Campbell v. DUKE UNIVERSITY HEALTH SYSTEM, COA09-581.

Decision Date16 March 2010
Docket NumberNo. COA09-581.,COA09-581.
Citation691 S.E.2d 31
PartiesBobby L. CAMPBELL, Plaintiff, v. DUKE UNIVERSITY HEALTH SYSTEM, INC., Critical Health Systems of North Carolina, P.C., Critical Health Systems, Inc., Southeastern Orthopedics Sports Medicine and Shoulder Center, P.A., Donald A. Edmondson, M.D., Cynthia Kaeger, CRNA, and Kevin P. Speer, M.D., Defendants.
CourtNorth Carolina Court of Appeals

The Law Office of James M. Johnson, by James M. Johnson; and Brenton D. Adams, Dunn, for plaintiff appellant.

McGuire Woods, LLP, by Mark E. Anderson and Monica E. Webb, Raleigh, for Critical Health Systems of North Carolina, P.C., Critical Health Systems, Inc., and Donald A. Edmondson, M.D., defendant appellees.

Crawford & Crawford, LLP, by Renee B. Crawford and Robert O. Crawford, III, Raleigh, for Southeastern Orthopedics and Kevin P. Speer, M.D., defendant-appellees.

HUNTER, JR., ROBERT N., Judge.

Bobby Campbell ("plaintiff") appeals from the trial court's order granting summary judgment in favor of Critical Health Systems of North Carolina, Inc., Critical Health Systems, Inc., Southeastern Orthopedics Sports Medicine and Shoulder Centers, P.A., Donald A. Edmondson, M.D., and Kevin P. Speer, M.D. ("defendants"). After review, we hold, notwithstanding that plaintiff's complaint facially complied with Rule 9(j) by including a statement that a medical expert qualified under Rule 702 would testify that defendants' actions did not comply with the standard of care where discovery subsequently established that the statement was not supported by the facts, dismissal is appropriate. Accordingly, we affirm the trial court's order.

I. FACTUAL BACKGROUND

On 25 November 2003, plaintiff suffered an injury to his right shoulder while working as a plumber at Cape Fear Valley Hospital in Fayetteville, North Carolina. An MRI showed that plaintiff sustained a large rotator tear as a result of his shoulder injury. On 16 December 2003, Dr. Bradley Broussard initially examined and diagnosed plaintiff with a combination of joint degenerative disease and rotator cuff tear to the right shoulder. Dr. Broussard injected plaintiff's right shoulder with pain medication, but informed plaintiff that he would need to undergo surgery.

On 14 January 2004, defendant, Dr. Kevin P. Speer, an orthopedic surgeon employed by codefendant, Southeastern Orthopedics Sports Medicine and Shoulder Center, P.A., examined plaintiff's right shoulder and concluded that he should undergo surgery. Dr. Speer performed a right shoulder arthroscopy and right open rotator cuff repair at Duke Raleigh Hospital on 9 February 2004. Defendant, Dr. Donald A. Edmondson, an anesthesiologist employed by codefendant, Critical Health Systems of North Carolina, P.C., served as the attending anesthesiologist during the surgical procedure. During the procedure, Dr. Edmondson and Dr. Speer were admittedly responsible for positioning, padding, and monitoring plaintiff's left arm.

At the beginning of the surgery, Dr. Edmondson and Dr. Speer placed plaintiff in the "beach chair" position. This position is the standard position used for many shoulder surgeries. In this position, the patient is placed in a semi-reclining, semi-sitting position with the patient's arms resting at either side and padded with various pads and foams to keep the patient in the position safely. There is no documentary evidence in Dr. Edmondson's records or any other record of whether or not plaintiff was properly padded and monitored during the procedure.

Plaintiff contends that he began to feel severe pain and numbness in his left arm, elbow, and fingers approximately one hour after surgery. During plaintiff's first follow up visit on 19 February 2004, after the initial 9 February 2004 surgery, Dr. Speer noted that plaintiff was doing well. Plaintiff first reported his painful condition to Dr. Speer on 1 April 2004, during a second follow-up visit. At that time, Dr. Speer noted that plaintiff was suffering from continued ulnar neuropathy1 at his left elbow. An EMG confirmed the left elbow ulnar neuropathy and Dr. Speer performed subcutaneous nerve transfer on plaintiff's left elbow on 21 July 2004. Plaintiff continued to see Dr. Speer on a monthly basis after his surgery until he was discharged to a long term pain management clinic.

In his sworn affidavit, plaintiff avers that he did not experience pain or medical problems with his left arm prior to the 9 February 2004 surgery and that his ulnar nerve neuropathy was not pre-existing. After the 21 July 2004 surgery and to the present date, plaintiff contends that he experiences pain in his left arm on a daily basis and that his arm is permanently damaged.

