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Schmidt v. Linville

Superior Court of Maine, Cumberland

February 17, 2015

HENRY SCHMIDT, AS PERSONAL REPRESENTATIVE OF THE ESTATE OF DOROTHY SCHMIDT, Plaintiff
v.
CORTNEY LINVILLE, D.O..; MELANIE RAND, PARKVIEW ADVENTIST MESCAL CENTER, AND PARKVIEW FAMILY HEALTH, Defendants

ORDER

Hon. Roland A. Cole, Justice, Superior Court

Before the court is the Plaintiffs Motion for Summary Judgment. This case arises from the hospitalizations and treatment of Dorothy Schmidt prior to her death. Plaintiff Henry Schmidt, as personal representative for the estate of Dorothy Schmidt, has alleged negligence that allegedly led to Mrs. Schmidt's death. The case has already proceeded through the mandatory pre-litigation screening process as required pursuant to 24 M.R.S. § 2851 et. seq.

Plaintiffs Complaint asserts four negligence claims: Count I is a negligence claim against Dr. Courtney Linville, Parkview Adventist Medical Center ("PAMC"), and Parkview Family Health ("PFH"); Count II is a negligence claim against Dr. Melanie Rand, PAMC, and PFH; Count III is a negligence claim against Dr. Matthew Mechtenberg[1] and PAMC; and Count IV is a negligence claim against PAMC. Plaintiff has moved for partial summary judgment against Defendants Dr. Rand and PAMC on the issue of deviation from the standard of care. Both Dr. Rand and PAMC have opposed the Plaintiffs Motion. The court held a hearing on this Motion where the parties were present with the exception of Dr. Rand's counsel owing to a misunderstanding. For the reasons detailed below, the court denies the Plaintiffs Motion as to both parties.

In addition, the court notes that after filing the Motion, the Plaintiff has subsequently moved pursuant to M.R. Civ. P. 56(d) to have the entirety of its statement of material facts admitted as to Dr. Rand. The court denies the Plaintiffs motion, as non-"practicable" and potentially prejudicial to the parties. The Plaintiffs Motion for Summary Judgment is itself on the narrow issue of deviation from the standard of care. For the reasons detailed below, the Plaintiff has not definitively established that either Dr. Rand or PAMC deviated from the standard of care. The court agrees with Plaintiffs argument that many of Dr. Rand's responses failed to comply with Maine Rule of Civil Procedure 56(h)(2). The court notes, however, that this action is distinguishable from Doyle v. Dept. of Human Servs., as Dr. Rand has managed to raise issues of material fact through her properly presented additional statement of material facts. 2003 ME 61, ¶ 11, 824 A.2d 48. Material facts regarding Mrs. Schmidt's condition, the standard of care, and whether Dr. Rand adhered thereto or breached are still in controversy. This is not an action where it is practicable or reasonable for the court to make the type of findings envisioned by Rule 56(d).

I. FACTUAL BACKGROUND:

From the outset, the court notes that there is substantial dispute between the parties, in particular between the Plaintiff and PAMC, regarding the relevant facts in this case, as well as the testimony offered by the treating physicians involved in this action. The Plaintiff has presented some testimony from Mrs. Schmidt's treating physician's that blurs the line between evidence of habit or routine practice and expert testimony See MR. Evid. 406, 702. The Plaintiff states that all parties reserved the right to rely on the treating physicians in their expert designations. However, the court was only able to find an expert designation from PAMC among the panel materials, and did not see any other expert designations in the file. PAMC's expert designation with respect to the treating physicians also appears narrower in scope than described by the Plaintiff. Summary judgment is not the appropriate time to decide whether expert opinion testimony is admissible from the treating physicians, especially given the missing expert designations. As a result, some of the disputed testimony is omitted from this factual background and a discussion of said testimony is more appropriate at a later time.

The following facts are gathered from the parties' statements of material facts, oppositions, additional statements of material facts, and replies that were properly supported by citations to the record.[2], [3]

On June 24, 2009, Mrs. Schmidt visited her physician Dr. Cortney Linville, to be evaluated for a scooter. (PL's S.M.F.¶ 1; PAMC O.S.M.F. 1.) At that appointment Mrs. Schmidt complained of shortness of breath. (PL's S.M.F. ¶ 1; Rand O.S.M.F. ¶ 1; PAMC O.S.M.F. ¶ 1.) Dr. Linville ordered a number of tests for Mrs. Schmidt. (PL's S.M.F. ¶ 2.) The labs showed that Mrs. Schmidt's hemoglobin and hematocrit levels were low. (PL's S.M.F. ¶ 3.) After she received the lab results, Dr. Linville noted in Mrs. Schmidt's record '"LMPTCB [left message patient to call back] needs admit!'", which indicates that Dr. Linville wanted Mrs. Schmidt to be admitted to the hospital. (PL's S.M.F. ¶ 4.)

