{ "id": 4267149, "name": "KATHERINE ADAMS, Plaintiff-Appellee, v. SARAH BUSH LINCOLN HEALTH CENTER et al., Defendants-Appellants", "name_abbreviation": "Adams v. Sarah Bush Lincoln Health Center", "decision_date": "2007-01-23", "docket_number": "No. 4\u201406\u20140284", "first_page": "988", "last_page": "1006", "citations": [ { "type": "official", "cite": "369 Ill. App. 3d 988" } ], "court": { "name_abbreviation": "Ill. App. Ct.", "id": 8837, "name": "Illinois Appellate Court" }, "jurisdiction": { "id": 29, "name_long": "Illinois", "name": "Ill." }, "cites_to": [ { "cite": "114 S. Ct. 337", "category": "reporters:federal", "reporter": "S. Ct.", "year": 1993, "pin_cites": [ { "parenthetical": "stating that petitioner died in Pontiac, Illinois" } ], "opinion_index": 0 }, { "cite": "126 L. Ed. 2d 245", "category": "reporters:federal", "reporter": "L. Ed. 2d", "year": 1993, "pin_cites": [ { "parenthetical": "stating that petitioner died in Pontiac, Illinois" } ], "opinion_index": 0 }, { "cite": "510 U.S. 910", "category": "reporters:federal", "reporter": "U.S.", "case_ids": [ 230257, 230499, 232700, 231687 ], "year": 1993, "pin_cites": [ { "parenthetical": "stating that petitioner died in Pontiac, Illinois" } ], "opinion_index": 0, "case_paths": [ "/us/510/0910-03", "/us/510/0910-04", "/us/510/0910-01", "/us/510/0910-02" ] }, { "cite": "113 S. Ct. 2927", "category": "reporters:federal", "reporter": "S. Ct.", "year": 1993, "opinion_index": 0 }, { "cite": "124 L. Ed. 2d 678", "category": "reporters:federal", "reporter": "L. 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App. 3d 763", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 1209127 ], "year": 2002, "pin_cites": [ { "page": "773" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/331/0763-01" ] }, { "cite": "810 N.E.2d 65", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2004, "pin_cites": [ { "page": "80" } ], "opinion_index": 0 }, { "cite": "348 Ill. App. 3d 423", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 4023513 ], "year": 2004, "pin_cites": [ { "page": "443" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/348/0423-01" ] }, { "cite": "417 N.E.2d 1322", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1981, "pin_cites": [ { "page": "1327" } ], "opinion_index": 0 }, { "cite": "84 Ill. 2d 186", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 3045513 ], "year": 1981, "pin_cites": [ { "page": "196" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/84/0186-01" ] }, { "cite": "821 N.E.2d 326", "category": "reporters:state_regional", "reporter": "N.E.2d", "weight": 3, "year": 2004, "pin_cites": [ { "page": "331" }, { "page": "331" } ], "opinion_index": 0 }, { "cite": "354 Ill. App. 3d 515", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 3216989 ], "weight": 3, "year": 2004, "pin_cites": [ { "page": "521" }, { "page": "521" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/354/0515-01" ] }, { "cite": "314 N.E.2d 623", "category": "reporters:state_regional", "reporter": "N.E.2d", "weight": 3, "year": 1974, "pin_cites": [ { "page": "626-27" } ], "opinion_index": 0 }, { "cite": "20 Ill. App. 3d 275", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 5346739 ], "weight": 3, "year": 1974, "pin_cites": [ { "page": "279" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/20/0275-01" ] }, { "cite": "365 N.E.2d 549", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1977, "pin_cites": [ { "page": "552", "parenthetical": "finding that the portion of the deposition not admitted was permissibly excluded by the trial court on the grounds that it was an impermissibly hypothetical question posed to the witness" } ], "opinion_index": 0 }, { "cite": "49 Ill. App. 3d 990", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 5638776 ], "year": 1977, "pin_cites": [ { "page": "995", "parenthetical": "finding that the portion of the deposition not admitted was permissibly excluded by the trial court on the grounds that it was an impermissibly hypothetical question posed to the witness" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/49/0990-01" ] }, { "cite": "823 N.E.2d 184", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2005, "pin_cites": [ { "page": "192" } ], "opinion_index": 0 }, { "cite": "355 Ill. App. 3d 257", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 3599190 ], "year": 2005, "pin_cites": [ { "page": "266" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/355/0257-01" ] }, { "cite": "857 N.E.2d 846", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2006, "pin_cites": [ { "page": "851" } ], "opinion_index": 0 }, { "cite": "368 Ill. 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App. 3d 881", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 5138652 ], "weight": 4, "year": 1992, "pin_cites": [ { "page": "888" }, { "page": "888" }, { "page": "888" }, { "page": "892" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/240/0881-01" ] } ], "analysis": { "cardinality": 1409, "char_count": 44745, "ocr_confidence": 0.768, "pagerank": { "raw": 5.935056634834337e-08, "percentile": 0.37041271518146424 }, "sha256": "a7b85769515b5384f9cbe55b723a5215ee93b3630f4b7cdcf70129920ed3bb3a", "simhash": "1:3f6c80e757878c4c", "word_count": 7100 }, "last_updated": "2023-07-14T20:04:07.948493+00:00", "provenance": { "date_added": "2019-08-29", "source": "Harvard", "batch": "2018" }, "casebody": { "judges": [], "parties": [ "KATHERINE ADAMS, Plaintiff-Appellee, v. SARAH BUSH LINCOLN HEALTH CENTER et al., Defendants-Appellants." ], "opinions": [ { "text": "JUSTICE MYERSCOUGH\ndelivered the opinion of the court:\nPlaintiff, Katherine Adams, sued defendants, Dr. Kellie JonesMonahan and Sarah Bush Lincoln Health Center, alleging that Dr. Jones-Monahan was negligent in removing Adams\u2019s gallbladder. The jury returned a verdict in Adams\u2019s favor and assessed damages against defendants in the amount of $561,389.90. The trial court denied defendants\u2019 motion for a new trial. On appeal, defendants argue that the trial court abused its discretion when it refused to allow defendants to present certain portions of Dr. Steven Strasberg\u2019s testimony during cross-examination or in their case in chief and that the trial court abused its discretion by allowing plaintiff to question defendants\u2019 expert Dr. Mark Kadowaki regarding his knowledge of Dr. Strasberg\u2019s views of Dr. Kadowaki\u2019s preferred surgical technique. We affirm.