Kershaw v. Hospital for Special Surgery
Bruce Kershaw v. Hospital for Special Surgery, Appellants-Respondents, and New York University Medical Center Hospital for Joint Diseases
Attorneys
APPEARANCES OF COUNSEL, Peltz & Walker, New York City (Bhalinder L. Rikhye of counsel), for appellants-respondents., Pollack, Pollack, Isaac & DeCicco, New York City (Brian J. Isaac of counsel), and Shoshana T. Bookson, New York City, for respondent-appellant., McAloon & Friedman, New York City (Gina Bernardi Di Folco of counsel), for respondent.
Full Opinion (html_with_citations)
OPINION OF THE COURT
Although raised in the context of a purported âcross motion,â resolution of this appeal requires us to once again revisit the issue of untimely summary judgment motions. As defendant Hospital for Special Surgery (together with codefendants Frelinghuysen and Girardi, HSS) concedes, its cross motion was untimely, and it did not allege any good cause for its delay. Accordingly, the cross motion was properly denied, regardless of its merits.
In 1994, when plaintiff was 53 years old, he underwent spinal surgery at defendant Hospital for Special Surgery, to address multilevel cervical stenosis with myelopathy and radiculopathy which, over the course of five years, had led to progressive weakness in his left shoulder and upper extremities. After surgery, he was pain-free but did not recover a full range of motion in his upper left arm.
About eight years later, in March 2002, plaintiff returned to HSS complaining of lower back pain and severe left leg pain; he was treated with a course of steroid injections. In April 2003, plaintiff again returned because he was experiencing increased weakness in his right upper arm. He was found to have âsignificantâ cervical stenosis and compression of his spinal cord, as well as cord signal change especially at C3-4 and C4-5. Plaintiff had âsignificant C-5 weakness of the right upper extremity.â The clinic notes indicated that plaintiff âneed[ed] a decompression at C3-4, C4-5 and C6-7,â that âprobablyâ this would be done in an anterior approach, and that âsurgery will be booked in the near future.â At a follow-up visit in June 2003, he was told that he might not fully recover his right arm motor loss; he was âsomewhat disappointedâ but acknowledged that his 1994 surgery had a similar result as to his left side. The clinic notes also indicate that plaintiff told the examining physician that he had recently secured a job and was not interested âwhatsoeverâ
Plaintiff returned to HSS in June 2004 complaining of increasing right shoulder dysfunction and neck pain, and decreasing balance. He was no longer working and was receiving social security disability benefits. The clinic notes of June 11, 2004 indicate that his âsymptoms have progressed with increased right shoulder atrophyâ; a new round of studies was scheduled. On October 1, 2004, plaintiff first met with defendants Peter Frelinghuysen, M.D. and Federico Pablo Girardi, M.D., both orthopedic surgeons at HSS. According to the clinic notes, the doctors advised plaintiff that surgery would likely not result in the return of muscle function, but that there was âa slight chanceâ of improvement.
He met with another HSS doctor on October 22, 2004, who wrote that the plan was to have plaintiff return in November to see Frelinghuysen âfor booking of his anterior disc fusion surgery.â At his next visit on November 12, 2004, a different doctor indicated in the clinic notes that Frelinghuysen and Girardi had recommended âwhat sounds like a two-level anterior cervical decompression and fusion,â and that plaintiff would follow up in one week âto discuss surgeryâ with Frelinghuysen.
Plaintiff testified that on his third visit with Frelinghuysen in December 2004, the doctor told him that they could not do the surgery, but did not give him âa reason that made any sense.â In Frelinghuysenâs words, he and Girardi decided that surgery âwould not help.â According to Girardi, after viewing the films, in his opinion the severity of plaintiffs spinal disease and the low prospect of improvement did not warrant the risks of
In February 2005, plaintiff sought treatment at defendant New York University Medical Center Hospital for Joint Diseases (HJD). According to the patient notes, the examining physician found severe upper extremity atrophy. After review of the MRI, he determined that no further surgery for the cervical spine was indicated and that there should be no lumbar spine surgery âat this time.â Physical therapy, pain management and treatment in HJDâs neurology, hand and shoulder clinics were recommended. Plaintiff undertook these programs through HJDâs clinic, and was treated continuously until September of 2005. An MRI taken of his right shoulder in May 2005 showed âsevere atrophyâ of certain muscles and âmild atrophyâ of other muscles, âlikely due to the patientâs cervical myelomalacia.â An MRI of his cervical spine taken the same day found âsevere central canal and severe neural foraminal stenosis,â resulting in âsevere myelomalacia of the spinal cordâ from C3 to mid-C5 level.
