Court Opinion

ID: 9411075
Source: CourtListenerOpinion
Date Created: 2023-07-25 18:05:09.306022+00
Date Added: 2024-06-11T17:21:02.694351
License: Public Domain

IN THE SUPERIOR COURT OF THE STATE OF DELAWARE

CHANTALE SIGNEY and HEROLD                   )
SIGNEY,                                      )
                                             )
                 Plaintiffs,                 )
                                             )
          v.                                 )      C.A. No. N20C-10-244 FJJ
                                             )
WILLIAM L. PLAFF, M.D., and                  )
LEWES SPINE CENTER, LLC,                     )
                                             )
                 Defendants.                 )

                               Submitted: July 7, 2023
                               Decided: July 25, 2023

                                      ORDER

      Upon Consideration of Defendants’ Motion to Strike Errata Changes:
                                 DENIED.

1. This medical negligence action arises from two spinal surgeries performed on

   Plaintiff Chantale Signey by Defendant Dr. William L. Pfaff at the Lewes Spine

   Center (collectively, with Dr. Pfaff, “Defendants”) in January 2019. On April

   6, 2023, Defendants deposed Dr. Nicholas Theodore, Ms. Signey’s medical

   expert in this case. Following that deposition, Dr. Theodore submitted an errata

   sheet setting forth multiple “clarifications” (“corrections”) of his deposition

   testimony. Defendants now move to strike a number of those corrections,

   arguing they materially change Dr. Theodore’s deposition answers.

2. After careful review of Dr. Theodore’s deposition testimony and errata sheet, it

   appears that his revisions to his deposition answers are not a tactical attempt to
   rewrite damaging deposition testimony.       Accordingly, for the reasons that

   follow, Defendants’ motion to strike the corrections is DENIED.

3. After a series of consultation appointments in late 2018, Dr. Pfaff performed two

   anterior cervical discectomies on Ms. Signey to address complaints of neck pain

   in early 2019.     Put simply, the intent of the procedures was to relieve

   compression of Ms. Signey’s nerve root and spinal cord.

4. Dr. Pfaff performed the first procedure on January 7, 2019. As he did so, he

   noted a fluid leak in the left region of Ms. Signey’s spine and sprayed a spine

   sealant in the area to stop the leak. When Ms. Signey awoke, she noted weakness

   in both arms and paralysis of her right leg. A post-surgical cervical MRI

   revealed severe spinal stenosis, most pronounced in the area Dr. Pfaff had just

   performed on, with abnormal cord signal consistent with compressive

   myelopathy. In other words, the surgery allegedly caused compression of the

   spine, where the intent of the procedure was decompression.

5. Dr. Pfaff performed the second procedure the next day. Prior to beginning the

   operation, Dr. Pfaff noted there was still cerebrospinal fluid leaking from the

   sides of the prior incision and collecting in the Jackson-Pratt reservoir.

   Nevertheless, he continued with the surgery and removed, among other things,

   the spine sealant from the day before.

6. Ms. Signey allegedly received no relief of her symptoms from the second

   surgery. As she claims, her extremities were effectively paralyzed. So, she was

   transferred on an emergency basis to Thomas Jefferson University Hospital in

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     Philadelphia, Pennsylvania, where orthopedic surgeons performed a posterior

     cervical decompression and instrumented fusion. These procedures (and the

     physical therapy that followed) allowed Ms. Signey to recover some motor and

     sensory capability in her upper and lower extremities, although she alleges

     significant deficits still remain.

  7. Initially, Ms. Signey filed this claim against the Defendants on October 26, 2020.

     She retained Dr. Theodore as her expert witness shortly after. Dr. Theodore

     provided his narrative report on November 1, 2021.

  8. The Defendants took Dr. Theodore’s deposition on April 6, 2023. At the

     conclusion of the deposition, Dr. Theodore exercised his right to review his

     deposition transcript.    As he did so, the Defendants moved for summary

     judgment on April 14, 2023. Nearly a month later, Dr. Theodore submitted an

     errata sheet that Defendants contend substantively supplemented and changed

     his deposition testimony. So, the Defendants filed this motion in response.

