{ "id": 7328590, "name": "HEATHER GUSKI, Independent Adm'r of the Estate of Gerald Parkison, Deceased, Plaintiff-Appellant, v. ASIM RAJA et al., Defendants-Appellees (Ingalls Memorial Hospital, Defendant)", "name_abbreviation": "Guski v. Raja", "decision_date": "2011-05-10", "docket_number": "No. 1\u201410\u20140108", "first_page": "686", "last_page": "704", "citations": [ { "type": "official", "cite": "409 Ill. App. 3d 686" } ], "court": { "name_abbreviation": "Ill. App. Ct.", "id": 8837, "name": "Illinois Appellate Court" }, "jurisdiction": { "id": 29, "name_long": "Illinois", "name": "Ill." }, "cites_to": [ { "cite": "319 Ill. App. 3d 116", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 1527760 ], "weight": 2, "year": 2001, "pin_cites": [ { "page": "145" }, { "page": "145" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/319/0116-01" ] }, { "cite": "403 Ill. App. 3d 42", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 4304038 ], "year": 2010, "pin_cites": [ { "page": "52-53" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/403/0042-01" ] }, { "cite": "37 Ill. 2d 494", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 2866138 ], "year": 1967, "pin_cites": [ { "page": "510" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/37/0494-01" ] }, { "cite": "236 Ill. 2d 83", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 3627624 ], "weight": 2, "year": 2010, "pin_cites": [ { "page": "100", "parenthetical": "quoting Pedrick v. Peoria & Eastern R.R. Co., 37 Ill. 2d 494, 510 (1967)" }, { "page": "100" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/236/0083-01" ] }, { "cite": "379 Ill. App. 3d 1", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 4275895 ], "year": 2008, "pin_cites": [ { "page": "19", "parenthetical": "holding that the circuit court properly rejects a tendered jury instruction where there is no evidence to support it" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/379/0001-01" ] }, { "cite": "311 Ill. App. 3d 7", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 415306 ], "year": 1999, "pin_cites": [ { "page": "15-16" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/311/0007-01" ] }, { "cite": "402 Ill. App. 3d 830", "category": "reporters:state", "reporter": "Ill. 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App. 3d 837", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 4295959 ], "weight": 2, "year": 2010, "pin_cites": [ { "page": "855" }, { "page": "855" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/398/0837-01" ] }, { "cite": "123 Ill. App. 647", "category": "reporters:state", "reporter": "Ill. App.", "case_ids": [ 875721 ], "year": 1906, "pin_cites": [ { "page": "656" } ], "opinion_index": 0, "case_paths": [ "/ill-app/123/0647-01" ] }, { "cite": "200 Ill. App. 347", "category": "reporters:state", "reporter": "Ill. App.", "case_ids": [ 5420414 ], "year": 1916, "pin_cites": [ { "page": "350" } ], "opinion_index": 0, "case_paths": [ "/ill-app/200/0347-01" ] }, { "cite": "251 Ill. App. 109", "category": "reporters:state", "reporter": "Ill. App.", "case_ids": [ 5587337 ], "year": 1928, "pin_cites": [ { "page": "115" } ], "opinion_index": 0, "case_paths": [ "/ill-app/251/0109-01" ] }, { "cite": "340 Ill. App. 475", "category": "reporters:state", "reporter": "Ill. App.", "case_ids": [ 4999183 ], "year": 1950, "pin_cites": [ { "page": "490" } ], "opinion_index": 0, "case_paths": [ "/ill-app/340/0475-01" ] }, { "cite": "3 Ill. App. 2d 235", "category": "reporters:state", "reporter": "Ill. App. 2d", "case_ids": [ 5127736 ], "year": 1954, "pin_cites": [ { "page": "246-47" } ], "opinion_index": 0, "case_paths": [ "/ill-app-2d/3/0235-01" ] }, { "cite": "399 Ill. App. 3d 1126", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 4300086 ], "weight": 2, "year": 2010, "pin_cites": [ { "page": "1134-35" }, { "page": "1134-35" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/399/1126-01" ] }, { "cite": "258 Ill. App. 3d 555", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 2879654 ], "year": 1993, "pin_cites": [ { "page": "557-58" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/258/0555-01" ] }, { "cite": "384 Ill. App. 3d 73", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 4278559 ], "year": 2008, "pin_cites": [ { "page": "90", "parenthetical": "citing Rockwood v. Singh, 258 Ill. App. 3d 555, 557-58 (1993)" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/384/0073-01" ] }, { "cite": "191 Ill. 2d 251", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 229700 ], "year": 2000, "opinion_index": 0, "case_paths": [ "/ill-2d/191/0251-01" ] }, { "cite": "304 Ill. App. 3d 369", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 564604 ], "weight": 3, "year": 1999, "pin_cites": [ { "page": "375-76", "parenthetical": "noting that a motion in limine is \"by definition a pretrial motion,\" and a ruling thereon is interlocutory (emphasis in original)" }, { "page": "377", "parenthetical": "stating that any attempt to object to the testimony would have \"ma[de] no sense\"" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/304/0369-01" ] }, { "cite": "366 Ill. App. 3d 156", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 4265580 ], "weight": 4, "year": 2006, "pin_cites": [ { "page": "165" }, { "page": "165" }, { "page": "165" }, { "page": "165" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/366/0156-01" ] }, { "cite": "228 Ill. 2d 439", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 5706410 ], "weight": 7, "year": 2008, "pin_cites": [ { "page": "460" }, { "page": "460" }, { "page": "460" }, { "page": "460" }, { "page": "460" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/228/0439-01" ] }, { "cite": "204 Ill. 2d 1", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 609707 ], "weight": 8, "year": 2003, "pin_cites": [ { "page": "23" }, { "page": "23-24" }, { "page": "46" }, { "page": "35" }, { "page": "35" }, { "page": "35" }, { "page": "36" }, { "page": "36" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/204/0001-01" ] }, { "cite": "198 Ill. 2d 541", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 29951 ], "weight": 5, "year": 2002, "pin_cites": [ { "page": "569" }, { "page": "569" }, { "page": "569" }, { "page": "569" }, { "page": "569" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/198/0541-01" ] }, { "cite": "404 Ill. App. 3d 20", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 4305174 ], "weight": 4, "year": 2010, "pin_cites": [ { "page": "40" }, { "page": "40" }, { "page": "40" }, { "page": "36-37" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/404/0020-01" ] }, { "cite": "237 Ill. 2d 100", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 3629460 ], "weight": 4, "year": 2009, "pin_cites": [ { "page": "106" }, { "page": "106" }, { "page": "106" }, { "page": "112" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/237/0100-01" ] } ], "analysis": { "cardinality": 1488, "char_count": 48503, "ocr_confidence": 0.763, "pagerank": { "raw": 4.03580807328026e-08, "percentile": 0.18894866071342384 }, "sha256": "123246099e1c9b7cc8dfa8633b0edff2ac4f8253aa51a813e38f81715da3811e", "simhash": "1:c3bf8d8a42a0d1a9", "word_count": 7781 }, "last_updated": "2023-07-14T17:25:27.574146+00:00", "provenance": { "date_added": "2019-08-29", "source": "Harvard", "batch": "2018" }, "casebody": { "judges": [], "parties": [ "HEATHER GUSKI, Independent Adm\u2019r of the Estate of Gerald Parkison, Deceased, Plaintiff-Appellant, v. ASIM RAJA et al., Defendants-Appellees (Ingalls Memorial Hospital, Defendant)." ], "opinions": [ { "text": "JUSTICE CONNORS\ndelivered the judgment of the court.