Title: Hegarty v. Hudson

State: alabama

Issuer: Alabama Supreme Court

Document:

Rel: 4/5/13 
Notice: T h i s o p i n i o n i s s u b j e c t t o 
f o r m a l r e v i s i o n b e f o r e p u b l i c a t i o n i n 
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o f Southern Reporter. 
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made b e f o r e t h e 
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Southern Reporter. 
SUPREME COURT OF ALABAMA 
OCTOBER TERM, 2012-2013 
1110578 
Daniel Ernest Hegarty, M.D., and 
Monroeville Medical C l i n i c 
v. 
Dixie Hudson 
Appeal from Monroe C i r c u i t Court 
(CV-06-86) 
BRYAN, J u s t i c e . 
D a n i e l E r n e s t Hegarty, M.D., and 
t h e 
M o n r o e v i l l e M e d i c a l 
C l i n i c ("the C l i n i c " ) 
a p p e a l from a judgment e n t e r e d by t h e 
Monroe C i r c u i t C o u r t i n 
f a v o r o f 
D i x i e Hudson i n 
h e r m e d i c a l -
1110578 
m a l p r a c t i c e a c t i o n . 
We r e v e r s e and render a judgment f o r Dr. 
Hegarty and the 
C l i n i c . 
F a c t s and P r o c e d u r a l H i s t o r y 
I n 
2004, Hudson moved from Montgomery t o 
M o n r o e v i l l e 
s h o r t l y b e f o r e she was t o g i v e b i r t h , and Dr. Hegarty, a b o a r d -
c e r t i f i e d f a m i l y p r a c t i t i o n e r w o r k i n g a t the C l i n i c , agreed t o 
t r e a t h e r .
1 
Dr. Hegarty d e l i v e r e d Hudson's baby v i a c e s a r i a n -
s e c t i o n ("C-section") on June 23, 2004. 
D u r i n g the o p e r a t i o n , 
but a f t e r the baby had been d e l i v e r e d , the p l a c e n t a became 
detached from the baby's u m b i l i c a l c o r d . Dr. Hegarty s e a r c h e d 
w i t h i n and beyond Hudson's u t e r u s but was unable t o l o c a t e the 
p l a c e n t a . 
Dr. Hegarty r e q u e s t e d a s s i s t a n c e from h i s p a r t n e r 
at the t i m e , Dr. A n g e l a P o w e l l , who 
a l s o t r i e d t o l o c a t e the 
p l a c e n t a but was u n s u c c e s s f u l . 
Dr. P o w e l l p l a c e d a t e l e p h o n e 
c a l l 
t o 
Dr. 
J e f f 
Fahy, 
a 
b o a r d - c e r t i f i e d 
o b s t e t r i c i a n -
g y n e c o l o g i s t ("Ob-Gyn"), f o r a d v i c e and guidance r e g a r d i n g the 
m i s s i n g p l a c e n t a . 
Based on Dr. Fahy's recommendations t o Dr. 
1 D r . Hegarty had been c e r t i f i e d i n f a m i l y p r a c t i c e by the 
American Board of F a m i l y P r a c t i c e , which i s now known as the 
American 
Board 
of F a m i l y M e d i c i n e . 
F a m i l y p r a c t i c e 
i s a 
d e f i n e d m e d i c a l s p e c i a l t y t h a t , Dr. Hegarty t e s t i f i e d , i n c l u d e s 
t r a i n i n g 
i n v a r i o u s p r a c t i c e 
a r e a s , 
i n c l u d i n g 
g e r i a t r i c s , 
p e d i a t r i c s , pulmonology, 
c a r d i o l o g y , 
o b s t e t r i c s , 
gynecology, 
and emergency m e d i c i n e . 
2 
1110578 
P o w e l l , which were r e l a y e d t o Dr. Hegarty, Dr. Hegarty c l o s e d 
Hudson's i n c i s i o n w i t h o u t r e t r i e v i n g the p l a c e n t a , w i t h a p l a n 
f o r f o l l o w - u p c a r e . F o l l o w i n g the o p e r a t i o n , Hudson e x p e r i e n c e d 
severe p a i n i n her abdomen and d r a m a t i c w e i g h t 
l o s s . 
Dr. 
Hegarty e v e n t u a l l y o r d e r e d a CT scan t o be performed on J u l y 
15, 2004, and, a t t h a t t i m e , a mass was l o c a t e d i n Hudson's 
abdomen. 
Dr. Hegarty then r e f e r r e d Hudson t o Dr. Fahy, who 
s u b s e q u e n t l y r e f e r r e d her t o a d o c t o r i n 
M o b i l e , who 
i d e n t i f i e d 
and 
s u r g i c a l l y removed the r e t a i n e d p l a c e n t a from Hudson's 
abdomen.
2 
I n 
2006, Hudson sued Dr. Hegarty, the C l i n i c , and the 
Monroe County H o s p i t a l 
("the H o s p i t a l " ) , a l o n g w i t h 
s e v e r a l 
f i c t i t i o u s l y named d e f e n d a n t s , a l l e g i n g one count of m e d i c a l 
n e g l i g e n c e 
r e l a t e d t o Dr. H e g a r t y ' s 
f a i l u r e t o remove the 
p l a c e n t a from Hudson. 
Hudson a l l e g e d t h a t Dr. Hegarty, the 
C l i n i c , and the H o s p i t a l had breached the a p p l i c a b l e s t a n d a r d 
of c a r e i n a number o f ways. Dr. Hegarty, the C l i n i c , and the 
H o s p i t a l 
each 
f i l e d 
an answer d e n y i n g 
the 
a l l e g a t i o n 
of 
n e g l i g e n c e and d e n y i n g any b r e a c h of the s t a n d a r d o f c a r e . 
2A " r e t a i n e d p l a c e n t a " i s 
an " i n c o m p l e t e s e p a r a t i o n of the 
p [ l a c e n t a ] and i t s f a i l u r e t o be e x p e l l e d a t the u s u a l time 
a f t e r d e l i v e r y of the c h i l d . " Stedman's M e d i c a l D i c t i o n a r y 1389 
(27th ed. 2000). 
