Gulino v. Zurawski, 2015 IL App (1st) 131587
Other than high cholesterol, Matthew Gulino was a healthy 49-year-old father of three and husband to plaintiff Joanne in early 2009. In June, he had a checkup with his primary care physician, which confirmed the same. However, on October 12, Matthew began to experience nausea, fatigue, shortness of breath, chills and lightheadedness. The symptoms persisted and on October 19 Matthew returned to his primary care physician, who ordered an EKG, stress test and partial blood test. The primary care physician diagnosed Matthew with anxiety and prescribed Xanax. On October 21, the doctor suggested that Matthew see a psychiatrist. The next day he sought treatment through Palos Community Hospital’s emergency department. The ER doctor prescribed Matthew a stronger anti-anxiety medication. On October 25, Matthew experienced slurred speech and loss of mobility in his left arm. He was taken to Advocate Christ Medical Center.
Matthew arrived at 8:57 a.m. and underwent tests, including, for the first time, a CBC. The CBC revealed low platelet count and damage to his red blood cells. Further tests discovered liver and kidney failure. The hematologist diagnosed Matthew with Thrombotic Thrombocytopenic Purpura (TTP) sometime after 4:00 p.m. TTP is a rare blood disease with fatal consequences if it’s not diagnosed and treated. TTP is diagnosed with a series of blood tests that includes a CBC. Plasmapheresis or plasma exchange therapy is the only effective treatment for TTP. AES was contacted at 4:30 p.m. to arrange treatment for Matthew and dispatched a nurse at 4:42 p.m. However, the nurse did not arrive at Advocate until 11 p.m., at which time Matthew suffered cardiac arrest. Matthew was pronounced dead at 11:40 p.m. due to multiple organ failure.
Joanne Gulino filed suit against Matthew’s primary care physician, the ER doctor at Palos, Advocate, AES and the nurse that AES dispatched, alleging claims of medical negligence. Specifically, Joanne alleged that AES and the nurse were negligent; that they failed to arrive promptly, failed to enforce a policy in which nurses arrive in a timely manner, failed to respond emergently, or failed to arrange for and provide plasmapheresis as ordered. The case then proceeded to trial.
At trial, testimony revealed that the nurse dispatched by AES did not proceed to Advocate right away, but instead performed a non-emergency procedure at Good Samaritan Hospital. The nurse then went home before going to Advocate. The nurse testified that it was common practice to confirm that preparations, which normally take two hours to complete, are completed before going elsewhere, even in the event of an emergency. She also acknowledged that the “common practice” was not AES policy, but rather put in place as a way to avoid wasting time. The nurse further testified that she made several attempts to contact Advocate to confirm that preparations were complete. At 10:00 p.m., approximately 6 hours after receiving the emergency assignment, she became worried that something went wrong and left for the hospital.
The Defendants appealed for, among other things, the court’s rulings on the scope of expert testimony. They argued first that plaintiff’s causation expert should not have been able to testify to the standards of care of a plasmapheresis nurse. Plaintiff’s causation expert was allowed to testify to his personal experiences with plasmapheresis nurses and use it as a basis to opine about how the doctor could have expected the AES nurse to arrive by 6 p.m. The Court found that the testimony did not constitute standard of care evidence. Moreover, the Court found that any improperly admitted testimony was harmless since it was duplicative of other properly admitted testimony.
The Defendants also argued that the court improperly precluded an expert testimony. The trial court allowed one Defendant’s two experts to opine in an attempt to rebut the Plaintiff’s experts. However, the trial court precluded the other Defendant’s attempt to use its own experts to similarly opine. The Court found that this was an error since each defendant should be entitled to its own defense and rebuttal of the plaintiff’s case in chief. Taylor v. County of Cook, 2011 IL (1st) 093085, ¶ 36. Nevertheless, the Court did not find the error to be have resulted in a prejudicial error warranting a new trial since the facts involved were strongly established by other competent evidence. Lebrecht v. Tuli, 130 Ill. App. 3d 457, 483 (1985).