Williams v. Manchester

• Decision Date: 03 April 2008
• Docket Number: No. 104524.,104524.
• Parties: Michelle WILLIAMS, Indiv. and as Special Adm'r of the Estate of Baby Doe, Deceased, Appellee, v. John C. MANCHESTER, Appellant.
• Court: Illinois Supreme Court

888 N.E.2d 1

228 Ill.2d 404

Michelle WILLIAMS, Indiv. and as Special Adm'r of the Estate of Baby Doe, Deceased, Appellee, v. John C. MANCHESTER, Appellant.

No. 104524.

Supreme Court of Illinois.

April 3, 2008.

Cremer, Kopon, Shaughnessy & Spina, LLC, Chicago (Francis A. Spina, Geoffrey M. Waguespack, of counsel), for appellant.

Paul P. Wolf, J.W. Mitchell, of Mitchell Hoffman & Wolf LLC, Chicago, for appellee.

OPINION

Justice FREEMAN delivered the judgment of the court, with opinion:

This appeal focuses on a wrongful-death claim that plaintiff, Michelle Williams, brought in the circuit court of Cook County against defendant, John Manchester. Plaintiff sought damages for the death of her unborn child, Baby Doe. The circuit court entered summary judgment in favor of defendant on that claim, but a divided panel of the appellate court reversed. 372 Ill.App.3d 211, 309 Ill.Dec. 722, 864 N.E.2d 963. We allowed defendant's petition for leave to appeal. 210 Ill.2d R. 315(a). We now vacate in part the judgment of the appellate court and remand the cause to the circuit court for further proceedings.

I. BACKGROUND

The record, which includes plaintiff's deposition testimony, contains the following pertinent evidence. In October 2002, plaintiff was 10½ weeks pregnant with Baby Doe, and she had been aware of her pregnancy for approximately one month. Plaintiff had planned to carry Baby Doe to term, and plaintiff and the child's father had been preparing for the birth.

On the night of October 15, 2002, plaintiff was a passenger in an automobile (hereafter, plaintiff's automobile) proceeding east on Montrose Avenue in Chicago. Defendant was driving west on Montrose. As plaintiff's automobile was proceeding through the intersection of Montrose and Western Avenues, defendant turned left, attempting to proceed south on Western Avenue. The two vehicles collided, with the driver's side of defendant's vehicle crashing into that of plaintiff's automobile. According to plaintiff, "[i]t was almost like a head-on" collision. Plaintiff's forehead broke through the windshield. When plaintiff regained consciousness, a firefighter was beside her in the automobile, and he extricated her from the windshield. Plaintiff felt pain not only in her head, but also in her hip.

An ambulance took plaintiff to Advocate Illinois Masonic Medical Center. According to plaintiff, she and Baby Doe's father met with a team of physicians and discussed her condition and treatment options. The physicians informed plaintiff that she did not suffer a spontaneous abortion and that the baby itself was not injured in the collision; rather, "the baby was fine."

However, the physicians informed plaintiff that she, herself, suffered a broken hip and pelvis. As a result, according to plaintiff:

"[The physicians] told me that because my pelvic bone was broke, they couldn't be certain that I would hold the baby. If I did choose to stay pregnant, I'd have to be bedridden and then the bones would heal themselves and then they might have to go back in and break them again. They couldn't promise that I would ever walk right. Pretty much everything they were saying is, they couldn't promise anything."

Plaintiff further described the meeting as follows:

"They said that if the bones healed on their own, they might have to go back in and rebreak them to set them again and I'd still have to have surgery but it would be afterwards; and they couldn't promise with x-rays and all that that [sic] the baby would even be okay."

Dr. Joanne Kirby, plaintiff's emergency room physician, told plaintiff that an X-ray had been taken of her, which, according to plaintiff, "could cause disabilities in the child and mental problems." According to her deposition, plaintiff understood these physicians to share the opinion that it would be best for plaintiff to terminate her pregnancy. Further, when plaintiff ultimately decided to terminate her pregnancy, no physician told her that it was a bad decision or that her decision was not in the best interest of her health. Plaintiff's hospital record indicated: "Patient desires consultation with high-risk OB/fetal specialist."

