Grechko v. Maimonides Med. Ctr.

• Court: New York Supreme Court — Appellate Division
• Citation: Grechko v. Maimonides Med. Ctr., 188 A.D.3d 832, 134 N.Y.S.3d 435 (N.Y. App. Div. 2020)
• Decision Date: 12 November 2020
• Docket Number: Index No. 12681/10,2016–03935
• Parties: Inna GRECHKO, etc., appellant, v. MAIMONIDES MEDICAL CENTER, et al., respondents, et al., defendants.

188 A.D.3d 832

134 N.Y.S.3d 435

Inna GRECHKO, etc., appellant,

v.MAIMONIDES MEDICAL CENTER, et al., respondents, et al., defendants.

2016–03935

Index No. 12681/10

Supreme Court, Appellate Division, Second Department, New York.

Argued - December 13, 2018

November 12, 2020

Jeffrey E. Michels, New York, NY, for appellant.

Aaronson Rappaport Feinstein & Deutsch, LLP, New York, N.Y. (Elliott J. Zucker of counsel), for respondents.

REINALDO E. RIVERA, J.P., JEFFREY A. COHEN, SYLVIA O. HINDS–RADIX, JOSEPH J. MALTESE, JJ.

DECISION & ORDER ON MOTION

In an action to recover damages for medical malpractice, the plaintiff appeals from a judgment of the Supreme Court, Kings County (Ellen Spodek, J.), entered February 25, 2015. The judgment, insofar as appealed from, upon a jury verdict, is in favor of the defendants Maimonides Medical Center and Reginald Orr and against the plaintiff, dismissing the complaint insofar as asserted against those defendants.

ORDERED that the judgment is reversed insofar as appealed from, on the law, with costs, the complaint is reinstated insofar as asserted against the defendants Maimonides Medical Center and Reginald Orr, and the matter is remitted to the Supreme Court, Kings County, for a new trial as to those defendants.

On June 1, 2008, the plaintiff's decedent presented to the emergency room at the defendant Maimonides Medical Center (hereinafter the Medical Center), where he was evaluated by the defendant Reginald Orr, an emergency room physician employed by the Medical Center. Orr diagnosed the decedent with pneumonia. In the decedent's medical record, Orr wrote that he "offered" the decedent hospitalization for fluids and IV antibiotics. However, the decedent was discharged from the emergency room the same day with oral antibiotics and instructions to follow up with his primary care physician. Although Orr testified at trial that he informed the decedent that his pneumonia was serious and required hospitalization, and that the decedent left the Medical Center against medical advice (hereinafter AMA), it is uncontested that Orr never requested that the decedent sign an AMA form before he was discharged.

On June 4, 2008, the decedent presented to his primary care physician, Vitaly Volovoy. After evaluating the decedent, Volovoy sent the decedent to Coney Island Hospital for further treatment. Emmanuil Rakhmanchik, an attending physician at Coney Island Hospital, wrote in the decedent's medical record that according to the decedent's primary care physician, the decedent signed an AMA form at the Medical Center. At a deposition, Volovoy testified that the decedent told him that he refused treatment at the Medical Center, and further that he was discharged home from the Medical Center. Additionally, Mohammed Uddin, a resident physician at Coney Island Hospital, wrote in the decedent's medical record that the decedent was recommended hospitalization at the Medical Center, but signed an AMA form. The decedent died at Coney Island Hospital on the evening of June 4, 2008.

The plaintiff alleges that the Medical Center and Orr were negligent in failing to recognize the seriousness of the decedent's pneumonia when he presented to the Medical Center on June 1, 2008. Prior to trial, the plaintiff moved, in limine, to preclude and/or redact so much of the entries by Rakhmanchik and Uddin in the decedent's medical record at Coney Island Hospital, and to preclude so much of the deposition testimony of Uddin and Volovoy, as pertained to discussions they had with the decedent. The Supreme Court denied the motion except for that branch of the motion which was to preclude so much of Rakhmanchik's entry as stated that, according to the decedent's primary care physician, the decedent signed an AMA form at the Medical Center, which the court determined was inadmissible hearsay. However, the court later permitted defense counsel to cross-examine the plaintiff's expert emergency medicine physician on the substance of Rakhmanchik's entry.

The jury returned a verdict in favor of the Medical Center and Orr (hereinafter together the defendants), and the Supreme Court entered a judgment, inter alia, dismissing the complaint insofar as asserted against them. On appeal, the plaintiff contends, inter alia, that the court should not have allowed the entries in the Coney Island Hospital record related to the decedent signing an AMA into evidence.

The defendants argue that the entries in the Coney Island Hospital records were admissible under the business records exception to the hearsay rule. Generally, "[a] hearsay entry in a hospital record is admissible under the business records exception to the hearsay rule if the entry is germane to the diagnosis or treatment of the patient" ( Berkovits v. Chaaya, 138 A.D.3d 1050, 1051, 31 N.Y.S.3d 531 ; see CPLR 4518[a] ). However, "where the source of the information on the hospital or doctor's record is unknown, the record is inadmissible" ( Ginsberg v. North Shore Hosp., 213 A.D.2d 592, 592, 624 N.Y.S.2d 257 ). This is because " ‘each participant in the chain producing the record, from the initial declarant to the final entrant, must be acting within the course of regular business conduct or the declaration must meet the test of some other hearsay exception’ " ( Memenza v. Cole, 131 A.D.3d 1020, 1022, 16 N.Y.S.3d 287, quoting Murray v. Donlan, 77 A.D.2d 337, 346, 433 N.Y.S.2d 184 ). Here, although the entries were germane to the decedent's diagnosis and treatment, because the record does not reflect that the source of the information in the entries was known, it cannot be established whether the source had a duty to make the statement or whether some other hearsay exception applied (see Bloechle v. Heritage Catering, Ltd., 172 A.D.3d 1294, 1296, 101 N.Y.S.3d 424 ; Ardanuy v. RB Juice, LLC, 164 A.D.3d 1296, 83 N.Y.S.3d 634 ; Matter of Progressive Northeastern Ins. Co. v. Randazzo, 24 A.D.3d 560, 560, 808 N.Y.S.2d 262 ; Ginsberg v. North Shore Hosp., 213 A.D.2d at 592, 624 N.Y.S.2d 257 ). Specifically, Uddin's entry does not identify the source of the information, and Uddin testified that he had no independent recollection of the decedent informing him that he signed an AMA. Although Rakhmanchik's entry identified the decedent's "PCI," or primary care internist, as the source of the information, Rakhmanchik testified that he did not recall speaking with the decedent's primary care physician and did not recall the physician's name. Accordingly, the entries were not admissible under the business records exception to the hearsay rule.

If an entry in the medical records "is inconsistent with a position taken by a party at trial, it is admissible as an admission by that par...