Title: Bybee v. Gorman

State: idaho

Issuer: Idaho Supreme Court (civil)

Document:

1 
 
IN THE SUPREME COURT OF THE STATE OF IDAHO 
 
Docket No. 40887 
 
SCOTT and MERI BYBEE, husband and  
wife, 
 
      Plaintiffs-Appellants, 
v. 
 
PATRICK D. GORMAN, M.D.,  
       
      Defendant-Respondent, 
 
and 
 
FRED MEYER PHARMACY, FRED  
MEYER STORES, INC., and JOHN DOE  
PERSONS I through V, 
 
      Defendants. 
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Boise, April 2014 Term 
 
2014 Opinion No. 96 
 
Filed: September 19, 2014 
 
Stephen Kenyon, Clerk 
 
Appeal from the District Court of the Seventh Judicial District of the State of  
Idaho, Bonneville County.  Hon. Darren B. Simpson, District Judge. 
 
The judgment of the district court is vacated and the case is remanded for further 
proceedings. 
 
 
Nalder Law Office, P.C., Idaho Falls, for appellants.  G. Lance Nalder argued. 
 
 
Quane Jones McColl, PLLC, Boise, for respondent.  Terrence S. Jones argued. 
 
                     _______________________________________________ 
 
HORTON, Justice. 
 
This appeal arises from a medical malpractice claim brought by Scott and Meri Bybee 
against Dr. Patrick Gorman. The district court granted Dr. Gorman’s motion for summary 
judgment after concluding that the Bybees’ medical expert had failed to show adequate 
familiarity with the applicable standard of health care practice in the relevant community as 
required by Idaho Code sections 6-1012 and 6-1013, rendering his opinion inadmissible. We 
vacate the judgment of the district court and remand for further proceedings.   
I. FACTUAL AND PROCEDURAL BACKGROUND 
2 
 
 
 Dr. Gorman is a board-certified cardiologist practicing in Idaho Falls. Scott Bybee 
sought treatment for atrial fibrillation from Dr. Gorman at Eastern Idaho Cardiology Associates 
in Idaho Falls in May and August of 2007. Dr. Gorman prescribed Bybee 200 mg tabs of 
amiodarone, a heart rhythm medication, and instructed him to take two tablets twice daily for 
one week and then to reduce the dose to one tablet twice daily. Dr. Gorman wrote a prescription 
for sixty, 200 mg tabs, with refills lasting one year.  
 
After a catheterization procedure in the fall of 2007, Dr. Gorman diagnosed Bybee with 
borderline two-vessel coronary artery disease. Dr. Gorman recommended continued medical 
therapy, including taking amiodarone, but reduced the dose to one 200 mg tab per day, unless 
Bybee experienced any “breakthrough symptoms,” in which case he was to resume taking two 
200 mg tabs per day. Bybee was instructed to return to the clinic for follow-up care in six 
months, or as needed, with routine lab work to be completed prior to Bybee’s visit. 
 
Bybee did not return to Dr. Gorman for a follow-up appointment, but continued taking 
amiodarone from August of 2007, through early 2010. Fred Meyer Pharmacy twice received Dr. 
Gorman’s authorization to refill the amiodarone prescription at Bybee’s request. 
 
In December of 2009, Bybee began suffering from a severe cough and shortness of 
breath. Bybee sought treatment from Dr. Reed Ward. Analysis of Bybee’s blood showed 
abnormally high thyroid levels. Based on the results, Dr. Ward recommended Bybee return to 
Dr. Gorman. Bybee made an appointment with Dr. Gorman for January 19, 2010, but that 
appointment was rescheduled to February 1, 2010. The February 1, 2010 appointment was 
canceled because Dr. Gorman was unavailable and was never rescheduled.  
Thereafter, Bybee sought treatment from Dr. David Liljenquist who concluded that 
amiodarone was causing Bybee’s thyroid problems. Dr. Liljenquist instructed Bybee to stop 
taking amiodarone and Bybee complied. Bybee had his thyroid surgically removed on March 9, 
2010. A pathology exam revealed degenerative changes of the thyroid gland characteristic of 
amiodarone toxicity.   
The Bybees filed their complaint on April 11, 2011, alleging that Dr. Gorman was 
negligent in his care and treatment of Bybee due to Dr. Gorman’s failure to monitor and 
periodically test Bybee for adverse side effects attributable to amiodarone.1 
                                                 
1 The Bybees’ complaint also alleged Fred Meyer was negligent in renewing the amiodarone prescription without 
proper authorization from Dr. Gorman. Fred Meyer filed a motion for summary judgment on January 7, 2013. After 
3 
 
