Source: http://masscases.com/cases/app/51/51massappct30.html
Timestamp: 2019-04-26 01:54:45+00:00

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LINDAMAE LUCAS vs. DANIEL J. COLLINS, JR.
CIVIL ACTION commenced in the Superior Court Department on September 5, 1997.
An order of dismissal was entered by Peter F Brady, J.
Daniel Malis for the plaintiff.
Curtis R. Deidrich for the defendant.
GREENBERG, J. A medical malpractice tribunal convened by the Superior Court found that Lindamae Lucas, the plaintiff, had experienced an unfortunate medical result, i.e., that the evidence presented to the tribunal, if properly substantiated, was not "sufficient to raise a legitimate question of liability appropriate for judicial inquiry" under G. L. c. 231, s. 60B, inserted by St. 1975, c. 362, s. 5. Thus, in order to maintain her action, the plaintiff had to file with the court a bond in the amount of six thousand dollars within thirty days of the finding. See G. L. c. 231, s. 60B, as amended through St. 1986, c. 351, s. 21. Upon the plaintiff's failure to post the required bond, a judgment of dismissal of the complaint entered on October 13, 1998, from which she now appeals. See McMahon v. Glixman, 379 Mass. 60 , 63-64 (1979).
care in two respects - in failing properly to control bleeding from the cystic artery and in failing to inspect adequately for arterial bleeding at the completion of the surgery. Although the tribunal did not (and was not required to) specify its reasons for finding the plaintiff's evidence inadequate, the record, briefs, and oral argument before us reveal the pivotal issue to be whether the offer of proof was sufficient with regard to the standard of care and its breach.
the alleged negligence was in the failure to observe the second branch of the artery and place hemoclips at that site, Dr. Rosenbaum did not explicitly state that the branching was something a surgeon exercising due care should have identified during the first procedure, rather than an anomalous anatomical configuration that was not reasonably detectable before the massive hemorrhage.
Placed in context, however, we do not think this shortcoming renders the result fatally deficient. Our conclusion is based on the governing principle found in the cases that an offer is sufficient if "anywhere in the evidence, from whatever source derived, any combination of circumstances could be found from which a reasonable inference could be drawn in favor of the plaintiff." St. Germain v. Pfeifer, 418 Mass. 511 , 516 (1994), quoting from Dobos v. Driscoll, 404 Mass. 634 , 656, cert. denied sub nom. Kehoe v. Dobos, 493 U.S. 850 (1989). "[A] plaintiff's expert need not state his opinion in formulaic terms," Nickerson v. Lee, 42 Mass. App. Ct. at 111, and a direct statement of the standard of care is not needed if "[t]he wrongs to which the language of the expert opinion letter speaks implicitly show how the defendant committed a breach of the standard of care owed to his patient." Ibid.
e.g., Kapp v. Ballantine, 380 Mass. 186 , 193-194 (1980); Blake v. Avedikian, 412 Mass. 481 , 484 (1992); Bradford v. Baystate Med. Center, 415 Mass. 202 , 207 n.6 (1993); Mataitis v. St. Goar, 416 Mass. 325 , 326-327 (1993); DiNozzi v. Lovejoy, 20 Mass. App. Ct. 973 , 973-974 (1985); Lambley v. Kameny, 43 Mass. App. Ct. 277 , 286-287 (1997).
The judgment dismissing the plaintiff's claim against the defendant is vacated. The matter is remanded to the Superior Court where the tribunal's decision is to be struck and, in substitution therefor, a determination shall be entered that the offer of proof by the plaintiff is sufficient to raise a legitimate question of liability appropriate for judicial inquiry.
[Note 1] The term refers to a coagulated mass of blood - i.e., a clot. See American Heritage Dictionary 362 (3rd ed. 1992).
[Note 2] In his brief, defense counsel wrote that "the record supports the argument that Dr. Collins clipped one branch of the cystic artery, and mistakenly cauterized a second branch of the cystic artery. This second branch of the cystic artery was not recognized until the [second] procedure." At oral argument, defense counsel stated, "there's no dispute here that there was an ancillary branch that was not identified, that was cauterized mistakenly." We do not adopt the plaintiffs view that the use of the word "mistakenly" is an admission of negligence; for purposes of decision, we take the meaning to be that Dr. Collins unintentionally and unknowingly cauterized the second artery branch.
[Note 3] The defendant, focusing on the usage of the singular word "hemoclip," argues that Dr. Rosenbaum's opinion should be disregarded as resting on the erroneous factual basis that only one hemoclip was used during the first procedure. Although this is one possible reading of the letter, it is not the only reasonable one. Doctor Rosenbaum's reference to the second branch's location as "adjacent to an intact hemoclip" may have been intended only to describe proximity, and would be literally correct even if multiple clips were present, one closer to the second branch than the other. Doctor Rosenbaum also noted that, during the second surgery, "[t]he cystic artery was also doubly clipped with hemoclips once again," suggesting an awareness of the use of multiple clips during the first surgery.
[Note 4] Omitted from the end of the quoted passage is the second theory of breach, "the failure at the conclusion of the procedure to adequately inspect the cystic artery for absence of bleeding . . . ." In light of our ultimate conclusion, we do not pass on the second theory because "the tribunal's function under s. 60B is limited to the ascertainment whether the offer of proof is sufficient as to any one of the theories." Kapp v. Ballantine, 380 Mass. 186 , 192 (1980). See Heyman v. Knirk, 35 Mass. App. Ct. 946 , 948 (1994).

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