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Cantrel v. United States

United States District Court, D. Maryland

August 12, 2014



JAMES K. BREDAR, District Judge.

Jana Cantrel ("Plaintiff") brought this suit against the United States of America ("Defendant") pursuant to the Federal Tort Claims Act ("FTCA"), 28 U.S.C. §§ 1346(b), et seq., alleging negligence and intentional infliction of emotional distress ("IIED"). Now pending before the Court is Defendant's motion for summary judgment (ECF No. 55). The issues have been briefed and no hearing is required. Local Rule 105.6. For the reasons set forth below, the motion will be granted in part and denied in part.


In 2007, prior to the events at the heart of this case, Plaintiff was diagnosed with hepatitis C.[2] (ECF No. 59-2, Ex. A, "Plaintiff's Answers to Interr.", No. 4.) After her diagnosis, Plaintiff underwent intensive interferon-based therapy treatment, which lasted until July 2008.[3] ( Id. )

On December 29, 2010, Plaintiff, who was feeling nauseous and experiencing abdominal pain, went to a Chase Brexton[4] facility in Columbia, Maryland, where she was examined by Dr. Santhia Mathew[5]. Dr. Mathew inquired about Plaintiff's previous medical history, and Plaintiff explained that she had been diagnosed with hepatitis C and had been treated by interferon-based therapy. (Mathew Depo. at 16; ECF No. 59-3 at 3, 8; ECF No 59-6 - Exhibit E, "Cantrel Aff., " at ¶ 3.) Dr. Mathew then ordered blood work, including a hepatitis panel in light of Plaintiff's medical history. (Mathew Depo. at 16; ECF No. 59-3 at 8; Cantrel Aff. at ¶ 3.)[6]

On January 7, 2011, Plaintiff returned to Chase Brexton for a follow-up appointment. (Mathew Depo. at 27; ECF No. 59-3 at 11; Cantrel Aff. at ¶ 4.) During this appointment, Dr. Mathew went through the results of some of Plaintiff's blood work with her. (Mathew Depo. at 27-32; ECF No. 59-3 at 14; Cantrel Aff. at ¶ 4.) In particular, the tests showed that Plaintiff had elevated "ALT" liver enzymes.[7] (Mathew Depo. at 28; ECF no. 59-3 at 14.) Such a result "could be from just normal fluctuations within the body itself. It could be from injury to the liver, through toxins, alcohol, medications, infection. Could be any of those." (Mathew Depo. at 28.) The ALT level can also be affected by a high level of the hepatitis C virus within the body though elevated ALT is not indicative of an "elevated viral load." ( Id. at 53.) Thus, Dr. Mathew's opinion, upon reviewing the lab work was that "[Plaintiff] had an elevated ALT and we were still waiting for the rest of her lab work." (Mathew Depo. at 30.) Dr. Mathew also referred Plaintiff to an infectious diseases specialist "[b]ecause of her history of hepatitis C and because of her concerns for hepatitis C and her questions. [Dr. Mathew] wanted her to see the infectious diseases specialist for her answers." (Mathew Depo. at 27-33; ECF No. 59-3 at 14; Cantrel Aff. at ¶ 4.)

In addition to these undisputed facts about the January 7 visit, Plaintiff has testified that Dr. Mathew also informed her that "based upon the blood work results [Plaintiff] would need to go back on Interferon for reoccurrence of hepatitis C." (Cantrel Aff. ¶ 4.) She has further provided that Dr. Mathew told her she was "going to die." ( Id. ) Defendant denies (1) telling Plaintiff she was going to die; (2) telling her she had a recurrence of hepatitis C; and (3) telling her she needed to go back on interferon treatment. (Mathew Depo. at 37.)

On January 21, 2011, Plaintiff had a third appointment with Dr. Mathew. (Mathew Depo. at 40; ECF No. 59-3 at 16; Cantrel Aff. at ¶ 6.) During this visit, Dr. Mathew told Plaintiff that her continuing abdominal pain might be caused by hepatitis C. (Mathew Depo. at 27-32; ECF No. 59-3 at 22; Cantrel Aff. at ¶ 6.) According to Plaintiff, Dr. Mathew told her that the pain " was due to hepatitis C." (Cantrel Aff. at ¶ 6 (emphasis added).) Dr. Mathew, for her part, recalls that she told Plaintiff that it was possible but unlikely that her abdominal pain was caused by a hepatitis C infection. (Mathew Depo. at 38, 40; ECF No. 59-6 at 22 ("Abdominal pain may be caused by Hep C Infection.").) Dr. Mathew also assessed Plaintiff's mental status and found that she had an increased risk of depression. (Mathew Depo. at 49.) Dr. Mathew further found that Plaintiff's depression was associated with her concerns that she had a reoccurrence of hepatitis C. ( Id. at 44, 45.)

