Articles Posted in Birth Injury

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this birth injury/personal injury case and its proceedings.)

PLAINTIFFS’ TRAIL BRIEF

Plaintiffs William White and Joan White submit the following trial brief in the above entitled matter.

PARTIES
Plaintiffs: William White and Joan White
Defendants: Cindy Brown, M.D., and SAC Medical Group
STATEMENT OF FACTS

Plaintiff, Joan White, began seeing Dr. Brown prior to or at the beginning of her pregnancy with her son, Ethan, who was born XX/XX/2003. During the pregnancy, Ms. White had an abnormal PAP smear. As a result of that abnormal PAP smear, on May 27, 2003, she underwent a colposcopy and a LEEP procedure, during which a portion of the cervix where the abnormal tissue is present is removed. This process can lead to an incompetent cervix and put Ms. White at high risk for pre-term labor.

In November of 2003, Ms. White discovered she was pregnant again, and started her prenatal care with Dr. Brown. In December of 2003, an ultrasound was performed and it was determined that Ms.. White was pregnant with twins. The ultrasound was performed in December by a radiologist at SanSkid Imaging Center. In February and March of 2004, Dr. Brown performed ultrasounds in her office; however, they were grossly inadequate and did not come close to complying with the guidelines set forth by the American College of Obstetrics and Gynecology. Ms. White began experiencing dizziness and lack of energy for which Dr. Brown recommended increasing her iron intake. Ms. White asked Dr. Brown if she could go on disability, and Dr. Brown advised her that it was too early in the pregnancy. (See Part 2 of 3.)

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(Please note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this birth injury/personal injury case and its proceedings.)

Request For Sanctions

California Code of Civil procedure Section 2023 provides for monetary sanctions where there is a failure to respond to interrogatories, evasive responses and objections lacking substantial justification are misuses of the discovery process. It further specifies that misuses of the discovery process include, but are not limited to, the following: …. (2) Using a discovery method in a manner that does not comply with its specified procedures; ….(4) Failing to respond or to submit to an authorized method of discovery; (5) Making, without substantial justification, an non-meritorious objection to discovery; (6) Making an evasive response to discovery; ….(8) Making or opposing, unsuccessfully and without substantial justification, a motion to compel or to limit discovery; and (9) Failing to confer in person, by telephone, or by letter with an opposing party or attorney in a reasonable and good faith attempt to resolve informally any dispute concerning discovery…… C.C.P. Section 2023.

Plaintiffs propounded special interrogatories to obtain information from defendant regarding the relevant facts and witnesses in the present action. The discovery was not propounded to harass the defendant and was propounded in good faith in order to obtain relevant information in this tragic birth injury matter.

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(Please note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this birth injury/personal injury case and its proceedings.)

University’s Assertion Of Boilerplate Objections Is Without Basis

In Greg Mannino v. Superior Court (1983) 142 Cal.App.3d 776, petitioner filed a personal injury action against real party in interest and propounded a six sets of special interrogatories. Real party filed a verified response after the date an answer was required and included numerous objections. Petitioner’s subsequent motion to compel further answers was denied.

On appeal, the Court vacated the order denying motion to compel, holding that real party did not file on time and provided no reasonable excuse for the delay. Id. at 778-779. The court reasoned that the objections contained in the responses were based on relevancy, remoteness, vagueness, ambiguity and the claim that the interrogatories are too burdensome, stating that it does not require more than 60 days to raise these familiar complaints. Although the delay was short in this case, and it was the sixth set of interrogatories propounded to real party in interest, the court emphasized that the discovery process is subject to frequent abuse and, like a cancerous growth, can destroy a meritorious cause or defense when the party with the greater resources chooses to employ it in an unethical manner. Id.

In the instant birth injury matter, the objections made by University to the first seven special interrogatories propounded by plaintiff are without merit.

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(Please note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this birth injury/personal injury case and its proceedings.)

In the instant matter, plaintiffs are entitled to an order compelling University to further respond to plaintiffs’ Special Interrogatories, Numbers One through Seven.

First, repeated attempts to meet and confer and to obtain the information from defendants have been unsuccessful. Plaintiffs received University’s written responses to their first set of special interrogatories on May 16, 2002, after granting four extensions. Thereafter, in an attempt to meet and confer over the inadequacy of the responses, plaintiffs sent a letter to University outlining the alleged deficiencies in responses to Special Interrogatories, One through Seven.

Thereafter, although defendant agreed to provide further responses to the specified interrogatories, no response has been received as of the date of this motion. Moreover, most recent additional meet and confer attempts by counsel for plaintiffs have been met with silence. Because, as discussed in detail below, University has not provided further responses to plaintiffs’ interrogatories after agreeing to do so, plaintiffs are entitled to an order compelling defendant University to provide further responses.

More importantly, the information being requested from University is directly relevant to the issue of negligence in this birth injury case.

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(Please note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this birth injury/personal injury case and its proceedings.)

