* The Honor able Joseph M
. Ho o d , Senior United States District J udg e for the Easter

n District of Ke ntucky , sitti ng by desig nation. 1 NO T R EC OM M EN DE D F OR F UL L- TEX T P UB LIC AT ION File Na me: 09a0772n.06 No. 08-6537 UN ITED STA TES C OU RT OF AP P EA LS F OR THE SI XT H C IR CU IT

PEGGY B ROWN, et al., ) ) Plaintif fs-Appellants, ) ON APPEALFROM THE U NI TED ) STATES DI STRI CT COURT FOR v. ) THE WESTERN DI STRI CT OF ) TENNESSEE UNI TED STATES OF AMERI CA, ) ) Defendant-

Appellee

. )

Before: ROG ERS an d KENNED Y, Ci rc u i t J u d g es ; a n d H O O D, S en i o r D i s tr i ct J udge. * HOOD, Seni or Distr ict Judge. This is an appea l from the dec ision o f the United States Di s tr ic t Co u rt f

o r th e We s te r

n D is tr ic t o f T e n n e s s e e , g r an ti n g D e f e n d an t- A p p e ll e e ’ s M o ti o nfor Summary J udg ment. The dist rict court dismiss ed P laintiffs-Appe llants’ claim for malprac tice af ter deter mining that Plaintiffs could not support their medica l malprac tice cla im, brou gh t u n d er the Fe dera l T ort Claims Ac t, 28 U.S.C. § 1346(b) (1), with ade quate opinion testimony as to the standar d of pr of e ssi on a l c are in M e mph is, Te nn e sse e , o r a c omm un ity de mon str a

bly sim ila r t o M e mphi s, Tenne ssee, a s require d by Tenn. Code Ann. § 29- 26-115(a ). P l ai n t i ff s ap peal the district c ourt’sNo. 08-6537

Brown v. United States

2 decision, ar g uing that the locality rule of T enn. Code Ann. § 29-26-115( a) should have been w aived by the district court in this instance. In the alter native, Plaintiffs argue that the district court e rre d in gr anting Def

endant’ s second Motion for Summary J udg ment having ear lier denie d Def endant’ s first Motion for Summary J udg ment, which also raised the issue of whe ther their opinion witness’s te sti mony wa s a de qu a te un de r the loc a lity ru le
. F or the re a so ns state d b e low , th e Court AF F IRMS the de c isi on

of the dis tr ic t c ourt
. I. F ac tu al a nd P r oc e dur al B ac kgr ound J ames S. Carmon under

went surg ery

on November

5, 2002, which was intended to improve the poor c irculation in his leg s resulting from per iphera l vascular disease. Plaintiffs alleg e that, as
a re su lt o f ma lpr a c tic e duri ng that sur g e ry , Car mon su ff e re d para ly sis of his ri g ht le g and pa re sis in his left leg and that a sur g ical catheter ba lloon was left in Carmon’s body , and that these c onditions eventua lly led to his death. The sur g ery took place at the Veter ans Administration Medical Cente r in Memphis, Tennessee
. A
. Defendan t’s F irst Mot ion f or Sum m ary Judgm ent Is Denied As discover

y prog resse d in the district c ourt, Dr. Donald Patrick was de signated by Plaintiffs as an opinion witness under Fe d. R. Ci v . P. 26. On J une 11, 2007, Plaintiffs’ counse l rec eived a letter fr om Dr. Patrick stating only that, in his opini on, Carmon’s operation was conducted “in such
a manne r that the . . . c omplications occurr ed i s a b re ac h o f t he ac cepta ble standar d of ca

re.” Th e Un ite d St a te s file d a fir st Mot ion fo r S umm ary

Judg me nt o n July

13 , 2 00 7, arguin g in pa rt that D r. Pa tr ic k h a d fa ile d to dem on str a te his fa mil iari ty wi th t

he sta nd ard of c are in M e mph is, Tenne ssee, a s require d under Tenne ssee law. Plaintiffs the n produce d an aff idavit from Dr. Patric kNo. 08-6537

