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York v. El-Ganzouri9/27/2004
UNPUBLISHED
Defendants, Abdel Raouf El-Ganzouri, M.D., his anesthesiology practice group, University Anesthesiologists, S.C. (hereinafter collectively referred to as Dr. El-Ganzouri), and Rush Presbyterian-St. Luke's Medical Center (Rush), appeal from a $12,598,591 medical malpractice judgment entered against them and in favor of plaintiff, James York, M.D., pursuant to a jury's verdict. On appeal, Dr. El-Ganzouri contends that the trial court's time limitation on voir dire, and effective preclusion of the use of Dr. York's day-in-the-life video by the voir dire time restriction, precluded him from receiving a fair trial. He also contends that the trial court erred in allowing his expert witness to be impeached with Supreme Court Rule 213(g) (177 Ill. 2d R. 213(g)) interrogatory answers not signed by the expert. Finally, he contends that the trial court should have reduced Dr. York's damages for past medical expenses by the amounts already compensated for by his health insurance. Rush, in addition to adopting Dr. El-Ganzouri's arguments, contends that the trial court should have granted its motion for directed verdict, and if not that motion, then its motion for judgment non obstante verdicto, or, at the very least, granted its request for a new trial because Dr. York proved neither that Rush held out Dr. El-Ganzouri as its agent nor that he sufficiently relied on Rush for his care for vicarious liability to attach. For all the reasons discussed below, we affirm as to both defendants.
I. FACTUAL BACKGROUND
Dr. James York was an orthopedic surgeon. He also led an active lifestyle outside of his work, running marathons, playing tennis, and providing free medical treatment in Africa through a church-sponsored program. However, athletics and aging led to knee problems for Dr. York requiring multiple surgeries. Dr. York always sought out the best surgeon for the procedures he required. Besides Chicago , Dr. York had traveled to Toronto, Canada, Pennsylvania, and Baltimore, Maryland, for knee surgeries.
On February 9, 1998, Dr. York was to undergo a cemented total knee arthroplasty in his left knee. This was to be his third surgery at Rush, all performed by his chosen surgeon, Dr. Rosenberg. Dr. El-Ganzouri and Dr. Miller, an anesthesiology resident at Rush at the time, came to perform a combined spinal epidural on Dr. York prior to the surgery.
In a combined spinal epidural procedure, a local anesthetic is first applied to the patient's back. This anesthetic prevents the patient from experiencing any pain when a large "Touhy" needle is inserted between the bones in the spine, but short of the spinal column itself. A finer "Whittaker" needle is then advanced through the Touhy needle. The Whittaker needle pierces the dura, a thick skin protecting an area known as the subarachnoid space which contains cerebral spinal fluid and the spinal cord itself. A doctor knows he has pierced the dura by feeling a pop, described at trial as akin to the feeling a user of a fork experiences when piercing the skin of a sausage. At that point, the anesthesiologist can confirm that he has accessed the subarachnoid space, and is ready to inject anesthesia, by aspirating cerebral spinal fluid. Needles are supposed to enter through the lumbar area of the spine, beneath the end of the spinal cord itself. The end of the spinal cord is known as the conus. By making the injection through the lumbar area, the anesthesiologist avoids the risk of contacting the spinal cord, though he still faces the risk of striking a complex of nerves that hang from the conus like a horse's tail, and are thus known as the cauda equina. After the injection of the spinal anesthesia, an epidural catheter is
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