Ruff v. Yale-New Haven Hospital, Inc.
161 A.3d 552
| Conn. App. Ct. | 2017Background
- Plaintiff Michael Ruff underwent right knee replacement at Yale-New Haven Hospital on Feb. 4, 2010; a Foley catheter was placed intraoperatively by RN Dianne Meltzer. Meltzer reported immediate urine return and some blood-tinged urine.
- After discharge, Ruff had urinary difficulties, multiple catheter changes, and ultimately presented in March 2010 to a urologist (Dr. Camilleri) who dilated a urethral stricture to place a catheter; Ruff had a long prior urologic history and took multiple medications including blood thinners.
- Ruff sued the hospital for malpractice alleging negligent insertion of the Foley catheter that punctured his prostate and caused ongoing injuries; he disclosed RN Donna Maselli as his sole standard-of-care expert for nursing care.
- Maselli’s background: nurse consultant for the state Department of Public Health (nonclinical) since 1995, CEO of a medical-legal consulting firm (reviewed records), and occasional private-duty nursing (basic care, no routine Foley insertions; last hospital catheter placement in the 1980s).
- The trial court granted the hospital’s motion in limine to preclude Maselli under Conn. Gen. Stat. § 52‑184c (b) and (d) for lack of ‘‘active involvement in the practice or teaching of nursing’’ within five years of the incident; after plaintiff rested, the court granted a directed verdict for the defendant for lack of expert proof of the standard of care.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Maselli was qualified under § 52‑184c(b) as a "similar health care provider" to testify as nursing standard‑of‑care expert | Maselli’s status as a licensed RN and nursing practice within five years (private duty/home care and dept. work) sufficed; no subclass of nurses should be created | Maselli lacked active clinical/hospital nursing involvement or recent catheterization experience within five years and thus failed § 52‑184c(b) | Court held Maselli not a similar health care provider under § 52‑184c(b) because she lacked required active clinical practice in the five years before the incident |
| Whether Maselli could testify under § 52‑184c(d) (residual catch‑all) | Even if not a similar provider, Maselli’s training, experience, and knowledge from related practice/teaching satisfied (d) | Maselli’s experience did not include active practice/teaching within five years in a related field sufficient to meet (d) | Court held Maselli also failed to satisfy § 52‑184c(d) because she lacked active involvement in practice/teaching within the five‑year period |
| Whether exclusion of Maselli was an abuse of discretion | Exclusion was erroneous — Maselli’s nonhospital roles still gave relevant nursing expertise | Exclusion was within trial court discretion under statutory framework and facts | Appellate court found no abuse of discretion; exclusion upheld |
| Whether directed verdict for defendant was proper after Maselli’s exclusion | Directed verdict was improper if other evidence could establish standard/causation | Without an admitted standard‑of‑care expert, plaintiff cannot establish a required element of malpractice | Directed verdict affirmed: plaintiff failed to present expert evidence as to the requisite standard of care, so no jury could lawfully find for plaintiff |
Key Cases Cited
- Wright v. Hutt, 50 Conn. App. 439 (trial court’s exclusion of expert reviewed for abuse of discretion)
- Bennett v. New Milford Hosp., Inc., 300 Conn. 1 (statutory five‑year active practice requirement for medical malpractice expert testimony)
- DiLieto v. County Obstetrics & Gynecology Group, P.C., 265 Conn. 79 (expert must be similar health care provider or satisfy § 52‑184c(d))
- Grondin v. Curi, 262 Conn. 637 (definition of prevailing professional standard and role of similar health care providers)
- Hayes v. Decker, 263 Conn. 677 (standards for admitting expert testimony)
- Mather v. Griffin Hosp., 207 Conn. 125 (expert testimony required to establish standard of care in malpractice cases)
- State v. Porter, 241 Conn. 57 (challenges to expert testimony reliability — alternative ground raised by defendant, not decided)