Case Title: Amanda Carney-Hayes v. Northwest Wisconsin Home Care, Inc.

Citation: 2005 WI 118

Docket Number: 2003AP001801

State: wisconsin

Court: Wisconsin Supreme Court

Date: 2005-07-12T00:00:00Z

Document:
2005 WI 118 
 
 
SUPREME COURT OF WISCONSIN 
 
 
 
 
 
CASE NO.: 
2003AP1801 
COMPLETE TITLE: 
 
 
Amanda Carney-Hayes, by her Guardian ad  
Litem Thomas A. McCormack, Walter  
Pietrzen and Linda Pietrzen,  
          Plaintiffs-Respondents-Cross- 
          Appellants, 
     v. 
Northwest Wisconsin Home Care, Inc. and  
Kathy Avery,  
          Defendants-Appellants-Cross- 
          Respondents. 
 
 
 
 
ON BYPASS FROM THE COURT OF APPEALS 
 
 
OPINION FILED: 
July 12, 2005   
SUBMITTED ON BRIEFS: 
        
ORAL ARGUMENT: 
November 4, 2004   
 
 
SOURCE OF APPEAL: 
 
 
COURT: 
Circuit   
 
COUNTY: 
Eau Claire   
 
JUDGE: 
Lisa K. Stark   
 
 
 
JUSTICES: 
 
 
CONCURRED: 
WILCOX, J., concurs (opinion filed).   
 
CONCUR/DISSENT: 
BRADLEY, J., concurs in part, dissents in part 
(opinion filed). 
ABRAHAMSON, C.J., and BUTLER, JR., J., join the 
concurrence/dissent. 
BUTLER, JR., J., concurs in part, dissents in 
part (opinion filed). 
ABRAHAMSON, C.J., and BRADLEY, J., join the 
concurrence/dissent. 
 
DISSENTED: 
        
 
NOT PARTICIPATING:         
 
 
 
ATTORNEYS: 
 
For the plaintiffs-respondents-cross-appellants there were 
briefs by Ardell W. Skow, Martha H. Heidt and Doar, Drill & 
Skow, S.C., Baldwin, and oral argument by Matthew A. Biegert. 
 
For the defendants-appellants-cross-respondents there was a 
brief by Donald K. Schott, Sarah E. Coyne, Emily M. Feinstein, 
O. Thomas Armstrong and Quarles & Brady LLP, Madison, and oral 
argument by Donald K. Schott. 
 
 
2
 
Amicus curiae briefs were filed by Lester A. Pines, Tamara 
B. Packard and Cullen Weston Pines & Bach LLP, Madison, on 
behalf of the Wisconsin Patients Compensation Fund. 
 
An amicus curiae brief was filed by Guy DuBeau, Joseph C. 
Copa and Axley Brynelson, LLP, Madison, on behalf of Civil Trial 
Counsel of Wisconsin. 
 
An amicus curiae brief was filed by William C. Gleisner, 
III and Law Offices of William Gleisner, on behalf of the 
Wisconsin Academy of Trial Lawyers. 
 
 
2005 WI 118 
NOTICE 
This opinion is subject to further 
editing and modification.  The final 
version will appear in the bound 
volume of the official reports.   
No.  2003AP1801 
(L.C. No. 
02 CV 0209 
STATE OF WISCONSIN  
 
 
   : 
IN SUPREME COURT 
 
 
Amanda Carney-Hayes, by her Guardian ad  
Litem Thomas A. McCormack, Walter  
Pietrzen and Linda Pietrzen,  
 
          Plaintiffs-Respondents-Cross- 
          Appellants, 
 
     v. 
 
Northwest Wisconsin Home Care, Inc. and  
Kathy Avery,  
 
          Defendants-Appellants-Cross- 
          Respondents. 
 
FILED 
 
JUL 12, 2005 
 
Cornelia G. Clark 
Clerk of Supreme Court 
 
 
 
 
 
APPEAL from an order of the circuit court for Eau Claire 
County, Lisa K. Stark, Judge.  Affirmed in part, reversed in 
part and cause remanded. 
 
¶1 
DAVID T. PROSSER, J.   This case is before the court 
on bypass pursuant to Wis. Stat. § (Rule) 809.60 (2001-02).1  The 
plaintiff, 
Amanda 
Carney-Hayes 
(Carney-Hayes) 
and 
the 
defendants, Northwest Wisconsin Home Care Inc. and Kathy Avery 
                                                 
1 All subsequent references to the Wisconsin Statutes are to 
the 2001-02 edition unless otherwise indicated. 
No. 2003AP1801 
2 
 
(collectively, Northwest) join in this interlocutory appeal from 
the evidentiary rulings of the Circuit Court for Eau Claire 
County, Lisa K. Stark, Judge.  Carney-Hayes sued Northwest, 
alleging that one of its employees, Kathy Avery, negligently 
provided emergency nursing treatment.  Carney-Hayes now seeks to 
compel 
expert 
opinion 
testimony 
regarding 
the 
applicable 
standards of care from three unwilling witnesses——Avery, Cheryl 
Fontaine, and Jodene Verbracken.  All three played a role in 
Northwest's treatment of Carney-Hayes, but only Avery is a named 
defendant.  All three refused to answer certain questions posed 
at their depositions, asserting the privilege we recognized in 
Burnett v. Alt, 224 Wis. 2d 72, 589 N.W.2d 21 (1999), and 
reiterated in Glenn v. Plante, 2004 WI 24, 269 Wis. 2d 575, 676 
N.W.2d 413.   
¶2 
Carney-Hayes filed motions asking the circuit court to 
compel the three witnesses to testify on these standard of care 
questions.  The circuit court held two separate motion hearings.  
At the first hearing, it granted Carney-Hayes' motion to compel 
Avery's testimony as to the standard of care because Avery is a 
named party and because "she was there," providing treatment to 
Carney-Hayes at the time of the incident in question.  The court 
believed that these facts distinguished Avery from Dr. Ernesto 
Acosta, the unwilling expert in Alt, because "the Alt hold[ing] 
can be limited to a nonparty, unpaid expert."  
¶3 
At the second hearing, however, the court denied a 
similar motion relating to Fontaine.  The court reasoned that 
Fontaine's position was different from Avery's because Fontaine 
No. 2003AP1801 
3 
 
"was not present . . . did not provide direct care to the 
plaintiff [and is] not a named party."  Fontaine's position, in 
the court's view, corresponded to Dr. Acosta's position in Alt. 
¶4 
The circuit court characterized its decision with 
respect to Verbracken as the most difficult of the three, 
because Verbracken had previously been a direct caregiver for 
Carney-Hayes and had written Northwest's "plan of care" for 
Carney-Hayes.  However, Verbracken was not at the scene of the 
incident, nor was she one of Carney-Hayes' direct caregivers at 
that time.  Therefore, the court directed Verbracken to answer 
questions about the standard of care "with respect to the plan 
of care, its preparation, its maintenance, and how it should be 
followed."  She was not required to answer questions eliciting 
her opinion about Avery's direct care to the plaintiff. 
¶5 
We take this opportunity to reaffirm our holdings in 
Alt and Glenn and to clarify the duties and privileges of 
medical witnesses in a medical malpractice case.  (1) A medical 
witness must testify about her own conduct relevant to the case, 
including her observations and her thought processes, her 
treatment of the patient, why she took or did not take certain 
actions, what institutional rules she believed applied to her 
conduct, and her training and education pertaining to the 
relevant subject.  (2) Subject to the compelling need exception 
recognized in Alt and Glenn, a medical witness who is unwilling 
to testify as an expert cannot be forced to give her opinion of 
the standard of care applicable to another person or her opinion 
of the treatment provided by another person.  Unless a medical 
No. 2003AP1801 
4 
 
witness who is unwilling to testify as an expert is alleged to 
have caused injury to the plaintiff by her medical negligence, 
the witness is not required to give her opinion on the standard 
of care governing her own conduct.  (3) A medical witness who is 
alleged to have caused injury to the plaintiff by her medical 
negligence may be required to give her opinion on the standard 
of care governing her own conduct.  A witness in this category 
may be a party defendant.  However, no medical witness may be 
named a party defendant for the purpose of eliciting the 
witness's expert opinion.  The circuit court may assess whether 
there is a reasonable basis for naming a medical witness as a 
party defendant.  The court should assure that any medical 
witness from whom expert opinion is required is qualified to 
testify as an expert, pursuant to Wis. Stat. § 907.02.  The 
court may employ evidentiary rules, including §§ 904.02, 904.03, 
and 906.11 to maintain the focus of a medical malpractice trial 
on whether the defendant conformed to the standard of care, not 
whether the defendant performed well as an expert witness.   
FACTS AND PROCEDURAL POSTURE 
¶6 
Carney-Hayes suffers from spina bifida and other 
congenital diseases.2  She cannot breathe on her own.  She is 
dependent on a ventilator and, at the time of the incident 
underlying this lawsuit, she received 24-hour home care from 
                                                 
2 The parties have submitted a limited record for our 
resolution of this interlocutory appeal.  Accordingly, some of 
the underlying facts of the lawsuit are not found in the record 
before us, but rather are stated by both sides in the briefs.   
No. 2003AP1801 
5 
 
Northwest.  At that time, Avery was Northwest's in-home "one on 
one" 
nurse, 
Verbracken 
was 
Carney-Hayes' 
"case 
manager" 
responsible for preparing care plans for treatment, and Fontaine 
was 
Northwest's 
"Director 
of 
Extended 
Care 
Services," 
a 
supervisor responsible for Avery's training.  
¶7 
On April 7, 1999, Carney-Hayes stopped breathing while 
she was at school.  Avery testified that this was not an 
infrequent problem for Carney-Hayes, and that it was even to be 
expected for patients suffering from Carney-Hayes' ailments.  
The usual cause, according to Avery, is the inability of such 
patients to clear secretions from their lungs.  The usual 
treatment is to suction the secretions out of the lungs.  Avery 
was present at the school with Carney-Hayes, and she testified 
that as she prepared to suction Carney-Hayes' secretions, she 
noticed that Carney-Hayes had no pulse.  Aided by bystanders, 
Avery immediately initiated cardiopulmonary resuscitation (CPR).  
Ultimately, Avery succeeded in saving Carney-Hayes' life, but 
Carney-Hayes alleges that she suffered serious injuries as a 
result of the incident.  
¶8 
Carney-Hayes alleges that Avery negligently failed to 
open her trachea before beginning CPR, and further alleges that 
if Avery had properly followed standard medical procedures, 
Carney-Hayes' heart never would have stopped.  Carney-Hayes 
filed suit against Northwest and Avery on March 28, 2002, 
alleging that they were negligent in her treatment.  Discovery 
ensued. 
No. 2003AP1801 
6 
 
¶9 
Carney-Hayes deposed Avery, Verbracken, and Fontaine.  
Avery's deposition took place on November 14, 2002.  It lasted 
almost 
six 
hours 
and 
produced 
173 
pages 
of 
testimony.  
Plaintiff's counsel asked and Avery answered many questions that 
called for Avery's opinion and her description of her training 
as well as her conduct, thoughts, and observations on the date 
of the incident.  The following exchanges took place between 
Avery and the plaintiff's attorney: 
Q: Is that a common problem for all ventilator 
dependent patients . . . that they have some problems 
moving their secretions from their lungs? 
A: They need to be suctioned periodically, yes. 
 