Dr. Gorman filed a motion for summary judgment on August 13, 2012. The Bybees’ 
response of October 24, 2012, was supported by the affidavit of Dr. Jeffery Osborn. In Dr. 
Gorman’s reply, he argued that Dr. Osborn’s affidavit was inadmissible as it failed to comply 
with the foundation requirements of Idaho Code sections 6-1012 and 6-1013, and I.R.C.P. 56(e). 
The Bybees moved to continue the summary judgment hearing or to supplement Dr. Osborn’s 
affidavit on November 5, 2012. At the beginning of the hearing for summary judgment on 
November 7, 2012, the presiding judge disqualified himself and the motion hearing was reset to 
November 28, 2012.  
On November 16, 2012, the Bybees submitted a Supplemental Affidavit of Dr. Osborn 
(the Supplemental Affidavit). On November 19, 2012, the Bybees filed a motion to shorten time 
so that their motion for leave to supplement Dr. Osborn’s affidavit could be heard at the 
November 28, 2012, hearing. The district court granted this motion. At the November 28, 2012, 
hearing, the Bybees moved to disqualify the judge, the judge agreed, and the hearing was reset 
for January 2, 2013.  
On December 4, 2012, the Bybees moved for the district court’s consideration of 
additional affidavits, or in the alternative, a continuance of the summary judgment proceedings 
pursuant to I.R.C.P. 56(f). In this motion, the Bybees asked the district court to consider all 
additional affidavits filed prior to December 19, 2012, when deciding Dr. Gorman’s motion for 
summary judgment. On December 14, 2012, the Bybees filed the affidavit of Dr. Matt 
Tannenbaum, who opined that Bybee’s thyroid gland tissue showed changes commonly 
associated with amiodarone toxicity. On December 19, 2012, the Bybees filed an additional 
supplemental affidavit of Dr. Osborn (the Second Supplemental Affidavit). On December 20, 
2012, Dr. Gorman moved to strike Dr. Tannenbaum’s Affidavit, and Dr. Osborn’s Supplemental 
and Second Supplemental Affidavits as untimely.  
On January 2, 2013, the district court heard Dr. Gorman’s motion for summary judgment 
and motion to strike, along with the Bybees’ motions regarding the supplemental affidavits. The 
district court denied Dr. Gorman’s motion to strike, reasoning that despite the untimeliness of the 
Bybees’ motion to supplement, the purpose of the time limitations established by I.R.C.P. 56(c) 
was fulfilled because Dr. Gorman had ample time to respond.  
                                                                                                                                                             
the Bybees filed a Notice of Non-Objection, Fred Meyer’s motion was granted. Thus, Fred Meyer is not a party to 
this appeal.  
4 
 
However, the district court concluded that Dr. Osborn’s affidavits were inadmissible 
because they failed to demonstrate that he was familiar with the applicable standard of health 
care practice for the relevant community as required by Idaho Code section 6-1012. The district 
court found that the relevant community was Idaho Falls, and because Dr. Osborn practiced in 
Pocatello, not Idaho Falls, he was not qualified to testify as to the applicable standard of health 
care practice in Idaho Falls. Further, the district court concluded that Dr. Osborn failed to meet 
the foundation requirements for an out-of-area expert because Dr. Osborn failed to identify the 
cardiologist with whom he conferred regarding the applicable standard of health care practice in 
Idaho Falls. Having found Dr. Osborn’s testimony to be inadmissible, the district court granted 
Dr. Gorman’s motion for summary judgment. The district court entered a final judgment on 
March 5, 2013. The Bybees timely appealed. 
II. STANDARD OF REVIEW 
 
“On appeal from the grant of a motion for summary judgment, this Court utilizes the 
same standard of review used by the district court originally ruling on the motion.” Arregui v. 
Gallegos-Main, 153 Idaho 801, 804, 291 P.3d 1000, 1003 (2012). Summary judgment is proper 
“if the pleadings, depositions, and admissions on file, together with the affidavits, if any, show 
that there is no genuine issue as to any material fact and that the moving party is entitled to a 
judgment as a matter of law.” I.R.C.P. 56(c). “When considering whether the evidence in the 
record shows that there is no genuine issue of material fact, the trial court must liberally construe 
the facts, and draw all reasonable inferences, in favor of the nonmoving party.” Dulaney v. St. 
Alphonsus Reg’l Med. Ctr., 137 Idaho 160, 163, 45 P.3d 816, 819 (2002).  
The admissibility of expert testimony offered in connection with a motion for summary 
judgment “is a threshold matter that is distinct from whether the testimony raises genuine issues 
of material fact sufficient to preclude summary judgment.” Arregui, 153 Idaho at 804, 291 P.3d 
at 1003. When deciding whether expert testimony is admissible, “[t]he liberal construction and 
reasonable inferences standard does not apply.” Hall v. Rocky Mountain Emergency Physicians, 
LLC, 155 Idaho 322, 325, 312 P.3d 313, 316 (2013) (quoting Dulaney, 137 Idaho at 163, 45 P.3d 
at 819). The trial court must look at the affidavit “testimony and determine whether it alleges 
facts which, if taken as true, would render the testimony of that witness admissible.” Id. at 325–
26, 312 P.3d at 316–17.  
5 
 
