I N T H E SUPR EM E C O UR T O F M I SS I SS I PPI NO. 2 0 1 0 - I A- 0 0 1 9 0 - S CT M I D-SOU TH

RETI NA , LLC
v. BERNICE CONNER
D A T E O F JU D G M E N T : 01/ 11/ 2010 TRI AL J UD GE: HO N. THO M AS W
. ALLEN CO UR T F RO M W HI CH AP P E AL E D: ATTO RN EYS FOR A PP ELLAN T: CO UN TY C OU RT O F COA HO M A C OU NTY S HE L BY KI RK M I L AM J OS I AH DE NNI S CO L E M AN A T T O R N E Y S F O R A P P E L L E E : D A N IE L M . C Z A M A N S K E , J R
. J OSEPH H AR LAN D W EBSTER NATURE OF THE CAS E: CI VI L - M EDI CAL NEGL I GENCE DI S P OS I T I ON: M OT I ON F OR RE HE AR I NG F I L E D: R E V E R SE D A N D R E N D E R E D - 09/ 08/ 2011 M ANDAT E I S S UE D:

EN BA NC
. CAR LS ON , PRES I DI NG J UST I CE, FOR TH E COU RT: ¶1. B erni ce Connerf i l ed a medi cal
- negl i gence sui tagai ns tM i d- Sout h R et i na, L L C
. T he C ount y Courtof

Coah oma Cou nty o r i gi na l l y g r a nt e d s umm a ry j ud gmen ti n f a vo rof M i dSout h, f i ndi ng thatC onnerhad f ai l ed t o est abl i s h t he nec es s ary el ementof caus at i on. T he tr i al courtthen r ever s ed i t s j udgm entupon r econs i der at i on and deni ed M i d- Sout h’ s m ot i on f ors um m ary j udgm ent . A ggr i eved, M i d- Sout h f i l ed a pe t i t i on f

ori nt er l ocut ory appea l , and
w e g ran ted th e p e tit ion
. F o r th e re aso n s d iscu ssed b elow , w e re v erse the tri al co u rt ’s

### 2

ju d g m e n t d e n y in g M id -S o u th ’s m o tio n fo r su m m a ry ju d g m e n t an d ren d e r ju d g m e n t h e re in f avorof M i d- Sout h. F ACT S AND P ROCE ED I NGS I N T HE T RI AL COURT ¶2. I n 2003, M i d- Sout h R et i na, L L C , and D r . B r ad Pr i es t er tr eat ed B erni ce C onnerf or age- r el at ed macul ardegene r at i on. A s par tof C onner ’ s tr eatm ent , s he i ntr avenous l y r ece i ved V isud y n e, a d rug tha t aids in c o ld-l ase r the rap y for m ac u lar de g en era ti o n . D u ri n g C o n n er’s
s econd vi s i tt o M i d- Sout h, V i s udyne i nf i l tr at ed the s of

tt i s s ue ar ound the i nj ect i on s i t e i n the bend of C onner ’ s el bow
. D r . Pr i es t erdet erm i ned t hatenough V i s udyne had e nt er ed C onner ’ s bl oods tr eam and pr ocee ded w i th the col d- l as erther apy. T he therapy ses s i on
c o n tin u e d w ith o u t in c id e n t. ¶ 3
. V is u d y n e is a p h o to d y n a m ic d ru g , a n d tissu e c o n tain in g th e d ru g c a n e a sily b u rn if expos ed t o s unl i ght
. D r . Pr i es t ert es t i f i ed that , because of

thi s s i de ef

f ect , he ens ur ed that C onner ’ s el bow w as s uf f i ci ent l y bandage d and cove r ed pr i ort o her l eaving M i d- Sout h. Shor t l y af

t erl eavi ng, C onnercal l ed M i d- Sout h com pl ai ni ng thatherarm w as hur t i ng. She
w as i nst ruct ed t o r eturn t o M i d- Sout h. U pon herr eturn, D r . Pr i es t ers entC onnert o a derm at ol ogi s t . T he der m at ol ogi s ti ns truct ed C onnert o go i m m edi at el y t o an emer gency
r oom . C onnerdi d notgo t o t he emer gency r oom , buti ns t ead r eturned t o herhom e. ¶ 4
. T h e n e x t d a y , D r. P rie ste r c o n tac ted C o n n e r, a n d sh e in fo rm e d h im th a t sh e w a s s til l i n pai n. D r . Pr i es t eri ns truct ed hert o go t o an em er gency r oom . C onnerw entt o an
emer gency r oom and w as r ef err ed t o a gener al s ur geon, w ho pr es cr i bed pai n m edi cat i on and ant i bi ot i cs . C onners aw the s ur geon tw o more t i m es i n 2003, a nd the s ur geon not ed thatt he i nj ury on C onner ’ s el bow m eas ur ed l es s than one c ent i m et eri n s i ze.

