United States District Court, D. Connecticut
ALBERTHA FLETCHER and DONNA SMITH, Administrators of the Estate of Lashano Gilbert Plaintiffs,
CITY OF NEW LONDON, et al. Defendants.
RULING ON MOTION FOR SUMMARY JUDGMENT
Michael P. Shea, USDJ
case arises out of the death of Lashano Gilbert while in
police custody on October 4, 2014, in New London,
Connecticut. The plaintiffs, Alberta Fletcher and Donna
Smith, are the administrators of Mr. Gilbert's estate.
They bring claims against several defendants, including
claims of medical malpractice and wrongful death against a
doctor, Deirdre Cronin-Vorih. Dr. Cronin-Vorih treated Mr.
Gilbert in the emergency room after his arrest on October 3,
2014, but before he was returned to police custody and
ultimately died. Now before me is Dr. Cronin-Vorih's
motion for summary judgment. (ECF No. 131.) She argues that
the plaintiffs have failed to raise a genuine dispute of
material fact as to whether she proximately caused Mr.
Gilbert's death because they do not intend to call an
expert to testify on causation. Because I conclude that
expert testimony is not required to establish proximate
causation in this case, the motion is DENIED.
assume familiarity with the record in this case, including my
previous ruling on summary judgment (ECF No. 126) and the
parties' Local Rule 56(a) statements, (ECF Nos. 131-3;
137-3). I also assume familiarity with the standard on
summary judgment, which I laid out in detail in my previous
ruling. (ECF No. 126 at 8-9.) In brief, summary judgment is
appropriate only when the moving party “shows that
there is no genuine dispute as to any material fact and the
movant is entitled to judgment as a matter of law.”
Fed.R.Civ.P. 56(a). I must “view the evidence in the
light most favorable” to the non-moving party,
Tolan v. Cotton, 134 S.Ct. 1861, 1866 (2014)
(internal quotation marks omitted), and “resolve all
ambiguities and draw all inferences in [its] favor, ”
Cronin v. Aetna Life Ins. Co., 46 F.3d 196, 203 (2d
Cronin-Vorih argues that the plaintiffs cannot establish a
causal connection between her alleged deviation from the
standard of care and Mr. Gilbert's death because they
have not identified an expert who will testify about
proximate cause. To establish proximate causation, the
plaintiffs must prove that Dr. Cronin-Vorih's conduct was
a “a substantial factor in producing [Mr.
Gilbert's] injury.” Poulin v. Yasner, 64
Conn.App. 730, 735 (2001) (quotation marks omitted). The key
question under the “substantial factor” test is
“whether the harm which occurred was of the same
general nature as the foreseeable risk created by the
defendant's negligence.” Id. This Court
has explained that expert testimony is often necessary in
medical malpractice cases “because the medical effect
on the human system of the infliction of injuries is
generally not within the sphere of the common knowledge of
the lay person.” Law v. Camp, 116 F.Supp.2d
295, 305 (D. Conn. 2000), aff'd, 15 Fed.Appx. 24 (2d Cir.
2001) (quotation marks omitted). In this case, the plaintiffs
plan to call Dr. Peter Petropoulos to testify that Dr.
Cronin-Vorih deviated from the standard of care in treating
Mr. Gilbert. (See ECF No. 137-2 at 2.) Dr.
Petropoulos is also prepared to testify that Dr.
Cronin-Vorih's failure to meet the standard of care
“ultimately caused the death of Lashano Gilbert.”
(Id. at 5.) Dr. Cronin-Vorih asserts that Dr.
Petropoulos's opinion is mere ipse dixit and is
insufficient to raise a genuine question of material fact
about causation. (ECF No. 131-1 at 17-20.)
not determine whether Dr. Petropoulos's opinion on
causation is valid, however, because I conclude that expert
testimony on causation is not required here. Courts in
Connecticut do not require expert testimony on causation
where the causal connection in question “falls within
the common knowledge of the lay person.” Camp,
116 F.Supp.2d at 305. For example, expert testimony is not
necessary where the medical condition is “obvious or
common in everyday life, ” or where “the
plaintiff's evidence creates a probability so strong that
a lay jury can form a reasonable belief.” Kalams v.
Giacchetto, 268 Conn. 244, 249 n.4 (2004).
about the events leading up to Mr. Gilbert's death,
together with Dr. Petropoulos's expert testimony on the
standard of care and Mr. Gilbert's condition when he was
discharged from the emergency department, is sufficient to
allow a reasonable lay juror to conclude that Mr.
Gilbert's death was the foreseeable result of Dr.
Cronin-Vorih's deviation from the standard of care. Mr.
Gilbert was arrested on October 3, 2014 after he jumped
“head first” through the driver's side window
of a woman's car while “speaking
unintelligibly” and making “stabbing
motions” at her. (Second Amended Complaint, ECF No. 56
at 7 ¶ 17-21; Defendant's Local Rule 56(a)(1)
Statement, ECF No. 131-3 ¶ 2-3.) The police report of
the incident states that, when an officer arrived, Mr.
