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Clark v. Martin

Clark v Martin 2024 NY Slip Op 33457(U) September 26, 2024 Supreme Court, Kings County Docket Number: Index No. 5085/15 Judge: Ellen M. Spodek Cases posted with a "30000" identifier, i.e., 2013 NY Slip Op 30001(U), are republished from various New York State and local government sources, including the New York State Unified Court System's eCourts Service. This opinion is uncorrected and not selected for official publication.

FILED: KINGS COUNTY CLERK 09/30/2024 INDEX NO. 5085/2015 NYSCEF DOC. NO. 346 RECEIVED NYSCEF: 10/01/2024

At an 1.4.S Term, Part 63 of the Supreme Court of the State of New York, held m and fortheCountyofKingsj atthe Courthouse,.at h!"'.~ Center, Brooklyn, New York, on the dh._.-\\\lay of September, 2024. PRES ENT: HON. ELLEN M. SPODEK, · · Justice. - -.. - - - - - -. - - - - .,. - - - - - - - - - - - - - - - - - - - - - - - -·X KENNETH CLARK and SARDE C'LARK, AS Co-Administrators of the Estate of (~HANNEL CLARK, decea;sed,

Plaintiffs, DECISI0N/ORDERIJuoGMENT

- a0. 0 aii1st. - Index No. 5085/15 DEAN MARTIN, NADIA PILE, KAJALPRUTHI, Mot. Seq. Nos. 8, 10-11 BROOKDALE HOSPITAL MEDICAL CENTER, and NEW YORK METHODIST HOSPITAL,

Defendants. - - - - - -··- - - - - .-' - - -· - - - - - -·."' - ·- ·- - - - - - -· - - ~ - - ""·X

The following e-filed . papers read hetein:. NYSCEF Doc Nos.: Notice of rvfotion/Cross Motion, Affirmations (Affidavits), and Exhibits Annexed ... , ............... , ......... . 139~196; 222-245: 247-265 Affirmations (Affidavits) in Opposition and Exhibits Annexed ..... , ...... , ................ . 274-287; 289-302; 303-316: 317 Reply Affirmations anc.l Exhibits Annexed: ........ , ..... , 319-337: 338; 339

In this action to¹·ecover damages for (among other things) medical malpractice and

wrongful death, defendants Nadia Pile, M.D. (sued herein as Nadia Pile) ("Dr. Pile''), and

Dean Martin, M.D. (sued herein as Dean Martin) ("'Dr. Martin"), separately; and Kajal

Angtas, M.D. {sued herein as Kajal Pruthi) ("Dr. Pruthi"), and Ne\v York--Presbyterian-

Brooklyn Methodist Hospital(sued herein as New York Methodist Hospital) ("'Methodist';)

j pint ly, mave for summary judgment dismissing the Verified. Amended Complaint, dated

Jttne 8~ .2022 (NYSCEF Doc No. 145) 1 .as agah1st each of them. 1

FILED: KINGS COUNTY CLERK 09/30/2024 INDEX NO. 5085/2015 NYSCEF DOC. NO. 346 RECEIVED NYSCEF: 10/01/2024

Discussion

Dr. Pile,.Dr .. Martin, and.Methodist have·each established a prima facie entitleme11t

tojudgment as a matter of lav,: through the submission ofthe patiene s medical records and

the detailed afftnnations of their respective expert obstetricians, 4 each ofwhom opined

within a reasonable degree of medical certainty that none of the respective defendants

depatted from the accepted standards of care and that any alleged departures ,vere not a

proximate cause of the- patient's suffering a cardiac arrest and bet subsequent death. See

Torres v Yakobov, 222 AD3d 692, 693-694 (2d Dept 2023); Getselevich v Ornstein, 219

AD3d 1493, 1495 (2d Dept 2023).

In opposition to defendant's prima facie showing, plaintiffs' expert obstetriciarihas

failed to raise a triable issue of fact for three principal reasons. See Diaz v New York

Downtown liosp., 99 NY2d 542, 544 (2002); Belak-Redl v Bollengier, 74 AD3d 1110,

1111 (2d Dept 2010). First, plaintiffs' expert obstetrician improperly raised a new theory

of liability in oppositi0i1·to.defendants'motions; namely,that defendants (individually and

collectively) failed to referthe patient to a cardiologist for diagnosis and treatment ofher

catdiopathy (the "cardiologist'-referral theOt):'"). Plaintiff's expert states ·•rt is my opinion

that Dr. Martin, Dr. Pile, and Methodist Hospital ... departed from good and accepted

medical practice in Jailing to refer Ms. Clark to a cardiolog1.st during her prenatal course..

