Opinion
No. CV04-4014953S
February 19, 2009
MEMORANDUM OF DECISION RE DEFENDANT'S MOTION FOR SUMMARY JUDGMENT (#272) PLAINTIFF'S OBJECTION (#277) AND DEFENDANT'S REPLY (#278)
This is a medical malpractice action. The plaintiff, as Conservator of her sister, claims negligence in the care of her sister, Leslie Milliun, while she was a patient at New Milford Hospital, in July 2002. The parties have filed many pretrial motions in this action, and have argued multiple times before this court in the preceding seven weeks. Most recently argued, on February 17, 2009, and the subject of this decision, is defendant's Motion for Summary Judgment (#272), plaintiff's Objection to Defendant's Motion (#277), and Defendant's Reply (#278), along with the respective memoranda of law, filed by the defendant, New Milford Hospital ("Hospital") on February 6, 2009 and by plaintiff, Ms. Milliun, on February 10, 2009. Having heard argument and reviewed the briefs and attached exhibits, this court grants the motion for summary judgment.
During the hearing on the Motion and Objection, held February 17th at 2:00 p.m., plaintiff sought to append to its Motion an additional Affidavit, the existence of which and content of which had not been disclosed previously to opposing counsel or provided to the Court. Defendant objected; the court disallowed the late appendage, which was marked as an I.D. Exhibit.
STANDARD FOR CONSIDERING SUMMARY JUDGMENT
"In any action, except administrative appeals which are not enumerated in Section 14-7, any party may move for a summary judgment at any time, except that the party must obtain the judicial authority's permission to file a motion for summary judgment after the case has been assigned for trial." Practice Book § 17-44. "Summary judgment is a method of resolving litigation when pleadings, affidavits, and any other proof submitted show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law . . . The motion for summary judgment is designed to eliminate the delay and expense of litigating an issue when there is no real issue to be tried." (Citations omitted.) Wilson v. New Haven, 213 Conn. 277, 279, 567 A.2d 829 (1989).
"However, since litigants ordinarily have a constitutional right to have issues of fact decided by a jury . . . the moving party for summary judgment is held to a strict standard . . . of demonstrating his entitlement to summary judgment." (Citation omitted; internal quotation marks omitted.) Kakadelis v. DeFabritis, 191 Conn. 276, 282, 464 A.2d 57 (1983).
In considering a motion for summary judgment, the court must determine whether the pleadings, affidavits and any other proof submitted show that there is no genuine issue as to any material fact and, if so, whether the moving party is entitled to judgment as a matter of law. Practice Book § 17-49. See also Mozeleski v. Thomas, 76 Conn.App. 287, 289, 818 A.2d 893, cert. denied, 264 Conn. 904, 823 A.2d 1221 (2003). In deciding a motion for summary judgment, the trial court must view the evidence in the light most favorable to the nonmoving party . . . The party seeking summary judgment has the burden of showing the absence of any genuine issue [of] material facts which, under applicable principles of substantive law, entitle him to a judgment as a matter of law . . . and the party opposing such a motion must provide an evidentiary foundation to demonstrate the existence of a genuine issue of material fact. (Internal quotation marks omitted.) Mozeleski v. Thomas, supra, 289-90, quoting H.O.R.S.E. of Connecticut, Inc. v. Washington, 258 Conn. 553, 558-59, 783 A.2d 993 (2001). A "material" fact has been defined adequately and simply as a fact which will make a difference in the result of the case. United Oil Co. v. Urban Redevelopment Commission, 158 Conn. 364, 379, 260 A.2d 596 (1969). [S]ummary judgment [is appropriate] in a medical malpractice case when . . . it is evident that the plaintiff will be unable to produce at trial an expert witness to testify regarding the applicable standard of care. (Internal quotation marks omitted.) Sullivan v. Yale-New Haven Hospital, Inc., 64 Conn.App. 750, 766, 785 A.2d 588 (2001).
The defendant, New Milford Hospital, moves for summary judgment based on its claim that there is no genuine issue of material fact that the plaintiff, Ms. Milliun, cannot meet her burden to prove all the required elements of her medical malpractice claim. In particular, it is the position of the defendant that the plaintiff "cannot support her claim that the defendant's alleged negligence caused the claimed injuries of the plaintiff's incompetent, Leslie Milliun. The defendant is therefore entitled to judgment as a matter of law."
