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*408 MEMORANDUM OPINION HUGHES, United States Magistrate Judge. This matter comes before the Court on motion of Defendants, Integrated Genetics, Genzyme Genetics, Genzyme Corporation, and Sterling Puck, M.D., for summary judgment. Also pending before the Court is Plaintiffsâ motion for leave of Court to amend the Complaint by joining Dr. Charles H. Hux and Shore Perinatal Associates as defendants. Both motions are opposed. The Court reviewed the partiesâ written submissions and conducted oral argument on September 8, 1998 and October 5, 1998. The parties have consented to the jurisdiction of the United States Magistrate Judge, pursuant to 28 U.S.C.A. § 636 and Fed.R.Civ.P. 73, for all purposes, including trial. I. BACKGROUND A. Procedural History On November 1, 1996, Plaintiffs Karen Provenzano and Thomas Provenzano filed a wrongful birth claim against Defendants, Integrated Genetics, Genzyme Genetics, Sterling Puck, M.D., and John Doe Medical Providers, in the Superior Court of New Jersey, Ocean County Vicinage. The Complaint was amended on December 27, 1997, joining Gen-zyme Corporation as a Defendant. Genzyme Genetics is the successor corporation to Integrated Genetics and a wholly owned subsidiary of Genzyme Corporation. (Defendantâs Answer ¶¶ 11-12). Dr. Puck was the Medical Director of Integrated Genetics on or about June 5,1995. (Defendantâs Answer ¶. 5). The Complaint, as amended, claims that Defendantsâ negligence led to the wrongful birth of one of Mrs. Provenzanoâs twin infants, Tiffany Provenzano (âTiffanyâ). More specifically, the Complaint alleges that Defendants negligently analyzed and diagnosed amniocentesis samples collected from Mrs. Provenzano during her pregnancy. The Complaint further alleges that Defendantsâ negligence deprived Plaintiffs of the necessary information to make an informed decision as to whether to opt for a selective reduction â a procedure in which one fetus of several may be terminated. Plaintiffs seek damages for emotional distress and extraordinary medical expenses attributable to Tiffanyâs birth defects, consistent with Procanik by Procanik v. Cillo, 97 N.J. 339 , 478 A.2d 755 (1984). On March 24, 1997, this action was removed, on diversity grounds pursuant to 28 U.S.C.A. § 1332 , to the United States District Court, District of New Jersey. Defendants filed an Answer to the Complaint on May 2,1997. On May 26, 1998, Plaintiffs filed a motion for leave to file an amended complaint seeking to join Dr. Charles Hux and Shore Perinatal Associates as defendants. Dr. Hux, a physician with Shore, was Mrs. Provenzanoâs primary physician regarding the instant pregnancy. The proposed amended complaint alleges that Dr. Hux âwas negligent and/or deviated from the applicable standard of care in conducting and reading the ultra sound studies that [Mrs. Provenzano] underwent.â (Amended Complaint ¶ 6.). Dr. Hux performed ultra sound examinations on Mrs. Provenzano every three to four weeks from June 5,1995 through the birth of the twins in October. (Plaintiffs Statement of Material Facts at ¶¶4-8). The proposed amended complaint further alleges that Shore Perinatal Associates âwas negligent and/or deviated from the applicable standard of care in setting up standards and guidelines for the performance and interpretation of ultra sound studiesâ and should be liable for Dr. Huxâs conduct under the doctrine of respondeat superior. Id. The proposed amended complaint further alleges that as a result of Dr. Huxâs and Shore Perinatal Associatesâ negligence, Plaintiffs did not have the choice of terminating the pregnancy of one of the fetuses. Plaintiffs contend that Dr. Hux and Shore Perinatal Associates should be joined as defendants at this late juncture because discrepancies between his medical records and his May 14, 1998 deposition testimony revealed the basis for a cause of action against him. Plaintiffs further argue that they moved to amend the Complaint prior to the June 12, 1998 Court ordered deadline for joining additional parties to this litigation. On June 1, 1998, Defendants filed opposition to Plaintiffsâ May 26, 1998 motion to *409 amend the Complaint. Because the treatment that Dr. Hux provided to Mrs. Proven-zano terminated on or around October 14, 1995, upon the birth of her twins, Defendants argue that the applicable statute of limitations had expired prior to May of 1998. Defendants also argue that allowing the amendment would unfairly prejudice them by causing undue delay and by defeating diversity jurisdiction. Defendants filed the present motion for summary judgment on September 1, 1998. Defendants argue that summary judgment is appropriate because Mrs. Provenzano is unable to testify that, but for any alleged negligence, she would have had an abortion. Plaintiffs oppose Defendantsâ motion alleging that genuine issues of material fact exist concerning the proximate cause element of Plaintiffsâ wrongful birth claim. The Court determined that the motions be heard together to promote efficient case management. B. Factual Background Mrs. Provenzano learned that she was pregnant in March of 1995. (Plaintiffsâ Exhibit (âP.Ex.â) A.). On April 13, 1995, Mrs. Provenzano was initially treated by Dr. Mel-vyn Ravitz. (Id.). Dr. Ravitz referred her to Dr. Charles Hux at Shore Perinatal Associates in May 1995 because Mrs. Provenzano, a thirty-eight year old, was considered a high risk obstetrical patient due to her age and the fact that she was carrying twins. (P.Ex. B, Deposition of Mrs. Provenzano at 43:24 to 45:1; P.Ex. C, Dr. Huxâs letter to Dr. Ravitz of May 22, 1995). More than twenty years earlier, Mrs. Provenzano had an abortion. (Id. at 100:2). Dr. Hux performed approximately seven ultra sound examinations on Mrs. Provenza-no during her pregnancy. (P.Ex. C). On June 5, 1995, Dr. Hux performed an ultra sound test which indicated the possibility of an enlarged cerebellum for fetus B, who was later named Tiffany. (Id.). Dr. Huxâs June 7, 1995 letter to Dr. Ravitz explained that he did not discuss the possibility of the enlarged cerebellum with Plaintiffs because âhe was not confident enough in the ultrasound finding at that time.