Preview
FILED: 'T' RICHMOND COUNTY CLERK 04/14/2016 02:36 PM INDEX NO. 150116/2012
I INDEX NU. lDUllb/4U.\.4
NYSCEF DOC.
|
NO. »
269 b D CGUNTY CLERK 12 28 I D 1 I I
RECEIVED NYSCEF: 04/14/2016
RECEIVED NYSCEF= 12/28/2015
NYSCEF Doc. NO. 256
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S U P R E M E C O U R T o F T H E S T A T E o F N E W Y O R K
C O U N T Y o F R IC H M O N D
X F
|f O B E R T \ } A L E N rI , DCM PART 1
P la in tif f , P r e s e n t:
HON. CHARLES M. TROIA
- a g a in s t-
D E c |s |o n ` A n D O R D E R
J O H N J . G A D O M S K I, M .D ., S H IM O N O A M I, N L D .,
L A B O R A T O R Y C O R P O R A T I OIndexNo.150116/2012
N o F A M E R IC A
H O L D IN G S , L A B O R A T O R Y C O R P O R A T IO N o F
A M E R IC A , P A T R IC IA c . M c C M
O Ro tMi o AnCN K o , s M
. 0. D
0 5. , a 0n 0d6 , 0
" J A N E D O E " , P .A ., in te n d e d to r e p r e s e n t th e f e m a le
P h y s ic ia n A s s is ta n t in th e o f f ic e o f D r. M c C o rm a c k
w h o w a s in v o lv e d in th e c a r e a n d tr e a tm e n t o f
p la in tif f, b u t w h o s e n a m e is n o t y e t k n o w n ,
Defendants .
.x
The following papers numbered 1 to 7 were marked submitted on the Wh day of
September 2015.
Papers
Numbered
Notice of motion For Summary Judgment by Defendant, John Gadomski M.D, I
with Supporting Papers and Exhibits
(dated March 19,
Notice of Motion for Summaw Judgment by Defendant, Laboratory
,Corporation of America, with Supporting Papers and Exhibits
(dated March 23,
Notice of Motion for Summary Judgment bv Defendant, Shimon Oami M.D.,
with Supporting Papers and Exhibits
(dated March 10, ....~...-.~--~-~~»~--»»-~
Aftirmation in Opposition by Plaintiff 4
(dated April 29,
Memorandum of Law In Opposition by Plaintiff
(dated Aprit 29,
Reply Affirmation by Defendant, Dr. Shimon Oami
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(dated September 1, 2045)...
n..-....--.~~~q,-n..--..~~~~~v-»~...~|~'-»..--..»...-~...~..~.
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Reply Affirmation by Defendant, Dr. John Gadomski l
(dated September 9, 2015) !
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V A L E N T I v G A D Q M S K I, e t_ a i.
Upon the foregoing papers, the motion by defendant, John Gadomski MD. (No.
1't56) for summaryjudgment dismissing the compiairit as against him is denied. Likewise,
the cross motions of Labcorp Corooration of America and Shimon Oami MD. (No. 1192,
1283, respectively) for similar relief are denied.
I
In this action sounding in medical malpractice, ail moving defendants are seeking
to dismiss all causes of action and cross claims as against each of them on the grounds
that they each as individual defendants did not deviate from the standard of care in the
medicat community and did not proximately cause any harm to plaintiff,
The facts of this case are as follows:
On October 1, 2009, plaintiff presented to the oftice of Dr, Gadomski complaining
of a growth between the 41" and 5th toe on his ieft foot. Dr. Gadomski diagnosed a "fungal
infection"and prescribed a ten day course of antibiotic and a fungai cream. On November
19, 2009 piaintiff returned to Dr. Gadomski's office. According to plaintiff the growth had
grown and hewas having difficultywearing shoes (seeVaEenti Transcript p52 lines 1 149).
Dr. Gadomski testified that on that date the iesion looked "...a Iittie bit better" and that he
discussed doing a biopsy of the area but did not do so at that time (see, Gadomski
Transcript pp 35, 43).
On January6, 2010 plaintiff returned for a follow up visit. The growth had doubled
in size and was necessitating open toed shoes (see Valenti Transcript pp 55, 56) On that
day Dr, Gadomski noted that the raised area of the mass wasapproximately 3-6 cubit
centimeters, and took a single "slice" biopsy of tissue from the space in between the fourth
and fifth loe on plaintiffs foot, Dr. Gadomski did not obtain any sample from below the
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V A L E N T I v G Q D O M S K I. e t a l.
v i si bi y
rai sed area (see G adom sk iT ranscri pt pp 57,67), T he sam pl e w as then pi ck ed up
by a L abCorp couri er and transported to a L abCorp processi ng f aci l i tyi n R ari tan, N ew
Jer sey w her e i t
w as " accessi oned, ex am i nedf ora gr oss descr i pt i on, pr ocessed and
prepared i nto sl i des"
(see, O am iT ranscri pt pp 2125, 41 and 46). T hi s process i nci udes
rem ov i ng the sam pl e f rom
the f i x ati v e sol uti on i n w hi ch i tw as pi aced by the requi si ti oni ng
phy si ci an, secti oni ng the ti ssue and pl aci ng i t on the appropri ate cassettes. T he sam pl e
w as then del i v ered by another L abCorp couri er to the L abCorp f aci l i ty i n U ni ondal e, L ong
I sl and f or ex am i nati on bv
def endant D r. O am i , a pathol ogi st (see O arni
T ranscri pt pp 23-
35) . A ccor di ng t o D r . O am i
w hen t he sam pl e w as sect i oned byt he L abC or pst af f
it
" becam e f ragm ented" and brok e apart w hen he rev i ew ed i t (see O am i
T ranScri pt p 32).
