hagen v. strobel, alaska (2015)

7/25/2019 Hagen v. Strobel, Alaska (2015)

1/13

Notice: This opinion is subject to correction before publication in the PACIFICREPORTER.

Readers are requested to bring errors to the at tention of the Clerk of the Appel late Courts,

303 K Street, Anchorage, Alaska 99501, phone (907) 264-0608, fax (907) 264-0878, em ail

[email protected].

THESUPREMECOURTOFTHESTATEOFALASKA

SHIRLEYHAGEN,WifeandPersonal

RepresentativefortheEstateof

GREGORYHAGEN,

Appellant,

v.

GUNNARSTROBEL,M.D.and

ALANE.SKOLNICK,M.D.,

Appellees.

)

) SupremeCourtNo.S-15479

SuperiorCourtNo.3AN-11-12832CI

OPINION

No.7018July10,2015

)

)

)

)

)

))

)

)

)

)

AppealfromtheSuperiorCourtoftheStateofAlaska,Third

JudicialDistrict,Anchorage,PatrickJ.McKay,Judge.

Appearances: James Alan Wendt, Law Offices of James

AlanWendt,Anchorage,forAppellant.TimothyJ.Lamb,

DonnaM.Meyers,andWhitneyL.Traeger,DelaneyWiles,

Inc.,Anchorage,forAppellees.

Before:

Fabe,ChiefJustice,Winfree,Stowers,Maassen,and

Bolger,Justices.

BOLGER,Justice.

I. INTRODUCTION

AcardiologistperformedpacemakersurgeryonGregoryHagenandthen

ordered an x-ray to examine the placement of the pacemaker leads and check for
mailto:[email protected]:[email protected]


2/13

complications.Asecondcardiologistreviewedthex-rayanddischargedGregoryfrom

the hospital. A radiologist also reviewed the x-ray, noted a potential nodule in

Gregoryslung,andrecommendedfollow-upx-rays. Buttheserecommendationswere

neverrelayedtoGregory,whodiedfromlungcancerapproximatelytwoyearslater.1Gregoryswife,ShirleyHagen, filedamedicalnegligencesuitagainstthe

twocardiologists,allegingthattheirfailuretorelaytheradiologistsrecommendations

resultedinalostchanceofsurvivalforGregory. Thesuperiorcourtgrantedsummary

judgmenttothecardiologistsonthegroundsthatexperttestimonyfromaboard-certified

cardiologistwasrequiredtoestablishthestandardofcareandthattheEstatehadfailed

toidentifysuchanexpert.Inthisappeal,theEstatearguesthatthereisagenuineissue

of material fact whether the cardiologist who ordered the x-ray later received the

radiologistsreport. ButtheEstatedoesnotshowhow this issue ismaterialto the

superiorcourtsdecisionregardingthenecessityofexperttestimonytoestablishthe

standardofcare.Wethereforeaffirm.

II. FACTSANDPROCEEDINGS

A. Facts

InNovember2007Dr.GunnarStrobel,aboard-certified 2cardiologistwith

theAlaskaHeartInstituteinAnchorage,implantedapacemakerinGregoryHagenat

Mat-SuRegionalMedicalCenterinPalmer. ThefollowingdayDr.Strobelorderedan

x-raytoexaminethepositioningofthepacemakerleadsandcheckforimplantation

1 Hereinafter,werefertoShirleyHageninhercapacitiesasGregoryHagens

wife and personal representative for Gregorysestate as theEstate. We refer to

GregoryandShirleyHagenindividuallybytheirfirstnameswherecontextrequires.

2 Hereinafter,weuseboard-certifiedassynonymouswithmeetingthe

requirementofAS09.20.185(a)(3): certifiedbyaboardrecognizedby thestateas

havingacknowledgedexpertiseandtrainingdirectlyrelatedtotheparticularfieldor

matteratissue.

-2- 7018


3/13

complications. HethenreturnedtoAnchorage.Dr.AlanSkolnick,anotherboard-

certifiedcardiologist, reviewedthex-rayforcomplicationsanddictatedadischarge

report.Gregorywasthendischargedfromthehospital.

