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Raven Taylor v. the County of Cook

July 21, 2011

RAVEN TAYLOR,
PLAINTIFF-APPELLANT,
v.
THE COUNTY OF COOK, A BODY POLITIC, D/B/A JOHN H.STROGER, JR. HOSPITAL, AND OAK FOREST HOSPITAL,
VIGNESH NARAYANAN, JANE PERRIN, SARITA BAJRACHARYA, JOEL BLOCK, AUGUSTINE MANADAN, SERGEY FURMANOV, THERESA MCCARTHY, ERNEST CHENG, AND MIA MARIKA G. LAZO, DEFENDANTS-APPELLEES.



Appeal from the Circuit Court of Cook County No. 06 L 004953 The Honorable Donald J. O'Brien, Judge Presiding.

The opinion of the court was delivered by: Justice Sterba

2011 IL App (1st) 093085

JUSTICE STERBA delivered the judgment of the court, with opinion. Justices Pucinski and Salone concurred in the judgment and opinion.

OPINION

¶ 1 In this medical malpractice case based on doctors' negligence, the jury found in favor of defendant doctors Joel Block, Augustine Manadan and Serger Furmanov and defendant Cook County Hospital. Plaintiff Raven Taylor appeals the circuit court's evidentiary rulings claiming that the errors resulted in prejudice and affected the outcome of her case. Taylor claims that the circuit court abused its discretion when it: (1) barred cross-examination of an expert witness concerning personal practice in treating patients diagnosed with polymyositis; (2) allowed Dr. Block's expert to testify regarding the applicable "standard of care" despite the expert's lack of understanding of the term "standard of care"; (3) allowed multiple experts to testify regarding the standard of care, causation and damages on the defendants' collective behalf; and (4) allowed defendants' experts to testify in violation of Illinois Supreme Court Rule 213(f) (eff. Jan. 1, 2007). Taylor also claims that the circuit court erred when it ruled that Taylor raised a new claim of lack of informed consent during trial. Taylor further claims that the circuit court erred in limiting the admissibility of her expert's testimony since the testimony was a logical corollary to disclosed opinions. Regarding the jury instructions, Taylor claims that the circuit court abused its discretion in modifying two instructions, which dealt with inconsistent witness conduct and adjustment of verdict awards. Taylor's last claim is that the errors deprived her of a fair trial. For the reasons stated below, we affirm.

¶ 2 I. BACKGROUND

¶ 3 The following facts are relevant to the instant appeal. In May 2005, Dr. Furmanov was a rheumatology fellow at the Cook County Hospital Rheumatology Clinic. Dr. Block supervised Dr. Furmanov in May 2005. Dr. Manadan supervised Dr. Furmanov in June 2005. In May 2005, Taylor was diagnosed with severe polymyositis, which is an inflammation of the muscles and results in weakened muscles. Defendant doctors diagnosed Taylor and began treating her for the condition. Taylor's polymyositis rapidly progressed, leaving her with permanent disabilities.

¶ 4 On May 11, 2006, Taylor filed an 11-count complaint. Taylor filed an amended four count complaint on April 20, 2009, which included the following counts: (1) negligence: Cook County Hospital; (2) negligence: Joel Block; (3) negligence: Augustine Manadan; and (4) negligence: Sergey Furmanov.

¶ 5 Taylor's jury trial took place from April 15, 2009, through May 6, 2009. Before the trial began, the parties filed motions in limine. Dr. Block filed a motion in limine to bar cross- examination of his expert, Dr. Amato, regarding his personal practice in treating patients with polymyositis. The circuit court granted this motion. Taylor filed a motion in limine to bar defendants' experts' testimony on the basis that the testimony was cumulative and the defense was aligned. Taylor claimed that the testimony regarding causation and standard of care would be cumulative and overwhelming because testimony regarding those issues would be provided by the defendants' three experts, the defendant doctors individually and three doctors employed at defendant hospital. Thus, Taylor claimed that each defendant would have nine doctors testifying regarding the standard of care. The circuit court denied this motion.

