Title: Jarrell McKenney et al. V. Jersey City Medical Center et al.
Citation: N/A
Docket Number: a-33-00
State: new-jersey
Issuer: new-jersey Supreme Court
Date: May 16, 2001

(This syllabus is not part of the opinion of the Court. It has been prepared by the Office of the Clerk for the convenience of the reader. It has been neither reviewed nor approved by the Supreme Court. Please note that, in the interests of brevity, portions of any opinion may not have been summarized). COLEMAN, J., writing for a unanimous Court. The narrow issues addressed by the Court are whether 1)defense counsel has an obligation to communicate to plaintiff's counsel material changes in defense witnesses' testimony when defense counsel discovers prior to trial that there will be such a change, and 2) whether plaintiffs were entitled to a mistrial when the anticipated change in testimony was not disclosed until after plaintiffs had concluded the presentation of their case. On November 24, 1990, Jannie McKenney gave birth to her son Jarrell by vaginal delivery. At birth, it was determined that Jarrell suffered from spina bifida, a defect of the spinal column consisting of the absence of a vertebral arch through which the spinal membranes may protrude. If a fetus has spina bifida, there are associated changes of the brain at the top of the spinal column, leading to a partial collapse of the frontal part of the head, resulting in a head that is lemon-shaped rather than oval. This is referred to as a lemon sign. The McKenneys claim that sonograms taken on August 13, 1990 exhibited the presence of a lemon sign. The McKenneys also contend that they would have terminated the pregnancy if they had known about Jarrell's condition, and that the doctor's aggravated Jarrell's condition by performing a vaginal delivery rather than a caesarian section. In November 1992, Jannie McKenney and her husband brought suit on behalf of themselves and Jarrell, seeking damages for wrongful birth, wrongful life, and injuries sustained during delivery. The complaint alleged that the Jersey City Medical Center (JCMC), the Family Health Center (FHC) (a subsidiary of JCMC), Dr. Long- Gue Hu, Sipra De, Dr. Alexander Prezioso, and Dr. Euk Kim failed to provide proper prenatal care and proper care during Jarrell's birth. The claims against Drs. Prezioso, Kim, and Hu are based on their failure to detect spina bifida from the sonograms and/or their failure to order a more targeted ultrasound study. Dr. Kim was also sued in his capacity as FHC director for failing to ensure continuity of medical care at FHC. The claims against Drs. Prezioso and Kim _ the latter in his capacity as a treating physician_ were limited to injuries sustained during delivery. The McKenneys eventually dismissed their independent claims against JCMC and FHC because of a $10,000 cap on hospital liability claims. JCMC and FHC remained in the case solely in a respondeat superior capacity. The liability theory against Sipra De was that she failed to ensure that the sonogram images she took on August 13 and 16 were read and interpreted by a doctor. Shortly before trial, the court granted summary judgment, dismissing all claims against De because the McKenney's had failed to prove that De had deviated from the accepted standard of care. The remaining defendants, however, were precluded from using the empty chair defense to argue to the jury that De was negligent. McKenney was treated at FHC from August 1990 until her delivery. The August 13 sonogram performed by De, a certified ultrasound sonographer, a JCMC was taken to determine the gestational age of the fetus. The sonogram was done at JCMC because the machine at FHC was broken. According to the McKenney's expert, one of the images taken on August 13 clearly indicated that Jarrell had spina bifida. De testified at her depositions that she did not detect a lemon sign from the sonograms. Dr. Hu, the chief Obstetric/Gynecological (Ob/Gyn) resident at JCMC, was assigned to FHC for the month of August. He reviewed the August 13 sonogram but did not detect spina bifida. There is uncertainty about when Dr. Hu reviewed the sonogram. In his deposition, Dr. Hu testified that the August 13 sonogram was probably taken at FHC and he most probably reviewed it on that date. At trial, however, Dr. Hu changed his testimony, stating that upon review of the JCMC sonogram log book, he was able to determine that the August 13 sonogram was taken at JCMC and that he probably did not review that sonogram until the end of August. This change in testimony was extremely significant because on August 13, McKenney was at or near twenty-four weeks into her pregnancy, and she would have been unable to get a legal abortion in New Jersey in 1990 after the twenty-fourth week. At the conclusion of trial, the jury found no negligence on the part of Drs. Kim and Prezioso. Although