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Tynes v. St. Peter's University Medical Center

July 14, 2009

MELISSA TYNES, BY HER NATURAL PARENT AND GUARDIAN AD LITEM, BRENDA HARRIS, AND BRENDA HARRIS, INDIVIDUALLY, PLAINTIFFS-APPELLANTS,
v.
ST. PETER'S UNIVERSITY MEDICAL CENTER, BELINDA CARTER, ALISIA D. MONTEIRO, SANDY WILKINS, DR. MICHAEL CARSON, DR. KIMBERLY DIXON, AND DR. HILLEL COHEN, DEFENDANTS-RESPONDENTS, AND BAXTER HEALTHCARE CORPORATION, DEFENDANT.



On appeal from the Superior Court of New Jersey, Law Division, Middlesex County, Docket No. L-7326-03.

The opinion of the court was delivered by: Yannotti, J.A.D.

NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION

APPROVED FOR PUBLICATION

Argued May 27, 2009

Before Judges Wefing, Yannotti and LeWinn.

Plaintiffs appeal from orders entered by the trial court on April 25, 2008, denying plaintiffs' motion to extend the time for discovery and granting summary judgment in favor of defendants. Plaintiffs also appeal from an order entered on June 20, 2008, denying their motion for reconsideration. For the reasons that follow, we affirm.

I.

This appeal arises from the following facts. On April 1, 2002, plaintiff Melissa Tynes ("Melissa") sought treatment at the emergency room of St. Peter's University Medical Center ("St. Peter's") due to an acute sickle cell crisis, and was thereafter admitted to the hospital. Melissa was eighteen years old at the time, and she had a history of sickle chest syndrome. On April 2, 2002, Melissa came under the care of defendants Dr. Michael Carson ("Carson"), and certain resident doctors, including Kim Dixon ("Dixon") and Hillel Cohen ("Cohen").*fn1 As part of her treatment, Melissa was placed on a patient controlled analgesia ("PCA") pump that was used to administer morphine.

On April 3, 2002, Carson, Dixon and another resident doctor increased the dosage of morphine. They also began blood transfusions to decrease the amount of hemoglobin. On April 4, 2002, at about 10:00 a.m., Carson and his team saw Melissa. Carson wrote in his chart that Melissa was tired but "arousable." Carson noted that Melissa's breathing was coarse throughout both of her lung fields. Carson noted that Melissa was experiencing "volume overload," pulmonary reactions to the blood transfusions and possible sickle chest syndrome. He also noted that Melissa was coughing and showing signs of a possible viral syndrome.

Later that day, at approximately 1:45 p.m., Dixon found Melissa lethargic with bilious material coming from her mouth. Melissa's father, Robert Tynes ("Tynes"), was present at the time. He allegedly told Dixon that he had activated Melissa's PCA pump, believing it to be the nurse's call button. Melissa experienced severe aspiration pneumonitis. She was "intubated" and transferred to the intensive care unit. She remained on a ventilator and was later transferred to another hospital. Melissa allegedly suffered permanent brain injuries as a result of the treatment she received at St. Peter's.

On October 10, 2003, Melissa's mother, Brenda Harris ("Harris"), filed an action against St. Peter's and Tynes individually and on behalf of Melissa. Plaintiffs alleged that Tynes had negligently activated the PCA pump causing Melissa to suffer an overdose of morphine. Plaintiffs further alleged that St. Peter's and its medical and nursing staff were negligent in failing to adequately monitor Melissa's condition.

On July 1, 2004, plaintiffs filed their first amended complaint, which added Baxter Healthcare Corporation ("Baxter") as a defendant. According to the complaint, Baxter designed, manufactured and distributed the PCA pump used to administer the morphine to Melissa. Plaintiffs alleged that the PCA pump was not suitable and safe for its intended purpose.

On September 1, 2004, plaintiffs filed their second amended complaint, which added St. Peter's nurses Belinda Carter ("Carter"), Alisia D. Monteiro ("Monteiro") and Sandy Wilkins ("Wilkins") as defendants. Plaintiffs alleged that Carter, Monteiro and Wilkins "were responsible for calibrating and setting up the PCA used in connection with" Melissa's care.

Thereafter, Carson provided St. Peter's counsel with a letter dated September 14, 2004. In his letter, Carson noted that he had been asked to review Melissa's chart and respond to questions regarding Melissa's care, specifically the dosing of morphine, the cause of Melissa's decompensation and the level of morphine administered to her.

Carson stated that the dose of morphine prescribed prior to Melissa's decompensation was "clinically appropriate." Carson said that there was nothing to indicate that the PCA pump was not calibrated and functioning appropriately. He added that, "it is impossible to say if the cause of her decompensation was the morphine [Melissa] received as a result of her father hitting the button or if it was simply a progression of the underlying lung process that we detected at 10[:00 a.m.]."

Carson also stated that the morphine had been prescribed to deal with Melissa's pain. He wrote that Melissa had presented with a "sickle crisis" and that Melissa believed that she required more medication to control her pain. Carson stated that the PCA dose was "adjusted quickly and . . . appropriately."

Carson was deposed on November 24, 2004. He testified that, although his notes were "somewhat definitive," after he had reviewed the chart and looked at the timeline of Melissa's care, the reasons for her decompensation had become less clear to him.

Carson stated that the PCA pump had a six-minute lockout and therefore Melissa would have only received a dose of morphine every six minutes. He said that he was no longer certain that Melissa's decompensation was due to "morphine dosing." Carson raised the possibility that Melissa's condition was due to an inadvertent "volume overload" caused by the intravenous fluids and blood transfusions.

On August 25, 2005, with leave of the trial court, plaintiffs filed a third amended complaint, in which they added Carson, Dixon and Cohen as defendants. Plaintiffs dropped their claims against Tynes.

On September 7, 2005, the court entered a case management order establishing a March 31, 2006 discovery end date. On March 29, 2006, the court entered another case management order, which extended the time for discovery to October 31, 2006.

Another case management order was entered on June 8, 2006, which required the parties to provide answers to interrogatories and responses to the notices to produce documents. The June 8, 2006 order also established dates for depositions of fact witnesses and parties, which were to be completed by August 11, 2006. The court entered another case management order on August 17, 2006. The order required, among other things, that Carson's re-deposition be completed by October 31, 2006, and that plaintiffs serve their expert reports by December 29, 2006.

On October 30, 2006, Carson filed a motion for summary judgment, arguing that the claims against him should be dismissed because they were asserted after the time prescribed by the applicable statute of limitations. On November 3, 2006, Dixon and Cohen filed a motion for summary judgment on the same ground. The trial court entered an order on February 22, 2007, denying the motions.

Thereafter, Carson, Dixon and Cohen filed motions for reconsideration. The trial court entered orders on April 10, 2007, denying the motions. The court also denied Carson's motion to stay further proceedings in the case pending an interlocutory appeal. On June 25, 2007, we denied motions by Carson, Dixon and Cohen for leave to appeal. It appears that, despite the order denying a stay of proceedings, discovery essentially came to a halt as Carson, Dixon ...


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