\nPresiding Justice Cunningham and Justice Harris concurred in the judgment.\nOPINION\nPlaintiff Heather Guski brought wrongful death and survival actions against defendants Dr. Asim Raja, Midwest Emergency Associates, and Ingalls Memorial Hospital in her capacity as the independent administrator of the estate of her father, Gerald Parkison, who was found dead in his home four days after visiting the emergency room at Ingalls. After Ingalls settled with plaintiff, the remaining parties proceeded to trial. The circuit court entered a partial directed verdict in favor of defendants Raja and Midwest on one issue and a jury found in favor of the defendants on the remaining issues. Plaintiff now appeals, arguing that: (1) the circuit court erred in several of its rulings on motions in limine-, (2) defense counsel\u2019s closing argument was \u201cunfair\u201d and warrants reversal; (3) the cumulative effect of those errors requires that she receive a new trial; and (4) the jury\u2019s verdict was against the manifest weight of the evidence. For the following reasons, we affirm the judgment of the circuit court.\nI. BACKGROUND\nOn December 25, 1999, Gerald Parkison arrived at the emergency room at Ingalls Memorial Hospital. A triage nurse took information about Parkison\u2019s symptoms and Parkison then saw Raja, the emergency room doctor. Raja performed a medical examination of Parkison, diagnosed him with an upper respiratory infection, prescribed antibiotics, and sent Parkison home with instructions to follow up with his family doctor or return to the emergency room if his condition worsened. Four days later, Parkison was found dead in his home. Plaintiff theorized that Raja failed to take an adequate medical history of Parkison and failed to order a CT scan, which would have detected the subarachnoid hemorrhage, or bleeding in the brain, that induced Parkison\u2019s fatal cardiac arrhythmia. Defendants\u2019 theory of the case was that Parkison died of a myocardial infarction or arrhythmia caused by atherosclerosis and unrelated to a subarachnoid hemorrhage.\nBefore trial, each party filed numerous motions in limine seeking to exclude certain evidence. Of particular relevance in this case, defendants filed a motion in limine to exclude evidence demonstrating that on several occasions, Raja failed to pass the examination for board certification in internal medicine. They argued that Raja would testify as an occurrence witness and not an expert witness; thus, any evidence of his prior failed attempts at board certification in an unrelated field was irrelevant. The court granted defendants\u2019 motion.\nDefendants also filed a motion in limine to exclude testimony by one of plaintiff\u2019s experts, criticizing Raja\u2019s documentation of Parki-son\u2019s symptoms on his medical chart. They argued that none of plaintiff\u2019s other experts would testify that such a failure was a proximate cause of Parkison\u2019s death. Plaintiff responded that \u201c[t]here is no testimony that a failure to chart anything caused the guy\u2019s death,\u201d but argued that \u201cwhat Dr. Raja charted and what he didn\u2019t chart becomes evidence of what his thought process was.\u201d The court granted defendants\u2019 motion.\nDefendants also sought to exclude hearsay testimony offered by Parkison\u2019s family members that purported to demonstrate the severity of Parkison\u2019s headaches before going to the emergency room. The court allowed Parkison\u2019s ex-wife to testify that Parkison had headaches, that she called his doctor, and that she took him to the emergency room, for the limited purpose of explaining why she took him to Ingalls. However, plaintiff could not use that testimony as proof that Parkison was in fact suffering from headaches.\nPlaintiff filed a motion in limine seeking to bar defense counsel from soliciting testimony from her expert about Parkison\u2019s use of marijuana, arguing that it was irrelevant to any issues in the case and that it was overly prejudicial. Defendants argued that the testimony rebutted plaintiff\u2019s claim that the only explanation for Parkison\u2019s passing out was that he was suffering from an aneurysm. The court denied plaintiffs motion.\nThe case proceeded to trial and the following relevant facts were adduced. Plaintiffs first called Raja to testify as an adverse witness. He testified that he was employed by Midwest, which contracted with Ingalls to provide emergency room doctors. He stated that when a patient arrives in the emergency room, he first reviews the patient\u2019s medical chart, which contains information that the patient gave to the triage nurse. In this case, the triage nurse wrote that Parkison had been vomiting, experiencing dizziness and body aches, and had passed out twice over the previous three days. Parkison made similar complaints to an intake nurse.\nRaja then conducted his own examination of Parkison, beginning with a conversation about Parkison\u2019s medical history. Raja acknowledged that Parkison did complain of vomiting, dizziness, and passing out, but he did not record that on Parkison\u2019s medical chart. Raja further testified that when he asked Parkison follow-up questions about those complaints, Parkison explained that he was no longer suffering from those symptoms, but that he had a cough, sinus pressure, and a sinus headache, which symptoms Raja also did not record on Parkison\u2019s medical chart. Raja testified that patients sometimes alter their statement of complaints between the time they arrive in the emergency room and the time they are seen by him. Raja said that Parkison told him that the coughing spells made him feel light-headed and dizzy, like he was going to pass out, but Parkison was not sure if he actually passed out.\nRaja acknowledged that vomiting, dizziness, and passing out, collectively, could indicate that Parkison suffered from a serious intracra-nial condition. He acknowledged that under these circumstances, he was required to do a \u201cneuro exam\u201d and cranial nerve testing on Parki-son, which included an examination of Parkison\u2019s eyes, ears, nose, throat, and facial muscles. Raja provided a detailed description of the \u201cneuro exam\u201d he performed on Parkison and described the results of that exam as normal. He documented that Parkison appeared normal. He also examined Parkison\u2019s lungs and found his breathing to be normal. He concluded that Parkison\u2019s clear nasal drainage, aches, chills, and cough indicated that he had a viral upper respiratory infection.\nRaja testified that he did not record Parkison\u2019s respiratory infection symptoms on his medical chart because he was using a new computerized documentation system at that time and he did not think he also needed to write the symptoms down. However, he did write orders on Parkison\u2019s chart.