Opinion
FBTCV175032966S
04-13-2018
John DOE v. CHILDREN’S CENTER OF HAMDEN, INC.
UNPUBLISHED OPINION
OPINION
BELLIS, J.
This action arises out of the alleged failure to report the existence of an ongoing sexual relationship between a minor child and an adult woman. On July 31, 2017, the plaintiff, John Doe PPA Jane Doe, filed a three-count amended complaint against the defendant, the Children’s Center of Hamden, Inc., sounding in both medical and ordinary negligence, and breach of a special duty of care owed to children. Count one of the amended complaint alleges the following facts. The minor plaintiff was admitted for residential in-patient mental health care and treatment at the defendant’s facility from June 6, 2015, through August 3, 2015. During that time period, he reported to staff members that he was engaged in an ongoing sexual relationship with an adult woman. After his disclosure, the plaintiff further alleges, the defendant deviated from the applicable standards of care in that the defendant, through its staff members, failed to make a report to the authorities concerning the sexual relationship in accordance with the requirements of General Statutes § 17a-101; failed to properly respond to the disclosure; failed to " provide proper and adequate care and treatment" to the plaintiff; failed to properly investigate the disclosure; and failed to " provide proper monitoring, supervision and training of staff members who provided care, treatment and supervision to the minor plaintiff." As a result, the plaintiff alleges, the plaintiff’s sexual assault, abuse, exploitation, and neglect were allowed to continue, thereby causing him injury and damage. The plaintiff asserts claims of medical negligence, breach of a special duty of care owed to children, and ordinary negligence in counts one, two, and three, respectively.
The plaintiff filed a request to amend his complaint, in conjunction with his proposed amended complaint, which was subsequently granted by the court, Arnold, J., on September 5, 2017, over the defendant’s objection. As a result, the court will consider the defendant’s motion to strike as against the plaintiff’s amended complaint filed on July 31, 2017.
On September 22, 2017, the defendant filed the present motion to strike, and accompanying memorandum of law in support, as to count one of the plaintiff’s amended complaint on the ground that the allegations therein do not support a claim of medical negligence. The plaintiff filed an objection and memorandum of law in opposition on October 20, 2017. On November 1, 2017, the defendant filed a reply and thereafter, on December 29, 2017, the plaintiff filed a surreply. The court heard oral argument at short calendar on January 2, 2018.
Although the plaintiff did not seek permission of the judicial authority to file a surreply; Practice Book § 11-10; the court will consider the memorandum.
DISCUSSION
" [A] motion to strike challenges the legal sufficiency of a pleading and, consequently, requires no factual findings by the trial court ... [The court] construe[s] the complaint in the manner most favorable to sustaining its legal sufficiency ... Thus, [i]f facts provable in the complaint would support a cause of action, the motion to strike must be denied ... Moreover, [the court notes] that [w]hat is necessarily implied [in an allegation] need not be expressly alleged ... It is fundamental that in determining the sufficiency of a complaint challenged by a defendant’s motion to strike, all well-pleaded facts and those facts necessarily implied from the allegations are taken as admitted ... Indeed, pleadings must be construed broadly and realistically, rather than narrowly and technically." (Internal quotation marks omitted.) Sepega v. DeLaura, 326 Conn. 788, 791, 167 A.3d 916 (2017).
In its memorandum of law in support, the defendant argues that count one of the plaintiff’s amended complaint must be stricken as it fails to state a claim for medical negligence. Specifically, the defendant asserts that the negligence alleged is not of a specialized medical nature arising out of a medical professional-patient relationship, as the mandated reporter laws apply to various professions that do not require medical training. Moreover, the defendant contends that the negligence alleged is not related to a medical diagnosis, nor does it involve the exercise of medical judgment. The defendant argues that reporting the disclosure of an inappropriate relationship between a minor child and an adult woman to the authorities does not require the exercise of medical judgment and therefore, the plaintiff’s claim for medical negligence fails. In its reply memorandum, the defendant further argues that the plaintiff’s claim does not involve esoteric or uniquely medical issues, or any complex issues requiring specialized knowledge, and, therefore, sounds in ordinary negligence rather than medical negligence.
