Case Title: Annette F. Johnson v. Troy A. Layton, M.D., and SportsMed Orthopaedic Specialists, P.C., d/b/a SportsMed Orthopaedic Surgery & Spine Center

Citation: 

Docket Number: 1091520

State: alabama

Court: Alabama Supreme Court

Date: 2011-05-13T00:00:00Z

Document:
REL: 05/13/2011
Notice: This opinion is subject to formal revision before publication in the advance
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SUPREME COURT OF ALABAMA
OCTOBER TERM, 2010-2011
____________________
1091520
____________________
Annette F. Johnson
v.
Troy A. Layton, M.D., and SportsMed Orthopaedic Specialists,
P.C., d/b/a SportsMed Orthopaedic Surgery & Spine Center
Appeal from Limestone Circuit Court
(CV-08-271)
MURDOCK, Justice.
Annette F. Johnson appeals from the Limestone Circuit
Court's summary judgment in favor of Troy A. Layton, M.D.
("Dr. Layton"), and SportsMed Orthopaedic Specialists, P.C.,
1091520
In her first amended complaint, Johnson related that,
1
"[a]fter Dr. Layton released [Johnson, she] went to
another doctor who diagnosed the damage and injury
2
d/b/a 
SportsMed 
Orthopaedic 
Surgery 
& 
Spine 
Center
("SportsMed"), in her medical-malpractice action.  We affirm
the judgment of the trial court.
I.  Facts and Procedural History
On June 25, 2004, Johnson visited Dr. Layton, a board-
certified orthopedic surgeon, at SportsMed, a medical group of
which he was a member, for treatment of injuries Johnson had
sustained to her left elbow, left arm, left wrist, and left
hand.  Dr. Layton and other personnel at SportsMed treated
Johnson several times for those injuries over the next three
years until her final visit on February 12, 2007.  
On August 4, 2008, Johnson filed a medical-malpractice
action against Dr. Layton, Dr. Saranya Nadella (another
physician at SportsMed), and SportsMed, alleging that they had
negligently and/or wantonly failed to properly diagnose and
treat Johnson's injuries and that this failure had resulted in
the loss by Johnson of the use of her left elbow, left arm,
left wrist, and left hand, as well as considerable pain and
suffering.   On November 6, 2008, Johnson filed her first
1
1091520
to the ulnar nerve in [Johnson's] left arm.  The new
d o c t o r  
p e r f o r m e d  
a n  
u l n a r  
n e r v e
release/transposition 
surgical 
procedure 
on
[Johnson's] left elbow which resulted in dramatic
and radical improvement in [Johnson's] left arm and
hand and [Johnson's] regaining the use of her left
hand."
3
amended complaint, specifically alleging that from the outset
of her treatment she had related to Dr. Layton that she was
experiencing pain, tingling, and numbness in the fingers of
her left hand, a condition a subsequent doctor told her was
indicative of an injury to the ulnar nerve in her left arm.
She averred in her complaint that Dr. Layton denied that
Johnson ever told him that she was experiencing those symptoms
and that he had related that her medical records did not
indicate that she ever mentioned such symptoms.  Johnson
charged that Dr. Layton's failure 
"to record the symptoms of damage and injury to the
ulnar nerve in [Johnson's] left arm, specifically,
the pain, tingling, and numbness in the little
finger and ring finger of [Johnson's] left hand as
well [Johnson's] loss of use of her left hand, in
[Johnson's] medical records evidences Dr. Layton's
failure to diagnose and treat the damage and injury
to the ulnar nerve of [Johnson's] left arm."
On July 21, 2009, Dr. Nadella filed a motion for a
summary judgment as to all claims against her.  On
September 16, 2009, SportsMed moved for a partial summary
1091520
4
judgment as to all vicarious-liability claims against it based
on Dr. Nadella's acts or omissions.  Johnson did not oppose
those motions, and the trial court entered an order on
October 30, 2009, granting both motions.
