Estate of Keenan v. Hoffman-Rosenfeld

• Decision Date: 29 July 2019
• Docket Number: Case No. 16-cv-0149 (SFJ)(AYS)
• Parties: The Estate of LANA KEENAN, PADRAIG KEENAN, SARA KEENEN, PIERCE KEENAN, a minor child, and DAMIEN KEENAN, a minor child, Plaintiffs, v. DR. JAMIE HOFFMAN-ROSENFELD, et al., Defendants.
• Court: U.S. District Court — Eastern District of New York

The Estate of LANA KEENAN, PADRAIG KEENAN, SARA KEENEN,PIERCE KEENAN, a minor child, and DAMIEN KEENAN, a minor child, Plaintiffs, v. DR. JAMIE HOFFMAN-ROSENFELD, et al., Defendants.

Case No. 16-cv-0149 (SFJ)(AYS)

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF NEW YORK

July 29, 2019

Memorandum and Order

(re: Northwell Defendants¹)

FEUERSTEIN, S., Senior District Judge:

I. Introduction

Plaintiffs the Estate of Lana Keenan ("Lana"), Padraig Keenan ( "Father"), Sara Keenan ("Sara"; together with Father, the "Parents"), Pierce Keenan ("Pierce"), and Damien Keenan ("Damien"; together with Pierce, the "Brothers"; collectively, with Lana and the Parents, the "Plaintiffs") commenced this action against Defendants Dr. Jamie Hoffman-Rosenfeld, s/h/a Jamie Hoffman-Rosenfeld, as an Individual acting under color of State Law ("Hoffman-Rosenfeld"), Dr. Ayse Avcioglu ("Avcioglu"),² Dr. Mark Adam Mittler, s/h/a Dr. Adam Mittler, Individually and as a Person Operating Under Color of State Law ("Mittler"), Cristin Gilleran ("Gilleran") (hereafter, together with Hoffman-Rosenfeld and Mittler, the "Northwell Trio"),Southside Hospital ("Southside"), Northwell Health System, s/h/a Northwell Health ("Northwell"), Long Island Jewish Medical Center, s/h/a Cohen Children's Medical Center ("CCHC") (hereafter, together with Southside and Northwell, the "Northwell Hospital Entities")(collectively, the "Northwell Defendants"), among other defendants, alleging, inter alia, various civil rights claims pursuant to 42 U.S.C. § 1983. (See generally Complaint (ECF No. 1); Amended Complaint (ECF No. 108).) Presently before the Court is the Northwell Defendants' motion seeking summary judgment in their favor on all of Plaintiff's claims (hereafter, the "Summary Judgment Motion") (see ECF No. 148; see also Mem. of Law in Supp. of Mot. Summ. J. (ECF No. 148-20) (hereafter, "Support Memo")), which Plaintiffs oppose (hereafter, "Opposition" or "Opp'n") (see ECF No. 150³). For the reasons that follow, Defendants' Summary Judgment Motion is GRANTED.

II. Background

A. Factual Background⁴

After a belated, home-based New Year's celebration with friends (see NW 56.1 Statement, ¶¶15, 17, 19-20), in the early morning of January 3, 2014, the Keenan family members awoke and, between 7:00 a.m. and 8:00 a.m., Mother began breastfeeding three-month-old Lana. (See id., ¶23.) After finishing feeding, Lana feel asleep. (See id., ¶24.) At approximately 9:15 a.m., Mother went downstairs to cook breakfast, leaving Lana alone, on her back, and in the middle of the Parents' bed. (See id., ¶25.) Father went outside to shovel snow. (See id., ¶26.) "Nobody went upstairs to check on [Lana] for as much as an hour and forty-five minutes until after [Father] was called back into the home for breakfast." (Id., ¶27.)

"After entering the home, [Father] immediately went upstairs and found [Lana] face-down on the bed in vomit [and] on her stomach." (Id., ¶28; cf., Plaintiffs' 56.1 Statement, [1].) She was not breathing. (See id., ¶¶29, 31, 42; cf., Plaintiffs' 56.1 Statement [1], [2].) Father carried Lana downstairs where CPR was performed on the infant, getting her to breathe again. (See id., ¶¶31-33; cf., Plaintiffs' 56.1 Statement, [2].) Thereafter, Lana was transported by ambulance to Southside. (See id., ¶¶35, 39; cf., Plaintiffs' 56.1 Statement, [3].) According to the ambulance call report, inter alia, Lana "began to regain more consciousness during transport and began to cry, no other findings upon exam," and had a "strong brachial pulse." (See id., ¶7 (internal quotation marks omitted).)

Lana was taken to the hospital's Emergency Department ("ED") at 11:17 a.m. (see id., ¶39; see also Plaintiffs' 56.1 Statement, [3]), and, after being triaged, was administered Narcan. (See id., ¶42; see also Plaintiffs' 56.1 Statement, [5].) Thereafter, the attending ED doctor ordered tests be performed on Lana's blood, which "all evidenc[ed] severe metabolic acidosis, which is a life-threatening condition." (Id., ¶43.) Subsequently, "[s]everal medications were administered prior to and concurrent with [Lana]'s intubation," i.e., Ativan, Versed, Lidocaine, and Propofol. (Id., ¶44; see also Plaintiffs' 56.1 Statement, [5].) Additionally, "[a]mong the tests ordered and performed at Southside was a brain computerized tomography scan ("CT scan") without contrast, entered at 11:54 AM, and performed after 12:56 PM. The CT scan wasread by Yasser Mir, MD, the attending radiologoist, at 1:09 PM." (Id., ¶48.) His findings "were suspicious for early global hypoxic injury" and, therefore, he recommended an MRI. (Id., ¶49; cf., Plaintiffs' 56.1 Statement, [6] ("At 1:09 p.m., a CT scan of Lana's brain showed early signs of Hypoxic Ischemic Encephalopathy (HIE), a condition caused by lack of oxygenated blood flow to the brain."). Later that day, Lana was transferred to CCHC, a level one pediatric trauma center which handles complex trauma cases (see id., ¶ 51; see also Plaintiffs' 56.1 Statement, [8], [9]), where she was admitted and remained through her death on February 6, 2014. (See id., ¶¶ 53, 54.)