“This Court reviews challenges to the trial court’s evidentiary rulings under the abuse of 
discretion standard.” Id. at 326, 312 P.3d at 317. This Court engages in a three-part inquiry when 
reviewing a lower court’s decision for an abuse of discretion: “(1) whether the lower court 
rightly perceived the issue as one of discretion; (2) whether the court acted within the boundaries 
of such discretion and consistently with any legal standards applicable to specific choices; and 
(3) whether the court reached its decision by an exercise of reason.” McDaniel v. Inland Nw. 
Renal Care Grp.-Idaho, LLC, 144 Idaho 219, 221–22, 159 P.3d 856, 858–59 (2007). 
III. ANALYSIS 
 
This case requires this Court to once again address the admissibility requirements for 
expert testimony under Idaho Code sections 6-1012 and 6-1013. The Bybees raise two main 
issues on appeal: First, whether the district court improperly defined the relevant community; 
and second, whether the district court erred in concluding that out-of-area experts may not rely 
upon unidentified health care providers to familiarize themselves with the applicable standard of 
health care practice in the community.  
A. The district court abused its discretion by concluding that Dr. Osborn’s affidavits were 
inadmissible. 
“To avoid summary judgment for the defense in a medical malpractice case, the plaintiff 
must offer expert testimony indicating that the defendant health care provider negligently failed 
to meet the applicable standard of health care practice.” Dulaney, 137 Idaho at 164, 45 P.3d at 
820. The overarching issue in this case is whether Dr. Osborn’s affidavits established that he had 
familiarized himself with the applicable standard of health care practice as required by Idaho 
Code sections 6-1012 and 6-1013.  
Idaho Code section 6-1013 requires that a medical malpractice plaintiff establish the 
defendant’s failure to meet the applicable standard of health care practice through the testimony 
of at least one “knowledgeable, competent expert witnesses.” The statute prescribes the 
foundation required for such testimony:  
(a) that such an opinion is actually held by the expert witness, (b) that the said 
opinion can be testified to with reasonable medical certainty, and (c) that such 
expert witness possesses professional knowledge and expertise coupled with 
actual knowledge of the applicable said community standard to which his or her 
expert opinion testimony is addressed . . . . 
I.C. § 6-1013. 
6 
 
 
Rule 56(e) of the Idaho Rules of Civil Procedure imposes additional requirements for the 
admission of expert testimony in medical malpractice actions. See Ramos v. Dixon, 144 Idaho 
32, 35, 156 P.3d 533, 536 (2007). Particularly,  
The party offering such evidence must show that it is based upon the witness’ 
personal knowledge and that it sets forth facts as would be admissible in evidence. 
The party offering the evidence must also affirmatively show that the witness is 
competent to testify about the matters stated in his [or her] testimony. Statements 
that are conclusory or speculative do not satisfy either the requirement of 
admissibility or competency under Rule 56(e). 
Hall, 155 Idaho at 326, 312 P.3d at 317 (quoting Dulaney, 137 Idaho at 164, 45 P.3d at 820). 
Idaho Code section 6-1012 requires that the applicable standard of health care practice be 
established by direct expert testimony, providing in pertinent part: 
 
In any case, claim or action for damages due to injury to or death of any 
person, brought against any physician and surgeon or other provider of health care 
. . . on account of the provision of or failure to provide health care or on account 
of any matter incidental or related thereto, such claimant or plaintiff must, as an 
essential part of his or her case in chief, affirmatively prove by direct expert 
testimony and by a preponderance of all the competent evidence, that such 
defendant then and there negligently failed to meet the applicable standard of 
health care practice of the community in which such care allegedly was or should 
have been provided, as such standard existed at the time and place of the alleged 
negligence of such physician . . . and as such standard then and there existed with 
respect to the class of health care provider that such defendant then and there 
belonged to and in which capacity he, she or it was functioning . . . As used in this 
act, the term “community” refers to that geographical area ordinarily served by 
the licensed general hospital at or nearest to which such care was or allegedly 
should have been provided. 
(emphasis added).  
Thus, the medical expert must show that he or she is familiar with the standard of health 
care practice for the relevant medical specialty, during the relevant timeframe, and in the 
community where the care was provided. Suhadolnik v. Pressman, 151 Idaho 110, 116, 254 P.3d 
11, 17 (2011); Dulaney, 137 Idaho at 164, 45 P.3d at 820. Further, the medical expert must 
explain “how he or she became familiar with that standard of care.” Dulaney, 137 Idaho at 164, 
45 P.3d at 820 (emphasis added).  
1. Although the district court erred by defining the relevant community as a matter 
of law, the error was harmless. 
As to the foundation requirements for the admissibility of expert testimony in this case, 
the parties agree that the relevant time frame is 2007 through 2009, and the relevant specialty is 
7 
 
