THIRD DIVISION May 30, 2007

Nos. 1-06-1007 and 1-06-1809 Consoli dated JA NE P ETR

E, Sp ec i al A dm i ni stra tor of the Esta te of ) A

ppe al f rom Jam es Petre, ) th e C i rc ui t Cou rt ) o f Co o k C o un t y. Plai ntif f-A ppel le e, ) ) v. ) ) CA RDIO VA SCUL

AR CONS ULTA

NTS, S.C ., ) d/b/a Cardiovascular Medical Associates, ) S.C., ) ) No. 02 L 14506 Defend ant -Ap pellant ) ) (Vi nc en t A. K uci ch , Robe rt E. App l eb aum

, ) Hers h el L. W i x , D av i d L ooy en ga , Rob er t ) P r en t ice , Ge o r ge Gu st af

so n, Hic ko r y ) Card i ology As soci ates, L td., and SSN H eal

th Ca re ) Co rp or at ion, d/ b/a S t . Fr ancis H os pit al and H ealt h ) Cent er , a No t -fo r- Pr ofit Co rp or at ion, ) Ho no r ab le ) Barbara A . McDonal d, Def endan ts). ) Judge Presidin g. PR ESI DI NG JU STI CETH EIS de l i

v er ed th e op i n i on of th e c our t: This is t he t hird t ime that t his case has c ome be for e t he ap pellat e co ur t . P laintiff Jane Petre (plai

ntif f), the speci

al adm in is trat or o f the es

tate o f Jam

es Petre (Petr e), fi

le d this me dic al ma lpractice action agai

nst def endan ts Cardiovas cul ar Consul

tants, S.C., d/b/a Cardi

ovascular Medical Associ ates, S.C. (CMA), Dr. Vincen t A. Kucich, Dr. Robert E. Appleb aum , Dr. Hershel L. Wi x, Dr. Davi

d Looyenga, Dr. Robert Prentice, Dr. George Gustafson, Hickory Cardi ology Associ ates, Ltd., and St. Franci s Hospital and Heal th Center. Plai

ntif f s ought recovery f

or inj uries1-06-1 007 & 1-06-1 809 cons.

2

su sta i n ed b y Pe tref ol l owi n g c oron ar y ar ter y b y pa ss su rg er y perf orm ed b y Dr . K uc i ch at S t. Franci s Hospital and Heal th Center i

n Bl ue Isl and, Illi

nois . Af ter t he surgery

, Petre developed a postope ra ti v e w oun d i n f ec ti on , w h i ch ul ti mate l y l ed to th e r em

ov al of Pe tre ’s ste rn um . Pr i or to t he firs t t r ial in 2 00 0, pla int iff en t er ed int o a s et t leme nt wit h S t . Fr an cis Ho sp it al a nd vo lun t ar ily di sm i sse d Dr. A

ppleb aum , Dr. Looy

enga, Dr. Pren

tic e, Dr. Gu staf

son, a nd Dr. Wi x f rom th e ca se. Fo llowing a t hird t rial, t he jur y ret ur ned a ver dict in favor of D r. Kucich bu t aga inst C MA, and awarded pl

ai ntif f $814,443.97. CMA n

ow appeals, contendi

ng that: (1) the tr ia

l c ourt abused i ts d i screti on i n s tri ki ng porti ons of CM A ’s rep l y i n s upp ort of i ts p osttri al moti on a nd al l of CMA’s a rg ument s sho uld be c ons ider ed by t his co ur t on a ppe al; (2 ) it is ent itled t o a judg ment notwithstandi

ng the verdict bec ause plai ntif f f ai le d to establ

is h a prima facie

case of n egl ige nce aga inst a ny non- physician emplo yee o r a gent of CM A; (3 ) it is ent itled t o a judg ment not wit hst anding t he ver dict beca use t he jur y’s verd ict is no t sup po rt ed by t he evide nce a nd because pla in tif f f ai le d to present any

aff irm ative evi dence of negl ige nce; (4) it is

entitled to a new trial because the trial

cour t err ed in

permi tt in g plai ntif f to go bey

ond t he scope of defendants’ ex amin at io n o f D r . Ku cic h inde fe nd an t s’ ca se - in- ch ief t o pr es en t de fe nd an t s’ t he o ry o f lia bilit y; and ( 5) t he jur y’s verd ict is a gainst t he manifest weight of t he evide nce. Fo r t he fo llowing reas ons, we rev

erse the tri al court’s j udgm en t and rem and f or a f ourth tri al
. The record d i scl osesthe f oll owi ng f acts a nd procedur

al history relev an t to t his ap

peal . In their s econd am

ended com

pla in t, plai ntif f al le ged the fol

lowi ng gen eral f acts. Plai ntif f was adm itted to St. Francis

Hospital on Novem

ber 18, 1996. Several

day s l ater, o n Novem

ber 26, 1996, Dr . Kucich , who was a memb er of the CMA pract ice, performed coro nary artery by pass1-06-1 007 & 1-06-1 809 cons.

3

surgery on Petre. Wh

il e he was under the care of Dr. K

uci ch an d CMA, Petre devel

oped a bacteria l i nf ection. Neve

rtheles s, Petre was disch

arged from

St. Francis

Hospital on Decem

ber 2, 199 6. Ult imately, in Janu ar y 1997 , P et re unde rw ent a se co nd su rg er y to co rr ect and c ur e t he i nf ection. Plai ntif f rai sed 19 cou nts against all of the def endants in volved, two o f whi

ch were agains

t CM A . In cou nt I , pl ai nti f f rai se d a medi cal mal pra cti cecl ai m ag ai ns t CM A ba se d on a theory of vicario us liabili

t y. Plaint iff

alleged t hat CMA, “act ing by and t hro ugh it s ag ent s, e mployees , a nd
medi cal staf f , i nc l udi ng b ut not li m i ted to [Dr.] K

uci ch and [Dr.] A

ppleb aum or others,” comm i tted medi cal mal practi ce by : “( a) Ca r ele ss ly and ne glig en t ly failing t o pr o vid e a pp r o pr iat e a nt ibio t ic pr o phyla xis fo r t he c ar dia c s ur ge ry p er fo rme d o f [ sic ] James P et re; (b) Car elessly and ne gligent ly presc ribed and u t ili zed exce ssive and unneces sary amou nts o f cor tico st ero ids which pred ispose to inf ect ion; (c) Ca rel es sl y an d neg l i ge ntl

y f ai l ed to rec ogn

izea s tern

al wou nd i nf ec ti on prior to t he di scharge of

Jam es Petre from St. Francis Hospital and Heal th Center on D ecember 2 , 19 96; (d) Careles sl

y a nd ne gli gently fai le d to respond appropriately to cul tures whi ch i dentif ie d the sternal

wound in fection; an

d (e) Careles sl

y a nd ne gli gently fai le d to provide respons ib le surgic al followup af ter di sch arge on Dece m ber 2, 199 6.” As a r esu lt, plaint iff

alleged t hat Pet re suffer ed g re at pain and menta l anguish, disability, a nd1-06-1 007 & 1-06-1 809 cons.

