Court Opinion

ID: 9931410
Source: CourtListenerOpinion
Date Created: 2024-02-08 22:04:23.288322+00
Date Added: 2024-06-11T12:16:11.806507
License: Public Domain

2024 IL App (1st) 230553-U

                                                                        FOURTH DIVISION
                                                                Order filed: February 8, 2024

                                       No. 1-23-0553

NOTICE: This order was filed under Supreme Court Rule 23 and is not precedent except in the
limited circumstances allowed under Rule 23(e)(1).
______________________________________________________________________________

                                          IN THE

                              APPELLATE COURT OF ILLINOIS

                                FIRST DISTRICT
______________________________________________________________________________

GEORGIY CHERKASSKY, as Independent                        )   Appeal from the
Administrator of the Estate of LENA CHERKASSKAYA,         )   Circuit Court of
Deceased,                                                 )   Cook County.
                                                          )
       Plaintiff-Appellant,                               )
                                                          )
v.                                                        )
                                                          )
SVETLANA TSIPURSKY M.D., ADVANCED EYE                     )
CARE, LTD, an Illinois Corporation, MELINDA FAIER,        )   No. 2019 L 003852
M.D., FOX VALLEY ANESTHESIA ASSOCIATES,                   )
S.C., a Dissolved Illinois Corporation, and NORTHWEST     )
SURGICARE, LLC, a Foreign Limited Liability               )
Company,                                                  )
                                                          )
       Defendants                                         )
                                                          )
(Melinda Faier, M.D., Fox Valley Anesthesia Associates,   )   Honorable
S.C., and Northwest Surgicare, LLC, Defendants-           )   Scott D. McKenna,
Appellees).                                               )   Judge, presiding.

       JUSTICE HOFFMAN delivered the judgment of the court.
       Justices Martin and Ocasio concurred in the judgment.

                                         ORDER
No. 1-23-0553

¶1     Held: In a medical malpractice action, the deposition testimony of three physicians was
             insufficient to qualify as a health professional report under section 2-622 of the
             Code of Civil Procedure when the testimony did not contain a determination that
             the defendant physician at issue had departed from the standard of care; dismissal
             with prejudice was warranted when the plaintiff deliberately chose not to file a
             section 2-622 report and had ample time to obtain one; the plaintiff’s claim that an
             anesthesiologist acted negligently in not allowing her to undergo surgery under
             general anesthesia was medical in nature and could not proceed as an ordinary
             negligence claim; and the plaintiff failed to plead the existence of an apparent
             agency relationship between her ophthalmologist and the hospital where her
             surgery occurred when the plaintiff admitted that her healthcare power of attorney
             relied on the ophthalmologist, and not the hospital, to provide her medical care.

¶2     In this interlocutory appeal filed pursuant to Illinois Supreme Court Rule 304(a) (eff. Mar.

8, 2016), Georgiy Cherkassky (“Georgiy”), as independent administrator of the Estate of Lena

Cherkasskaya (“the Estate”), appeals the dismissal of five claims that Lena Cherkasskaya

(“Lena”), and then the Estate after her passing, brought against Melinda Faier, M.D., Fox Valley

Anesthesia Associates, S.C. (“FVAA”), and Northwest Surgicare, LLC (“Surgicare”). The circuit

court dismissed those counts based on the Estate’s failure to comply with section 2-622 of the of

Code of Civil Procedure (“Code”) (735 ILCS 5/2-622 (West 2020)) for its claims involving Dr.

Faier and for the Estate’s failure to plead facts that could establish that Surgicare had an agency

relationship with either Dr. Faier or the other defendant physician, Svetlana Tsipursky, M.D. We

see no merit to the Estate’s arguments on appeal and affirm the circuit court’s rulings.

