Defense Summary Judgment Denied Where Expert Opinions Ignore Record Evidence and Where PHL § 2801-d Requires Proof of No Deprivation of Resident Rights (Pressure-Ulcer Care)

1. Introduction

Balgobin v Jamaica Hosp. Med. Ctr. (2026 NY Slip Op 03938 [2d Dept June 24, 2026]) addresses summary judgment burdens in (i) medical malpractice claims involving pressure-ulcer prevention and treatment at a hospital and a nursing home, and (ii) a statutory claim under Public Health Law § 2801-d against the nursing home.

The plaintiff alleged that Jamaica Hospital Medical Center (the hospital) and Jamaica Hospital Nursing Home Company, Inc. (the nursing home) negligently failed to properly prevent and treat his pressure ulcer during his admissions. The Supreme Court, Queens County granted summary judgment to both defendants (malpractice as to both; and additionally dismissed the plaintiff’s Public Health Law § 2801-d claim against the nursing home). The Second Department reversed, holding that (a) the hospital’s motion should have been denied because plaintiff’s expert created triable issues, and (b) the nursing home failed to satisfy its prima facie burden both on malpractice and on the § 2801-d claim.

2. Summary of the Opinion

  • Hospital (medical malpractice): Although the hospital made a prima facie showing through an expert affirmation that it did not depart from the standard of care and that the ulcer was “unavoidable,” the plaintiff’s expert raised triable issues of fact regarding departures (including the hospital’s bed positioning/elevation as part of prevention planning) and causation, and also rebutted “unavoidability.” Conflicting expert opinions required jury resolution.
  • Nursing home (medical malpractice): The nursing home did not establish prima facie entitlement to judgment because its expert failed to address record evidence suggesting the pressure ulcer may not have been healed at discharge—undermining the expert’s central factual premise (healed within 48 hours).
  • Nursing home (Public Health Law § 2801-d): The nursing home did not establish prima facie entitlement to judgment because its proof was insufficient to show the plaintiff “received the necessary treatment and services to promote healing” of the pressure ulcer under 10 NYCRR 415.12[c][2], and because § 2801-d liability is about deprivation of rights conferred by law/regulation—not medical malpractice deviation analysis.

3. Analysis

A. Precedents Cited

1) Summary judgment framework in medical malpractice

The court anchored its malpractice analysis in a familiar burden-shifting line of cases:

  • Paxton v Sosnowski and Rodriguez v Avshalumov: These authorities restate the defendant’s prima facie burden on summary judgment—showing either no departure from accepted practice or lack of proximate causation.
  • Deane v Tracer: Cited both for the plaintiff’s responsive burden after a defendant makes a prima facie showing and for the proposition that “conflicting medical expert opinions” typically preclude summary judgment.
  • Campbell v Ditmas Park Rehabilitation & Care Ctr., LLC: Reinforces that where expert opinions clash (including on pressure-ulcer issues), summary judgment is often inappropriate; the decision also serves as a comparison point (“cf.”) in evaluating the “unavoidable pressure ulcer” contention.

2) Pressure-ulcer cases and the “unavoidable” defense

  • Russell v River Manor Corp. and Cummings v Brooklyn Hosp. Ctr.: These cases support the proposition that a defendant can meet its prima facie burden with expert proof that care complied with accepted standards and that a pressure ulcer was unavoidable given comorbidities—i.e., a recognized defense theory in ulcer litigation.

3) Adequacy and foundation of expert opinions

  • Darrisaw v Interfaith Med. Ctr.: Used to reject the argument that plaintiff’s expert was speculative or conclusory; the Second Department emphasized that record support can supply the necessary grounding.
  • Mehtvin v Ravi and Cerrone v North Shore-Long Is. Jewish Health Sys., Inc.: Cited for the important practical point that when an expert opines within their specialization, the expert is not necessarily required at the summary judgment stage to attach “official medical guidelines or other foundational evidence” to establish reliability—so long as the opinion is competent and tied to the facts.
  • Swiatocha v Koenigsdorf: Invoked to emphasize that conflicting expert opinions create credibility issues for a jury, not a motion court.

4) When a movant fails to meet its prima facie burden

  • Woehrle v Buono and Faicco v Golub: These cases reinforce that a defense expert’s failure to confront key contrary record evidence can render the opinion insufficient to establish prima facie entitlement to judgment. The nursing home’s expert premise (healed within 48 hours) was not reconciled with evidence suggesting non-healing at discharge.
  • Winegrad v New York Univ. Med. Ctr.: The court applied the classic rule: if the movant fails to meet its initial burden, the motion must be denied “without regard to the sufficiency of the plaintiff’s opposition papers.”

5) Public Health Law § 2801-d: nature of liability and proof

  • Henry v Sunrise Manor Ctr. for Nursing & Rehabilitation and Vissichelli v Glen-Haven Residential Health Care Facility, Inc.: These cases support that a § 2801-d claim can be predicated on violations of nursing-home regulations; they frame the evidentiary showing required to defeat or obtain summary judgment on such statutory claims.
  • Schwartz v Partridge: Central to the court’s characterization of § 2801-d: the statute is not keyed to “deviation from accepted standards of medical practice” or “breach of duty of care,” but rather to injury caused by “deprivation of a right” conferred by contract, statute, regulation, code, or rule.

B. Legal Reasoning

1) Hospital: prima facie showing met, but triable issues created by plaintiff’s expert

The Second Department accepted that the hospital met its initial burden through an expert physician’s affirmation stating: (i) no departure from the accepted standard of care in prevention/treatment, and (ii) “unavoidability” due to the plaintiff’s medical condition and comorbidities. The decision then turned on whether the plaintiff’s opposition created triable issues.