\nRaja was asked about aneurysms specifically. He acknowledged that a CT scan is an appropriate method of investigating and diagnosing an aneurysm or a hemorrhage in the subarachnoid space in the skull. He testified that in the past, he has ordered CT scans when he believed patients had neurological problems. While practicing emergency medicine, he has diagnosed an aneurysm or subarachnoid hemorrhage about five to seven times. However, in this case, he did not order a CT scan for Parkison because he believed that Parkison had an upper respiratory infection. He testified that in his experience and personal knowledge, the \u201ccardinal symptom\u201d of a ruptured aneurysm is an \u201cexcruciating headache, the most severe headache you ever had in your life,\u201d which is a patient\u2019s prominent complaint. He stated he had never heard that a subarachnoid hemorrhage following a ruptured aneurysm could induce a cardiac arrhythmia.\nPlaintiff then called Dr. Paul Stiegler to testify as an expert on the standard of care for emergency medicine physicians. Steigler opined that Raja deviated from the standard of care by not taking an adequate medical history of Parkison. He testified that after reviewing the triage nurse\u2019s notes on Parkison\u2019s medical chart, a reasonably careful physician would have investigated Parkison\u2019s complaints of vomiting, dizziness, passing out, and body aches as symptoms of either a cardiac problem or a serious intracranial problem, like subarachnoid hemorrhage, encephalitis, or meningitis. Steigler testified that Raja\u2019s indications that Parkison had a cough and clear nasal discharge indicative of an upper respiratory infection were inconsistent with the symptoms Parkison reported to the triage nurse. However, pursuant to the court\u2019s ruling on a motion in limine, the court instructed the jury that any criticisms of Raja\u2019s documentation of symptoms could be considered for credibility purposes only and not as a deviation from the standard of care.\nSteigler also opined that Raja deviated from the standard of care by failing to order a CT scan. He stated that the symptoms Parkison reported suggested a subarachnoid hemorrhage or another intracra-nial problem and a reasonably careful physician would have ordered a CT scan to investigate that possibility. He testified that the \u201cneuro exam\u201d conducted by Raja would not, by itself, detect a subarachnoid hemorrhage. Steigler ultimately concluded to a reasonable degree of medical certainty that Raja deviated from the standard of care by failing to take an adequate medical history and failing to order a CT scan.\nOn cross-examination, Steigler acknowledged that before his deposition, he had only reviewed Parkison\u2019s medical records, the autopsy report prepared by Dr. Young Kim, an incomplete deposition of Dr. Kim, and the depositions of Raja and Parkison\u2019s ex-wife. He also acknowledged that vomiting, dizziness, and passing out are not symptoms specific to a subarachnoid hemorrhage, but are present in other illnesses; specifically, an upper respiratory infection.\nOn cross-examination, Steigler testified that marijuana usage could also cause a person to pass out, although it was rare. Steigler was then presented with Parkison\u2019s toxicology report that accompanied his autopsy report. Steigler stated that he had not previously reviewed that report. He acknowledged that it showed that Parkison had marijuana metabolites in his system at the time of his death. Plaintiff did not object to this testimony at trial. The toxicology report also showed that Parkison had the chemical PPA in his blood stream, which Steigler acknowledged could cause cardiac arrhythmia, heart rhythm disturbances, and elevated blood pressure when taken in toxic amounts.\nPlaintiff then called Dr. Colin Bloor, a pathologist, to testify as an expert witness on the cause of Parkison\u2019s death. He concluded that Parkison died of a cardiac arrhythmia that was induced by a subarachnoid hemorrhage. He explained that when the subarachnoid space fills with blood, that puts pressure on the brain, which triggers a sympathetic nervous system response, and leads to a fatal cardiac arrhythmia. He stated that subarachnoid hemorrhage is commonly caused by a ruptured aneurysm. He also stated that the autopsy report noted that blood clots were present around the hemorrhage, which indicated to him that the blood had been in that area for one or two days and that the patient was alive when the clotting occurred.\nHe also testified that Parkison did not die of a heart attack, known as a myocardial infarction. He acknowledged that Parkison suffered from extensive coronary artery disease, but stated that the autopsy provided no indication that Parkison suffered a heart attack. However, he acknowledged on cross-examination that if a patient does not survive a sudden heart attack for at least four hours, there would be no physical indication that a heart attack occurred and, thus, Kim\u2019s failure to document changes in the heart did not rule out sudden death by heart attack.\nOn direct examination, Bloor testified that he rendered his opinions on cause of death with a reasonable degree of medical certainty, which he later acknowledged to be \u201c95 percent or more true.\u201d However, on cross-examination, he admitted that he rendered his opinions with a \u201cdegree of medical probability,\u201d which is \u201cgreater than 51 percent\u201d true. He testified that he could not testify to a reasonable degree of medical certainty because, despite looking for it, Kim found no evidence of a ruptured aneurysm during the autopsy. Bloor also acknowledged that as a pathologist specializing in cardiology, he would not be \u201ccalled in\u201d if the primary cause of death was a subarachnoid hemorrhage, but he might discover the hemorrhage while examining a patient\u2019s cardiac system.\nOn cross-examination, Bloor testified that if Parkison had a ruptured aneurysm in his brain, he would expect to see a hole in the blood vessel during the autopsy. Bloor acknowledged that Kim did not report any ruptured or unruptured aneurysms in his autopsy report. In forming his opinions, Bloor also considered the fact that Kim testified in his deposition that he did not believe that Parkison had a ruptured aneurysm. Bloor also acknowledged that Kim did not account for the source of the blood he found in Parkison\u2019s brain in his autopsy report. Bloor agreed that Kim\u2019s report did not indicate the presence of the three signs of a subarachnoid hemorrhage: blood pooled across the back of the brain, herniation, and cerebral edema. Bloor also recognized that Kim did not perform a microscopic evaluation of the heart and, thus, there was no physical evidence to support his theory that a sympathetic nervous system response caused Parkison\u2019s arrhythmia.\nDr. Ronald Young testified as an expert in neurosurgery. He testified that the symptoms of a subarachnoid hemorrhage include headache, nausea, vomiting, dizziness, loss of consciousness, and neu-rologic symptoms like paralysis and loss of feeling. He opined that Parkison\u2019s subarachnoid hemorrhage was caused by a ruptured aneurysm, although he acknowledged that Kim did not report finding one. He believed, based on Parkison\u2019s reported symptoms, that Parki-son\u2019s aneurysm ruptured between one and four days before he reported to the hospital. Young stated that although there are other causes of subarachnoid hemorrhage, there was no evidence to support those other causes.