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Joynt v. Barnes

OPINION FILED APRIL 19, 1979.

PATRICK D. JOYNT ET AL., PLAINTIFFS-APPELLANTS,

v.

ROBERT F. BARNES, M.D., ET AL., DEFENDANTS-APPELLEES. — (WILLIAM E. FREDERICK, M.D., ET AL., DEFENDANTS.)



APPEAL from the Circuit Court of Kane County; the Hon. PAUL W. SCHNAKE, Judge, presiding.

MR. JUSTICE LINDBERG DELIVERED THE OPINION OF THE COURT:

On July 3, 1974, the plaintiffs-appellants, Patrick and Shirley Joynt, filed an eight-count complaint alleging malpractice against six doctors and two hospitals. Prior to trial, motions for summary judgment were granted as to two of the defendants, Drs. William E. Frederick and Noel Strasser. This summary judgment is not being appealed. A jury was impaneled and after plaintiffs presented their case each of the remaining defendants moved for a directed verdict. The trial court directed verdicts in favor of four of the defendants, Drs. James C. Pritchard, Harry Slobodin, Geneva Community Hospital, hereafter referred to as Community Hospital, and Mercy Center for Health and Care Services, hereafter referred to as Mercy Center, and denied the motions for directed verdicts as to Drs. Robert F. Barnes and Richard C. Bodie. After hearing the evidence and arguments the jury returned a verdict in favor of Drs. Barnes and Bodie.

Plaintiffs appeal, contending that the trial court erred in granting a directed verdict for Drs. Pritchard and Slobodin, and the two hospitals, the jury's verdict in favor of Drs. Barnes and Bodie is contrary to the manifest weight of the evidence, and numerous prejudicial errors occurred during the course of this lengthy trial. We have reviewed the 5,040 pages of the trial transcript and the common law record and have considered the numerous arguments raised in the plaintiff's brief. It is our opinion that none of the issues raised by the plaintiffs nor any combination of them warrant a reversal. Accordingly, we affirm the judgment of the Circuit Court of Kane County.

On February 16, 1974, doctors, at Rush-Presbyterian-St. Luke's Hospital in Chicago, Illinois, not parties to this suit, diagnosed Patrick Joynt (hereafter referred to as Joynt) as having a form of tracheal cancer. It is the plaintiff's basic theory that the defendants committed malpractice by failing to correctly diagnose Joynt's condition. Plaintiffs further contend that as a result of this failure, Joynt was denied a possible course of treatment, namely surgery, that might have improved his prognosis.

This opinion would be lengthened needlessly if we engaged in a full discussion of the facts. Therefore we confine our discussion of the facts to the scope necessary to provide an explanation of our holding.

On October 22, 1973, Joynt went to the office of his family physician, Dr. Robert F. Barnes for the purpose of having a complete physical. On that day, besides having been Joynt's family physician for some twelve years, Dr. Barnes had a report from Dr. Noel Strasser, a radiologist, concerning chest X rays taken two days earlier at Community Hospital. Dr. Strasser's report stated he saw "a right peritrachael mass" and recommended a bronchoscopy or a scalene node biopsy. Dr. Barnes informed Joynt of the radiologist's suspicion of a mass, but did not inform him of the recommended tests. However, Dr. Barnes did refer him to a specialist in thoracic surgery, Dr. Richard C. Bodie, of Aurora, Illinois.

Dr. Bodie saw Joynt for the first time on October 27, 1973. After taking a case history and reviewing the X rays taken at Community Hospital, Dr. Bodie sent Joynt to Mercy Center for additional X rays. There the standard posterior-anterior (PA) and lateral views taken at Community Hospital were repeated, and a series of specialized X rays, known as laminograms, were taken. These additional X rays were ordered in part because Dr. Bodie did not agree with Dr. Strasser's interpretation of the X rays taken at Community Hospital on October 20, 1973.

The X rays and laminograms taken on October 27, 1973, at Mercy Center were interpreted by Dr. Harry Slobodin, a radiologist. His report indicated no abnormalities in either the standard PA and lateral views or in the laminograms. After reviewing all of the X rays himself, and reading Dr. Slobodin's report, Dr. Bodie wrote letters to Dr. Barnes and to Joynt, essentially informing each that he, Dr. Bodie, could find no evidence of a tumor in Joynt's chest. In those letters Dr. Bodie also recommended that Joynt stop smoking.

At this point it is necessary for us to review Joynt's medical history and to note what was undisputably known by Dr. Barnes and/or Dr. Bodie and what may or may not have been known by them in October of 1973.

Joynt became Dr. Barnes' patient in 1961, when he was 16 years of age. As a result of their long-standing doctor-patient relationship, Dr. Barnes knew, on October 22, 1973, that Joynt was 28 years old and that he had smoked between 1 and 4 packs of cigarettes a day since he was 16 years of age. At the time of the October 22, 1973, visit Joynt complained of a nonproductive cough lasting over the past six weeks. Dr. Barnes' notes also revealed that Joynt had been experiencing dyspnea (shortness of breath) for the previous three months, and that he had lost 18 to 20 pounds in the previous six weeks without dieting. There is no mention in the doctor's notes of that date of any complaint of wheezing or hemoptysis (spitting up of saliva mixed with blood). Prior to October 1973, the last time that Dr. Barnes had personally seen Joynt was in February 1973, when he had diagnosed him as having influenza syndrome with tracheitis (inflammation and infection of the trachea).