â (Id.). Also on June 5, 1995, Dr. Hux conducted an amniocentesis for each of Plaintiffs fetuses and sent amniotic samples to Defendant Integrated Genetics. (Id.) An amniocentesis is a procedure involving âthe insertion of a long needle into the motherâs uterus and the removal therefrom of a sample of amniotic fluid containing living fetal cells.â Berman v. Allan, 80 N.J. 421, 424 , 404 A.2d 8 (1979) citing W. Fuhtmann & F. Vogel, Genetic Counseling 91-94 (2d Ed.1976). Then, through âkaryotype analysis,â a procedure in which the number and structure of the cellsâ chromosomes are examined, the sex of the fetus as well as the presence of gross chromosomal defects can be detected. Id. The test results were negative for genetic defects. (P.Ex. D, Chromosome Analysis of June 15, 1995). On July 6,1995, after performing an ultrasound on Mrs. Provenzano, Dr. Hux noted âa 30-40% difference in fetal sizeâ and good interval growth for twins A and B. (P.Ex. C, Dr. Huxâs letter to Dr. Ravitz of July 6, 1995). At that time, he advised a close follow up. (Id.). Dr. Hux wrote that he âexplain[ed] the findings to this couple in some detail; however, [he did] not believe that they understood at the time the potential impact of such a diagnosis.â (Id.). On August 17, 1995, Dr. Hux noted a âcyst headâ in his records without specifying to which fetus he was referring. (P.Ex. C). On September 14, 1995, Dr., Huxâs records refer to a diagnosis of a âSubarachnoid or Dandy-Walker cyst in twin B.â (Id). On October 12, 1995, two days before the birth of the twins, Dr. Huxâs records indicated the following: âcyst in head twin B and dilated bowel. Growth discrepancy about 800 grams. High morbidity, consider delivery within 1-2 weeks max at level 2 center. Discussed with neonatology and pediatric neurologist.â (Id.). Mrs. Provenzano gave birth to twin girls on October 14, 1995. Shortly afterwards, Tiffany was moved to the Childrenâs Hospital of Philadelphia. (P.Ex. E). Due to the seriousness of Tiffanyâs condition, the slides from the June 5,1995 amniocentesis were reexamined. The reexamination revealed that a Tri *410 somy 14 mosaicism, a genetic disease, in fetus B had been overlooked when the slides were originally examined on or around June 5, 1995. (P.Ex. F., Deposition of Richard L. Nue, at 66). The discharge diagnosis from Childrenâs Hospital of Philadelphia, dated January 10,1996, confirmed Tiffanyâs genetic disease. Mr. Nue, the Laboratory Director for Defendant, Genzyme Genetics, testified that such a finding âwould be expected to be clinically significant.â (Id.). Tiffany died on June 5,1996. Mrs. Provenzano was deposed on March 12, 1998. The following testimony was elicited: Counsel for Defendants: It was your understanding that one of the fetuses was coming along just fine, but the other was having some type of problems? Mrs. Provenzano: Yes. Q: Did you ask him [Dr. Hux], Well, is the one who is having problems going to hurt the other fetus? A: Yes. Q: Who did you ask that? A: Hux. Q: What did he say? A: Itâs too soon to tell. Q: Did you ask him, Well, maybe we should abort one of the fetuses? A: No, it never came up. Q: Why did it never come up? A: Because I was never given an opportunity. No one told me. Q: No one told you what? A: That I could terminate one pregnancy. Q: As you sit here now, do you know whether you could have terminated one pregnancy? A: No. Q: As you sit here now do you know whether you would have terminated one pregnancy? A: No. (Defendantâs Exhibit (âD.Ex.â) D, Deposition of Mrs. Provenzano at 76:7 to 77:7). Mrs. Provenzano further testified about the choice of terminating the pregnancy as follows: Q. What choice are you referring to? A. To abort the one that was ill and keep the other one. Q. And are you saying thatâs what you would have done? A. Iâm not sure. (D.Ex. D at 82:24 to 83:4). Mr. Provenzano was also deposed on March 12,1998. He testified that during the pregnancy he and his wife had not discussed whether they would have aborted fetus B. (D.Ex. D, Deposition of Mr. Provenzano at 114:18-21). Mr. Provenzano then testified as follows: Counsel for Defendants: [Wjould you have agreed to terminate one of the fetuses? A: No, I wouldnât have agreed to terminate one of the fetuses. Thereâs no need to. I mean, I wanted both of them. (Id. at 114:22 to 115:8). On August 4, 1998, however, Mr. Provenzano submitted a certification (P.Ex. G, at ¶ 8) in which he alleged that, if he had been advised during his wifeâs pregnancy that fetus B was afflicted with a genetic disease, he would have favored a selective reduction, i.e., terminating the pregnancy of one of the fetuses. Mr. Provenzano testified that he would have strongly encouraged his wife to the same end. (Id.). Mr. Provenzano further stated that his deposition testimony taken on March 12, 1998 was inaccurate because he had not slept in approximately 21 hours. (Id. at ¶ 5). II. DISCUSSION A. Amended Complaint It has been the accepted and encouraged policy that leave to amend pleadings should be liberally granted, when justice so requires. Fed.R.Civ.P. 15(a); Cruz v. City of Camden, 898 F.Supp. 1100, 1105 (D.N.J.1995). The determination of a motion to amend falls within the sound discretion of the trial court and is guided by Fed.R.Civ.P. 15(a). See Foman v. Davis, 371 U.S. 178 , 83 S.Ct. 227 , 9 L.Ed.2d 222 (1962). The United States Supreme Court articulated this liberal standard in Foman , which states, in relevant part: *411 In the absence of any apparent or declared reason â such as undue delay, bad faith, or dilatory motive on the part of the movant, repeated failure to cure deficiencies by amendments previously allowed, undue prejudice to the opposing party by virtue of the amendment ..., the leave sought should, as the rules require, be freely given. Id. at 182 , 83 S.Ct. 227 . Therefore, when the movantâs request to amend is âa proper subject of relief, he ought to be afforded an opportunity to test his claim on the merits.