Correa-Carrillo v. Grupo HIMA San Pablo-Fajardo Inc.
| Decision Date | 29 March 2022 |
| Docket Number | CIVIL NO. 17-2253 (RAM) |
| Citation | 594 F.Supp.3d 414 |
| Parties | Linnoska CORREA-CARRILLO, in representation of her minor daughter JPC, Plaintiff, v. GRUPO HIMA SAN PABLO-FAJARDO INC. et al., Defendants. |
| Court | U.S. District Court — District of Puerto Rico |
Alberto J. Perez-Hernandez, David Efron, David Efron Law Offices, San Juan, PR, for Plaintiff.
Eduardo J. Ortiz-Declet, Guaynabo, PR, Roberto E. Ruiz-Comas, RC Law and Litigation Services PSC, San Juan, PR, for Defendant Grupo HIMA San Pablo, Inc.
Roberto E. Ruiz-Comas, RC Law and Litigation Services PSC, San Juan, PR, for Defendant CMT HIMA San Pablo Fajardo.
Pending before the Court are Defendant CMT HIMA San Pablo (Fajardo), Inc.’s ("Defendant" or "HIMA") Motion for Judgment as a Matter of Law as per FRCP 50(B) (Docket No. 152); Motion for New Trial as per FRCP 59 and/or Remittitur (Docket No. 153); and Motion Requesting Amendment of Judgment Entered (Docket No. 154) (jointly, "the Motions "). Plaintiff's mother Linnoska Correa-Carrillo, in representation of her minor daughter JPC ("Plaintiff"), filed an opposition to Defendant's Motions ("Opposition "). (Docket No. 159). Defendant subsequently replied to Plaintiff's Opposition ("Reply "). (Docket No. 168). For the reasons discussed below, Defendant's Motion for Judgment as a Matter of Law is DENIED , Defendant's Motion for New Trial and/or Remittitur is GRANTED IN PART AND DENIED IN PART , and Defendant's Motion Requesting Amendment of Judgment Entered is DISMISSED AS MOOT .
On July 9, 2021, a jury determined that HIMA and Dr. Luis E. Pardo-Toro ("Dr. Pardo")1 committed negligent acts prior to and during Plaintiff's birth that proximately caused her cerebral palsy
and other serious medical problems. (Docket No. 147). The jury apportioned forty (40%) percent of the negligence to HIMA and the remaining sixty percent to Dr. Pardo. Id. at 3. The jury then awarded $8,000,000 for Plaintiff's physical damages and an additional $8,000,000 for her past and future mental anguish and suffering. Id. 2
Defendant now asks this Court to set aside the jury's finding of negligence and its damages award.
On August 6, 2021, Defendant filed its posttrial Motions. (Docket Nos. 152 and 153).3 In those Motions , Defendant asks the Court to dismiss Plaintiff's claims in their entirety or, alternatively, grant a new trial or remit the "shocking" and "excessive" award of damages. Id. On September 24, 2021, Plaintiff filed her combined Opposition to the Motions , arguing the jury verdict should be upheld. (Docket No. 159). And on October 20, 2021, Defendant filed its Reply , addressing each of the contentions made in the Opposition. (Docket No. 168). On August 9, 2021, Defendant also filed a Motion Requesting Amendment of Judgment Entered , which is addressed below in section II.D. (Docket No. 154).
Pursuant to Fed. R. Civ. P. 50 (" Rule 50"), a party may renew a motion for judgment as a matter of law "[n]o later than 28 days after the entry of judgment—or if the motion addresses a jury issue not decided by a verdict, no later than 28 days after the jury was discharged[.]" Fed. R. Civ. P. 50(b). In ruling on the renewed motion, the court may: "(1) allow judgment on the verdict, if the jury returned a verdict; (2) order a new trial; or (3) direct the entry of judgment as a matter of law." Id. "Courts may only grant a judgment contravening a jury's determination when the evidence points so strongly and overwhelmingly in favor of the moving party that no reasonable jury could have returned a verdict adverse to that party." Rivera Castillo v. Autokirey, Inc., 379 F.3d 4, 9 (1st Cir. 2004) (internal quotation marks and citation omitted). In conducting this analysis, "courts may not consider the credibility of witnesses, resolve conflicts in testimony, or evaluate the weight of the evidence." Annoni Mesias v. Hosp. HIMA San Pablo, 2021 WL 1125019, at *1 (D.P.R. 2021) (internal quotation marks and citation omitted).
The substantive law of Puerto Rico governs this medical malpractice diversity suit. See Marcano Rivera v. Turabo Med. Ctr. P'ship, 415 F.3d 162, 167 (1st Cir. 2005). "To prevail on a medical malpractice claim under Puerto Rico law, a party must establish (1) the duty owed; (2) an act or omission transgressing that duty; and (3) a sufficient causal nexus between the breach and the harm." Id. (internal quotation marks and citation omitted). Here, Defendant challenges the sufficiency of the evidence as to the duty owed and causation (i.e. , prongs one and three). (Docket No. 152).