Aradiologistalsoreviewedthex-rayanddictatedareport(theRadiologist

Report). Inadditiontonotingtheplacementofthepacemakerleads,theRadiologist

Reportobserved:

A1cmdensityprojectsintherightupperlobe. Itisseenin

thesecondanteriorinterspaceneartheintersectionwiththe

fourthposteriorribspace.Thepossibilityofthenoduleis

raised.Whenthepatientsconditionpermits,PA,shallow

obliques,lateral[,]andapicallordoticviewsaresuggestedfor

furtherevaluation.

AndundertheheadingImpression,theRadiologistReportnoted:Equivocalforright

upper lobe nodule. Recommend followup with PA, lateral, obliques[,] and apical

lordoticwhenthepatientsconditionstabilizes.

InMarch2008 Gregory sawDr. Strobel for a follow-upappointment.

AccordingtoDr.Strobel,thepurposeofthevisitwastocheckthepacemaker,discuss

thechestpain[Gregory]hadexperiencedinDecember2007,and[discuss]theresultsof

[the]Decembernuclearstresstest[thatfollowed].ThepartiesagreethatGregorynever

received any information about the contents of the Radiologist Report or the

recommendationforfurtherx-rays.

Overoneyearlater,Gregorywasdiagnosedwithpoorlydifferentiated

non-smallcellcarcinoma,aformoflungcancer. ThiscancerresultedinGregorys

deathinDecember2009.

-3- 7018


4/13

B. Proceedings

InDecember2011theEstatefiledawrongfuldeathandsurvivalaction

againstDr.StrobelandDr.Skolnick(collectively,thecardiologists).3 Initscomplaint

theEstateallegedthattheRadiologistReportincludedreferencetoanodulethatwould

havebeendiagnosedasearlystagelungcancerhadfurtherstudiesbeenadministered.

TheEstateclaimedthatthecardiologistsfailedtomeetprevailingstandardsofmedical

care,resultinginalostchanceofsurvivalforGregory.

Thesuperiorcourtenteredapretrialorderrequiringthepartiestoidentify

retainedexpertwitnessesbySeptember2,2013.Inanemailtoopposingcounsel,the

EstatesattorneyidentifiedanoncologistwhomtheEstateplannedtocallasanexpert,

but the Estate never filed a list of retained expert witnesses. On October 4 the

cardiologistsfiledanunopposedmotiontoprecludetheEstatefromcallinganyexperts

otherthantheoncologist.Thecourtgrantedthismotion.

Thecardiologiststhenfiledamotionforsummaryjudgment,supported

primarilybyanaffidavitfromDr.Strobel.Dr.Strobelattestedthatinhisexpertopinion,

thecardiologistsmettheappropriatestandardofcarethroughoutGregorystreatment.

Dr.Strobelfurtheropinedthathedidnothaveadutytogobackthroughtheentire

chart,andcheckallothercareproviders[]medicalrecordswhenGregoryreturnedfor

hisfollow-upvisit.

Intheirmemoranduminsupportofsummaryjudgment,thecardiologists

pointed to our statement in Trombley v. Starr-Wood Cardiac Group, PC that [i]n

medicalmalpracticeactions...thejuryordinarilymayfindabreachofprofessionalduty

3 TheEstatealsonamedtheradiologistwhoreviewedGregorysx-raysand

afamilyphysicianwhohadreferredGregorytoDr.Strobel.Butbothdoctorswere

subsequentlydismissedfromthesuit.

-4- 7018


5/13

only on the basis of expert testimony.4 The cardiologists also highlighted

AS 09.20.185(a), whichprovides that ina professional negligence case, an expert

testifyingontheappropriatestandardofcaremustbeboard-certifiedandtrainedand

experiencedinthesamedisciplineorschoolofpracticeasthedefendantorinanarea

directly related toamatteratissue. Accordingly,thecardiologistsarguedthat the

Estatewasrequiredtoidentifyaboardcertifiedcardiologistwhowouldtestifythat[the

cardiologists]medicalcareandtreatmentfellbelowthestandardofcare.

