Gniady v. Ochsner Clinic Found.
| Docket Number | 2023-CA-0215 |
| Decision Date | 28 December 2023 |
| Parties | DAVID GNIADY v. OCHSNER CLINIC FOUNDATION |
| Court | Court of Appeal of Louisiana — District of US |
1
DAVID GNIADY
v.
OCHSNER CLINIC FOUNDATION
No. 2023-CA-0215
Court of Appeals of Louisiana, Fourth Circuit
December 28, 2023
APPEAL FROM CIVIL DISTRICT COURT, ORLEANS PARISH NO. 2017-11897, DIVISION "A" Honorable Ellen M. Hazeur, Judge.
Harry E. Forst, COUNSEL FOR PLAINTIFF/APPELLANT, David Gniady.
Peter E. Sperling, Halley S. Carter, FRILOT L.L.C. COUNSEL FOR DEFENDANT/APPELLEE, Ochsner Clinic Foundation.
Court composed of Judge Paula A. Brown, Judge Dale N. Atkins, Judge Nakisha Ervin-Knott.
DALE N. ATKINS, JUDGE.
This is a medical malpractice action. Appellant, David Gniady ("Mr. Gniady"), seeks review of the trial court's November 23, 2022 judgment, which denied his "Motion for Judgment Notwithstanding the Jury Verdict [and/or] Motion for a New Trial" ("Motion for JNOV/New Trial") and dismissed his medical malpractice claims against Appellee, Ochsner Clinic Foundation ("Ochsner"), with prejudice. For the following reasons, we affirm.
FACTUAL BACKGROUND AND PROCEDURAL HISTORY
Petition for Damages
On December 12, 2017, Mr. Gniady filed a "Petition for Damages" ("Petition") in Orleans Parish Civil District Court. Therein, he named Ochsner as a defendant and stated that during certain events and times described in his Petition, he received medical treatment from Dr. Samuel Colby Danna ("Dr. Danna")[1] at the Ochsner Clinic Foundation-Baptist Campus ("Ochsner Baptist"). Mr. Gniady contended that, as the employer of Dr. Danna, Ochsner was liable for Dr. Danna's
actions under the theory of respondeat superior. Thereafter, Mr. Gniady outlined the series of events which he alleged constituted medical malpractice.[2]
In his Petition, Mr. Gniady explained that he ran for four miles on September 30, 2015, after which time "he suffered severe chest pain which he had never experienced before" and which felt "like a strong cramp." Mr. Gniady further explained that "after walking for a bit, the pain went away." However, according to his Petition, Mr. Gniady went on a two-mile run the next day, October 1, 2015, after which "the same thing happened" as the day prior, i.e., "a severe chest pain that resembled a cramp" that "after walking a bit . . . went away." Then, on October 4, 2015, Mr. Gniady attended a New Orleans Saints football game and "had another episode of severe chest pain" while walking up a ramp to reach his seat. According to his Petition, Mr. Gniady "was able to walk to his seat[;]" and "[t]he pain . . . subside[d,] and he watched the game."
As explained in his Petition, thereafter, on the morning of October 5, 2015, Mr. Gniady attempted to contact his doctor, Dr. Danna, but could not reach Dr. Danna's office directly, so Mr. Gniady used "the Ochsner Medical Center [call] service" and "asked to see [Dr. Danna] as soon as possible." Mr. Gniady's Petition
stated that he received a response that the earliest Dr. Danna could see Mr. Gniady was the morning of the next day, October 6, 2015. Mr. Gniady summarized his visit with Dr. Danna in his Petition:
The doctor examined him, listened to his heart, and did an EKG[3] on him. After the examination, Dr. Danna stated that he did not see anything that caused him to be alarmed. He said there were some minor abnormalities in his EKG, it was abnormal, but they were not the cause for any immediate concern. Dr. Danna recommended that he have a stress test done the following week to see whether they could determine the exact cause of the pain. Mr. Gniady was sent home. Dr. Danna did not suggest that he go to the emergency room nor did he suggest that he immediately see a cardiologist or immediately refer him to another doctor despite that he presented with cardiac symptoms and an abnormal EKG.
According to Mr. Gniady's Petition, at approximately 11:10 p.m. on October 6, 2015 (the same day as his appointment with Dr. Danna), Mr. Gniady "experienced a severe pain in the middle of his chest" like the pain he had experienced on the three prior occasions "but much more painful" and "very intense." Mr. Gniady's Petition stated that his family contacted emergency medical services, who transported Mr. Gniady to Ochsner Baptist.