In response, the plaintiff argues that its medical negligence claim is legally sufficient, as the defendant is being sued in its capacity as a medical professional; the alleged negligence is of a specialized medical nature that arises out of the medical professional-patient relationship; and the alleged negligence is substantially related to medical diagnosis or treatment and involved the exercise of medical judgment. The plaintiff contends that the alleged negligence occurred during the time in which he was admitted for residential in-patient mental health care at the defendant’s facility, and, therefore, is of a specialized medical nature that arises out of the medical professional-patient relationship. The plaintiff maintains that its allegations of failing to make a report, failing to respond to his disclosure, failing to provide proper and adequate care and treatment, failing to properly investigate the disclosure, and failing to provide proper supervision of staff members are substantially related to medical diagnosis involving the exercise of medical judgment. The plaintiff further argues that his allegations go beyond merely failing to report the disclosure of the inappropriate relationship and therefore are " sufficiently intertwined with medical diagnosis and treatment of the plaintiff involving the exercise of medical judgment," and, accordingly, requests that the defendant’s motion to strike be denied.
" The classification of a negligence claim as either medical malpractice or ordinary negligence requires a court to review closely the circumstances under which the alleged negligence occurred. [P]rofessional negligence or malpractice ... [is] defined as the failure of one rendering professional services to exercise that degree of skill and learning commonly applied under all the circumstances in the community by the average prudent reputable member of the profession with the result of injury, loss, or damage to the recipient of those services." (Emphasis in original; internal quotation marks omitted.) Gold v. Greenwich Hospital Assn., 262 Conn. 248, 254, 811 A.2d 1266 (2002). " Furthermore, malpractice presupposes some improper conduct in the treatment or operative skill [or] ... the failure to exercise requisite medical skill ..." (Emphasis in original; internal quotation marks omitted.) Boone v. William W. Backus Hospital, 272 Conn. 551, 562, 864 A.2d 1 (2005). " From those definitions, we conclude that the relevant considerations in determining whether a claim sounds in medical malpractice are whether (1) the defendants are sued in their capacities as medical professionals, (2) the alleged negligence is of a specialized medical nature that arises out of the medical professional patient relationship and (3) the alleged negligence is substantially related to medical diagnosis or treatment and involved the exercise of medical judgment." Trimel v. Lawrence & Memorial Hospital Rehabilitation Center, 61 Conn.App. 353, 358, 764 A.2d 203, appeal dismissed, 258 Conn. 711, 784 A.2d 889 (2001). In determining whether a claim sounds in medical malpractice or ordinary negligence, " [i]t is not the label that the plaintiff placed on each count of her complaint that is pivotal but the nature of the legal inquiry." Votre v. County Obstetrics & Gynecology Group, P.C., 113 Conn.App. 569, 580, 966 A.2d 813, cert. denied, 292 Conn. 911, 973 A.2d 661 (2009). " The rule of law that distinguishes between medical malpractice and ordinary negligence requires a determination of whether the injury alleged occurred during treatment because of a negligent act or omission that was substantially related to treatment." Trimel v. Lawrence & Memorial Hospital Rehabilitation Center, supra, 360. Accordingly, in order to determine whether the plaintiff in the present case has sufficiently alleged a cause of action for medical negligence, the court will address each of the aforementioned factors in turn.
I
The first factor requires that the defendant be sued in its capacity as a medical professional. Trimel v. Lawrence & Memorial Hospital Rehabilitation Center, supra, 61 Conn.App. 358. In the present case, the plaintiff alleges that the defendant " was a corporation organized and existing under the laws of the State of Connecticut with a business address of 1400 Whitney Avenue, Hamden, Connecticut and at all times it acted through its agents, servants, apparent agents, employees, and associated staff and physicians to provide residential and outpatient mental health care and treatment to children." The defendant does not dispute that it is being sued in its capacity as an institution providing mental health care and treatment. Thus, the allegations of count one of the plaintiff’s amended complaint sufficiently satisfy the first Trimel factor regarding medical negligence claims.