. . . .  
Q: I understand that you can recount the day, but I 
would also like you, if you can, to recount the 
conversation that you had with Kathy Johnson and 
perhaps Kelly . . . what did you tell them? 
A:  . . . I explained what had happened.  I told them 
that the vent went off.  I went to check on it.  It 
said high pressure.  Went to grab a suction catheter 
and looked at Amanda.  She was cyanotic.  And 
diaphoretic and had clear secretions coming out of her 
nose, mouth and trach.  And at that time I reached for 
her brachial pulse and did not feel one.  I reached 
for carotid pulse and did not feel one.  Took her bag, 
dumped it out, grabbed the ambu bag, took the vent 
off.  I threw the circuit, put the ambu bag on her 
trach, started ventilating her.  Then I need to back 
up.  Before——before——when I started bagging her, at 
that time I called——I hollered for somebody to call 
911.  And the teacher was there by me.  I had her hold 
onto the ambu bag and told her to squeeze it together 
until it met in the middle and release it so she could 
exhale, and do that rather fast. Unhooked her from the 
seat belt, straightened out her legs and we——there was 
somebody else there.  And between the two of us, we 
slid her to the floor.  I asked if anybody knew C.P.R. 
No. 2003AP1801 
7 
 
and somebody came up and started doing compressions 
and I was doing the bagging . . .  
Q: In your opinion, did Amanda have a mucous plug on 
April 7th of 1999? 
A: In my opinion on that day I do not know what 
happened.  
Q: Can a mucous plug cause the trach to become 
obstructed? 
A: It can. 
Q: Can a mucous plug cause someone who is ventilator 
dependent to lose the ability to breathe? 
A: If the trach was obstructed, yes. 
Q: When you saw the secretions coming out of her mouth 
and her nose, as one of the things did you consider 
the fact that she might have an obstruction of her 
trachea at that point? 
A: It didn't matter at that point.  It was an 
emergency situation.   
Q: The question is a little different, though, whether 
it mattered or not.  The question is, did you consider 
it? . . .  
A: No. 
¶10 In addition, plaintiff's counsel asked and received 
answers to questions about Avery's school coursework, her 
clinical experience, and her on-the-job training at Northwest.  
Defense counsel did not object to any of these questions.  
Despite these questions and answers, plaintiff's counsel claimed 
at the motion hearing that "Defendants in this case refused to 
allow Kathy Avery to express any opinions regarding her own 
decisions in handling the cardiopulmonary arrest event of a 
ventilator-dependent child."  
No. 2003AP1801 
8 
 
¶11 Defense counsel did object to the following question: 
Q: I have a number of questions that I want to ask 
you, Kathy, regarding the standard of care of what it 
is that a registered nurse would do in treating Amanda 
Carney-Hayes, okay? 
Carney-Hayes brought the first motion to compel in response to 
defense objections to questions related to the standard of care.  
¶12 Plaintiff's counsel took Verbracken's deposition on 
February 13, 2003.  Verbracken created Northwest's "plan of 
care" for Carney-Hayes.  Plaintiff's counsel asked about 
Verbracken's education, her training, the medical treatises she 
used, the process of creating the plan of care, and a detailed 
examination of the plan of care.  Verbracken answered many 
questions calling for an expert opinion regarding what she 
personally would have done when faced with a hypothetical 
situation similar to the one that Avery faced: 
Q: . . . You tell me that you're familiar with what 
the procedures would be for initiating CPR on a trach 
dependent 
child. 
 
Could 
you 
tell 
us 
what 
the 
procedures would have been for Amanda Carney-Hayes 
back on April 7th, 1999? 
A: That's hard to say because I wasn't there. 
Q: Okay. And can you give us some sense of the types 
of decisions you would make in order to make decisions 
about what you would do for someone that needs CPR who 
is trach dependent? 
A: Certainly. 
Q: Okay.  Tell us what that is. 
A: First I would look at her and assess her for all of 
the things that we talked about in the care plan such 
as, you know, wheezes.  I'd be listening for if she 
had secretions.  Was the air actually going in when 
No. 2003AP1801 
9 
 
the vent was giving a breath or was it not going in?  
Was she purple or blue?  And then I guess I need the 
next step first before I would make any decisions, 
that would be my first assessment is her air, is she—— 
Q: Let's assume for the purposes of the question that 
she's not receiving any air.   
A: She's not receiving any air. 
Q: She's not receiving any air.  If that's the case, 
what would be the next step? 
A: I would take her off the vent and bag her. 
Q: If a person's lungs aren't moving up and down, 
would that be an indication of the fact that someone 
is not receiving air?  
A: Right. 
Q: And if someone is not receiving air, can one of the 
reasons be that a person isn't receiving air the fact 
that they have either a [mucous] plug or increased 
secretions? 
A: Yes. 
Q: Would one of the ways that one would have to 
attempt to restore air to a ventilator dependent child 
be to remove the increased secretions or remove the 
[mucous] plug by suctioning? 
A: Yes. 
¶13 Defense counsel objected only when plaintiff's counsel 
began asking questions about the applicable "standard of care."  
Carney-Hayes brought her second motion to compel in response to 
these objections.  
¶14 Fontaine's deposition took place on February 20, 2003.  
Although shorter, it bears many similarities to Avery's and 
Verbracken's depositions.  Defense counsel did not object to 
questions about Fontaine's education history, her training, the 
No. 2003AP1801 
10 
 
training procedures Fontaine used to train nurses like Avery or 
plaintiff's 
counsel's 
substantial 
questioning 
regarding 
Northwest's policies and procedures specific to "nursing cares."  
Defense counsel did object when plaintiff's counsel questioned 
Fontaine regarding the "accepted standard of care" for a manager 
supervising or training a nurse like Avery.  Carney-Hayes 
incorporated 
her 
request 
that 
the 
court 
overrule 
these 
objections in her second motion to compel. 
¶15 The circuit court ruled separately on each of the 
three witnesses.  The court held the first motion hearing, 
addressing Avery's testimony, on February 5, 2003.  The court 
held that the Alt privilege applied to Avery, but concluded that 
"there is a compelling circumstance to justify her testimony," 
and granted the plaintiff's motion to compel Avery to provide 
opinion answers to the plaintiff's standard of care questions.  
The court believed that compelling circumstances existed because 
"she was there, she has unique information, she has unique 
knowledge about the facts and circumstances that provide a 
compelling interest."  The circuit court noted that the 
plaintiff's case would become very difficult without the sought-
after testimony from Avery: "I'm certain that the case could go 
in without much evidence from Defendant Avery, but I also think 
that the defense would want to put in some evidence from her 
concerning this issue."  The court also stated its belief that 
the Alt holding was limited to nonparty, unpaid experts.  
¶16 The second motion hearing, addressing Fontaine and 
Verbracken, was held on May 30, 2003.  The court refused to 
No. 2003AP1801 
11 
 
compel expert testimony from Fontaine because it believed that 
factually, her position was very similar to Dr. Acosta's in the 
Alt case: she is not a named party, provided no direct care to 
the plaintiff, has no firsthand knowledge of what happened, and 
was not at the scene.  Accordingly, the court denied the motion 
requesting that it compel Fontaine to answer questions about the 
appropriate standard of care and whether she believed that Avery 
complied with that standard.  
¶17 At the same hearing, the court adopted a middle ground 
with Verbracken, essentially holding that she had to provide 
answers to some standard of care questions but not others.  The 
court directed Verbracken to answer questions about the standard 
of care "with respect to the plan of care, its preparation, its 
maintenance, and how it should be followed."  The court 
cautioned, though, that Verbracken could not be questioned about 
her opinion as to the standard of care applicable to Avery's 
direct care to the plaintiff.  
ANALYSIS 
¶18 We must decide whether the circuit court's rulings on 
the permissibility of the standard of care questions were 
correct.  We review a circuit court's evidentiary rulings under 
the erroneous exercise of discretion standard.  Martindale v. 
Ripp, 2001 WI 113, ¶28, 246 Wis. 2d 67, 629 N.W.2d 698.  We 
"will uphold a decision to admit or exclude evidence if the 
circuit court examined the relevant facts, applied a proper 
legal standard, and, using a demonstrated rational process, 
reached a reasonable conclusion."  Id.  However, "[w]hether a 
No. 2003AP1801 
12 
 
witness has a legal privilege to refuse to provide expert 
opinion testimony is a question of law, which we review de 
novo."  Glenn, 269 Wis. 2d 575, ¶14 (citing Alt, 224 Wis. 2d at 
84).   
¶19 We begin with the well-accepted general rule that 
litigants have a right to every person's evidence.  Alt, 224 
Wis. 2d at 88.  However, this right is not absolute; it is 
"tempered 
by 
constitutional, 
common 
law, 
or 
statutory 
privileges."  Glenn, 269 Wis. 2d 575, ¶20 (citing United States 
v. Nixon, 418 U.S. 683, 709-10 (1974); State v. Gilbert, 109 
Wis. 2d 501, 505, 326 N.W.2d 744 (1982)).  In Wisconsin, this 
common law rule is now statutory:   
Except as provided by or inherent or implicit in 
statute or in rules adopted by the supreme court or 
required by the constitution of the United States or 
Wisconsin, no person has a privilege to: 
(1) Refuse to be a witness; or  
(2) Refuse to disclose any matter; or  
(3) Refuse to produce any object or writing or  
(4) Prevent 
another 
from 
being 
a 
witness 
or 
disclosing any matter or producing any object or 
writing.   
Wis. Stat. § 905.01.   
¶20 This statute, along with our common law tradition, led 
us to the unremarkable declaration that "Privileges are the 
exception, not the rule."  Alt, 224 Wis. 2d at 85.   
¶21 In Alt, the plaintiff alleged that the defendant's 
negligent performance during a cesarean section caused her baby 
No. 2003AP1801 
13 
 
to be born with "catastrophic injuries."  Alt, 224 Wis. 2d at 
79-80.  The plaintiffs named a number of experts, including Dr. 
Acosta, who had provided prenatal care to Dawn Alt but was not 
present at the time of her baby's injury.  Id. at 80.  During 
discovery, Acosta's attorney directed him not to answer the 
following two questions: 
Q: And if you were the OB that was treating this woman 
at the time knowing that there had been an ultrasound 
done and wanting to see that report, what would you 
have done? 
Q: No matter what the cause, a patient with a history 
of term pregnancy and a gush of blood, that's 
abnormal? 
Alt, 224 Wis. 2d at 81.   
¶22 The Alt court held that Acosta did not have to answer 
these 
questions, 
recognizing 
a 
privilege 
inherent 
in 
Wis. Stat. § 907.06.3  That statute, entitled "Court Appointed 
Experts," allows a circuit judge to appoint an expert, but 
provides that "An expert witness shall not be appointed by the 
judge 
unless 
the 
expert 
witness 
consents 
to 
act."  
Wis. Stat. § 907.06(1).   
¶23 The Alt court held that this sentence in § 907.06(1) 
implied a broader privilege inherent in the statute: 
We 
conclude 
that 
this 
express 
grant 
implies 
a 
privilege to refuse to testify if the expert is called 
by a litigant.  If a court cannot compel an expert 
witness to testify, it logically follows that a 
                                                 