LEGAL ARGUMENT
Plaintiffs Are Entitled to an Order Compelling Responses To Special Interrogatories

Code of Civil Procedure section 2030(f) requires that a party to whom interrogatories have been propounded shall respond in writing under oath separately to each interrogatory by (1) an answer containing the information sought to be discovered, (2) an exercise of the parties option to produce writings, or (3) an objection to the particular interrogatory. Further, section 2030(f)(l) specifies that each answer in the response shall be as complete and straightforward as the information reasonably available to the responding party permits. If an interrogatory cannot be answered completely, it shall be answered to the extent possible.

Lastly, section 2030(1) provides that if the propounding party, on receipt of a response to interrogatories, deems that (1) an answer to a particular interrogatory is incomplete or evasive, (2) an exercise of the option to produce documents under paragraph (2) of subdivision (f) is unwarranted of the required specification of those documents is inadequate, or (3) an objection to an interrogatory is without merit or is too general, that party may move for an order compelling a further response.

In the instant birth injury matter, plaintiffs are entitled to an order compelling University to further respond to plaintiffs’ Special Interrogatories, Numbers One through Seven. (See Part 4 of 6.)

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(Please note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this birth injury/personal injury case and its proceedings.)

Contrary to defendant’s objection as stated in their Special Interrogatory Responses, these individuals were not identified in the medical records in the possession of plaintiffs and/or their counsel. The medical records only identify Dr. Green and Dr. Brown as involved in the neonatal resuscitation and one labor/delivery nurse attending the birth. However, it has come out during depositions and through the course of discovery, through testimony of family and friends, that there was a resuscitation team as well as a great number of people in the room during the birth and the immediate post-birth period.

Also uncovered during the course of discovery is the fact that, according to University’s own pediatric department rules and regulations, a neonatal team “would include a neonatal transport nurse and a NICU nurse, as well as the neonatologist or his/her designee.” Further, University’s women and infants services procedure manual specifies that an Advance Practice Nurse, Transitional RN or NICU Charge RN shall be present at every delivery. Thus, it is clear that there are individuals known to University who were present who are not identified or reflected in the McCoy records.

By letter dated June 16, 2002, defendant University indicated that it would provide further Responses to Plaintiffs’ Special Interrogatories, Set One. Defendant agreed to provide supplemental responses on or before July 13, 2002. In addition, defendant agreed to extend plaintiffs time for filing a motion to compel further responses, up to and including July 27, 2002.

On or about July 16, 2002, after not having received any further responses to Plaintiffs’ Special Interrogatories Set One, counsel for plaintiffs telephoned defense counsel Andy Stone in order to obtain a status of the responses. Mr. Stone informed plaintiffs’ counsel that defense counsel Barbara Stein would be handling the responses and would give a status update by the end of business that day.

At the end of the day, having not received a call from Ms. Stein, plaintiffs counsel called her to again inquire as to the status of the responses. Plaintiffs’ counsel left a message for Ms. Stein and her assistant that an update on the responses was necessary or plaintiffs would be forced to file a motion to compel further responses. Defense counsel did not respond.

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(Please note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this birth injury/personal injury case and its proceedings.)

Memorandum of Points and Authorities in Support of Plaintiffs’ Motion to Compel Answers to Special Interrogatories, and for Monetary Sanctions
INTRODUCTION

This is an action for medical negligence arising out of the birth of the minor plaintiff, John Smith, at University Hospital in Sacramento in April 2000 which resulted in severe neurologic injury to the minor. Plaintiffs allege that defendant University Medical Center (“University”) and others carelessly and negligently managed the medical care of plaintiffs including but not limited to delivery and post-delivery care of minor plaintiff John Smith. As a result of defendant’s negligence John Smith suffered severe brain injury, paresis and other neurological damage, resulting in impairment of mental and bodily function.

STATEMENT OF FACTS
Plaintiffs served their first set of Special Interrogatories on defendant University on February 28, 2002. University requested four extensions of time to respond to the interrogatories, all of which were granted by plaintiffs. After having an extended six weeks to answer, University served written responses on May 16, 2002. Defendant responded to Special Interrogatory, Numbers One through Seven, with an inadequate boiler plate objection, stating that defendant did not have to produce the information because it was equally available to plaintiffs.
Plaintiffs’ counsel attempted to meet and confer with University with regard to their deficient responses to the special interrogatories by letter dated May 31, 2002. In their meet and confer correspondence, plaintiffs’ counsel outlined each alleged insufficient interrogatory response, the answer given by University as well as the reason the answer was inadequate, and an explanation as to why the information requested in the interrogatories was relevant.

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(Please note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this birth injury/medical malpractice case and its proceedings.)

To meet this burden of proof, the defendant must show that either one or more elements of the cause of action cannot be established or there is a complete defense to that cause of action (Code Civ. Proc., § 437c(o)(2).) This means that where plaintiff has the burden of proof at trial by a preponderance of evidence, the defendant must present evidence that would require a reasonable trier of fact not to find the underlying material fact more likely than not. Otherwise, he [defendant] would not be entitled to judgment as a matter of law. But would have to present his evidence to a trier of fact [the jury]. (Brackets added.) (Aguilar, supra, 25 Cal.4th at p.851.)