4

di sf i gur em en t, wh i ch ren de red hi m unab l e to p urs

uehi s oc cu pa ti on a nd res ul ti ng i n l oss of i nc ome. In c oun

t XI, pl ai nti f f al l eg ed tha t asa re sul

t of Petre’ s i njury , pl ai nti f f wa s dep ri

ve d of Petre’s compan

ions hi p, val uabl e servi ces, and n ormal fam il y rel ations. Dr. Kuci

ch an d CMA f il ed an an swe r den y i ng m i scon duct. Th e c as e w as t rie d fo r t he fir st t ime in 2 00 0. As no t ed abo ve, pr io r t o t hat t ria l, p laint iff settl ed wi th St. Fra nc i s Hosp i

tal and vol unta ri l y di sm i sse d Dr. A

ppleb aum , Dr. Looy

enga, Dr. Prenti ce , Dr . Gu sta f

son , an d D r. W i x f rom the ca se . The j ury

retu rn ed a verd i ct i n f av or of pla int iff in t he amo un t o f $4 65 , 00 0 a ga inst Dr . Ku cic h a nd CM A. De fen da nt s a pp ea led , an d t his cou rt re ve rs ed , h ol di

ng tha t the tri al cou rt “ erred asa m atte r of l aw both i n prec l udi ng ev i de nc e of t he dismissed Hicko ry physicians’ c ond uct and in r efusing t o g ive the app ro pr iate jury inst ru ct ion, thereby deny in g defen dants a f ai r trial .” Petre v. Kuci ch , 331 Ill . App. 3d 935, 938, 771 N.E. 2d 1084, 1 087 (2 002). W

e the n re manded the ca se f

or a sec ond trial
. Th e s ec ond

tri al occurred i n 2 003 . In

tha t i ns tan ce , th e j ury

retu rn ed a verd i ct i n f av or of Dr. Kuci ch an

d CMA. Pl

ai ntif f appea le d, and thi s court r eversed, h oldi ng that the trial

court was re quir ed t o g ive the long -fo rm jury inst ru ct ion o n so le pr oximat e ca use t o e xplain t o t he jur y the i m pact of the evi den ce of thi rd-par ty n egl i gen ce on def endan ts’ n egl i gen ce. Petre v. Kuci ch , 356 Il l . Ap p. 3d 57 , 66, 824

N.E.2d 1 117, 11 24 (20 05). W e thu s rem

anded the ca se a

gai n. The case then

proceeded to trial

in 2005. However, because two of pla in tif f’ s wi tnesses were una va i l ab l e, the court dec l ared a

m i stri al
. T he ca se wa s s ub se qu en t ly t r ied fo rt he t hir d t ime, an d t ha t t r ial is t he su bje ct o f t his appe al . At tha

t trial , pl ai nti f f and Petre’ s y

ounge r si ster, Di

an e Pri ndl e, testif i ed th at Petre1-06-1 007 & 1-06-1 809 cons.

5

suf f ered a he art attack on

Novem ber 18, 19 96. Ei

ght da y s later, Petre

und erwent coronary

artery by pas s su rgery . Petre wa s su

bs eque ntl y di sch arged f rom th e hospi tal on De cem

ber 2, 199 6. Rou gh l y a m on th l ate r, on De cem b er 31 , 19 96 , pl

ai n ti f f re mov ed Pe tre ’s b an dage s to cl ean h is wound and di scovered a y el low bl is ter larger than a quarter. Several day s l ater, t hey learned that Pet re had a se vere inf ect ion. A plastic surge on subsequ ently removed Pet re’s stern um and perf orme d reconstructi

ve surg ery of the are a us i

ng P etre’ s pe ctorali s m

usc l es. Petre ul tim atel y di ed i n D ecem ber 2000of u

nre l ated l i ver can cer. Pl ai n ti f f of f er ed th e te sti mon y of two ex pert p h y si ci ans. A n i n f ec ti ous dise as e e x

pert opine d that Pet re suff

ered from a l ike ly sternal osteo my el iti s, or an in

fection of the sternum

bone, whi ch was due

to a m ethic il li n-resi stant staphyl

ococcus epiderm

idi s (MRSE) in

fection that seeded at t he t ime o f Pe t r e’ s byp as s s ur ge r y. A ca r dio t ho r ac ic s ur ge ry exp er t o pin ed t ha t Pe t r e s ho uld have be en pr op hylactica lly administe re d an a nt ibiot ic called V anco mycin, which is effect ive agai nst me thicil l i n-re si stan t bacteri a. Plai ntif f al so exam in ed defe ndan t Dr. Vincen

t Kuci ch as an

adverse wi

tness. Dr. Kuci

ch testifi ed that he was a cardi

ot horacic surgeon and perf

ormed Petre’s by

pass surgery

and ex pla in ed the proc ed ure an d c are . In pa rti cul ar, ca

re f or Petre’ s s

urg i cal wou nd wa s done ac cord i ng to a prot ocol. Dr. Kucic

h would a ls o check Petre’s wound daily . On Decem

ber 2, 1996, Petre had a sm al l a mount of se

rous, o r clea

r, fl uid drai ni ng f rom his surgi cal

wound. Dr. Kucic

h ex pla in ed that clear f

lui d drain age i s comm

on and usual

ly not a sign

of i nf ection. If the

re were no ot her signs o f inf

ect ion, suc h as feve r, re dnes s, o r t ende rne ss, Dr . Ku cich wo uld no t do anything f urthe r. Depe ndi ng on the n ature of the f l ui d, Dr. K

uci ch would obtai

n a cul ture on i t.1-06-1 007 & 1-06-1 809 cons.

6

Plai nti f f ’s cou ns el the n c onf ron ted Dr. K uc i ch wi th th e te sti mony he ga ve at h i s dep osi ti on in 1999. At that t im

e, Dr. Kuci ch stated that serous fl uid drai nage “ would be cul tured ro utinel

y.” He fur t he rst at ed t ha t if he sa w s uc h d r ain ag e, he wo uld o r de ra c ult ur e. He ad mit t ed in his depo sition that he foll

owe d t his proced ure wit h Pet re and o rder ed t he cultur e just pr ior t o P etr e’s di scha rge . How ever, i

n h i s te sti mony at tri al , Dr . K uc i ch que sti one d w he the r h e h ad done s o, observi ng that if he h ad ordered a culture of Petre’s surgi cal wound drain

age, Petre’s medi

cal chart would ha

ve contai ned a n ot ation that he ordered a cul ture, and the medi

cal chart contain

ed no s uc h or de r. H e al so state d that he di d n ot rem em be r gi vi ng the orde r f or th e cul ture or dir ec t ing t ha t a n ur se do it
. He ad de d t ha t o ft en , nu r se s w ill o r de ra c ult ur e o n t he ir o wn an d t ell t he do ct o rlat er . He did no t ex pla in w he n a nu r se wo uld o r de ra c ult ur e o rwh en a d o ct o rwo uld or whe n the n urse would tell

the d octor of the

resu l ts. Neverthel ess, Dr. Kuci

ch adm itted that somebody

obtaine d a cul

ture o f Petre’s surgi

cal wound drai

na ge. Howe

ver, wh ethe

r Dr. K uci ch wasthe i ndi vi dual to foll ow up on

the c ul ture would have “ depended on t he ci rcumstances.” Dr. Kucich did not elab orat e on these “ci rcumstances.” He did state t hat he did not perso nal ly check every

culture because there ar e so ma ny taken. General

ly , he would onl

y f oll ow up if the drain age was purulent or if

the patien

t had other sy m ptoms of i nf ection. T he cu lt ur e in t his c as e w as po sit ive fo rMR SE . Ho we ve r , Dr . Ku cic h d id n o t lea rn t his un ti l som eti me b ef oreh i s dep osi

ti on i n 19 99 . H ad

h e k n own, h e w oul

d h av e f ol l owe d u p w i th Petre. R ather, Dr. W i

x, Petre’ s c ard

i ol ogi st i n K an ka ke e, h ad the res pon si bi l i ty to f ol l ow u p on t he cu lt ur e. T his w as be ca us e P et r e c ho se no t t o co nt inu e h is c ar e in Blu e I sla nd
. A no t e in1-06-1 007 & 1-06-1 809 cons.