3 In Burnett v. Alt, 224 Wis. 2d 72, 86 n.4, 589 N.W.2d 21 
(1999), the circuit court approved counsel's objection to the 
first question but not the second. 
No. 2003AP1801 
14 
 
litigant should not be able to so compel an expert.  
It makes little if any sense to conclude that a 
litigant has greater rights than a court with respect 
to obtaining testimony from experts.   
We conclude that a witness's privilege to refuse 
to 
provide 
expert 
testimony 
is 
inherent 
in 
Wis. Stat. § 907.06.  
Any 
other 
result 
would be 
inconsistent and fly in the face of logic. 
Alt, 224 Wis. 2d at 86.4 
                                                 
4 In Alt, a spirited dissenting opinion found fault with the 
majority's methodology.  Alt, 224 Wis. 2d at 99 (Bradley, J., 
dissenting). 
 
The 
dissent 
specifically 
objected 
to 
the 
majority's 
belief 
that 
the 
privilege 
was 
inherent 
in 
Wis. Stat. § 907.06. 
No. 2003AP1801 
15 
 
                                                                                                                                                             
The existence of the privilege recognized in Alt is not 
revolutionary.  We note that a similar privilege has been 
recognized in several other jurisdictions.  See, e.g., Young v. 
United States, 181 F.R.D. 344, 346 (W.D. Texas 1997) ("In the 
absence of a statute to the contrary, a professional witness may 
not generally be compelled to testify as an expert at the 
request of a private litigant, as such testimony is a matter of 
contract or bargain."); Agnew v. Parks, 343 P.2d 118, 123 (Cal. 
App. 1959) (treating physician must testify regarding facts 
learned during examination and treatment of patient, but cannot 
be compelled to give expert opinion of standard of care or of 
treatment 
provided 
by 
another); 
Mason 
v. 
Robinson, 
340 
N.W.2d 236, 242-43 (Iowa 1983) (expert witness is free to refuse 
to provide opinion testimony absent a "compelling necessity" for 
the testimony); Commonwealth v. Vitello, 327 N.E.2d 819, 827 
(Mass. 1975) ("[A] party may not by summons compel the 
involuntary testimony of an expert witness solely for the 
expertise he may bring to the trial, and in the absence of any 
personal knowledge on his part related to the issues before the 
judge and the jury"); Klabunde v. Stanley, 181 N.W.2d 918, 921 
(Mich. 1970) ("By definition, an expert is one who gives opinion 
testimony, and not testimony concerning 'relevant facts.'  He 
has a property right in his opinion and cannot be made to 
divulge it in answer to a subpoena."); Stanton v. Rushmore, 169 
A. 721 (N.J. 1934) (expert may be compelled to give factual 
testimony but not expert opinion); People ex rel. Kraushaar 
Bros. & Co. v. Thorpe, 72 N.E.2d 165, 166 (N.Y. 1947) (real 
estate expert could be compelled to give testimony as to what he 
had seen on the premises in question, but could not be compelled 
to testify as to his expert opinion); Penn. Co. for Ins. on 
Lives & Granting Annuities v. City of Philadelphia, 105 A. 630, 
630 (Pa. 1918) ("The process of the courts may always be invoked 
to require witnesses to appear and testify to any facts within 
their knowledge; but no private litigant has a right to ask them 
to go beyond that [and give expert testimony]"); Owens v. 
Silvia, 838 A.2d 881, 901-02 (R.I. 2003) ("Absent extraordinary 
circumstances . . . a non-party expert cannot be compelled to 
give opinion testimony against his or her will.") (citing Sousa 
v. Chaset, 519 A.2d 1132, 1136 (R.I. 1987)).  Generally, these 
courts have determined that the privilege is rooted in the 
common law.  Id.  See also Buchman v. State, 59 Ind. 1 (1877); 
Cooper v. Norfolk Redevelopment & Housing Authority, 90 S.E.2d 
788 (Va. 1956). 
 
No. 2003AP1801 
16 
 
¶24 Having recognized a privilege inherent in the statute, 
the court sought to define its scope.  After considering the 
alternatives, the court adopted the test the Iowa Supreme Court 
articulated in Mason v. Robinson, 340 N.W.2d 236 (Iowa 1983).  
Under that test, absent a showing of compelling circumstances by 
the party seeking the testimony, a witness cannot be compelled 
to testify as an expert.  Alt, 224 Wis. 2d at 89.  If there are 
a number of people in a given field of expertise with similar 
knowledge, each capable of rendering an expert opinion on a 
particular question, then any one expert's opinion is not unique 
or "irreplaceable," and there is no compelling need for a 
particular expert's testimony.  Id. at 89. 
¶25 To compel an expert to testify involuntarily, a party 
must not only show a compelling need for the testimony but also 
present a plan of reasonable compensation.  Id.  The unwilling 
expert may only be compelled to give existing opinions and may 
not be asked to undertake additional preparation.  Id.; Glenn, 
269 Wis. 2d 575, ¶34.  
¶26 In Glenn we refined the privilege recognized in Alt.  
We reiterated that "there must be a link between a finding of 
compelling 
circumstances 
and 
the 
uniquely 
necessary 
or 
irreplaceable opinion testimony that the expert could provide."  
Glenn, 269 Wis. 2d 575, ¶30.  In Glenn, the expert, Dr. Charles 
Koh, was a gynecologist who treated the patient, Glenn, and 
based on his observations, recommended that she sue one of her 
former providers for negligent and unnecessary treatments.  Id., 
¶¶7, 17.  However, Dr. Koh refused to provide expert testimony 
No. 2003AP1801 
17 
 
at trial, and even wrote a letter to the court noting that few 
doctors would want to serve as an expert witness against another 
local physician.  Id., ¶7.5  This court refused to compel Dr. 
Koh's testimony, holding that other gynecologists could provide 
testimony as to the applicable standard of care.  Id., ¶¶2, 30.   
¶27 However, the court was careful to note that Dr. Koh 
might still have to testify at trial: 
Even if Koh is not required to give expert 
opinion testimony in this case, he may be compelled to 
testify as to his observations as Glenn's treating 
physician.  Such compulsion is considerably different 
than forcing a physician to testify as to the standard 
of 
care 
and 
treatment 
provided 
by 
another 
physician. . . .  [W]e emphasize that a physician can 
be required to testify 
as to 
his or 
her own 
observations regarding his or her care and treatment 
provided to the patient while serving as the patient's 
treating physician. 
Glenn, 269 Wis. 2d 575, ¶31. 
¶28 The decision in Alt has generated some confusion and 
controversy.  Some of that confusion was addressed last term in 
Glenn, where we emphasized the duty of any medical witness to 
testify as to the facts.  A medical witness may be asked about 
her own conduct relevant to the case, including her observations 
and thought processes, her treatment of the patient, why she 
took or did not take certain actions, what institutional rules 
and regulations she believed applied to her conduct, and her 
                                                 
5 Cf. Griffith v. Harris, 17 Wis. 2d 255, 116 N.W.2d 133 
(1962).  Dr. Koh's concern is even more pressing here, where the 
unwilling experts are not only members of the same local medical 
community, but also work (or worked) in the same office. 
No. 2003AP1801 
18 
 
training and education pertaining to the relevant subject.  
Every person has a right to this factual evidence.  See Alt, 224 
Wis. 2d at 88.   
¶29 To illustrate the sort of fact questions that a 
medical witness must answer, we cite the following exchange from 
Avery's deposition: 
Q: At that point did you have, after you checked her 
pulse, did you have any suspicion as to why it was 
that she had no pulse? 
A: There was a lot of things that I surmised that I 
thought was going on. 
Q: What did you surmise? 
A: I thought there was something——I was wondering if 
there was something wrong with the vent.  I was 
wondering if she was having a seizure.  It looked like 
something neuro was going on.  If she was having a 
stroke with the past history of the shunt that she had 
problems with.  And then I was wondering if there was 
something cardiac that I didn't know about. 
As a general rule, questions relating to a medical witness's 
thought processes during an incident are not objectionable.   
¶30 Moving to a second category of witness, the heart of 
the Alt opinion is that a medical witness who is unwilling to 
testify as an expert cannot be forced to give her opinion of the 
standard of care applicable to another person or her opinion of 
the treatment provided by another person.   
¶31 Alt deemed this ability to refuse to give an expert 
opinion 
a 
privilege. 
 