Ophthalmology resident Jing Lee, MD: evaluated Lana on January 3, 2014 at 4:40 p.m. (see id., ¶56); found "two retinal hemorrhages of the left eye described as: (1) retinal hemorrhage with central whitening, and (2) flame shaped sub-retinal hemorrhage" (id.); and, discussed those findings with attending physician Majida Gaffar who, after evaluating Lana on January 4, 2014, "confirmed the presence of two faint intra-retinal hemorrhages, without peripheral hemorrhage." (Id., ¶57.)

Also on January 3, 2014, [Lana] was evaluated by a pediatric neurology fellow and pediatric attending physician. The examinations documented that [Lana] was intubated, sedated, and required pressor support after administration of Propofol and Versed prior to and during intubation induction. Also documented was a reported history of eye deviation, but the examination was limited secondary to the paralytics administered. The plan included performing an EEG on January 4, 2014, and to monitor for continued seizure activity.

(Id., ¶58.) Later that evening, at approximately 11 p.m., a social worker documented that she consulted with Hoffman-Rosenfeld, the pediatric abuse specialist, and that the Parents were made aware of the availability of social work services and support. (See id. ¶59.)

On January 4, 2014, a CT scan revealed Lana had worsening HIE with cerebellar infarcts (hereafter, the "January 4th Scan"). (See id., ¶60 (referencing Sharon Dial, MD, a Pediatric Intensive Care Unit ("PICU") intensivist).) That morning, Hoffman-Rosenfeld consulted with the Parents, including repeating "the pertinent history from Southside" and "the finding of retinal hemorrhages". (Id., ¶61.) Her "physical examination of the infant was unremarkable, although she documented that on examination by the ophthalmology resident, two retinal hemorrhages were detected; they were awaiting further examination by the attending physician." (Id., ¶64.") Hoffman-Rosenfeld's notes further indicate that she explained to the Parents: "that many tests were going to be done to help understand the etiology of this episode and that a comprehensive evaluation for traumatic injury was being conducted because traumatic injury was part of the differential diagnosis . . . that there was unexplained hypoxic ischemic encephalopathy in an infant who was previously well" (id., ¶ 65); and "if injury or a marker of possible injury, for example, retinal hemorrhages, [is] found, a report to the New York State Central Registry might be made - and that the [Parents] expressed understanding" (id., ¶66).

Later that afternoon, a physician assistant: evaluated Lana; noted, inter alia, that the January 4th Scan "showed infarcts with global ischemic injury" and "no signs of head trauma"; and discussed the case with Mittler, the neurosurgery attending physician, who opined that Lana's "prognosis was extremely poor". (Id., ¶¶67, 68.) Mittler, inter alia: spoke about Lana's case with Hoffman-Rosenfeld and Dr. Dial; agreed with the plan to conduct an MRI of Lana's brain; and "opined that[,] as the event etiology remained unclear, non-accident injury must be included in the diagnosis." (Id., ¶¶68, 69.)

Also on January 4, 2014, "[a]fter consulting with . . . Hoffman-Rosenfeld, social worker Elyse Davidson, MSW[,] contacted the Statewide Central Register of Child Abuse andMaltreatment and made a mandated report of suspected child abuse based on [Lana]'s condition." (Id., ¶ 70.) Sometime thereafter, a CPS employee arrived at Lana's bedside to meet the Parents (see id., ¶ 72), as did members of the Suffolk County Police Department to interview them (see id., ¶73).

On January 5, 2014, Mittler, together with a PICU doctor, had a discussion with the Parents addressing "the evolution of HIE with brain swelling and herniation" as well as Lana's "grim prognosis". (Id., ¶74.) He also reviewed a CT scan performed that day, leading to his reconfirmation "that there was no neurosurgical intervention that would provide benefit." (Id., ¶77; see also id., ¶75 (discussing CT scan interpretation by Dr. Nguyen), ¶77 ("Mittler personally evaluated the infant on January 6, 2014 and restated his findings.").)

On January 6, 2014, "Hoffman-Rosenfeld re-consulted . . . and documented that two unilateral retinal hemorrhages were seen, and although the pattern was nonspecific and although traumatic injury was in the differential diagnosis, they were not conclusive evidence of trauma or abuse." (Id., ¶ 78.) CPS employees Peterson and Pidel "were both provided a medical update." (Id., ¶79.) Thereafter, various CPS personnel participated in a case conference regarding Lana during which information from Hoffman-Rosenfeld was presented, to wit: Hoffman-Rosenfeld's "assessment of the infant was 'inconclusive'"; "there was no conclusion of child abuse"; and that the doctors "were continuing to assess for possible organic causes of [L...