Brown v. United States

3 which stated, in re levant par t, “I am familiar with the rec og nized standa rd of pr ofessional pra ctice in the c omm

un ity wh e re the inj ur

y to Mr
. Carm on oc c ur

re d. Th e sta

nd ard s of pr a c ti ce fo r t hese ty pes of proce dures are not local in nature, but national in nature due to the specia liz ation require d for this are a of me dical pra ctice...” On September

21, 2007, the di strict court denied the first Motion for Sum mary J udg ment on the g rounds that it was premature to strike Dr. Patrick’ s repor t and g rant summary

judgme nt, even if Dr. Patric k’s letter r eport a nd aff idavit w ere inadequate at that time, as Plaintiffs had indicate d that Dr. Patrick w ould submit a more detailed repor t a fter rec eiving additional discovery from De fenda nt and following the deposition of Carmon’s attending phy sician. B. Discover y Continu es Follo w in g th e d e n ia l o f

th e D e f e n d an t’ s f

ir s t M o ti o nf

o r Summ ar y Ju d g me n t, Pl a in tiffs produce d a document captioned “Rule 26(a) (1)( A) and (B ) R eport of Ex pert W itness,” i n which Dr
. Pa tr ic k a ff

ie d th a t he wa s “f

a mil iar wit

h the sta nd ard of c are fo r p hy sic ians pr a c tic ingme dic ine in the [ sic ] Memphis , Tenne ssee.” During the evidentiar y deposition of Dr. Patrick on Marc h 5, 2008, the following exchang e occ urre d:

Q. I t’s my

understanding , Doctor, t h at y our pra ctice ha s pr ima ri ly be e n in Ark ans a s sinc e 19 73 , exce pt fo r one y e ar i n Te xas? A. Th a t’ s c or

re c t. Q. And we’re just a couple hours from Memphis, wher e we are rig ht here in Searc y , and then F ort Smit h – A. I t takes us two hours to g et there
.No. 08-6537

Brown v. United States

4

Q. I s it fair to say

that y ou’re fa m i l i ar with the standard of c are of thorac ic surg eons in the Memphis, are a, Doc tor? A. Yes, t o t h e ex tent that there should be no diffe renc e in the way medicine’ s prac ticed in Memphis , o r frankly any wher e e lse in t he Un ite d St a te s. On c ro ss- e xami natio n, Dr . Patr ic k te sti fi e d a s f oll ow s: Q. I s it y our testimony that y ou are rely

ing in your opinions on a national standar d? A. Ye s.
On re dir e c t, D r. Pa tr ic k te sti fi e d a s f oll ow s: Q. I s it f

air to sa y that y ou’re familiar with the standards of car e in M e mph is? A. As much as I

am in any other city wher e I haven’ t prac ticed. Q
. O k ay. A. I n the sense that – if y ou’re askin g b ec ause I ’ve done something in Memphis before, that there’ s something a bout Te n n e s s e e la

w th a t yo uh a v e to b e in a a d ja c e n t s tate or something. B ut the bottom li ne is , it makes no diffe renc e whether y ou’re in N ew York City or Memphis or Timbuktu; the standar ds are the same. Q. I s that beca

use this is a vascular

surg ery specia lity and that the sta nd ard s are the same natio na lly fo r s pe c ia lit ie s su c h a s th is?
A. For

all specia lities, it ’s the same
. C. Defendan t’s Sec ond Motion f or Sum m ary Judgm ent is Gr antedNo. 08-6537

Brown v. United States

5 Duri nga Marc h 2 0, 20 08 , s ta tus c on fe re nc e , the dis tr ic t c ourt g ra nte d D e fe nd ant l e a ve to f

ile
a sec ond Motion to Dism iss or for Summary J udg m en t , which wa s then filed on Apr il 21, 2008. Plaintiffs’ Response did not raise the issue of whe ther the loc ality rule of Tenn. Code Ann. § 29-26- 115(a) could or should be wa ived by the d i strict court, nor did it ra ise the issue of whe ther it was pr op e r fo r the dis tr ic t court to de c ide the se c on d Moti on fo r Summ ary Judg me nt h a vin g pr e vio us ly denied De fenda

nt’s first Motion for Summary J udg ment, bo th

o f which ra ised arguments conce rning the application of Tenn. Code Ann. § 29- 2 6 -1 15(a) ’s locality rule. The district court g rante d Def endant’ s Motion for Summary J udg ment on October

