Lewis v. OSF Healthcare Sys.

233 N.E.3d 238

2022 IL App (4th) 220016

Elton LEWIS, Individually and as Independent Administrator of the Estate of Tyrone Lewis, Deceased, Plaintiff-Appellant,

v.OSF HEALTHCARE SYSTEM, a Not-for-Profit Illinois Corporation, Individually and d/b/a OSF Medical Group and St Francis Medical Center; Dr. Tricia Teoh; Dr. Matthew Jager, Dr. Terry Smith; Dr. Kavitha Kalvakuri; Dr. James Graumlich; Dr. Daniel Montemayor; Dr. Stosh Eichennauer; Dr. Joanna Shepherd; Dr. Annie Marial; and Dr. Bryan McVay, Defendants

(Dr. Matthew Jager, Defendant-Appellee).

NO. 4-22-0016

Appellate Court of Illinois, Fourth District.

Filed October 6, 2022

Appeal from the Circuit Court of Peoria County, No. 17L173, Honorable Stephen A Kouri, Judge Presiding.

Michael W. Rathsack, of Park Ridge, for appellant.

Ann C. Barron, of Heyl, Royster, Voelker & Allen, P.C., of Edwardsville, for appellee.

OPINION

JUSTICE DOHERTY delivered the judgment of the court, with opinion.

¶ 1 Plaintiff Elton Lewis, individually and as independent administrator of the estate of Tyrone Lewis, deceased, appeals from a summary judgment entered on September 2, 2021, by the circuit court of Peoria County in favor of defendant Dr. Matthew Jager in this medical negligence action. Although this case remains pending as to other defendants, the trial court made a finding pursuant to Illinois Supreme Court Rule 304(a) (eff. Mar. 8, 2016), and this appeal ensued.

¶ 2 The only issue on appeal is the nature and extent of Dr. Jager’s involvement in decedent’s medical care on August 29, 2014: was Dr. Jager in a doctor-patient relationship with decedent sufficient to impose a duty? In granting summary judgment for defendant, the trial court found there was no physician-patient relationship between decedent and Dr. Jager and, therefore, no conduct on the part of Dr. Jager proximately causing decedent’s death. Plaintiff appeals, arguing that summary judgment was improperly entered because a question of material fact exists as to defendant’s responsibilities for the care and treatment of decedent and as to proximate cause.

¶ 3 We reverse and remand.

¶ 4 I. BACKGROUND

¶ 5 In August 2016, plaintiff filed a multi-count complaint in medical negligence in Cook County against numerous defendants, which was transferred to Peoria County in May 2017. Plaintiff filed a third amended complaint in October 2018, of which counts II (survival) and XII (wrongful death) were directed against defendant, Dr. Jager, regarding his alleged care and treatment of decedent on August 29, 2014. On that date, decedent presented at Heartland Community Health Clinic (Heartland) and was examined by a third-year resident, Dr. Tricia Teoh. Dr. Jager, a teaching physician at Heartland, reviewed Dr. Teoh’s examination and treatment recommendations and noted his approval of them in the patient’s chart.

¶ 6 A. Third Amended Complaint

¶ 7 1. General Allegations

¶ 8 Plaintiff alleges that, on August 6, 2014, decedent was admitted to Saint Francis Medical Center (Saint Francis) with difficulty breathing. Decedent was intubated during his hospital admission and was released on August 22. On August 29, decedent presented to Heartland for follow-up care with purported Symptoms of respiratory distress and was, according to the third amended complaint, examined, treated, and/or seen by Dr. Teoh, a resident, and Dr. Jager. Following that visit, decedent was allegedly seen by other medical providers on three subsequent occasions, including a short hospitalization at Saint Francis. On September 27, decedent was transported via ambulance to the emergency room at Saint Francis, where he died later that day.

¶ 9 2. Allegations Against Dr. Jager

¶ 10 Count II of the third amended complaint asserted a survival claim against Dr. Jager, and count XII asserted a wrongful death claim. Both counts alleged that during the month of August 2014 decedent was under the "medical care, supervision, and treatment" of Dr. Jager and Dr. Teoh. Specifically, plaintiff alleges that Dr. Jager committed one or more of the following wrongful acts or omissions on August 29: (a) failed to treat and provide proper, adequate, and timely medical care, (b) failed to intervene to provide such care, (c) failed to timely diagnose the cause of decedent’s respiratory distress, (d) failed to consult with an appropriate specialist, including an ear, nose, and throat doctor, (e) failed to timely and emergency admit decedent to a hospital to diagnose the cause of and treat decedent’s respiratory distress, and (f) failed to order an appropriate scope procedure to examine decedent’s throat.