While continuing at HJD, plaintiff also sought treatment at Mt. Sinai, where he was first seen in the orthopedic clinic on April 21, 2005. The progress notes from June 25, 2005 indicate, in part, that he had âmarked stenosis throughout spine,â and âmarked atrophy at both shoulder girdles.â In July 2005, he was examined by an orthopedic surgeon who determined that plaintiff needed surgery to prevent his condition from worsening, not in order to regain function. Plaintiff underwent a two-stage cervical spine surgery in December 2005. Postoperatively, in February and April 2006, plaintiff indicated that he felt returning strength in his right arm although not his left, and a general âslow improvement.â The Mt. Sinai orthopedic surgeon observed that he did not âsee a substantial neurologic improvement on [his] objective testing, but the patient does feel subjectively like he is improving.â
Ten months after the surgery at Mt. Sinai, in October 2006, plaintiff returned to HJDâs neurology clinic, reporting a lack of improvement in upper extremity strength, and some pain and numbness in the right arm and hand. Electrical studies performed on October 26, 2006 revealed no significant change from those done in 2005 although there was evidence of fibrotic
Plaintiff commenced his lawsuit in May 2007, claiming medical malpractice and failure to secure informed consent. The gravamen of his claim is that HSS and HJD failed to timely perform surgery upon him, leaving him with neurological and muscular damage that would not have occurred had the surgery been performed earlier.
HJD timely moved for summary judgment on November 11, 2011. Its motion papers included an affidavit of a medical expert who discussed plaintiffs medical history as seen in the records. In the opinion of HJDâs expert, surgery would have been an âunjustifiable and extraordinarily risky and aggressive treatment option,â as no surgery would have been able to reverse plaintiffs âsignificantâ neurological deficits that had existed for many years. The best that surgery could do was stop the myelopathy, but there was risk of permanent paralysis or death, âwell beyond the standard for such risks for cervical spine cases.â He further opined that there was no identifiable injury sustained in the four-month period between plaintiffs first visit at HJD and when he first went to Mt. Sinai.
By notice of cross motion dated January 10, 2012, HSS moved for summary judgment and dismissal, relying on HJDâs expertâs affidavit and that of defendant Girardi. HSS also argued that the claim of lack of informed consent should be dismissed, given that no procedure requiring consent had been performed. HSS admitted that its motion seeking summary judgment and dismissal of the complaint as against it was filed nearly two months after the court-imposed deadline for making dispositive motions,
Plaintiff opposed defendantsâ motions for summary judgment, although he did not address the claim of lack of informed consent. He submitted the affidavit of his medical expert, Michael J. Murphy, M.D., an orthopedic surgeon practicing in Connecticut. According to the affidavit, Murphy reviewed the medical records and opined that surgery for plaintiff was âindicated as early as June 2003 when the diagnosis of cervical spondylitic
The motion court granted HJDâs motion and denied the motion of HSS. As to HJD, the court found that, âwithout any doubt, [its] moving papers, primarily through the thorough opinions expressed by [its expert], [made] out a prima facie case for the relief sought.â In opposition, Murphyâs opinions were âsomewhat conclusory.â He did not separate the claims plaintiff made against HJD and HSS, and did not address the opinions of HJDâs expert regarding causation. Thus, plaintiff failed to rebut HJDâs prima facie entitlement to summary judgment.
As to HSS, the court clearly held that because the cross motion was filed impermissibly late with no reason offered for the lateness, it should be denied. The court then went on to comment in dicta that if its merits were examined, summary dismissal should be denied as there are substantial questions of fact barring summary resolution. It wrote,
âThe question remains whether HSS should remain a viable defendant in this case. The answer is yes. First of all, under the authority of Brill [2 NY3d 648 (2004)], the cross[ ]motion was clearly untimely without any explanation, and counsel is simply wrong when he argues that the cross[ ]motion raises the same issues as the motion timely made by [HJD]. Differences necessarily exist because [plaintiff] was a patient at HSS for an extended time before he came to [HJD]. At [HJD] he was a patient from only February 2005 to September 2005, and he was also a patient at Mt. Sinai for much of that time. Therefore, the motion must be denied as untimely.â
Thus, the rationale for the courtâs denial was articulated as being that the âcross motionâ was untimely.
