Yanello v. Park Family Dental
2017 IL App. (3d) 140926 (2017)
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Rule of Law:
Using an anatomical model as substantive evidence to support an expert's opinion, rather than purely as a demonstrative aid to illustrate testimony, constitutes reversible error if the model was not disclosed pre-trial and no foundation was laid to show it accurately represents the specific patient's anatomy.
Facts:
- In 2009 and 2010, Dr. Jae S. Roh extracted eight of Nancy Yanello's upper teeth and inserted four dental implants into her maxilla (upper jaw).
- On March 16, 2011, Yanello returned to Dr. Roh with loose and painful implants; Dr. Roh determined three implants had failed and noted significant bone loss in Yanello's maxilla.
- On April 20, 2011, Dr. Roh removed the failed implants and placed four new ones, observing that there was barely enough bone depth for the procedure.
- Still experiencing pain, Yanello went to the University of Iowa two weeks after a June 16, 2011, visit with Dr. Roh.
- Specialists at the University of Iowa, including Dr. Robert Schneider and Dr. Richard Burton, determined that Dr. Roh's implants had failed and were improperly placed.
- On November 18, 2011, a resident surgeon under Dr. Burton's supervision surgically removed all of the implants placed by Dr. Roh.
- Following the removal, Yanello's ongoing pain was determined to be the result of permanent damage to her nasopalatine nerve caused by one of Dr. Roh's improperly placed implants.
Procedural Posture:
- Nancy Yanello filed a professional negligence lawsuit against Dr. Jae S. Roh and Park Family Dental in the Circuit Court of Will County, Illinois.
- Following a jury trial, a verdict was entered in favor of the defendants.
- The jury answered special interrogatories, finding that the defendants were not negligent and that Yanello was guilty of negligence that contributed to her injuries.
- Yanello appealed the trial court's judgment to the Illinois Appellate Court, Third District.
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Issue:
Does the use of undisclosed anatomical skulls as substantive evidence to support a defense expert's opinion, without a proper foundation linking the skulls' anatomy to the plaintiff's, constitute reversible error in a medical malpractice case?
Opinions:
Majority - Presiding Justice Holdridge
Yes. The use of the undisclosed skulls constituted reversible error because they were used as real, substantive evidence rather than merely as a demonstrative aid. The defense expert, Dr. Panomitros, used the skulls not just to illustrate general anatomy, but to provide substantive support for his opinions that Dr. Roh complied with the standard of care by implicitly suggesting the skulls' anatomy was analogous to Yanello's. To use the skulls in this manner, the defense was required to lay a foundation establishing that the skulls were an accurate representation of Yanello's specific anatomy, which it failed to do. Furthermore, the failure to disclose the skulls prior to trial, as required by Illinois Supreme Court Rule 213, was fundamentally unfair as it prevented Yanello's counsel from preparing an effective cross-examination. This error was highly prejudicial as it went to the heart of the malpractice claim, warranting a new trial.
Analysis:
This case reinforces the critical distinction between demonstrative evidence (a visual aid) and real evidence (an object with substantive probative value). The court's decision serves as a strong caution against using generic anatomical models to make specific claims about a plaintiff's condition without laying a proper foundation showing the model is substantially similar to the patient. The ruling underscores the importance of pre-trial disclosure rules in ensuring fairness and preventing 'trial by ambush.' This precedent will require future litigants who wish to use models substantively to meticulously prove the model's accuracy in representing the specific patient's anatomy, or else strictly confine its use to general illustration.