According to Dr. Bodie, Joynt reported to him many of the same symptoms he had reported to Dr. Barnes, although the time duration of some of them varied. For example, Dr. Bodie's notes reveal Joynt had complained of a nonproductive cough for the previous six months instead of the six weeks reported to Dr. Barnes. Dr. Bodie's notes are in conformity with Dr. Barnes' on the question of weight loss and the lack of wheezing or hemoptysis. However, Dr. Bodie's notes make no mention of dyspnea. Patrick Joynt also complained to Dr. Bodie that his voice had not returned to normal since an incident some six months earlier when he had lost it yelling at a fellow worker. There was evidence that the plaintiffs had telephoned Dr. Barnes for advice when the incident occurred and that he had advised Joynt that the problem was traumatic laryngitis and that his voice would return after a few days rest. While Joynt asserts that his voice never came back to normal, he never saw Dr. Barnes regarding the problem nor do Dr. Barnes' office records note any change in Joynt's voice.

From October 22, 1973, until January 16, 1974, Dr. Barnes saw Joynt on at least three occasions — November 6, November 30, and December 24, 1973. The plaintiffs contend that Dr. Barnes also saw Joynt on November 1, 1973, but Dr. Barnes' office records indicate that this was only a telephone conversation. The November 6 visit was for the purpose of running additional tests. These various tests failed to reveal anything new and the results were reported to Joynt at the November 30, 1973 office visit.

Based upon the letter from Dr. Bodie ruling out the possibility of a tumor, the negative results of the additional tests and Joynt's history of smoking and high-strung nature, Dr. Barnes diagnosed Joynt as suffering from chronic bronchitis with a manifestation of anxiety.

The December 24, 1973, consultation between Dr. Barnes and Joynt was made at Community Hospital where Dr. Barnes examined Joynt's knee which had been injured in a snowmobiling accident. At that time the doctor noted no new or changing symptoms, nor did Joynt make any additional complaints.

The next consultation between Dr. Barnes and Joynt occurred on January 16, 1974, when he came in for a physical prior to undergoing some rather extensive oral surgery. At that time Dr. Barnes found Joynt to be ill. He ruled out the oral surgery and prescribed inhalation therapy at Community Hospital for a condition he diagnosed as acute respiratory infection. Joynt did not respond to treatment and on January 21, 1974, he was admitted to Community Hospital after coming home from work completely exhausted and suffering from a fever.

Upon admission to Community Hospital, Joynt had the following symptoms: dyspnea, loss of voice, fatigue, and generalized pain in the chest. Chest X rays were taken on January 21, 1974, and revealed pleurisy in the right lung. This condition did not respond to treatment and eventually developed into bronchial pneumonia. During his hospital stay Joynt displayed two additional and disturbing symptoms. On at least one occasion he was observed to be wheezing and on January 25, 1974, for the first and only time he coughed up blood — hemoptysis. These new and disturbing symptoms plus a request by Joynt's wife prompted Dr. Barnes to once again call in Dr. Bodie.

On February 2, 1974, Dr. Bodie again examined Joynt and concluded that a bronchoscopy examination would be necessary to determine the cause of his medical problem. However, Dr. Bodie recommended that such an examination be put off until the pneumonia cleared up. Joynt was informed of the need of the bronchoscopy and a tentative appointment for the procedure was set for February 22, 1974.

Joynt finally responded to treatment for his pneumonia and was scheduled to leave Community Hospital on February 13, 1974. However, at the request of his wife, Shirley, he was allowed to stay for an additional day so that he could go directly from Community Hospital to Rush-Presbyterian-St. Luke's Hospital in Chicago where Shirley had arranged for him to be admitted on February 15, 1974. The next day, February 16, a bronchoscopy examination was performed on Joynt. The examination revealed a tumor at the lower end of the trachea, or windpipe, at the point where the trachea splits off to form the two main bronchial tubes to each lung. This point is called the carcina. A biopsy was performed which revealed the tumor to be a primary, poorly differentiated adenocarcinoma of the trachea. In layman terms the diagnosis of Joynt's condition means he was suffering from cancer of the poorly differentiated adenocarcinoma type of cell that had originally developed in the trachea. Subsequent examinations revealed Joynt had developed superior vena cava syndrome, which meant that the cancer had become involved in the superior vena cava — the vein that drains the blood from the upper part of the body into the heart. Because the superior vena cava cannot be surgically removed or replaced, superior vena cava syndrome totally precluded a surgical remedy for Joynt's unfortunate malady. Joynt's doctors at Rush-Presbyterian-St. Luke's Hospital, Drs. LeRoy Pittfield Faber, Charles Kittle and Robert Jensik, placed him on radiation and chemotherapy. This treatment may have been successful in prolonging Patrick Joynt's life beyond the time his doctors originally expected him to live. However, Joynt died on January 23, 1979.

An important factor in this case is that tracheal cancer is a relatively rare disease — only 400 cases have been reported in world medical literature. The type of cancer cell and the location of Joynt's tumor made his malady even more rare. Another factor making the situation in this case even rarer is the fact that he was only 28 years old at the time the lesion was discovered. Most ...


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