15, 2008. II. Stand ard of Review This Court revie ws the di strict court' s g rant of summar y judgme nt de novo. Mazur v. Y oung, 507 F.3d 1013, 1016 ( 6th Cir. 2007). “Summary judgme nt is proper if the evidenc e, take n in the light most favor able to the nonmoving par ty , shows that there are no g enuine issues of material fa ct and that the moving pa

rty is entitled to a judgme nt as a m at ter of la w.” Id. (c i t i n g Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 5 7 4 , 5 8 7 (1986); F ed. R. Civ. P. 56(c)). “ Be cause we
re vie w t he g ra nt o f s umm ary

jud g me nt de novo, we may aff irm the judgme nt on gr ounds other than those employ ed by the lower c ourt, as long as the pa rty opposing summar

y judgme nt is not denied the opportunity

to respond.” Thornton v. Fe d. Express Corp., 530 F.3d 451, 456 n. 2 ( 6th Cir. 2008); see also Nance v. Goody ear Tire & Rubber Co., 527 F.3d 539, 553 ( 6th Cir. 2008). III . Ana lys is A. P laintif

fs’ Argum ents Are Waived on App ealNo. 08-6537

Brown v. United States

6 On appe al, Plaintiffs argue that application of the locality rule stated in T enn. Code Ann. § 2 9 -2 6 -1 1 5 (a ) m ay

an d s h o u l d h av e b ee n wa i v edb y

t h e d i s t ri ct co u rt i nt h i s i n s t an ce , ci t i n g Chi ldr ess
v . B e nn e tt , 816 S.W .2d 3 1 4 (T en n. 1991). Plaintiffs next arg ue that the district er red in g ranting De fe n d an t ’s s ec o n d

M o t i o nfo r S u m m ary

J u d gm en t , h av i n g al re ad y d en i edDe fe n d an t ’s first Motion fo r Summ ar

y Ju d g me n t, w h e n b o th M o ti o n s a d dr e s s e d th e is s u e o f w h e th e r a p p li c a ti o nof the locality rule would ba

r Dr. Per kins’ testimony
. Neither of t hese arg uments wer e ra ised befor e the district court and are waived on a ppeal to this Court. Sc ott sd aleIn s. Co. v . F

low e rs , 513 F.3d 546, 55 2 ( 6th Cir
. 20 08 ) (“ [A]n argume nt no t ra ise d be fo re the dis tr ic t c ourt is w a ive d o n a pp e a l to thi s Court.”). B. P lai nt iffs’ Ar gum e nt s o n Ap pe al A r e Wit houtM e r it Even if we wer e to de termine that Plaintiffs’ arguments wer e not w aived, we conclude that they ar e wi t h o u t merit. Plainti ffs’ c laim for malpra ctice unde r the F eder al Tort Claims Act was pr op e rl y dis mis se d a s th e re wa s n o is su e a s to any ma te ri a l f

a c t and De fe nd ant w a s e nti tle d to judgme n t a s a

matt e r o f la w . F e d
. R. Ci v . P. 5 6 ( c )
. Sp e c if ic a ll y , Pl a in ti f

f s ’ d e s ig n a te d

o pinion witness failed to de monstrate knowledg e of the applicable standard of car e in Memphis, Tenne ssee, the community

in which the doctors who alleg edly cause d dece dent’s injuries prac tice, as r equire d in a medica l malprac tice case by Tenn. Code Ann. § 29-26-115( a). Plaintiffs have not identified any ins tanc e in w hic h th e “ loc a lity ru le ” of Te nn . Cod e Ann. § 29 -2 6- 11 5( a ) may be wa ive d by a c ourt , no r w a s it e rr or fo r t he di st ri ct c ourt

to g ra nt D e fe nd ant’ s Mo tio n f

or Sum mary

Judg me nt o n th is g ro un d, e ve n th ou g h it de c lin e d to do so upon De fe nd ant’ s earl ie r M oti on fo r S umm ary