~ See Expert Affirmation of Thomasena Ellison,. M.D., dated December 20, 2023. on behalf of Dr.. Pile; Expert Affirmation of Gary Mucciolo, M,D,, dated February 23, 2024, oil behalf of Dr. Martin; and Expert Affinnation of Taraheh·Shirazfan, M.b:; dated February 21, 2024; on behalf of the Methodistdefendants.(NYSCEF Doc Nos. 142, 225, and 250, respectively). io

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. , in a patient such as Ms. Clark, good, and accepted medical practice required referral to a

cardiologist to follow the patient during the prenatal course fot., appropriate monitoring and

testing .... "). (Plaintiffs Expert Aff., pg. 8). See A1endoza v Maimonides lvfed. Ctr., 203

AD3d 715. 717 (2d Dept 2022}. Second, plaintiffs' nevdy advanced cardiologist-referral

theory is speculative in nature because it is based on a string of assumptions that are not

supported by facts in the record and cannot raise a triable issue offact as to whether the

lac;k of such refenal was a c_ompetent producing cause of the patient's injuries. (Plaintiffs

Expert Aff., pg 8) Plaintiffs expert stated ''[HJ ad a cardiology consult been appropriately

completed. Ms. Clark's cardiomyopathy would have been timely diagnosed, and she would

have delivered her baby before her cardiac arrest." See Kiernan v Arevalo-Valencia. 184

AD3d 727, 729,730 (2d Dept 2020); Shahid v New York City Health & Hasps. Corp., 47

AD3d 800, 801-802 (2d Oept 2008), partially overruled on other grounds by Stuka,s v

Streiter, 83 AD3d 18, 27 (2d Dept 2011). Third and finally; plaintiffs; expert obstetrician

co1np Ietely ignored the patient's• departure from Brookdale's ER against tnedi cal advice on

January 12, 2013 when she was experiencing a hypertensive urgency until her delayed

presentation to Methodist's ER on January 15, 2013 by which time her hypertensive

urgency had progressed fo a hypertensive ernergency,5 See Audette v Toussaiflt,Milord;

201 AD3d 779,780-781 (2d Dept 2022) (where; after delivery, the plaintiff did not pennit

defendant o bstetricfan or· nurses to examine her uterus and left the hos pi(al against medical

advice, her medical in.al practice claiJn that defendant obstetrician failed· to diagnose her

~See Plain ti ff' s Expert Affinnation, page 6 .(omitting. from the recitati6n of facts ·the patient's presentation to Brookdale's ERori January !², 2013). · · ll

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With placenta increta_; \\ias dismissed on sunimaryjudgment because '~any alleged departure

,vas not a proximate cause of the plaintiffs injuries'').

Conclusion

Based on the foregoing, it is

ORDERED that in Seq. No. 8, Dr.. Pile's motion for summaryjudgment is granted,

and the amended complaint is dismissed as against her in its entirety Without costs and

disbursements; and it is forth er

OR])ERED that in Seq. No, 10, Dr. Martin's motion for summary judgment is

gtanted,and the amended complaint is dismissed as against him in its entirety without costs

and disbursements; and itis further

ORDERED that in Seq. No. 11, the initial branch of the joint motion of Dr. Pruthi

and Methodist for summary judgment dismissing the amended complaint as against

Dr. Pmthi is granted without opposition, and the amended complaint is dismissed in its

entirety as against Dr. Pruthi Without costs or disbursements; and it is further

ORDERED that in Seq. No. 11, the remaining branch ofthe joint motion of

Dr. Pruthi and Methodist for summary judgment dismissing the amended complaint as

against Methodist is granted; and the amended complaint is dismissed in its entirety as

against Methodist withm1t _co:,ts or. disbtirsem ents; and -it is further

ORDERED that Dr. Pruthi and Methodist's Joint counsel is directed to

electroriically ser\'e a co·py of this _Decision/Order/Judgment wjth notice ofentry on the

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other parties' respective counsel and to electronically file an affidavit of service thereof

with the Kings County Clerk.