7

Pe t r e’ s me dic al r ec o r d, wh ich wa s a dmit t ed int o ev ide nc e, co nfir ms t ha t Pe t r e w o uld co nt inu e h is ca r e w it h D r . Wix in K an ka ke e d ue t o t he dis t an ce . I t fur t he rind ica t ed t ha t Pe t r e w o uld ca ll CMA ’soff

i ce i f he had an y probl ems. The note was w

ri tten by one of CMA ’ssecretaries. The i ndi vi dual s on Dr. Kucich ’sstaf

f wh o woul d ha

ve ch ecke d on the cul

ture res ul t were Ma ril y n K am ak , ph y si ci an ’s as sista nt I an Ti m m s, or nu rs e Su e W es en sten. How ever, non

e of t he m ch ec ke d t he r es ult
. Dr . Ku cic h ne ve rex pla ine d h o w o rwh en an y o f t he se ind ividua ls w o uld noti f y hi m of a cul ture res ul t. Petre was disch

arged from

St. Francis

Hospital on Decem

ber 2, 1996. CMA s ent a l etter to Dr. Wi x c onf i rm i ng th at Petre woul

d con tin ue h i s postoper

ati ve care wi th Dr. W i x. Su bse qu en t ly, D r . Ku cic h le ar ne d t ha t Pe t r e s uffe r ed fr o m an MR SE infe ct io n, wh ich r es ult ed in the s urgi cal rem oval of Pe tre’s stern um by another doctor. After plaintif

f rested , defendant s read t he evidence deposit ion of Dr. Hershel Wi x, Pet re’s cardiol ogist, in to the record. Dr. Wi

x be gan treating Petre af

ter his heart attack. He al so treat ed Pet re follow ing his dischar ge fr om t he ho spit al. H e sa w P et re on D ece mber 6 , 1 996 , a nd he seem ed “qui te stable” a

t t hat tim e. Dr. Wix

saw Petre again

on Decem

ber 10, 1996. At that t im e, he n ot ed that Petr e’s surgi

cal wound was sti ll

drain in g and that i

n som e sm al l a reas, the drain

age was causi ng “ mi ld b reakdown,” or det erioration, of the skin around the in

ci si on. These f

in din gs wer e no t at ypical. H ow ever , D r. Wix saw P et re aga in on De cember 13 a nd 20 , 1 996 , a nd he appeared norma

l on those dates. Dr. Wi

x saw Petre agai

n on Jan uary 3, 1997, and a

t t hat tim e, his sur gical wo und s how ed t wo ar eas of d et er ior at ion. Dr . Wix t hen su spe ct ed a n infect ion and ref erred Petre to Dr. Da

vi d Drey f uss , a pl asti c su rgeon , f or fu rther c are.1-06-1 007 & 1-06-1 809 cons.

8

De f en da n ts th en re ad th e ev i den ce

de pos i ti on of pl ai n ti f f ’s i n f ec ti ous di se as e e x

pert i n to t he r ec o r d. I n t ha t t es t imo ny, t ha t do ct o ro pin ed t ha t pr o ph ylac t ic u se o f Va nc o mycin w o uld have caused an i

ncreased risk of a sternal wound in fection. A cardiothoracic surgeo n al so testifi ed as an e xpert for the defe

nse. He opi

ned that i t would not have b een proper to adm in is ter Vanc omycin t o P et re pr ior t o his s ur ger y and co nclude d t hat Dr . Ku cich co mplied wit h t he stan dard of care i n c ari ng f or Petre. Defe ndan ts then cal

le d Dr. Kuci ch to test if

y f or t he second ti

me . He testifi

ed agai n ab out t he byp as s s ur ge r y and wh at st ep s he t o o k t o gu ar d a ga inst infe ct io n. He als o ad de d t ha t he did
n ot s ee Pe treaf ter h e w as di sch arge d f

rom th e h osp i tal on De cem b er 2, 1 99 6. R

ef er ri n g to Pe t r e’ s me dic al c ha r t , Dr . Ku cic h c it ed t he no t e b y his s ec r et ar y t ha t Pe t r e w o uld co nt inu e h is care wi th Dr. W i x i n K an kake e due

to the di stan

ce. On cross-exam

in ation, Dr. Kuci

ch adm itted that “whether or not [he] or dered [a culture] or [ he] knew about it, [he] knew that there was a cultur e taken o n Decem ber 2, 1996. ” He also reiterated that he noticed serous drai nage f rom the surgical

wound for the f

irst tim e on Decem

ber 2, 1996, but t hat such drai nage was very comm on and n ot considered a compl

ic ation. Dr. Kuci

ch the n a dm i tted th at s ometi mescul ture res ul ts w ere not a l wa y s del i ve red to the pe rs on to w

hom t hey wer e ad dr esse d. Acco rd ingly, if a cultu re was or der ed by his t eam pe rso nally, and no t t he ho sp it al, t he n his t ea m wo uld fo llo w u p o n it
. Ho we ve r , t he y wo uld no t fo llo w u p o n it un les s his team ’sna me was on the report. Dr. K uci ch al so adm i tted that “ we al way s get cul tures on ev ery f l ui d,” an d tha t a cul ture was taken on Petre according to “standard procedure.” Plai ntif f’ s counsel

then asked Dr. K

uci ch1-06-1 007 & 1-06-1 809 cons.