\nYoung testified that the first step in diagnosing a subarachnoid hemorrhage is performing a CT scan. He stated that a CT scan is in the \u201c90 percent plus range\u201d of accuracy in detecting subarachnoid hemorrhages. In his opinion, a CT scan would have revealed that Parkison had a subarachnoid hemorrhage at the time he was in the emergency room. Young stated that if the hemorrhage had been detected, Parkison would have been admitted to the hospital and undergone an angiogram to determine the source of the bleeding. He determined that had an angiogram been performed, the aneurysm would have been discovered. He then described the process by which an aneurysm is treated to prevent further bleeding. He ultimately opined to a reasonable degree of medical certainty that the failure to perform a CT scan on Parkison caused or contributed to Parkison\u2019s death.\nOn cross-examination, Young acknowledged that Kim likely knew that the leading cause of subarachnoid hemorrhage was an aneurysm. Young admitted that although he was not a pathologist, he did not believe that Kim, the pathologist charged with determining cause of death, looked for a ruptured aneurysm while conducting Parkison\u2019s autopsy. Young also admitted that if Parkison did not have an aneurysm prior to his death, then Kim\u2019s description of the blood vessels in Parkison\u2019s brain was appropriate.\nJody Yepsen, Parkison\u2019s ex-wife, testified that she was with Parki-son and their children on the night that Parkison went to the emergency room. She testified that at one point in the evening, she saw Parkison sitting at the table holding his head in his hands. Parki-son told her he had a headache, she then called Parkison\u2019s doctor, and then took Parkison to the emergency room. Pursuant to defendants\u2019 motion in limine, the court instructed the jury that it could only consider that testimony as background information to explain why she took Parkison to the emergency room. Yepsen drove Parkison to the emergency and remained in the waiting room for the 20 minutes that Parkison met with Raja. After leaving the hospital, Yepsen drove to a drug store to fill Parkison\u2019s prescription and Parkison went home shortly thereafter. She did not see Parkison again until after his death and did not know whether he went to work in the intervening days. Brandon Parkison, the deceased\u2019s son, also testified that he and his family went to the emergency room because his father said he had a headache. The court again gave the jury a limiting instruction. Brandon said that he also saw his father holding his head in his hands.\nAfter the close of plaintiffs case, defendants moved for a partial directed verdict on the issue of Raja\u2019s failure to take an adequate medical history because neither Bloor nor Young testified that that alleged deviation from the standard of care caused or contributed to Parkison\u2019s death. Rather, defendants argued that the causation experts only testified that the failure to order a CT scan caused Parkison\u2019s death. Additionally, defendants moved to strike Steigler\u2019s testimony that Raja\u2019s failure to take an adequate medical history was a deviation from the standard of care. Plaintiff responded that the failure to take an adequate medical history is \u201cpart and parcel\u201d of the failure to order a CT scan. The court took defendants\u2019 motion under advisement.\nDr. Nancy Jones, the chief medical examiner in Cook County, testified as defendants\u2019 expert forensic pathologist. In her position, she encounters a subarachnoid hemorrhage about once a month while performing autopsies. She testified that after discovering a subarach-noid hemorrhage during an autopsy, a pathologist is trained to first determine the source of the bleeding, which is ordinarily caused by a ruptured aneurysm or trauma.\nJones opined that in this case, the blood and blood clots that Kim reported finding in the subarachnoid space during Parkison\u2019s autopsy were postmortem \u201cartifacts,\u201d meaning that they were not related to the cause of death hut appeared after death as a result of the way that Kim conducted the autopsy. She described that when performing an autopsy, a pathologist removes the brain from the skull and the major organs from the body cavity for examination. If the organs are removed before the skull is opened, then blood in the brain will drain to the empty body cavity by force of gravity. If the skull is opened before the organs are removed, then residual blood in the brain will drain into the back of the skull. Based on Kim\u2019s chronological description of Parkison\u2019s autopsy and the photographs of the autopsy, Jones concluded that the blood located in Parkison\u2019s skull cavity was an artifact that occurred because Kim opened Parkison\u2019s skull before removing his internal organs. She specifically opined that the blood in Parkison\u2019s skull cavity was not a subarachnoid hemorrhage caused by a ruptured aneurysm. Furthermore, when Parkison\u2019s body was found in his home, he was lying on his back on a heating pad. Jones stated that his elevated body temperature accelerated decomposition, making blood vessels weaker and more likely to leak blood.\nJones also opined that Kim\u2019s autopsy report and his deposition indicated to her that Kim looked for an aneurysm, but did not find one, and that if he had found evidence of an aneurysm, he would have indicated that in his report. Jones also opined that Kim\u2019s report made no mention of swelling or herniation, which she would expect to see following a subarachnoid hemorrhage.\nJones concluded that the cause of Parkison\u2019s death was coronary atherosclerosis, or narrowing of the arteries from plaque or cholesterol, and the mechanism of death was either a myocardial infarction or arrhythmia. There was insufficient evidence to determine which of those mechanisms occurred. However, according to Kim\u2019s report, she stated that there was no blood clot in any of Parkison\u2019s arteries. She testified that she sees cases like Parkison\u2019s about once a week. She agreed that in cases like this, where a myocardial infarction or arrhythmia occurs without a blood clot, the condition is referred to as the \u201csilent killer\u201d because, for the \u201c50 to 75 percent of individuals who have heart disease, their first symptom that they have heart disease is they drop dead.\u201d Jones acknowledged that the theory proposed by Bloor and Young \u2014 that Parkison suffered an arrhythmia following a sympathetic nervous system response to a ruptured aneurysm \u2014 was possible. However, she stated that in this case, there was no evidence in Parki-son\u2019s medical records indicating that he suffered the extreme degree of pain required to cause a nervous system response that would trigger a fatal arrhythmia.