Find Legal Information

FIFTH DIVISION
November 3, 2000

No. 1-99-0519

This appeal concerns a medical malpractice action brought on behalf of plaintiff, Taylor Susnis, a minor, by her parents,plaintiffs, Brian and Jami Susnis. Plaintiffs sought recovery forinjuries Taylor allegedly sustained days after her birth due to thenegligence of defendants. Taylor suffered from cardiorespiratoryarrest due to a congenital heart condition and during resuscitation, an interosseous line was inserted that subsequently resulted indamage to the growth plate in her left leg.

At the close of plaintiffs' case, the trial court granted adirected verdict in favor of defendants Dr. Mark Jundanian and BlueIsland Radiology Associates (Blue Island). At the conclusion of thetrial, the jury rendered a verdict in favor of defendants Dr.Jeffrey Lin and Pronger-Smith Medical Associates (Pronger-Smith).The trial court entered an order of mistrial as to defendants Dr.Baroukh Radfar and St. Francis Hospital and Health Center (St.Francis) when the jury was unable to arrive at a verdict. Onappeal, plaintiffs contend that: (1) the trial court erred ingranting a directed verdict for Dr. Jundanian and Blue Island on theissue of proximate cause where plaintiffs produced sufficientevidence that Dr. Jundanian breached the standard of care; and (2)pursuant to Supreme Court Rule 213 (177 Ill. 2d R. 213), the trialcourt erred in barring plaintiffs' expert from testifying that theactions of Dr. Lin and Pronger-Smith caused or contributed toTaylor's injuries. For the reasons that follow, we affirm.

The following facts were adduced at trial. Taylor Susnis wasborn on August 22, 1992, at St. Francis. On August 23, 1992, Dr.Radfar, a pediatrician on staff at St. Francis, examined Taylor andfound her to be a normal newborn. On August 24, 1992, atapproximately 6:30 a.m., a nurse observed that Taylor's heart ratewas rapid, her lips were blue, and she was hypoactive orunresponsive when moved. The nurse moved Taylor to a special carenursery for further observation and contacted Dr. Radfar atapproximately 7:30 a.m. to inform him of her condition. Based onTaylor's condition, Dr. Radfar ordered several tests, including anelectrocardiogram (EKG), which is used to evaluate heart rate andrhythm, and a chest X ray. A nurse contacted Dr. Radfar again atapproximately 1 p.m. on August 24, 1992, and informed him thatTaylor was stable and active and that she was not having any moreproblems. Dr. Radfar testified that after he examined Taylor atapproximately 6:30 p.m. the same day, he evaluated her chest X rayand found it be normal. Dr. Radfar also testified that hecustomarily relied on the expertise of radiologists to interpret Xrays and that he relied on the expertise of Dr. Jundanian in thiscase to interpret Taylor's chest X ray.

Dr. Radfar stated that Taylor's condition on August 24, 1992,was due to fluid in the lungs, which is a normal and temporarycondition in a newborn, and was not due to cardiac problems. However, Dr. Radfar testified in an earlier deposition that Taylordid not have fluid in her lungs. The record indicates that thiscondition was not mentioned in Taylor's medical charts. Dr. Radfaralso admitted that he did not order an echocardiogram, which is thedefinitive test for diagnosing cardiac problems. Dr. Radfarindicated that, in his opinion, the echocardiogram was unnecessarybecause Taylor did not have any persistent problems. Dr. Radfarfurther testified that he did not order a consultation with apediatric cardiologist for the same reason. In 1992, the standardof care would have required a pediatric consult if the doctor saw acardiac anomaly or an enlarged heart.

Dr. Jundanian testified that he read Taylor's chest X ray onAugust 24, 1992, but did not recall if he actually spoke with Dr.Radfar about her condition. Dr. Jundanian stated in his report thatTaylor's pulmonary vascularity was slightly prominent, which, amongother things, could have been a cardiac abnormality. Dr. Jundanianfurther testified that he thought Taylor's heart size was withinnormal limits and not enlarged. However, Dr. Jundanian alsotestified that if Dr. Radfar had called and asked whether Taylor'schest X ray was normal or abnormal he would have told him that itwas abnormal.

