Opinion
No. CV10-6002960S
May 19, 2011
FACTS
The Plaintiff, Julie Penry, brings this action against the Defendant, Yale New Haven Hospital (YNHH), seeking to recover for injuries and damages she claims to have sustained in a November 24, 2008 automobile accident.
On that date, at approximately 8:30 a.m., the Plaintiff was operating a vehicle on William Street in Shelton. After she brought her vehicle to a stop, in response to a stop sign at the intersection of William Street and Meadow Street, she was struck by a vehicle operated by Dr. Alma Tsyrulnik. As a result of the collision, the Plaintiff claims to have suffered injuries and damages.
At the time of the accident, Dr. Tsyrulnik was a resident physician, employed by Yale New Haven Hospital. She had completed a twelve-hour shift at the hospital, and was on her way home, when the collision occurred.
Dr. Tsyrulnik took responsibility for the accident at the scene. She admitted that the accident was her fault, and that she had fallen asleep while operating the vehicle (Deposition TR, p. 5).
After Dr. Tsyrulnik fell asleep at the wheel, her vehicle veered to the right, and struck the driver's side of the Plaintiff's automobile.
Prior to the accident, Dr. Tsyrulnik was on duty at YNHH. Her shift began at 7 a.m., on November 23, and ended at 7 a.m. on the morning of the accident. After completing her assigned shift, the doctor signed out, and left the hospital at approximately 7:20 a.m.
The work schedule for interns at YNHH required the physician to work four shifts in a row, each shift consisting of twelve hours. According to Dr. Tsyrulnik, the November 23 to November 24 shift was her third shift, in the four-shift rotation (Deposition TR, p. 13-14).
Yale New Haven Hospital governs the working hours of interns and residents, pursuant to a policy promulgated by Graduate Medical Education (GME). The regulations require an average of no more than eighty hours, over a four-week period (Deposition TR, p. 23).
The GME policy is adhered to by Yale New Haven Hospital, which has adopted its provisions.
The Plaintiff, Julie Penry, claims that the hospital was negligent, in permitting Dr. Tsyrulnik to work excessive hours without sleep prior to the accident, and further alleges that hospital personnel permitted her to leave the premises when it was unsafe for her to do so.
The Plaintiff does not allege that Dr. Tsyrulnik was operating her vehicle within the scope of her employment by Yale New Haven Hospital. She does maintain, however, that requiring the physician to adhere to the mandatory work schedule was negligent, and that the hospital's negligence was the proximate cause of the automobile accident.
The Defendant, Yale New Haven Hospital, has moved for summary judgment. It insists, as a matter of law, that it owed no duty of care to Julie Penry, and that any negligence on the part of the hospital was not the proximate cause of the November 24, 2008 accident.
SUMMARY JUDGMENT-STANDARD OF PROOF
A trial court may properly enter a summary judgment when documentary and other evidence demonstrate that no genuine issue of material fact remains between the parties, and that the moving party is entitled to judgment as a matter of law. Miller v. United Technologies Corp., 233 Conn. 732, 751 (1995); Daily v. New Britain Machine Co., 200 Conn. 562, 568 (1986). Summary judgment is appropriate, only if a fair and reasonable person could conclude only one way. Haesche v. Kissner, 229 Conn. 213, 216 (1994).
The party moving for summary judgment has the burden of establishing the absence as to any genuine issue as to all material facts. Suarez v. Dickmont Plastics Corp., 229 Conn. 99, 105 (1994). A material fact has been defined as one which will make a difference in the result of the case. United Oil Co. v. Urban Redevelopment Commission, 158 Conn. 364, 379 (1969). The test to be applied is whether the party seeking summary judgment would be entitled to a directed verdict on the same facts. Neuhaus v. Decholnoky, 280 Conn. 190, 199 (2006).
In determining a motion for summary judgment, a court is required to construe all of the evidence in the light most favorable to the non moving party. Rawling v. New Haven, 206 Conn. 100, 104 (1988).
Although the purpose of a motion for summary judgment is to test for the presence of contested factual issues, the use of a motion for summary judgment to challenge the legal sufficiency of a complaint is appropriate, where the effect cannot be cured through re-pleading. Larobina v. McDonald, 274 Conn. 392, 401 (1995).
