Opinion
Civ. No. H-98-770.
June 1999.
MEMORANDUM AND ORDER
In this civil action, Ronald Johnson, II ("Johnson") is seeking compensatory damages for improper dental care and treatment. At the time of the matters in suit, Johnson was a resident of a juvenile facility known as Victor Cullen Academy ("Victor Cullen"), where he had been confined as a result of juvenile proceedings held in a Montgomery County Court. Named as defendants in this case are Dr. Atulkumar P. Purohit ("Purohit" or "Dr. Purohit"), Dr. Eugene L. Klupt ("Klupt" or "Dr. Klupt") and Youth Services International of Maryland, Inc. ("Youth Services"), which owns and operates Victor Cullen. Diversity jurisdiction exists under 28 U.S.C. § 1332(a).
The amended complaint is in three counts. In Count I plaintiff Johnson seeks a recovery from defendants Purohit and Klupt for the negligent extraction of four of his teeth. Count II asserts a claim of negligence against defendant Youth Services. Count III is based on a theory of lack of informed consent and seeks a recovery from defendants Klupt and Purohit. Defendant Youth Services has filed a counterclaim against plaintiff Johnson seeking to recover the amount paid by it to defendants Purohit and Klupt for dental work performed on plaintiff.
Pursuant to Scheduling Orders entered by the Court, the parties have engaged in discovery. Discovery has now been completed, and defendant Youth Services has filed a motion for summary judgment which is presently pending before the Court.
Memoranda and voluminous exhibits have been filed by the parties in support of and in opposition to the pending motion. Following its review of the pleadings, memoranda and exhibits, this Court has concluded that no hearing is necessary for a ruling on the pending motion. See Local Rule 105.6. For the reasons stated herein, this Court has concluded that the motion of defendant Youth Services for summary judgment must be denied.
I Background Facts
In 1995, plaintiff Johnson was found in juvenile proceedings to have committed auto theft and was placed in Victor Cullen by Order of a Montgomery County Court. Youth Services is a private corporation which operates Victor Cullen pursuant to a contract with the State of Maryland. Johnson at the time was 17 years of age, and in April of 1996, while a resident of Victor Cullen, he complained of tooth pain to a nurse at the facility. Defendants Purohit and Klupt are licensed dentists who practice dentistry in Frederick, Maryland. In April of 1996, defendant Klupt had a contract with Youth Services whereby he agreed to provide dental care and treatment to residents of Victor Cullen. At the time, Dr. Purohit and Dr. Klupt shared office space, with Dr. Klupt seeing new patients initially and then referring them to Dr. Purohit for endodontics and restorative work.
On April 17, 1996, Johnson was transported to Dr. Klupt's office for examination and treatment. Following an initial examination and x-rays of his teeth, Johnson was turned over to Dr. Purohit for more advanced dental treatment. Following his examination of Johnson, Dr. Purohit concluded that several of plaintiff's teeth needed root canals or had to be extracted. Ms. Terry Doster ("Doster"), the office receptionist, telephoned a nurse at Victor Cullen, seeking authorization for dental treatment to be given to plaintiff. She reported the results of her inquiry to Dr. Klupt, who in turn reported to Dr. Purohit. On April 30, 1996, Dr. Purohit extracted four of plaintiff's front teeth under local anesthesia.
According to plaintiff Johnson, defendants Purohit and Klupt negligently provided dental care and treatment to him when four of his teeth were unnecessarily extracted and when these defendants acted without securing the consent of Johnson's parents. Plaintiff further claims that defendant Youth Services negligently authorized the unnecessary extractions of his four teeth. Defendant Youth Services has moved for summary judgment on the ground that there is on this record no genuine issue of material fact relating to the claim of negligence asserted against it by plaintiff Johnson.
II Summary Judgment Principles
The principles to be applied by this Court in considering a motion for summary judgment under Rule 56, F.R.Civ.P., are well established. A party moving for summary judgment bears the burden of showing the absence of any genuine issue of material fact and that the movant is entitled to judgment as a matter of law.Barwick v. Celotex Corp., 736 F.2d 946, 958 (4th Cir. 1984). Where, as here, the nonmoving party will bear the ultimate burden of persuasion at trial, "the burden on the moving party [at the summary judgment stage] may be discharged by `showing' — that is, pointing out to the district court — that there is an absence of evidence to support the nonmoving party's case." Celotex Corp. v. Catrett, 477 U.S. 317, 325 (1986).