cardiology. However, the parties sharply disagree as to the range of the geographical area 
ordinarily served by the hospitals2 in Idaho Falls. 
Idaho Code section 6-1012 defines “community” as “that geographical area ordinarily 
served by the licensed general hospital at or nearest to which such care was or allegedly should 
have been provided.” The district court determined that Pocatello was not within that 
geographical area. Specifically, the district court explained:  
Although Idaho Falls lies within one hour’s distance of Pocatello, it is served by 
Eastern Idaho Regional Medical Center [EIRMC]. Pocatello is served by Portneuf 
Medical Center. In between Idaho Falls and Pocatello lies the city of Blackfoot, 
itself served by Bingham Memorial Hospital. 
Osborn testified that EIRMC serves Pocatello patients as well as Idaho 
Falls patients. Taken as true for purposes of summary judgment, the fact that 
EIRMC serves patients from throughout the region does not alter the requirement 
that the Bybees must produce direct expert testimony of the applicable standard of 
health care practice of the community in which such care alleged was or should 
have been provided. The “community” at issue is Idaho Falls, not Pocatello. To 
hold otherwise would nullify the definition of “community” provided by the 
Idaho Legislature in Idaho Code § 6-1012. 
On appeal, the Bybees argue that this conclusion was in error. The Bybees assert that the 
geographical scope of the community is a factual issue and that the record reflects that the 
general hospitals in Idaho Falls regularly served patients from Pocatello. The Bybees also argue 
that the geographical area that makes up the community in this case is a fact in dispute, and the 
district court erred by not viewing the facts in the Bybees’ favor. The Bybees continue that if the 
district court had properly determined Pocatello to be within the community, then Dr. Osborn’s 
affidavits would meet the foundation requirements of a local expert with actual knowledge of the 
applicable standard of health care practice. In response, Dr. Gorman argues that it is undisputed 
that the care was provided in Idaho Falls, making the relevant community Idaho Falls, not 
Blackfoot, Pocatello, or the greater undefined area of Eastern Idaho.  
                                                 
2 Both parties argue that the relevant community is defined by the service area of Eastern Idaho Regional Medical 
Center (EIRMC) or Mountain View Hospital (MVH). In this respect, the parties err. The standard prescribed by 
Idaho Code section 6-1012 is defined by reference to a single hospital, specifically “the licensed general hospital at 
or nearest to which such care was or allegedly should have been provided.” (emphasis added). The district court 
focused on EIRMC, presumably because that is the only hospital for which information was provided as to the 
source of its patient base. The record is completely silent as to the geographical origins of the patients served by 
MVH. We note that the record is similarly silent as to whether EIRMC and MVH are licensed general hospitals. 
Because the parties have not identified this as an issue on appeal, we will not address it further.  
8 
 
