Weiss v. Goldfarb

Decision Date16 June 1998
Docket NumberI-V
Citation713 A.2d 427,154 N.J. 468
PartiesNancy WEISS, Executrix of the Estate of Russell M. Wood, and Nancy Weiss, Executrix of the Estate of Christine Wood, and Robert E. Wood, individually and Nancy Weiss, individually, Plaintiffs-Respondents, v. Irvin GOLDFARB, M.D.; W.R. Chenitz, M.D.; Bassam Haddad, M.D.; Mary Lee Doe, R.N. (a fictitious name); Guy Doe, R.N. (a fictitious name); Jane Smith, R.N. (a fictitious name); Donald Rubinstein, M.D.; Amer Al-Zarka, M.D.; Adolf Senft, M.D.; Cecil Matthews, M.D.; \Edward Manzella, M.D.; Michael Guma, M.D.; A. Josephine Villanueva, R.N.; A. Jose Dairo, L.P.N.; Lily Matulac, R.N.; R. Barcelona, R.N.; and Jane Moe(a fictitious name), Defendants, and St. Michael's Medical Center and Angelina Forshage, R.N., Defendants-Appellants.
CourtNew Jersey Supreme Court

Patrick J. Hughes, Roseland, for defendants-appellants (Connell, Foley & Geiser, attorneys; Ernest W. Schoellkopff, on the briefs).

Arthur L. Raynes, Morristown, for plaintiffs-respondents (Wiley, Malehorn and Sirota, attorneys).

The opinion of the Court was delivered by

COLEMAN, J.

The issue raised in this medical malpractice case is whether a jury should receive an ultimate outcome instruction that, at the time of the alleged malpractice, the Charitable Immunity Act, N.J.S.A. 2A:53A-8, limited a hospital's liability to no more than $10,000. The trial court declined to give such an instruction. The Appellate Division in a published opinion concluded that the instruction should have been given. 295 N.J.Super. 212, 231-32, 684 A.2d 994 (1996). We granted St. Michael's petition for certification, limited to the question of the ultimate outcome instruction. 150 N.J. 26, 695 A.2d 669 (1997).

We reverse and hold that an ultimate outcome instruction should not be given to a jury concerning the statutory limitations of a hospital's liability.

I

On June 19, 1989, Russell M. Wood was admitted to St. Joseph's Medical Center (St. Joseph's) in Paterson, New Jersey for treatment of heart disease and chronic renal failure. At the time, he was sixty-seven years old and suffered from long-term hypertension and various coronary and renal problems. Wood was diagnosed as suffering from non-sustained ventricular tachycardia, atrial fibrillation, and chronic kidney failure. An angiogram revealed some blockage of a coronary artery. He was placed on a heart monitor and began receiving dialysis treatments on a three-day-a-week schedule, remaining on the heart monitor during the treatments. Wood's cardiologist recommended the performance of electro-physiologic cardiac studies. Because St. Joseph's did not have the equipment needed to perform those studies, Wood was transferred to defendant St. Michael's Medical Center (St. Michael's) on Thursday, July 13, 1989.

Upon Wood's arrival at St. Michael's, he was immediately admitted to the telemetry unit where he was connected to a cardiac monitor under continuous supervision. Wood missed his Friday, July 14, dialysis treatment, and his doctor arranged to have that treatment provided the next day. Wood was taken to the dialysis unit about noon that Saturday, July 15. He arrived unconnected to a cardiac monitor, notwithstanding that no order had been written in his chart discontinuing the monitor. Although the dialysis unit was equipped with a cardiac monitor, Wood was never connected to it.

During dialysis treatment on July 15, Wood's vital signs remained normal from approximately 12:30 p.m. through 2:00 p.m. At 2:25 p.m., however, a nurse found Wood unresponsive with no blood pressure. Despite being successfully resuscitated, he sustained irreversible brain damage as a result of the loss of oxygen and remained in a coma until his death on August 28, 1989. Plaintiff's experts opined that had his heart been monitored during the dialysis treatment, the cardiac arrest could have been avoided altogether or counteracted in time to avoid brain damage.

Plaintiff instituted the present litigation against St. Michael's, two dialysis nurses, two residents who had attended decedent in the telemetry unit, and all the attending doctors, Drs. Rubenstein, Goldfarb, Senft, Haddad, and Chenitz. Prior to trial, partial summary judgments were granted dismissing Dr. Chenitz and the two residents. Following the close of plaintiff's case, her claims against Dr. Goldfarb and the two dialysis nurses were dismissed pursuant to Rule 4:37-2(b). The case was submitted to the jury against St. Michael's and Drs. Rubenstein, Senft, and Haddad. As noted previously, the trial court denied plaintiff's request to inform the jury that St. Michael's liability was capped at $10,000.

