FOURTH D I VI SI ON DI L LA RD, P. J. , B ROWN and PA DGETT, JJ.

N O T IC E : M o tions for r e c ons i de r a tion m us t be phy s ic a lly r

e ce iv ed i n our c le r k ’s offic e w ithin te n da y s of the da te of de c is ion to be de e m ed tim e ly file d.

https ://w w w

. ga a ppe a ls .us /r ule s

A u gust 2, 2024



# In t he C ourt o f A ppe a ls o f G e o r g ia

A 24A 0 7 49

. K A T H Y B OON E et a l v

. V A SCUL A R SURGI CA L A SSOCI A TES, P. C. , et al.

D I L L A R D , Presid ing J u d ge.

Pau la Thac k er su f

f ered d ebilitating inj urie s an d u ltimately d ied f o llo w ing

med ic al treatment f

o r a series o f small stro k es. Thereaf ter, K athy B o o n e—Pau la’ s

d au ghter—f

iled a med ic al- malp rac tic e su it a gainst nu mero u s ind iv id u als and

c o mp a nies, inc lu d ing V asc u lar Su rgic al A sso c iates, N orthw est N eu ro lo gy, P. C. , D r.

Sand y M c Gaf

f igan, D r. A ru n Cherv u , and D r. Gary J ac o bso n. 1 The c ase p ro c eed ed

to a ju ry trial, af

ter w hic h a v erd i c t w a s entered in f av o r o f the ap p ellees. B o o ne

ap p eals, argu ing the trial c o u rt erred b y ( 1 ) p ermitting an u nqu alif ied d ef ense exp ert

1 V asc u lar Su rgic al A sso c i a t e s w ill ref erred to as “ VSA ” thro u gho u t this

o p inio n, and V SA , N o rthw est N eu ro lo gy, P. C. , D r. Sand y M c G af f igan, D r. A r u n Cherv u, and D r. Gary J ac obso n w ill be c o llec t iv e ly ref erred to as “ the ap p ellees. ”to testif

y, and (2) giv ing “ no

- gu arantee” and “ dif f e ring- v iew s” j u ry instru c t io ns. Fo r

the f o llo w ing reaso ns, w e af

f irm. 2

V iew ing t he e v id e nc e in the light mo st f a v o r able t o t h e j u ry’ s v erd ic t, 3 the

rec o rd sho w s that, in 201 6 , Thac k er was d iagno sed w ith c aro tid artery d isease in her

lef t and right c a ro t id arteries. Generally, the symp to ms o f the d isease are “ so me so rt

o f stro ke- lik e ev ent that co u ld be related to tho se c a ro t id s[,]” bu t a t the time she w as

d iagno sed , Thac ker w as asymp to matic

. N ev ertheless, as a p rev entativ e m e a s u r e ,
Thac k er w a s p resc ribed asp irin and a high- d o se statin med ic atio n.

On M arc h 25, 201 8, T hac k er b egan feeling nu mbness o n the right sid e o f her

f ac e, a nd B o one to o k her t o W ellstar Pau ld ing H o sp ital. Onc e t hey arriv ed , Thac k er

w as e v alu ated by a d oc to r w h o d e t e rmined she had su f fered a series o f “ small

2 Oral argu m e n t w as held o n M ay 1 , 2024, and is arc hiv ed o n this Co u rt’ s

w ebsite. S ee Co u rt o f A p p eals o f the State o f Geo rgi a , O r a l A rgu ment, Case N o. A 24A 07 49 (M ay 1, 2024), av ailable a t http s: //v imeo

. c o m/9 4207 6 47 8. Of no te, tw o ap p ellee b r i e f

s w ere su bmitted in this c ase, one by V SA , D r. Cherv u , and D r. J ac o bso n, and ano ther by N o rthw est N eu ro lo gy and Sand y M c Gaf figan.

3 S ee Amu v

. Ba rn es , 286 Ga. Ap p

. 7 25, 7 25 (6 50 SE2d 288) (2007 ) (“ [W hen]

a j u ry retu rns a v erd ic t, the same mu st be af firmed on ap p eal if there is any ev id enc e to su p p o r t i t , and the ev id e nc e is to be c o nstru ed in a light mo st f av o rable to the p rev ailing p arty w ith ev ery p resu m p tio n and inf er e nc e in fav o r o f su staining the

v erd ic t. ” (p u nc tu a tio n o mitted )).

