SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
A-6056-00T2
JENNIFER BARKER,
Plaintiff-Appellant,
v.
JOHN ALLEN BRINEGAR, DOLLAR
SYSTEMS, INC., SPARTAN FOODS
OF AMERICA, INC., AND STATE
FARM INSURANCE COMPANIES,
Defendants-Respondents.
___________________________________
Submitted: November 5, 2001 - Decided: January 18, 2002
Before Judges Kestin, Steinberg, and Alley.
On appeal from the Superior Court of New
Jersey, Law Division, Bergen County, L-3652-
99.
Koulikourdis and Associates, attorneys for
appellant (Jae Park, on the brief).
Darlene P. Butler, attorney for respondents
John Allen Brinegar and Spartan Foods of
America, Inc. (Christopher E. McIntyre, on the
brief).
The opinion of the court was delivered by
STEINBERG, J.A.D.
Pursuant to leave granted, plaintiff Jennifer Barker appeals
from an interlocutory order which precluded her, on the basis of
collateral estoppel, from introducing any evidence in her personal
injury action regarding MRI reports and testimony relative to her
claim that she suffered spinal injuries in an accident and was
required to undergo spinal surgery. We reverse.
On May 13, 1997, a motor vehicle operated by plaintiff was
struck by a vehicle operated by defendant, John Allen Brinegar.
The vehicle operated by Brinegar was owned by defendant Dollar
Rent-A-Car.See footnote 11 At the time of the accident, Brinegar was employed by
defendant Spartan Foods of America, Inc. In the fifth count of her
complaint, plaintiff sought damages against her insurance carrier,
defendant State Farm Insurance Companies (State Farm), contending
that it would not pay any personal injury protection (PIP) benefits
subsequent to November 10, 1998. Specifically, she alleged that
she was scheduled to have orthopedic surgery and "may need further
physical therapy, thereby, incurring additional medical expenses."
Immediately after the accident, plaintiff went to Hackensack
Medical Center's emergency room. She was given emergency treatment
and was told to follow up with her private physician. On May 15,
1997, she went to her personal physician, Dr. Adeniyi Ogunkoya, for
treatment. Dr. Ogunkoya's initial diagnosis was posttraumatic
lumbosacral sprain/strain; posttraumatic cervical sprain/strain;
muscle spasms, shoulder tenderness, and wrist pain. Dr. Ogunkoya
ordered an MRI of the lumbosacral spine, which showed "abnormal
appearance of the L4 vertebral body with posterior displacement of
the posterior wall especially prominent at the endplace causing
severe stenosis of the bony canal. Lateral recesses and neural
foramina." Upon discharge, on December 30, 1997, Dr. Ogunkoya
rendered the following diagnosis: Chronic traumatic lumbosacral
sprain/strain; posttraumatic cervical sprain/strain; posttraumatic
left wrist pain; headaches; and hypertension. He also noted that
at the time of discharge, plaintiff was still experiencing severe
discomfort and significant limitation of range of motion in the
lumbosacral spine area. He recommended that she continue to
exercise and return to his office for further re-evaluation or
orthopedic referral if her condition worsened.
On July 16, 1998, at the request of State Farm, plaintiff was
evaluated by Dr. Lawrence Kraut, an orthopaedic surgeon. In his
report, dated July 16, 1998, Dr. Kraut said he found no objective
signs of permanent orthopedic disabilities or radiculopathies
related to the accident. He also opined that "the reported MRI
scan of the lumbosacral spine [did] not represent acute accident-
related pathology." He noted that no further treatment was
necessary other than a self-directed home therapy program if
plaintiff had further subjective complaints.
Plaintiff continued to experience pain in her lower back and
legs. Consequently, she was referred to Dr. Calvin C. Matthews, an
orthopaedic surgeon. Dr. Matthews had an MRI conducted on
plaintiff on August 26, 1998. He concluded that she suffered from
a severe spinal stenosis at the L4 level. He further opined that
at L3-L4, there appeared to be a mild disc bulge and a suggestion
of a disc herniation at L4-L5 centrally and to the left. He
recommended that she receive decompression surgery on her spine.
The surgery was performed on December 3, 1998. Thereafter,
plaintiff had several follow-up examinations. She continued to
complain of pain and underwent physical therapy treatments.
Plaintiff continued treating with Dr. Matthews until April 3, 2000.
At that time, although there was some improvement, plaintiff still
experienced discomfort and tenderness to her spine.
While her personal injury action was pending, plaintiff sought
payment of her medical bills from State Farm. Unable to amicably
resolve her request for payment of her outstanding medical bills,
on June 2, 1999, plaintiff filed a demand for arbitration of the
dispute with the American Arbitration Association (AAA). On July
7, 1999, plaintiff filed an amended demand for arbitration. At the
time the demand for arbitration was made, plaintiff's attorney
possessed a discharge summary from East Orange General Hospital,
which referred to the hospitalization for the surgery, and a March
22, 1999 report from Dr. Matthews relating to plaintiff's progress
after the surgery. Both reports were very brief and did not
mention the accident.