II
The second factor requires that the negligence alleged by the plaintiff be of a specialized medical nature that arises out of the medical professional-patient relationship. Trimel v. Lawrence & Memorial Hospital Rehabilitation Center, supra, 61 Conn.App. 358. See also Nichols v. Milford Pediatric Group, P.C., 141 Conn.App. 707, 713-14, 64 A.3d 770 (2013) (finding medical professional-patient relationship existed where injuries occurred during course of medical examination); Doe v. Institute of Living, Superior Court, judicial district of Hartford, Docket No. CV-07-5007981-S (August 10, 2007, Wiese, J.) (44 Conn.L.Rptr. 5) (where minor plaintiff was coerced into engaging in sexual acts with another patient while under care of defendant mental health facility, allegation that incident occurred while minor plaintiff was being treated at that facility sufficient to satisfy medical professional-patient relationship factor). Here, the plaintiff alleges that the negligence occurred while he was admitted for residential inpatient mental health care and treatment at the defendant’s facility. Reading the complaint in the light most favorable to the plaintiff; Geysen v. Securitas Security Services USA, Inc., 322 Conn. 385, 398, 142 A.3d 227 (2016); count one of the plaintiff’s amended complaint sufficiently alleges that the negligence complained of arose out of his medical professional-patient relationship with the defendant.
Nonetheless, the requirements of this particular factor are twofold. While the plaintiff satisfies the medical professional-patient relationship component, he has not sufficiently alleged that the negligent conduct of the defendant was of a " specialized medical nature." There are no allegations to indicate that the alleged negligence was connected to any medical condition suffered by the plaintiff, nor do the present allegations involve any matters intrinsically medical in nature, such as the administration of medication. See Boone v. William W. Backus Hospital, supra, 272 Conn. 566 (decision by medical personnel concerning whether patient’s adverse reaction to prescription medication required further treatment or readmission was of specialized medical nature); Jefferson v. Waveny Care Center, Inc., 52 Conn.Supp. 254, 262-63, 40 A.3d 825 (2010), aff’d, 134 Conn.App. 727, 39 A.3d 1239 (2012) (claims that negligence arose from prevention and treatment of pressure ulcers and treatment of MRSA were of specialized medical nature because they directly involved plaintiff’s medical condition). " Merely because the alleged event occurred in a medical facility does not mean that medical malpractice is the proper cause of action." Doe v. The Institute of Living, supra, Superior Court, Docket No. CV-07-5007981-S. Accordingly, count one of the plaintiff’s complaint does not satisfy the second Trimel factor.
III
As for the third factor that the court must consider in determining whether a claim sounds in medical negligence, the alleged negligence must have been " substantially related to medical diagnosis or treatment and involved the exercise of medical judgment." (Emphasis added.) Trimel v. Lawrence & Memorial Hospital Rehabilitation Center, supra, 61 Conn.App. 358. Compare Brawley v. Norwalk Hospital Assn., Superior Court, judicial district of Stamford-Norwalk, Docket No. CV-06-5002205-S (March 22, 2007, Tobin, J.) (43 Conn.L.Rptr. 126) (alleged negligence substantially related to treatment and involved exercise of medical judgment where health care providers instructed plaintiffs’ decedent to turn left and right during performance of x-ray procedure, causing plaintiffs’ decedent to fall from table and sustain injuries), with DeJesus v. Veterans Memorial Medical Center, Superior Court, judicial district of New Britain, Docket No. CV-99-0498385-S (October 19, 2000, Kocay, J.) (28 Conn.L.Rptr. 522) (complaint sounded in ordinary negligence where allegations that health care provider failed to strap patient into her bed, raise safety bar on bed, and keep nurse or aide nearby to prevent plaintiff from falling from bed " did not occur during a medical procedure or from any specialized medical care or treatment the defendant may have provided" ).