On August 25, 1992, Dr. Radfar examined Taylor again prior toher discharge from the hospital. Dr. Radfar testified that hisexamination indicated that she was doing well, her heart was beatingwith a regular rhythm, and she had no fluid in her lungs. Taylorwas discharged from St. Francis on August 25, 1992, and Dr. Radfar arranged to see her two days later to ensure that she continued todo well.

On August 26, 1992, Jami Susnis brought Taylor to Dr. JeffreyLin's office for a checkup. Jami Susnis informed Dr. Lin ofTaylor's problems at the hospital. After a complete examination,Dr. Lin determined that Taylor was doing well; she was alert andactive, her skin color was normal and her heart sounds were regular. Dr. Lin also discovered that a chest X ray had been taken but didnot order or examine the X-ray charts. Although Dr. Lin contactedSt. Francis and noted that Taylor's chest X ray stated that therewas "increased lung marking," he did not order a second chest X ray.

On August 28, 1992, Dr. Lin examined Taylor again because shehad gained more weight than average for a newborn of her age. Dr.Lin testified that the baby appeared normal at the exam and hearranged for another checkup a week later.

On August 30, 1992, Jami Susnis observed "white stuff" comingout of Taylor's mouth and nose. Jami Susnis attempted to clearTaylor's nose and mouth, but when she remained congested, JamieSusnis contacted Dr. Lin's office. Another doctor at the officeadvised that Taylor was probably suffering from a cold. However,when Taylor seemed to worsen, Jami Susnis took her to the emergencyroom at St. Francis.

Taylor suffered a cardiorespiratory arrest in the St. Francisemergency room. Taylor was resuscitated and then transferred toChrist Hospital. In order to save her life, the doctors at ChristHospital inserted an interosseous line in her leg to resuscitateher. An interosseous line is a form of emergency vascular access toinsert fluids or other medications in cases where a patient'speripheral veins are not easily accessible. A special needle ismanually drilled into the hollow center of the bone and then fluidis pumped directly into the center of the bone.

Taylor was treated for multi-organ failure, and on September18, 1992, she underwent heart surgery to treat an interrupted aorticarch. Although Taylor's heart problems were resolved, she sufferedsevere damage to the growth plate in her left leg, apparently as aresult of the interosseus line.

Dr. Mark Moran testified that he first saw Taylor on March 3,1997. By this time, Taylor had undergone at least two unsuccessfulsurgeries in an attempt to repair the damage to the growth plate inher left leg. Dr. Moran observed that Taylor's condition began withpartial growth arrest of her tibia and by the time he treated her,the entire proximal tibia had stopped growing. Dr. Moran testifiedthat X rays performed early on in her treatment indicated that thegrowth plate appeared normal for a child of Taylor's age. However,Dr. Moran further testified that, as Taylor gets older, there willbe a leg length discrepancy with the left leg becoming progressivelyshorter than the right.

Brian and Jami Susnis filed a complaint on Taylor's behalf andindividually and alleged that Dr. Radfar, Dr. Lin and Dr. Jundanianeach failed to observe abnormal cardiac and pulmonary vascularfindings in Taylor's chest X ray. Plaintiffs also sued Pronger-Smith, a multispecialty practice group to which Dr. Lin belongs, andBlue Island, Dr. Jundanian's practice group. While these entitiesare parties to this appeal, plaintiffs allege only that the doctorsare agents of these entities and they make no claims that theentities were independently negligent. Count II of the complaintalleged that St. Francis failed to timely and adequately triageTaylor upon her arrival to the emergency room.