\nDr. Martin Hermann, a neurosurgeon, testified as defendants\u2019 causation expert. He testified that, based on Kim\u2019s autopsy report, Kim looked for an aneurysm in the appropriate areas of Parkison\u2019s brain, but did not find one. He further opined that the blood in Parki-son\u2019s brain was not a subarachnoid hemorrhage because Kim\u2019s report and deposition revealed no herniation or swelling that typically result from subarachnoid hemorrhage. He concluded that Parkison\u2019s death was cardiac related. He further concluded that Bloor\u2019s and Young\u2019s descriptions of arrhythmia caused by a sympathetic nervous system response were possible, but unlikely. Hermann opined that Parkison\u2019s fatal cardiac arrhythmia could have been caused by his ingesting ephe-dra, which can no longer be sold because of its tendency to cause cardiac arrhythmias. Hermann believed that Parkison was taking ephedra because his toxicology report at autopsy showed he had PPA, an ephedra metabolite, in his system.\nFollowing the close of all evidence, defendants renewed their partial motion for directed verdict on plaintiffs allegation that Raja failed to take an adequate medical history. They argued that plaintiffs experts did not testify that the deviation was a proximate cause of Parkison\u2019s death. The court granted defendants\u2019 motion. The court then provided instructions to the jury and the only issue of liability was whether Raja\u2019s failure to order a CT scan proximately caused Parkison\u2019s death. The jury returned a verdict in favor of defendants. Plaintiff filed a posttrial motion, which the court denied. This appeal followed.\nII. ANALYSIS\nA. Forfeiture\nPlaintiff asserts several claims of error based on the circuit court\u2019s evidentiary rulings. As an initial matter, defendants claim that all of those issues have been forfeited on appeal for various reasons. We will address each of defendants\u2019 claims of forfeiture in turn.\nA court\u2019s evidentiary rulings are unreviewable on appeal if they have not been properly preserved. Thornton v. Garcini, 237 Ill. 2d 100, 106 (2009). When the court makes its rulings before trial pursuant to the parties\u2019 motions in limine, the rulings are interlocutory and remain subject to reconsideration by the court throughout the trial. Cetera v. DiFilippo, 404 Ill. App. 3d 20, 40 (2010). Consequently, denial of the complaining party\u2019s pretrial motion to exclude evidence is not sufficient to preserve the issue for appeal. Simmons v. Garces, 198 Ill. 2d 541, 569 (2002); Cetera, 404 Ill. App. 3d at 40. The complaining party must also make a contemporaneous objection at trial when the evidence is introduced to allow the court the opportunity to revisit its earlier ruling. Simmons, 198 Ill. 2d at 569. Failure to object at trial results in forfeiture of the issue on appeal. Simmons, 198 Ill. 2d at 569; Cetera, 404 Ill. App. 3d at 40.\nAdditionally, where the court excludes evidence that its proponent sought to introduce, the proponent must make an adequate offer of proof to inform the court, opposing counsel, and the court of review of the basis for the admissibility of the evidence. Snelson v. Kamm, 204 Ill. 2d 1, 23 (2003). Absent an adequate offer of proof, the issue is unreviewable on appeal. Snelson, 204 Ill. 2d at 23-24. However, where it appears that the circuit court understood the nature and character of the evidence sought to be presented, we may relax the forfeiture rule. In re Leona W., 228 Ill. 2d 439, 461 n.5 (2008).\nHere, plaintiff has indeed forfeited the majority of her claims on appeal. She first contends that the court erroneously denied her motion in limine to exclude Steigler\u2019s testimony concerning Parkison\u2019s marijuana use. However, she failed to renew her objection at trial when that testimony was introduced. Therefore, the issue is forfeited. Simmons, 198 Ill. 2d at 569.\nIn reply, plaintiff argues that she was not required to make a \u201cuseless in-court objection\u201d because the court\u2019s ruling on the motion in limine was so definitive that \u201cshe was entitled to conclude that it would continue to make the same ruling,\u201d citing Spyrka v. County of Cook, 366 Ill. App. 3d 156, 165 (2006), in support. However, the Spyrka decision was not well reasoned and we decline to follow it.\nSpyrka concluded that a litigant need not object to the introduction of evidence at trial after an adverse ruling on a motion in limine where \u201cthe full context of the evidentiary issue develops at trial, such that a motion thereon no longer presents the risk of an erroneous ruling that a pretrial motion in limine presents.\u201d Spyrka, 366 Ill. App. 3d at 165. In such cases, Spyrka held, \u201cany ruling on the merits [of the motion in limine] is not interlocutory, and the unsuccessful movant need not object further to preserve the issue for review.\u201d Spyrka, 366 Ill. App. 3d at 165.\nHowever, in reaching that conclusion, Spyrka improperly relied on the holding in McMath v. Katholi, 304 Ill. App. 3d 369 (1999), rev\u2019d on other grounds, 191 Ill. 2d 251 (2000), which was based on an entirely different procedural posture. McMath made clear, in a section entitled \u201cMotions in limine, Contrasted With Motions To Bar,\u201d that although the plaintiff in that case styled her motion as a motion in limine, it was actually a motion to bar testimony, made on the last day of trial. McMath, 304 Ill. App. 3d at 375-76 (noting that a motion in limine is \u201cby definition a pretrial motion,\u201d and a ruling thereon is interlocutory (emphasis in original)). On the other hand, the court\u2019s ruling on the merits of a motion to bar testimony made at trial was not interlocutory in nature, and, therefore, the litigant was not required to object to the introduction of the evidence \u201cwithin minutes\u201d of the court\u2019s ruling to preserve the issue for review. McMath, 304 Ill. App. 3d at 377 (stating that any attempt to object to the testimony would have \u201cma[de] no sense\u201d). Thus, Spyrka applied McMath for precisely the opposite legal proposition for which it stands. Consequently, we decline to follow Spyrka for that proposition of law and reject plaintiffs argument.\nNotwithstanding our criticism of Spyrka, we also reject plaintiff s argument because Spyrka is distinguishable on its facts: the defendant in that case objected to the admission of the contested evidence four times at trial, despite the court\u2019s erroneous holding that it was not required to do so. Spyrka, 366 Ill. App. 3d at 165. Here, plaintiff failed to make any objection at trial. We can conceive of no reason to excuse plaintiffs failure to object at trial and deem the issue forfeited. Simmons, 198 Ill. 2d at 569.\nPlaintiff also claims that the court erroneously excluded evidence demonstrating that Raja failed the examination for board certification in internal medicine multiple times. She concedes that evidence of a physician-defendant\u2019s failure to obtain board-certification credentials is irrelevant and inadmissible where, as here, he testifies only as an occurrence witness and not as an expert. See Jones v. Rallos, 384 Ill. App. 3d 73, 90 (2008) (citing Rockwood v. Singh, 258 Ill. App. 3d 555, 557-58 (1993)). She does not contend on appeal that the court erred in granting defendants\u2019 motion with that limitation in place. Rather, her argument is that Raja\u2019s testimony exceeded the limitations imposed by the court and that Raja actually testified as an expert witness because he gave opinions on the standard of care based on his \u201cexperience and knowledge.