Dunham v. Univ. of Md. Med. Ctr.
| Decision Date | 28 June 2018 |
| Docket Number | No. 260, 1443, Sept. Term, 2017,260, 1443, Sept. Term, 2017 |
| Citation | 187 A.3d 752,237 Md.App. 628 |
| Parties | Stanley DUNHAM, et al. v. UNIVERSITY OF MARYLAND MEDICAL CENTER, et al. |
| Court | Court of Special Appeals of Maryland |
Argued by: Damien R. Banks (Marissa B. Joelson, Law Office of Peter Angelos on the brief) all of Baltimore, MD, for Appellant.
Argued by: Anthony J. Breschi (Kaitlan M. Skrainar, Waranch & Brown, LLC on the brief) all of Lutherville, MD, for Appellee.
Panel: Eyler, Deborah S., Graeff, Nazarian, JJ.*
This consolidated appeal arises from a medical malpractice action filed by appellants, Stanley and Renee Dunham, against the University of Maryland Medical Center, LLC ("UMMC"), Maryland General Hospital, Inc., d/b/a University of Maryland Medical Center Midtown Campus ("Midtown"), and the University of Maryland Medical System Corporation ("UMMS") (collectively, appellees). The Dunhams allege that appellees breached the standard of care in failing to implement procedures to prevent pressure ulcers
from developing and/or progressing and failing to treat the pressure ulcers once they developed.
The claim initially was filed in the Health Care Alternative Dispute Resolution Office ("HCADRO") and transferred to the Circuit Court for Baltimore City, which granted appellees' motion to strike the certificate of qualified expert and motion to dismiss, without prejudice ("Dunham I "). Mr. and Mrs. Dunham appealed the dismissal of Dunham I.
The Dunhams then filed in the HCADRO, using the same claim number as the initial claim, a motion for extension of time for filing a certificate of qualified expert. The HCADRO granted an extension, the Dunhams filed a second certificate, and the claim was transferred to the circuit court, which again dismissed the claim ("Dunham II ").
On appeal from the rulings in Dunham I and Dunham II , Mr. and Mrs. Dunham present the following questions for this Court's review, which we have rephrased slightly, as follows:
For the reasons set forth below, we shall vacate the judgment of the circuit court in Dunham I and dismiss as moot the appeal in Dunham II.
This is a medical malpractice action relating to the care of Mr. Dunham from October 28, 2013, through February 6, 2014. Because the issues on appeal are procedural in nature and do not involve the merits of the underlying dispute, we provide only a brief synopsis of Mr. Dunham's medical history, as set forth in the pleadings.
On October 28, 2013, Mr. Dunham was admitted to UMMC for a medical procedure to replace his aortic heart valve. Upon his admission, he was "assessed using the Braden Scale for predicting pressure ulcer
risk and was given a score of less than 15," which indicated that Mr. Dunham was "at a high risk for developing pressure ulcers
."
Following the completion of his medical procedure, Mr. Dunham's medical care was complicated by hypotension, and he later required treatment for ESBL Klebsiella pneumonia
, which ultimately resulted in a tracheostomy
.1 Mr. Dunham was in the intensive care unit at UMMC until November 15, 2013.
On November 2, 2013, during his stay at UMMC, Mr. Dunham began developing bilateral pressure ulcers
on his buttocks. By November 5, the ulcers had worsened, resulting in skin tears and peeling, and by November 11, Mr. Dunham had "full thickness skin necrosis."
On November 15, 2013, Mr. Dunham was transferred to Midtown for further care to address the pressure ulcers
. On February 6, 2014, after receiving additional treatment for the pressure ulcers, he was discharged with instructions to receive intravenous antibiotics and continue at-home wound care.