TheEstatehadidentifiednosuchexpertandwasprecludedfromdoingso

by the superiorcourtspriororder. AndtheEstatedidnot opposethecardiologists

motion for summary judgment or submit additional evidence. The superior court,

concludingthattheEstatewasrequiredtoidentifyaboard-certifiedcardiologisttorebut

Dr.Strobelsswornaffidavit,grantedsummaryjudgmentanddismissedthesuitagainst

thecardiologistswithprejudice.

The Estate moved for reconsideration, contending that the court had

overlooked amaterialfactormisconceiveda materialquestion. Specifically, the

Estatearguedthatthecardiologistsfactualaccountwasinternallyinconsistent:the

cardiologistsinitiallyadmittedintheiranswerthattheRadiologistReportwasprovided

toDr.Strobel,butDr.Strobellaterclaimedinhisdepositiontestimonythathenever

receivedit.TheEstatealsofiledamotiontoamendthecomplaint,pointingtoDr.

StrobelsstatementinhisdepositionthathedidnotreadtheRadiologistReportbecause

anAlaskaHeartInstituteemployeefailedtoplaceacopyinhisinbox.TheEstateargued

thatbecausethecardiologistsfailedtoidentifyallpotentiallyresponsiblepersonsas

4 3P.3d916,919(Alaska2000)(secondalterationinoriginal)(quoting

Kendall v. State, Div. of Corr.,692P.2d953,955(Alaska1984))(internalquotation

marksomitted).

-5- 7018


6/13

requiredunderAlaskaCivilRule26(a)(1)(H),5 itshouldbegrantedleavetoamendits

complainttoaddallegationsagainstAlaskaHeartInstitute.

The superior court denied theEstates motion for reconsideration and

enteredfinaljudgmentinthecardiologistsfavor. ThecourtdidnotruleontheEstates

motiontoamend.

III. STANDARDOFREVIEW

Wereviewagrantofsummaryjudgmentdenovo,affirmingiftherecord

presentsnogenuineissueofmaterialfactandifthemovantisentitledtojudgmentasa

matteroflaw.6Wemustdeterminewhetheranygenuineissueofmaterialfactexists,

andinsodoingallfactualinferencesmustbedrawninfavorofandthefactsmustbe

viewedinthelightmostfavorabletothepartyagainstwhomsummaryjudgmentwas

granted.7

[A]partyseekingsummaryjudgmenthastheinitialburdenofproving,

throughadmissibleevidence,thatthereareno[genuine]disputedissuesofmaterialfact

5 Inrelevantpart,Rule26(a)(1)(H)requires,

Excepttotheextentotherwisedirectedbyorderorrule,a

partyshall,withoutawaitingadiscoveryrequest,provideto

otherparties...theidentity,withasmuchspecificityasmay

beknownatthetime,ofallpotentiallyresponsiblepersons

...,andwhetherthepartywillchoosetoseektoallocate

faultagainsteachidentifiedpotentiallyresponsibleperson.

6 Kelly v. Municipality of Anchorage,270P.3d801,803(Alaska2012)

(quotingBeegan v. State, Dept of Transp. & Pub. Facilities,195P.3d134,138(Alaska2008))(internalquotationmarksomitted).

7 Id.(footnoteomitted)(quotingNielson v. Benton,903P.2d1049,1051-52

(Alaska 1995)) (citingRockstad v. Erikson, 113 P.3d 1215, 1219 (Alaska 2005))

(internalquotationmarksomitted).

-6- 7018


7/13

andthatthemovingpartyisentitledtojudgmentasamatteroflaw.8 Oncethemoving

partyhas made that showing, the burdenshifts to the non-movingparty to set forth

specificfactsshowingthathecouldproduceevidencereasonablytendingtodisputeor

contradictthemovantsevidenceandthusdemonstratethatamaterialissueoffact

exists.9

IV. DISCUSSION

A. The Superior Court Did Not Err In Granting The Cardiologists

MotionForSummaryJudgment.