3 
1110578 
I n 
2010, the 
t r i a l 
c o u r t 
e n t e r e d a summary 
judgment 
d i s m i s s i n g the c l a i m a g a i n s t the H o s p i t a l , which judgment was 
made f i n a l on August 17, 2011, by a Rule 5 4 ( b ) , A l a . 
R. 
C i v . 
P., 
c e r t i f i c a t i o n . The case proceeded t o t r i a l 
a g a i n s t Dr. 
Hegarty and the C l i n i c 
( h e r e i n a f t e r r e f e r r e d t o c o l l e c t i v e l y 
as "the d e f e n d a n t s " ) . 
B e f o r e 
t r i a l , Hudson 
i d e n t i f i e d Dr. 
Gregory Banks as an e x p e r t w i t n e s s who would t e s t i f y on h e r 
b e h a l f as t o Dr. Hegarty's 
a l l e g e d b r e a c h o f the s t a n d a r d o f 
c a r e . 
A f t e r Dr. Banks was deposed, the defendants moved the 
t r i a l c o u r t t o p r e c l u d e Dr. Banks from t e s t i f y i n g a t t r i a l and 
t o 
s t r i k e 
h i s a f f i d a v i t 
and d e p o s i t i o n 
t e s t i m o n y . 
The 
defendants argued t h a t , p u r s u a n t t o 
§ 6-5-548, A l a . Code 1975,
3 
Dr. 
Banks, who was a b o a r d - c e r t i f i e d Ob-Gyn,
4 was not a 
s i m i l a r l y 
s i t u a t e d h e a l t h - c a r e p r o v i d e r t o Dr. Hegarty and, 
t h e r e f o r e , c o u l d not t e s t i f y as t o the s t a n d a r d o f care Dr. 
Hegarty s h o u l d have e x e r c i s e d w i t h r e g a r d t o 
the removal o f 
the 
p l a c e n t a . 
The t r i a l c o u r t d e n i e d the d e f e n d a n t s ' motion. 
The 
defendants 
then 
f i l e d a motion i n l i m i n e s e e k i n g , among o t h e r 
t h i n g s , t o p r e c l u d e Dr. Banks from t e s t i f y i n g as an e x p e r t . 
3The p e r t i n e n t p a r t s o f § 6-5-548 a r e q u o t e d i n f r a . 
4Dr. Banks had been b o a r d - c e r t i f i e d as an Ob-Gyn by the 
American C o l l e g e of O b s t e t r i c s and Gynecology. 
4 
1110578 
The 
t r i a l c o u r t d e n i e d t h e 
motion i n s o f a r as i t r e l a t e d t o 
Dr. 
Banks's t e s t i m o n y . 
The 
case was t r i e d b e f o r e a j u r y . 
Dr. Banks 
t e s t i f i e d 
t h a t , as a b o a r d - c e r t i f i e d Ob-Gyn, he c o u l d d e l i v e r b a b i e s and 
t h a t Dr. Hegarty, as a b o a r d - c e r t i f i e d 
f a m i l y 
p r a c t i t i o n e r , 
c o u l d a l s o d e l i v e r b a b i e s . He t e s t i f i e d f u r t h e r t h a t , a l t h o u g h 
t h e r e was commonality i n 
how b a b i e s a r e d e l i v e r e d , Ob-Gyn and 
f a m i l y p r a c t i c e a r e s e p a r a t e and d i s t i n c t m e d i c a l s p e c i a l t i e s 
and 
t h a t 
he had never been 
t r a i n e d , 
l i c e n s e d , 
o r b o a r d -
c e r t i f i e d as a f a m i l y p r a c t i t i o n e r . 
Dr. 
Banks 
t e s t i f i e d 
t h a t 
Dr. Hegarty was 
p r a c t i c i n g 
o b s t e t r i c s when he d e l i v e r e d Hudson's baby. 
A c c o r d i n g t o 
Dr. 
Banks, t h e p r a c t i c e 
o f o b s t e t r i c s 
" p r i m a r i l y 
... 
i n v o l v e s 
t a k i n g care o f a mom ... up t o t h e time o f 
h e r d e l i v e r y , 
t a k i n g 
care o f h e r through t h e d e l i v e r y , and then a f t e r t h e d e l i v e r y 
p r o c e s s . " 
He 
s t a t e d 
t h a t 
Dr. Hegarty 
d e v i a t e d 
from t h e 
a p p l i c a b l e 
s t a n d a r d o f c a r e when he 
f a i l e d t o remove t h e 
p l a c e n t a from Hudson when he performed t h e C - s e c t i o n and t h a t 
a second d e v i a t i o n from t h e s t a n d a r d o f c a r e , "which h i n g e [ d ] 
on t h e f i r s t , " 
o c c u r r e d when Dr. Hegarty f a i l e d t o p e r f o r m a 
CT scan i m m e d i a t e l y a f t e r t h e c o n c l u s i o n o f t h e C - s e c t i o n , o r 
a t l e a s t t h e next day. 
5 
1110578 
However, Dr. Banks 
a l s o 
t e s t i f i e d 
t h a t 
Dr. H e g a r t y ' s 
o b s t e t r i c a l 
t r e a t m e n t o f Hudson 
f e l l 
w i t h i n 
the scope o f 
p r a c t i c e f o r a b o a r d - c e r t i f i e d f a m i l y 
p r a c t i t i o n e r because 
Hudson was a l o w - r i s k o b s t e t r i c p a t i e n t . 
Dr. Banks a l s o s t a t e d 
t h a t , i n p e r f o r m i n g the C - s e c t i o n on Hudson, Dr. H e g a r t y was 
d o i n g what he was f u l l y a u t h o r i z e d t o do based on h i s t r a i n i n g 
and e d u c a t i o n as a f a m i l y p r a c t i t i o n e r and t h a t h i s a c t i o n s 
were w i t h i n the scope o f f a m i l y p r a c t i c e . 