¶ 6 During the trial, Taylor testified on her behalf. Taylor called Dr. Anthony Bohan, as an expert, to testify regarding the standard of care defendants provided to Taylor and in treating polymyositis. Taylor's and Dr. Bohan's testimony is summarized below. Defendant Cook County Hospital called Dr. Oddis as an expert, and Dr. Block called Dr. Wortmann and Dr. Amato as experts. Defendants' experts testified regarding the applicable standard of care in treating polymyositis, and on the issues of causation and damages. Defendants' experts' testimony is summarized below.

¶ 7 During trial, Taylor testified that she was 19 years old in the spring of 2005 and was attending Butler University located in Indianapolis. Taylor went to the emergency room in March 2005 because she had a migraine and was losing her peripheral vision. Taylor was sent home with ibuprofen. Taylor began struggling to get to her class on the third floor of a building when she took the stairs carrying her backpack. Approximately two weeks later after returning to the Chicago area, Taylor went to Oak Forest Hospital because she was very stiff and her joints and knees hurt. The hospital admitted Taylor and she stayed there for two or three days. Taylor was discharged from the hospital and returned to school. The doctor at Oak Forest Hospital scheduled an appointment for Taylor at the gastrointestinal clinic at Cook County Hospital on April 22, 2005. Taylor went to the appointment and stated that she was achy and that her joints and body were hurting. Taylor returned to Cook County Hospital on April 26, 2005, and described the same ailments to the doctors. Taylor again returned to Cook County Hospital on May 3, 2005, but this time she was accompanied by her aunt, Gwendolyn Johnson. When they arrived at the clinic, Johnson retrieved a wheelchair for Taylor because she was walking very slowly. On May 4, 2005, Taylor was admitted into Cook County Hospital. Taylor's mom took her to the hospital because a doctor told Johnson that Taylor's kidneys were failing.

¶ 8 Taylor was admitted at Cook County Hospital from May 4 through May 10, 2005. During her hospital admission, Taylor saw Dr. Furmanov twice, and she became more weak. Taylor needed a muscle biopsy to confirm a diagnosis of polymyositis. While she was at Cook County Hospital, Taylor received prednisone to treat the suspected diagnosis of polymyositis. Doctors Block and Furmanov did not discuss other treatment options with Taylor. Taylor was transferred to Oak Forest Hospital to receive in-patient physical therapy. Taylor's diagnosis of polymyositis was confirmed while she was at Oak Forest Hospital and she began doing passive range of motion exercises.

¶ 9 Taylor visited the rheumatology clinic at Cook County Hospital on May 27, 2005. Because Taylor was unhappy at Oak Forest Hospital, she asked Dr. Furmanov if she could be discharged from that hospital. Dr. Furmanov agreed to the request since her family could learn the daily activity care that she was receiving at Oak Forest Hospital. Dr. Furmanov prescribed azathioprine as additional medicine and did not give her any other treatment options. Taylor was discharged from Oak Forest Hospital on June 4, 2005. On approximately June 10, 2005, Taylor returned to the rheumatology clinic at Cook County Hospital. Taylor only remembers that she saw Dr. Manadan during this visit. Taylor testified that she has been on steroids continuously since May 6, 2005.

¶ 10 Dr. Anthony Bohan testified as an expert on Taylor's behalf. Dr. Bohan is a rheumatologist who treats patients diagnosed with polymyositis. Dr. Bohan has experience with hundreds of polymyositis cases throughout his career and has seen approximately five severe polymyositis cases like Taylor's. Polymyositis is a disease that occurs when the immune system begins to attack the muscle fibers and causes inflammation of the muscles. A patient who first develops polymyositis experiences weakness, tiredness and fatigue. When the symptoms progress enough for the patient to visit a doctor, a doctor performs a blood test. The results of the blood test reveals an increase in CPK enzymes in the bloodstream. The CPK enzyme level informs the doctor that there is inflamation of the muscle because the CPK enzymes leak out of the muscle fibers into the blood when there is inflammation or damage to the muscle fibers. In severe polymyositis cases, muscle weakness develops very rapidly and deteriorating muscle strength is apparent. The muscles in a severe polymosits case become swelled and inflamed, causing muscle pain. As the disease progresses, the patient experiences difficulty breathing because the chest muscles do not have the strength to expand the lungs, difficulty swallowing because the muscles in the esophagus do not work and difficulty eating, requiring a gastric tube.