On 8 February 2007, plaintiff filed a professional negligence claim alleging that his left arm was permanently damaged and injured due to defendants' failure to comply with the applicable standard of care when padding, positioning, and monitoring his left arm, wrist, and hand during the 9 February 2004 surgery to his right shoulder. Plaintiff's theory of the case is that the ulnar neuropathy in his left arm was caused by defendants' failure to properly monitor his arm during the operation. Because his injury was not pre-existing and he began to experience pain in his left arm one hour after the surgery, he contends that his arm became mis-positioned during the procedure resulting in his injury. Plaintiff does not rely on the doctrine of res ipsa loquitur.

On 2 November 2007, plaintiff named Dr. Jeffrey Cocozzo, an anesthesiologist practicing in Fort Lauderdale, Florida, as his expert witness who would testify pursuant to the heightened pleading requirements of N.C. R. Civ. P. 9(j) that defendants breached the applicable standard of care and proximately caused plaintiff's injuries. Defendants answered and denied the alleged negligence and injuries. A consent discovery order was entered by the trial court on 17 January 2008, pursuant to which plaintiff designated Dr. Cocozzo and defendant Speer as the intended expert witnesses for trial. On 10 December 2008, Dr. Cocozzo was deposed and gave the following sworn testimony regarding defendants' alleged negligence:

Q. ... Do you believe that because Mr. Campbell sustained a nerve injury whose symptoms you believe first appeared postoperatively, do you believe because he sustained a nerve injury, negligence must have occurred?
A. Well, it's basically what he did say, right. Hehe states that he did not have any nerve injury before and did end up having nerve injury during— during the surgery. So therefore that would be—that would be negligence, yes.
....
Q. You're presuming that there was negligence based on the fact that there is an injury in this case; is that correct?
A. Yes.
Q. And you can't point to any specific incident that happened during the surgery that would have caused this injury, it's just based on your presumption of negligence because there was an injury at the end of the surgery; is that correct?
A. Right, right.
Q. And if Mr. Campbell did, in fact, have a pre-existing condition, then that doesn't mean there was anything that happened during the surgery that caused his injury; is that correct?
A. Right. If he had something that was a pre-condition and he already had an injury, then obviously he already had an injury.
....
Q. Okay. And tell me, what is the basis of your opinion that improper positioning and/or padding resulted in damage to Mr. Campbell's ulnar nerve?
A. Well, basically he—from—from what I know so far talking to him and looking at the records, his—I don't have any reason to believe that—that he didn't have a normal functioning before the surgery.
He went in for surgery that—where you can get a complication of having— from malpositioning of an ulnar nerve injury and within a day or so after the surgery he seemed to have—started having complaints of ulnar nerve injury.

Dr. Speer and Dr. Edmondson both contend that plaintiff was properly padded, positioned, and monitored during surgery solely because it is their custom to do so during shoulder surgery. However, Dr. Edmondson admitted that he had no independent recollection of plaintiff's surgery or what he did or did not do during plaintiff's surgery.

On 22 December 2008, defendants Dr. Speer and Southeastern Orthopedics Sports Medicine and Shoulder Center, P.A., filed motions for summary judgment on the basis that the affidavit and testimony of Dr. Cocozzo show that "(1) there is no evidence from a qualified expert that Dr. Speer's care was not in accordance with the applicable standards of care and (2) that no act or omission of Dr. Speer was a proximate cause of the plaintiff's alleged injury." Subsequently, on 23 December 2008, defendants Critical Health Systems of North Carolina, P.C., Critical Health Systems, Inc., and Donald A. Edmondson, M.D., filed a motion for summary judgment based on a contention that there is no genuine issue of material fact with regard to "whether any actions or inactions of the defendants were the proximate cause of plaintiff's alleged injury." The trial court granted both the 22 and 23 December 2008 motions for summary judgment and cited to Kenyon v. Gehrig, 183 N.C.App. 455, 459, 645 S.E.2d 125, 128 (2007), disc. review denied, 362 N.C. 176, 658 S.E.2d 272 (2008), as the basis for the decision (holding that where "plaintiff's expert witnesses based their opinions only on the fact of the injury itself; their assignation of negligence on defendants' part constituted mere speculation" and is insufficient to withstand a motion for summary judgment). Plaintiff appeals.

II. STANDARD OF REVIEW

Summary judgment is properly granted when "the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that any party is entitled to a judgment as a matter of law." N.C. Gen. Stat. § 1A-1, Rule 56(c) (2007). When reviewing a trial court's...

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