LAURA INGRAM AS EXECUTOR OF THE ESTATE OF CAROL EWINGS DECEASED PLAINTIFF RESPONDENT v. CUBA MEMORIAL HOSPITAL INC CUBA MEMORIAL HOSPITAL INC SKILLED NURSING FACILITY RAJAN GULATI ARUN PARMANAND PATEL OLEAN MEDICAL GROUP LLP DEFENDANTS APPELLANTS ET AL DEFENDANTS (2026)

MEMORANDUM AND ORDER

It is hereby ORDERED that the order so appealed from is unanimously affirmed without costs.

Memorandum: Plaintiff, as executor of the estate of her mother (decedent), commenced this medical malpractice action seeking damages for decedent's physical injuries and death arising from a stroke she allegedly sustained after her anticoagulant medication was discontinued while a resident of both defendant Cuba Memorial Hospital, Inc. Skilled Nursing Facility (Cuba Nursing Home) and defendant The Pines Healthcare & Rehabilitation Center Olean Campus (Pines Nursing Home). Defendant Rajan Gulati, M.D., was the medical director at Cuba Nursing Home, and defendant Arun Parmanand Patel, M.D., was the medical director at Pines Nursing Home. Cuba Nursing Home is affiliated with defendant Cuba Memorial Hospital, Inc. (collectively, Cuba defendants), and Gulati and Patel were both employed by defendant Olean Medical Group, LLP (collectively, Olean defendants). Following discovery, the Cuba defendants and the Olean defendants moved for summary judgment dismissing the complaint against them. Supreme Court, inter alia, denied the Cuba defendants’ motion in part and denied the Olean defendants’ motion. We affirm.

A defendant moving for summary judgment dismissing the complaint against them in a medical malpractice action has the “initial burden of establishing [their] entitlement to judgment as a matter of law on ․ deviation [or] causation by submitting [an] expert affidavit [that is] detailed, specific and factual in nature, opining that [they] did not deviate from good and accepted medical practice [or] that [their] care and treatment ․ did not proximately cause any injury” (Nesterenko v Hall, 239 AD3d 1314, 1315 [4th Dept 2025]; see Wicks v Virk, 198 AD3d 1315, 1315 [4th Dept 2021]; Webb v Scanlon, 133 AD3d 1385, 1386 [4th Dept 2015]). Where the defendant meets their initial motion burden on both deviation and causation, the burden shifts to the plaintiff “to raise triable issues of fact by submitting an expert's affidavit both attesting to a departure from the accepted standard of care and that defendant[’s] departure from that standard of care was a proximate cause of the [alleged] injur[ies]” (Nesterenko, 239 AD3d at 1315 [internal quotation marks omitted]; see Ziemendorf v Chi, 207 AD3d 1157, 1157-1158 [4th Dept 2022]; Webb, 133 AD3d at 1386). Where the plaintiff submits an expert opinion that “squarely opposes” the opinion of the defendant's expert, “a classic battle of the experts [is presented] that is properly left to a jury for resolution” (Mason v Adhikary, 159 AD3d 1438, 1439 [4th Dept 2018] [internal quotation marks omitted]; see Cully v Ricottone, 228 AD3d 1240, 1240 [4th Dept 2024]; Blendowski v Wiese [appeal No. 2], 158 AD3d 1284, 1286 [4th Dept 2018]).