While the plaintiff relies on Votre v. County Obstetrics & Gynecology Group, P.C., supra, 113 Conn.App. 569, in support of his claim that the present facts similarly sound in medical negligence, the court is not persuaded. In Votre v. County Obstetrics & Gynecology Group, P.C., supra, 573, the plaintiff was a high risk patient placed on bedrest by the defendants due to pregnancy complications. In light of her previous pregnancy that ended in the death of her child and her diagnosis of an incompetent cervix, the plaintiff requested, both before and during her hospitalization, that the defendants enlist physicians from the hospital’s high risk pregnancy group to consult and to take over her treatment. Despite the plaintiff’s worsening condition and repeated requests, the defendants refused to turn over her care to the Yale high risk group or to treat her in accordance with the group’s recommendations. Subsequently, the plaintiff’s son was born prematurely and died shortly after birth. As a result, the plaintiff filed an eight-count complaint asserting claims for negligent, reckless and intentional infliction of emotional distress, breach of contract and negligent, reckless and intentional misrepresentation on the basis of defendants’ care of the plaintiff during her pregnancy. The defendants filed a motion to dismiss for lack of subject matter jurisdiction, and argued that the plaintiff’s claims sounded in medical malpractice requiring a certificate of good faith and a written opinion of a similar health care provider under General Statutes § 52-190a. The plaintiff contended that her claims sounded in ordinary tort and breach of contract, and therefore did not require a certificate or written opinion. The trial court agreed with the defendants, and consequently granted the motion to dismiss.
In affirming the trial court’s determination that the plaintiff’s complaint sounded in medical malpractice, the Appellate Court found that " the factual allegations underlying the claims [required] proof of the defendants’ deviation from the applicable standard of care of a health care provider, specifically, that of an obstetrician." Votre v. County Obstetrics & Gynecology Group, P.C., supra, 113 Conn.App. 580. In particular, the court noted that the plaintiff’s claim that the defendants " disregarded the recommendation of [the] high risk physicians during [her] stay at the hospital" and " refused [her] requests for no valid medical reasons" definitively arose out of the " professional-patient relationship between the defendants and the plaintiff, as the facts underlying the claim occurred solely in the context of the defendants’ ongoing medical treatment of the plaintiff." (Internal quotation marks omitted.) Id., 577. The court further stated that the plaintiff’s claim was of a " specialized medical nature" because it " directly [involved] the plaintiff’s medical condition: her high risk pregnancy." Id. Finally, the court agreed with the trial court’s statement that " whether or when the plaintiff needed a high risk physician during her hospitalization is a question involving the exercise of medical judgment and ... could not be determined by [a] fact [finder] without expert testimony. Similarly, whether the defendants followed the recommendations from the Yale high risk group is a question that is also substantially related to the plaintiff’s treatment and involves medical judgment and ... could not be determined without the guidance of specialized knowledge." Id., 578. Thus, the court determined that the defendants were " required to diagnose and treat the plaintiff’s symptoms using their medical judgment," which included " consideration of the merits of consulting with the Yale high risk group or referring the plaintiff to that group according to her well stated wishes and their potential effect on her well-being and that of her child" and " evaluation of the Yale high risk group’s recommendations and whether valid medical reasons supported the defendants’ actions." Id.
In contrast, in the present case, the determination of whether the defendant or its staff members failed to meet the applicable standard of care does not require the guidance of specialized medical knowledge. The allegations concerning proper care and treatment, and monitoring, supervision, and training, also do not require specialized medical knowledge. There are also no allegations to suggest that the staff members located at the defendant’s facility exercised any medical judgment in allegedly failing to report, respond to, and investigate, the plaintiff’s disclosure. Rather, as mandated reporters, the defendant and its staff members were not entitled to rely on their medical knowledge to make a discretionary " judgment call" on whether to report the plaintiff’s disclosure. This is distinctly unlike the circumstances presented in Votre, where the health care providers were required to use their medical judgment in order to evaluate a variety of factors, including the plaintiff’s symptoms and the potential effects of consulting with the high risk group on her and her unborn child’s well-being.
