Shinn v. St. James Mercy Hosp.
| Decision Date | 16 December 1987 |
| Docket Number | No. CIV-83-577T.,CIV-83-577T. |
| Parties | Morris SHINN, Plaintiff, v. ST. JAMES MERCY HOSPITAL, Nasar A. Chaudhry, and Hungi Eswara, Defendants. |
| Court | U.S. District Court — Western District of New York |
Julien, Schlesinger & Finz, P.C. (Donald Grady, of counsel), New York City, for plaintiff.
Damon & Morey (Mark Spitler, of counsel), Buffalo, N.Y., for St. James Mercy Hosp.
Maloney, Gallup, Roach, Brown & McCarthy, P.C. (Joseph McCarthy, of counsel), Buffalo, N.Y., for Hungi Eswara.
Johnstone, Skok, Loughlin & Lane (Franz J. Skok, of counsel), New York City, for Nasar A. Chaudhry.
INTRODUCTION
Currently before the Court are several post-trial motions filed by defendants. Plaintiff Morris Shinn brought this action alleging that defendants Dr. Nasar A. Chaudhry ("Chaudhry"), Dr. Hungi Eswara ("Eswara"), and St. James Mercy Hospital ("St. James") were negligent in their care and treatment of Mr. Shinn while he was a patient at St. James in 1981. A jury trial was had in this Court commencing on October 26, 1987. On November 4, the jury returned a verdict finding: (1) no liability on the part of any of the defendants for negligence in the diagnosis, care, and treatment of Morris Shinn; (2) liability on the part of Dr. Chaudhry for failure to obtain Morris Shinn's informed consent to the administration of certain drugs; (3) no liability on the part of Dr. Eswara for failure to obtain Morris Shinn's informed consent; (4) vicarious liability on the part of St. James for the actions of Dr. Chaudhry; and (5) apportioning 99% of the liability to Dr. Chaudhry and 1% to St. James. The Court granted the parties until November 13, 1987 to file post-trial motions.
Dr. Chaudhry has moved pursuant to Fed.R.Civ.P. 50 for judgment notwithstanding the verdict, or, in the alternative, for an order pursuant to Fed.R.Civ.P. 59 for a new trial. Defendant St. James has moved pursuant to Fed.R.Civ.P. 49(b) to correct the verdict by apportioning 0% fault to St. James and 100% fault to Dr. Chaudhry, and for judgment notwithstanding the verdict pursuant to Fed.R.Civ.P. 50(b) with respect to the jury's finding of vicarious liability on the part of St. James for the acts of Dr. Chaudhry. Plaintiff Morris Shinn has made no post-trial motions.
I hold that the jury's verdict finding Dr. Chaudhry liable for failing to obtain Morris Shinn's informed consent is against the weight of the evidence, and cannot stand. In light of this determination, I decline to address at this time the remaining motions of Dr. Chaudhry and St. James.
Because my ruling concerns only that portion of the verdict involving the issue of informed consent to the administration of Dilantin and Phenobarbital, I restrict my recitation of the facts primarily to those facts relevant to plaintiff's claims against the defendant physicians. The following recitation of facts views the evidence in a light most favorable to the plaintiff. Dominic v. Consolidated Edison Company of New York, Inc., 822 F.2d 1249, 1251 (2d Cir.1987).