On July 6, 2009, Mrs. Schmidt was admitted to PAMC for evaluation, diagnostic testing, and a blood transfusion. (PL's S.M.F. ¶ 5; Rand 0.S.M.F. ¶ 5; as qualified by PAMC's 0.S.M.F. ¶ 5.) The Emergency Room Report indicates that at the time that she was admitted her chief complaint was symptomatic anemia, and she denied any flank pain or urinary symptoms, was afebrile, denied fever or chills, was well-appearing, and lived independently. (Rand A.S.M.F. ¶ 7.)

Starting at 5:00 p.m. on July 6, Dr. Melanie Rand was the on-call covering physician at PAMC. (PL's S.M.F. ¶ 6.) Dr. Rand is a family medicine practitioner, and in 2009 she performed both office primary care as well as in-patient medicine. (Rand A.S.M.F. ¶ 1; PL's R.S.M.F. ¶1.) She testified that for overnights the on-call covering physician conducts the admission and orders appropriate tests, but the physician would only respond to results that are critical enough to be brought to the on-call physician's attention overnight. (Rand A.S.M.F. ¶5.) She stated that the hospitalist would take over in the morning and manage the patients' hospital stay, look up test results, and report results to the patient. (Rand A.S.M.F. ¶ 5.) She also stated, however, that if she is with the patient at the time, or the patient is awake, she would report the test results to the patient; under alternative circumstances whether or not she would relay the results to the patient would depend upon the urgency of the situation. (PL's R.S.M.F. ¶ 5.) Dr. Mark Rohrer, Plaintiffs expert witness, opined however, that the ordering physician remains responsible for following-up on test results and thereafter administering appropriate treatment. (PL's R.S.M.F. ¶ 5.)

As a part of her diagnostic testing, Dr. Rand chose to obtain a urinalysis for Mrs. Schmidt. (PL's S.M.F. ¶ 6.) There is some dispute among the parties regarding why Dr. Rand ordered the urinalysis.[4] (PL's S.M.F. ¶ 8; Rand O.S.M.F. ¶ 8; PAMC O.S.M.F. ¶ 8.) Dr. Rand's review of systems included that Mrs. Schmidt had experienced memory loss and incontinence. (PL's S.M.F. ¶ 8; Rand O. S.M.F. ¶ 8.)

While Dr. Rand was still the on-call covering physician, Mrs. Schmidt's urine sample was collected on July 7th at 1:45 a.m. and it was received at 1:53 a.m. (PL's S.M.F. ¶¶ 9-10). The urinalysis results would have been available in the electronic medical records within one to three hours. (PL's S.M.F. ¶ 12.)

The urinalysis revealed that Mrs. Schmidt's urine was cloudy, positive for nitrates, contained small leuk esterase, contained occasional squamous cells, contained many bacteria, and had a white blood count of 10-20/hpf. (PL's S.M.F. ¶ 13 as qualified by Rand O.S.M.F. ¶ 13.) In addition, the urinalysis also was negative for blood, negative for glucose, negative for bilirubin, negative for ketone, and there were no red blood cells. (Rand O.S.M.F. ¶ 13.)[5] A urine culture was also completed for Mrs. Schmidt. (PL's' S.M.F. ¶ 17.) A urine culture identifies the types of bacteria present. (PL's S.M.F. ¶ 14 as qualified by Rand O.S.M.F. H 14.)

Dr. Rand has testified that she did not get the lab results, although she also agreed that the urinalysis results would have been available to her in the electronic medical records within one to three hours. (Rand A.S.M.F. ¶ 6; PL's R.S.M.F. ¶ 6; PL's S.M.F. ¶ 12.) Dr. Linville, a coworker of Dr. Rand's, stated that at times the hospital in-patient lab results would automatically populate their outpatient desktop and at other times the in-patient lab results were not automatically sent to them. (Rand A.S.M.F. ¶ 9.) PAMC IT made the determination regarding whether the function was turned on or off. (Id.) If Dr. Rand received a result regarding one of her patients in the hospital, she would look at the result and press a button indicating that she acknowledged receipt of the result, but she would leave the hospitalist to manage the patient. (Rand A.S.M.F. ¶ 4.)

Dr. Rand also testified that if one of her patients is admitted to the hospital, she notes any test results that are provided to her, but the hospitalist provides all in-patient care and follow-up. (Rand A.S.M.F. ¶ 3; PL's R.S.M.F. ¶3). In this case, however, Dr. Rand was unaware of Mrs. Schmidt's urinalysis results until Mrs. Schmidt returned to the hospital on ...


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