Holmes v. Hartford Hosp.

147 Conn.App. 713

84 A.3d 885

Edith HOLMES, Administratrix (Estate of Arnold F. Holmes)

v.HARTFORD HOSPITAL.

No. 30979.

Appellate Court of Connecticut.

Argued Sept. 26, 2013.

Decided Jan. 28, 2014.

Neil Johnson, Hartford, for the appellant (substitute plaintiff).

Michael G. Rigg, Hartford, with whom, on the brief, were Robert D. Silva and Claire V. Morgan, Hartford, for the appellee (defendant).

SHELDON, KELLER and WEST, Js.

WEST, J.

In this medical malpractice action, the plaintiff, Edith Holmes, ¹ in her capacity as administratrix of the estate of Arnold F. Holmes (decedent), appeals from the judgment of the trial court rendered in favor of the defendant, Hartford Hospital, following a jury trial. Specifically, the plaintiff claims that the trial court improperly (1) denied her motion to set aside the verdict; (2) denied her motion for a new trial; and (3) ordered her to pay the defendant's expert witness fees. We affirm the court's judgment as to the plaintiff's first two claims, and affirm in part and reverse in part the judgment as to the plaintiff's third claim.

The following facts and procedural history are relevant to our review. On February 8, 2007, the plaintiff served a complaint against the defendant claiming medical malpractice. Thereafter, on March 3, 2009, the plaintiff filed an amended complaint alleging that the defendant breached the standard of care owed to the decedent, by failing to provide him proper treatment following his cyst gastronomy. Specifically, she alleged that, after the decedent's surgical procedure, the defendant negligently transferred the decedent from the procedure suite to the recovery room and another unit of the hospital without monitoring him or providing him oxygen. The plaintiff also alleged that, as a result of the defendant's negligence, the decedent suffered cardiac arrest that went undetected for twenty minutes. By the time the defendant resuscitated and intubated the decedent, he had suffered neurological deterioration and respiratory failure, causing him to die approximately two weeks later.

In its answer, filed on March 5, 2009, the defendant denied the allegations that it violated the standard of care. In anticipation of trial, the parties conducted discovery and, in accordance with Practice Book § 13–4, filed expert witness disclosures. In mid-December, 2008, the defendant deposed the plaintiff's expert witnesses, David Crippen and Donna Querim, regarding whether the defendant comported with the nursing standard of care. In late January, 2009, the plaintiff deposed the defendant's expert witnesses, including Steven Angelo, Peter Schulman, David Pleet, and Anne Holland. A jury trial began on February 23, 2009, and, on March 6, 2009, the jury entered its verdict in favor of the defendant. This appeal followed. Additional facts will be set forth as they pertain to each claim.

I

The plaintiff first claims that the court improperly denied the plaintiff's motion to set aside the verdict, which motion was predicated on the court's improper evidentiary rulings limiting the testimony of the plaintiff's experts as to the defendant's analgesic policy. We disagree. The following facts are relevant to our review of this claim.

In late August, 2008, the plaintiff sent the defendant an informal request for copies of any policies related to the transfer of patients. The defendant responded to this request by letter, dated September 12, 2008. The defendant's response did not, however, include the defendant's analgesic policy, which pertains to the care of patients who are moderately sedated during medical procedures. The plaintiff first learned of the analgesic policy while deposing Angelo in late January of 2009. On January 30, 2009, the plaintiff obtained a copy of the policy during Schulman's deposition, and subsequently sent it to her experts, Querim, a registered nurse, and Crippen, a critical care physician, to review before trial.

On the basis of their review, both Querim and Crippen formulated new opinions that conflicted with their deposition testimony. They determined that the defendant breached the standard of care by transferring the decedent to an unmonitored unit while his condition was unstable. The plaintiff did not amend her expert disclosures to reflect these new opinions or to identify the analgesic policy as a potential source of the experts' testimony. See Practice Book § 13–4(b)(1).

