Court Opinion

ID: 9732741
Source: CourtListenerOpinion
Date Created: 2023-08-26 16:33:28.375673+00
Date Added: 2024-06-11T18:26:32.418732
License: Public Domain

STEIN, J.,
dissenting.
In this medical-malpractice ease, a mother who had delivered a healthy baby boy was informed by nurses approximately twenty-four hours after birth about a “problem” with her baby. She rushed to the nursery, discovered that the baby had stopped breathing, and saw a team of physicians and nurses using cardiac compressions and respirational aids in an attempt to resuscitate the infant. She was told to call her husband and to summon a family priest. Although medical personnel were able to restore the infant’s heartbeat, the loss of oxygen to the brain caused severe brain damage. The parents were informed that even if the baby survived he would be in a permanent vegetative state. Both parents observed the future course of the infant’s treatment, including the insertion of respirational and nutritional tubes, during the forty-five-day period that terminated with his death.
The Court holds that notwithstanding evidence of severe emotional distress, and irrefutable evidence that the mother was present and directly observed the infant’s injury sustained as a result of the alleged malpractice, the mother’s claim for emotional-distress damages is barred because she did not observe and was unaware of the antecedent nursing and medical malpractice that allegedly caused her infant son to stop breathing. Ante at 302-303, 654 A.2d at 975-976. The allegations of malpractice focus on the failure of the hospital staff to respond to discernible symptoms of distress and to seek expert intervention before the infant lost consciousness on the morning following his birth. In my view, the requirement that the mother observe and be aware of the malpractice overstates our holding in Frame v. Kothari, 115 N.J. 638, *304560 A.2d 675 (1989), and imposes an artificial exclusion from the already narrow category of cases in which we recognize claims for emotional distress based on injury to a loved one.
Recognition of a cause of action for emotional distress caused by the death or serious bodily injury of a loved one derives from our holding in Portee v. Jaffee, 84 N.J. 88, 417 A.2d 521 (1980). There, the plaintiffs seven-year-old son became trapped in the elevator of a Newark apartment building, between the elevator’s outer door and the wall of the elevator shaft. When the elevator was activated, the boy was dragged up to the third floor. For approximately four and one-half hours the mother watched as police officers struggled to free him. He died while trapped in the elevator, having suffered multiple bone fractures and massive internal hemorrhaging. The plaintiffs action against the building’s owner and the two elevator companies responsible for maintaining the elevator was based on the defendants’ failure to provide a safe elevator. In addition to the survival and wrongful-death claims that she asserted in her representative capacity, the mother also sued individually for her mental and emotional distress resulting from the observance of her son’s suffering and death. In Portee, we recognized a cause of action for negligent infliction of emotional distress based on proof of the following elements: “(1) the death or serious physical injury of another caused by defendant’s negligence; (2) a marital or intimate, familial relationship between plaintiff and the injured person; (3) observation of the death or injury at the scene of the accident; and (4) resulting severe emotional distress.” Id. at 101, 417 A.2d 521.
Our holding in Portee imposed no requirement that the plaintiff observe the negligent act that caused the injury. We also rejected as arbitrary the requirement imposed by Falzone v. Busch, 45 N.J. 559, 569, 214 A.2d 12 (1965), that the plaintiff be subjected to risk of physical harm, but noted that “the scope of recovery must be circumscribed to negligent conduct which strikes at the plaintiffs basic emotional security.” Portee, supra, 84 N.J. at 99, 417 *305A.2d 521. Accordingly, we limited the cause of action for emotional distress only to those family members who observed the death or injury at the scene of the accident:
Discovering the death or serious injury of an intimate family member -will always be expected to threaten one’s emotional welfare. Ordinarily, however, only a witness at the scene of the accident causing death or serious injury will suffer a traumatic sense of loss that may destroy his sense of security and cause severe emotional distress. * * * Such a risk of severe emotional distress is present when the plaintiff observes the accident at the scene. Without such perception, the threat of emotional injury is lessened and the justification for liability is fatally weakened. The law of negligence, while it redresses suffering wrongfully caused by others, must not itself inflict undue harm by imposing an unreasonably excessive measure of liability. Accordingly, we hold that observing the death or serious injury of another while it occurs is an essential element of a cause of action for the negligent infliction of emotional distress.
[Id. at 99-100, 417 A.2d 521.]