â Id. In applying Fed.R.Civ.P. 15(a), the Third Circuit Court of Appeals regards the possibility of prejudice to the non-moving party as the âtouchstone for the denial of the amendment.â Bechtel v. Robinson, 886 F.2d 644, 652 (3d Cir.1989) quoting Cornell & Co., Inc. v. Occupational Safety and Health Rev. Commân, 573 F.2d 820, 823 (3d Cir.1978). Absent undue prejudice, âdenial must be grounded in bad faith or dilatory motives, truly undue or unexplained delay, repeated failure to cure deficiency by amendments previously allowed or futility of amendment.â Heyl & Patterson International, Inc. v. F.D. Rich Housing of the Virgin Islands, 663 F.2d 419, 425 (3d Cir.1981) citing Cornell & Co., Inc., 573 F.2d at 823 . 1. Futility of Amendment/Statute of Limitations Where a defendant raises futility of amendment as a defense, the Court must apply the standard of a motion to dismiss, pursuant to Fed.R.Civ.P. 12(b)(6). Jablonski v. Pan American World Airways, Inc., 863 F.2d 289, 293 (3d Cir.1988). By adhering to a Rule 12(b)(6) standard, the court is assured that any new claims, without true merit, will fail. Massarsky v. General Motors Corp., 706 F.2d 111, 125 (3d Cir.1983); Snyder v. Baumecker, 708 F.Supp. 1451, 1457 (D.N.J.1989); see also Adams v. Gould, Inc., 739 F.2d 858, 864 (3d Cir.1984), cert. denied, 469 U.S. 1122 , 105 S.Ct. 806 , 83 L.Ed.2d 799 (1985). In accordance with Fed.R.Civ.P. 15(a), it is within the discretion of the trial court to deny leave to amend for futility of amendment. In examining the futility of the proposed amendment, the district court should consider the merits of the proposed amendment prior to deciding whether to grant leave to amend. Snyder, 708 F.Supp. at 1457 . When considering a motion to dismiss pursuant to Fed.R.Civ.P. 12(b)(6), the Court shall take all allegations as true and consider them in the light most favorable to the plaintiff. Hurst v. Beck, 1992 WL 189496 , at *3, n. 4 (E.D.Pa.1992) (citations omitted). The complaint will only be dismissed if âit is clear that no relief could be granted under any set of facts that could be proved consistent with the allegations.â Id. (Citations omitted). Defendants argue that Plaintiffsâ motion to amend the Complaint must be denied because it was filed after the two-year statute of limitations expired on October 15, 1997. Indeed, Dr. Hux ceased treating Mrs. Provenzano in October 1995 after the birth of the twins, and Plaintiffs filed the instant motion in May of 1998. Clearly, Plaintiffs motion would not withstand a motion to dismiss if it were barred by the statute of limitations. Plaintiffs, however, argue that the statute of limitations should be tolled under the âdiscovery rule.â See Lopez v. Swyer, 62 N.J. 267 , 300 A.2d 563 (1973). The discovery rule provides that a cause of action will not accrue until the injured party discovers, or by an exercise of reasonable diligence and intelligence should have discovered, that a basis for an actionable claim exists. Cruz v. City of Camden, 898 F.Supp. 1100, 1113 (D.N.J.1995) citing Fernandi v. Strully, 35 N.J. 434 , 173 A.2d 277 (1961). The Supreme Court of New Jersey further explained the discovery rule as follows: *412 Cruz, 898 F.Supp. at 1113 quoting Savage v. Old Bridge-Sayreville Medical Group, 134 N.J. 241 , 633 A.2d 514 (1993). *411 In essence, the discovery rule applies and the statute of limitations begins to run when the plaintiff is aware of an injury and knew that the injury was caused by a third person. The rule is designed to toll the statute of limitations in a situation where the plaintiff realizes an injury but does not know that the injury can be attributed to another. The rule does not require, as the plaintiff suggests, that the plaintiff realize the injurerâs exact identity. *412 As established in Lopez , the seminal discovery rule case decided by the Supreme Court of New Jersey, courts recognize two classes of injured claimants whose ignorance of a cause of action should not, without more, bar relief. 62 N.J. at 271 , 300 A.2d 563 ; see also Cruz, 898 F.Supp. at 1113 n. 16. First, a claimant may be unaware that she has sustained an injury until after the statute of limitations has run. Id. See e.g., Diamond v. N.J. Bell Telephone Co., 51 N.J. 594 , 242 A.2d 622 (1968) (The court held that the limitations period did not start to run until the plaintiff discovered, nine years after the event, that the defendantâs installation of a conduit had damaged their sewer line). Second, a claimant may be aware that she has suffered an injury, but the injured party may not know the damages are attributable to the fault or neglect of another. See e.g., Lopez, 62 N.J. at 274 , 300 A.2d 563 . In Lopez , the plaintiff suffered burns from radiation therapy administered by the defendants. 62 N.J. at 271 , 300 A.2d 563 . After the plaintiffs relationship with the defendants ended, the plaintiff sought medical assistance elsewhere. Id. While in a hospital for reconstructive surgery, she overheard a doctor who had been treating her say to several colleagues, âAnd there you see, gentlemen, what happens when the radiologist puts a patient on the table and goes out and has a cup of coffee.