The trial began on February 23, 2009, on which date the defendant filed a motion in limine to preclude the plaintiff's experts from testifying about alleged violations of the defendant's policies. In support of its motion, the defendant argued that a hospital's policies, as a matter of law, do not establish the standard of care because they may impose a level of care that differs from the national standard. See General Statutes § 52–184c (a); Smith v. Andrews, 289 Conn. 61, 69, 959 A.2d 597 (2008) (Connecticut follows national standard of care). Accordingly, the defendant argued that there was a high risk that the jury would conflate the policies with the standard of care in reaching its verdict. The plaintiff filed an objection to the defendant's motion in limine, and a hearing was held on February 25, 2009. Although the court orally denied the defendant's motion, it stated that the admissibility of the policies would be contingent upon the plaintiff demonstrating that they were equivalent to the applicable standard of care.

Consistent with this ruling, Querim testified at trial that the defendant's analgesic policy comported with the standard of care and, consequently, the court admitted it into evidence. Querim opined that, on the basis of her review of the analgesic policy and the anesthesia flow sheet, the decedent's vital signs were unstable while he was in the recovery room. Therefore, she testified, the defendant violated the standard of care when the recovery room nurses transferred the decedent to an unmonitored unit before his condition stabilized. On cross-examination, the defendant impeached Querim's credibility with her deposition testimony, wherein she had stated that the decedent's vital signs were stable while he was in the recovery room.

On direct examination, Crippen testified that, following his deposition, he reviewed additional records that altered his opinion as to whether the defendant had violated the standard of care. Consequently, the court issued a sua sponte side bar ruling precluding Crippen from testifying as to any opinions formed after his deposition. The jury entered its verdict in favor of the defendant on March 6, 2009. On March 16, 2009, the plaintiff moved to set aside the verdict, arguing that the court had improperly precluded the plaintiff's experts from testifying about the analgesic policy. The plaintiff argued that without the analgesic policy, she could not satisfy her burden of proof.

At a hearing on March 23, 2009, the court denied the plaintiff's motion to set aside the verdict, stating: “[T]he policy of a hospital is not equal to the standard of care. If a hospital wants to adopt a policy which requires a higher level of care, [it's] free to do so, but if [it violates] that policy, that doesn't mean [it] violated the standard of care. It defies logic to think that two medical professionals [Querim and Crippen] could have their opinions changed as to whether or not ... the decedent ... was stable ... before seeing the policy, based presumably on their knowledge of the standard of care, and then, say [he] was wildly unstable after [seeing] the policy.... [T]he bottom line is that these two medical professionals said that [the decedent] was quite stable when they were deposed and then changed their opinions, and it defies logic that the standard of care changed between ... six months before [trial] when their depositions were taken and at the time of trial.... [T]he jury heard about the policies, [and] the interpretation of the policies.... I think that everyone got a fair trial, and in order to accept the plaintiff's argument here [is] to accept that the experts six months before [trial] thought the standard of care—which is something really not dependent on hospital policies—was quite different from that which it was at the time of trial, and I just don't think I can accept that, so I'm going to deny the motion to set aside [the verdict].” This appeal followed.

“Our standard of review, where the trial court's action on a motion to set aside a verdict is challenged, is whether the trial court clearly abused its discretion.... The decision to set aside a verdict is a matter within the broad legal discretion of the trial court and it will not be disturbed unless there has been a clear abuse of that discretion.... A trial court has the inherent power to set aside a verdict where it finds it has made, in its instructions, rulings on evidence, or otherwise in the course of the trial, a palpable error which was harmful to the proper disposition of the case and probably brought about a different result in the verdict.... It is proper for a trial court, using due caution, and in the exercise of its discretion, to set aside a verdict when satisfied that ... its rulings on evidence were erroneous and that those erroneous ... rulings were consequential enough to have had a substantial effect on the verdict.” (Citations omitted; internal quotation marks omitted.) Melo v. Spencer, 62 Conn.App. 727, 729–30, 774 A.2d 217 (2001).

In denying the plaintiff's motion to set aside the verdict, the court set forth a well reasoned explanation for its evidentiary rulings limiting the plaintiff's experts' testimony as to the defendant's analgesic policy. In particular, the court found illogical the plaintiff's contention that the standard of care changed during the few months between the time of the plaintiff's experts' depositions and the time of their trial testimony. Accordingly, as a matter of law, the court's contested...