\nI. BACKGROUND\nPlaintiff went to Sarah Bush Lincoln Health Center on November 15, 2002, for routine laparoscopic gallbladder-removal surgery, also known as cholecystectomy. The surgery was performed by Dr. Kellie Jones-Monahan. Prior to the surgery, Dr. Jones-Monahan warned plaintiff of possible complications that could result from the surgery, including injury to the common bile duct. Dr. Jones-Monahan also informed plaintiff of the possibility that she may have to convert the surgery from a laparoscopic procedure to open surgery if she encountered any problems. Plaintiff consented.\nDuring the surgery, Dr. Jones-Monahan noted the gallbladder was intrahepatic, meaning it was almost completely encased by the liver. Dr. Jones-Monahan also noticed chronic scarring in the area of the bile ducts. During the surgery plaintiffs gallbladder was removed. However, Dr. Jones-Monahan also divided plaintiff\u2019s common bile duct, which is not supposed to be severed during this type of surgery. This created a serious injury to plaintiffs remaining biliary system. While still in the operating room after the surgery, Dr. Jones-Monahan conducted an X-ray, called a cholangiogram. The cholangiogram allowed Dr. Jones-Monahan to discover plaintiff had been injured. Also while still in the operating room, Dr. Jones-Monahan contacted Dr. Steven Strasberg, who was a surgeon specializing in hepatobiliary surgery at Barnes-Jewish Hospital in St. Louis, Missouri (Barnes). The injury to plaintiff\u2019s common bile duct required her to be transported to Barnes via ambulance. At Barnes, Dr. Strasberg became plaintiff\u2019s treating physician. In February 2003, Dr. Strasberg performed surgery to repair the injury to plaintiffs common bile duct.\nAt trial, plaintiff presented Dr. Richard Vasquez as an expert witness. Dr. Vasquez testified that it was his opinion that Dr. JonesMonahan did not comport with the standard of care in performing plaintiff\u2019s cholecystectomy. Dr. Vasquez explained the relevant anatomy and fundamentals of the surgery to the court. First, he explained that the liver creates bile and that the gallbladder acts as a reservoir for bile created by the liver. Its function is to break down the fats in food. Dr. Vasquez explained that the bile is carried through the liver by the right and left hepatic ducts. These two ducts join to form the common hepatic duct. The cystic duct from the gallbladder joins the common hepatic duct. Above this junction, the duct is referred to as the hepatic duct. Below this junction, it is called the common bile duct. The common bile duct empties bile into the opening of the small intestine, which is called the duodenum.\nTo remove the gallbladder, a doctor must identify and cut the cystic duct and the cystic artery. Nothing else need be cut to remove the gallbladder. Doctors may use what is called the triangle of Calot to identify the structures properly. The triangle of Calot is an area bordered by the cystic artery, the cystic duct, and the common hepatic duct. If the doctor is uncertain whether she has identified the right structures, she may perform a cholangiogram, which is an X-ray conducted in the operating room that uses dye to show the doctor the location of the ducts. The doctor may also choose to open the patient\u2019s abdomen and perform open surgery.\nDr. Jones-Monahan did conduct a cholangiogram on plaintiff but not until after she had divided structures inside of her. Dr. Vasquez testified that Dr. Jones-Monahan should have used a cholangiogram prior to cutting any structures. Dr. Vasquez stated that Dr. JonesMonahan was not operating within the triangle of Calot. He stated that failure to dissect within the triangle of Calot was a deviation from the standard of care. Dr. Vasquez said that Dr. Jones-Monahan\u2019s notes from the operation indicate that the cystic duct, which was the intended duct to dissect, was isolated. However, Dr. Vasquez points out that her notes never indicate that she had identified that duct or the cystic artery. Instead, Dr. Vasquez surmises that she was looking at the common bile duct, which she eventually cut. Dr. Vasquez said that the cholangiogram, if performed prior to cutting, would have shown Dr. Jones-Monahan that she was wrong. He also testified that Dr. Jones-Monahan\u2019s failure to convert the surgery into an open procedure violated the standard of care.\nDr. Vasquez stated that variations in anatomy do not excuse injury. Any variations or abnormalities encountered by the doctor can be clarified by X-ray or by converting the procedure into an open surgery rather than laparoscopic. Dr. Vasquez agreed that telling a patient of the risks inherent in cholecystectomy surgery does not allow a doctor to injure the duct.\nDr. Jones-Monahan\u2019s testimony agreed with Dr. Vasquez\u2019s account of how the injury to plaintiffs common bile duct occurred. Dr. JonesMonahan admitted a misidentification occurred and that the common bile duct had been mistakenly dissected. She said that at the conclusion of the procedure it appeared to her that plaintiffs hepatic duct had been divided. Dr. Jones-Monahan said that she would not refer to plaintiffs anatomy as abnormal. She said there was inflammation of the gallbladder, but that is to be expected of a patient who is having her gallbladder removed.\nDr. Jones-Monahan testified that she believed the hepatic duct may have been hiding or looped behind the cystic duct. She then said that it was possible that she put a clip on both and subsequently divided both structures. She testified that her theory about the ducts being looped around each other occurred to her after surgery and that she had no evidence that this was, in fact, what happened. She agreed that she still was unsure of how plaintiffs injury occurred.\nDr. Jones-Monahan testified that she used the critical-view technique to identify the structures. This technique involves finding the cystic duct and cystic artery and isolating them before cutting. She agreed that the failure to achieve a critical view of these structures is an indication that the surgery should be converted to an open procedure. Based on the fact that the wrong structures were ultimately cut, Dr. Jones-Monahan stated that she had not obtained a critical view of the proper structures.\nDr. Jones-Monahan testified that at the time of the surgery she believed that her dissection of all the tissues to expose the ducts and arteries was complete and only realized that she had performed an incomplete dissection after the surgery. She agreed that an incomplete dissection was a deviation from the standard of care. Although she thought she divided the cystic duct, she admitted she instead cut the hepatic duct.