On October 14, 2016, Mr. and Mrs. Dunham filed a statement of claim with the HCADRO "alleging medical negligence on the part of [UMMC], Midtown, and UMMS" relating to the development and progression of pressure ulcers
. On November 16, 2016, Mr. and Mrs. Dunham filed a certificate of qualified expert and report ("certificate") and then waived arbitration.2
The certificate, completed by Antonios P. Gasparis, M.D., stated, in pertinent part:
Based upon my review of this matter, and upon my knowledge, training, and experience in the field of vascular surgery and wound
care, and as set forth more fully in the attached Report, it is my opinion to a reasonable degree of medical probability that Health Care Providers, University of Maryland Medical Center, LLC, Maryland General Hospital, Inc, d/b/a University of Maryland Medical Center Midtown Campus, and University of Maryland Medical System Corporation, through their agents, servants, and/or employees, breached the applicable standard of care in their care and treatment of Stanley Dunham in and around October 28, 2013 through February 6, 2014, and that these breaches of the standard of care caused injury to Mr. Dunham.
Although the certificate named UMMC, Midtown, and UMMS, "through their agents, servants, and/or employees," as responsible for the breach of the standard of care, which caused Mr. Dunham's injury, it did not identify the specific agents, servants, or employees whose care was at issue. In his corresponding report, Dr. Gasparis again identified the health care providers generally as UMMC, Midtown, and UMMS, "through their agents, servants, and/or employees," without specifying which of appellees' individual health care providers he believed to have provided deficient care.3
On December 1, 2016, after the Dunhams waived arbitration and the HCADRO issued an order of transfer, Mr. and Mrs. Dunham filed a two-count complaint against appellees, case number 24–C–16–006500 ("Dunham I "). The first count asserted a claim of negligence, alleging that appellees, and their "agents, servants, and employees," owed a duty to Mr. Dunham to "render and provide health care within the ordinary standards of medical, hospital and nursing care," to exercise care in its selection of personnel, and to supervise and provide patients with treatment "commensurate with the condition from which the patient suffers." It alleged that appellees and their agents were under a duty to provide care "in accordance with the standards of practice among members of the nursing profession," but the "actions and inactions of the [appellees], through their agents, servants, and employees, breached the applicable standards of nursing care," and as a result of the negligence of appellees, "acting through their agents, servants and employees, Mr. Dunham suffered severe and permanent injuries." The second count alleged loss of consortium, incorporating the allegations set forth in the first count and stating that the damages were caused by "the wrongful acts and omissions of the [appellees] directly and by and through their actual and apparent agents, servants, and/or employees."
On February 2, 2017, appellees filed a Motion to Strike Plaintiffs' Certificate of Merit and Report and Motion to Dismiss and Request for Hearing. They argued that Dr. Gasparis' certificate and report "fail[ed] to meet the mandatory minimum requirements set forth by the Health Care Malpractice Claims Act" because they "fail[ed] to identify by name [or specialty] any licensed professional health care provider(s) at [UMMC], [Midtown], and [UMMS] who [we]re alleged to have breached the standard of care." Appellees also argued that a proper certificate and report was an " ‘indispensable step’ and a condition precedent to the medical malpractice process," and "when a plaintiff fails to file an appropriate certificate and report, her case must be dismissed by the Circuit Court."
The Dunhams filed an opposition, asserting that their certificate sufficiently stated the health care providers that breached the standard of care, noting that the health care institutions were named. The Dunhams argued that the certificate was not required "to identify specific agents when a Defendant is an institutional agency."
The Dunhams also argued that the certificate and report "contain[ed] sufficient detail to allow for the [appellees] to identify which, of their own agents, servants and/or employees, treated [Mr. Dunham] throughout his lengthy, five (5) month admissions." In that regard, they asserted that it was "wholly unreasonable" to expect them "to identify the multitude of physicians and nursing staff who attended to [Mr. Dunham]" because, "[l]ike most medical charts, [Mr. Dunham's] record [was] replete with illegible handwritten notes that [were] impossible to decipher."
Alternatively, Mr. and Mrs. Dunham argued that, if the court was persuaded that the certificate and report were deficient, the court was required to grant a 90–day extension to file an amended certificate pursuant to CJP § 3–2A–04(b)(1)(ii).4 The Dunhams asserted that the extension was a matter of right and was not discretionary.
In reply, appellees reiterated their argument that it was the Dunhams' burden to identify the individual licensed professionals whose care was criticized in the certificate. They argued that, by naming only corporate entities, appellees were "unable to determine which of the thousands of licensed professionals that act as their employees, agents, and/or servants [were] being criticized for allegedly breaching the applicable standard of care." Appellees disputed the claim that the medical records were "impossible to...
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