Holston v. Sisters of The Third Order of St. Francis, 1-88-2618

• Decision Date: 24 February 1993
• Docket Number: No. 1-88-2618,1-88-2618
• Citation: 247 Ill.App.3d 985,618 N.E.2d 334,187 Ill.Dec. 743
• Parties: , 187 Ill.Dec. 743 Byron J. HOLSTON and Heather L. Holston Co-Administrators of the Estate of Theodora Holston, Deceased, Plaintiffs-Appellees, v. The SISTERS OF THE THIRD ORDER OF ST. FRANCIS, as Owners and Operators of St. Anthony Medical Center, Defendants-Appellants.
• Court: United States Appellate Court of Illinois

Page 334

618 N.E.2d 334

247 Ill.App.3d 985, 187 Ill.Dec. 743

Byron J. HOLSTON and Heather L. Holston Co-Administrators of the Estate of Theodora Holston, Deceased Plaintiffs-Appellees, v. The SISTERS OF THE THIRD ORDER OF ST. FRANCIS, as Owners and Operators of St. Anthony Medical Center Defendants-Appellants.

No. 1-88-2618.

Appellate Court of Illinois First District, Third Division.

Feb. 24, 1993.

Rehearing Denied July 15, 1993.

Baker & McKenzie, Francis D. Morrissey, Norman J. Barry, Jr. and Thomas W. Cushing, Chicago, for appellants.

Albert F. Hofeld and Howard Schaffner, Chicago, for appellees.

Justice CERDA delivered the opinion of the court:

One of the defendants, The Sisters of the Third Order of St. Francis ("defendant"), which was the owner and operator of St. Anthony Medical Center, appeals after a jury trial in which plaintiffs, Byron J. Holston and Heather L. Holston, co-administrators of the Estate of Theodora Holston ("decedent"), were awarded $7.3 million in their medical malpractice action. Defendant argues that: (1) the trial court erred in denying its motion to transfer venue to Winnebago County; (2) in violation of Supreme Court Rule 220 (134 Ill.2d R. 220), the trial court improperly allowed plaintiffs' expert, Dr. Alden, to testify regarding opinions that were not provided to defendant before trial; (3) the trial court erred in barring Susan Burns from testifying as to the standard of care for nurses; (4) the jury should not have been instructed to consider conscious pain and suffering, disability, and disfigurement because there was no evidence of these damages; (5) the trial court erred in barring evidence of the separation of decedent and her husband 18 months prior to her death; and (6) the jury verdicts were excessive. We affirm.

Plaintiff's first complaint for wrongful death and survival named the following defendants: The Rockford Surgical Service, S.C., a corporation; Dr. Edward H. Sharp; R. Glenn Smith; Dr. George Arends, individually and d/b/a Rockford Anesthesiology Group; John Szewczyk, individually and d/b/a Rockford Anesthesiology Group; St. Anthony Hospital; The Sisters of the Third Order of St. Francis, a not-for-profit corporation; Christine Carlson; K. Flatley; Donald E. Bonicki; C.R. Bard, Inc. ("Bard"); Becton, Dickinson and Company, a corporation; Bard Parker, a Division of Becton, Dickinson and Company, a corporation ("Bard Parker"); Bard Consumer Products ("Bard Consumer"); Bard Home Health Division, a division of Bard ("Bard Home") The Burrows Company a corporation; and Ginders Hospital Supply Co., a corporation. Bard, Becton, Bard Parker, Bard Consumer, Bard Home, Burrows, and Ginders allegedly designed, manufactured, distributed, and sold to defendant a central venous pressure ("cvp") catheter that was defective and unreasonably dangerous.

Rockford Surgical filed a motion for dismissal or for transfer of venue to Winnebago County because of the existence of an identical action in Federal court, because the cause of action arose in Winnebago County, and because all defendant doctors resided and practiced in Winnebago County. This motion and other defendants' motions for change of venue were denied.

Plaintiffs' fourth amended complaint alleged in count I against defendant that: (1) St. Anthony owned and operated the hospital in Rockford; (2) decedent was admitted to the hospital on January 9, 1978, under the care of Dr. Sharp who performed gastric bypass surgery on her on January 12, 1978; (3) Dr. Arends was the anesthesiologist for decedent's surgery and placed a cvp catheter in her; (4) the cvp catheter penetrated decedent's heart on January 12, 1978, resulting in an atrial perforation; (5) the cvp catheter delivered intravenous fluid through the atrial perforation into the pericardial sac surrounding decedent's heart, resulting in a condition of cardiac tamponade; (6) as a result of the cardiac tamponade, decedent suffered cardiac arrest, which resulted in permanent brain damage; (7) defendant was negligent because: (a) although the nurse caring for decedent believed that she should be seen by a physician immediately, the nursing supervisor refused to allow the nurse to notify Dr. Sharp and failed to notify a physician herself; (b) when standard nursing practice required that a physician be notified concerning decedent's vital signs, defendant failed to notify a physician in a timely manner; and (c) defendant failed to adequately care for decedent; and (8) as a result of defendant's negligence, decedent became injured and sustained conscious pain and suffering, disability, and disfigurement until she died on January 19, 1978. Count I sought damages of $1.5 million.