### 3

¶5. C onnerf

i l ed s ui ta gai ns tM i d-So uth and D r. P ri est er i n 2 00 4, al l eging m edica l
n eg li g en ce in th e ad m inistrati o n o f V isud y n e. T h e d efe n d an ts fi led a m o ti o n for su m m ary j udgm ent , ar gui ng thatC onnerhad f ai l ed t o des i gnat e an e xpertw i tnes s . C onnert hen des i gn at ed L aD on na N orthingt on , a regi st ered nu rs e, as her onl y expertw i tnes s . N orthi ngt on sta ted in h e r a ffid a v it th a t th e M id -S o u th n u rse s w e re n e g lig e n t in fa ili n g to d o c u m e n t fu lly C o n n er’s tr ea tm en t and the V isud y n e infil tr ati o n . T h e d efe n d an ts f il ed a re b u tt al t o C o n n er’s des i gnat i on, cl ai m i ng t hatC onnerhad notes t abl i s hed the nec es s ary el ementof caus at i on. A t th e su m m ary jud g m en t hea ri n g , C o n n er c o n ce d ed that su m m ary jud g m en t w as a p p ro p ria te
a s to D r. P rie ste r. O n A u g u st 1 0 , 2 0 0 9 , th e tria l co u rt g ra n ted su m m a ry ju d g m e n t o n b e h a lf of D r . Pr i es t erand M i d- Sout h, f i ndi ng thatC onnerhad nots uf f i ci ent l y es t abl i s hed al l t he
e l e me n t s o f

h e rme d i c a l
- n e g l i g e n c e c l a i m. ¶6
. O n A ugus t20, 2009, C onnerf i l ed a mot i on f

orr econs i de r a t i on, at t achi ng a
s uppl ement al af

f i davi tf r om N or thi ngt on. M i d- Sout h moved t o s tr i ke the af f i davi t , ar gui ng thatC onnershoul d notbe abl e t o cor r ectt he def i ci enci es i n herpre vi ous af f i davi tthr ough a pos t - j udgm entm ot i on f

orr econs i der at i on. T he tr i al courtf ound thatC onner ha d, att hat t i m e, es t abl i s hed al l the nec es s ary el ement s of he rmedi cal
- negl i gence c l ai m . T hus , the tr i al
courtdeni ed M i d- Sout h’ s m oti on t o s tr i ke the s uppl ement al af f i davi ts ubm i t t ed by N ort hingt on, r ever s ed i t s pr evi ous gr antof s um m ary j udgm enti n f avorof M i d- Sout h, and deni ed M i d- Sout h’ s m ot i on f ors um m ary j udgm ent . M i d- Sout h then pet i t i oned thi s C our tf or an i nt er l ocut ory appea l , and w e gr ant ed M i d- Sout h’ s pet i t i on. DI S CU S S I ON

### 4

¶ 7
. M id -S o u th ra is e s th re e is s u e s o n in ter lo c u to ry a p p e a l: (1 ) w h e th e r N o rth in g to n is qual i f i ed t o r enderan expe r topi ni on on m edi cal caus at i on; ( 2) w hetherthe tr i al courterr ed i n denyi ng M i d- Sout h’ s m ot i on forsumm ary j udgm ent ; and ( 3) w hetherthe tr i al courterr ed in co n side ri n g N o rth ing ton ’s su p p lem en tal affidav it
. B ec au se th e firs t tw o issue s are d is p o s itiv e , w e d e c lin e to a d d re s s th e fi n a l is s u e o n a p p e a l. See B er r y v. P atten , 51 So. 3d 934, 937 ( M i s s . 2010)
. W e combi ne ourdi s cus s i on of the f i r s ttw o i s s ues f

orthe purpos es
o f to d a y ’s a p p e a l. W HE T HE R MI D- S OU T H I S E NT I T LE D T O S UM M ARY J UDGM EN T B E CA US E CO NN E R H AS F AI L E D T O E S T AB L I S H A L L OF T HE NE CE S S ARY E LE M EN TS OF HER M ED I CAL - NE GLI GENC E C L A I M. ¶8. I n or dert o es t abl i s h a pr i m a f aci e cas e of

medi cal negl i gence , the pl ai nt i f f m us t pr ove the fol l ow i ng el em ents : ( 1) the def

endanthad a duty t o conf or m t o a s peci f

i c s t andar d of

conductf

or the pr ot ect i on of

other s agai ns tan unr eas onabl e r i s k of i nj ury; ( 2) the d efe n d an t f

ail ed to co n form to tha t r eq u ir ed stan d ard ; ( 3 ) th e d efe n d an t’ s br eac h of

dut y w as a p r oxi m at e ca us e of the pl ai nt i f

f’ s i nj ury, and; ( 4) the p lain tiff w a s in

ju re d a s a re su lt. McD on ald v. Mem ’l

Hosp. at G u l

fport , 8 So. 3d 175, 180 (M i s s . 2009) ( quot i ng D elta R eg ’l Med. Ctr. v. V

enton , 9 6 4 S o . 2 d 5 0 0 , 5 0 4 (M iss. 2 0 0 7 )) ( o ther c it ati o n s o m itted). In
m ed ical-ne g li g en ce ca ses, ex p ert testi m o n y is ge n era ll y req u ir ed to su rviv e su m m ary ju d g m e n t. McD o n a ld , 8 So. 3d at18 0. Sum m ary j udgm enti s appr opr i at e w hen the
n o n mo v i n g p a r ty h a s f

a i l e d s u f f i c i e n t l y t o e s t a b l i s h a n e s s e n t i a l e l e me n to f th a tp a r ty ’ s c l a i m. B uckel v. Chaney , 4 7 S o . 3 d 1 4 8 , 1 5 3 (M iss. 2 0 1 0 ) (cit ati o n s o m itted).