¶ 11 Dr. Bohan stated that a corticosteroid, such as prednisone, is commonly used to reduce the muscle inflamation. Solu-Medrol is the intravenous (IV) form of prednisone and is marginally stronger than prednisone. Immunosuppressive drugs suppress the immune system.

The drug Imuran and its generic equivalent azathoprine is also used to treat polymyositis, as is the drug methotrexate, which are immunosuppressive drugs. Imuran takes months to work and methotrexate works in weeks. Prednisone begins to work in four hours and in treating polymyositis shows its effect within days. Providing Solu-Medrol or IV pulse therapy three days in a row typically demonstrates effects in treating polymyositis within days.

¶ 12 Dr. Bohan testified that defendants breached the standard of care causing severe and permanent injury to Taylor. When Taylor was seen at Cook County Hospital on May 4, 2005, her illness had been progressing for approximately six weeks. While Taylor was admitted at Cook County Hospital, the polymyositis progressed and her strength upon discharge to Oak Forest Hospital deteriorated to essentially zero. Also during her admission at Cook County Hospital, her CPK enzyme level "was hugely elevated" denoting the fact that "very, very aggressive inflammation going on in her muscles at that time." Dr. Bohan also expressed the opinion that the defendant doctors Block and Furmanov did not render treatment to Taylor on May 6, 2005, that complied with the standard of care because they prescribed 60 milligrams of prednisone even though she had an extraordinarily rapid and severe disease that required much more aggressive treatment. Dr. Bohan opined that "the standard of care required much more aggressive treatment, she should have been treated right off the bat day one with at least 100 milligrams of Prednisone, not 60, maybe 120." Dr. Bohan further opined that "the standard of care required either intravenous high dose-very high dose methylprednisolone, Medrol, SoluMedrol, 1,000 milligrams IV for three days and/or-and/or 100 to 120 milligrams of Prednisone per day, that was the standard of care." Dr. Bohan also stated that immunosuppressives, such as methotrexate, should have been initiated within a week of prescribing prednisone.

¶ 13 Dr. Bohan's opinion was that Taylor's transfer from an acute care hospital to a rehabilitation facility worsened her condition. Dr. Bohan believed that continuous monitoring by a rheumatologist at the time of transfer was critical. Dr. Bohan also stated that rehabilitation doctors are experienced in providing rehabilitative care, but are not experienced in treating a patient with polymyositis.

¶ 14 Dr. Bohan's opinion was also that defendants deviated from the standard of care following Taylor's May 27, 2005, office visit. According to Dr. Bohan, the standard of care required Dr. Furmanov to transfer Taylor back to Cook County Hospital for careful monitoring and to increase the dosage of prednisone, as well as starting Taylor on methotrexate, a more rapidly acting drug than Imuran, which the doctors prescribed for Taylor. Dr. Bohan also expressed his opinion that due to the treatment that defendants provided to Taylor, the polymyositis became more refractory to treatment and more damage occurred to Taylor's muscles. When a disease becomes refractory to treatment, the disease is more difficult to bring under control at a later stage than it would have been if it was treated at an earlier stage. When treating a patient, a window of opportunity to treat the disease exists, and if the disease is untreated within that window, the disease becomes refractory to treatment.

¶ 15 Dr. Chester Oddis testified on behalf of Cook County Hospital. Dr. Oddis specializes in rheumatology with a special interest in myositis, which includes polymyositis. Dr. Oddis testified that there are a variety of options to treat polymyositis, which is a rare disease. The hallmark therapy is high-dose prednisone therapy. The disease could also be treated with an intravenous steroid or with an immunosuppressive. Dr. Oddis testified that doctors Manadan, Block and Furmanov complied with the standard of care in treating Taylor. Specifically, it was within the standard of care for doctors Block and Furmanov to treat Taylor with 60 milligrams of prednisone. Doctors Furmanov and Block also complied with the standard of care when they allowed Taylor to transfer to Oak Forest Hospital for rehabilitative treatment. Doctors Furmanov and Block also complied with the standard of care on May 27, 2005, when they continued Taylor on 60 milligrams of prednisone and added 100 milligrams of azathioprine. Dr. Oddis further opined that it would have been within the standard of care to treat Taylor with methotrexate. During Taylor's June 10, 2005 visit, it was within the standard of care for doctors Manadan and Furmanov to maintain Taylor on 60 milligrams of prednisone and increase the dosage of azathioprine from 100 to 150 milligrams.

