Del Valle v. Sanchez

• Decision Date: 25 September 2001
• Docket Number: No. 99-0049-CIV.,99-0049-CIV.
• Citation: 170 F.Supp.2d 1254
• Parties: Kevin DELVALLE, et al., Plaintiffs, v. Dr. Rafael SANCHEZ, et al., Defendants. Dr. Rafael Sanchez, et al., Cross-Claimants, v. United States of America and Coconut Grove Family Health Center, Inc., Cross-Defendants.
• Court: U.S. District Court — Southern District of Florida

170 F.Supp.2d 1254

Kevin DELVALLE, et al., Plaintiffs, v. Dr. Rafael SANCHEZ, et al., Defendants.

Dr. Rafael Sanchez, et al., Cross-Claimants, v. United States of America and Coconut Grove Family Health Center, Inc., Cross-Defendants.

No. 99-0049-CIV.

United States District Court, S.D. Florida.

September 25, 2001.

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Mark Press, Esq., Miami Beach, FL, for Plaintiffs.

Moises Thomas Grayson, Esq., Blaxberg Grayson & Singer, Miami, FL, Benito Diaz, Esq., Diaz & Morel-Saruski, Coral Gables, Maureen Donlan, Esq., Miami, FL, Scott Kirschbaum, Esq., Coral Gables, Joel Wolpe, Esq., Miami, FL, Ramon Abadin, Esq., Abadin & Jaramillo, Miami, FL, Alan Gordon Cohen, Esq., Cohen & Kandell, Miami, FL, Frederick E. Hasty, III, Esq., Wicker Smith O'Hara Mcoy, et al., Miami, FL, John Stephen Derr, Tallahassee, FL, for Defendants.

ORDER ON MOTIONS FOR SUMMARY JUDGMENT

GOLD, District Judge.

THIS CAUSE is before the court upon the defendants' motions for summary judgment (DE # 193, 218, 237, 269, 364). The plaintiffs, Kevin Del Valle ("Del Valle") and Idania Fernandez ("Fernandez"), have filed a fourth amended complaint against the defendants, Dr. Rafael Sanchez ("Dr. Sanchez"); Dr. Lourdes Ramon ("Dr.Ramon"); United States of America; Dr. Jose Portuondo ("Dr.Portuondo"); Damus, Ecker, Rosenthal & Marshall, M.D., P.A., d/b/a Emergency Room Medical Associates ("ERMA"); Mercy Hospital, Inc.; Dr. Luis Fernandez-Rocha ("Dr.Fernandez-Rocha"), and Sanchez, Fernandez-Rocha, & Pou, P.A.¹ The plaintiffs allege medical negligence in the care of Fernandez during her pregnancy. Dr. Sanchez, Dr. Fernandez-Rocha, Dr. Ramon, and Sanchez, Fernandez-Rocha, & Pou, P.A. have filed a crossclaim against the United States and the Coconut Grove Family Health Center, Inc. for indemnification.² Subject matter jurisdiction exists pursuant to 28 U.S.C. § 1331 and 1367.

The plaintiffs' third amended complaint was removed from state court on January 8, 1999, by the Family Health Center and the United States. In the notice of removal, the defendants alleged that the Family Health Center was an entity receiving federal grant money and an employee of the United States for purposes of the Federal Tort Claims Act. Both 42 U.S.C. § 233(c) and 28 U.S.C. § 2679(d)(2) provide that, upon certification by the Attorney General, any civil action or proceeding commenced in a state court shall be removed by the Attorney General to the district court and shall be deemed to be an action or proceeding against the United States under the provisions of Title 28. On June 24, 1999, the United States was substituted as the proper party defendant in place of the Family Health Center.

The United States now requests summary judgment on the crossclaim and the fourth amended complaint to the extent that the parties seek to hold the United States liable for the actions of Dr. Sanchez, Dr. Fernandez-Rocha, Dr. Ramon, and Sanchez, Fernandez-Rocha, & Pou, P.A. Dr. Sanchez seeks summary judgment on the same issue. Mercy Hospital, Dr. Ramon, and Dr. Portuondo and ERMA have filed motions for summary judgment in which they argue that the record is devoid of any evidence that would support a finding of negligence against them. On July 27, 2001, the court heard oral arguments on the defendants' motions. After carefully considering the pleadings, evidence, and arguments of counsel, the court grants the United States's motion, grants in part and denies in part Mercy Hospital's motion, and denies the remaining defendants' motions.

Statement of Facts³

I. The Parties

The Helen B. Bentley Family Health Center ("Family Health Center"), which was formerly known as the Coconut Grove Family Health Center, Inc., provides medical services to low income individuals in Miami-Dade County, Florida. The plaintiff, Idania Fernandez, first presented to the Family Health Center on or about January 10, 1996 for a pregnancy test, which was positive. Fernandez received prenatal care at the Family Health Center from January 1996 to April 1996. Throughout her pregnancy, Fernandez experienced complications, which she claims were misdiagnosed by doctors at Mercy Hospital and the Family Health Center. Due to these complications, on April 27, 1996, Idania Fernandez gave birth prematurely to a son, plaintiff Kevin Del Valle, at Jackson Memorial Hospital. Since his birth, Del Valle has suffered from severe respiratory and developmental problems, including cerebral palsy and microcephaly.