the jury found Dr. Hu negligent, it did not find that his negligence deprived McKenney of the opportunity to terminate her pregnancy or that Jarrell's condition was made more serious due to the vaginal delivery. The McKenneys moved for a judgment notwithstanding the verdict, which was denied. The Appellate Division affirmed the verdict. The Supreme Court granted certification on the limited issues set forth above. HELD: Defense counsel has a continuing obligation to notify the court and opposing counsel of any material changes in defense witnesses' testimony when defense counsel discovers the change prior to trial. A mistrial should have been granted because of the prejudicial effect of the undisclosed, unanticipated testimony. 1. Defense counsel knew of the material change in testimony their witnesses intended to make at trial. Defense counsel had a continuing obligation to disclose to the trial court and counsel for the McKenneys any anticipated material changes in a defendant's or a material witness's deposition testimony. Lawyers have an obligation of candor to each other and to the judicial system, which includes a duty of disclosure to the court and opposing counsel. (Pp. 11-16) 2. Although the McKenney's attorney did not make a formal motion to vacate the summary judgment dismissing the complaint as to De, that was part of the relief sought at the end of her testimony on direct. Thus, that issue was preserved. In addition, the motion for a mistrial at the end of De's direct testimony preserved the McKenney's right to seek a new trial as to all defendants. (P. 16) 3. The prejudicial impact of the unanticipated testimony is clear. The McKenney's wrongful birth action is predicated on the ability to prove that Dr. Hu's negligence was a proximate cause of the parents being deprived of the option to have an elective abortion. The surprise testimony of both Dr. Hu and De was prejudicial because: 1) both De and Hu testified after the McKenney's had concluded their trial preparation and after they had concluded their evidentiary presentation; 2) there was only a narrow window of time where an abortion was a viable option; and 3) although the summary judgment order dismissing De from the case precluded the defense from using an empty chair defense, that order did not preclude De from accepting more fault than she had in her depositions. (Pp. 16-21) 4. Dr. Hu's changed trial testimony that he may not have looked at the sonogram until the end of August had the clear capacity to influence the jury's decision on proximate cause. Under the circumstances, there can be no confidence in the jury's determination that Dr. Hu's negligence did not deprive the McKenneys of the opportunity to terminate the pregnancy during the second trimester. The failure to grant a mistrial was an abuse of discretion.; the trial was inconsistent with the spirit of the rules of discovery that are designed to eliminate concealment and surprise. (Pp. 21-23) Judgment of the Appellate Division is REVERSED and the matter is REMANDED for a new trial. The McKenneys are granted leave to file a motion to vacate the judgment dismissing the case against De. CHIEF JUSTICE PORITZ and JUSTICES STEIN, LONG, VERNIERO, LAVECCHIA and ZAZZALI join in JUSTICE COLEMAN'S opinion. JARRELL McKENNEY, an infant by his Guardians ad Litem, EDWARD J. McKENNEY, and JANNIE McKENNEY, and EDWARD J. McKENNEY and JANNIE McKENNEY, Individually, Plaintiffs-Appellants, v. JERSEY CITY MEDICAL CENTER, JERSEY CITY FAMILY HEALTH CENTER, ADMINISTRATORS, EMPLOYEES AND/OR OFFICERS OF THE JERSEY CITY FAMILY HEALTH CENTER 1 thru 24 (fictitiously denominated), ALEXANDER N. PREZIOSO, M.D., LONG-GUE HU, M.D., EUK KIM, M.D., DIRECTOR OF OB/GYN CLINIC OF THE FAMILY HEALTH CENTER and SIPRA DE, Defendants-Respondents, and KRERGRKRAI HASANEE, M.D., DILARA E. SAMADI, M.D., SURACHAT CHATKUPT, M.D., JOHN/JANE DOE PHYSICIANS 1 thru 43 (fictitiously denominated) and RADIOLOGISTS/SONOGRAM READERS 1 thru 49 (fictitiously denominated). Defendants. On certification to the Superior Court, Appellate Division, whose opinion is reported at 330 N.J. Super. 568 (2000). Eric Stewart Lentz argued the cause for appellants (Garces &amp; Grabler, attorneys). Sam Rosenberg argued the cause for respondent Long-Gue Hu, M.D. (Reiseman Sharp Brown &amp; Rosenberg, attorneys). Roger G. Ellis argued the cause for respondent Sipra De (Bumgardner &amp; Ellis, attorneys). Thomas H.E. Hallett argued the cause for respondents Jersey City Medical Center and Jersey City Family Health Center, Administrators, Employees and/or Officers of the Jersey City Family Health Center 1 thru 24 (fictitiously denominated). Judith A. Wahrenberger submitted a letter in lieu of brief on behalf of respondent Euk Kim, M.D. (Wahrenberger &amp; O'Brien, attorneys). Craig S. Combs submitted a letter in lieu of brief on behalf of respondent Alexander N. Prezioso, M.D. (Giblin &amp; Combs, attorneys). The opinion of the Court was delivered by COLEMAN, J. This medical malpractice case raises two narrow issues: whether defense counsel has an obligation to communicate material changes in defense witnesses' testimony to counsel for the plaintiffs when defense counsel discovers that there will be such change prior to trial, and whether plaintiffs were entitled to a mistrial when the anticipated change in testimony was not disclosed until after plaintiffs had rested. We conclude that because a mistrial should have been declared, plaintiffs are entitled to a new trial. [McKenney v. Jersey City Med. Ctr., 330 N.J. Super. 