Idaho Code section 6-1013’s foundation requirements for the admissibility of expert 
testimony compel plaintiffs to show how the expert is familiar with the standard of health care 
practice for the community at issue. See Ramos, 144 Idaho at 37, 156 P.3d at 538. Thus, a 
threshold matter to the admissibility of the expert’s testimony is defining the community. 
Importantly, “[t]he liberal construction and reasonable inferences standard does not apply” when 
deciding whether the testimony is admissible in connection with a motion for summary 
judgment. Hall, 155 Idaho at 325, 312 P.3d at 316. This Court has consistently explained that 
“[t]he admissibility of the expert testimony is an issue that is separate and distinct from whether 
that testimony is sufficient to raise genuine issues of material fact . . . .” Id.  
Previously, this Court has considered the meaning of “ordinarily served” for the purpose 
of defining the community in medical malpractice cases only to observe the absence of evidence 
on the subject. In Ramos, we considered the situation of a physician, who practiced in Idaho 
Falls about thirty miles from Blackfoot. We stated that “Idaho Falls could be within the 
geographical area ordinarily served by the Bingham Memorial Hospital in Blackfoot. The 
existence of a licensed general hospital in Idaho Falls would not preclude Idaho Falls from being 
within that geographical area. Hospitals in nearby towns can certainly be in competition with 
each other.” 144 Idaho at 35, 156 P.3d at 536. We concluded that “whether Idaho Falls is within 
the geographical area ordinarily served by the hospital in Blackfoot is a factual issue. . . .” Id. 
Noting the complete absence of evidence in the record on this issue, we upheld the district 
court’s determination that Idaho Falls was not within the geographical area served by Bingham 
Memorial Hospital. Id. 
Likewise, this Court addressed the geographical scope of the community in Gubler v. 
Boe, where the plaintiff was treated and the alleged negligence occurred in Pocatello. 120 Idaho 
294, 295, 815 P.2d 1034, 1035 (1991). We affirmed the district court’s conclusion that an expert 
witness who practiced in Idaho Falls was not adequately familiar with the standard of care for the 
relevant community because the community was Pocatello, and did not include Idaho Falls. Id. at 
298, 815 P.2d at 1038. As in Ramos, the plaintiff in Gubler made no attempt to show that Idaho 
Falls was in that area ordinarily served by the licensed general hospital in Pocatello. Id.  
The district court’s explanation of its holding that Pocatello was not within the 
geographical area ordinarily served by EIRMC appears to reflect its view that the geographical 
scope of the community was a legal, rather than factual, determination. To this extent, the district 
9 
 
court erred. However, because we conclude that the Bybees failed to provide necessary evidence 
that would support such a finding, we find this error to be harmless.  
This case provides us with the opportunity to provide further guidance as to the meaning 
of “ordinarily served” in Idaho Code section 6-1012, although we recognize that our explanation 
will likely leave judges and practitioners unsatisfied. This is a consequence of the legislature’s 
choice of language defining “community.” Rather than choosing to define community by means 
of distance from the nearest licensed general hospital, the legislature chose to define community 
by reference to the locations from which the patient base of the hospital is derived. If users of the 
hospital’s services commonly go from one location to the place where the hospital is located, 
then that location falls within the geographical area which constitutes the community. As we 
implicitly recognized in Ramos, it is because people residing at one location may commonly use 
the services provided by more than one hospital, communities may overlap one another. 144 
Idaho at 35, 156 P.3d at 536. 
The imprecision of this definition of community lies in the word “ordinarily.”3 Although 
the word signifies some degree of frequency, judges4 viewing the same evidence may reach 
differing conclusions as to whether patients from a particular location use a hospital’s services on 
a regular or common basis. Although perhaps creating uncertainty for the parties and their 
lawyers, this is entirely consistent with the discretionary nature of the decision confronting a trial 
judge addressing a challenge to the admissibility of a medical expert’s testimony.  
We now consider the foundation that the Bybees attempted to establish as to Dr. 
Osborn’s direct knowledge of the applicable standard of health care practice in Idaho Falls. On 
this subject, his first affidavit simply stated: “I have been licensed to practice medicine in Idaho 
                                                 
3 “Ordinarily” is an adverb derived from the adjective “ordinary” meaning: “1. Usually; as a rule 2. In an ordinary 
manner or to an ordinary degree.” Webster’s New World Dictionary 1001 (2d College ed.1976). “Ordinary,” in this 
context, means “1. customary; usual; regular; normal 2. a) familiar; unexceptional; common.” Id.  
4 The Bybees are incorrect in their assertion that the jury is the factfinder as to the geographical scope of the 
community. Rather, I.R.E. 104(a) places this responsibility upon the judge. Rule 104, I.R.E., provides:  
(a) Questions of admissibility generally. Preliminary questions concerning the 
qualifications of a person to be a witness, the existence of a privilege, or the admissibility of 
evidence shall be determined by the court, subject to the provisions of subdivision (b). In making 
its determination it is not bound by the rules of evidence except those with respect to privileges.  
We caution judges that, in making such decisions, the trial court should refrain from resolving conflicting factual 
disputes. Thus, the “trial court should not involve itself in weighing the conflicting evidence” but simply determine 
“whether, for the purposes of surviving summary judgment,” the plaintiff has offered sufficient evidence. See 
Montgomery v. Montgomery, 147 Idaho 1, 7, 205 P.3d 650, 656 (2009) (noting the “well-established rule that a trial 
court, in ruling on a motion for summary judgment, is not to weigh evidence or resolve controverted factual 
issues.”). 
10 
 
