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Ciluffo v. Middlesex General Hospital

Decided: February 3, 1977.


Halpern, Allcorn and Botter. The opinion of the court was delivered by Botter, J.A.D.


[146 NJSuper Page 478] Plaintiff appeals from the dismissal of her medical malpractice action against defendant Dr. Maddatu

at the conclusion of her proofs. No appeal was taken from the earlier entry of a summary judgment in favor of defendant Dr. Litt or from the dismissal with prejudice and without objection of her action against defendant Middlesex General Hospital.

The evidence showed that plaintiff injured her neck in the late evening of April 25 or the early morning hours of April 26, 1972, when she fell down a flight of stairs while visiting the apartment of a friend. She was experiencing pain but did not report to the emergency room at the Middlesex General Hospital until after 4 P.M. on April 26. She was seen there by defendant Maddatu, x-rays were taken, and she was sent home with a cervical collar, medication for her pain and instructions for rest and further care.

The next morning Dr. Litt, a radiologist, reviewed the x-rays and asked that plaintiff report back to the emergency room for further studies because the original x-rays showed abnormal angulation in her cervical spine. Neither a second set of x-rays nor a series of other x-rays known as tomograms revealed a fracture, although the abnormal angulation was substantiated. More sophisticated examination was then made by millimeter tomograms. These finally revealed a fracture of the cervical spine in the area of C-2.

Plaintiff was then treated for the fracture. She was placed in skeletal traction, which involved inserting tongs in her skull. Complications developed from this procedure, namely blood poisoning caused by drainage from the scalp incision, bronchitis and pneumonia. The pneumonia developed around May 15 as a result of the blood poisoning.

There was evidence to support plaintiff's contention that Dr. Maddatu did not comply with appropriate standards of medical care when she sent plaintiff home without making further studies to determine the extent of her injury. However, the trial judge dismissed the action against Dr. Maddatu for several reasons. He found that the evidence did not support the conclusion that the delay in treatment was the cause of any of the complications that prolonged plaintiff's

treatment and recovery. Dr. Litt, who was called as a witness for plaintiff, testified that in his opinion the delay in further treatment from April 26 to April 27, a period of less than 24 hours, did not cause the infection or blood poisoning, the bronchitis or the pneumonia which complicated plaintiff's recovery. Although another medical witness for plaintiff expressed the conclusionary opinion that the short delay did cause the complications in her condition, that witness, an internist, testified on cross-examination that he could not say how long plaintiff would have remained in traction had her condition been diagnosed promptly. As for the blood poisoning and pneumonia, this same witness admitted that he could not "speculate as to what would have been the case if she had been admitted immediately." Finally he conceded that: "I can't say directly that the infection was caused by delay, that is correct."

In this state of the evidence we conclude that the trial judge properly ruled that plaintiff could not charge Dr. Maddatu for complications in her recovery, specifically including the blood poisoning, bronchitis and pneumonia, since they were not causally related to the delay in treatment caused by Dr. Maddatu's conduct.

The trial judge also dismissed plaintiff's claim for added pain and suffering for the period between her release from the emergency room and the time she reported back to the hospital for further treatment which was allegedly caused by defendant Maddatu's malpractice. Plaintiff had previously accepted $30,000 in settlement of her claim against the owner of the premises where she fell. In dismissing her claim against Dr. Maddatu, the trial judge stated, in effect, that the claim for pain and suffering during the period of less than 24 hours during which treatment was delayed would not support a verdict in excess of the $30,000 already paid to plaintiff. The trial judge concluded that plaintiff would not be entitled to any further recovery from Dr. Maddatu unless the injuries caused by her wrongdoing exceeded $30,000.

We conclude that the trial judge erred in dismissing plaintiff's claim against Dr. Maddatu for damages suffered because of the delay in treatment during the initial 24 hour period. Certainly the jury could have reached the logical conclusion that plaintiff's recovery, hence her pain and suffering, was prolonged by the period of time before proper treatment was undertaken. Although plaintiff proved no other consequences of this delay, she was entitled to be compensated for the pain and suffering endured for the period of the delay, if she proves ...

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