568, 578 (App. Div. 2000).] Plaintiffs claim that sonograms taken August 13, 1990 exhibited the presence of a lemon sign. Ibid. Plaintiffs contend that McKenney would have terminated her pregnancy if she had foreknowledge about Jarrell's condition, and that the doctors aggravated Jarrell's condition by performing a vaginal delivery rather than a caesarian section. The complaint that was filed in November 1992 also named Dr. Long-Gue Hu; Sipra De; Dr. Alexander Prezioso, who treated McKenney in November 1990; and Dr. Euk Kim, who treated McKenney late in her pregnancy and who was also the director of the FHC in 1990. The claims against Drs. Prezioso, Kim, and Hu are based on their failure to detect the spina bifida in the ultrasound films and/or their failure to order a more targeted ultrasound study. Plaintiffs also sued Dr. Kim in his capacity as FHC director for failing to ensure continuity of medical care at the FHC. The claims against Drs. Prezioso and Kim -- the latter in his capacity as a treating physician -- were limited to injuries sustained during delivery because those doctors did not treat McKenney until well into the third trimester. Plaintiffs dismissed their independent claims against the JCMC and FHC because at that time the hospital was subject to a $10,000 limitation on liability, see N.J.S.A. 2A:53A-8, and plaintiffs preferred to risk no recovery than to allow a jury the option of finding only the capped defendants liable. The JCMC and FHC remained in the case solely in a respondeat superior capacity. The theory of liability against De was that she failed to ensure that the sonogram images she took on August 13 and 16 were read and interpreted by a doctor. The trial court granted summary judgment to De in February 1997, dismissing the complaint for want of proof that De had deviated from the standard of care. The remaining defendants were precluded from using the empty- chair defense to argue to the jury that De was negligent. See Bahrle v. Exxon Corp., 279 N.J. Super. 5, 22 (App. Div. 1995), aff'd on other grounds, 145 N.J. 144 (1996). In a related area, we have held that a party has a continuing duty to disclose the opinions of its experts and a failure to do so may, in the trial judge's discretion, result in the exclusion of that expert's opinion evidence. See, e.g., Waters v. Island Transp. Corp., 229 N.J. Super. 541, 548 (App. Div. 1989); Fanfarillo v. East End Motor Co., 172 N.J. Super. 309, 312 (App. Div. 1980); Maurio v. Mereck Construction Co., Inc., 162 N.J. Super. 566, 569 (App. Div. 1978); Hamilton v. Letellier Construction Co., 156 N.J. Super. 336, 338 (App. Div. 1978); Clark v. Fog Contracting Co., 125 N.J. Super. 159, 161 (App. Div.), certif. denied, 64 N.J. 319 (1973). Even if no written report is prepared, we have said that a party must disclose the substance of its expert's report in advance of trial. Clark v. Fog Contracting Co., 125 N.J. Super. at 161-62. Where, as here, an attorney knows that his client or a material witness intends to deviate from his deposition testimony in a crucial way, we believe that the attorney has an ethical obligation to convey that fact to his adversary. Our procedures for discovery are designed to eliminate the element of surprise at trial by requiring a litigant to disclose the facts upon which a cause of action or defense is based. See Saia v. Bellizio, 103 N.J. Super. 465, 468 (App. Div.), aff'd, 53 N.J. 24 (1968). The search for truth in furtherance of justice is paramount. Caparella v. Bennett, 85 N.J. Super. 567, 571 (App. Div. 1964). This basic principle is designed to ensure that the outcome of litigation shall depend on its merits in the light of all of the available facts, rather than on the craftiness of the parties or the guile of their counsel. Lang v. Morgan's Home Equipment Corp., 6 N.J. 333, 338 (1951). By contrast, JCMC's position is akin to trial by ambush. Plaza 12 Associates v. Carteret Borough, 280 N.J. Super. 