2stro kes[,]” w hic h c a n c au se d amage to p arts o f the brai n

. A s a r e s u lt, o n M arc h 26 ,

201 8, sh e w as transf

erred to Co bb H o sp ital f o r a vasc u lar c o nsu lt. Later that d ay,

Thac k er w as seen by Dr. M c Gaf f igan, a neu r olo gist, as w ell as o ther

p hysic ians—inc lu d ing a c ard io lo gist and a v asc u lar su rgeo n

. F o llo w ing these

ev alu atio ns, Thac k er w as d iagno sed w ith “ cresc end o TI A s , ” w hic h is a “situ atio n

w here a p atient is hav ing mu ltip le ev ents m ore and mo re o f ten. ” T h a c k e r w as then

p lac ed o n an “ I V o r intrav eno u s hep arin inf u s io n d rip

. ” A nd that night, ev en tho u gh

Thac k er w as tak ing hep a r in, asp irin, and w as rec eiv ing I V flu id s, she su f f ered an

ep iso d e o f right f

ac ial d ro o p ing, nu mbness in her right hand , a nd had d if f ic u lty

sp eak ing.

I nitially, D r. J e f

f rey Winter—a v asc u lar su r geo n—sc hed u led Thac k er to

u nd ergo a c aro tid end arterec to my. 4 B u t the next d ay, o n M arc h 27 , 2 0 1 8 , D r.

C herv u—ano t her v a scu l a r s u r g e o n

— e v a l u a t e d T h a ck e r a n d d e t e r m i n e d t h a t , i n s t e a d ,
she need ed t o hav e a t ransc aro tid artery rev asc u lari z a t i o n (“ TCA R” ) p ro c ed u re,

w hic h is a tec hniqu e by whic h a metal stent is p lac ed in t h e patient’ s c a ro t id artery.

4 Caro tid end arterec to my is “ a p ro c ed u re to treat c aro tid a rtery d isease. ” Ma yo C li n i c , http s: //w ww .mayo c linic

. o rg/tests- p ro ced u res/c aro tid

- end arterec to my/ abo u t/p ac

- 2039 337 9 (Last v isited J u ly 30, 2024).

3A nd the next mo rning, o n Marc h 28, 201 8, Cherv u p erf o rmed the TCA R p ro c ed u re.

Relev ant here, Cherv u ad mitted that he d ev iated f ro m his med ic al training b y w aiting

to ad minister Plav ix 5 to Thac k e r u ntil ap p ro ximately three ho u rs after the p ro c ed u re,

rather th a n bef

orehand

. A nd in the c o ntext o f this c ase, this p rac tic e inv o lv ed

c o mbining a sp irin and Plav ix, and is ref erred t o a s d u al- antip latelet therap y
(“ DA PT” ). 6 Cherv u d id no t ad minister this t herap y to Thac k er p rio r to su rgery

bec au se he w as c o nc erned abo u t c o mbining these med ic atio ns d ue to the heightened

risk o f bleed ing.

Sho rtly a f ter the p r o c ed u re, D r. Cherv u to ld B o o ne he w as c o nc erned Thac k er
might hav e exp erienc ed a new stro k e bec au se her blo o d p ressu re rep eate d l y sp ik ed

d u ring su rgery. B ut the d o c t o rs w ho assessed Thac k er that a f terno o n co nc lu d ed she

had no t su f

f ered a n ew stro k e

. A d d itio nally, Cherv u ask ed D r. M c Gaf f igan f o r help

5 Plav ix is “ u sed alo ne o r to gether w ith asp irin to lessen the chanc e o f a heart

a t t a c k o r s t r o k e

. ” M a y o C l i n i c , h t t p s : / / w w w

. m a y o c l i n i c

. o r g / d ru gs- su p p lements/c lo p id o grel- o r al- ro u te/d esc rip tio n/d rg- 2006 31 46 (Last v isited J u ly 30, 2024).

6 D u al anti p l a t e let therap y “ w ith a sp irin a nd oral P2Y inhibito rs remains the

c o r nersto ne o f therap y f

o r p atients w ith ac u te c o ro nary synd ro me (A CS). ” Ma y o C l i n i c , h t t p s : / / w w w

. m a y o c l i n i c p r o c e e d i n g s

. o r g /artic le/S0025- 6 1 9 6 (22)001 27

- 6 /f u lltext (Last v i s ited J u ly 30, 2024) (f o o tno t e
o mitted )

.