O n or about January 12, 2010, D r. G adom sk i recei v ed a report f rom
L abCorp di agnosi ng
t he sam pl e as a V er ruca V ul gar i s w i t h no m ent i on of
any f ungal i nf ect i on. T he f esi on
how ev er conti nued to grow and D r. Gadom ski , on January 21 S', February 4" ', and February
18" ', conti nued to treat the grow th as a w art and topi cal ty
appl i ed tri chl oroaceti c aci d to
t he r ai sed
por t i on
of t he l esi on
( see G adom sk i T r anscr i pt
pp 83.90, 96) . Pl ai nti f f 's
condi ti on c o n t i n u ed
to w o r senan d h e l astsaw D r.G ad o m sk ion M ar c h 11, 2010.
A ccordi ng to D r. G adom sk i
he nev er consi dered cancer as a di agnosi s, di dhot order any
other di agnosti c studi es rel ated to pl ai nti f f
and di d not ref er ptai nti f f
to any other prov i der
f or an ev al uati on and/or consul tati on G adom sk i T ranscri pt p 94).
O n M ay 7, 2010 pl ai nti f f w as treated by a phy si ci ans assi stant at the of f i ce of
non-
m ov i ng def endant D r . Pat ri ci a M cC or m i ck .
D r . M ccor m i ck 's st at f
cont i nued t ot r eat |
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pl ai nti f f s condi ti on as a w an, appi y i ng l i qui d ni trogen w i thout orderi ng any
i ndependent |
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V A L E N T I v G A D O M S K I, e t a l.
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anal y si s or di agnosti cs (see Pl ai nti f f
T ranscri pt pp 75-79). O n June 1, pl ai nti f f
w as seen
bv D r. M cCorm i ck w ho el ected to begi n the f i rst of
three l aser procedures to burn of fthe
l esi on onpl ai nt i f f 's f ool
( see M cC or m i ckT r anscr i pt
p 98) . O ne m ont h af t er
t he l aser
treatm ent began D r. M cCorm i ck secured a copy of the bi opsy report f romD r. G adom sk i .
A ccordi ng to pl ai nti f f , D r. M cCorm i ck " di dn't l i k e"
the pri or bi opsy (see Pl ai nti f f
T ranscri pt
p 86) and choseto perf orm a second bi opsy w hi ch w as sent to D erm Path L aboratory . T he
D erm Path report noted that " ...al though the surf ace of
thi s l esi on i s di gi tated..., there i s a
si gni f i cant
endop hy t i cand cy st i c
com ponen t ...squam ous c el l car ci nom a canno t be
ex cl uded" . A f ter recei v i ng thi s report D r. M cCorm i ck recom m ended that pl ai nti f f
see D r.
D av i d K i k en, a surgeon, w ho conf i nm ed that pl ai nti f f
had sk i n cancer. I n A ugust 2010,
pl ai nti f f
underw ent a surgi cal ex ci si on of
the m ass at Ri chm ond U ni v ersi ty M edi cal Center.
T he pathol ogy resul t ofthe surgery i ndi cated that pl ai nti f f
had squam ous cel l carci nom a
w hi ch had spr ead to t he bone. on Sept em ber 20, 2010, pl ai nt i f f
under w ent sur gi cal
am putati on ofthe f i f th toe on hi s l ef t f oot at M em ori al
Sl oan K etteri ng Cancer Center. T he
post O perati v e di agnosi s i ndi cated adv anced squam ous carci nom a i nv ol v i ng the f i f th toe
and i nterdi gi tal
space of the l ef t f oot.
i t i s ax i om ati c that the requi si te el em ents of
proof i n a m edi cal
m al practi ce acti on
are a dev i ati on or departure f rom
accepted com m uni ty standards of m edi calpracti ce, and
ev i dencel hatsuch dev i ati on or departurew as a prox i m ate cause of
i nj ury or dam age" (L au
v V ttart. 93 A D 3d 763, 765, Castro v N ew.Y ork Ci ty H eal th &H osps. Corp. , 74 A D 3d 1005).
"A def endant phy si ci an m ov i ng f or sum m ary j udgm ent i n a m edi cal
m al practi ce acti on has
the i ni ti al
burden of establ i shi ng. pri m a f aci e, ei ther the absence of
any departure f rom
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V A L EN T 1 vGA D o;y1s;< 1, gt aL
good and accepted m edi cal practi ce or that anydeparture w as not the prox i m ate cause
of the al l eged i nj uri es"
(see Shi chm an v Y asm er , 74 A D 3d 1316; L airseg v L oyQhusu_k , 55
A D 3d 560, 561).