\u201d Therefore, she argues, Raja\u2019s board-examination failures are relevant and she is entitled to a new trial.\nHowever, plaintiff made no objection at trial when Raja gave the testimony of which she complains, and she cannot now raise the issue on appeal. Thornton, 237 Ill. 2d at 106. Nor did she make any effort to bring to the court\u2019s attention the alleged violation of the motion in limine or move to strike the offending testimony or seek to introduce evidence of Raja\u2019s failed examinations on redirect examination in response to the alleged expansion of his testimony on cross-examination. Hardy v. Cordero, 399 Ill. App. 3d 1126, 1134-35 (2010). Therefore, she has forfeited review of this issue as well. Thornton, 237 Ill. 2d at 106; Hardy, 399 Ill. App. 3d at 1134-35.\nPlaintiff\u2019s alternative contention \u2014 that the legal rule barring evidence of Raja\u2019s failure to pass a board-certification examination because he testified as an occurrence witness and not an expert witness is a \u201cbad rule, inimical to justice, productive of unfairness and constitutes an inherent due process deprivation of procedural rights [sic]\u201d \u2014 was raised for the first time in her posttrial motion and is also forfeited on appeal. See Thornton, 237 Ill. 2d at 112.\nPlaintiff also argues that she was denied a fair trial because defendants\u2019 theory of the case was \u201cunfair.\u201d She specifically attacks defendants\u2019 closing argument, which, she claims, improperly implied that Parkison\u2019s death was an \u201cact of God.\u201d That, she claims, violates the decades-old legal rule that any human intervention that contributes to the cause of an injury cannot, by definition, be deemed an act of God, citing McClean v. Chicago Great Western Ry. Co., 3 Ill. App. 2d 235, 246-47 (1954), Chapman v. Baltimore & Ohio R.R. Co., 340 Ill. App. 475, 490 (1950), Republic Co. of Rockford v. City of Rockford, 251 Ill. App. 109, 115 (1928), Mueller Grain Co. v. Chicago, Peoria & St. Louis R.R. Co., 200 Ill. App. 347, 350 (1916), and Quincy Gas & Electric Co. v. Schmitt, 123 Ill. App. 647, 656 (1906).\nAgain, this argument is forfeited. Plaintiff failed to object during defendants\u2019 closing argument when the allegedly prejudicial remarks were made. Wilbourn v. Cavalenes, 398 Ill. App. 3d 837, 855 (2010). Forfeiture notwithstanding, defendants\u2019 argument was properly based on the evidence and did not deprive her of a fair trial.\nCounsel is allowed wide latitude in drawing reasonable inferences from the evidence. Wilbourn, 398 Ill. App. 3d at 855. Here, defense counsel argued that Parkison died of \u201can unpredictable and unpreventable tragedy. Cardiac death \u2014 sudden cardiac death [ ] happens to hundreds and thousands of people\u201d every year. Jones testified on direct examination that for the \u201c50 to 75 percent of individuals who have heart disease [like Parkison\u2019s], their first symptom that they have heart disease is they drop dead,\u201d which is why this type of heart disease is known as the \u201csilent killer.\u201d Counsel\u2019s argument was based directly on Jones\u2019s testimony, to which plaintiff also never objected at trial. Thus, plaintiffs argument fails.\nB. Evidentiary Rulings\nAs to the issues that are preserved for review, none are meritorious. Plaintiff contends that the circuit court erroneously excluded hearsay testimony by Yepsen and Brandon Parkison as to the severity of the headaches Gerald Parkison suffered before he went to the hospital.\nWhether to admit or exclude evidence, specifically pursuant to a motion in limine, is a decision left to the discretion of the circuit court. Leona W., 228 Ill. 2d at 460. The court\u2019s ruling on such motions will not be disturbed on review absent an abuse of that discretion. Leona W., 228 Ill. 2d at 460. \u201cThe threshold for finding an abuse of discretion is high.\u201d Leona W., 228 Ill. 2d at 460. The court\u2019s evidentiary ruling will not be deemed an abuse of discretion unless it may be said that no reasonable person would take the view adopted by the court. Leona W., 228 Ill. 2d at 460. Moreover, even if an abuse of discretion has occurred, we will not reverse the judgment unless \u201cthe record indicates the existence of substantial prejudice affecting the outcome of the trial.\u201d Leona W., 228 Ill. 2d at 460.\nAlthough defendants claim that this issue is also forfeited because plaintiff failed to make a formal offer of proof in the hearing on the motions in limine, our review of the transcript reveals that the circuit court understood the nature and character of the evidence plaintiff sought to introduce and, thus, we will relax forfeiture here and address the merits. See Leona W., 228 Ill. 2d at 461 n.5.\nDefendants\u2019 motions in limine sought to exclude 36 hearsay statements made by Yepsen at her deposition and 8 hearsay statements made by Brandon at his deposition. The court ruled on the admissibility of each statement. Plaintiff does not identify in her brief the specific statements she claims were erroneously excluded. However, after reviewing the motions, it appears that she is arguing that Yepsen could have testified that \u201cGerald complained that his head, back and neck hurt, that light hurt his eyes, and [that he] requested she rub his neck\u201d and that Brandon could have testified that \u201cGerald said that he had a headache and his muscles hurt.\u201d\nThere is no dispute that the barred testimony consists of hearsay statements, which are out-of-court statements offered to prove the truth of the matter asserted, and that such statements are generally inadmissible unless they fall within an exception to the hearsay rule. People v. Cloutier, 178 Ill. 2d 141, 154-55 (1997). Plaintiff argues that the family members\u2019 testimony was admissible as an exception to the hearsay rule because it was evidence of Parkison\u2019s state of mind before going to the hospital. Specifically, she argues that the barred testimony about the intensity of the headaches Parkison suffered before going to the hospital was \u201can important indicator of a subarachnoid hemorrhage.\u201d That, she claims, would have supported her theory that Parkison was suffering from an undiagnosed aneurysm at the time he reported to the hosptial.\nPlaintiff relies on People v. Floyd, 103 Ill. 2d 541, 546 (1984), to support her argument that evidence of the declarant\u2019s state of mind is admissible as an exception to the hearsay rule if (1) the declarant is unavailable to testify, and (2) there is a reasonable probability that the proffered hearsay statements are reliable. Floyd, 103 Ill. 2d at 546. However, conspicuous by its absence is any discussion by the plaintiff of the third requirement for admission of state-of-mind testimony under Floyd: the declarant\u2019s state of mind must be relevant to a material issue in the case. Floyd, 103 Ill. 2d at 546.