The import of the more likely than not in the foregoing quote is that a moving defendant must generally present evidence that, if uncontradicted, would constitute a preponderance of evidence that an essential element of the plaintiff’s case cannot be established…. The same is true when a moving defendant seeks to secure dismissal of the complaint based on an affirmative defense. (Emphasis added.) (Kids’ Universe v. In2labs (2002) 95 Cal.App.870, 879.) Consequently, if the Defendants’ expert declaration is disputed by a declaration by plaintiff’s expert, then the matter is contradicted and the summary judgment must be denied.

Consequently, if the defendants fail to meet the above burden or persuasion, their motion must be denied:

Therefore, at the summary judgment stage, the defendants in the present case had an initial burden of production to make a prima facie showing that their conduct came within the exposure exemption. [Citations omitted.] If they failed to meet that burden, the plaintiff need not make any showing at all. (Pepperell v. Scottsdale Ins. Co. (1998) 62 Cal.App.4th 1045, 1054…].) Defendants contend that Dr. Amendola’s declaration, together with Consumer Cause’s discovery responses, shifted the burden of production to Consumer Cause. We disagree. (Consumer Cause, Inc. v. SmileCare (2001) 91 Cal.App.4th 454, 469 – 470.

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(Please note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this birth injury/medical malpractice case and its proceedings.)

THE MOVING PARTY HAS THE BURDEN OF PERSUASION
A party who seeks an court’s action in his or her favor bears the burden of persuasion thereon:

Evidence Code, § 500 states as follows: Except as otherwise provided by law, a party has the burden of proof as to each fact the existence or nonexistence of which is essential to the claim for relief or defense that he or she is asserting.

As our Supreme Court recently explained:
[

F]rom commencement to conclusion, the party moving for summary judgment bears the burden of persuasion that there is no triable issue of material fact and that he is entitled to judgment as a matter of law. That is because of the general principle that a party who seeks a court’s action in his favor bears the burden of persuasion thereon. “There is a triable issue of material fact if, and only if, the evidence would allow a reasonable trier of fact to find the underlying fact in favor of the party opposing the motion in accordance with the applicable standard of proof….” (Aguilar v. Atlantic Richfield Co. (2001) 25 Cal.4th 826, 850.)

In effect, the defendants in this medical malpractice action as the moving parties for summary judgment bear the burden of persuasion that one or more elements of the cause of action in question “cannot be established,” or that “there is a complete defense” thereto. (Aguilar, supra, 25 Cal.4th at p.850.) Consequently, the burden of persuasion does not shift. Rather, when the court rules, one party has met its burden of persuasion and the other has not.

Regarding the burden of proof, the Supreme Court addressed that issue as follows:
[T]he party moving for summary judgment bears an initial burden of production to make a prima facie showing of the nonexistence of any triable issue of material fact; if he carries his burden of production, he causes a shift, and the opposing party is then subjected to a burden of production of his own to make a prima facie showing of the existence of a triable issue of material fact. A prima facie showing is one that is sufficient to support the position of the party in question.

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(Please note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this birth injury/medical malpractice case and its proceedings.)

PLAINTIFF HAS PRESENTED HIS EXPERT DECLARATION WHICH DISPUTES THE DEFENDANT’S EXPERT’S CONCLUSIONS – AND THIS DISPUTE REQUIRES DENIAL OF THE SUMMARY JUDGMENT

Plaintiff’s obstetric and gynecology, John Zee, M.D. has properly presented his opinion in his declaration testimony. Plaintiff’s expert declaration, which disputes the declaration of the Defendant’s expert declaration, requires denial of this motion for summary judgement. Dr. Zee meets all the requirements of expert testimony – including the standard of care as it relates to nurses and physicians:

To qualify a witness as a medical expert, it must be shown that the witness (1) has the required professional knowledge, learning and skill of the subject under inquiry sufficient to qualify him to speak with authority on the subject; and (2) is familiar with the standard required of a physician under similar circumstances; where a witness has disclosed sufficient knowledge of the subject to entitle his opinion to go to the jury, the question of the degree of his knowledge goes more to the weight of the evidence than to its admissibility. (Emphasis added.) (Evans v. Ohanesian (1974) 39 Cal.App.3d 121, 128.)

Consequently, Defendant is not in a position to argue the “weight” of Dr. Zee’s testimony; that is the domain of the trier of fact, in this case, the jury. The Plaintiffs have properly presented their expert testimony on standard of care and causation. Defendants’ experts’ declarations are now controverted by the Plaintiffs’ expert who concludes the Defendants’ actions were below the standard of care and also significant contributing factors in the cause of the child’s condition:

And counter affidavits disclosing evidence or inferences reasonably deducible from such evidence of a triable issue of fact require denial of the motion.
(Emphasis added.) (Sesma v. Cueto, supra, 129 Cal.App.3d at p. 113.)

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