NY DailyRecord appeals court reinstates malpractice lawsuit

A state appeals court has revived a medical malpractice lawsuit against Erie County Medical Center.

Plaintiff Francis L. Guadagno, administrator of the estate of his son, Francis J. Guadagno, filed the lawsuit against the hospital in state Supreme Court in Buffalo in August 2015.

On the afternoon of Sept. 16, 2014, Francis J. Guadagno was at home with his family when his father noticed that he was agitated and acting strangely.

Guadagno fell over and gradually lost consciousness. He began drooling and his eyes rolled into the back of his head.

His father called 911 about 3:15 p.m., and an ambulance arrived at the home less than 10 minutes later.

Guadagno did not want to be taken to the hospital, but his father insisted. At the hospital, the son was so agitated he had to be restrained with straps and given sedatives.

About 9:30 p.m., a nurse told the family: “We’ve got him. You can go home.”

The family claims hospital personnel told them there was a plan in place to take him to a drug treatment facility the next morning.

But hospital officials let Guadagno sign himself out at 11:57 p.m., and he died of an overdose the next day — Sept. 17, 2014.

“The defendant, ECMC, its agents, servants and/or employees did fail to properly recognize, timely treat and otherwise properly render medical care and treatment to the decedent, Francis J. Guadagno, and did breach the standard of care, failed to follow general and proper practices and were otherwise negligent, careless and reckless in their care and treatment of the decedent,” according to the suit.

“The negligence, carelessness, recklessness and breach of the standard of care by the defendant, ECMC, its agents, servants and/or employees caused the decedent, Francis J. Guadagno to endure conscious pain and suffering, fear of impending death and caused his death on September 17, 2014,” according to the complaint.

The defense claimed they were not liable because Guadagno refused medical treatment.

In August 2024, state Supreme Court Justice Donna M. Siwek granted a defense motion for summary judgment dismissing the complaint.

The plaintiff appealed and the Appellate Division of state Supreme Court, Fourth Department, unanimously reversed Siwek’s ruling, denied the defense motion, and reinstated the complaint.

“We conclude, under the circumstances of this case, that defendant had a duty to ensure that decedent was no longer incapacitated to the degree that there was a likelihood to result in harm to decedent or others in order to allow for his discharge,” the Fourth Department wrote.

A hospital does not owe an intoxicated patient, who went to the hospital voluntarily, a duty to prevent that patient from leaving the hospital against medical advice even when that patient has been admitted to the hospital for medical treatment, according to the decision.

But Francis J. Guadagno was admitted involuntarily under Mental Hygiene Law, which governs the involuntary retention of individuals incapacitated by alcohol or drugs, who object to treatment. They may be held for emergency care if a physician finds they are incapacitated and pose a likelihood of harm to themselves or others.

“Defendant therefore had a duty to retain decedent for emergency treatment if decedent was incapacitated by alcohol or substances to such a degree that there was a likelihood to result in harm to decedent or others,” the court wrote.

Assuming that the defense met its burden of demonstrating that it did not breach its duty to ensure that Guadagno was no longer incapacitated to the degree that there was a likelihood to result in harm to him or others, we conclude that plaintiff raised an issue of fact, the court wrote.

The plaintiff’s expert opinion was that “under the circumstances, and especially in such proximity to the events that occurred in the hospital in the hours prior to discharge, it was a breach of the standard of care to allow decedent to be discharged,” the court wrote.

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