Opinion ID: 2204066
Heading Depth: 1
Heading Rank: 4

Heading: Doe's Case in Chief

Text: Doe testified that she met Albert in April 1996, when she was 44 years old and he was 41. Doe, a college-educated small-business owner, had responded to a personal ad placed by Albert in a free weekly local newspaper. Doe described Albert as looking healthy when they first met, and the couple thereafter began to date on a steady basis. Prior to her becoming more intimate with Albert, Doe initiated a discussion with him about sexually transmitted diseases. She informed Albert that she had practiced safe sex in the past, that she had previously had an AIDS test [5] and that she was disease-free. Doe described herself as being very aware of sexually-transmitted diseases and concerned that she did not want to expose [herself] to any. Doe asked Albert if he had anything to tell her on this subject. He answered her questions and she believed his answers. [6] Doe first kissed Albert in July 1996, and, thereafter, they had sexual intercourse using a condom in late July or early August. When Doe saw Albert naked, she noticed unusual dark-colored pigmentation on his genitalia, and she asked him about it. Albert told her that he had previously suffered from genital warts and that he had them surgically removed by cauterization. Albert explained to her that because he had worked as a landscaper he handled plant and fungal materials that contaminated not only his hands, but also areas of his body that his hands touched. Doe believed Albert's explanation. As Doe and Albert became closer, she decided to pursue her relationship with him with the intention of marrying him and having his child. With this in mind, the couple had unprotected sexual intercourse in late August 1996. In September 1996, Doe became ill with flu-like symptoms, a very high fever, and a rash. Because the symptoms quickly resolved, Doe believed it was simply the flu. She therefore did not seek medical treatment and made no connection between these symptoms and her unprotected sexual intercourse with Albert. Doe stated that around this same time, Albert complained about having difficulty walking straight. Albert experienced dizziness and was unstable and not sure-footed. In the fall of 1996, Albert traveled to Wyoming to purchase a bar/restaurant. Doe and Albert became engaged around the end of 1996, and Doe visited him in Wyoming in early 1997. At that time Doe found Albert looking a little tired and worn out, thin. She asked him about his appearance and believed whatever he told her. Doe acknowledged that during this visit with Albert, she observed that he had very dry skin, which was almost ashen looking. During Doe's stay in Wyoming, Albert invited her to accompany him to Reno, Nevada, where he had an appointment to consult with a doctor about his health condition of heavy-metal poisoning. Doe did not visit the doctor's office with Albert, but Albert gave her a printout of lab test results from a hair analysis that had been previously performed on him, showing that he had heavy-metals in his system. In May 1997, Doe met Albert's parents, Kirk and Betty, for the first time, when the Dillings returned to the Chicago area from their winter residence. Kirk and Betty invited Doe and Albert to join them for dinner at their home. According to Doe, the topic of Albert's health came up during this visit. Betty told Doe that Albert had heavy-metal poisoning but that he would get well and that it was Albert's only health problem. Betty also told Doe that she and Kirk were in charge of [Albert's] medical care, and that Kirk, by virtue of his long career as an attorney handling food and drug cases, was a medical expert in these matters. In addition, Betty told Doe that she and Kirk were very concerned about their son's health; that he would be just fine; that everything would be just fine. [7] Doe believed that the Dillings were concerned about the couple's happiness together. The subject of Albert's health was a constant topic of conversation between Doe and the Dillings throughout 1997 and 1998, both during discussions over the phone and in person. The Dillings repeatedly told Doe that heavy-metal poisoning was Albert's only health ailment, that he was receiving care from the right doctors and that eventually he would get well. Approximately a week after Doe met the Dillings, Albert had to be taken to the emergency room because he suffered adverse reactions after he had injected himself with ozone. [8] Doe believed Albert had experienced a stroke. On October 27, 1998, Albert was again taken to the emergency room, this time by