On February 9, 2010, Dr. Layton and SportsMed filed a
motion for a summary judgment as to the remaining claims in
the medical-malpractice action.  They supported the motion
with an affidavit from Dr. Layton.  In the affidavit,
Dr. Layton affirmed that he had "personal knowledge of all the
matters stated herein."  The affidavit further provided, in
pertinent part:
"I first examined the plaintiff on June 25, 2004
for complaints of pain in her elbow. She was seen on
several occasions in my office.  The care and
treatment 
I 
provided 
to 
Annette 
Johnson 
was
appropriate and was within accepted standards of
care for an orthopedic surgeon.  At no time did I
deviate from or fall below any standard of care.
"It is my further opinion that the plaintiff's
alleged injuries and damages for which she seeks
recovery in this litigation are unrelated to any
alleged negligent act or violation of the standard
of care on my part. Simply stated, the plaintiff did
not suffer any of the injuries and damages for which
she seeks a recovery in this litigation because of
any care or treatment I provided or documentation in
my office chart.  None of the plaintiff's alleged
injuries were caused by my care.
1091520
5
"It is my further opinion that none of the
plaintiff's alleged injuries or damages were caused
by any of the care provided by any employee or agent
of the defendant designated as [SportsMed]."
(Emphasis added.)  On March 9, 2010, the trial court set
April 16, 2010, as the date for a hearing on the pending
motion for a summary judgment.  
On April 13, 2010, Johnson filed a motion to strike
Dr. Layton's affidavit, contending that it did not comply with
Rule 56(e), Ala. R. Civ. P., because the affidavit mentioned
Johnson's medical records -- a reference to the portion of the
affidavit emphasized above concerning "documentation in my
office chart" -- but Dr. Layton failed to attach Johnson's
medical chart to his affidavit.  Also on April 13, 2010,
Johnson filed her response in opposition to Dr. Layton and
SportsMed's 
summary-judgment 
motion. 
 
Johnson's 
sole
contention in her response was that because Dr. Layton's
affidavit was due to be stricken, the "burden of proof never
shifted" to Johnson; thus, she argued, she was "not required
to substantively oppose" Dr.  Layton and SportsMed's motion
for a summary judgment.  
On April 14, 2010, Dr. Layton and SportsMed filed their
reply to Johnson's response.  In their reply, Dr.  Layton and
1091520
6
SportsMed contended that Dr. Layton's affidavit relied upon
Dr. Layton's personal knowledge of his treatment of Johnson
and his professional medical opinion, not upon documents that
were not attached to the affidavit.  Nonetheless, Dr. Layton
and SportsMed submitted with their reply over 100 pages of
Johnson's medical records.
On April 15, 2010, Johnson filed what she styled a
"Notice Pursuant to Rule 56(c)(2)[, Ala. R. Civ. P.,] that she
does not consent to [the] hearing" scheduled for April 16,
2010, regarding the motion for a summary judgment.  In this
filing, Johnson contended that by filing Johnson's medical
records two days before the hearing, Dr. Layton and SportsMed
"failed 
to 
comply 
with 
the 
pertinent 
provisions 
of
Rule 56(c)(2) of Ala. R. Civ. P."  Johnson stated that because
of this failure, she "does not consent to this Honorable
Court's hearing Dr. Layton's and SportsMed's Motion For
Summary Judgment at 10:00 a.m. on Friday, April 16, 2010."  
Despite Johnson's filing, the trial court held the
hearing as scheduled.  Following the conclusion of the
hearing, the trial court, on April 16, 2010, entered an order
that provided that, "[h]aving considered the motion and the
1091520
7
material offered in support thereof, the Court is of the
opinion that the motion is well taken and due to be granted."
Accordingly, the trial court entered a judgment in favor of
Dr. Layton and SportsMed as to all claims against them.
On May 16, 2010, Johnson filed a motion to alter, amend,
or vacate the trial court's summary judgment in favor of
Dr. Layton and SportsMed on all of her claims.  Johnson's sole
contention in that postjudgment motion consisted of a
reiteration of the argument she presented in her opposition to
Dr. Layton and SportsMed's motion for a summary judgment.  
On June 14, 2010, the trial court entered an order
denying Johnson's postjudgment motion.  Johnson then filed a
timely appeal.  
II.  Standard of Review
"To grant a motion for a summary judgment, the court
must determine that there is no genuine issue of
material fact and that the moving party is entitled
to a judgment as a matter of law.  Mitchell v.