Prior to trial, several motions in limine were filed, includinga motion to limit any testimony regarding Dr. Lin's deviations fromthe standard of care unsupported by testimony or evidence ofcausation which the trial court granted. The court also grantedDr. Lin's motion in limine barring plaintiffs' opinion witnessesfrom offering any opinions not previously expressed in depositionsor Rule 213 interrogatories. Dr. Jundanian adopted Dr. Lin'smotions as they applied to him. The court also granted Dr. Radfar's motion in limine barring plaintiffs' experts fromtestifying as to causation not previously testified to in discovery.

During trial, Dr. Marilyn Siegel, one of plaintiffs' experts,testified that, in her opinion, Dr. Jundanian did not meet thestandard of care. Dr. Siegel opined that Dr. Jundanian should haveknown from the chest X ray that Taylor's heart was enlarged.

Dr. Robert Lerer provided expert testimony that, in hisopinion, Dr. Radfar and Dr. Lin deviated from the standard of careby not requesting a cardiology consult for Taylor based upon thesigns and symptoms she exhibited after delivery. In Dr. Lerer'sopinion, Taylor's chest X ray was abnormal and her heart wasenlarged. Dr. Lerer testified that, based upon these signs, anechocardiogram should have been ordered or a cardiology consultshould have occurred. As to Dr. Lin specifically, Dr. Lerertestified that he deviated from the standard of care by failing toobtain all of Taylor's medical records on August 26, 1992, and onAugust 28, 1992. Dr. Lerer added that Dr. Lin deviated from thestandard of care by not examining Taylor's femoral pulses on August26, 1992, and August 18, 1992. However, on cross-examination, Dr.Lerer testified that there was nothing in the physical examinationthat would have suggested heart disease to a reasonably well-qualified pediatrician and that it was unreasonable to have expectedDr. Lin to have had Taylor's hospital records by the first time heexamined her on August 26, 1992.

Plaintiffs' interrogatories and supplemental interrogatoriesdated November 5, 1998, named Dr. David C. Schwartz as a witness whowould provide testimony that Taylor suffered injury as a result ofthe interosseous line placed in her leg. In plaintiffs' answers toRule 213 interrogatories, plaintiffs stated that Dr. Schwartz wouldrender the following opinions: (1) based upon Taylor's symptoms, theEKG and the chest X ray, Taylor should have been examined by apediatric cardiologist; and (2) if a pediatric cardiologist hadexamined Taylor, an echocardiogram would have been ordered whichwould have shown the congenital heart condition.

At Dr. Schwartz's deposition, the following testimony waselicited:

"Q. Do you have any opinions in this case regarding the cause of the left tibial growth arrest forTaylor Susnis in her left leg?

A. No.

Q. Have you reviewed any records pertaining to the left tibial growth arrest?

A. No.

Q. When Taylor Susnis was first examined by Dr.Radfar, was it appropriate for Dr. Radfar to order anEKG and x-ray?

*** A. I don't think so, because I believe that exam was the - the day of birth, or at least within 24hours. And my impression, from the medical record, wasthat at that point the baby was fine. There were nosymptoms being recorded by the nurses. And his evaluationpresumably was that the baby was normal.  My impression is that that EKG, more likely than not, is abnormal, and maybe even 90 percentlikely to be abnormal. In that setting, I would not say'possible.' I would say maybe probable, and maybe evenstronger than that.

Q. So you believe that the EKG that was performed on Taylor Susnis and read in the hospital whenshe was two days old was actually an abnormal EKG?

A. Yes.

Q. Do you have an opinion as to whether or not Dr. Radfar deviated from the standard of care in this case?

A. Yes.

Q. And what is your opinion?

A. My opinion is that he did deviate by not recognizing, based on the nurse's description of thisinfant in the nursery and the questionable EKGinterpretation and the x-ray interpretation which alsoincluded abnormality in the pulmonary vascular pattern.

If you didn't put all that together and come to the conclusion that the baby could possibly have aheart defect, and, therefore, request a cardiologyconsult, considering that in his deposition he says hegets a hundred cardiology consults a year - I mean, that'salmost unbelievable. If that's true, I can't imagine whathis tolerance is for getting a cardiac consult."