ambulance. As with his earlier visit to the emergency room, he had again suffered an adverse reaction from an ozone injection. Doe again believed that Albert had suffered a stroke because he was temporarily unable to speak. At the end of December 1998, Doe and Albert traveled to her mother's home in Michigan. During this visit Albert suffered abdominal distress that was so severe he was screaming in pain. Doe and her mother took Albert to the local emergency room. Although Albert was treated and released, he was in such severe pain that he was unable to complete the trip home to Chicago in one day, and the couple was forced to stop overnight on the way back. After Doe and Albert returned to Chicago from Michigan, Doe told Betty about what had happened on the trip, including the fact that Albert had showed Doe a toilet bowl full of blood. At that time Doe was getting more and more concerned about Albert's health, and she asked Betty about the heavy-metal poisoning and why Albert was not improving. Betty then asked Doe what Albert had eaten during the Michigan trip, and Doe responded that she had purchased some fresh cheese. Betty thought the cheese might have been spoiled, and Doe agreed that maybe it was, and that it could be food poisoning. Doe, however, further confided in Betty that she was anxious about the deteriorating state of Albert's health. Doe told Betty that Albert could be more seriously ill than what you think he has with this heavy-metal poisoning. He appears to be . . . if I didn't know better, I would say he almost looked like a man who has AIDS. Could he have AIDS? Is there some . . . Could he be really sick? Is there something more wrong with him? Betty answered Doe in the negative. Doe stated that this conversation occurred within the earshot of Kirk, who participated in it. Doe believed the Dillings' statements. During 1999 Doe and Betty spoke on the phone at least every other day, and Betty continued to tell Doe that Albert was suffering from heavy-metal poisoning. During these conversations, Kirk would also often be on the speakerphone. Doe believed everything the Dillings told her. Doe cared for the Dillings and felt like she was part of the family. Doe believed that the Dillings also cared for her like a daughter-in-law, even though she and Albert were not yet married. After Doe and Albert returned from their Michigan trip, and also around Father's Day 1999, Doe suggested to the Dillings that Albert should be evaluated by other physicians. Doe was getting very discouraged that [Albert] wasn't getting any better and was frantic about his condition. Doe specifically suggested to the Dillings that Albert should go to the Mayo Clinic for an evaluation. Doe had seen the Mayo Clinic on the news and believed that since [Albert's] problem was so unique    [the Mayo Clinic] might be a good place to address it. Betty did not agree with Doe's suggestion. However, Doe admitted that the Dillings did not prevent Albert from going to the Mayo Clinic and that the only question was who would pay for the trip and treatment. Albert had no insurance and such a trip and examination would have been extremely expensive. Albert's health continued to decline throughout 1999. Doe and Albert lived in her apartment for almost a year until his death. During that time, Doe did everything for Albert. When Albert could no longer feed, dress or care for himself, Doe assisted him. Doe also financially supported Albert. Albert eventually lost his ability to drive and did not venture outside except for when Doe took him to visit the Dillings on the weekends. In the summer of 1999, Albert went to see Dr. Hauser, who had been one of Kirk's clients. Doe accompanied Albert on every visit to Dr. Hauser and discussed Albert's condition with him. Dr. Hauser performed tests on Albert and, in June 1999, Dr. Hauser gave Doe a laboratory report, which showed that Albert was suffering from Lyme disease. Doe immediately called Betty and told her, We finally have a diagnosis. Now we know what's really wrong with Albert. Doe believed    the doctor when he said Albert had Lyme disease. Toward the end of summer 1999, Doe began to notice changes in her own physical condition. She had not paid much attention to her own health prior to this period because she was focused exclusively on Albert and his health concerns. Doe began to get very fatigued. Her hair began to fall out, her gums bled profusely and she had a yeast infection. In addition, her skin started splitting at various points on her body and she developed sores all over. She attributed these changes to the fact that she was a full-time