Gilbert “leapt from the front seat of the [car] and ran
directly at [the officer, ] yelling incoherently and flailing
his arms wildly.” (ECF No. 137-2 at 53.) The officer
stopped Mr. Gilbert by tasing him. (Id.) Four more
officers assisted in subduing Mr. Gilbert as he was
transported to the hospital. (Id. at 54). Based on
this evidence, a reasonable juror could conclude, without
expert testimony, that Mr. Gilbert was experiencing a serious
mental health problem on October 3, 2014. He was delirious,
combative, and potentially violent. Mr. Gilbert's bizarre
and erratic behavior was obvious, and a juror would not need
medical training to understand that he posed a potential
threat to himself and others. Further, a juror could conclude
that Mr. Gilbert's condition had caused him to attempt to
physically attack a police officer, and that the officer had
felt sufficiently threatened to warrant tasing Mr. Gilbert.
plaintiffs' medical expert, Dr. Petropoulos, opines that
Dr. Cronin-Vorih failed to meet the standard of care when she
treated Mr. Gilbert in the emergency room after his arrest
because she allowed Mr. Gilbert to be discharged to police
while he was experiencing “ongoing delirium/alteration
of mental status.” (ECF No. 137-2 at 7-8.) When Mr.
Gilbert arrived at the hospital, he “was initially not
responsive to questions” and “alternated between
periods of calmness and yelling, screaming, and
thrashing.” (ECF No. 131-3 ¶ 10.) Dr.
Cronin-Vorih's emergency department report states that
Mr. Gilbert was “extremely agitated” and he was
“restrained to a stretcher given [the] risk of harm to
himself and/or staff.” (ECF No. 137-2 at 33.) Mr.
Gilbert told hospital staff that his behavior was the result
of a spell his aunt had placed on him. (ECF No. 137-2 at 33.)
Although Dr. Cronin-Vorih's report states that, by the
end of his stay, he was “stable to be discharged into
the care of the police” (id.), Dr. Petropoulos
opines that “there is no documented repeat examination
by Dr. Cronin-Vorih that demonstrates that [Mr.
Gilbert's] delirium had resolved by the time of
discharge.” (ECF No. 137-2 at 7.) Dr. Petropoulos
identifies several steps that Dr. Cronin-Vorih should have
taken to stabilize Mr. Gilbert and to uncover and address the
underlying causes of his altered mental status before
releasing him. (Id. at 6-8.) Based on this expert
testimony, a reasonable juror could conclude that Dr.
Cronin-Vorih knew or should have known that Mr. Gilbert still
had an altered mental status, but she negligently failed to
determine the cause or treat his altered mental status before
discharging him to police. Further, a juror could find that
Dr. Cronin-Vorih's failure to meet the standard of care
created a risk that Mr. Gilbert would again attempt to
physically attack police officers and would be injured as a
there is sufficient evidence in the record to raise a genuine
dispute of fact about whether the harm Mr. Gilbert suffered
“was of the same general nature as the foreseeable risk
created by [Dr. Cronin-Vorih's] negligence.”
Yasner, 64 Conn.App. at 735. Specifically, a juror
could conclude that, as a result of Dr. Cronin-Vorih's
negligence, Mr. Gilbert was still delirious after he was
discharged and his delirium caused his confrontation with
police. As Mr. Gilbert exited the hospital, police reports
indicate that he asked an officer “to put a cover over
his head . . . He said something about his Aunt being able to
pull his hair out if [it was] not covered.” (ECF No.
137-2 at 50.) A reasonable juror could find that Dr.
Cronin-Vorih, who had just authorized his release, should
have known he was still delusional. He continued to complain
about his aunt trying to pull out his hair when he arrived at
the station, but his aunt was never present. (Id.)
He later tried to hang his jeans from a vent in the station
and accused police of “putting poison into the air
coming through the vent in an attempt to kill him.”
(ECF No. 137-2 at 56.) When police confronted Mr. Gilbert out
of fear that he would attempt to hang himself with the jeans,
he lunged at them, beginning the altercation that ended with
his death. (Id. at 57-58; ECF No. 131-2 at 25.)
the evidence in the record would allow a reasonable lay juror
to find that (1) Mr. Gilbert was suffering from paranoid
delusions that caused him to attack a police officer before
he was taken to the hospital on October 3, 2014; (2) Mr.
Gilbert remained agitated at the hospital and Dr.
Cronin-Vorih knew or should have known that he presented a
potential threat to himself and others as a result of his
altered mental status; and (3) Dr. Cronin-Vorih failed
identify and address the underlying cause of Mr.
Gilbert's delirium and discharged him to police while he
still had an altered mental status. Especially because of his
violent confrontation with the police before arriving at the
hospital, of which Dr. Cronin-Vorih knew or should have
known, a reasonable juror could conclude that Mr.
Gilbert's subsequent altercation with police, resulting
in his death, was a foreseeable consequence of Dr.
Cronin-Vorih's deviation from the standard of care. This
causal chain would not require a juror to draw any complex
medical inferences. Mr. Gilbert engaged in a violent
altercation before he was hospitalized. Dr. Cronin-Vorih
allegedly failed to address the underlying condition that
caused him to initiate that altercation. It was reasonably
foreseeable, then, that Mr Gilbert would initiate another
violent altercation when discharged to the police. As a
result, “the plaintiff's evidence creates a
probability so strong that a lay jury can form a reasonable
belief” without expert testimony. Giacchetto,
268 Conn. at 249 n.4; see also Yasner, 64 Conn.App.
at 748 (“The third exception to a need for expert
testimony in lost chance cases revolves around whether lay
jurors can resolve the issue by use of their common
knowledge.”) Here, expert testimony is ...