Judg me nt. With ou t c omp e te nt o pin ion te sti mony c on c e rn ing that sta nd ard of c are , Pla int if

fs c ann ot m e e t th e irNo. 08-6537

Brown v. United States

7 burden of establi shing the local standa rd of c are as re quired by

Tenne ssee statute, a

nd summary judgme nt was appr opriate.

1. Tennessee’s Locality Rule under Tenn . C o deA nn . § 2 9 - 2 6 -115(a) (1) M ay Not Be Waived
The Fe dera l T ort Claims Act, pursuant to which Plaintiffs’ bringtheir cla im, provides that the United States may

be liable for m edica l malprac tice “if a private per son would be liable to the plaintiff in acc ordanc e with the law of the place wher e the a ct or omission occurr ed.” 28 U .S.C. § 1346(b)( 1). Tenne ssee law provides that mea sure in the instant matter. To obtain relief

upon a claim of medical malprac tice in Tenne ssee, a plaintiff must present competent opinion evidenc e establishing e ach of the three elements set f

orth in Tenn. Code Ann.§ 29-26-115( a): the applicable standard of car e, the defe ndant’s violation of that standard, and a c ausal
connec tion between the defe ndant’s conduc t and the plaintiff’ s injury
. Seave rs v. Me thodist Med. Ctr. of Oak Ridge , 9 S.W. 3d 86 , 9 3 ( Te nn . 1 99 9) ; By rd v . H all , 847 S.W .2d 208, 210 (Tenn. 1993) ; Bl oc k e r v. Re gio na l Me d. Ctr

. at M

e mp his , 7 22 S.W. 2d

66 0, 66 1 ( Te nn . 1 98 7) ; Hessme r v. Miranda , 13 8 S. W.3 d 2 41 , 2 44 (T e nn . Ct . App . 2 00 3). Ten n. Cod e Ann. § 2 9- 26 -1 15 (a ) a lso imp os e s a “loca lity rule” in medical malpra ctice c ases, whic h serve s as a mea sure of the compe t en cy

of the proposed phy sician witness. See Fe d. R. Evid. 601 (“in civil actions and pr ocee dings, w ith respec t to an eleme nt of a c laim or defen se as to which State la w supplies the rule of

decision, the competenc y

of a w itness shall be deter mined in acc ordanc e with State law.” ). Thus, a pla intiff bear s the b u rd en of demonstrating “ [t ]he recog nized standard of a cce ptable prof essional pra ctice in the profe ssion and the spec iality there of, if any , that the defe ndant prac tices in the community in whichNo. 08-6537

Brown v. United States

8 the def endant pr actice s or in a similar community at the time the alleg ed inj ury or wrong ful ac tion
occur red.” Tenn. Code Ann. § 29- 26-115(a )(1)
. “F or the purpose of Tenn. Code Ann. § 29-26-115( a), the only rele vant ‘c ommunity ’ is the community

in t h e wh i ch the de fenda nt phy sician ac tually

prac tices or in a similar c ommunity .” Ke ny on v . H

an da l, 122 S.W .3d 743, 762 (Tenn. Ct. App. 2003). The plainti ff must demonstrate that
an o pin ion

wi tne ss h a s k

no wl e dg e of

the sta nd ard of c are a

pp lic a ble in t he de fe nd ant’ s c omm

un ity or in a c ommunity

that the par

ty demonst ra tes to be similar to that where the def endant pr actice s medicine. Robinson v