     The corrections on the errata sheet Defendants move to strike are as follows:

Transcript             Question                Answer                 Desired Corrections
89:18 – 90:6           Q. My apologies         A. On the CT scan      A. On the CT scan
                       (statement).            obviously we talked    obviously we talked
                                               about bony             about bony
                                               osteophyte and         osteophyte and
                                               even in the scan       even in the scan
                                               report and it's        report and it's
                                               obvious to look at,    obvious to look at,
                                               even the CT report     even the CT report
                                               said there is still    said there is still
                                               osteophyte there       osteophyte there
                                               and there is           and there is
                                               evidence of seeing a   evidence of seeing a
                                           3
                                           cord compression        cord compression
                                           and recommend           and recommend
                                           MRI. Okay. The          MRI. Okay. The
                                           MRI was done and        MRI was done and
                                           what the MRI scan       what the MRI scan
                                           shows is, you know,     shows is, you know,
                                           new high signal         new high signal
                                           edema acute type        edema acute type
                                           injury in the spinal    injury in the spinal
                                           cord at C6-7 with       cord at C6-7 with
                                           significant ongoing     significant ongoing
                                           compression of the      compression of the
                                           spinal cord. Worse      spinal cord. Worse
                                           than it was             than it was
                                           preoperatively.         preoperatively.
                                                                   That is a deviation
                                                                   from the standard
                                                                   of surgical care –
                                                                   that is negligence.
90: 12 – 91:1   Q. In your opinion,        A. So I think we        A. So I think we
                can the                    went back and said went back and said
                postoperative              part of the issue is, I part of the issue is, I
                changes that we see        mean, again, we         mean, again, we
                on the MRI and CT          know that you can       know that you can
                of the 7th and or          have a worsening        have a worsening
                8th, can that be due       after surgery. But I after surgery. But I
                to anything other          guess the part I        guess the part I
                than negligence in         have an issue with      have an issue with
                your opinion?              is that we have this is that we have this
                                           imaging which           imaging which
                                           shows that the          shows that the
                                           compression is          compression is
                                           ongoing and severe, ongoing and severe,
                                           to me worse than it to me worse than it
                                           was before the          was before the
                                           surgery, and that to surgery, and that to
                                           me represents an        me represents an
                                           emergency.              emergency caused
                                                                   by negligence.
92: 1 - 20      Q. Let me get the          A. Hold on. Let's       A. Hold on. Let's
                right words. I             get this right for      get this right for
                apologize then.            one second here. So one second here. So
                Hang on so I can           certainly it is         certainly it is
                                       4
             get your report.            improper to damage      improper to damage
             Well I won't fight          the spinal cord. Can    the spinal cord. Can
             with you on it but          it happen? Yes, but     it happen? Yes, but
             it's in your report.        it's not proper. It's   it's not proper. It's
             So let me pull it up.       not what we are         not what we are
                                         trained to do. It's     trained to do. It's
                                         not what we do. It's    not what we do. It's
                                         not our intent. So      not our intent. And
                                         we're working in a      where there is
                                         tight space and         more compression
                                         obviously               present post-
                                         something               surgery that is a
                                         happened. Not           negligent
                                         proper. There was       deviation.
                                         some manipulation,
                                         something               So we're working in
                                         happened at the         a tight space and
                                         time of surgery. So,    obviously
                                         again, the patient      something
                                         now wakes up with       happened. Not
                                         a deficit and we've     proper. There was
                                         got new imaging.        some manipulation,
                                         That's where we         something
                                         are. So I would say     happened at the
                                         improper. Is that       time of surgery. So,
                                         negligent in and of     again, the patient
                                         itself? Maybe not.      now wakes up with
                                                                 a deficit and we've
                                                                 got new imaging.
                                                                 That's where we
                                                                 are. So I would say
                                                                 again where more
                                                                 6 compression was
                                                                 caused by the
                                                                 procedure that is
                                                                 negligent.
93: 9 - 19   Q. Okay. So that's     A. Yes.                      A. Yes. In addition
             what we're on right                                 to severe
             now. The failure of                                 compression
             Dr. Pfaff in this                                   caused during the
             particular case is his                              procedure.
             failure to appreciate
             the CT, the MRI
                                     5
                   and this patient who
                   is waking up with
                   this lower extremity
                   weakness and I
                   don't mean to
                   confine it to that,
                   failing to appreciate
                   that and then going
                   back and
                   immediately
                   addressing that.
                   That's the failure of
                   Dr. Pfaff on
                   standard of care in
                   your mind; fair?
95: 17 – 21        Q. And then that's           A. Yes.                  A. Causing severe
                   sort of the first                                     compression was
                   deviation by Dr.                                      first deviation.
                   Pfaff in your mind
                   in terms of having
                   the information to
                   get her back. Is that
                   a fair statement?
100: 18 – 101: 7   Q. And, likewise,            A. Well if the same      A. Well if the same
                   even if the very first       thing happened, in       thing happened, in
                   surgery on the 7th,          other words, if the      other words, if the
                   the one done at 3:30         same operation           same operation
                   or so, had been              occurred and             occurred and severe
                   done perfectly with          something                compression
                   a full                       happened during          happened during
                   decompression in             surgery which I'm        surgery which I'm
                   your mind, she still         calling improper in      calling improper in
                   may have had some            that we don't want       that we don't want
                   permanent                    that to be -- it's not   that to be -- it's not
                   neurologic sequela;          proper to bang into      proper to bang into
                   correct?                     the spinal cord, so      the spinal cord, so
                                                something                something
                                                happened. So that's      happened. So that's
                                                what I'm calling         what I'm calling
                                                improper.                improper and
                                                                         negligent.
101: 12 - 17       Q. I understand. I           A. That's correct.       A. In this instance
                   understand. When                                      causing severe
                                            6
                             you say improper                                       compression was
                             you are equating                                       negligent.
                             improper to we
                             don't want that to
                             happen, but
                             improper does not,
                             per se, equal
                             negligence in your
                             mind?

