Marcantonio v. Moen

959 A.2d 764 (2008) 406 Md. 1 Charles MARCANTONIO, Personal Representative of The Estate of Sherri Schaefer, et al. v. Melissa MOEN, M.D., et al. No. 4, September Term, 2008. Court of Appeals of Maryland. November 5, 2008. ⁷⁶⁵ Jack A. Gold (Lawrence S. Lapidus of Karp, Frosh, Lapidus, Wigodsky & Norwind, P.A., Rockville; Anthony G. Newman of Newman & McIntosh, Bethesda), on brief, for petitioners. George S. Tolley, III, Dugan, Babij & Tolley, LLC, Timonium, David M. Kopstein, Kopstein & Perilman, Seabrook, brief of Amicus Curiae Maryland Trial Lawyers Ass'n.

Barry J. Nace, Christopher T. Nace, Jonathan B. Nace, Paulson & Nace, Washington, DC, amicus curiae brief of Karen Costello. Marianne DePaulo Plant (Craig B. Merkle and Jason B. Penn of Goodell, DeVries, Leech & Dann, LLP; Thomas C. Marriner of Wharton, Levin, Ehrmantraut & Klein, Annapolis; Catherine W. Steiner of Whiteford, Taylor & Preston, LLP, Baltimore), all on brief, for respondents. Argued before BELL, C.J., HARRELL, BATTAGLIA, GREENE, JOHN C. ELDRIDGE (Retired, Specially Assigned), IRMA S. RAKER (Retired, Specially Assigned) and ALAN M. WILNER (Retired, Specially Assigned), JJ. GREENE, J. In this case we must determine whether the Circuit Court for Anne Arundel County erred in striking the affidavits of two proposed expert witnesses pursuant to Maryland Rule 2-501(e).

Because we conclude that it was error to strike the affidavits, we shall hold that the Circuit Court improperly granted summary judgment in favor of Respondents, Melissa Moen, M.D. et. al ("The Medical Providers"), [1] on the basis that Petitioners, Charles Marcantonio, et al. ("Marcantonios"), failed to establish that The Medical Providers' negligence was the proximate cause of Sherri Schaefer's death. I. In August of 2000, Sherri Schaefer visited her gynecologist, Melissa Moen, M.D., and informed Dr. Moen that she was experiencing abnormal vaginal bleeding. It is ⁷⁶⁶ alleged that Dr. Moen ordered a transabdominal and transvaginal pelvic ultrasound to aid her in determining the cause of the bleeding, but failed to perform an endometrial biopsy at that time. [2] The ultrasound was performed on September 11, 2000, and subsequently interpreted by radiologist, Paula DeCandido, M.D. When interpreting the ultrasound, Dr. DeCandido failed to report a 1.5 centimeter mass located on Ms. Schaefer's right ovary. After the August and September, 2000 visits, Ms. Schaefer continued to experience physical problems and complained to Dr. Moen of pelvic symptoms and irregular bleeding.

In April of 2001, Dr. Moen performed an endometrial biopsy of Ms. Schaefer's uterus and discovered that Ms. Schaefer had endometrial cancer. In May of 2001, after being diagnosed with cancer, Ms. Schaefer began treatment with Robert Bristow, M.D., a gynecological oncologist, at the Johns Hopkins Medical Center. Dr. Bristow operated on Ms. Schaefer in June of 2001; however, the operation did not help Ms. Schaefer survive her cancer. Dr. Bristow continued to treat Ms. Schaefer until her death on May 18, 2005.

Prior to her death, Ms. Schaefer and her husband, Charles Marcantonio, filed a cause of action for medical negligence against The Medical Providers alleging that they negligently failed to diagnose and treat Ms. Schaefer's endometrial and ovarian cancer in August and September of 2000. Specifically, the complaint alleged that Dr. Moen breached the applicable standard of care by failing to perform an endometrial biopsy in August of 2000 and that Dr. DeCandido breached the standard of care by failing to report the 1.5 centimeter mass disclosed as a result of Ms. Schaefer's September 2000 ultrasound. After Ms. Schaefer's death, Charles Marcantonio amended the complaint to add wrongful death and survivorship claims against The Medical Providers.

II

The depositions of two of the Marcantonios' expert witnesses, Drs. Hutchins and Shmookler, are pertinent to our review of this case. At his deposition, Dr. Hutchins testified that he believed to a reasonable degree of medical probability that Dr. Moen departed from the applicable standard of care in failing to perform an endometrial biopsy of Ms. Schaefer's uterus during or shortly after Ms. Schaefer's August 2000 visit. Dr. Hutchins opined that if Dr. Moen had performed the endometrial biopsy, she would have been able to properly diagnose and treat Ms. Schaefer's condition.

