Cammon v. West Suburban Hospital Medical Center

Case Date: 11/25/1998
Court: 1st District Appellate
Docket No: 1-97-3625



Cammon v. West Suburban Hospital Medical Center, No. 1-97-3625

1st Dist. 11-25-98



FOURTH DIVISION

FILED: 11/25/98





No. 1-97-3625

BONITA CAMMON, Special Administratorof the Estate of EDDIE CAMMON,Deceased,

Plaintiff-Appellant,

v.

WEST SUBURBAN HOSPITALMEDICAL CENTER,

Defendant-Appellee,

and

MARK TOMERA,

Defendant.

APPEAL FROM THE

CIRCUIT COURT OF

COOK COUNTY



HONORABLE

SOPHIA H. HALL,

PRESIDING JUDGE.

JUSTICE HOFFMAN delivered the opinion of the court:

The plaintiff, Bonita Cammon, special administrator of the estate of Eddie Cammon,deceased, appeals from an order of the circuit court dismissing counts III, IV, and V of heramended complaint against the defendant, West Suburban Hospital Medical Center (WestSuburban). For the reason which follow, we: 1) affirm in part and reverse in part the dismissal ofcounts III and IV; 2) reverse the dismissal of count V; and 3) remand the case to the circuit courtfor further proceedings.

The facts necessary to our resolution of this appeal are not in dispute. Eddie Cammon (Cammon)suffered from renal disease and malignant hypertension. He was admitted to West Suburban fortreatment on June 19, 1992, after experiencing abdominal pain. Upon admission, it wasdetermined that Cammon's peritoneal catheter was not functioning. On July 2, 1992, Dr. MarkTomera removed the catheter, but Cammon's abdominal pain increased after the procedure. CTscans were performed on July 7, 8, and 9, 1992. Drs. Reza Lofti, Julio Rossi, and ReginaLiebman, all radiologists, interpreted the scans as revealing the presence of an abdominalabscess. On July 10, 1992, Tomera performed an exploratory laparotomy which revealed thepresence of an inter-abdominal hematoma, not an abscess. Within hours of that surgery,Cammon experienced sudden cardiopulmonary arrest. He died on July 11, 1992.

On January 24, 1994, the plaintiff filed the instant action. In her eight-count original complaint,she sought recovery against Tomera, Lofti, Rossi, Liebman, and West Suburban. Counts I and IIof the plaintiff's original complaint charged Tomera with negligence in his performance of thesurgeries on July 2 and 10, 1992; his misdiagnosis of the inter-abdominal hematoma; his failureto order timely CT scans; and his failure to achieve adequate hemostasis following theexploratory laparotomy. Counts III through VIII of that complaint were directed against Lofti,Rossi, Liebman, and West Suburban. The plaintiff charged that Lofti, Rossi, and Liebman werenegligent in that they misinterpreted the CT scans and that West Suburban was vicariously liablefor their negligent conduct. The plaintiff attached to her original complaint the report of a healthcare professional as required by section 2-622 of the Code of Civil Procedure (Code) (735 ILCS5/2-622 (West 1996)).

Liebman filed a motion for summary judgment on May 7, 1997. On May 14, 1997, prior to ahearing on Liebman's motion, the plaintiff voluntarily dismissed her claims against Lofti, Rossi,and Liebman. The counts against Tomera and West Suburban remained pending. On May 27,1997, West Suburban moved for summary judgment on all claims pending against it. Theplaintiff did not respond to that motion, instead moving for leave to file an amended complaint. On June 11, 1997, the circuit court granted the plaintiff's motion, and she filed her amended complaint that same day.

Counts I and II of the plaintiff's amended complaint set forth claims against Tomera which arestill pending and are not the subject of this appeal. Counts III, IV, and V of the plaintiff'samended complaint were directed solely against West Suburban. Count III, a survival action, andcount IV, a wrongful death action, were based on the same allegations of negligence. Unlike thecounts directed against West Suburban in the plaintiff's original complaint, however, neither ofthese counts sought recovery for the conduct of Lofti, Rossi, and Liebman. Rather, the claimsasserted in counts III and IV of the amended complaint were based on West Suburban's allegedvicarious liability for the acts and omissions of unnamed nurses, residents, medical technicians,anesthesiologists, and other health care professionals in failing to: (1) achieve adequatehemostasis following the exploratory laparotomy; (2) properly monitor Cammon during and afterthe exploratory laparotomy; (3) recognize the effects of Dilaudid on Cammon; (4) order oradminister the proper dosage of Dilaudid; (5) monitor the administration of Dilaudid; and (6)properly treat Cammon to reverse the effects of excessive doses of Dilaudid.

