SANDRA NICHOLAS VS. HACKENSACK UNIVERSITY MEDICAL CENTER (L-4839-12, MIDDLESEX COUNTY AND STATEWIDE) ( 2018 )


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  •                 NOT FOR PUBLICATION WITHOUT THE
    APPROVAL OF THE APPELLATE DIVISION
    SUPERIOR COURT OF NEW JERSEY
    APPELLATE DIVISION
    DOCKET NO. A-5165-15T2
    SANDRA NICHOLAS and CORY LEO,
    individually and as Administrators
    Ad Prosequendum of the ESTATE OF
    SANTINO MICHAEL LEO,
    APPROVED FOR PUBLICATION
    Plaintiffs-Appellants,
    September 24, 2018
    v.                                                APPELLATE DIVISION
    HACKENSACK UNIVERSITY MEDICAL CENTER,
    Defendant-Respondent,
    and
    BRUCE FRIEDMAN, M.D., MARK SIEGEL, M.D.,
    STEPHEN PERCY, M.D., and ABRAHAM
    ZERYKIER, M.D.,
    Defendants.
    __________________________________________
    Argued January 16, 2018 – Decided August 9, 2018
    Before Judges Messano, Accurso and Vernoia.
    On appeal from Superior Court of New Jersey, Law
    Division, Middlesex County, Docket No. L-4839-12.
    William L. Gold argued the cause for appellants
    (Bendit Weinstock, PA, attorneys; William L. Gold,
    on the briefs).
    Richard J. Mirra argued the cause for respondent
    (Hoagland, Longo, Moran, Dunst & Doukas, LLP,
    attorneys; Richard J. Mirra, of counsel and on the
    brief; Andrew J. Obergfell, on the brief).
    The opinion of the court was delivered by
    VERNOIA, J.A.D.
    Plaintiffs Sandra Nicholas and Cory Leo, individually and as
    administrators ad prosequendum of the estate of their four-year-old son
    Santino Michael Leo, appeal from orders resulting in the dismissal of their
    medical malpractice action against defendant Hackensack University Medical
    Center (HUMC). We reverse.
    I.
    After suffering seizures, Santino Michael Leo was admitted to HUMC
    on April 30, 2011. While in HUMC's pediatric intensive care unit (PICU), it
    was   determined    he   had   an   airborne    infection,   methicillin-resistant
    staphylococcus aureus, and pneumonia.          He developed acute respiratory
    distress, multiple organ failure and sepsis, and passed away on May 13, 2011.
    In July 2012, plaintiffs filed a wrongful death and survivorship medical
    malpractice complaint against HUMC, the child's treating physicians, Dr.
    A-5165-15T2
    2
    Bruce Friedman, Dr. Stephen Percy, and Dr. Mark Siegel,1 and fictitiously-
    named physicians, nurses and other HUMC staff.               At the time of the
    malpractice alleged in the complaint, each of the named physicians was board
    certified in pediatrics and in pediatric critical care.
    In support of their complaint, plaintiffs filed affidavits of merit (AOM)
    from Dr. Howard Eigen, and Alisha Wursten, R.N., B.S.N. In his AOM, Dr.
    Eigen states he is a licensed physician in the state of Indiana, "board certified
    and credentialed by a hospital for at least five years in the [sub]specialties of
    pediatric pulmonology and critical care" and, "[d]uring the year immediately
    preceding the date of the occurrence that is the basis of the claim or action, . . .
    devoted a majority of [his] professional time to the active clinical practice of
    pediatric pulmonology and critical care." Dr. Eigen subsequently provided
    three reports opining as to the alleged deviations from the standard of care by
    Drs. Friedman, Percy and Siegel, and other HUMC personnel,2 and the manner
    1
    Dr. Abraham Zerykier was also named as a defendant but was subsequently
    dismissed from the action by stipulation of the parties.
    2
    In Dr. Eigen's report dated June 18, 2014, he asserted the absence of a
    "systematic method for enforcing infection control measures" in HUMC's
    PICU fell "below the standard of care, and increased the risk of nosocomial
    infections . . . at the time that Santino [Michael] Leo was being treated." Dr.