. In suppor t of t he m ot i ons f or
sum m ar y j udgm ent each m ov i ng def endant , D r .
G adom sk i , D r. O am i
and L abCorp respect i v el yassert t hat thei r care and treatm ent of
pl ai nt i f f
di d not depar t f romgood and accepted m edi cal practi ce, di d not
dev i ate f rom
accepted m edi cal standards w i thi n the m edi cai
com m uni ty and di d not prox i m atel y cause
any resul ti ng i nj ury to pl ai nti f f . M ore speci f i cal l y i n supportof
hi s ow n m oti on D r. Gadom sk i
annex es the ex pert af f i rm ati on of
D r. John Rom ano, a board certi ti ed derm atol ogi st. D r.
Rom ano, i n ref erenci ng both the m edi calrecords and deposi ti on testi m ony concl udes to
a r easonabl e degr ee of m edi cal cer t ai nt y
t hat( 1)D r . G adom sk i
pr oper t ydi agnosed
pl ai nti f f s condi ti on as a w art, (2) ti m el y
and property perf orm ed a bi opsy ; (3) at al l
ti m es
prov i ded appropri ate care and treatm ent to pl ai nti f f , and (4) di d not cause or contri bute to
the l ater di agnosi s of
sk i n cancer and subsequent am putati on.
l n support ofthe m oti ons f or sum m ai y j udgm entdi sm i ssi ng the com pl ai nt as to each
of t hem , l abC or p and D r . Shi m on O am i
r el y
upon t he ex per taf f i r m at i on of
D r. D av i d
Si l v ers, a board certi f i ed, derm apathol ogi st. D r. Si l v ers concl uded af ter rev i ew i ng al l of
the
m edi cairecords i ncl udi ng the ori gi nal
L abcorp sl i des aSw el l
as the D erm apath speci m ens
that " there i s nothi ng i n the L abcorp pathoi ogy
speci m en that w outd be consi stent w i th
ei ther a k eratoacanthom a or any other ty pe squam ous cel l
carci nom a because there i s no
pathol ogi cf eatures i n that speci m en to i ndi cate a m al i gnancy and nothi ng i n the speci m en
that speci m en that show s cancer i n any f orm " . D r. Si l v ers al so rev i ew ed the D erm Path
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V A L E N T I v G A D O M S K I. e t a l.
specimen taken on July 13, 2010 "which when correlated with the clinical history and
temporal profile of the lesion are consistent with a Keratoanthema type squamous cell
carcinoma".lt is Dr. Silvers opinion within a reasonable degree ofmedical certatntythat the
specimen taken bv Dr, Gadomski and sent to LabCorp was of adequate size and
sufficiently stained and preserved to make the diagnosis aS to whether or not cancer was
present. According to Dr. Silver, Dr. Oami, whose sole role was limited to an interpretation
and diagnosis of the tissue specimen was correct in h.is interpretation that no pathofogicat
features existed on the specimen to indicate a malignancy (see Gadomski Motion Exhibit
"B"). Fudher, it is Dr. Silvers opinion that given that there was no questionable
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pathological indication, Dr. Oami had no duty to order or recommend further studies,
diagnostic tests or procedures (see, Gadomski Motion Exhibit "3").
Here, the defendants Dr. Gadomski, LabCorp and Dr. Oami established their prima
f a c ie e n title m e n t to ju d g m e n t a s a m a tte r'o f la w d is m is s
a s s e rte d a g a in s t e a c h o f th e m b y s u b m ittin g th e a ff id a v its
they did not deviate or depart from accepted medicai practice. However, in opposition, the
plaintiff raised a triable issue of fact, through the affirmation of his expert, as to whether
these defendants departed from good and accepted medicat practice and, if so, whether
such a departure was a proximate cause of the decedent's injuries (seeSchmitt v_lVledford
.Kidney Ctr., 121 AD3d 1088). The contention of Dr. Gadomski that the ptaintiff's expert
was unqualified to give an expert opinion on the standard of care of a dermatologist merely
because the expert was a board certified pathologist is without merit. An expert witness
must possess the requisite skitl, training, knowledge, or experience to ensure that an
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V A L E N T I v G A D O M S K I. e t a l.
opinion rendered is reliable (see Tsimbler v Feii, 123 AD3d 1009, 1009-10101, Behar v
Coren, 21 AD3d 1045). Once a medicaI expert establishes, as was done here, his or her
knowledge of the relevant standards of care, he or she need not be a specialist in the
particular area at issue to offer an opinion (see Tsimbler v Fell, 123 AD3d at 1009;
Bodensiek v Schwartz, 292 AD2d 411). Any lack of skill or expertise goes lo the weight
ofhis or her opinion as evidence, not its admissibility (seeAdamy v.Zirialgls, 92 Ny2d396,
Leavy v. Merriam, 2015 N App Div LEXiS 8290, 2015 NY Siip Op 08148 (NY App Div
2d Dept. Nov. f2, 2015).
