In its written opinion filed on March 29, 2016, the Court of Special Appeals of Maryland (“Appellate Court”), which is Maryland’s intermediate appellate court, determined that the trial court did not commit error in entering summary judgment in favor of a former Maryland stent doctor and the other named defendants in a Maryland medical malpractice lawsuit that alleged that the doctor had committed fraud by intentional misrepresentation and that the defendant hospital had committed fraud by concealment, because there was no evidence that the defendant doctor knowingly misstated the percentage of stenosis in the plaintiff’s left anterior descending coronary artery (“LAD”), or that he was recklessly indifferent to what that percentage of stenosis was, and there was no evidence that the defendant hospital knew or should have known about the defendant doctor’s alleged prior misconduct.
The Appellate Court further held that because the plaintiff’s fraud claims against the defendants were properly disposed of by summary judgment in favor of the defendants, those claims could no longer be deemed to have tolled the statute of limitations, which had long since run on the plaintiff’s medical malpractice claims.
The Alleged Underlying Facts
In October 2004, after experiencing chest pain, shortness of breath, and a feeling of tightness in his chest, the plaintiff underwent a cardiac catheterization procedure during which it was discovered that there was a stenosis in the plaintiff’s LAD that had reached 95%, for which a stent was placed in the plaintiff’s LAD.
The plaintiff continued to experience shortness of breath for which the defendant doctor performed a second catheterization. The plaintiff’s Maryland medical malpractice lawsuit alleged that before the defendant doctor placed the second stent, while the plaintiff was laying on the operating table, the defendant doctor advised him that the stenosis had reached 70% (the laboratory report the defendant doctor later prepared suggested that the stenosis was 80%) and that he would need a second stent to avoid a complete blockage of the artery, after which the defendant doctor placed another stent in the plaintiff’s LAD.
Five years after the second stent implantation, the plaintiff read a newspaper article suggesting that the defendant doctor had been performing unnecessary stent implantations. Two years later, the plaintiff filed his Maryland medical malpractice lawsuit, alleging that the defendant doctor had breached the standard of care applicable to stent implantation procedures by implanting a stent when there had been insufficient evidence to justify such a procedure and that the defendant doctor had deliberately misled the plaintiff to induce him to undergo the second stent implantation procedure. The plaintiff’s medical expert opined that the level of arterial stenosis was about 30% to 40% at the time of the second stent procedure.
The Appellate Court noted that the plaintiff’s expert testified in his deposition that “[Y]ou never treat coronary artery disease with stents unless there is severe stenosis.” However, the plaintiff’s expert did not specify what level of stenosis constitutes “severe stenosis” or what a reasonable margin of error might be in reading an angiogram with the naked eye (the only available tool for making such an assessment at that time). The Appellate Court stated that the plaintiff had provided no evidence that the defendant doctor knew his assessment of stenosis, whether it be 70% or 80%, was incorrect, and that the disparity between the plaintiff’s expert’s testimony and the statements made by the defendant doctor suggests, at most, that the defendant doctor may have been negligent, perhaps even grossly negligent, in his diagnosis. The Appellate Court held, however, that a difference of opinion concerning the applicable standard of care is insufficient to establish fraud.
The Appellate Court stated that fraud requires knowledge of the falseness of the statement, or at least a reckless indifference as to the truthfulness of the statement made by the defendant, whereas negligence does not. The Appellate Court held that without evidence that the defendant doctor knowingly misstated the percentage of stenosis in the plaintiff’s LAD, or that he was recklessly indifferent to what that percentage of stenosis was, the plaintiff’s claim of fraud by misrepresentation could not withstand summary judgment and thus the circuit court did not err in granting summary judgment.
Source Crystal v. Midatlantic Cardiovascular Associates, P.A., et al., No. 1687.
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