HSS appealed from the denial of its âcross motionâ and plaintiff cross-appealed from the grant of HJDâs motion.
To prevail on a summary judgment motion, the moving party must produce evidentiary proof in admissible form sufficient to warrant the direction of summary judgment in his or her favor
The motion court properly dismissed the case as against HJD. HJD met its burden of showing prima facie entitlement to summary judgment, proffering evidence that plaintiff was not caused to suffer any injury between February 2005 when HJD found that surgery was not indicated, and April 2005 when he first consulted with Mt. Sinai. In opposition plaintiffâs expert did not offer an opinion as to what specific injury plaintiff endured as a result of HJDâs decision not to perform surgery and made only broad conjectures which were insufficient to defeat HJDâs motion (see Foster-Sturrup v Long, 95 AD3d 726 [1st Dept 2012]; Callistro v Bebbington, 94 AD3d 408 [1st Dept 2012], affd 20 NY3d 945 [2012]). In addition, the motion court correctly dismissed the second cause of action alleging lack of informed consent as plaintiffs papers did not address this claim.
The motion court also correctly denied summary judgment to HSS because its motion was untimely made without any explanation for its untimeliness, let alone good cause {see CPLR 3212 [a]).
Plaintiff filed his note of issue on August 24, 2011. Thereafter, the motion court issued an order which provided that â[t]he time for the various defendants to move for summary judgment is extended through November 14, 2011.â On November 11, 2011, HJD moved for summary judgment, making its motion returnable on December 14, 2011. On January 10, 2012, well after the deadline for dispositive motions had passed, HSS âcross-movedâ for summary judgment without providing any explanation whatsoever for its delay. HSS argued to the motion court, as it does to this Court, that its motion should be considered on the merits because it merely presents the same arguments made by HJD. In opposing the âcross motion,â the plaintiff argued that it was untimely, and, secondarily, that it was devoid of merit.
Brill draws a bright line based on the two elements of CPLR 3212 (a): the statutorily-imposed or court-imposed deadlines for filing summary judgment motions, and the showing of good cause by a late movant in order for its motion to be considered. In Brill the Court of Appeals indicated that late-filed summary judgment motions are âanother example of sloppy practice threatening the integrity of our judicial systemâ (2 NY3d at 653 [emphasis added]), and pointed to its earlier decision, Kihl v Pfeffer (94 NY2d 118 [1999]), which affirmed dismissal of the complaint because the plaintiff failed to respond to a court order within the court-ordered time frame. Brill reiterates KihVs statement that, â â[i]f the credibility of court orders and the integrity of our judicial system are to be maintained, a litigant cannot ignore court orders with impunityâ â (2 NY3d at 652-653, quoting Kihl at 123).
While the Brill rule may have caused some practitioners and courts to wince at its bright line, by the time the motions at issue in this case were made, the Court of Appeals had already reiterated on more than one occasion, and in varying contexts, that it meant what it said (see Gibbs v St. Barnabas Hosp., 16 NY3d 74 [2010] [dismissal after repeated failures to serve bill of particulars and noncompliance with enforcement order], citing Brill; Andrea v Arnone, Hedin, Casker, Kennedy & Drake,
As most recently articulated in Gibbs:
âThe failure to comply with deadlines not only impairs the efficient functioning of the courts and the adjudication of claims, but it places jurists unnecessarily in the position of having to order enforcement remedies to respond to the delinquent conduct of members of the bar, often to the detriment of the litigants they represent. Chronic noncompliance with deadlines breeds disrespect for the dictates of the Civil Practice Law and Rules and a culture in which cases can linger for years without resolution. Furthermore, those lawyers who engage their best efforts to comply with practice rules are also effectively penalized because they must somehow explain to their clients why they cannot secure timely responses from recalcitrant adversaries, which leads to the erosion of their attorney-client relationships as wellâ (16 NY3d at 81).
The dissent considers our application of Brill in this instance to be ârote,â and that our interpretation is antithetical to that decisionâs policy considerations of preventing eve-of-trial summary judgment motions. It contends that in the interest of judicial economy we should not depart from âprior authorityâ that affords the court discretion to entertain a âmarginally late filingâ when there is merit to the application and no prejudice has been demonstrated, citing Burns v Gonzalez (307 AD2d 863
The dissent expresses concern about an extra burden to the courts and litigants if we strictly enforce Brill âwithout taking into consideration the circumstances of the case.â It reasons that because Brill emphasizes the advantages of summary judgment, with which we of course agree, those advantages outweigh a consistent application of the statute. However, bending the rule results in the practical elimination of the âgood cause shownâ aspect of CPLR 3212 (a), and the clear intent of Brill.