Richmond, 754 So. 2d 627, 628 (Ala. 1999).  If the
party moving for a summary judgment makes a prima
facie showing that there is no genuine issue of
material fact, the burden then shifts to the
nonmovant to present substantial evidence creating
a genuine issue of material fact.  Id. at 628."
Bank of Brewton, Inc. v. International Fid. Ins. Co., 827
So. 2d 747, 752 (Ala. 2002).
1091520
8
III.  Analysis
On appeal, Johnson relies upon the same two arguments she
expressed to the trial court as to why a summary judgment
should not have been entered against her.  First, she contends
that Dr. Layton's affidavit should have been stricken because
Dr.  Layton failed to attach documents referred to in the
affidavit.  Without Dr. Layton's affidavit, Johnson insists,
Dr.  Layton and SportsMed failed to make a prima facie showing
that no genuine issues of material fact exist, and, therefore,
the burden never shifted to her to present a substantive
response to their summary-judgment motion.  Second, Johnson
contends that the trial court committed reversible error by
holding a hearing on Dr.  Layton and SportsMed's motion for a
summary judgment two days after they filed copies of her
medical records despite the fact that she expressly stated in
accordance with Rule 56(c)(2), Ala. R. Civ. P., that she did
not consent to the hearing.  
Rule 56(e), Ala. R. Civ. P., provides:
"Supporting and opposing affidavits shall be made on
personal knowledge, shall set forth such facts as
would be admissible in evidence, and shall show
affirmatively that the affiant is competent to
testify to the matters stated therein.  Sworn or
certified copies of all papers or parts thereof
1091520
9
referred to in an affidavit shall be attached
thereto or served therewith.  The court may permit
affidavits 
to 
be 
supplemented 
or 
opposed 
by
depositions, answers to interrogatories, or further
affidavits."
(Emphasis added.)  
Johnson contends that in his affidavit Dr. Layton
referred to "documentation in my office chart" but failed to
attach a copy of Johnson's medical chart to his affidavit and
that this failure was fatal to Dr. Layton's affidavit.
According to Johnson, the trial court should have stricken
Dr. Layton's affidavit, leaving Dr.  Layton and SportsMed
without evidentiary support for their motion for a summary
judgment.  Johnson argues that the failure to attach her
medical chart to the affidavit was particularly egregious,
given that she specifically alleged in her amended complaint
that Dr. Layton's failure to record in her medical chart the
symptoms she related to him was indicative of his failure to
render acceptable care.
Dr. Layton and SportsMed counter that a plain reading of
Dr. Layton's affidavit shows that he did not rely upon
Johnson's medical chart in expressing his opinion in his
affidavit about the medical care he rendered.  Instead, as the
1091520
10
affidavit states, Dr. Layton relied upon "his personal
knowledge" of the medical care he provided to Johnson and upon
his "familiar[ity] with the standard of care required of board
certified orthopedic surgeons treating patients similar to
Annette Johnson."  According to Dr.  Layton and SportsMed,
Dr. Layton did not attach Johnson's medical chart to his
affidavit initially because the reference to "documentation in
my office chart" was made only in passing, as the sentence in
which it is used indicates:  "Simply stated, [Johnson] did not
suffer any injuries and damages for which she seeks a recovery
in this litigation because of any care or treatment I provided
or documentation in my office chart."  
A plain reading of Dr. Layton's affidavit confirms
Dr. Layton and SportsMed's contention that Dr. Layton did not
focus or rely upon Johnson's medical chart in expressing his
opinion that his treatment met the standard of care for
orthopedic surgeons.  Indeed, Johnson does not argue that
Dr. Layton relied upon her medical chart for the opinion
expressed in his affidavit; she argues only that he referred
to her chart and that Rule 56(e), Ala. R. Civ. P., mandates
that any reference to outside materials requires that a sworn
1091520
11
or certified copy of those materials be attached to the
affidavit.  The pertinent question that arises from the
parties' arguments on this issue, therefore, is whether
Dr. Layton's reference in his affidavit to "documentation in
my office chart" required the attachment of Johnson's medical
chart to the affidavit in order for the affidavit to be
admissible evidentiary support for Dr.  Layton and SportsMed's
motion for a summary judgment.  An examination of our cases
addressing this issue indicates that it did not.  
