dissenting:
I respectfully dissent from the majority opinion where they find that plaintiff proved an institutional negligence case against Loyola University Medical Center (Loyola). I believe the trial judge’s decision should be affirmed; however, I agree that the verdicts were not inconsistent.
Illinois has long recognized that hospitals may be held liable for their own negligence. In Darling v. Charleston Community Memorial Hospital, 33 Ill. 2d 326, 333 (1965), our Illinois Supreme Court acknowledged an independent duty of hospitals to assume responsibility for the care of their patients. “Ordinarily, this duty is administrative or managerial in character.” Jones v. Chicago HMO Ltd. of Illinois, 191 Ill. 2d 278, 291 (2000), citing Advincula v. United Blood Services, 176 Ill. 2d 1, 28 (1996). To fulfill its duty, a hospital must act as a “reasonably careful hospital” would under similar circumstances. Advincula, 176 Ill. 2d at 29. Liability is predicated on the hospital’s own negligence, not the negligence of the physician. Jones, 191 Ill. 2d at 284. This independent negligence of the hospital is known as institutional negligence or direct corporate negligence.
In a medical negligence case, a plaintiff must prove by a preponderance of the evidence that: (1) the defendant owed a duty of care; (2) the defendant breached that duty; and (3) the plaintiff’s resulting injury or death was proximately caused by the breach. Hooper v. County of Cook, 366 Ill. App. 3d 1, 6 (2006). I find no evidence in the record of this case of either a breach of duty or causation. Plaintiff’s expert, Dr. Avery, testified that Loyola breached its duty because “basically everybody needs to be on the same page in terms of what each team member’s role is in the team.” Dr. Avery’s testimony concerning the “same page” was based on the fact that Drs. Foy and Mullen described the role of a procuring surgeon under the Loyola system differently than Dr. Parvathaneni did. Reynolds v. Mennonite Hospital, 168 Ill. App. 3d 575 (1988), is instructive as to whether the evidence in this case could support a verdict against Loyola for its claimed failure to instruct Dr. Parvathaneni about his role on the heart transplant team. In Reynolds, plaintiffs alleged that the hospital was institutionally negligent because it failed to implement or follow standards of review to ensure the competency of its surgeons to diagnose thoracic outlet syndrome. Reynolds, 168 Ill. App. 3d at 578-79. The appellate court affirmed the trial court’s entry of summary judgment for the hospital because there was no evidence that would have placed the hospital on notice of any malpractice by the surgeons. Reynolds, 168 Ill. App. 3d at 580. In Reynolds, the plaintiff’s expert opined that the hospital should have known, through proper review procedure, that its surgeons were improperly diagnosing thoracic outlet syndrome; but the trial court concluded that the plaintiff’s expert’s testimony was insufficient because there were no facts to substantiate that opinion. Reynolds, 168 Ill. App. 3d at 579-80. See also Rohe v. Shivde, 203 Ill. App. 3d 181, 202 (1990) (plaintiff presented no evidence that the hospital failed to review the performance of the attending pediatrician as to her compliance with hospital policy in examining newborn infants).
In the case at bar, there was no evidence that Loyola knew or should have known if Dr. Parvathaneni had ever deviated from Loyola’s institutional policies or did not understand his role on the heart transplant team. Plaintiff’s expert needed to identify what Loyola failed to do that a “reasonably careful” hospital would have done under similar circumstances. Advincula, 176 Ill. 2d at 29.
However, even if plaintiff was able to show the second element, namely, a breach of the standard of care, there was no evidence of the third element, namely, a causal relationship between an alleged breach of duty and the death at issue. “ ‘[I]n order to sustain the burden of proof, a plaintiffs expert must demonstrate within a reasonable degree of medical certainty that the defendant’s breach in the standard of care is more probably than not the cause of the injury’ ” Bergman v. Kelsey, 375 Ill. App. 3d 612, 625 (2007), quoting Knauerhaze v. Nelson, 361 Ill. App. 3d 538, 549 (2005).
