ELI BETHEA, III v. CORRECTIONAL MEDICAL SERVICES
Annotate this CaseNOT FOR PUBLICATION WITHOUT THE
APPROVAL OF THE APPELLATE DIVISION
SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-2398-08T1
ELI BETHEA, III,
Plaintiff-Appellant,
v.
CORRECTIONAL MEDICAL SERVICES,
DR. JOHN GODINSKY, NEW JERSEY
DEPARTMENT OF CORRECTIONS,
KAMAL PATEL, M.D.,
Defendants-Respondents,
and
ST. FRANCIS MEDICAL CENTER,
Defendant.
April 30, 2010
Argued March 8, 2010 - Decided
Before Judges Lisa, Baxter and Alvarez.
On appeal from the Superior Court of New
Jersey, Law Division, Mercer County, Docket
No. L-2442-06.
Patrick J. Whalen argued the cause for
appellant.
Sean Robins argued the cause for respondents
Correctional Medical Services, Inc. and John
Godinsky, M.D. (Marks, O'Neill, O'Brien &
Courtney, attorneys; Mr. Robins, on the
brief).
Sharon K. Galpern argued the cause for
respondent New Jersey Department of
Corrections (Stahl & DeLaurentis, attorneys;
Ms. Galpern, on the brief).
Michael D. Lindner, Jr. argued the cause for
respondent Kamal Patel, M.D. (Blumberg &
Lindner, attorneys; Mr. Lindner, on the
brief).
PER CURIAM
Plaintiff Eli Bethea, III, an inmate in Northern State
Prison, appeals from a December 2, 2008 award of summary
judgment to defendants New Jersey Department of Corrections
(NJDOC) and Kamal Patel, M.D. The motion court, despite the
absence of a similar filing on behalf of defendants Correctional
Medical Services (CMS) and John Godinsky, M.D., granted those
defendants summary judgment as well. For the reasons that
follow, we reverse except as to the fifth count of the
complaint, which alleges that defendants' conduct violated
plaintiff's constitutional rights and rights under the State's
Civil Rights Act (CRA), N.J.S.A. 10A:6-1 to -2. Dismissal of
the fifth count of the complaint is affirmed.
The complaint alleges medical negligence, breach of
contract, ordinary negligence, breach of N.J.S.A. 10A:16-1.1 to
-15.8 (setting forth the standard of care for inmates),
violations of the CRA, and violations of the New Jersey State
Constitution. The motion court dismissed the complaint due to
plaintiff's failure to produce a medical expert in support of
A-2398-08T1
2
his claims. Plaintiff contends, in opposition to the motion for
summary judgment, as he does on appeal, that the doctrine of
common knowledge, as applied to the circumstances here, means he
is not required to produce expert testimony to establish a
deviation from the standard of care. The motion court granted
summary judgment to all defendants, despite the fact that only
Patel and NJDOC filed motions seeking the dismissal of
plaintiff's complaint.
On February 15, 2005, plaintiff was assaulted by other
prisoners. He was brought into the infirmary shortly after
10:00 a.m. and seen by Godinsky, the staff physician on duty,
who immediately ordered an x-ray. The x-ray, completed within
minutes, revealed a tibial plateau fracture which, according to
Godinsky's deposition testimony, looked "like a pretty severe
injury." As a result, Godinsky ordered an emergency room
consult at defendant St. Francis Medical Center (SFMC), NJDOC's
contract medical services provider, as in his opinion plaintiff
might require surgery that same day. Because of unspecified
"transport problems," plaintiff was not taken to the hospital
emergency room for the orthopedic consult until approximately
9:00 p.m., and was not triaged until 10:15 p.m.
Plaintiff was examined at SFMC by Patel, the on-duty
emergency room physician, who x-rayed the knee a second time.
A-2398-08T1
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As she stated during depositions, because Patel considered the
fracture to be stable, and because of the lateness of the hour,
she did not call in an orthopedic surgeon for a consult that
night. Instead, Patel discharged plaintiff back to Northern
State with instructions and a prescription for pain medication.
The instructions said: "The patient was asked to follow up
AM. ADDITIONAL NOTES: FOLLOW UP WITH PRISON/ORTHO IN AM." At
deposition, Patel said she meant that plaintiff needed to be
seen by an orthopedic surgeon the following morning, February
16.
Godinsky claimed he read the note and assumed that
plaintiff had been evaluated by an orthopedic surgeon at St.
Francis. As he put it, he interpreted Patel's instruction to
mean that "the injury [was] not urgent and can be followed up in
the clinic."
After two days in the infirmary without additional care
except treatment for pain, the extent of which plaintiff
disputes, plaintiff was transferred to administrative
segregation. He remained there for ten to eleven days until he
filed a grievance with the prison administrator, who immediately
returned him to the infirmary.
On March 3, 2005, plaintiff was finally seen by a prison
orthopedic specialist who x-rayed plaintiff's knee and scheduled
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him for surgery. Plaintiff was accordingly transferred to St.
Francis on March 8 and underwent surgery on March 9, 2005. He
was discharged from the hospital on March 14, 2005. The
operative report noted:
Due to the length of time of the delay prior
to surgery and the intra-articular nature of
the fracture [plaintiff] is at a high risk
of problems with fixation, infection as well
as long-term degenerative changes and a
possible need for additional surgery in the
future.
The motion judge premised his grant of summary judgment on
his conclusion that the doctrine of common knowledge was simply
inapplicable. He characterized the issues as complex, because
each doctor believed the other deviated from a standard of care.
For that reason, he determined that expert testimony was
necessary.