There 
are 
several 
policy 
reasons 
underlying this "privilege." 
No. 2003AP1801 
19 
 
¶32 Early on, there were two distinct schools of thought 
about "expert" witnesses.  One was to treat them the same as lay 
witnesses, requiring them to come to court as a duty of 
citizenship and testify for a statutory witness fee.  This was 
the rule in Philler v. Waukesha County, 139 Wis. 211, 120 N.W. 
829 (1909), where a "competent physician" was engaged by a 
criminal 
defense 
attorney 
to 
make 
a 
"careful 
medical 
examination" of the defendant and then testify as an expert 
witness.  The county refused to pay the physician more than 
$1.50 per day, the statutory witness fee.  The county's refusal 
was upheld, and the same archaic law was still being applied in 
1947.  Bergstrom Paper Co. v. Cont'l Ins. Co., 7 F.R.D. 548 
(E.D. Wis. 1947).  The opposing view was well stated in Ex parte 
Roelker, 20 F. Cas. 1092 (D. Mass. 1854) (No. 11995), where the 
court said: 
When a person has knowledge of any fact pertinent to 
an issue to be tried, he may be compelled to attend, 
as a witness.  In this, all stand upon equal ground.  
But to compel a person to attend, merely because he is 
accomplished in a 
particular science, 
[art], or 
profession, would subject the same individual to be 
called upon, in every cause in which any question in 
his department of knowledge is to be solved.  Thus, 
the most eminent physician might be compelled, merely 
for the ordinary witness fees, to attend from the 
remotest part of the district, and give his opinion in 
every trial in which a medical question should arise.  
This is so unreasonable, that nothing but necessity 
can justify it. 
This policy determination is reflected in Alt, where the court 
concluded that the law stated in Philler is no longer valid.  
Alt, 224 Wis. 2d 72, ¶37.   
No. 2003AP1801 
20 
 
 
¶33 A second policy reason underlying the privilege was 
echoed in Glenn when Dr. Koh stated his reluctance to testify 
against a local physician.  Glenn, 269 Wis. 2d 575, ¶17.  There 
is a heavy strain on the relationships in a hospital, clinic, or 
other health care facility when one health care provider is 
required to make a public assessment under oath about another 
health 
care 
provider's 
professional 
performance. 
 
People 
understand a requirement that a witness must divulge facts; they 
are often more sensitive to a colleague's critical opinion.  The 
resulting 
tension 
can 
destroy 
friendships, 
working 
relationships, and economic relationships.  In the absence of 
necessity, there are practical reasons to avoid these familiar 
human problems by not requiring non-essential opinion testimony 
from certain witnesses.  Again, Alt incorporated this rationale.   
 
¶34 A third closely related policy reason is that the 
relationships among local health care providers may affect the 
objectivity of their testimony.  Some witnesses may have a 
financial stake in the outcome of malpractice litigation.  As a 
result, they may shade their testimony to advance their own 
interests, guard their own reputations, or protect their co-
workers. 
¶35 Hence, unless the circumstances are exceptional, a 
medical witness who is unwilling to testify as an expert should 
not be required to give her opinion on the standard of care 
applicable to another person or be asked to second-guess another 
person's performance.  In most fields, the answers to questions 
No. 2003AP1801 
21 
 
of this nature are not "unique" or "irreplaceable."  Another 
"expert" in the appropriate field could answer such questions.6   
¶36 This 
brings 
us 
to 
the 
third 
category, 
medical 
witnesses who have been accused of malpractice——negligence 
causing injury——who may be party defendants.   
¶37 Medical malpractice cases require expert testimony to 
establish the standard of care.  Kuehnemann v. Boyd, 193 Wis. 
588, 214 N.W. 326 (1927).  At trial, the plaintiff must 
establish the standard of care, show that the defendant failed 
to conform to the standard of care, and prove that the 
defendant's failure to conform to the standard of care caused 
the plaintiff's injury.  Olfe v. Gordon, 93 Wis. 2d 173, 180, 
286 N.W.2d 573 (1980). 
¶38 A strong case can be made for the proposition that a 
defendant witness should not be required to address her own 
standard of care and that a finder of fact should compare the 
                                                 
6 At oral argument, plaintiff's counsel protested that the 
Alt holding means that a party could be forced to "pay $2000 per 
hour" to fly in an expert if that expert and the witness are the 
only experts in the field.   
We note that plaintiff named numerous independent experts.  
Plaintiff's "Notice of Expert Witnesses" listed several medics 
from Eau Claire Fire & Rescue; "employees of Apria," a home 
medical equipment supplier; four medical doctors from Luther 
Hospital 
in 
Eau 
Claire; 
five 
medical 
doctors 
from 
the 
Minneapolis Children's Medical Center; three registered nurses; 
a medical doctor from Cardio-Medicine, Ltd. in Minneapolis; and 
the school nurse on duty at Carney-Hayes' school at the time of 
the incident.   
 
No. 2003AP1801 
22 
 
defendant's required factual explanation of her own actions and 
thought processes to the standard of care established by other 
experts in the field, to determine whether there was negligence. 
¶39 Nonetheless, the rule in this state since Shurpit v. 
Brah, 30 Wis. 2d 388, 141 N.W.2d 266 (1966), has been otherwise: 
The 
plaintiff 
was 
permitted, 
both 
on 
adverse 
examination and in cross-examination, to inquire into 
what the defendant did in examination and treatment 
but was not allowed to inquire as to Dr. Brah's 
opinion as to the cause or proper treatment in view of 
the history and his examination of the plaintiff. 
 
We do not perceive that plaintiff should have 
been so limited under our adverse examination statute. 
 
. . . .  
 
While we recognize the trial court has some 
discretion in the scope and extent of the cross-
examination of a witness, we deem it was error to 
prohibit 
cross-examination 
of 
the . . . defendant, 
upon the sole ground that it called for an opinion of 
the witness. 
Id. at 397, 399. 
 
¶40 Shurpit cited and quoted extensively from Lawler v. 
Calaway, 147 P.2d 604 (Cal. 1944), and McDermott v. Manhattan 
Eye Hospital, 203 N.E.2d 469 (N.Y. 1964).  Innumerable cases 
could be cited supporting this rule, including Anderson v. 
Florence, 181 N.W.2d 873 (Minn. 1970), and Jistarri v. Nappi, 
549 A.2d 210 (Pa. 1988), both of which cite Shurpit.  See also 
88 A.L.R.2d 1186 (1963), "Right To Elicit Expert Testimony From 
Adverse Party Called As Witness." 
 
¶41 The Minnesota court's thinking was set out at length 
in Anderson: 
No. 2003AP1801 
23 
 
 
The medical malpractice action is a unique and 
difficult type of lawsuit.  It is usually more bitter 
and contentious than an ordinary negligence suit and 
its effect on litigants is often profound. . . .  
 
Not only are medical malpractice actions unique; 
the defendant physician . . . is in a unique position.  
He is called upon to fill three possible roles during 
discovery and at trial, namely, those of an adverse 
party, an eyewitness, and an expert witness.  As the 
adverse party, he, like plaintiff, can be required to 
testify both before and at trial as fully on material 
matters as any witness in any civil action. . . .  
 
A defendant physician in a medical malpractice 
suit is also an eyewitness and often the only person 
with firsthand knowledge of critical evidence.  As 
such, he can be required to testify to facts coming 
under 
his 
observation 
during 
performance 
of 
professional duties. . . .   
[An expert witness] is the third role defendant is 
asked to assume.  To testify as an expert, a witness, 
whether a nonparty or an adverse party, must be 
qualified, i.e., found competent in the special skill 
or knowledge about which he is to testify.  According 
to the agreed statement of facts in this case, 
defendant is a "duly qualified and licensed physician 
and surgeon in the State of Minnesota, specializing in 
the field of orthopedic surgery."  This stipulation 
compels us to accept defendant as qualified to answer 
the questions propounded despite the implication that 
plaintiff, by instituting this action, is challenging 
his expertise. 
 . . .  Some courts have considered it unfair and 
contrary to the purpose of the adverse-witness rule to 
allow one party to prove his case by the opposing 
party's expert testimony.  In one sense this argument 
is akin to the concept that a party to a law-suit 
should establish his case in a "sporting" manner.  But 
in malpractice actions the argument assumes a slightly 
different 
and 
more 
specific 
quality: 
It 
is 
unreasonable and unfair to allow a plaintiff in a 
malpractice action to elicit expert testimony from the 
defendant 
whose 
expertise 
he 
is 
attempting 
to 
condemn. . . .  The courts assert that the question of 
unfairness to individuals should not be controlling, 
No. 2003AP1801 
24 
 
since the inquiry is directed to one who has been a 
participant in the occurrence and withholding relevant 
testimony by litigants obstructs the administration of 
justice. . . .  Furthermore . . . the purpose of the 
adverse-party-witness 
rule 
"is 
to 
permit 
the 
production in each case of all pertinent and relevant 
evidence that is available from the parties to the 
action."  . . . As the New York court recognized, the 
usual and customary medical procedures and whether 
defendant deviated therefrom are certainly "pertinent 
and relevant" to a malpractice action. 
Anderson, 181 N.W.2d at 878-79. 
 
¶42 In affirming the rule in Shurpit, we understand that a 
plaintiff may be motivated to name a medical witness as a 
defendant or otherwise accuse the medical witness of causal 
negligence in order to transform the person from an Alt witness 
(who is not required to give expert opinions) to a Shurpit 
witness who is so required.  It is improper to name a person a 
party defendant for the purpose of eliciting an expert opinion 
from the person, because such a person will not be compensated 
as an expert, will have to spend time preparing for testimony as 
an expert, and will normally have to retain counsel.  Courts 
should not permit litigants to make end runs around Alt and 
Glenn by using this tactic.  Accordingly, the circuit court may 
assess the reasonableness and good faith of a decision to make a 
person a Shurpit witness by naming the person as a defendant or 
otherwise accusing the witness of causal negligence. 
 
¶43 The Minnesota court justified its "Shurpit" rule, in 
part, saying, "To testify as an expert, a witness . . . must be 
qualified, i.e., found competent in the special skill or 
knowledge about which he is to testify."  Id. at 878.  It added: 
No. 2003AP1801 
25 
 
"It should be emphasized that a defendant physician's general 
expertise is not on trial or in issue; the question to be 
resolved is whether his conduct and medical judgment in a 
particular case amounted to a professional mistake."  Id. at 
879.  We agree. 
 