Dr. James Keller, a high-risk obstetrician-gynecologist, testified in a deposition, relying on several notes in plaintiff's hospital record. At the time of the accident, Dr. Keller was the director of high-risk obstetrics at Illinois Masonic. On October 17 and 18, 2002, he met plaintiff and consulted on her care, but did not actually provide any treatment. He explained that, as a consulting physician, his role was "[t]o make sure that [plaintiff] had as much information as possible, to make sure that the orthopedic surgeon understood the relevant issues, so that they could make a decision as to what the best course of action would be." The counseling that physicians at Illinois Masonic give to patients is "nonjudgmental." Dr. Keller explained that physicians there "just make sure that the patient has the information to make a decision. * * * [O]ur overall goal is to be as nonguiding as possible."

In terms of plaintiff specifically, Dr. Keller needed plaintiff to understand the following issues: plaintiff's optimal therapy and the attendant risks of that therapy on the fetus; the best course of treatment for the fetus and the negative effects it would have on plaintiff; and possible "intermediate scenarios." At the time of Dr. Keller's consultation, plaintiff had a viable pregnancy that could have gone to term. However:

"To the fetus there's the risk of her [plaintiff's] drug and radiation exposure prior to this point; to the mother there's an increase of prolonged immobilization with a pelvic fracture, which carried short-term and long-term risks. The short-term risks would be mainly an increased risk of embolic phenomenon, thrombosis and embolism, blood clots. The long-term risks I would sort of defer to orthopedics, but they said that the longer that she waited to repair the hip the worse her outcome would be."

Thus, Dr. Keller opined that there were "risks involved to the mother and the fetus of continuing the pregnancy."

Regarding Baby Doe's exposure to radiation, Dr. Keller opined:

"With any individual fetus you won't be able to say, well, this is what would happen with this fetus; but in a general term, if you want to know what's the risk, there is no safe threshold for radiation to a fetus, meaning that once she's radiated there is an increased risk of problems related to radiation."

Dr. Keller explained that, generally, radiation exposure may cause organs to develop incorrectly, existing organs to grow and mature incorrectly, and an increased risk of childhood and adult malignancies. Dr. Keller based his opinion on "general medical knowledge" and an unidentified "whole body of literature talking about the damages caused by radiation." He explained that "it's sort of part of the general obstetric literature * * * that radiation is a known teratogen or cause of birth defects."

However, Dr. Keller recognized that Baby Doe would not inevitably have had problems because of the radiation to which it was exposed up to the time of his consultation. Also, Dr. Keller could not opine whether Baby Doe would have had problems even with additional radiation exposure throughout the pregnancy. Indeed, Dr. Keller answered in the affirmative the question: "There is no way with absolute certainty to conclude what the ultimate effects of radiation exposure is to a fetus?" Dr. Keller actually "had plenty of patients who have had exposure to radiation who have delivered perfectly healthy babies." Dr. Keller would defer to radiology specialists as to quantifying the amount of radiation to which Baby Doe was exposed and the corresponding risk. Dr. Keller did not consider himself an expert in medical radiation exposure so as to render an opinion in this case. Although he stated that he could so qualify himself through personal research and consultation with radiology specialists, he did not plan to do so in this case.

Dr. Keller read his consultation notes into the deposition record. When he first met plaintiff, he discussed plaintiff's case only generally. He needed to know the impact of continuing the pregnancy on her orthopedic treatment and what the alteration of such treatment to benefit the fetus would mean to plaintiff's long-term outcome. His notes indicated: "Patient would like to continue pregnancy but not at risk to her long-term outcome." Dr. Keller's notes indicated that he would speak with plaintiff's orthopedist "to get better idea of drug/radiation exposure, risk of waiting, and then revisit with patient."

Dr. Keller also read into the record a note from plaintiff's orthopedist, Dr. David Beigler, which stated: "If child is desired, then nonoperative care is recommended." However, the note continued: "If the fetus is not wanted," termination of pregnancy "is suggested such that ORIF or open reduction, internal fixation could be performed. Similarly, if spontaneous abortion occurs, ORIF may be contemplated."¹ Remembering his conversation with Dr. Beigler, Dr. Keller testified: "it seems the gist of the conversation was that the longer we waited the worse the long-term outcome for the mother is going to be."

After consulting with plaintiff's orthopedist, Dr. Keller had a second meeting with plaintiff. Baby Doe's father was also present. Dr. Keller discerned four options: (1) immediate pelvis surgery without termination of pregnancy; (2) immediate termination of pregnancy and, postrecovery, pelvis surgery; (3) delayed pelvis surgery until second trimester of pregnancy; and (4) delayed pelvis surgery until plaintiff gave birth. The first option put the fetus at risk for loss as a result of the pelvis surgery itself, "as well as long-term problems due to radiation/medicine which would be difficult to quantify." The third option would decrease the risk to the fetus of drug and radiation exposure. However, the...