Marian Lee, as Administratrix of the Estate of Mary Tsong Lee v. Montefiore Medical Center, et al.
Attorneys and Parties
Brief Summary
Medical malpractice—hospital liability for maintenance and functionality of specialized cardiac equipment (rotablator) and proximate cause when a physician independently chooses an alternative course.
The Supreme Court, Bronx County denied Montefiore Medical Center’s motion for summary judgment dismissing all direct claims against it.
The Appellate Division reversed and granted Montefiore’s motion, dismissing the direct claims against the hospital.
Even assuming a departure in not ensuring the rotablator’s functionality, the alleged deviation was not a proximate cause; Dr. Shih independently opted to perform multiple angioplasties on a hemodynamically stable patient, and the last angioplasty caused the artery dissection.
Background
Decedent was scheduled for an atherectomy using a rotablator. The device’s foot pedal malfunctioned in the catheterization lab. Plaintiff’s expert asserted the hospital deviated from accepted practice by failing to maintain and ensure the rotablator’s functionality, noting the availability of manufacturer service contracts and regular inspection protocols for non-single-use components such as the foot pedal. Montefiore’s expert countered that accepted practice did not require the hospital to own or routinely test the rotablator outside imminent use. Maintenance records submitted by Montefiore on reply were procedurally improper and, in any event, reflected only periodic visual and electrical safety checks without showing compliance with accepted practice. After discovering the malfunction, Dr. Shih could have postponed the atherectomy because the patient was hemodynamically stable, but instead he performed six angioplasties; the last caused a dissection of the left main artery.
Lower Court Decision
The Supreme Court, Bronx County (Justice Michael A. Frishman) denied Montefiore Medical Center’s motion for summary judgment on the direct claims, finding triable issues as to whether the hospital departed from accepted practice by failing to ensure the rotablator was functional prior to the planned atherectomy.
Appellate Division Reversal
Reversing on the law, the Appellate Division held that Montefiore established prima facie entitlement to summary judgment because any alleged departure was not a proximate cause or substantial factor in the injury. Both experts agreed Dr. Shih could have postponed the procedure; his independent choice to perform multiple angioplasties on a stable patient, culminating in the dissection, broke the causal chain. The court granted Montefiore’s motion and dismissed the direct claims against it.
Legal Significance
The decision underscores that, in hospital malpractice claims premised on equipment maintenance or availability, proximate cause remains dispositive. Even where a question of fact exists on departure, a physician’s independent decision to proceed with an alternative intervention on a stable patient can sever causation and warrant summary judgment for the hospital. The court also notes that submitting new maintenance records on reply is improper and, here, insufficient to establish compliance with accepted practice.
Hospitals may avoid liability on direct malpractice claims where an alleged equipment maintenance lapse did not proximately cause the injury, particularly when a physician’s independent treatment decision intervenes and causes the harm.