Count V of the plaintiff's amended complaint was a negligence action against West Suburban forspoliation of evidence (hereinafter referred to as the "spoliation claim"). In that count, theplaintiff alleged that West Suburban breached its duty to preserve the operative report for theexploratory laparotomy performed on July 10, 1992, thereby prejudicing her claims againstTomera and West Suburban.

On July 2, 1997, West Suburban filed a motion, pursuant to section 2-619 of the Code (735 ILCS5/2-619 (West 1996)), seeking the involuntary dismissal of counts III, IV, and V of the plaintiff'samended complaint. West Suburban asserted that: 1) all three counts were time-barred pursuantto the four-year statute of repose set forth in section 13-212(a) of the Code (735 ILCS 5/13-212(a) (West 1996)); and 2) the plaintiff had failed to comply with the affidavit and health careprofessional report requirements of section 2-622 of the Code (735 ILCS 5/2-622 (West 1996)). A plaintiff's failure to comply with the requirements of these two Code sections is the basis fordismissal under sections 2-619(a)(5) and 2-619(a)(9) of the Code respectively. 735 ILCS 5/2-619(a)(5),(9) (West 1996).

On August 25, 1997, the circuit court granted West Suburban's motion on both 2-619(a)(5) and(9) grounds, and dismissed counts III, IV, and V of the plaintiff's amended complaint. Thecircuit court inserted in its dismissal order the requisite findings of finality and appealability asset forth in Supreme Court Rule 304(a) (155 Ill. 2d R. 304(a)), and this appeal followed.

As the counts in issue were dismissed in response to a motion for involuntary dismissal pursuantto section 2-619 of the Code, our review is de novo. Kedzie & 103rd Currency Exchange, Inc. v.Hodge, 156 Ill. 2d 112, 116, 619 N.E.2d 732 (1993).

The parties do not dispute that the claims asserted against West Suburban in counts III and IV ofthe plaintiff's amended complaint are based on allegations of medical negligence, making themsubject to the provisions of sections 13-212(a) and 2-622 of the Code. There is, however, adispute regarding the applicability of those Code sections to count V. Consequently, we willaddress the propriety of the dismissal of counts III and IV before turning our attention to thedismissal of count V.

The plaintiff's original and amended complaints were filed on January 24, 1994, and June 11,1997, respectively. Under section 13-212(a) of the Code, an action seeking damages for injury ordeath resulting from patient care cannot be brought more than two years after the date on whichthe plaintiff knew or should have known of the injury or death and, in no event, more than fouryears past the date on which the act or omission alleged to have caused the injury or deathoccurred. 735 ILCS 5/13-212(a) (West 1996). West Suburban argues that counts III and IV ofthe amended complaint are time-barred as they were filed more than four years after Cammon'sdeath, which occurred on July 11, 1992. The plaintiff, relying on the provisions of section 2-616(b) of the Code (735 ILCS 5/2-616(b) (West 1996)), contends that the claims are not time-barred as the filing of her amended complaint relates back to the date she filed her originalcomplaint.

Section 2-616(b) of the Code allows the filing of an amended pleading to relate back to the dateof the original pleading if the original pleading was timely filed and if the causes of actionasserted in the amended pleading grew out of the same transaction or occurrence as was set up inthe original pleading. 735 ILCS 5/2-616(b)(West 1996); Zeh v. Wheeler, 111 Ill. 2d 266, 270-71,489 N.E.2d 1342 (1986). There is no question that the plaintiff's original complaint was filedwithin the applicable two-year limitations period set forth in section 13-212(a) of the Code. Ouranalysis will focus on the question of whether the claims asserted against West Suburban incounts III and IV of the plaintiff's amended complaint grew out of the same transaction oroccurrence that was set up in her original complaint.

The plaintiff takes the position that the transaction or occurrence set out in her original complaintencompasses the entire course of treatment rendered to Cammon from his admission to WestSuburban until his death. She acknowledges that the specific allegations of negligence in countsIII and IV of her amended complaint differ from those set forth in her original complaint. However, relying upon Figueroa v. Illinois Masonic Medical Center, 288 Ill. App. 3d 921, 681N.E.2d 64 (1997), the plaintiff argues that the claims in both complaints nevertheless grew out ofthe same transaction or occurrence because the original complaint put West Suburban "on noticethat it was being held responsible for negligence leading to the death of Eddie Cammon duringhis care and treatment while a patient in the hospital." Therefore, the plaintiff concludes, the trialcourt erred in dismissing as time-barred counts III and IV of her amended complaint.