At trial, plaintiffs' counsel attempted to ask Dr. Schwartz thefollowing question:

"Q. Doctor, based on everything we've gone
over, is it your opinion again that the deviations fromDr. Radfar, deviations from standard of care, to areasonable degree of certainty caused or contributed tothe cardiac arrest?

A. Yes.

Q. Is it your opinion to -

[Defendant's Counsel:] Objection, your Honor, on
Rule 213."

Defendants' counsel objected on the grounds that this question wasnot in the answers to the Rule 213 interrogatories or in thedeposition. Defendants' counsel argued that the depositiontestimony failed to elicit whether Dr. Schwartz had an opinion thatthese deviations caused the cardiac arrest; therefore, this questioncould not be asked at trial. Plaintiff's counsel argued thatalthough that specific question was not asked of Dr. Schwartz duringthe deposition, he was asked a series of questions which elicitedthe same information - that Dr. Radfar's deviations from thestandard care caused or contributed to Taylor's cardiac arrest. The court ruled that Dr. Schwartz's answers in the depositionand Rule 213 interrogatories did not suggest that Dr. Radfar'salleged deviations proximately caused the cardiac arrest. Therefore, the judge prohibited counsel from asking that specificquestion during trial. The trial judge specifically stated thefollowing: "Now, if you want to ask questions that were asked andanswered in discovery that you feel cover that issue but indifferent words, I'll allow you to do that if they're in discovery." After this ruling, plaintiffs' counsel asked the following:

"Q. Had Dr. Radfar met the standard of care,
how would the cardiac arrest have been avoided?

A. By the appropriate treatment of the congenital
heart defect.

Q. Had Dr. Lin met the standard of care, how wouldthe cardiac arrest have been avoided?

A. Same thing, by appropriate treatment of
the cardiac defect.

* * *

Q. And to a reasonable degree of medical
certainty, had Dr. Radfar met the standard of care, wouldthis multi-organ damage failure have been avoided?

A. Yes.

Q. The same way with Dr. Lin. Had Dr. Lin to 
a reasonable degree of medical certainty met the standardof care, would the multi-organ damage have been avoided?

A. Yes.

* * *

Q. Had Dr. Radfar and Dr. Lin to a reasonable
degree of medical certainty met the standard of care,would the heart failure have been avoided?

A. Yes."

On cross-examination, Dr. Schwartz was impeached with his depositiontestimony wherein he had testified that Dr. Lin had acted within thestandard of care on both August 26 and August 28.

At the close of plaintiffs' case, several defendants filedmotions for directed verdicts. Dr. Jundanian and Blue Island arguedin their motion for directed verdict that plaintiffs failed toestablish by expert testimony that Dr. Jundanian deviated from thestandard of care and that plaintiffs failed to link Dr. Jundanian'salleged negligence to Taylor's injury.

The trial court granted a directed verdict in favor of Dr.Jundanian and Blue Island and dismissed the case against them withprejudice on December 10, 1998. The court found that plaintiffsfailed to establish that the negligence of Dr. Jundanian was thecause of any injuries Taylor suffered. Plaintiffs filed a post-trial motion on December 16, 1998.

Dr. Jan Ellen Berger, a pediatrician, testified on behalf ofDr. Lin. Dr. Berger reviewed Taylor's medical record, Dr. Lin'soffice notes, the emergency department record at St. Francis and thedepositions of all parties and witnesses. Based on this review, Dr.Berger testified that Dr. Lin was not required to obtain Taylor'smedical records by August 26 or August 28 or to refer her to apediatric cardiologist. Dr. Berger testified that based on the twoexams conducted by Dr. Lin, Taylor's condition was normal andstable. In Dr. Berger's opinion, Dr. Lin performed within thestandard of care.

At the conclusion of trial, the jury was instructed thatplaintiffs claimed that Taylor was injured and that Dr. Lin wasnegligent in: (1) failing to order an echocardiogram or obtaining acardiac consultation; and (2) failing to observe symptoms of acongenital heart condition.