\nDr. Strasberg was the treating physician who subsequently performed surgery on plaintiff to repair her injury. Plaintiff conducted an evidence deposition of Dr. Strasberg. To expedite the deposition, defendants and plaintiff agreed to reserve all objections except those based on form. Plaintiffs counsel questioned Dr. Strasberg. Defendants\u2019 counsel cross-examined. Plaintiffs counsel then conducted his redirect, stating that he was conducting his redirect subject to an objection he intended to make at trial regarding the scope of some of defense counsel\u2019s questions on cross-examination.\nDuring the evidence deposition of Dr. Strasberg, which was taken prior to trial, plaintiffs attorney indicated he intended to object to portions of defense counsel\u2019s cross-examination of Dr. Strasberg. At trial, plaintiffs attorney moved to strike portions of defendants\u2019 cross-examination of Dr. Strasberg for being beyond the scope of his direct examination. Plaintiff argued that he had not questioned Dr. Strasberg regarding standard of care and that defendants\u2019 cross-examination questioned Dr. Strasberg on the applicable standard of care. Defendants argue that plaintiffs counsel opened the door to cross-examination regarding the applicable standard of care during direct examination. Defendants contend that during direct examination, plaintiffs counsel referenced articles that Dr. Strasberg had written and that these articles discuss the standard of care.\nDuring direct examination, plaintiffs attorney asked Dr. Strasberg whether his articles were authoritative. Dr. Strasberg said that they were. Defendants argue that this opened the door for questions about a specific article on cross-examination. Plaintiff never introduced any articles at trial. Defendants\u2019 questions on cross-examination included questions such as:\n\u201cQ. First of all, is it true that in a lap-coli, a laparoscopic cholecystectomy[,] there are several accepted ways of identifying the cystic bile?\n* * *\nQ. And secondly, regardless of which method is used to identify the cystic duct, not one single method has proven to be infallible; would you agree with that?\n* *\nQ. And would you also agree that because we can\u2019t eliminate the risk of a bile duct injury, it is standard of care to warn the patient preoperatively that this is a potential complication from the laparoscopic cholecystectomy?\n* * *\nQ. And some of these various methods of finding the cystic duct that you just identified have become more popular with some surgeons or others, but throughout their 15 years there still has been a recognized complication rate?\n$ $ ^\nQ. Okay. And has the \u2014 has the complication rate for bile duct injuries say leveled off now that we\u2019ve been more than five and ten years past the beginning or the introduction of the procedure here in the United States?\n* * \u2756\nq *** Nevertheless, it\u2019s still standard of care for you and for every surgeon to warn the patient in advance that this very thing could happen?\u201d\nThe trial court granted plaintiff\u2019s motion to strike portions of defendants\u2019 cross-examination of Dr. Strasberg on the ground that the challenged questions on cross-examination impermissibly went into the issue of standard of care. Defendants then moved to have Dr. Strasberg\u2019s cross-examination entered as part of defendants\u2019 case in chief. Plaintiff objected because of the use of leading questions, and the court denied defendants\u2019 motion.\nPlaintiff presented the trial court with a videotape of Dr. Strasberg\u2019s evidence deposition. Dr. Strasberg said that in the past 15 years, he had repaired about 120 injuries to the bile-duct system created after another doctor attempted a laparoscopic cholecystectomy. Dr. Strasberg said that the primary purpose of plaintiffs first admission to Barnes was to \u201cstabilize her for later reconstruction of the biliary injury, diagnosis, and stabilization.\u201d Dr. Strasberg said that after a biliary injury occurs, it sometimes progresses postoperatively because the blood vessels supplying the bile ducts may also be injured. He categorized the type of injury that plaintiff sustained as an E4 injury in which the left and right bile ducts were separated from each other. He said that there was no common bile duct left after surgery either because of scarring or because it had been completely removed during surgery. Dr. Strasberg testified that he had to reconnect the remaining bile duct with the intestine. The name of the procedure was an anterior hepaticojejunostomy. The procedure included a \u201cRoux-en-Y,\u201d which was a way of preparing a piece of intestine to be reconnected to a new structure, and was not specifically related to this specific type of biliary surgeiy\nDr. Strasberg said he first identified where the bile duct was injured and then joined the piece of intestine he had performed the Roux-en-Y on to the two ducts. The part of the bile duct that is connected to the intestine replaces the bile duct that had been removed or injured.\nDr. Strasberg said after the reconstruction surgery in February 2003, he continued to follow plaintiffs progress. He said that during the first six months after surgery it is important to make sure that the incisions heal well, that the patient is maintaining nutritional status, and that the patient is returning to normal activity. Another reason he continued to monitor plaintiff was to observe whether the repair was working well and that her liver was functioning appropriately. He said that plaintiffs liver function is a long-term interest that will likely be followed for about five years.\nDr. Strasberg said that his records indicated plaintiff was feeling well until February 2005. After a magnetic resonance imaging (MRI), Dr. Strasberg said the radiologist who conducted the test was concerned about a stenosis, which meant a narrowing at the place where Dr. Strasberg had attached the right bile duct to the intestine. Dr. Strasberg decided to monitor plaintiff because she appeared asymptomatic. However, in March 2005, plaintiffs alkaline phosphatase level had risen to a point that concerned Dr. Strasberg. He decided to check on her levels again in six months. That six-month period was about to conclude at the time of Dr. Strasberg\u2019s deposition. Dr. Strasberg testified that it is his practice to monitor patients for up to five years, although some doctors may choose to monitor patients the rest of their lives and others choose not to monitor a patient\u2019s liver function at all unless the patient appears symptomatic.