. Le Corps , 8 3 S. W.3 d 7 18 , 7 24 (T e nn . 2 00 2) . I f a pla int if f’ s o pin ion

wi tne ss
c ann ot d e mon str ate a de qu a te kn ow le dg e c on c e rn ingthe me dic a l r e so ur c e s and sta nd ard s o f c a re in the community

in which the defe ndant practices, the plaintiff’s claim must fail. Mabon v. JacksonMadison County Gen. Hosp. , 9 68 S.W. 2d 82 6, 83 1 ( Te nn . Ct . App . 1 99 7) ; Cardwell v. Bechtol , 724 S.W .2d 739, 754 (Tenn. 1987)
. An op ini on wi tne ss m ay

no t ba se his or

he r t e sti mony so le ly

on his or he r f a mil iari ty wi th a national, r eg ional, or st atewide standard of profe ssional prac tice. J oh ns on v . P ra tt , No. W2003- 02110-COA-R3-CV, 2005 WL1353636, at *7 (Tenn. Ct. App. J une 9, 2005) (no perm. app. filed); Kenyon, 12 2 S. W.3 d at 76 2; Totty v. Thompson, 121 S.W .3d 676, 678-79 (Tenn. C t
. Ap p . 2 003); Howell v. Baptist Hosp., No. M 2001-02388-COA- R3-CV, 2003 WL 112762, at *8 (Tenn. Ct. App. J an. 14, 2003). While an opinion witness’s di scussion of a broade r st andar d of care does not require
e xc l u s i o n o f t h e t e s t i m o n y , i t m ay n o t s u b s t i tu t e f o r e v i d e n c e t h a t e s t a

b l i s h e s t h e loc a lit y require ments of Tenn. Code A nn.§ 29-26-115( a)( 1). See S to v a ll v . Cla rke , 113 S.W .3d 715, 722 ( T e nn . 2 00 3) ; Robinson , 8 3 S. W.3 d at 72 4; Tay lor v . J ac k so n- Ma dis on Cou nty

Ge n. Ho sp . D ist
. ,No. 08-6537

Brown v. United States

9 23 1 S. W.3 d 3 61 , 3 66 (T e nn . Ct
. Ap p. 20 06 ). No r is i t su ff ic ie nt f or an o pin ion

wi tne ss t o me re ly
asser t familiarity

with the local standa

rd of c are to demonstr at e k n owledg e under the statutory standard. Allen v. Methodist Healthcare Mem phis Hosp. , 237 S.W .3d 293, 295-96 (Te nn. Ct. App. 2007) (loca lity

rule not satisfied whe re doc tor from Na shville offer ed testimony as t o s t an dard of
c are in M e mph is w ith ou t sh ow ingof sim ila ri ty in c omm un iti e s or oth e r ba sis fo r k no wl e dg e ); Eck

ler v. Allen , 2 31 S.W. 3d

37 9, 38 5- 87 (T e nn . Ct . App . 2 00 6) ; Mabon , 968 S.W .2d at 831. Rather, the opinion witness must indicate the ba sis for his or her familiarity

with the l o ca l s t an d ar d of ca re. Robinson , 8 3 S. W.3 d at 72 4; W illiams v. Bap t i s t

Me m’ l Hosp. , 193 S.W .3d 545, 553-54 (Te nn. 2006). This must be firsthand knowledg e “g ained ‘in person without the intervention of anothe r.’” Allen , 2 3 7 S
. W
. 3 d

at 2 9 5 -9 6 (q u o t i n g Eck

ler , 231 S.W .3d at 386). Statut or y and pr e c e de nti a l f

ra me wo rk a sid e , w e fi nd

that Pla int if

fs ’ c a se is n e a rl y ind ist inguis ha

ble fr om Robinson . I n Robinson , the plaintiffs attempted to e stablish the standard of pr of e ssi on a l c are in N a sh vil le –th e re le va nt co mmunit

y –b y pr of fe ri ng a do c tor wh o wa s li c e ns e d in Tenne ss ee b u t p rac ticed in J ohnson City , Tenne ssee. Robinson , 83 S.W .3d at 724. The doc tor te sti fi e d o nly

