Court Opinion

ID: 9926273
Source: CourtListenerOpinion
Date Created: 2024-01-24 15:06:17.441624+00
Date Added: 2024-06-11T09:22:14.956814
License: Public Domain

NOT FOR PUBLICATION WITHOUT THE
                                APPROVAL OF THE APPELLATE DIVISION
         This opinion shall not "constitute precedent or be binding upon any court." Although it is posted on the
      internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3.

                                                         SUPERIOR COURT OF NEW JERSEY
                                                         APPELLATE DIVISION
                                                         DOCKET NO. A-0279-22

ESTATE OF JENIFER S. TOWLE
and BRICE TOWLE, as
administrator of the estate of
JENIFER S. TOWLE,

       Plaintiffs-Appellants,

v.

HUDSON COUNTY, HUDSON
COUNTY DEPARTMENT OF
CORRECTIONS, and GD
CORRECTIONAL SERVICES,
LLC,

       Defendants,

and

CFG HEALTH SYSTEMS, LLC,

     Defendant-Respondent.
______________________________

                 Submitted December 12, 2023 – Decided January 24, 2024

                 Before Judges Rose and Smith.
            On appeal from the Superior Court of New Jersey, Law
            Division, Hudson County, Docket No. L-2674-19.

            The Marchese Law Firm, LLC, attorneys for appellants
            (Daniel G. Marchese, of counsel and on the brief).

            Holtzman, McClain & Londar, PC, attorneys for
            respondent CFG Health Systems, LLC (Stephen D.
            Holtzman, of counsel; Jeffrey S. McClain, on the brief).

PER CURIAM

      Plaintiffs, the Estate of Jenifer S. Towle and her father Brice Towle, in his

capacity as administrator of the estate, appeal from a May 12, 2020 Law

Division order granting reconsideration of a March 9, 2020 order and dismissing

their complaint against defendant CFG Health Systems, Inc. The motion court

found plaintiffs failed to comply with the affidavit of merit statute, N.J.S.A.

2A:53A-26 to -29. For the following reasons, we affirm.

                                            I.

      Jennifer Towle died on July 14, 2017, while in the custody of Hudson

County Department of Corrections and under the care of CFG Health Systems,

LLC (CFG), a private correctional healthcare provider. Plaintiffs allege Towle

suffered from severe psychiatric and mental health issues, causing her to be

admitted to the jail's infirmary and placed on suicide watch. Plaintiffs further

allege that hours before her death, Towle complained of excruciating stomach

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pain to CFG staff. An autopsy revealed Towle had ingested foreign items such

as Styrofoam, plastic wrappers, drink cartons, paper, and a nail clipper. The

foreign material resulted in a perforated gastric ulcer and ultimately sepsis.

       Plaintiffs filed their complaint on July 1, 2019, alleging failure to properly

monitor Towle's eating behaviors, address Towle's mental health issues, or

provide appropriate medical care to Towle. On the case information sheet,

plaintiffs categorized the case as "Tort-Other."

       CFG filed its answer on August 9, 2019, asserting as a defense failure to

file an appropriate affidavit of merit for a claim of professional negligence as

required by N.J.S.A. 2A:53A-26. Its answer also provided the names and

specialties of potentially liable healthcare providers. 1 CFG's case information

sheet identified the case type as medical malpractice.

       On November 1, 2019, plaintiffs timely filed and served on CFG the

affidavit of merit of Dr. Kevin J. Kikta, DO, a physician board certified in

emergency medicine.        Although the court did not schedule a Ferreira2

1
   The potentially liable physicians identified by CFG were advanced nurse
practitioners, psychologists, and medical doctors board-certified in psychiatry,
family medicine, internal medicine, and infectious diseases.
2
    Ferreira v. Rancocas Orthopedic Assocs., 178 N.J. 144, 147 (2003).
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                                          3
conference, neither party requested one. The 120-day statutory window for

timely submission of affidavits of merit expired on December 7, 2019.

      On December 17, CFG moved to dismiss the complaint. It argued plaintiff

failed to timely serve an affidavit from a qualified person as required by the

statute. Plaintiffs filed a cross-motion to extend time to serve an appropriate

affidavit. The motion court denied CFG's motion in a written opinion and

extended discovery by sixty days to allow plaintiffs additional time to file

appropriate affidavits. The court found that while the affidavit of merit statute

applied and that Dr. Kikta's affidavit of merit was inadequate, 3 extraordinary

circumstances warranted denial of CFG's motion, namely:              the merit of

plaintiffs' claim; plaintiffs' counsel filed an AOM (albeit insufficient) within the

120-day deadline; the court's failure to schedule a Ferreira conference; and the

lack of prejudice to CFG given the early stage of litigation. Plaintiffs later

submitted additional affidavits of merit by a nurse practitioner, a board-certified

psychiatrist, and a board-certified internal medicine specialist on May 8, 12, and

14, 2022, respectively.