Nor do the eases applying the Portee rule reflect any requirement that observation and awareness of the negligent act that caused the death or injury is a prerequisite to recovery. For example, in Polikoff v. Catabro, 209 N.J.Super. 110, 506 A.2d 1285 (App.Div.1986), the defendant anesthesiologist’s misplacement of a catheter in a child’s jugular vein during surgery resulted in the accumulation of hyper-alimentation fluid in the child’s pericardial sac, causing her death. The child’s mother was with her when the hyper-alinientation began, and witnessed her distress as well as the unsuccessful efforts to resuscitate her. The court held that the mother’s observation of the introduction of hyper-alimentation fluid into the incorrectly positioned catheter and the child’s resultant injury and death were sufficient to satisfy Portee’s requirements for a cause of action to recover emotional-distress damages. Id. at 114-15, 506 A.2d 1285. No requirement that the mother observe or be aware of the negligent misplacement of the catheter was imposed.'
Similarly, in Mercado v. Transport of New Jersey, 176 N.J.Super. 284, 422 A.2d 800 (Law Div.1980), the mother of the eight-year-old decedent did not witness her child being struck by defendant’s bus, but learned of the accident moments later when her daughter told her what had happened. The plaintiff ran *306outside and saw her son lying in the street, unconscious and severely injured. The court held that the mother’s observation of the child at the accident scene shortly after the actual impact satisfied the requirements of Portee, notwithstanding that the mother had not observed the impact or the allegedly negligent conduct of the defendants. Id. at 238, 422 A.2d 800.
Our holding in Portee relied significantly on the California Supreme Court’s decision in Dillon v. Legg, 68 Cal. 2d 728, 441 P.2d 912, 69 Cal.Rptr. 72 (1968), which held that a bystander’s cause of action for emotional-distress damages depended on three factors:
“(1) Whether plaintiff was located near the scene of the accident as contrasted with one who was a distance away from it. (2) Whether the shock resulted from a direct emotional impact upon plaintiff from the sensory and contemporaneous observance of the accident, as contrasted with learning of the accident from others after its occurrence. (3) Whether plaintiff and the victim were closely related, as contrasted with an absence of any relationship or the presence of only a distant relationship.”
[Portee, supra, 84 N.J. at 97, 417 A.2d 521 (quoting Dillon, supra 68 Cal.2d at 740, 441 P.2d at 920, 69 Cal.Rptr. at 80).]
Applying the Dillon guidelines, a California appellate court had occasion specifically to consider whether in a malpractice context Dillon requires that the plaintiff observe and be aware of the negligent act as a prerequisite to recovery. In Mobaldi v. Board of Regents, 55 Cal.App. 3d 573, 127 Cal.Rptr. 720 (1976), overruled on other grounds, Baxter v. Superior Court, 19 Cal. 3d 461, 563 P.2d 871, 138 Cal.Rptr. 315 (1977) (in banc), a foster mother brought an action against a university medical center and two physicians to recover emotional-distress damages on the basis of injuries inflicted on a foster child by an injection of overstrength glucose solution in the course of a pyelogram, an x-ray procedure designed to enhance the visibility of the organ to be studied. The procedure contemplated injection of a dye as part of a five-percent glucose solution, but a physician mistakenly used a fifty-percent glucose solution. While in the presence of his foster mother, the child began to breathe peculiarly. In a short time, the child became spastic and eonvulsant, and eventually comatose. The child suffered irreversible brain damage, and became quadriplegic, *307permanently blind and severely retarded. The foster mother’s complaint sought, among other relief, emotional-distress damages because of the depression and distress she had experienced as a direct consequence of witnessing the child’s injury.
In determining whether the plaintiff satisfied the Dillon guideline that her distress result from “a direct emotional impact * * * from the sensory and contemporaneous observance of the accident,” Dillon, 68 Cal.2d at 740, 441 P.2d at 920, 69 Cal.Rptr. at 80, the court distinguished between requiring observation of the act of malpractice and observation of its consequences:
Foreseeability depends upon what the emotionally traumatized plaintiff observes. It is observation of the consequences of the negligent act and not observation of the act itself that is likely to cause trauma so severe as to result in physical injury.
So long as the plaintiffs observation of the results of the defendant’s infliction of harm upon another is direct and contemporaneous, there is no significance in the plaintiffs lack of awareness that the defendant’s conduct inflicting the injui-y is negligent. To reason otherwise would deny the protection of Dillon to a mother observing a child killed by a driver, whose only negligence is his intoxication, simply because the mother can not be aware of the fact of drunkenness until after the accident.