### Inf i n d i n gth at

th e tri a lc o urt

h a de rr e dins tri k i n ga l lo f th e nur s e ’ s t e s t i m o ny, we 1 

### st at ed: I nas m uch as w e have hel d thatK el l ercoul d nott es t i f y a s t o m edi cal caus at i on, the tr i al cou rtdi d notabus e i t s di s cr et i on i n notal l ow i ng t es t i m ony f r om K ell er tha t th e n eg li g en t acts of B ap ti st n u rses p rox im ately c au sed V au g h n ’s s t aph i nf ect i on. W hi l e the tr i al courtdi d erri n barr i ng K el l er ’ s t es t i m ony ou t ri ghtand s tr i ki ng the port i on of the af f i davi tr egar di ng the el ement s of sta n d a rd o f c a re a n d d e v iatio n s fr o m th e n u rsin g sta n d a rd o f c a re , this a ss ig n m e n t o f e rro r is m o o t, g iv e n th a t w e h a v e h e ld su m m a ry ju d g m e n t in th is cas e w as pr oper l y gr ant ed. I d . at655. 

### 5 ¶9. C i t i ng ourr ecent opi ni on i n V aughn v. Mis s is s i

ppiB aptis t

Medical Center , 20 S o. 3d 645 ( M i s s . 2009) , M i d- Sout h cont ends thatN or thi ngt on cannotof f eran opi ni on on
m edi c a l c a us a t i on , a nd thu s , Conne rha s f a i l e d t o e s t a bl i s h the ne c e s s a ry e l e mentof
caus at i on. I n Vaughn , w e “e xpl i ci t l y [ hel d] thatnur s es cannott es t i f y as t o m edi cal
caus at i on. ” I

d . at652. ¶10. I n Vaughn , th e p la in tif f’ s o n ly e x p e rt -c a u s a tio n w itn e s s w a s a re g is te re d n u rs e . I d. at651. The tr i al courtgr ant ed the def endant ’ s m ot i on f

ors um m ary j udgm ent , f i ndi ng t hat V a u g h n h a d fa iled to sh o w h o w h e r in ju ry w a s th e p ro x im a te re su lt o f th e d e fe n d a n t’s a c ts
o r o m is s io n s . I

d . at 65 0
. T h e tri al c o u rtalso stru ck V au g h n ’s ex p ert de sign ati o n o f a
r egi s t er ed nur s e, “f

i ndi ng thatnur s es c oul d notpr oper l y of f erexpertt es t i m ony as t o m edi cal
caus at i on. ” I

d . A lth o u g h w e fo u n d that the tri al co u rterred in stri k ing all o f th e n u rse’s test im o n y , w e u lt im ately fo u n d that su m m ary jud g m en t w as p rop er. I d . at6 55. C i t i ng 1 R i char ds on v. Met

hodis t Hos pital of H atties burg, I

nc. , 80 7 S o . 2d 12 44 , 12 47 -48 (M i ss. 2 0 0 2 ), a n d n u m ero u s h o lding s fro m o ther jurisdicti o n s, w e h eld th at “n u rses c an n o t t esti fy

### 6

as t o m edi cal caus at i on. ” Vaughn , 20 So. 3d at652. A ccor di ngl y, w e hel d thatthe tr i al
courti n Vaughn did not err i n g rant i ng sum m ary j ud gm ent i n favor of the d efendan tbecau se th e p la in tif

f h a d fa ile d to e s ta b lis h th e n e c e s s a ry e le m e n t o f c a u s a tio n . I d . at653. ¶11. I n t oday’ s c as e, Connera r gues thatthe i s s ue of w hetherN or thi ngt on m ay r enderan
ex p ert op inion o n cau sati o n w as n o t befo re the tr ial co u rtan d there fore is no t pro p erly b efo re thi s C our ton i nt er l ocut ory a ppeal
. M i d- Sout h moved f ors um m ary j udgm enton O ct ober22, 2 0 0 8 , arg u in g th a t itw a s e n tit led to su m m a ry ju d g m e n t b e c a u se C o n n e r h a d fa iled to des i gnat e an e xpertw i tnes s . I n r es pons e t o M i d- Sout h’ s m ot i on , C onnerdes i gnat ed N or thi ngt on, a r egi s t er ed nur s e, a s he re xpertw i tnes s . I n N ovember2008, C onners ubm i t t ed N o rth in g to n ’s a ffid a v it an d filed a re sp o n se to M id -S o u th ’s m o tio n fo r su m m a ry ju d g m e n t,
s t at i ng thats he had now de s i gnat ed an expertw i tnes s a nd thatN or thi ngt on w as “compet ent
a n d q u a lified ” to o ffe r tes tim o n y . M id -S o u th fil e d a re b u ttal m e m o ra n d u m in su p p o rt o f its
m o ti o n for su m m ary jud g m en t i n D ec em b er 2 0 0 8
. T h e tri al co u rtg ran ted M id-S o u th’s
m ot i on f ors um m ary j udgm ent , f i ndi ng thatN or thi ngt on w as notf ami l i arw i th V i s udyne admi ni s tr at i on and thatC onnerhad notes t abl i s hed t he nece s s ary el ementof caus at i on. T he trial c o u rten tered it s o ri g inal o rde r, g ran ti n g M id-S o u th’s m o ti o n for su m m ary jud g m en t, in A u g u st 2 0 0 9 . C o n n e r f iled h e r m o tio n fo r r e c o n sid e ra tio n , a n d M id -S o u th re sp o n d e d in A ugus t2009 as w el l
. T he tr i al j udge ent er ed hi s or derdenyi ng M i d- Sout h’ s m ot i on f or
su m m a ry ju d g m e n t u p o n rec o n sid e ra tio n in Ja n u a ry 2 0 1 0
. W e h a n d e d d o w n o u r o p in io n in Vaughn i n O ct ober2009 – tw o mont hs a f t erthe part i es had f

