Health Law and Regulation Update Blog Post by Eric Frisch.

The Georgia Court of Appeals affirmed the trial court’s ruling that the standard of care opinion of an expert is admissible and that a genuine issue of material fact existed as to whether the patient’s injuries could have been avoided had the hospitalist properly diagnosed the condition in compliance with the standard of care. Further, the Court of Appeals affirmed the trial court’s ruling that a genuine issue of material fact existed as to whether the hospital’s failure to adequately respond to the patient’s emergent medical condition constituted a breach of standard of care.

Plaintiff attached the affidavits of two experts to its Complaint, an internal medicine physician and a cardiologist. Both experts opined Defendants deviated from the standard of care. After discovery, Defendant moved for summary judgment arguing Plaintiff did not establish any negligence that Defendant proximately harmed Plaintiff. Defendant further moved to exclude standard of care opinions of the cardiologist on the grounds that he lacked the qualifications required by O.C.G.A § 24-7-702, specifically that he lacked experience practicing hospitalist and that he only practiced three of the last five years. The trial court denied both motions holding there are genuine issues of material facts concerning both the alleged negligence of defendants and the causal connection between defendant’s negligence and Plaintiffs’ injuries. The trial court further denied Defendant’s motion to exclude the cardiologists’ testimony ruling that even though the Defendant is a hospitalist and the expert is a cardiologist, the expert has the requisite knowledge to give standard of care testimony.

When deciding the admissibility of expert affidavits, the Court of Appeals opined the pertinent question is whether an expert has an appropriate level of knowledge in performing the procedure or teaching others how to perform the procedure, not whether the expert himself has actually performed or taught that specific procedure. Further, the Court held, the trial court must consider whether the expert has “sufficient knowledge about [diagnosing the condition] — however generally or specifically it is categorized, so long as it is the [condition] that the Defendant is alleged to have [diagnosed] negligently.” The Court further held the area of specialty is dictated by the allegations in the complaint, not the apparent expertise of the treating physician. The Court utilizes a flexible approach in determining an expert’s appropriate level of knowledge. Here, the expert cardiologist, though not currently practicing hospitalist medicine, did meet the requirements of Rule 702 because he treated patients with pericardial diseases and patients who undergo surgical or interventional procedures. The cardiologist was also called to consult in the emergency room up to 5 times a year for suspected pericardial effusions.  The Court explains a medical doctor in one specialty may have the requisite knowledge and experience under O.C.G.A § 24-7-702(c)(2) to give expert opinion testimony of a medical doctor in another specialty.

Next, Defendant argued there is no expert testimony to show causation to a degree of medical certainty, essentially, there is no evidence to show that his alleged breach of standard of care caused Plaintiff’s injury. Both experts opined the alleged breach occurred at different times, but the Court explains, despite the experts offering conflicting evidence regarding causation, it is the province of the jury to decide which testimony is believable, hence a fact dispute does exist as to causation.

Finally Defendant argued the trial court erred in only considering negligence claims justified by the expert’s testimony. Defendant alleges the expert testimony did not establish “with a degree of medical certainty” that the alleged negligence caused Plaintiff’s injuries. The trial court denied the motion for summary judgment, ruling there were several other claims alleged by appellees including failure to review and act upon a previous physician’s notes, failure to ensure timely compliance with policies, failure to adequately respond to an emergent situation. The Court of Appeals affirmed the trial court’s ruling and held summary judgment may not be obtained by relying solely on opinion evidence. However, a summary judgment motion may be contested by the use of opinion evidence.

Take-home: An expert practicing in a different area of medicine is considered qualified for purposes of Rule 702 as long as the expert has the requisite knowledge to give standard of care testimony. Further, conflicting expert testimony is exactly the type of evidence that leads to a jury question, and may not be decided on summary judgment. Lastly, a summary judgment motion may only be contested by use of opinion evidence, a party may not rests its summary judgment motion on opinion evidence.

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