Lebrecht v. Tuli
| Decision Date | 17 January 1985 |
| Docket Number | E-7,No. 4-83-0831,4-83-0831 |
| Citation | 473 N.E.2d 1322,85 Ill.Dec. 517,130 Ill.App.3d 457 |
| Parties | , 85 Ill.Dec. 517 Linda Lee LEBRECHT, Plaintiff-Appellant and Cross-Appellee, v. K. TULI, M.D., Link Clinic, M.R. Carlson, M.D., Christie Clinic, and Wilfred L. Brunswick, M.D., Defendants-Appellees and Cross-Appellants, and AreaHospital Association, Operating as Mattoon Memorial Hospital, Defendant. |
| Court | United States Appellate Court of Illinois |
Richard F. Record, Jr., Richard C. Hayden, Craig & Craig, Mattoon, for Dr. Tuli, Link Clinic and Dr. Brunswick.
Medical malpractice.
Bifurcated trial.
Patient won on statute of limitations.
Doctors won on negligence.
Appeal and cross-appeal.
We affirm across the board.
Linda Lee Lebrecht, a paraplegic, brought a medical malpractice action against Drs. Tuli and Brunswick and Link Clinic (Tuli); Dr. Carlson and Christie Clinic (Carlson); and the Area E-7 Hospital Association, Mattoon Memorial Hospital (Memorial). Memorial was subsequently dismissed.
Plaintiff asserted defendants negligently failed to examine, appropriately test, diagnose, and treat her disc condition. As a result, by the time a myelogram was performed, plaintiff's 5/6 cervical disc had herniated and ruptured, causing a complete block of the spinal fluid. Because of the blockage, the pantopaque dye used in performing the test could not be removed. Plaintiff alleged she developed arachnoiditis and eventual paralysis as a result of the retained dye.
Defendants asserted they were not negligent and that the statute of limitations barred the action. A bifurcated trial was held. The jury returned a verdict in plaintiff's favor on the statute of limitations question and a separate jury returned a verdict for defendants on the negligence issue. Plaintiff appeals the negligence finding and defendants cross-appeal the statute of limitations finding.
We affirm.
Plaintiff raises eight principal issues on appeal: whether the jury's verdict is contrary to the manifest weight of the evidence; whether the trial court erred in admitting evidence about plaintiff's character and marital status, in applying Supreme Court Rule 212(b) (87 Ill.2d R. 212(b)), in ruling that evidence of plaintiff's negligence was admissible, in allowing the defendants to cross-examine co-defendants, in various rulings on expert testimony, in ruling on closing arguments and in instructing the jury.
Defendants raise four principal issues on cross-appeal: whether the trial court erred in denying defendants' motions for judgment notwithstanding the verdict; whether the trial court erred in certain evidentiary rulings in instructing the jury, and in not sending an exhibit to the jury room.
Dr. Kasturi Tuli, a board certified internist, testified that he examined plaintiff in his office. Plaintiff's presenting complaints were neck pain--of one week's duration--with joint stiffness in the mornings. Tuli reviewed plaintiff's medical history of cancer and heart disease. He performed a physical which revealed tenderness in plaintiff's neck and swollen fingers. Tuli considered tenderness subjective.
Tuli testified further that he performed a screening neurological examination of plaintiff's upper extremities, which consisted of testing for weakness and deep tendon reflexes. All his findings were normal. Tuli did not do a sensory examination. His examination was tailored to the plaintiff's presenting complaints and he diagnosed On cross-examination after testifying in his own behalf, Tuli stated he did not believe plaintiff had a herniated disc when he saw her. Tuli learned how to do a complete neurological examination in medical school.
[85 Ill.Dec. 523] plaintiff's condition as arthritis or osteoarthritis. He prescribed moist heat with medication to relieve muscle spasms. Tuli noted no psychological factors and was sure he told plaintiff to return if her condition worsened.
Plaintiff testified she had numbness on March 8, 1977, and her pain was nagging.
Plaintiff testified she saw Dr. Freesmeier, a chiropractor, because her pain was worse. She began experiencing numbness in her fingers and tingling. Freesmeier's fee was too high so plaintiff received no treatment.