Instead, the present case is more akin to Badrigian v. Elmcrest Psychiatric Institute, Inc., 6 Conn.App. 383, 505 A.2d 741 (1986). In Badrigian, the plaintiff’s decedent was hospitalized at the defendant’s psychiatric institute, which offered both inpatient and outpatient treatment and care. After being discharged from inpatient care, the plaintiff’s decedent was accepted as a day patient. The outpatient or day facility was located across the state highway from the main facility. While crossing the state highway from the day facility to get lunch at the main facility, the plaintiff’s decedent was struck and killed. The plaintiff filed suit, and alleged that the defendant was negligent in failing to supervise its patients, particularly in crossing the state highway. The trial court determined that the plaintiff’s cause of action sounded in ordinary negligence, rather than medical malpractice, and therefore was " subject to proof of the standard of care owed by a reasonably prudent person under the particular facts and circumstances." Id., 386. The Appellate Court found no error in the trial court’s submission of the case to the jury under the theory of ordinary negligence, and explicitly noted that " one need not be guided by medical experts in determining whether a mentally ill person should be allowed to cross on foot a heavily traveled four-lane state highway without supervision." Id., 387. Importantly, the court further stated that there was " no esoteric or uniquely medical issue to be determined under the allegations of [the] case," and that the trial court " correctly categorized the negligence charged against the hospital as involving no materia medica, nor any complex issue requiring specialized knowledge." (Internal quotation marks omitted.) Id.
Like in Badrigian, the claims in the present case do not involve " esoteric or uniquely medical issues" requiring specialized medical knowledge. Here, the plaintiff’s allegations of failure to report, failure to respond to and investigate a disclosure, failure to provide proper and adequate care and treatment, and failure to provide proper monitoring, supervision and training of staff members may properly be evaluated under a reasonably prudent person standard. To paraphrase, one need not be guided by medical experts in determining whether a mandated reporter’s failure to report, respond to, and investigate, the disclosure of an inappropriate sexual relationship between a minor child and an adult woman is negligent. Badrigian v. Elmcrest Psychiatric Institute, Inc., supra, 6 Conn.App. 387. Additionally, the allegations concerning proper care and treatment, and monitoring, supervision, and training under the circumstances presented similarly do not involve any uniquely medical issues such that the standard of proof applicable to medical negligence claims is necessary. See Delaney v. Newington Children’s Hospital, Superior Court, judicial district of Hartford, Docket No. CV-9-93-0524063-S (May 9, 1994, Wagner, J.) (complaint sounded in ordinary negligence and did not involve " esoteric or uniquely medical issue[s]" where minor child was sexually assaulted by another child while admitted inpatient at psychiatric unit of hospital and plaintiff alleged that defendant hospital was " negligent, careless, and reckless" in supervision and care).
There are also no allegations to indicate that the alleged negligence was substantially related to the plaintiff’s medical diagnosis or treatment. Although the plaintiff alleges that he was " admitted for residential in-patient mental health care and treatment," through one of the defendant’s programs entitled " New Choices Residential Substance Abuse Treatment Program," it is not clear, from a reading of the complaint, that the alleged negligence was substantially related to any treatment that he received at that program, or to any mental health or substance abused related diagnosis that he may have had. See Fallo v. McLean Assn., Inc., Superior Court, judicial district of New Britain, Docket No. CV-99-0499101-S (July 17, 2001, Shapiro, J.) (30 Conn. L. Rtpr. 217) (complaint did not sound in medical malpractice where alleged injury did not occur during medical treatment or arise from it).
