Admitted MRI Evidence Must Be Meaningfully Made Available to the Jury During Deliberations; Denial Can Require a New Trial on Proximate Cause Under CPLR 4404(a)

1. Introduction

In J.T.M. v Parrinello (2026 NY Slip Op 03787 [2d Dept Jun. 17, 2026]), the Appellate Division, Second Department, reviewed a defense verdict in a medical malpractice action arising from alleged failures by pediatric providers to timely diagnose and treat an infant’s arachnoid cyst and to refer the infant to a neurologist or neurosurgeon, allegedly resulting in brain damage.

The plaintiffs sued, among others, pediatric defendants Barbara J. Cusumano and Robert J. Gottlieb, and defendant Alexandra Halitsky, along with Southampton Pediatric Associates, P.C. Following a jury trial, the jury found no departure by Cusumano or Gottlieb, found a departure by Halitsky (failure to refer at the 16-month visit on November 12, 2009), but found that Halitsky’s departure was not a substantial factor in causing the infant plaintiff’s injury. The plaintiffs moved under CPLR 4404(a) to set aside the causation finding (both as against the weight of the evidence and in the interest of justice). The trial court denied the motion and entered judgment dismissing the complaint as against these defendants.

The principal appellate issue became not whether the evidence could support the jury’s causation verdict, but whether the trial court’s handling of a deliberating jury’s request to view admitted MRI images deprived the plaintiffs of a fair trial on proximate cause.

2. Summary of the Opinion

The Second Department modified the judgment. It held:

  • The jury’s finding that Halitsky’s departure was not a substantial factor in causing injury was not against the weight of the evidence.
  • However, the trial court committed prejudicial error (as to Halitsky) by failing to respond meaningfully to the jury’s deliberation request to view “all of the infant plaintiff’s MRI images,” which had been admitted into evidence. The court refused on the ground that MRI review was “beyond the ken of a juror.”
  • That refusal was harmless as to Cusumano and Gottlieb (because the jury found no departure as to them), but it deprived the plaintiffs of “substantial justice” on the critical contested issue of proximate cause as to Halitsky.
  • The court therefore granted, under CPLR 4404(a) “in the interest of justice,” a new trial limited to whether Halitsky’s departure at the November 12, 2009 visit was a substantial factor in causing the infant plaintiff’s injury, and, if necessary, damages.
  • The appellate court rejected plaintiffs’ additional claim that the trial court’s pre-deliberation conduct cumulatively deprived them of a fair trial.

3. Analysis

A. Precedents Cited

1) Core medical malpractice elements (departure and causation)

  • Nugent v Highland Rehabilitation & Nursing Ctr., 240 AD3d 601: cited for the governing formulation that malpractice liability requires proof of both a deviation from accepted standards and proximate cause; and for the “more probable than not”/“substantial factor” articulation of causation in malpractice cases, as well as deference to credibility determinations and the jury’s prerogative in choosing between experts.
  • Gruen v Brathwaite, 215 AD3d 927: cited alongside Nugent for the same elements of malpractice and the substantial-factor causation standard.
  • Velasquez v Ruiz, 203 AD3d 786: cited for the evidentiary burden on plaintiffs to present medical proof allowing a reasonable conclusion that the departure was more probably than not a substantial factor.

2) Weight-of-the-evidence review and deference to the jury

  • Lolik v Big V Supermarkets, Inc., 86 NY2d 744: anchors the high threshold for setting aside a verdict as against the weight of the evidence—i.e., only where the verdict could not have been reached on any fair interpretation of the evidence.
  • Krohn v Schultz Ford Lincoln, Inc., 246 AD3d 90, and Thompson v Northwell Health, Inc., 234 AD3d 1006: reinforce the Lolik standard and its application.
  • Kirkland v Ranchers Best Wholesale Meats, Inc., 152 AD3d 656: provides the presumption that, if a verdict is reconcilable with a reasonable view of the evidence, the court assumes the jury adopted that view.
  • Abbene v Conetta, 198 AD3d 849: cited for deference to jury credibility determinations and the jury’s right to credit one expert over another.
  • Angieri v Musso, 225 AD3d 43, and Russo v Mignola, 142 AD3d 1064: used to support the conclusion that the causation verdict (as a weight-of-the-evidence matter) was supported by a fair interpretation of the record.

3) “Interest of justice” new trials and jury-note responses

  • Duman v Scharf, 186 AD3d 672, quoting Allen v Uh, 82 AD3d 1025: cited for the breadth of CPLR 4404(a) “interest of justice” review (admissibility rulings, charge issues, misconduct, newly discovered evidence, surprise).
  • Schuster v Sourour, 207 AD3d 491: cited both for the CPLR 4404(a) framework and for granting relief where trial-level errors undermine substantial justice.
  • Maiorani v Adesa Corp., 83 AD3d 669: central precedent for the proposition that a party may be deprived of a fair trial when the court fails to respond meaningfully to deliberating jury questions. The court used Maiorani to characterize the refusal to allow the jury to view admitted MRI images as a failure to respond meaningfully.
  • Cleveland v Djeu, 152 AD3d 483, and Meyer v Saint Francis Hosp., Poughkeepsie, N.Y., 151 AD3d 1501: cited for the principle that an inadequate response to a jury note that prevents fair consideration of a critical issue may constitute prejudicial error requiring a new trial.
  • Micallef v Miehle Co., Div. of Miehle-Goss Dexter, 39 NY2d 376: cited for the “substantial justice” touchstone in determining whether an error warrants a new trial in the interest of justice.
  • Raineri v Lalani, 191 AD3d 814: reinforces that relief is warranted where error undermines substantial justice.