In Welch v. Houston County Hospital Board, 502 So. 2d 340
(Ala. 1987), this Court noted:
"In Oliver v. Brock, [342 So. 2d 1, 4-5 (Ala.
1976)], this Court held as follows:
"'Mrs. Oliver contends in her affidavit
that she has reviewed the chart prepared by
the defendant physicians stating the names
of the doctors who treated her daughter.
She says she has read on the "discharge
summary" that Dr. Brock was consulted and
assisted in prescribing the treatment of
her daughter. However, that document is not
made a part of the record.  [Ala.  R.  Civ.
P.] 56(e) requires that sworn or certified
copies of all papers or parts thereof
referred to in [answers to interrogatories
or depositions] (in support of or in
opposition 
to 
a 
motion 
for 
summary
judgment) shall be attached thereto or
served therewith.
1091520
Now 10A Charles Alan Wright, Arthur R.  Miller, and Mary
2
Kay Kane, Federal Practice and Procedure:  Civil § 2722, 380-
81 (1998).
12
"'"...  This means that if
written documents are relied upon
they actually must be exhibited;
[answers to interrogatories or
depositions] 
that 
purport 
to
describe a document's substance
or 
an 
interpretation 
of 
its
contents are insufficient...."
Wright & Miller, Federal Practice
and Procedure:  Civil § 2722.'"
502 So. 2d at 343 (emphasis omitted; emphasis added).  Thus,
this Court on two separate occasions has endorsed the
interpretation in Wright and Miller's treatise  of the
2
document-attachment requirement in Rule 56(e) that if the
documents referred to are relied upon by the affiant, then
they must be attached to the affidavit.  Application of the
rule in subsequent cases bears out this interpretation.  
In Ex parte Head, 572 So. 2d 1276 (Ala. 1990), this Court
stated, in pertinent part:
"Strauss's testimony regarding the relationships
among 
the 
defendants, 
purportedly 
made 
'from
personal knowledge' gained from the records of the
probate court, does not comply with the requirements
of Rule 56(e) and, therefore, is inadmissible in
support of Thistle's motion for summary judgment.
Despite 
Rule 
56(e)'s 
mandate 
that 
affidavit
testimony 'set forth such facts as would be
admissible in evidence,' no copies of the probate
1091520
13
records from which Strauss gained her 'personal
knowledge' were provided with Strauss's affidavit in
support of her allegations regarding the defendants.
The total absence of copies of the probate records
referred to by Strauss rendered inadmissible her
statements based on these documents."
572 So. 2d at 1281 (emphasis added).  In Head, the affiant
relied upon probate-court records for her "personal knowledge"
of the relationship among the defendants, but she failed to
attach the probate-court records to her affidavit, rendering
the affidavit inadmissible.  In contrast, Dr. Layton relied
upon his personal knowledge of the treatment he provided to
Johnson for his opinion as to the standard of care he
rendered.  
In Pettigrew v. LeRoy F. Harris, M.D., P.C., 631 So. 2d
839 (Ala. 1993), this Court explained:
"Dr. Harris also moved to strike Dr. Musher's
affidavit on the ground that the facts on which an
expert bases his opinion must be facts that are in
evidence.  Dr. Harris argued that, because the
medical records on which Dr. Musher's opinion were
based were not introduced into evidence, they are
inadmissible 
hearsay and, therefore, that the
opinion relying on them is also inadmissible.
Although the trial judge granted the motions to
strike these affidavits, he gave the Pettigrews
additional opportunities to respond appropriately to
the motion for summary judgment filed by Dr. Harris.
"The issue before this Court is whether the
trial court committed reversible error by granting
1091520
14
Dr. Harris's motion to strike directed towards the
material filed in opposition to Dr. Harris's pending
motion for summary judgment.  More specifically, the
Pettigrews argue that Dr. Musher's affidavit should
not have been stricken, because, they say, Ala. R.
Civ. P. 56(e) requires only that an expert opinion
be based on evidence that would be admissible at
trial, and, they argue, such evidence need not be
admitted at the time for the ruling on the motion
for summary judgment.