At all relevant times, Dr. Sanchez, Dr. Ramon, and Dr. Fernandez-Rocha were employees of the professional association, Sanchez, Fernandez-Rocha & Pou, M.D., P.A.⁴ During that time, Dr. Sanchez, Dr. Ramon, and Dr. Fernandez-Rocha were engaged in the private practice of obstetrics and gynecology in Miami-Dade County, Florida. Dr. Portuondo was an employee of ERMA, which provided emergency room care at Mercy Hospital.

II. Fernandez's Treatment During Her Pregnancy

A. Fernandez's Emergency Room Visit

Fernandez began to experience complications early in her pregnancy. On April 15, 1996, she was seen in Mercy Hospital's emergency room. Fernandez stated that she chose Mercy Hospital because she believed that Dr. Ramon and Dr. Fernandez-Rocha "belonged" to, or were employed by, the hospital; a sign at the Family Health Center instructed all patients to go there; and the Family Health Center would transport its patients to Mercy Hospital for a tour of the labor and delivery facilities. See Fernandez Depo. at 50-53. Additionally, Fernandez claims that a plaque at Mercy Hospital listed Dr. Sanchez, Dr. Ramon, and Dr. Fernandez-Rocha as staff employees. See Fernandez Depo. at 83-86.⁵

Mercy Hospital's emergency room physician, Dr. Jose Portuondo,⁶ ordered a urinalysis, complete blood count, and a pelvic ultrasound. The ultrasound was interpreted by Dr. Rafael Ramirez. Dr. Ramirez diagnosed Fernandez as having an incompetent cervix.⁷ Shortly after making this diagnosis, Dr. Ramirez telephoned his findings to Dr. Portuondo, but Dr. Portuondo never independently diagnosed Fernandez as having an incompetent cervix nor did he relay Dr. Ramirez's findings to another doctor. See Ramirez Depo. at 18-19, 57-58.

Later that evening, Fernandez was transferred to the labor and delivery department, and she came under the care of Dr. Sanchez, the on-call obstetrician for the Family Health Center. Despite the fact that there were numerous indications making it mandatory that a doctor examine the patient and perform several tests, Dr. Sanchez never did so. See Creevy Depo. at 140-41. Fernandez was discharged from Mercy Hospital on April 16, 2001 with discharge instructions "to be seen and for Ampicillin prescription." Edwards Depo. at 106 (emphasis added). No one who saw Fernandez at Mercy Hospital ever informed her of Dr. Ramirez's diagnosis of an incompetent cervix.

B. Dr. Ramon's Treatment of Fernandez

Dr. Ramon's care of Fernandez during her pregnancy involves two visits by Fernandez to the Family Health Center. The first occurred on February 25, 1996, when she was examined by Dr. Ramon. The complaint contains no allegations of negligence regarding this visit.

The second interaction occurred on April 17, 1996, when Dr. Ramon wrote Fernandez a prescription for ampicillin while Fernandez was at the clinic. See Creevy Depo. at 155. Fernandez went to the Family Health Center on that date because, upon her discharge from the hospital on April 16, her written instructions by the hospital were to be seen at the Family Health Center and to pick up a prescription for ampicillin. Dr. Ramon was the doctor seeing gynecological and obstetrical patients on April 17. She wrote Fernandez's prescription, but she did not examine her or take a medical history.

Although Fernandez had visited the hospital on the prior day, and doctors had administered an ultrasound and had discovered leakage of amniotic fluid, Dr. Ramon had no knowledge of this hospital visit when she wrote the prescription because the hospital never transmitted this information to the Family Health Center. See Creevy Depo. at 156. According to Dr. Ramon, if one of the physicians at the Family Health Center was caring for a patient with an incompetent cervix, this information would be relayed to all members of the group because such a condition places the patient in a high-risk situation. See Ramon Depo. at 29-33. Dr. Sanchez and Dr. Fernandez-Rocha also testified that the Family Health Center had a procedure whereby the doctors would communicate with each other concerning the condition of certain patients they were treating together. Sanchez Depo. at 13-15; Fernandez-Rocha Depo. at 87-88. Despite the existence of this procedure, the doctors of the Family Health Center did not communicate to each other regarding Fernandez's condition.

Dr. Donald Creevy, the plaintiff's expert, has stated:

Dr. Ramon should have had information about the hospital visit of April 15th, April 16th, with the ultrasound, with the complaint of leakage of amniotic fluid. And if, in fact, she had that information available to her, she should have done an actual visit and examine the patient, not just handing the nurse a prescription.

Creevy Depo. at 156. Dr. Creevy added that Dr. Ramon's lack of knowledge about Fernandez's hospital visit was not her "failing specifically. It's a failing of the clinic and the staff doctors there as a group." Id. Dr. Ramon has averred that she had no obligation to undertake transmission of Fernandez's records between Mercy Hospital and the Family Health Center.

III. Facts Relevant Under the Federal Tort Claims Act

On or about December 4, 1995, the professional association, Sanchez, Fernandez-Rocha & Pou, M.D., P.A. entered into an agreement with the Family Health Center to provide obstetrical and gynecological services at the clinic for the period of December 4, 1995 to December 4, 1996. See United States, Ex. 1.⁸ During the time...