4) Trial management, judicial conduct, and claims of unfairness

  • Abdenbi v Walgreen Co, 240 AD3d 731, and Caserta v Levittown School Dist., 12 AD3d 549: cited for the trial court’s broad discretion to control the scope of witness examination.
  • Ioffe v Seruya, 134 AD3d 993, quoting Nunez v New York City Health & Hosps. Corp. [Elmhurst Hosp. Ctr.], 110 AD3d 686: cited for the court’s broad authority to control the courtroom and proceedings, tempered by the duty to remain impartial.
  • DeCrescenzo v Gonzalez, 46 AD3d 607, and Porcelli v Northern Westchester Hosp. Ctr., 110 AD3d 703: applied to reject claims of judicial bias and disproportionate admonishment of counsel.
  • Albano v K.R. & S. Auto Repair, Inc., 123 AD3d 748, and Rizzo v Kay, 79 AD3d 1001: cited to distinguish this case from those involving repeated prejudicial intrusions preventing calm and unprejudiced consideration of the evidence.

B. Legal Reasoning

  1. Two distinct CPLR 4404(a) pathways: The court separated (i) weight-of-the-evidence review (a highly deferential standard under Lolik) from (ii) “interest of justice” review, which focuses on whether trial-level error undermined fairness and substantial justice.
  2. Why the causation verdict survived “weight” review: Even though the jury found a departure by Halitsky, the panel held the record permitted a fair interpretation supporting no substantial-factor causation. Under the cited authority, credibility and expert conflicts are for the jury; the appellate court will not substitute its view when the verdict can be reconciled with a reasonable view of the evidence.
  3. Why the same verdict failed under “interest of justice” review: The deliberating jury specifically asked to view all admitted MRI images. The trial court refused because it deemed image review “beyond the ken of a juror.” The Second Department treated that refusal as a failure to respond meaningfully to a jury request, particularly because the images were already admitted evidence, and because the request went to a “critical issue” the jury had to decide—proximate cause (i.e., the causal relationship between the failure to refer and the injury).
  4. Targeted harmless-error analysis: The panel parsed prejudice defendant-by-defendant and issue-by-issue. The error was harmless for Cusumano and Gottlieb because the jury never reached causation for them (no departure). But it was prejudicial as to Halitsky because the jury did find a departure and was deciding whether that departure caused injury—precisely where diagnostic imaging could matter in assessing timing, progression, and the significance of the cyst as argued by experts.
  5. Scope of remedy: The court ordered a new trial limited to proximate cause for Halitsky’s departure at the 16-month visit and, if needed, damages—preserving the jury’s departure findings and the defense verdict for the other defendants.

C. Impact

The opinion’s practical doctrinal contribution is its clear signal that, when a deliberating jury requests access to admitted technical or medical exhibits (including diagnostic images), a trial court cannot deny access simply by characterizing the material as “beyond the ken of a juror.” If the evidence is admitted, and the request bears on a critical issue (here, proximate cause), refusal may constitute a non-meaningful response to a jury note and warrant a new trial “in the interest of justice,” even where the verdict withstands weight-of-the-evidence review.

For future malpractice trials—especially those involving radiology, neurology, obstetrics, or any condition where imaging chronology matters—the decision encourages:

  • More careful judicial handling of deliberation requests for admitted exhibits;
  • Use of practical safeguards (e.g., ensuring the jury can view what was admitted) rather than outright denial on “ken” grounds;
  • Sharper appellate focus on whether an evidentiary-handling error is issue-specific and defendant-specific (harmless as to one, prejudicial as to another).

4. Complex Concepts Simplified

  • CPLR 4404(a): A post-trial motion rule allowing a court to set aside a verdict and order a new trial. It can be granted either because the verdict is against the weight of the evidence or “in the interest of justice” due to trial errors that undermined fairness.
  • “Weight of the evidence”: Not “did the jury get it right,” but whether the verdict is so unsupported that it could not be reached on any fair interpretation of the evidence (Lolik v Big V Supermarkets, Inc.).
  • Proximate cause / “substantial factor”: In malpractice cases, plaintiffs must show it is more likely than not that the departure materially contributed to the injury—not merely that the departure occurred.
  • “In the interest of justice”: A broader fairness-based review: even if a verdict could be supported by evidence, a new trial may be required if a significant trial error prevented “substantial justice” (Micallef v Miehle Co., Div. of Miehle-Goss Dexter).
  • Jury note and “meaningful response”: When jurors ask a question or request evidence during deliberations, the court must respond in a way that allows the jury to fairly decide key issues; a non-responsive or obstructive answer can be reversible error (Maiorani v Adesa Corp.).
  • “Beyond the ken of a juror”: A phrase implying something is too technical for lay jurors. This case indicates that, at least as to viewing admitted evidence requested during deliberations, that rationale cannot justify refusing access where the exhibit is part of the evidentiary record and central to the decision.

5. Conclusion

J.T.M. v Parrinello draws a sharp line between deference to a jury’s causation finding on “weight of the evidence” review and the appellate court’s willingness to order a new trial “in the interest of justice” when the trial court’s handling of deliberations prevents fair consideration of a critical issue. By holding that refusal to permit the jury to view admitted MRI images—based on the notion that they were “beyond the ken of a juror”—was prejudicial as to proximate cause, the Second Department reinforces that admitted evidence must be meaningfully available to jurors when they request it, particularly where it may bear directly on causation in a medical malpractice case.