The plaintiff’s expert did so by offering record-based opinions that the hospital’s approach itself contributed to ulcer development—specifically, identifying elevation of the head of the bed as a departure in the context of pressure-injury prevention and linking it to causation. The court also credited plaintiff’s expert’s rebuttal of “unavoidable” ulcer causation, treating the issue as a classic battle of experts unsuitable for resolution on summary judgment.

Two additional holdings have practical importance:

  • Non-speculative expert proof: The court rejected the hospital’s characterization of plaintiff’s expert as speculative/conclusory because the opinion was “supported by the record” (Darrisaw v Interfaith Med. Ctr.).
  • No requirement to attach formal guidelines: Where the expert opines within their specialization, the court reiterated that the expert need not supply “official medical guidelines or other foundational evidence” at this stage (Mehtvin v Ravi; Cerrone v North Shore-Long Is. Jewish Health Sys., Inc.). The thrust is that admissible, competent expert reasoning tied to the clinical record can be sufficient to raise fact issues.

2) Nursing home malpractice: failure to address contrary evidence defeats prima facie burden

Unlike the hospital, the nursing home never cleared the prima facie threshold. Its expert asserted that the ulcer seen on admission healed within 48 hours, implying no causation and no negligent care. The appellate court found that this opinion failed to grapple with evidence suggesting the ulcer remained unhealed at discharge.

The key doctrinal point is methodological: a defense expert opinion that depends on a factual premise must confront material record evidence that undermines that premise. If it does not, the opinion may be deemed insufficient to establish prima facie entitlement to judgment (Woehrle v Buono; Faicco v Golub).

3) Nursing home PHL § 2801-d: distinct theory—deprivation of rights under regulations

The court separated malpractice from § 2801-d: malpractice focuses on deviation from accepted medical standards and causation; § 2801-d focuses on whether the patient was deprived of statutory/regulatory rights and thereby injured (Schwartz v Partridge).

Applying that framework, the court held the nursing home’s expert affirmation did not establish, prima facie, that the plaintiff received required services to promote healing of the pressure ulcer as contemplated by 10 NYCRR 415.12[c][2]. Because the movant failed its initial burden, dismissal was improper regardless of the plaintiff’s opposition (Winegrad v New York Univ. Med. Ctr.).

C. Impact

  • Sharper scrutiny of defense expert submissions: The decision reinforces that expert affidavits must be internally coherent and must address record facts that cut against the expert’s narrative—particularly in pressure-ulcer timelines (condition on admission, evolution during stay, status at discharge). A “healed quickly” assertion that ignores contradictory charting is a common vulnerability.
  • “Unavoidable pressure ulcer” remains litigable, not dispositive: Even where defendants present comorbidity-based unavoidability opinions, plaintiffs can defeat summary judgment with a competent expert who explains how prevention measures were inappropriate or inadequately implemented and ties that to causation. The case signals that “unavoidability” often presents fact issues rather than a clean summary judgment pathway.
  • PHL § 2801-d claims require a different defense strategy: Nursing homes seeking summary judgment on § 2801-d must address the specific regulatory rights alleged to have been deprived (here, services to promote ulcer healing under 10 NYCRR 415.12[c][2]), not merely deny malpractice. Proof aimed only at “standard of care” may miss the statutory target.
  • Reduced incentive for guideline-heavy motion practice: By reiterating that experts need not always attach “official medical guidelines” when opining within their specialty, the decision may influence motion practice toward record-anchored clinical reasoning rather than dueling guideline compilations—though guidelines can still be persuasive in appropriate cases.

4. Complex Concepts Simplified

  • Summary judgment: A procedural device to decide a case (or claim) without trial when there is no genuine dispute of material fact. In malpractice cases, it often turns on whether dueling experts create fact questions for a jury.
  • Prima facie burden: The moving party must first present evidence that, if unrebutted, would entitle it to win as a matter of law. If it fails, the motion is denied even if the opposing papers are weak (Winegrad v New York Univ. Med. Ctr.).
  • Departure from accepted standard of care: In malpractice, whether the provider acted outside what reasonably competent providers would do under similar circumstances.
  • Proximate cause: A legally sufficient causal link between an alleged departure and the injury—i.e., that the departure substantially contributed to the harm.
  • “Unavoidable” pressure ulcer: A defense position that, due to serious illness/comorbidities and despite appropriate care, a pressure ulcer could not have been prevented. Whether an ulcer was truly “unavoidable” commonly depends on factual disputes about risk assessment, repositioning, offloading, nutrition, moisture management, and documentation.
  • Public Health Law § 2801-d: A statutory cause of action focused on injury caused by a nursing home’s deprivation of rights granted by law or regulation. It is not simply a malpractice claim by another name (Schwartz v Partridge).
  • 10 NYCRR 415.12[c][2]: A nursing-home regulatory provision referenced by the court in evaluating whether the resident received necessary treatment and services to promote healing of pressure ulcers—framing the “right” at issue for § 2801-d purposes in this case.

5. Conclusion

Balgobin v Jamaica Hosp. Med. Ctr. underscores two practical rules in New York pressure-ulcer litigation: (1) summary judgment in malpractice will often be denied when qualified experts offer record-supported, conflicting accounts of departures and causation, including disputes over “unavoidable” ulcers; and (2) defendants—especially nursing homes—must meet their prima facie burden with expert proof that confronts contrary record evidence and, for Public Health Law § 2801-d claims, directly addresses whether the resident was deprived of rights conferred by applicable regulations (here, services to promote ulcer healing under 10 NYCRR 415.12[c][2]).