The jury returned a verdict in favor of Dr. Lin and Pronger-Smith on December 21, 1998. Plaintiffs filed a posttrial motion onJanuary 6, 1999, and argued that the verdict was against themanifest weight of the evidence. Plaintiffs' posttrial motionfurther argued that the trial court erred in barring plaintiffs'expert, Dr. Schwartz, from testifying that the acts and omissions ofDr. Lin caused or contributed to the multi-organ damage and cardiacarrest Taylor suffered. The court subsequently denied plaintiffs'posttrial motions and this timely appeal followed.

Plaintiffs first contend that the trial court erred in grantinga directed verdict for Dr. Jundanian and Blue Island. We first notethat the parties are in disagreement concerning the applicablestandard of review for directed verdicts. Plaintiffs argue that theproper standard of review is de novo. Defendants assert that wereview a judgment for directed verdict under an abuse of discretionstandard.

We hold that review of a grant of a directed verdict is denovo. City of Mattoon v. Mentzer, 282 Ill. App. 3d 628, 633, 668N.E.2d 601 (1996). While we recognize that there is authority tothe contrary in Illinois (Boatmen's Bank v. Dowell, 208 Ill. App. 3d994, 1001, 567 N.E.2d 739 (1991); Johnson v. National Supermarkets,Inc., 257 Ill. App. 3d 1011, 1015, 630 N.E.2d 934 (1994); Cohan v.Garretson, 282 Ill. App. 3d 248, 256, 667 N.E.2d 1325 (1996); NWIInternational, Inc. v. Edgewood Bank, 291 Ill. App. 3d 247, 261, 684N.E.2d 401 (1997)), we nevertheless find that de novo review isproper because the standard of review on appeal should be the sameas that applied by the trial court, which, as City of Mattoonstates: "fits the definition of de novo: '[a]new; afresh; a secondtime.'" (Emphasis in original). City of Mattoon, 282 Ill. App. 3dat 633. Although defendants argue that Mattoon is not controllingbecause it is a Fourth District case, our research has revealedFirst District case law in which the de novo standard of review hasbeen applied to directed verdicts. Green v. Jackson, 289 Ill. App.3d 1001, 682 N.E.2d 409 (1997); Dunlap v. Alcuin Montessori School,298 Ill. App. 3d 329, 698 N.E.2d 574 (1998); Los Amigos Supermarket,Inc. v. Metro Bank & Trust Co., 306 Ill. App. 3d 115, 713 N.E.2d 686(1999).

A motion for directed verdict should be granted when "all ofthe evidence, when viewed in its aspect most favorable to theopponent, so overwhelmingly favors the movant that no contraryverdict based on the evidence could ever stand." Pedrick v. Peoria& Eastern R.R. Co., 37 Ill. 2d 494, 510, 229 N.E.2d 504, 513-14(1967). A directed verdict is improper where "there is anyevidence, together with reasonable inferences to be drawn therefrom,demonstrating a substantial factual dispute, or where the assessmentof credibility of the witnesses or the determination regardingconflicting evidence is decisive to the outcome." Maple v.Gustafson, 151 Ill. 2d 445, 454, 603 N.E.2d 508 (1992).

Plaintiffs contend that sufficient evidence was presented towithstand a directed verdict as to Dr. Jundanian and Blue Island. Plaintiffs first assert that Dr. Radfar's trial testimony providedthe causal link between Dr. Jundanian's conduct and Taylor's cardiacarrest which ultimately led to the growth plate injury. Defendantsargue that the use of Dr. Radfar's testimony as expert witnesstestimony was improper because he was not disclosed as an expertwitness and his opinions were only speculative. In response,plaintiff maintains that Dr. Radfar was properly disclosed as anexpert witness during his deposition.