â Id. The court determined that the statute of limitations began to run when she overheard that statement and thereby discovered that her injuries were caused by the fault of another. Id. In Cruz, 898 F.Supp. 1100 , the original complaint, filed on August 5, 1993, alleged that the plaintiff was wrongfully arrested and incarcerated. The complaint named various John Doe defendants. Id. On April 11,1995, the plaintiff filed a motion to amend the complaint alleging that two depositions taken in March 1994 implicated two new defendants whose identity was previously unknown to the plaintiff. Id. at 1103-04 . The plaintiff sought to invoke the discovery rule with respect to the previously unidentified defendants. Id. at 1104 n. 3. The Cruz court found that: The discovery rule is inapplicable since the plaintiff knew at the time of his arrest that there was a problem with the warrant. Indeed, this is the basis of his cause of action. Moreover, he knew or believed that his âinjuryâ, i.e., his arrest and incarceration was attributable to the fault of others. He simply did not know, at that time, the exact identities of all allegedly responsible parties. Id. at 1113 . In the case at hand, Plaintiffs clearly had knowledge of the alleged injury before the statute of limitations ran. Plaintiffs discovered that Integrated Genetics had failed to analyze Tiffanyâs amniocentesis samples accurately between October 14, 1995 when the twins were born and January 10, 1996 when Tiffany was discharged from the Childrenâs Hospital of Philadelphia. Moreover, Plaintiffs originally filed this cause of action on November 1, 1996, less than thirteen months after Tiffanyâs birth. Therefore, it is clear that Plaintiffs knew or by an exercise of reasonable diligence and intelligence should have discovered, no later than January 10, 1996, that the deprivation of their choice as to whether they would have terminated fetus B was the result of some negligent conduct. As the Cruz court noted âmany of the discovery rule cases use the phrase âfault of anotherâ and âidentity of anotherâ interchangeably.â 898 F.Supp. at 1113 . The court specifically declined to apply the discovery rule âsimply because a plaintiff knew that his injury was caused by the fault of another, but did not know them exact identity.â Id. As noted above, Plaintiffs in the present case were aware of the fault of another when they discovered that Integrated Genetics had failed to analyze the amniocentesis samples accurately. In addition, Plaintiffs obviously knew the identity of Dr. Hux and Shore Perinatal Associates as early as May of 1995. Moreover, Plaintiffs knew first hand what Dr. Hux advised them and could have had access to his records. Like Cruz , the instant case is clearly distinguishable from Lopez because Plaintiffs were aware of the fault and even the exact identity of an *413 other long before the applicable statute of limitations expired. Plaintiffs nonetheless contend that they did not learn that they had a potential cause of action against Dr. Hux and Shore Perinatal Associates until Dr. Hux deposition was taken on May 12,1998. Plaintiffsâ argument, however, ignores the fact that Plaintiffs had access to Dr. Huxâs medical records prior to the expiration of the statute of limitations. Dr. Huxâs records contain a June 7, 1995 letter to Dr. Ravitz which specifically indicates that he noted an enlarged cerebellum in fetus B on June 5, 1995, yet he did not notify Plaintiffs of his finding. Plaintiffs had ample opportunity to join Dr. Hux and Shore Perinatal Associates as defendants based on his medical records. Allowing Plaintiffs to join Dr. Hux and Shore Perinatal Associates at this point in the litigation defeats the very purpose of the statute of limitations. Since the discovery rule is not applicable, New Jersey law dictates that the statute of limitations begins to run at the time when the potential plaintiffs are aware, or should be aware, of the existence of the injury. Cruz, 898 F.Supp. at 1115 citing Viviano v. CBS Inc., 101 N.J. 538 , 503 A.2d 296 (1986). Mr. and Mrs. Provenzano were aware of the instant cause of action no later than January 10, 1996 when Tiffany was discharged from the Childrenâs Hospital of Philadelphia. The statute of limitations, therefore, expired no later than January 11, 1998. Therefore, Plaintiffsâ motion to amend the Complaint to join Dr. Hux and Shore Perinatal Associates is denied as futile. B. Summary Judgment Summary judgment may be granted only if there is no genuine issue as to any material' fact and the moving party is entitled to judgment as a matter of law. Fed.R.Civ.P. 56; Celotex Corp. v. Catrett, 477 U.S. 317, 322 , 106 S.Ct. 2548 , 91 L.Ed.2d 265 (1986). In a summary judgment motion, the non-moving party receives the benefit of all reasonable doubts and any inferences drawn from the underlying facts. Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587 , 106 S.Ct. 1348 , 89 L.Ed.2d 538 (1986). If the non-moving party bears the burden of proof at trial as to a dispositive issue, Rule 56(e) requires him to go beyond the pleadings and designate specific facts showing that there is a genuine issue for trial. Celotex, 477 U.S. at 324 , 106 S.Ct. 2548 ; Schoch v. First Fidelity Bancorporation, 912 F.2d 654, 657 (3d Cir.1990). Issues of material fact are genuine only âif the evidence is such that a reasonable jury could return a verdict for the non-moving party.â Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 , 106 S.Ct. 2505 , 91 L.Ed.2d 202 (1986). 1. Cause of Action/Wrongful Birth New Jersey law provides two separate causes of action, âwrongful lifeâ and âwrongful birth,â that may arise when negligent medical treatment deprives parents of the option to terminate the pregnancy of a defective fetus. Procanik by Procanik v. Cillo, 97 N.J. 339, 348 , 478 A.2d 755 (1984). Here, Plaintiffs have filed a wrongful birth claim. Wrongful life claims were first recognized by the New Jersey Supreme Court in Procanik, 97 N.J. at 347 , 478 A.2d 755 . The term â âwrongful lifeâ refers to a cause of action brought by or on behalf of a defective child who claims that but for the defendant doctorâs negligent advice to or treatment of its parents, the child would not have been born.