¶ 16 During cross-examination, Dr. Oddis testified that when Taylor was transferred to Oak Forest Hospital for rehabilitation, doctors Block and Furmanov were required to provide instructions to the rehabilitation facility regarding her care. The instructions regarding physical therapy and the range of motion exercises would have been determined by the rehabilitation specialists in conjunction with the rheumatologist. Dr. Oddis testified that the standard of care required doctors Block and Furmanov to inform the doctors at Oak Forest Hospital that if Taylor's condition deteriorated, they must call and inform the rheumatologists of Taylor's weakening condition. On redirect, Dr. Oddis clarified that the decision of what type of therapy a polymyositis patient requires is not dictated by a rheumatologist, but by the rehabilitation doctor who is specialized in treating patients with neuromuscular diseases.

¶ 17 Dr. Robert Wortmann testified on behalf of Dr. Block. Dr. Wortmann practiced in rheumatology with a special subinterest in crystal-induced arthritis and in diseases that affect skeletal muscles. Dr. Wortmann testified that various options existed in 2005 to treat myositis.

According to Dr. Wortmann, the experts state that steroids are the first treatment for myositis and the dosage ranges from 60 milligrams a day to 1 or 2 milligrams per kilogram. Other options included treating the patient with IV steroids or use the combination of steroids and a medicine such as azathioprine or methotrexate. Dr. Wortmann opined that defendant doctors Block and Furmanov complied with the standard of care in treating Taylor from May 5 through May 27, 2005.

¶ 18 Dr. Anthony Amato testified through a videotaped evidence deposition on behalf of Dr. Block. Dr. Amato's specialty is in neurology, with a subspeciality in neuromuscular medicine and neuromuscular disease. Polymyositis is a neuromuscular disease. In 2005, multiple options existed within the standard of care to treat a patient with polymyositis. One option was to treat the patient with 60 milligrams of prednisone, as defendant rheumatologists did in treating Taylor. Other options included: (1) starting the patient with 100 milligrams of prednisone for two weeks and then reducing the treatment to every other day; (2) starting the patient with SoluMedrol IV for three days; (3) starting a second line agent, such as Imuran or methotrexate; (4) starting treatment with mycophenolate mofetil; and (5) starting IVIG therapy. Dr. Amato opined that Dr. Block complied with the standard of care in treating Taylor in 2005. Dr. Amato elaborated that there is no one right way to treat polymyositis nor are there two right ways to treat the disease because many treatment options exist.

¶ 19 During cross-examination, Dr. Amato stated that the drug methotrexate was a treatment option for Taylor. The side effects of methotrexate could have been discussed with Taylor. Dr. Amato also stated that a reasonably well-qualified rheumatologist and/or neurologist would be required to go over treatment options with Taylor.

¶ 20 Throughout the approximate three-week trial, numerous Rule 213 objections were raised by both parties and the circuit court sustained some and overruled other objections. During the jury instructions conference, the parties agreed that any instruction falling within the numeric sequence of 1.01 through 3.01 would be obtained from the 1995 Civil Illinois Pattern Jury Instructions, Civil (IPI). Taylor proposed the following two pattern instructions:

(1) Illinois Pattern Jury Instructions, Civil, No. 3.01 (1995) (hereinafter, IPI Civil (1995) No. 3.01), which states:

"The credibility of a witness may be attacked by introducing evidence that on some former occasion the witness made a statement or acted in a manner inconsistent with the testimony of the witness in this case on a matter material to the issues. Evidence of this kind may be considered by you in connection with all the other facts and circumstances in evidence in deciding the weight to be given to the testimony of that witness."

(2) Illinois Pattern Jury Instructions, Civil, No. 3.03 (Supp. 2008) (hereinafter, IPI Civil (Supp. 2008) No. 3.03), which states:

"Whether a party is insured or not insured has no bearing on any issue that you must decide. You must refrain from any inference, speculation, or discussion about insurance.

If you find for the plaintiff, you shall not speculate about or consider any possible sources of benefits the plaintiff may have received or might receive. After you have returned your verdict, the court will make whatever adjustments are necessary in this regard."