caretaker and running Albert to the doctor two or three times a week and taking care of [her] business and running around intensivelytrying to keep it all together. Between 1994 and 1999 Doe never saw a doctor for any type of medical treatment. Even though Dr. Hauser diagnosed Albert with Lyme disease and had given him antibiotics, Doe saw no improvement in his condition. Around October 1999, Doe questioned Dr. Hauser about Albert's lack of response and improvement, and he suggested that Albert see a neurologist. Prior to that next appointment, Betty told Doe for the first time that Albert had a blood transfusion in 1979. Doe asked Betty why she was just telling her this now and not earlier. Betty told Doe that she did not know why she never told her. Doe admitted, however, that she had knowledge prior to this statement by Betty that Albert previously had a blood transfusion, but that Doe doubted that information at that time. On November 2, 1999, Doe took Albert to see Dr. Waitley, who tested Albert for HIV. Doe admitted that she told Dr. Waitley that she and Albert had been married for 15 months, even though that was not true and they only remained engaged. Doe was with Albert when Dr. Waitley informed them that Albert was HIV-positive. About one week later, Doe was also tested and discovered that she, too, was HIV-positive. Dr. Waitley told Doe that she could be his patient or she could get treatment elsewhere, and that she had some time to start treatment. Three weeks later, on November 29, 1999, Albert died of AIDS. In March 2000, Doe sought treatment for the first time for her own HIV infection. Doe did not commence treatment earlier because she was in deep despair and anguish and in grief over what had happened and how the Dillings had treated her. At that point, she saw Dr. Finlayson, a physician who took a more holistic approach to medicine. Doe testified that Dr. Finlayson did not prescribe any medications, such as antiretroviral drugs; instead, he told Doe to take vitamin supplements. Doe saw Dr. Finlayson three more times between March 1, 2000, and February 2001. In March 2001, Doe started seeing Dr. Michelle Till, who is her current treating physician. Dr. Till is the medical director of the Women's HIV Program at Northwestern Memorial Hospital. In May 2001, Dr. Till started Doe on highly active antiretroviral therapy (HAART). Doe stated that her condition improved once she began the HAART treatment. As part of her case in chief, Doe presented the videotaped deposition of Kirk Dilling, who had passed away prior to the case going to trial. Kirk had been an attorney for 54 years, and the primary focus of his legal practice was food and drug litigation, a practice for which he became internationally known. During his career, Kirk had represented many doctors, including Dr. Fuller Royal in Nevada, Dr. Helmut Keller, who practiced in Germany, and Dr. Ross Hauser, who practiced in the Chicago area. Kirk had recommended that Albert see all of these doctors for his health ailments at one time or another. In 1997 Kirk knew of the existence of HIV and AIDS, and also that it was passed from person to person through unprotected sexual intercourse and compromised a person's immune system. Kirk, however, denied that Albert ever had AIDS. Kirk believed that Dr. Waitley had misdiagnosed Albert as being HIV-positive and that he killed [Albert] with drugs that caused his death in less than three weeks. In 1992, Kirk had recommended that Albert see Dr. Keller in Germany about his genital warts. Dr. Keller, to Kirk's knowledge, specialized in treating patients with cancer and did not treat patients with HIV. Further, Kirk understood that Dr. Keller's practice included treating his patients with a modality called Carnivora. Kirk believed that Carnivora was used to treat cancer. Kirk denied that he knew by 1997 that it was used to treat the immune system. Notwithstanding this, Kirk previously stated in a discovery deposition that Carnivora was a remedy thought to benefit the immune system and not to fight cancer. Kirk responded that Carnivora affects the immune system, but not that it was a remedy for it. [9] When questioned as to why he failed to specifically list Dr. Keller in his answers to interrogatories which asked to identify all physicians who treated Albert from 1992 until the time of Albert's death, Kirk stated that he listed the name of Dr. Keller's clinic and that he had also noted that Albert was treated for genital warts there. Over the years, Kirk would recommend a specific treatment for Albert if he knew anything about it. One treatment that Kirk felt qualified