In an action for medical negligence, the plaintiff has the burden of

establishingthedegreeofcareordinarilyexercisedunderthecircumstancesbyhealth

careprovidersinthedefendantsfieldorspeciality....10 Andinsuchactions,thejury

ordinarily may find a breach of professional duty only on the basis of expert

testimony.11

Thecardiologistsarguedintheirmotionforsummaryjudgmentthatthe

Estatewouldneed topresentexperttestimonyfromaboard-certifiedcardiologist to

8 Christensen v. Alaska Sales & Serv., Inc.,335P.3d514,517(Alaska2014)

(alterationsinoriginal)(quotingMitchell v. Teck Cominco Alaska Inc.,193P.3d751,

760n.25(Alaska2008))(internalquotationmarksomitted).

9 Id.(quotingState, Dept of Highways v. Green,586P.2d595,606n.32

(Alaska1978))(internalquotationmarksomitted).

10

Achman v. State,323P.3d1123,1129(Alaska2014)(citingAS09.55.540(a)).

11 Trombley v. Starr-Wood Cardiac Grp., PC,3P.3d916,919(Alaska2000)

(quotingKendall v. State, Div. of Corr.,692P.2d953,955(Alaska1984))(internal

quotationmarksomitted).

-7- 7018


8/13

establishthatabreachofdutyowedoccurred.12Thesuperiorcourtagreed,concluding

that

themedical issues in this litigation concerning theduties

owedbycardiologist[s]Dr.StrobelandDr.Skolnickrelative

to the care they provided to [Gregory] are beyond the

comprehension of lay jurors, and therefore they require

expertmedicaltestimonyfromaboardcertifiedphysicianor

physicians in the area or areasof specialty at issue in this

case,whichiscardiology.

As the superiorcourt noted, the cardiologists submitted anaffidavit fromaboard-

certifiedcardiologist,Dr.Strobel,whiletheEstatefailedtosimilarlyofferswornexpert

testimonyasnecessarytomeetitsburdenofproduction.Thecourtconcludedthat

summaryjudgmentwasthereforeappropriate.

Wemustfirstdeterminewhetherthecardiologistsmettheirburden,asthe

movingparties,ofshowingthattherewasnogenuineissueofmaterialfact.Withrespect

toDr.Skolnick,Dr.Strobelattestedthatinhisopinion,

Dr.Skolnickdidnotneedtowaituntilaftertheradiologists

typedreportwasavailablebeforeauthorizingthedischarge

of [Gregory] from the hospital. The purpose of Dr.

Skolnicksviewingthex-raywastocheckthattheleadsin

12 UnderAS09.20.185(a)anexpertwitnesstestifying[i]nanactionbased

onprofessionalnegligencemustbe:

(1)aprofessionalwhoislicensedinthisstateorin

anotherstateorcountry;

(2)trainedandexperiencedinthesamedisciplineor

school ofpractice as the defendant or inan area directlyrelatedtoamatteratissue;and

(3) certified by a board recognized by the state as

havingacknowledgedexpertiseandtrainingdirectlyrelated

totheparticularfieldormatteratissue.

-8- 7018


9/13

the wall of the heart had not become displaced, that

[Gregory]didnothaveapneumothorax,etc. Itwasnottodo

a thorough radiological evaluation of [Gregorys] overall

health.

Dr.StrobelfurtheropinedthatDr.Skolnickmettheappropriatestandardofcareas

describedinAS09.55.540...requiredofcardiologistsinAlaska.

Astohisownactions,Dr.Strobeldefinedtheappropriatestandardofcare

bystatinginhisaffidavit:

It is .. .my expert opinion thatwhen[Gregory]returned

approximately[fourandone-half]monthsafterimplantation

ofapacemaker...forapacemakercheck...,Ididnothave

adutytogobackthroughtheentirechart,andcheckallother

care providers[] medical records, etc. The chest x-ray

reviewbyDr.SkolnickinNovemberhadalreadyconfirmed

thepacemakerimplantationdidnothavecomplications. The

purposeofthatvisitwastocheckthepacemaker,discussthe

chestpainhehadexperiencedinDecember2007,andthe

resultsofthatDecembernuclearstresstest....