¶44 Normally plaintiff's counsel will attempt to discredit 
a medical defendant or other medical witness accused of 
negligence and diminish the effect of the person's testimony by 
challenging the person's reliability, expertise, intelligence, 
and veracity 
in adverse 
examination 
or cross-examination.  
Another goal of counsel will be to prove the plaintiff's case 
through the defendant's "expert" testimony.  The sport in 
turning a defendant's words against her could alter the focus of 
the trial.7 
 
¶45 The circuit court must assure that a defendant/witness 
from whom expert testimony is required is not asked to give 
opinions on subjects beyond the witness's competence.  In other 
words, the witness must be qualified to answer each question 
asked.  Wis. Stat. § 907.02.  The court may also employ 
evidentiary 
rules 
including 
Wis. Stat. §§ 904.02 
(relevant 
evidence; irrelevant evidence), 904.03 (exclusion of relevant 
evidence on grounds of prejudice, confusion), and 906.11 (mode 
and order of interrogation and presentation; control by judge) 
to maintain the focus of a medical malpractice trial on whether 
                                                 
7 See, e.g., Alan T. Radnor, Cross-Examining Doctors: A 
Practical Guide § 1.04, at 8-9 (1999). 
No. 2003AP1801 
26 
 
the defendant conformed to the applicable standard of care, as 
provided in the appropriate jury instruction, not whether the 
defendant performed well as an expert witness.  After all, the 
purpose of the defendant's required testimony is to aid in the 
search for truth. 
APPLICATION 
¶46 With these guidelines in mind, we turn to the three 
medical witnesses in this case who were unwilling to testify as 
experts. 
¶47 The first medical witness, Kathy Avery, is a named 
defendant and is accused of causal negligence.  She was Carney-
Hayes' primary home care nurse.  Avery was with Carney-Hayes 
during the incident underlying the lawsuit, and her actions are 
of critical importance in determining whether the suit will 
succeed.  Under these circumstances, Avery must testify about 
her own conduct relevant to the case, including her observations 
and thought processes, her treatment of the patient, why she 
took or did not take certain actions, what institutional rules 
and regulations she believed applied to her conduct, and her 
training and education pertaining to the relevant subject.  An 
examination of the deposition transcript shows that she did so.  
See supra ¶¶ 9, 29.  As we have noted, Avery was extensively 
questioned about her education and training, and gave a detailed 
description of the events during the incident, including her 
observations, her actions, and her rationale for her behavior.   
¶48 Further, Avery was asked a series of questions 
intended to determine the extent of her knowledge about 
No. 2003AP1801 
27 
 
ventilator-dependent 
patients, 
many 
of 
which 
included 
hypothetical questions and called for opinion answers.  Avery 
answered all these questions without objection.  The following 
exchange illustrates some of these questions: 
Q: Did they give you any instruction at all as to what 
you should be doing once that high pressure alarm 
would go off on a ventilator dependent patient?  
A: I don't remember any formal instructions.  The 
first thing would be always to check the patient. 
Q: And when you say check the patient, what do you 
mean by check the patient? 
A: Check for color, check to——overall assessment to 
see how they're doing. 
Q: After having made that assessment, what would be 
the next step? 
A: Just——well, it depends on what their assessment 
was. 
 If it didn't 
sound like 
they 
needed 
a 
suctioning, there was no secretions, their color was 
pink, they were alert, you would probably silence the 
alarm. 
¶49 Then plaintiff's counsel attempted to question Avery 
about the appropriate standard of care.  We conclude that Avery 
was required to answer questions about the standard of care 
governing her conduct because she is accused of negligence and 
is central to the case.   
¶50 We affirm the circuit court on this question but for 
different reasons.  The Alt privilege does not apply to Avery 
because, as a defendant accused of causal negligence, she is a 
Shurpit witness.   
 
No. 2003AP1801 
28 
 
JODENE VERBRACKEN 
 
¶51 Jodene Verbracken was Northwest's "case manager" for 
Carney-Hayes and had previously been a direct caregiver for her.  
She must testify as to her own conduct in preparing the 
Northwest "plan of care" for Carney-Hayes.  She must testify 
regarding references she used in preparing that plan and why she 
felt the plan was appropriate for Carney-Hayes.  If relevant, 
she must testify about her past care of the plaintiff.  However, 
she cannot be forced to testify to the general standard of care 
for preparing a similar plan of care, nor may she be forced to 
testify whether she believes Avery's conduct conformed to the 
standard of care.   
 
¶52 We tend to see Verbracken as an Alt witness.  Like Dr. 
Acosta and Dr. Koh, Verbracken had provided direct care to the 
patient but was not present at the time of the unfortunate 
incident.  Her expert opinion is not unique or irreplaceable.  
No exceptional circumstances require her testimony.8   
 
¶53 Verbracken is not accused of causal negligence.  In 
discovery, the plaintiff obtained the plan of care that 
Verbracken prepared for Carney-Hayes and Verbracken must explain 
that plan of care.  Verbracken is not a unique or irreplaceable 
witness for establishing the standard of care for such plans.   
                                                 
8 "[I]t is a well-settled rule of law that employee-experts 
who acquire information for trial solely because they were 
actors or viewers with respect to the occurrences forming the 
subject matter of the lawsuit must be treated as ordinary fact 
witnesses, and not as experts."  Young, 181 F.R.D. at 346. 
No. 2003AP1801 
29 
 
¶54 Although a case manager may be negligent in preparing 
a plan of care, it is not evident from the limited record before 
us whether Carney-Hayes is alleging that Verbracken negligently 
prepared the care plan.  We are unwilling to permit the mere 
possibility of such an allegation to transform a normal Alt 
witness into a Shurpit witness and require that witness to 
assume burdens beyond the burden of being a fact witness. 
 
¶55 An Alt witness who is unwilling to testify as an 
expert may not be compelled to answer a hypothetical question 
aimed at establishing the witness's perception of her own 
standard of care or a general standard of care.  Such a question 
would be akin to the question we held impermissible in Alt: 
whether a gush of blood is abnormal under any circumstances in 
an expectant mother with a history of term pregnancy.  It can 
often be transposed into the standard of care applicable to 
another person, pitting one against the other. 
 
¶56 We 
note 
that 
impermissible 
questions 
about 
the 
standard of care, phrased hypothetically or otherwise, may 
easily be transformed into permissible questions about the 
specific 
conduct 
of 
the 
medical 
witness. 
 
For 
example, 
plaintiff's counsel asked Verbracken the following impermissible 
question:  
Q: Does the standard of care require that this care 
plan be reviewed and periodically updated? 
 
¶57 The 
question 
would 
have 
been 
permissible 
if 
plaintiff's counsel had instead asked: 
No. 2003AP1801 
30 
 
Q: Did you periodically update and review the care 
plan for Amanda Carney-Hayes? 
In fact, plaintiff's counsel asked——and Verbracken answered——a 
similar question: 
Q: And does Northwest require that this care plan be 
reviewed and updated on some periodic basis? 
A: Yes. 
Q: How frequently is the care plan, first of all, to 
be reviewed? 
A: I don't recall for sure, but I believe it was on a 
monthly basis. 
 
¶58 After a medical witness has described her own conduct, 
the plaintiff may establish the applicable standard of care 
through independent experts, and then show that the person's 
conduct did not meet that standard.  Thus, hypothetically, if 
the plaintiff's experts established that a care plan should be 
reviewed weekly, Verbracken's testimony quoted in the preceding 
paragraph would show that Northwest's monthly updates did not 
satisfy the standard of care. 
 
¶59 On the basis of the record in front of us, the circuit 
court erred in requiring Verbracken to answer questions about 
the standard of care "with respect to the plan of care, its 
preparation, its maintenance, and how it should be followed."  
Nonetheless, in light of this decision, we remand this case to 
the circuit court so that the plaintiff has the opportunity to 
allege that Verbracken is a Shurpit witness because she was 
negligent or the plan of care she prepared was defective. 
 
No. 2003AP1801 
31 
 
CHERYL FONTAINE 
 
¶60 Cheryl Fontaine is Northwest's "Director of Extended 
Care Services."  She must testify about her own actions, any 
training she provided to Avery, and any of Northwest's corporate 
training standards she believed governed her actions.  However, 
she cannot be forced to testify to the general standard of care 
required of a nursing supervisor, nor may she be forced to 
testify whether she believes Avery's conduct conformed to the 
applicable standard of care.  On Fontaine's testimony, we affirm 
the circuit court. 
CONCLUSION 
¶61 We reaffirm our decisions in Alt and Glenn and take 
this opportunity to clarify the duties and privileges of 
witnesses in a medical malpractice case.  (1) A medical witness 
must testify about her own conduct relevant to the case, 
including her observations and her thought processes, her 
treatment of the patient, why she took or did not take certain 
actions, what institutional rules she believed applied to her 
conduct, and her training and education pertaining to the 
relevant subject.  (2) Subject to the compelling need exception 
recognized in Alt and Glenn, a medical witness who is unwilling 
to testify as an expert cannot be forced to give her opinion of 
the standard of care applicable to another person or her opinion 
of the treatment provided by another person.  Unless a medical 
witness who is unwilling to testify as an expert is alleged to 
have caused injury to the plaintiff by her medical negligence, 
the witness is not required to give her opinion on the standard 
No. 2003AP1801 
32 
 
of care governing her own conduct.  (3) A medical witness who is 
alleged to have caused injury to the plaintiff by her medical 
negligence may be required to give her opinion on the standard 
of care governing her own conduct.  A witness in this category 
may be a party defendant.  However, no medical witness may be 
named a party defendant for the purpose of eliciting the 
witness's expert opinion.  The circuit court may assess whether 
there is a reasonable basis for naming a medical witness as a 
party defendant.  The court should assure that any medical 
witness from whom expert opinion is required is qualified to 
testify as an expert, pursuant to Wis. Stat. § 907.02.  The 
court may employ evidentiary rules, including §§ 904.02, 904.03, 
and 906.11 to maintain the focus of a medical malpractice trial 
on whether the defendant conformed to the standard of care, not 
whether the defendant performed well as an expert witness. 
¶62 We affirm the circuit court's evidentiary rulings with 
respect to Kathy Avery and Cheryl Fontaine.  We reverse the 
circuit court's evidentiary ruling with respect to Jodene 
Verbracken.  By misapplying our holdings in Alt and Glenn with 
respect to Verbracken, the circuit court erroneously exercised 
its discretion.  We remand the cause for further proceedings 
consistent with this opinion. 
By the Court.—The orders of the circuit court are affirmed 
in part and reversed in part and the cause is remanded. 
 