9

whet her it w ou ld be a br eac h of t he st anda rd of c ar e if someo ne in his office kne w abo ut t he cult ur e r esu lt bu t did no t hing. P laintiff’s co unse l did no t spe cify whethe r he was re ferr ing t o t he stan dard of care f or a card i othoraci c su rgeon or to some

other s tandard of

care . Plai ntif f’ s counsel

then conf ronted Dr. Kucich

with h is depositi on testim

ony. A t t hat tim e, wh en as ke d w he t he rhe at t emp t ed t o o bt ain an d lo o k a t t he cu lt ur e r ep o r t wit hin a we ek o f it bei ng ordered, Dr. Kucich

responded that he personal ly did n ot , but someone on h

is staff ma y have. Whe

n asked i f h e knew “ for sure” whe

ther any one di d, Dr. Kucic

h responded that “[s]omeb ody obvi

ously did b ecause the resul

t was noted.” Base d o n his dep os itio n, D r. Kucich t hen t est ifi ed a t t rial t hat he did no t kno w abo ut t he cu lt ur e r es ult at t he t ime, bu t o nly lea r ne d o f it aft er wa r d. Ho we ve r , he ad mit t ed t ha t “[ i]f my offi ce knew and didn ’t t ell

someone, t hen y

eah, there’s a breach of standard o f care.” He also adm itted that CMA, hi s off

ic e, was al so a defen

dant in the case an

d that nurse Sue Wes ensten was worki ng u nde r his di rection. On redi rect exam in ation, Dr. Kuci

ch exam in ed Petre’s me dic al

records. An entry

dated Janu ar y 8, 1 997 , indica t ed t hat a cu ltu re was do ne o n Janu ar y 3, 1 997 , w hich had be en o rd er ed by Dr. Wi x. The n ot es contain

no entry f

rom the week of De cem

ber 2, 1996. Dr. Kuci ch added that his de posi tion testi mony di d not m

en tion wh en CMA rece i ve d the resu l ts of th e cul ture rep ort from Decem ber 2, 1996. Other than Dr. Kuci ch’s secretary’ s note from Dec em ber 4, 1996, which indicat ed t hat Pet re wo uld co nt inue his ca re wit h Dr . Wix in Kankak ee d ue t o t he dist ance , a nd th e C MA l ette r f rom De cem b er 9, 1 99 6, w

h i ch con f i rm ed th at P etre w oul

d c on ti n ue h i s c ar e wi

th Dr. W i x, there a re no notati ons f

rom D ecem

ber 1996i

n Pe tre’s medi cal record.1-06-1 007 & 1-06-1 809 cons.

10

Fol l owi ng cl osi ng arg um en ts, th e j ury wa s g i ve n v ari ousi ns truc ti ons . The on

l y i ns truc ti on giv en to the jury

on how to det ermi

ne the standard of

care pertain

ed to a medi cal

docto r. That in struction provided:

“A me dic al docto r who holds

hi ms el f out as a speci

al is t and provides ser vice in his spec ialty must po sses s and app ly the kno wledg e and use t he sk ill and care ordinari

ly used by a reasonabl

y wel l qua

li fi ed speci al is t under circum

stances si mi la r to those shown b

y the evi dence. A fai lure to do so is professi

onal negl ige nce. The only way in which you may decide whet her a De fendant po sses sed and ap plie d t he kn o wle dg e a nd us ed t he sk ill and ca r e w hic h t he law r eq uir ed o f him is f rom e xpe rt testi mony pres en ted i n the tri al
. You must not att em

pt t o determin

e this question f

rom any personal knowl edge

you ha ve .” This i nstructi on i s b ase d on the Il l i noi s Pattern

Jury Instructi on f

or profe ssi

onal ne gli gen ce. Ill i noi s P atte rn Ju ry In truc ti ons , Ci

vi l , No. 105 .01 (20 06) (h ere i na f ter I PI) . The j ury

wa s n ot gi ven a ny spe ci f i c i nstructi ons on

stan dard of care f or any other ty pe of medi cal pers onnel
. However, the jury was gi

ven an in struct ion on vi

carious li abili ty, which pro vided that CMA was a cor porati on an d c oul d on l y ac t th rou gh i ts o f f i cers an d e m pl oy ee s. Th e v

i ca rious l i ab i l i ty i ns truc ti on f urth er p rovi de d that D r. K

uc i ch “ wa s th e age nt” of CM A ; th ere f ore, an y ac t or omissio n of D r. Kucich w as a n act or omissio n of CM A. T he inst ru ct ion d id no t re fer t o a ny ot her employee s o f CMA.1-06-1 007 & 1-06-1 809 cons.

11

Th e j ury ul ti mate l y retu rn ed a verd i ct i n f av or of pl ai nti f f ag ai ns t CM A i n th e a moun t of $814,443.97 and i

n f avor of Dr. Kuci

ch. CMA then f il ed a tim el y posttrial motion raisi

ng three is sues. Fi rst, CMA argued that plai ntif f f ai le d to establ

is h a prima facie

case of n egl ige nce because t here was no evidence of any b reach o r t hat suc h a breach pro xim ate ly caused P etr e’s i n j ur y . Se con d, CMA argu ed th at i t wa s e n ti tl ed to a n ew trial b ec au se th e tr i al cou rt a b us ed i ts di scre tion i n pe rm i ttin g pl ai nti f f to cross-ex

am i ne Dr. K uci ch usi ng h i s de posi tion testi mony . Thi rd, CM A a rgued that the j ury ’sverdict was

agai nst the m an i f est we i ght of

the evi den ce. In re spon se, p l ai

nti f f ass erted, inter al

ia , that i t h ad estab l i sh ed al l of th e e l em en ts o f i ts prima facie

ca se of ne gl i ge nc e agai

ns t CM A . Re ga rdi ng the f i rs t el em en t, du ty or s tan da rd of ca r e, pla int iff cit ed Dr . Ku cic h’s t es t imo ny o n c r o ss - ex amina t io n w he r e h e a dmit t ed t ha t if someone i n hi s off ic e knew of

the resul t o f the Dec em

ber 2, 1996 cul

ture and did n

ot hi ng, then that would be a b

reach of the s

tandard of care. In rep l y , CM A as serted f or th e f i rs t ti me that p l ai

nti f f cou l d n ot rel y on th e te sti mony of Dr . Ku cich fro m his cro ss- examinat ion d ur ing defend ant s’ ca se- in-chief as e vidence of t he standard of care. Thereaf ter, plai ntif f f il ed a m ot ion to strike the portions of CM A’s postt rial mot ion which r aised t hese objec t ions t o D r. Kucich’s t est imony with r esp ect t o t he du t y element of negl ige nce f or t he f irst tim e arguin g that t hese argum

ents had b een wai

ved. Followi

ng a h ea ri n g, t h e tr i al cou rt agr ee d a

n d s tru ck th ose se cti on s f rom CM A ’s repl y i n su pp ort of i ts posttri al motion
. Ulti ma tely, the court deni

ed CMA ’s posttrial m

ot ion on A

pril 3, 2006. CMA f

il ed a notice of appe al

on April 7, 2006. However, plai ntif f s ubsequen tly fi le d a m ot ion f or Rule 1371-06-1 007 & 1-06-1 809 cons.

