Clarifying Summary Judgment Standards and Physician-Patient Relationship in Medical Malpractice

Introduction

Mathura v. Makaryus, 2025 NY Slip Op 02063 (App. Div. 2d Dept. Apr. 9, 2025), arises from the tragic death of Kumar Mathura, who suffered an unrecognized aspergillus pneumonia and died shortly after hospital admission. His wife, individually and as administrator of his estate, sued multiple healthcare providers (including Plainview Hospital, several treating physicians, and two private practitioners) for medical malpractice. The Supreme Court, Nassau County, denied all defendants’ motions for summary judgment. On appeal, the Appellate Division reversed and granted summary judgment in favor of each defendant. Key issues included the proper allocation of burdens on summary judgment in medical malpractice cases, the necessity of expert proof of breach and causation, and the existence (or non-existence) of a physician-patient relationship with non-treating providers.

Summary of the Judgment

The Appellate Division held:

Defendants Gulati & Goyal, LLP and Dr. Mohammud Alam established prima facie that no physician-patient relationship existed—each learned of the hospitalization only after the decedent was in ICU or deceased.
Plainview Hospital and the treating physicians (Drs. Sharma, Schmuter, Pahlavan) presented expert affirmations that no departure from accepted community standards occurred, and any alleged departure was not a proximate cause of death.
Plaintiff’s expert affirmations were ruled speculative and conclusory, failing to address the defendants’ specific expert opinions or evidence.
Accordingly, summary judgment dismissing all malpractice claims against each defendant was granted, and costs were awarded to appellants.

Analysis

Precedents Cited

Armond v. Strangio (227 AD3d 758): Articulates the elements of medical malpractice—departure from community standards and proximate cause.
Hiegel v. Organe Regional Med. Ctr. (219 AD3d 910): Confirms that a moving defendant must rebut specific allegations in the plaintiff’s bill of particulars.
Corujo v. Caputo (224 AD3d 729) and Myers v. Ferrara (56 AD3d 78): Hold that general or conclusory expert opinions cannot defeat a properly supported summary judgment motion.
McHale v. Sweet (217 AD3d 666) and Templeton v. Papathomas (208 AD3d 1268): Demand that opposing experts specifically address movant’s evidence and explain their reasoning.
Blau v. Benodin (190 AD3d 922) and Thomas v. Hermoso (110 AD3d 984): Define the physician-patient relationship, including implied relationships arising from advice given through other professionals.
Tanzman v. Ghislaine (205 AD3d 837) and Johnson v. Peloro (62 AD3d 955): Support dismissal where defendants demonstrate lack of any relationship or knowledge of patient care.
Torres v. Yakobov (222 AD3d 692) and Kielb v. Bascara (217 AD3d 756): Reinforce the requirement of expert proof that no departure or causation existed.

Legal Reasoning

The court applied the well-established burden-shifting framework for summary judgment in medical malpractice:

Defendant’s Prima Facie Case: Each defendant bore the initial burden to show either no breach of community standards or no proximate cause—or, in the case of Gulati & Alam, no physician-patient relationship. They did so by submitting:
- Expert affirmations attesting to adherence to standards of care and to lack of causation.
- Deposition testimony demonstrating absence of any doctor-patient bond until after the decedent’s critical illness or death.
Shift to Plaintiff: Once the prima facie case was made, the burden shifted to the plaintiff to raise a triable issue by means of competent, non-speculative expert evidence that directly contradicted defendants’ proofs.
Plaintiff’s Failure: The plaintiff’s experts offered conclusory statements without crucial factual analysis or direct engagement with the defense experts’ reasoning and record citations. Under Corujo, Myers, McHale and Templeton, such opinions are insufficient to withstand summary judgment.

Impact

Mathura v. Makaryus reinforces and clarifies three important aspects of New York medical malpractice practice:

Physician-Patient Relationship: Providers who have no active role in diagnosis or treatment, and only learn of the patient’s hospitalization post facto, cannot be held liable. This narrows the scope of implied relationships.
Expert Evidence Quality: Plaintiffs must submit detailed, fact-specific expert affirmations that engage with each element of the defense’s proof—mere allegations of negligence will not suffice.
Streamlined Disposition: Courts are encouraged to grant summary judgment where proper proof shows no breach or causation, thereby conserving judicial resources and reducing protracted litigation.

Complex Concepts Simplified

Summary Judgment: A court determination that no factual issues require trial, appropriate when a party proves entitlement to judgment as a matter of law.
Bill of Particulars: A detailed statement by the plaintiff setting forth the allegations of negligence—used by defendants to identify and rebut specific claims.
Prima Facie Burden: The initial showing a moving party must make to establish entitlement to judgment before any issues shift to the opponent.
Proximate Cause: The link between the alleged negligence and the injury; must be more than speculative.
Physician-Patient Relationship: A prerequisite for malpractice liability, created by rendering and accepting professional healthcare services.

Conclusion

Mathura v. Makaryus is a landmark decision that strengthens the rule that medical malpractice claims must be supported by detailed, non-conclusory expert proof and that liability cannot rest upon absent or implied doctor-patient relationships where no direct treatment or advice occurred. By affirming summary judgment for all defendants, the Appellate Division has underscored the judiciary’s commitment to rigorous application of summary judgment standards and to limiting malpractice exposure to those truly responsible for patient care decisions. This ruling will guide practitioners in both mounting and defending medical negligence actions, ensuring that only well-founded claims proceed to trial.