¶ 11 The third amended complaint further alleged that, as a direct and proximate result of one or more of Dr. Jager’s wrongful acts and omissions, decedent suffered severe injuries, including, but not limited to, a lost chance of survival and/or recovery from decedent’s underlying respiratory distress condition and a worsening of decedent’s underlying respiratory distress that ultimately led to and caused his death on September 27, 2014.

¶ 12 B. Motion for Summary Judgment and Supporting Evidence

¶ 13 1. Motion for Summary Judgment

¶ 14 Dr. Jager moved for summary judgment, arguing that he had "no involvement" in decedent’s care at Heartland on August 29 and that, on that date, decedent was assigned to a resident physician, Dr. Teoh. The motion argued that Dr. Jager "did not see or interact with [decedent] at all on August 29, 2014," and that, as a result, "causation cannot be established as a matter of law and summary judgment is warranted."

¶ 15 The following information can be gleaned from the depositions and medical records submitted in support of and in opposition to the motion for summary judgment.

¶ 16 2. Dr. Jager

¶ 17 Dr. Jager is a doctor of Osteopathic Medicine and board certified in internal medicine. In 2014, he was employed by the University of Illinois College of Medicine and, beginning back in 2011, worked as an attending physician at Heartland where he supervised residents in the care of patients. Dr. Jager explained this role as follows: "[T]he residents go and see the patient and then they come back after seeing the patient and discuss the history and physical exam they obtained. We call that staffing the patient." Dr. Jager continued, "And then from there, we help ensure that their assessment and plan of the patient are correct and help, when needed, to teach, you know, how to order things and finish up the other logistics involved in the patient care."

¶ 18 Dr. Jager testified that the type of supervision he provided differs, depending on the seniority of the resident. "[W]e have to see all first year resident patients regardless." Dr. Jager testified, "the resident sees the patient, they come back and discuss the patient with us, then we go back either with the resident or by ourselves to see the patient and talk to them and examine the patient." Once the resident becomes a senior resident—starting in the resident’s second year—"we don’t have to see *** all their patients anymore."

¶, 19 Whether Dr. Jager would see a senior resident’s patient depended upon several factors, including the complexity of the patient and whether there were multiple medical problems. Dr. Jager explained,

"The only standard when we have to see the patient is if the complexity is high enough that were going to bill at a higher level. Otherwise, it’s *** left up to us as an attending, which would entail like I didn’t feel like the history or what they told me was precise or I didn’t, you know, get the total story that I was expecting. Or if there was any concern from what they told me, then I would go see the patient to make sure the information or exam was correct."

¶ 20 Dr. Jager had previously seen decedent on August 18, 2014, during decedent’s early August admission to Saint Francis while decedent was in intermediate care following release from ICU. However, Dr. Jager did not treat decedent at that time.

¶ 21 3. The August 29, 2014, Visit to Heartland

¶ 22 On August 29, decedent presented at Heartland on follow-up from his Saint Francis discharge and was examined by Dr. Tricia Teoh, a third-year internal medicine resident. Decedent’s chief complaint was listed as "hospital follow-up for angioedema." Decedent reported that he still had shortness of breath, but was "improving," and that it "feels like there’s a lot of chest congestion." He related he had been "coughing yellow phlegm" which was "unchanged from hospitalization." He further reported he had "completed [a] course of Levaquin for bacteremia."

¶ 23 Dr. Teoh’s exam revealed "upper airway sounds," which she described as not significant. Dr. Teoh testified that she did not reach a single diagnosis on August 29, but instead thought decedent was still recovering from the angioedema. She recommended Mucinex and gave decedent a prescription for a nebulizer machine.

¶ 24 According to Dr. Teoh, the normal post-exam process called for her to discuss her exam and findings with Dr. Jager, "and then I would finish the note, and then he signs off on it." However, she had no independent memory of the conversation on August 29 relating to decedent.

¶ 25 Dr. Jager reviewed Dr. Teoh’s examination report and checked the box under "Teaching Physician Documentation," as follows: "I was immediately available during this visit. I reviewed the history, exam findings, labs/tests, and medical decision making with resident at time of visit." He further checked the box, "I agree with resident’s medical decision making." Dr. Jager testified, "there was nothing concerning about the encounter when she staffed it with me. *** [W]hich is why I didn’t choose to see him that day." Dr. Jager continued, "He sounded very stable and expected course. So I wasn’t alarmed." Dr. Jager did not see or examine decedent on August 29 and had no direct contact with him.

¶ 26 During his deposition, Dr. Jager was asked the question, "As the—you referred to yourself as the...