At bar, Dr. Rakesh K. Abbi, a board certified pathologist, submitted an expert
affidavit in opposition to all three defendants motions for summary judgment. ln addition
to reviewing all of plaintiffs medical records, all of the deposition testimony and the
affirmations of Drs. Romano and Sitvers, Dr. Abbi performed a microscopic review and
study of the LabCorp specimen taken by Dr. Gadomski.
. with regards to Dr. Gadomski, Dr. Abbi concluded with a reasonable degreeof
medicat certainty that Dr. Gadomski misdtagriosed and mistreated the lesion on plaintiffs
foot as a fungus while faiiing to ever take a fungal culture, delayed doing a biopsy despite
the rapid growth of the lesion, relying on a substandard, superficial "shave biopsy" which
did not sampte tissue representative of the entirety of the lesion, failed to question the
results of the biopsy which indicated "verruca vulgaris, ofd" while the lesion was continuing
to increase "substantially and rapidly". Dr. Abbi also determined that Dr. Gadomski was
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V A L E N T I v G A D O M S K I, e t a l.
negl i gent i n not prov i di ng pl ai nti f f 's " perti nent cl i ni cal and m edi cal hi story " to both L abCorp lf
and D r. O am i1 D r. A bbi A f f i rm ati on annex ed to af f i rm ati on i n opposi ti on).
w i th regards to L abCorp and D r. O am i , D r. A bbi
contends that they both departed
f r omt he st and ar d
of c ar e t hat
t hey ow ed pl ai nt i f f
by f ai l i ng
to consi der or not e t he
rel ati onshi p and si m i l ar appearance of
squam ous cel l carci nom a to v erruca v ul gari s. D r,
A bbi al so opi nes that i t w as i m proper f or both the L ab and the pathol ogi st to " ...render a
def i ni ti v e beni gn di agnosi s... gi v en that the f ragm ents of
the v ery sm al l
sam pl e rev eal ed
the presence of hy perk erl oti c, perak eratoti c and papi l l om atoti c ti ssue, i t w as i m perati v e
that L abCorpand D r. O am i prov i de al erti ng notati ons w arni ng that m al i gnancy
coul d not
be ex cl uded and recom m endi ng ex ci si onal
bi opsy " . D r. A bbi al so concl udes that both D r.
O am iand L abCorp shoul d hav e noti f i ed D r. G adom sk i that the sam pl e w as def i ci ent and
not di agnosti cal l y adequate f or a def i ni ti v edi agnosi s. D r. A bbi
f i nai l y
concl uded that he
di sagreed w i th both D r. Si l v er and D r. Rom ano's f i ndi ng and that an earl i er consi derati on
of squam ous cel l carci nom a w oul d hav e l ed to a qui ck er di agnosi s and that the departures
bv al i three m ov i ng def endants w ere a prox i m ate cause and substanti al l y contri buted to the
i nv asi on of
the cancer deeper i nto pl ai nti f f s f oot resul ti ng i n the am putati on of
hi s toe.
l t i s cl ear to thi s C ourt af ter a rev i ew
of al lof t he conf l i cti ng ex pert subm i ssi ons
rel i ed upon that sum m ary j udgm ent m ust be deni ed as to each of
the m ov i ng def endants
'Pl ai nti f f testi f i ed that he sm ok ed a pack of ci garettes per day f or tw enty y ears and
conti nues to sm ok e and that he used tanni ng sal ons tw i ce a w eek f or a peri od of ei ght y ears (see,
V al enti D eposi ti on Pgs. 28, 34)
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" Sum m ary j udgm ent i s not appropri ate i n a m edi cal
m al practi ce acti on w here i N e parti es
adduce conf l i cti ng m edi cal
ex pert opi ni ons. Such credi bi l i ty
i ssues can onl y be resol v ed
by aj ury "
( } .uto v Staten l s. U ni v . H osp.
,t06 A D 3d 696; Fei nberg v Fel t, 23 A D 3d 517, 519).
Fi nal l y thi s Court has consi dered L abCorps argum ent w i th respect to di sm i ssal
of
t he act i on as t o t hem
on t he gr ounds t hatD r . O am i
i s an i ndependent cont r act or
and
accordi ngty they are not l i abl e f or hi s acts of
negl i gence (see A i v arado v
B eth I srael M ed.
Ctr. , 78 A D 3d 873). E v en i f
L abCorp coul d estabti sh that D r. O am i
w as an i ndependent
contractor, pl ai nti f f s ex pert has rai sed num erous tri abi e i ssues of f act regardi ng L abCorp's
i n d epen den t
ac t s ofn egl i g enc e w h i c h
w ar r an t
d eni al
of t h ei r
m oti on T ot h v .
B l osri i nsk y , 39 A D 3d 848)
A ccordi ngl y , i t i s
O R D E R ED , the m ot i ons by
def endant s D r . John J. G adom sk i
( 005), L aborat oi y
C or por at i on of
A m er i ca H ol di ngs, L abor at or y
C or por at i on of
A m er i ca ( 008)
, and D r .