    Eigen also noted that the "[l]ack of sterile procedure has a high likelihood of
    introducing bacteria into the blood stream at the time of the central l ine
    (continued)
    A-5165-15T2
    3
    in which the deviations proximately caused the child's death.       The parties
    waived the Ferreira3 conference.
    Almost three years later, Dr. Eigen testified during his March 2015
    deposition that he was board certified in pediatrics and in the subspecialty of
    pediatric critical care, and in 2011 was credentialed at the Riley Hospital for
    Children to practice pediatric and pediatric critical care medicine. He also
    testified that from 2006 through 2011, he served as the medical director of the
    hospital's PICU, and was on call approximately ten weeks per year providing
    care to the PICU patients. When he was not on call, Dr. Eigen administered
    the PICU and served as the vice-chairman of pediatrics for clinical affairs. Dr.
    Eigen testified that between 2006 and 2011 he devoted twenty-five percent of
    his time to direct patient care in the PICU, fifty percent to administrative
    (continued)
    placement" in the child, and other lapses in procedure "greatly increased [the
    child's] risk of sepsis and death."
    3
    In Ferreira v. Rancocas Orthopedic Assocs., 
    178 N.J. 144
     (2003), the Court
    determined that "a 'case management conference [shall] be held within ninety
    days of the service of an answer in all malpractice actions' . . . [where] a
    'defendant [is] required to advise the court whether he has any objections to
    the adequacy of the affidavit' that has been served on him." Buck v. Henry,
    
    207 N.J. 377
    , 394 (2011) (third alteration in original) (internal citation
    omitted) (quoting Ferreira, 
    178 N.J. at 154-55
    ); see also Meehan v. Antonellis,
    
    226 N.J. 216
    , 221 (2016) (reinforcing the importance of such a conference).
    A-5165-15T2
    4
    duties and twenty-five percent to seeing outpatients and teaching residents in
    the outpatient clinics.
    Drs. Friedman, Percy and Siegel moved for summary judgment, arguing
    plaintiffs lacked proof they deviated from the requisite standard of care
    because Dr. Eigen was not qualified to testify as an expert under the New
    Jersey Medical Care Access and Responsibility and Patients First Act, N.J.S.A.
    2A:53A-37 to -42. The physicians claimed Dr. Eigen was not qualified to
    testify because he did not devote the majority of his professional time to
    clinical practice during the year preceding the alleged malpractice in 2011, and
    therefore did not satisfy the requirements of N.J.S.A. 2A:53A-41(a)(2).
    In its written opinion, the court noted the physicians' summary judgment
    motions presented the following issue: "whether [p]lainiffs' proffered expert[,
    Dr. Eigen,] is qualified as an expert under N.J.S.A. 2A:53A-41(a)(1) or
    N.J.S.A. 2A:53A-41(a)(2) as required under Nicholas v. Mynster, 
    213 N.J. 463
    (2013)." The court determined that although Dr. Eigen is board certified in
    pediatrics and pediatric critical care, he did not satisfy the requirements of
    either N.J.S.A. 2A:53A-41(a)(2)(a) or N.J.S.A. 2A:53A-41(a)(2)(b), "which
    require either devotion to practice or the teaching requirement mandated for a
    board certified expert." The court concluded Dr. Eigen did not satisfy the
    statutory requirements because he "only devoted a small percentage of his
    A-5165-15T2
    5
    practice time to pediatric critical care in the year prior to the date of the
    alleged malpractice[.]"
    In separate orders dated September 22, 2015, the court barred Dr.
    Eigen's testimony against Drs. Siegel and Friedman, and granted summary
    judgment in their favor, and barred Dr. Eigen's testimony against Dr. Percy.
    Two weeks later, the court entered an order granting Dr. Percy summary
    judgment.
    In October 2015, plaintiffs moved for an order permitting Dr. Eigen to
    testify as to the standard of care and causation against HUMC. Plaintiffs
    argued the court's order barring Dr. Eigen's testimony as to the defendant
    physicians under the Patients First Act did not preclude him from testifyi ng as
    an expert against HUMC.
    After hearing argument, the court denied the motion in a December 11,
    2015 order. In its written opinion, the court noted plaintiffs' liability claims
    against HUMC were premised on the hospital's alleged vicarious liability for
    the negligence of the defendant physicians, who the court found were
    "employees of" HUMC. The court reasoned that its prior disqualification of
    Dr. Eigen as an expert against the physicians precluded his testimony against
    the hospital, and found it could not "allow [p]laintiff[s] to bootstrap into
    evidence the excluded testimony of [the] dismissed defendant doctors[']
    A-5165-15T2
    6
    deviation [from] the standard of care under the circumstances." The court
    determined that plaintiffs could not use Dr. Eigen's testimony to support their
    claim HUMC is liable due to the defendant physicians' deviation from the
    standard of care because Dr. Eigen was not qualified to testify concerning the
    physicians' alleged negligence under the Patients First Act.        The court
    concluded Dr. Eigen was not permitted to testify as to HUMC's alleged
    deviation from the standard of care "because it would violate the rule of
    N.J.S.A. 2A:53A-41(a) et. seq."
    Plaintiffs filed a motion to correct the court's December 11, 2015 order
    to permit Dr. Eigen to offer proximate causation testimony as to HUMC. 4 In a
    February 11, 2016 order, the court denied the motion. In its written opinion,
    the court found Dr. Eigen's proximate causation testimony would be "unduly
    prejudicial under the circumstances of this case" because he "disavowed"
    offering standard of care opinions as to HUMC in his reports and deposition.
    In addition, the court found that permitting Dr. Eigen to testify about
    proximate causation would be unduly prejudicial to HUMC because the court 's
    order barring his testimony as to the defendant physicians would necessarily
    4
    Plaintiffs intended to rely on Wursten as their expert witness on HUMC's
    alleged deviation from the standard of care.
    A-5165-15T2
    7
    preclude HUMC from cross-examining Dr. Eigen about the physicians' alleged
    deviations from the standard of care.
    On February 17, 2016, HUMC moved for summary judgment claiming
    plaintiffs lacked expert testimony establishing proximate causation. Plaintiffs
    cross-moved to allow late service of an expert report from Dr. Emily Dawson
    and substitution of Dr. Dawson for Dr. Eigen as their expert. Plaintiffs argued
    that late submission of the report should be permitted because they could not
    have anticipated what they characterized as the court's "novel" rulings barring
    Dr. Eigen's testimony, and because Dr. Eigen retired and was no longer
    available.
    On June 3, 2016, the court denied plaintiffs' cross-motion, finding their
    need for a new expert was the result of their failure to comply with N.J.S.A.
    2A:53A-41, and their request was made too late - a year and a half after the
    discovery end date and following seven scheduled trial dates.         The court
    granted HUMC's summary judgment motion, finding plaintiffs lacked an
    expert on proximate cause that was essential to their malpractice claim. On
    July 8, 2016, the court denied plaintiffs' motion for reconsideration of its June
    3, 2016 orders. This appeal followed.
    Plaintiffs do not appeal the orders barring Dr. Eigen's testimony as to the
    physicians or granting the physicians' summary judgment motions. Instead,
    A-5165-15T2
    8
    plaintiffs challenge the December 11, 2015 order barring Dr. Eigen from
    testifying as to the standard of care and proximate cause as to HUMC , the
    February 11, 2016 order barring Dr. Eigen from testifying as to proximate
    cause as to HUMC, the June 3, 2016 orders granting HUMC summary
    judgment and denying plaintiffs' cross-motion permitting the late filing of a
    new expert report, and the July 8, 2016 order denying their motion for
    reconsideration. In its brief on appeal, plaintiffs make clear they do "not seek
    reversal of any of the [o]rders as to any of the individual doctors and only
    seek[] to reinstate the claim against HUMC."
    Plaintiffs present the following arguments for our consideration:
    POINT I
    THE MOTION COURT IMPROPERLY BARRED
    THE TESTIMONY OF PLAINTIFFS' EXPERT
    UNDER THE RELEVANT STATUTES WHICH ARE
    APPLICABLE ONLY TO PHYSICIANS, NOT TO
    HOSPITALS.
    POINT II
    BECAUSE DR. EIGEN WAS QUALIFIED UNDER
    N.J.S.A. 2A:53A-41(a)(1), BARRING  HIS
    TESTIMONY IS REVERSIBLE ERROR.
    POINT III
    BARRING DR. EIGEN FROM TESTIFYING ON
    PROXIMATE CAUSE IS REVERSIBLE ERROR.
    A-5165-15T2
    9
    POINT IV
    DISMISSAL OF PLAINTIFFS' CASE WAS TOO
    HARSH A REMEDY.
    II.
    The orders barring Dr. Eigen's testimony against HUMC and granting
    HUMC summary judgment are founded on the court's initial determination that
    Dr. Eigen was not qualified to testify against the physicians because he did not
    satisfy the requirements of N.J.S.A. 2A:53A-41(a)(2)(a) or N.J.S.A. 2A:53A-
    41(a)(2)(b).     We therefore first consider whether the court correctly
    determined Dr. Eigen was not qualified to testify as an expert under the
    Patients First Act.
    "[W]e apply . . . [a] deferential approach to a trial court's decision to
    admit expert testimony, reviewing it against an abuse of discretion standard."
    Borough of Saddle River v. 66 E. Allendale, LLC, 
    216 N.J. 115
    , 154-55 (2013)
    (alterations in original) (quoting Pomerantz Paper Corp. v. New Cmty. Corp.,
    
    207 N.J. 344
    , 371-72 (2011)). "Absent a clear abuse of discretion, an appellate
    court will not interfere with the exercise of that discretion." Carey v. Lovett,
    
    132 N.J. 44
    , 64 (1993).
    Enacted in 2004, "[t]he [Patients First Act] establishes certain
    qualifications that expert witnesses in medical malpractice actions must
    possess."   Castello v. Wohler, 
    446 N.J. Super. 1
    , 14 (App. Div.) (citation
    A-5165-15T2
    10
    omitted), certif. denied, 
    228 N.J. 154
     (2016). The Patients First Act "generally
    requir[es] the challenging expert to be equivalently-qualified to the
    defendant[.]" Ryan v. Renny, 
    203 N.J. 37
    , 52 (2010).
    In pertinent part, the Patients First Act provides:
    In an action alleging medical malpractice, a person
    shall not give expert testimony or execute an affidavit
    pursuant [N.J.S.A. 2A:53A-26 to -28]5 on the
    appropriate standard of practice or care unless the
    person is licensed as a physician or other health care
    professional in the United States and meets the
    following criteria:
    a. If the party against whom or on whose behalf the
    testimony is offered is a specialist or subspecialist
    recognized by the American Board of Medical
    Specialties [ABMS] or the American Osteopathic
    Association and the care or treatment at issue involves
    that specialty or subspecialty . . . , the person
    providing the testimony shall have specialized at the
    time of the occurrence that is the basis for the action
    in the same specialty or subspecialty, . . . , as the party
    against whom or on behalf the testimony is offered,
    and if the person against whom or on whose behalf the
    testimony is being offered is board certified and the
    care or treatment at issue involves that board specialty
    or subspecialty . . . the expert witness shall be:
    5
    In relevant part, N.J.S.A. 2A:53A-26 to -28 generally provides that in any
    action for damages for personal injury, wrongful death or property damage
    resulting from the negligence of certain licensed persons, including physicians
    in the practice of medicine or surgery, the plaintiff must file an affidavit of an
    appropriately licensed person that there exists a reasonable probability the
    defendant's conduct fell outside of acceptable professional or occupational
    standards.
    A-5165-15T2
    11
    (1) a physician credentialed by a hospital to treat
    patients for the medical condition, or to perform the
    procedure, that is the basis for the claim or action; or
    (2) a specialist or subspecialist recognized by the
    American Board of Medical Specialties or the
    American Osteopathic Association who is board
    certified in the same specialty or subspecialty, . . .
    during the year immediately preceding the date of the
    occurrence that is the basis for the claim or action,
    shall have devoted a majority of his professional time
    to either:
    (a) the active clinical practice of the same health care
    profession in which the defendant is licensed, and, if
    the defendant is a specialist or subspecialist . . . , the
    active clinical practice of that specialty or
    subspecialty . . . ; or
    (b) the instruction of students in an accredited medical
    school, other accredited health professional school or
    accredited residency or clinical research program in
    the same health care profession in which the defendant
    is licensed, and, if that party is a specialist or
    subspecialist . . . accredited residency or clinical
    research program in the same specialty or subspecialty
    . . . ; or
    (c) both.
    [N.J.S.A. 2A:53A-41(a) (emphasis added).]
    In Nicholas, our Supreme Court explained N.J.S.A. 2A:53A-41(a)'s
    requirements where, as here, a plaintiff proffers an expert who is board
    certified in a specialty and a subspecialty to testify about the care or treatment
    A-5165-15T2
    12
    rendered by another physician in the same specialty and subspecialty. 6 213
    N.J. at 479-88. The Court first noted that where "a physician is a specialist
    and the basis of the malpractice action 'involves' the physician's specialty, the
    challenging expert must practice in the same specialty." Id. at 481-82; accord
    Castello, 446 N.J. Super. at 16. A plaintiff's expert "must be a specialist in the
    same field in which the defendant physician specializes . . . ." Nicholas, 213
    N.J. at 482; see N.J.S.A. 2A:53A-41(a); see also Meehan, 226 N.J. at 233
    (explaining N.J.S.A. 2A:53A-41(a) requires that a "proposed expert . . . must
    have specialized in the same specialty or subspecialty" as the defendant
    physician).
    N.J.S.A. 2A:53A-41(a) imposes additional expert qualifications where a
    defendant physician practices in an ABMS specialty and is also board certified
    in the specialty. Nicholas, 213 N.J. at 482. The Court explained that "if the
    defendant-physician specializes in a practice area 'and . . . is board certified
    and the care or treatment at issue involves that board specialty . . . , the expert
    witness' then must" satisfy the requirements of "either" N.J.S.A. 2A:53A-
    6
    Where the treatment at issue is not provided by a specialist, or is provided by
    a specialist but does not involve the physician's specialty, the requirements for
    the qualification of an expert to testify against a general practitioner apply.
    Buck, 207 N.J. at 391; see also N.J.S.A. 2A:53A-41(b). The standard has no
    application here because the defendant physicians were specialists in pediatrics
    and subspecialists in pediatric critical care and their alleged malpractice
    involved that specialty and subspecialty.
    A-5165-15T2
    13
    41(a)(1) "or" N.J.S.A. 2A:53A-41(a)(2).       Ibid. (citation omitted); see also
    Castello, 446 N.J. Super. at 15 (noting that where the defendant physician is
    board certified in the specialty involved in the alleged malpractice , the
    challenging expert must satisfy the requirements of N.J.S.A. 2A:53A-41(a),
    and "the additional qualifications set forth in subsections (a)(1) or (a)(2)");
    Lomando v. United States, 
    667 F.3d 363
    , 383 (3d Cir. 2011) (finding N.J.S.A.
    2A:53A-41(a) requires that an expert offering testimony against a board -
    certified specialist share that specialty and meet the requirements of either
    N.J.S.A. 2A:53A-41(a)(1) or (a)(2)).
    To satisfy N.J.S.A. 2A:53A-41(a)(1)'s requirements, the expert must be
    "credentialed by a hospital to treat the condition at issue . . . ." Nicholas, 213
    N.J. at 482. To satisfy the requirements of N.J.S.A. 2A:53A-41(a)(2), the
    expert must be "board certified in the same specialty in the year preceding 'the
    occurrence that is the basis for the claim or action,'" ibid. (quoting N.J.S.A.
    2A:53A-41(a)(2)), and during the year immediately preceding the occurrence
    he or she must have devoted a majority of his or her time to "either" clinical
    practice as defined in N.J.S.A. 2A:53A-41(a)(2)(a) or the instruction of
    students as defined in N.J.S.A. 2A:53A-41(a)(2)(b), ibid.
    Measured against the statutory standards as explained by the Court in
    Nicholas, we are convinced the court erred by determining Dr. Eigen was not
    A-5165-15T2
    14
    qualified to testify against the defendant physicians. In the first instance , Dr.
    Eigen met the requirements of N.J.S.A. 2A:53A-41(a). He was a licensed
    physician and, at the time of the alleged malpractice, "specialized . . . in the
    same specialty, [pediatrics, and] subspecialty [pediatric critical care,]"
    involved in the treatment and care at issue.       See N.J.S.A. 2A:53A-41(a).
    Although Dr. Eigen's administrative duties as director of the PICU and as a
    hospital administrator consumed a substantial amount of his professional time
    in 2011, his clinical practice was devoted exclusively to the practice of
    pediatrics and pediatric critical care. See Buck, 
    207 N.J. at 391
     (finding "[a]
    physician may practice in more than one specialty").
    N.J.S.A. 2A:53A-41(a) does not require that a proposed expert devote a
    majority of his or her professional time to the practice of the pertinent
    specialty. It requires only a showing that a proposed expert "practice in the
    same specialty" as a defendant physician.       Nicholas, 213 N.J. at 486.       In
    Nicholas, the Court determined the plaintiff's proposed expert did not satisfy
    N.J.S.A. 2A:53A-41(a)'s requirements because although credentialed at a
    hospital and board certified in the pertinent specialties, the expert "did not
    specialize" in those specialties when the alleged malpractice occurred. Id. at
    487. Similarly, in Castello, 446 N.J. Super. at 16-17, we determined that a
    proposed expert did not satisfy "the preliminary qualification of specialization"
    A-5165-15T2
    15
    under N.J.S.A. 2A:53A-41(a) because he retired from the practice of medicine
    prior to the time of the alleged malpractice occurrence.
    In contrast, here the evidence shows Dr. Eigen practiced pediatrics and
    pediatric critical care in 2011 when the defendant physicians provided the care
    at issue.     Although he had duties independent of his clinical practice, he
    devoted all of his clinical practice to pediatrics and pediatric critical care in
    2011. Thus, Dr. Eigen satisfied N.J.S.A. 2A:53A-41(a)'s requirement that he
    practice and specialize in the specialty and subspecialty of the defendant
    physicians.
    The defendant physicians were board certified in pediatrics and pediatric
    critical care, and therefore Dr. Eigen was required to satisfy the additional
    requirements of either N.J.S.A. 2A:53A-41(a)(1) or (a)(2) to qualify as an
    expert witness under the Patients First Act.        Nicholas, 213 N.J. at 482;
    Castello, 446 N.J. Super. at 15-16.       The court found Dr. Eigen was not
    qualified because he did not devote the majority of his professional time to the
    active clinical practice of pediatrics and pediatric critical care during the year
    immediately preceding the alleged malpractice.        In other words, the court
    found Dr. Eigen was not a qualified expert because he failed to satisfy the
    requirements of N.J.S.A. 2A:53A-41(a)(2)(a).
    A-5165-15T2
    16
    To be sure, Dr. Eigen's qualifications did not satisfy the requirements of
    N.J.S.A. 2A:53A-41(a)(2)(a). The court erred, however, because it did not
    consider that Dr. Eigen satisfied the requirements of N.J.S.A. 2A:53A-
    41(a)(1).   When the alleged malpractice occurred in 2011, Dr. Eigen was
    credentialed at the Riley Hospital for Children to provide pediatric and
    pediatric critical care, and thus "to treat patients for the medical condition, or
    to perform the procedure, that is the basis for" plaintiffs' medical malpractice
    claim. See N.J.S.A. 2A:53A-41(a)(1). Dr. Eigen satisfied the requirements of
    N.J.S.A. 2A:53A-41(a)(1), and his lack of qualifications under N.J.S.A.
    2A:53A-41(a)(2) did not permit or require his disqualification as an expert
    witness against the defendant physicians. Nicholas, 213 N.J. at 412; Castello,
    446 N.J. Super. at 15-16. The court erred in holding otherwise and in barring
    Dr. Eigen's testimony as to the defendant physicians.
    The court's orders granting HUMC summary judgment and denying
    plaintiffs' request to serve a late expert report were founded on its
    determination Dr. Eigen was not a qualified expert under the Patients First Act
    in the first instance. Because we conclude the determination was in error , we
    are constrained to reverse the court's order granting summary judgment to
    HUMC and denying plaintiffs' request to serve a late expert report.
    A-5165-15T2
    17
    We are not persuaded by HUMC's contention that even if Dr. Eigen was
    qualified to testify under the Patients First Act, the court properly barred his
    testimony as to proximate causation and granted HUMC summary judgment
    because Dr. Eigen disavowed providing a proximate causation opinion as to
    HUMC in his deposition. The record does not support HUMC's contention.
    During his deposition, Dr. Eigen was asked directly if his reports
    included an opinion that HUMC "and its nurses or personnel departed from the
    applicable standard of care of a hospital." He incorrectly stated his reports did
    not include such an opinion,7 and agreed, subject to a caveat,8 that he did not
    express an opinion concerning HUMC's deviation from the standard of care.
    7
    Dr. Eigen's June 18, 2014 report included an opinion HUMC deviated from
    the standard of care that was not dependent on the actions of the defendant
    physicians. See footnote 2, supra.
    8
    The caveat was that he did not offer an opinion as to HUMC's deviation from
    the standard of care but only if the defendant physicians were not HUMC
    employees. In other words, Dr. Eigen made clear that if the physicians were
    HUMC employees, his opinion was that HUMC was liable for their deviation
    from the standard of care detailed in his reports and otherwise in his testimony.
    The record is unclear whether the defendant physicians were HUMC
    employees. In its brief, HUMC states it is undisputed the physicians were not
    HUMC employees, but fails to cite to any evidence in the record supporting
    the assertion. See R. 2:6-2; see also State v. Mauti, 
    448 N.J. Super. 275
    , 314
    n.17 (App. Div.) (noting it is the parties' responsibility to refer to specific parts
    of the record to support their arguments on appeal), certif. denied, 
    230 N.J. 170
     (2017). In the trial court's written opinion supporting its December 11,
    2015 order denying plaintiffs' motion to permit Dr. Eigen to test ify against
    HUMC, the court expressly found the defendant physicians were HUMC
    (continued)
    A-5165-15T2
    18
    Dr. Eigen was not similarly asked if he had an opinion on proximate
    causation, and our review of the portion of the transcript from his deposition
    provided by HUMC makes clear he never disavowed offering an opinion on
    proximate cause. HUMC's contention Dr. Eigen was properly barred as an
    expert witness because he disavowed offering an opinion on proximate
    causation as to HUMC is unavailing.
    It is unnecessary to address plaintiffs' arguments that the court's orders
    should be reversed for reasons other than its erroneous conclusion Dr. Eigen
    was not a qualified expert under the Patients First Act. Because the court 's
    order granting HUMC summary judgment was founded on the incorrect
    conclusions that Dr. Eigen was not a qualified expert witness and he
    disavowed offering an opinion as to proximate cause, we reverse the summary
    judgment order and remand for further proceedings.          Our determination
    renders it unnecessary to address plaintiffs' contention the court erred by
    denying their motions to serve the late expert report of Dr. Dawson and for
    reconsideration.
    (continued)
    employees. It is unnecessary to resolve this factual dispute, however, because
    we have determined the court erred by finding Dr. Eigen was not a qualified
    expert under the Patients First Act.
    A-5165-15T2
    19
    Dr. Eigen has retired and is no longer available to provide expert
    testimony. On remand, the court shall allow plaintiffs to serve Dr. Dawson's
    report as plaintiffs' new expert report, and permit such other discovery as the
    court deems necessary under the circumstances.
    Reversed and remanded for further proceedings in accordance with this
    opinion. We do not retain jurisdiction.
    A-5165-15T2
    20