Gulino v. Zurawski
43 N.E.3d 1102
Ill. App. Ct.2015Background
- Plaintiff Joanne Gulino sued AES and on-call nurse Maria Zurawski after her husband Matthew died of thrombotic thrombocytopenic purpura (TTP) on October 25, 2009; jury awarded $12,261,131 against AES and Zurawski (Advocate later settled).
- Matthew first sought care Oct 19–22 for nonspecific symptoms; no CBC was ordered by his PCP or the ER physician; on Oct 25 he presented to Advocate, was diagnosed with TTP, and required urgent plasmapheresis.
- Advocate ordered plasmapheresis and three units of fresh frozen plasma (FFP); AES was called at ~4:30 p.m. and Zurawski was dispatched but did not arrive until ~11:00 p.m.; Matthew coded and died before plasmapheresis began.
- Plaintiff alleged AES/Zurawski negligently failed to respond promptly to an emergency plasmapheresis request and that the delay proximately caused death.
- Trial featured competing expert testimony: plaintiff’s hematologist said timely plasmapheresis would likely (>50%) have saved Matthew (could be effective even by 9:00 p.m.); defendants’ experts testified Matthew already had irreversible multi‑organ failure and plasmapheresis would not have helped.
- Circuit court denied defendants’ JNOV motion and defendants appealed; the Appellate Court affirmed, deferring to jury credibility determinations and upholding most evidentiary rulings.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether JNOV should have been granted | Gulino: record contained admissible expert proof of nursing standard breach and proximate causation by delayed response | AES/Zurawski: plaintiff lacked qualified expert on nursing standard and failed to prove causation (other delays at hospital made plasmapheresis impossible) | Denied — viewing evidence in plaintiff's favor, conflicting expert testimony created factual issues for jury; JNOV standard not met |
| Whether verdict was against manifest weight of evidence | Gulino: jury reasonably credited plaintiff's experts that timely plasmapheresis likely would have saved Matthew | AES/Zurawski: conflicting evidence showed patient already irreversibly ill and hospital delays, so verdict unreasonable | Affirmed — jury resolved expert conflict; appellate court will not reweigh credibility |
| Admissibility: plaintiff's nursing expert qualifications | Gulino: MacVean (ICU/oncology nurse) competent to testify about basic nursing protocols and STAT-response obligations | AES/Zurawski: MacVean lacked plasmapheresis/TTP experience and thus incompetent to opine on standard | Admitted — court did not abuse discretion; MacVean’s testimony addressed matters within her experience and was relevant |
| Scope of expert testimony limitations | Gulino: sought to admit contextual testimony about expectations after plasmapheresis call; defense sought broad hematology testimony | AES/Zurawski: various limits (and exclusions) hampered defense rebuttal | Mixed — court properly limited a physician from giving nursing‑standard testimony; limiting a hematologist’s cumulative testimony was error but harmless; exclusion of hypothetical ‘defer to ICU’ opinion was within discretion |
Key Cases Cited
- Pedrick v. Peoria & Eastern R.R. Co., 37 Ill. 2d 494 (explains standard for JNOV and reviewing evidence in light most favorable to nonmovant)
- York v. Rush-Presbyterian-St. Luke’s Medical Center, 222 Ill. 2d 147 (discusses high standard for JNOV and de novo review scope)
- Maple v. Gustafson, 151 Ill. 2d 445 (verdict not to be overturned as against manifest weight merely because evidence conflicts)
- Sullivan v. Edward Hospital, 209 Ill. 2d 100 (requirements for medical expert testimony; foundational elements)
- Thompson v. Gordon, 221 Ill. 2d 414 (trial court’s discretion to admit healthcare expert testimony; abuse‑of‑discretion review)
- Neade v. Portes, 193 Ill. 2d 433 (elements of medical negligence claim)
- Heastie v. Roberts, 226 Ill. 2d 515 (when lay factfinder need not have expert because negligence is within common knowledge)