Dr. Hutchins' exact words were as follows: My opinion is that in response to the abnormal bleeding [Dr. Moen] was required to do an endometrial biopsy as soon as is possible. The longer you wait, the more likely the patient is to suffer the consequences of the delay. And the whole time period from the 25th of August until ultimately the biopsy was done, in that whole time period, I guess we would have to say until [Dr. Moen] did it, she was in breach of the standard of care. Moreover, Dr. Hutchins indicated that had Ms. Schaefer's condition been properly diagnosed and treated in August or September of 2000, she would have had an 80 percent chance of survival.

During the ⁷⁶⁷ course of the deposition, the following exchange also occurred: Counsel: Are you going to be rendering an opinion within reasonable medical probability as to M[s]. Schaefer's cause of death? Dr. Hutchins: No. In a subsequent affidavit, Dr. Hutchins stated: This will confirm that I hold the following opinion within a reasonable degree of medical probability: Dr. Moen's failure to properly diagnose Ms. Scheaffer's [sic] condition as an early carcinoma of the uterus, and/or a precancerous lesion and/or some form of hyperplasia in August or September of 2000 and the resultant failure to begin immediate treatment were the proximate cause of Ms. Scheaffer's [sic] death. The second expert witness, Dr. Shmookler, testified at his deposition that the 1.5 centimeter mass on Ms. Schaefer's right ovary that Dr. DeCandido failed to report in September of 2000 was in all probability benign, yet a precursor to cancer.

He went on to opine that had Ms. Schaefer's condition been properly diagnosed in September 2000, that in all medical probability, her cancer would have been curable. Later in his deposition, the following exchange occurred: Counsel for The Medical Providers: Do you have an opinion to a reasonable degree of medical probability as to what [Ms. Schaefer's] staging[ [3] ] was in July of 2001? Dr. Shmookler: No, I don't, because as I said, that's more—particularly in a case like this, I would defer to the oncologist or gynecologic oncologist. They would stage this. * * * Counsel for The Medical Providers: Do you have an opinion within reasonable medical probability as to Ms. Schaefer's prognosis[ [4] ] in May of 2001?

Dr. Shmookler: Not as far as survival or anything like that. I'm not going to be going into that. * * * Counsel for Dr. Shmookler: Just so counsel is clear, [Dr. Shmookler] does have an opinion as to whether the cancer could have been cured if the treatment was rendered back at the time of the sonogram. It's not exactly your question, but I don't want you to be surprised at trial if [Dr. Shmookler] renders opinions as to the histopathology[ [5] ] and the—whether it was curable earlier on. * * * Counsel for The Medical Providers: Do you have an opinion as to Ms. Schaefer's prognosis at any point in time from August 2000 through July of 2001? ⁷⁶⁸ Dr. Shmookler: Well, I believe, at the time of the sonogram, the first sonogram, which was . . . September of 2000 again, as far as the ovary, as I said, we know there was a complex mass there.

We also know that it was one to one and a half centimeters. I believe at that point it was, as I said earlier, a cystadenoma, which is a benign tumor, so there is no chance of metastasis there, and I also mentioned that the endometrial tumor was in a much earlier stage, that it was not invasive, it was probably atypical hyperplasia or maybe carcinoma in situ, so I think, had that been diagnosed in September of 2000, in all medical probability that uterine cancer would have been curable. In a subsequent affidavit, Dr. Shmookler stated: I have reviewed the pathology slides of the decedent, Sherri Scheaffer [sic], as well as the original endometrial biopsy and other medical records. I provided a deposition at the request of the defendants to this action. . . .

The failure to properly evaluate the ovarian tumor of Sherri Scheaffer [sic] in September of 2000, when it was in an early stage, was a substantial factor in proximately causing her death. Upon motions by The Medical Providers, the Circuit Court for Anne Arundel County struck the affidavits of Drs. Shmookler and Hutchins on the basis that the affidavits materially contradicted the experts' deposition testimony in violation of Maryland Rule 2-501(e). [6] Subsequently, the Circuit Court granted The Medical Providers' joint motion for summary judgment on all counts against the Marcantonios, concluding that the Marcantonios had failed to provide sufficient evidence that The Medical Providers' negligence proximately caused Ms. Schaefer's death. The Circuit Court elaborated on its conclusion as follows: The Court will grant the Defense motions for summary judgment, because I think that the case of Fennell v. Southern Maryland Hospital, 320 Md. 776 [ 580 A.2d 206 ], is controlling in the sense that the [Marcantonios], even assuming the things that have been pointed out in the depositions, have not offered evidence that would establish proximate causation of 51 percent or more of the chance of loss . . . of survival.