since 2005 and am familiar with the standard of care applicable to cardiologists in the Idaho 
Falls/Pocatello area as it existed during 2007 through 2009. . . .” This conclusory statement of 
familiarity with the applicable standard of health care practice, without identifying the manner in 
which such familiarity was developed, is insufficient to establish foundation for the admissibility 
of Dr. Osborn’s testimony. Ramos, 144 Idaho at 37, 156 P.3d at 538; see also McDaniel v. 
Inland Nw. Renal Care Grp.-Idaho, LLC, 144 Idaho 219, 223, 159 P.3d 856, 860 (2007); Hoover 
v. Hunter, 150 Idaho 658, 662-63, 249 P.3d 851, 855-56 (2011). 
The only evidence as to whether Pocatello is within the geographical area ordinarily 
served by EIRMC is found in the Supplemental Affidavit. There, Dr. Osborn attempted to define 
the applicable community by reference to a licensed general hospital, stating: “The community, 
in terms of the area served by EIRMC hospital in Idaho Falls, consisted of people from both 
Idaho Falls and Pocatello.”5 We find this statement to be too conclusory to satisfy the foundation 
requirements of Idaho Code sections 6-1012 and 6-1013. This statement does not identify the 
basis of Dr. Osborn’s knowledge as to where EIRMC patients come from and, more importantly, 
it does not attempt to identify, or even approximate, the frequency which patients from Pocatello 
elect to receive services at EIRMC as opposed to Portneuf Medical Center, Bingham Memorial 
Hospital, MVH or other hospitals. In the absence of such evidence, we find the district court’s 
error to be harmless.  
2. The district court erred by concluding that Dr. Osborn’s reliance upon an 
unidentified Idaho Falls cardiologist to familiarize himself with the applicable 
standard of health care practice was fatal to the admissibility of Dr. Osborn’s 
affidavits. 
 After concluding that Dr. Osborn did not meet the foundation requirements of a local 
expert, the district court considered whether Dr. Osborn qualified as an out-of-area expert who 
adequately familiarized himself with the applicable standard of health care practice by speaking 
with a local specialist. In the Supplemental Affidavit, Dr. Osborn testified that he spoke with an 
unidentified board-certified cardiologist who maintained a practice in Idaho Falls6 during the 
time period 2007 through 2009. The district court concluded that Dr. Osborn’s “failure to name 
the cardiologist with whom he conferred proves fatal to the admissibility of his affidavit.” The 
                                                 
5 We note that the Supplemental Affidavit contains information relating to Dr. Osborn’s Pocatello practice, in which 
he treated patients from both Idaho Falls and Pocatello, and his understanding that Idaho Falls-based cardiologists 
saw patients from both cities. This information is irrelevant to the pertinent hospital’s service area. 
6 The parties both agree that Idaho Falls is within the geographical scope of the relevant community. 
11 
 
district court continued, Dr. Osborn’s “consultation with a cardiologist practicing in Idaho Falls 
during the relevant time period is vital, but without revelation of the cardiologist’s name, 
Gorman is estopped from investigating his or her credentials and personal knowledge of the 
standard of care.”  
The Bybees argue that there is no requirement that the identity of a consulting physician 
be disclosed to meet the foundation requirements of Idaho Code section 6-1013 and I.R.C.P. 
56(e). Dr. Gorman counters that use of an anonymous consultant will always fail to meet the 
foundation requirements for admissibility of an out-of-area medical expert’s testimony.  
Idaho Code section 6-1013 specifically provides that the requirement that a plaintiff offer 
testimony of an expert familiar with the applicable standard of health care practice does not 
“prohibit or otherwise preclude a competent expert witness who resides elsewhere from 
adequately familiarizing himself with the standards and practices” of the relevant community. 
“One method for an out-of-area expert to obtain knowledge of the local standard of care is by 
inquiring of a local specialist.” Hall, 155 Idaho at 327, 312 P.3d at 318 (quoting Dulaney v. St. 
Alphonsus Reg’l Med. Ctr., 137 Idaho 160, 163, 45 P.3d 816, 819 (2002)). This Court has 
consistently held that the out-of-area expert’s affidavit must state how the local expert became 
familiar with the community standard of care. Id.; see also Dulaney, 137 Idaho at 164, 45 P.3d at 
820.  
However, this Court has never held that failure to name the local expert with whom an 
out-of-area expert confers is fatal to the admissibility of that affidavit so long as the other 
foundation requirements are met. See e.g. Dulaney, 137 Idaho at 169, 45 P.3d at 825 (explaining 
that the affidavit did “not allege specific facts showing that the anonymous professor was 
familiar with the standard of care” for the specialty, at the time, and in the place of the alleged 
negligence). Indeed, a majority of this Court recently expressed “grave misgivings” about a 
plurality opinion’s suggestion “that the identity of the local health care provider with whom a 
Plaintiff’s expert consults must be disclosed as part of the foundation for that opinion,” 
expressing our concern that such a rule “elevated the requirements for an expert’s affidavit 
beyond the requirements of I.C. § 6–1013.” Arregui v. Gallegos-Main, 153 Idaho 801, 811, 291 
P.3d 1000, 1010 (2012) (Horton, J., specially concurring).  
Today we hold that an affidavit that fails to identify an anonymous consultant does not 
categorically fail to comply with the foundation requirements for admissibility of an out-of-area 
12 
 
