Krizek v. Queens Med. Ctr.
| Decision Date | 25 May 2021 |
| Docket Number | CIV. NO. 18-00293 JMS-WRP |
| Parties | HELENA KRIZEK, Birth Mother of BIANCA HELEN KRIZEK (DECEDENT), Plaintiff, v. QUEENS MEDICAL CENTER; HAWAII RESIDENCY PROGRAM; DR. NOBUHIRO ARIYOSHI; DR. ITTIKORN SPANUCHART; DR. WENDY W. HSU; and DR. HAO CHIH HO, Defendants. |
| Court | U.S. District Court — District of Hawaii |
ORDER GRANTING IN PART AND DENYING IN PART DEFENDANTS THE QUEEN'S MEDICAL CENTER, WENDY W. HSU, M.D., AND HAO CHIH HO M.D.'S MOTION FOR SUMMARY JUDGMENT, ECF NO. 310.
Before the court is a Motion for Summary Judgment brought by The Queen's Medical Center ("QMC"), Wendy W. Hsu, M.D., and Hao Chih Ho, M.D. (collectively the "QMC Defendants"). ECF No. 310. Plaintiff Helena Krizek ("Plaintiff") initiated this wrongful death lawsuit following the death of her adult daughter, Bianca Krizek ("Bianca"), while Bianca was hospitalized at QMC. The QMC Defendants contend they are entitled to summary judgment because Plaintiff does not have sufficient admissible evidence to establish any purported negligence as to each QMC Defendant. For the foregoing reasons, the court GRANTS in part and DENIES in part QMC Defendants' Motion for Summary Judgment.
On December 28, 2015, at 3:43 p.m., Bianca was admitted to QMC's Emergency Room ("ER") "with a chief complaint of weakness x3 days, left leg pain, erythematous skin, chills, cough and nausea." Dr. David Systrom's Report, ECF No. 311-4 at PageID # 3404. Bianca had a history of several medical conditions, including alcoholism, cirrhosis, withdrawal seizures, hypokalemia, anorexia, severe protein energy malnutrition, and cellulitis. Id. At 11:50 p.m., Bianca was assigned to the Medical Intensive Care Unit ("ICU") with a "presumptive diagnosis of septic shock/severe sepsis due to cellulitis." Id. Beginning around 8:00 a.m. on December 29, 2015, Bianca was recorded as exhibiting periods of confusion, which escalated throughout the day. Id. at PageID # 3405. She was later given a nasogastric feeding tube. Id. At approximately 8:55p.m., Bianca was sedated and intubated. Id. She was then given a chest x-ray, which revealed "new airspace disease consistent with aspiration pneumonia." Id. Bianca continued to decline over the next few weeks, losing renal function and brainstem reflexes. Id. She suffered cardiac arrest and passed away on February 5, 2016, while still at QMC. Id.
Bianca's care team included a number of QMC doctors and nurses, as well as two resident physicians, Drs. Ariyoshi and Spanuchart. The residents were enrolled at the University of Hawaii John A. Burns School of Medicine (the "University") and employed by the Hawaii Residency Programs, Inc. ("HRP"), a non-profit corporation affiliated with the University. See ECF No. 322-6 at PageID # 3605. The residents were on rotation at QMC as part of a joint training program established by QMC and the University pursuant to a 2011 Letter of Agreement and a 2014 Affiliation Agreement. ECF No. 322-3; ECF No. 322-5. Among other things, the Agreements delineate the responsibilities of the University, QMC, and HRP with respect to residents participating in the program. Per the Agreements, HRP employs the residents and provides them with financial support, health benefits, and medical malpractice insurance. ECF No. 322-3 at PageID ## 3545-46. The University, meanwhile, retains "authority for the oversight, conduct, and direction of the resident education programs within[QMC]." ECF No. 322-5 at PageID # 3596. And QMC is "responsible for providing appropriate teaching of the resident(s) along with the adequate supervision of the resident(s) during the course of their educational training." ECF No. 322-3 at PageID # 3546.
Plaintiff's expert, Dr. David Systrom ("Dr. Systrom") opines that two standards of care were violated in the patient care of Bianca.
First, Dr. Systrom opines that Bianca suffered from undiagnosed Wernicke's encephalopathy. ECF No. 311-4 at PageID # 3405.2 Specifically, he opines that failure to administer thiamine prior to administering glucose "led to Wernicke's encephalopathy, increased confusion and ultimately aspiration pneumonia." Id. at PageID # 3406. "A secondary violation of a standard of care was failing to control nausea and vomiting . . . , check gastric residuals and protect the patient from aspiration pneumonia in a confused patient unable to protect her upper airway." Id. According to Dr. Systrom, "[t]he development of Wernicke'sencephalopathy, agitation and confusion, nausea and vomiting with an inability to protect the airway" led to Bianca's death. Id.