12

(134 Ill . 2d R. 137) sanctions on May 3, 2006. The court deni

ed pl ai ntif f’ s m ot ion f or Rule 137 san cti ons on Jun e 23, 2 006, a

nd CMA f i l ed a n ew n otice of a ppea l on Ju ne 26, 200 6. A l l of the i ss ue s th at C MA rai se s i n th i s a ppe al turn on w he the r i t wa s a ppr opri atef or pla in tif f to rely on Dr. Kuci ch’s

testim ony on c ross-exam

in ation duri ng def endan ts’ case-i n-chi ef to establi sh the elem

ents of plai

ntif f’s prima facie

case of n egl ige nce agai nst CMA . In this

regard, CMA co nt ends t hat t he t rial co ur t er re d in denying it s mot ion fo r jud gment not wit hst anding t he verdict because pl

ai ntif f f ai le d to establ

is h a prima facie

case of negl

igen ce agains t it. CMA speci fi cally cl ai ms that Dr. Kucich ’s response to a hy pot hetic al question on cross-exa

mi nation was insuff ici ent eviden

ce of the standard of care for a non-physi cian empl oyee of CMA. CMA

also clai m s tha t the j ury ’sverdi ct was

agai nst the m an i f est we i ght of

the evi den ce f or si m i l ar rea sons . Ho we ve r , we mus t init ially a dd r es s w he t he rCM A w aiv ed t his is su e b y failing t o r ais e it pr ior t o it s re ply in suppo rt of it s po st t rial mot ion, at which po int t he t rial co ur t st ru ck t he argument for failure to r aise i t so oner. I t is well

-sett led that an iss

ue is wai ved on appeal unl

ess a par t y makes an o bject ion at t he t ime of a p ur po rt ed e rr or and s pec ifi cally raises t he issue in a wri tten posttrial

motion
. Ka

psouris v . Ri

vera , 319 Ill . App. 3d 844, 848, 747 N.E. 2d 427, 431 (2001 ). Here, because CMA fai led to o bj ect t o t he cross-exami nation of Dr. Kucich on these grounds un

til i ts repl y bri ef i n s upport of i ts posttri al

motion , the issue i s wa

i ve d. Ka ps o ur is , 319 Ill. App . 3 d at 848 , 7 47 N .E .2 d at 431 . N ever t heless, beca use waiver is a lim itat ion o n t he pa r t ies , an d n o t o n t he co ur t , we may c o nsid er an iss ue no t r ais ed in t he t r ial c o ur t if t he iss ue is one of l aw an d i s f ull y bri ef ed b y the p arti es. Comm

ittee for Educational

Ri ghts v. Edgar , 17 4 I ll.1-06-1 007 & 1-06-1 809 cons.

13

2d 1 , 1 1, 672 N. E. 2d 1 178 , 1 183 (1 996 ). Base d o n t his principle, and be cau se w e find, fo r t he re aso ns t hat follow , t hat t he t rial co ur t er re d in denying CM A’s mot ion fo r jud gment notwi thstan di ng th e v erdi ct, we de cl

i ne to appl y wai ver. A moti on f or j udg men t notwi ths tan di ng the ve rdi ct s hou l d b e gran ted onl y when “‘a l l of the evi den ce, wh en vi ewed i n the l i ght m ost fa vorab l e to the oppon

en t, so overw

he l m i ngl y f av ors [a] movan t t hat no contrary verdi

ct based on that evi

dence could ever stand.’ ” Yo rk v. R ushPresby terian-St. Luke’s Me dic al Center , 222 Il

l . 2d 147 , 178, 85 4 N.E.2d 635, 65 2 (200 6), quot in g Ped ri ck v. Peor i a & Eastern R.R . Co. , 37 Ill . 2d 494, 510, 229 N.E .2d 504, 513-14 (196 7). Put anot her way, “a mot ion for judgment [no twit hstanding the ver dict] p resent s ‘a qu es t io n o f law as t o wh et he r , wh en all o f t he ev ide nc e is co nsid er ed , t o ge t he rwit h a ll re as o na ble i nf ere nc esf rom i t i n i ts a sp ec t most f

av orab l e to the p l ai

nti f f s, th ere i s a total f ai l ure or lac k of evi dence to prove any

necess ary el

em ent of the [pl ai

ntif f’ s] case.’ ” York , 222 Ill . 2d at 178, 854 N.E.2d at 652, quot in

g Merlo v. Pub l i c Se

rvi ceCo. , 381 Ill . 300, 311, 45 N.E .2d 665, 672 (1 942 ). We re view a t rial co ur t ’s de cision t o d eny a mot ion fo r jud gment not wit hst anding t he
v erdi ct de novo
. York , 22 2 I ll. 2 d a t 17 8, 85 4 N . E . 2d 65 2. Whe n t he t r ial c o ur t ha s e rr o ne o us ly den i ed a m oti on f or j udgm en t n otwi th sta n di n g th e v erdi ct, we wi l l re v er se th e v erdi ct wi th out a reman d. See Ma

ple v . Gu sta f

son , 151 Il

l . 2d 445 , 453, 60 3 N.E.2d 508, 51 2 (199 2). Our supreme

court has arti cul ated a dif feren t standard for the grantin

g of a new

trial be ca us e t he ev ide nt iar y sit ua t io n t ha t wo uld r eq uir e a ne w t r ial d iffer s fr o m a s it ua t io n t ha t wo uld j usti f y the e ntry of a j udgm en t notwi thstan di ng th e v erdi ct. Ma ple , 151 Ill . 2d at 453, 603 N. E.2d at 512 . A motion for a new trial sh ould be granted where t he j ury’s v erdict is agai

nst the mani

fest1-06-1 007 & 1-06-1 809 cons.

14

wei ght of the e vi den ce. Ma ple , 1 51 I ll. 2d a t 454 , 6 03 N .E .2 d at 512 . A ve rd ict is a gainst t he manifest w eight of t he evide nce w her e t he o ppo site co nclusio n is clear ly evident o r w her e t he f i ndi ngs of the j ury

are un reas onab l e, arb i

trary , and not b ase d on a

ny of the ev i den ce. Ma ple , 151 Ill . 2d at 454, 603 N.E. 2d at 5 12-13. Because the decision whether t o gr ant a new tr ial is a ma tt er of the trial

court ’s di scretion, we wi ll not reverse i

ts ruli ng on such

a m ot ion a bsen t an abuse of that di scre

tion
. Ma ple , 151 Il

l . 2d at 45 5, 603 N .E.2d at 51 3. In a n eg l i ge nc e m

edi cal mal pra cti ceca se , a p l ai

nti f f m us t prov e: (1) the prop er s tan da rd of ca reag ai n st w h i ch th e def en da n t’s con du ct is m ea su re d; (2 ) a n un sk i l l ed or n eg l i gen t f ai l ur e to co mply with t he ap plicable st anda rd ; and ( 3) a r esu lting injury pr oximat ely cause d by t he def endan ts wan t of sk i l l or care. Sull

iv an v . Edward Hospital , 209 Ill . 2d 100, 112, 806 N.E .2d 64 5, 6 53 (2 00 4) . U

n l es s th e n eg l i gen ce i s s o gross l

y appa re n t or th e trea tmen t so com mon as to be wi thin the every

day knowl edge of a lay

person, exper t medical

test im ony i s required to establi sh the standard of

care . Garley

v. Colum bia LaGrange

Mem orial Hospital , 351 Ill . App. 3d 398, 404-0 5, 813 N .E.2d 103 0, 1036 (2004 ). He re, pl ai nti f f ’s the ory of ne gl i ge nc e i s b as ed

on w ha t Dr. K uc i ch ’s sta f f , a n urs e or othe rwise , sh oul d have c om

m un i ca ted to hi m . Th i s ty peof ne gl i ge nc e i s n

ot the ty peof negl ige nce that would b e so grossly apparent that it would “ speak f or itself ,” nor could a laypers on be expe ct ed t o k now what a do ct or wo uld have expe ct ed his nu rse t o ha ve com m un i ca ted to hi m an d w h en . Th er ef ore , w e f i n d th at ex pert te sti mon y wa s req ui re d to estab l i sh the standard of

care i n th i s ca se. Se e, e.g. , Wi

ngo v. Rockford Mem

orial Hospital , 292 Ill. App . 3 d 89 6, 904 , 6 86 N .E .2 d 72 2, 728 (1 997 ) ( using e xper t t est imony to det er mine the1-06-1 007 & 1-06-1 809 cons.

