Mammarella v. Evantash
2014 Del. LEXIS 217
Del.2014Background
- Mammarella sued radiologist Evantash, OB/GYN Maynard, and All About Women for alleged medical malpractice arising from a six-month delay in breast cancer diagnosis.
- Initial screening in Oct 2009 found a nodule; follow-up in Oct 2009 deemed non-mmalignant, with six-month follow-up recommended.
- Mammarella insisted on earlier screening; Maynard scheduled a six-month follow-up in response to her concerns.
- Biopsy after the delay (May 2010) confirmed cancer; tumor measured 11 millimeters; treatment team discussed options.
- Biggs, the sole causation expert, testified he could not say with reasonable medical probability that treatment would have differed six months earlier.
- Trial court granted judgment as a matter of law based on Biggs’s inability to establish causation; appellate review affirmed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Causation proof via expert testimony | Mammarella argues Biggs can prove causation that delay altered treatment. | Healthcare Providers contend Biggs cannot opine with reasonable medical probability on changed treatment. | No reasonable medical probability shown; judgment affirmed. |
| Effectiveness of affidavit of merit for causation | Affidavit of merit suffices to establish causation at trial. | Affidavit aids gatekeeping but does not alone prove causation. | Affidavit alone insufficient to raise triable causation issue. |
| Recanted Biggs testimony viability | Recast Biggs statement could show 'likely' not 'probably' and prove causation. | Waived; even if considered, testimony remains inconclusive. | Waiver waived consideration; cannot establish causation. |
| Statutory standard for causation evidence | Del. 18 § 6853(e)(3) permits causation proof by expert. | Statute requires competent expert testimony; Biggs’s testimony was speculative. | Statutory standard unmet; summary judgment affirmed. |
Key Cases Cited
- Kardos v. Harrison, 980 A.2d 1014 (Del.2009) (causation and expert testimony standards)
- O’Riley v. Rogers, 69 A.3d 1007 (Del.2013) (causation expert testimony requirements)
- Floray v. State, 720 A.2d 1132 (Del.1998) (standard for medical negligence proof)
- Oxendine v. State, 528 A.2d 870 (Del.1987) (evidentiary standards in negligence actions)
- Dishmon v. Fucci, 32 A.3d 338 (Del.2011) (evidentiary burden and expert testimony)
- Brown v. Liberty Mut. Ins. Co., 774 A.2d 232 (Del.2001) (causation and damages considerations)