Hudson attempted t o a r g u e , however, t h a t , i n s p i t e of 
h i s 
f a m i l y - p r a c t i c e c e r t i f i c a t i o n , Dr. H e g a r t y had h e l d h i m s e l f out 
as a s p e c i a l i s t i n o b s t e t r i c s . Hudson r e l i e d on Dr. H e g a r t y ' s 
c u r r i c u l u m 
v i t a e ("CV"), i n which he had w r i t t e n t h a t he had 
p r a c t i c e d 
"complete 
o b s t e t r i c s 
and 
p e d i a t r i c s 
and 
f a m i l y 
m e d i c i n e " w h i l e w o r k i n g a t Atmore Complete F a m i l y H e a l t h . 
Dr. 
H e g a r t y 
t e s t i f i e d 
t h a t the term "complete" on h i s CV meant 
"from ... b i r t h u n t i l o l d age." 
Dr. H e g a r t y ' s CV a l s o 
s t a t e d 
t h a t he had done a f e l l o w s h i p i n r u r a l f a m i l y m e d i c i n e , where 
he had r e c e i v e d " i n t e n s i v e t r a i n i n g i n h i g h r i s k and o p e r a t i v e 
o b s t e t r i c s . " 
Dr. Banks t e s t i f i e d t h a t , based on Dr. H e g a r t y ' s CV and 
h i s h o s p i t a l c r e d e n t i a l s , Dr. H e g a r t y was a f a m i l y p r a c t i t i o n e r 
who a l s o p r a c t i c e d o b s t e t r i c s . 
Dr. Banks a l s o t e s t i f i e d 
t h a t 
6 
1110578 
p e r f o r m i n g "complete o b s t e t r i c s " f o r 
a l o w - r i s k 
p a t i e n t 
i s 
w i t h i n the scope o f the f a m i l y - p r a c t i c e s p e c i a l t y , t h a t Hudson 
was 
a l o w - r i s k p a t i e n t , and 
t h a t Dr. Hegarty c o u l d care 
f o r 
Hudson w i t h i n h i s e x p e r i e n c e and t r a i n i n g as a b o a r d - c e r t i f i e d 
f a m i l y p r a c t i t i o n e r . 
At the c l o s e of Hudson's case, and a g a i n a t the c l o s e 
o f 
a l l 
the e v i d e n c e , the d e f e n d a n t s moved f o r a judgment as 
a 
m a t t e r of law, 
a r g u i n g , among o t h e r t h i n g s , 
t h a t Hudson 
had 
f a i l e d t o p r o f f e r e x p e r t t e s t i m o n y from a s i m i l a r l y 
s i t u a t e d 
h e a l t h - c a r e 
p r o v i d e r , p u r s u a n t t o § 6-5-548. 
The 
t r i a l 
c o u r t 
d e n i e d b o t h m o t i o n s . 
The 
t r i a l c o u r t d e t e r m i n e d t h a t a q u e s t i o n o f f a c t e x i s t e d 
as t o whether Dr. Hegarty had h e l d h i m s e l f out as a s p e c i a l i s t 
i n 
o b s t e t r i c s so as t o b r i n g h i m s e l f 
w i t h i n the s t a n d a r d 
of 
care e x p e c t e d of 
o b s t e t r i c i a n s and, 
t h e r e f o r e , whether 
Dr. 
Banks 
was 
q u a l i f i e d t o 
t e s t i f y 
a g a i n s t 
Dr. 
Hegarty 
as 
a 
s i m i l a r l y s i t u a t e d h e a l t h - c a r e p r o v i d e r . 
Thus, the t r i a l 
c o u r t 
charged the j u r y w i t h d e c i d i n g whether Dr. Hegarty had 
a c t e d 
"beyond t h a t which a b o a r d c e r t i f i e d f a m i l y p r a c t i t i o n e r 
who 
had 
o b s t e t r i c s t r a i n i n g and 
d e l i v e r e d b a b i e s would 
t y p i c a l l y 
p a r t i c i p a t e 
i n and 
t h a t such was 
h i s s t a t u s 
a t the time 
he 
r e n d e r e d care t o D i x i e Hudson." 
The 
t r i a l c o u r t n o t e d t h a t i f 
7 
1110578 
Dr. Hegarty had a c t e d beyond the scope o f h i s s p e c i a l t y i n h i s 
care o f Hudson, Dr. Banks c o u l d t e s t i f y as a s i m i l a r l y s i t u a t e d 
h e a l t h - c a r e p r o v i d e r as t o the s t a n d a r d o f care t h a t s h o u l d 
a p p l y . 
However, the 
t r i a l 
c o u r t ' s i n s t r u c t i o n s t o the 
j u r y 
a l s o s t a t e d t h a t , i f i t determined t h a t Dr. Banks's t e s t i m o n y 
s h o u l d not be c o n s i d e r e d , " t h e r e would be no e v i d e n c e 
b e f o r e 
[ t h e m ] ... t h a t Dr. Hegarty b r e a c h e d the a p p l i c a b l e s t a n d a r d 
of c a r e . " 
The 
defendants 
and Hudson o b j e c t e d t o the 
t r i a l 
c o u r t ' s a l l o w i n g the j u r y t o determine the a d m i s s i b i l i t y o f Dr. 
Banks's t e s t i m o n y . 
On September 16, 
2011, 
the 
j u r y r e t u r n e d a v e r d i c t i n 
f a v o r o f Hudson i n the amount of $150,000. 
The 
t r i a l 
c o u r t 
e n t e r e d 
a 
f i n a l 
judgment 
based 
on 
t h a t 
v e r d i c t . 
The 
defendants 
f i l e d a renewed motion f o r a judgment as a m a t t e r 
of law and, i n the a l t e r n a t i v e , a motion f o r new 
t r i a l . 
A t the 
h e a r i n g on the postjudgment motion, the t r i a l c o u r t s t a t e d : 
"[T]he reason t h a t I s u b m i t t e d [ t h e q u e s t i o n of Dr. 
Banks's q u a l i f i c a t i o n as an e x p e r t ] t o the j u r y 
was 
because 
t h e r e 
was 
a 
c o n t e s t 
i n the 
f a c t s 
about 
whether 
or 
not 
[ D r . 
H e g a r t y ] 
d i d go 
beyond 
h i s 
s p e c i a l t y and I thought t h a t was 
a f a c t q u e s t i o n t o 
be determined by the j u r y . 
However, i f I had t o r u l e 
as a m a t t e r o f law, I would have a l l o w e d Dr. Banks t o 
t e s t i f y . 