expert’s testimony under Idaho Code section 6-1013. Rather, the inquiry remains whether the 
out-of-area expert demonstrates how he or she became adequately familiar with the community 
standard of health care practice, making it sufficiently clear that the expert consulted with a local 
specialist7 who had actual knowledge of the standard of health care practice for the proper class 
of provider during the relevant time period.  
This holding is consistent with our decision in Dunlap v. Garner, 127 Idaho 599, 903 
P.2d 1296 (1994). In Dunlap, the plaintiff’s out-of-area expert testified in his affidavit that he 
had spoken with two local practitioners regarding the community standard of health care 
practice. 127 Idaho at 602, 903 P.2d at 1299. In response, the defendants submitted the affidavits 
of the local practitioners, who both indicated that they had not discussed the standard of care 
with plaintiff’s expert. Id. at 603, 903 P.2d at 1300. The district court granted defendant’s 
summary judgment motion after concluding that plaintiff’s expert was not credible as to his 
actual knowledge of the local standard of care, rendering his affidavit inadmissible. Id. at 604, 
903 P.2d at 1301. We concluded that the district court erred by weighing the relative credibility 
of the parties’ experts and resolving the conflicting accounts given in their affidavits. Id. at 605, 
903 P.2d at 1302. The statements of the plaintiff’s expert, taken as true, were sufficient to qualify 
him to express an expert opinion regarding whether the defendant violated the community 
standard of health care practice. Id.  
In the Supplemental Affidavit, Dr. Osborn stated: 
4. I have spoken with a board certified cardiologist who maintained a clinical 
practice in Idaho Falls, Idaho during the 2007-2009 time frame about the standard 
of care in prescribing Amiodarone in Idaho Falls and Pocatello. From my 
conversations and my own clinical practice in Pocatello during that time frame, I 
am familiar with the standard of care for cardiologists in prescribing Amiodarone 
in both Idaho Falls as well as Pocatello.  
Accepting the truth of this affidavit, the unidentified physician practiced in the relevant 
community at the same time as the events that gave rise to the action and in the same specialty as 
Dr. Gorman. This is sufficient to demonstrate that the unidentified consultant was familiar with 
                                                 
7 “[T]hat specialist need not have practiced in the same field as the defendant, so long as the consulting specialist is 
sufficiently familiar with the defendant’s specialty.” Suhadolnik v. Pressman, 151 Idaho 110, 116, 254 P.3d 11, 17 
(2011) (citing Newberry v. Martens, 142 Idaho 284, 292, 127 P.3d 187, 195 (2005)). “The plaintiff’s expert can also 
make inquiries to another out-of-area specialist, so long as that specialist has had sufficient contacts with the area in 
question to demonstrate personal knowledge of the local standard.” Id. (citing Shane v. Blair, 139 Idaho 126, 130, 
75 P.3d 180, 184 (2003)). 
 
 
13 
 
the relevant and applicable standard of health care practice.8 Accordingly, we hold that the 
district court applied an erroneous legal standard and therefore erred in concluding that Dr. 
Osborn’s affidavit was inadmissible solely because he relied on an unidentified physician to 
familiarize himself with the community standard of health care practice.  
3. Dr. Osborn’s affidavits complied with Idaho Code section 6-1013 and I.R.C.P. 
56(e). 
As an out-of-area expert, Dr. Osborn’s affidavits met all other foundation requirements of 
Idaho Code section 6-1013 and I.R.C.P. 56(e). Idaho Code section 6-1013 “requires that ‘the 
expert must show that he or she actually holds the opinion, that it is held with a reasonable 
degree of medical certainty, and that he or she is not only an expert but has actual knowledge of 
the applicable community standard.’ ” Shane, 139 Idaho at 129, 75 P.3d at 183 (quoting Kolln v. 
St. Luke’s Reg’l Med. Ctr., 130 Idaho 323, 329, 940 P.2d 1142, 1148 (1997)).  
Dr. Osborn testified to the following in his first affidavit: 
1. I am a cardiologist, board certified, with licenses to practice in both Idaho and 
Utah. I have maintained a cardiology practice in eastern Idaho . . .  I have been 
licensed to practice medicine in Idaho since 2005 and am familiar with the 
standard of care applicable to cardiologists in the Idaho Falls/Pocatello area as it 
existed during 2007 through 2009 . . . .  
. . . . 
Amiodarone/Pacerone must be thoughtfully prescribed, carefully monitored for its 
effects in the human system, and followed very closely by the prescribing 
physician. This requirement of careful monitoring of Amiodarone/Pacerone is 
now and was during the 2007 through 2009 time frame applicable as the standard 
of care in both east Idaho as well as Utah, and all other places that I have 
practiced.  
. . . . 
It is my opinion that Dr. Gorman violated the applicable standard of care for a 
physician practicing in Idaho Falls, Idaho in prescribing and monitoring of 
Amiodarone/Pacerone for Scott Bybee. 
In his Supplemental Affidavit, Dr. Osborn testified: 
From my conversations and my own clinical practice in Pocatello during that time 
frame [2007-2009], I am familiar with the standard of care for cardiologists in 
prescribing Amiodarone in both Idaho Falls as well as Pocatello.  
. . . . 
                                                 