On February 16, 1981, the plaintiff Morris Shinn, a seaman recruit in the Navy, was visiting his parents in the State of New York. Following a severe headache resulting in unconsciousness, Mr. Shinn was taken by ambulance to the emergency room at St. James. Mr. Shinn was examined by Dr. Chaudhry and admitted to the hospital. (T. 166-174) On February 17, Dr. Eswara examined Mr. Shinn as a neurological consultant. (T. 47)
On February 18, two days after his admission, Mr. Shinn exhibited seizure-like activity. The medical records indicate the Mr. Shinn experienced "recurrent syncopal episodes, each lasting a minute or two and occurring every five minutes or so," including spasms and crying out. (T. 190-191) Based on this seizure activity, Dr. Chaudhry prescribed Dilantin, and Dr. Eswara concurred in that prescription. (T. 74, 85, 210, 650). They viewed Mr. Shinn's seizure activity as a life-threatening situation. (T. 85, 650-652)
There was conflicting testimony concerning the nature of the discussions between the physicians and Mr. Shinn prior to the administration of Dilantin. Dr. Eswara testified that he could not recall whether he had any discussions with Mr. Shinn concerning the possible side effects of Dilantin therapy. (T. 662) Dr. Chaudhry initially testified that he could not recall the nature of his discussions with Mr. Shinn concerning the administration of Dilantin, but that it was his practice to discuss with a patient the possible side effects of medications prior to their administration. (T. 201-203, 207-209) However, Dr. Chaudhry later testified that he discussed with Mr. Shinn the side effects of Dilantin, and that he routinely discussed with his patients the possibility of Stevens-Johnson syndrome prior to the administration of Dilantin. (T. 684-685)
Mr. Shinn initially testified that neither Dr. Eswara nor Dr. Chaudhry discussed with him the possible side effects of Dilantin. (T. 270-271) He later stated that the physicians had discussed the Dilantin treatment with him, but that his memory concerning the conversation was "fuzzy". (T. 331) Mr. Shinn further testified that while he was generally aware that certain medications could have side effects, he was not aware that Dilantin could produce Stevens-Johnson Syndrome. He stated, "I did not know that this could happen to me, because if I had I would have not taken the damn shit." (T. 515-516, 518-519)
Throughout his stay at St. James, Mr. Shinn continued to receive Dilantin. In addition, he received Phenobarbital and several other medications. (T. 114, 117) From February 18 through March 2, Mr. Shinn continued having seizures. (T. 117-120, 701) On March 1, Mr. Shinn experienced approximately 21 seizures. (T. 660) Due to the continued seizure activity, commencing February 23, Drs. Eswara and Chaudhry attempted to have Mr. Shinn transfered to Strong Memorial Hospital where continuous observation and advanced diagnostic procedures were available. (T. 120-123, 251-254, 652) However, Mr. Shinn and his family opposed the transfer, and insisted that he be moved to a Naval facility. (T. 507-508, 541, 555-557, 676-677) Mr. Shinn remained at St. James through March 3, 1981 when he was transferred to the Portsmouth, Virginia Naval Medical Center. (T. 243, 248)
Following his admission to the Portsmouth Naval Medical Center, Mr. Shinn was diagnosed as suffering from a full-blown Stevens-Johnson Syndrome. (T. 341) He developed a rash all over his body consisting in "raised, macular lesions which developed bullous vesicles," corneal erosion, fevers, cellulitis, and penile and scrotal lesions. (T. 341) Mr. Shinn also developed a corneal ulcer which has virtually blinded him in his right eye. His eyes are sensitive to light, and he wears sunglasses at all times. (T. 291) Mr. Shinn's eyes are red and dry, and he must disinfect them each morning. (T. 292) There was expert testimony that the impairment of Mr. Shinn's vision was permanent, and that his vision impairment is the result of Stevens-Johnson syndrome. (T. 569, 571, 576).
This case involved a substantial amount of medical expert testimony. Concerning the question of negligence in the diagnosis, treatment, and care of Mr. Shinn, the primary issue was whether the defendant physicians exercised due care in initially diagnosing Mr. Shinn as suffering from organic seizures rather than emotional or pseudo-seizures, and in continuing to treat his symptoms as resulting from organic seizures throughout his hospitalization at St. James.
Plaintiff's expert, Dr. Milford Blackwell, and defendants' expert, Dr. Patrick Hughes, agreed that while Dilantin and Phenobarbital are effective in the treatment of organically caused seizures, these medications are of no benefit in the treatment of pseudo-seizures. (T. 365-366, 717-719, 749) The experts also agreed that Dilantin and Phenobarbital are competent producing causes of Stevens-Johnson Syndrome. (T. 387, 738) Dr. Blackwell and Dr. Hughes further agreed that Stevens-Johnson Syndrome is an extremely rare, hypersensitivity reaction to drugs including, among others, Dilantin, Phenobarbital, aspirin, and penicillin. (T. 239-241, 450-451, 721) Dr. Blackwell testified in pertinent part as follows:
Similarly, Dr. Hughes testified that in 25 years of practice he had never had a patient experience Stevens-Johnson Syndrome reaction to the drug Dilantin. (T. 723) As Dr. Hughes stated, "I would say I am at more risk going home to Buffalo tonight on the New York State Thruway than I would be by taking Dilantin." (T. 723)
Dr. Hughes and Dr. Blackwell further agreed that a patient suffering from organic seizures must be treated immediately. Otherwise, he can suffer brain damage or even death. (T. 458, 716) As Dr. Hughes testified:
(T. 716-717) Further, both experts agreed that the proper treatment of organic seizures is the administration of Dilantin or Phenobarbital, or alternatively, Tegretol, which is also known to produce Stevens-Johnson Syndrome. (T. 455-456, 487-488, 717-720) Moreover, Dr. Blackwell testified that there is no known means of determining whether an...
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