 
No.  2003AP1801.jpw 
 
1 
 
 
¶63 JON P. WILCOX, J.   (concurrence).  Although I agree 
with the result the majority opinion reaches, I write separately 
because I believe the majority opinion and concurrence/dissent, 
in their attempt to explore the boundaries of the expert 
privilege recognized by this court in Burnett v. Alt, 224 
Wis. 2d 72, 589 N.W.2d 21 (1999), and reaffirmed last term in 
Glenn v. Plante, 2004 WI 24, 269 Wis. 2d 575, 676 N.W.2d 413, 
may be losing sight of the forest through the trees.  Thus, I 
write separately to set forth some clear rules regarding the 
analysis to be employed in applying the expert privilege, in 
hopes of providing guidance to litigants and judges dealing with 
this seemingly difficult area of the law.  
¶64 I begin by restating a basic proposition recognized by 
Justice Butler's concurrence/dissent:  experts in Wisconsin are 
qualified on a question-by-question basis.  Justice Butler's 
concurrence/dissent, ¶101 (quoting 7 Daniel D. Blinka Wisconsin 
Practice:  Wisconsin Evidence § 702.4, at 490 (2d ed. 2001)).  
The first step in the Alt analysis is thus whether the question 
posed to the witness calls for an expert opinion.  Alt, 224 
Wis. 2d at 82.  "A question asks for expert testimony if it 
requires 
'scientific, 
technical, 
or 
other 
specialized 
knowledge,' 
Wis. Stat. § 907.02 
(1993-94), 
to 
answer 
the 
question."  Id. at 83 (footnote omitted).   
¶65 If the question does not call for an expert opinion, 
but rather asks a witness to testify as to his or her personal 
observations——i.e., calls for a witness to testify as to facts——
No.  2003AP1801.jpw 
 
2 
 
the Alt privilege does not apply.  Id. at 87 (noting that even 
under the absolute privilege the court ultimately rejected, "the 
witness is only required to testify regarding his or her 
observations, just as any other witness"); id. at 87 (noting 
that under the qualified privilege the court adopted, a witness 
cannot, absent compelling circumstances, be forced "to give 
expert testimony")(emphasis added); id. at 90 (ruling that Dr. 
Acosta must testify "as to his observations" regarding the 
prenatal care he provided to Dawn Alt).  See also, Glenn, 269 
Wis. 2d 575, ¶2 (clarifying that "Alt does not apply to 
observations made by a person's treating physician . . . but 
rather applies to expert testimony . . . "); id., ¶28 ("[A] 
treating physician may still be required to testify regarding 
his or her observations relating to the care or treatment 
provided to his or her patient[.]").   
¶66 If, on the other hand, the question calls for expert 
testimony, then the witness has a qualified privilege to refuse 
to answer the question.  Alt, 224 Wis. 2d at 89 ("[W]e hold that 
absent a showing of compelling circumstances, an expert cannot 
be compelled to give expert testimony whether the inquiry asks 
for the expert's existing opinions or would require further 
work.").  See also Glenn, 269 Wis. 2d 575, ¶26 (reaffirming the 
qualified privilege set forth in Alt).   
¶67 The difficulty in applying Alt and Glenn is apparently 
determining of what constitutes "compelling circumstances."  In 
Glenn, we clarified that "[t]he compelling circumstances should 
focus on whether there is unique or irreplaceable opinion 
No.  2003AP1801.jpw 
 
3 
 
testimony 
sought 
from 
an 
expert . . . ." 
 
Glenn, 
269 
Wis. 2d 575, ¶2 (emphasis added).  However, it is often asserted 
that there is a compelling need for a witness to provide an 
expert opinion because they have unique factual knowledge based 
on their personal observations.  See, e.g., Justice Butler's 
concurrence/dissent, ¶96 n.6.  In my opinion, such assertions 
confuse the second prong of the Alt inquiry with the first 
prong.   
¶68 As already discussed, the Alt privilege does not apply 
to questions that call for non-expert testimony, i.e., factual 
knowledge.  "'[U]nlike factual testimony, expert testimony is 
not unique and a litigant will not be usually deprived of 
critical evidence if he cannot have the expert of his choice.'"  
Alt, 
224 
Wis. 2d at 
89 
(quoting 
Mason 
v. 
Robinson, 
340 
N.W.2d 236, 242 (Iowa 1983)).  When courts are analyzing whether 
compelling circumstances are present, they must have necessarily 
already determined that the question calls for expert testimony, 
not factual knowledge.  As noted by this court in Alt:  "An 
expert's testimony is generally based on applying the expert's 
specialized knowledge to a certain set of facts to then draw 
conclusions and render an opinion."  Id. at 88-89.   
¶69 Because witnesses are qualified on a question-by-
question basis, the fact that an expert witness may also have 
unique factual knowledge due to his or her personal observations 
simply has no bearing on whether there is a compelling need for 
his or her answer to a question calling for an opinion based on 
those facts.  This is so because regardless of whether there are 
No.  2003AP1801.jpw 
 
4 
 
compelling circumstances so as to force an expert to provide an 
opinion in response to a question, a witness is always required 
to provide factual testimony under Alt and Glenn.  "Even if Koh 
is not required to give expert opinion testimony in this case, 
he may be compelled to testify as to his observations as Glenn's 
treating physician."  Glenn, 269 Wis. 2d 575, ¶31 (emphasis 
added).  The pertinent question is whether there is a compelling 
need 
for 
a witness' expert 
opinion 
regarding 
a set of 
established facts.   
¶70 This conclusion was explicitly recognized by the court 
in Alt:  
Dr. Acosta may be unique with respect to the prenatal 
care provided to Dawn Alt and he must testify as to 
his observations in that role.  However, he does not 
appear to be unique with respect to the question asked 
[whether it was abnormal for a patient with a history 
of term pregnancy to have a gush of blood].  Dr. 
Acosta's prenatal care of Dawn Alt and authoring her 
discharge summary make him no more and no less 
qualified than any other obstetrician to give an 
expert opinion about whether a gush of blood in a 
patient who has a history of term pregnancy is 
abnormal. 
Alt, 224 Wis. 2d at 90 (emphasis added).  Thus, the fact that a 
witness has crucial factual testimony regarding his or her own 
observations is irrelevant for purposes of determining whether 
there is a compelling need for his or her expert opinion 
regarding the significance of those facts.   
 
¶71 The appropriate inquiry as to whether compelling 
circumstances are present focuses "on whether there is unique or 
irreplaceable opinion testimony sought from an expert . . . ."  
Glenn, 269 Wis. 2d 575, ¶2 (emphasis added).  As we stated in 
No.  2003AP1801.jpw 
 
5 
 
Alt, 224 Wis. 2d at 89:  "As appears to be the case here, there 
can be a number of people within a field with similar 
specialized knowledge capable of rendering an expert opinion on 
the question or questions asked.  In such instance, the opinion 
of one particular expert is not irreplaceable."  (Emphasis 
added.)   
 
¶72 In other words, under Alt and Glenn, a doctor or nurse 
is always required to answer questions relating to his or her 
personal observations or factual knowledge concerning the care 
of a particular patient.  Alt and Glenn simply do not apply to 
questions calling for factual testimony.  The same witness may 
be forced to answer a question calling for the witness to render 
an expert opinion based on those facts, if there is a compelling 
need for such testimony.  A compelling need is present if such 
testimony is irreplaceable, such as when there are not other 
individuals in the relevant field qualified to answer the 
question.  Conversely, if there are "a number of people within a 
field with similar specialized knowledge capable of rendering an 
expert opinion on the question or questions asked[,] . . . the 
opinion of one particular expert is not irreplaceable[,]" Alt, 
224 Wis. 2d at 89, and compelling circumstances are not present.  
Further, the fact that a witness qualified as an expert may have 
unique factual knowledge in the form of personal observations 
regarding the care and treatment of a patient "make[s] him [or 
her] no more and no less qualified than any [expert in the 
relevant field] to give an expert opinion about [those facts]."  
Id. at 90.  Finally, the "procedural aspects of the case" have 
No.  2003AP1801.jpw 
 
6 
 
no bearing on whether compelling circumstances are present.  
Glenn, 269 Wis. 2d 575, ¶2.   
 
¶73 If such compelling circumstances are present, then the 
witness may be forced to render an expert opinion if two 
additional requirements are met.  First, the party seeking 
testimony must present a plan for reasonable compensation for 
the expert.  Id., ¶2; Alt, 224 Wis. 2d at 89.  Second, the 
expert can be compelled only to provide existing opinions and 
cannot be required to do additional preparation.  Glenn, 269 
Wis. 2d 575, ¶2; Alt, 224 Wis. 2d at 89.  Thus, if the witness 
has not formed the opinion necessary to answer the question and 
would be required to perform additional work to render such an 
opinion, his or her testimony as to that opinion may not be 
compelled.   
 
¶74 In sum, a proper Alt/Glenn analysis is as follows:  1) 
Does the question call for the witness to render expert 
testimony or simply answer a factual question based on personal 
knowledge and/or observation?; 2) If the question calls for the 
witness to render an expert opinion, are there compelling 
circumstances for such testimony independent of the procedural 
posture of the case or any factual testimony the witness may 
have provided, such as where there are no other individuals 
qualified to render the opinion for which the question asks?; 3) 
Has the party requesting the testimony provided a reasonable 
plan of compensation?; and 4) Will the witness be required to 
perform additional work in order to develop an opinion he or she 
has not yet formed?   
No.  2003AP1801.jpw 
 
7 
 
 
 
No.  2003AP1801.awb 
 
1 
 
 
 
¶75 ANN 
WALSH 
BRADLEY, 
J.   (concurring 
in 
part, 
dissenting in part).  This court's decision in Burnett v. Alt, 
224 Wis. 2d 72, 589 N.W.2d 21 (1999) left much uncertainty in 
its wake.  Seminars were conducted to explore its meaning, 
committees were established to curb the abuses proliferating 
from its application, and articles from both the defense bar and 
plaintiffs' bar appeared decrying the confusion.9 
                                                 
9 For example: 
• State Bar of Wisconsin Litigation Section, Litigation News, 
Vol. 30, No. 1, Winter 2004 (litigation section board 
activities in 2004 included "[r]eviewing practice issues 
and abuses arising from application of the decision in 
Burnett v. Alt"). 
• 2004 Tort Seminar, sponsored by Wisconsin Academy of Trial 
Lawyers, December 3 & 4, 2004 (Friday Morning Sessions - 
"Hot Topics":  8:30 a.m. Alt v. Cline - presentation by 
Lynn R. Laufenberg). 
• Michael P. Russart, Just the Facts, Ma'am:  Glenn v. Plante 
and the Reluctant Expert, Wisconsin Civil Trial Journal, 
Fall 2004. 
• Minutes of the State Bar Board of Governors, July 11, 2003, 
p. 4 (President Burnett appointed committee to "study and 
report on . . . special problems presented by Alt v. 
Cline."). 
• State 
Bar 
of 
Wisconsin 
Litigation 
Section 
Board 
of 
Directors Minutes, Teleconference, June 30, 2003 ("It was 
agreed by those present that the interpretation being given 
Alt by physicians and other experts as well as trial and 
appellate courts affected all litigation practitioners 
within the state.  A request from the State Bar was 
received for funding of a committee chaired by Attorney 
Marie Stanton of Madison to study the Alt issue with an eye 
towards proposing a new rule or legislation needed to 
remediate the Alt interpretations."). 
• Timothy J. Aiken, David M. Skoglind and William C. 
Gleisner, III, Why Alt v. Cline Violates the Constitutional 
Rights of Plaintiffs, Wisconsin Academy of Trial Lawyers, 
"The Verdict," (Vol. 26:3, Summer 2003). 
No.  2003AP1801.awb 
 