\nDr. Strasberg said the standard of care does not require doctors to monitor patients the rest of their lives. However, Dr. Strasberg said that, although rare, there have been occurrences of patients needing repairs of their bile duct reconstruction 30 years after the initial surgery. Patients remain at a risk of restenosis the rest of their lives. \u201cRestenosis\u201d is the term for a narrowing of the area that connects the bile duct to the intestine after reconstructive surgery. Dr. Strasberg, however, stated that the highest rates of stenoses, however, occur two to five years after surgery.\nDefendants\u2019 expert, Dr. Mark Kadowaki, began his testimony by showing a videotape of himself performing portions of a cholecystectomy. Dr. Kadowaki explained that four techniques were used to perform a gallbladder removal and that Dr. Jones-Monahan had not used the critical-view technique. During cross-examination, plaintiffs attorney reminded him that Dr. Jones-Monahan testified earlier in the trial that she had used the critical-view technique during plaintiffs surgery. Dr. Kadowaki responded that more than one technique could be employed during a single surgery.\nDr. Kadowaki stated that it was his opinion that Dr. JonesMonahan met the standard of care in performing plaintiffs surgery. Dr. Kadowaki stated that an adequate dissection is included in the applicable standard of care for a cholecystectomy. Dr. Kadowaki said that there was no conclusive identification of the structures in this case. During plaintiffs cross-examination of Dr. Kadowaki, the following exchange occurred:\n\u201cQ. Would you agree that Dr. Monahan did not do an adequate dissection in this case?\nA. No.\nQ. Because, she says she didn\u2019t do an adequate dissection as she reflects upon it now. So, you disagree with her?\nA. Yes.\n* \u00ed\u00a1< *\nQ. Does the standard of care require an adequate dissection?\nA. Yes, at the time of surgery. In retrospect, you can look at things differently.\n* * *\nQ. In fact, in this case, the critical view wasn\u2019t obtained because the wrong structures were clipped and divided, is that true?\nA. I don\u2019t think I would go from one to the other. The wrong structures were clipped. There was a misidentification. At the time, the dissection was deemed to be adequate. In retrospect, it is deemed not to be. This is true.\u201d\nDr. Kadowaki said that the standard of care requires the doctor to use a technique for gallbladder removal with which she is comfortable. He testified that no technique is guaranteed to completely avoid injuries to the common bile duct. He said that the complication rate for this surgery consists of injuries that occur absent negligence.\nThe jury returned a verdict in favor of plaintiff in the amount of $561,389.90. The jury awarded plaintiff $95,570.90 for necessary medical care, treatment, and services; $3,819 in lost earnings; $250,000 for pain and suffering; and $212,000 for loss of normal future life experience. Defendants filed a posttrial motion requesting a new trial. Defendants again argued that their cross-examination of Dr. Strasberg was proper and should have been allowed either as cross-examination or in defendants\u2019 case in chief and that plaintiffs cross-examination of defendants\u2019 expert, Dr. Kadowaki, was improper. The trial court denied defendants\u2019 posttrial motion. This appeal followed.\nII. ANALYSIS\nA. The Trial Court\u2019s Refusal To Allow Defendant\u2019s Cross-Examination of Dr. Strasberg Was Not an Abuse of Discretion\nDefendants first argue that the trial court erred when it barred portions of defendants\u2019 cross-examination of Dr. Strasberg. Before reaching the merits of defendants\u2019 argument, this court notes that the record is incomplete. The testimony was presented in court via videotape. It was not reported. A copy of that videotape is not contained within the record on appeal even though the trial court stated the following before issuing its ruling on the posttrial motion:\n\u201cLet me first note counsel that the file contains a copy of the transcript of Dr. Strasburg\u2019s [sic] [e]vidence [deposition, but it is not the edited transcript. If you\u2019ll recall a [sic] trial I had what I might call a work copy, and I was making notes on it in connection with objections that were made, and rulings, and portions of the doctor\u2019s testimony that were stricken. I believe the file also has a disk of the testimony, but I am not entirely certain about that. So if this case goes up on appeal you might recall for the Appellate Court that [plaintiff\u2019s [e]xhibit [No.] 15 \u2018A\u2019 is an unedited portion of the transcript of Dr. Strasburg\u2019s [sic] [e]vidence [deposition.\u201d\nThe unedited transcript is in the record. The record also contains defendants\u2019 DVD (digital video disc) of the portions of Dr. Strasberg\u2019s cross-examination that were stricken by the trial court, but this court does not have computers capable of reading DVDs. No edited transcript or DVD of the testimony from Dr. Strasberg\u2019s evidence deposition that was actually played for the jury is contained in the record on appeal. Furthermore, defendants\u2019 brief did not direct this court to plaintiffs exhibit No. 15 \u201cA.\u201d\nAn incomplete record is a violation of the supreme court rules. Supreme Court Rule 323(a) requires that the record on appeal \u201cshall include all the evidence pertinent to the issues on appeal.\u201d 134 Ill. 2d R. 323(a). It is the appellants\u2019 duty to supply a complete record to the reviewing court. Kim v. Evanston Hospital, 240 Ill. App. 3d 881, 888, 608 N.E.2d 371, 375 (1992). The record should allow the reviewing court to be fully informed of the pertinent issues. Kim, 240 Ill. App. 3d at 888, 608 N.E.2d at 375. Absent a sufficient record, the reviewing court presumes that the trial court conformed to the law and that its rulings were supported by the evidence. Kim, 240 Ill. App. 3d at 888, 608 N.E.2d at 375.