â Procanik, 97 N.J. at 348 , 478 A.2d 755 . See also Rossi v. Somerset Ob-Gyn Associates, 879 F.Supp. 411, 414 (D.N.J.1994). In Procanik, 97 N.J. at 342 , 478 A.2d 755 , the infant plaintiff, Peter Procanik, filed a wrongful life suit alleging that the defendant doctors negligently failed to diagnose that his mother had contracted German measles in the first trimester of her pregnancy. As a result, the plaintiff was born with congenital rubella syndrome. Id. The. original complaint included a wrongful birth claim filed by the infant plaintiffs parents. Id. at 344 , 478 A.2d 755 . The trial court, however, determined âthat the parentsâ wrongful birth claim was barred by the two-year statute of limitations contained in N.J.S.A. 2A:14r-2.â Id. However, in recognizing the infant plaintiffs wrongful life claim, the court reasoned as follows: *414 Whatever logic inheres in permitting parents to recover for the cost of extraordinary medical care incurred by a birth-defective child, but in denying the childâs own right to recover those expenses, must yield to the inherent injustice of that result. ... The present ease proves the point. Here, the parentsâ claim is barred by the statute of limitations. Does this mean that Peter must forego medical treatment for his blindness, deafness, and retardation? We think not. Id. at 351-52 , 478 A.2d 755 . Consequently, the court held that âa child or his parents may recover special damages for extraordinary medical expenses incurred during infancy .... â Id. at 352 , 478 A.2d 755 . In recognizing wrongful life claims, the court limited the available damages. Id. at 342-43 , 478 A.2d 755 . The court noted that an infant plaintiff âmay not recover general damages for emotional distress or for an impaired childhood.â Id. On the other hand, a wrongful birth cause of action is brought by parents who claim that ânegligent medical advice or treatment deprived them of the choice of avoiding conception or ... of terminating the pregnancy.â Procanik, 97 N.J. at 348 , 478 A.2d 755 . The New Jersey Supreme Court first recognized a wrongful birth cause of action in Berman v. Allan, 80 N.J. 421 , 404 A.2d 8 (1979). In Berman , the parents of Sharon Ber-man, suing both in their own names and as guardians ad litem for their infant daughter, filed a medical malpractice action on claims of wrongful life and wrongful birth. 80 N.J. 421 , 404 A.2d 8 . The plaintiffs alleged that the defendants negligently failed to inform Mrs. Berman during her pregnancy of the existence of the amniocentesis procedure. Id. at 424 , 404 A.2d 8 . The plaintiffs further alleged that due to Mrs. Bermanâs age, thirty-eight, the risk that her child would be born with Downâs Syndrome was sufficiently great that sound medical practice at the time of pregnancy required the defendants to inform her of that risk and the availability of amniocentesis. Id. at 425 , 404 A.2d 8 . The complaint further asserted that had Mrs. Berman been so informed, she would have submitted to the amniocentesis procedure, discovered that the fetus was going to suffer from Downâs Syndrome, and aborted the fetus. Id. In light of the United States Supreme Courtâs ruling in Roe v. Wade, 410 U.S. 113 , 93 S.Ct. 705 , 35 L.Ed.2d 147 . 410 U.S. 113 , 93 S.Ct. 705 , 35 L.Ed.2d 147 (1973), the Berman court reasoned that a physician, whose negligence deprived a mother of her right to decide whether her fetus should be aborted, âshould be required to make amends for the damage he has proximately caused.â 80 N.J. at 432 , 404 A.2d 8 . Consequently, the Berman court permitted the parents to recover damages for emotional distress and anguish caused by the defendantsâ negligence. 80 N.J. at 433 , 404 A.2d 8 . In Schroeder v. Perkel, 87 N.J. 53 , 432 A.2d 834 (1981), the New Jersey Supreme Court liberalized the recovery available in a âwrongful birthâ cause of action by permitting parents to recover the extraordinary medical expenses incurred in raising their child. In Sehroeder, the parents of Thomas Sehroeder (âThe Schroedersâ), filed a wrongful birth claim against the defendant physicians alleging that the defendants negligently failed to diagnose cystic fibrosis, a hereditary disease, in the plaintiffsâ first child. 87 N.J. 53 , 432 A.2d 834 . The Schroeders did not learn that their first child had cystic fibrosis until it was four years old, though the condition is easily detectible in infants. Id. at 59 , 432 A.2d 834 . By the time they learned of their first childâs condition, Mrs. Sehroeder was eight months pregnant with Thomas who also suffered from cystic fibrosis. Id. at 58 , 432 A.2d 834 . Thus, the plaintiffs alleged that they were âdeprived of an informed choice of whether to assume the risk of a second child.â Id. The court held that parents âhave the right of their own either to accept or reject a parental relationship, and the deprivation of that right by negligent misconduct of another, creates a cause of action in the parents.â Id. at 66 , 432 A.2d 834 . 2. Causation/Standard Defendantsâ motion for summary judgment relies heavily on Rossi v. Somerset Ob-Gyn *415 Associates, 879 F.Supp. 411 (D.N.J.1994). In Rossi suit was filed by plaintiffs Frank and Eileen Rossi as individuals and by Eileen Rossi as guardian ad litem of her infant son, Michael Rossi. 879 F.Supp. at 412 . The suit alleged claims of wrongful life and wrongful birth. Id Both claims alleged that the physician defendants negligently failed to determine that Michael Rossi suffered from congenital birth defects during Mrs. Rossiâs pregnancy. Id. The complaint further alleged that as a result of defendantsâ negligence, Mr. and Mrs. Rossi did not have the choice of terminating the pregnancy. Id. Having found that the parentsâ wrongful birth claim was barred by the applicable statute of limitations, the court granted the defendantsâ motion for summary judgment on the wrongful birth claim. Id. (Emphasis added). Initially, the court denied the defendantsâ motion for summary judgment on the infant plaintiffs wrongful life claim based on the belief that New Jeisey law did not require a showing that his parents would have chosen to have an abortion if they had been aware of his condition. Id. However, following jury selection, the court reconsidered its opinion and decided that its original view of New Jersey law on wrongful life was incorrect. Id. âBased upon plaintiffsâ counselâs representations that neither parent would testify that the infant would have been aborted if the parents had known of his condition, the court concluded that the infant plaintiff could not sustain a prima facie case for âwrongful life.