Chiero v. Chicago Osteopathic Hospital
392 N.E.2d 203, 74 Ill. App. 3d 166, 29 Ill. Dec. 646 (1979)
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Rule of Law:
In a medical malpractice action, summary judgment is appropriate when the plaintiff fails to present expert medical testimony establishing the standard of care and its breach, particularly when the alleged negligence involves complex medical procedures beyond common lay understanding, and the plaintiff's own expert states there was no negligence.
Facts:
- In March 1970, Louis Chiero was admitted to Chicago Osteopathic Hospital because he was found to have a congested, obstructed prostate.
- Louis Chiero underwent a transurethral resection (TUR) of his prostate gland at the hospital.
- During the TUR procedure, Louis Chiero suffered a cardiac arrest.
- Louis Chiero was successfully revived through emergency measures but allegedly suffered brain damage.
- In 1972, Louis Chiero filed a medical malpractice lawsuit against various defendants, including Chicago Osteopathic Hospital and several doctors, alleging negligence during the surgery and subsequent care.
- An air embolism is a recognized and reported risk of the TUR surgical procedure and can occur as a "normal happenstance" without negligence.
Procedural Posture:
- In 1972, Louis Chiero filed a medical malpractice action in the circuit court of Cook County (trial court/court of first instance) against various defendants.
- From 1972 to 1976, the parties engaged in extensive pretrial discovery, including the deposition of Louis Chiero's expert witness, Dr. Dennis Streeter, in November 1976.
- The defendants subsequently moved for summary judgment.
- On May 2, 1977, the trial court granted the defendants’ motion for summary judgment.
- On June 1, 1977, Louis Chiero filed a motion requesting the trial court to reconsider its order granting summary judgment.
- The trial court denied Louis Chiero's motion to reconsider, and Louis Chiero, as appellant, appealed this decision.
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Issue:
Does a plaintiff in a medical malpractice case, who failed to present expert testimony establishing a breach of the standard of care after the defense deposed the plaintiff's expert who testified there was no negligence, have a genuine issue of material fact precluding summary judgment?
Opinions:
Majority - Linn, J.
Yes, a plaintiff in a medical malpractice case who fails to present expert testimony establishing a breach of the standard of care, especially after their own expert testifies there was no negligence, does not have a genuine issue of material fact and summary judgment is appropriate. The court affirmed the trial court's grant of summary judgment, finding that the plaintiff failed to establish the necessary elements of a negligence cause of action, specifically the breach of the standard of care. In medical malpractice cases, this standard must generally be established through expert medical testimony. The plaintiff's own expert witness, Dr. Streeter, testified that an air embolism is a recognized risk of the TUR procedure and can occur without negligence. Crucially, Dr. Streeter stated he had no criticism of the care rendered by any of the defendants and that their conduct met the prevailing standard of care, explicitly concluding there was no professional negligence. The court rejected the plaintiff's arguments that the negligence was so gross a layman could appraise it (as the TUR procedure and air embolism are complex), that the expert testimony requirement should be abrogated (reiterating it's widely recognized and custom is not conclusive but indicative of due care), and that res ipsa loquitur applied (because an air embolism during a TUR is not an event that ordinarily occurs in the absence of negligence within common lay understanding, and the expert stated no negligence occurred). The court also found the plaintiff waived objections to Dr. Streeter's testimony and that his reliance on medical records was proper. Despite the difficulty in securing expert testimony in malpractice cases, the court concluded that the plaintiff had every opportunity to establish his case and failed to demonstrate negligent acts or omissions by expert testimony.
Analysis:
This case reinforces the critical role of expert medical testimony in medical malpractice actions in Illinois, particularly for complex medical procedures. It clarifies that a plaintiff cannot rely on "common knowledge" exceptions or res ipsa loquitur when the medical event (like an air embolism during a TUR) is a recognized risk that can occur without negligence, and their own expert explicitly states no negligence occurred. The decision highlights that while customary practice is not conclusive evidence of due care, its adherence, combined with a lack of contrary expert opinion, is sufficient to warrant summary judgment if no genuine issue of material fact regarding a breach of the standard of care is raised. This case makes it clear that plaintiffs must secure an expert who can testify to a breach of the standard of care, or show that the standard itself is negligent, to survive summary judgment in such cases.