Even if Dr. Parvathaneni had been properly advised of his role to evaluate the donor’s heart for transplant purposes and advised Dr. Foy of his findings, there is no evidence that Dr. Foy would not have used the donor’s heart. Plaintiffs expert, Dr. Avery, testified that if Dr. Parvathaneni had evaluated, the donor heart after it was removed and before he made the “final phone call” to Dr. Foy, he would have found what Dr. Foy later found: “a thick heart of significant hypertrophy and considerable plaque in the coronaries.” Even though the donor heart had more hypertrophy than Dr. Foy expected based on the echo-cardiogram, Dr. Foy knew this and still decided that the heart was acceptable to transplant to the decedent. Dr. Foy rejected the option of using an artificial heart instead.3 Dr. Foy made his decision based on the decedent’s grave medical condition resulting from his failing heart.
The evidence in the record further indicates that after the heart was removed, Dr. Parvathaneni found even more hypertrophy than he initially observed. The record contains no medical testimony concerning the effect of those observations or their medical significance for causation.
After Dr. Parvathaneni removed the donor heart and made the telephone call to the hospital, Dr. Foy removed the decedent’s heart and placed the decedent on the heart machine. If the donor’s heart had not been used, there is no expert testimony of how long the decedent could have lived; how long it would have taken to obtain a new donor; or if the decedent was placed on a Jarvik-type artificial heart, how long the decedent could have lived with the artificial heart.
This was a complex medical malpractice case that required a medical basis for the expert’s opinion that Loyola’s breach of duty was a cause of the decedent’s death, and it is not found in this record.
Dr. Avery’s testimony concerning causation was limited to the following:
“Q. Was Mr. Longnecker’s death caused as a result of the deviations from the standard of care that we talked about today?
A. I believe they are.”
There was no basis for that opinion, and as a result, the element of causation was lacking. “An expert’s opinion is only as valid as the basis and reasons for the opinion.” Wilson v. Bell Fuels, Inc., 214 Ill. App. 3d 868, 875 (1991), citing McCormick v. Maplehurst Winter Sports, Ltd., 166 Ill. App. 3d 93, 100 (1988). “A party must lay a foundation sufficient to establish the reliability of the bases for the expert’s opinion.” Petraski v. Thedos, 382 Ill. App. 3d 22, 28 (2008), citing Turner v. Williams, 326 Ill. App. 3d 541, 552-53 (2001).
In Aguilera v. Mount Sinai Hospital Medical Center, 293 Ill. App. 3d 967, 968 (1997), the plaintiffs decedent was taken to the emergency room complaining of numbness on the right side of his body. About six or seven hours later, a CT scan was taken, revealing a brain hemorrhage. Aguilera, 293 Ill. App. 3d at 969. The patient died a few days later. Aguilera, 293 Ill. App. 3d at 969. Plaintiff presented two experts who testified that the emergency room physician’s delay in taking the CT scan caused the decedent’s death. Aguilera, 293 Ill. App. 3d at 969. It was the plaintiffs theory that a diagnosis of the condition would have triggered surgical intervention to prevent the decedent’s death. Aguilera, 293 Ill. App. 3d at 969-70. However, on cross-examination, plaintiffs experts admitted that they would defer to a neurosurgeon as to whether surgery should have even been performed; yet the only neurosurgeons testifying in the case stated that surgery would not have been appropriate. Aguilera, 293 Ill. App. 3d at 969-70. This court held that the opinions offered by the plaintiffs experts lacked a sufficient factual basis and were therefore based on conjecture. Aguilera, 293 Ill. App. 3d at 975.
There just is not enough evidence in the record concerning breach of duty and causation for this court to reverse the decision of the trial court. I would affirm.
If Dr. Foy found that the donor’s heart was not suitable, he testified he could have placed the decedent on a Jarvik-type artificial heart.