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Cavallaro v. Hospital of Saint Raphael


In this medical malpractice action, the substitute plaintiff, Carol Monday, appeals from the judgment of the trial court rendered in favor of the defendants after it granted their motion for summary judgment. On appeal, the plaintiff claims that the court improperly (1) precluded the decedent's treating physician from testifying as an expert witness on the issue of causation and (2) concluded that certain notations found in the decedent's hospital records could not be introduced in lieu of expert testimony that generally is required to establish causation in a claim for medical malpractice. We affirm the judgment of the trial court.

The following facts and procedural history are relevant to our resolution of the plaintiff's appeal. On May 7, 1997, the plaintiff's decedent, Peter Cavallaro, entered the defendant hospital to undergo bilateral knee replacement. In preparation for the procedure, the decedent had blood drawn for use in the event that a blood transfusion was necessary. After the surgery, a transfusion was necessary. A unit of blood that did not belong to the decedent was administered to him. The plaintiff, in the complaint, alleged that following the blood trans-fusion, the decedent exhibited "tendencies of a reaction to the transfusion, specifically feeling extreme cold; chills; severe subjective complaints of feeling unwell; anxiety; disorientation; wheezing; headache; and shortness of breath . . . ." The plaintiff further alleged that the hospital and the defendant Lynn Plourde, a nurse on the hospital staff, failed to monitor or treat that initial reaction.

During the next eleven months, the decedent allegedly suffered from "severe, permanent and disabling injuries . . . ." Throughout that time period, the decedent's treating physician was Brett J. Gerstenhaber, a pulmonologist. On April 22, 1998, the decedent returned to the hospital and was admitted by Gerstenhaber with a diagnosis of acute community acquired pneumonia. Two days later, the decedent died.

On May 5, 1999, the decedent's wife, Regina Cavallaro, as administratrix of his estate, brought the present medical malpractice action against the defendants. Specifically, she alleged that the blood transfusion administered to the decedent resulted in a reaction to the transfusion and that the defendants' negligence in failing to monitor or to treat that reaction resulted in injuries to the decedent that culminated in death.

More than four years passed from the initiation of the lawsuit until the commencement date of the trial, which was scheduled for the beginning of September, 2003. During that time period, the plaintiff disclosed only two expert witnesses. Specifically, the plaintiff disclosed two nurses for the purpose of testifying as to "the nursing standard of care and also as to the causal relation of the same to the incident alleged in the complaint." As of September, 2003, the plaintiff had not disclosed the decedent's treating physician, Gerstenhaber, as an expert witness. In addition, the plaintiff also had failed to respond to multiple discovery requests from the defendants' counsel as well as requests for medical authorizations.

In an effort to protect his position and gain access to the medical records of Gerstenhaber, the defendants' counsel disclosed Gerstenhaber as the defendants' expert on August 25, 2003. The disclosure was worded broadly and included the possibility of causation testimony. Upon receipt of Gerstenhaber's records in September, 2003, the defendants' counsel obtained a note that indicated that Gerstenhaber had informed Regina Cavallaro in August, 1998, that the question of causation was ultimately "unanswerable."

Although the pla

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