A majority of the Court of Special Appeals agreed with the Circuit Court's conclusion that the affidavits of Drs. Hutchins and Shmookler materially contradicted the experts' deposition testimony. Marcantonio v. Moen, 177 Md.App. 664 , 937 A.2d 861 (2007). In regard to the decision to ⁷⁶⁹ strike Dr. Hutchins' affidavit, the intermediate appellate court [7] reasoned as follows: At deposition, Dr. Hutchins flatly said he was not going to be giving an opinion as to the cause of Ms. Schaefer's death.

In his affidavit, Dr. Hutchins expressed an opinion as to the cause of Ms. Schaefer's death. In other words, without any explanation ( see Md. Rule 2-501(e)(2)), Dr. Hutchins did the exact opposite of what he said at deposition that he was not going to do. It is difficult to imagine a more stark contradiction than the one complained about by [The Medical Providers]. Marcantonio, 177 Md.App. at 693 , 937 A.2d at 878 .

Pertaining to Dr. Shmookler's affidavit, the court reasoned: [I]n a case of this sort, it is highly relevant as to what a decedent's chance of survival is at the time the appropriate treatment commenced. Without an opinion in that regard, no expert, no matter how well qualified, can say in a case like this whether it is more probable than not that a healthcare provider's negligence caused the patient's death. We therefore agree with the circuit court and with [The Medical Providers] that there was a material contradiction between what Dr. Shmookler told the attorneys in deposition and what he said in his affidavit. Marcantonio, 177 Md.App. at 697 , 937 A.2d at 880 .

The Court of Special Appeals concluded that "without [the affidavits of Drs. Shmookler and Hutchins], summary judgment was appropriate because the evidence, taken in a light most favorable to the [Marcantonios], showed only a possibility that [The Medical Providers'] negligence caused Ms. Schaefer's death." Marcantonio, 177 Md.App. at 691 , 937 A.2d at 877 . In a dissenting opinion, Judge Meredith concluded that the "[t]he affidavits were not irreconcilably at odds with the opinions expressed by [the experts] at their depositions, and . . . should not have been considered mere shams subject to being stricken under Rule 2-501(e)." Marcantonio, 177 Md.App. at 706 , 937 A.2d at 885 (Meredith, J., dissenting). We granted the Marcantonios' petition for writ of certiorari, [8] Marcantonio v. Moen, 404 Md. 152 , 945 A.2d 1270 (2008), and for the reasons stated herein, we shall reverse the judgment of the Court of Special Appeals.

III

Rule 2-501 (e), Contradictory Affidavits or Statements The "sham affidavit" rule is a doctrine that was first articulated by the Second ⁷⁷⁰ Circuit in Perma Research and Development Co. v. Singer Co., 410 F.2d 572 (2d Cir.1969). Collin J. Cox, Reconsidering the Sham Affidavit Doctrine, 50 DUKE L.J. 261, 267 (2000). Since Perma, the doctrine has been adopted, to some extent, by every federal circuit and many state courts. Shelcusky v. Garjulio, 172 N.J. 185 , 797 A.2d 138, 144-45 (2002).

This Court first considered the sham affidavit rule in Pittman v. Atlantic Realty, 359 Md. 513 , 754 A.2d 1030 (2000) where we summarized the rule, as originally articulated in Perma, as follows: "Stated strictly, the Perma [sham affidavit] rule is that, if an interested party has personal knowledge of the relevant facts, and if that party cannot explain a material contradiction between deposition testimony and a subsequent affidavit by the acquisition of newly acquired evidence, then a trial court may disregard the affidavit as a `sham,' i.e., as one failing to `raise [] any issue which [the trial court] can call genuine.'" Pittman, 359 Md. at 529 , 754 A.2d at 1038 . In Pittman , we declined to adopt the Perma sham affidavit rule, or any variation thereof, utilized by the federal courts. Because the reasoning and analysis in Pittman is dispositive to our interpretation of Maryland Rule 2-501(e), we discuss the opinion at some length below. In Pittman , Shari Hall ("Hall") and her young son, Terran, filed an action against the owners of a residential property. 359 Md. at 518 , 754 A.2d at 1032 .