Unlike the dissent, we do not find that a straightforward interpretation of the statute, or Brill, leads to âabsurd and unintended consequences,â especially as the Court of Appeals acknowledges in Brill that if the strictures of CPLR 3212 (a) are applied âas written and intended,â there may be situations where a meritorious summary judgment motion may be denied, âburdening the litigants and trial calendar with a case that in fact leaves nothing to tryâ as was the result in Brill (2 NY3d at 653). However, the solution, the Court of Appeals explains, is not for the courts to overlook or bend CPLR 3212 (a) to fit the particular circumstances, but for âpractitioners [to] move for summary judgment within the prescribed time period or offer a legitimate reason for the delayâ (id.). In other words, Brill calls on the courts to lead by enforcing the words of the statute, rather than let attorney practice slowly eat away at the integrity of our judicial system. When the courts consistently âreĂąiste] to countenanceâ violation of statutory time frames, there will be fewer instances of untimely, improperly labeled motions, because âmovants will develop a habit of complianceâ with the statutory and court-ordered time frames, and late motions will include a good cause reason for the delay (id.).
In the case at bar, HSS relies on Lapin v Atlantic Realty Apts. Co., LLC (48 AD3d 337 [1st Dept 2008]) for the principle that there is an exception to Brill for cases where a late motion or cross motion is essentially duplicative of a timely motion. However, the Court of Appeals intended no such exception, and to the extent this Court has created one, it did so, whether knowingly or unwittingly, by relying on precedents which predate Brill and which, if followed, will continue to perpetuate a culture of delay. This is clear by tracing Lapinâs antecedents.
Lapin is one in a line of cases holding that an untimely cross motion may be considered on its merits when it and the timely motion address essentially the same issues. Lapin relied on Altschuler v Gramatan Mgt., Inc. (27 AD3d 304 [1st Dept 2006]), which held it proper to consider the untimely âcross motion,â in particular because it was âlargely basedâ on the same arguments raised in the timely motion for summary judgment, and the same findings would apply for both it and the timely motion. Altschuler, in turn, relied on a pre-Brill decision, James v Jamie Towers Hous. Co. (294 AD2d 268, 272 [1st Dept 2002], affd 99 NY2d 639 [2003]). In James, the defendant moved for summary judgment and the codefendant served its cross motion late but before the original motion had been decided; James held that the untimely cross motion should have been considered as the original motion was still pending and both could have been decided together.
It is true that since Brill was decided, this Court has held, on many occasions, that an untimely but correctly labeled cross motion may be considered at least as to the issues that are the same in both it and the motion, without needing to show good cause (see e.g. Palomo v 175th St. Realty Corp., 101 AD3d 579 [1st Dept 2012]; Conklin v Triborough Bridge & Tunnel Auth., 49 AD3d 320 [1st Dept 2008]; Filannino v Triborough Bridge & Tunnel Auth., 34 AD3d 280, 281-282 [1st Dept 2006], appeal dismissed 9 NY3d 862 [2007]; Osario v BRF Constr. Corp., 23 AD3d 202, 203 [1st Dept 2005]). Some decisions also reason that because CPLR 3212 (b) gives the court the power to search the record and grant summary judgment to any party without the necessity of a cross motion, the court may address an untimely cross motion at least as to the causes of action or issues that are the subject of the timely motion (see Filannino, 34 AD3d at 281, citing Dunham v Hilco Constr. Co., 89 NY2d 425, 429-430 [1996]). The problem in the case at bar is that HSSâs motion, in addition to being untimely, is not a true cross motion.
A cross motion is âmerely a motion by any party against the party who made the original motion, made returnable at the same time as the original motionâ (Patrick M. Connors, Practice Commentaries, McKinneyâs Cons Laws of NY, Book 7B, CPLR C2215:l; see CPLR 2215). A cross motion offers several advantages to the movant. There is a shorter minimum notice requirement, three or seven days, as compared with the minimum eight-day notice requirement in CPLR 2214 (b). The cross movant may rely on the papers submitted with the main motion to support the relief sought. By making a cross motion, the party saves an extra day in court, and quite possibly the time and trouble of amassing fresh proof, if it happens that all or part of the evidentiary foundation on which the cross motion is based has already been produced for consideration (Patrick M. Connors, Practice Commentaries, McKinneyâs Cons Laws of NY, Book 7B, CPLR C2215:l, C2215.-2).
