New York Law Review

Tag: Medical Malpractice

  • Flanagan v. Mount Eden General Hospital, 24 N.Y.2d 427 (1969): Statute of Limitations in Foreign Object Medical Malpractice

    Flanagan v. Mount Eden General Hospital, 24 N.Y.2d 427 (1969)

    In cases of medical malpractice involving a foreign object negligently left in a patient’s body, the statute of limitations begins to run when the patient could have reasonably discovered the malpractice.

    Summary

    Josephine Flanagan underwent gall bladder surgery at Mount Eden General Hospital in 1958. During the procedure, surgical clamps were left in her body. She experienced severe pain in 1966, and X-rays revealed the clamps. She sued the hospital and the surgeon’s estate for negligence. The defendants argued the statute of limitations had expired. The New York Court of Appeals reversed the lower courts, holding that in foreign object medical malpractice cases, the statute of limitations begins to run when the patient could reasonably discover the malpractice, not from the date of the negligent act.

    Facts

    In June 1958, Josephine Flanagan was treated by Dr. Max Eisenstat for a gall bladder ailment.

    Dr. Eisenstat determined surgery was necessary, and Flanagan entered Mount Eden General Hospital.

    On July 14, 1958, the surgery was performed, and surgical clamps were negligently left inside Flanagan’s body.

    In the spring of 1966, Flanagan experienced severe abdominal pain and consulted a doctor.

    On June 3, 1966, X-rays revealed the presence of surgical clamps in her abdomen.

    On June 10, 1966, another surgery was performed to remove the clamps.

    Procedural History

    Flanagan sued Mount Eden General Hospital and Dr. Eisenstat’s estate on October 20, 1966 and November 2, 1966, respectively, alleging negligence.

    Both defendants moved to dismiss, arguing the statute of limitations had expired.

    Special Term granted the motions to dismiss.

    The Appellate Division affirmed.

    The New York Court of Appeals granted leave to appeal.

    Issue(s)

    Whether, in a foreign object medical malpractice case, the statute of limitations begins to run from the date of the negligent act or when the patient could have reasonably discovered the malpractice.

    Holding

    Yes, in cases where a foreign object has been negligently left in a patient’s body, the statute of limitations does not begin to run until the patient could have reasonably discovered the malpractice because the traditional rule places an undue strain upon common sense, logic, and simple justice when an object is unknowingly left in the patient’s body.

    Court’s Reasoning

    The Court reasoned that the purpose of statutes of limitations is to protect defendants from defending stale claims after a reasonable time has elapsed, embodying a policy of repose.

    The Court distinguished this case from previous rulings, such as Schwartz v. Hayden Newport Chem. Co., noting a fundamental difference between negligent medical treatment/medication cases and those involving foreign objects left in a patient’s body.

    The Court stated that in foreign object cases, the risk of fraudulent claims is minimal, and there is a direct causal link between the negligence and the injury.

    The Court emphasized that a clamp retains its identity even after a long period, meaning a defendant’s ability to defend a “stale” claim is not unduly impaired. As the court quoted, “It simply places an undue strain upon common sense, reality, logic and simple justice to say that a cause of action had `accrued’ to the plaintiff until the X-ray examination disclosed a foreign object within her abdomen and until she had reasonable basis for believing or reasonable means of ascertaining that the foreign object was within her abdomen as a consequence of the [operation]” (Morgan v. Grace Hosp., 149 W. Va. 783, 792).

    The Court acknowledged the division among jurisdictions but found the discovery rule more equitable and consistent with the purpose of the statute of limitations.

    The Court dismissed the argument that the legislature’s failure to pass bills amending the statute indicated a legislative intent to freeze the existing interpretation, stating that legislative inaction is a weak reed upon which to lean.

    The Court asserted its authority to adjust court-made rules when justice demands it, citing precedents like Woods v. Lancet and Greenberg v. Lorenz.

    The dissenting opinion argued that the court was overstepping its bounds by altering a statutory rule, especially given the legislature’s repeated consideration of the issue. The dissent argued that the statute of limitations should run from the commission of the wrong, noting that while a discovery rule might be preferable, it is a matter for the legislature to decide. The dissent also emphasized the importance of stare decisis and the court’s recent adherence to the existing rule in Schwartz v. Heyden Chem. Corp.. The dissent noted that the existence of express statutory provisions for a discovery rule in fraud actions indicates a deliberate legislative choice not to extend such exceptions to malpractice cases.

  • Toth v. Community Hospital at Glen Cove, 22 N.Y.2d 255 (1968): Physician’s Duty to Monitor and Respond to Nursing Staff Observations

    Toth v. Community Hospital at Glen Cove, 22 N.Y.2d 255 (1968)

    A physician may be liable for medical malpractice if they fail to adequately monitor and respond to information, such as nurses’ notes, that indicates their orders are not being followed, and this failure contributes to patient injury.

    Summary

    In this medical malpractice case, the plaintiffs, infants who developed retrolental fibroplasia (RLF) due to excessive oxygen administration after premature birth, sued the hospital and the attending pediatrician, Dr. Hellmann. The Court of Appeals reversed a jury verdict in favor of Dr. Hellmann and the dismissal of the claim against the hospital, holding that the trial court erred in not allowing the jury to consider whether Dr. Hellmann was negligent in failing to notice and act upon the hospital nursing staff’s recorded deviations from his prescribed oxygen dosage, and whether this failure contributed to the infants’ injuries. The court emphasized a physician’s duty to be aware of and respond to pertinent patient information.

    Facts

    The infant plaintiffs were born prematurely and placed in an oxygen-rich environment as part of their care. Dr. Hellmann, the pediatrician, ordered a specific oxygen dosage regimen, which included reducing the oxygen level after an initial period. Hospital nurses’ notes indicated instances where the prescribed oxygen levels were not consistently followed. The infants subsequently developed RLF, a condition linked to excessive oxygen exposure in premature infants.