¶3     On April 10, 2019, Georgiy, acting as Lena’s power of attorney for property, filed his initial

complaint raising two claims of medical malpractice against defendants Dr. Tsipursky and

Advanced Eye Care, Ltd. According to the allegations in the complaint, Lena, who was ninety-

two years old at the time and incapacitated by dementia, was injured by the medical negligence of

the defendants during an eye cataract surgery performed on April 11, 2017. During the surgery,

part of the nucleus descended into the vitreous, and the surgery was aborted. Georgiy alleged in

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No. 1-23-0553

the complaint that Lena required an emergent vitrectomy under general anesthesia to remove the

nucleus fragments but that her anesthesiologist, Dr. Faier, would not authorize general anesthesia

without clearance from Lena’s primary care physician and without cardiac testing because Lena’s

lungs had become congested. Lena’s primary care physician would not authorize the procedure

without an evaluation by a cardiologist.

¶4     On April 13, 2017, a retinal specialist, Dr. Enrique Garcia-Valenzuela, performed a

vitrectomy on Lena’s right eye without placing her under general anesthesia. Because Lena was

not sedated and was not able to hold still during the procedure, the vitrectomy was not successful.

During a follow-up visit on April 20, 2017, Dr. Garcia-Valenzuela recommended that Lena

undergo another vitrectomy under general anesthesia as soon as possible. From April 23 to May

1, 2017, Lena was admitted to the hospital for leukocytosis. During that time, she was evaluated

by a cardiologist and was cleared to receive general anesthesia. However, on May 2, 2017, Dr.

Garcia-Valenzuela again examined Lena and determined that she was blind in her right eye. As a

result, Dr. Garcia-Valenzuela did not recommend any further surgery.

¶5     Georgiy did not attach a section 2-622 report to the initial complaint and instead filed an

affidavit averring that he was unable to obtain a report prior to the expiration of the statute of

limitations. On July 9, 2019, Georgiy filed a section 2-622 affidavit and a report from David M.

Salvay, M.D., an ophthalmologist. The report only addressed the actions of Dr. Tsipursky and only

examined the ophthalmological aspects of Lena’s care. It did not mention or discuss Dr. Faier’s

involvement.

¶6     On July 9, 2019, Georgiy filed a first amended complaint against Dr. Tsipursky and

Advanced Eye Care, with the section 2-622 affidavit and report attached. On June 7, 2020, Lena

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No. 1-23-0553

died from causes unrelated to her eye surgery. Georgiy continued to prosecute the suit in his

capacity as administrator of the Estate.

¶7     On October 13, 2021, after having deposed Drs. Tsipursky, Faier, and Garcia-Valenzuela,

the Estate filed a second amended complaint adding Dr. Faier, FVAA, and Surgicare as defendants.

In relevant part, the second amended complaint, which is the operative complaint for the issues on

appeal, raised one count of medical malpractice against Dr. Faier; one count of medical malpractice

against FVAA through Dr. Faier acting as its agent; two counts of medical malpractice against

Surgicare through Drs. Faier and Tsipursky acting as its agents; and one count against Surgicare

for failing to obtain Lena’s informed consent, through Dr. Tsipursky acting as its agent. For the

two counts relating to Dr. Faier, although each was titled as a “Medical Malpractice Survival

Action,” the Estate alleged that Dr. Faier’s conduct amounted to gross negligence and that expert

testimony and a section 2-622 report were, therefore, not necessary. Accordingly, the Estate

attached the same section 2-622 affidavit and report that it had included with the first amended

complaint. The report again only addressed issues relating to Dr. Tsipursky’s care and did not

mention or discuss Dr. Faier’s actions.

¶8     On April 18, 2022, Dr. Faier filed a motion to dismiss under section 2-619 of the Code

(735 ILCS 5/2-619 (West 2022)) on the grounds that the Estate had failed to comply with the

requirements of section 2-622 for its claims against her. FVAA and Surgicare joined Dr. Faier’s

motion.

¶9     On April 25, 2022, Surgicare filed its own motion to dismiss under sections 2-619 and 2-

1010 (735 ILCS 5/2-1010 (West 2022)) on the grounds that it was neither directly nor indirectly

involved in the events at issue in the second amended complaint. Surgicare attached an affidavit

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No. 1-23-0553

from its CEO, Brent Fitzgerald, averring that it was not involved in Lena’s care and that neither

Dr. Tsipursky nor Dr. Faier acted as its agent.