Count II was for wrongful death based on the negligence alleged in count I, and it further alleged that decedent's husband Byron C. Holston, son Byron J. Holston, and daughter Heather L. Holston sustained substantial pecuniary loss, loss of services and consortium, and severe damage by reason of decedent's death. Count II sought damages of $8.5 million.

Plaintiffs made a motion in limine barring testimony regarding decedent's separation from her husband. Plaintiffs' attorney argued at the hearing that they were separated about one and one-half years prior to decedent's death, that they did not consult a lawyer, that it was not a formal separation, that they were separated for four to six months, that they saw a marriage counselor, and that they were reunited. The trial court orally ruled that the incident was not relevant to the quality of the marriage on the date of decedent's death and was prejudicial.

The testimony that is relevant to the issues raised on appeal is summarized below.

Dr. Sharp testified for plaintiff as an adverse witness to the following. Decedent was morbidly obese and that her gastric bypass operation was performed to reduce her weight. No abnormality in her heart was noted before the surgery. Dr. Arends, the anesthesiologist, placed a cvp catheter in decedent for the gastric bypass surgery. The purpose was to monitor the fluid shifts. No complications were revealed to Dr. Sharp during the surgery, and decedent's heart did not suffer any trauma during the surgery.

After the surgery, decedent was taken to the intensive care unit. Her vital signs were monitored in the afternoon. One of the vital signs was pulse, and tachycardia was a rapid heart beat, which could be one of the signs of cardiac tamponade. Other signs of cardiac tamponade were increased cvp and a drop in blood pressure. Decedent's pulse rate was 78 at 1:30 p.m., 94 at 2 p.m., and 120 at 2:30 p.m. A pulse of 120 one hour after surgery if a patient was awake and feeling pain was not unreasonable. Decedent's pulse, blood pressure, and respiration rates were within normal limits up to 5 p.m. Her blood pressure and cvp were within the range of normal at 5 p.m. At 5 p.m., decedent was repositioned to her left side, and she was given a rubber glove to blow up for a medical reason. These activities could have increased the heart rate.

Compared to earlier measured blood pressure recordings, decedent's blood pressure of 100/60 at 5 p.m. was within the normal range. The only arguably significant or abnormal vital sign at 5 p.m. was the 140 pulse, and Dr. Sharp would have wanted to know about it. Her pulse rose to 148 at 6 p.m. Dr. Sharp received a telephone call at 6:20 p.m., when her pulse was 166 and her cvp was 22.

Dr. Sharp arrived at decedent's bedside at 6:43 p.m. He said something to decedent, and she squeezed his hand but he did not think she was able to speak because of the presence of an endotracheal tube. She was awake enough that he felt she had a functioning brain. He did not recall, but thought that decedent was still conscious when she was taken to the operating room to have an exploratory laparotomy. He did not think that she then would have been able to respond to pain, but this question was in the area of neurology. No anesthesia was given to her when he opened her abdomen in the second operation, but he did not think that she experienced any pain.

In the second operation, Dr. Sharp found no bleeding to account for decedent's condition. Decedent had a cardiac arrest, and he had to perform an emergency left thoractomy, in which he severed the tissue in her left chest. Her heart stopped for slightly over five minutes. He squeezed her heart to help return some blood flow to her brain. The heart did not feel normal because of a large amount of fluid around it in the sac. He made a small opening and about 100 or 200 cubic centimeters ("cc") of fluid came out. From 1 to 7 p.m., she had received intravenous ("iv") fluid at the rate of 100 cc per hour. Her heart started to beat after the fluid was relieved. He felt the cvp catheter within the right atrium. Decedent never regained consciousness.

A patient would experience pain after the gastric bypass operation upon awakening from anesthesia. Gastric bypass surgery caused a tightening of the muscles that was a response to pain. The cvp would rise as a result because the pressure within the abdomen rises. Decedent was resting comfortably at 4 p.m., yet her cvp was up from the previous hour. There was nothing in the nurse's notes to indicate that she was in pain from 5 to 6 p.m. She was given medicine at 3:30 p.m. for her complaint of abdominal pain. At 6 p.m., she was complaining of abdominal discomfort. Decedent was so large that she would have had tremendous pain after the surgery. It did not mean that she had no pain if there was never a notation of pain from the time she arrived in the intensive care unit until after the second surgery. It was possible that a patient could have pain and the nurse would not record it because it was expected.

On January 25, 1988, plaintiffs' attorney stated that plaintiffs' expert, Dr. Alden, had no criticism of the hospital when he gave his deposition because Dr. Maxwell had testified at his own...