).

The plaintiffs remaining contention is without merit.

CHAMBERS, J.P., MILLER, GENOVESI and DOWLING, JJ., concur.