Clayton Bias v. Dr. Frederico Del Toro

STATE OF LOUISIANA
COURT OF APPEAL, THIRD CIRCUIT

11-291

CLAYTON BIAS, ET AL.

VERSUS

FREDERICO DELTORO, ET AL.

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APPEAL FROM THE
FIFTEENTH JUDICIAL DISTRICT COURT
PARISH OF LAFAYETTE, NO. C-2010-4632, DIV. B
HONORABLE JULES D. EDWARDS, III, DISTRICT JUDGE

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J. DAVID PAINTER
JUDGE
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Court composed of John D. Saunders, J. David Painter, and James T. Genovese,
Judges.

REVERSED AND REMANDED.

Dorwan G. Vizzier
Broussard, Halcomb, & Vizzier
P.O. Box 1311
Alexandria, LA 71309-1311
COUNSEL FOR PLAINTIFFS/APPELLANTS:
Clayton Bias, individually and as administrator of the estate of his
minor child, Courtney Bias, and Danielle Bias, and Jeremy Bias

James R. Shelton
Durio, McGoffin, Stagg & Ackermann
P.O. Box 51308
Lafayette, LA 70505
COUNSEL FOR DEFENDANTS/APPELLEES:
Dr. Frederico Del Toro, Dr. Rolando Saenz, and Louisiana Medical
Insurance Company

Marc W. Judice
Michelle R. Judice
Judice & Adley
P.O. Box 51769
Lafayette, LA 70505-1769
COUNSEL FOR DEFENDANTS/APPELLEES:
Dr. Steven J. Snatic and Louisiana Medical Mutual Insurance Company

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PAINTER, Judge

Plaintiffs in this medical malpractice suit appeal the grant of summary

judgment in favor of one of the multiple healthcare-provider defendants and his

insurer as well as the denial of their motion to continue. For the reasons that

follow, we reverse the grant of summary judgment in favor of Dr. Steven Snatic

and his insurer, Louisiana Medical Mutual Insurance Company (LAMMICO), and

remand that matter to the trial court.

FACTS AND PROCEDURAL HISTORY

The present matter arises out of a medical malpractice claim brought by

Plaintiffs, Clayton Bias, individually and as administrator of the minor child,

Courtney Bias, and Danielle Bias, and Jeremy Bias, against Dr. Federico Del Toro

(a physician practicing in the field of internal medicine), Dr. Steven Snatic (a

neurologist), Dr. Rolando Saenz (an infectious disease physician), Dr. Akshey

Gupta (a nephrologist), and LAMMICO (which insured each of the named

healthcare providers). Defendants treated the decedent, Ruby Bias, who was the

wife of Clayton and the mother of Courtney, Danielle, and Jeremy, at Our Lady of

Lourdes Regional Medical Center in Lafayette, Louisiana, from February 4, 2007,

until her death on February 23, 2007. Mrs. Bias had a history of lupus and was

taken to the emergency room at Opelousas General Hospital on February 4, 2007,

after her husband was unable to awaken her from a nap. She was transferred to

Our Lady of Lourdes later that day. She was eventually diagnosed with

cryptococcal meningitis. Plaintiffs claim that Defendants failed to provide

appropriate care, that her underlying medical condition was misdiagnosed, and that

Mrs. Bias died as a result thereof.

A medical review panel, comprised of Dr. Julio E. Figueroa, II (a specialist

in the field of infectious disease), Dr. Kevin R. Hargrave (a neurologist), and Dr.
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Leo P. Blaize (a specialist in internal medicine), found that the care administered

by the named healthcare providers was appropriate and within the standard of care

because Mrs. Bias was appropriately diagnosed with membranous

glomerulonephritis and that when she presented with encephalopathy. The panel

further found that it was appropriately assumed and diagnosed, based on MRI and

CT findings, that she had cerebritis, and treatment of this presumptive diagnosis

did result in improvement of her condition. The panel specifically noted that it is

well established in the literature that a diagnosis of cryptococcal meningitis is

difficult to make and even more so in an immunocompromised patient.