This constitutes the Decision/Order/Judgment of the Court.

ENTER,

~⁵.,JJ~ y J. S. C. HON. ELLEN M. SPODEK

r • C. ' J '- ; _ _ ,:l ~~L l t... ,.J =--= C: o h:::..: w-<('""

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Footnotes

[1] The relnain ing defendant, Brookdale Hospital Medical Center, \Vas dismissed froin this action wjthout oppositibll .by Decision.& Order; dated June25, 2024 {NYSCEF Doc No. 340.). [* 1] 1 of 13 . ................................. _.,_, ___ __ .,, , __ Plaintiffs Kenneth Clark and Sarde Clark, as the co-administrators of the estate of Channel Clark, deceased ("plaintiffs'), do not oppose those_ branches of defendants' motions which seek summmy judgment dismissing plaintiffs' second, third, and fourth causes of action sounding in lack of infmrned consent; negligent hiring/retention, and negligent credentialing,tespectively. See Cla!'ke v New York City Health & Hasps., 210 AD3d 631, 633 (2d Dept 2022); Carcia v Greif, 182 AD3d 464, 466 (1st Dept 2020); Wright v Morning Star Ambulette Servs., Inc., 170 AD3d 1249. 1252 (2d Dept 2019). Moreover, plaintiffs, in opposing defendari:ts' motions; have abandoned their claims as against Dr. Pruthi who was Methodist's resident at the time. The remainder of this Decisi on/Otder/J udgment address es pl_ainti ffs' fitst and fourth causes of action sounding in medical malpractice and wrongful death, respectively, as against Dr. Pile; De Martin, &nd Methodist (coHectively, "defendants"), Background On June 25, 2012, plaintiffs' decedent, Channel Clark {the "patient''), was seen and examined by nonparty Nurse Practitioner Audrey Stedford C'Nurse Stedford';) at Dr. Martin 'S Ob/Gyn private practice fat her first pre-natal appointment. She was then seven weeks pregnant. She had a history of three prior pregnancies, resulting in two live births and one miscairiage. Her blood pressure, on presentation to Dr. Martin's practice, viassignific:antly elevated at.164/109. She was morbidly obese with a BMI of38,.based on het Weight .of 259 poL111ds and her height of 69 inches, Nurse Stedford noted that the patient's pregnancy was high risk because of her morbid ·obesity, .chronic hypertension,

[2] of 13 [* 2] and idiopathic thrombocytopenia (low platelet count). At Nurse Stedford's recomrhendation, the patient immediately went to Methodist's Labor & Delivery emergency room ("Methodisf s ER';) for treatment of her high blood pressure. At Methodist's ER, thepatienfs systolic blood pressure was elevated at 146/84. The patient however, "[l]eft [Methodist's ER] [w]ithout [b]eing [s]een" by any healthcare provider other than the triage nurse. On July 18, 20l2, the patient presented to Methodist's outpatiertt Maternal Fetal Medicine clinic (''Methodist's MFM clinic'') Where she was se'en and examined by nonparty Jacque-line Bush, M,D. ('"Dr. Bush"). The patiei1fs blood pressµre, at the time, was significantly elevated ,at 160/100 and (oh re-measurement) at 162/100. Dr. Bush gathered from the patient's medical history that the patient had been sµffering from chronic hyp-e1tension for approximately six years since the birth of her second child in 2006. Dr. Bush tecotnmended that the patient immediately go to Methodist's ER because bet antihypertensive medication at the time - Aldomet - was inadequate to control her blood pressure. Because the patient declined Dr. Bush's recommendation to visit Methodist's ER, Dr. Bush instructed the patient to returti to Dr. Martin''s practice as soon as possible; to monitor her blood pressure at home, and to return to Dr. Bush at Methodist's MFM clinic in one vveek. The patient, at the time, failed to follow up with Dr. Bush. Approximately one month later on August 14, 2012, the patient returned. to Dr. Martin;s practice where she \Vas seen and examined by Nurse Stedford. Her systolic biood pressure was bordedine hype11ensive at 130/70 at the dme. Nurse Stedford;s plan 3.