â â Id. at 412-13 (emphasis added). As a result, the court granted judgment in favor of the defendants under Fed.R.Civ.P. 50(a). Id. at 413 . Thus, the court ultimately followed the precedent established in Procanik, 97 N.J. 339 , 478 A.2d 755 , and concluded that âthe New Jersey Supreme Court would require a plaintiff [pursuing a wrongful Ufe claim] to establish that, but for the defendantsâ negligence, he would not have been born.â Id. at 414 . However, the present cause of action, filed by Mrs. and Mr. Provenzano, is a âwrongful birthâ claim. Notwithstanding distinctions between âwrongful birthâ and âwrongful lifeâ claims drawn by the Procanik court, Defendants argue that the causes of action are identical requiring the same standard for causation. (Defendantsâ Brief at 7, citing Procanik, supra; Rossi supra). Specifically, Defendants argue that a âwrongful birthâ claimant must prove that but for the doctorâs neghgent advice the child would not have been born. (Defendants Reply Brief at 3, citing Procanik, supra). Although at first blush understandable, Defendantsâ reliance on Procanik and Rossi is, in this Courtâs view, misplaced. Both cases were initially filed with distinct counts setting forth wrongful life and wrongful birth claims. Procanik, 97 N.J. at 343 , 478 A.2d 755 ; Rossi 879 F.Supp. at 412 . In each ease, however, the respective trial courts dismissed the counts alleging wrongful birth claims as being barred by the applicable statute of limitations. Procanik, 97 N.J. at 344 , 478 A.2d 755 ; Rossi 879 F.Supp. at 412 . Thus, Pro-canik and Rossi are not controlling authorities as they relate to wrongful birth claims. Defendants argue that summary judgment should be granted because Mrs. Provenzanoâs deposition testimony did not conclusively establish that she would have terminated fetus B but for Defendantsâ failure to inform her and her husband of the accurate test results. In Rossi, the plaintiffs mother similarly did not testify that she would have undergone an abortion had she known of the childâs birth defects. 879 F.Supp. at 415 . Mrs. Rossi provided the following testimony: Q. This lawsuit is about a claim that the doctors failed to detect these abnormalities when Michael was in your uterus. Is it your contention that had you known of these abnormalities that you would have aborted Michael? A. Itâs my contention that I was never given the choice. Id. While wrongful life claims require a but for proximate cause test, the Supreme Court of New Jersey has never established such a high standard for a wrongful birth claim, as Defendants allege, nor can this Court predict that it would do so. Wrongful birth is a distinct cause of action from that of informed consent, but both doctrines share notable similarities. In *416 formed consent is âa negligence concept, predicated on the duty of a physician to disclose to a patient such information as will enable the patient to make an evaluation of the nature of the treatment and of any attendant substantial risks, as well as of available options in the form of alternative therapies.â Largey v. Rothman, M.D., 110 N.J. 204 , 540 A.2d 504 (1988). In Largey , the Supreme Court of New Jersey, following the lead of the federal courts, established a new standard in New Jersey for informed consent cases. 110 N.J. 204 , 540 A.2d 504 citing Canterbury v. Spence, 464 F.2d 772 (D.C.Cir.), cert. denied, 409 U.S. 1064 , 93 S.Ct. 560 , 34 L.Ed.2d 518 (1972). The court applied the âprudent patientâ standard which focuses on âwhat a physician should disclose to a reasonable patient in order that the patient might make an informed decision.â Id. at 206 , 540 A.2d 504 . Under the prudent patient standard, in informed consent cases, âcausation must be shown: i.e., that the prudent person in the patientâs position would have decided differently if adequately informed.â Largey, 110 N.J. at 215 , 540 A.2d 504 quoting Perna v. Pirozzi, 92 N.J. 446 , 460 n. 2, 457 A.2d 431 (1983). While carefully distinguishing informed consent from wrongful birth, Defendants argue that summary judgment is appropriate because Plaintiffs cannot prove that Defendantsâ negligence was the proximate cause of Plaintiffsâ injury. Thus, Defendants contend that a critical aspect of a wrongful birth claim is whether parents, if adequately informed, would decide to terminate a fetus with a birth defect. In arguing that Plaintiffs did not conclusively establish that they would have aborted fetus B, had they received sufficient information to make an informed decision, Defendants adopt a subjective approach to proximate cause. Such an approach would require the Court to analyze Plaintiffsâ testimony, their religious convictions, and other evidence that would tend to prove whether Plaintiffs would have opted for an abortion. For example, if Plaintiffs ardently opposed a womanâs right to an abortion for religious reasons, the Court could reasonably conclude, subjectively, that Plaintiffs failed to establish proximate cause because they would not have opted for the abortion, even if Defendants had properly advised them of the choice. In contrast, Plaintiffs argue for an objective proximate cause standard consistent with the prudent patient standard followed in informed consent cases. That is, whether a reasonably prudent patient would abort a fetus under the same circumstances. Such analysis would ignore the plaintiffs involved in a particular case and have the factfinder predict what the mythical prudent patient would have done under the same