\nAlthough noncompliance with Rule 323(a) is grounds for summary affirmance of the trial court, having pieced together Dr. Strasberg\u2019s testimony from the line references in the transcript, we will address the merits. Since the record contains a reference to the lines of the transcript of Dr. Strasberg\u2019s deposition that were stricken, we can discern Dr. Strasberg\u2019s digitally recorded testimony from the record.\nDefendants also present this court with an extensive analysis of a recent Third District Appellate Court Rule 23 order, Andris v. Clemson, No. 3\u201405\u20140396 (June 5, 2006) (unpublished order under Supreme Court Rule 23), which they argue is factually analogous to the present case and should be followed by this court. Defendants also attach this order to their brief. Rule 23(e) states that an unpublished order is not precedential and may not be cited by any party except to support contentions of double jeopardy, res judicata, collateral estoppel, or law of the case. Defendant is not using Andris for any of these purposes. Andris is not controlling.\nWhen a party challenges a trial court\u2019s evidentiary ruling, the standard of review is abuse of discretion. Leonardi v. Loyola University of Chicago, 168 Ill. 2d 83, 92, 658 N.E.2d 450, 454-55 (1995). Clearly, the scope and extent of cross-examination and recross-examination are within the discretion of the court. People v. Kirchner 194 Ill. 2d 502, 536, 743 N.E.2d 94, 112 (2000); Johns-Manville Products Corp. v. Industrial Comm\u2019n, 78 Ill. 2d 171, 181, 399 N.E.2d 606, 611 (1979). \u201c[Cjross-examination should be kept within fair and reasonable limits, and it is only in a case of clear abuse of such discretion, resulting in manifest prejudice to the defendant, that a reviewing court will interfere.\u201d People v. Halteman, 10 Ill. 2d 74, 86, 139 N.E.2d 286, 294 (1956).\nPlaintiff offered Dr. Strasberg\u2019s evidence deposition as the testimony of a treating physician in this case, not plaintiffs expert. Dr. Vasquez testified as plaintiffs expert in the case. Dr. Strasberg\u2019s direct testimony during his videotaped evidentiary deposition was limited to the reconstructive surgery he performed on plaintiff. Dr. Strasberg stated that he had written several articles and chapters on laparoscopic bile duct injuries. Plaintiff asked, \u201cAs an example, there\u2019s an article you authored, \u2018Laparoscopic Bile Duct Injuries,\u2019 which is it the \u2014 which journal did that appear in?\u201d Dr. Strasberg replied:\n\u201cWell, you would have to show me the particular article, because I\u2019ve authored a number of them. This looks like it\u2019s a chapter as a \u2014 in a book, and I\u2019m not sure what chapter it is to tell you the truth, because I\u2019ve written a lot of chapters. I\u2019m not sure when this particular one was done just from looking at it because it\u2019s \u2014 it\u2019s\u2014 there\u2019s nothing on here that indicates which chapter this is. But it is something that I wrote. It doesn\u2019t say the date or the place where it was published. I\u2019ve probably written 30 articles and chapters on this subject, so I can\u2019t identify a particular chapter without a little more information.\u201d\nPlaintiff then asked, \u201cAnd would you consider your articles to be authoritative on the subject of laparoscopic bile-duct injuries?\u201d Dr. Strasberg replied, \u201cyes.\u201d The only other time this article or chapter came up was when Dr. Strasberg requested that he be able to point out the injuries plaintiff sustained using a diagram in the chapter rather than the one the attorney had provided.\nThe trial court sustained plaintiffs objection to defendants\u2019 cross-examination of Dr. Strasberg regarding the issue of standard of care because it was beyond the scope of plaintiffs direct examination of the witness. Defendants\u2019 cross-examination begins by questioning Dr. Strasberg about different methods of performing a laparoscopic cholecystectomy, which is a subject he had not testified to during direct examination. Defendants\u2019 questioning began by asking Dr. Strasberg, \u201c[I]s it true that in a lap-coli, a laparoscopic cholecystectomy[,] there are several accepted ways of identifying the cystic bile?\u201d Defendants also asked Dr. Strasberg, \u201cAnd would you also agree that because we can\u2019t eliminate the risk of a bile-duct injury, it is standard of care to warn the patient preoperatively that this is a potential complication from the laparoscopic cholecystectomy?\u201d Defendants\u2019 cross-examination continued to question Dr. Strasberg about these different methods as well as his personal experience performing laparoscopic cholecystectomies.\nDefendants argued that plaintiff\u2019s reference to articles Dr. Strasberg had written opened the door to the issue of standard of care because these articles addressed that issue. However, the articles were never introduced into evidence.\nIn ruling on defendants\u2019 posttrial motion for a new trial, the trial court held:\n\u201cIt\u2019s probably an oversimplification to say that there\u2019s a heart of any medical malpractice case, but with that in mind, I am certainly of the opinion that the heart of any medical malpractice case almost, without exception, is the testimony of expert witnesses with regard to standard of care and claimed breaches thereof.\nIn my review of Dr. Strasburg\u2019s [sic] deposition and in particular his direct examination, I noted the following: Plaintiff\u2019s attorney asked no questions about standard of care in regard to laparoscopic cholecystectomies. He asks no questions about acceptable ways of identifying the cystic duct during surgery. He asks no questions about risks attendant to laparoscopic cholecystectomy procedures. He asked no questions about the appropriate preoperative warnings to be given a patient. He asked no questions about the critical-view method of identifying the cystic duct during surgery. He asked no questions about the infundibular approach. He asked no questions about the use of intra-operative colanalgiagrams [sic]. He asks no questions about tracing the cystic duct to form the common bile duct and identifying all three by dissection. And he asks no questions about complication rates.\nFrom my review of the direct examination[,] it is abundantly and overwhelmingly clear that the plaintiffs attorney steered clear, and well clear, of making any inquiries about standard of care or the breach thereof, and the many subjects which I have previously noted. Given this method of direct examination of the expert witness who repaired the injury suffered by the plaintiff, I remain convinced that the cross-examination conducted by [defendants\u2019 attorney] which was stricken by the [c]ourt was clearly outside the scope of direct and was clearly not permissible by reason of a contention that the plaintiffl ] somehow opened the door to all of these inquiries by asking about whether certain articles or a certain article was authoritative.