"So, 
i f the Supreme C o u r t wonders does 
t h i s 
Judge 
t h i n k t h a t [ D r . 
H e g a r t y ] 
s h o u l d have been 
8 
1110578 
a l l o w e d t o t e s t i f y , and i f we 
t o l d him, you have got 
t o d e c i d e t h a t , what would he d e c i d e ? I would d e c i d e 
t h a t he c o u l d t e s t i f y , 
so, you know, i f I e r r e d i n 
s u b m i t t i n g the 
i s s u e t o the 
j u r y and 
i f i t s h o u l d 
have been d e t e r m i n e d by me, my d e t e r m i n a t i o n would be 
the same t h a t the j u r y ' s was 
" 
The 
t r i a l c o u r t e x p l a i n e d t h a t , by s t a t i n g i n h i s CV t h a t he 
d i d "complete o b s t e t r i c s and p e d i a t r i c s and f a m i l y 
m e d i c i n e , " 
Dr. Hegarty " h e l d h i m s e l f out t o be more than he was 
and thus 
went o u t s i d e of h i s s p e c i a l t y and I so h o l d [ t h a t ] he 
h e l d 
h i m s e l f out as d o i n g more than a f a m i l y p r a c t i t i o n e r would do 
i n my o p i n i o n . " T h e r e f o r e , the t r i a l c o u r t c o n c l u d e d , the j u r y 
c o u l d have c o n s i d e r e d 
Dr. Banks's t e s t i m o n y 
as 
a 
s i m i l a r l y 
s i t u a t e d h e a l t h - c a r e p r o v i d e r , p u r s u a n t t o § 6-5-548, as t o the 
a l l e g e d b r e a c h of the s t a n d a r d of c a r e . 
The 
t r i a l c o u r t d e n i e d 
the d e f e n d a n t s ' m o t i o n s , and the defendants appealed. 
I s s u e s 
The 
defendants 
contend 
t h a t 
the 
t r i a l 
c o u r t 
e r r e d 
i n 
a l l o w i n g 
Dr. 
Banks 
t o 
t e s t i f y 
as 
an 
e x p e r t 
r e g a r d i n g 
the 
a p p l i c a b l e s t a n d a r d of c a r e and Dr. Hegarty's a l l e g e d b r e a c h 
t h e r e o f . 
The 
d e f e n d a n t s a l s o argue t h a t the 
t r i a l 
c o u r t ' s 
charge t o the j u r y was improper and t h a t the judgment a g a i n s t 
Dr. Hegarty v i o l a t e s p u b l i c p o l i c y . 
S t a n d a r d of Review 
9 
1110578 
"'"The 
s t a n d a r d 
o f 
r e v i e w 
a p p l i c a b l e 
t o whether an 
e x p e r t 
s h o u l d be p e r m i t t e d t o t e s t i f y i s 
w e l l 
s e t t l e d . 
The 
m a t t e r 
i s 
' l a r g e l y 
d i s c r e t i o n a r y 
w i t h 
the 
t r i a l 
c o u r t , 
and 
t h a t 
c o u r t ' s 
judgment 
w i l l 
not 
be 
d i s t u r b e d 
absent 
an abuse of 
d i s c r e t i o n . ' 
Hannah v. Gregg, B l a n d 
& B e r r y ,  
Inc., 
840 
So. 
2d 839, 
850 
( A l a . 
2002). 
We 
now 
r e f e r 
t o 
t h a t 
s t a n d a r d 
as 
a 
t r i a l 
c o u r t ' s 
'exceeding 
i t s d i s c r e t i o n . ' 
See, 
e.g., 
V e s t a 
F i r e 
I n s . Corp. 
v. 
 
Milam & Co. C o n s t r . , I n c . , 901 So. 
2d 
84, 
106 
( A l a . 2004) 
('Our 
r e v i e w of the r e c o r d s u p p o r t s 
the 
c o n c l u s i o n 
t h a t the 
t r i a l 
c o u r t 
d i d 
not exceed i t s d i s c r e t i o n i n 
f i n d i n g 
t h a t Jones was 
p r o p e r l y 
q u a l i f i e d as an e x p e r t under Rule 
702[, 
A l a . 
R. 
E v i d . , ] 
and 
i n 
c o n s i d e r i n g 
h i s 
t e s t i m o n y . ' ) . 
However, the s t a n d a r d 
i t s e l f 
has 
not changed." 
"'Kyser 
v. H a r r i s o n , 908 
So. 
2d 914, 
918 
( A l a . 
2005).' 
"Robinson v. B a p t i s t H e a l t h Sys., 
I n c . , 
1119, 
1125 
( A l a . C i v . App. 
2009). 
"'"'The 
s t a n d a r d 
of 
r e v i e w 
a p p l i c a b l e t o 
a 
motion 
f o r 
d i r e c t e d 
v e r d i c t 
or 
judgment 
n o t w i t h s t a n d i n g 
t h e 
v e r d i c t [now r e f e r r e d t o 
as 
a p r e v e r d i c t and 
a 
p o s t v e r d i c t motion f o r a 
judgment as a m a t t e r 
of 
law] i s i d e n t i c a l t o the 
s t a n d a r d 
used 
by 
the 
24 
So. 
3d 
10 
1110578 
t r i a l 
c o u r t i n g r a n t i n g 
or d e n y i n g the 
motions 
i n i t i a l l y . 
Thus, 
when 
r e v i e w i n g 
the 
t r i a l 
c o u r t ' s r u l i n g on e i t h e r 
motion, 
we 
determine 
whether 
t h e r e 
was 
s u f f i c i e n t 
e v i d e n c e 
t o 
produce 
a 
c o n f l i c t 
w a r r a n t i n g 
j u r y 
c o n s i d e r a t i o n . And, 
l i k e 
the t r i a l c o u r t , we must 
view any e v i d e n c e most 
f a v o r a b l y 
t o 
t h e 
non-movant.'" 
" ' G l e n l a k e s R e a l t y Co. v. Norwood, 721 So. 
2d 174, 177 
( A l a . 1998) 
( q u o t i n g Bussey v.  
John Deere Co., 531 So. 2d 860, 863 ( A l a . 