Dr.Strobelconcludedthat,likeDr.Skolnick,hemettheappropriatestandardofcare.

Inlightofthesestatementswhichwerenotchallengedbyconflicting

experttestimonyweconcludethatthecardiologistsmettheirburdenasthemoving

partiesbyshowingthattherewasnogenuineissueofmaterialfactastothestandardof

care. Thus to avoid summary judgment, the Estate was required todemonstrate a

genuineissueofmaterialfactastotheappropriatestandardofcareanelementon

whichtheEstateboretheburdenofproof.13 ButtheEstatedidnotfileanopposition

brieforsubmitadditionalevidence. Thesuperiorcourtsgrantofsummaryjudgment

wasthereforeappropriate.

13 See Achman,323P.3dat1129(citingAS09.55.540(a)).

-9- 7018


10/13

OnappealtheEstateargues,asitdidinitsmotionforreconsideration,that

thecardiologistsnarrativewasinconsistent,andthatthisinconsistencycreatedanissue

ofmaterialfact.TheEstatenotesthecardiologistsadmissionintheiranswerthat

[u]pon information and belief [a] copy of the x-ray report containing [the

radiologists]recommendationwasprovidedto[Dr.]Strobel. TheEstatecontraststhis

admission with Dr. Strobels subsequent deposition testimony that, although the

RadiologistReportwasscannedinattheAlaskaHeart[Institute][o]ffice,henever

receivedacopyinhisofficeinbox.

Weseenoinconsistencyinthesestatements. Critically,Dr.Strobelnever

deniedthathewasprovidedtheRadiologistReport;hemerelytestifiedthathenever

receivedacopyinhisofficeinbox.Andinthecardiologistsmotionforsummary

judgment,theyadmitted that[a]copyoftheradiologyreportwassent toDr.Strobelat

[AlaskaHeartInstitute]. (Emphasisadded.)Evenreadingtherecordinthelightmost

favorabletothenon-movingpartyandmakingallreasonableinferencesinitsfavor, 14

thefactthatacopyoftheRadiologyReportwassenttoDr.Strobelandscannedin

totheAlaskaHeartInstituteselectronicrecord-keepingsystemdoesnotsuggestthatDr.

Strobelactuallyreceived it in his inbox.AndtheEstatepointstonothingelseinthe

recordgivingrisetoagenuineissueoffact.

Moreover,theexistenceofa disputedfactualissuewillonlypreclude

summary judgment if it is a material issue,15 and [a] factual issue will not be

consideredmaterialif,evenassumingthefactualsituationtobeasthenon-movingparty

contends,heorshewouldstillnothaveafactualbasisforaclaimforreliefagainstthe

14 Bachner Co. v. Weed,315P.3d1184,1188(Alaska2013)(quotingWitt v.

State, Dept of Corr.,75P.3d1030,1033(Alaska2003))(internalquotationmarks

omitted).

15 Sonneman v. State,969P.2d632,635(Alaska1998)(emphasisinoriginal).

-10- 7018


11/13

movingparty.16Herethesuperiorcourtgrantedsummaryjudgmentonthegroundthat

expert testimony from a board-certified cardiologist was required to establish the

standardofcare,andtheEstateputforthnosuchexpert.Onappeal,theEstatedoesnot

explainhowDr.StrobelsreceiptoftheRadiologistReportwouldhaveimpactedthis

determinativeissue.17AndtheEstatepointstonothingelseintherecordcreatinga

materialissueoffactastotheappropriatestandardofcare.

B. TheEstateWaivedItsArgumentThatTheSuperiorCourtErredIn

DenyingItsMotionForReconsideration.

