## Facts

- Maria Strino, previously a cesarean patient, selected Dr. James R. Lindemulder for obstetric care and agreed to attempt a vaginal birth after cesarean for her 1997 pregnancy.
- Maria was admitted to a hospital for delivery on March 27, 1997, signed hospital consent forms, and underwent induced labor.
- Labor progressed slowly; the next day she received additional induction medication and experienced uterine hyperstimulation and recurring fetal heart-rate decelerations.
- The Strinos alleged negligent labor and delivery management caused severe injury to their son, Joseph, who later died at 20 months; they also sought damages for his pain and suffering.
- The defense argued (1) no negligence in obstetrical management and (2) Maria’s husband Frank, acting on her behalf, refused a cesarean section that would have improved the child’s survival chances.
- Over plaintiffs’ objections, the defense introduced evidence of Frank’s labor-room conduct and statements opposing forceps and a cesarean section.
- At trial, Dr. Lindemulder testified Frank threatened him if forceps were used; plaintiffs sought to impeach him with deposition testimony using different wording, but the court limited the cross-examination.
- The jury returned a general verdict for Premier Healthcare Associates, P.C., and Dr. Lindemulder after two days of deliberations.

## Issues

1. Whether sufficient evidence supported submitting to the jury that Frank acted as Maria’s agent for medical decision-making, making his conduct relevant and admissible on liability and contributory-negligence theories.
2. Whether the trial court abused its discretion by limiting impeachment cross-examination about differences between the physician’s deposition and trial testimony describing Frank’s threat.
3. Whether claimed errors in other evidentiary rulings, jury instructions (including contributory negligence), and responses to jury questions warranted reversal, or were waived or non-prejudicial given the general verdict.

## Decision

- The appellate court affirmed the judgment on the jury’s general verdict for defendants.
- It held the evidence permitted a jury finding that Frank acted as Maria’s agent in communicating or making care decisions during labor.
- It found no abuse of discretion in restricting impeachment because the deposition and trial accounts were not materially inconsistent on the point that Frank made a hostile threat if forceps were used.
- It held several additional appellate claims were waived for lack of proper preservation at trial and in post-trial motions.
- It declined to reverse based on the contributory-negligence instruction because the general verdict, absent a requested special interrogatory, made it impossible to show the instruction affected the outcome.

## Legal Principles

- Agency between spouses for medical decision-making is a fact question; when the evidence permits competing inferences, the issue is properly left to the jury.
- Evidence of an alleged agent’s conduct may be relevant to liability and contributory negligence if the jury could find the agent acted with the patient’s authorization or acquiescence.
- Limits on impeachment and cross-examination are reviewed for abuse of discretion; differences in phrasing are insufficient when they do not create a material inconsistency.
- Appellate review of trial error generally requires preservation through timely objection and inclusion in a post-trial motion; failure results in waiver.
- When a jury returns a general verdict that could rest on independent grounds, a party challenging an instruction must seek a special interrogatory or otherwise demonstrate prejudice; without it, alleged instructional error may not be reversible.

## Conclusion

The court affirmed a defense verdict in an obstetrical malpractice case, holding that the jury could treat the husband as the patient’s agent for medical decisions, that limiting impeachment over non-material wording differences was within the trial court’s discretion, and that the plaintiffs could not establish prejudice from a contributory-negligence instruction after a general verdict without a special interrogatory.


Strino v. Premier Healthcare Assocs., P.C., 850 N.E.2d 221 (Ill. App. Ct. 1st Dist. 2006)