Dreier, J.d.c., Temporarily Assigned.
In this medical malpractice action defendant Dr. Charles J. Grubin has moved for summary judgment. This case raises an issue of first impression in New Jersey concerning the alleged abandonment by a physician who had referred a patient for specialized services.
Both R. 4:46-2 and the cases interpreting this rule and its predecessor R. 4:58-3 dictate that this court must find that there is an absence of dispute as to material facts, and must give to plaintiff all favorable inferences reasonably to be drawn from the expert's report, depositions and interrogatories. Judson v. Peoples Bank & Trust Co. of Westfield, 17 N.J. 67, 74-76 (1954). This court, therefore, has searched the depositions and other documents supporting plaintiff's position to see if there is a palpably genuine issue as to any material fact. From that point of departure, the following facts appear.
Defendant Dr. Grubin is a licensed and practicing physician of the State of New Jersey engaged in the general practice of medicine. He is alleged to have been the physician of plaintiff, the decedent's mother, but her depositions show his earlier services had been limited to signing one or two death certificates for the family. On October 25, 1971, and for some time prior thereto, decedent, George F. Brandt,
Jr., then 21 years of age, was alleged to have experienced periods of anxiety, loneliness and insomnia, as described by Dr. Grubin. On this date (and perhaps one other occasion) decedent consulted Dr. Grubin for examination, care and treatment of these conditions.
In answers to interrogatories Dr. Grubin stated:
The patient was seen on 10/25/71. He came to defendant's office at 123 Hillside Avenue, Hillside, New Jersey. He showed symptoms of anxiety, loneliness and insomnia. He presented a history of having LSK [ sic ] but no other drugs. He gave an impression of schizo-phrenia and was referred to Elizabeth Mental Hygiene Clinic or the Mount Carmel Guild Mental Hygiene Clinic in Cranford. He was given a prescription of thorazine 10 mmgs. #15 one or two three times daily no refills. * * *
At his deposition Dr. Grubin characterized the decedent's mental condition on October 25, 1971 as "an anxiety syndrome." He admitted that he was not a psychiatrist, but nevertheless prescribed thorazine to be taken by decedent "to take the edge off his anxiety." He admitted that the principal contraindication for the use or prescription of thorazine is depression, and the second most important contraindication is liver disease. With respect to depression as a contraindication, he noted that "the literature says in the presence of depression thorazine should be used very cautiously and that's all I have to see and I don't touch it.
After this one visit, and perhaps an additional contact a few days later (see Mrs. Freda's deposition quoted infra), decedent did not return to Dr. Grubin. A month later, on November 21, 1971, decedent was treated at the Elizabeth General Hospital Emergency Room and was again advised to go to the Union County Psychiatric Clinic for further treatment. Two days later (on November 23, 1971) he was again admitted into the hospital's medical ward, and then placed in the psychiatric ward just prior to his suicide on November 26, 1971.
On the subject of Dr. Grubin's later alleged unavailability, decedent's sister, Mrs. Frances Freda, stated in her depositions
that the family attempted repeatedly to contact Dr. Grubin the week prior to decedent's confinement at Elizabeth General Hospital on November 23, 1971. She testified that "for the whole weekend we tried to reach Dr. Grubin and we just got a series of runarounds," and further:
My mother's neighbor was there also. She even attempted to get in touch with Dr. Grubin. We called the priest to come. He said he needs a doctor. There was nothing he could do. I mean, it just seemed that Dr. Grubin was evasive.
At one point my mother called him and spoke with the nurse again. We explained to him all these times it was an emergency, that we had to speak to him immediately. We told him who we were, who we were calling for, and this last time when my mother called she asked him has Dr. Grubin returned yet and the nurse said, "Returned? He's always been here. He hasn't gone anyplace." It was as if, you know, we are lying, that we are calling him and we never really talked to any of the answering services. We waited and Dr. Grubin wasn't there from what we gathered from the answering service, that's as far as I can remember.
Plaintiff has submitted an expert report from Dr. Lewis J. Vorhaus II, of New York City. This report is over seven single-spaced typewritten pages in length, less than a page of which concerns the actions of Dr. Grubin. Although the basis for Dr. Grubin's alleged liability is set forth in one paragraph, in reality three separate claims are made. Set apart, these are:
With respect to Dr. Grubin I think that he was also guilty of departing from accepted standards of practice in not adequately assessing the seriousness of the situation when he saw the patient in his office. It was not enough that he merely suggest to the patient that he get psychiatric help. He obviously was not competent to make judgments for himself or to follow directions given by a physician. Responsibility for this should have been placed in the hands of the family and they should have been notified about the seriousness of his problem.
The treatment that was given was totally inadequate. If there was any question in Dr. Grubin's mind about the severity of the psychiatric problem he should have seen to it that the patient got psychiatric consultation and evaluation before making any recommendations whatsoever. Simply to give the patient a small dose of thorazine and tell the ...