TheEstateappearstoarguethatthesuperiorcourtshouldhavegrantedits

motionforreconsideration,assertingthatthecourterredbyconcludingthattherewas

noevidence[relevant]tothesummaryjudgmentmotionthatthecourtshouldpauseto

reconsider.ButtheEstategivesonlycursorytreatmenttothisissueintheargument

sectionofitsopeningbriefandomittedtheissuefromthebriefsstatementofpointson

appeal.

[W]hereapointisgivenonlyacursorystatementintheargumentportion

ofabrief,thepointwillnotbeconsideredonappeal.18 WeconcludethattheEstates

argumentregardingitsmotionforreconsiderationwaswaivedforinadequatebriefing.

16 Id.;see also Christensen v. Alaska Sales & Serv., Inc.,335P.3d514,519

(Alaska2014)([A]materialfactisoneuponwhichresolutionofanissueturns.).

17 TheEstatedoesarguethat[t]hereclearlyexistedanissue[asto]whether

[Dr.]Strobelhadindeedbeenprovidedacopyofthereport.Thereisnoissuethatthe

failuretofollow-uponsuchareportisimproperas[Dr.Strobel]admittedasmuchinhis

deposition. ButDr.Strobeldidnotadmitthatitwouldbeimpropernottoexamineareporthehadreceived;hemerelystatedthathewouldnormallyreadthesetypesof

reports.

18 See Glover v. Ranney,314P.3d535,545(Alaska2013)(internalquotation

marksomitted).

-11- 7018


12/13

C. TheEstate WaivedItsArgument ThatTheSuperiorCourtShould

HaveGrantedItsMotiontoAmendTheComplaint.

TheEstatearguesthatthesuperiorcourtshouldhavegranteditsmotionto

amenditscomplaint.Inrequestingleavetoamend,theEstatepointedtoDr.Strobels

depositiontestimonythatanAlaskaHeartInstituteemployeefailedtoplaceacopyofthe

RadiologistReportinhisinboxandarguedthatthecardiologistsfailedtoidentifyall

potentiallyresponsiblepersonsasrequiredunderCivilRule26(a)(1)(H).Accordingly,

theEstateaskedtoamenditscomplainttoaddtheAlaskaHeartInstituteasadefendant;

toaddnewallegationsconcerningtheAlaskaHeartInstitutesallegedfailuretodeliver

acopyoftheRadiologistReporttoDr.Strobel;andtoaddanegligencecauseofaction

againsttheAlaskaHeartInstitute.AlthoughthesuperiorcourtdeniedtheEstatesmotion

forreconsideration,itneverruledonitsmotiontoamend.

TheEstateomittedthis issue from its statementof issuespresented for

reviewanddiscussesitonlybrieflyintheargumentportionofitsbrief,assertingthatthe

cardiologistsviolatedRule26(a)(1)(H)andthatthisprejudiced[the][p]laintiffs. But

theEstatecitesnolegalauthorityfortheimpliedpropositionthatthesuperiorcourtwas

requiredtograntleavetoamendevenaftergrantingsummaryjudgmentanddismissing

thecardiologistsfromthesuit.19NordoestheEstateciteAlaskaCivilRule15orany

otherlegalauthorityregardingasuperiorcourtsdiscretioninconsideringamotionfor

leavetoamendacomplaint.20Aswenoteabove,wewillnotconsideranissuegiven

19

Cf. Bush v. Elkins,342P.3d1245,1250-52(Alaska2015)(analyzingasuperior courts denial ofa motion for leave toamend after the plaintiff had been

dismissedfromthecase).

20 See, e.g.,Miller v. Safeway, Inc., 102 P.3d 282, 294 (Alaska 2004)

(recognizingseveralreasonstodenyleavetoamendacomplaint).

-12- 7018


13/13

onlyacursorystatementintheargumentportionofabrief.21 Wethusconcludethatthe

Estatehaswaivedthisargumentthroughinadequatebriefingonappeal.

V. CONCLUSION

WethereforeAFFIRMthesuperiorcourtsjudgment.

21 See Glover,314P.3dat545.

-13- 7018

hagen v. strobel, alaska (2015)

Documents