Lance's Corner

New York State Appellate Division Fourth Department Reinstates Dental Malpractice Case Against Certain Dentist Defendants

Feb 26, 2024

The Appellate Division, Fourth Department, of the New York State Supreme Court reinstated a dental malpractice case -- Grammatico v. Lamar -- against specific defendant dentists on the basis that plaintiffs’ expert affidavit squarely opposed the defendants’ affidavits, creating a classic battle of the experts, which should be resolved by the trier of fact and not by the defendants’ motion for summary judgment.  The case is a good explanation of how competing experts are treated by the courts and also how adhering to correct procedural tactics by all litigants is critical to malpractice cases.  A copy of the court opinion is below.

Decided on February 9, 2024

SUPREME COURT OF THE STATE OF NEW YORK
Appellate Division, Fourth Judicial Department

PRESENT: WHALEN, P.J., LINDLEY, MONTOUR, OGDEN, AND DELCONTE, JJ.

1040 CA 23-00087

ROBYN GRAMMATICO AND LOUIS GRAMMATICO, PLAINTIFFS-APPELLANTS,

v

JAMES R. LAMAR, D.M.D., FRANK R. LAMAR, JR., D.D.S., ELMWOOD DENTAL GROUP-IMPLANT AND RESTORATION, P.C., AND ELMWOOD DENTAL GROUP-FAMILY, P.C., DEFENDANTS-RESPONDENTS. (APPEAL NO. 1.)

GERARD A. STRAUSS, NORTH COLLINS, FOR PLAINTIFFS-APPELLANTS.

ADDELMAN CROSS & BALDWIN, PC, BUFFALO (KARA M. ADDELMAN OF COUNSEL), FOR DEFENDANTS-RESPONDENTS.

Appeal from an order of the Supreme Court, Monroe County (Craig J. Doran, J.), entered November 30, 2022.  The order granted the motion of defendants for summary judgment dismissing the complaint.

It is hereby ORDERED that the order so appealed from is unanimously modified on the law by denying the motion in part and reinstating the first and third causes of action against defendants James R. Lamar, D.M.D., Elmwood Dental Group-Implant and Restoration, P.C., and Elmwood Dental Group-Family, P.C., and as modified the order is affirmed without costs.

Memorandum:

Plaintiffs commenced this dental malpractice action seeking damages for injuries allegedly sustained by Robyn Grammatico (plaintiff) as a result of defendants' negligence during treatment of plaintiff, including extraction of a tooth in March 2016.  In appeal No. 1, plaintiffs appeal from an order that granted defendants' motion for summary judgment dismissing the complaint.  In appeal No. 2, plaintiff appeals from an order that denied her motion to settle the record on appeal in appeal No. 1.

Preliminarily, in appeal No. 2, plaintiff contends that Supreme Court improperly excluded necessary and relevant documents from the record on appeal in appeal No. 1.  We reject that contention.  The reply affidavit of defendant Frank R. Lamar, Jr., D.D.S., was withdrawn at oral argument, and therefore it was not a document "upon which the . . . order [in appeal No. 1] was founded" (CPLR 5526; see Greater Buffalo Acc. & Injury Chiropractic, P.C. v Geico Cas. Co., 175 AD3d 1100, 1101-1102 [4th Dept 2019]).  Further, defendants' memorandum of law, which may be included in the record on appeal "only for the limited purpose of determining whether the contentions on appeal are preserved for our review" (Town of West Seneca v Kideney Architects, P.C., 187 AD3d 1509, 1510 [4th Dept 2020]), is not necessary here, and the correspondence between the parties and the court is not relevant to any of the issues in appeal No. 1.