On April 26, 1999, Dr. Kraut authored an additional report.See footnote 22
In that report, Dr. Kraut concluded that while plaintiff may have
suffered "soft tissue sprains" as a result of the accident, he also
said she did not suffer an acute fracture of the L4 vertebral body.
Rather, he opined that her symptoms were "most likely Paget's
disease . . . [which] usually manifests and produces signs and
symptoms of spinal stenosis." He concluded that "the diagnosis of
spinal stenosis as well as the subsequent back surgery of 12/3/98
[was] not causally related to the motor vehicle accident of
5/13/97."
On January 15, 1999 and January 27, 1999, plaintiff's attorney
had written to Dr. Matthews requesting a report. On April 27,
1999, counsel was advised by Matthews that the report was completed
and would be sent upon payment of $250 for its preparation. On
June 28, 1999, counsel forwarded a check for $250 to Matthews and
again requested the report.
On November 8, 1999, the arbitration took place. At that
time, plaintiff's attorney still did not have a diagnostic report
from Dr. Matthews. The arbitrator allowed plaintiff twenty days to
submit additional evidence, presumably the report of Dr. Matthews,
and State Farm was granted an additional twenty days to respond.
On November 10, 1999, counsel again wrote Dr. Matthews requesting
a report. Apparently, none was submitted. Consequently, on
February 12, 2000, the arbitrator rendered his decision, concluding
that plaintiff had "failed to prove, by a preponderance of the
credible evidence, that the unpaid claims included in [the]
arbitration were causally related to the accident or were medically
necessary." Finally, on December 1, 2000, plaintiff's attorney
received Dr. Matthews's report, dated October 30, 2000.
In that report, he offered the following diagnosis:
sprain/strain, cervical spine; compression fracture, L4 vertebrae;
sciatica; and strain/sprain, left wrist with contusion. He also
noted that plaintiff's "symptomatologies suggested radiculopathy
into the left lower extremity, weakness of the left lower extremity
and sensory deficit." He reported that the surgery had been
performed. He further noted a number of follow-up visits as a
result of pain suffered by plaintiff. He prescribed a course of
physical therapy and concluded that plaintiff's injuries were
"within reasonable medical judgment causally related to the
accident of 5/13/97."
Prior to trial in the personal injury action, defendants
Brinegar and Spartan Foods moved to exclude any evidence or
testimony regarding plaintiff's back surgery and related medical
expenses. The motion judge determined that the arbitrator's
decision had preclusive effect and granted the motion. Plaintiff
appeals, contending that the motion judge erred in giving
preclusive effect to the determination of the arbitrator, because
she "lacked a full and fair opportunity to litigate the issue of
causation" in the arbitration proceedings.
"In appropriate circumstances, arbitration awards may be given
collateral estoppel effect in subsequent judicial proceedings."
Konieczny v. Micciche,
305 N.J. Super. 375, 384 (App. Div. 1997).
Collateral estoppel allows a defendant who is not a party to an
action involving a common plaintiff to use a finding of fact from
the prior action to preclude litigation of the issue in a pending
case. See id. at 385-86. The doctrine "bars relitigation of
issues previously litigated and determined adversely to the party
against whom [it] is asserted." Kortenhaus v. Eli Lilly & Co.,
228 N.J. Super. 162, 164 (App. Div. 1988). Collateral estoppel is
designed to protect litigants from relitigating identical issues
and to promote judicial economy. Ibid. Thus, the doctrine is
premised upon efficiency and is designed "to promote efficient
justice by avoiding the relitigation of matters which have been
fully and fairly litigated and fully and fairly disposed of." Id.
at 166. In all cases in which collateral estoppel is sought to be
invoked, the court must, in the exercise of its discretion, weigh
economy against fairness. Batson v. Lederle Labs.,
290 N.J. Super. 49, 54 (App. Div. 1996), aff'd as modified,
152 N.J. 14 (1997).
Because collateral estoppel is an equitable doctrine, it will not
be applied if it is not fair to do so. Kozlowski v. Smith,
193 N.J. Super. 672, 675 (App. Div. 1984). Efficiency is subordinated
to fairness and, consequently, if the court is satisfied that
efficiency would lead to an unjust result, its application should
not be tolerated. See Kortenhaus, supra, 228 N.J. Super. at 166.
"New Jersey courts follow the doctrine of collateral estoppel
or the rule of issue preclusion described in the Restatement of
Judgments." Hernandez v. Region Nine Hous. Corp.,
146 N.J. 645,
659 (1996). In Restatement (Second) of Judgments § 29, titled
"Issue Preclusion in Subsequent Litigation with Others," a
plaintiff must, in order to avoid the preclusion bar, demonstrate
either "that he lacked full and fair opportunity to litigate the
issue" in a prior proceeding, or there are "other circumstances
[that] justify affording [plaintiff] an opportunity to relitigate
the issue." Restatement (Second) of Judgments § 29, at 291 (1982).