[Mobaldi, supra, 127 Cal.Rptr. at 727.]
In Ochoa v. Superior Court, 39 Cal.3d 159, 703 P.2d 1, 216 Cal.Rptr. 661 (1985), the California Supreme Court endorsed that aspect of the holding in Mobaldi, describing as anomalous a requirement that a “plaintiff must be aware of the tortious nature of defendant’s actions.” Id. at 170, 703 P.2d at 8, 216 Cal.Rptr. at 668.
Our holding in Frame, supra, should not be understood to impose a requirement, in all cases involving bystander emotional-distress claims based on malpractice, that the bystander observe both the malpractice and its consequences. The requirement that the bystander be aware of the malpractice and its consequences was introduced in Frame as an accommodation, in recognition of the fact that many malpractice cases would not involve “observation of the death or injury at the scene of the accident,” Portee, supra, 84 N.J. at 101, 417 A.2d 521, in a context sufficiently *308shocking to satisfy the Portee guidelines. We noted in Frame that
diagnosis is an intellectual undertaking, requiring the physician to analyze symptoms and reach a conclusion. The nature of a misdiagnosis is such that its results may neither manifest themselves immediately nor be shocking. Hours, days, or months may separate a misdiagnosis, the manifestation of the injury to the patient, and the family member’s observation of the injury. Thus, the event may not cause the simultaneous concurrence or rapid sequence of events associated with a shocking event. The observing family member will not be exposed to the harm of seeing a healthy victim one moment and a severely injured one the next.
[115 N.J. at 644-45, 560 A.2d 675.]
To illustrate its point, the Court’s opinion in Frame reviewed a number of malpractice cases in which a bystander’s claim for emotional-distress damages had been denied. Id. at 645-47, 560 A.2d 675. We noted that
the common thread running through these cases is that a misdiagnosis normally does not create the kind of horrifying scene that is a prerequisite for recovery. Rarely will a member of the patient’s family contemporaneously observe the immediate consequences of the defendant’s misdiagnosis, and even more rarely will the results of the misdiagnosis be the injury or death of a loved one contemplated by the gruesome scene portrayed in Portee.
[Id. at 647-48, 560 A.2d 675.]
Accordingly, the Frame opinion offers a modification of the standard Portee framework, to permit bystander recovery of emotional-distress damages in a malpractice context that does not meet the Portee guidelines: “In an appropriate case, if a family member witnesses the physician’s malpractice, observes the effect of the malpractice on the patient, and immediately connects the malpractice with the injury, that may be sufficient to allow recovery for the family member’s emotional distress. Such an event could be shocking.” Id. at 649, 560 A.2d 675.
In my view, Frame’s modification of Portee should be understood as an exception from, not as a substitute for, the Portee guidelines. If in a malpractice case the family member does not observe directly the act of malpractice, but directly witnesses the death or serious bodily injury resulting from the malpractice in a setting that satisfies Portee’s contemplation of a traumatic emotional event, 84 N.J. at 99-101, 417 A.2d 521, a requirement that *309the observer also have witnessed and been aware of the malpractice appears to be redundant. As the court noted in Mobaldi, supra: “It is observation of the consequences of the negligent act and not observation of the act itself that is likely to cause trauma so severe as to result in physical injury.” 127 Cal.Rptr. at 727.
That principle has specific relevance to the facts before us. Whether Mrs. Gendek was aware that the pediatric nurses had deviated from generally accepted standards in the hours following her son’s birth is of limited significance when compared to the trauma that she claims to have experienced the following morning when she was summoned to the nursery to watch a team.of physicians attempt unsuccessfully to resuscitate her baby in time to avoid irreversible brain damage.
We noted in Frame that the line-drawing responsibility of courts, in distinguishing recoverable claims from those in which compensation is denied, invites claims of arbitrariness. 115 N.J. at 649, 560 A.2d 675. To avoid arbitrary rules and results, we must on occasion clarify lines previously drawn to serve better the interests of justice. The Court should make clear that a bystander’s medical-malpractice action for emotional-distress damages that satisfies the Portee standards should succeed even if the plaintiff was unaware of the malpractice when it occurred.
I would reverse the judgment of the Appellate Division and remand the matter for trial.
For affirmance — Chief Justice WILENTZ, and Justices HANDLER, POLLOCK, O’HERN and GARIBALDI — 5.
For reversal and remandment — Justice STEIN — 1. '