Nonetheless, even if the court were to determine that the alleged negligence is substantially related to the plaintiff’s medical diagnosis or treatment, that negligence did not involve the exercise of medical judgment. The failure to report in accordance with § 17a-101 necessarily cannot require the exercise of medical judgment, as there are various professions listed as mandated reporters that do not require any specialized medical knowledge or background. See General Statutes § 17a-101(b) (persons deemed to be mandated reporters include coaches and directors of youth athletics, members of clergy, licensed foster parents, DCF employees, paid youth camp directors, and family relations counselors or trainees employed by judicial department); see also Geising v. Blefeld, Superior Court, judicial district of New London, Docket No. CV-99-0549307-S (April 25, 2002, Corradino, J.) (32 Conn.L.Rptr. 68) (mandated reporters include " classes of people who either do not have or are not likely to have medical training and experiences and whose judgment on abuse would not be subjected to the standard of care requirements in malpractice cases" ). The failure to properly respond to and investigate the disclosure of an inappropriate sexual relationship between a minor child and an adult woman similarly does not involve the exercise of medical judgment.
As to the allegations that the defendant failed to " provide proper and adequate care and treatment" or " provide proper monitoring, supervision and training of staff members who provided care, treatment and supervision to the minor plaintiff," there is no indication in the complaint that these claims involved the exercise of medical judgment. In Katz v. Harborside Healthcare Arden House Rehabilitation & Nursing Center, Superior Court, judicial district of New Haven, Docket No. CV-03-477016-S (September 23, 2003, Blue, J.) (35 Conn.L.Rptr. 543), the decedent, while being moved from her wheelchair to her bed, suffered a fracture in her left arm. The defendant knew that the decedent had weakened bones and skeletal structure as a result of certain treatments and radiation therapy she was receiving at the facility. Moreover, staff members were required to periodically move the decedent, specifically with the assistance of a sling known as a " Hoyer lift transfer," to prevent bed sores and " to assure that her circulatory system was not unduly compromised." During the incident that caused the decedent her injuries, the staff members did not use the " Hoyer lift transfer" as required and instead, lifted the decedent up by her arms. In support of his argument that his complaint sounded in ordinary negligence, rather than medical malpractice, the plaintiff maintained that because " the line staff had been given a specific directive on how to move [the decedent] from the wheelchair to the bed," and because the staff " disregarded that directive," he was not challenging the defendant’s " judgment," and instead was challenging the defendant’s " ability to follow the instructions of the medical professionals." The trial court disagreed with the plaintiff, and found that " the specifications of negligence [in the plaintiff’s complaint] are not specifications of the purely ministerial kind suggested in the [plaintiff’s brief in opposition to the motion to strike]. Rather, the specifications of negligence allege failure ‘to provide for the proper care and treatment of [the decedent] insofar as her movement was concerned’; failure ‘properly to train staff on how to move patients’ with medical conditions like [the decedent’s]; failure [to] ‘properly to supervise staff on such movement; failure ‘to assure that staff were aware of the medical needs of [the decedent]’ ; failure ‘to assure that there were enough properly trained staff on duty to assure that staff members had sufficient time to provide appropriate care for residents’; and failure ‘to provide proper notice to all employees on the manner and means by which [the decedent] could be moved from wheelchair to bed.’ The ‘failures’ so asserted are not ‘ministerial’ in nature. Each of them [involved] the judgment of a health care professional." In contrast, in the present case, the plaintiff’s amended complaint is devoid of any allegations to show that his claims regarding proper care, treatment, monitoring, supervision, and training, involved the staff members’ exercise of their medical judgment.
In sum, the plaintiff is " attempting to transform this case from one of simple negligence into that of medical malpractice requiring expert medical testimony to prove a medical standard of care and a breach thereof" ; Badrigian v. Elmcrest Psychiatric Institute, Inc., supra, 6 Conn.App. 386; without allegations sufficient to support such a claim. Accordingly, count one of the plaintiff’s amended complaint must be stricken.
CONCLUSION
Based on the foregoing, the court grants the defendant’s motion to strike as to count one of the plaintiff’s amended complaint.