{ "id": 5155781, "name": "RAYMOND EARL LEE, a Minor, by Ray Lee, his Father and Next Friend, Plaintiff-Appellant, v. INGALLS MEMORIAL HOSPITAL et al., Defendants-Appellees", "name_abbreviation": "Lee v. Ingalls Memorial Hospital", "decision_date": "1992-10-26", "docket_number": "No. 1\u201491\u20140525", "first_page": "154", "last_page": "161", "citations": [ { "type": "official", "cite": "238 Ill. App. 3d 154" } ], "court": { "name_abbreviation": "Ill. App. Ct.", "id": 8837, "name": "Illinois Appellate Court" }, "jurisdiction": { "id": 29, "name_long": "Illinois", "name": "Ill." }, "cites_to": [ { "cite": "541 N.E.2d 1115", "category": "reporters:state_regional", "reporter": "N.E.2d", "opinion_index": 0 }, { "cite": "127 Ill. 2d 642", "category": "reporters:state", "reporter": "Ill. 2d", "opinion_index": 0 }, { "cite": "536 N.E.2d 1292", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1989, "opinion_index": 0 }, { "cite": "181 Ill. App. 3d 312", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 8498437 ], "year": 1989, "opinion_index": 0, "case_paths": [ "/ill-app-3d/181/0312-01" ] }, { "cite": "571 N.E.2d 492", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1989, "opinion_index": 0 }, { "cite": "213 Ill. App. 3d 134", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 2604301 ], "year": 1989, "opinion_index": 0, "case_paths": [ "/ill-app-3d/213/0134-01" ] }, { "cite": "588 N.E.2d 337", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1991, "opinion_index": 0 }, { "cite": "225 Ill. App. 3d 653", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 5246519 ], "year": 1991, "opinion_index": 0, "case_paths": [ "/ill-app-3d/225/0653-01" ] }, { "cite": "534 N.E.2d 472", "category": "reporters:state_regional", "reporter": "N.E.2d", "opinion_index": 0 }, { "cite": "179 Ill. App. 3d 214", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 2607854 ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/179/0214-01" ] }, { "cite": "571 N.E.2d 840", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1989, "opinion_index": 0 }, { "cite": "212 Ill. App. 3d 779", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 2600885 ], "year": 1989, "opinion_index": 0, "case_paths": [ "/ill-app-3d/212/0779-01" ] }, { "cite": "548 N.E.2d 1066", "category": "reporters:state_regional", "reporter": "N.E.2d", "opinion_index": 0 }, { "cite": "128 Ill. 2d 661", "category": "reporters:state", "reporter": "Ill. 2d", "opinion_index": 0 }, { "cite": "540 N.E.2d 770", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1989, "opinion_index": 0 }, { "cite": "185 Ill. App. 3d 64", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 2648185 ], "year": 1989, "opinion_index": 0, "case_paths": [ "/ill-app-3d/185/0064-01" ] }, { "cite": "580 N.E.2d 108", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1989, "opinion_index": 0 }, { "cite": "141 Ill. 2d 536", "category": "reporters:state", "reporter": "Ill. 2d", "year": 1989, "opinion_index": 0 }, { "cite": "573 N.E.2d 279", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1991, "opinion_index": 0 }, { "cite": "214 Ill. App. 3d 47", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 5297337 ], "year": 1991, "opinion_index": 0, "case_paths": [ "/ill-app-3d/214/0047-01" ] }, { "cite": "567 N.E.2d 330", "category": "reporters:state_regional", "reporter": "N.E.2d", "opinion_index": 0 }, { "cite": "136 Ill. 2d 542", "category": "reporters:state", "reporter": "Ill. 2d", "opinion_index": 0 }, { "cite": "559 N.E.2d 1155", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1991, "opinion_index": 0 }, { "cite": "202 Ill. App. 3d 27", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 2587546 ], "year": 1991, "opinion_index": 0, "case_paths": [ "/ill-app-3d/202/0027-01" ] } ], "analysis": { "cardinality": 688, "char_count": 15006, "ocr_confidence": 0.769, "pagerank": { "raw": 7.54314262457722e-08, "percentile": 0.44777475443549025 }, "sha256": "f6579a4ccbafc8c38b3fc9844fcf2a0d73607e6c5595476069881708220820b6", "simhash": "1:a99729c337130296", "word_count": 2467 }, "last_updated": "2023-07-14T19:49:43.416061+00:00", "provenance": { "date_added": "2019-08-29", "source": "Harvard", "batch": "2018" }, "casebody": { "judges": [], "parties": [ "RAYMOND EARL LEE, a Minor, by Ray Lee, his Father and Next Friend, Plaintiff-Appellant, v. INGALLS MEMORIAL HOSPITAL et al., Defendants-Appellees." ], "opinions": [ { "text": "JUSTICE O\u2019CONNOR\ndelivered the opinion of the court:\nPlaintiff, Raymond Earl Lee, by his father and next friend, Ray Lee, sought damages from defendant, Ingalls Memorial Hospital, and codefendant, Dr. Jalai Abtahi, for injuries received because of defendants\u2019 alleged negligence during Raymond\u2019s birth at the hospital on February 27, 1977. At the ensuing trial, a jury returned a verdict against Dr. Abtahi for $3.3 million. The jury also returned a verdict in favor of the hospital. Plaintiff appeals from the jury\u2019s verdict in favor of the hospital.\nWe affirm.\nCynthia Lee, Raymond\u2019s mother, testified that she arrived at the hospital at 12:20 a.m. on February 27, 1977. Following her admission, two nurses performed a preliminary examination of her. Mrs. Lee did not recall being given any medication at this point. Later, Mrs. Lee was transferred to the labor room where she received medication intravenously. Not long after, Dr. Abtahi entered the room and told her to push. After pressing on her stomach, he told her that she had to be put to sleep. Mrs. Lee next saw Dr. Abtahi after she had recovered, and he informed her that he had experienced difficulty in delivering the baby\u2019s shoulders and that he had had to \u201cuse some instruments.\u201d Mrs. Lee stated that Raymond has trouble with his right arm, which he cannot use in a normal manner.\nAccording to plaintiff\u2019s expert, Dr. Ronald Lorenzini, Raymond\u2019s birth was complicated by a condition known as dystocia, which arises when a baby\u2019s shoulders cannot be delivered following the delivery of the infant\u2019s head during the course of a normal birth. Lorenzini stated that the medical care and treatment afforded to Mrs. Lee in this case were not within the accepted standard of medical care. Specifically, Lorenzini faulted the hospital\u2019s \u201cinjudicious\u201d use of Pitocin and Dr. Abtahi\u2019s \u201cexcess force.\u201d Pitocin is an oxytocic drug which causes the uterus to contract forcefully and is used to stimulate labor. Lorenzini noted that, according to the hospital record of Raymond\u2019s birth, Pitocin was given to Mrs. Lee intravenously at some time \u201cpredelivery.\u201d Lorenzini stated that if Pitocin was given pursuant to a verbal order of the doctor, then no deviation from the standard of care occurred. Moreover, Lorenzini admitted that Pitocin has no relationship to the development of dystocia and that there was no indication that the administration of Pitocin to Mrs. Lee prior to Raymond\u2019s delivery caused or contributed to the injury at issue. Lorenzini stated the child\u2019s injury was due to Abtahi\u2019s inappropriate use of forceps and excess force.\nDr. Abtahi testified that he received two telephone calls from the hospital on February 27, 1977, regarding Mrs. Lee\u2019s labor. During one of the calls, he ordered Demerol, a painkiller, for Mrs. Lee. According to the nursing progress notes, no oxytocic drugs were administered to Mrs. Lee while she was in the labor room. Abtahi could not recall if he ordered Pitocin for Mrs. Lee. If he did order Pitocin verbally, there would not be a written order for it on Mrs. Lee\u2019s chart. The only indication of such a verbal order would be an \u201cX\u201d on the delivery room record, which, in fact, appeared on Mrs. Lee\u2019s chart. If, however, Pitocin was given to Mrs. Lee without his order, then a deviation from the accepted standard of care had occurred. During Raymond\u2019s delivery, the baby\u2019s shoulders became lodged behind Mrs. Lee\u2019s pelvis. To facilitate the delivery, Abtahi used forceps and performed maneuvers. After the child was born, Abtahi noticed that the child\u2019s right arm was injured.