West Suburban posits that, since the claims asserted against it in the plaintiff's original complaintwere premised solely on the acts of three named radiologists in misreading Cammon's CT scans,the transaction or occurrence set up in the plaintiff's original complaint for purposes of applyingsection 2-616(b) of the Code should be restricted to Cammon's preoperative radiological care. West Suburban argues that, prior to the expiration of the four-year repose period, it was neversupplied with the information necessary to defend against the claims asserted in counts III and IVof the amended complaint (see Flynn v. Szwed, 224 Ill. App. 3d 107, 112-14, 586 N.E.2d 539(1991)) and that the claims set out in those counts could not be sustained by the proofs necessaryto sustain the allegations contained in the original complaint (see Weber v. Cueto, 253 Ill. App.3d 509, 516-17, 624 N.E.2d 442 (1993)). These contentions lead West Suburban to conclude thatthe claims pled in counts III and IV of the plaintiff's amended complaint do not grow out of thesame transaction or occurrence set forth in her original complaint and that they are, therefore,time-barred as they were not filed before the expiration of the applicable statute of repose.

We find West Suburban's analysis too restrictive and the plaintiff's analysis too encompassing. Neither position adequately harmonizes the respective purposes of the four-year statute of reposeset forth in section 13-212(a) of the Code and the relation back doctrine embodied in section 2-616(b).

Statutes of limitation are designed to eliminate prejudice by allowing a defendant an opportunityto investigate the facts upon which its liability is based while those facts are still accessible. Boatmen's National Bank v. Direct Lines, Inc., 167 Ill. 2d 88, 102, 656 N.E.2d 1101 (1995); Wolfv. Dominick's Finer Foods, Inc., 282 Ill. App. 3d 546, 551, 668 N.E.2d 207 (1996). Statutes ofrepose further this end by placing an outer limit on the time within which a claim may beasserted, thereby circumscribing the " 'long tail' " exposure to liability that may result from theapplication of the discovery rule. See Anderson v. Wagner, 79 Ill. 2d 295, 312, 402 N.E.2d 560(1979).

The purpose of the relation back provision of section 2-616(b) of the Code is to insure fairness tothe litigants and to preserve causes of action against loss by application of technical rules ofpleading. Boatman's National Bank, 167 Ill. 2d at 102; Halberstadt v. Harris Trust & SavingsBank, 55 Ill. 2d 121, 124-25, 302 N.E.2d 64 (1973). The rationale behind the same transaction oroccurrence rule set forth in section 2-616(b) "is that a defendant will not be prejudiced by anamendment so long as 'his attention was directed, within the time prescribed or limited, to thefacts that form the basis of the claim asserted against him.' [Citation.]" Boatman's NationalBank, 167 Ill. 2d at 102. In allowing the filing of certain amended pleadings to relate back to thedate the original pleadings were filed, thereby avoiding the effect of a limiting statute, "thelegislature struck a balance between a preference for resolving disputes on their merits andpreventing surprise or prejudice to a party resulting from a lack of notice of the conduct orcondition upon which liability is asserted against him." Yette v. Casey's General Stores, Inc., 263Ill. App. 3d 422, 425, 635 N.E.2d 1091 (1994).

In determining whether the relation back doctrine should be applied, we must focus not on theidentity of the causes of action asserted in the original and amended complaint but rather on theidentity of the transaction or occurrence on which the causes of action are based. Zeh, 111 Ill. 2dat 272-73; Weber, 253 Ill. App. 3d at 516. We take this approach because "if the defendant hasbeen made aware of the occurrence or transaction which is the basis for the claim, he can prepareto meet the plaintiff's claim, whatever theory it may be based on." Zeh, 111 Ill. 2d at 279. Central to our inquiry is the question of whether the record reveals that the defendant was onnotice, before the expiration of the statutory time period, of the facts upon which the claim set outin the amended complaint is based. Wolf v. Meister-Neiberg, Inc., 143 Ill. 2d 44, 46-48, 570N.E.2d 327 (1991).