\nWe must first address an apparent discrepancy in the presentation of the third element of this rule. Some recent cases state that the rule requires the \u201cstatement\u201d to be relevant for admissibility. See People v. Caffey, 205 Ill. 2d 52, 88 (2001); Serrano v. Rotman, 406 Ill. App. 3d 900, 913 (2011); People v. Munoz, 398 Ill. App. 3d 455, 479 (2010); People v. Dunmore, 389 Ill. App. 3d 1095, 1107 (2009). However, Floyd, on which plaintiff and those cases rely, more precisely states the rule as requiring the declarant\u2019s \u201cstate of mind\u201d to be relevant. We wish to clarify that the rule does not require the substantive content of the statement to be relevant for admissibility; such an interpretation would contravene the purpose of the hearsay rule. See Munoz, 398 Ill. App. 3d at 481; Michael H. Graham, Graham\u2019s Handbook of Illinois Evidence \u00a7 801.5 (10th ed. 2010). Rather, the aforementioned cases\u2019 reference to the relevance of the \u201cstatement\u201d must refer to the fact that when an out-of-court statement is used to demonstrate the declarant\u2019s state of mind, that statement is no longer considered hearsay because it is not used for its substantive content. Dunmore, 389 Ill. App. 3d at 1106; Graham, supra. The courts in the aforementioned cases properly applied the rule to the relevance of the declarant\u2019s state of mind, according to Floyd. Serrano, 406 Ill. App. 3d at 913; Munoz, 398 Ill. App. 3d at 481; Dunmore, 389 Ill. App. 3d at 1107.\nHere, plaintiff fails to make any argument as to how Parkison\u2019s state of mind before he went to the hospital is relevant to any material issue in this case. Rather, on appeal, she argues the relevance of the content of the hearsay statement, which makes clear that she misapprehends the operation of the state-of-mind exception. That is, she contends that the barred testimony contains Parkison\u2019s account that he suffered severe headaches, which proves that he suffered severe headaches \u2014 that being \u201can important indicator of a subarachnoid hemorrhage\u201d and proof that he was suffering from an undiagnosed aneurysm when he went to the hospital. Put another way, plaintiff sought to use the content of the hearsay statement to prove its truth, which is precisely what the hearsay rule seeks to prevent. Munoz, 398 Ill. App. 3d at 482. A hearsay statement admitted under the state-of-mind exception may only be used for the limited purpose permitted by the exception, not for its own truth. Munoz, 398 Ill. App. 3d at 481 (citing People v. Caffey, 205 Ill. 2d 52, 89-90 (2001)). Thus, Yepsen\u2019s testimony could never be used for the purpose that plaintiff now claims on appeal and her argument fails. Munoz, 398 Ill. App. 3d at 481 (citing Caffey, 205 Ill. 2d at 89-90). The court recognized plaintiffs misapplication of the rule and barred the testimony. We cannot say that no reasonable person would have taken that view and, thus, it was not an abuse of discretion. Cetera, 404 Ill. App. 3d at 36-37.\nPlaintiff next attacks a \u201cconstellation of orders\u201d implicating Raja\u2019s alleged deviation from the standard of care in failing to accurately chart Parkison\u2019s symptoms and, in turn, failing to instruct the jury on that deviation. It is first necessary to identify exactly what the parties argued below and how the court ruled. Defendants filed their motion in limine number 33, seeking to prevent Steigler from testifying that Raja failed to accurately chart Parkison\u2019s symptoms; specifically, that Raja failed to properly document Parkison\u2019s symptoms on his medical chart. The court granted defendants\u2019 motion on the ground that it was irrelevant, given that none of plaintiffs experts would testify that charting deficiencies caused Parkison\u2019s death. The court also rejected plaintiff\u2019s tendered jury instruction that included the charting deficiencies as a proximate cause of Parkison\u2019s death.\nSteigler separately opined that Raja deviated from the standard of care by not taking an adequate medical history; specifically, Raja did not properly follow up with Parkison on his reported symptoms of vomiting, nausea, and fainting during the examination. Steigler testified to that deviation from the standard of care at trial. However, defendants moved for a directed verdict on this issue after the close of all evidence, arguing that none of plaintiffs experts testified that the failure to take an adequate medical history caused Parkison\u2019s death, and the court granted defendants\u2019 motion.\nAdditionally, Steigler opined that Raja deviated from the standard of care by failing to order a CT scan. Steigler rendered that opinion at trial as well. Young provided expert testimony to support the allegation that Raja\u2019s failure to order a CT scan proximately caused Parki-son\u2019s death and that issue was presented to the jury, which ultimately rendered its verdict in favor of defendants.\nAs to the court\u2019s ruling on defendants\u2019 motion in limine number 33, we conclude that the court properly exercised its discretion in excluding Steigler\u2019s testimony on charting deficiencies as irrelevant. \u201cEvidence is relevant if it tends to prove a fact in controversy or render a matter in issue more or less probable.\u201d In re A.W., 231 Ill. 2d 241, 256 (2008). In a medical negligence case, the plaintiff must prove: (1) the standard of care by which the physician\u2019s treatment is measured, (2) that the physician deviated from the standard of care, and (3) that the deviation proximately caused injury to the plaintiff. Johnson v. Ingalls Memorial Hospital, 402 Ill. App. 3d 830, 843 (2010). To establish proximate cause, the plaintiff must provide expert testimony to a reasonable degree of medical certainty that the deviation caused his injury, and the causal connection must not be \u201c \u2018contingent, speculative, or merely possible.\u2019 [Citation.]\u201d Johnson, 402 Ill. App. 3d at 843.\nHere, plaintiffs counsel admitted at the hearing on the motion in limine that \u201c[t]here is no testimony that a failure to chart anything caused [Parkison\u2019s] death.\u201d Thus, the court was well within its discretion to conclude that the testimony was irrelevant in proving negligence absent testimony that the alleged deviation proximately caused Parkison\u2019s death. See Snelson, 204 Ill. 2d at 46; Seef v. Ingalls Memorial Hospital, 311 Ill. App. 3d 7, 15-16 (1999). Furthermore, absent evidence of proximate cause, the court properly rejected plaintiffs tendered jury instruction, which included the alleged charting deficiency as a proximate cause of death. Beard v. Barron, 379 Ill. App. 3d 1, 19 (2008) (holding that the circuit court properly rejects a tendered jury instruction where there is no evidence to support it); see also Serrano, 406 Ill. App. 3d at 911.\nOn appeal, plaintiff suggests that Raja\u2019s charting deficiencies are synonymous with his failure to take an adequate medical history and, thus, the charting deficiencies \u201cwere a precipitating cause of the failure to order the necessary CT scan.