Allowing movants to file untimely, mislabeled âcross motionsâ without good cause shown for the delay affords them an unfair and improper advantage. Were the motions properly labeled they would not be judicially considered without an explanation for the delay. Moreover, the exception discussed in Filannino allowing the courts to consider proper but untimely cross motions, at least as to issues shared with the original motion, addresses the dissentâs concern that a cross-moving party might be caused to file its motion late because it had insufficient time before the deadline occurred. Of course, it must be pointed out that the cross movant would have good cause for its late motion in that situation, and the cross motion would be evaluated on its merits (see e.g. Parker v LIJMC-Satellite Dialysis Facility, 92 AD3d 740, 741-742 [2d Dept 2012] [failure to receive significant outstanding discovery before the deadline for making motion for summary judgment provides good cause for allowing a late-filed motion for summary judgment]; see also Kase v H.E.E. Co., 95 AD3d 568, 569 [1st Dept 2012] [courtâs clerical error, explained through an affidavit of the paralegal, provided good cause for granting the motion seeking renewal of the motion for summary judgment]).
The argument that HSSâs motion should be considered on the merits because it âsought relief on the same issues raised in HJDâs timely motion,â ignores the distinction in the CPLR between motions and cross motions and perpetuates an increasingly played end run around the Court of Appealsâ bright-line rule in Brill. Even if we were to find that the Court of Appeals intended for an exception to be carved out of Brill for incorrectly labeled âme too cross motions,â that is, motions relying
Nor is this Courtâs recent holding in Levinson v Mollah (105 AD3d 644 [1st Dept 2013]) on point. In Levinson we held that there was no reason to address whether one of the âcross motionsâ was untimely because the moving defendantsâ timely motion had put plaintiff on notice that he needed to rebut the prima facie showing that he had not met the serious injury threshold; when the plaintiff in Levinson failed to do this, the complaint was correctly dismissed as to all codefendants. Here, however, because HSS and HJD have different treatment histories with plaintiff, HJDâs timely motion did not clearly put plaintiff on notice of the need to gather evidence in opposition to the arguments ultimately proffered by the HSS defendants.
We are concerned that the respect for court orders and statutory mandates and the authoritative voice of the Court of Appeals are undermined each time an untimely motion is consid
Finally, we note the dissentâs concern that allowing this litigation to proceed based on plaintiffâs particular theory of negligence could result in placing surgeons in an impossible situation either of performing a procedure that is deemed ill-advised and being subject to any liability for aggravation of a condition, or declining and being subject to liability for refusing to assume the risk that the surgery entails. Our decision is not one on the merits of plaintiffâs claim, and it is therefore premature to bemoan that we have opened a Pandoraâs box for surgeons. Rather, it will be for a trial court and a jury to hear plaintiffâs case, and should plaintiff prevail, then, assuming a timely appeal is taken and perfected, and only then, will we have occasion to consider the merits of the claim against HSS.
Accordingly, the order of the Supreme Court, New York County (Alice Schlesinger, J.), entered July 16, 2012, which, insofar as appealed from as limited by the briefs, granted the summary judgment motion of defendants Hospital for Special Surgery, Peter Frelinghuysen, and Federico Pablo Girardi only to the extent of dismissing plaintiffs claim of lack of informed consent, and otherwise denied the motion, should be affirmed, without costs; the judgment of the same court and Justice, entered August 20, 2012, dismissing the complaint as against defendant New York University Medical Center Hospital for Joint Diseases, should be affirmed, without costs.
. Girardi testified that the notation that he and Frelinghuysen had recommended any particular surgery was âincorrect.â
. Supreme Courtâs extension of the time to file dispositive motions had given the parties a total of 82 days after the filing of the note of issue on August 24, 2011. As a point of reference, the statutory 120-day maximum expired on December 22, 2011.
. In Cadichon v Facelle (18 NY3d 230 [2011]), the Court reversed a âministerialâ dismissal based on the failure to timely file the note of issue because the trial court did not provide notice to the parties or issue a formal order; the decision notes that the record showed that neither set of parties acted âwith expediency in moving th[e] case forward,â and that deadlines must not be disregarded (id. at 236, citing Andrea, Miceli, Brill, and Kihl).
. The dissent overlooks the very different lengths of treatment offered to plaintiff by HSS and HJD.