Shi m on O am i(007) f or sum m on/j udgm ent are hereby deni ed
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FILED: 'T' RICHMOND COUNTY CLERK 04/14/2016 02:36 PM INDEX NO. 150116/2012 I INDEX NU. lDUllb/4U.\.4 NYSCEF DOC. | NO. » 269 b D CGUNTY CLERK 12 28 I D 1 I I RECEIVED NYSCEF: 04/14/2016 RECEIVED NYSCEF= 12/28/2015 NYSCEF Doc. NO. 256 6`~ 4 * S U P R E M E C O U R T o F T H E S T A T E o F N E W Y O R K C O U N T Y o F R IC H M O N D X F |f O B E R T \ } A L E N rI , DCM PART 1 P la in tif f , P r e s e n t: HON. CHARLES M. TROIA - a g a in s t- D E c |s |o n ` A n D O R D E R J O H N J . G A D O M S K I, M .D ., S H IM O N O A M I, N L D ., L A B O R A T O R Y C O R P O R A T I OIndexNo.150116/2012 N o F A M E R IC A H O L D IN G S , L A B O R A T O R Y C O R P O R A T IO N o F A M E R IC A , P A T R IC IA c . M c C M O Ro tMi o AnCN K o , s M . 0. D 0 5. , a 0n 0d6 , 0 " J A N E D O E " , P .A ., in te n d e d to r e p r e s e n t th e f e m a le P h y s ic ia n A s s is ta n t in th e o f f ic e o f D r. M c C o rm a c k w h o w a s in v o lv e d in th e c a r e a n d tr e a tm e n t o f p la in tif f, b u t w h o s e n a m e is n o t y e t k n o w n , Defendants . .x The following papers numbered 1 to 7 were marked submitted on the Wh day of September 2015. Papers Numbered Notice of motion For Summary Judgment by Defendant, John Gadomski M.D, I with Supporting Papers and Exhibits (dated March 19, Notice of Motion for Summaw Judgment by Defendant, Laboratory ,Corporation of America, with Supporting Papers and Exhibits (dated March 23, Notice of Motion for Summary Judgment bv Defendant, Shimon Oami M.D., with Supporting Papers and Exhibits (dated March 10, ....~...-.~--~-~~»~--»»-~ Aftirmation in Opposition by Plaintiff 4 (dated April 29, Memorandum of Law In Opposition by Plaintiff (dated Aprit 29, Reply Affirmation by Defendant, Dr. Shimon Oami I | (dated September 1, 2045)... n..-....--.~~~q,-n..--..~~~~~v-»~...~|~'-»..--..»...-~...~..~. 1ll5 i | Reply Affirmation by Defendant, Dr. John Gadomski l (dated September 9, 2015) ! I I I { i I l ! 9 i I E V i J V A L E N T I v G A D Q M S K I, e t_ a i. Upon the foregoing papers, the motion by defendant, John Gadomski MD. (No. 1't56) for summaryjudgment dismissing the compiairit as against him is denied. Likewise, the cross motions of Labcorp Corooration of America and Shimon Oami MD. (No. 1192, 1283, respectively) for similar relief are denied. I In this action sounding in medical malpractice, ail moving defendants are seeking to dismiss all causes of action and cross claims as against each of them on the grounds that they each as individual defendants did not deviate from the standard of care in the medicat community and did not proximately cause any harm to plaintiff, The facts of this case are as follows: On October 1, 2009, plaintiff presented to the oftice of Dr, Gadomski complaining of a growth between the 41" and 5th toe on his ieft foot. Dr. Gadomski diagnosed a "fungal infection"and prescribed a ten day course of antibiotic and a fungai cream. On November 19, 2009 piaintiff returned to Dr. Gadomski's office. According to plaintiff the growth had grown and hewas having difficultywearing shoes (seeVaEenti Transcript p52 lines 1 149). Dr. Gadomski testified that on that date the iesion looked "...a Iittie bit better" and that he discussed doing a biopsy of the area but did not do so at that time (see, Gadomski Transcript pp 35, 43). On January6, 2010 plaintiff returned for a follow up visit. The growth had doubled in size and was necessitating open toed shoes (see Valenti Transcript pp 55, 56) On that day Dr, Gadomski noted that the raised area of the mass wasapproximately 3-6 cubit centimeters, and took a single "slice" biopsy of tissue from the space in between the fourth and fifth loe on plaintiffs foot, Dr. Gadomski did not obtain any sample from below the _ 2 _ L r 4 i J V A L E N T I v G Q D O M S K I. e t a l. v i si bi y rai sed area (see G adom sk iT ranscri pt pp 57,67), T he sam pl e w as then pi ck ed up by a L abCorp couri er and transported to a L abCorp processi ng f aci l i tyi n R ari tan, N ew Jer sey w her e i t w as " accessi oned, ex am i nedf ora gr oss descr i pt i on, pr ocessed and prepared i nto sl i des" (see, O am iT ranscri pt pp 2125, 41 and 46). T hi s process i nci udes rem ov i ng the sam pl e f rom the f i x ati v e sol uti on i n w hi ch i tw as pi aced by the requi si ti oni ng phy si ci an, secti