i l ed thei rl as tpr etr i al m ot i ons
a n d re s p o n s e s , b u t th re e m o n th s b e fo re th e tr ia l c o u rt h a d ru le d o n th e m o tio n s . Vaughn , 20 So. 3d at645.

### Although Mid- South did not expl ic itly argue bef orethe tria l court that nurses in 2 

### gene ra l m ay not

tes ti fy as to medi ca l ca

usati on, theis sueof Northington’ s qua li fi cati ons wa s brought bef orethetria l c ourt . In it s rebutta l m em orandum, Mid- South argu ed that Northingt on was not quali fi ed t o givean e xpert opini on on Vis udyne a dminis tration. The trial court also d id n ot ad dress th e issue o f wh ether nurses inge neral maytestify as to me dic alca

usati on, but

did f ind ultimate ly t

hat Northingt on was quali fi ed to rende r an expe rt opini on in t oday’ s c as e. 7 ¶1 2
. T h e p arti es in tod ay ’s ca se w ere w ith o u t th e b en efito f Vaughn du ri ng t he p retri al phas e ment i oned above , and w e r ecogni ze thatourhol di ng i n Vaughn w a s no tbr ought bef or e the l earned tr i al j udge as pa r tof the part i es ’ pr etr i al ar gum ent s . T he rul e i n Vaughn is c le a r: N u rs e s c a n n o t r e n d e re x p e rt o p in io n s o n m e d ic a l c a u s a tio n . I d. at652. T hus t he
re lev a n t in q u iry b e fo re u s is w h e th e r th is e x p licit ru le a p p lies to to d a y ’s a p p e a l. ¶ 1 3
. G e n e ra lly , “ a ll ju d icia l d e c isio n s a p p ly re tro a c tiv e ly u n les s th e C o u rt h a s sp e c ifica lly
s t at ed the rul i ng i s pr os pect i ve. ” Cle v e land v. Mann , 942 So. 2d 108, 113 ( M i s s . 2006) ( ci t i ng Mis s . Trans

p. Com m ’n v. R onald A dam s Contr actor , I nc. , 753 So. 2d 1077, 1093 (M is s . 2 0 0 0 ); Mo rg a n v. S ta te , 7 0 3 S o . 2 d 8 3 2 , 8 3 9 (M iss . 1 9 9 7 )). F u rth e r, “n e w ly
e n u n c iate d ru les o f la w a re a p p lied re tro a c tiv e ly to c a se s th a t ar e p e n d in g trial orthatar e on appeal , and notfi nal atthe t i m e of the enunc i at i on. ” T

h ompson v. Cit

y of V i cksbu rg , 813 S o . 2 d 7 1 7 , 7 2 1 (M iss. 2 0 0 2 ) (em p h asis ad d ed ). ¶14. U nder s t andabl y, C onner cont ends that M i d- Sout h m ay not ar gue on appea l an i s s ue th a t itd id n o t ra ise b e fo re th e trial c o u rt . O u r p re c e d e n t d isc u ss in g re tro a c tiv ity o f n e w ly 2
an n o u n ce d rules o f l aw , h o w ev er, ru n s co n tr ary to C o n n er’s ass erti o n . In R o n a ld A da ms Contr actor

, I nc. , w e q u o ted th e U n ited S tate s S u p re m e C o u rt’s d isc u ss io n o f th re e p o ss ib le
w ays an i s s ue of

r etr oact i vi ty m ay be r es ol ved:

### 8

Fi r s t , a dec i s i on m ay be made f ul l y r etr oact i ve, appl yi ng both t o t he part i es bef or e the courtand t o al l other s by and aga i ns tw hom c l ai m s m ay be pr es s ed, cons i s t entw i th r es j udi cat a and procedur al barr i er s s uch as s t atut es of lim itatio n s. T h is p ra c tice is o v e rw h e lm in g ly th e n o rm , an d is in k e e p in g w ith the tr adi t i onal f

