Janie Duncan v. State of Illinois

OPINION

BURNS, J. This claim is before the Court upon a recommendation from Commissioner Herbert B. Rosenberg following an evidentiary hearing.

Claimant, Janie Duncan, as the Administratix of the Estate of Wade Earle, deceased, is seeking damages for the wrongful death of Wade Earle. Claimant is requesting $100,000 in damages for each four surviving family members of Wade Earle. The four surviving family members are: Janie Duncan (mother), Scott Earle (brother), Alexander Earle (brother), and William Earle (brother). In October of 2008, Wade Earle (“Wade”) voluntarily admitted himself to the Elgin Mental Health Center (“Center”) in Elgin, Illinois, an agency of the Respondent.

Wade received treatment and medication while at the Center. Wade was discharged on November 25, 2008 to stay at the Jack Clark House, a drug and alcohol rehabilitation center.

Wade was found dead in his bed at the rehabilitation center on the evening of November 30, 2008. Claimant alleges that Respondent is liable for the death of Wade due to negligent medical care provided to Wade that fell short of the requisite standard of care.

On August 28, 2015, evidentiary hearings were held before Commissioner Herbert B. Rosenberg. Mr. Edward G. Proctor Jr. of the Law Offices of Munday, Nathan & Schulkin appeared on behalf of the Claimant. Mr. Martin W. Burzawa from the Office of the Illinois Attorney General appeared on behalf of the Respondent. Ms. Nichole M. Pawlicki of Jensen Litigation Solutions, a Certified Shorthand Reporter and Registered Professional Reporter, recorded the transcript of the hearing.

FACTS

The evidence in the record shows that Wade died on November 30, 2008. Wade was 30 years old. Prior to his death, Wade was treated at the Center from October 23, 2008 until discharge on November 25, 2008. While at the Center, Wade received Klonopin, an anti-anxiety medication, along with Trazadone. For much of his time at the Center, Wade received a daily dosage of 1.5 mg of Klonopin. However, Wade was approved to stay at the Jack Clark House, which does not allow patients taking Klonopin. Therefore, Wade was tapered off of Klonopin by being given 1.0 mg for two days and 0.5 mg for two days. Wade received his last dose of Klonopin on the evening of November 21, 2008. The postmortem report by the Cook County [*139] Medical Examiner did not note any Klonopin in the toxicology analysis, but it did disclose that Wade had an enlarged heart with his left ventricle measuring 0.7 inches in thickness.

Prior to his stay at the Center, Wade had a history of anxiety and had been diagnosed with bipolar disorder and obsessive-compulsive disorder. At times in his life, Wade had intermittently been under a doctor’s care for his bipolar disorder and obsessive-compulsive disorder. Wade also had a history of substance abuse. At such times, Wade had actively used cocaine and had also been known to have used Ecstasy, Xanax, LSD, methamphetamines, and cannabis.

LEGAL ANALYSIS

For the Claimant to recover against the State, the Claimant “must prove by a preponderance of the evidence through expert testimony, a breach of duty, the standard of care required, that Respondent deviated from the standard of care, and that the deviation was a proximate cause of the claimant’s injury.” Masterson v. State, 54 Ill. Ct. Cl. 272, 276 (2001). In the present case, the Claimant’s claims being pursued against Respondent allege that Wade’s death was caused by the medical care provided to Wade at the Center which fell short of the proper standard of care with respect to the time period to withdraw a patient from the medication Klonopin which was provided to Wade at the Center.

To establish the standard of care, Claimant introduced the testimony of Dr. Gregory Collins, a Board Certified psychiatrist with 35 years of experience at the Cleveland Clinic, as an expert witness. Dr. Collins has written and published numerous works on a number of topics including the topic of drug withdrawal. Dr. Collins reviewed the hospital records along with the deposition of Dr. Patel, the medical director of the community psychiatric services at the Center, the deposition of Mr. Duncan (the case worker for Wade while Wade was at the Center), and Dr.

Collins’ own prior deposition. Dr. Collins testified as to the standard of care for the treatment provided to Wade at the Center. Dr. Collins’ opinion was that the proper standard of care should have been to taper Wade off Klonopin in a much more gradual manner. Dr. Collins testified that the manufacturer’s recommendation for a taper of a 1.5 mg daily dosage of Klonopin would be 15 days. However, on cross-examination Dr. Collins admitted that a psychiatrist would not defer to a manufacturer’s recommendation. Rather a psychiatrist would prescribe a withdrawal treatment based on their medical judgment and evaluation of a patient. Additionally, Dr. Collins admitted that he does not always treat patients in accordance with the manufacturer’s recommendations. Dr. Collins also testified that it was a deviation from the standard of care to have Trazadone added to the Klonopin, and to discharge Wade after discontinuing Klonopin.