The complaint alleged that Terran had become ill due to lead paint exposure while at the property. Id. During discovery, Hall provided "vague, confused and inconsistent" information pertaining to the duration of Terran's stay at the subject premises. Pittman, 359 Md. at 519 , 754 A.2d at 1033 .

In response to interrogatories, Hall indicated that Terran lived at the premises from 1992 to 1993 and was cared for there from 8:00 am to 4:00 pm Monday through Friday. Id. At deposition, however, Hall indicated that Terran lived at the premises for a maximum of two months and visited the premises around two times per week before residing there and three to four times a week after residing there. Pittman, 359 Md. at 520-21 , 754 A.2d at 1034 .

Based on the information that Hall provided at her deposition, her and Terran's causal relation expert, Howard Klein, M.D., opined that a two month residency was an insufficient period of exposure to make the premises a substantial factor in causing Terran's injuries. Pittman, 359 Md. at 522-23 , 754 A.2d at 1034-35 . Citing Dr. Klein's deposition testimony, the defendants moved for summary judgment and asserted that Hall had failed to establish that exposure to lead at the subject premises was a substantial causal factor in bringing about Terran's injuries. Pittman, 359 Md. at 523 , 754 A.2d at 1035 .

In opposition to the motion for summary judgment, Hall submitted an affidavit stating that Terran lived at the residence for longer than five months and visited the premises for seven to eight hours daily before and after living there. Id. In light of this information, Dr. Klein also filed an affidavit opining that the presence of lead paint in the subject premises was a substantial cause of Terran's elevated blood lead levels. Pittman, 359 Md. at 524 , 754 A.2d at 1036 .

The Circuit Court for Baltimore City struck the affidavits, concluding that they significantly contradicted Hall's deposition testimony. [9] Pittman, 359 Md. ⁷⁷¹ at 524-25, 754 A.2d at 1036 . As a result of striking the affidavits, the motions court granted summary judgment. Pittman, 359 Md. at 529 , 754 A.2d at 1036 . The Court of Special Appeals affirmed the Circuit Court's grant of summary judgment, thereby approving the trial judge's decision to strike the affidavits, and in doing so, adopted the sham affidavit rule as articulated by the federal courts.

Pittman, 359 Md. at 526 , 754 A.2d at 1036-37 . This Court reversed, holding that the sham affidavit rule was inconsistent with Maryland law because the rule improperly shifts credibility determinations from the trier of fact to the trial court on summary judgment. Pittman, 359 Md. at 540-42 , 754 A.2d at 1041 . In so holding, we stated: If we were to adopt the sham affidavit rule in order to address what may be a relatively small number of cases in which sham affidavits are presented, the downside possibly would be an increase in the filings of summary judgment motions that are based on an attempt to convince the trial court that some variation in the nonmovant's affidavit was completely and inexplicably contradictory and that the variation was not simply a clarification or an elaboration.

If a need develops for a sham affidavit rule, that need ordinarily would be discerned initially by our Standing Committee on the Rules of Practice and Procedure. Pittman, 359 Md. at 541-42 , 754 A.2d at 1045 . In 2003, the Rules Committee recommended amending Maryland Rule 2-501 to include a subsection that addresses contradictory affidavits or statements. 30 Md. Reg. 1907 -08 (Dec. 26, 2003). The Reporter's Note accompanying the Rules Committee's recommendation indicates that the proposed amendment was "intended to respond to the Court of Appeals' invitation in Pittman v. Atlantic Realty Co., 359 Md. 513 , 754 A.2d 1030 (2000), for the Rules Committee to study the issue of `sham affidavits.'" 30 Md. Reg. 1125 (Aug. 22, 2003).

The Court acted on the Rules Committee's recommendation and amended Maryland Rule 5-201 to include subsection (e) In relevant part Rule 2-501(e) specifically provides that "[i]f the court finds that the affidavit or other statement under oath materially contradicts the prior sworn statement, the court shall strike the contradictory part. . . ." In the instant case, The Medical Providers argue that the plain language of Rule 2-501(e) mandates that the Rule applies any time an affiant contradicts any prior sworn statement and not only when an affiant irreconcilably contradicts a prior statement of fact. They further maintain that the Circuit Court appropriately applied Rule 2-501(e) when striking the affidavits of Drs. Hutchins and Shmookler. According to The Medical Providers, Dr. Hutchins' affidavit materially contradicts his prior deposition testimony because the affidavit renders an opinion as to the cause of Ms. Schaefer's death, whereas at his deposition, Dr. Hutchins stated he was not going to be giving an opinion on this matter. [10] As to Dr. Shmookler, The Medical Providers contend that Dr. Shmookler materially ⁷⁷² contradicted his deposition testimony that he did not have an opinion as to Ms. Schaefer's staging in July of 2001 or prognosis in May of 2001 by later stating in his affidavit that the failure to properly evaluate Ms. Schaefer's tumor in September of 2000 was a substantial factor in proximately causing her death.