unct i on of

the court s t o deci de cas es bef or e them base d upon their be st cu rre n t un d erstan d ing o f th e law
. Italso reflects th e d ec laratory t heory of l a w , a c c or di ng t o w hi c h the c ou r t s a r e u nd e r s t oo d on l y t o f i nd t he l aw , nott o m ake i t. . . . Second, t her e i s the purpos el y pr os pect i ve met hod of o v e rru l i n g , u n d e rwh i c h a n e w ru l e i s a p p l i e d n e i th e rt o th e p a r t i e s i n th e l a wm a k in g d e c isio n n o r to tho se o th e rs a g a in st o r b y w h o m itm ig h t be ap p lied to conductorevents occurr i ng bef or e thatdeci s i on. T he ca s e i s deci ded under th e o ld law b u t b e c o m e s a v e h icle fo r a n n o u n c in g th e n e w , e ffe c tiv e law w ith re sp e c t to a ll co n d u c t o c c u rrin g a fte r th e d a te o f th a t d e c isio n . . . . T h is a p p ro a c h c laim s ju stific a tio n in its a p p re c iatio n th a t . . . to a p p ly th e n e w ru le t o part i es w ho r el i ed on the ol d one w oul d of f end bas i c not i ons of

j us t i ce a nd f ai rnes s . B utthi s equi t abl e m ethod has i t s ow n dra w back: i tt ends t o r el ax the f o r c e o f p r e c e d e n t , b y m i n i mi z i n g th e c o s t s o f o v e rru l i n g , a n d th e r e b y a l l o ws th e c o u rt s to a c t w ith a fr e e d o m c o m p a ra b le to th a t o f l e g is la tu re s . F in a lly , a co u rtm ay ap p ly a n ew ru le in the ca se in w h ich it i s p ron o u n ce d , then return t o the ol d one w i th r es pectt o al l other s ar i s i ng on f act s pr edat i ng the p ro n o u n c e m e n t. T h is m e th o d
. . . b re a c h e s th e p rin c ip le th a t li tig a n ts in s i m i l ar si tuat i ons s houl d be tr eat ed the s ame, a f undament al componentof s t ar e dec i s i s and the rul e of l aw gener al l y. Ronald Adam s Contr ac tor , I nc . , 753 So. 2d at1092- 93 ( quot i ng Ja m e s B. Beam D is til ling Co . v. G e o rg ia , 5 0 1 U
. S
. 5 2 9 , 53 5 -37 , 11 1 S
. C t. 24 3 9 , 2 4 4 3 -44 , 1 1 5 L
. E d
. 2 d 4 8 1 (19 9 1 ), supersededby st atut e on other groun ds (cit ati o n s o m itted)). ¶15. H i s t or i cal l y, w e hav e appl i ed t he f i r s tappr oach des cr i bed and have appl i ed t he l aw
as i texi s t ed atthe t i m e of a ppel l at e r evi ew . O urde ci s i ons “ ar e pr es um ed t o have r etr oact i ve ef f ectunl es s otherw i s e s peci f i ed. ” R onald Adam s Con tractor, I nc. , 753 So. 2d at1093 ( ci t i ng Mor

gan , 703 So. 2d at839)
. I n Vaughn , w e di d nots t at e t hatourrul i ng w as p ro s p e c tiv e . T h u s i t is p re s u m a b ly re tr o a c tiv e . See R onald A dam s Contr actor , I nc. , 753 S o. 2 d at1093 ( ci t i ng Mor gan , 70 3 S o . 2d at 8 3 9 ). A cc o rdin g ly, w e ap p ly ou r ho ld in g in Vaughn w i th the f

ull for ce of the p recedent that i ti s.

### 9 CO NC L US I ON ¶16
. N o rt h ing ton , B erni ce C on ner’ s on l y desi gn at ed exp ert , m ay no tr end er a n ex p ert
o p in io n o n m e d ic a l c a u s a tio n . See Vaughn , 20 So. 3d at652. W i thoutexpertt es t i m ony on
m edi cal caus at i on, C onnerhas f ai l ed t o es t abl i s h al l of the nec es s ary el em ent s of her
m e d ic a l- n e g li g e n c e c la im
. See McD o n a ld , 8 S o . 3 d a t 1 8 0 . B e c a u se C o n n e r h a s fa iled to
e sta b lish a n e c e ss a ry e lem e n t o f h e r c laim , M id -S o u th is e n titled to su m m a ry ju d g m e n t. A cc o rdin g ly, w e re v ers e the tr i al cou rt ’s j ud gm ent deny i ng M i d-S o u th’s m o ti o n for su m m ary j u d g me n tu p o n r e c o n s i d e r a t i o n a n d r e n d e rj u d g me n th e r e i n f a v o ro f M i d
- So u th Re t i n a , LL C. ¶ 1 7
. RE VE RS ED AND RE NDE RE D. W AL LE R, C. J . , DI CK I NS ON , P . J . , RA ND OL P H, LA M AR, CHANDL ER AND PI ERCE, J J . , CO NCU R. KI TCHEN S , J . , DI S S ENTS W I TH SEP ARA TE W RI TTEN O P I N I O N J O I N E D B Y K I N G , J . KI T CH E NS , J US T I CE , DI S S E NT I NG : ¶ 1 8
. B e c a u se I d o n o t a g re e th a t n u rse s in v a ria b ly sh o u ld b e e x c lu d e d fro m tes tify in g in M iss iss ip p i co u rts a s e x p e rt w itn e ss e s o n issu e s o f m e d ica l ca u sa tio n , I re sp e c tfu lly d iss e n t. ¶1 9. D ur i ng t he cour s e of C onner ’ s sui tagai ns tM i d- Sou th f ormedi cal negl i gence
as s oci at ed w i th t he i ntr avenous ( I V ) dos e of V i s udyne adm i ni s t er ed t o heron A pr i l 10, 2003, C o n n er d esig n ated L aD o n n a N o rth ing ton , R
. N
. , as h er e x p ert w itn ess. In h er a ffi d av i t , N urse N o rth in g to n a ttes ted th a t sh e w a s fa m ili a r w ith th e a p p ro p ria te s tan d a rd o f n u rsin g ca re w ith
re g a rd to IV p lac e m e n t, an d w ith co m p lica tio n s su c h as inf iltra tio n s. S h e a lso a ttes ted th a t, bas ed on hereduca t i on and expe r i ence as a nur s e and nur s i ng pr of es s or , a r evi ew of