      CFG filed a motion for reconsideration. At the motion hearing, plaintiffs'

counsel explained that the suit "was inadvertently mislabeled." On May 12,

3
  The court found that Dr. Kitka was not qualified in the same specialties as the
potentially liable physicians identified by defendant.
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2020, the court granted reconsideration and dismissed plaintiffs ' claims in a

written opinion. The court found it had "erred only with respect to its analysis

in finding extraordinary circumstances by undervaluing the plain allegations of

the [c]omplaint with respect to medical malpractice and overvaluing both

[p]laintiff[s'] uncertainty that an [affidavit of merit] was required and the

absence of a Ferreira conference." The court acknowledged CFG filed a timely

answer, raising the affidavit of merit statute as a defense and providing the

names and specialties of the medical professionals involved. Citing Paragon

Contractors, Inc. v. Peachtree Condominium Association, 202 N.J. 415, 423, 426

(2010), the court reasoned "neither attorney inadvertence nor the court's failure

to hold a Ferreira conference warrant[ed] a finding of extraordinary

circumstances"    and   that   plaintiffs       "cannot   create   the   extraordinary

circumstances upon which [they rely]."

      On appeal of the court's May 12 order granting reconsideration of the

court's order dismissing plaintiffs' complaint with prejudice, plaintiffs argue the

following:

             I. THE LOWER COURT IMPROPERLY REVERSED
             ITS       OWN        DECISION       ON
             DEFENDANT/RESPONDENT'S    MOTION   FOR
             RECONSIDERATION.

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            II. PLAINTIFFS SHOULD NOT BE PENALIZED
            BECAUSE A TIMELY AFFIDAVIT OF MERIT WAS
            INITIALLY    FILED,  BUT   NO  FERREIRA
            CONFERENCE       WAS    SCHEDULED     OR
            OTHERWISE HELD BY THE COURT BEFORE
            DEFENDANT/RESPONDENT'S FILED ITS INITIAL
            MOTION TO DISMISS.

                                       II.

      A decision on a motion for reconsideration is reviewed under the abuse of

discretion standard. See Branch v. Cream-O-Land Dairy, 244 N.J. 567, 582

(2021). An abuse of discretion is a ruling that "represents a manifest denial of

justice." In re Estate of Lash, 329 N.J. Super. 249, 263 (App. Div. 2000).

      We review de novo a trial court's decision to dismiss a complaint under

the affidavit of merit statute. Castello v. Wohler, 446 N.J. Super. 1, 14 (App.

Div. 2016). We also review de novo a trial court's determination of whether the

plaintiff has demonstrated extraordinary circumstances as a defense to the

affidavit of merit statute. Triarsi v. BSC Grp. Servs., LLC, 422 N.J. Super. 104,

113 (App. Div. 2011).

                                      III.

      We first consider whether the motion court abused its discretion by

granting reconsideration of its March 9, 2020 order. Plaintiffs contend CFG did

not argue the court's decision was arbitrary, capricious, or unreasonable, and

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that CFG only presented a general dissatisfaction with the court's order which is

not sufficient grounds for reconsideration under Rule 4:49-2. CFG argues that

Rule 4:49-2 applies only to final orders or judgments, and that the applicable

rule in this case is Rule 4:42-2 which applies to interlocutory orders.

      As a preliminary matter, we address the appropriate standard. We recently

explained and distinguished the two discrete standards a trial court employs in

reconsideration. Lawson v. Dewar, 468 N.J. Super. 128 (App. Div. 2021).

"Rule 4:49-2 applies only to motions to alter or amend final judgments and final

orders, and [it] doesn't apply when an interlocutory order is challenged."

Lawson, 468 N.J. Super. at 134. A motion for reconsideration of a final order

pursuant to Rule 4:49-2 is considered under a more demanding standard that

requires a showing "that the challenged order was the result of a 'palpably

incorrect or irrational' analysis or of the judge's failure to 'consider' or

'appreciate' competent and probative evidence." Ibid. (quoting Cummings v.

