Court Opinion

ID: 9405155
Source: CourtListenerOpinion
Date Created: 2023-06-27 17:03:56.087137+00
Date Added: 2024-06-11T17:20:19.938119
License: Public Domain

NOTICE: NOT FOR OFFICIAL PUBLICATION.
 UNDER ARIZONA RULE OF THE SUPREME COURT 111(c), THIS DECISION IS NOT PRECEDENTIAL
                 AND MAY BE CITED ONLY AS AUTHORIZED BY RULE.

                                    IN THE
             ARIZONA COURT OF APPEALS
                                DIVISION ONE

                  MELANIE PHILLIPS, Plaintiff/Appellant,

                                        v.

              JAY L. SCHWARTZ, et al., Defendants/Appellees.

                             No. 1 CA-CV 22-0487
                               FILED 6-27-2023

           Appeal from the Superior Court in Maricopa County
                          No. CV2019-004189
              The Honorable Bradley H. Astrowsky, Judge

                                  AFFIRMED

                                   COUNSEL

DKL Law PLLC, Phoenix
By David W. Lunn, Kathryn A. Lunn
Counsel for Plaintiff/Appellant

Jones Skelton & Hochuli PLC, Phoenix
By Stephen A. Bullington, Eileen Dennis GilBride, Cory E. Tyszka
Counsel for Defendants/Appellees
                        PHILLIPS v. SCHWARTZ, et al.
                            Decision of the Court

                        MEMORANDUM DECISION

Presiding Judge Jennifer M. Perkins delivered the decision of the Court, in
which Judge Angela K. Paton and Judge D. Steven Williams joined.

P E R K I N S, Judge:

¶1            Melanie Phillips appeals the grant of summary judgment for
Jay L. Schwartz and Jay L. Schwartz, D.O., P.C., and the denial of her motion
for a new trial. We affirm.

             FACTS AND PROCEDURAL BACKGROUND

¶2            In September 2017, Schwartz performed bilateral LASIK
surgery on Phillips and implanted in her right eye a device known as a
Raindrop Near Vision Inlay (“Raindrop Inlay”). The Raindrop Inlay is a
curved disc implanted in the cornea of one eye with the intent to improve
near vision. Before surgery, Phillips signed an informed consent document
warning that use of the Raindrop Inlay can cause permanent glare affecting
night driving. Phillips later testified she could not read the document when
she signed it because of her vision problems. In March 2018, Schwartz
removed Phillips’ Raindrop Inlay because she was experiencing post-
operative decreased visual acuity because of corneal haze (cloudiness or
opacity).

¶3           Beginning in September 2018, Phillips sought treatment from
other health care providers to improve her vision. In October 2018, the
United States Food and Drug Administration recalled the Raindrop Inlay
because of an increased risk of corneal haze, which can cause glare.

¶4             In 2019 and 2020, Phillips reported glare, hazy vision, and
eventual cessation of night driving to her then-treating health care
provider, Dr. Robert McCulloch. A higher glare measurement reveals more
significant glare. In 2019, McCulloch measured Phillips’ glare as 20/200 in
her right eye as compared to 20/40 in her left eye. In 2020, McCulloch
measured her glare as 20/400 in each eye. In October 2020, Phillips had an
independent medical exam with Dr. Todd Lefkowitz, who noted
paracentral opacity in the cornea of both her eyes. In 2021, McCulloch again
examined Phillips and measured her glare as 20/25 in her right eye and
20/20 in the left.

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                      PHILLIPS v. SCHWARTZ, et al.
                          Decision of the Court

¶5           Phillips sued Schwartz for professional negligence, lack of
informed consent, and battery. Phillips testified at her deposition that if she
had been told she could have permanent glare, she would have declined
the Raindrop Inlay procedure.

¶6            At his deposition, Lefkowitz criticized Schwartz for offering
and implanting the Raindrop Inlay, for not obtaining informed consent
before doing so, and for not removing it earlier. Lefkowitz first testified
that, to a reasonable degree of medical probability, if the Raindrop Inlay
had been removed earlier, then Phillips would not have developed corneal
opacities. Lefkowitz also testified that the Raindrop Inlay caused corneal
damage to her right eye, specifically opacities in the central corneal surface.