[3] of 13 [* 3] for the patient \Vith a "'high risk" pregnancy was "manageinent by [a] high risk [pregnancy] specialist," (i.e., Dr. Bush at Methodist's MFM clinic). Two weeks later on August 28, 2012,the patient visited Dr. Martin'-s practice where she \Vas seen and examined by Dr. Martin. Her blood pressure, at the time, was under control at 126/80. She was continued on Aldomet. On Septe1rtber 21, 2012, the patient again returned to Dr. Martin's practice where she was seen and examined by Nurse Stedford. Her blood pressure, at the tiine, was significantly elevated at 150/102. She reported as '"having farnily problems.'' At Nurse Stedford's insistence, the patient went to Methodist's ER immediately. For approximately two weeks from Septe1nber 21,2012 to September 25, 2012, the patient was hospitalized at Methodist for chronic hypertension, low platelet couht; and elevated liver enzymes. While hospitalized at Methodist, she was seen and consulted at bedsideby the·specialists fromthe hematology,cardiology, and MFM clinics. HerAldomet (:an older, narrow-,spectrum antihypertensive agent}was replaced with Labetalol (a newer, wide-spectrum antihypcrtensive agent). While on Labetulol, the patient's blood pressure returned to normal baseline by the time of her discharge from Methodist. Her discharge diagnoses were chronic hypertension and low platelet count. At discharge, she was instn1cted to follow up with. Dr. Martin's practice Jtnd with Methodist's outpatient hematology clinic. On October 5,. 20.12, the patient \Vas seen at Methodist's ot1tpatient hematology .clinic for continued treatment of her low blood count with a steroid.. The patient's blood 4

[4] of 13 [* 4] pressure, at the time, \Vas once again significantly elevated at 185/116. She also had a bilateral '"l+'' pitting ederna;" Although she was given a Labetalol tablet in the hematology clinic, her blood pressure failed to drop. Because of the persistent hypertension, Methodist's hematology clinic referred the patient to Methodist's ER for eval uati ori. She immediately went to Methodist's ER as instructed. There, her blood pressure readings were significantly elevated at 174/105,. 158/103, and 171/107. She reported. by way of her medical history, that her blood pressure teadings had been as high as in excess of 200/100 before her current pregnancy. She was examined in Methodist's ER by Dr. Bush (an MFM specialist) then on duty. According to Dr. Bush's note, she doubted that the patient was suffering from "superimposed preeclampsia at [that] time" because her preeclamptic laboratory results were negative. To manage the patient's intractable hype11ension, Dr. Bush doubled the doseofthe patient's Labetalol from 2()0 mg twice daily to 400 mg twice daily and recommended a repeat urinalysis. After a three:-hour stay in Methodist's ER; the patient was discharged home the same day with instructions to take the ne,vly increased dose ofLabetalol,torepeaturinalysis, and to follow upas an outpatient {Which she never did}with a nephrologist. On October 9, 2012, the patient returned to Dr. Martin's practice where she was seen and examined by .Dr. Pile, an employee physician of Dr .. Martin;s practice. The patienfs bl9od pressure, once again~ w1:ts significantly elevated at 185/110. Dr. Pile explained to the patient thatshe needed to. take two (not one}200 mg tablets ofLabetalol 5 • • ••• ,, ... _.,_, __ , ___ .,,_ ................. ,, ... ,._..,._~~.--••-"•"'"~w .. ,••. - -

