A recent appellate court decision has upheld a jury verdict in favor of a major healthcare provider after allegations of wrongful death and medical malpractice were brought by the family of a deceased patient. The ruling clarifies the standards for expert testimony and addresses concerns about fairness in civil trials involving complex medical evidence.
Geraldine Kittis, individually and as administrator for the estate of Dennis Kittis, filed an appeal with the Ohio Eighth District Court of Appeals following a Cuyahoga County jury’s verdict in favor of the Cleveland Clinic Foundation. The judgment was released and journalized on March 12, 2026.
The dispute centers on whether actions taken by hospital staff contributed to the death of Mr. Dennis Kittis after he was hospitalized for a bowel obstruction. According to court documents, Mr. Kittis underwent surgery to remove the obstruction but developed complications including low blood pressure and high lactate levels. Medical staff initially attributed these symptoms to dehydration and treated him with intravenous fluids. When his condition did not improve, further diagnostic procedures were considered but not immediately performed.
Kittis’s legal team argued that the hospital failed to recognize signs indicating a need for earlier surgical intervention or diagnostic imaging such as a CT scan. The central claim was that this delay prevented timely identification and correction of what they believed could have been a surgically repairable cause of bowel ischemia—a condition resulting from reduced blood flow to the intestines—which ultimately led to Mr. Kittis’s death at age 74.
In an earlier phase of litigation (Kittis v. Cleveland Clinic Found., 2024-Ohio-659), summary judgment had been granted in favor of the Clinic based on perceived deficiencies in expert testimony regarding causation. However, that decision was reversed on appeal when it was determined that plaintiff’s expert had sufficiently opined that delayed recognition and treatment—not necessarily identifying the precise cause of ischemia—was enough to establish proximate cause for purposes of trial.
At trial, both sides presented competing theories through expert witnesses. Dr. David Brooks testified for Kittis, maintaining that an earlier surgery might have revealed torsion or another correctable issue causing ischemia; however, he conceded under cross-examination that there was no evidence found during exploratory surgery supporting those specific causes such as blood clots or venous obstruction.
Testimony from treating physician Dr. Toms Augustin indicated that mild bowel ischemia can be expected in patients who are hypotensive and receiving vasopressors (medications used to raise blood pressure). This assertion became a focal point during cross-examination by Kittis’s counsel, who sought to challenge changes between Dr. Augustin’s deposition statements and his trial testimony regarding causation factors.
The admissibility and scope of certain expert opinions became contentious issues during trial proceedings. The court permitted Dr. Brooks to testify about medical facts related to echocardiogram results but limited his ability to interpret those findings or offer new opinions beyond what had been disclosed before trial—a restriction requested by Kittis’s own counsel during argument over objections from defense attorneys.
Ultimately, after hearing all evidence—including arguments over whether any surgically correctable condition existed at any point prior to Mr. Kittis’s decline—the jury concluded that there had been no breach in the standard of care by the Cleveland Clinic Foundation.
On appeal, Geraldine Kittis asserted two main assignments of error: first, that previously undisclosed opinions offered at trial constituted unfair surprise or “trial by ambush,” violating rules requiring supplementation of discovery responses; second, that limitations placed on her own expert’s rebuttal testimony deprived her case of fairness necessary under civil procedure rules.
The appellate majority rejected these claims primarily on grounds that any potential error regarding introduction or exploration of new theories—such as Dr. Augustin’s references to vasopressors—was either invited by plaintiff’s own questioning or forfeited due to lack of timely objection or request for curative instruction at trial. Furthermore, even if error occurred, it was deemed harmless because it did not affect substantial rights given the overall evidence presented.
However, Judge Kathleen Ann Keough dissented from this conclusion, arguing that cumulative procedural missteps—including failure by defense witnesses to supplement discovery with new causation theories before trial—resulted in serious prejudice against Ms. Kittis’s case: “I would have reversed and remanded this matter for a new trial,” she wrote in her opinion.
Attorneys representing Geraldine Kittis included James M. Kelley II, Marilena Disilvio, and Antonia Mysyk from Elk & Elk Co., Ltd.; counsel for Cleveland Clinic Foundation were Stephen W. Funk, Emily K. Anglewicz, and Joseph E. Herbert from Roetzel & Andress LPA. The case is identified as No. 114990 (Cuyahoga County Court Case No. CV-19-920144).
Source: 2026Ohio828_Kittis_v_The_Cleveland_Clinic_Foundation_Opinion_Ohio_Court_of_Appeals.pdf