Supreme Court Rule 213 requires mandatory disclosure of allopinion testimony, including that of a party to the litigation. 177Ill. 2d R. 213; McMath v. Katholi, 304 Ill. App. 3d 369, 377, 711N.E.2d 1135 (1999). A review of the record reveals that Dr. Radfarwas properly disclosed as a witness.

In a medical malpractice action, a plaintiff must prove: (1)the proper standard of care by which to measure the defendant'sconduct; (2) a negligent breach of the standard of care; and (3) theresulting injury proximately caused by the defendant's lack of skillor care. Saxton v. Toole, 240 Ill. App. 3d 204, 210, 608 N.E.2d 233(1992). Proximate cause in a medical malpractice case must beestablished by expert testimony to a reasonable degree of medicalcertainty. Aguilera v. Mount Sinai Hospital Medical Center, 293Ill. App. 3d 967 (1997), citing First National Bank v. Porter, 114Ill. App. 3d 1, 13, 448 N.E.2d 256 (1983). Questions concerningproximate cause are factual matters for the jury to decide. Espinoza v. Elgin, Joliet & Eastern Ry. Co., 165 Ill. 2d 107, 114,649 N.E.2d 1323 (1995). However, if the plaintiff fails to proveproximate cause, the plaintiff has not sustained the burden ofmaking a prima facie case and a directed verdict is proper. Wojtowicz v. Cervantes, 284 Ill. App. 3d 524, 532, 672 N.E.2d 357(1996).

Defendants assert that plaintiffs failed to establish that Dr.Jundanian's failure to interpret Taylor's X ray's was the proximatecause of her injuries. Plaintiffs argue that the evidence showsthat had Dr. Jundanian properly interpreted Taylor's chest X ray,subsequent doctors would have had the opportunity to treat hercondition and possibly avoid or minimize the injury to her growthplate.

We hold that even viewing the evidence against Dr. Jundanian inthe light most favorable to plaintiffs, the evidence of proximatecause was insufficient to submit to the jury. A review of therecord establishes that plaintiffs' expert witnesses only offered anopinion on the deviations from the standard of care, but no expertevidence was adduced to a reasonable degree of medical certaintythat Dr. Jundanian's alleged deviations from the standard of carecaused Taylor's injuries. The mere possibility of a causalconnection is not sufficient to sustain the burden of proof ofproximate cause. The causal connection must not be contingent,speculative or merely possible. Saxton, 240 Ill. App. 3d at 210. The record demonstrates that plaintiffs failed to establishthat Taylor's cardiac abnormalities would have been diagnosed if Dr.Jundanian had noted an enlarged heart on the X-ray report. Inaddition to Dr. Jundanian, plaintiffs' expert witnesses alsotestified that the findings in Dr. Jundanian's report were abnormal. They also testified that these findings, in conjunction with theother signs and symptoms available to Dr. Radfar, should have causedDr. Radfar to diagnose Taylor's cardiac anomalies. Plaintiffs'argument that Dr. Radfar would have acted differently if Dr.Jundanian's report had indicated that Taylor had an enlarged heartis speculative.

Moreover, plaintiffs failed to show that Taylor's injuries wereforeseeable. Plaintiffs were unable to show that it was foreseeablethat Taylor's cardiac arrest and the subsequent placement of theinterosseous line would result in damage to the growth plate in herleg. Indeed, Dr. Moran testified that growth plate arrest is not aknown complication of the placement of an interosseous line. Thus,the directed verdict granted in favor of Dr. Jundanian and BlueIsland was proper.

Plaintiffs finally contend that the trial court erred inbarring a portion of the testimony of Dr. Schwartz under Rule 213(g)(177 Ill. 2d R. 213(g)). Plaintiffs assert that opinions disclosedin answers to interrogatories and depositions addressed almost theexact issues as those elicited during trial. Defendants assert thatDr. Schwartz's opinions were never disclosed during discovery inviolation of Supreme Court Rule 213.