    Procedural History

    The plaintiffs sued both the hospital and Dr. Hellmann, alleging medical malpractice. The jury returned a verdict in favor of Dr. Hellmann, and the trial court dismissed the claim against the hospital. The Appellate Division affirmed. The New York Court of Appeals reversed the lower court’s decision regarding both Dr. Hellmann and the hospital, ordering a new trial.

    Issue(s)

    Whether the trial court erred in failing to instruct the jury to consider if Dr. Hellmann committed malpractice by neglecting to observe and respond to nurses’ notes indicating deviations from his oxygen orders, and whether this contributed to the infants’ RLF.

    Holding

    Yes, because a physician has a duty to monitor a patient’s condition and respond appropriately to information, including nurses’ observations, that indicates a deviation from prescribed treatment and a potential risk to the patient’s health.

    Court’s Reasoning

    The Court reasoned that the trial court’s charge to the jury was inadequate because it did not specifically address the issue of Dr. Hellmann’s potential negligence in failing to monitor the nurses’ notes. The Court emphasized that a physician’s duty of care extends to being aware of and responding to pertinent information regarding a patient’s condition and treatment. The court stated, “It is not enough that a doctor prescribe a proper course of treatment; he must also be alert to signs that the treatment is not being properly carried out.”

    The Court found that the nurses’ notes provided potentially critical information about the infants’ oxygen exposure, and Dr. Hellmann’s failure to observe these notes and adjust the treatment accordingly could constitute negligence. The court noted that “[t]he doctor’s failure to observe that his orders were not being carried out caused or contributed to cause the development of RLF in the plaintiffs, or its development in a more severe form than would otherwise have developed…”

    The dissenting opinion argued that the plaintiffs’ counsel did not present this specific theory of negligence (failure to monitor nurses’ notes) to the jury during summation and that the general charge on negligence and malpractice was adequate. The dissent also contended that there was no proof that the variable quantities of oxygen actually administered, as shown in the nurses’ notes, would have made any difference in the infants contracting RLF.

  • McDermott v. Manhattan Eye, Ear and Throat Hospital, 15 N.Y.2d 20 (1964): Using Adverse Party Testimony to Establish Medical Malpractice

    McDermott v. Manhattan Eye, Ear and Throat Hospital, 15 N.Y.2d 20 (1964)

    In a medical malpractice action, the plaintiff may call the defendant doctor to the stand and question them as both a factual witness about the case and as an expert to establish the accepted medical practice in the community.

    Summary

    Kathleen McDermott sued several doctors and a hospital for malpractice, alleging they misrepresented the outcome of a corneal transplant surgery and that the surgery was contraindicated given her condition. The trial court dismissed the complaint after the plaintiff failed to provide expert medical testimony supporting her claim of malpractice. The Appellate Division modified the dismissal to be “without prejudice.” The New York Court of Appeals addressed whether the plaintiff should have been allowed to establish her claim by questioning the defendant doctors about whether the surgery was proper given the plaintiff’s condition. The Court of Appeals held that a plaintiff in a malpractice action can call the defendant doctor to testify as both a factual witness and an expert witness to establish the accepted medical practice.

    Facts

    Kathleen McDermott, suffering from a corneal disease, consulted Dr. Schachat, who suggested a corneal transplant. Dr. Schachat referred her to Dr. Patón. Dr. Patón diagnosed her with Fuch’s dystrophy. He recommended a curettement followed by a corneal transplant on her left eye. Dr. Kleinhandler performed the operations under supervision. The operations were unsuccessful, rendering her left eye virtually blind. McDermott sued, claiming misrepresentation and that the surgery was contraindicated.

    Procedural History

    The trial court dismissed the complaint against all defendants at the close of the plaintiff’s case due to lack of expert testimony. The Appellate Division affirmed the dismissal as to some defendants but modified as to others, Drs. Patón and Kleinhandler, and the hospital, making the dismissal “without prejudice,” allowing the plaintiff to refile the case. The plaintiff appealed to the New York Court of Appeals.

    Issue(s)

    Whether a plaintiff in a medical malpractice case can call the defendant doctor to the stand and question them as an expert witness to establish the accepted medical practice and whether the defendant’s actions deviated from that standard.

    Holding

    Yes, because the defendant doctor’s knowledge of proper medical practice and any deviation is relevant to the case, and enabling the plaintiff to access this information aligns with the purpose of the adverse-party-witness rule. This is especially important when securing independent expert witnesses is difficult.

    Court’s Reasoning

    The Court of Appeals reasoned that while some jurisdictions limit the scope of questioning defendant doctors to only factual matters, allowing inquiry into expert opinions aligns with the purpose of the adverse-party-witness rule. This rule intends to allow “the production in each case of all pertinent and relevant evidence that is available from the parties to the action.” The court acknowledged the difficulty in securing independent expert witnesses who are willing to testify against other doctors. Allowing the plaintiff to question the defendant doctor as an expert addresses this challenge. The court distinguished this case from People ex rel. Kraushaar Bros. & Co. v. Thorpe, which held that a person cannot be compelled to testify as an expert against their will, noting that Kraushaar involved a disinterested witness, not a defendant in the action. The court emphasized that a defendant in a civil suit has no right to remain silent and must answer questions relevant to the issues. The court stated: “If a defendant in a malpractice action may truthfully testify that his conduct conformed to the standard required, his case is, of course, substantially strengthened and, if he cannot so testify, the plaintiff’s chances of recovery are unquestionably increased. In either case, the objective of the court in doing justice is achieved.”