The circuit court modified the above proposed instructions. In IPI Civil (1995) No. 3.01, the circuit court deleted "or acted in a manner inconsistent" from the instruction. In IPI Civil (Supp. 2008) No. 3.03, the circuit court deleted the last sentence of the instruction. The jury found in favor of defendants on May 6, 2009. Taylor filed a posttrial motion on July 22, 2009, which the circuit court denied on October 2, 2009. Taylor timely appealed.

¶ 21 II. STANDARD OF REVIEW

¶ 22 A circuit court's evidentiary rulings regarding the admissibility of testimony and on a motion in limine are within its sound discretion and this court will not reverse such rulings unless the circuit court abused its discretion. Davis v. Kraff, 405 Ill. App. 3d 20, 28 (2010). A circuit court abuses its discretion when its ruling "is arbitrary, fanciful, unreasonable, or where no reasonable person would take the view adopted by the trial court." People v. Caffey, 205 Ill. 2d 52, 89 (2001). An abuse of discretion standard is highly deferential to the circuit court. Davis, 405 Ill. App. 3d at 28.

¶ 23 III. ANALYSIS

¶ 24 A. Expert Witness Testimony

¶ 25 On appeal, Taylor first raises four claims of error regarding the circuit court's rulings on the admissibility of defendants' expert witness testimony. First, Taylor claims that the circuit court abused its discretion in granting Dr. Block's motion in limine to exclude the cross-examination of Dr. Amato about his personal practice in treating a patient with severe polymyositis. Taylor claims that Dr. Amato stated in his evidence deposition that treatment with 60 milligrams of prednisone was within the standard of care, but stated in his discovery deposition that he provides three-day IV pulse therapy to patients with severe polymyositis.

Taylor claims that the circuit court erred when it did not allow Taylor to impeach Dr. Amato with his testimony that 60 milligrams of prednisone was within the standard of care, but in his practice, he prescribes IV pulse therapy to patients with severe polymyositis.

¶ 26 The circuit court did not abuse its discretion in granting Dr. Block's motion in limine limiting Taylor's cross-examination of Dr. Amato. During his evidence deposition, Dr. Amato stated that multiple treatment options exist that comply with the standard of care to treat a patient with severe polymyositis, which consisted of 60 milligrams of prednisone, 120 milligrams of prednisone and IV pulse therapy for three days. In treating his patients, Dr. Amato prefers the pulse therapy treatment option. Taylor sought to impeach Dr. Amato based upon his preference of using the pulse therapy to treat his patients exhibiting severe polymyositis. Dr. Amato's preference to use one of the three treatment options that he opined is within the standard of care to treat polymyositis does not give rise to permissible impeachment testimony. Dr. Amato's preference for one method is not inconsistent with his testimony that three treatment options exist, including his preferred option and the option used by defendants.

¶ 27 Taylor's reliance on Gallina v. Watson, 354 Ill. App. 3d 515 (2005), and Schmitz v. Binette, 368 Ill. App. 3d 447 (2006), is misplaced. In Gallina, a medical expert testified that his personal practice was to always treat type II fractures with surgery and the defendant physician did not violate the standard of care by not performing surgery on the patient, who had such a fracture. Gallina, 354 Ill. App. 3d at 521. This court held that the trial court abused its discretion in excluding the testimony because the testimony was relevant in establishing the expert's credibility in rendering his opinion that the defendant physician acted within the standard of care. Id. In Schmitz, the medical expert testified at trial that the standard of care did not require a doctor to perform an indigo carmine dye test and that the test was unreasonably dangerous and ineffective. Schmitz, 368 Ill. App. 3d at 461-62. During his deposition, the medical expert stated that he personally performed the test " 'quite readily, quite commonly.' " Id. at 461. This court held that the jury was entitled to hear the inconsistent testimony, which may have provided additional insight to the jury regarding the testimony. Id.

