158 Conn.App. 680
Conn. App. Ct.2015Background
- Decedent Linda Jablonski presented to Stamford Hospital ER with headache, nausea and vomiting; treated and discharged by Dr. Samuel Maryles; next day she was found disoriented and later died of herpes simplex encephalitis.
- Plaintiff (administratrix) sued for medical malpractice alleging failure to diagnose/treat; Maryles was not disclosed as an expert and no foundation for expert opinion was laid at trial.
- During plaintiff’s direct examination Maryles (called as a fact witness) agreed that an "atypical" headache generally requires CT and lumbar puncture; plaintiff’s counsel said he was not offering Maryles as an expert.
- On defendants’ later direct examination the court allowed Maryles to give expanded medical-opinion testimony under the "open the door" doctrine; plaintiff’s objections were overruled and plaintiff was restricted in cross-examining Maryles about his credentials and a prior New York consent order.
- Jury found for defendants (plaintiff failed to prove deviation from standard of care); trial court denied motion for new trial. Appellate court reversed and ordered a new trial, finding abusive admission of out-of-foundation expert testimony and improper limitation on cross-examination that was harmful.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether court abused its discretion by permitting Maryles to give expert opinions without foundation under the open-door doctrine | Plaintiff: Maryles was not disclosed or qualified as an expert; defendants’ direct examination exceeded the scope of plaintiff’s limited elicited opinion and improperly introduced expert testimony | Defendants: Plaintiff opened the door by eliciting medical opinion on direct, so defendants could elicit explanatory opinion within the same scope | Court: Abuse of discretion — defendants’ questioning went beyond scope necessary to rebut and admitted expert opinion without required foundational qualification; admission was improper and harmful |
| Whether plaintiff was denied a fair opportunity to cross-examine Maryles about credentials and prior disciplinary matter | Plaintiff: Once defendants elicited expert-level testimony, plaintiff should have been allowed to probe Maryles’ qualifications and credibility, including background that would impeach him | Defendants: Motion in limine barred inquiry into the prior NY consent order and related disciplinary details as unduly prejudicial | Court: Abuse of discretion — plaintiff was wrongly precluded from testing Maryles’ qualifications and credibility after his expert-style testimony; cross-examination is a substantial right |
| Whether Stamford Hospital owed a nondelegable duty to ER patients (motion to strike) | Plaintiff: State and federal regulations requiring hospitals to provide emergency care create a nondelegable duty making hospital liable for malpractice of contracted ER physicians | Stamford Hospital: Connecticut law does not recognize such a nondelegable duty in this context; regulations do not create one | Court: Affirmed motion to strike — regulations cited do not impose a nondelegable duty here; Connecticut has not recognized this species of hospital liability |
| Whether apparent agency could render Stamford Hospital vicariously liable for Maryles (trial-court ruling) | Plaintiff: Hospital may be liable under apparent agency theory | Defendants: Jury’s verdict in favor of Maryles rendered apparent-agency claim moot | Court: Issue was moot on appeal (jury found Maryles not liable), so appellate court declined to reach merits of apparent agency question |
Key Cases Cited
- Prentice v. Dalco Electric, Inc., 280 Conn. 336 (standard: evidentiary rulings overturned only for clear abuse of discretion)
- Swenson v. Sawoska, 215 Conn. 148 (erroneously admitted evidence is harmful only if it likely affected the result)
- State v. George, 194 Conn. 361 (expert must have skill/knowledge beyond juror; danger of ‘‘gloss of expertise’’)
- Somers v. LeVasseur, 230 Conn. 560 (open-the-door doctrine permits limited inquiry necessary to remove unfair prejudice)
- State v. Graham, 200 Conn. 9 (purpose and limits of opening the door to rebuttal evidence)
- Blanchard v. Bridgeport, 190 Conn. 798 (court must preliminarily assess sufficiency of expert qualifications)
- Weaver v. McKnight, 313 Conn. 393 (party offering expert must establish special skill/knowledge foundationally)
- Gold v. Greenwich Hospital Assn., 262 Conn. 248 (definition of standard of care in medical malpractice)
- Machado v. Hartford, 292 Conn. 364 (nondelegable duty doctrine and when it creates vicarious liability)