[5] of 13 [* 5] at the.same time twice _daily-to m_ake up for the .i_n.cr~u$.ed 400 mg dose ofLabet.~lol twice daily,_ The patient was· inst_tu_cted to follow up···,vith a.nephrologist and with Dt .. Bush at Methodist's outpatientclinics, as well as to returnto Dr. Martin's practice in. thre.e weeks. On November 9, 2012, ~he patient rntumed to br. Martin's practice where she was seen and examined by Dr. Martin. Her blood pressure, at the time, was within the normal range. of 127/84. She was ·instructed to return to· Dr. Martin's practice in three. weel<.s; On November 3()~ 2012, the patient presented to Dr. Martin's practice after an earlie_r, same-day visit to M~thodist's hematqlogy clinic where her blood pressure was measured at 179/111. At Dt,. Martin's practice, she \vas seen (but was rtot-exan'lined) by Nurse St.edford. Although.the patient's blood pressur(;: remainedsignific~mtly elevated, the patient "did not want to be ·evaluated by [Nurse Stedford].;' Although Nurse -Stedford insisted thatthepatient go to Methodist 1 s·ERimmedfately, the patient refused to·do so. On January 2, 2013°, the Ji~tient visited Dr..__Martin's practice where ·she was seen and exainined by br. Pile·. The··patient~s blood pressure, at the time, was· within the nonnal n1ngc of 135/82. She wa~ five ,veeks and four days away froin hct due date of February 1Q, 2013. Dr. Pile discussed pret~nn labor precautions with the patient and instrµct~d her to -return to· Dr. Martin's ptactfoe-intwo -weeks. Ten days lat_ernnJartmu-y 12~_2013 .at l.2:30 a:m;, the paJient.ptesented to{thesince- disrnissed defendant) Brookdale .Hospfral Medical Center (''Btookdale") 1 with ahypertensive urgency. Her bloocl pressur~ in the triage \vas 168/130 and (ort repeat) 175/120, des_pite het;having taken Labetalol at 10:30 p.m .. the night before. Further•. she 6

[6] of 13 [* 6] exhibited bilateral lower extremity pitting edema. Less than one hour after her presentation to Brookdale's ER, however, the patient leftagainst medical advice. The Brookdale. ER staff explained to the patient that her extremely high blood pressure could cause her to suffer a stroke, resulting in damage both to her and her fetus. The patient informed the Btookciale ER staff that she understood the risks, and that she would take a taxi to .Methodist's ER. At l: 17 a.in. on January 12, 2013, the patient signed out of Brookdale's ER against medical advice but, contrary to her assurances to the ER staff; she did not immediately go to Methodist2 Three days_ later on January 15, 20J3 at 8: 17 a.m., the patient presented to Methodist's ER with a hypertensive emergency. At triage, the patient com plained of the ''acute onset ofdyspnea, epigastdc pain, diaphoresis and non-productive Qough that started earlier [inthe day] after she dropped off [her] daughter at school." ByS:20 a.m., Dr. Pruthi (Methodist's resident then on duty in the ER), together with theattendingobstetrician,were at the patient's bedside. The patienfs blood pressure was then catastrophically high at 2 According to tlie Brookdale ER records: ''[The patient] called' the ambulance because he!' blood pressure was very high. Patient stated [that] she got into an a!terca.tioi1 with her boyfriend earlier [that l'1ight], found out he was being.i.mfaithful. , .. [The] patient states· [that] she. has a l)lood-pressure monitor at home and the [that her] blood· pressure was l20/70s the day befc>rt\ 13Jood pr~ssure in triage [is] 168/ 13 0, [atJ repeat [is] l 75/ 120, [her] heart rate [is] 128 [beat~ perm in ute, which is tachycl'l:rdic]. [The] patient [p1·esentsJ with pitting edema ... ([whi¢h has] worseri(ed] today as per [the]· padent). [The]· patient refused vaginal exam. [TheJ patient appears ver)' anxiolis, she is short of breath. She. is upset that the am bu lance brought her [ to Brookdale] and wailts fo. sign out against medical -advice; [The ER staft] explained [to het] 'that a b Iood pressure th is high cou Id give her a: strdke if no[ t] treated; [could] cal.is[e] lier death and [her] baby ':s death as well. [The] patient is. a,;vare of the risks; and .stated she wm take a taxi to Methodisc. [The] patient signed otit aga:instniedica\ advice;'' BroO:kqale ER.records, page 2 of 3 (NYSC,Ei=' Doc l\19, 265) (abbr~viatfons speJled oui and typographic.al error$ corrected). 7