oni ng the ti ssue and pl aci ng i t on the appropri ate cassettes. T he sam pl e w as then del i v ered by another L abCorp couri er to the L abCorp f aci l i ty i n U ni ondal e, L ong I sl and f or ex am i nati on bv def endant D r. O am i , a pathol ogi st (see O arni T ranscri pt pp 23- 35) . A ccor di ng t o D r . O am i w hen t he sam pl e w as sect i oned byt he L abC or pst af f it " becam e f ragm ented" and brok e apart w hen he rev i ew ed i t (see O am i T ranScri pt p 32). O n or about January 12, 2010, D r. G adom sk i recei v ed a report f rom L abCorp di agnosi ng t he sam pl e as a V er ruca V ul gar i s w i t h no m ent i on of any f ungal i nf ect i on. T he f esi on how ev er conti nued to grow and D r. Gadom ski , on January 21 S', February 4" ', and February 18" ', conti nued to treat the grow th as a w art and topi cal ty appl i ed tri chl oroaceti c aci d to t he r ai sed por t i on of t he l esi on ( see G adom sk i T r anscr i pt pp 83.90, 96) . Pl ai nti f f 's condi ti on c o n t i n u ed to w o r senan d h e l astsaw D r.G ad o m sk ion M ar c h 11, 2010. A ccordi ng to D r. G adom sk i he nev er consi dered cancer as a di agnosi s, di dhot order any other di agnosti c studi es rel ated to pl ai nti f f and di d not ref er ptai nti f f to any other prov i der f or an ev al uati on and/or consul tati on G adom sk i T ranscri pt p 94). O n M ay 7, 2010 pl ai nti f f w as treated by a phy si ci ans assi stant at the of f i ce of non- m ov i ng def endant D r . Pat ri ci a M cC or m i ck . D r . M ccor m i ck 's st at f cont i nued t ot r eat | I : pl ai nti f f s condi ti on as a w an, appi y i ng l i qui d ni trogen w i thout orderi ng any i ndependent | I i| | > -3_ r | I r II I | r V A L E N T I v G A D O M S K I, e t a l. L anal y si s or di agnosti cs (see Pl ai nti f f T ranscri pt pp 75-79). O n June 1, pl ai nti f f w as seen bv D r. M cCorm i ck w ho el ected to begi n the f i rst of three l aser procedures to burn of fthe l esi on onpl ai nt i f f 's f ool ( see M cC or m i ckT r anscr i pt p 98) . O ne m ont h af t er t he l aser treatm ent began D r. M cCorm i ck secured a copy of the bi opsy report f romD r. G adom sk i . A ccordi ng to pl ai nti f f , D r. M cCorm i ck " di dn't l i k e" the pri or bi opsy (see Pl ai nti f f T ranscri pt p 86) and choseto perf orm a second bi opsy w hi ch w as sent to D erm Path L aboratory . T he D erm Path report noted that " ...al though the surf ace of thi s l esi on i s di gi tated..., there i s a si gni f i cant endop hy t i cand cy st i c com ponen t ...squam ous c el l car ci nom a canno t be ex cl uded" . A f ter recei v i ng thi s report D r. M cCorm i ck recom m ended that pl ai nti f f see D r. D av i d K i k en, a surgeon, w ho conf i nm ed that pl ai nti f f had sk i n cancer. I n A ugust 2010, pl ai nti f f underw ent a surgi cal ex ci si on of the m ass at Ri chm ond U ni v ersi ty M edi cal Center. T he pathol ogy resul t ofthe surgery i ndi cated that pl ai nti f f had squam ous cel l carci nom a w hi ch had spr ead to t he bone. on Sept em ber 20, 2010, pl ai nt i f f under w ent sur gi cal am putati on ofthe f i f th toe on hi s l ef t f oot at M em ori al Sl oan K etteri ng Cancer Center. T he post O perati v e di agnosi s i ndi cated adv anced squam ous carci nom a i nv ol v i ng the f i f th toe and i nterdi gi tal space of the l ef t f oot. i t i s ax i om ati c that the requi si te el em ents of proof i n a m edi cal m al practi ce acti on are a dev i ati on or departure f rom accepted com m uni ty standards of m edi calpracti ce, and ev i dencel hatsuch dev i ati on or departurew as a prox i m ate cause of i nj ury or dam age" (L au v V ttart. 93 A D 3d 763, 765, Castro v N ew.Y ork Ci ty H eal th &H osps. Corp. , 74 A D 3d 1005). "A def endant phy si ci an m ov i ng f or sum m ary j udgm ent i n a m edi cal m al practi ce acti on has the i ni ti al burden of establ i shi ng. pri m a f aci e, ei ther the absence of any departure f rom I - 4_ | i I | M l r V A L EN T 1 vGA D o;y1s;< 1, gt aL good and accepted m edi cal practi ce or that anydeparture w as not the prox i m ate cause of the al l eged i nj uri es" (see Shi chm an v Y asm er , 74 A D 3d 1316; L airseg v L oyQhusu_k , 55 A D 3d 560, 561). . In suppor t of t he m ot i ons f or sum m ar y j udgm ent each m ov i ng def endant , D r . G adom sk i , D r. O am i and L abCorp respect i v el yassert t hat thei r care and treatm ent of pl ai nt i f f