\nI want to be clear in my remarks. I think [defendants\u2019 attorney] suggested that the questions posed by the plaintiff\u2019s attorney on the subject of \u2018the articles opened the door a wee bit or a tiny bit\u2019 and I don\u2019t think so. I don\u2019t think it was opened even a crack.\u201d\n\u201cA trial court abuses its discretion only if it \u2018act[s] arbitrarily without the employment of conscientious judgment, exceedfs] the bounds of reason and ignore[s] recognized principles of law [citation] [,] or if no reasonable person would take the position adopted by the court.\u2019 \u201d Schmitz v. Binette, 368 Ill. App. 3d 447, 452, 857 N.E.2d 846, 851 (2006), quoting Popko v. Continental Casualty Co., 355 Ill. App. 3d 257, 266, 823 N.E.2d 184, 192 (2005). The trial court\u2019s analysis of this issue is a thorough, articulated, detailed, and well-reasoned ruling that is firmly rooted in the prevailing law. Clearly the court\u2019s well-reasoned explanation of its ruling is not arbitrary. Furthermore, the trial court\u2019s decision that defendants\u2019 cross-examination went beyond the scope of plaintiff\u2019s direct examination is correct and does not constitute an abuse of discretion.\nB. Dr. Strasberg\u2019s Cross-Examination Was Permissibly Barred From Being Introduced as Direct Examination in Defendants\u2019 Case in Chief\nDefendants argue that even if their cross-examination of Dr. Strasberg was impermissible as cross-examination, they should have been able to use Dr. Strasberg\u2019s cross-examination testimony in their own case in chief. Addressing this issue in defendants\u2019 posttrial motion, the trial court held:\n\u201cMy understanding of the appropriate procedure under such circumstances is simply this. For the plaintiff\u2019s attorney in my judgment so clearly and evidently steers clear of asking questions on the surgical procedures, the standard of care, and any claim reached or the standard of care, he [sic] defense attorney has to know that under our procedures, he or she is not going to be able to make inquiry about \u2014 into those subjects on cross.\nThat he or she then has the option[ ] under our applicable rules to proceed pursuant to the notice that was given regarding the scheduling of the evidence deposition to take the doctors [sic] deposition for the defendants [sic] use during their case-in-chief. This does not appear to involve any particular additional expenditure of time. I note that Rule 206(b) provides \u2018that when a notice of the taking of a deposition has been served, any party may take a deposition under the notice, etc.\u2019 In plain English, I think it was abundantly clear that the plaintiffs attorney was not going to touch on certain subjects during the direct examination of the doctor in which case the defendant\u2019s [sic] attorney could proceed to take the deposition of the doctor at the same time and place and correct \u2014 and proceed to conduct a direct examination of the doctor with regard to the various subjects which were, in my opinion, outside the scope of the cross-examination.\nI have also noted Rule 206(c)(2) which says, \u2018the examination and cross shall be the same as though the deponent was testifying at trial.\u2019 I can only tell you in this regard if Dr. Strasburg had been testifying at trial, I would have made the same rulings. I would have barred the cross-examination and I think the defendants would have had the same option to take the direct examination of the doctor on subjects which were not covered during the plaintiffs direct.\u201d\nSupreme Court Rule 212(c) states that when a party admits only a part of a deposition into evidence, the other party may then use any other part of that deposition \u201cwhich ought in fairness to be considered in connection with the part read or used.\u201d 210 Ill. 2d R. 212(c). \u201cAn evidence deposition is not the \u2018property\u2019 of the party who takes it, and any portion of an evidence deposition may be offered by either side.\u201d Prince v. Hutchinson, 49 Ill. App. 3d 990, 995, 365 N.E.2d 549, 552 (1977) (finding that the portion of the deposition not admitted was permissibly excluded by the trial court on the grounds that it was an impermissibly hypothetical question posed to the witness), citing Dobkowski v. Lowe\u2019s, Inc., 20 Ill. App. 3d 275, 314 N.E.2d 623 (1974).\nThe trial court\u2019s ruling that defendants\u2019 cross-examination was \u201cclearly\u201d beyond the scope of plaintiffs direct examination serves to inform this court that Dr. Strasberg\u2019s cross-examination, which defendants sought to admit, was based on the trial court\u2019s assessment of fairness to the parties. Cross-examination during an evidentiary deposition must be conducted the same as though the deponent were testifying at trial. Dobkowski, 20 Ill. App. 3d 275, 314 N.E.2d 623. In Dobkowski, the court stated:\n\u201cWe believe that a party receives an unfair advantage if he introduces an evidence deposition in which he had the right to cross-examine the deponent while the other party was restricted to direct examination. A party who takes an evidence deposition, therefore, should have the opportunity to use the deposition in his case.\u201d Dobkowski, 20 Ill. App. 3d at 279, 314 N.E.2d at 626-27.\nRule 212(c) does not state that when one party admits part of a deposition the other party automatically gets to admit any other part of the deposition it chooses regardless of content. Rather, the rule states that the other party is entitled to admit parts of the deposition that should be considered \u201cin connection with the part read or used.\u201d 210 Ill. 2d R. 212(c). In this case, the trial court found that the cross-examination testimony was barred because it was beyond the scope of plaintiff\u2019s direct. It is inherent in the court\u2019s ruling that the part defendants sought to admit was not \u201cconnected\u201d to the part of the deposition that was admitted. Therefore, refusing to allow defendants\u2019 cross-examination of Dr. Strasberg to be admitted separately as direct examination is not a violation of Rule 212(c).