The plaintiff conservator objects to the defendant Hospital's motion for summary judgment upon the ground that there are disputed issues of material facts. In the memorandum of law accompanying the objection, the plaintiff directs the court throughout to the 1987 Connecticut Supreme Court case, Asiazu v. Orgera, 205 Conn. 623, for support of its position that certain references in the treatment reports of the Mayo Clinic treating physicians are admissible, and should be brought to the trier of fact, to establish causation.
PROCEDURAL HISTORY OF THIS MEDICAL MALPRACTICE MATTER
This action was commenced, via writ, summons and complaint on October 5, 2004. Leslie Milliun, who was then party plaintiff, (hereinafter, the "Ward") alleged that she had been admitted to New Milford Hospital on or about July 9, 2002, with "chief complaints of possible seizure activity and exacerbation of stiff person syndrome." The Ward alleged that as a result of the Hospital's failure to treat her decreased respirations, she suffered certain damages, including "anoxic injury to the brain," "cognitive decline", and "cognitive function changes." See also Amended Complaint, May 10, 2007 and Revised Complaint July 11, 2008.
At some point during the pendency of this matter, Lynnia Milliun, Leslie's twin sister, was substituted as party plaintiff. Leslie Milliun was declared incompetent by the Probate Court, with Lynnia Milliun appointed her conservatrix.
This matter has an extensive procedural history, including three successive complaints and many pretrial motions. The court records, now encompassing six files, show a multitude of scheduling and discovery trial management orders, made by administrative and trial judges in two judicial districts.
The court in the Litchfield Judicial District (Pickard, Administrative Judge) first entered scheduling Orders on June 1, 2006. Pursuant to the scheduling order: plaintiff was to disclose experts by August 1, 2006; the depositions of plaintiff's experts were to be accomplished by December 1, 2006; the defendants were to disclose experts by February 1, 2007; the depositions of defendant's experts were to be completed by June 1, 2007; and, counsel were scheduled to begin jury selection on August 7, 2007. Administrative Judge Pickard denied the plaintiff's motion, filed on August 1, 2006, for additional time to disclose experts. Plaintiff filed expert disclosures, of Drs. Baker and Warrington, on October 16, 2006. Reviewing that disclosure, Administrative Judge Pickard then granted the defendants' motions compelling the plaintiff to file more specific expert disclosures, within 30 days or by March 7, 2007. Plaintiff never revised the expert disclosures of Drs. Baker or Warrington, and oral argument on defendant's motion for nonsuit was held before Waterbury Administrative Judge Agati. No ruling was issued by the court on the defendant's motion for nonsuit.
Plaintiff retained new counsel, the current plaintiff's counsel in this matter, in April 2007. New trial management scheduling orders were entered by the Administrative Judge, discovery deadlines were further extended, and jury selection was rescheduled to begin on September 8, 2008. In May 2007, Complex Litigation Administrative Judge Hiller denied plaintiff's motion to transfer the case to the complex litigation docket, but in view of the anticipated length of the trial, the judge changed the venue to Waterbury Superior Court, with the proviso that the trial date be maintained. In January 2008, the defendants moved to preclude the plaintiff from disclosing any expert witnesses, as she had failed to disclose any such witnesses in accordance with the latest agreed-upon trial management scheduling order. The Court did not rule on the motion to preclude, and the plaintiff again amended her liability allegations in her complaint, in February 2008. Defendant disclosed an additional expert witness in March 2008.
A trial management status conference, before the Waterbury Administrative Judge, was held in July 2008. At that time, the plaintiff sought and received, over the strong opposition of the defendants, a further continuance of the trial date. Another trial management scheduling order was entered by the Administrative Judge, mandating the disclosure of plaintiff's experts by September 15, 2008, and setting a trial date of January 21, 2009. On the deadline, September 15, 2008, the plaintiff disclosed nine expert witnesses. Among those experts were five physicians or Ph.D.s, all employees of the Mayo Clinic in Rochester, Minnesota, identically disclosed on causation and damages. The defendant moved, in November 5, 2008, to preclude those witnesses from testifying at trial claiming prejudice which would result from its having to conduct pretrial discovery so close to the forthcoming trial date. On December 22, 2008, at short calendar, the trial court, Alvord, J., heard oral argument on the defendant New Milford Hospital's Motion to Preclude (251) the plaintiff's expert witnesses, based on the plaintiff's failure to make them properly available, in particular the five of the nine experts who practice in Minnesota. (Tr. p. 4-5 L18-12.) There was no responsive pleading filed by plaintiff to the defendant's December 22, 2008 motion to preclude, however, at that hearing, plaintiff's counsel orally represented that the experts from Minnesota were actually "treating physicians, . . . I did not pick them. They weren't specially retained." (December 22, 2008 Tr. p. 6 L19-20) and that they had been disclosed as expert witnesses on causation for the sole purpose of introducing their treatment reports at trial. It was not until this December 22, 2008 hearing that plaintiff shared with the defendant and the trial court that plaintiff did not intend to call causation expert(s) to testify at trial, rather the plaintiff would rely on their treatment reports.