M i dSout h’ s m edi cal r ecor ds , and the depos i t i ons of D r . Pr i es t er(Conner ’ s t r eat i ng phys i ci an at M i d- Sout h) , B erni ce Conner , and N ur s e M ar i l yn H ampt on ( the nur s e w ho admi ni s t er ed the

### 10

V isu d y n e IV ), sh e w a s o f th e o p in io n th a t M id -S o u th w a s n e g lig e n t in th e c a re p ro v id e d to B erni ce C onneron ora boutA pr i l 10, 2003, a nd thats uch negl i gence w as a vi ol at i on of the
a p p lica b le sta n d a rd o f c a re w ith re g a rd to th e IV a d m in istra tio n o f V isu d y n e a n d th e re q u isite f ol l ow up car e. N ur s e N or thi ngt on s peci f i cal l y not ed thatM i d- Sout h’ s f ai l ur e t o document th e m a n n e r a n d m e th o d in w h ich th e IV w a s p lac e d a n d m o n ito re d w a s b e lo w th e a p p lica b le sta n d a rd o f c a re a n d th a t th e re w a s n o e v id e n c e th e in filtratio n site h a d b e e n b a n d a g e d to pr eventi nci dent al expos ur e t o s unl i ght
. Fi nal l y, she op i ned t o a r eas onabl e degr ee of
m ed ical pro b ab il ity that the e n u m era ted n eg li g en t acts had cau sed or co n tr ibu ted to the injury
a n d s c a rr in g s u ff

e re d b y C o n n e r. ¶ 2 0
. F o llo w in g th e trial c o u rt’s g ra n tin g o f M id -S o u th ’s m o tio n fo r su m m a ry ju d g m e n t, bas ed on C onner ’ s f

ai l ur e t o es t abl i s h a p rim a fa c ie cas e of m edi cal m al pr act i ce, C onnerf i l ed
a m o ti o n to rec o n side r w ith an att ac h ed su p p lem en tal affidav itfrom N u rse N o rth ing ton . In her supp l em ental aff

i dav i t , N urse N orthingt on op i ned that, based o n h er experi ence a s a
nur s e and nur si ng prof es s or , ther e w as nothi ng uni que ordi f f er entaboutadmi ni s t er i ng V i s udyne as oppos ed t o otherI V drugs , w i th the exc ept i on of the nee d t o i ns tructthe pat i ent t o s t ay outof

the s un. She f

ur thers t at ed that“the r i s ks of i nfi l t rat i on f

r om the i ntr avenous admi ni s tr at i on of

thi s drug .
. . w oul d be no di f f er entthan the r i s k of

i nf i l tr at i on f

r om ot her i ntr avenous drugs , exce ptthatthe r es ul t s of i nf i l tr at i on ar e more caus t i c and the nee d t o s t ay outo f s un l i gh t[ w ou l d be g r e a t e r ] i f s uc h a n i nf

i l tr a t i on d i d oc c ur . ” Bas e d on the medi cal
r ecor ds and the depos i t i ons of both the nur s e w ho admi ni s t er ed the V i s udyne t o C onnerand C onner ’ s tr eat i ng phys i ci an, N ur s e N or thi ngt on f ur theropi ned thatthe I V admi ni s tr at i on of V isud y n e w as n o t pro p erly m o n it o red an d that, o n ce the in fi ltrati o n h ad o cc u rred , C o n n er’s

### 11

tr eatm entpr ovi der s w ere neg l i genti n havi ng f ai l ed t o coverthe ar ea a nd pr ot ecti tf r om
acc i dent al expos ur e t o s unl i ght
. T hes e negl i gentact s , acc ordi ng t o N ur s e N or thi ngt on, p ro x im a te ly c a u s e d o r c o n tr ib u te d to C o n n e r’ s in ju ry . ¶21. T he tr i al courtgr ant ed C onner ’ s m ot i on t o r econs i derand deni ed M i d- Sout h’ s m ot i on f ors um m ary j udgm ent . M i d- Sout h appeal ed, and, fort he f i r s tt i m e on appeal , ar gued that N u rse N o rth in g to n w a s n o t q u a lified to s e rv e a s a n e x p e rt b a se d o n th is C o u rt’s d e c isio n in V au gh n v. Miss. B ap tist

