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Court debates medical negligence versus plaintiff’s compliance. Audette v. Toussaint-Milford, 2019 N.Y. Slip Op. 30823 (N.Y. Sup. Ct. 2019)


In the medical malpractice case of Audette v. Toussaint-Milford, 2019 N.Y. Slip Op. 30823 (N.Y. Sup. Ct. 2019), the issue of the patient’s role in contributing to their medical condition. The plaintiff file a lawsuit against the medical staff that were involved in her care and the delivery of her baby. Her delivery was complicated. However, the plaintiff was uncooperative and chose to leave the hospital early, against medical advice.

Leaving a hospital against medical advice (AMA) occurs when a patient chooses to discharge themselves from a healthcare facility despite recommendations from medical professionals to stay for further treatment. This decision is typically documented in the patient’s medical record, noting that the patient has been informed of the potential health risks and consequences of leaving prematurely. The reasons for leaving AMA can vary, including personal obligations, financial concerns, dissatisfaction with care, or mistrust of medical staff. However, this action can lead to worsened health outcomes, complications, or incomplete treatment, and may affect the patient’s ability to claim damages in cases of subsequent medical issues. If a medical malpractice claim is filed, leaving AMA complicates the case, as it must be determined whether the worsening condition is due to the original medical issue, the alleged malpractice, or the patient’s decision to leave.

Background Facts
On September 24, 2014, Jeannine Audette, 37, pregnant and on methadone, was admitted to Brookdale Hospital with premature ruptured membranes at 27 weeks. Labor was delayed to allow fetal development. Post-delivery on September 29, complications arose with the placenta not being fully delivered and retained, leading to a diagnosis of placenta accreta. Placenta accreta is a serious pregnancy condition where the placenta grows too deeply into the uterine wall. Normally, the placenta detaches from the uterine wall after childbirth. However, with placenta accreta, part or all of the placenta remains attached. This can cause severe bleeding during or after delivery, posing risks to the mother.

This condition was overlooked until Audette returned on October 15, experiencing severe bleeding. Emergency surgery was performed to remove the retained placenta, resulting in a cervical hysterectomy to prevent further hemorrhage. Audette’s injuries included significant blood loss and subsequent pain from the retained placenta.

Whether the defendants deviated from standard medical practices in their treatment of Ms. Audette, particularly concerning the management of her placenta post-delivery, and if such deviation was the direct cause of her subsequent health issues.

The court granted the defendants’ motion for summary judgment, effectively dismissing the case. The decision was based on the determination that the defendants met their burden of proof in showing adherence to medical standards and that any alleged departures were not causally linked to Ms. Audette’s injuries.

The court found that the defendants provided adequate medical care under challenging circumstances, marked by Ms. Audette’s non-cooperation. Expert testimonies and medical records suggested that the medical staff acted within the bounds of standard practice. The court also noted Ms. Audette’s own actions, including leaving the hospital against medical advice, contributed to her complications, which undermined her claims of malpractice.

The defendants successfully demonstrated that they did not depart from accepted practices or that any supposed departures did not lead to Ms. Audette’s alleged injuries. Consequently, the burden shifted to Ms. Audette, who failed to provide sufficient evidence to establish that a genuine issue of fact existed.

Note that in addition to leaving AMA, many other actions by the plaintiff made her a difficult patient and weakened her claim. For example, she consistently refused necessary medical examinations and treatments, including pelvic exams and the application of fetal monitoring devices. She removed critical medical devices, such as her IV and fetal monitoring strips, and left her hospital unit several times without permission, disrupting her medical supervision. Her lack of cooperation during the delivery process, refusing to assist in the delivery or allow doctors to perform their duties, further complicated her care.

If you or a loved one has experienced complications during childbirth that you believe are due to medical negligence, it is critical to seek legal guidance. Contact an experienced New York birth injury lawyer who can help you understand your rights and the potential for recovering damages.

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