On January 28, 2011, Plaintiff saw Tonia Poteat, who, at the time, worked as a physician assistant in Chase Brexton's Baltimore facility and specialized in the treatment of patients with HIV and hepatitis C.[8] (ECF No. 55-3, Ex. 2, "Poteat Depo." at 7.) Plaintiff "complained of pain in her liver... and stated that she was worried that her hepatitis C had come back." ( Id. 11; see also ECF No. 55-7, Ex. 6, "Cantrel Depo." at 47.) In particular, Plaintiff explained that she had seen "hard copies of blood work that indicated an elevated viral load as well as elevated liver enzymes" (Poteat Depo. at 11), that Dr. Mathew had told her that her hepatitis C was back, and that she was meeting with Ms. Poteat to discuss treatment options (Cantrel Depo at 47).

Ms. Poteat consulted Plaintiff's medical record and, based on the results from the tests ordered by Dr. Mathew, "came to the conclusion that [Plaintiff] had been exposed to [h]epatitis C in the past based on her antibody test results and that she did not currently have [h]epatitis C based on her viral load and genotype results." (Poteat Depo. at 15, Cantrel Depo. 47-48.) One of the tests results, however, the ALT test, was not listed in Plaintiff's medical record.[9] (Poteat Depo. at 37.) At her deposition, Ms. Poteat reviewed the results of this ALT test and concluded that it was indicative of "some liver inflammation" but had "very little" to do with a recurrence of hepatitis C. ( Id. at 38.) In particular, she explained that "[t]here are many things that can cause inflammation of the liver, especially at that low level. It could be something as simple as a glass of wine the night before having your blood drawn or it could be a multitude of other things." ( Id. )

Plaintiff was very surprised by Ms. Poteat's diagnosis. (Poteat Depo. at 52; Cantrel Depo. at 47-48.) She insisted that "she had seen hard copies of lab results" and that it was possible that Ms. Poteat simply hadn't seen these test results. (Poteat Depo. at 52.) As a result, Ms. Poteat called Dr. Mathew. (Poteat Depo. at 52-54; Cantrel Depo. at 12.) Ms. Poteat stepped out to make the phone call. (Poteat Depo. at 52-54.) She asked Dr. Mathew if there were hard copies of any test results that were not part of Plaintiff's medical record and was told that there were not. ( Id. )[10]

Plaintiff has testified that she is "99 percent sure" that when Ms. Poteat came back into her office, after the phone call, she told Plaintiff that "Dr. Mathew just said, oops, I must have read the blood wrong." (Cantrel Depo. at 48.) For her part, Ms. Poteat has explained that she is "99 percent sure that Dr. Mathew did not" make any such statement. (Poteat Depo. at 59.)

Ms. Poteat ordered some additional blood work for Plaintiff. (Poteat Depo. at 33.) She explained that she did so because Plaintiff seemed so concerned about the pain in her liver and the possibility that she might have a reoccurrence of hepatitis C. ( Id. ) Based on the results of these tests, Ms. Poteat was able to confirm her diagnosis that Plaintiff did not have a reoccurrence of hepatitis C.[11] ( Id. at 33-36.)

With regard to standards of care, in her deposition testimony, Dr. Mathew explained that it would be "wrong" and "bad medicine" to tell a patient they have hepatitis C, or a reoccurrence of hepatitis C, before an infectious diseases doctor has had the opportunity to review all the relevant lab results. (Mathew Depo. at 41-42, 47-48.) Indeed, Dr. Mathew has no experience treating or diagnosing hepatitis C and would therefore need to consult with a specialized physician to diagnose or treat the infection. ( Id. at 17, 21, 65.) Ms. Poteat also provided that if a patient with a history of hepatitis might have a reoccurrence of the infection, the normal procedure for a family medicine physician, such as Dr. Mathew, would be to order hepatitis C antibody ...

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