"....
"Rule 56(e) governs what must be filed with
affidavits in support of, and in opposition to, a
motion for summary judgment ....
"The Pettigrews 
focus 
on 
the 
first 
[requirement]
of Rule 56(e). They contend that the hospital
records 
relied 
upon 
by 
Dr. 
Musher 
would 
be
admissible at trial, and, therefore, that the
affidavit complies with the rule and should be
considered in opposition to Dr. Harris's motion for
summary 
judgment. 
However, 
it 
is 
the 
second
[requirement] of the rule that is at issue. That
sentence is a mandatory provision. That sentence
provides that 'sworn or certified copies of all
papers or parts thereof referred to in an affidavit
shall be attached thereto or served therewith.' 'The
total absence of copies of the [hospital] records
referred to by [Dr. Musher] rendered inadmissible
[his] statements based on [those] documents.' Ex
parte Head, 572 So. 2d 1276, 1281 (Ala. 1990)."
631 So. 2d at 841 (emphasis omitted).  Again, in Pettigrew a
doctor failed to attach to an affidavit medical records upon
which the affiant expressly and solely relied for his expert
opinion.  
1091520
15
In a fact situation similar to the one in Pettigrew, this
Court reached a similar conclusion.  In Waites v. University
of Alabama Health Services Foundation, 638 So. 2d 838 (Ala.
1994), this Court stated:
"The defendants counter Waites's contentions by
arguing 
that 
Dr. 
Kirshenbaum's 
affidavit 
was
defective because, they say, 'it consisted of
opinions based on his review of medical records
which were not in evidence, properly authenticated,
or attached to or served with the affidavit.'  We
agree.
"The testimony of Waites's expert was proffered
in opposition to the defendants' properly supported
Rule 56, [Ala.] R. Civ. P., motion for summary
judgment. 
It 
was 
necessary, 
then, 
that 
Dr.
Kirshenbaum's affidavit meet the requirements of
Rule 56(e) .... 
"This Court, in Ex parte Head, 572 So. 2d 1276
(Ala. 1990), held that 'the requirements of Rule
56(e) are mandatory.'  Although the Head decision
dealt with the provisions of Rule 56(e) requiring
that the affidavit 'be made on personal knowledge'
and that it 'set forth such facts as would be
admissible in evidence,' our holding that the
requirements of Rule 56(e) are mandatory certainly
can not be limited to those two requirements.
Indeed, the two further requirements -- that the
affidavit 'show affirmatively that the affiant is
competent to testify to the matter stated therein'
and that '[s]worn or certified copies of all papers
or parts thereof referred to in an affidavit shall
be attached thereto or served therewith' -- are no
less critical in testing the propriety of an
affidavit in support of, or in opposition to, a
summary judgment motion.
1091520
16
"We hold, therefore, that because no medical
records were attached to or served with the
affidavit of Dr. Kirshenbaum, the affidavit was
properly disregarded by the trial court."
638 So. 2d at 842 (emphasis added).  
The decisions from Welch, Head, Pettigrew, and Waites
demonstrate that an affiant must submit with his or her
affidavit documents that he or she has relied upon in
rendering the opinion expressed in the affidavit.  As
indicated, a plain reading of Dr. Layton's affidavit shows
that his mention of "documentation in my office chart" was not
a statement that he relied upon Johnson's chart for his
opinion that he met the standard of care for orthopedic
surgeons 
in 
providing 
medical 
treatment 
to 
Johnson.
0Therefore, Dr. Layton's affidavit did not violate the
requirement of Rule 56(e), and the trial court did not err in
declining to strike his affidavit.  
In light of our decision that it was not necessary for
Dr. Layton to attach to his affidavit the medical chart at
issue, we pretermit discussion of Johnson's argument that
Dr. Layton and SportsMed's submission of her medical records
two days before the hearing on the motion for a summary
judgment violated Rule 56(c)(2), Ala. R. Civ. P.  
1091520
17
The trial court's judgment is affirmed.
AFFIRMED.
Cobb, C.J., and Woodall, Bolin, and Main, JJ., concur.