\u201d We find that argument disingenuous. The court and the parties treated those claims as separate deviations in the court below and their experts testified as such. Notably, not one of plaintiffs experts equated charting deficiencies with a failure to take an adequate medical history. Thus, we reject her attempt to commingle those issues here.\nTo the extent that plaintiff is challenging the court\u2019s directed verdict on Raja\u2019s failure to take an adequate medical history, we affirm the court\u2019s ruling on that issue as well. A directed verdict is proper where all of the evidence, viewed in the light most favorable to the nonmoving party, \u201c \u2018so overwhelmingly favors movant that no contrary verdict based on that evidence could ever stand.\u2019 \u201d Lazenby v. Mark\u2019s Construction, Inc., 236 Ill. 2d 83, 100 (2010) (quoting Pedrick v. Peoria & Eastern R.R. Co., 37 Ill. 2d 494, 510 (1967)). Where the circuit court finds that the plaintiff failed to present evidence on every element of the cause of action, our review is de novo. 527 S. Clinton, LLC v. Westloop Equities, LLC, 403 Ill. App. 3d 42, 52-53 (2010).\nIn the court below, Raja\u2019s alleged failure to take an adequate medical history was offered by plaintiff as a distinct basis for Raja\u2019s alleged negligence. Our review of the record reveals that plaintiff failed to provide expert testimony to support her claim that the failure to take an adequate medical history proximately caused Parkison\u2019s death. A verdict for plaintiff on that issue could never stand absent such evidence, and, thus, the directed verdict was proper. See Lazenby, 236 Ill. 2d at 100.\nAgain, plaintiff appears to argue on appeal that Steigler\u2019s testimony that Raja failed to order a CT scan encompasses Raja\u2019s failure to take an adequate medical history; therefore, Young\u2019s testimony that the former deviation was the proximate cause of death applies equally to the latter deviation. Even if she had not improperly bootstrapped this argument, an expert\u2019s \u201cimplied\u201d testimony \u2014 in plaintiffs words \u2014 about the deviation from the standard of care is insufficient to satisfy plaintiffs burden to present expert testimony \u201cto a reasonable degree of medical certainty that the deviation caused [Parkison\u2019s] injury,\u201d without being \u201c \u2018contingent, speculative, or merely possible.\u2019 [Citation.]\u201d Johnson, 402 Ill. App. 3d at 843. Therefore, her argument fails.\nIn light of the fact that we have rejected all of plaintiffs claims of error, we also reject her argument that the court\u2019s rulings, in toto, require reversal. Caffey, 205 Ill. 2d at 118.\nC. Manifest Weight of the Evidence\nFinally, plaintiff argues that the jury\u2019s verdict was against the manifest weight of the evidence. Specifically, she contends that Raja\u2019s version of events was contradicted by other evidence, making it \u201cof virtually no value.\u201d\nIt is well established that in reviewing a jury verdict, this court \u201cmay not simply reweigh the evidence and substitute its judgment for that of the jury.\u201d Snelson, 204 Ill. 2d at 35. Rather, we may only reverse a jury\u2019s verdict if it is contrary to the manifest weight of the evidence. Snelson, 204 Ill. 2d at 35. A verdict is against the manifest weight of the evidence if the opposite conclusion is clearly evident or if the jury\u2019s findings are unreasonable, arbitrary, or not based on the evidence. Snelson, 204 Ill. 2d at 35.\nHere, relying largely on the autopsy report prepared by Kim, plaintiffs experts opined that Parkison suffered a fatal arrhythmia triggered by a sympathetic nervous system response to a subarachnoid hemorrhage, which was caused by a ruptured aneurysm. Moreover, they concluded that Raja\u2019s failure to order a CT scan for Parkison when he appeared at Ingalls\u2019s emergency room was a proximate cause of his demise because the CT scan would have detected the subarach-noid hemorrhage and led to proper treatment. Defendants\u2019 experts\u2019 interpretation of the autopsy report led them to conclude that the subarachnoid hemorrhage was an artifact of the order in which Kim performed the autopsy, not the result of an undetected ruptured aneurysm. Defendants\u2019 experts opined that Parkison suffered a myocardial infarction or arrhythmia caused by atherosclerosis.\nThis case is a \u201c \u2018classic battle of the experts,\u2019 \u201d where well-qualified experts in their respective fields of expertise gave their opinions on the issues and provided reasons therefor. Snelson, 204 Ill. 2d at 36 (quoting Snelson v. Kamm, 319 Ill. App. 3d 116, 145 (2001)). The jury weighed the conflicting evidence, including any discrepancies in Raja\u2019s testimony, and made a determination as to which parties\u2019 witnesses were more credible. Ultimately, the jury believed defendants\u2019 experts, not plaintiff\u2019s, and rendered its verdict for defendants. We will not substitute our judgment for the jury\u2019s when the evidence \u201cdid not greatly preponderate either way.\u201d (Internal quotation marks omitted.) Snelson, 204 Ill. 2d at 36 (quoting Snelson v. Kamm, 319 Ill. App. 3d at 145). The verdict was not against the manifest weight of the evidence.\nIII. CONCLUSION\nAccordingly, we conclude that plaintiff forfeited review of several evidentiary rulings and her claim that defendants\u2019 closing argument was \u201cunfair.\u201d Of those evidentiary matters that were properly preserved, we find that the circuit court did not abuse its discretion in making its rulings. Finally, we conclude that the jury\u2019s verdict was not against the manifest weight of the evidence. For all of these reasons, we affirm the judgment of the circuit court.\nAffirmed.\nAlthough plaintiff argues that the testimony is admissible under Rules 803(3) and 803(4) of the Federal Rules of Evidence, at the time of this trial, Illinois abided by the common law rules of evidence pertaining to the state-of-mind exception.\nPlaintiff argues that the issue also involves defendants\u2019 motion in limine number 31, but that motion pertains to the admissibility of medical literature that postdates Parkison\u2019s hospital visit, which is not implicated here.", "type": "majority", "author": "JUSTICE CONNORS" } ], "attorneys": [ "Robert A. Strelecky and Sean E Driscoll, both of Clifford Law Offices, of Chicago, for appellant.", "James K. Horstman, Rodney E. VanAusdal, and Melissa H. Dakich, all of Cray Huber Horstman Heil & VanAusdal LLC, of Chicago, for appellees." ], "corrections": "", "head_matter": "HEATHER GUSKI, Independent Adm\u2019r of the Estate of Gerald Parkison, Deceased, Plaintiff-Appellant, v. ASIM RAJA et al., Defendants-Appellees (Ingalls Memorial Hospital, Defendant).\nFirst District (2nd Division)\nNo. 1\u201410\u20140108\nModified opinion filed May 10, 2011.\nRobert A. Strelecky and Sean E Driscoll, both of Clifford Law Offices, of Chicago, for appellant.\nJames K. Horstman, Rodney E. VanAusdal, and Melissa H. Dakich, all of Cray Huber Horstman Heil & VanAusdal LLC, of Chicago, for appellees." }, "file_name": "0686-01", "first_page_order": 702, "last_page_order": 720 }