For example, the plaintiff's expert disclosure of Dr. Keith Josephs, Rochester Minnesota, reads in full:
(a) the subject matter on which the expert is expected to testify:
The nature, scope and cause of Leslie Milliun's cognitive and memory impairments.
(b) the substance of the facts and opinions to which the expert is expected to testify;
Dr. Josephs is expected to testify that Leslie Milliun suffers from cognitive and memory impairments which significantly impact her activities of daily life. It is further expected that Dr. Josephs will testify that Ms. Milliun's impairments were caused as a result of the respiratory arrest and anoxic injury which occurred in the New Milford Hospital in July of 2002. A copy of Dr. Joseph's report is attached to this disclosure.
THE COURT: Are all eight of them flying here to Connecticut for trial:
MR. JOSEL: No.
THE COURT: So, how are you using the eight of them?
MR. JOSEL: I'm using their medical records.
MS. GOODUSKY: That's news to me, Your Honor.
MR. JOSEL: I mean, the Minnesota —
THE COURT: Okay. All three of you out there. Talk how this trial is going to start . . . you, [plaintiff] disclose to them [defendants] exactly who you are using, how you are using them and how they [defendants] are going to get an opportunity [to depose the experts].
Pursuant to the suggestion of both counsel, as to how plaintiff's experts would be made available for deposition, at the conclusion of the December 22, 2008 hearing, the court ordered the depositions of two of the Minnesota witnesses to be obtained by teleconference on or before January 9, 2009, and ordered that dates for the depositions of the remaining eight plaintiff witnesses, also deemed treating physicians, would be provided to defense counsel by the plaintiff no later than January 5, 2009.
MS. GOODUSKY: Yes, Your Honor. We do have an agreement. Attorney Josel, having represented that the Mayo Clinic experts, all five of them, will not appear to testify at trial. We have agreed to take their very limited depositions by telephone, starting tomorrow. And as a precondition, we would like to state on the record that the depositions will be limited to the reports that they have already published just so that there are no further surprises . . . It also appears that the remaining experts will be available to be deposed within a reasonable time.
THE COURT: Prior to trial which is still scheduled for —
MS. GOODUSKY: January the 21st.
CT Page 3666
THE COURT: That's when you are starting to pick your jury:
MS. GOODUSKY: Correct.
THE COURT: Okay. That's your agreement, Attorney Josel?
MR. JOSEL: Yes, Your Honor.
The deposition of Dr. Ivnik, a neuropsychologist with the Mayo Clinic, was begun on January 9, 2009, but not completed, due to the intervention of his employer, the Mayo Clinic. (January 9, 2009 Tr. p. 61-62, L16-25, L1-16). Dr. Ivnik declined to give an opinion on causation; and affirmed that he had not been retained, employed, or otherwise been made aware that he was expected to provide an "expert opinion" on causation or any other expert opinion in this medical malpractice case. (January 9, 2009 Tr. p. 9 L15-25; p. 10, L1-13). Dr. Ivnik did not recall reviewing any medical records before conducting neuropsychological testing of Leslie Milliun in 2005. (January 9, 2009 Tr. p. 12, L20-25; p. 13, L1-4.) Dr. Ivnik was unaware of the claimed cause of Leslie Milliun's alleged cognitive impairment, and did not provide any opinion as to the cause. (January 9, 2009 Tr. p. 6, L24-25; p. 7-8; p. 9 L1-2.) Because, Dr. Ivnik sought the assistance of counsel for the Mayo Clinic to protect him from counsel's efforts to elicit testimony he could not give, plaintiff's counsel did not finish his questioning of Dr. Ivnik. The second deposition of Dr. Trenerry, another neuropsychologist disclosed by the plaintiff as an expert on causation, was scheduled to proceed on January 9, 2009, but was not taken as the result of an error by the court reporting firm.