1 9 8 8 ) ) . ' 
" P a r k e r 
v. 
W i l l i a m s , 
977 
So. 
2d 
476, 
480 
( A l a . 
2 
0 
0 
7 ) . " 
S p r i n g h i l l Hosps., I n c . v. C r i t o p o u l o s , 87 So. 3d 1178, 1180-81 
( A l a . 
2011). 
D i s c u s s i o n 
The defendants 
f i r s t argue t h a t t h e y are e n t i t l e d t o a 
judgment as a m a t t e r o f law because, t h e y argue, Dr. Banks was 
not a s i m i l a r l y s i t u a t e d h e a l t h - c a r e p r o v i d e r t o Dr. H e g a r t y 
under § 6-5-548, and, t h u s , he s h o u l d not have been p e r m i t t e d 
t o t e s t i f y a g a i n s t Dr. Hegarty as t o the a l l e g e d b r e a c h o f the 
s t a n d a r d of c a r e . 
In Holcomb v. Carraway, 
945 So. 2d 
1009, 
1012-13 ( A l a . 2006), t h i s C o u r t s t a t e d : 
11 
1110578 
"The 
p l a i n t i f f i n a m e d i c a l - m a l p r a c t i c e a c t i o n 
must prove by s u b s t a n t i a l e v i d e n c e t h a t the defendant 
h e a l t h - c a r e 
p r o v i d e r 
' f a i l e d 
t o 
e x e r c i s e 
such 
r e a s o n a b l e 
c a r e , 
s k i l l , 
and 
d i l i g e n c e 
as 
o t h e r 
s i m i l a r l y s i t u a t e d h e a l t h care p r o v i d e r s i n the same 
g e n e r a l l i n e of p r a c t i c e o r d i n a r i l y have and e x e r c i s e 
i n a 
l i k e 
case.' 
§ 6-5-548(a), A l a . Code 1975. 
To 
meet t h i s burden, a p l a i n t i f f o r d i n a r i l y must p r e s e n t 
e x p e r t 
m e d i c a l 
t e s t i m o n y ; 
however, 
such 
e x p e r t 
t e s t i m o n y i s a l l o w e d o n l y from a ' s i m i l a r l y s i t u a t e d 
h e a l t h care p r o v i d e r . ' See 
§ 6-5-548(e), A l a . Code 
1975; 
Leonard v. P r o v i d e n c e Hosp., 590 
So. 
2d 
906 
( A l a . 1991). 
" S e c t i o n 6-5-548, a p r o v i s i o n of the Alabama 
M e d i c a l L i a b i l i t y A c t , § 6-5-504 e t seq., A l a . Code 
1975 
('the AMLA'), p r o v i d e s 
two 
d e f i n i t i o n s 
o f 
a 
' s i m i l a r l y s i t u a t e d h e a l t h care p r o v i d e r , ' depending 
upon whether the defendant h e a l t h - c a r e p r o v i d e r i s a 
' s p e c i a l i s t ' or a ' n o n s p e c i a l i s t . ' See § 6-5-548(b) 
and 
( c ) , A l a . Code 1975. 
... " 
S e c t i o n 6-5-548(c) p r o v i d e s : 
"(c) 
N o t w i t h s t a n d i n g 
any 
p r o v i s i o n 
o f 
the 
Alabama R u l e s 
of Evidence 
t o the c o n t r a r y , i f the 
h e a l t h care p r o v i d e r whose b r e a c h o f the s t a n d a r d of 
care i s c l a i m e d t o have c r e a t e d the cause of a c t i o n 
i s 
c e r t i f i e d by an a p p r o p r i a t e American b o a r d as a 
s p e c i a l i s t , i s t r a i n e d and e x p e r i e n c e d i n a m e d i c a l 
s p e c i a l t y , 
and 
h o l d s 
h i m s e l f or h e r s e l f 
out 
as 
a 
s p e c i a l i s t , 
a 
' s i m i l a r l y 
s i t u a t e d 
h e a l t h 
c a r e 
p r o v i d e r ' 
i s one 
who 
meets a l l of 
the 
f o l l o w i n g 
r e q u i r e m e n t s : 
"(1) 
I s 
l i c e n s e d by 
the 
a p p r o p r i a t e 
r e g u l a t o r y b o a r d or agency of t h i s or some 
o t h e r 
s t a t e . 
"(2) I s t r a i n e d and e x p e r i e n c e d i n the 
same s p e c i a l t y . 
12 
1110578 
"(3) I s c e r t i f i e d by an a p p r o p r i a t e 
American b o a r d i n 
t h e same s p e c i a l t y . 
"(4) Has p r a c t i c e d i n t h i s 
s p e c i a l t y 
d u r i n g t h e year p r e c e d i n g t h e date t h a t t h e 
a l l e g e d 
b r e a c h o f t h e s t a n d a r d o f c a r e 
o c c u r r e d . " 
R e g a r d i n g t h e a p p l i c a b i l i t y o f § 6-5-548(c), t h i s C o u r t 
has 
s t a t e d : 
"In 
o r d e r t o d e t e r m i n e whether t h e defendant 
h e a l t h - c a r e p r o v i d e r 
q u a l i f i e s as a s p e c i a l i s t , we 
must f i r s t determine t h e f i e l d o f m e d i c a l p r a c t i c e i n 
which t h e n e g l i g e n c e i s a l l e g e d t o have o c c u r r e d . 
I f 
the defendant h e a l t h - c a r e p r o v i d e r i s 
a s p e c i a l i s t i n 
the 
f i e l d o f p r a c t i c e i n 
which the a l l e g e d n e g l i g e n c e 
o c c u r r e d , then t h e 
p r o f f e r e d e x p e r t w i t n e s s must a l s o 
be a s p e c i a l i s t i n t h a t 
f i e l d , under § 6-5-548(c), 
A l a . Code 1975. See a l s o M e d l i n v. Crosby, 583 So. 2d 
1290, 1293 ( A l a . 1991)." 
Holcomb, 945 So. 2d a t 
1013. 
