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Simpson v. United States

United States District Court, D. Connecticut

February 15, 2018



          Hon. Vanessa L. Bryant United States District Judge.

         I. Introduction

         Before the Court are Defendant United States of America's Motions to Exclude Expert and for Summary Judgment. [Dkts. 57, 59.] Plaintiff Jean Simpson, individually and as executrix of the estate of William Simpson, opposes the motions. [Dkts. 66, 74.] For the reasons discussed below, Defendant's Motion for Summary Judgment is GRANTED and the Motion to Exclude Expert is found as moot.

         II. Factual Background

         The United States Department of Veterans Affairs operates a hospital in West Haven, Connecticut (the “VA Hospital”). [Dkt. 61-1 at Ex. B (Daily Dispensing Log), Dkt. 61-2 at Ex. F (Deposition of George Whetstine, R.N.).] The VA Hospital operates an opiate treatment program which provides Methadone, weekly group meetings, and relapse prevention. Whetstine Dep. at 8-9. Prior to administering Methadone, a VA Hospital staff member determines whether the patient is registered as one who requires a urinalysis and if so, collects a sample for testing. [Id. at 11; Dkt. 74-5 (Deposition of Dr. Kishorchandra Gonsai) at 14.] The sample is sent to a urinalysis lab for testing later that day. The VA Hospital does not immediately receive urinalysis results and does not rely on that day's urinalysis results to determine whether to dispense Methadone, but rather uses the results to develop a future treatment plan. Id.

         After collecting a urine sample, a nurse then speaks with the patient to determine whether the patient is unstable. Whetstine Dep. at 11. Indications of instability may include if the patient is “heavy lidded, ” unable “to have a conversation, ” or if the patient's behavior otherwise leads the nurse to believe the patient is “under some drug use.” Id. Other indications of instability might include “slurring his words, . . . wearing shoes on different feet, . . . [being] slumped over and looking . . . like he had either [consumed] alcohol or was in some way intoxicated.” Id. at 39. If the patient is stable, the nurse then administers Methadone and speaks with the patient again to confirm that he or she swallowed the dose. Id. at 12. If a patient's behavior “in any way seems inappropriate, ” the administrating nurse does not administer Methadone, but instead escorts the patient to the psychiatric emergency room and arranges for the patient to be seen by a doctor. Id. at 16.

         Frank Defurio was a patient at the VA Hospital's opiate treatment program who received daily doses of Methadone. Id. at 16; [Dkt. 61-1 at Ex. E (Report of Dr. Mark Kraus) at 1; Dr. Gonsai Dep. at 13.] He was a patient in good standing in the program and on the date of the events at issue had been receiving Methadone for approximately five years. Dr. Kraus Report at 2; Dr. Gonsai Dep. at 12. Mr. Defurio had a history of post-traumatic stress disorder (PTSD), depression, opiate dependency, and substance abuse. Whetstine Dep. at 16; Dr. Kraus Report at 1-2.

         At 8:00 a.m. on September 9, 2013 3George Whetstine, R. N., met with Mr. Defurio. [Dkt. 61-1 at Ex. A (Progress Note).] George Whetstine was Mr. Defurio's clinician, is familiar with Mr. Defurio's medical history, and has been a nurse with the VA Hospital for approximately 24 years. Whetstine Dep. at 37; [Dkt. 81 (Affidavit of Dr. Gonsai) at 2.]. Mr. Whetstine recorded a progress note memorializing the 8:00 a.m. meeting, stating Mr. Defurio “presented for [a] scheduled [appointment]” and “expressed desire to restart [the] VA wellness program.” Id. His treatment notes indicate Mr. Defurio requested a “10 mg increase in Methadone ‘back to 110 mg, '” which was his dose prior to a recent hospitalization. Id. Mr. Defurio denied experiencing opiate withdrawal symptoms, cravings, or relapse, but requested the return to his prior, higher dosage because “I know my body, I want to get back on my dose.” Id. The progress note indicates a plan to increase Mr. Defurio's Methadone dose “as per MD and OTP team review.” Id.