Following the medical review panel’s April 5, 2010 opinion, Plaintiffs filed

this suit. Dr. Del Toro, Dr. Saenz, and LAMMICO filed a motion for summary

judgment based on the panel opinion. Dr. Snatic, Dr. Gupta, and LAMMICO also

filed a motion for summary judgment. The motions alleged that despite the lapse

of over two years from the filing of the complaint, Plaintiffs failed to identify any

experts to testify to as to a breach in the standard of care. The motions for

summary judgment were set for hearing on December 13, 2010. Plaintiffs moved

for a continuance based on their allegation that their expert physician, Dr. David

Pitrak, had advised them that he would be unable to provide an affidavit until after

the first week of December 2010. The motion to continue was addressed by

telephone conference and denied by the trial court. The hearing on the motions for

summary judgment went forward as scheduled, with Plaintiffs re-urging their

motion to continue, which was again denied. Plaintiffs submitted the affidavit of

Dr. Paul O. Warshawsky, a cardiologist and board certified internist, in opposition

to the motions for summary judgment. The trial court then denied the motion for

summary judgment as to Dr. Del Toro and LAMMICO as his insurer. The trial

court granted the motion for summary judgment in favor of Dr. Saenz, Dr. Snatic,
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Dr. Gupta, and LAMMICO as the insurer of these physicians. As Plaintiffs had no

opposition to the motions of Dr. Saenz and Dr. Gupta, this appeal concerns only

the trial court’s grant of summary judgment in favor of Dr. Snatic and his insurer,

LAMMICO, and the denial of Plaintiffs’ motion to continue.

DISCUSSION

In Djorghi v. Glass, 09-461, pp. 2-3 (La.App. 3 Cir. 11/4/09), 23 So.3d 996,

998, writ denied, 09-2614 (La. 2/5/10), 27 So.2d 306, this court discussed the

standard of review applicable to summary judgments in medical malpractice cases:

A motion for summary judgment is reviewed on appeal de
novo, with the appellate court using the same criteria as the trial
court to determine whether summary judgment is appropriate;
whether there is a genuine issue of material fact, and whether the
movant is entitled to judgment as a matter of law. La.Code Civ.P.
art. 966; Samaha v. Rau, 07-1726 (La.2/26/08), 977 So.2d 880. A
motion for summary judgment shall be granted if “the pleadings,
depositions, answers to interrogatories, and admissions on file,
together with the affidavits, if any, show that there is no genuine
issue as to material fact, and the mover is entitled to judgment as a
matter of law.” La.Code Civ.P. art. 966(B). Louisiana Code of Civil
Procedure Article 966(C)(2) provides:

The burden of proof remains with the movant.
However, if the movant will not bear the burden of proof
at trial on the matter that is before the court on the
motion for summary judgment, the movant’s burden on
the motion does not require him to negate all essential
elements of the adverse party’s claim, action or defense,
but rather to point out to the court that there is an absence
of factual support for one or more elements essential to
the adverse party’s claim, action, or defense. Thereafter,
if the adverse party fails to produce factual support
sufficient to establish that he will be able to satisfy his
evidentiary burden of proof at trial, there is no genuine
issue of material fact.

In the present case, the defendant, who is the movant in the
Motion for Summary Judgment, does not bear the burden of proof at
trial on the issue of whether medical malpractice was committed.
Louisiana Revised Statutes 9:2794(A) provides “that a medical
malpractice plaintiff must establish the following elements by a
preponderance of the evidence: (1) the standard of care applicable to
the defendant; (2) that the defendant breached the standard of care;
and (3) that there was a causal connection between the breach and the
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resulting injury.” See Brown v. Riverland Med. Ctr., 06-1449, p. 4
(La.App. 3 Cir. 3/7/07), 952 So.2d 889, 892, writ denied, 07-0740
(La.6/1/07), 957 So.2d 177. Expert testimony is generally required
for a medical malpractice plaintiff to establish the applicable standard
of care and breach of that standard of care. Samaha, 977 So.2d 880.
Thus, the defendant is only required to point out that there is an
absence of factual support for one or more elements essential to the
plaintiff’s claim to support that there is no genuine issue of material
fact. Id.

Here, Dr. Snatic will not bear the burden of proof at trial on the issue of

whether medical malpractice was committed. Plaintiffs must prove the three

aforementioned things. La.R.S. 9:2794(A). Dr. Snatic met his initial burden of

proof on his motion for summary judgment based on the panel’s opinion that there

was no breach in the applicable standard of care, which is an essential element of

Plaintiffs’ claim. Thus, the burden shifted to Plaintiffs. In an attempt to meet that

burden, Plaintiffs submitted the affidavit of Dr. Warshawsky. Defendants, Dr.

