Katsetos v. Nolan

• Citation: 368 A.2d 172,170 Conn. 637
• Court: Supreme Court of Connecticut
• Decision Date: 20 April 1976
• Parties: Steve KATSETOS, Administrator (ESTATE of Freda KATSETOS) v. John J. NOLAN et al.

Page 172

368 A.2d 172

170 Conn. 637

Steve KATSETOS, Administrator (ESTATE of Freda KATSETOS) v. John J. NOLAN et al.

Supreme Court of Connecticut.

April 20, 1976.

Henry J. Lyons, Bridgeport, for appellant (named defendant).

Gregory C. Willis, Bridgeport, for appellant (defendant Clayton B. Weed, Jr.).

Richard A. Silver, Stamford, with whom, on the brief, was David S. Golub, Stamford, for appellee (plaintiff).

Before HOUSE, C.J., and LOISELLE, BOGDANSKI, LONGO and BARBER, JJ.

BARBER, Associate Justice.

The defendants have appealed from a judgment rendered by the Superior Court in favor of the plaintiff administrator. In their preliminary statement of issues, error is claimed in numerous portions of the court's charge to the jury; in the court's denial of the defendants' motions to strike the testimony of four doctors called as expert witnesses for the plaintiff; in seventy-eight rulings by the court concerning the admission of evidence; in the court's denial of the defendants' motions for a directed verdict and judgment notwithstanding the verdict; and in the court's denial of the defendants' motions to set aside the verdict as excessive.

The trial required sixteen weeks, and the transcripts run close to 4000 pages. At the outset of this opinion, we shall briefly summarize the facts of the case, discussing particular rulings in more detail where warranted.

The decedent, Freda Katsetos, then forty-one, entered St. Joseph Hospital in Stamford on January 8, 1969, for delivery of her fourth child. She was the patient of the defendant, John J. Nolan, a physician specializing and board certified in gynecology and obstetrics. At 9:25 that morning, she had a normal delivery of a normal child. Some twenty minutes later, the attending anesthesiologist, Frank J. D'Andrea, advised Dr. Nolan that Mrs. Katsetos was experiencing an abrupt and precipitous drop in blood pressure and a rapid pulse. At about this same time, the decedent entered into a state of shock. Dr. Nolan, suspecting internal bleeding, conducted a physical examination of the decedent and, on the basis of this and subsequent physical examinations, ruled out internal bleeding as the cause of shock. He then suspected either pulmonary embolism or amniotic fluid embolism as the probable diagnosis. The treatment of both of these conditions falls outside the realm of Dr. Nolan's specialty, and he therefore called upon the defendant Clayton B. Weed, Jr., for assistance.

Dr. Weed, who is board certified in the specialty of internal medicine, first examined the decedent at about 10:30 a.m. and listed the most probable diagnosis of the cause of shock as pulmonary embolism. The cause of shock was in fact severe internal bleeding, caused by a ruptured intrauterine artery. The bleeding was not discovered by either Dr. Nolan or Dr. Weed. At approximately 1:45 p.m., the decedent lepsed into unconsciousness, and at 5 p.m. on the same day she was pronounced dead.

The plaintiff administrator brought the present action, naming as defendants Dr. Nolan, Dr. Weed, Dr. D'Andrea, and St. Joseph Hospital, claiming that malpractice on the part of the doctors and the hospital had resulted in the wrongful death of the decedent. The complaint alleged that, although the decedent had exhibited the classic symptoms of severe internal bleeding, the defendant doctors had failed properly to diagnose the condition or perform any of the easily performed tests which would have aided their diagnosis; that the defendant doctors failed to follow any of the recognized protocols for the treatment of shock; that the defendant doctors failed to remain in constant attendance upon their patient while she was in a critical condition; and that the defendant hospital failed properly to oversee the treatment given the decedent to ensure that she was given adequate care.

At trial, the plaintiff introduced an autopsy report and the testimony of a pathologist, to show that the cause of death was shock resulting from severe internal bleeding. He then presented four doctors as expert witnesses who testified that, from the symptoms exhibited, the decedent's condition should have been readily diagnosed by any practicing physician; that tests which would have conclusively affirmed or ruled out a diagnosis of internal bleeding were readily available, could have been performed easily and in little time, and should have been known to the doctors; that no recognized protocol for the treatment of shock had been followed, although the doctors knew or should have known of those protocols; and that, if the bleeding had been discovered, the decedent's life would probably have been saved. The jury returned a verdict in favor of the defendants D'Andrea and St. Joseph Hospital and against the defendants Nolan and Weed in the amount of $400,000. Judgment was rendered accordingly, despite the defendants' post-verdict motions.