¶ 10   In its response to Dr. Faier’s motion, the Estate asserted that the depositions of Drs. Faier,

Tsipursky, and Garcia-Valenzuela collectively satisfied the section 2-622 requirement because

their testimonies identified the reasons why a reasonable and meritorious cause for the action

existed. In the Estate’s view, the depositions spoke for themselves regarding the merits of its suit

and no further professional report was necessary.

¶ 11   In its response to Surgicare’s motion to dismiss, the Estate alleged that Surgicare held itself

out as a skillful provider of surgical care and that neither Georgiy nor Lena had any way of

knowing that Drs. Tsipursky and Faier were independent contractors and not agents of Surgicare.

The Estate further asserted that Surgicare’s patient consent form, which stated that Surgicare

maintains personnel and facilities to assist physicians and surgeons and that generally those

physicians and surgeons are independent contractors and not its agents, was ambiguous and

confusing and also not signed by either Georgiy or Lena, creating a fact question regarding whether

either should have known that Dr. Tsipursky was not Surgicare’s agent. However, the Estate also

admitted that it was Dr. Tsipursky who chose Surgicare as the location for Lena’s surgery and that

“[Lena’s] Health Care Power of Attorney at the time [Georgiy] more likely than not relied on [Dr.

Tsipursky] rather than Surgicare to provide ophthalmology surgical treatment to [Lena] for her

cataract surgery at Surgicare.” The Estate contended that, while Georgiy relied on Dr. Tsipursky,

there was a question of fact as to whether Lena, due to her dementia, did as well, and that neither

Lena nor Georgiy chose Dr. Faier to be Lena’s anesthesiologist.

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No. 1-23-0553

¶ 12   The circuit court entered an order on March 8, 2023, granting both motions to dismiss.

Regarding Dr. Faier’s motion, the court explained that over the course of three complaints the

Estate had “failed to name any of the three moving Defendants in a Section 622 Report, either

stating what standard of care was required of each or what breaches of such standards were

committed by each,” and that “[f]ailing to so file a proper 622 Report after three separate

Complaint filings indicates that Plaintiff does not have good cause to name these entities as

defendants, and the dismissals are thus with prejudice.” Further, the court rejected the Estate’s

argument that the physicians’ deposition testimonies could take the place of a section 2-622 report,

and the court found that the testimonies also did not establish a meritorious cause of action against

Dr. Faier, FVAA, or Surgicare.

¶ 13   As for Surgicare’s motion, the court found that the Estate had failed to sufficiently plead

the existence of an agency relationship between Surgicare and Dr. Tsipursky. Specifically, the

court found that the Estate failed to rebut with any competent evidence Fitzgerald’s affidavit

disclaiming any involvement in Lena’s care, other than merely citing to its own pleadings.

¶ 14   On March 9, 2023, the court entered an order under Supreme Court Rule 304(a) finding

that there is no just reason to delay enforcement or appeal of its March 8 order. This appeal follows.

¶ 15   On appeal, the Estate raises what we view as four issues: (1) whether the deposition

testimonies of Drs. Faier, Tsipursky, and Garcia-Valenzuela satisfied the requirements of section

2-622; (2) whether such a failure to comply with section 2-622 warranted dismissal with prejudice;

(3) whether the Estate’s claims against Dr. Faier should have nonetheless been allowed to proceed

as ordinary negligence claims; and (4) whether the Estate sufficiently pleaded the existence of an

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No. 1-23-0553

agency relationship between Surgicare and Dr. Tsipursky. We find the Estate’s arguments on these

issues to be without merit, and we will address them each in turn.