The jury returned a verdict finding no cause of action against the doctors, but finding the hospital negligent. The jury awarded total damages of $150,000. The trial court molded the verdict and entered judgment for $10,000 based on the Charitable Immunity Act. Plaintiff's subsequent motion for a new trial was denied. She appealed several court rulings, including the denial of her request to give an ultimate outcome charge to the jury.

The Appellate Division affirmed the partial summary judgments in favor of Drs. Chenitz and the two residents. 295 N.J.Super. at 220, 684 A.2d 994. It also affirmed the dismissal of the complaint against Dr. Goldfarb and one of the nurses. Id. at 221-22, 684 A.2d 994. The court reversed the dismissal of the claim against Nurse Forshage at the end of plaintiff's case. Id. at 227, 684 A.2d 994. It also reversed the jury's verdict of no cause of action in favor of Dr. Haddad. Id. [713 A.2d 429] at 226-27, 684 A.2d 994. The court affirmed the judgment of liability against St. Michael's and the amount of the damages award of $150,000. Id. at 233, 684 A.2d 994. The court determined that plaintiff was entitled to an ultimate outcome charge instructing the jury on the limitation on St. Michael's liability. Id. at 232, 684 A.2d 994. It remanded the case for a new trial on liability only against Dr. Haddad and Nurse Forshage. Id. at 233, 684 A.2d 994. The retrial, however, would require apportionment of liability if either Dr. Haddad or Nurse Forshage was found liable. Therefore, the case against St. Michael's was remanded as well for apportionment purposes. Id. at 228, 684 A.2d 994.

II

St. Michael's argues that the Appellate Division's decision impermissibly interferes with its legislatively created limited immunity under the Charitable Immunity Act. The hospital asserts that by ordering an ultimate outcome charge on the statutorily limited liability, the decision conflicts with the holding in Johnson v. Mountainside Hospital, 239 N.J.Super. 312, 571 A.2d 318 (App.Div.), certif. denied, 122 N.J. 188, 584 A.2d 248 (1990).

St. Michael's maintains that an ultimate outcome charge is distinguishable from similar charges given in comparative negligence cases and the lost-chance line of cases following Scafidi v. Seiler, 119 N.J. 93, 574 A.2d 398 (1990), because the charge in the present case does more than merely advise the jury of the legal effect of its findings. St. Michael's argues that in comparative negligence and Scafidi-type cases, the ultimate outcome charge guides a jury in its essential function of apportioning responsibility for the total injury involved. The hospital maintains that its legislatively mandated limitation on liability is irrelevant to the role of the jury as fact-finder.

Plaintiff maintains that Johnson, supra, was wrongly decided and is contrary to the holding of Roman v. Mitchell, 82 N.J. 336, 413 A.2d 322 (1980), that required an ultimate outcome charge in comparative negligence cases. Plaintiff expresses concern that in situations in which, as in this case, both the hospital and individuals employed by it are represented by the same attorney, that in the absence of an ultimate outcome instruction, an attorney will attempt to misguide the jury into finding liability against only the hospital because of the hospital's statutorily limited liability.

III

-A-

The Charitable Immunity Act was enacted by the Legislature in response to Benton v. Y.M.C.A., 27 N.J. 67, 141 A.2d 298 (1958), Collopy v. Newark Eye & Ear Infirmary, 27 N.J. 29, 141 A.2d 276 (1958), and Dalton v. St. Luke's Catholic Church, 27 N.J. 22, 141 A.2d 273 (1958), which overruled judicially declared immunity for certain charitable organizations. In 1959, subsequent to the Collopy spitapy trilogy of cases, the Legislature passed N.J.S.A. 2A:53A-8, which provides charitable immunity for nonprofit hospitals for negligence liability exceeding $10,000. The statute states:

[A]ny nonprofit corporation, society or association organized exclusively for hospital purposes shall be liable to respond in damages to such beneficiary who shall suffer damage from the negligence of such corporation, society or association or of its agents or servants to an amount not exceeding $10,000.00, together with interest and costs of suit, as the result of any 1 accident and to the extent to which such damage, together with interest and costs of suit, shall exceed the sum of $10,000.00 such nonprofit corporation, society or association organized exclusively for hospital purposes shall not be liable therefor.

[N.J.S.A. 2A:53A-8.

] 1

The constitutionality of the statute, which is not before us, was upheld in Edwards v. Our Lady of Lourdes Hospital, 217 N.J.Super. [713 A.2d 430] 448, 526 A.2d 242 (App.Div.1987). The Legislature expressed the purpose of the Charitable Immunity Act as follows:

This act shall be deemed to be remedial and shall be liberally construed so as to afford immunity to the said corporations, societies and associations from liability as provided herein in furtherance of the public policy for the protection of nonprofit corporations, societies and associations organized for religious, charitable, educational or hospital purposes.

[ N.J.S.A. 2A:53A-10.]

In furtherance of that purpose, this...

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