[7] of 13 [* 7] 201/13.5, and her heart..r.ate- wa·s. tachycardic at· 14Qs.,. i_50s beats per minute. Dr. Pruthj's note-.(tirt1ed at 11 :37 a~ri.1. of that day) indicates: "[The] patient [was:] in respiratory distress[~] lungs bilaterally cleat, kncnvn history of chronic hypertension and immune thrombocytopenia, non- cotnpliaht, blood ptessure values noted, discussed [the] patient with [the] .anesthesia [team]. Diagnoses: pulmonary edema, severe preec.lampsia, pulmonary embolism. Decided to bring: [the] patient to [the]· (}per~tin.g:-r.ooni for intubation, stabilization, and deliveryrJ tThe] patient coded in [th,e1 :op.~rating room [i,e., became unrespo11sive ;ind -pulseless, at_ 9.:3:0 a.m_.]. Ultrasound in [the] o.peiatingsoom [for] fetal heart rate [was at] 50 [beats'per minute]. [The] patient [was] already [intubated] and code in progress. Advised immediate delivery [of the baby boy], [his] heart rate [was] less than

[100] [beats per minute]. [The] baby [was] dried and given oxygen by mask, [his:] heart rate [increas_ed to] grep.ter .than 100,. and [th{;'.J pediatricians continued tesuscit&_tion. [The patient regai_ne.d _h_erj:mlse at 9:46 a.m.J:" 3 Dr, Pruthi (together with Dr. Pile who arrived at patient's bedsid~ .at 9:14 a;m.) delivered the baby boy at 9:3$ a'.m. after making the first incision one 1111rtute earlier at 9:37 a.m. At five minutes of life, the baby hoy was "vigorous, crying; [albeit] with decreased muscle tone :and acrocyanosis, and -sta,rt;ed developing chest retr!:!,o_ticms." The baby was inim¢<Hately t_i'an_sfe1red to the neonatal intep.sive care unit. The haby boy subsequently recovered. No claims in this :action have bee11 asserted on his behalf. As the consequence ofthe 16-minute-Iong cardiac arrest from 9:30 a.m, to9:46 a.m. on.Jart_Uaiy 15, 2013, the·.pa,t:i"ertt suffeted a ••hypoxic encephaiopathy without brain death." The patient was deemed to be .in persistent vegetative state- after 25 days··of not waking up." 3 Methodist's chart for the patieilt's Janumy 15, -2013 hospitalization, pages O12-013 (abbreviations spelled out and typographicaierrcirs corrected), , . s· 8 of 13 [* 8] On April 2, 2013, the patient was discharged from Methodist to nonparty Rutland Nursing Home where she passed away on December 27, 2016 from a cardiopulmonary arrest due to (or as a consequence ot) diabetesmellitus and essential hypertension, On a motion for summary judginet1t dismissing a medical malpractice cause of action, a defendant has the prima facie burden of establishing that there was no departure from good and accepted medical practice, or, if there was a departure, the departure was not the proximate cause ofthe alleged injuries. Brinkley v. Nassau Health Ccire Corp,, 120 A.D.3d 1287 (2d Dept. 2014); Stukas v Streiter; 83 AD3d 18, 24-26 (2d Dept. 2011). Once the defendant has made such a showing, the burden shifts to the plaintiff to submit evidentiary facts or materials to rebut the prima facie showing made by the defendant, so as to demonstrate the existence of a triable issue of fact. Alvarez v Prospect Hosp., 68 NY2d 320,324 (1986);Brinkley v. Nassau HeaJthCare Corp., supra,; Fritzv. Burman, 107 A.D .3 d 9 36, 940 {2d Dept.2013); Lingfe iSunv; City ofNew York, 99 AD3 d 673, 615 (2d Dept. 2012);Bezerman v; Bailine, 95AD3d 1153,, 1154 (2dDept 2012);Stukasv; Streiter, at 24. A pla,intiff succeeds in a medical malpractice action by showi11g that a defendant deviated from accepted standards of medical practice and that this deviation proximately paused plaintiff's injury .. Contreras v AdeyemL,_ 102 AD3d 720, 721 (2d Dept 2013); Gillespie vNew York Hosp. Queens, 96 A.D.3d 901,902 (2d Dept. 2012); Semel v Guzman, 84 AD3d 1054, .1055~56 (2d Dept. 2011). The plaintift'oppbsing a defendant physician's motion for summaryjudgment must only submit evidentiary.facts or materials to re:but the defendant's primafac.ie shm,ving. Stukas,at 24. 9 9 of 13 [* 9]