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Pryzbowski v. U.S. Healthcare

September 9, 1999

LINDA PRYZBOWSKI,
PLAINTIFF,
V.
U.S. HEALTHCARE, INC., MEDEMERGE, P.A., ET AL.,
DEFENDANTS.



The opinion of the court was delivered by: Maryanne Trump Barry U.S.D.J.

FOR PUBLICATION

O P I N I O N

BARRY, District Judge

This matter comes before the court upon the motion for summary judgment of defendants Medemerge, P.A. ("Medemerge") and John Pilla, M.D. ("Dr. Pilla"), Kent Ellis, M.D. ("Dr. Ellis"), and Carol Sgambelluri, M.D. ("Dr. Sgambelluri") *fn1 (collectively as "the doctor defendants"). *fn2 This court having reviewed the submissions of the parties without oral argument pursuant to Fed. R. Civ. P. 78, and for the reasons discussed below, defendants' motion for summary judgment will be granted.

I. Statement of the Case

On November 10, 1993, plaintiff sought treatment at Medemerge, her primary care center, after experiencing increasing back pain for several days. See Lang Cert., *fn3 Exh. A-1. A CT Scan of plaintiff's lower back was performed on November 29, 1993, revealing: a neurostimulator, implanted during a previous surgery; disc degeneration; and a "large extra-dural defect . . . compressing the thecal sac" consistent with disc herniation. See Exh. B.

Plaintiff was evaluated on December 3, 1993 by Dr. Alan J. Sarokhan ("Dr. Sarokhan") based on a referral from Dr. Ellis of Medemerge. See Exh. C. Dr. Sarokhan noted in his report that plaintiff's was "an extremely complicated case" that "really falls outside of my range of expertise and probably out of the range of expertise of most of the surgeons in this area." Id. at 2. He observed that plaintiff has "had five prior back surgeries, [and] has a lot of scarring in an implanted nerve stimulator." Id. Furthermore, Dr. Sarokhan noted that plaintiff "certainly needs a neurosurgical evaluation and needs one promptly" and stated that Dr. Pilla, also of Medemerge, with whom he had been in contact, "was kind enough to arrange it." Id.

Plaintiff was subsequently evaluated on December 9, 1993, upon referral, by neurosurgeon Dr. Aiden J. Doyle ("Dr. Doyle"). See id., Exh. D. Dr. Doyle's report, which noted plaintiff's "multiple lumbar disc surgeries" and the insertion of an "epidural transducer" in her back, concluded that "in view of [the fact that] this electrode array overlays the area of the surgery, she should go back to the surgeon who put [the epidural transducer or neurotransmitter] in. I have discussed this with them and obviously I really don't feel that I should be fiddling with that." Id. The surgeon who implanted the device in question was Dr. Giancarlo Barolat ("Dr. Barolat") of Thomas Jefferson University Hospital ("TJUH"). See Exh. E.

Because Dr. Barolat was an "out of network" physician, *fn4 on December 15, 1993, Medemerge sought -- and received -- approval from U.S. Healthcare for the referral. See Exh. A-2. On January 19, 1994, Dr. Barolat evaluated plaintiff and concluded that she was in "excruciating pain" and had a "definite lesion . . . that has to be removed." Exh. E. He stated that:

the following things would be required for us to take care of this lady:

1. Surgical intervention by me with a re-do laminectomy and removal of large disc herniation.

2. Spinal instrumentation and fusion by a separate orthopaedic surgeon.

3. Pulmonary clearance by Dr. Cohen who is our pulmonary specialist who would also be following her during the hospital stay in case of problems.

4. Consultation with the Pain Service for pre and postop pain management.

5. Possible psychological assessment and follow-up during the hospital stay to cope with her ...


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