Respondent entered into evidence the deposition of Dr. Malini Patel as an expert witness with respect to the standard of care. Dr. Patel is the medical director of community psychiatric services at the Center and is Board Certified in psychiatry. Dr. Patel reviewed Wade’s medical chart, the postmortem examination report by the Cook County Medical Examiner, and the report by Mr. Collins. Dr. Patel testified that the standard of care would not require a taper off of Klonopin for the dosage provided to Wade.

[*140] Both parties have entered into evidence testimony from expert witnesses with respect to the standard of care and whether the treatment provided to Wade at the Center met the standard of care. However, to succeed on a claim, the Claimant must also prove by a preponderance of the evidence that any breach of the standard of care by the Respondent was the proximate cause of Wade’s death. A claimant sustains the burden by proving through expert testimony that the respondent’s breach of the standard of care is more probably true than not the cause of the claimant’s injury. Cleckly v. State, 47 Ill. Ct. Cl. 235, 257 (1994). Proximate cause is not established where casual connection is contingent, speculative or merely possible. Id. In the case at hand, the Claimant has not met his burden.

Claimant contends that Wade’s death was the result of complications from a seizure that was caused from rapid withdrawal from Klonopin without properly tapering the medication and monitoring Wade’s condition. However, there is no affirmative evidence or testimony in the record that Wade actually suffered a seizure. Wade did not have documented history of having seizures. The postmortem examination did not present any observations consistent with a person that had suffered a seizure, which was highlighted in the deposition testimony by Dr. Patel and supported by deposition testimony admitted into evidence from the forensic pathologist Dr.

Michel J. Humilier who performed the postmortem examination. There were not any witnesses presented from the Jack Clark House or anywhere else that could testify whether Wade had a seizure. There was no evidence that Wade was experiencing symptoms of Klonopin withdrawal.

Dr. Collins testified that he believed that Wade had a massive seizure, but Dr. Collins’ testimony is not conclusive in its entirety. When asked about the basis of his opinion, his testimony was that “lacking any other explanation…,” Wade died from withdrawal seizure from Klonopin.

Trial Tr. Pg. 32. 1, 21 - pg. 33. 1. 3. Also, Dr. Collins conceded that there were no eyewitnesses when Wade died or no other direct evidence of a seizure. Trial Tr. Pg. 60, ll. 13-16. Claimant has shown that Wade was removed from Klonopin over a four-day period and that Wade died when he no longer had Klonopin in his system. However, to cite an adage from statistics, correlation does not imply causation. Respondent has presented evidence of other explanations which could explain Wade’s untimely death at age 30. The postmortem examination noted that Wade had an enlarged heart with a left ventricle that measured 0.7 inches in thickness. Also, Wade had a documented medical history of drug use including cocaine and methamphetamine use. Malini Patel Dep. 15:19-22. These factors may have been the cause of Wade’s sudden death. Malini Patel Dep. 37:5-13; Michel Humilier Dep. 23:5-12. While these facts do not necessarily prove that Wade’s death was caused by an enlarged heart or drug abuse, they do provide another possible explanation. It is the possibility of another explanation for Wade’s death that undermines the testimony provided by Dr. Collins which is predicated on a lack of other explanations for the cause of Wade’s death. The bottom line is that the burden is on the Claimant to show that it was more likely than not that a breach of the standard of care by Respondent produced Wade’s death. The Claimant has regrettably not met this burden.

Based on the evidence entered into the record, Claimant has failed to meet the burden of proof. Claimant did not provide sufficient evidence to show that the death of Wade was caused by Respondent breaching the standard of care to Wade by Wade’s four-day taper off from Klonopin.

[*141] The Court acknowledges that the Claimant, Janie Duncan, was treated in a rude, impersonal, and unprofessional manner when seeking answers in the aftermath of her son’s death. Hopefully this type of behavior by the Center to a grieving patient is an isolated incident.

Any time a parent must bury their child is heartbreaking and the fact that Wade was only 30 years old compounds the tragedy. However, Claimant has not shown that the Respondent is legally responsible for Wade’s untimely death.

RECOMMENDATION

IT IS HEREBY ORDERED that Claimant’s claim is denied.