On December 20, 2019, Plaintiff filed her Second Amended Complaint ("SAC") asserting a wrongful death lawsuit on behalf of her daughter, Bianca Krizek. ECF No. 190. Plaintiff names as Defendants QMC; Dr. Wendy W. Hsu, the Supervising Attending Physician at QMC; and Dr. Hao Chih Ho, the admitting doctor at QMC's ICU (the "QMC Defendants").3 Id. at PageID ## 1534, 1536-37. Plaintiff also names as Defendants HRP and the resident physicians, Nobuhiro Ariyoshi, M.D. and Ittikorn Spanuchart, M.D. (the "HRP Defendants"). Id.
Plaintiff alleges the following claims: (1) negligence against all Defendants, id. at PageID # 1561; (2) gross negligence for failure to adequately supervise against the QMC Defendants, id. at PageID # 1562; (3) negligence against QMC and HRP for failure to implement proper procedures and identifyproper standards of care, id.; and (4) gross negligence for wrongful death against all Defendants, id. at PageID #1564.
On September 21, 2020, the court issued a Daubert order as to the admissibility of Dr. Systrom's testimony. See ECF No. 289 ("Daubert Order"). Among other things, the court found that Dr. Systrom, an ICU physician, was qualified to proffer testimony as to the ICU physicians in the case—namely the remaining QMC Defendants and HRP Defendants.
The court limited Dr. Systrom's testimony to two standard of care opinions: (1) failure to provide thiamine prior to the administration of glucose; and (2) failure to protect Bianca from "aspiration pneumonia" by failing to control her "nausea and vomiting," or check her "gastric residuals." Id. at PageID ## 3005-06, 3019, 3023-24 (Daubert Order summarizing the standard of care opinions).
In its Daubert Order, the court also rejected an argument made by the QMC Defendants and HRP Defendants that Dr. Systrom's testimony was inadequate because he failed to explain how each Defendant individually violated an applicable standard of care. Id. at PageID ## 3020-21. The court explained that:
Dr. Systrom can provide evidence as to an appropriate standard of care, but Plaintiff will still be required at trialto show that a particular Defendant violated that standard.
Id. at PageID # 3020.
On February 10, 2021, the QMC Defendants and HRP Defendants filed Motions for Summary Judgment. ECF No. 308 (HRP Defendants' Motion); ECF No. 310 (QMC Defendants' Motion). The Motions, in large part, reasserted the argument that Dr. Systrom's standard-of-care opinions are legally insufficient because they failed to identify how each Defendant violated a standard of care. See generally ECF Nos. 308, 310. The QMC Defendants' Motion raised additional arguments related to negligent supervision, vicarious liability, and damages.
On February 23, 2021, the court denied the HRP Defendants' Motion in its entirety, and the QMC Defendants' Motion in part because their arguments regarding Dr. Systrom's opinions had already been rejected in the Daubert Order. See ECF No. 316. The court did not address the remaining arguments raised in the QMC Defendants' Motion. Id.
On March 29, 2021, both Plaintiff and the HRP Defendants filed responses to the remaining aspects of QMC Defendants' Motion for Summary Judgment. ECF Nos. 321, 323. On April 5, 2021, QMC Defendants filed their Reply. ECF No. 326. The court held a hearing on April 19, 2021. ECF No. 329.
Summary judgment is proper where there is no genuine dispute as to any material fact and the moving party is entitled to judgment as a matter of law. Fed. R. Civ. P. 56(a); see also, e.g., Sandoval v. Cnty. of San Diego, 985 F.3d 657, 665 (9th Cir. 2021). Rule 56(a) mandates summary judgment "against a party who fails to make a showing sufficient to establish the existence of an element essential to the party's case, and on which that party will bear the burden of proof at trial." Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986); see also Nissan Fire & Marine Ins. Co., Ltd. v. Fritz Cos., Inc., 210 F.3d 1099, 1103 (9th Cir. 2000).
"The party moving for summary judgment bears the initial burden of identifying those portions of the pleadings, discovery and affidavits which demonstrate the absence of a genuine issue of material fact." Olivier v. Baca, 913 F.3d 852, 857 (9th Cir. 2019) (citing Celotex, 477 U.S. at 323). Where, as here, the moving party does not have the ultimate burden of persuasion at trial, they bear both the initial burden of production and the ultimate burden of persuasion on their motion for summary judgment. Friedman v. Live Nation Merch., Inc., 833 F.3d 1180, 1188 (9th Cir. 2016) (citing Nissan Fire, 210 F.3d at 1102). "'[W]hen the moving party has carried its burden under Rule 56[(a)] its opponent must do more than simply show that there is some metaphysical doubt as to the material facts,'"but must come forward with specific facts showing that there is a genuine dispute for trial. Scott v. Harris, 550 U.S. 372, 380 (2007) (quoting Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586-87 (1986)). "[A]t least some significant probative evidence" must be produced. Hexcel Corp. v. Ineos Polymers, Inc., 681 F.3d 1055, 1063 (9th Cir. 2012) (internal citation and quotation omitted). "'If the evidence is merely colorable, or is not significantly probative, summary judgment may be granted.'"...
To continue reading
Request your trial