that the a pp lic a ble sta nd ard of c are in N a sh vil le “ wo uld be e xpe c te d” to b e the same as the national standard of car e wi t h wh i ch he w as familiar. Id. The doc tor also testified that
or tho pa e dic surg e on s–

wh ic h w a s th e de fe nd ant’ s spe c ia lity –“ wo uld sta nd the same te st a

nd wo uld be expected to have the same knowledg e and to pr actice in very simil ar f ashions by

the Amer ican Boa rd of Or thopaedic Surg eons.” Id. a t 72 4- 25 . T he do c tor , h ow e ve r, did no t make any a tte mpt to
re la te the ba sis fo r his kn ow le dg e of the sta nd ard of c are in N a sh vil le or e xpla in w hy

the Na sh vil le medical c ommunity

was similar to the communi ty wher e the doctor him self pra cticed. Id. at 725.No. 08-6537

Brown v. United States

Th e Te nn e sse e Sup re me Cou rt a lso no te d it s d isc on te nt w iththe loc a lity ru le a s a wh ole 1 and su g g e ste d to the Ge ne ra l As se mbl y that it b e c ha ng e d to a c c ou

nt f or the fa c t th a t na

tio na l no rm s, 10 B a se d o n th is e vid e nc e , th e Te nn e sse e Sup re me Court ru le d tha t the te sti mony wa s n ot s uf

fi c ie nt t o establi sh the standar d of ca re in the r eleva

nt community

under the locality

rule a nd was thus appropr iately

denied a dmission at trial. Id. L ikewise in the instant c ase, Plaintiffs off ere d no evidenc e that Dr . Patrick has a ny persona l kn o w l e d g e o f

t h e r e l e v an ts t an d ar d

o f m e d i c a l c ar e i nM e mp h i s o r i na c o m m u n i t y

d e m o n s t r a

b ly simil ar to M e mp h is
. I nh is a f

f id a v it s , d a te d

A u g u s t 1 0 , 2 0 0 7 , an d

F e b r u ar y 1 4 , 2 0 0 8 , D r . Patr ick state d th a t he wa s “ fa

mil iar w iththe re c og nize d s tand ard of pr of e ssi on a l pr a c tic e in t

he c omm un ity wher e the injury

to [ Dec edent] occur

red,” but qua lified his assertion by stating that “the standa

rds of pra ctice f

or thes e t y

p es o f p rocedures a

re not loca l in nature, but national in nature due to the specia liz ation require d for this are a of medica l prac tice.” I n his deposition, Dr. Patrick testified that he wa s familiar with the standa rd of c are for thora cic surg eons in the Memphis are a “to the e x tent that there should be no diffe renc e in the wa y medicine’ s prac ticed in M emphis, or fra nkly any wher e i nt h e U n i t e d

S t a t e s . ” F u rt h e r

m o r e , a l t h o u g h D r . P a t r i c k t e s t i f i e d t h a th e p r a c t i c e d

i nS e a r c y, Arka nsas, “just a couple of hours fr om Memphis,” neither D r. Patrick nor any other witness off

ere d
e vid e nce that Se arc y , A rk ans a s, or any oth e r c omm

un ity wi th w hic h D r. Pa tr ic k w a s f a mil iar i s simil ar to Memphis, Tenne ssee. Ac cording ly , we f ind Robinson c on tr oll ingand sim ila rl y ru le that, notwithstanding the f

act that Dr. Patrick prac ticed in othe r communities a nd was fa miliar with the national standar d of ca

re, the evidence p ro v i d ed by Plaintiffs is si mply

not enoug h to meet the locality require ment of Tenn. Code Ann. § 29-26-115( a). 1No. 08-6537