Snatic and LAMMICO, contend that this affidavit was insufficient to defeat their

motion for summary judgment because it did not demonstrate the “training or

experience” required by La.R.S. 9:2794(D)(1)(c).

Ordinarily, “[w]hen alleged acts of negligence raise issues peculiar to a

particular medical specialty, then only those qualified in that specialty may offer

evidence of the applicable standards.” Richard v. Wijayasuriya, 93-1410, p. 10

(La.App. 3 Cir. 10/5/94), 645 So.2d 708, 713, writ denied, 95-158 (La. 3/17/95),

651 So.2d 273 (citing Boudreaux v. Panger, 490 So.2d 1083 (La.1986) and Felice

v. Valleylab, Inc., 520 So.2d 920 (La.App. 3rd Cir.1987), writs denied 522 So.2d

562, 522 So.2d 563 (La.1988)). However, this court, in Hebert v. Podiatry Ins. Co.

of America, 96-567, p. 10 (La.App. 3 Cir. 10/9/96) 688 So.2d 1107, 1113, writs

denied, 96-2726, 96-2728 (La. 1/6/97) 685 So.2d 117, recognized that:

“it is a specialist’s knowledge of the requisite subject matter, rather
than the specialty within which the specialist practices, which
determines whether a specialist may testify as to the degree of care
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which should be exercised;....” Turner [v. Massiah, 94-29 (La.App. 5
Cir. 7/1/94)]; 641 So.2d [610,] at 617[, reversed in part on other
grounds, 94-2548 (La.6/16/95); 656 So.2d 636]; Soteropulos [v.
Schmidt, 556 So.2d [276] at 278 [(La.App. 4 Cir. 1990)]. Where
medical specialties overlap, a specialist in one field can testify as to
the standard of care applicable to a procedure which is common to
both disciplines, where there is no proof that the standard of care is
different in each discipline. The party offering the expert must prove
the witness’ training, expertise, and skill in the procedure. Ricker v.
Hebert, 94-1743 (La.App. 1 Cir. 5/5/95); 655 So.2d 493. The
determination of an expert’s qualifications to testify as to the standard
of care must be made on a case-by-case basis. McLean v. Hunter,
495 So.2d 1298 (La.1986).

The trial court determined that the affidavit of Dr. Warshawsky did not

contain any assertions that he possessed, by experience or training, competency in

the field of neurology. Based on this finding, the trial court stated: “There simply

is no assertion that he possesses that experience or training, so there is no need to

even think about evaluating the credibility of such assertions.”

After our thorough review of the record, we find that there is a specific

assertion in Dr. Warshawsky’s affidavit that the standards of care of internal

medicine and neurology that are at issue in this case with respect to the care and

treatment of Mrs. Bias by Dr. Snatic, that is the diagnosis and treatment of

cryptococcal meningitis and associated complications in patients with lupus, are

common to the specialties of internal medicine and neurology and that the

standards of care “are common to both the specialties and are equivalent and

known” to him. Dr. Warshawsky further opined that Dr. Snatic breached the

standard of care, that said breach contributed to the progression of the cryptococcal

meningitis, and that said breach caused Mrs. Bias to lose a substantial chance of

survival. We find that there are genuine issues of material fact as to whether or not

Dr. Snatic deviated from the standard of care as alleged by Plaintiffs, and, thus, the

trial court erred in granting the summary judgment in favor of Dr. Snatic. We

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therefore reverse the trial court’s grant of summary judgment in favor of Dr. Snatic

and his insurer and remand the matter to the trial court for further proceedings.

Plaintiffs finally argue that, if we agree with the trial court that the affidavit

of Dr. Warshawsky was insufficient to defeat the motion for summary filed by Dr.

Snatic, then we should find an abuse of discretion by the trial court in not granting

their motion to continue. We will not disturb the denial of a motion for

continuance absent a showing of an abuse of discretion by the trial court.

Hargrove v. Goods, 41,817 (La.App. 2 Cir. 2/28/07), 953 So.2d 968. However,

based on our reversal of the trial court’s grant of summary judgment in favor or Dr.

Snatic and his insurer, we need not address this issue.

DECREE

For all of the foregoing reasons, the summary judgment granted in favor of

Dr. Snatic and his insurer, LAMMICO, is reversed, and the matter is remanded for

further proceedings. Costs of this appeal are assessed to Defendants/Appellees,

Dr. Steven J. Snatic and LAMMICO.

REVERSED AND REMANDED.

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