471, 477 (App. Div. 1995). Although our rules of practice do not specifically provide that there is a continuing duty to disclose where it can reasonably be anticipated that a party or material witness will depart significantly from his or her deposition testimony, their purpose and spirit mandate such a course. We thus take this opportunity to make explicit what is plainly implicit in our discovery practice. We have found no reported New Jersey opinion dealing with the precise issue. The Federal Rules of Procedure require a party to supplement its pretrial disclosures if it learns that in some material respect the information disclosed is incomplete or incorrect . . . . Fed. R. Civ. P. 26(e)(1). Although the Advisory Committee's notes indicate that the provision establishing a continuing duty to disclose does not apply to deposition testimony, the express language of the Rule is not so limited. Moreover, the Rule has been said to apply where a party has deliberately concealed new facts inconsistent with its deposition testimony. Bunch v. United States, 680 F.2d 1271, 1281 (9th Cir. 1982). We think this is the correct position. An attorney is under a duty seasonably to apprise his adversary where he obtains information upon the basis of which he knows that his client's or witness's prior deposition was incorrect in a material respect when made, or he knows that the deposition, though correct when made, is no longer true in a material respect. We emphasize that this principle does not place a greater risk on an attorney than he now has when he learns of a significant change in a client's or witness's position. At present, an attorney's failure to apprise his adversary of such a change may result in sanctions, such as preclusion or the declaration of a mistrial. Nor do we regard our conclusion as inconsistent with the attorney-client privilege. We have held that the privilege yields when confidential communications are made a material issue in a judicial proceeding. United Jersey Bank v. Wolosoff, 196 N.J. Super. 553, 567 (App. Div. 1984); see also Kinsella v. Kinsella, 150 N.J. 276, 300-03 (1997); Weingarten v. Weingarten, 234 N.J. Super. 318, 330 (App. Div. 1989) (holding that wife waived attorney-client privilege to extent that her communications to her attorney were necessary to her husband's defense of her motion to vacate divorce settlement based on former husband's misrepresentations and to extent that information was not available elsewhere); Arena v. Saphier, 201 N.J. Super. 79, 88-89 (App. Div. 1985); Valentin v. Bootes, 325 N.J. Super. 590, 601 (Law Div. 1998). The rule we have announced here applies only where a party has placed in issue a communication which goes to the heart of the claim in controversy. In that specific setting, the attorney-client privilege is pierced because the policy underlying the need for secrecy is outweighed by the interests of fairness and justice. See In re Koslov, 79 N.J. 232, 243-44 (1979). We perceive this as a minimal intrusion. [McKenney, supra, 330 N.J. Super. at 586-590 (footnote omitted).] We agree completely with the Appellate Division's analysis and conclusion that defense counsel had a continuing obligation to disclose to the trial court and counsel for plaintiffs any anticipated material changes in a defendant's or a material witness's deposition testimony. Lawyers have an obligation of candor to each other and to the judicial system, which includes a duty of disclosure to the court and opposing counsel. Kernan v. One Washington Park Urban Renewal Assocs., 154 N.J. 437, 461-67 (1998) (Pollock, J., concurring). As Justice Douglas wrote, discovery and pretrial procedures make a trial less a game of blind man's [bluff] and more a fair contest with the basic issues and facts disclosed to the fullest practicable extent. United States v. Proctor &amp; Gamble Co., 356 U.S. 677, 683, 78 S. Ct. 983, 986-87, 2 L. Ed. 2d 1077, (1958). Modern litigation is too time consuming and expensive for courts to tolerate discovery abuses. For over fifty years, courts have endeavored to transform civil litigation from a battle royal to a search for truth. Kernan, supra, 154 N.J. at 467 (Pollock, J., concurring). The fact that plaintiffs' counsel may have been remiss in some respects begs the question of whether defense counsel should have made an early disclosure that a party and a former party who would be called as material witnesses would change their testimony. We hold that such disclosure was required. Although plaintiffs' counsel did not make a formal motion to vacate the summary judgment dismissing the complaint as to De, that was part of the relief sought at the end of her testimony on direct. That issue was preserved under Rule 1:7-2. Furthermore, the motion for a mistrial at the end of De's direct testimony preserved plaintiffs' right to seek a new trial as to all defendants. State v. Farrell, 61 N.J. 99, 106 (1972). NO. A-33 JARRELL McKENNEY, etc., et al., Plaintiffs-Appellants, v. JERSEY CITY MEDICAL CENTER, et al., Defendants-Respondents. DECIDED May 16, 2001 Chief Justice Poritz