Med. Ctr. , 20 So. 3d 645 ( M i s s . 2009)
. T he maj or i ty acknow l edges thatthi s ar gum entw as f i r s tpr es ent ed on appe al , butr eas ons thatthe rul e appl i ed
re tr o a c tiv e ly to e x c lu d e N u rs e N o rt h in g to n ’s e x p e rt o p in io n . M a j. O p . a t ¶ 1 5
. ¶ 2 2
. Vaughn hel d thatn urses are ex pli ci t l y prohibi t ed fr om tes t i fyi ng as t o m edi cal
c a u s a tio n . I

d. at652. I n Vaughn , I d iss e n ted , rea so n in g th a t: [ T ] he i s s ue of

w hethera part i cul arnur s e, by vi r tue o f hi s orherknow l edge, s ki l l , exper i ence , tr ai ni ng oreduca t i on, pos s es s es s uch abi l i ty i s bett er d e ter m in e d b y a c a se -b y -c a se in q u iry th a n b y a b ro a d , “o n e -siz e -fits-a ll” j udi ci al pont i f

i cat i on t o the ef

f ectthatno nur s e i n the w or l d w i l l everbe a llo w e d to tes tify a s to m e d ica l ca u sa tio n in a n y M iss iss ip p i co u rt c a se . A s is true of any otherpr of

es s i on, the educat i on, exper i ence and under s t andi ng of n u rse s s p a n a b ro a d sp e c tru m . W e sh o u ld n o t e n u n c iate a h a rd a n d fa st ru le th a t p e rm a n e n tly fo re c lo s e s th e p o ss ib ili ty o f a n y n u rse ’s b e in g q u a lified to give exp ertt est i m on y o n m edical causat i on i n any and al l cases that m ay ari se i n the f utur e. I d. at656- 57 ( K i t chens , J
. , di s s ent i ng)
. I echo thats ame r eas oni ng i n the ca s e s ub j udi ce i nas m uch as “i ti s the s cope of t he w i tnes s ' know l edge and notthe art i f i ci al cl as s i f

i cat i on by t i t l e thats houl d govern the thr es hol d ques t i on of admi s s i bi l i ty. ” B r ow n v. Mladineo , 504 So. 2d 1201, 1202 ( M i s s . 1987) ( quot i ng Fi t z m aur i c e v. Fl

y nn , 356 A
. 2d 887, 892 ( C onn. 1975) )
. O therj ur i s di ct i ons i n both c r i m i nal a nd ci vi l cas es have a gr eed w i th the pr emi s e that

### See a lso Mo ha jer v. Co mm on wea lth of Va. , 579 S. E.2d 359, 364 (Va . App. 2003) 3 

### (find ing that a sexual assau lt nurse examin er needno t be licen sed to practice med icine to off er an e xpert opinion on the c aus ation of inj uri es re sulting from an al le ged s exua l a ss ault) ; Parrisv. Uni Med, I

nc ., 86 1 S .W.2 d6 94 , 69 9 (M o. App . E.D . 19 93 ) (find ing no error in tria l c ourt al lowing nurses to t es ti fy a s e xperts on theca useand tre atme nt of

bed s ore s) ; Me llie s v. N

a t’ l H e r itag e, I

n c ., 

### 636 P.2d 215, 224 (Kan. App. 1981) (holding that whe n a prope r f oundation is l ai d a s t o thenurs e' s e xperie ncewith bed s ore s, that nur secan “qua li fy as an e xpert a s t o ca

usati on and a s t o suc h parts of tre atme nt and cur e that ar e pe rf orm ed by suchnurse.”). Our own Court of

Appe al s, in a

c ri minalc as e in whic h the def endant wa s c onvic te d 4 

### of gratif ic ation of lus t, re je ct ed the de fe ndant ’s argume nt that expe rt tes timony by a s exua l as sa ult nurs e e xam ine r wa s erro neously a dmi tt ed be ca useit was beyond the s copeof he r qu alification s. See Mu rray v. State , 20 So . 3d7 39 , 7 41 (M iss. C t. App . 20 09 ), ce rt. de nie d, 27 So . 3d40 4 (M iss. 20 10 ). In d oin g so , the co urt reco gn ized th at “nursing pro fession als routine ly t es ti fy as to whethe r a vic tim' s inj uri es areconsi st ent with a s exua l a ss ault. ” Id. at 742 (c itingHa vard

v. Sta te , 988 So. 2d 322, 332 ( Mis s. 2008) (nurs e te stif ie d that injurie s receive db ym in o r victim w ere the resu lt of sexual trauma); Ad am s v. Sta te , 772 So. 2d 1010, 1017 ( Mis s. 2000) (nurs e t es ti fi ed that thevi ctim ' s hym en wa s t orn and that t his inj ury was co nsistent withpen etrationbya pen is, finger, or oth er ob ject)). Th e app ellate court held that t he e xpert wi tne ss was an e xperie nce d em ergenc y room nurs e, had c onduct ed num erous sexu al assault ex aminatio ns, an d h ad p erson ally co ndu ct edth e examin ationof th e victim; thus “ her te stim ony as si st ed t