circumstances. Plaintiffsâ argument is based on an unreported case that was tried in the Superi- or Court of New Jersey, Middlesex County, Law Division, Patel v. Shaw, Docket No. L-12557-93. In Patel, an informed consent case, the court instructed the jury that an objective, reasonable person standard would apply to proximate cause. New Jersey Jury Verdict Review & Analysis, February 1998, Vol. 18, Issue 9, at 11-12. There was no evidence regarding whether the mother would have undergone an abortion. Id. Although Plaintiffs advocate the prudent patient standard as it was used in the Patel trial, the Court cannot consider Patel an authoritative source of New Jersey law as there exists no opinion, embodying all relevant facts, upon which to rely. Having found that New Jersey case law does not specifically address proximate causation in a wrongful birth context, this Court must predict how the New Jersey Supreme Court would address this issue. See Polselli v. Nationwide Mutual Fire Ins. Co., 126 F.3d 524 , 528 n. 3 (3d Cir.1997). The Court finds that neither Defendantsâ strict âbut forâ analysis nor Plaintiffsâ âprudent patientâ approach is suitable to the case at hand. In wrongful birth cases, the issue of proximate causation does not conclusively depend upon whether the plaintiff parents would have aborted a fetus with a birth defect, had they been advised of them option to do so. Rather, proximate cause may be established by evidence demonstrating that the defendantâs negligence deprived the plaintiffs of their right to accept or reject a parental relationship. Here, giving Plaintiffs the benefit of all reasonable doubts and infer- *417 enees drawn from the underlying facts, the Court is satisfied that Plaintiffs have produced sufficient evidence that Defendants failed to provide Plaintiffs accurate amniocentesis samples and thereby deprived Plaintiffs of their right to decide whether to abort fetus B. Should the jury find Defendants liable for Plaintiffsâ injury, the issue of whether Plaintiffs would have actually decided to abort fetus B is a question for the jury to assess, along with other facts, when they consider proximate cause and damages. The Court believes that the New Jersey Supreme Court would most likely adopt the reasoning expressed in a recent New Jersey Appellate Division ease. See Lynch v. Scheininger, 314 N.J.Super. 318 , 714 A.2d 970 (App.Div.1998). Mrs. Lynch was treated by several physicians during a 1984 pregnancy that resulted in a stillbirth. Lynch, 314 N.J.Super. 318, 321 , 714 A.2d 970 . The stillbirth resulted from erythroblastosis fetalis, which is essentially âa condition caused by the incompatibility of maternal and fetal blood Rh factors.â Id. at 322 , 714 A.2d 970 . In 1986, Mr. and Mrs. Lynch brought a malpractice action seeking damages for the stillbirth and injury to Mrs. Lynchâs childbearing capacity which led to a settlement. Id. During the pendency of the prior action, Mrs. Lynch gave birth to Joseph Lynch on January 11, 1987, who was born with serious neurological impairments. Id. Like the 1984 stillbirth, Josephâs condition was caused by erythroblastosis fetalis. Id. In January of 1990, Mr. and Mrs. Lynch, and Joseph Lynch, an infant, filed the suit which led to the Lynch decision. Id. The plaintiffs alleged, inter alia, that the defendants failed to diagnose and treat Mrs. Lynchâs Rh isoim-munization which caused the 1984 stillbirth and contadbuted to Josephâs disabilities. Id. at 322-23 , 714 A.2d 970 . On appeal, the Appellate Division considered âwhether Joseph [was] barred from any recovery for Dr. Scheiningerâs malpractice because his parentsâ voluntary and intentional act of conceiving him despite their awareness of Mrs. Lynchâs sensitized condition constituted a supervening cause of his disabilities.â Id. at 326 , 714 A.2d 970 . The court likened a parentâs decision to continue a pregnancy to an intervening cause and held that Joseph was not barred from pursuing a malpractice claim against Dr. Scheininger. Id. In so holding, the court set forth principles of tort law applicable to the case at hand: [A] tortfeasor is generally held answerable for injuries which result in the ordinary course of events from his negligence and it is generally sufficient if his negligent conduct was a substantial factor in bringing about the injuries. The fact that there were also intervening causes which were foreseeable or were normal incidents of the risk created would not relieve the tortfea-sor of liability. Although the limit of proximate cause is, ultimately, an issue of law that entails a consideration of public policy and fairness, questions of proximate or intervening cause are ordinarily factual determinations for the jury. Id. at 326-27 , 714 A.2d 970 (citations and quotations omitted). Similarly, in a case currently pending before the New Jersey Supreme Court, the Appellate Division noted that the determination of proximate cause is to be based upon âa mixed consideration of logic, common sense, justice, policy and precedent.â Canesi v. Wilson, 295 N.J.Super. 