Counsel commenced jury selection on January 21, 2009, advising prospective jurors that the trial would commence on February 3, 2009 and proceed over three weeks. On January 26, 2009, this court met with counsel, again, relating to monitoring compliance with the terms and conditions of previous discovery orders. The court also discussed with counsel the anticipated date for completion of jury selection and the witness schedule for the upcoming trial. Counsel were ordered to report back on January 29, 2009 for: continued monitoring of the out-of-state depositions and for discussion of pending pretrial motions/motions in limine.
On January 29, 2009, as jury selection was ongoing, this court was made aware that no arrangements had been made to complete the out-of-state depositions of plaintiff's remaining four Mayo Clinic witnesses. Counsel for the plaintiff affirmed on the record that the sole opinions on causation he intended to offer were contained in the treatment reports of the Mayo Clinic physicians and psychologists. Plaintiff's counsel noted, for the court, precisely where in those treatment reports he maintained the expert opinions on causation were set forth. Evaluating this information, the court noted that the statements contained in the reports pertaining to causation were either predicated on inadmissible hearsay, as they were made by the patient and her sister; or predicated upon the "expert" opinions of lay witnesses. The court considered the plaintiff's position: that certain notes found in the patient's treatment records at the Mayo Clinic would be introduced in lieu of the expert testimony that generally is required to establish causation in a claim for medical malpractice. The court heard the clear opposition of defense counsel to this manner of establishing one of the two essential elements of plaintiff's claim. The court then advised counsel that this limited language, embedded in the reports of treating physicians and psychologists, was an improper foundation for an expert opinion to be provided to the trier of fact on causation of the claimed injuries and damages.
At this January 29, 2009 hearing and immediately after the court's above ruling, the plaintiff submitted a Motion for Commission, (dated two days previous, January 27, 2009), to obtain the out-of-state depositions of the Mayo Clinic experts. Counsel for the defendant had not been provided a copy of said motion prior to the hearing, and the motion was not yet filed with the court. Given that jurors had already been selected for the February 3, 2009 trial commencement date, the court required defense counsel to orally provide responding argument to the plaintiff's motion, at that time. (On January 30, 2009 the defendant submitted a brief opposing the Motion for Commission, but the court declined to hold a hearing to reconsider its January 29 bench ruling.) At the hearing, the defendant's position in opposing plaintiff's Motion for Commission was that neither Connecticut law nor the law of the jurisdiction in which the Commission will be obtained permits the physician-deponents to testify beyond the scope of their reports, and accordingly, the plaintiff cannot introduce properly predicated evidence on causation. This being the case, the defendant claimed entitlement to a judgment of nonsuit, judgment in its favor, or a dismissal of this action.
Also on January 29, 2009, defendant filed its Motion in Limine to Preclude Mayo Clinic Experts' Evidence regarding Causation (#266). In this motion, and pursuant to Section 15-3 of the Practice Book, the defendant requested the court make an order in limine precluding the plaintiff from offering any evidence regarding causation from any of the five Mayo Clinic expert witnesses "whom she recently disclosed, whether in the form of testimony, by the offering any medical records authored by the witnesses or relied upon by them, or by the expert "reports" attached to Mayo witnesses' disclosures." In that January 29, 2009 motion, it was the defendant Hospital's stated position that all the evidence that could be offered by the Mayo Clinic witnesses is insufficient as a matter of law to support an inference of legal causation.
The court declined, at the time of the hearing on January 29, 2009, to grant any of the defendant's requests, without prejudice; instead, and after hearing from both counsel, the Motion for Commission was granted in part and denied in part. The court ruled that the plaintiff would not be permitted, in any event, to present the reports or opinions of three of the Minnesota experts, those who were psychologists, and not M.Ds, to establish causation of anoxic injury to the brain. The court granted the plaintiff's Motion for Commission to take the depositions of the two physician experts in Minnesota, Dr. Keith Josephs, and Dr. Kathleen McEvoy, stating that their depositions should take place over four hours; during the upcoming week; and that the cost of the depositions should be shared by the plaintiff and the defendant equally. The court determined that if these physicians did not testify adequately at deposition to support the basis of their purported opinions on causation, their reports would be admissible to the triers of fact as treaters, with those portions of the reports referring to causation redacted, to prevent prejudice to the defendant and confusion to the fact finders, at trial.
