Russell v. Kantamneni
| Decision Date | 19 May 2022 |
| Docket Number | A22A0378 |
| Parties | RUSSELL et al. v. KANTAMNENI et al. |
| Court | United States Court of Appeals (Georgia) |
In this medical malpractice action arising out of an alleged failure to diagnose lupus, Allison and Thomas Russell ("the parents") appeal from the superior court's order granting Dr. Arun Kantamneni and Insight Psychiatric Services, Inc.'s (collectively "the defendants") motion to dismiss based upon OCGA § 9-11-9.1. The parents contend that the trial court erred by concluding that the affidavit of their expert, Dr. Putterman could not be used to satisfy their obligation under OCGA § 9-11-9.1. For the reasons explained below, we agree and therefore reverse.
Under OCGA § 9-11-9.1 (a), the plaintiff in a professional malpractice action is required to attached to the complaint the "affidavit of an expert competent to testify, which affidavit shall set forth specifically at least one negligent act or omission claimed to exist and the factual basis for each such claim." OCGA § 24-7-702 (e) mandates that an expert must meet the requirements of OCGA § 24-7-702 "in order to be deemed qualified to testify as an expert by means of the affidavit required under Code Section 9-11-9.1." "Under OCGA § 24-7-702, it is the role of the trial court to act as a gatekeeper of expert testimony." Yugueros v. Robles, 300 Ga. 58, 67 (793 S.E.2d 42) (2016).
The qualification of an expert witness under [OCGA § 24-7-702] is generally a matter committed to the sound discretion of the trial court. Although an appellate court usually reviews a trial court's order on a motion to dismiss de novo, when the trial court has held a hearing on the competency of a witness to give affidavit testimony in compliance with OCGA § 9-11-9.1, our review determines only whether the trial court has abused [its] discretion . [I]t is irrelevant whether or not evidence was offered at the hearing.
(Citations and punctuation omitted.) Graham v. Reynolds, 343 Ga.App. 274, 276-277 (2) (807 S.E.2d 39) (2017).
In this case, the parents' complaint alleges that their 18-year-old daughter, Elianna Russell, "died from complications from [l]upus" on June 25, 2019. With regard to Dr. Kantamneni's alleged negligence, the complaint asserts that Elianna came under his care during a hospital admission that began on December 15, 2018, and that his negligence caused injury resulting in her death as outlined in the affidavit of Dr. Putterman attached to the complaint. Dr. Putterman is an internal medicine doctor "with a specialty in [r]heumatology. . . ."
He opined that Dr. Kantamneni "deviated from the requisite standard of care by not recognizing and ensuring timely treatment of Elianna Russell for [l]upus in view of the available information, to include, but not limited to, her age, gender, race, family history, episodes of psychosis, pantocytopenia and abnormal ANA and anti-dsDNA laboratory findings."
Defendants moved to dismiss the parents' complaint, asserting that Dr. Putterman, a rheumatologist, "cannot provide standard of care opinions as to the psychiatric care provided by Dr. Kantamneni" and that Dr. Putterman's affidavit "fails to specifically describe the actual negligent conduct attributed to Dr. Kantamneni or the factual bases for [his] opinions." The parents filed an amended complaint with a much more detailed affidavit from Dr. Putterman regarding Dr. Kantamneni's alleged negligence.
In this affidavit, Dr. Putterman averred that he was familiar with the "medical care and skill exercised by doctors generally, to include . . . [p]sychiatrists . . . under the same and similar . . . surrounding conditions as those presented by Elianna Russell in 2018 and 2019 to [Dr. Kantamneni]" and that "[f]rom the mid-1990s to the present and on a yearly basis, I have regularly and frequently treated many patients with autoimmune diseases such as . . . lupus . . ., either diagnosed prior to my medical involvement or diagnosed under my medical care and treatment." He explained that lupus is more prevalent and severe in 15-to-45-year-old females, especially in the minority population to which Elianna belonged; that psychosis and pantocytopenia are classic signs of lupus; and that lupus can be ruled out by ANA and anti-dsDNA antibody tests because "an elevated anti-dsDNA finding is essentially conclusive of [l]upus." He stated:
As taught in medical school and as known by any doctor who evaluates and/or treats patients, there are widely accepted and employed classification criteria (signs and symptoms) for [l]upus. . . . Since the criteria for [l]upus cover a wide area of signs and symptoms, a broad array of [p]rimary [c]are [p]hysicians and specialists are typically the first to encounter and examine such a patient, and therefore are required, pursuant to the requisite standard of care, to recognize the potential for [l]upus and refer the patient to a specialist, such as a [r]heumatologist, for further work up and evaluation. . . . The doctors who should understand the classification and criteria for [l]upus would, without question, include [p]rimary [c]are [p]hysicians, [h]ematologists, [p]sychiatrists, and [f]amily [p]ractice [p]hysicians, among other specialists.
With regard to Elianna's treatment, Dr. Putterman stated that Elianna was sent to the hospital from a behavioral health center to determine if her psychosis was the result of physiological causes rather than being purely psychiatric in nature; that Dr. Kantamneni began evaluation and treatment of Elianna five days after her admission (December 20, 2018) and four days before she was discharged; that a nurse practitioner "apparently [ ] associated" with Dr. Kantamneni charted on December 22, 2018, that Elianna's father described a family history of lupus and suggested that Elianna be evaluated for lupus; that Dr. Kantamneni reviewed this entry on December 27, 2018, three days after Elianna was discharged from the hospital; that Elianna was correctly diagnosed with pantocyptopenia after her admission and her ANA was elevated on December 24, 2018, and her anti-dsDNA was abnormally elevated on December 25, 2018; that no doctor responded to these abnormal test results, including Dr. Kantamneni; and that Dr. Kantamneni never charted a potential for lupus or referred Elianna for an evaluation for lupus.
According to Dr. Putterman, Elianna's "psychosis symptoms subsided with time," but returned in June 2019. Following a second hospitalization in a different facility, she was immediately started on a treatment for lupus, but she died of "organ failure from [l]upus" as a result of Dr. Kantamneni's failure "to ensure timely treatment and follow[-]up."
After holding a hearing on the motion, the trial court granted defendants' motion to dismiss, reasoning as follows:
Dr. Putterman's affidavits and CV certainly indicate a requisite level of expertise in rheumatology and the diagnosis and treatment of autoimmune disorders, including [l]upus. However, although he has worked with psychiatrists in the treatment of [l]upus patients in a hospital setting, he does not indicate having practiced as a psychiatrist nor having a specialized knowledge of the standard of care of psychiatrists. While a doctor of one medical specialty may have sufficient expertise or experience to opine about the appropriate standard of care of a different medical specialty, the Court does not find that to be the case here. Therefore, . . . the Court finds [the parents] have not submitted a sufficient expert medical affidavit in this case under OCGA § 9-11-9.1 as to [Dr.] Kantamneni.
On appeal, the parents contend that the trial court misinterpreted the requirements of OCGA § 24-7-702 when determining whether Dr. Putterman was qualified to render an opinion in this case. OCGA § 24-7-702 (c) (2) (C) (i) "requires that an expert in a medical malpractice case generally must be 'a member of the same profession' as the defendant about whose alleged malpractice the expert will testify." Dubois v. Brantley, 297 Ga. 575 581 (2) (775 S.E.2d 512) (2015). As both Dr. Putterman and Dr. Kantamneni are medical doctors, this requirement is satisfied. See Graham v. Reynolds, 343 Ga.App. 274, 278 (2) (a) (807 S.E.2d 39) (201...
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