The factual allegations which form the basis of the negligence claims asserted against WestSuburban in counts III and IV of the plaintiff's amended complaint are found in paragraph 6 ofeach count. The identical allegations read as follows:

"6. The defendant WEST SUBURBAN MEDICAL CENTER, individually or through itsduly authorized actual or apparent agents or employees, was guilty of one or more of thefollowing careless and negligent acts or omissions in the examination, treatment ordiagnosis of the plaintiff's decedent:
(a) Failed to achieve adequate hemostasis following an exploratory laparotomyperformed because of the suspected presence of an abscess;
(b) Failed to properly monitor Mr. Cammon during and following the exploratorylaparotomy to adequately assess his condition and his respiratory status;
(c) Failed to recognize the effects of Dilaudid on Mr. Cammon knowing his kidney condition;
(d) Failed to order the proper dosage of Dilaudid for Mr. Cammon;
(e) Failed to monitor the administration of Dilaudid to Mr. Cammon;
(f) Allowed for excessive doses of Dilaudid to be administered to Mr. Cammon; and or
(g) Failed to properly treat Mr. Cammon to reverse the effects of the excessive doses ofDilaudid."

Nothing in either the original complaint or the record even remotely suggests that, prior to thefiling of the plaintiff's amended complaint, she was asserting that Cammon's injury or death wasthe result of an inappropriate administration of Dilaudid, a failure to monitor or reverse theeffects of that drug, or a failure to monitor Cammon's respiratory status during and following theexploratory laparotomy. Therefore, West Suburban was not placed on notice, prior to thepassage of the statute of repose, that the plaintiff was claiming the effects of Dilaudid uponCammon or a failure to monitor his respiratory status in any way contributed to his injury ordeath. The same cannot be said, however, of the plaintiff's claim that Cammon's injury and deathresulted from a failure to achieve adequate hemostasis following the exploratory laparotomy.

Counts I and II of the plaintiff's original complaint charged Tomera with negligence for failingto achieve adequate hemostasis following the exploratory laparotomy. Further, the health careprofessional whose report was attached to the plaintiff's original complaint opined that, followingthe laparotomy, Cammon's abdomen was closed before adequate hemostasis had been achievedand that postoperative bleeding was the proximate cause of Cammon's death. According to thereport, the health care professional reviewed West Suburban's own records before reaching thisconclusion. Here, as in Zeh, the negligence alleged against West Suburban in counts III and IVof the amended complaint involves different conduct by different persons than was alleged insupport of the claims asserted against West Suburban in the original complaint. See Zeh, 111 Ill.2d at 275. However, it is clear from the record before us that West Suburban has been on noticefrom the very outset of this litigation, prior to the passage of the applicable time limitation, thatthe plaintiff was claiming that a failure to achieve adequate hemostasis following the exploratorylaparotomy was a proximate cause of Cammon's injury and subsequent death. Therefore, therelation-back provision of section 2-616(b) is triggered as to this particular charge of negligence. See Wolf, 143 Ill. 2d at 47.

We conclude that the claims against West Suburban predicated on the negligent conduct allegedin paragraphs 6(a) of counts III and IV of the plaintiff's amended complaint relate back to thefiling of her original complaint and are not barred by the four-year statute of repose set forth insection 13-212(a) of the Code. For the reasons stated above, though, the claims predicated uponthe allegations of negligence set forth in paragraphs 6(b) through (g) of these counts do not relateback to the filing of the original complaint and are time-barred.

Having determined that the claims asserting West Suburban is vicariously liable for the failure ofvarious unnamed health care professionals to achieve adequate hemostasis following theexploratory laparotomy are not time-barred, we must next determine whether these claims wereproperly dismissed by reason of the plaintiff's failure to comply with section 2-622 of the Code.

Section 2-622 of the Code requires that the plaintiff in a medical malpractice action mustsupplement her complaint with: 1) an affidavit, her attorney's or her own if proceeding pro se,certifying that the affiant consulted with a qualified health care professional in whose opinionthere is a reasonable and meritorious cause for the filing of the action; and 2) a copy of thathealth professional's written report setting forth the reasons for his determination. 735 ILCS 5/2-622(a)(1) (West 1994); McCastle v. Mitchell B. Sheinkop, M.D., Ltd., 121 Ill. 2d 188, 190, 520N.E.2d 293 (1987). In the event that multiple defendants are named in a single medicalmalpractice action, the statute requires that a separate report shall be filed as to each defendant. 735 ILCS 5/2-622(b) (West 1994). A single report, however, may suffice as to multipledefendants if the report is sufficiently broad, adequately discussing the deficiencies in themedical care rendered by each defendant and containing reasons in support of the conclusion thata reasonable and meritorious cause exists for filing an action against each defendant. Comfort v.Wheaton Family Practice, 229 Ill. App. 3d 828, 832, 594 N.E.2d 381 (1992); Premo v. Falcone,197 Ill. App. 3d 625, 632, 554 N.E.2d 1071 (1990); Hagood v. O'Conner, 165 Ill. App. 3d 367,373-74, 519 N.E.2d 66 (1988). No report need be filed as to any defendant whose claimedliability is wholly vicarious provided that a report in compliance with section 2-622 has beenfiled as to the individuals whose conduct forms the basis of the vicarious liability. Comfort, 229Ill. App. 3d at 833-34.