In Phoenix Sav. Loan, Inc. v. Aetna Cas. Co., 381 F.2d 244, 249 (4th Cir. 1967), the Fourth Circuit Court of Appeals summarized the principles applicable under Rule 56 as follows: "It is well settled that summary judgment should not be granted unless the entire record shows a right to judgment with such clarity as to leave no room for controversy and establishes affirmatively that the adverse party cannot prevail under any circumstances."Id. Hence, the party opposing a motion for summary judgment is entitled to all favorable inferences which can be drawn from the evidence. See, e.g., Adickes v. S.H. Kress Co., 398 U.S. 144, 158-59 (1970); Cram v. Sun Life Ins. Office, Ltd., 375 F.2d 670, 674 (4th Cir. 1967).
The party moving for summary judgment has the burden of establishing that there is no genuine issue of material fact.Barwick, 736 F.2d at 958. This burden is met by consideration of affidavits exhibits, depositions and other discovery materials.Id. Nevertheless, "[t]he facts, and the inferences to be drawn from the facts, must be viewed in the light most favorable to the party opposing the motion." Ballinger v. North Carolina Agric. Extension Serv., 815 F.2d 1001, 1004-05 (4th Cir. 1987), cert.denied, 484 U.S. 897 (1987) (citing Ross v. Communications Satellite Corp., 759 F.2d 355, 364 (4th Cir. 1985)).
Following its review of the record here, this Court has concluded that the disputed issue of negligence which arises in this case under plaintiff's claim against defendant Youth Services cannot be resolved before trial by way of the pending motion for summary judgment. Where facts are disputed, a court, in considering a defendant's motion for summary judgment, must accept the plaintiff's version of the events if supported by deposition testimony, exhibits or other documentary evidence. See Magnuson v. Peak Technical Servs., Inc., 808 F. Supp. 500, 504 (E.D. Va. 1992). Insofar as plaintiff's claim of negligence against defendant Youth Services is concerned, there are a number of disputed questions of material fact which cannot now be determined on this record as a matter of law.
III Discussion
In support of its motion for summary judgment, defendant Youth Services contends (1) that it discharged any duty to provide reasonable health care to plaintiff by retaining Drs. Klupt and Purohit to render dental treatment; (2) that plaintiff cannot in the absence of the requisite expert testimony establish that defendant Youth Services breached the applicable standard of care owed by it to the plaintiff; and (3) that the record establishes as a matter of law that defendant Youth Services did not improperly interfere with plaintiff's dental care and did not act improperly with respect to authorizing plaintiff's dental care and treatment.
In advancing these arguments, defendant Youth Services miscomprehends the precise nature of plaintiff's claim against it. This defendant has not been charged with dental malpractice. Rather, plaintiff has alleged that Youth Services was negligent in authorizing the extraction of plaintiff's teeth and in failing to secure the consent of plaintiff's parents for this dental treatment. Plaintiff is not in this case asserting that Victor Cullen failed to offer him legally adequate dental treatment. Defendant's reliance on State v. Johnson, 108 Md. App. 54 (1996) is therefore misplaced. The claim is that defendant Youth Services, as custodian of the juvenile plaintiff, violated the duty of due care owed by it to him.
Under Maryland law, negligence is doing something that a person using ordinary care would not do or not doing something that a person using ordinary care would do. MPJI 19:1. Ordinary care means that caution, attention or skill a reasonable person would use under similar circumstances. Id. Negligence is a relative term and must be decided upon the facts of each particular case. Fowler v. Smith, 240 Md. 240, 246 (1965). As the Court of Appeals has stated in an oft-quoted passage in that case (Id.):
Ordinarily [negligence] is a question of fact to be determined by the jury, and before it can be determined as a matter of law that one has not been guilty of negligence, the truth of all the credible evidence tending to sustain the claim of negligence must be assumed and all favorable inferences of fact fairly deducible therefrom tending to establish negligence drawn. . . . And Maryland has gone almost as far as any jurisdiction that we know of in holding that meager evidence of negligence is sufficient to carry the case to the jury. The rule has been stated as requiring submission if there be any evidence, however slight, legally sufficient as tending to prove negligence, and the weight and value of such evidence will be left to the jury.
(Emphasis supplied.)
See also Giant Food, Inc. v. Scherry, 51 Md. App. 586, 592 (1982).