15

stan dard of care perti nent to com

m uni cations b etween a

phy sici an and a n urse ). The sup re me co ur t in Purt il l v . Hess , 111 Ill . 2d 229, 489 N.E. 2d 867 (1986), art ic ula ted a t hre e- st ep p ro ces s for det er mini ng whe t her an exp er t is co mpet ent t o t est ify re gar ding t he stan dard of care i n a particul ar ca se. Al

m v . Loyola

Uni versi ty Medi cal Center , No. 1- 06-0067, slip op. at 5 (April

20, 2007). Initia

ll y, pl ai ntif f’ s proff ered expert mus

t satisf y two foundational requi rem en ts. Alm , N o. 1- 06- 006 7, slip op . a t 5. First , t he exp er t must be licensed in the def endan t’s gi ven s chool of

m edi ci ne . Sull iv an , 20 9 Ill. 2d at 112 -13 , 80 6 N. E. 2d at 654 ; Garley , 351 Ill. App . 3 d at 406 , 8 13 N .E .2 d at 103 7. Sec ond , t he pr offer ed e xper t must also sho w t hat he is famil iar w ith t he met hod s, p ro ced ur es a nd t re at ments or dinar ily obs er ved by o t her s in the def endan t’s c omm uni ty or a si m i l ar com m uni ty. Sull iv an , 209 Ill . 2d at 112-113, 806 N.E.2d at 654 ; Garley

, 3 51 Ill. App . 3 d a t 40 7, 81 3 N .E .2 d a t 10 38 . I f t he p ro ffer ed exp er t fails t o sa t isfy either of these two foundational requi rements, the inqui

ry ends there, and “ ‘the trial cour t must dis al low the ex

pert’s testim

ony.’ ” Sull

iv an , 209 Ill . 2d at 113, 806 N. E.2d at 654, quot in g Jones v. O ’Yo ung , 15 4 Il

l . 2d 39, 44, 607N.E .2d

224 , 22 6 (1 992 ); se e al so Alm , No . 1- 06
- 00 67 , slip op. at 6. If the proff

ered expert satisf

ie s the two foundational

requirem ents, the anal

ys is proceeds to the third step, i

n wh ic h the trial court exerci ses i

ts discretion to determi

ne if the proff

ered ex pert i s com

peten t to t estif y i n the parti

cul ar ca se b ef

ore the c ourt. Alm , No. 1- 06-0067, sli p op. at 6. Re ga

rdi ng the f i rs t of the two Pu r t ill

f ounda tion al requi rem en ts, both the s uprem e court and the l egi slature h

av e rec ogni

zed n ursi ng a s un i que s chool of

medi ci ne . Garley

, 351 Ill . App. 3d a t 407 , 8 13 N .E .2 d at 103 8. In a ddit ion, a de fendant is ent itled t o ha ve his co nduc t t est ed by1-06-1 007 & 1-06-1 809 cons.

16

t he st an da r ds o f his o wn sc ho o l o f med icine ; o t he rwis e, a h igh er st an da r d o f ca r e c o uld be un fair ly im posed on a defen

dant who does not belong to the sam e school of

me dic in e as the proff

ered ex pert. Sull iv an , 209 Ill . 2d at 113, 806 N. E.2d at 654 ( dis cussi ng Dolan v. Gal luz zo , 77 Ill . 2d 279 , 3 96 N .E .2 d 13 (1 979 )) . T hus, t he su pr eme co ur t held in Sull iv an tha t a p hy si ci an ca nn ot testi f y to the stan

dard of care f or nurs i ng procedur

es. Sull iv an , 209 Ill . 2d at 119, 806 N. E.2d at 65 7. H owev er , the s

up re me c our

t re cog n ize d a l i m i ted ex ce pti on to th e l i ce n si n g r eq ui re men t, which wa s first ar t iculat ed in Wi ngo v. Rockford Mem

orial Hospital , 292 Ill . App. 3d 896, 686 N.E.2d 722 (1997). See Sull iv an , 2 09 I ll. 2d a t 118 -1 19, 806 N. E. 2d a t 657 (d istingu ishing Wi ngo , 292 Il

l . Ap p. 3d a t 906, 686N.E.2d a

t 729). In Wi ngo , t his co ur t held t hat wher e t he allega t ions o f negligence do not co ncer n a nur sing pr oc edu re but , r at her , r elat e t o w hat a nur se is r equ ired t o c ommunicat e t o a physician, the li censi ng requi remen t o f the Pu r t ill

test doesnot app l

y . Wi ngo , 292 Ill . App. 3d at 906, 686 N. E. 2d a t 729 . T his is becau se t he pr oblem o f im po sing a highe r st anda rd of c ar e o n a de fendant i s n ot pre sent w

he re th ere i s n o dif f ere nt s tan da rd b etw een th

e p rof f ere d e xp ert’ s s ch

ool of
medi ci ne and the sch ool of medi ci ne to which the def endan t bel ongs . Wi ngo , 292 Ill . App. 3d at 906, 68 6 N.E.2d

at 729. Moreover, as the Wi

ngo co ur t r ec o gn ize d, “[ w] he t he rt he ex pe r t is q ua lified t o t es t ify is not dep ende nt on w het her he is a member of t he sa me spe cialty o r su bspe cialty as t he de fendant but , r at her , w het her t he allega t ions o f negligence co ncer n matt er s wit hin his know ledge and observati on.” Jones , 1 54 I ll. 2d a t 43, 607 N. E. 2d a t 226 . T hus, in Wi ngo , a ltho ugh t he pr offer ed e xper t s, o bst et ricians, wer e no t licensed nur ses, it “wa s est ablished t hat t he allega t ions1-06-1 007 & 1-06-1 809 cons.