¶ 16   First, the Estate contends that the deposition testimonies of Drs. Faier, Tsipursky, and

Garcia-Valenzuela were sufficient to satisfy the requirements of section 2-622 and that, as a result,

dismissal of the Estate’s claims against Dr. Faier for failure to comply with section 2-622 was not

warranted. Section 2-622 requires a plaintiff in in any medical malpractice action to file an affidavit

from the plaintiff or the plaintiff’s attorney certifying, among other things, that they have

“consulted and reviewed the facts of the case” with a qualifying health professional and that the

health professional “has determined in a written report, after a review of the medical record and

other relevant material involved in the particular action that there is a reasonable and meritorious

cause for the filing of such action.” 735 ILCS 5/2-622(a)(1) (West 2020). “In the event that

multiple defendants are named in a single medical malpractice action, the statute requires that a

separate health professional's written report shall be filed as to each defendant.” Mueller v. North

Suburban Clinic, Ltd., 299 Ill. App. 3d 568, 573 (1998). “[O]ur review of the issue of whether a

physician's report complies with section 2-622 is de novo.” Id. at 572.

¶ 17   The Estate argues that the depositions satisfied the requirements of section 2-622 because

Drs. Faier, Tsipursky, and Garcia-Valenzuela each met the statute’s qualifications for rendering

an opinion on the merits of a medical malpractice claim and because their testimonies demonstrate

that there is a reasonable and meritorious cause for the filing of a medical malpractice action

against Dr. Faier. However, regardless of whether those assertions are true, the physicians’

deposition testimonies in this case do not satisfy the requirements of section 2-622 for the simple

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No. 1-23-0553

reason that they do not contain a “determin[ation] *** that there is a reasonable and meritorious

cause for the filing of such action.”

¶ 18   The case of Moyer v. Southern Illinois Hospital Service Corporation, 327 Ill. App. 3d 889,

903 (2002), is illustrative of this issue. There, this court held that a plaintiff who was suing a nurse

and her employing hospital could rely on the deposition testimony of a consulting physician in lieu

of a written report to satisfy the requirements of section 2-622. However, unlike in the present

case, the deposed physician in Moyer was not one of the named defendants and, importantly, the

physician explained why the nurse’s actions increased the risk of injury and opined that the nurse

had deviated from the standard of care. Id. at 903. Thus, because the physician had rendered a

determination that the nurse had not met the standard of care, the testimony contained the opinion

of a qualifying physician that the plaintiff had a meritorious cause of action and, therefore, satisfied

the requirements of section 2-622. Id.

¶ 19    In the present case, the Estate has not identified any portion of any of the three deposition

testimonies in which any of the physicians explained what Dr. Faier’s standard of care was or

expressed an opinion on whether Dr. Faier deviated from that standard of care. The depositions

lack that crucial aspect of a section 2-622 report, which is the opinion from a qualified expert

determining that the plaintiff has a meritorious claim. Instead, the Estate’s position requires that

we make that determination ourselves. But courts are not physicians and are not experts in the

various fields of medicine. That is precisely why section 2-622 exists, so that a qualified medical

professional can tell the court that the plaintiff has a meritorious claim. See DeLuna v. St.

Elizabeth's Hospital, 147 Ill. 2d 57, 75 (1992) (“By requiring litigants to obtain, at an early point,

the opinion of an expert who agrees that a meritorious cause of action exists, the statute will help

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No. 1-23-0553

ensure that only claims with some merit are presented.”). The depositions of the physicians in this

case do not satisfy that basic requirement. Accordingly, the circuit court did not err in finding that

the deposition testimonies of Drs. Faier, Tsipursky, and Garcia-Valenzuela were insufficient to

satisfy the requirements of section 2-622.

¶ 20   The next issue then becomes whether dismissal with prejudice was appropriate or whether

the circuit court should have granted the Estate an opportunity to obtain a section 2-622 report

concerning Dr. Faier’s involvement in Lena’s care. We review this question for an abuse of

discretion. Mueller, 299 Ill. App. 3d at 572.