¶ 28 Here, the circuit court did not err in barring the cross-examination of Dr. Amato because no inconsistent testimony exists and Dr. Amato's credibility was not compromised based on his testimony. Dr. Amato's testimony that he would have treated Taylor using pulse therapy is not inconsistent with his testimony that prescribing 60 milligrams of prednisone as defendant doctors did to treat a patient with severe polymyositis was within the standard of care. Unlike in Gallina, Dr. Amato did not state that he always uses the IV pulse therapy or that he never uses the 60 milligrams of prednisone treatment provided by defendant doctors, thereby raising a question concerning his credibility. Dr. Amato also did not testify that treating a patient with pulse therapy was dangerous but that he nonetheless provides this treatment to patients, thereby raising a credibility issue for the jury to decide as in Schmitz. In light of the consistency in Dr. Amato's testimony as to the treatment options considered within the standard of care and his preference for one of the options, we conclude that the circuit court did not abuse its discretion in granting defendant Dr. Block's motion in limine to exclude Dr. Amato's personal practice testimony.

¶ 29 Taylor's second claim of error is that the circuit court abused its discretion in admitting Dr. Amato's standard of care testimony because he incorrectly defined the phrase "standard of care" during his discovery deposition. Taylor claims that to be consistent with Illinois pattern jury instructions, "standard of care" should be defined as "what a reasonably careful doctor would do or would not do under circumstances similar to those shown by the evidence." Taylor maintains that Dr. Amato's definition of "standard of care" as "what a reasonable physician might consider appropriate in terms of evaluation or treatment" was not a correct definition because Dr. Amato did not include "in the same or similar circumstances" in his definition. Taylor similarly contends that Dr. Amato's definition was incorrect because he defined the standard of care as "what a physician might do" instead of "what a physician would do." (Emphasis added in the words "might" and "would"). Thus, Taylor claims that the jury should not have considered Dr. Amato's testimony regarding the "standard of care" because his testimony was unreliable given his incorrect definition of "standard of care." Taylor claims that because Dr. Amato did not correctly define "standard of care," he did not understand what "standard of care" meant, rendering his testimony unreliable. Accordingly, Taylor claims that the circuit court abused its discretion in allowing Dr. Amato to testify regarding the standard of care in treating polymyositis.

¶ 30 The circuit court did not abuse its discretion in admitting Dr. Amato's standard of care testimony. Taylor's complained-of definition of "standard of care" provided by Dr. Amato was not submitted to the jury because it was stricken from Dr. Amato's evidence deposition and, thus, had no prejudicial impact upon the jury. Nonetheless, Taylor claims that Dr. Amato's standard of care testimony was unreliable because Dr. Amato misunderstood the correct meaning of "standard of care."

¶ 31 In medical negligence actions, the plaintiff bears the burden of establishing what the standard of care by which the defendant doctor's conduct is to be measured against through expert witness testimony. Advincula v. United Blood Services, 176 Ill. 2d 1, 24 (1996). For expert testimony to be admissible, an adequate foundation must be laid establishing that the information that the expert bases the opinion upon is reliable. Ford v. Gizzle, 398 Ill. App. 3d 639, 649 (2010). Expert testimony is admissible "if the proffered expert is qualified as an expert by knowledge, skill, experience, training, or education and the testimony will assist the trier of fact in understanding the evidence." Matuszak v. Cerniak, 346 Ill. App. 3d 766, 771-72 (2004).

¶ 32 Here, the omission of "from similar circumstances" in Dr. Amato's definition of "standard of care" and use of the word "might" instead of "would" does not render his testimony unreliable. Dr. Amato stated his qualifications in his evidence deposition, including his education, training and experiences as a physician treating patients with polymyositis. Ford, 398 Ill. App. 3d at 649. Dr. Amato based his testimony upon his experience as a specialist who treats polymyositis, what he has taught about the disease and what he has read through the literature. Dr. Amato's definition of the term "standard of care" and its failure to comply verbatim with the Illinois pattern jury instruction definition of the term does not render an otherwise reliable testimony unreliable. Since Dr. Amato is a medical physician who specializes in polymyositis, the circuit court did not abuse its discretion in admitting his testimony regarding the standard of care. Moreover, Dr. Amato's definition of "standard of care" was not submitted to the jury and the circuit court read the Illinois pattern jury instruction definition of "standard of care" to the jury. Thus, the jury would not have been misled by Dr. Amato's definition of "standard of care."