On the record here, this Court is satisfied that there is sufficient evidence of negligence on the part of defendant Youth Services, when viewed in a light favorable to the plaintiff, to indicate that there is in this case a genuine dispute of material fact as to that issue. The testimony of Terry Doster ("Doster"), the doctors' receptionist, is crucial in this respect. She testified at her deposition that she contacted a nurse at Victor Cullen seeking authorization for dental treatment of Johnson by Drs. Klupt and Purohit. She told the nurse that either a root canal or an extraction of Johnson's teeth was needed. Doster testified that she was in turn told by the nurse that Victor Cullen wanted the teeth extracted. When this information was relayed to Dr. Purohit, he complied with these instructions and proceeded to extract the four teeth in question. Defendant's attack on the veracity of Doster's testimony is unavailing. Clearly, questions of credibility cannot be determined by the Court on a motion for summary judgment. Batchelor v. Legg Co., 52 F.R.D. 553, 561 (D. Md. 1971).
Evidence of record indicates that the Victor Cullen nurse who was contacted by Doster gave no reason for authorizing the extraction of plaintiff's teeth rather than the root canal treatment. The nurse was told by Doster that plaintiff's teeth could be saved, or that if Victor Cullen decided not to choose the root canal option, the alternative was to extract the teeth. Dr. Gabriel R. Coulon, one of plaintiff's experts, has testified that it was a violation of the applicable standard of care to extract plaintiff's four front teeth. According to him, attempts should have been made to restore and save plaintiff's teeth. Doster's testimony indicates that the Victor Cullen nurse did not, before authorizing the extractions, seek further information concerning the nature of and the cost of the root canal work, which was one of the options recommended by the dentists. Moreover, although it was the policy of Victor Cullen to notify the parents of a resident juvenile of a major procedure like a tooth extraction and secure the parents' consent before the extraction was undertaken, there was no such notification and consent in this case.
These circumstances are sufficient to support plaintiff's claim that defendant Youth Services acted negligently and that its negligence caused harm to plaintiff Johnson. As a committed juvenile, plaintiff Johnson was a ward of Victor Cullen which had a guardianship responsibility to make prudent decisions concerning dental treatment for this minor. Victor Cullen had a duty to obtain sufficient information concerning the choices outlined by the dentists before making a final decision as to the treatment options. The record here, viewed in a light favorable to plaintiff, supports the assertion that Victor Cullen's failure to satisfy that duty amounted to actionable negligence.
Although much of the evidence of defendant's negligence is sharply disputed, it will be for the jury to resolve the disputes of fact. Contrary to defendant's contention, no expert testimony is required to support the claim of negligence asserted by plaintiff against Youth Services. If the jury credits the evidence relied upon by plaintiff, it would be entitled to find that defendant Youth Services did not exercise due care in authorizing the extraction of four of plaintiff's teeth without the consent of his parents.
Defendant further contends that the prior consent of plaintiff's parents was not required because they had signed a form granting permission for plaintiff to have dental treatment performed. However, this form also indicates that plaintiff's parents were entitled to notification of any dental surgery to which they may have consented. There was no such notification here. In view of testimony indicating that it was the policy of Victor Cullen to secure the consent of the parents for a major dental procedure like an extraction, it will be for the jury to determine whether under the circumstances here defendant was negligent in failing to secure the consent of plaintiff's parents before authorizing the extraction of his teeth.
Defendant Youth Services argues that in her testimony Doster remembered calling Victor Cullen only with respect to two rather than four of plaintiff's teeth. However, Doster has also testified that, although she does not remember the word-for-word response of the Victor Cullen nurse to her inquiry, she was basically told "that they wanted the teeth extracted." Dr. Purohit has testified that Dr. Klupt told him that he had communicated with Victor Cullen, and that all four teeth were to be extracted. Viewing this evidence in a light favorable to the plaintiff, this Court concludes that there is sufficient evidence of negligence in the record to support plaintiff's claim that Victor Cullen personnel did not use ordinary care in authorizing the extraction of all four of plaintiff's teeth without the consent of his parents.
IV Conclusion
For all the reasons stated, this Court has concluded that defendant Youth Services is not on the record here entitled to the entry of summary judgment in its favor. Accordingly, it is this _____ day of June, 1999 by the United States District Court for the District of Maryland,
ORDERED that the motion for summary judgment of defendant Youth Services International of Maryland, Inc. is hereby denied.