he j ury and was both rel evant and re li abl e. ” Mu rray, 20 So. 3d at 74 2. I c it e Mu rray , a case in whichthis Co urt unan imou sly v otedto d enycertiorari, to illustrate th at I see no distin ctionin h owRu le 70 2 sh ou ld b e app liedi nacivil v ersus a 12 n u rses w ith the “ p rop er trai n ing , ex p erti se, an d ex p erien ce are q u ali fi ed to g ive e x p ert opi ni ons on m edi cal caus at i on i n appr opr i at e ci r cumst ance s . ” V e la zq u e z v . Co m m o n w e a lth of V a. , 5 5 7 S
. E
. 2 d 2 1 3 , 2 1 8 (V a. 20 0 2 ). 3 ¶23. I f

i nd no basi s i n t he l ang uag e o f M i ssi ssi pp i R ule of E vidence 702 “f or any pref er ence of l i cens ed phys i ci ans f

ors uch medi cal t es t i m ony. ” S ta te v . W h ite , 4 57 S. E
. 2d 841, 858 ( N
. C
. 1995) ( hol di ng t hats exual as s aul tnur s e exa m i ner s ar e qual i f i ed t o t es t i f

y as t o the ca us e of

a phys i cal i nj ury des pi t e notbei ng l i cens ed t o di agnos e i l l nes s es orpr es cr i be tre a tm e n t). M iss iss ip p i R u le o f E v id e n c e 7 0 2 p ro v id e s th a t:

4

### criminal case. Vaughn has the effect of pr ec luding nurs es from t es ti fying as to m edi ca l causatio n ev en inthe co ntex t of a crimin al sexu al assault case. SeeVa ughn , 20 So. 3d at 652 (“We n owexp licitly h oldthat nurses canno t testify as to medical cau sation .”).

13 I f s ci ent i fi c, t echn i cal , or other s peci al i zed know l edge w i l l as s i s t the tr i erof f actt o under s t and the evi dence t o det erm i ne a f acti n i s s ue, a w i tnes s qual i f i ed as an expe r tby know l edge, s ki l l , exper i ence , tr ai ni ng, or e ducat i on, m ay tes tify th e re to in th e fo rm o f a n o p in io n o r o th e rw ise , if (1 ) th e tes tim o n y is b a se d u p o n su ffic ien t fa c ts o r d a ta, (2 ) th e tes tim o n y is th e p ro d u c t o f re liab le pr i nci pl es and met ho ds, an d (3) the w i tnes s has appl i ed the pr i nci pl es and m e th o d s re lia b ly to th e fa c ts o f t h e c a s e . I n the ca s e s ub j udi ce , i ti s cl earthatN ur s e N or thi ngt on m etthe r equi r ement s of R ul e 702. W e s houl d notpr ohi bi tourtr i al j udges and j ur or s f r om hear i ng and cons i der i ng pr of es s i onal
o p in io n s o f t h is q u a lity
. ¶24. M i s s i s s i ppi R ul e of C i vi l Pr ocedur e 56( c) pr ovi des thats um m ary j udgm enti s pr oper

“ if th e p lea d in g s, d e p o sitio n s, a n sw e rs to in te rr o g a to ri e s a n d a d m is s io n s o n fi le , to g e th e r w ith the af f i davi t s , i f

any, show t hatt her e i s no genui ne i s s ue as t o any mat er i al f actand thatthe
m o v ing p arty is en ti tl ed to a ju d g m en t as a m att er o f l aw . ” In o rde r t o w ith stan d su m m ary ju d g m e n t, th e p a rty o p p o sin g th e m o tio n “m a y n o t res t up o n the m e re alle g a tio n s o r d e n ials of hi s pl eadings, bu this res po nse . . . m ustsetfor th specif i c fact s sho w i ng that there i s a genui ne i s s ue f

ortr i al
. ” W

h itin g v. U

n i v. of S. Miss. , 62 So. 3d 9 07 , 914 (M i s s . 2011) (q u o tin g M is s . R . C iv . P . 5 6 (e ))
. ¶25. N ur s e N or thi ngt on’ s expertopi ni on w as thatC onner ’ s i nj ury w as pr oxi m at el y caus ed b y M id-S o u th’s b rea ch o f th e a p p lica b le st an d ard o f ca re o w ed to C o n n er in the IV ad m inis tra tion o f V isud y n e. B ec au se th is ex p ert sho u ld n o t be e x clud ed o n the n ec essa ry

### 14

el ementof

c aus at i on, I a m of

the opi ni on thatConnerdi d notf ai l t o es t abl i s h a p rim a fa c ie
cas e of m edi cal negl i gence . In thi s cas e, suf f i ci entevi dence exi s t s t o cr eat e genui ne i s s ues
o f m a ter ial fa c t as to w h e th e r N u rse H a m p to n , th e n u rse w h o h a d a d m in iste re d V isu d y n e to C onneratM i d- Sout h, had br eac hed the appr opr i at e s t andar d of nur s i ng care and w hether
s uch br eac h pr oxi m at el y c aus ed C onner ’ s i nj ury. A ccor di ngl y, s um m ary j udgm entw as not ap p rop ri ate in this ca se. T h u s, I w o u ld affi rm th e tr ial co u rt ’s j u d g m en t den y ing M id-S o u th’s
m o tio n fo r su m m a ry ju d g m e n t. KI NG, J . , J OI NS THI S OP I NI ON.