17

of negl ige nce were wel

l wi thin the testif yi ng doctor s’ kn

owledge an

d experience.” Wi

ngo , 292 Ill. App . 3 d at 906 , 6 86 N .E .2 d at 729 . T he t est ify ing o bst et ricians in Wi

ngo establ

is hed that they knew what an o bst et ric nu rse sho uld have co mmunicate d t o a n obs t et rician u nder t he circu msta nces pr ese nt in the c ase by tes t ify ing t hat t hey ta ught obs t et ric nu rsing p ro gr ams and worked w

i th n urse s un der s i m i l ar ci rcum stan ces . Wi ngo , 292 Ill . App. 3d at 903-04, 686 N.E .2d at 727 . T her efo re , t he co ur t in Wi ngo conc l uded that the prof f ered e xpe rts i n that cas e wer

e qua l i f i ed “ to tes ti f y ab out wh at [a ph y si ci an ] i s enti tl ed to rel y upon i n th e a rea of com m un i ca ti on from a nurse i n the context of an

obstetrical

team rende

rin g care to a pat ie

nt in a hospi tal.” Wi ngo , 292 Il

l . Ap p. 3d a t 906, 686N.E.2d a

t 729. Thus , Wi ngo reli eves a pa rty of sati sf

yi ng the l ic ensi ng prong of the Pu r t ill

foundational t est wher e t he allega t ions o f negligence co ncer n co mmunicatio ns bet wee n members o f different sch ools of m edi ci ne acti ng as pa rt of th e sa

me team. Wi

ngo , 292 Ill . App. 3d at 906, 686 N.E .2d at 729 . H ow ever , t he pa rt y offering t he exp er t t est imony must s t ill sat isfy the se co nd pr ong of t he Pu r t ill test by establi

shi ng that the al le gations of

negl ige nce were wi

thin that expert’s knowle dge and ex pertise. See Wi

ngo , 292 Ill . App. 3d at 906, 686 N.E .2d at 729. More re cent ly, in Garley

, thi s c ourt co nsi der ed t he e ffec t o f Sull iv an on Wi ngo , w ith t he pl ur al i ty of t he co ur t co ncluding th at Wi ngo remai ns v ia ble. Wri ting f or t he m aj ority, Justice Quinn ch ar acte rized Sull

iv an ascre ati ng a ri gi d, f orm al i sti c, b righ t-li ne l i cens i ng rul e b arr i ng an y doc tor f rom testi f y i ng to the stan dard of c ar e r elevant to any

other ty pe of medi cal prof ess i onal
. Garley

, 351 Il l . Ap p. 3d a t 409-10, 8 13 N.E.2 d at 104 0. To the ex ten t tha t Ju sti ceQu i nn ’s opi ni on in Garley h ol dsth at Sull

iv an overruled Wi

ngo , we1-06-1 007 & 1-06-1 809 cons.

18

dis agree. See Ga r le y , 351 Ill. App . 3 d at 411 -1 2, 813 N. E. 2d a t 104 2. Jus t ices G re iman and Hartman al so disagreed a

nd w rote sep ar at ely in Garley . Ju st ice Gr eiman’s sp ecially conc ur ring opi ni on in G arley

poi nt ed o ut t hat t he su pr eme co ur t in Sull iv an speci fi cally dis tingui shed Wi ngo . Sull iv an , 20 9 Ill. 2d at 118 -19 , 80 6 N. E. 2d at 657 ; Garley , 35 1 I ll. App. 3d

at 413-14, 813 N. E.2d at 104 3- 44 ( Gr eiman, J. , sp ecially conc ur ring) . T hu s, the spe ci al ly concurrin

g opini on criti cized Justice Qu i nn ’s ch ara cte ri za ti on o f t he rule o f law fr o m Sull iv an an d c on cl ud ed th at Wi ngo remai ned appr opri ate

pr ec ed en t t o fo llo w in that case. Garley , 351 Ill . App. 3d at 413-14, 813 N.E .2d at 1043- 44 (G re iman, J., speciall

y concurrin

g). Ho wever, because t he do ct or expe rt s in Garley did no t limit t he ir testi m ony to matters

of c ommunicat ion, t he sp ecially conc ur ring opi n i on ul ti mate l y ag re ed wi th t he maj ori ty th at Sull iv an ba r r ed t he ir

testi mony . Garley

, 351 Ill . App. 3d at 413-14, 813 N.E .2d at 1043-44 (Greim

an, J., special ly

concurrin

g). The special ly

concurrin

g opi nio n also cr iticized t he f oun da ti on testim ony on the

second prong of the Pu r t ill tes t, t ha t the doc tor ex

pe rts ta ugh t or prepared r ele va nt man ua ls, as lac kin g in de pt h o rde t ail. Garley , 35 1 I ll. App. 3d at 415, 813 N.E. 2d at 1044 (Greim

an, J., special ly

concurrin

g). Disse ntin g, Justice Hartman a

greed th at Wi ngo wa s s t ill viabl e, but found that the i ssue had been wai ved b ecause n

o object ion was m

ade to the do cto rs’ t est imony at tria l
. Garley , 351 Ill . App. 3d at 415-16, 813 N.E.2d at 1045 (Hartm an , J., disse

nti ng)
. We a gr ee w ith t he sp ecially conc ur ring a nd diss ent ing o pinions in Garley
. Sull iv an very cl early dis tingui shed Wi ngo because i

t found t hat the “precise fact ual sc enar io” o f co mmunicatio ns between a n urse and a ph y sici an wasnot pres en

t in that ca se. Sull

iv an , 209 Ill . 2d at 118-19, 806 N.E.2d at 657. We theref ore disagree

wit h Jus t ice Qu inn’s op inion in Garley on t his po int and find Wi ngo to remai

n a ppropri ate pre cede

nt f or thi s court to f

oll ow.1-06-1 007 & 1-06-1 809 cons.

19

Applying t his law t o t he pr es en

t ca se , the on

l y testi mon y i n th e r ec ord

re l ati n g to the standard of car e fo r a non- physician emplo yee o f CMA is Dr . Ku cich’s o ne- line admission o n cross exam i na ti on durin g defen dants’ case -in

-chief that “[i]f m y of fi ce knew [ab out the Decem ber 2, 1996 cul ture result] and didn’t tell someone, then

yeah , there ’sa b reach of stan dard of care .” This case falls sq ua rel y wi thi n th e e xc ep ti on

t o t he lice nsin g r eq uir eme nt ar t icu lat ed in Wi ngo . Al though Dr. Kuci ch i s n ot a n urs e, p l ai nti f f ’s the ory of neg li gence conce

rns wh at Dr. Kucich ’s n

urse, Sue Wesens t en, orsome other staff me mb er shoul d have comm

unicatedto hi

m regardi ng the Decem

ber 2, 1996 c ul ture of Petre. Th

eref ore, under Wi

ngo , plai ntif f i s reli eved of satisf

yi ng the licensing requirem ent of the Pu r t ill

f ounda tion al test f or qual i f i cation of an ex pert. Howev er, we fi nd that this

testim ony c ann ot be used

as evi dence of the sta nd ard of ca re f or a no n- phys ician emp lo yee o f CMA bec au se it fails t o sa t isfy t he s ec o nd o f t he Pu r t ill foundational requiremen

ts. Dr . Ku cic h’s t es t imo ny ne ve res t ab lishe d t ha t he wa s fa miliar wit hth e m eth ods, pro cedures, an

d tr ea tmen ts ordinari ly observed by ot her staff

or employees of

a m edi cal practice l ike CMA. Al though pla

in tif f m ai ntain s that because CM

A wasDr. Kuci ch’s

me dic al corpo ration, he was “o bvi o us ly” knowledgeable about its practices and procedu res, Dr . Ku cic h ne ve rac t ua lly expl ai ned on th e re cord what p rotocol

s or proc ed ure s w ere i n p l ac e f orhow, when, an

d why to take cultures orhow , w hen, and w hy

to notif y pa tients an d ot her personnel

about the results. Rather, Dr. Kuci ch al lude d to , but never ela

borated upon, t he f

act that the

re were “ sta nd ard proc ed ure [s ]” i n p l ac e f or t aking and f

oll owing up on c

ultures. Dr. Kuci

ch also suggested that how, when, and wh o wo u ld perf orm these tasks would “depend upon the ci rcumstances,” but nev

er ela borated on what ci rcumstances would dictate what procedure. Without this f oundational

t es t imo ny, Dr . Ku cic h c o uld1-06-1 007 & 1-06-1 809 cons.