Section 2-622(g) of the Code provides that a plaintiff's failure to comply with the pleadingrequirements of section 2-622(a)(1) shall be "grounds for dismissal under section 2-619." 735ILCS 5-2-622(g) (West 1994). Section 2-622(g) does not, however, mandate that such adismissal be with prejudice. McCastle, 121 Ill. 2d at 192-93.

In this case, the plaintiff attached to her original complaint a health care professional's reportwhich complied fully with the requirements of section 2-622. The report adequately discussedthe deficiencies in the medical care rendered by Tomera, Lofti, Rossi, and Liebman andcontained reasons in support of the conclusion that a reasonable and meritorious cause existed forthe filing of an action against each of them. This report also met the requirements of section 2-622 with respect to claims asserted against West Suburban which were predicated solely upon itsalleged vicarious liability for the conduct of Lofti, Rossi, and Liebman.

When the plaintiff dismissed her claims against Lofti, Rossi, and Liebman and filed her amendedcomplaint, though, she omitted any claims against West Suburban predicated upon the conduct ofthose doctors. Counts III and IV of the plaintiff's amended complaint, which asserted instead thatWest Suburban was vicariously liable for the claimed negligence of unnamed nurses, residents,medical technicians, anesthesiologists, and other health care professionals, were left unsupportedby an affidavit or health care professional's report as mandated by section 2-622. The section 2-622 report filed by the plaintiff did not discuss deficiencies in the medical care rendered by theseunnamed individuals or support a conclusion that a reasonable and meritorious cause existed forthe filing of an action against West Suburban by reason of their conduct. Consequently, WestSuburban is correct in its assertion that counts III and IV of the plaintiff's amended complaintwere not filed in compliance with the requirements of section 2-622. However, our finding inthis regard does not equate to a finding that those counts were properly dismissed with prejudice.

"Section 2-622 is a pleading requirement designed to reduce frivolous lawsuits, not a substantivedefense which may be employed to bar plaintiffs who fail to meet its terms." Steinberg v.Dunseth, 276 Ill. App. 3d 1038, 1042, 658 N.E.2d 1239 (1995); see also McCastle, 121 Ill. 2d at193. Accordingly, the statute should be liberally construed and not mechanically applied todeprive a plaintiff of her substantive rights. Apa v. Rotman, 288 Ill. App. 3d 585, 589, 680N.E.2d 801 (1997). The plaintiff in a medical malpractice action should be allowed everyreasonable opportunity to establish her case. Steinberg, 276 Ill. App. 3d at 1042; Peterson v.Hinsdale Hospital, 233 Ill. App. 3d 327, 332, 599 N.E.2d 84 (1992).

The decision as to whether an action should be dismissed by reason of the plaintiff's failure tocomply with the requirements of section 2-622 is a matter committed to the discretion of the trialcourt. McCastle, 121 Ill. 2d at 193. When, as in this case, a plaintiff fails to attach the requisiteaffidavit and health care professional's report to a complaint based on medical malpractice, asound exercise of discretion mandates that she be at least afforded an opportunity to amend hercomplaint to comply with section 2-622 before her action is dismissed with prejudice. Apa, 288Ill. App. 3d at 589-90.

Based upon the foregoing analysis, we: affirm the dismissal of counts III and IV of the plaintiff'samended complaint to the extent that those counts are based upon the allegations of negligenceset forth in paragraphs 6 (b) through (g), inclusive; reverse the dismissal of counts III and IV ofthe plaintiff's amended complaint to the extent that those counts are based upon negligence infailing to achieve adequate hemostasis following the exploratory laparotomy as alleged inparagraphs 6(a); and direct the circuit court on remand to afford the plaintiff a reasonableopportunity to amend counts III and IV to comply with the requirements of section 2-622 of theCode.