         At or around the time of his 8:00 a.m. meeting with Mr. Whetstine, Mr. Defurio provided a urine sample, which was sent for lab testing that afternoon. Dr. Gonsai Dep. at 25-27. At 8:44 a.m., Marie Souza, R.N., dispensed 100 mg of Methadone to Mr. Defurio. Daily Dispensing Log at 2. When the laboratory tested Mr. Defurio's urine sample, it revealed a negative result for Methadone. Dr. Gonsai Dep. at 25-26. Since Mr. Defurio received daily doses of Methadone, and since a urine sample would test positive for Methadone if it had been ingested within the last five days, Dr. Gonsai opined that the negative urinalysis may have been caused by a laboratory or sampling error, or if Mr. Defurio provided a false urine sample. Id. at 23, 26-27. There is no evidence in the record establishing the actual cause of Mr. Defurio's negative test result. As discussed infra, Mr. Defurio submitted to additional urinalysis later that day which was positive for Methadone.

         At approximately 12:07 p.m., 68 year-old William Simpson began walking in a diagonal crosswalk from the southwest corner toward the northeast corner of a four-way intersection on the VA Hospital's property. Police Report at SIMP00035-36. Mr. Defurio drove a pickup truck along the southbound roadway on the VA Hospital's property, approached the stop sign at the crosswalk, and may have made a complete stop. Id. (explaining that video footage is unclear as to whether Mr. Defurio made a complete stop). Mr. Defurio then turned left and struck Mr. Simpson, who was over halfway across the crosswalk. Id. Mr. Simpson suffered injuries including death as a result of the collision. Id.

         After the collision, Mr. Defurio pulled over and he and his passenger, William Slater, exited the vehicle. Id. at SIMP00054. At the scene, Mr. Defurio reported to police that he had been “heading east . . . as he approached the . . . intersection, . . . stopped at the stop sign and continued east bound ‘straight on through.'” Id. Mr. Defurio asserted Mr. Simpson “jumped in front of my car” and denied fault for the collision. Id. Mr. Defurio stated he “never made contact with the pedestrian (Simpson) and further stated even if he did, he was going very slow[ly], so he could not have hurt him.” Id. Mr. Defurio elaborated that the prior day someone “had tied a rope to his pickup . . . and was ‘surfing' in the roadway behind his truck as he exited the parking lot.” Id. He asserted Mr. Simpson was the same person, and stated immediately following the September 9, 2013 incident he found rope tangled in and attached to his vehicle. Id. Mr. Defurio later changed his account, stating Mr. Simpson “slip[ped] on something in the road.” Id. Throughout the interview with police, Mr. Defurio's pupils were dilated, and he appeared “very anxious and was agitated one moment, then apologetic the next.” Id. at SIMP00054. Police reported that Mr. Defurio's account of the collision was inconsistent with the video footage captured on the VA Hospital's surveillance camera, and that he seemed “confused” and “delusional.” Id. at SIMP00033. Police found no rope or string at the scene. Id. at SIMP00054.

         At the police station, Mr. Defurio voluntarily submitted to a breath test which indicated he had consumed no alcohol. Id. at SIMP00055. He also submitted to two additional urinalyses, which both indicated Mr. Defurio had consumed Methadone and Lamotrigine, a seizure medication. Id. at SIMP00058. Mr. Defurio's medical records reflect that he is prescribed Lamotrigine. Id. at SIMP00057.

         Police also interviewed William Slater, Jr., who was in the passenger seat of the pickup truck at the time of the collision. Id. at SIMP00056. Mr. Slater, who also receives daily doses of Methadone from the VA Hospital, stated he saw Mr. Simpson in the crosswalk prior to the collision and warned Mr. Defurio to “slow down” because “this guy's to[o] close to the truck.” Id. at SIMP00055-56. Mr. Defurio then collided with Mr. Simpson, and Mr. Slater “watched as Simpson disappeared from his view, then he felt a ‘hump.'” Id. Mr. Slater then told Mr. Defurio to “pull over” and found that “sure enough we hit him.” Id.

         Dr. Kraus authored an expert report for the Government in this case and testified at a deposition. [Dkt. 74-3 (Dr. Kraus Dep.) at 121.] Dr. Kraus is an internist and addiction specialist, and Plaintiff has not moved to exclude Dr. Kraus's expert report or testimony. [Dr. Kraus Report at 5; Dkt. 65 at 9.] Dr. Kraus reviewed Mr. Whetstine's September 9, 2013 medical notes and found no indication that the VA Hospital should have involuntarily admitted Mr. Defurio. Dr. Kraus Dep. at 121. Dr. Kraus also testified that he reviewed police records, medical records from the VA Hospital, the Complaint, and the Plaintiff's expert's report, and found ...

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