In 
t h i s 
case, i t 
was u n d i s p u t e d t h a t Dr. H e g a r t y was 
c e r t i f i e d by an American 
b o a r d as a 
s p e c i a l i s t 
i n f a m i l y 
p r a c t i c e , t h a t he was t r a i n e d and e x p e r i e n c e d as a s p e c i a l i s t 
i n 
f a m i l y 
p r a c t i c e , 
and t h a t he 
h e l d 
h i m s e l f 
out as a 
s p e c i a l i s t i n f a m i l y p r a c t i c e . 
Hudson a l l e g e d t h a t Dr. Hegarty 
b r e a c h e d t h e a p p l i c a b l e s t a n d a r d o f c a r e d u r i n g h i s performance 
of h e r C - s e c t i o n 
when he f a i l e d t o remove t h e 
p l a c e n t a from h e r 
abdomen. 
Dr. Banks t e s t i f i e d , and i t 
was not d i s p u t e d , 
t h a t 
Dr. Hegarty's performance o f 
Hudson's C - s e c t i o n f e l l w i t h i n t h e 
13 
1110578 
scope 
of 
h i s 
f a m i l y - p r a c t i c e 
s p e c i a l t y .
5 
Because 
i t 
was 
u n d i s p u t e d t h a t Dr. Hegarty was 
c e r t i f i e d i n and p r a c t i c i n g h i s 
s p e c i a l t y of f a m i l y p r a c t i c e when the 
a l l e g e d b r e a c h of 
the 
s t a n d a r d 
of care o c c u r r e d , 
we conclude t h a t s u b s e c t i o n 
§ 
6-5-
548(c) a p p l i e d . 
Because Dr. Hegarty was 
a s p e c i a l i s t f o r purposes of § 
6-
5-548(c), § 6-5-548(e), A l a . Code 1975, 
a l s o a p p l i e s . See 
Ex 
p a r t e W a d d a i l , 827 
So. 2d 789, 
794 
( A l a . 2001) 
( h o l d i n g t h a t , 
i f 
the defendant h e a l t h - c a r e 
p r o v i d e r 
" i s not 
a 
s p e c i a l i s t 
under s u b s e c t i o n 
( c ) , § 6-5-548(e) of the [AMLA] does not 
a p p l y 
. . . . " ) . 
S e c t i o n 6-5-548(e) 
p r o v i d e s : 
"(e) The purpose of t h i s s e c t i o n i s t o e s t a b l i s h 
a 
r e l a t i v e 
s t a n d a r d 
of 
care 
f o r 
h e a l t h 
care 
p r o v i d e r s . A h e a l t h care p r o v i d e r may 
t e s t i f y as 
an 
e x p e r t w i t n e s s i n any 
a c t i o n f o r i n j u r y or damages 
a g a i n s t 
another 
h e a l t h 
care 
p r o v i d e r 
based 
on 
a 
b r e a c h of the s t a n d a r d 
of care o n l y i f he or she i s 
a 
' s i m i l a r l y 
s i t u a t e d 
h e a l t h 
care 
p r o v i d e r ' 
as 
d e f i n e d above. I t i s the 
i n t e n t of the 
L e g i s l a t u r e 
t h a t i n the event the defendant h e a l t h care 
p r o v i d e r 
i s 
c e r t i f i e d by an a p p r o p r i a t e American b o a r d or i n 
a 
p a r t i c u l a r 
s p e c i a l t y 
and 
i s 
p r a c t i c i n g 
t h a t 
5Hudson and 
the 
t r i a l 
c o u r t 
r e l i e d on statements i n 
Dr. 
Hegarty's 
CV 
t h a t 
he 
p r a c t i c e d 
"complete 
o b s t e t r i c s " 
as 
e v i d e n c e i n d i c a t i n g t h a t he was p r a c t i c i n g o u t s i d e h i s f a m i l y -
p r a c t i c e s p e c i a l t y . However, statements i n a CV as t o the scope 
of h i s p r a c t i c e a t a p r i o r f a c i l i t y do not c o n s t i t u t e e v i d e n c e 
i n d i c a t i n g t h a t Dr. Hegarty a c t e d o u t s i d e h i s s p e c i a l t y a t the 
time of the 
a l l e g e d b r e a c h of the 
s t a n d a r d 
of care 
i n 
t h i s 
case. 
14 
1110578 
s p e c i a l t y a t t h e time o f t h e a l l e g e d b r e a c h o f 
t h e 
s t a n d a r d o f c a r e , a h e a l t h c a r e p r o v i d e r may 
t e s t i f y 
as an e x p e r t w i t n e s s w i t h 
r e s p e c t t o an 
a l l e g e d 
b r e a c h o f the s t a n d a r d o f c a r e i n any a c t i o n f o r 
i n j u r y , damages, o r w r o n g f u l death a g a i n s t a n o t h e r 
h e a l t h c a r e p r o v i d e r o n l y i f 
he o r she i s c e r t i f i e d  
by t h e same American b o a r d i n 
t h e same s p e c i a l t y . " 
(Emphasis added.) 
Dr. Hegarty i s c e r t i f i e d by t h e American Board of F a m i l y 
M e d i c i n e ; Dr. Banks i s c e r t i f i e d by t h e American C o l l e g e o f 
O b s t e t r i c s and Gynecology. 
C l e a r l y , Dr. Hegarty and Dr. Banks 
are not c e r t i f i e d i n t h e same s p e c i a l t y by t h e a p p r o p r i a t e 
American board. 
Because Dr. Hegarty i s c e r t i f i e d by t h e 
American Board o f F a m i l y M e d i c i n e , because he was p r a c t i c i n g 
i n t h a t s p e c i a l t y a t t h e time he performed t h e C - s e c t i o n on 
Hudson, and because Dr. Banks was n o t c e r t i f i e d by t h e same 
American b o a r d i n 
t h e 
same s p e c i a l t y , p u r s u a n t t o § 6-5-548(e) 
Dr. Banks was not p e r m i t t e d t o t e s t i f y as a s i m i l a r l y s i t u a t e d 
h e a l t h - c a r e p r o v i d e r t o t h e s t a n d a r d o f c a r e t o which Dr. 
Hegarty was t o be h e l d . 