Bahr, 295 N.J. Super. 374, 384 (1996)). On the other hand, reconsideration of

interlocutory orders under Rule 4:42-2 has a "far more liberal approach" in

comparison:

                   Rule 4:42-2 declares that interlocutory orders
            "shall be subject to revision at any time before the entry
            of final judgment in the sound discretion of the court in
            the interest of justice." A motion for reconsideration

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                                        7
            does not require a showing that the challenged order
            was "palpably incorrect," "irrational," or based on a
            misapprehension or overlooking of significant material
            presented on the earlier application. Until entry of final
            judgment, only "sound discretion" and the "interest of
            justice" guides the trial court, as Rule 4:42-2 expressly
            states.

            [Ibid.]

      In its motion papers, CFG, despite its contention on appeal that the court

should have decided the motion under Rule 4:42-2, moved for reconsideration

pursuant to Rule 4:49-2. The motion judge, in turn, decided the motion under

the Rule 4:49-2 standard. However, because the March 9 order was not a final

order or judgment, the motion should have been reconsidered as an interlocutory

order under the standard set forth in Rule 4:42-2.

      Despite the court's analysis using the heightened Rule 4:42-9 standard, its

conclusion is nonetheless correct. The court went beyond the appropriate, more

liberal Rule 4:42-2 standard, which grants wide discretion to amend

interlocutory orders in the interest of justice and found its own March 9 ruling

"failed to appreciate the significance of probative, competent evidence." The

court found that it erred "with respect to its analysis in finding extraordinary

circumstances by undervaluing the plain allegations of the [c]omplaint with

respect to medical malpractice and overvaluing both [p]laintiff's uncertainty that

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                                        8
an [affidavit of merit] was required and the absence of a Ferreira conference."

The court identified what it viewed as an error in its analysis and sought to

correct it to conform with the law. Given the liberty our trial courts have to

revisit an interlocutory order in the interest of justice, we conclude the trial

court's order granting reconsideration was not an abuse of discretion.

      We now consider the merits of whether plaintiffs' failure to submit a

timely affidavit of merit is excused by extraordinary circumstances.          The

affidavit of merit statute requires plaintiffs in professional malpractice actions

to:

            within 60 days following the date of filing of the answer
            to the complaint by the defendant, provide each
            defendant with an affidavit of an appropriate licensed
            person that there exists a reasonable probability that the
            care, skill or knowledge exercised or exhibited in the
            treatment, practice or work that is the subject of the
            complaint, fell outside acceptable professional or
            occupational standards or treatment practices. The
            court may grant no more than one additional period, not
            to exceed 60 days, to file the affidavit pursuant to this
            section, upon a finding of good cause.

            [N.J.S.A. 2A:53-27.]

      In medical malpractice actions, N.J.S.A. 2A:53A-41 requires the expert

executing an affidavit of merit to "be equivalently-qualified to the defendant"

physician. Buck v. Henry, 207 N.J. 377, 389 (2011). In other words, when a

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                                        9
defendant is a board-certified specialist, the plaintiffs must provide an affidavit

of merit from a physician board-certified in the same specialty. See N.J.S.A.

2A:53A-41(a).

      "The failure to provide an [affidavit of merit] is considered 'a failure to

state a cause of action' under N.J.S.A. 2A:53A-29 and warrants a dismissal with

prejudice." A.T. v. Cohen, 231 N.J. 337, 346 (2017) (quoting N.J.S.A. 2A:53-

29). "The core purpose underlying the statute is 'to require plaintiffs . . . to make

a threshold showing that their claim is meritorious, in order that meritless

lawsuits readily could be identified at an early stage of the litigation.'" Paragon,

202 N.J. at 421 (quoting Alan J. Cornblatt, P.A. v. Barrow, 153 N.J. 218, 242

(1998)).

      Recognizing the harsh consequences of failing to comply with the

procedural requirements created by the statute, the Supreme Court in Ferreira

issued a mandate to trial courts to conduct a case management conference

("Ferreira conference") within ninety days of the service of an answer in all

malpractice actions. Ferreira, 178 N.J. at 154. The court explained:

             At the conference, the court will address all discovery
             issues, including whether an affidavit of merit has been
             served on defendant. If an affidavit has been served,
             defendant will be required to advise the court whether
             he has any objections to the adequacy of the affidavit.
             If there is any deficiency in the affidavit, plaintiff will

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                                        10
            have to the end of the 120-day time period to conform
            the affidavit to the statutory requirements. If no
            affidavit has been served, the court will remind the
            parties of their obligations under the statute and case
            law.

            [Id. at 155.]