di d not depar t f romgood and accepted m edi cal practi ce, di d not dev i ate f rom accepted m edi cal standards w i thi n the m edi cai com m uni ty and di d not prox i m atel y cause any resul ti ng i nj ury to pl ai nti f f . M ore speci f i cal l y i n supportof hi s ow n m oti on D r. Gadom sk i annex es the ex pert af f i rm ati on of D r. John Rom ano, a board certi ti ed derm atol ogi st. D r. Rom ano, i n ref erenci ng both the m edi calrecords and deposi ti on testi m ony concl udes to a r easonabl e degr ee of m edi cal cer t ai nt y t hat( 1)D r . G adom sk i pr oper t ydi agnosed pl ai nti f f s condi ti on as a w art, (2) ti m el y and property perf orm ed a bi opsy ; (3) at al l ti m es prov i ded appropri ate care and treatm ent to pl ai nti f f , and (4) di d not cause or contri bute to the l ater di agnosi s of sk i n cancer and subsequent am putati on. l n support ofthe m oti ons f or sum m ai y j udgm entdi sm i ssi ng the com pl ai nt as to each of t hem , l abC or p and D r . Shi m on O am i r el y upon t he ex per taf f i r m at i on of D r. D av i d Si l v ers, a board certi f i ed, derm apathol ogi st. D r. Si l v ers concl uded af ter rev i ew i ng al l of the m edi cairecords i ncl udi ng the ori gi nal L abcorp sl i des aSw el l as the D erm apath speci m ens that " there i s nothi ng i n the L abcorp pathoi ogy speci m en that w outd be consi stent w i th ei ther a k eratoacanthom a or any other ty pe squam ous cel l carci nom a because there i s no pathol ogi cf eatures i n that speci m en to i ndi cate a m al i gnancy and nothi ng i n the speci m en that speci m en that show s cancer i n any f orm " . D r. Si l v ers al so rev i ew ed the D erm Path _5_ F I V A L E N T I v G A D O M S K I. e t a l. specimen taken on July 13, 2010 "which when correlated with the clinical history and temporal profile of the lesion are consistent with a Keratoanthema type squamous cell carcinoma".lt is Dr. Silvers opinion within a reasonable degree ofmedical certatntythat the specimen taken bv Dr, Gadomski and sent to LabCorp was of adequate size and sufficiently stained and preserved to make the diagnosis aS to whether or not cancer was present. According to Dr. Silver, Dr. Oami, whose sole role was limited to an interpretation and diagnosis of the tissue specimen was correct in h.is interpretation that no pathofogicat features existed on the specimen to indicate a malignancy (see Gadomski Motion Exhibit "B"). Fudher, it is Dr. Silvers opinion that given that there was no questionable \ pathological indication, Dr. Oami had no duty to order or recommend further studies, diagnostic tests or procedures (see, Gadomski Motion Exhibit "3"). Here, the defendants Dr. Gadomski, LabCorp and Dr. Oami established their prima f a c ie e n title m e n t to ju d g m e n t a s a m a tte r'o f la w d is m is s a s s e rte d a g a in s t e a c h o f th e m b y s u b m ittin g th e a ff id a v its they did not deviate or depart from accepted medicai practice. However, in opposition, the plaintiff raised a triable issue of fact, through the affirmation of his expert, as to whether these defendants departed from good and accepted medicat practice and, if so, whether such a departure was a proximate cause of the decedent's injuries (seeSchmitt v_lVledford .Kidney Ctr., 121 AD3d 1088). The contention of Dr. Gadomski that the ptaintiff's expert was unqualified to give an expert opinion on the standard of care of a dermatologist merely because the expert was a board certified pathologist is without merit. An expert witness must possess the requisite skitl, training, knowledge, or experience to ensure that an -6- V A L E N T I v G A D O M S K I. e t a l. opinion rendered is reliable (see Tsimbler v Feii, 123 AD3d 1009, 1009-10101, Behar v Coren, 21 AD3d 1045). Once a medicaI expert establishes, as was done here, his or her knowledge of the relevant standards of care, he or she need not be a specialist in the particular area at issue to offer an opinion (see Tsimbler v Fell, 123 AD3d at 1009; Bodensiek v Schwartz, 292 AD2d 411). Any lack of skill or expertise goes lo the weight ofhis or her opinion as evidence, not its admissibility (seeAdamy v.Zirialgls, 92 Ny2d396, Leavy v. Merriam, 2015 N App Div LEXiS 8290, 2015 NY Siip Op 08148 (NY App Div 2d Dept. Nov. f2, 2015). At bar, Dr. Rakesh K. Abbi, a board certified pathologist, submitted an expert affidavit in opposition to all three defendants motions for summary