The defendants' joint brief raises eight distinct issues, which we will consider in the order presented in their brief. The claims of error not briefed are considered abandoned. DiMaggio v. Cannon, 165 Conn. 19, 21, 327 A.2d 561; Maltbie, Conn.App.Proc. § 327.

I

All four doctors called by the plaintiff were permitted to testify over the defendants' repeated objections that the doctors were not qualified to testify as experts and the court denied the defendants' motions to strike the testimony of each doctor. The defendants have assigned error in each of these rulings. A brief synopsis of the qualifications of each doctor, as presented at trial, will serve to place the defendants' claims in context.

Dr. Nathan Kase was, at the time of the trial, a professor and chairman of the department of obstetrics and gynecology at Yale Medical School and chief of the obstetrics and gynecology service at Yale-New Haven Hospital. He has been licensed to practice medicine and surgery in Connecticut and associated with Yale University since 1962. Prior to January 8, 1969, he was board certified as a specialist in obstetrics and gynecology and was on the consultant staff of hospitals in New Britain, New Haven and New London. Prior to January, 1969, he had visited Stamford Hospital once or twice per year for purposes of lecturing, conducting rounds and discussing the general state of his specialty as well as particular problems with local physicians. Physicians from the Stamford Hospital had referred patients to him on a regular basis. Dr. Kase testified that the diagnosis and treatment of shock fell within the field of all medical specialties, and within the field of the general practitioner. He testified that he was familiar with the standard of care ordinarily exercised by both physicians and surgeons in the Stamford area, in the state of Connecticut as a whole, in the New York City area, and in the nation as a whole in the care, treatment and diagnosis of shock. He then testified that the standard of care in this regard was the same in Stamford, New York City, and throughout Connecticut.

Vincent Andriole was, both at the time of trial and in January, 1969, an associate professor of internal medicine at the Yale Medical School. He has been licensed to practice in Connecticut since 1961, and conducts daily rounds at Yale-New Haven Hospital. Prior to January, 1969, he was on the consultant staff of hospitals in Bridgeport, New Haven, and Hartford, and lectured at hospitals throughout Connecticut. He lectured at Stamford Hospital once every two years, had treated patients at Stamford Hospital as a consultant, and had consulted with physicians in the Stamford area, all prior to 1969. Dr. Andriole testified that he knew the standard of care ordinarily exercised by both physicians and intermists in the care and treatment of shock in both the Stamford area and throughout the state of Connecticut, and that the standard of care was the same for each.

William C. Shoemaker is a surgeon who lives in California and is licensed to practice in that state and in New York, Massachusetts, and Illinois, but he has never been licensed to practice in Connecticut. He is a full professor of medicine at Mount Sinai Medical School in New York City, a position he held in January, 1969. Dr. Shoemaker has specialized in the care and treatment of shock throughout his career. His experience in Connecticut prior to 1969 was limited to two days spent visiting at Hartford Hospital, and conversations and consultations with physicians from the Stamford area. Dr. Shoemaker testified that he was familiar with the standard of care, skill and diligence ordinarily exercised by physicians and surgeons in the general neighborhood of New York City in the care, diagnosis and treatment of shock as of January 8, 1969. He was also familiar with the same standards for the general neighborhood of Stamford. He also testified that there was a national standard of care for the treatment of shock throughout the United States as of January 8, 1969.

Joseph Rovinsky was, at the time of trial, a professor of obstetrics and gynecology at the Health Sciences Center of the State University of New York at Stonybrook and also chairman of the department of obstetrics and gynecology at the Long Island Jewish Medical Center at Hillside, Queens, New York. On January 8, 1969, he was an associate professor of the Mount Sinai School of Medicine in New York. He is licensed to practice in New York, Pennsylvania and California, but not in Connecticut. During 1967 and 1968, Dr. Rovinsky served as an examiner for the American Board of Obstetrics and Gynecology and, in this capacity, examined seventy or eighty doctors applying for certification over the two-year period. These seventy or eighty applicants included doctors practicing in Connecticut. Dr. Rovinsky testified that, based on this experience, he was able to form a conclusion as to the standard of practice in the state of Connecticut.

The purpose to be served by, and the need for, expert testimony in a...