Young v. U.S.

• Decision Date: 05 October 2009
• Docket Number: Civil No. SKG-07-875.
• Parties: Pauline YOUNG v. UNITED STATES of America.
• Court: U.S. District Court — District of Maryland

667 F.Supp.2d 554

Pauline YOUNG v. UNITED STATES of America.

Civil No. SKG-07-875.

United States District Court, D. Maryland.

October 5, 2009.

Eric H. Haversack, Hyatt and Weber PA, Annapolis, MD, for Pauline Young.

Melanie L. Glickson, Maryland Office of the United States Attorney, Baltimore, MD, for United States of America.

MEMORANDUM OPINION

SUSAN K. GAUVEY, United States Magistrate Judge.

Following administrative denial,¹ plaintiff filed this action for personal injury against the United States of America in the District Court under the Federal Tort Claims Act, 28 U.S.C. §§ 1346(b), 2671-80, as amended ("FTCA"). Plaintiff alleges that an employee of the United States Postal Service ("USPS"), while acting within the scope of his employment, negligently caused her injury. (Paper No. 1). Specifically, this suit arises out of an automobile accident in which a USPS truck collided with plaintiff's car while the latter was parked in a parking lot. (Paper No. 1 at 2). Plaintiff claims that the impact injured her right hand and wrist. (Id.). The District Court has jurisdiction over this action under 28 U.S.C. § 1346(b)(1) and 39 U.S.C. § 409(a).

Currently pending before the Court is defendant's motion for summary judgment. (Paper No. 40). Defendant raises two related arguments in its motion: (1) that plaintiff cannot show that defendant's negligence proximately caused plaintiff's specific injuries and (2) that, to the extent plaintiff's unsuccessful reconstructive surgery (and subsequent, related operations) caused her harm, defendant is not liable, as the unnecessary, unsuccessful reconstuctive surgery is a superceding cause. For the reasons below, the Court DENIES defendant's motion for summary judgment. Because resolution of the motion involves somewhat complicated issues of medical care and treatment, the Court sets out the facts and opinions in some detail.²

I. Factual Background

Plaintiff Pauline Young is a retired insurance claims handler. (Ex. 1 at 9, 13). Plaintiff spent much time typing throughout her career. (Id. at 29, 101). On the date of the accident, September 10, 2004, she was 61 years old. (Id. at 2).

Plaintiff's Right Hand and Wrist Problems Prior to the September 10, 2004 Automobile Accident

In 1990, plaintiff injured her right hand in an automobile accident, "from grabbing the steering wheel and holding it so hard." (Ex. 2 at 9-10; Ex. 1 at 24-27). She experienced numbness in her right hand after the accident and underwent right carpal tunnel release surgery, performed by Dr. Thomas Dennis of the Orthopaedic and Sports Medicine Center, to address the injury. (Id. at 25-26, 32). Her symptoms did not fully resolve after the procedure, and plaintiff had a re-release surgery on the same hand in 1994. (Id. at 33).

Nine years later, plaintiff returned to Dr. Dennis, complaining of "significant [right] wrist pain" and "numbness from time to time." (Ex. 3 at 4). Dr. Dennis recognized that "[s]he does a lot of typing and this certainly impacts on it," and ordered radiographs that showed "significant arthritis." (Id.). Dr. Dennis' impression was that "she is definitely having some recurrence of her carpal tunnel syndrome in the RIGHT and it is probably caused by the start of pantrapezial arthritis." (Id.).

Plaintiff continued to see Dr. Dennis in connection with her arthritis and carpal tunnel symptoms throughout the winter and spring of 2004. (Id. at 5-11). On April 14, 2004, Dr. Dennis commented that "most of her persistent pain in the RIGHT hand is more related to the osteoarthritis than anything else." (Id. at 7). On June 22, 2004, about two and a half months before the accident, plaintiff had a third right carpal tunnel release surgery to address the carpal tunnel syndrome in her right wrist. (Id. at 10).

September 10, 2004 Automobile Accident

On September 10, 2004, plaintiff stood beside her parked car in a parking lot adjacent to a Wendy's restaurant. (Ex. 2 at 7). She was photographing the scene of an earlier accident in connection with her job duties. (Id.). Meanwhile, a USPS vehicle driven by Mr. Thomas Rey passed through the same lot at about five miles per hour, headed into the Wendy's lot to make a delivery. (Ex. 1 at 46; Ex. 4 at 42-47). Mr. Rey did not see plaintiff's car as he turned, and the side of his truck bumped into the car's left rear bumper. (Ex. 4 at 42-44). Plaintiff testified that she heard the truck coming and then saw it out of the corner of her eye immediately before impact. (Ex. 1 at 46). She placed her right hand on top of her car to brace herself and avoid falling. (Ex. 2 at 7). Plaintiff testified that Rey's truck "went up under the car." (Ex. 1 at 40). Although plaintiff did not fall as a result of the impact, (Ex. 1 at 54), she reported suffering trauma to her right wrist, (Ex. 2 at 7).