The Medical Providers also contend that it was a material contradiction for Dr. Shmookler to give an opinion as to the cause of Ms. Schaefer's death via affidavit when Dr. Shmookler stated at his deposition that he would defer to a oncologist or gynecological oncologist regarding Ms. Schaefer's July 2001 staging. [11] The Marcantonios counter that the affidavits of Drs. Hutchins and Shmookler do not materially contradict the experts' earlier deposition testimony and that the Circuit Court erroneously struck those documents. The Marcantonios urge that Pittman is instructive in determining if the affidavits in this case materially contradict the experts' earlier deposition testimony. They further point out that, in Pittman , the Court stated that, theoretically, the sham affidavit rule only applies when there is a flat contradiction of material fact between deposition testimony and affidavits opposing summary judgment.

The Marcantonios contend that neither Dr. Hutchins' nor Dr. Shmookler's affidavit contains flat contradictions of material fact. They posit that Dr. Hutchins did not state that he could not render an opinion as to causation, or that The Medical Providers' negligence was not a cause of Ms. Schaefer's death. Rather, they assert, that at the time of deposition, Dr. Hutchins simply conveyed that he did not intend to render an opinion as to causation. The Marcantonios' argument in regard to Dr. Shmookler is that, his act of providing an opinion regarding the ramifications of the failure to properly evaluate Ms. Schaefer's tumor in September of 2000 does not materially contradict his statements that he would defer to another type of specialist as to her prognosis in May of 2001 or would not be rendering an opinion as to her staging in July of 2001.

We hold that the affidavits of Drs. Hutchins and Shmookler do not materially contradict their respective deposition testimony within the meaning of Rule 2-501(e). [12] Rule 2-501(e) does not define "material contradiction," and thus, we interpret the terms as they are ordinarily and popularly understood in the English language. See King v. State, 400 Md. 419, 429 , 929 A.2d 169, 175 (2007) (noting that when construing a rule, we must first look to the words of the rule, giving them their ordinary and plain meaning). A contradiction is an "act of contradicting"; to contradict means to "express or assert the opposite of a statement." WEBSTER'S II NEW COLLEGE DICTIONARY 251 (3d ed. 2005); See also Kucharczyk v. State, 235 Md. 334, 338 , 201 A.2d 683, 685 (1964) ("When a witness says in one breath that a thing is so, and in the next breath that it is not so, his testimony is too inconclusive, contradictory, and uncertain to be the basis of a legal conclusion.").

A contradictory statement ⁷⁷³ or action is material if it is significant or essential. BLACK'S LAW DICTIONARY 998 (8th ed. 2004); See also Miller v. Bay City, 393 Md. 620, 631 , 903 A.2d 938, 945 (2006) (indicating that a fact is material if it "affect[s] the outcome of the case"). Accordingly, a material contradiction under 2-501(e) is a factual assertion that is significantly opposite to the affiant's previous sworn statement so that when examined together the statements are irreconcilable. [13] Cf. Pittman, 359 Md. at 542 , 754 A.2d at 1045 (indicating that the sham affidavit rule applies to "flat" contradictions of material fact).

This definition of material contradiction addresses concerns raised by affidavits like Shari Hall's in Pittman . During the Rules Committee's deliberations on the issue of sham affidavits, the Committee Chair [14] characterized Hall's affidavit as a "180 degree recantation that was difficult to believe." Minutes of the Court of Appeals Standing Committee on the Rules of Practice and Procedure, 56-57 (Nov. 17, 2000). Pittman thus provides an example of an affidavit that contains a "material contradiction" that would be properly struck under Rule 2-501(e). Hall's affidavit contained factual statements that were irreconcilable with her previous deposition testimony.

In other words, both Hall's affidavit and her prior statements could not have been true. Terran and Shari Hall could not have both lived at the subject premises for five-and-a-half months and for a maximum of two months. Hinch v. Lucy Webb Hayes Nat. Training, 814 A.2d 926 (D.C.2003), however, provides an example of an affidavit that does not materially contradict prior sworn testimony.

Hinch is similar to the case at bar. In Hinch , the trial court granted summary judgment in favor of the defendants as to the medical negligence claim, on the basis that the plaintiff had failed to provide sufficient evidence