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Stubblefield v. Morristown-Hamblen Hospital Association

Court of Appeals of Tennessee, Knoxville

June 11, 2019


          Session February 22, 2018

          Appeal from the Circuit Court for Hamblen County No. 15CV193 Alex E. Pearson, Judge

         This appeal involves a re-filed health care liability action[1] in which the plaintiff challenges the summary judgment dismissal of her claim. We reverse the court's grant of summary judgment, in part. The case is remanded for further proceedings consistent with this opinion.

         Tenn. R. App. P. 3 Appeal as of Right; Judgment of the Circuit Court Reversed in Part, Affirmed in Part; Case Remanded

          Mark T. Hurt, Abingdon, Virginia, for the appellants, Bobbie Seals Stubblefield.

          F. Michael Fitzpatrick and Rachel Park Hurt, Knoxville, Tennessee, for the appellees, Morristown-Hamblen Hospital Association d/b/a Morristown Hamblen Healthcare System and Angela Adams, R.N.

          James G. O'Kane and Raymond G. Lewallen, Jr., Knoxville, Tennessee, for the appellees, Morristown Heart Consultants, PLLC and Sunil T. Ramaprasad, M.D.

          John W. McClarty, J., delivered the opinion of the Court, in which Charles D. Susano, Jr., J. and D. Michael Swiney, C.J., joined.



         I. BACKGROUND

         The claim at issue relates to the alleged negligent post-operative care of Bobbie Seals Stubblefield ("Plaintiff") at Morristown-Hamblen Hospital Association ("the Hospital"). On October 20, 2010, Plaintiff underwent a cardiac catheterization performed by Pragnesh Patel, M.D. at the Hospital. Plaintiff remained at the Hospital overnight for routine post-operative care and was attended to by Angela Adams, R.N., among others. Per Dr. Patel's instruction, Nurse Adams administered nitroglycerin intravenously throughout the night. Plaintiff later complained that the nitroglycerin was causing "an unbearable headache and nausea." Plaintiff claims that she "begged" Nurse Adams to stop administering nitroglycerin, while Nurse Adams claims that Plaintiff consented to further doses once she was advised of the medical necessity. It was later discovered that Plaintiff developed a hematoma and pseudoaneurysm in her groin at the catheterization site. The hematoma continued to grow, despite treatment provided by the nurses on staff. The nurses paged the cardiologist on-call, Sunil T. Ramaprasad, M.D. for assistance. He did not report to the Hospital. Instead, he ordered placement of a device to stop the bleeding and arranged for the intervention of a vascular surgeon, who reported to the hospital immediately and performed emergency surgery to repair the femoral artery in the early morning hours of October 21.

         As pertinent to this appeal, On February 7, 2012, Plaintiff filed a medical malpractice action against the Hospital, Nurse Adams, Morristown Heart Consultants, PLLC ("MHC"), and Dr. Ramaprasad (collectively "Defendants"). She also filed a separate battery claim against Nurse Adams based upon the nurse's continued administration of nitroglycerin over her objection. Plaintiff voluntarily dismissed the initial suit on December 5, 2014, after extensive discovery. Plaintiff then filed a second suit pursuant to the saving statute on December 2, 2015, in compliance with the health care liability pre-suit notice statutes.

         Defendants denied wrongdoing and filed motions for summary judgment with supporting affidavits and depositions taken during the pendency of the first lawsuit. Nurse Adams attested that Plaintiff gave her consent to the continued administration of nitroglycerin once advised of the medical necessity. Nurse Adams explained that she would have contacted the treating physician to obtain additional orders if Plaintiff had so objected to the necessary medical treatment. She further attested that the hospital care and treatment rendered by her and others was in accordance with the standard of care for registered nurses in the Hamblen County community.

         Likewise, Dr. Ramaprasad attested as follows:

On October 21, 2010, I was on call for [the Hospital], and I received telephone calls from the cardiac care unit nursing staff regarding [Plaintiff]. After being advised that she had bleeding, my responses included ordering the placement of a Fem-o-stop, a device which is used to prevent further bleeding, asking for an experienced and skilled cardiac cath technician to go to the cardiac care unit, ordering an ultrasound, and I arranged for a vascular surgeon, Dr. Assadnia, to intervene and evaluate the patient and formulate a treatment plan for [Plaintiff]. I consulted Dr. Assadnia because it is within his area of speciality to treat the large hemotoma and psuedoaneurysm that developed in [Plaintiff's] right groin area, and it is not within my area of expertise to provide corrective treatment for this. All times on [October 21], I responded promptly and appropriately to the information provided to me by the cardiac care unit nursing staff, issued appropriate orders, and arranged for proper consultation, with the result that [Plaintiff's] hematoma and psuedoaneurysm were promptly treated by Dr. Assadnia[.]
It is my opinion within a reasonable degree of medical certainty that I complied in all respects with the standard of care applicable to the care and treatment of patients such as [Plaintiff] who experienced the events that occurred on [October 21], as that standard of care applies in Morristown, Tennessee, or in similar communities. Having complied with the standard of care there was no negligence or other fault by me as alleged in the Complaint, and [Plaintiff's] injuries and damages claimed in the Complaint were not due to any breach of standard of care by me.

         On May 4, 2016, Plaintiff responded to the motion for summary judgment by requesting additional time in which to conduct discovery, including taking the deposition of Dr. Assadnia. The court granted Plaintiff's request for more time on May 27. Plaintiff then deposed Dr. Assadnia on August 9. Plaintiff again requested additional time on September 13, and the case was re-set for hearing on October 4. While Plaintiff provided responses to Defendants' statement of undisputed material facts and filed various motions reiterating her belief that Defendants' breached the applicable standard of care, Plaintiff never set forth any evidence by affidavit, deposition, or otherwise to show that there was a genuine issue of material fact for trial. However, on September 1, 2016, Plaintiff served via email and mail a supplemental response to Defendants' interrogatories in which Plaintiff identified two experts, Melanie Jill Ogle, R.N. and William M. Lieppe, M.D., and provided a summary of their expected expert opinions.

         Plaintiff's supplemental response provided, in pertinent part, that Nurse Ogle was "expected to testify, within a reasonable degree of professional certainty, that [the Hospital's] nurses breached the applicable standard of care in their treatment." Plaintiff also provided that Dr. Lieppe was expected to testify concerning Dr. Ramaprasad's failure to comply with the applicable standard of care in his treatment and "on causation as to breaches of the ...

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