\nBettie Yale, one of the labor and delivery room nurses who attended Mrs. Lee on the night in question, testified that, after Mrs. Lee\u2019s admission to the hospital, Dr. Abtahi was telephoned. At 1 a.m., Dr. Abtahi was called to come to the hospital because Mrs. Lee\u2019s labor had progressed. Mrs. Lee was given Demerol intravenously pursuant to the doctor\u2019s telephone order. Mrs. Lee was brought into the delivery room at 1:25 a.m. According to Yale, the labor was stimulated with the aid of Pitocin, which was given intravenously in the delivery room. Yale swore that she did not give Mrs. Lee Pitocin without an order from the doctor. During deliveries, Pitocin commonly is ordered verbally because the physician cannot take the time to write out a written order. In contrast, a written order is required if the drug is to be administered in the labor room.\nRoseanne Rooney was the other labor and delivery room nurse who attended Mrs. Lee on February 27. Rooney made entries on Mrs. Lee\u2019s chart, noting her vital statistics and the medicinal orders received by phone from Dr. Abtahi. These drugs were noted on Mrs. Lee\u2019s labor room record and on her \u201cIV fluid sheet.\u201d According to Rooney, Dr. Abtahi did not order Pitocin over the phone, and Mrs. Lee did not receive the drug in the labor room because if such an order had been given, Pitocin would have been noted on Mrs. Lee\u2019s labor room record, on her medication record and on her IV fluid sheet. Mrs. Lee began receiving medicine intravenously at 1 a.m., and she was taken to the delivery room at 1:25 a.m. According to Mrs. Lee\u2019s delivery room record, she was given Pitocin in the delivery room \u201cpredelivery\u201d on the verbal order of Dr. Abtahi. Rooney swore that she did not administer Pitocin without the doctor\u2019s order. Neither Rooney nor Yale could state positively that she entered the \u201cX\u201d on Mrs. Lee\u2019s delivery room record, indicating that Pitocin had been administered.\nMary Sandra Weaver, the hospital\u2019s coordinator of nursing policy and procedure, testified that, during 1977, 10 to 12 policies were in effect, one of which was an obstetric and gynecology policy book and one of which was a general nursing policy book. The obstetric and gynecology policy book applied only to nurses working in that specialty area. The general policy book governed the entire nursing department. According to Weaver, verbal and written order policy concerning the drug Pitocin would not be contained in the general nursing policy book because that drug is only administered in the specialty area of obstetrics and gynecology. Weaver identified the general nursing policy book revised on August 8, 1978. That particular policy made no reference to Pitocin. Weaver attempted to search for the policy manual in effect during the time in question, but could not locate it. Weaver did not know the practice of Pitocin administration in delivery room situations in 1977 because she was not a \u201clabor/delivery\u201d room nurse.\nBoth defendants\u2019 experts testified that the \u201cX\u201d on the delivery room record indicated that Pitocin was administered to Mrs. Lee and that such a procedure comported with the standard of care. Both doctors testified that the administration of Pitocin did not cause or contribute to Raymond\u2019s injury.\nFollowing closing arguments, the jury returned the verdicts indicated above. The circuit court denied all post-trial motions, and this appeal followed.\nPlaintiff first asserts that circuit court erred by refusing to allow certain rebuttal evidence. Plaintiff contends the hospital, at trial, claimed to be in compliance with applicable written hospital policies, contrary to the position it took during discovery, when it claimed that such policies did not exist. Specifically, plaintiff sought to admit the following interrogatory answer provided by the hospital during discovery:\n\u201cThere is no hospital protocol for documentation of verbal orders for the date of this incident. The policy was written in 4/7/ 76, revised in 5/25/76, and revised in 8/8/78 and therefore it is unclear from the 1978 policy what policy was in effect in 1976 and therefore this policy will not be turned over as it is an irrelevant post-occurrence policy.