\nDefendants argue that the form of the questions should not preclude using the cross-examination of Dr. Strasberg in their case in chief. Defendants contend that they did not need to establish Dr. Strasberg as a defense witness by asking his name, background, training, and experience at the close of plaintiff\u2019s examination. However, defendants chose to cross-examine Dr. Strasberg instead of conducting their own direct examination. The trial court\u2019s decision not to allow defendants\u2019 cross-examination to be entered into evidence as direct testimony in their case in chief does not, as defendants contend, emphasize form over substance. The questions defendants posed to Dr. Strasberg were leading questions consistent with the form of questions allowed on cross-examination. These types of questions are not allowed on direct examination.\nSince the trial court\u2019s decision to grant plaintiff\u2019s objection to defendants\u2019 cross-examination of Dr. Strasberg was proper, this court does not need to address the issue of whether defendants were prejudiced by the trial court\u2019s ruling. Defendants apparently chose not to depose Dr. Strasberg directly. Defendants should not be allowed to present evidence that is otherwise inadmissible because they elected not to depose a witness. The trial court\u2019s ruling to prohibit Dr. Strasberg\u2019s cross-examination testimony to be used as evidence in defendants\u2019 case in chief avoids an unfair result.\nC. Plaintiffs Questions to Dr. Kadowaki Regarding Standard of Care Were Permissible\nDefendants argue that plaintiffs cross-examination of Dr. Kadowaki was improper. The trial court\u2019s decision to allow plaintiff to question Dr. Kadowaki over defendants\u2019 objection is reviewed by this court for abuse of discretion. Leonardi, 168 Ill. 2d at 92, 658 N.E.2d at 454.\nDefendants first objected to plaintiffs question, \u201cOkay. And so, Dr. Strasberg and Dr. Soper [(Dr. Strasberg\u2019s former partner)] described, advocated, and wanted everybody to use the critical view of safety technique, correct?\u201d The trial court overruled defendants\u2019 objection and allowed Dr. Kadowaki to answer plaintiffs question. A few questions later, plaintiff asked Dr. Kadowaki, \u201cAnd they advise others to abandon your technique, is that wrong?\u201d\nDefendants argue that plaintiffs questions regarding Dr. Kadowaki\u2019s personal preferences were in violation of point VI of defendants\u2019 motion in limine, which the trial court had granted prior to trial. During the pretrial hearing on defendants\u2019 motion in limine, plaintiff objected to the motion, stating that it was plaintiffs position that inquiries into defendants\u2019 expert\u2019s personal practices were allowed for the purpose of credibility during cross-examination and to test the expert\u2019s opinion. Defense counsel responded:\n\u201cMy concern was, more less [sic], with direct examination, especially of Dr. Vasquez *** I don\u2019t really have a quarrel with the Gallina [v. Watson, 354 Ill. App. 3d 515, 821 N.E.2d 326 (2004),] case that is cited *** [i]t is well-reasoned law ***. Gallina says that, on cross-examination, if a witness has said standard of care allows a certain procedure to be done a certain way, then the witness can be questioned, \u2018Well, don\u2019t you yourself prefer a different way.\u2019 I don\u2019t have a problem with that. But, that is something on cross[-]examination [sic] as it relates only to credibility.\u201d\nThe trial court granted defendants\u2019 motion in limine stating, \u201cIn granting this, I am certainly not precluding cross-examination as suggested in colloquy here that was designed to impeach a witness, but I am granting the motion to preclude a witness on direct from saying, this is how I do it.\u201d\nIn this case, the testimony of Dr. Kadowaki on direct seemingly violates defendants\u2019 own motion in limine. Dr. Kadowaki not only testified as to his personal practices and preference but, over plaintiffs objection, defendants presented a DVD of Dr. Kadowaki performing a cholecystectomy. During the video, defendants would pause the DVD, and Dr. Kadowaki would explain to the court what structures were being viewed and what actions he was taking as part of the surgery. Defendants contend that the DVD\u2019s purpose was purely to inform the jury of the actual view the doctor has of the structures while she performs the surgery.\nAdditionally, Dr. Kadowaki specifically cited Dr. Strasberg\u2019s approval of the \u201ccritical[-]view\u201d technique to perform cholecystectomies. The trial court found that during his direct examination Dr. Kadowaki testified to the following:\n\u201c1. The technique he uses to identify the cystic duct;\n2. What active surgeons do and don\u2019t do;\n3. What he doesn\u2019t do anymore;\n4. That he doesn\u2019t do what another surgeon recommends;\n5. The techniques he used in the film presentation of his surgical procedure;\n6. What his practice is;\n7. What practice he employs to identify the cystic duct;\n8. That a certain procedure to identify the cystic duct is not described in any textbook or paper, and is, therefore, in his opinion, unnecessary;\n9. An accepted technique to identify the cystic duct, known as \u2018the critical view,\u2019 has been talked about by Dr. Strasberg;\n10. His practice is to warn patients of possible injuries to structures near the gallbladder;\n11. In his personal experience, pancreatic tissue has been removed with the gallbladder and reported by the pathologist.\u201d\nThe trial court ruled:\n\u201cThe foregoing testimony offered by the defendants during the direct examination of their expert clearly conveyed to the jury the personal practices of that expert, his disinclination or refusal to do what another surgeon recommends or what no paper or textbook discusses, an accepted technique discussed by another surgeon and writer (Dr. Strasberg), his practice regarding warnings to his patients, his experience regarding warnings to his patients, his experience regarding the removal of pancreatic tissue in connection with his own surgeries, and more. *** Given this presentation, the [pllaintiff was entitled to fully explore what other practices or procedures, discussed or written about, the expert does or does not follow. *** The court is of the opinion that this cross[-]examination was fair, given the presentation on direct, even without consideration of Gallina. With consideration of Gallina, it was a fair approach to test the \u2018credibility and persuasive value\u2019 of the expert\u2019s opinions.