8 The corollary of this holding is that defendants should be permitted to conduct discovery as to the identity of 
consulting physicians. As in Dunlap, an expert’s claim to have consulted with a local practitioner in order to gain 
familiarity with the applicable standard of health care practice may present questions of credibility for consideration 
by the ultimate trier of fact.    
14 
 
My opinion remains the same. Dr. Gorman violated the applicable standard of 
care for a physician practicing in Idaho Falls, Idaho in prescribing and monitoring 
Amiodarone/Pacerone for Scott Bybee . . . . 
Then, in the Second Supplemental Affidavit, Dr. Osborn stated:  
The opinions expressed in my initial affidavit and the opinions expressed herein I 
hold to a reasonable degree of medical certainty.  
These affidavits contain specific facts showing that Dr. Osborn had familiarized himself 
with the applicable standard of health care practice and held the opinion, to a reasonable degree 
of medical certainty, that Dr. Gorman violated the standard of health care practice for 
cardiologists in Idaho Falls between 2007 and 2009. Because Dr. Osborn’s expert testimony 
complied with Idaho Code sections 6-1012 and 6-1013, and I.R.C.P. 56(e), the district court 
failed to apply the applicable legal standards and thus, abused its discretion by determining Dr. 
Osborn’s affidavit testimony to be inadmissible. Accordingly, we vacate the judgment in favor of 
Dr. Gorman. 
B. Dr. Gorman is not entitled to attorney fees on appeal.  
Dr. Gorman requests attorney fees on appeal pursuant to Idaho Code section 12-121 and 
I.R.C.P. 54(e)(1). Idaho Code section 12-121 authorizes an award of attorney fees in a civil 
action to the prevailing party. Because Dr. Gorman is not the prevailing party on appeal, he is not 
entitled to fees. Johnson v. Highway 101 Investments, LLC, 156 Idaho 1, 5, 319 P.3d 485, 489 
(2014). 
IV. CONCLUSION 
 
We vacate the judgment of the district court dismissing the Bybees’ action against Dr. 
Gorman and remand the matter to the district court for further proceedings consistent with this 
opinion. We award costs on appeal to the Bybees.  
 
 
Chief Justice BURDICK and Justices EISMANN and W. JONES, CONCUR. 
 
J. JONES, Justice, specially concurring. 
 
I concur in the Court’s opinion, particularly the holding that an affidavit which fails to 
identify an anonymous consultant does not categorically fail to comply with the foundation 
requirements for admissibility of an out-of-area expert’s testimony under Idaho Code section 6-
1013. I do not read the opinion in Arregui v. Gallegos-Main, 153 Idaho 801, 291 P.3d 1000 
(2012) to say that failure to name a local expert with whom an out-of-state expert confers is fatal 
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to the admissibility of the latter’s testimony. In Arregui, the identity of the local expert was 
merely part of a laundry list of problems identified with regard to the local expert’s experience 
and qualifications. With regard to the out-of-state expert, we stated “she never identified the 
local chiropractor, she did not describe the type of chiropractic practice he ran, nor how he 
became aware of the local standard of care, how long he practiced in the Nampa-Caldwell area, 
or whether he was familiar with torticollis, and the specific procedures allegedly used on the 
Patient.” 153 Idaho at 809, 291 P.3d at 1008. The focus was not upon the fact that the local 
expert was unnamed, but that there was nothing in the out-of-state expert’s affidavit to show the 
qualifications of the local chiropractor to testify as to the local standard of care for the procedure 
at issue in that case. I would certainly never subscribe to the proposition “that the identity of the 
local health care provider with whom a Plaintiff’s expert consults must be disclosed as part of the 
foundation for that opinion.”