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Merritt v. United States

February 2, 2007


The opinion of the court was delivered by: Gilbert, District Judge


This matter comes before the Court on defendant Union County Hospital District's (UCHD) motion for summary judgment (Doc. 65). The plaintiff, Kenneth D. Merritt (Merritt), has responded (Doc. 67) and UCHD has replied to that response (Doc. 68). For the following reasons UCHD's motion for summary judgment will be GRANTED.


I. Merritt's Claim

On Saturday, March 22, 2003, Merritt was prying a nail when a piece of it broke off and struck him in his right eye. Dr. William Ribbing (Ribbing), an emergency room physician at Union County Hospital (owned by UCHD), treated Merritt on the day of the injury. Merritt contends that Ribbing was acting as an agent of UCHD when he negligently diagnosed and treated his injury and that his negligence -- as well as the negligence of several other doctors -- caused the loss of his eye. Merritt claims Ribbing deviated from the standard of care by failing to acquire a complete history of the care Merritt received from another doctor, failing to recognize the significance of the injury, failing to perform appropriate diagnostic procedures, failing to make a proper diagnosis of the injury and by treating the injury improperly. UCHD claims it has immunity from this claim under the Local Government and Governmental Employees Tort Immunity Act (Tort Immunity Act), 745 ILCS §§ 10/6-105 & 6-106(a).

II. Facts

Construing the evidence in the light most favorable to Merritt, and drawing all reasonable inferences in his favor, the admissible evidence establishes the following facts:

After Merritt was injured, he went to see his family physician, Dr. Charlot. Charlot examined his eye and observed a scratch or corneal abrasion; Charlot referred him to Dr. Michaelis Jackson, an ophthalmologist practicing in Carbondale, Illinois. Merritt's family drove him from Charlot's office in Cairo, Illinois to Jackson's office, but by the time they arrived, Jackson had left. On his way home, Merritt stopped at the emergency room at the Union County Hospital and saw Ribbing.

Merritt told Ribbing about the events of the day: that part of a nail had struck him in the eye, that Charlot saw a scratch or corneal abrasion and referred him to Jackson, that Jackson was not at his office and that he had stopped at the ER to get some pain medication for the weekend until he could meet with Jackson the following Monday. (Ribbing Dep. at 7). Initially, spasms in Merritt's eye made it difficult for Ribbing to perform an examination. Ribbing applied tetracaine, a topical anesthetic, which stopped the spasms and allowed him to begin his examination. At first, Ribbing did not see signs of significant injuries -- all he saw was dye residue left over from Charlot's examination. Upon closer inspection, he observed an abrasion over the central portion of the pupil. (Ribbing Dep. at 8-9). Based on Merritt's history and his examination, Ribbing concluded that the nail did not cause a perforation and that nothing was in the eye; in his words, the possibility of a penetrating injury "was nil." (Ribbing Dep. at 32).

Ribbing ruled out a perforation or penetrating injury -- and decided that no further tests, and no referral, were necessary -- for a number of reasons. First, as "a large piece of nail" hit Merritt in the eye, Ribbing would have expected to see "more substantial damage" had the nail actually pierced the eye. (Ribbing Dep. at 10). Second, he relied on the fact that Charlot had seen nothing more than a corneal abrasion. Third, given the size of the nail, he would have expected it to be clearly observable had it been in the eye. (Ribbing Dep at 10-11). Ribbing gave several slightly more technical reasons as well. In any event, Ribbing did not perform any additional diagnostic tests or refer Merritt to a specialist. (Ribbing Dep. at 15). He told Merritt that he had a corneal abrasion, placed an antibiotic ointment (gentamicin) in the eye, placed a patch on the eye, gave him pain medication and told him to come back to the emergency room the next day for a follow up. (Ribbing Dep. at 20). Merritt denies that Ribbing told him to come back the next day. Whatever the reason, Merritt did not go to the emergency room on March 23.

On March 24, Merritt went to see Jackson. After conducting a number of tests, Jackson diagnosed a perforated globe with endophthalmitis -- "the most severe infection [one] can acquire . . . imbedded in all layers of the eye" -- and a retained intraocular foreign body. (Jackson Dep. at 20). Jackson felt Merritt needed to see a retinal surgeon immediately and referred him to a doctor in St. Louis. (Jackson Dep. at 43). Merritt eventually had his eye removed by a surgeon in St. Louis.


I. Summary Judgment Standard

Summary judgment is appropriate where "the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law." Fed. R. Civ. P. 56(c); see Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986); Spath v. Hayes Wheels Int'l-Ind., Inc., 211 F.3d 392, 396 (7th Cir. 2000). In determining the existence of a genuine dispute of material fact, the Court construes all facts in the light most favorable to the nonmoving ...

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