¶ 21   The Estate argues that the Code does not require a dismissal with prejudice on the basis of

a technical deficiency in a pleading in a medical malpractice case. See Hagood v. O’Conner, 165

Ill. App. 3d 367, 371 (1988); see also Calamari v. Drammis, 286 Ill. App. 3d 420, 433–34 (1997)

(collecting cases holding that it is an abuse of discretion to dismiss a claim with prejudice when

the plaintiff had substantially complied with section 2-622 and had proposed amendments to cure

any technical defects). However, the Estate’s failure to comply with section 2-622 in this case is

not due to a mere technical deficiency. Rather, the Estate’s failure in this case is substantive.

Indeed, the Estate affirmatively chose not to comply with section 2-622, stating in its second

amended complaint that Dr. Faier’s negligence was so readily apparent that no expert testimony

was necessary and that, for that reason, it was not filing a section 2-622 report regarding Dr. Faier.

Given that more than a year had already passed since Dr. Faier had been deposed by that point, we

agree with the circuit court that the lack of a section 2-622 report addressing Dr. Faier is not a

technical deficiency but rather indicated that the Estate did not have good cause to name Dr. Faier

as a defendant. This is particularly true when contrasted with the fact that the Estate had filed a

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No. 1-23-0553

comprehensive section 2-622 report addressing Dr. Tsipursky, demonstrating that it understood

how to comply with section 2-622 and apparently had no trouble doing so. Accordingly, we do not

see an abuse of discretion in the court’s decision to dismiss the Estate’s claims against Dr. Faier

with prejudice.

¶ 22   The third issue in this appeal is whether the circuit court should have allowed the Estate’s

claims against Dr. Faier to proceed as ordinary negligence claims for which a section 2-622 report

is not required. The Estate contends that no expert testimony is necessary to prove that Dr. Faier

acted negligently in not allowing Lena to go under general anesthesia for an emergency vitrectomy

despite having cleared her for general anesthesia earlier in the day. However, whether expert

testimony is required is not the determining factor for whether a negligence claim is medical in

nature and whether a section 2-622 report is, therefore, required. See 735 ILCS 5/2-622 (West

2020) (requiring a health professional report “[i]n any action *** in which the plaintiff seeks

damages for injuries or death by reason of medical, hospital, or other healing art malpractice”).

Indeed, “there are three types of negligence suits against providers of medical services: (1)

malpractice suits requiring expert testimony; (2) malpractice cases not requiring expert testimony;

and (3) negligence suits, essentially common-law in character, that happen to be directed against

health care providers.” Woodard v. Krans, 234 Ill. App. 3d 690, 705 (1992). Only the last of those

three does not require compliance with section 2-622. Id. We have little trouble concluding that

the Estate’s allegations against Dr. Faier in this case do not fall under that third category. The issue

is whether Dr. Faier acted negligently in refusing to allow the ninety-two-year-old Lena to be

placed under general anesthesia after Lena’s lungs had become congested. This is plainly a medical

question outside of the ken of an average lay juror and not a common-law negligence issue, and

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No. 1-23-0553

the Estate has not provided us with any authority suggesting differently. Thus, the circuit court did

not err in requiring compliance with section 2-622.

¶ 23   The final issue in this appeal is whether the circuit court erred in dismissing the Estate’s

agency-based claims against Surgicare for failing to sufficiently plead the existence of an agency

relationship. Although the Estate brought claims against Surgicare through alleged agency

relationships with both Dr. Faier and Dr. Tsipursky, our affirmance of the dismissal of both claims

against Dr. Faier on section 2-622 grounds leaves only the two agency-based claims involving Dr.

Tsipursky at issue. Section 2-1010(a) of the Code provides that “[i]n any action *** in which the

plaintiff seeks damages for injuries or death by reason of medical, hospital, or other healing art

malpractice, a party may, in lieu of answering or otherwise pleading, file an affidavit certifying

that he or she was not directly or indirectly involved in the occurrence or occurrences alleged in

the action.” 735 ILCS 5/2-1010(a) (West 2022). In this case, Surgicare filed such an affidavit

through its CEO, Brent Fitzgerald. It was then up to the Estate to oppose the dismissal by

“show[ing] that the certifying party was directly or indirectly involved in the occurrence or

occurrences alleged in the action.” Id. § 2-1010(b).