Plaintiff testified that her pain was very bad and she went to Memorial's emergency room.
Dr. Kristrall Patari, board certified in family practice and board eligible in neurology, testified that he examined plaintiff in the emergency room on April 3, 1977. Plaintiff complained of pain of three weeks' duration, but he found no objective indications of neurological problems. Patari performed a screening neurological examination of plaintiff concentrating on her upper extremities because she complained of neck pain. His examination consisted of checking plaintiff visually and checking her range of neck motion and for weakness, atrophy, and strength. Patari's records indicate plaintiff had a "functional overlay" or highly emotional pain response.
Patari further testified he did a pin prick and light touch sensory examination but found no objective indications of disc pathology. Objective indications are changes in reflexes, sensation or strength. Complaints of numbness or pain are not significant, absent positive findings.
Patari diagnosed plaintiff's condition as tension headache. He prescribed tranquilizers and a muscle relaxant.
APRIL 5, (MORNING)
Dr. Milton Carlson, board certified in orthopedic surgery, testified that he examined plaintiff in his office. Plaintiff's presenting complaints were pain in her neck, shoulders, and upper arms of approximately two months' duration. She did not report pain or paresthesia in the lower arms. Plaintiff reported numbness, but Carlson considered numbness subjective. Plaintiff reported that she had trouble sleeping, had been told she had arthritis, had been prescribed tranxene, and had seen a chiropractor. Plaintiff told Carlson she thought she might be depressed.
Carlson performed a screening neurological examination of plaintiff's upper extremities which showed no abnormalities. He reviewed plaintiff's records. He noted plaintiff had a "flat affect" or a nonemotional appearance which is consistent with depression. Depression can cause or alter a person's perception of pain.
Carlson further testified that since he could not determine the cause of plaintiff's pain and thought that she might be depressed, he referred her to a psychiatrist for consultation. Although he did not make a specific return appointment for plaintiff, his record said "PRN" which means return as needed. Carlson was sure he told plaintiff to return if her condition worsened and that he would see her after the consultation. He did not see plaintiff again.
On redirect, in retrospect, Carlson agreed that plaintiff had a herniated disc when he saw her.
Plaintiff testified she had no intention of seeing Carlson or a psychiatrist because she knew her pain was real. Carlson never told her to return.
APRIL 5, (EVENING)
Plaintiff testified the pain was acute and she returned to Memorial's emergency room. Dr. Stephen Allen, board certified in emergency medicine, testified he examined
[85 Ill.Dec. 524] plaintiff in Memorial's emergency room. Plaintiff's presenting complaints were pain in the back of her neck and down her right arm. Allen conducted a screening neurological examination which resulted in no abnormal findings.
Dr. Wilfred Brunswick, board certified in internal medicine, testified that he examined plaintiff in his office. Plaintiff's presenting complaints were pain in her neck, shoulders, and top half of her back of approximately six weeks' duration. Plaintiff complained of numbness in her hand, two weeks before the examination. Brunswick thought it was transient numbness but did not record it as such.
Brunswick further testified that he reviewed plaintiff's records, which showed she had experienced neck and back pain before, checked her reflexes, and checked for weakness. He found a marked spasm in plaintiff's neck. Although he noted plaintiff was divorced, he attached no significance to it. He concluded plaintiff might have degenerative joint disease. He renewed her pain medication. Plaintiff did not tell him of her visit to Carlson.
Brunswick testified degenerative joint disease may cause disc herniation without trauma. Although plaintiff's symptoms may indicate disc pathology, when he saw her, she had no objective indications of disc pathology. Brunswick did not plan traction, a myelogram, or other treatment.
Plaintiff returned to the emergency room and was admitted.
Brunswick testified he next saw plaintiff in Memorial on April 8; she had been admitted as his patient the night before. Brunswick performed a neurological examination which included: checking facial strength, cranial nerves, deep tendon reflexes, strength, and checking sensation with light touch. Brunswick testified he checked plaintiff's gait, had her do a finger-to-nose test, and had her do rapidly alternating movement tests. The results were all within normal ranges.
Brunswick did not check temperature, vibration, or position sense, nor did he do a pin prick examination or check strength with a...
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