\u201d\nThe circuit court refused to admit this answer into evidence during rebuttal.\nGenerally, the allowance of rebuttal evidence lies within the discretion of the circuit court, and its ruling on the issue will not be set aside absent an abuse of discretion. (Danhof v. Richland Township (1990), 202 Ill. App. 3d 27, 559 N.E.2d 1155, appeal denied (1991), 136 Ill. 2d 542, 567 N.E.2d 330.) Here, the hospital claimed it complied with the policies contained in its Obstetrics and Gynecology Policy and Procedure Manual which was in effect in 1977. This was produced to plaintiff during discovery and was referred to by the various witnesses at trial. Mary Sandra Weaver, the hospital\u2019s coordinator of policy during the time in question, testified that she was unable to locate any general written policy for verbal orders prior to the one effective August 8, 1978. We have examined the testimony presented and the material produced during discovery and find that circuit court did not abuse its discretion in this matter because the hospital\u2019s position at trial was consistent with the answers given during discovery.\nPlaintiff further argues that the circuit court erred in admitting the testimony of Mary Sandra Weaver, the hospital\u2019s coordinator of nursing policy, because no foundation was laid as to Weaver\u2019s opinion regarding the hospital\u2019s policies in 1977.\nAfter carefully reviewing Weaver\u2019s testimony, we are satisfied that Weaver did not render any opinions regarding compliance with the standard of care nor did she give any opinion as to how a verbal order for Pitocin should be entered on the delivery room chart. In fact, Weaver stated that she did not know how Pitocin was administered in the labor and the delivery room because she was not a \u201clabor/delivery\u201d nurse. Weaver merely testified that the hospital did indeed have policy manuals with regard to the various nursing departments. Weaver, as the hospital\u2019s coordinator of nursing policy, was certainly competent to identify which policy manual governed which particular nursing department. No error occurred as a result of Weaver\u2019s testimony.\nFinally, plaintiff contends that the circuit court, by striking a portion of his expert\u2019s testimony, improperly prevented him from establishing the theory of his case.\nPrior to trial, Dr. Lorenzini was deposed by the hospital. During the deposition, the following questions and answers were given:\n\u201cQ. \u2018Does Pitocin have any relationship to the development of the shoulder dystocia?\u2019\nA. \u2018No, sir.\u2019\nQ. \u2018Was the Pitocin or the use of Pitocin any part of a mechanism of injury in this case?\u2019\nA. \u2018No, sir.\u2019\nQ. \u2018Doctor, is there any indication that the delivery of Pitocin used prior to delivery caused or contributed to this child\u2019s injury?\u2019\nA. \u2018No, sir.\u2019\nQ. \u2018Do you have any criticism of the nursing care or the hospital care afforded to this patient?\u2019\nA. \u2018This patient was given Pitocin. There\u2019s no documentation that Pitocin was used in any of the medication order sheets.\u2019\nQ. T thought we had commented in an earlier point after a lot of discussion about the Pitocin that had no relationship to the injury to the fetus?\u2019\nA. \u2018Correct.\u2019\n\u2018So if that\u2019s a criticism, it is a criticism that does not relate to the injury in this case?\u2019\nAnswer: \u2018Correct.\u2019 \u201d\nBefore the beginning of the trial, the circuit court entered an order, pursuant to Supreme Court Rule 220(d) (134 Ill. 2d R. 220(d)), which stated that no expert would be allowed to \u201cgo beyond the testimony that has been disclosed in their depositions.