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Gallagher v. Cayuga Medical Center

Supreme Court of New York, Third Department

June 15, 2017

TIMOTHY W. GALLAGHER et al., Individually and as Administrators of the Estate of JACK O'BANNON GALLAGHER, Deceased, Appellants,
CAYUGA MEDICAL CENTER et al., Respondents.

          Calendar Date: April 27, 2017

          Thaler & Thaler, PC, Ithaca (Thomas D. Cramer of counsel), for appellants.

          Levene Gouldin & Thompson, LLP, Vestal (Justin L. Salkin of counsel), for Cayuga Medical Center, respondent.

          Aswad & Ingraham, Binghamton (Mary E. Saitta of counsel), for Auguste L. Duplan, respondent.

          Connors, LLP, Buffalo (Christina L. Saccocio of counsel), for Cayuga Emergency Physicians LLP and others, respondents.

          Before: Peters, P.J., Garry, Devine, Mulvey and Aarons, JJ.


          Peters, P.J.

         Appeal from an order of the Supreme Court (Rumsey, J.), entered June 27, 2016 in Tompkins County, which granted defendants' motions for summary judgment dismissing the complaint.

         This action arises out of the tragic suicide of Jack O'Bannon Gallagher (hereinafter decedent), a 17-year-old high school student, on February 6, 2012. Defendant Auguste L. Duplan, a child adolescent psychiatrist employed by defendant Cayuga Medical Center (hereinafter CMC), first treated decedent in July 2011. At that time, decedent was admitted to CMC complaining of "extreme mood swings, self-injury, cuts and burns to [his] arms [and] suicidal ideation." Decedent reported to Duplan that he had made a suicide attempt a month prior to his admission by an Albuterol overdose. Diagnosed with "substance induced mood disorder, " decedent was treated and discharged five days later and prescribed an antidepressant.

         On February 6, 2012, at approximately 1:00 p.m., decedent was transported by ambulance from his high school to CMC's emergency room after a school nurse had indicated that decedent was hyper and then lethargic, had elevated blood pressure and may have abused a substance. Plaintiffs, decedent's parents, arrived shortly thereafter. Defendant Christopher R. Scianna, the attending emergency room physician, attended to decedent until his shift ended and he subsequently "signed out" decedent at 4:00 p.m. to defendant Drew Koch, another emergency room physician employed by defendant Cayuga Emergency Physicians LLP. Scianna ordered a drug screen and a mental health evaluation of decedent, and the drug screen tested positive for the presence of barbiturates. The mental health evaluation was performed by Meghan Beeby, a registered nurse from CMC's behavioral health unit, in consultation with Duplan, the on-duty psychiatrist.

         Ultimately, using the information obtained from the mental health evaluation, collateral sources and other medical records, but without personally meeting with decedent, Duplan concluded that decedent was safe to be discharged from CMC's emergency department to return to his home with his parents. Beeby reviewed the evaluation and recommendation with Koch, who discharged decedent from CMC at 7:04 p.m. with a diagnosis of "substance abuse." Decedent's father signed the discharge instructions, which indicated that decedent should call 911 or return to the emergency room if he felt suicidal or homicidal, and instructed that it was essential that decedent follow up with substance abuse treatment recommendations. A short time after arriving home, decedent committed suicide by shooting himself in the head.

         Plaintiffs commenced this action against defendants asserting causes of action for medical malpractice, negligence, wrongful death and emotional distress. The gravamen of the complaint is that the decision to discharge decedent from CMC on February 6, 2012 was not grounded upon a proper mental health evaluation. Following joinder of issue and discovery, all defendants moved for summary judgment dismissing the complaint. Supreme Court granted the motions, and plaintiffs appeal. [1]

         "In a medical malpractice action, the plaintiff must show that the defendant 'deviated from acceptable medical practice, and that such deviation was a proximate cause of the plaintiff's injury'" (Mazella v Beals, 27 N.Y.3d 694, 705 [2016], quoting James v Wormuth, 21 N.Y.3d 540, 545 [2013]). It is well settled that a physician "may not be held liable for a mere error in professional judgment" (Ballek v Aldana-Bernier, 100 A.D.3d 811, 813 [2012] [internal quotation marks and citation omitted]; see Nestorowich v Ricotta, 97 N.Y.2d 393, 398-399 [2002]; Paradies v Benedictine Hosp., 77 A.D.2d 757, 759 [1980], lvs dismissed 51 N.Y.2d 710, 1006, 1010 [1980]). This rule is particularly relevant to cases involving mental health treatment, given that psychiatry is not an exact science and, therefore, decisions related to mental health treatment and discharge often involve a measure of calculated risk (see Schrempf v State of New York, 66 N.Y.2d 289, 295-296 [1985]; Taig v State of New York, 19 A.D.2d 182, 183 [1963]). Thus, "'for a psychiatrist to be held liable for malpractice based upon a decision made in connection with a patient's treatment or a decision to discharge a patient from a hospital, it must be shown that the treatment decisions represented something less than a professional medical determination... or that the psychiatrist's decisions were not the product of a careful evaluation'" (Ballek v Aldana-Bernier, 100 A.D.3d at 813, quoting Ozugowski v City of New York, 90 A.D.3d 875, 876 [2011]; see Schrempf v State of New York, 66 N.Y.2d at 295-296; Tkacheff v Roberts, 147 A.D.3d 1271, 1272 [2017]; Park v Kovachevich, 116 A.D.3d 182, 190-191 [2014], lv denied 23 N.Y.3d 906');">23 N.Y.3d 906 [2014]).

         Defendants, as the proponents of the respective summary judgment motions, "bore the initial burden of establishing that they did not depart from acceptable standards of care or that any such departure did not cause the injury" (Longtemps v Oliva, 110 A.D.3d 1316, 1317 [2013]; see Johnson v Nassau Univ. Med. Ctr., 140 A.D.3d 704, 706 [2016]). In support of their respective motions, Duplan and CMC submitted, among other things, the deposition testimony of Duplan and Beeby, decedent's medical records and the sworn expert opinions of psychiatrists Peter Martin and Ralph Carotenuto. The medical records and deposition testimony indicated that, before decedent was discharged, Duplan considered the 2011 medical record of decedent's prior admission under his care in CMC's adolescent psychiatry unit and required Beeby to contact and solicit the opinion of Lauren Franklin, the outpatient therapist with whom decedent was then treating. Duplan also reviewed and considered ...

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