The plaintiff, Karen Guerri, the administrator of the estate of Craig S. Guerri (decedent), appeals from the judgment of the trial court rendered after a jury verdict in favor of the defendant Mark Fiengo, a cardiologist.
The following facts and procedural history are relevant to the present appeal. At approximately 8 a.m. on December 17, 2006, the decedent, suffering from chest pains and numbness in his left arm, went to the emergency room of the Pequot Treatment Center in Groton. Pursuant to established procedures, a triage nurse performed an electrocardiogram. The results of the electrocardiogram indicated an "abnormal result."
On March 16, 2009, the plaintiff commenced the present action against the defendant alleging medical malpractice. Paragraph 20 of the operative complaint, filed on June 10, 2010, alleged that the defendant was negligent in that he: "(a) failed to record a complete and accurate reading of the electrocardiogram that had been taken from the decedent ... that morning, (b) failed to call the Pequot
At trial, the plaintiff offered the expert testimony of Mark Schiffer, a board certified cardiologist. On direct examination, the plaintiff's attorney questioned Schiffer about the standard of care applicable to each allegation of negligence contained in the complaint. Schiffer offered the following testimony relating to the allegation of negligence contained within paragraph 20(b):
"Q. What is the standard of care regarding calling the emergency room doctor caring for the patients with ... critical findings [on their electrocardiogram]?
"A. The standard of care requires the interpreting cardiologist to call the referring doctor, or the treating doctor, to inform him of the critical findings."
Shortly thereafter, Schiffer offered the following testimony relating to the allegation of negligence contained within paragraph 20(h):
"Q. What is the standard of care regarding the cardiologist's duty to contact the people at [the] treatment center and/or the treating physician to further discuss issues concerning the patients?
"A. In the course of calling to report the critical findings, the standard of care would be to have a discussion if initiated by the treating physician regarding circumstances of the case to shed further light on the clinical situation to further aid the doctor in making the most accurate interpretation of the treating possible."
During cross-examination, defense counsel asked Schiffer the following question: "[I]f the overreader reads the [electrocardiogram] and is of the opinion that it does not present evidence of a critical value then he was to record his interpretations and that interpretation then gets filed?" Schiffer responded, "Yes." Defense counsel continued: "You're not suggesting that every single [electrocardiogram] that has on it from the computer `abnormal' requires the overreader to [contact] the ordering physician?" Schiffer responded, "Certainly not."
After the close of evidence, the defendant objected to the court's proposed jury instructions pertaining to the allegation of negligence set forth in paragraph 20(h), arguing that the broadness of the allegation would require an overreading cardiologist to contact the treating physician in every circumstance but that the standard of care established by Schiffer's testimony requires such contact only when a critical value is present. The court agreed and, accordingly, refused to instruct the jury on the allegation of negligence set forth in paragraph 20(h). The jury subsequently returned a verdict in favor of the defendant. This appeal followed.
On appeal, the plaintiff claims that the court erred in concluding that Schiffer's testimony did not demonstrate that the standard of care owed by the defendant as an overreading cardiologist included a duty to contact Alper despite the absence of a critical value. The plaintiff argues that, as a result, the court improperly prevented the jury from considering the allegation of negligence contained within paragraph 20(h).
"Our standard of review concerning claims of instructional error is well settled.... The trial court must adapt its instructions to the issues raised in order to give the jury reasonable guidance in reaching a verdict and not mislead them.... Claims of error addressed to the [jury] charge are tested by the pleadings and by the evidence.... The court has a duty to submit to the jury no issue upon which the evidence would not reasonably support a finding.... The court should, however, submit to the jury all issues as outlined by the pleadings and as reasonably supported by the evidence." (Citation omitted; internal quotation marks omitted.) Rua v. Kirby, 125 Conn.App. 514, 516-17, 8 A.3d 1123 (2010); see also DiLieto v. County Obstetrics & Gynecology Group, P.C., 297 Conn. 105, 136, 998 A.2d 730 (2010). "When reviewing a trial court's decision that the evidence was not sufficient to support the submission of an issue to the jury, we must consider the evidence produced by the plaintiff in the light most favorable to him.... Whether the plaintiff has established a prima facie case entitling the plaintiff to submit a claim to a trier of fact is a question of law over which our review is plenary." (Citation omitted.) DiStefano v. Milardo, 276 Conn. 416, 421-22, 886 A.2d 415 (2005).
The elements of a medical malpractice claim are well established. The plaintiff is required to prove the following by a preponderance of the evidence: "(1) the requisite standard of care for treatment, (2) a deviation from that standard of care, and (3) a causal connection between the deviation and the claimed injury." (Internal quotation marks omitted.) Hayes v. Camel, 283 Conn. 475, 484, 927 A.2d 880 (2007). "Physicians are required to exercise the degree of skill, care, and diligence that is customarily demonstrated by physicians in the same line of practice.... To prove that a physician has breached the standard of care, the plaintiff must produce some evidence that the conduct of the physician was negligent....
The allegation of negligence at issue in the present case is that the defendant "failed to contact the Pequot Treatment Center and/or the treating physician to further discuss the [decedent]." This paragraph alleges that an overreading cardiologist has a duty to discuss every electrocardiogram with the treating physician. The record contains no evidence supporting such a standard of care. Indeed, Schiffer's testimony affirmatively indicates that the overreading cardiologist has a duty to contact the treating physician when a critical value is present. Specifically, when questioned directly by the plaintiff's attorney about the standard of care applicable to the allegation of negligence contained in paragraph 20(h), Schiffer stated that "[i]n the course of calling to report the critical findings, the standard of care would be to have a discussion if initiated by the treating physician regarding circumstances of the case to shed further light on the clinical situation...." (Emphasis added.)
The plaintiff contends that, despite the previously cited testimony of Schiffer, the standard of care required to support the allegation of negligence contained within paragraph 20(h) may be found elsewhere in Schiffer's testimony. Specifically, the plaintiff draws this court's attention to a portion of Schiffer's testimony regarding the issue of lead misplacement.
The judgment is affirmed.
In this opinion the other judges concurred.