Brown v. United States

espe ci al l y wi t h respe ct to specia liz ed proc edure s such as the one in question here, a re of ten repr esentative of the loca l norms. Robinson v. Le Corps , 83 S.W. 3 d 7 1 8 , 7 2 4 ( T e n n . 2 0 0 2 )
. We a g re e wi th the Te nn e sse e Sup re me Court and a lso e nc oura g e the Ge ne ra l Asse mbl y to a dd re ss t his iss ue . How e ve r, we a re no t on ly bo un d, a s w a s th e Te nn e sse e Sup re me Cou rt , b y the e xistin g statut e bu t are a lso bo un d by the Te nn e sse e Sup re me Cou rt ’s int e rp re ta tio n o f t

he loc a lity

ru le pr ov ide d in Robinson
. 11 No r m ay co u rt s wa i v e t h e l o ca l i t y ru l e, as P l ai n t i ff s ar gu e, ci t i n g Chi ldress v . B e nn e e tt , 915 S.W .2d 314 (Tenn. 1991)
. Chi ldr ess did not addre ss the l ocality rule stated in Tenn. Code Ann. § 29-26-115( a). Rathe r, the Chi ldr ess court wa s conce rned w ith a sec o n d p ar t o f the loca lity rule, found in Tenn. Code Ann. § 29-26-115( b), which require s that an opini on witness in a malpra ctice
case be license d to pr actice in T ennesse e or a contig uous border ing state in the y ear prec eding the date of the alleg ed injury

or wrong ful ac t. C

h i ld re ss , 8 16 S.W. 2d

a t 31 6. As re c og nize d in Chi ldr ess , Tenn. Code Ann. § 29- 26-115(b) expli citly provides that its require ments may be wa ived by the trial court. Id
. Tenn. Code Ann. § 29- 26-115(a ) includes no suc h provision for wa iver, a nd Tenn. Code Ann. § 29- 26-115(b) ’s waive r provision is not a pplicable to subse ction (a) . Thus, the district court could not have waived the locality rule of T enn. Code Ann. § 29- 26-115(a ). 2. District Court Has Inhere nt P ower to Rec onsid er Inte rlocutor y Orders Be for e Ent r y o f F ina l Ju dgm e nt Finally , there is no merit to Plaintiff’ s argument that the trial court er re d i n granting Def endant’ s second Motion for Sum mary J udg ment, having ear lier denie d Def endant’ s first Motion for Summary

J udg ment. The district court had the power to a ct beca use no final judgme nt had bee n enter ed in the ca se, and “ [d] istrict courts have inhere nt power to rec onsider int erloc utory order s andNo. 08-6537

Brown v. United States

12 reope n any

part of a case befor e entr

y of a f inal judgme nt.” In re Saffady , 524 F.3d 799, 802- 803 (6th Cir. 2008) (q u o t i n g Mallory v. Ey rich, 922 F.2d 1273, 1282 ( 6th Cir. 1991)). VI . CO NC LU SION F or a ll o f t he re a so ns state d a

bo ve , th e de c isi on

of the dis tr ic t c ourt

is AF F IR M ED
.No. 08-6537

Brown v. United States

13 Roger s, J., concurr ing. The majority opinion demonstrates the ineluc table conc lusion require d i n t h i s ca se. I

write sepa

rate ly , howeve r, to express my discomfort with our holding . A strict locality

rule in medica l malprac tice ca ses precluded ex pert testim ony reg ardingthe standar d of ca re in a locality other than the one in which the a lleg ed malpra ctice oc curr ed. E.g. , Haskins v. Ho war d , 1 6 S. W.2 d 20 , 2 2- 23 (T e nn . 1 92 9) (“ lia bil ity fo r n e g lig e nc e in t

hat r e g ard wa s e xpre ssl y lim ite d to a

failure to ‘ re nd e r s uc h tr e a tme nt a nd re lie f a s a

n o rd ina ri ly pr ud e nt d oc tor

e ng a g e d in the pra ctice of

medicine a

nd surg ery ’ in the same loc ality would have rende red” ). The pur pose of the str ic t lo c a lity

ru le wa s to re lie ve ru

ra l or sma ll t ow n do c tor s o f t

he ne c e ssi ty

of pr a c tic ingup to
a big city standard w hen that wa s not reasona bly require d. Shilkret v. Annapolis Emerge ncy H osp. Assoc. , 349 A.2d 245, 248 (Md. 1975). The perce ived downsi de of the rule was that it made it har d for plaintiffs to re cover

