On appeal from the Superior Court of New Jersey, Law Division, Camden County.
Before Judges Dreier, Newman and Villanueva. The opinion of the court was delivered by VILLANUEVA, J.A.D. (retired and temporarily assigned on recall).
The opinion of the court was delivered by: VILLANUEVA
The opinion of the court was delivered by
VILLANUEVA, J.A.D.(retired and temporarily assigned on recall).
Defendant, Ronald Jaffee, M.D. ("Dr. Jaffee" or "defendant"), plaintiff's obstetrician, appeals from a medical malpractice verdict in the amount of $1,162,100 plus prejudgment interest. We affirm.
Plaintiff became pregnant in early 1989. Plaintiff engaged the services of defendant's medical group for her prenatal care. She visited defendant's offices on April 10 and May 3, 1989, while she was in her second trimester of pregnancy. Plaintiff had additional prenatal visits on June 7, July 5, and July 25. During these checkups, plaintiff's blood pressure was recorded as 100 over 70, urine samples were negative for protein, and she had experienced normal weight gain.
Plaintiff had her last prenatal checkup on August 22, 1989. At this time, plaintiff's blood pressure was 120 over 86. She had a three plus reading for protein in her urine. Additionally, she had gained nine pounds since her previous checkup. Defendant indicated that these values, in light of the information he had regarding his patient, did not in his judgment require aggressive patient management, such as immediate admission to the hospital to induce labor.
On August 31, 1989 at 10:00 a.m., plaintiff went to Cooper Hospital, in an advanced stage of labor. Nurse Sue Sherman admitted plaintiff to the delivery and labor unit. At 10:15 a.m., Sherman made a note in plaintiff's chart indicating that plaintiff's initial blood pressure was 170 over 120. Plaintiff was then rolled to her left side and another blood pressure reading was taken which showed that plaintiff's blood pressure had changed to 186 over 118. Sherman's note also indicated that plaintiff's reflexes were plus two and there was a "large amount of edema noted in legs." A resident on duty at this time, Dr. Maccarone, indicated that plaintiff's condition was not normal of edema in that she had "massive pitting lower extremity, edema on both sides" and that she also tested abnormally for deep tendon reflexes.
When defendant arrived on the scene, he was given plaintiff's records and was asked if he wished to administer magnesium sulfate to lower the patient's blood pressure. Dr. Jaffee did not order magnesium sulfate, nor did he order a urine test for protein.
Plaintiff's blood pressure was recorded regularly up until delivery. Plaintiff's baby was born at 12:05 p.m. and the next recorded blood pressure was at 12:45 p.m. Plaintiff suffered a stroke during or immediately after delivering the baby, her first child.
Evidence was presented to the jury indicating that there were some complications with plaintiff's delivery. Dr. Maccarone testified that there was some indication that plaintiff's delivery was slightly abnormal in that her leg fell out of the delivery stirrup. Plaintiff's expert testified that, "We do know from subsequent notes that at some point after the delivery before going to recovery, the patient was felt to have a leg falling from the stirrup and that she was particularly lethargic or drowsy."
In his deposition, defendant was asked about a visit he paid to the plaintiff after he was informed of her paralysis later on the day of her delivery. At that time he attributed the weakness in plaintiff's leg to some cerebral accident. Later, in his deposition, defendant stated that someone made a note in plaintiff's chart that her leg had fallen off of the delivery table. On cross-examination at trial, defendant was confronted with this statement, and he stated that his deposition testimony was "obviously incorrect" and he felt the plaintiff's stroke occurred in the recovery room.
Defendant co-signed the standard postpartum orders written by Dr. Maccarone. Recovery room nurses took plaintiff's blood pressure at 12:45 p.m., 1:00 p.m. and 1:55 p.m. There were no recorded blood pressures from 1:55 to 4:00 p.m. At 4:00 p.m., Nurse E. Boale found plaintiff's right arm dangling off ...