judgment. ln addition to reviewing all of plaintiffs medical records, all of the deposition testimony and the affirmations of Drs. Romano and Sitvers, Dr. Abbi performed a microscopic review and study of the LabCorp specimen taken by Dr. Gadomski. . with regards to Dr. Gadomski, Dr. Abbi concluded with a reasonable degreeof medicat certainty that Dr. Gadomski misdtagriosed and mistreated the lesion on plaintiffs foot as a fungus while faiiing to ever take a fungal culture, delayed doing a biopsy despite the rapid growth of the lesion, relying on a substandard, superficial "shave biopsy" which did not sampte tissue representative of the entirety of the lesion, failed to question the results of the biopsy which indicated "verruca vulgaris, ofd" while the lesion was continuing to increase "substantially and rapidly". Dr. Abbi also determined that Dr. Gadomski was _77 V A L E N T I v G A D O M S K I, e t a l. negl i gent i n not prov i di ng pl ai nti f f 's " perti nent cl i ni cal and m edi cal hi story " to both L abCorp lf and D r. O am i1 D r. A bbi A f f i rm ati on annex ed to af f i rm ati on i n opposi ti on). w i th regards to L abCorp and D r. O am i , D r. A bbi contends that they both departed f r omt he st and ar d of c ar e t hat t hey ow ed pl ai nt i f f by f ai l i ng to consi der or not e t he rel ati onshi p and si m i l ar appearance of squam ous cel l carci nom a to v erruca v ul gari s. D r, A bbi al so opi nes that i t w as i m proper f or both the L ab and the pathol ogi st to " ...render a def i ni ti v e beni gn di agnosi s... gi v en that the f ragm ents of the v ery sm al l sam pl e rev eal ed the presence of hy perk erl oti c, perak eratoti c and papi l l om atoti c ti ssue, i t w as i m perati v e that L abCorpand D r. O am i prov i de al erti ng notati ons w arni ng that m al i gnancy coul d not be ex cl uded and recom m endi ng ex ci si onal bi opsy " . D r. A bbi al so concl udes that both D r. O am iand L abCorp shoul d hav e noti f i ed D r. G adom sk i that the sam pl e w as def i ci ent and not di agnosti cal l y adequate f or a def i ni ti v edi agnosi s. D r. A bbi f i nai l y concl uded that he di sagreed w i th both D r. Si l v er and D r. Rom ano's f i ndi ng and that an earl i er consi derati on of squam ous cel l carci nom a w oul d hav e l ed to a qui ck er di agnosi s and that the departures bv al i three m ov i ng def endants w ere a prox i m ate cause and substanti al l y contri buted to the i nv asi on of the cancer deeper i nto pl ai nti f f s f oot resul ti ng i n the am putati on of hi s toe. l t i s cl ear to thi s C ourt af ter a rev i ew of al lof t he conf l i cti ng ex pert subm i ssi ons rel i ed upon that sum m ary j udgm ent m ust be deni ed as to each of the m ov i ng def endants 'Pl ai nti f f testi f i ed that he sm ok ed a pack of ci garettes per day f or tw enty y ears and conti nues to sm ok e and that he used tanni ng sal ons tw i ce a w eek f or a peri od of ei ght y ears (see, V al enti D eposi ti on Pgs. 28, 34) .8- I V A L EN T Iv G A D O I V I SK I , et al . " Sum m ary j udgm ent i s not appropri ate i n a m edi cal m al practi ce acti on w here i N e parti es adduce conf l i cti ng m edi cal ex pert opi ni ons. Such credi bi l i ty i ssues can onl y be resol v ed by aj ury " ( } .uto v Staten l s. U ni v . H osp. ,t06 A D 3d 696; Fei nberg v Fel t, 23 A D 3d 517, 519). Fi nal l y thi s Court has consi dered L abCorps argum ent w i th respect to di sm i ssal of t he act i on as t o t hem on t he gr ounds t hatD r . O am i i s an i ndependent cont r act or and accordi ngty they are not l i abl e f or hi s acts of negl i gence (see A i v arado v B eth I srael M ed. Ctr. , 78 A D 3d 873). E v en i f L abCorp coul d estabti sh that D r. O am i w as an i ndependent contractor, pl ai nti f f s ex pert has rai sed num erous tri abi e i ssues of f act regardi ng L abCorp's i n d epen den t ac t s ofn egl i g enc e w h i c h w ar r an t d eni al of t h ei r m oti on T ot h v . B l osri i nsk y , 39 A D 3d 848) A ccordi ngl y , i t i s O R D E R ED , the m ot i ons by def endant s D r . John J. G adom sk i ( 005), L aborat oi y C or por at i on of A m er i ca H ol di ngs, L abor at or y C or por at i on of A m er i ca ( 008) , and D r . Shi m on O am i(007) f or sum m on/j udgm ent are hereby deni ed `§><* ie.Jc 4C & »»w p Q 'i 55;101$" EN T E R ./""?' `9 . ._ S Hon.` § \e s M . 'Y v & a S u s tic e o \` W e S u p re m e C o u r 1 ng 19° D574 -9-