The f a c t t h a t t h e r e i s 
some o v e r l a p 
or 
commonality i n t h e p r a c t i c e o f a b o a r d - c e r t i f i e d 
f a m i l y 
p r a c t i t i o n e r and 
a b o a r d - c e r t i f i e d Ob-Gyn ( i . e . , t h a t b o t h were 
t r a i n e d t o p e r f o r m C - s e c t i o n s ) i s i r r e l e v a n t . 
I n Johnson v. 
P r i c e , 743 So. 2d 436, 438 ( A l a . 1999), t h i s C o u r t h e l d : 
15 
1110578 
"The 
f a c t t h a t [two c e r t i f y i n g boards] may have t h e 
same purpose, t h a t t h e y may c e r t i f y p r o v i d e r s f o r 
t h e 
 
same p r o c e d u r e s , o r t h a t t h e y may r e q u i r e t h e same  
q u a l i f i c a t i o n s 
would 
be 
i r r e l e v a n t . 
S e c t i o n 
6-5-548(e) p l a i n l y s t a t e s t h a t i f 
t h e two p r o v i d e r s 
are not c e r t i f i e d by t h e same o r g a n i z a t i o n , then one 
cannot t e s t i f y as t o t h e s t a n d a r d o f c a r e a p p l i c a b l e 
to 
t h e o t h e r . A l l q u e s t i o n s o f p r o p r i e t y , wisdom, 
n e c e s s i t y , u t i l i t y , and e x p e d i e n c y o f l e g i s l a t i o n a r e 
e x c l u s i v e l y f o r t h e L e g i s l a t u r e and a r e q u e s t i o n s 
w i t h which t h i s C o u r t has no c o n c e r n . " 
(Emphasis added.) 
For 
t h e s e 
r e a s o n s , we 
conclude 
t h a t t h e t r i a l 
c o u r t 
exceeded i t s d i s c r e t i o n when i t 
p e r m i t t e d Dr. Banks t o t e s t i f y 
as a s i m i l a r l y s i t u a t e d h e a l t h - c a r e p r o v i d e r i n t h i s case. The 
o n l y 
e v i d e n c e 
i n d i c a t i n g 
t h a t 
Dr. 
Hegarty 
breached 
t h e 
a p p l i c a b l e s t a n d a r d o f c a r e came from Dr. Banks. 
Because t h a t 
t e s t i m o n y was i m p r o p e r l y a d m i t t e d i n t o e v i d e n c e and because 
t h e r e was no o t h e r t e s t i m o n y as t o t h e s t a n d a r d o f c a r e , t h e 
t r i a l 
c o u r t e r r e d i n d e n y i n g t h e d e f e n d a n t s ' motions f o r 
a 
judgment as a m a t t e r o f law. A c c o r d i n g l y , 
we r e v e r s e t h e t r i a l 
c o u r t ' s judgment and render a judgment as a m a t t e r o f law 
i n 
f a v o r o f t h e d e f e n d a n t s .
6 
REVERSED AND JUDGMENT RENDERED. 
6Our d e c i s i o n t o r e v e r s e and t o render a judgment on t h i s 
b a s i s p r e t e r m i t s d i s c u s s i o n o f t h e r e m a i n i n g i s s u e s r a i s e d by 
the defendants on a p p e a l . 
16 
1110578 
Moore, C.J., and S t u a r t , B o l i n , P a r k e r , Shaw, Main, and 
Wise, J J . , concur. 
Murdock, J . , concurs 
s p e c i a l l y . 
17 
1110578 
MURDOCK, J u s t i c e ( c o n c u r r i n g 
s p e c i a l l y ) . 
I c o n c u r . 
I w r i t e s e p a r a t e l y t o a d d r e s s a 
p r o c e d u r a l 
i s s u e and t o e x p l a i n my agreement w i t h the main o p i n i o n as t o 
the 
m e r i t s . 
A. The 
J u r y Charges 
Because q u e s t i o n s 
e x i s t e d as 
t o whether D a n i e l 
E r n e s t 
H e g a r t y , M.D., 
the p h y s i c i a n d e f e n d a n t , h e l d h i m s e l f out as a 
s p e c i a l i s t and whether the p l a i n t i f f ' s p r o f f e r e d e x p e r t was 
a 
" s i m i l a r l y s i t u a t e d h e a l t h c a r e p r o v i d e r , " 
the 
t r i a l 
c o u r t 
gave i n s t r u c t i o n s t h a t a l l o w e d the j u r y t o d e c i d e 
f o r 
i t s e l f 
whether i t c o u l d 
c o n s i d e r 
the 
t e s t i m o n y 
of the 
p l a i n t i f f ' s 
e x p e r t 
w i t n e s s . 
Both 
s i d e s 
o b j e c t e d 
t o 
t h i s 
p r o c e d u r e . 
U n d e r s t a n d a b l y so. 
I t i s fundamental t h a t i t i s the t a s k of the t r i a l 
c o u r t , 
not the j u r y , t o d e c i d e whether the t e s t i m o n y 
of a w i t n e s s i s 
a d m i s s i b l e . 
A 
j u r y does not 
d e c i d e 
whether 
i t may 
hear 
e v i d e n c e ; 
the 
t r i a l 
c o u r t 
makes 
t h a t 
d e c i s i o n . 
See 
R u l e 1 0 4 ( a ) , A l a . R. E v i d . ( " P r e l i m i n a r y q u e s t i o n s 
c o n c e r n i n g 
the 
q u a l i f i c a t i o n s 
of a p e r s o n t o be 
a w i t n e s s 
... 
or 
the 
a d m i s s i b i l i t y of e v i d e n c e s h a l l be d e t e r m i n e d by the c o u r t . " ) ; 
S t a r F r e i g h t , I n c . v. S h e f f i e l d , 587 So. 2d 946, 956-57 ( A l a . 
18 
1110578 
1991) 
( h o l d i n g t h a t 
the 
a d m i s s i b i l i t y 
of 
e v i d e n c e 
i s 
a 
q u e s t i o n of law f o r the 
t r i a l c o u r t t o d e c i d e ) . 
A 
f o r t i o r i , 
i t was 
not 
f o r the 
j u r y i n t h i s 
m e d i c a l -
m a l p r a c t i c e 
case 
t o 
d e c i d e 
f o r 
i t s e l f 
whether 
an 
e x p e r t 
w i t n e s s p r o f f e r e d by one of the p a r t i e s was competent under 
our 
l e g a l s t a n d a r d s 
t o t e s t i f y . 
