United States District Court, D. Connecticut
JEAN SIMPSON, INDIVIDUALLY & AS EXECUTRIX OF THE ESTATE OF WILLIAM SIMPSON Plaintiffs,
THE UNITED STATES OF AMERICA, Defendant.
MEMORANDUM OF DECISION REGARDING DEFENDANT'S
MOTIONS FOR SUMMARY JUDGMENT AND TO EXCLUDE EXPERT
Vanessa L. Bryant United States District Judge.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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 ...