Dr. Josephs' deposition was two hours long, equal time being afforded to the plaintiff and defendant counsels, and concluded after two hours of questioning, by counsel for the Mayo Clinic. During examination, Dr. Josephs could not support any opinion on causation with any facts besides those set forth in his report. He did not recall the patient; he could not say that he reviewed any records before undertaking his evaluation of Leslie Milliun, and he noted that he had not understood until fifteen minutes before his deposition convened that he was expected to give expert testimony. (January 30, 2009 Tr. p. 6, L3-5.) He offered no expert opinion on causation or on standard of care and said he had none to offer.
MS. MARTIN: You're arguing with this witness. You're being abusive, and I think the time has concluded for this deposition.
MS. MARTIN: . . . he's here and this is his understanding and the clinic's understanding. He's here solely as a treating physician to give testimony about his care and treatment of this patient and not to render expert opinions that go to standard of care, causation, but really to testify as to his care and treatment of this patient on this day. (January 30, 2009 Tr. p. 8-9, L22-05.)
On February 4, 2009, defendant Hospital submitted a Supplemental Brief in Opposition to Continuation of Depositions of Mayo Clinic Physicians (269). Defendant, in its memorandum, contended that the deposition of Dr. Josephs, which was commenced on February 2, 2009, should not be continued, and that the deposition of Dr. Kathleen McEvoy not be undertaken. For its position, defendant relied on Connecticut jurisprudence holding that these witnesses, as nonparties to the action, could not be compelled to give expert opinions against their will, citing Hill v. Lawrence Memorial Hosp., 2008 WL 2802907, 45 Conn. L. Rptr. 789 (Shapiro, J., June 30, 2008). Prior to the commencement of the February 4, 2009 hearing, Minnesota counsel for the Mayo Clinic had faxed a Motion for Protective Order to both counsel for the plaintiff and defendant and to the court. Counsel for the plaintiff objected to the court hearing argument on said motion, on the basis that said Mayo Clinic counsel had not filed an appearance in the case. For that reason, the Mayo Clinic motion was not argued. Mayo Clinic counsel was able to listen to the hearing, via telephonic link.
After hearing the compelling arguments of counsel for both parties, and considering the transcript of the February 2, 2009 Minnesota deposition, and persuasive Connecticut case law, the court stated:
Drown v. Markowitz, 41 Conn. L. Rptr. 855, 2006 WL 2604986 (August 18, 2006, Rittenband, J.T.R.) and Hill v. Lawrence Memorial Hosp., 45 Conn. L. Rptr. 789, 2008 WL 2802907 (June 30, 2008, Shapiro, J.).
The court in Hill, granted the motions for protective order, holding that:
Counsel are prohibited from questioning the movants on the issues of opinion concerning damages or causation, as to whether, if the mass had been detected in November 2001, the decedent could have been treated and would have survived, as specified in the plaintiffs' disclosure of expert witnesses as pertaining to them. They may be questioned as to factual matters related to their own conduct and treatment of the decedent.
Hill, supra, emphasis added.
The Hill decision cited another Connecticut Superior Court opinion in support of its grant of the Motions for Protective Order.
This court agrees with Izquierdo v. Kia Motors America, Superior Court, Complex Litigation Docket at Tolland, Docket No. X07 CV 00 0075599 (June 16, 2003, Sferrazza, J.), where the court, also citing Thomaston, but not characterizing the issue as one of "expert privilege," stated that "[a]n adversary can subpoena and force an expert witness retained and disclosed by the other side to disgorge an expert opinion at trial . . . Except for that particular scenario, however, one cannot usually require an expert to appear and render an opinion, even if qualified to do so, if the expert refuses to offer the opinion voluntarily. (Emphasis added.)
"It is my ruling today that these two doctors cannot be compelled to be expert witnesses for the plaintiff. That I am vacating my ruling on the plaintiff's request for commission. I'm vacating my orders that the doctors subject themselves to deposition of a reasonable time which was suggested to be four hours, and that that be completed by the end of this week . . . that's my decision." Accordingly, the Mayo Clinic doctors were advised, through their in-house counsel, that they were no longer under subpoena.
The court marked the matter over to the short calendar, February 9. 2009, 11:00 a.m. for consideration of any filed/pending motions.