¶7            But Lefkowitz conceded that he found evidence of some
opacity in both eyes and that, if the LASIK procedure caused some of the
corneal opacity, that is not evidence of negligence by Schwartz. He testified
that because the haze was bilateral, that reveals the haze was more a result
of the LASIK surgery than the Raindrop Inlay. Lefkowitz had no way to
quantify the amount of opacity caused by the Raindrop Inlay versus the
LASIK procedure and stated that the degree of paracentral opacity was
fairly minimal. He could not say to a reasonable degree of medical
probability that the Raindrop Inlay permanently damaged Phillips’ right
eye. And Lefkowitz could not state whether Phillips’ outcome would have
been any different had Schwartz removed the Raindrop Inlay earlier or if
he had never implanted the Raindrop Inlay.

¶8             Schwartz moved for summary judgment. In response,
Phillips provided an undated and unsworn declaration from Lefkowitz
stating that, to a reasonable degree of medical probability, implantation of
the Raindrop Inlay caused Phillips to suffer opacity in her right cornea and
glare. Schwartz moved to strike the declaration, which the superior court
denied.

¶9             Phillips also attached to her response a deposition correction
page stating Lefkowitz’s opinion that (1) to a reasonable degree of medical
probability, implantation of the Raindrop Inlay caused Phillips to suffer
glare in her right eye; (2) to a reasonable degree of medical probability, the
Raindrop Inlay caused some paracentral opacity in the right cornea; and (3)
because the haze in her right eye is grossly more significant than in the left,
that the Raindrop Inlay caused more harm to that eye. The court granted
Schwartz summary judgment, finding the corneal opacity was minimal,
bilateral, and probably caused by the LASIK procedure.

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                       PHILLIPS v. SCHWARTZ, et al.
                           Decision of the Court

¶10            Phillips moved for a new trial. The superior court denied her
request based on the conclusory nature of the deposition corrections, which
Phillips failed to establish were reliable. The court noted that Lefkowitz
never explained the basis for his opinion that Phillips’ injuries were caused
by the Raindrop Inlay.

¶11          We have jurisdiction over Phillips’ timely appeal. A.R.S. § 12-
2101(A)(1) and (A)(5)(a).

                                DISCUSSION

¶12           Phillips argues the superior court erred in finding no genuine
issue of material fact in support of her negligence claim involving the
Raindrop Inlay. Phillips does not argue on appeal that the superior court
erred in granting summary judgment on her claim for battery or for
professional negligence involving the part of the surgery that involved the
LASIK procedure.

¶13           We review de novo the superior court’s grant of summary
judgment to determine whether the court properly applied the law and
whether any genuine issues of material facts exist. Ariz. R. Civ. P. 56(a);
Orme School v. Reeves, 166 Ariz. 301, 310 (1990). We view the facts in the light
most favorable to Phillips. Dinsmoor v. City of Phoenix, 251 Ariz. 370, 373, ¶
13 (2021). We review the denial of a motion for a new trial for abuse of
discretion. Health for Life Brands, Inc. v. Powley, 203 Ariz. 536, 542, ¶ 28 (App.
2002).

¶14             Medical malpractice claims include claims for lack of
informed consent. A.R.S. § 12-561(2); see Gorney v. Meaney, 214 Ariz. 226,
230, ¶ 11 (App. 2007). A plaintiff bears the burden of establishing through
expert testimony that the health care provider proximately caused
harm. See A.R.S. § 12-563(2); Gregg v. Nat’l Med. Health Care Servs., Inc., 145
Ariz. 51, 54 (App. 1985). A plaintiff alleging lack of informed consent must
show two types of causation: (1) she would have declined the treatment
with adequate disclosure and (2) the treatment proximately caused harm.
Rice v. Brakel, 233 Ariz. 140, 146, ¶ 23 (App. 2013); Gorney, 214 Ariz. at 231,
¶ 15.

¶15          Phillips’ testimony that she would have declined the
implantation of the Raindrop Inlay if she had been told she could have
permanent glare satisfies the first prong of the informed-consent causation
burden. See Rice, 233 Ariz. at 146, ¶ 23. But Phillips failed to provide expert
testimony in support of the second prong—that implantation of the
Raindrop Inlay caused her to suffer glare. See Gorney, 214 Ariz. at 231, ¶ 15.