YALE NEW HAVEN HOSPITAL (YNHH) OWED A DUTY TO THE PLAINTIFF
The Plaintiff claims that YNHH was negligent, and that its negligence was the proximate cause of the November 24, 2008 accident, and of the injuries she suffered as a result of the accident.
Negligence involves the breach of a duty owed by one person, to another. The existence of a duty of care, involves a legal conclusion about the relationships between parties made after the fact, and is a prerequisite for maintaining an action sounding in negligence. R.K. Constructors, Inc. v. Fusco Corp., 231 Conn. 381, 384-85 (1994); Lachowicz v. Rugens, 119 Conn.App. 866, 868 (2010). The existence of a duty is a question of law. Petriello v. Kalman, 215 Conn. 377, 382 (1990); Shore v. Stonington, 187 Conn. 147, 151 (1982). Only if a duty is found to exist, does the trier of fact then determine whether the defendant breached that duty, based upon the facts of the case. Mendillo v. Board of Education, 246 Conn. 456, 483 (1998).
The test for the existence of a legal duty entails a two-fold analysis: 1) a determination of whether an ordinary person in the defendant's position, knowing what the defendant knew or should have known, would anticipate that harm of the general nature of that suffered by the plaintiff was likely to result, and 2) a determination on the basis of public policy, of whether the defendant's responsibility for any negligent conduct should extend to the particular consequences or to the particular plaintiff in the case. Lodge v. Arett Sales Corp., 246 Conn. 563, 572 (1998); Jaworski v. Kiernan, 241 Conn. 399, 404-05 (1997).
The Defendant first argues that YNHH could not have foreseen that injury to Julie Penry was a likely result of its actions.
In determining whether injury to a plaintiff was foreseeable, the question is whether the ordinary person, in the defendant's position, knowing what it knew or should have known, would anticipate that harm of the general nature of that suffered by the plaintiff was likely to result, if care was not exercised. Frankovitch v. Burton, 185 Conn. 14, 20-21 (1981); Orle v. Connecticut Co., 128 Conn. 231, 237 (1941).
While all harms, with the flawless perspective of 20/20 hindsight, may be literally "foreseeable," due care does not require one to guard against eventualities which are too remote to be reasonably foresable. Lodge v. Arett Sales Corp., Supra, 575; Edwards v. Tardiff, 240 Conn. 610, 618 (1997); Noebel v. Housing Authority, 146 Conn. 197, 202 (1959).
Here, Dr. Tsyrulnik was a resident physician at YNHH, and had just completed working a twelve-hour shift, 7 p.m. to 7 a.m. at the hospital. The working hours were set unilaterally by the hospital, and were mandatory for resident physicians and interns.
Guidelines had been established, administratively, by the hospital, in order to regulate working hours. These guidelines, according to Dr. Tsyrulnik, were promulgated in response to litigation some years ago (Deposition TR, p. 21).
The Plaintiff, in her memorandum in opposition to the motion for summary judgment, quoted from a treatise entitled "Dying to Sleep, Using Federal Legislation and Tort Law to Cure the Effects of Fatigue on Medical Residency Programs." The article concerned the issue of sleep-deprived resident physicians falling asleep while driving, and posing a danger to themselves and others.
The hospital work schedule is not a matter of negotiation between the hospital, and its resident physicians. The work schedule, and the guidelines to be followed, are conditions of employment imposed on the physician.
Based upon an examination of the facts, construed most favorably to the Plaintiff, Julie Penry, it is found that the Plaintiff's claim against YNHH satisfied the requirement of "foreseeability" in an action sounding in negligence.
However, the fact that harm to the Plaintiff is foreseeable does not end the inquiry, and is not sufficient, standing alone, to establish the existence of a duty.
Even though a particular harm is foreseeable, for public policy reasons, recovery may not be allowed. Maloney v. Conroy, 208 Conn. 392, 400-01 (1988). In order to satisfy the test for existence of duty, it must be determined, as a matter of law, that the defendant's responsibility should extend to the result. Mazurek v. Great American Ins. Co., 284 Conn. 16, 29-30 (2007).