¶ 24   In its response to Surgicare’s motion to dismiss, the Estate alleged that Surgicare “held

itself out to be reasonably skillful and careful in rendering surgical and/or anesthesia services and

medical care and treatment” and that neither Georgiy nor Lena had any way of knowing that Dr.

Tsipursky was an independent contractor and not an agent of Surgicare. The Estate further asserted

that Surgicare’s patient consent form, which stated that Surgicare maintains personnel and

facilities to assist physicians and surgeons and that generally those physicians and surgeons are

independent contractors and not its agents, was ambiguous and confusing and also not signed by

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No. 1-23-0553

either Georgiy or Lena, creating a fact question regarding whether either should have known that

Dr. Tsipursky was not Surgicare’s agent. However, the Estate also admitted that it was Dr.

Tsipursky who chose Surgicare as the location for Lena’s procedure and that “[Lena’s] Health

Care Power of Attorney at the time [Georgiy] more likely than not relied on [Dr. Tsipursky] rather

than Surgicare to provide ophthalmology surgical treatment to [Lena] for her cataract surgery at

Surgicare.” The Estate contended that, while Georgiy relied on Dr. Tsipursky to provide Lena’s

medical care, there was a question of fact as to whether Lena, due to her dementia, did as well.

¶ 25   “[U]nder the doctrine of apparent authority, a hospital can be held vicariously liable for the

negligent acts of a physician providing care at the hospital, regardless of whether the physician is

an independent contractor, unless the patient knows, or should have known, that the physician is

an independent contractor.” Gilbert v. Sycamore Municipal Hospital, 156 Ill. 2d 511, 524 (1993).

The plaintiff must show that:

       “ ‘(1) the hospital, or its agent, acted in a manner that would lead a reasonable person to

       conclude that the individual who was alleged to be negligent was an employee or agent of

       the hospital; (2) where the acts of the agent create the appearance of authority, the plaintiff

       must also prove that the hospital had knowledge of and acquiesced in them; and (3) the

       plaintiff acted in reliance upon the conduct of the hospital or its agent, consistent with

       ordinary care and prudence.’ ” Id. (quoting Pamperin v. Trinity Memorial Hospital, 144

       Wis. 2d 188, 207–08 (1988)).

¶ 26   We find the Estate’s allegations in support of the existence of an apparent agency

relationship between Surgicare and Dr. Tsipursky to be severely lacking. The Estate has not made

any specific allegations regarding how any actions of either Dr. Tsipursky or Surgicare created the

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No. 1-23-0553

impression that Dr. Tsipursky was Surgicare’s agent. Further, the Estate’s own admission that

Georgiy, acting as Lena’s healthcare power of attorney, relied on Dr. Tsipursky rather than

Surgicare to provide Lena’s care defeats the third element of the test. While the Estate argues that

it is nonetheless uncertain whether Lena also relied on Dr. Tsipursky rather than Surgicare, that

question is irrelevant. The Estate admitted in its second amended complaint that at all times

relevant to this action Lena’s dementia “caused her to be cognitively impaired and incapable of

managing her person and/or estate” and that Lena “could not comprehend her rights and/or the

nature of the acts giving rise to this cause of action.” And that is precisely why she had Georgiy

acting as her healthcare power of attorney. Accordingly, only Georgiy’s reliance is of any

consequence. Because Georgiy relied on Dr. Tsipursky rather than Surgicare and because it was

Dr. Tsipursky who chose Surgicare as the location for Lena’s surgery, the Estate failed to

sufficiently plead the existence of an apparent agency relationship. See Pamperin, 144 Wis. 2d

211–12 (explaining that there is no apparent agency when the patient enters a hospital seeking care

from a specific physician rather than from the hospital). Therefore, the circuit court did not err in

dismissing the agency-based claims against Surgicare.

¶ 27   For the foregoing reasons, we affirm the order of the circuit court dismissing the Estate’s

claims against Dr. Faier, FVAA, and Surgicare.

¶ 28   Affirmed.

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