      In addition to mandating check-in conferences, the Supreme Court has

carved out equitable exceptions to "temper the draconian results of an inflexible

application of the statute." Id. at 151. First, "[a] complaint will not be dismissed

if the plaintiff can show that he [or she] has substantially complied with the

statute." Id. at 155 (citing Palanque v. Lambert-Woolley, 168 N.J. 398, 405-06

(2001)).   Second, "[w]here extraordinary circumstances are present, a late

affidavit will result in dismissal without prejudice." Ibid. (citing Cornblatt, 153

N.J. at 414-15). To determine whether extraordinary circumstances are present,

the court must engage in "a fact-sensitive [case-by-case] analysis." Tischler v.

Watts, 177 N.J. 243, 246 (2003) (alteration in original) (quoting Hartsfield v.

Fantini, 149 N.J. 611, 618 (1997)).

      Our courts have recognized the affidavit of merit statute "does not impose

overly burdensome obligations. The plaintiff must keep an eye on the calendar

and obtain and serve the expert's report within the statutory timeframe."

Ferreira, 178 N.J. at 146. As such, the Supreme Court has firmly established

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                                        11
"attorney inadvertence will not support the extraordinary circumstances

standard." Palanque, 168 N.J. at 405; see also Ferreira, 178 N.J. at 152 ("[W]e

do know that attorney inadvertence is not such a circumstance entitling plaintiff

to a remedy of dismissal of a complaint without prejudice."). "[P]arties are

presumed to know the law and are obliged to follow it." Triarsi, 422 N.J. Super.

at 122. Our Supreme Court has also held that despite the court's obligation to

conduct a Ferreira conference, the failure to do so is not by itself extraordinary

circumstances. Paragon, 202 N.J. at 426 ("[G]oing forward, reliance on the

scheduling of a Ferreira conference to avoid the strictures of the Affidavit of

Merit statute is entirely unwarranted and will not serve to toll the statutory time

frames.").

      Applying these principles, we conclude the facts presented here do not

rise to extraordinary circumstances.        The record can be summarized as

expiration of the 120-day calendar, combined with lack of a Ferreira conference.

The record neither reveals why the court did not schedule a Ferreira conference

nor why plaintiffs' counsel was unable to comply with the statutory burden or

seek a Ferreira conference to clarify their statutory obligation. Nonetheless, it

is well established that the court's oversight in scheduling a Ferreira conference

will not toll the statutory time frame or constitute extraordinary circumstances

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                                       12
by itself. Paragon, 202 N.J. at 426. Similarly, attorney inadvertence does not

constitute extraordinary circumstances.    Palanque, 168 N.J. at 405.      These

circumstances, either individually or in combination, have not been recognized

as extraordinary.

      Plaintiffs' reliance on Paragon is misplaced. In Paragon, a defendant

raised the affidavit of merit statute as a defense, but a Ferreira conference was

never conducted. 202 N.J. at 420. After the 120-day period, the court granted

defendant's motion to dismiss for failing to comply with the statute. Ibid. The

Supreme Court reversed, finding extraordinary circumstances due to conflicting

Appellate Division decisions regarding the tolling effect of a court's failure to

schedule a Ferreira conference. Id. at 425-26. The Court concluded with the

firm warning that "going forward, reliance on the scheduling of a Ferreira

conference . . . is entirely unwarranted and will not serve to toll the statutory

time frames." Id. at 426. The mixed-signals present in Paragon no longer exist,

and the case cannot be analogized to the circumstances here.

      Plaintiffs' reliance on Buck is similarly misplaced. In Buck, the plaintiff

brought a medical malpractice claim against a defendant who was board -

certified in emergency medicine. 207 N.J. at 382. The plaintiff's counsel did

not know the capacity in which the defendant was practicing at the time, and so

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                                      13
filed two affidavits from physicians board-certified in psychiatry and emergency

medicine. Ibid. No Ferreira conference was held, and the trial court dismissed

the complaint because the defendant certified that he treated plaintiff in his role

as a practitioner of family medicine, and the affidavits filed were not by

equivalent specialists. Id. at 383. The Supreme Court reversed, holding "[t]his

is not a case of a desperate plaintiff unable to find a physician willing to aver to

a claim of malpractice. . . . Rather, this is a case of a plaintiff who has made

good-faith attempts to satisfy the statute." Id. at 395. The Court concluded by

mandating that going forward, physician defendants must include in their answer

"the field of medicine in which he specialized, if any, and whether his treatment

of the plaintiff involved that specialty." Id. at 396.

      Here, again plaintiffs' case is distinguishable from Buck. While it is true

a Ferreira conference was not held in either case, the similarities end there. CFG

complied with the mandate issued in Buck and identified the relevant medical

staff by name and specialty. Plaintiffs had every opportunity to produce a timely

filed affidavit by a similarly equivalent specialist. On this record, we discern

no extraordinary circumstances.

      Affirmed.

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