to recommend to Albert was chelation therapy. [10] Kirk and Betty had paid thousands of dollars for Albert's medical treatment. Kirk acknowledged that Doe had suggested that Albert be evaluated at the Mayo Clinic, but that he and Betty didn't agree to pay for it. Kirk admitted telling Doe that Albert was suffering from heavy-metal poisoning and Lyme disease. When asked if he told Doe that Albert was infected with HIV, Kirk stated, No, because he wasn't. Kirk denied ever telling Doe that Albert had AIDS, because he didn't [have it]. The Dillings' former son-in-law, James Walgreen, also testified on Doe's behalf at trial by evidence deposition which was read to the jury. Walgreen was married to the Dillings' daughter, Victoria, for 20 years. He knew Albert, who was Victoria's twin brother. At the time of his deposition, Walgreen had been recently divorced from Victoria. During their marriage, Walgreen and Victoria were concerned about Albert's health and they were told that Albert suffered from Lyme disease and lead poisoning. Walgreen testified to an incident that occurred while he was still married to Victoria that he said took place approximately a year before [Albert] passed away, meaning in November of 1998. Walgreen and Victoria were visiting the Dillings' home, and Betty told them that Albert had AIDS. This conversation occurred in the sunroom of the Dillings' home. Walgreen noted that someone should inform [Doe]. He was then told by Kirk and Betty that they had not yet met Doe, and that he should keep quiet because it was none of [his] business. Counsel for the Dillings extensively questioned Walgreen with respect to his bias against them as a result of his divorce proceedings with their daughter Victoria. Walgreen maintained that his testimony had nothing to do with his divorce. He denied being biased against the Dillings, and he stated that he liked Kirk. Walgreen also admitted that he never passed along the information of Albert's AIDS to Doe, even though he had several opportunities to do so. Betty Dilling also testified at trial as part of Doe's case in chief as an adverse witness under section 2-1102 of the Code of Civil Procedure (735 ILCS 2-1102 (West 2002)). Betty stated that on occasion Kirk held himself out as an expert in the field of health with respect to certain areas. Betty acknowledged that Kirk did this when they discussed Albert's health with Doe. She, Kirk and Doe had countless conversations about Albert's health, both over the phone and in person. Betty acknowledged that she and Kirk were very involved in Albert's health care and medical treatment, and that sometimes Kirk would confer with Albert's doctors and then share with her what he had learned. Occasionally, Kirk would review the records and reports of the doctors who cared for Albert, although Betty stated that she didn't understand that information. Betty also knew that Kirk had arranged for Albert to see Dr. Keller in Germany in 1992 and that Dr. Keller was Kirk's client. Plaintiff also introduced the evidence deposition of Dr. Joel Cornfield as part of her case in chief, and it was read to the jury at trial. Dr. Cornfield, a urologic surgeon, treated Albert for genital warts from April 1992 to July 1992. Albert came to see him because his father, Kirk, had been a friend of Dr. Barry, and Dr. Cornfield had taken over Dr. Barry's practice. However, Dr. Cornfield did not personally know Kirk. Albert suffered from a severe case of genital warts, which Dr. Cornfield described as a sexually transmitted disease. Because Albert had a very significant number of these warts, Dr. Cornfield believed the best treatment was to surgically cauterize them. However, Albert never showed up for the scheduled surgical procedure. Dr. Cornfield thereafter spoke to Albert over the phone and it was at that time that Albert informed him that he was HIV-positive. Dr. Michelle Till, Doe's treating physician, also testified as part of Doe's case in chief via evidence deposition, but was cross-examined by defense counsel live. When Doe first came to her for treatment in March 2001, Doe was asymptomatic. In May 2001 Doe began HAART therapy and her blood tests began to show improvement. Doe's subsequent response to treatment has been fair. In Dr. Till's medical opinion, the delay from spring 1997 to November 1999 of Doe learning of her HIV exposure caused irreversible damage to her immune system. Dr. Till explained that an individual's T cells are types of white blood cells used by the body to fight off infections and malignancies. HIV infects T cells and begins to kill them, eventually causing the cell count