Defendant argues Plaintiff failed to establish the standard of care applicable to nurses in Puerto Rico. Id. at 49-50. In discussing the standard of care owed specifically by nurses, the Supreme Court of Puerto Rico has held that " ‘[a] nurse should exercise a certain standard of reasonable care to see that no unnecessary harm comes to the patient, and said standard of care must be the same as the standard of care exercised by other nurses in the locality or similar localities.’ " Morales v. Monagas, 723 F. Supp. 2d 416, 422 (D.P.R. 2010) (quoting Blas v. Hosp. Guadalupe, 146 D.P.R. 267, 307 (1998) ). Additionally, "[n]urses have the unavoidable duty to fulfill medical orders with the required urgency and in accordance with each patient's particular circumstances." Id. (internal quotation marks and citation omitted).
The standard of care ordinarily must be established through expert testimony.
See Lama v. Borras, 16 F.3d 473, 478 (1st Cir. 1994) (). In the case at bar, Plaintiff relied solely on the testimony of her expert witness, Dr. Barry Schifrin ("Dr. Schifrin"), to establish the standard of care applicable to the HIMA nursing staff. At trial, Dr. Schifrin answered many questions about the applicable standard of care, and explained that, generally, nurses "have a duty to report things that are abnormal and if they are sufficiently abnormal, not only to alert the doctor but to insist upon the presence of the doctor at the patient's bedside." (Docket No. 152-2 at 46). He also testified about the specific duties the nurses in the emergency room and delivery room had here. Most notably, according to Dr. Schifrin, the nurses had a duty to continually monitor Plaintiff's mother's fetal monitoring
strips, particularly when the physician was not present. Id. at 54, 67.
While he provided helpful testimony to the jury regarding the duty owed by the HIMA nurses to Plaintiff and her mother, Dr. Schifrin was unable to articulate a professional standard of care for nurses that is specific to Puerto Rico. Id. at 21. Defendant primarily challenges Dr. Schifrin's testimony on this ground, arguing that his inability to articulate a Puerto-Rico-specific standard of care rendered his testimony too general, and thus Plaintiff failed to provide sufficient evidence to establish the duty owed by the HIMA nurses (prong one of Plaintiff's cause of action). (Docket No. 152 at 51-52). However, while the Court notes Dr. Schifrin's admitted limitations,4 Defendant failed to establish how the local standard of care is different in any material respect from the standard of care that Dr. Schifrin testified to at trial . In fact, just last month, the First Circuit held that the jury in a very similar case was entitled to credit the plaintiff's expert's opinion "that the applicable standards of care in Puerto Rico and the rest of the United States are the same." Rodriguez-Valentin v. Doctors’ Ctr. Hosp. (Manati), Inc., 27 F.4th 14, 21 (1st Cir. 2022).5 Similarly, here, the jury properly credited Dr. Schifrin's opinion as to the applicable standard of care. Dr. Schifrin's testimony provided the jury with sufficient evidence from which to discern the duty owed by the HIMA nurses to Plaintiff and her mother in this case.
Defendant also contends that Plaintiff failed to submit any evidence to establish a causal link between HIMA's negligence and Plaintiff's cerebral palsy
(prong three of Plaintiff's cause of action). (Docket No. 152 at 38-49). Defendant raises three specific causation arguments. First, HIMA contends that Plaintiff fatally relied solely on Dr. Schifrin's testimony to establish causation, while Dr. Schifrin, by his own admission, was not a causation expert. Id. at 38-40. Second, Defendant argues that the medical record objectively shows that there was no hypoxic event in this case, and thus it was impossible for a hypoxic event to have caused Plaintiff's harm. Id. at 40-43. Finally, Defendant claims that Dr. Schifrin's medical opinions and testimony were improperly based on the incorrect premise that Dr. Pardo was not at the hospital during key moments in this case, and thus his testimony as to causation should be disregarded. Id. at 43-49. Each argument is addressed in turn below.
First, Defendant posits that Dr. Schifrin's testimony was insufficient to establish causation because Dr. Schifrin, by his own admission, was not able to conclusively tie Plaintiff's cerebral palsy
to Defendant's alleged negligence. Id. at 38-40. Further, Defendant contends that Plaintiff failed to meet her burden of proof on causation because Dr. Schifrin was not able to rule out other potential causes of Plaintiff's cerebral palsy. (Docket No. 152 at 39-40). In his Daubert hearing, Dr. Schifrin testified that he was only qualified to "contribute to causation" but could not "be the expert who assigns the injury to the patient." (Docket No. 152-1 at 28). And on cross examination at trial, he testified he would not make a specific statement that Plaintiff's cerebral palsy was exclusively caused by the hypoxic event that occurred during delivery. (Docket No. 152-2 at 115).
While the Court agrees that Dr. Schifrin, as Plaintiff's...
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