Illinois Supreme Court Rule 213 became effective January 1,1996, and replaced Supreme Court Rule 220 (134 Ill. 2d R. 220). Rule 213(g) explicitly states the following:

"An opinion witness is a person who will offer
any opinion testimony. Upon written interrogatory, theparty must state:

(i) the subject matter on which the
opinion witness is expected to testify;

(ii) the conclusions and opinions of
the opinion witness and the bases therefor; and

(iii) the qualifications of the
opinion witness;

and provide all reports of the opinion witness." 177 Ill. 2d213(g).

Rule 213(i) provides:

"A party has a duty to seasonably supplement
or amend any prior answer or response whenever new oradditional information subsequently becomes known to thatparty.

If a deposition of an opinion witness is
taken, the witness' testimony at trial will be limited tothe opinion expressed therein, in addition to thoseopinions identified in answers to Rule 213(g)interrogatories.

The opinions expressed in a deposition need
not be later specifically identified in Rule 213(g)answers but, upon objection at trial, the burden is on theproponent of the witness to prove the opinions wereprovided in deposition or Rule 213(g) interrogatory." 177Ill. 2d 213(i).

Rule 213 disclosure requirements are mandatory and subject to strictcompliance. Seef v. Ingalls Memorial Hospital, 311 Ill. App. 3d 7,21, 724 N.E.2d 115 (1999). Admission of evidence pursuant to Rule213 is within the sound discretion of the trial court, and thecourt's ruling will not be disturbed absent an abuse of thatdiscretion. Department of Transportation v. Crull, 294 Ill. App. 3d531, 537 (1998). In Department of Transportation, this court held:

"Rule 213 establishes more exacting standards regardingdisclosure than did Supreme Court Rule 220 ***, whichformerly governed expert witnesses. Trial courts shouldbe more reluctant under Rule 213 than they were underformer Rule 220 (1) to permit the parties to deviate fromthe strict disclosure requirements, or (2) not to imposesevere sanctions when such deviations occur. Indeed, webelieve one of the reasons for new Rule 213 was the needto require stricter adherence to disclosure requirements." Department of Transportation, 294 Ill. App. 3d at 538-39.

Given this stricter standard of compliance, the trial court didnot abuse its discretion in sustaining the objection to the questionasking Dr. Schwartz if it was his opinion that Dr. Radfar'sdeviations from the standard of care caused or contributed toTaylor's cardiac arrest. On appeal, plaintiffs concede that "[i]tis true no one questioned Dr. Schwartz during the deposition withthe 'magic' words as to whether or not the deviations from thestandard of care by Dr. Lin caused or contributed to the cardiacarrest or injuries suffered by Taylor Susnis." A review of therecord reveals that the interrogatories also did not contain thisopinion as to either Dr. Radfar or Dr. Lin. It is also significantthat prior to trial the court considered extensive motions in limineand responses thereto. The court barred plaintiffs' experts fromtestifying as to opinions not previously expressed in depositions orRule 213 interrogatories. This court has recently interpretedSupreme Court Rule 213 to require strict disclosure of this type ofopinion testimony. Copeland v. Stebco Products Corp., No. 1-99-3940(September 29, 2000).

Further, the record demonstrates that plaintiffs' counsel wasallowed to elicit this testimony after rephrasing the questions. Plaintiffs' counsel was specifically allowed to ask Dr. Schwartz ifDr. Radfar and Dr. Lin had met the standard of care, whetherTaylor's cardiac arrest would have been avoided. Under thesecircumstances, we hold that the trial court's decision to excludethis portion of Dr. Schwartz's testimony was not an abuse ofdiscretion.

Finally, plaintiffs do not argue that the verdict for Dr. Linwas not supported by the evidence. Even if the court had improperlybarred Dr. Schwartz from answering the specific question at issue,any error was harmless. See LoCoco v. XL Disposal Corp., 307 Ill.App. 3d 684, 691, 717 N.E.2d 823 (1999).

Based on the foregoing reasons, the judgment of the circuitcourt of Cook County is affirmed.

Affirmed.

GREIMAN, J., and THEIS, J., concur.