to drop to a level where the body cannot fight off infections. AIDS occurs when the T-cell count is either below 200 or opportunistic infections develop. In Dr. Till's medical opinion, Doe became infected with HIV in late summer 1996 when she had unprotected sexual intercourse with Albert. Doe experienced flu-like symptoms in September 1996 that were consistent with an acute HIV infectionan illness which develops shortly after someone is infected with the virus. Doe is a rapid progressor, meaning that she is one in whom the virus reproduces rapidly. This, in turn, causes a patient to more quickly progress from an HIV infection to full-blown AIDS. As a result, such patients are in need of faster and earlier treatment to prevent this progression. When Doe first came to Dr. Till for treatment in March 2001, Doe had a T-cell count of 129, which signified that she had already progressed to AIDS. A rapid progressor such as Doe should have been under HAART therapy before her T cells declined under 200. According to Dr. Till, the vast majority of individuals who are exposed to HIV seroconvert within six months of the exposure, with some taking a couple of weeks, and others a few months. Seroconversion means the point at which the person who is infected develops antibodies against the HIV virus, and that can be detected by a [positive HIV] blood test. Dr. Till surmised that Doe most likely would have seroconverted by spring 1997. Data suggests that treating someone within six months of seroconversion may help preserve the specific immune response to HIV that is lost thereafter. Dr. Till believed that Doe's delay in discovering her HIV infection between spring 1997 and November 1999 damaged her immune system and led to more advanced HIV disease. Treatment in spring 1997 would have been significant because it would have been within six months of Doe's seroconversion and, therefore, [s]he would not have continued to lose T cells and progress to AIDS. People who begin therapy at lower T-cell counts do not respond as well to therapy as do those who are treated with a more moderate T-cell count. Dr. Till believed Doe could have been helped if her disease had been detected by spring 1997. Doe, however, suffered little harm from the delay in starting treatment from the date she tested positive for HIV on November 9, 1999, until the time that she started HAART treatment in May 2001. Dr. John McGillen also testified on plaintiff's behalf in her case in chief at trial via evidence deposition and in person. Dr. McGillen was an expert originally hired by defendants and thereafter called to testify by Doe as her expert. Dr. McGillen was in private practice and was board certified in internal medicine and infectious diseases. Over the years, he had treated several patients infected with HIV, but stated that, on average, only 1% of his patients were HIV-positive. In the course of examining Albert's medical records, Dr. McGillen observed the results of a blood test performed on Albert by Dr. Keller in 1992. Based upon the test results, Albert was infected with HIV as of December 1992. Further, based upon the medical records, Dr. McGillen concluded that Albert did not have heavy-metal poisoning or Lyme disease. In light of all of the information available to him, Dr. McGillen opined that it was likely that Doe was infected with HIV by Albert, and that the flu-like symptoms she experienced in September 1996 constituted an episode of acute HIV infection. Dr. McGillen noted that it is of benefit to treat someone who has a newly acquired HIV infection very aggressively because only a very small window of opportunity exists to do so. He explained that the optimum period for treatment is within two weeks of the onset of the acute viral infection, and that the treatment period could be closed by two months after the infection. When asked whether there would be benefit in starting therapy nine months after the infection, as Doe alleged in her suit, Dr. McGillen replied, No, there is no benefit at all. Potentially it is somewhat hazardous. When asked whether the delay of 2½ years in diagnosing Doe's HIV condition affected the outcome for the treatment of Doe's condition, Dr. McGillen answered that such a delay had no effect at all on her prognosis or survival rates. None whatsoever. The reason for this was because there is no clear correlation    that early treatment other than in that little couple-month window improves the survival with the illness.    And I just don't believe that there is any evidence at all that her prognosis would be otherwise altered by a delay of a period of time like that.