Next, we address the dismissal of count V of the plaintiff's amended complaint. The plaintiffargues that the trial court erred in applying either the repose period contained in section 13-212(a) of the Code or the certificate of merit requirement of section 2-622 of the Code to herspoliation claim. We agree.

The two-year limitations period and four-year repose period found in section 13-212(a) of theCode are applicable to all actions seeking "damages for injury or death against any physician,dentist, registered nurse or hospital ***, whether based upon tort, or breach of contract, orotherwise, arising out of patient care ***." (Emphasis added.) 735 ILCS 5/13-212(a) (West1996). By its very terms, section 13-212(a) applies only to actions for damages arising out ofpatient care. "The phrase 'arising out of' is broad and generally means 'originating from,''growing out of,' or 'flowing from.' " Miller v. Tobin, 186 Ill. App. 3d 175, 177, 542 N.E.2d 173(1989).

The breach of duty necessary to support a medical negligence action is the defendant's deviationfrom the proper medical standard of patient care. Borowski v. Von Solbrig, 60 Ill. 2d 418, 423,328 N.E.2d 301 (1975). The damages suffered in such an action arise out of inappropriate patientcare. By contrast, a negligence action for spoliation of evidence is predicated upon a breach ofduty to preserve evidence. Boyd v. Travelers Insurance Co., 166 Ill. 2d 188, 195, 652 N.E.2d267 (1995). Although the plaintiff in an action alleging the negligent destruction of evidenceresulting in an inability to prove a cause of action for medical negligence must prove the meritsof the underlying medical negligence claim (see Boyd, 166 Ill. 2d at 197-98), the fact remainsthat the damages suffered by the plaintiff in such a case arise from the defendant's destruction ofevidence, not the breach of a medical standard of patient care.

The damages sought by the plaintiff in count V of her amended complaint arise as a consequenceof West Suburban's alleged breach of a duty to preserve evidence and not as the result of itsbreach of any medical standard of care owed to Cammon. Consequently, the time limitation forthe commencement of the action is not governed by the provisions of section 13-212(a) of theCode. The limitations period for the commencement of a negligence action for spoliation ofevidence is not otherwise provided for by statute and is, therefore, governed by the five-yearlimitation period set forth in section 13-205 of the Code (735 ILCS 5/13-205 (West 1996)). Evenassuming that West Suburban lost or destroyed the operative report of Cammon's exploratorylaparotomy on July 10, 1992, the day of the surgery, the filing of count V of the plaintiff'samended complaint on June 11, 1997, was within the five-year statute of limitations.

As an alternative ground for the dismissal of count V, West Suburban argued that the plaintifffailed to file the requisite affidavit and health care professional report required by section 2-622of the Code. In Jackson v. Michael Reese Hospital & Medical Center, 294 Ill. App. 3d 1, 689N.E.2d 205 (1997), this court was faced with the issue of whether a plaintiff in an action fornegligent spoliation of evidence resulting in the loss of an action for medical negligence wasrequired to comply with the provisions of section 2-622. After an exhaustive analysis of both thelanguage and purpose of section 2-622, it was determined that the statute was inapplicable to aspoliation claim. Jackson, 294 Ill. App. 3d at 6-9. We have reviewed the opinion in Jackson andfind no reason to deviate from its reasoning or holding on this issue.

Because count V of the plaintiff's amended complaint was filed within the applicable five-yearlimitations period and section 2-622 of the Code is inapplicable to the action pled, we find thatthe trial court erred in dismissing the count. Accordingly, we reverse the dismissal of count V ofthe plaintiff's amended complaint.

In summary, we: 1) affirm the dismissal of counts III and IV of the plaintiff's amended complaintto the extent that those counts are based upon the allegations of negligence set forth in paragraphs6 (b) through (g), inclusive; 2) reverse the dismissal of counts III and IV of the plaintiff'samended complaint to the extent that those counts are based upon negligence in failing to achieveadequate hemostasis following the exploratory laparotomy as alleged in paragraphs 6(a); 3)reverse the dismissal of count V of the plaintiff's amended complaint; and 4) remand this cause tothe circuit court with directions to afford the plaintiff a reasonable opportunity to amend countsIII and IV to comply with the requirements of section 2-622 of the Code.

Affirmed in part and reversed in part; cause remanded with directions.

McNAMARA and WOLFSON, JJ., concur.