when they

had to g et a d o ct o r- wi tness from the same community as the doctor-de fenda

nt. Id. at 249. Statutory

ref orms in many

states, such a s Tennesse e, per mitted doctors to testify to the standard of

a doctor from the same “or

a similar” c ommunity
. See Tenn. Code. Ann. § 2 9- 26 -1 15 (a )( 1) ; Totty v. Thompson , 121 S.W .3d 676, 679 (Tenn. Ct. App. 2003) ( “the 1975 Ac t lib e ra lize d wh a t wa s the n the ‘s tr ic t loc a lity ru le ’ by le g isl a tiv e ly mand a tin g a ‘s imi lar lo cal ity rule’” ). A prominent c asebook e x plains that a “similar c ommunity rule” is “desig ned to balanc e the
ne e d to a vo id e va luatin g a g e ne ra l pr a c tit ion e r i n a ru ra l are a by the same sta

nd ard s a s a

sp e c ia lis t in an urba n teac hing hospital w ith the need of the plaintiff for acc ess to expert testimony .” Victor Schwar tz, et al., P ROS S ER , W ADE , & S C HW AR TZ ’ S T OR TS : C AS ES AND M A T ER I A LS 182 (10th ed. 2000).No. 08-6537

Brown v. United States

14 The Te nnessee Supreme Court has g one beyond the literal languag e of the statute in requiring that an expert doctor be f amiliar with the standar d of ca re in the loc ality

wher e the a lleg ed malprac tic e occur

red. The Tenne ssee statutory “similar community ” provision dea ls with the standard to be applied and not with the qua lification of expert witnesses. ( The subseque nt subse ction (b ), wh ic h d oe s e xplic itl y

re qu ir e so me qu a lif

ic a tio ns fo r me dic a l expe rt s, wa s com pli e d with in t his
case .) Unde r Tenne ss ee co m m o n law, howe ver, the witness must appare ntly be fa miliar with the community

in which the alleg ed malpra ctice oc curr ed, and it is appa rentl y not sufficient for

the doctor-w itness to be familiar with the standa rd of c are in a locality

that the c ou rt

may de te rm ine to be similar in terms o f s i z e, we alth, prese nce of a medica l school, etc. Such a strict qualification standard e ffe ctively g uts the ref orm aspec t of the “similar community ” lang uag e of the Tenne ssee statute. Th e on ly conce iva ble purp os e of

the str ic t w itn e ss q

ua lif ic a tio n r ule , o the r t

ha n s imp ly
re du c ingme dic a l ma lpr a c tic e su its g e ne ra lly , wo uld be to re du c e so me pe rc e ive d pr ob le m of jur ie s’ be ingmis le d b y

hig h- po we re d p ro fe ssi on a l w itn e sses fro m ou t of s ta te . B ut s uc h a pr ob le m is
s i mp l y n o tp r e s e n ti nt h e F e d e r a l T o rtC l a i m s A c tc o n t e x t , w h e r e t h e r e i s n o j u r y. There is thus no good r eason f or the strict witness-qua lification aspec t of the Tenne ssee locality rule to be carrie d over to the Fede ral Tor t Claims Act context . Doing so frustrates the dual purposes of the Fe dera l Tort Cl aims Act, which w ere “to re lieve Cong ress of the overw helming pressure s and burde ns of private relief bills, and .
. . to do justice to those who had suff ere d injuries or losses throug h the wrong s of g overnme nt employ ees.” 1-3 L ester J ay son & Robert L ong streth, H ANDL I NG F ED ER A L T OR T C LA I M S § 3.01 (2007). As the majority notes, howeve r, Fed. R . Evid. 601No. 08-6537

Brown v. United States

15 re qu ir e s th e a

pp lic a tio n o f s tate evi den tiar y ru le s r e g ard ingthe qu a lif ic a tio n o f e xpe rt

wi tne sse s. Affir mance appea

rs there fore to be re quired in this case
.