2 
 
¶76 We attempted to clarify the nature and extent of the 
Alt privilege in Glenn v. Plante, 2004 WI 24, 269 Wis. 2d 575, 
676 N.W.2d 413.  There, we announced that "Alt does not apply to 
observations made by a person's treating physician regarding the 
care and treatment provided to the patient, but rather applies 
to expert testimony from such a physician as to the standard of 
care and treatment provided by another physician."  Glenn, 269 
Wis. 2d 575, ¶2. 
¶77 Now the instant case is before us, again requiring 
clarification of the Alt doctrine.  Unfortunately, rather than 
clarify, the majority has added to the confusion.  With this 
opinion, lower courts and practicing attorneys are left with 
something just short of a Byzantine maze.  Accordingly, I write 
separately to express regret for not only what the court is 
doing, but what it has failed to do. 
¶78 Here is what the court has done:  The bench and bar 
will have to learn new categories of witnesses.  The first is an 
ordinary "medical witness."  These witnesses must testify about 
their own conduct relevant to the case, including their 
observations and thought processes, treatment of the patient, 
why 
they 
took 
or 
did 
not 
take 
certain 
actions, 
what 
institutional rules they believed applied to their conduct, and 
their training and education pertaining to the relevant subject.  
Majority op., ¶5. 
                                                                                                                                                             
• Patrick O. Dunphy, Ramifications of Alt v. Cline, presented 
at the State Bar of Wisconsin Annual Convention Litigation 
Section, May 2, 2001.   
No.  2003AP1801.awb 
 
3 
 
¶79 The second category is an "Alt medical witness."  
Subject to the compelling need exception recognized in Alt, 
these witnesses cannot be forced to give their opinion of the 
standard of care applicable to another person or their opinion 
of the treatment provided by another person.  Id.  These 
witnesses also cannot be required to give an opinion on the 
standard of care governing their own conduct.  Id. 
¶80 Finally, the third category is a "Shurpit medical 
witness."  These witnesses differ from the previous two kinds in 
that they are alleged to have caused injury to the plaintiff by 
their medical negligence.  Id.  As a result, they may be 
required to give their opinion on the standard of care governing 
their own conduct.  Id.   
¶81 In addition, the majority sets forth duties for the 
circuit court.   It would have the circuit court "assess the 
reasonableness and good faith of a decision to make a person a 
Shurpit witness by naming the person as a defendant or otherwise 
accusing the witness of causal negligence."  Id., ¶42.  It 
mandates that the circuit court "assure that a defendant/witness 
from whom expert testimony is required is not asked to give 
opinions on subjects beyond the witness's competence."  Id., 
¶45.  The court explains that such a mandate means "[i]n other 
words, the witness must be qualified to answer each question 
asked." Id.  Additionally, the majority instructs that the 
circuit court "may employ evidentiary rules, including §§ 
904.02, 904.03, and 906.11 to maintain the focus of a medical 
malpractice trial on whether the defendant conformed to the 
No.  2003AP1801.awb 
 
4 
 
standard of care, not whether the defendant performed well as an 
expert witness."   Id., ¶5. 
¶82 Essentially the court has failed to clarify the Alt 
morass.  The majority opinion seems to raise more questions than 
it answers: 
• Does the opinion apply only to medical witnesses, or does 
it apply to all expert witnesses? 
• Even though an expert witness may not be required to 
opine on the standard of care question, can the witness 
still be required to give expert testimony in response to 
other questions? 
• Can an Alt witness be transformed into a Shurpit witness?  
Can a Shurpit witness be transformed into an Alt witness?  
How does such a transformation take place? 
• If a hospital is accused of causal negligence, why are 
not all of its agents/employees who worked with the 
patient potential Shurpit witnesses? 
• If the heart of the Alt opinion is that a medical witness 
cannot be forced to give her opinion of the standard of 
care applicable to another person, why cannot an Alt 
witness be asked to give an opinion of the standard of 
care applicable to herself? 
¶83 Ultimately, what the majority has failed to do is set 
forth a simple standard for all medical witnesses:  (1) No 
witness, except a voluntary expert witness, should be forced to 
testify about someone else's standard of care.  (2) Any witness 
may testify about his or her own standard of care regardless of 
No.  2003AP1801.awb 
 
5 
 
whether the person is a named party and regardless of any 
allegation of negligence, as long as that testimony is relevant. 
¶84 In light of the majority opinion, I have no doubt that 
Alt issues will continue to plague the litigants and courts of 
this state.  Inevitably we will see these issues again.  For the 
foregoing reasons, I respectfully concur in part and dissent in 
part. 
¶85 I am authorized to state that Chief Justice SHIRLEY S. 
ABRAHAMSON and Justice LOUIS B. BUTLER join this opinion.   
No. 2003AP1801.lbb 
 
1 
 
 
 
  
¶86 LOUIS B. BUTLER, JR., J.  (concurring in part, 
dissenting in part).  I respectfully dissent in part.  I would 
conclude that Carney-Hayes should be allowed to ask two of the 
witnesses here, Avery and Verbracken, about their own standards 
of care, provided Carney-Hayes can qualify them as experts.  I 
would conclude that the answers to these questions are not 
privileged under Burnett v. Alt, 224 Wis. 2d 72, 589 N.W.2d 21 
(1999), and this court's decision just last term in Glenn v. 
Plante, 2004 WI 24, 269 Wis. 2d 575, 676 N.W.2d 413. 
¶87 Before jumping into 
the 
analysis, 
the 
following 
background provides context.  Carney-Hayes has filed suit 
against Northwest Wisconsin Homecare, Inc., and Avery.  Carney-
Hayes has alleged that on April 7, 1999, Carney-Hayes suffered 
injury while under the custody, care, supervision, and/or 
treatment of Avery.  Carney-Hayes alleged that her injuries and 
resulting damages were caused by negligence of Northwest, its 
agents, servants, ostensible agents, and/or employees, and/or 
Kathy Avery. 
¶88 During discovery, the following disputes arose: 
 
Carney-Hayes 
wants 
to 
ask 
Avery 
(Carney-Hayes' 
registered nurse) about her standard of care. 
   
Carney-Hayes wants to ask Verbracken (Carney-Hayes' 
case manager who wrote Carney-Hayes' plan of care) about 
her standard of care and about Avery's standard of care.   
 
Finally, 
Carney-Hayes 
wants 
to 
ask 
Fontaine 
(a 
supervisor responsible for Avery's training) about what a 
No. 2003AP1801.lbb 
 
2 
 
manager's standard of care was regarding orienting a 
nurse to a new patient and whether Avery acted according 
to the standard of care.10  
 
¶89 Turning to Alt, one of the issues in that case was 
whether an expert witness had a legal privilege to refuse to 
answer questions posed that required expert opinions.  Alt, 224 
Wis. 2d at 82.   In that case, Cline, an obstetrician, delivered 
a child, Cody Alt, after performing a cesarean section on the 
mother, Dawn Alt.  Id. at 79-80.  Cody sustained serious 
injuries from the delivery.  Id. at 80.  The Alts (Cody, Dawn, 
and the father, Mark), sued Cline for negligence.  Id.  The Alts 
named one of Cody's treating physicians, Acosta, as an expert.  
Id.  Acosta provided prenatal care to Dawn and wrote her 
discharge summary following Cody's birth, but he was not present 
at the delivery.  Id.  During discovery, the Alts asked Acosta a 
question that called for an expert opinion.  Id. at 81, 84.  
Specifically, the question was, "No matter what the cause, a 
patient with a history of term pregnancy and a gush of blood[,] 
                                                 
10 Carney-Hayes 
has 
not 
asked 
Fontaine 
any 
questions 
requiring expert opinions about her own conduct.  To the extent 
Carney-Hayes wants to ask Fontaine to levy opinions about 
another's standard of care, I agree that these questions fall 
under the Burnett v. Alt, 224 Wis. 2d 72, 589 N.W.2d 21 (1999), 
privilege.  If Fontaine were asked about her own standard of 
care, I would conclude that these questions are not privileged 
under Alt for the same reasoning that applies to Avery and 
Verbracken.  Before the answer to that question would be 
admissible, however, Carney-Hayes would have to first qualify 
Fontaine to answer the question and would have to proffer a 
theory of relevance.  Because Fontaine has not yet been asked 
about her own standard of care, it is academic to consider 
issues surrounding Fontaine at this time.   
No. 2003AP1801.lbb 
 
3 
 
that's abnormal?"  Id. at 81 (brackets in original).  Acosta 
refused to answer the question.11 
¶90 This court recognized that as a general rule, no 
person has a privilege to refuse to give evidence.12  Id. at 84.  
The Alt court also recognized that "[p]rivileges are the 
exception, not the rule."  Id. at 85.  
¶91 Nevertheless, this court found an implicit expert-
privilege in Wis. Stat. § 907.06(1).  Alt, 224 Wis. 2d at 86.  
That section provides that "[t]he judge may appoint any expert 
witnesses agreed upon by the parties, and may appoint witnesses 
of the judge's own selection.  An expert witness shall not be 
appointed by the judge unless the expert witness consents to 
act."  Id. (emphasis in original).  The Alt court concluded that 
"this express grant implies a privilege to refuse to testify if 
the expert is called by a litigant."  Id.  Because a court 
cannot 
compel 
an 
expert 
witness 
to 
testify, 
this 
court 
                                                 
11 Dr. Acosta was directed not to answer the question by his 
attorney.  Burnett v. Alt, 224 Wis. 2d 72, 81, 589 N.W.2d 21 
(1999). 
12 According to Wis. Stat. § 905.01: 
Except as provided by or inherent or implicit in 
statute or in rules adopted by the supreme court or 
required by the constitution of the United States or 
Wisconsin, no person has a privilege to: 
(1) Refuse to be a witness; or 
(2) Refuse to disclose any matter; or 
(3) Refuse to produce any object or writing; or 
(4) Prevent another from being a witness or disclosing 
any matter or producing any object or writing. 
No. 2003AP1801.lbb 
 
4 
 
determined that "it logically follows that a litigant should not 
be able to so compel an expert."  Id.  
¶92 This 
"unearthed 
and 
hitherto 
unknown 
privilege 
permitting expert witnesses to decline to give opinions against 
their will," 7 Daniel D. Blinka, Wisconsin Practice:  Wisconsin 
Evidence, § 702.7, at 514 (2d ed. 2001), was not limitless, 
however.  Striking a balance "between the right of expert 
witnesses to be free from testifying against their will and the 
needs of the court and litigants for testimony," Alt, 224 
Wis. 2d at 88, this court outlined the parameters of this newly 
created broad qualified expert privilege as follows: 
[A]bsent a showing of compelling circumstances, an 
expert cannot be compelled to give expert testimony 
whether the inquiry asks for the expert's existing 
opinions or would require further work.  In addition 
to demonstrating a compelling need for the expert's 
testimony, the party seeking the expert's testimony 
must 
present 
a plan 
of 
reasonable compensation.  
Finally, if the party seeking an expert's opinion is 
able to show a compelling need for the expert's 
opinion, an expert can only be compelled to give 
existing opinions.  Under no circumstances can an 
expert be required to do additional preparation. 
Id. at 89 (footnote omitted).  
 