With respect to appeal No. 1, plaintiffs first contend that the court erred in dismissing the first cause of action, for negligence and medical malpractice.  We agree in part.  On that part of their motion for summary judgment dismissing the first cause of action, defendants "had the initial burden of establishing either that there was no deviation or departure from the applicable standard of care or that any alleged departure did not proximately cause [plaintiff's] injuries" (Stradtman v Cavaretta [appeal No. 2], 179 AD3d 1468, 1469 [4th Dept 2020] [internal quotation marks omitted]).  Defendants met that burden through the submission of the affidavits of defendants James R. Lamar, D.M.D., and Frank R. Lamar, Jr., D.D.S., which contained "opinion evidence . . . based on facts in the record or personally known to the witness[es]" (Tirado v Koritz, 156 AD3d 1342, 1344 [4th Dept 2017] [internal quotation marks omitted]) and were " 'detailed, specific and factual in nature' and addresse[d] [each of] plaintiff[s'] specific factual claim[s] of negligence" (Campbell v Bell-Thomson, 189 AD3d 2149, 2150 [4th Dept 2020]; see Czereszko v Procopio, 149 AD3d 1531, 1532 [4th Dept 2017]).

The burden then shifted to plaintiffs to raise a triable issue of fact by submitting " 'evidentiary facts or materials to rebut the prima facie showing by the defendant[s]' beyond mere '[g]eneral allegations of medical malpractice' " (Webb v Scanlon, 133 AD3d 1385, 1386-1387 [4th Dept 2015], quoting Alvarez v Prospect Hosp., 68 NY2d 320, 324-325 [1986]).  Plaintiffs met that burden with respect to defendants James R. Lamar, Elmwood Dental Group-Implant and Restoration, P.C., and Elmwood Dental Group-Family, P.C., through the submission of an expert affidavit opining that defendant James R. Lamar deviated from the applicable standard of care while performing the March 2016 procedure on plaintiff, causing injuries to her.  Where, as here, "a nonmovant's expert affidavit 'squarely opposes' the [affidavits] of the moving parties' expert[s], the result is 'a classic battle of the experts' " (Mason v Adhikary, 159 AD3d 1438, 1439 [4th Dept 2018]), which should be determined by the trier of fact.  This is not a case in which plaintiffs' expert "misstate[d] the facts in the record, nor is the affidavit vague, conclusory, [or] speculative" (id. [internal quotation marks omitted]).

Plaintiffs did not meet their burden with respect to defendant Frank R. Lamar, Jr., however, inasmuch as their expert affidavit did not provide an opinion that defendant Frank R. Lamar, Jr. deviated from the applicable standard of care (see Emerson v Kaleida Health, 217 AD3d 1540, 1541 [4th Dept 2023]).

We therefore modify the order in appeal No. 1 by denying defendants' motion in part and reinstating the first cause of action and the third cause of action, for loss of consortium, against defendants James R. Lamar, Elmwood Dental Group-Implant and Restoration, P.C., and Elmwood Dental Group-Family, P.C.

Plaintiffs also contend that the court erred in dismissing the second cause of action, for lack of informed consent.  We reject that contention.  The complaint alleged that plaintiff underwent a procedure in March 2016, which included a tooth extraction, and that defendants "failed to provide proper informed consent for the procedure at issue."  In support of their motion for summary judgment made following discovery, defendants, inter alia, submitted the written informed consent form for the March 2016 procedure, signed by plaintiff.  Plaintiffs then opposed the part of defendants' motion that sought to dismiss the cause of action for lack of informed consent by arguing that there was no consent for a separate procedure that defendant James R. Lamar performed in September 2016, which also included a tooth extraction.  That is a new theory of recovery, and thus could not be raised to defeat defendants' motion (see generally DeMartino v Kronhaus, 158 AD3d 1286, 1287 [4th Dept 2018]).  We note that plaintiffs did not move to amend the complaint or bill of particulars to include allegations pertaining to the September 2016 procedure.  We conclude that the court did not err in granting defendants' motion with respect to the second cause of action.

Entered: February 9, 2024

Ann Dillon Flynn
Clerk of the Court

USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc