ANN GIESGUTH VS. ANTHONY J. COSTANZA (L-1533-16, ATLANTIC COUNTY AND STATEWIDE) ( 2019 )


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  •                                 NOT FOR PUBLICATION WITHOUT THE
    APPROVAL OF THE APPELLATE DIVISION
    This opinion shall not "constitute precedent or be binding upon any court." Although it is posted on the
    internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3.
    SUPERIOR COURT OF NEW JERSEY
    APPELLATE DIVISION
    DOCKET NO. A-3501-17T2
    ANN GIESGUTH ,
    Plaintiff-Appellant,
    v.
    ANTHONY J. COSTANZA and
    JOYCE M. COSTANZA,
    Defendants-Respondents.
    __________________________________
    Submitted December 4, 2018 – Decided January 8, 2019
    Before Judges Suter and Firko.
    On appeal from Superior Court of New Jersey, Law
    Division, Atlantic County, Docket No. L-1533-16.
    The Carroll Law Firm, attorneys for appellant (James J.
    Carroll, III and Benjamin B. Brenner, on the briefs).
    Law Offices of Debra Hart, attorneys for respondents
    (Eleanore Rogalski, of counsel and on the brief).
    PER CURIAM
    Plaintiff Ann Giesguth 1 appeals from an order of summary judgment in
    favor of defendants, Anthony J. Costanza and Joyce M. Costanza, in her verbal
    threshold case.    Finding that plaintiff failed to demonstrate a permanent
    condition meeting the requirements of the verbal threshold statute or a causal
    relationship between that condition and the accident that is the subject of suit,
    we affirm.
    Viewed in the light most favorable to plaintiff, see R. 4:46-2(c); Brill v.
    Guardian Life Ins. Co. of Am., 
    142 N.J. 520
    , 540 (1995), the summary judgment
    record reveals the following facts and procedural history.
    I.
    Plaintiff was involved in a motor vehicle accident on July 18, 2014, with
    a vehicle driven by Anthony J. Costanza. The police report states that as
    defendant was pulling out of Smithville Cleaners, he was unable to see plaintiff's
    vehicle and struck it on the right side. She did not seek medical attention. A
    week later, plaintiff was found unresponsive at her home and she was
    transported by ambulance to AtlantiCare Medical Center and diagnosed with a
    1
    Regrettably, plaintiff passed away on June 27, 2017. The record does not
    disclose whether a motion for leave to file and serve an amended complaint was
    ever made to permit an Administrator Ad Prosequendum to pursue the action on
    behalf of plaintiff's estate.
    A-3501-17T2
    2
    pulmonary embolism.        The hospital progress notes stated that plaintiff
    "apparently suffered a closed head injury, TBI [(traumatic brain injury)], and
    may    be    suffering   from   post-concussive,    intermittent   delirium   with
    disorientation." After being discharged from the hospital, she was transferred
    to Royal Suites Rehabilitation where it was recommended that she undergo a
    neuropsychological evaluation to determine if the TBI was contributing to "her
    loss of memory and behavioral aberrancies." No such evaluation was ever
    performed.
    In his memorandum of decision on motion, the judge stated, "there is not
    sufficient objective credible medical evidence to reach a jury on the question of
    whether [p]laintiff suffered a brain injury causing permanent 'mental decline .'"
    His decision further held: "There are no medical records which specifically
    diagnose [p]laintiff with TBI." None of her specialists opined that plaintiff
    suffered the requisite permanent injury. Only plaintiff's family physician, Dr.
    Robert H. Williams, who treated her for ten years and examined her shortly
    before the accident, opined generally that, "[p]laintiff suffered a severe decline
    in mental status; that in his professional opinion the decline in mental status was
    caused by the car accident; and that '[t]his injury has not healed to function
    A-3501-17T2
    3
    normally and will not heal to function normally with further medical treatment.'"
    The judge concluded that this constituted a "net opinion."
    Plaintiff's counsel argues that the order should be reversed because
    sufficient, objective medical evidence was presented to show that plaintiff
    sustained a permanent injury as defined in N.J.S.A. 39:6A-8(a) because her
    mental acuity tests showed a "mild cognitive impairment" and "mental decline"
    that satisfies the verbal threshold. Further, counsel contends that Dr. Williams
    is in a superior position to opine as to plaintiff's mental decline because he
    treated her for nearly a decade and he evaluated her a month before the accident.
    II.
    A plaintiff who is subject to the limitation on lawsuit threshold in N.J.S.A.
    39:6A-8(a) must present "objective clinical evidence" that the injury falls within
    one of the categories of injuries enumerated in the statute. DiProspero v. Penn,
    
    183 N.J. 477
    , 489 (2005); Serrano v. Serrano, 
    183 N.J. 508
    , 518 (2005). We are
    convinced that plaintiff failed to present sufficient "objective clinical evidence"
    of a permanent injury here as defined in N.J.S.A. 39:6A-8(a) to vault the
    threshold.
    In order to vault the threshold, a physician must certify that, "the
    automobile accident victim suffered from a statutorily enumerated injury."
    A-3501-17T2
    4
    Davidson v. Slater, 
    189 N.J. 166
    , 181 (2007). That opinion must be based on
    "objective clinical evidence," N.J.S.A. 39:6A-8(a), a standard that is the
    equivalent of the "credible, objective medical evidence" standard described in
    Oswin v. Shaw, 
    129 N.J. 290
    , 314 (1992); DiProspero, 
    183 N.J. at 495
    . Under
    that standard, which is a critical element of the cost-containment goals of
    AICRA,2 the necessary objective evidence must be "derived from accepted
    diagnostic tests and cannot be 'dependent entirely upon subjective patient
    response.'" Davidson, 
    189 N.J. at 181
     (quoting N.J.S.A. 39:6A-8(a)).
    A physician opining on the permanency of a plaintiff's injury must make
    such a determination through the use of objective medical evidence.
    DiProspero, 
    183 N.J. at 489
    . If the objective evidence depends on diagnostic
    and medical testing, those tests "may not be experimental in nature or dependent
    entirely upon subjective patient response."        N.J.S.A. 39:6A-8(a).       The
    Legislature intended these rigorous standards to ensure that a plaintiff could use
    only honest and reliable medical evidence and testing procedures to prove that
    an injury met the threshold. DiProspero, 183 N.J. at 489; see, e.g., N.J.A.C.
    11:3-4.5.
    2
    Automobile Insurance Cost Reduction Act, N.J.S.A. 39:6A-1.1.
    A-3501-17T2
    5
    Here, the report prepared by Dr. Williams is based only upon his own
    general observations of plaintiff's behavior. He did not perform any objective
    testing on her as required by statute. In fact, no medical tests were performed
    on plaintiff in accordance with N.J.S.A. 39:6A-4.7, and no neurological exam
    was conducted. In a similar vein, Dr. Williams's permanency certification
    simply states that the accident caused plaintiff's mental decline. No medical
    records establish a TBI diagnosis either.
    Plaintiff presented no evidence of a causal connection through objective,
    credible medical evidence that her apparent mental decline resulted from the
    accident. In her certified answers to interrogatories, the only injury claimed by
    plaintiff was a "significant decline in her mental status." No depositions were
    taken in this case, and the only proffer made to the motion judge in opposition
    was Dr. Williams's physician certification. The judge aptly found that Dr.
    Williams offered a net opinion because no records or medical tests substantiated
    his bare conclusions.
    We apply a "deferential approach to a trial court's decision to admit expert
    testimony, reviewing it against an abuse of discretion standard." Pomerantz
    Paper Corp. v. New Comm. Corp., 
    207 N.J. 344
    , 371 (2011). "[A] court must
    ensure that the proffered expert does not offer a mere net opinion." 
    Id. at 372
    .
    A-3501-17T2
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    A net opinion is "an expert's bare opinion that has no support in factual evidence
    or similar data . . . ." 
    Ibid.
    An expert witness's opinions that are not reasonably supported by the
    factual record and an explanatory analysis from the expert may be excluded as
    net opinion. Creanga v. Jardal, 
    185 N.J. 345
    , 360 (2005); accord Greenberg v.
    Pryszlak, 
    426 N.J. Super. 591
    , 607 (App. Div. 2012). In general, an expert
    should provide the "whys and wherefores" supporting their analysis. Beading
    v. William Bowman Assocs., 
    355 N.J. Super. 70
    , 87 (App. Div. 2002). As this
    court has explained, "[e]xpert testimony should not be received if it appears the
    witness is not in possession of such facts as will enable him [or her] to express
    a reasonably accurate conclusion as distinguished from a mere guess or
    conjecture.'" Dawson v. Bunker Hill Plaza Assocs., 
    289 N.J. Super. 309
    , 323
    (App. Div. 1996) (alterations in original) (quoting Vuocolo v. Diamond
    Shamrock Chem., 
    240 N.J. Super. 289
    , 299 (App. Div. 1990)).
    We agree with the motion judge that Dr. Williams offered a net opinion
    because it is based upon speculation and therefore, not reliable. In light of these
    circumstances, we conclude that plaintiff did not satisfy the required showing
    of a permanent injury sufficient to withstand summary judgment.
    Affirmed.
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