\u201d During his testimony at trial, however, Dr. Lorenzini attempted to state that the administration of Pitocin caused Dr. Abtahi to use forceps and apply the excessive force. The hospital objected to this testimony, arguing that Lorenzini\u2019s testimony contradicted the opinions he previously had given in his deposition.\nSupreme Court Rule 220(d) (134 Ill. 2d R. 220(d)) safeguards against an expert witness from testifying during direct examination in a manner inconsistent \"with the facts known or the opinions disclosed during discovery. The rule also prevents the expert from going beyond the fair scope of the opinions or facts given at the deposition. (Baird v. Adeli (1991), 214 Ill. App. 3d 47, 573 N.E.2d 279, appeal denied (1991), 141 Ill. 2d 536, 580 N.E.2d 108; Bart v. Union Oil Co. (1989), 185 Ill. App. 3d 64, 540 N.E.2d 770, appeal denied (1989), 128 Ill. 2d 661, 548 N.E.2d 1066.) To that end, Rule 220 was promulgated so as to allow litigants the opportunity to discover and rely upon the opinions of the experts retained by their opponents. (134 Ill. 2d R. 220, Committee Comments.) Thus, an expert\u2019s testimony is restricted to the opinions expressed in the expert\u2019s deposition. (Zajac v. St. Mary of Nazareth Hospital Center (1991), 212 Ill. App. 3d 779, 571 N.E.2d 840.) As a result, any opinion expressed by an expert in addition to the opinion expressed in his deposition must be excluded. See Ramos v. Pyati (1989), 179 Ill. App. 3d 214, 534 N.E.2d 472.\nPlaintiff\u2019s counsel, at oral argument, maintained that the hospital, during its deposition, failed to ask Dr. Lorenzini the proper questions regarding the \u201cintervening sequence\u201d between the injury and the administration of the drug and, as a result, should not now be allowed to benefit from that failure. We disagree.\nDr. Lorenzini was asked several times, during his deposition, whether Pitocin \u201ccaused or contributed to\u201d or was \u201cany part of a mechanism of\u201d Raymond\u2019s injury. He consistently responded that it did not. He also agreed that Pitocin had no \u201crelationship\u201d to the injury at issue. Given these responses to the questions, we cannot say that the hospital failed to question Lorenzini adequately. The deposition questions, as noted above, clearly invited Lorenzini to make a causal connection between Pitocin and the excess force used by Dr. Abtahi. Apparently, Lorenzini did not have that opinion at the time of the deposition. However, at trial, Lorenzini stated that \u201cwhen Pitocin was administered to this patient, the contractions became very quick, forceful, and promoted the doctor to use the forceps to protect the infant\u2019s head with the delivery of the infant as he so stated.\u201d This opinion was contrary to the opinion given in the deposition. Accordingly, the circuit court did not err in refusing to allow Lorenzini to testify beyond the scope of his deposition testimony. See Chicago & Illinois Midland Ry. Co. v. Crystal Lake Industrial Park, Inc. (1992), 225 Ill. App. 3d 653, 588 N.E.2d 337; Marshall v. Osborn (1991), 213 Ill. App. 3d 134, 571 N.E.2d 492; Stringham v. United Parcel Service, Inc. (1989), 181 Ill. App. 3d 312, 536 N.E.2d 1292, appeal dismissed (1989), 127 Ill. 2d 642, 541 N.E.2d 1115.\nFor the foregoing reasons, the judgment of the circuit court must be affirmed.\nAffirmed.\nBUCKLEY, P.J., and CAMPBELL, J., concur.", "type": "majority", "author": "JUSTICE O\u2019CONNOR" } ], "attorneys": [ "Donald Y. Young, of Chicago, for appellant.", "Laura J. Ginett, Hugh C. Griffin, and Kathryn C. Wyatt, all of Lord, Bissell & Brook, of Chicago, for appellees." ], "corrections": "", "head_matter": "RAYMOND EARL LEE, a Minor, by Ray Lee, his Father and Next Friend, Plaintiff-Appellant, v. INGALLS MEMORIAL HOSPITAL et al., Defendants-Appellees.\nFirst District (1st Division)\nNo. 1\u201491\u20140525\nOpinion filed October 26, 1992.\nDonald Y. Young, of Chicago, for appellant.\nLaura J. Ginett, Hugh C. Griffin, and Kathryn C. Wyatt, all of Lord, Bissell & Brook, of Chicago, for appellees." }, "file_name": "0154-01", "first_page_order": 172, "last_page_order": 179 }