354, 362 , 685 A.2d 49 (App.Div.1996), cert. granted, 149 N.J. 139 , 693 A.2d 109 (1997). In Canesi , the infant, Brandon, and his parents brought a medical malpractice suit against several physicians. The plaintiffs alleged that the defendants were liable for Brandonâs birth defects and for failing to advise Mrs. Canesi of potential hazards related to the use of a proges-tational agent, Provera. Id. at 360 , 685 A.2d 49 . The plaintiffs further alleged that the defendantsâ negligence deprived her of the opportunity to elect to terminate the pregnancy. Id. Having found no valid evidence of a cause and effect relationship between the use of Provera and Brandonâs abnormalities, the court held that the plaintiffs had not established proximate causation. Id. at 363 , 685 A.2d 49 . The court further held that, absent a showing of proximate causation, the defendants were not liable for failing to inform and warn Mrs. Canesi. Id. Nor were *418 they liable for her lost opportunity to abort. Id. Canesi is distinguishable from the present case as the issue of proximate causation here does not concern whether Defendantsâ negligence caused Tiffanyâs Trisomy 14 mosai-cism. The cause of Tiffanyâs genetic condition is not at issue. The alleged injury is Tiffanyâs very birth, or otherwise put, the deprivation of the Provenzanoâs opportunity to abort fetus B. Whether Defendantsâ alleged negligence caused Plaintiffsâ injury is an issue best left for the jury. Defendantsâ essential argument that Mrs. Provenzanoâs testimony fails to establish proximate cause is, in the final analysis, unpersuasive. As noted above, in a wrongful birth claim, Plaintiffsâ indecisiveness in saying definitively that they would have decided to abort a defective fetus should not be fatal to their claim. See Schroeder, supra. The very basis for the parentsâ cause of action, inaccurate information resulting from Defendantsâ negligence, is underscored by Plaintiffsâ later indecision and anguish and forms the necessary link between the negligent act and the resulting injury. This indecision and confusion, along with other circumstances in the case, like a prior abortion and Mr. Pro-venzanoâs advice and desire to continue or abort the pregnancy, are all genuine issues of fact to be determined by a jury. For example, here, Mr. Provenzano has given conflicting statements under oath. Mr. Provenzano initially testified that, had he been informed of fetus Bâs birth defects, he would have wanted his wife to proceed with the pregnancy anyway. Later, he submitted a certification changing his position. It is uniquely for a jury, and not a court, to decide these issues. Finally, Defendants argue that Defendant, Integrated Genetics, did not breach any duty under the informed consent doctrine. Defendants argue that Integrated Genetics only had a duty to advise Mrs. Provenzanoâs physician of its findings. The duty to advise a physician, and not a patient directly is called the âlearned intermediaryâ doctrine. Under the learned intermediary doctrine, âa pharmaceutical manufacturer generally discharges its duty to warn the ultimate user of prescription drugs by supplying physicians with information about the drugâs dangerous propensities.â Niemiera v. Schneider, 114 N.J. 550, 559 , 555 A.2d 1112 (1989). The learned intermediary doctrine bears a superficial application to the instant case. A positive amniocentesis (the accurate result here) would be sufficient to alert the parent to a problem with only minimal interpretation by the doctor. As noted above, the Supreme Court of New Jersey held that parents âhave the right of their own either to accept or reject a parental relationship, and the deprivation of that right by negligent misconduct of another, creates a cause of action in the parents.â Schroeder, 87 N.J. at 66 , 432 A.2d 834 . Therefore, the Court finds that the duty to provide accurate information that may lead to the decision to terminate a pregnancy, may be extended to a laboratory providing amniocentesis samples to a physician. If the Defendants did indeed provide inaccurate information, it seems clear to this Court that Integrated Genetics breached its duty to Mrs. Provenzano, which deprived her of the opportunity to reject, or accept, a parental relationship with Tiffany. Granted, Dr. Hux would ultimately present the results of the amniocentesis to Mrs. Provenzano, but that presentation would essentially involve an indication of positive or negative results. Clearly, the present situation is distinguishable from âlearned intermediaryâ cases where a pharmaceutical company distributes a product to a physician who may then choose to prescribe the product to a particular patient. No one can doubt that the decision to terminate a pregnancy is the single most personal and important moral decision that a woman can make during her lifetime. Thus, some may say that the âbut forâ test is appropriate; that is, if the mother cannot even make this decision, how can someone else possibly make it? But, the Court believes that this standard is too harsh. Similarly, the prudent person standard is not appropriate in a case involving such a uniquely personal and moral decision. In *419 the final analysis, a jury should consider all of the facts and circumstances (e.g., the motherâs later failure to say she would have aborted, her religious views, her husbandâs testimony, a prior abortion) to determine proximate cause. Further, it is for a jury to determine damages. It may well be that Mrs. Provenzanoâs inability to testify that she would have had an abortion would operate as a limitation on damages (i.e., compensation for her emotional distress and suffering but not medical expenses for the child). However, the parties have not had a fair opportunity to present this issue to the Court. Resolution of the damages issue, though, is not necessary to decide this summary judgment motion. It is uniquely for a jury, and not a court, to decide these issues. The primary factual issue to be decided is whether Defendantsâ alleged negligence was a substantial factor in bringing about Plaintiffsâ injury, the wrongful birth of Tiffany. The additional fact that there may have been an intervening cause of Tiffanyâs birth (i.e., .the failure of the parents to unequivocally say that she would be aborted) does not require dismissal as a matter of law. Even if the parents would have exercised their moral prerogative to continue with the pregnancy of fetus B, they were entitled to accurate amniocentesis results. Therefore, summary judgment is inappropriate and the motion will be denied. III. CONCLUSION For the reasons stated herein, Plaintiffsâ motion for leave to amend the Complaint is denied, and Defendantsâ motion for summary judgment is denied.
Case Information
- Court
- D.N.J.
- Decision Date
- October 13, 1998
- Status
- Precedential