On February 6, 2009, defense counsel filed a Motion for Permission to File Summary Judgment, pursuant to § 17-44 of the Practice Book. Attached to that motion were a copy of the proposed Motion for Summary Judgment and Memorandum of Law in support. In that Motion for Permission, the defendant Hospital represented "that the Motion for Summary Judgment will not delay the progress of the case toward trial, and is necessary to determine whether the case should proceed to a jury. If the issues are resolved by means of Summary Judgment, it will prevent a lengthy, costly and complicated trial." As previously ordered, on February 9, 2009 at 11:00 a.m., the court heard from both plaintiff and defendant on Motion for Permission (and two other pending motions unrelated to this decision). The court granted the Motion for Permission and postponed the hearing on the Summary Judgment Motion until February 11, 2009 at 2:00 p.m., because with this scheduling, the court would be able to avoid again delaying the trial of this matter, thereby managing the case while maintaining the fairness and integrity of the proceeding. Two hours before the scheduled hearing, arguments were necessarily delayed at the request of plaintiff's counsel, due to illness. The hearing was held, as rescheduled, on February 17, 2009, at 2:00 p.m.
LAW AND DECISION
[T]o prevail in a medical malpractice action, the plaintiff must prove (1) the requisite standard of care for treatment, (2) a deviation from that standard of care, and (3) a causal connection between the deviation and the claimed injury . . . Generally, the plaintiff must present expert testimony in support of a medical malpractice claim because the requirements for proper medical diagnosis and treatment are not within the common knowledge of laypersons. (Citation omitted; internal quotation marks omitted.) Boone v. William W. Backus Hospital, 272 Conn. 551, 567, 864 A.2d 1 (2005).
The court finds nothing in the records, nor any other evidence, to indicate that the person(s) who had made the comments, to the treating physicians, advocating a causal connection between the patient's symptoms and her stay at the Hospital, were qualified to give expert testimony regarding causation. Absent such evidence, the patient and sister opinions regarding causation captured in the treatment records are not independently admissible. See River Dock Pile Inc., v. O G Industries, Inc., 219 Conn. 787, 799, 595 A.2d 839 (1991) (opinion included within otherwise admissible business record admissible only if entrant would be qualified to give that opinion in testimony).
Accordingly, in order for the notations found in the decedent's hospital records to be introduced in lieu of expert testimony on causation, the case would have to fall into one of the narrow exceptions to the general rule that expert testimony is required to establish a case for medical malpractice. See Sherman v. Bristol Hospital, Inc., 79 Conn.App. 78, 89 (2003). The injuries to the Ward, including an anoxic injury to the brain, that are claimed to have been caused by treatment rendered to her at the Hospital, are not "obvious or common in everyday life." (Internal quotation marks omitted.) Id. At 89. Second, the professional negligence alleged by the plaintiff was not "so gross as to be clear even to a lay person." Id.
An exception to the general rule [requiring] expert medical opinion evidence . . . is when the medical condition is obvious or common in everyday life . . . Similarly, expert opinion may not be necessary as to causation of an injury or illness if the plaintiff's evidence creates a probability so strong that a lay jury can form a reasonable belief . . . Expert opinion may also be excused in those cases where the professional negligence is so gross as to be clear even to a lay person. (Citations omitted; internal quotation marks omitted.) Boone v. William W. Backus Hospital, supra, 272 Conn. at 567. In this state, decisions indicating that the exception to the general rule of expert testimony in medical malpractice case might be applicable have involved foreign objects discovered in the body of a patient after surgery or abnormal injuries sustained during surgery [ Puro v. Henry, 188 Conn. 301, 308, 449 A.2d 176 (1982)] (needle found in patient after hernia operation); Console v. Nickou, 156 Conn. 268, 274-75, 240 A.2d 895 (1968) (needle left in patient after delivery of child); Allen v. Giuliano, 144 Conn. 573, 575, 135 A.2d 904 (1957) (lacerations to patient's leg in removal of cast); Slimak v. Foster, 106 Conn. 366, 370, 138 A.2d 153 (1927) (piece of surgical instrument left in patient after nose operation).
This court finds that the plaintiff's allegations in the medical malpractice complaint do require expert medical opinion to establish causation. The court concludes that the notations found in Ms. Milliun's treatment records could not be introduced in lieu of expert testimony that is generally required to establish causation in this claim for medical malpractice. There is no genuine issue of material fact that the plaintiff, Ms. Milliun, cannot meet her burden to prove all the required elements of her medical malpractice claim. In particular, the court holds that the plaintiff cannot support her claim that the defendant's alleged negligence caused the claimed injuries of the plaintiff's incompetent, Leslie Milliun. Accordingly, the court renders summary judgment in favor of the defendant Hospital.