¶93 Applying 
this 
privilege 
to 
Acosta, 
this 
court 
concluded that Acosta did not have to answer the question 
presented because he was no more or less qualified than any 
other obstetrician to give an expert opinion regarding the 
No. 2003AP1801.lbb 
 
5 
 
question asked.  Id. at 90.  However, Acosta did have to testify 
as to his observations regarding Dawn's prenatal care.  Id.13  
¶94 This court revisited Alt last term in Glenn.  In that 
case, Glenn's gynecologist, Plante, performed various surgical 
procedures to treat abdominal pain.14  Glenn, 269 Wis. 2d 575, 
¶4.  Glenn visited another physician, Koh, after the procedures.  
Id.  Koh told Glenn that the procedures were unnecessary, and 
Glenn then sued Plante for negligence.  Id., ¶¶4-5.  However, 
Glenn failed to timely name her expert witnesses, so Glenn named 
Koh.  Id., ¶6.  Koh objected, stating that he did not want to be 
part of a malpractice action against a fellow local physician.  
Id., ¶7.   
¶95 At issue in Glenn was whether there were "compelling 
circumstances" to justify requiring Koh to give expert opinion 
testimony regarding the standard of care and treatment provided 
by another physician.  Id., ¶¶14, 22.  This court concluded that 
there were not, as compelling circumstances are linked to "the 
uniquely necessary or irreplaceable opinion testimony that the 
expert could provide."  Id., ¶30.  Koh's testimony on another 
physician's standard of care was not uniquely necessary since 
other experts could likely testify as to this issue.  Id.  
                                                 
13 This court stated:  "Dr. Acosta may be unique with 
respect to the prenatal care provided to Dawn Alt and he must 
testify as to his observations in that role."  Alt, 224 Wis. 2d 
at 90. 
14 Those procedures included a laparotomy with a right 
ovarian cystectomy, a right oophorectomy, and hysterectomy.  
Glenn v. Plante, 2004 WI 24, ¶4, 269 Wis. 2d 575, 676 N.W.2d 
413.   
No. 2003AP1801.lbb 
 
6 
 
However, this court concluded that Koh could be "compelled to 
testify as to his observations as Glenn's treating physician.  
Such compulsion is considerably different than forcing a 
physician to testify as to the standard of care and treatment 
provided by another physician."  Id., ¶31.   
¶96 In sum, both Alt and Glenn involved questions that 
required the treating physicians to offer opinions about another 
physician's treatment.  This court in Glenn characterized Alt as 
concluding that "Acosta was not so unique as to be required to 
answer a deposition question that required his expert opinion 
about another physician's treatment."  Id., ¶27 (citing Alt, 224 
Wis. 2d at 90).  And in Glenn, this court concluded that "a 
treating physician may still be required to testify regarding 
his or her observations relating to the care or treatment 
provided 
to his or her 
patient, 
as 
such 
compulsion is 
considerably different than forcing a physician to testify as to 
the 
standard 
of 
care 
and 
treatment 
provided 
by 
another 
physician."15  Glenn, 269 Wis. 2d 575, ¶28. 
                                                 
15 It is error for the trial court to limit cross-
examination of a medical expert witness upon the sole ground 
that the questions called for expert opinions.  Shurpit v. Brah, 
30 Wis. 2d 388, 397, 399, 141 N.W.2d 266 (1966). In Shurpit, 
this court stated as follows:  
While we recognize the trial court has some 
discretion in the scope and extent of the cross-
examination of a witness, we deem it was error to 
prohibit cross-examination of the expert witnesses, 
including the defendant, upon the sole ground that it 
called for an opinion of the witness. 
We have concluded it was error to restrict the cross-
examination of the defendant and his expert witness so 
as to prohibit their opinions as to the quality of the 
No. 2003AP1801.lbb 
 
7 
 
¶97 Outside of these types of questions, I would conclude 
that the rules of evidence govern the scope of questioning.  I 
begin with the general proposition that, subject to other rules, 
all relevant evidence is admissible.  Wis. Stat. § 904.02.16  If 
a witness is qualified as an expert under Wis. Stat. § 907.02, 
that witness can testify to scientific, technical, or other 
specialized knowledge if it will assist the trier of fact to 
understand the evidence or determine a fact in issue.  In 
addition, testimony in the form of an opinion or inference that 
is otherwise admissible is not objectionable because it embraces 
an ultimate issue to be decided by the trier of fact.  
Wis. Stat. § 907.04.   
¶98 I recognize that Alt found an implicit privilege under 
Wis. Stat. § 907.06.  Under that section, an expert witness 
"shall not be appointed by the judge unless the expert witness 
consents to act," Wis. Stat. § 907.06(1), and is compensated, 
Wis. Stat. § 907.06(2).  While I may not have reached the same 
conclusion Alt did based on this particular statute, I accept 
the holdings of Alt and Glenn under principles of stare decisis.  
                                                                                                                                                             
care and treatment rendered by the defendant to the 
plaintiff. 
Id. at 399-00. 
16 Wisconsin Stat. § 904.02 provides: 
All 
relevant 
evidence 
is 
admissible, 
except 
as 
otherwise provided by the constitutions of the United 
States and the state of Wisconsin, by statute, by 
these rules, or by other rules adopted by the supreme 
court.  Evidence which is not relevant is not 
admissible. 
No. 2003AP1801.lbb 
 
8 
 
Because privileges are the exception and not the rule, however, 
see Wis. Stat. § 905.01, I would not extend this implicit 
privilege beyond the circumstances of Alt and Glenn.  Under 
those cases, an expert witness cannot be compelled to testify as 
to another's standard of care.   
¶99 An expansive reading of this privilege undermines many 
rules of evidence (discussed above) and disregards the parties' 
right and ability to effectively cross-examine witnesses.  As we 
recently stated, "Cross-examination has been described as the 
greatest legal engine ever invented for the discovery of truth."  
State v. Stuart, 2005 WI 47, ¶26 n.7, __ Wis. 2d __, 695 N.W.2d 
259 (quoting California v. Green, 399 U.S. 149 (1970) (citation 
and quotations omitted).17   
¶100 Consistent with these principles, and beginning with 
the proposition that evidentiary privileges are to be narrowly 
construed, see Glenn, 269 Wis. 2d 575, ¶20, I would conclude 
that under Alt and Glenn, Avery and Verbracken do not have a 
privilege to refuse to answer questions regarding their own 
standard of care.  In contrast to the circumstances presented in 
Alt and Glenn, we are confronted with persons who are already 
testifying material fact witnesses, who may also be experts.  To 
the extent that Carney-Hayes wants to ask them about their own 
standard of care as it relates to the treatment that that 
particular witness provided to Carney-Hayes, she should be 
allowed to do so.  As the Glenn court suggested, this compulsion 
                                                 
17 I respectfully disagree with the sentiments expressed in 
the majority opinion regarding cross-examination.  See majority 
op., ¶44.   
No. 2003AP1801.lbb 
 
9 
 
"is considerably different than forcing a physician to testify 
as to the standard of care and treatment provided by another 
physician."  Id., ¶28.  It is one thing to force an expert to 
take the stand and render an opinion about what someone else 
did, it is quite another to ask a fact witness on the stand 
questions that relate to his or her own conduct.  I would not 
extend the Alt privilege beyond that which was identified in 
Glenn.    
¶101 That said, before Carney-Hayes can ask the questions, 
she bears the burden, as the proponent of the evidence, of 
qualifying 
each 
witness 
to 
answer 
the 
questions. 
 
See 
Wis. Stat. § 907.02.  Whether an expert is qualified to offer an 
opinion is a discretionary determination that rests with the 
trial court. 
 Simpsen v. 
Madison 
Gen. Hosp. 
Ass'n, 48 
Wis. 2d 498, 509, 180 N.W.2d 586 (1970).  Although the witnesses 
here may have various sorts of expertise, "the witness[es] must 
be qualified for each and every question."  7 Daniel D. Blinka, 
Wisconsin Practice:  Wisconsin Evidence, § 702.4 at 490 (2d ed. 
2001). 
 
¶102 If Carney-Hayes qualifies Avery and Verbracken to 
answer the standard of care questions with respect to their own 
conduct, I would also conclude that the responses to those 
questions are relevant.  An ultimate issue of fact in a 
negligence case is whether the jury believes that the defendants 
(one of which includes the home care provider that employed 
Avery and Verbracken) acted according to the standard of care.  
See Nowatske v. Osterloh, 198 Wis. 2d 419, 433-34, 438-39, 543 
No. 2003AP1801.lbb 
 
10 
 
N.W.2d 265 (1996); Ceplina v. South Milwaukee Sch. Bd., 73 Wis. 
2d 338, 342, 243 N.W.2d 183 (1976).  The jury will first have to 
resolve what the standard of care is.  If Avery and Verbracken 
have opinions on what the standard of care is with respect to 
their own conduct, and whether their own actions conformed to 
that standard of care, that is all evidence that cuts to the 
heart of Carney-Hayes' claims. 
 
¶103 Thus, because Alt does not apply to questions posed to 
already testifying material fact witnesses regarding their own 
standard of care, I would conclude that Carney-Hayes should be 
allowed to ask both Avery and Verbracken18 about their own 
standards of care, provided Carney-Hayes can qualify them as 
experts.  Assuming they can be qualified, I would conclude that 
the witnesses can be compelled to answer as those questions are 
relevant to an ultimate issue of fact.  I would also conclude 
that neither Verbracken nor Avery could be compelled to answer 
questions about any other person's standard of care, as these 
questions fall precisely within the holdings of Alt and Glenn.  
 
¶104 Accordingly, I would affirm the decision and order of 
the trial court in all respects.  For the foregoing reasons, I 
therefore respectfully dissent from that portion of the majority 
opinion with respect to Verbracken.  I concur with the result 
                                                 
18 Alternatively, I would agree with the trial court's 
conclusion that Verbracken is required to answer questions about 
the standard of care with respect to the plan of care, its 
preparation, its maintenance and how it should be followed 
because she was a caregiver for Carney-Hayes and the person who 
wrote the plan of care that was followed by Avery.  
No. 2003AP1801.lbb 
 
11 
 
reached by the majority opinion with respect to Avery and 
Fontaine.   
 
¶105 I am authorized to state that Chief Justice SHIRLEY S. 
ABRAHAMSON and Justice ANN WALSH BRADLEY join this opinion.       
 
 
 
 
No. 2003AP1801.lbb 
 
 
 
1