The doctrine should not be rigidly applied if the party sought to
be precluded "did not have an adequate opportunity or incentive to
obtain a full and fair adjudication in the initial action." Id.
§ 28, at 274. An example of other compelling circumstances making
it inappropriate to invoke the doctrine is that new evidence has
become available that could likely lead to a different result. Id.
§ 29 comment j, at 297.
The party seeking to invoke the doctrine of collateral
estoppel in order to preclude relitigation of an issue must
demonstrate:
(1) the issue [sought] to be precluded is
identical to the issue decided in the prior
proceeding; (2) the issue was actually
litigated in the prior proceeding . . . [and]
that "the litigant against whom issue
preclusion is invoked [had] a full and fair
opportunity to litigate the issue . . ."; (3)
the court in the prior proceeding issued a
final judgment on the merits; (4) the
determination of the issue was essential to
the prior judgment; and (5) the party against
whom the doctrine is asserted was a party to
or in privity with a party to the earlier
proceeding.
[In re Estate of Dawson,
136 N.J. 1, 20-21
(1994) (citations omitted).]
Accord Selective Ins. Co. v. McAllister,
327 N.J. Super. 168, 173-
74 (App. Div.), certif. denied,
164 N.J. 188 (2000); Pivnick v.
Beck,
326 N.J. Super. 474, 485 (App. Div. 1999), aff'd,
165 N.J. 670 (2000).
Applying these principles of law, we conclude that the judge
erred in granting the motion. Indeed, the motion judge never
balanced the potential for unfairness occasioned by precluding
litigation of the issue against the efficiency of preclusion.
Rather, the judge merely determined that the issue of causation had
been fully litigated in the arbitration proceedings, thus requiring
preclusion. We reject any notion that plaintiff must demonstrate
that she could not have discovered or obtained the report with due
diligence. Unlike an application to set aside a final judgment
which implicates principles of finality, we are not here concerned
with whether a prior determination should be set aside because
efficiency requires treating the prior determination as conclusive.
Rather, we must decide whether the overarching principle of
fairness requires that we reject rigid application of collateral
estoppel under the circumstances here presented. Restatement
(Second) of Judgments, supra, § 29 comment j, at 297. We agree
that the judge may consider diligence, or lack of diligence, in
determining whether the prior determination should be given
preclusive effect. However, we hold that a lack of diligence does
not require invocation of collateral estoppel particularly where,
as here, plaintiff attempted to obtain Dr. Matthews's evaluation
prior to the arbitration proceeding.
We recognize that we have previously held that arbitration
awards may be given preclusive effect even though the claimant had
subsequently obtained an expert's report that may have changed the
result of the arbitration proceeding when the report was reasonably
obtainable prior to the arbitration proceedings. Konieczny, supra,
305 N.J. Super. at 387; Kozlowski, supra, 193 N.J. Super. at 675.
Here, however, unlike Konieczny and Kozlowski, the record
demonstrates that plaintiff made diligent efforts to obtain Dr.
Matthews's supplemental report prior to the arbitration
proceedings. Unfortunately, it was not until nearly one year after
the proceedings had been concluded and an award made that she was
able to obtain the report that may have changed the result.
Because the doctrine of collateral estoppel is essentially one
of fairness, we conclude that the judge erred in giving preclusive
effect to the arbitration proceedings. The arbitrator did not
determine after considering all of the evidence that plaintiff's
complaints regarding her back and the ultimate surgery were not
related to the accident. The arbitrator merely held that based
upon the evidence presented, plaintiff had not established by a
preponderance of the evidence that her complaints regarding her
back were related to the accident. It is one thing to deny
plaintiff PIP benefits. It is quite another thing to deny
plaintiff the opportunity to recover for her pain and suffering
related to the back surgery, as well as any temporary or permanent
disability. We hold that while considerations of efficiency may
have suggested giving preclusive effect to the arbitration
proceedings, the overarching principles of fairness and justice
require a different result. Consequently, we reverse and remand.
Finally, for the sake of completeness, we note and reject
defendants' contention that because a final determination by a
dispute resolution professional of a PIP claim is binding, N.J.S.A.
39:6A-5.1(c), plaintiff is bound by the determination in the
personal injury action. We hold that the binding effect of the
dispute resolution simply means that plaintiff may not seek
recovery for PIP benefits. However, N.J.S.A. 39:6A-5.1(c) does not
require a finding that the binding nature of the PIP determination
precludes plaintiff from seeking recovery in another action for her
pain and suffering and her temporary and permanent disability, if
any, from a potential tortfeasor.
Reversed and remanded for further proceedings consistent with
this opinion.
Footnote: 1 1Improperly pled as Dollar System's, Inc. Footnote: 2 2The report is directed to Maryann Levering, LPN, of United Review Services. The capacities of Levering and United Review Services are unclear from the record.