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                       PHILLIPS v. SCHWARTZ, et al.
                           Decision of the Court

¶16            Phillips first argues that McCulloch’s deposition testimony
provides the requisite causal link and paraphrases his testimony, claiming
McCulloch testified that “Ms. Phillips has difficulty with glare in her right
eye which was most likely caused by the previous Raindrop Inlay implant
and explant surgeries performed by Dr. Schwartz.” The record does not
support the paraphrase. In the cited portions of the deposition transcript,
McCulloch testified generally as to the symptoms a person could have with
astigmatism and the characteristics and significance of a fibrotic layer in the
cornea. He also stated he could not answer whether the fibrotic layer in
Phillips’ cornea was causing any problems. Phillips concedes in her reply
brief that McCulloch did not confirm to a reasonable degree of medical
certainty that the Raindrop Inlay caused the fibrotic layer and resultant
glare in Phillips’ right eye.

¶17            Phillips then argues that Lefkowitz’s declaration provided the
requisite causal link. But because the declaration is unsworn and undated,
we do not consider it. Ariz. R. Civ. P. 80(c) (when the rules allow a matter
to be established by a sworn written declaration or affidavit, the same may
be unsworn and have the same force and effect if it is dated); Airfreight Exp.
Ltd. v. Evergreen Air Ctr., Inc., 215 Ariz. 103, 112, ¶ 25 (App. 2007) (finding
an undated declaration insufficient); see also Kiser v. A.J. Bayless Mkts., Inc.,
9 Ariz. App. 103, 106 (1969) (noting the party responding to the summary
judgment motion must provide “sworn proof” in response to the movant’s
positive sworn facts on a material issue).

¶18            Finally, Phillips argues that Lefkowitz’s corrected deposition
testimony satisfies the second prong of the informed-consent causation test.
Arizona Rule of Civil Procedure (“Rule”) 30(e)(1)(B) permits timely changes
in form or substance to a deposition provided the deponent lists the reasons
for making the changes in a statement to the reporting firm. The record does
not establish that Lefkowitz or Phillips delivered that statement.

¶19           Although Lefkowitz’s deposition changes directly contradict
the substance of his original testimony, arguably Rule 30(e)(1)(B) permits
him to make those changes. See Valley Nat. Bank v. Nat’l Ass’n for Stock Car
Auto Racing, Inc., 153 Ariz. 374, 380 (App. 1987) (referencing federal court
decisions holding that a deponent may make changes that directly
contradict testimony given in the examination, but the original answers
remain, and a witness can be impeached with the former answers). But the
superior court found Lefkowitz’s substantive deposition changes
conclusory and unreliable. We agree.

                                       5
                       PHILLIPS v. SCHWARTZ, et al.
                           Decision of the Court

¶20           Under Arizona Rule of Evidence 702, the court acts as a
gatekeeper in assessing whether expert testimony is relevant, reliable, and
based on sufficient facts and data. Ariz. R. Evid. 702(b). Here, the record
shows that Phillips suffered from equal bilateral glare in 2020, yet the
Raindrop Inlay was only implanted in her right eye. The glare measurement
in both eyes improved in 2021, with minimal difference between the eyes.
Even assuming as true Lefkowitz’s corrected opinion, Lefkowitz could not
quantify the amount of opacity caused by the Raindrop Inlay versus the
LASIK procedure and agreed that the degree of paracentral opacity was
fairly minimal. See Kreisman v. Thomas, 12 Ariz. App. 215, 218 (1970) (noting
“causation must be shown to be Probable and not merely Possible, and
generally medical expert testimony that a subsequent illness or disease
‘could’ or ‘may’ have been the cause of the injury is insufficient”).

¶21            Ultimately, Lefkowitz’s deposition corrections provide no
basis to find a genuine issue of material fact as to causation. Barrett v. Harris,
207 Ariz. 374, 378, ¶ 12 (App. 2004) (“Ordinarily, a plaintiff in a medical
malpractice lawsuit must prove the causal connection between an act or
omission and the ultimate injury through expert medical testimony, unless
the connection is readily apparent to the trier of fact.”). Phillips thus failed
to establish an essential element of her claim. Summary judgment was
appropriate.

                                CONCLUSION

¶22          For these reasons, we affirm the superior court’s ruling. We
award costs to Schwartz upon compliance with Arizona Rule of Civil
Appellate Procedure 21.

                             AMY M. WOOD • Clerk of the Court
                             FILED:    JT

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