D e c i d i n g whether the 
j u r y 
s h o u l d have h e a r d 
t h i s t e s t i m o n y i n the 
f i r s t p l a c e was 
a 
g a t e - k e e p i n g 
f u n c t i o n p e c u l i a r l y w i t h i n the p r o v i n c e of the 
t r i a l c o u r t i t s e l f . 
I f a f a c t u a l q u e s t i o n must be r e s o l v e d 
f o r 
purposes 
of p e r f o r m i n g 
t h i s g a t e - k e e p i n g 
f u n c t i o n , 
then 
the 
t r i a l 
c o u r t must r e s o l v e i t . 
See, 
e.g., 
M e d l i n 
v. 
 
Crosby, 583 So. 2d 1290 
( A l a . 1991) 
( d i s c u s s i n g the s t a n d a r d 
to be a p p l i e d by the t r i a l c o u r t i n d e c i d i n g the competence of 
an e x p e r t w i t n e s s i n a m e d i c a l - m a l p r a c t i c e c a s e ) . 
Because the 
t r i a l 
c o u r t a l l o w e d the 
j u r y t o hear 
the 
t e s t i m o n y of the p l a i n t i f f ' s e x p e r t and t h e n , h a v i n g a l r e a d y 
h e a r d 
t h a t t e s t i m o n y , 
d e c i d e 
f o r 
i t s e l f 
whether 
i t c o u l d 
c o n s i d e r 
t h a t 
t e s t i m o n y , 
a 
l e g a l 
e r r o r 
was 
committed. 
N o r m a l l y , a new 
t r i a l would be r e q u i r e d . 
The d i s p o s i t i o n of 
t h i s case made by the C o u r t today, however, o b v i a t e s the need 
f o r 
a remand and a new 
t r i a l . 
19 
1110578 
B. 
The 
M e r i t s 
In M e d l i n , Ex p a r t e W a d d a i l , 827 So. 2d 789 ( A l a . 2001), 
and H o l l y v. H u n t s v i l l e H o s p i t a l , 865 So. 2d 1177 ( A l a . 2003), 
t h i s C o u r t appeared t o t r e a t the emergency-room p r a c t i c e o f 
the p h y s i c i a n d e f e n d a n t i n each case as p a r t of a d i s c i p l i n e 
or s c h o o l o f p r a c t i c e beyond or d i f f e r e n t from the f i e l d of 
f a m i l y p r a c t i c e i n w h i c h the d e f e n d a n t was 
b o a r d - c e r t i f i e d . 
See, e.g., H o l l y , 865 So. 2d a t 1186 
( d i s c u s s i n g the C o u r t ' s 
e a r l i e r h o l d i n g s i n M e d l i n and W a d d a i l and s t a t i n g t h a t "[w]e 
h e l d t h a t , because the d e f e n d a n t d o c t o r had been 
p r a c t i c i n g 
o u t s i d e 
h i s 
s p e c i a l i t y 
i n c o m m i t t i n g the 
a l l e g e d 
m e d i c a l 
n e g l i g e n c e , he was not a ' s p e c i a l i s t ' i n the case then b e f o r e 
u s " ) . 
Based on my r e a d i n g of t h e s e t h r e e c a s e s , the manner 
i n which the l a s t s e n t e n c e of § 6-5-458(e), A l a . Code 1975, i s 
worded, and the 
f a c t 
t h a t the 
l e g i s l a t u r e 
added t h e 
l a s t 
s e n t e n c e of s u b s e c t i o n 
(e) t o t h a t s t a t u t e soon 
a f t e r 
t h i s 
C o u r t ' s d e c i s i o n i n O l s e n v. R i c h , 657 So. 2d 875, 880 ( A l a . 
1995), I am c o m p e l l e d t o concur i n the main o p i n i o n . 
I f 
t h i s were a m a t t e r of making 
a p o l i c y 
c h o i c e , 
one 
c o u l d 
q u e s t i o n the 
s t r i c t n e s s 
o f the 
r u l e 
chosen 
by 
the 
l e g i s l a t u r e 
and 
argue 
t h a t , 
i n 
a 
case 
such 
as 
t h i s , 
20 
1110578 
Dr. Gregory Banks, assuming he c o u l d t a i l o r h i s t e s t i m o n y t o 
the 
s t a n d a r d o f c a r e f o r 
a p h y s i c i a n i n t h e p o s i t i o n o f 
Dr. 
H e g a r t y , 
s h o u l d be deemed competent t o do so. 
T h i s , 
however, i s n o t 
t h e 
p r e s c r i p t i o n f o r competence t h a t has been 
w r i t t e n by our l e g i s l a t u r e . Having been p r e s e n t e d no argument 
as t o t h e c o n s t i t u t i o n a l i t y o f t h i s 
p r e s c r i p t i o n -- and 
assuming f o r t h e 
sake o f t h i s case t h a t t h e r e i s none -- i t i s 
not our r o l e t o p r e s c r i b e some d i f f e r e n t r u l e . 
See, e.g., 
Ex p a r t e T.D.T., 745 
So. 
2d 899, 904 ( A l a . 1999) ( " [ I ] t i s 
n o t 
the d u t y o f t h i s C o u r t t o q u e s t i o n t h e 
wisdom, o r t h e l a c k 
t h e r e o f , used by t h e 
L e g i s l a t u r e i n 
e n a c t i n g t h e 
laws o f t h i s 
S t a t e . " ) ; P e o p l e v. M c I n t i r e , 461 M i c h . 147, 
159, 
599 N.W.2d 
102, 
109 
(1999) 
("[A] 
l e g i s l a t u r e 
i s 
f r e e 
t o make 
i n e f f i c a c i o u s o r 
even unwise p o l i c y c h o i c e s . The c o r r e c t i o n 
o f 
t h e s e p o l i c y c h o i c e s i s n o t 
a j u d i c i a l f u n c t i o n as l o n g as t h e 
l e g i s l a t i v e 
c h o i c e s do n o t o f f e n d t h e c o n s t i t u t i o n . " ) . I 
t h e r e f o r e must concur. 
21