"A trial court's interpretation of the law and the legal
consequences that flow from established facts are not entitled
to any special deference." Manalapan Realty v. Twp. Comm. of
Manalapan,
140 N.J. 366, 378 (1995) (citations omitted). A
reviewing court is "not bound by a trial judge's 'construction
of legal principles,'" and considers such issues as if it is the
court of first instance. Smerling v. Harrah's Entertainment,
Inc.,
389 N.J. Super. 181, 186-87 (App. Div. 2006) (quoting
A-2398-08T1
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Lombardo v. Hoag, 269 N.J. Super. 36, 47 (App. Div. 1993),
certif. denied,
135 N.J. 469 (1994)).
160 N.J. 454
In Chin v. St. Barnabas Medical Center,
(1999), the Court began its analysis by reiterating the general
rule in medical malpractice cases: deviation from the standard
of care must be established by expert testimony. Id. at 469.
The Court then went on to consider the doctrine of common
knowledge, however, which in the rare case, "permits exception
to the general rule; when it is applied, expert testimony is not
needed to establish the applicable standard of care." Ibid.
(citing Schueler v. Strelinger,
43 N.J. 330, 345 (1964)). The
doctrine of common knowledge results in the matter being tried
"essentially no different[ly] from 'an ordinary negligence
case.'" Ibid. (quoting Rosenberg ex rel. Rosenberg v. Cahill,
99 N.J. 318, 325 (1985)). The test is whether the
"'carelessness of the defendant is readily apparent to anyone of
average intelligence and ordinary experience'"; in other words,
whether the issue of negligence is unrelated to technical
matters beyond the ken of the average juror. Id. at 469-70
(quoting Rosenberg, supra,
99 N.J. at 325).
After our independent review of the record and
consideration of the submissions and oral arguments of counsel,
we believe that the grant of summary judgment was improvident as
A-2398-08T1
6
a matter of law. The legal question posed by these
circumstances was well within the ken of a person "'of average
Id. at 469 (quoting
intelligence and ordinary experience.'"
Rosenberg, supra,
99 N.J. at 325). See Hubbard ex rel. Hubbard
v. Reed,
168 N.J. 387, 396-97 (2001) (pulling the wrong tooth is
a matter of common knowledge exempt from the necessity of expert
testimony); Palanque v. Lambert-Woolley,
168 N.J. 398, 406-07
(2001) (doctrine of common knowledge applicable where doctor
misread laboratory results resulting in patient undergoing
unnecessary surgery).
Godinsky claims Patel erred by not providing plaintiff with
medical treatment when he had been sent there for that express
purpose. Patel maintains Godinsky erred by not providing
plaintiff with an orthopedic consultation as directed in the
emergency room note accompanying plaintiff when he was returned
to the prison. The determination of who, if anyone, bears
responsibility for plaintiff's delayed treatment is one a jury
can readily make applying principles of ordinary negligence.
Therefore, the doctrine of common knowledge absolves plaintiff
from the obligation to produce a medical expert, and we reverse
the award of summary judgment as to the first four counts of the
complaint.
A-2398-08T1
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We concur, however, as to the dismissal of the fifth count
of plaintiff's complaint, alleging a violation of the CRA and
the State Constitution. An order or judgment may be affirmed on
appeal if it is correct, even though the trial judge relied on
Aquilio v. Continental Ins., 310 N.J.
an incorrect analysis.
Super. 558, 561 (App. Div. 1998) (citing Isko v. Planning Bd. of
Twp. of Livingston,
51 N.J. 162, 175 (1968)). In this case, in
order for plaintiff to recover pursuant to the CRA, he would
have to establish that the State facility "showed a 'deliberate
indifference to . . . serious medical needs'" in providing him
with the medical care related to his injury. Seeward v.
Integrity, Inc., 357 N.J. Super. 474, 485 (App. Div. 2003)
(quoting Estelle v. Gamble,
429 U.S. 97, 104,
97 S. Ct. 285,
291,
50 L. Ed. 2d 251, 260 (1976)). A serious medical need is
defined as a condition which has either been diagnosed as
requiring treatment or one obviously requiring treatment. Ibid.
The trial court ruled incorrectly that plaintiff's civil rights
claim could not be brought against the NJDOC because it was a
State agency. Our courts recognize a breach of the government's
duty to provide medical care to prisoners may be so egregious as
to violate a prisoner's civil and constitutional rights. Ibid.
There is no doubt that plaintiff's injury was one that even
a lay person would know required a doctor's attention. But
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"'accidental or inadvertent failure to provide adequate medical
care to a prisoner' does not," establish the deliberate
indifference necessary in order for a plaintiff to be able to
prevail on a claim of a violation of the CRA. Pryor v. Dep't of
Corrs.,
395 N.J. Super. 471, 494 (App. Div. 2007) (quoting
Helling v. McKinney,
509 U.S. 25, 32,
113 S. Ct. 2475, 2480,
125 L. Ed. 2d 22, 31 (1993)). In order to prevail on this basis,
plaintiff must prove scienter. Ibid. (citations omitted).
Examining the facts in the best possible light for plaintiff, as
we are obliged to do for purposes of this review, he has not
presented circumstances that demonstrate deliberate indifference
as opposed to ordinary negligence. Although we concur with the
court as to the outcome, we do not agree with the analysis
leading to the result.
Lastly, plaintiff also claimed that his civil rights
pursuant to our State Constitution were violated by the State's
failure to provide him with adequate medical care. Generally,
"mere allegations of malpractice do not raise issues of
constitutional dimension." Seeward, supra,
357 N.J. Super. at
485 (citing Estelle, supra,
429 U.S. at 106 n.14,
97 S. Ct. at
292 n.14,
50 L. Ed. 2d at 261 n.14). For this reason, although
the judge did not explicitly discuss this as part of count five,
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we affirm the dismissal of the entire count as plaintiff simply
does not have a viable claim.
Reversed in part; affirmed in part.
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