Per Mr. Gniady's Petition, when Mr. Gniady arrived at Ochsner Baptist, Dr. Siddharth Bhansali ("Dr. Bhansali") was the cardiologist who treated Mr. Gniady and operated on him to "put a stent into his heart and relieve the blockage since he had experienced a severe heart attack." Mr. Gniady's Petition explains that he
spent twelve days in the intensive care unit ("ICU") of the hospital and was released from the ICU on October 19, 2015, after which time he spent an additional five days in the hospital before returning home. However, according to Mr. Gniady's Petition, Mr. Gniady began to experience "issues with fluid building up around his heart," for which he had to spend another five days in the hospital.[4]The Petition further stated that Mr. Gniady "ha[d] not returned to his normal work routine," that he "suffer[ed] with shortness of breath," and that "he continue[d] to follow up with Dr. Bhansali."
In his Petition, Mr. Gniady asserted that Ochsner acted negligently and breached the standard of care (via its employee Dr. Danna) in the following ways:
1. When Mr. Gniady made his initial call to the Ochsner Medical service complaining of chest pain, he should have been advised and routed to go to the emergency room immediately.
2. On October 6, 2015, when he saw Dr. Danna, Dr. Danna should have sent him with a history of chest pain and abnormal E[K]G, to the emergency room.
3. The patient presented with symptoms and an abnormal EKG that should have prompted immediate referral.
3. [sic] Dr. Danna should have had the EKG that he had run, read by a cardiologist immediately and he should have had a cardiology consult immediately on October 6, 2015.
4. The EKG was read at a resting heart rate and the doctor should have asked him to walk around to increase his heart rate before administering the EKG.
5. The doctor could have also done a cardiac enzyme test in his office.
6. The E[K]G showed he had inverted T-waves in leads VI, V2, and biphasic in V3, which was indicative of "Wellen's Syndrome".[5] This should have alerted Dr. Danna that Mr. Gniady was at a greater risk to have a heart attack within the next few days to weeks and should have been sent immediately to the emergency room.
Mr. Gniady asserted that, as a result of the above negligent actions and breaches of the standard of care, "his heart sustained permanent damage with an ejection fraction of 38%-40%[;]" he "suffer[ed]with congestive heart failure, shortness of breath, and [an inability] to do even simple physical task[s;]" and that "[h]is life may well have been shortened as a result of this incident."
August 2022 Jury Trial
This matter ultimately proceeded to a jury trial that commenced on August 15, 2022, and concluded on August 19, 2022. In pertinent part, the jury heard testimony from Dr. Lee Fischer ("Dr. Fischer"), Dr. Danna, Dr. Frank Wilkow ("Dr. Wilkow"), and Dr. Christopher Lege ("Dr. Lege). The jury also watched the video depositions of Dr. Gary Tamkin ("Dr. Tamkin"), Dr. Bhansali, and Dr. Joseph Klapper ("Dr. Klapper").
Mr. Gniady's Case-in-Chief
Dr. Fischer
First, Mr. Gniady called Dr. Fischer as a witness, and Dr. Fischer testified that he was a board-certified family physician[6] and had been in private practice for
thirty-one years until 2006. Thereafter, from 2006 until 2018, Dr. Fischer explained that he served part-time as a supervising physician at a family medicine residency program. At the time of Mr. Gniady's heart attack in 2015, Dr. Fischer noted that in addition to his role as a supervising physician at the family medicine residency program, he also reviewed medical files for a short- and long-term disability company, and he reviewed medical files and testified in legal matters. Dr. Fischer stated that, at the time of trial, he worked as an independent medical consultant for the Social Security Administration and as an assistant professor, instructor, facilitator, and grader for students at the College of Osteopathic Medicine at Marian University. The trial court accepted Dr. Fischer as an expert in the fields of family practice and primary care.
Dr. Fischer testified that after reviewing Mr. Gniady's medical records and the depositions of Mr. Gniady, Mr. Gniady's wife, one of Mr. Gniady's daughters, and Dr. Danna, his opinion was that Mr. Gniady's chest pain on September 30, October 1, and October 4, 2015, "was consistent with a heart problem, . . . specifically unstable angina" and that "Dr. Danna [should have] recognized" it. Dr. Fischer described unstable angina as a "significant narrowing of one of the main arteries in . . . the chest" and asserted that Mr. Gniady's EKG indicated unstable angina in the exact artery for which Mr. Gniady ultimately required emergency surgery to relieve a blockage. Further, Dr. Fischer opined that Mr. Gniady's EKG was abnormal[7] and that "[e]ven if Dr. Danna did not know the significance of the
abnormality, he knew it was abnormal." Dr. Fischer contended that, given Mr. Gniady's recent history of pain in the center of his chest during activity and an abnormal EKG, Dr. Danna should have immediately transferred Mr. Gniady to the emergency room, "where further testing [could have] been done and more likely than not prevented [Mr. Gniady] from having the heart attack that he had about 12 hours later." In particular, Dr. Fischer explained that "if somebody has a heart attack or even an impending heart attack, [there are] certain blood tests that will show that." Additionally, Dr. Fischer observed that once a patient is admitted to the emergency room, this presents the option to call in specialists, such as cardiologists. Dr. Fischer alternatively opined that...
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