\u201d\nDefendants\u2019 motion in limine prohibited plaintiff from establishing a prima facie case of negligence based on the testimony of what another physician would have done differently. However, an expert\u2019s testimony on personal preference, such as Dr. Kadowaki\u2019s, is not per se inadmissible. Gallina, 354 Ill. App. 3d at 521, 821 N.E.2d at 331. Testimony regarding personal preference is admissible if it addresses issues of the witness\u2019s credibility and the persuasiveness of the expert\u2019s testimony. Gallina, 354 Ill. App. 3d at 521, 821 N.E.2d at 331. By referencing Dr. Strasberg\u2019s approval of Dr. Kadowaki\u2019s own preferred technique during his direct examination, defendants opened the door to questions regarding Dr. Kadowaki\u2019s knowledge of Dr. Strasberg\u2019s views on cholecystectomy techniques. Therefore, the trial court\u2019s ruling on defendants\u2019 objection to plaintiffs questions during cross-examination was correct.\nD. The Record Does Not Support Defendants\u2019 Claim That Articles or Treatises Were Presented to the Court as Substantive Evidence\nDr. Kadowaki referred to Dr. Strasberg\u2019s critical-view technique on direct examination when he said that Dr. Strasberg has been associated with the critical-view technique. During cross-examination of Dr. Kadowaki, plaintiff asked him questions regarding Dr. Strasberg\u2019s critical-view technique, which Dr. Strasberg had not testified about. Defendants argue that plaintiffs cross-examination impermissibly allowed a publication authored by Dr. Strasberg to be used as a substitute for direct testimony.\nWhile defendants did raise this issue in their posttrial motion, no objection related to this issue was made at the time of trial. To preserve an issue for appeal, the party must both make an objection at the time of trial and in a posttrial motion. Kim, 240 Ill. App. 3d at 892, 608 N.E.2d at 378. In this case, the record does not support defendants\u2019 contention that plaintiffs attorney was waving the article around during Dr. Kadowaki\u2019s cross-examination. Defendants claim that the trial court and jury were fully aware of the article to which plaintiff was referring when he asked about Dr. Strasberg\u2019s opinions. However, nothing in the record reflects plaintiffs alleged use of the article in the courtroom, and defendants make no specific reference to any portion of the record that supports their contention. Furthermore, nothing in the transcripts suggests to this court that any text of an article was read and/or admitted into evidence.\nRegardless, an expert may be cross-examined with literature that he relied on if that literature is used to impeach that witness. The supreme court adopted Federal Rule of Evidence 703 in Wilson v. Clark, 84 Ill. 2d 186, 196, 417 N.E.2d 1322, 1327 (1981). People v. Munoz, 348 Ill. App. 3d 423, 443, 810 N.E.2d 65, 80 (2004) (noting that in 1981 when the supreme court adopted Rule 703, it read, \u201c \u2018The facts or data in the particular case upon which an expert bases an opinion or inference may be those perceived by or made known to the expert at or before the hearing. If of a type reasonably relied upon by experts in the particular field in forming opinions or inferences upon the subject, the facts or data need not be admissible in evidence\u2019 \u201d), quoting Fed. R. Evid. 703. Facts that are relied upon by the expert in his case in chief are permissible grounds for cross-examination. Rios v. City of Chicago, 331 Ill. App. 3d 763, 773, 771 N.E.2d 1030, 1038 (2002). Dr. Kadowaki\u2019s reliance on Dr. Strasberg\u2019s approval of the critical-view method in his direct opened the door for plaintiff s questions regarding methods condoned and condemned by Dr. Strasberg. Interestingly enough, when plaintiff asked Dr. Kadowaki whether Dr. Strasberg disapproved of Dr. Kadowaki\u2019s preferred technique, which was the infundibular method, Dr. Kadowaki answered \u201cno.\u201d\nPlaintiffs questions concerning Dr. Strasberg\u2019s method were not being offered to prove the truth of the matter asserted and were not inadmissible hearsay. People v. Pasch, 152 Ill. 2d 133, 176, 604 N.E.2d 294, 311 (1992), cert. granted, 508 U.S. 959, 124 L. Ed. 2d 678, 113 S. Ct. 2927 (1993), order vacated by 510 U.S. 910, 126 L. Ed. 2d 245, 114 S. Ct. 337 (1993) (stating that petitioner died in Pontiac, Illinois).\nIn this case Dr. Kadowaki relied on Dr. Strasberg\u2019s opinion explicitly in his direct examination. The supreme court in Pasch held, \u201cClearly, if an expert admits relying upon a report, that party may be impeached with the contents of that report.\u201d Pasch, 152 Ill. 2d at 178, 604 N.E.2d at 312. However, no specific article of Dr. Strasberg\u2019s was referenced by Dr. Kadowaki when he testified about Dr. Strasberg\u2019s opinion during direct examination. Similarly, plaintiff\u2019s cross-examination only involved general references to Dr. Strasberg\u2019s techniques. Therefore, no error occurred regarding an alleged article being used on cross-examination of Dr. Kadowaki when no specific article is referenced in the record or in the parties\u2019 argument on appeal.\nIII. CONCLUSION\nTherefore, based on the foregoing reasons, we find that the trial court\u2019s evidentiary rulings in this case did not constitute an abuse of the trial court\u2019s discretion, and we affirm.\nAffirmed.\nAPPLETON and McCULLOUGH, JJ., concur.", "type": "majority", "author": "JUSTICE MYERSCOUGH" } ], "attorneys": [ "Kevin M. Miller (argued) and Adam E Chaddock, both of Quinn, Johnston, Henderson & Pretorius, Chtrd., of Peoria, for appellants.", "Steven K. Jambois and Alexander M. Sukhman, both of Kralovec, Jambois & Schwartz, and Michael W Rathsack (argued), both of Chicago, for appellee." ], "corrections": "", "head_matter": "KATHERINE ADAMS, Plaintiff-Appellee, v. SARAH BUSH LINCOLN HEALTH CENTER et al., Defendants-Appellants.\nFourth District\nNo. 4\u201406\u20140284\nArgued December 19, 2006.\nOpinion filed January 23, 2007.\nKevin M. Miller (argued) and Adam E Chaddock, both of Quinn, Johnston, Henderson & Pretorius, Chtrd., of Peoria, for appellants.\nSteven K. Jambois and Alexander M. Sukhman, both of Kralovec, Jambois & Schwartz, and Michael W Rathsack (argued), both of Chicago, for appellee." }, "file_name": "0988-01", "first_page_order": 1004, "last_page_order": 1022 }