20

not ha ve rendered an opi ni on on th e rel ev an t stand ard of care . Dr. Ku cic h’s t es t imo ny he r e is a sha rp co nt ra st t o t he t est imony pre sent ed in Wi ngo , in whi ch t he pr offer ed e xper t s est ablished t hat t he y w er e no t only famil iar w ith w hat a nur se w ou ld have comm uni catedto a docto r under si mi la r conditions, butal so t h at t he y t au gh t nu r se s w ha t t o t ell doctors un

der s i m i l ar con di tions. Wi ngo , 292 Ill . App. 3d at 903-04, 686 N.E .2d at 727. Because Dr. K uc i ch ’s tes ti mony f ai l s to s ati sf

y th is foundational

requirem ent of the Pu r t ill

tes t, h e w asnot qual if ie d to ren de r an opi ni on on the sta nd ard of care for what a nurse

should have comm

unicated to a doctor

r eg ar din g a cu lt ur e r es ult
. T he r efo r e, Dr . Ku cic h’s t es t imo ny t ha t “[ i]f my off ic e knew [about t he Decem

ber 2, 1996 cultur e result ] and didn’t t ell someone, then yeah, t here’s a b rea ch of standard of care,” sh

ould not have

been considered by

the jury as evi dence of the standard of care. Wi thout any competent expert testim ony to establ

is h the standa rd of care f

or any n on-physi ci an em ploy ee of CMA, we must conclude that t he jur y’s verd ict w as a gainst t he manifest weight of t he evi den ce a nd th at the tri al court ab use d i ts di scre tion i n de ny i ng CMA a n ew trial
. In re aching this

concl usi on, we mus

t also recogni

ze that pl ai

ntif f never reque sted a

nd th e j ury was ne ve r gi ve n a n i ns truc ti on on

how to det er mine the s t anda rd of c ar e fo r a nyone o t her t han a doctor. As n o t ed ab o ve , t he o nly instr uct ion t he jury

was gi ven , a modi fi

ed form of IPI Civ

il (2006) No. 105.01, descri

bed h ow to determi

ne the standard of

care for a docto r. “Each l iti gant hast he r ight to have subm itt ed t o t he jur y instr uct ions w hich inform t he jur or s o f the issues pr ese nt ed, t he prin ci ple s of law t o be app lied, a nd t he nec essa ry fact s t o be pr o ve d in support o f a v erdict.” Howat
v. Don el son , 305 Ill . App. 3d 183, 186, 711 N.E. 2d 44 0, 4 42 ( 199 9). In addi ti on, j uri esdo n ot possess roving comm

iss i onsto a ward dama

ges as they

ple ase but, rather, must be gi ven le gal1-06-1 007 & 1-06-1 809 cons.

21

stan dards to gui

de th em . Tri-G, Inc. v. Burke, Bossel ma n & W eaver , 222 Ill . 2d 218, 252, 856 N.E.2d 389, 40 8-09 (2 006). Wi thout an i nstructi on on th

e stan dard of care f or anyone other than a doc tor, t h e j ury ’s ve rd ict cannot be j ustif ie d by hy pot hesi zi ng that the jury

appl ie d some other theory. See Tri -G , 222 Il l . 2d at 25 2, 856 N .E.2d at 40 9. On appeal, plai

ntif f attempts to rely

upon a l in

e of cases dea ling with i nsti tut iona l negl ige nce to as sert th at D r. K

uc i ch ’s tes ti mony reg ard i ng the sta nd ard of care was pro per. How ever, p lai ntiff ’s case ag ain st CM A w as ne ve rba se d o n a t he o ry o f inst it ut io na l n eg l i ge nc e, w hi ch i s a the ory of negl ige ncebase d on

hos pi tal pol i ci esor proce dur

es , ra the r th an on th e a ctsof pr ofe ssio nals wo rk ing f orthe hospi

tal. See Dar ling

v. Charl eston Comm

uni ty Mem orial Hospital , 33 Ill . 2d 326, 330-331, 211 N.E.2d 253, 256- 57 ( 19 65 ) ( dis cu ss ing a h o sp it al’ s d ut y t o a p at ien t in an i nsti tut iona l n egl ige nce case ); Brya

nt v. LaGran

ge Mem orial Hospital , 345 Ill . App. 3d 565, 574-75, 803 N.E .2d 76, 84 (2003) ( dis tingui shi

ng m edi cal ma lpractice clai

m b ased on negl

ige nce of prof

essi onal s f rom an in stitutional ne gl i gen ce c l ai m agai nst a hosp i

tal). Rather, as

pl ai ntif f ’scom pl ai nt m akes clear, plain tiff ’s t he o r y ag ain st CM A w as ba se d o n vic ar io us liabilit y fo rso me ne gl i ge nt a ct or om i ss i on of a CMA em pl oye e. Moreov

er, the j ury wa s o nly gi v en i n str uc ti on s p er

tai n i n g to a v i ca rious l i ab i l i ty t he o ry; it wa s ne ve rgiv en an inst ruc t io n o n ins t it uti on al n eg lige nc e. Be ca us e t he jur y ult imat ely fou nd t ha t Dr . Ku cic h d id

no t act negligen

tly, a vi carious li abili ty negl igen ce clai m agai nst CMA could onl y be ba sed on the ne gli gen t act or omissi

on of som e other e m ploye e of CMA . Howev er, as we ha ve jus t dis cu ss ed , t he o nly ev ide nc e u po n w hic h t he jur y co uld have based such a ver dict was not co mpet ent . D r. Kucich, who was t he o nly exp er t o ffer ed by pla int iff to t es t ify re gar ding th e stan

da rd of ca ref or a n on -p h y si ci an em pl oy ee of CM A , w as n ot qu alifie d to render1-06-1 007 & 1-06-1 809 cons.

22

such an opini on. Because there

wasno com

peten t testi mony regar di ng th e stan dard of care f or such anem ployee, we find t hat t he jur y’s verd ict w as a gainst t he manifest weight of t he evide nce. We there f ore conc l ude the tri al

court ab use d i ts di scre tion i n de ny i ng CMA ’smotion

f or a ne w tri al
. Ac co r di ng ly, werev

ers e the j udg

men t of t he t r ial c o ur t an d r ema nd t his c au se fo ra n ew t r ial. Because we fi

nd that r eversal i

s warranted based on this i ss ue, w e need not consider CMA’s rem ai ni ng c onten tions i n th i s ap peal
. Rev erse d an d rem anded. GREIM AN and K AR NEZIS , JJ., c oncu

r.