A police officer arrived at the scene and completed an incident report. (Ex. 6 at 5-7). Plaintiff did not report any injuries and told the police officer that she did not wish to go to the hospital. (Ex. 1 at 69). Plaintiff returned to her office for 10 or 15 minutes, and then went home. (Id. at 74).

Plaintiff's Treatment after the Automobile Accident

Before chronicling plaintiff's treatment and diagnoses following the subject accident, it is helpful to provide background information on injuries to the hand and wrist area. The scaphoid and lunate are two adjacent bones in the wrist. (Ex. 11 at 9-10). The scapholunate ligament connects these two bones, and the area between them is the scapholunate interval. (Id. at 10; Ex. 8 at 9). Disruption occurs when the ligament completely detaches from one bone. (Id.).

Plaintiff received treatment for three separate injuries: a right wrist sprain, a right thumb ulnar collateral ligament sprain, and a tear of the right scapholunate ligament. (Ex. 7 at 1; Ex. 8 at 1).

Plaintiff's Visit to Nighttime Pediatrics and Adult Care Center on the Night of the Accident

On the night of the accident, plaintiff went to Nighttime Pediatrics and Adult Care Center in Annapolis, Maryland. (Ex. 7 at 1). Plaintiff's arm was X-rayed and she was diagnosed with a right wrist sprain. (Id.). She was released with instructions to ice her wrist, take Aleve, and consult with an orthopedist. (Id.). Plaintiff returned to work the following day. (Ex. 1 at 74-75).

Plaintiff's Visits to Chesapeake Orthopaedic & Sports Medicine Center during Fall 2004

Plaintiff visited Chesapeake Orthopaedic & Sports Medicine Center ("COSMC") in Glen Burnie, Maryland, on September 15, October 6, and December 15, 2004. (Ex. 8 at 1-7).

Plaintiff first visited COSMC on September 15, 2004, five days after the accident. (Id. at 1). Plaintiff was examined by a nurse practitioner, Karen Pipkin, and complained of pain in her right wrist. (Ex. 8 at 1; Ex. 11 at 43-45). X-rays revealed some scapholunate widening, but no acute findings, and showed mild degenerative changes. (Ex. 8 at 1). Nurse Practitioner Pipkin observed "a mild amount of edema . . . along the volar aspect of her RIGHT wrist,"³ with a full range of motion and no other tenderness, and concluded that plaintiff had suffered a right wrist sprain. (Id.). The nurse instructed plaintiff to wear her splint, take pain medicine, return to work the next day, and come back for a follow-up. (Id.). She further instructed plaintiff to begin hand therapy if she experienced no improvement in two weeks. (Id.).

Plaintiff returned to COSMC on October 6, 2004, (Ex. 8 at 3), where she was again examined by Nurse Practitioner Pipkin. (Ex. 11 at 61). Plaintiff reported that she was still experiencing discomfort in her right wrist as well as some weakness.⁴ (Ex. 8 at 3). Nurse Practitioner Pipkin observed "tender[ness] primarily along the first dorsal compartment of the RIGHT wrist. . . . [and] some burning along the volar aspect of the wrist extending into the thenar area. . . . She is able to gently flex and extend the wrist and digits." (Id.). Because plaintiff's pain had "not improved at all" and the x-ray showed "some mild scapholunate widening," an MRI was ordered to rule out a ligament tear. (Id.).

Plaintiff had an MRI on October 11, 2004, which showed:

1. Scapholunate separation with a possible scapholunate ligament tear.

2. Somewhat poor definition of the ulnar collateral ligament of the thumb, a finding which may be seen with sprain, related to a gamekeeper's type injury. Clinical correlation is recommended.

3. Scarring surrounding the median nerve compatible with postoperative change of prior carpal tunnel release. The nerve itself is mildly edematous.

(Ex. 8 at 5-6).

On December 15, 2004, plaintiff again visited COSMC, where she reported continuing discomfort in her right wrist and weakness in her right hand. (Ex. 8 at 7). For the first time, examination of plaintiff showed tenderness in the scapholunate area, although her overall swelling had significantly decreased. (Id.). Dr. O'Donovan reviewed plaintiff's MRI and diagnosed her with (1) a right wrist sprain with scapholunate tear, and (2) a right thumb ulnar collateral ligament sprain/ gamekeeper's thumb. (Id.). Plaintiff elected to undergo right wrist scapholunate reconstructive surgery. (Id.).

Right Wrist Scapholunate Ligament Repair Surgery and BLATT Reconstruction Procedure

On January 20, 2005, Plaintiff underwent right wrist scapholunate ligament repair surgery, as well as a BLATT reconstruction procedure.⁵ (Ex. 8 at 9). Dr. O'Donovan, who performed both procedures, testified that the former is a major procedure because it is a "real reconstruction of the wrist." (Ex. 11 at 88-89). It requires the surgeon to cut into bone, place anchors inside the groove with thread attached, and sew the ligament to the bone. (Id. at 84-88). Dr. O'Donovan also performed a BLATT reconstruction, a similar procedure which increases the stability of the repair. (Id. at 18-21, 86-87).

Upon entering plaintiff's wrist, Dr. O'Donovan noted disruption of the scapholunate ligament—that...