Here, with respect to the medical malpractice claims concerning Gulati, the Olean defendants met their initial burden of establishing their entitlement to judgment as a matter of law on both deviation and causation by submitting Gulati's expert affirmation, which was detailed, specific and factual in nature, opining that he did not deviate from good and accepted medical practice and that his care and treatment of decedent did not proximately cause her injuries and death (see Webb, 133 AD3d at 1386). In opposition, plaintiff submitted an expert affirmation attesting to multiple departures from the accepted standards of care by Gulati and that the departures from the standards of care were a proximate cause of decedent's injuries and death, squarely opposing Gulati's affirmation and thereby raising triable issues of fact (see Cooke v Corning Hosp., 198 AD3d 1382, 1383 [4th Dept 2021]; Mason, 159 AD3d at 1439). Contrary to the Olean defendants’ contention, plaintiff's expert affirmation is sufficient to raise a triable issue whether the subsequent care and treatment by other healthcare providers, including Patel, after decedent left Cuba Nursing Home, was so “extraordinary under the circumstances, not foreseeable in the normal course of events, or [so] independent of or far removed from [Gulati's] conduct” such that it would constitute a superseding act that “break[s] the causal nexus” (Mazella v Beals, 27 NY3d 694, 706 [2016] [internal quotation marks omitted]; see generally Hain v Jamison, 28 NY3d 524, 529-530 [2016]). Contrary to the Olean defendants’ further contention, the fact that plaintiff's expert was not a gastroenterologist does not render his opinion speculative inasmuch as “[i]t is well settled that [a] physician need not be a specialist in a particular field to qualify as a medical expert and any alleged lack of knowledge in a particular area of expertise goes to the weight and not the admissibility of the testimony” (Martingano v Hall, 188 AD3d 1638, 1641 [4th Dept 2020], lv denied 36 NY3d 912 [2021] [internal quotation marks omitted]; see Goldschmidt v Cortland Regional Med. Ctr., Inc., 190 AD3d 1212, 1215 [3d Dept 2021]).

With respect to the medical malpractice claims concerning Patel, the Olean defendants met their initial burden of establishing their entitlement to judgment as a matter of law on the element of deviation by submitting Patel's expert affirmation, which is detailed, specific and factual in nature, opining that he did not deviate from good and accepted medical practice (see Webb, 133 AD3d at 1386). Contrary to the Olean defendants’ contention, they failed to meet their initial burden on the element of causation inasmuch as Patel continued to provide care and treatment to decedent after she was seen by other medical providers and, thus, plaintiff was not required to address that element as it relates to Patel in opposing the Olean defendants’ motion (see Fargnoli v Warfel, 186 AD3d 1004, 1005 [4th Dept 2020]). In opposition, plaintiff submitted an expert affirmation attesting to multiple departures from the accepted standards of care by Patel, squarely opposing Patel's affirmation and thereby raising a triable issue of fact with respect to the element of deviation (see Cooke, 198 AD3d at 1383; Mason, 159 AD3d at 1439).

With respect to the Cuba defendants, contrary to their contention concerning the surviving medical malpractice claims against them, they failed to meet their initial burden on the element of deviation (see generally Groff v Kaleida Health, 161 AD3d 1518, 1521-1522 [4th Dept 2018]) and, thus, plaintiff's expert affirmation was not required to address that element as it relates to the Cuba defendants (see generally Fargnoli, 186 AD3d at 1005). We conclude, however, that the Cuba defendants met their initial burden on causation by submitting an expert affirmation that is detailed, specific and factual in nature, opining that the Cuba defendants’ care and treatment of decedent, even if negligent, did not proximately cause her injuries and death (see generally Noga v Brothers of Mercy Nursing & Rehabilitation Ctr., 198 AD3d 1277, 1279 [4th Dept 2021]). In opposition, plaintiff submitted an expert affirmation attesting that the negligence of the Cuba defendants, as well as the alleged malpractice by Gulati, was a proximate cause of decedent's injuries and death, squarely opposing the Cuba defendants’ expert affirmation and thereby raising a triable issue of fact (see Cooke, 198 AD3d at 1383; Mason, 159 AD3d at 1439).

Finally, contrary to the Cuba defendants’ further contention, they also failed to meet their initial burden on the surviving Public Health Law article 28 claims against them inasmuch as their own motion submissions present triable issues of fact whether they, inter alia, failed to obtain a necessary consultation and failed to keep decedent's family informed of critical developments in her care (see 10 NYCRR 415.1 [b] [1]; 415.11 [c] [1]; 415.12 [m] [2]). Thus, the court properly denied the Cuba defendants’ motion insofar as it sought summary judgment dismissing those claims “regardless of the sufficiency of the opposing papers” (Winegrad v New York Univ. Med. Ctr., 64 NY2d 851, 853 [1985]).

Entered: July 24, 2026

Ann Dillon Flynn

Clerk of the Court