¶ 33 Taylor's third claim is that the circuit court erred in allowing defendants to elicit from multiple expert witnesses the applicable standard of care and causation testimony. Taylor contends that defendants' expert doctors, Oddis, Amato and Wortmann, testified that defendants all complied with the standard of care, and the experts all testified regarding causation and damages. Taylor claims that because the defendants had an aligned defense, expert testimony should have been limited based on the cumulative nature of the testimony. Taylor also claims that an imbalance existed regarding the evidence presented at trial because the circuit court granted defendants' motion in limine to limit Taylor's expert witnesses and to limit Taylor's aunt Johnson's testimony. Taylor maintains that the impact of the expert witnesses' testimony collectively was overwhelming, especially given their qualifications and the number of doctors permitted to testify resulting in prejudice to her case.

¶ 34 The circuit court did not abuse its discretion when it denied Taylor's motion in limine to bar defendants' expert testimony on the basis that the testimony was cumulative. Although doctors Oddis, Wortmann and Amato testified regarding the standard of care provided by defendants, doctors Oddis's and Wortmann's specialty was rheumatology whereas Dr. Amato's specialty was neurology. Dr. Block named Dr. Wortmann and Dr. Amato as expert witnesses and Cook County Hospital named Dr. Oddis as an expert witness. The testimony of these doctors collectively was not overwhelmingly prejudicial to Taylor's case.

¶ 35 When multiple defendants are named in a case, each defendant is entitled to present an expert in defense of the case. Tsoukas v. Lapid, 315 Ill. App. 3d 372, 383 (2000). Two rheumatologists provided expert testimony, but different defendants called these experts as witnesses. Taylor also claims as error the circuit court allowing Dr. Block to testify on his own behalf and stating that the treatment provided to Taylor was within the standard of care for all of defendants. The circuit court did not abuse its discretion in allowing a defendant to testify on his own behalf at trial. If Dr. Block's testimony benefitted the other defendants because he expressed his opinion that Taylor received medical care that complied with the standard of care, the circuit court did not abuse its discretion by admitting the testimony where multiple doctors cared for Taylor.

¶ 36 Dr. Oddis testified at trial on behalf of Cook County Hospital regarding the standard of care provided by defendant doctors working at the hospital. Dr. Oddis testified that doctors Manadan, Block and Furmanov complied with the standard of care in 2005 when they treated Taylor, and in starting treatment by prescribing 60 milligrams of prednisone. Dr. Oddis also testified that it was within the standard of care for doctors Furmanov and Block to transfer Taylor to Oak Forest Hospital. Dr. Oddis further testified that it was within the standard of care for Dr. Furmanov to continue Taylor on 60 milligrams of prednisone and adding 100 milligrams of azathioprine. Regarding the June 10, 2005 visit, doctors Manadan and Furmanov complied with the standard of care to maintain Taylor on 60 milligrams of prednisone and increase the dosage of azathioprine from 100 to 150 milligrams. Allowing Taylor to go home following the June 10, 2005, visit was also within the standard of care.

¶ 37 During trial, Dr. Wortmann testified as an expert witness on behalf of Dr. Block. Dr. Wortmann testified that doctors Block's and Furmanov's treatment of Taylor complied with the standard of care. Dr. Wortmann testified that it was within the standard of care for doctors Block and Furmanov to recommend 60 milligrams of prednisone for Taylor on May 6, 2005.

Dr. Wortmann further testified that it was within the standard of care for Dr. Furmanov on May 27, 2005, to continue Taylor on prednisone at a dose of 60 milligrams and adding azathioprine at a dose of 100 milligrams. Dr. Wortmann continued to testify that it was within the standard of care for Dr. Furmanov to allow Taylor to return to Oak Forest Hospital after her clinic visit on May 27, 2005.

ΒΆ 38 Dr. Amato participated in an evidence deposition testifying on Dr. Block's behalf. Dr. Amato specializes in treating patients with myositis. Thus, Dr. Amato stated that he is familiar with the standard of care applicable to a doctor diagnosing and treating a patient with polymyositis. Dr. Amato indicated that based upon his review of all the material and his background, training and experience, Dr. Block complied with the standard of care when he treated Taylor in 2005. According to Dr. Amato, it was within the standard of care for doctors Block and Furmanov to recommend 60 milligrams of prednisone for Taylor on May 6, 2005. Dr. Amato stated that it was appropriate at the May 27, 2005 clinic visit for Dr. Furmanov to recommend continuing prednisone at 60 milligrams and ...


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