Yale New Haven Hospital argues that it owed no duty to Julie Penry, in that it was not in control of the situation which produced her injuries. The hospital maintains that it could not prevent a resident physician from driving an automobile following a shift, and that no hospital employee realized that Dr. Tsyrulnik was unable to drive a vehicle, when she left YNHH at 7:20 a.m.
To impose a duty under these circumstances, the hospital argues, is inappropriate, as a matter of public policy, because a duty would be owed to every operator of a motor vehicle on a public highway.
This argument is not persuasive.
As a matter of hospital policy, YNHH requires interns and residents work a twelve-hour shift, and to treat patients in need of medical care. It recognizes that sleep deprivation may affect the quality of medical care, and has adopted a policy concerning the number of hours to be worked.
The Defendant's reliance upon Weigold v. Patel, 81 Conn.App. 347 (2004), is not well taken.
In Weigold, the question concerned the duty of a psychiatrist or a psychologist to warn a patient not to operate a motor vehicle, after taking a dosage of prescribed medication. The patient subsequently fell asleep, while driving a vehicle.
In that case, the court determined that the physicians were powerless to control the activities of the patient. Weigold v. Patel, supra, 354.
Here Yale New Haven Hospital controlled the work schedule of its resident physicians, and adopted policies governing the number of hours worked. The hospital was in control of the work environment, and established the conditions of employment.
The ability to "control" the actions of the employee, was also absent in Luderman v. East Hartford ( 2004 WL 3049746) (Levine, J.). In that case the employee, a diabetic, left work, because she was feeling ill. Her condition was not connected with her employment.
On the facts provided here, the number of hours worked by resident physicians has been discussed and debated. Literature has been devoted to the subject, and the effects of prolonged sleep deprivation are known to hospital and medical personnel.
Based upon the facts of this case, it is therefore found that a duty of care exists on the part of Yale New Haven Hospital, and that duty was owed to the Plaintiff, Julie Penry.
The Plaintiff may recover for a breach of that duty.
PROXIMATE CAUSE PRESENTS A QUESTION OF FACT
The Defendant also argues that any negligence on the part of Yale New Haven Hospital, cannot, as a matter of law, be the proximate cause of the automobile accident of November 24, 2008.
To prevail in a negligence action, a plaintiff must establish that the conduct of the defendant legally caused his injuries. Wu v. Fairfield, 204 Conn. 435, 438 (1987). There are two components to the test for legal cause, 1) causation in fact — or whether the injury would have occurred but for the act of the defendant, and 2) proximate cause. Paige v. St. Andrews Roman Catholic Church Corp., 250 Conn. 14, 24-25 (1999). Proximate cause has been defined as an actual cause (cause in fact), that is a substantial factor in causing the resulting injury or harm. Barry v. Quality Steel Products, Inc., 263 Conn. 424, 446 (2003); Boehm v. Kish, 201 Conn. 385, 391 (1986)
The existence of proximate cause of an injury is determined by looking from the injury, to the negligent act complained of, for the necessary connection. Petersen v. Oxford, 198 Conn. 740, 749 (1983); Miranti v. Brookside Shopping Center, 159 Conn. 24, 29 (1969).
The question of proximate cause, except in unusual circumstances, is a question of fact for the jury. The question should be submitted to the trier of fact, if there is room for reasonable disagreement. Hughes v. National Car Rental, Inc., 22 Conn.App. 586, 590 (1990).
While YNHH had no ability to prevent Dr. Tsyrulnik from operating her vehicle on the morning of November 24, 2008, the trier of fact could find that the policy it employed concerning hours worked was negligent, and that negligence was a substantial factor in impairing Dr. Tsyrulnik's ability to drive a vehicle.
It cannot be said, as a matter of law, that any negligence on the part of YNHH was not a substantial factor in causing both the accident of November 24, 2008, and any resulting personal injuries to Julie Penry.
CT Page 11046
CONCLUSION
The motion for summary judgment filed by the Defendant, Yale New Haven Hospital, is DENIED.