    9. While Delaware Superior Court Civil Rule 30(e) allows a deponent to make

        changes to their deposition testimony in form or substance, it does not allow

        them to improperly alter what they testified to under oath.1 “A deposition is not

        a practice quiz. Nor is it a take home exam.”2 An errata sheet exceeds the scope

        of the type of revisions contemplated by Rule 30(e) when the corrections “are

        akin to a student who takes her in-class examination home, but submits new

        answers only after realizing a month later the import of her original answers

        could possibly result in a failing grade.”3

    10. In support of their position, Defendants primarily rely on this Court’s recent

        decision in Alberts v. All About Women.4 The Alberts Court was concerned with

        a defense expert’s substantive testimonial changes to deposition testimony after

        the plaintiff’s expert had taken time (at the plaintiff’s expense) to review the

        defense expert’s deposition and prepare a Supplemental Disclosure.5 Finding

1
  Alberts v. All About Women, 2020 WL 6588643, at *3 (Del. Super. Nov. 10, 2020).
2
  Id. (citations omitted).
3
  Id.
4
  See generally id.
5
  Id. at *7.

                                                       7
             the changes improper, Alberts concluded that “[a] tactic, the sole purpose of

             which is to subvert a procedural device prescribed by the Court’s rules of civil

             procedure, simply cannot be countenanced.”6

          11. The facts in this case, however, lead to a different conclusion from the one

             reached in Alberts. As presented above, Dr. Theodore used the word “improper”

             multiple times during his deposition when describing the trauma that Dr. Pfaff

             allegedly caused to Ms. Signey’s spinal cord. But his errata sheet does not

             attempt to rewrite his deposition testimony. Instead, it merely clarifies the

             conclusions in his written narrative report that “the only cause of [Ms. Signey’s]

             spinal cord compression [is] from direct injury to the spinal cord or nerves,

             incomplete decompression of the spinal cord or nerves, and potentially an

             excessive improper use of [spine sealant].” Those conclusions have been a

             prominent part of this case record since November 2021.

          12. Dr. Theodore’s errata sheet does not attempt to “game the system.” At most, it

             suggests that when surgical injury causes additional post-surgery spinal

             compression, that is a deviation from the accepted standard of care. Given that

             Dr. Theodore has maintained this position for nearly two years, Defendants’

             claim that the errata sheet will cause them prejudice is rejected.

6
    Id.

                                                   8
   13. The Court will permit thorough cross-examination of Dr. Theodore at trial.

      Whether his credibility is impaired by reason of the changes he has made to his

      sworn testimony will be a matter for the jury, and not the Court, to decide.

   14. Based on the foregoing, Defendants’ motion to strike errata changes is

      DENIED.

      IT IS SO ORDERED.

                                                         /s/ Francis J. Jones, Jr.
                                                       Francis J. Jones, Jr., Judge

Original to Prothonotary
cc:   Leroy Tice, Esquire
      Jonathan Landua, Esquire
      Gregory McKee, Esquire

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