4ev alu ating Thac k er bec au se she w as a neu ro lo gist; and af ter do ing so , she lik ew ise d id

no t believ e Thac k er had su f f ered ano ther stro k e

. Thac k er’ s c o nd itio n imp ro v ed

thro u gho u t the d ay, and w hen Cherv u ev alu a ted her at 6 :30 p. m. , she w as mo re alert,
her sp eec h had imp ro v ed , and she had inc reased range o f mo tio n in her right arm.

N ev ertheless, Thac k e r’ s c o nd itio n w o rsened o v er the next sev eral ho u rs, and
by 8: 00 p

. m

. , the n u rse o n d u ty f ou nd her unresp o nsiv e

. The nu r se immed iately

p erf o rmed an “ N I H Stro k e Sc ale assessment,” w hic h requ ired him to assign a sc o re

to v a r io u s c a tego r ies o f symp to m s

. Thac k er’ s to tal sc o re ind ic a ted that she had

su f fered a “ sev ere stro k e. ” T he nu rse also c a lc u lated a “Glasgo w Co ma Sc ore,” and

f o u nd that Thac k er’ s sc o re had f allen f ro m 15 to 1 0, w hic h su ggested she w as

exp erienc ing neu r o lo gic a l p ro ble m s

. T h e n , a ro und 8: 55 p

. m. , the nu rse c alled D r.
J ac o bso n—w ho w as the v asc ular su rgeo n o n c all—to tell him abo ut t he situ atio n. B u t

ac c ord ing to J ac obso n, du ring the c all, he w as no t inf o rmed o f the sc o res Thac k er

rec eiv ed o n the f

o r ego ing sc ales o r anything else su ggesting the stent imp lanted in her

artery w as blo c k ed

. A f

ter Thac k er w as released f ro m the ho sp ital, her symp to ms go t

“ wo rse and w o rse o v er time” ; and tragic ally, she p a ssed aw ay.

5Thereaf t er, o n D e c e mber 1 9 , 201 8, Thac k er—by and thro u gh her next f riend ,

B oo ne—f iled a malp r ac tic e su it against VSA , D r. Cherv u , and D r. J ac o bso n. 7 B o o ne

later amend ed her c o m p l a i n t t o i n cl u d e m e d i ca l

- malp rac tic e claims a gainst N o rthw est

N eu ro lo gy and D r

. M c Gaf f igan. 8 On Febru ary 1 1 , 20 2 2 , B oo ne f iled a sec o nd

amend ed c o mp laint “ in a ntic ip atio n o f the up co ming trial

. . . . ” Relev ant here, B o o ne
alleged that Cherv u w as negligent in f ailing to a d minister D A PT to Thac k er p rio r to

the TCA R p ro c ed u re. Fo llo w in g p r o t r a ct e d d i s c o v e r y, the c ase p ro c eed e d to t rial, and

the j u ry rend ere d a v e r d i c t in f av o r o f the ap p ellees. B o o ne f iled a mo tio n fo r a new
trial, raising, in ter a li

a , the same argu m ents she d o es no w o n ap p eal; bu t f o llo w ing a
hearing o n the matter, the trial c o u rt d enied it. This ap p eal by B o o ne f o llo w s.

7 Desp ite the v o lu mino u s 4,46 5 p a g e rec o rd , no ne o f t he p arties p ro v id e a d esc rip tio n, alo ng with rec o rd c itatio ns, o f the p r o c ed u ral histo ry u nd erlying this ap p eal. A nd B oo ne’ s f

ailu re to d o so is in v io latio n o f o u r r u les. S ee C T

. A P P

. R. 25 (a) (5) (requ iring an ap pellant, in her brief , “ to d esc ribe[ ] the r elev ant p ro c eed ings belo w

. . . with ap p ro p riate c itatio ns t o the rec o rd ). N e ed less to say, this Co u rt w ill no t “ c u ll the rec o rd o n behalf

o f a p arty, p artic u larly in a c ase s u c h as this where the r ec o rd is

v o lu mino u s. ” C

a l l a w a y v

. W i lla rd , 351 Ga. A p p

. 1 , 5 ( 1) (830 SE2d 46 4) (201 9 ) (p u nc tu atio n o mitted ). So , w hile it ap p ears o u r ind ep end ent rev iew o f the rec o rd has lik ely id entif

ied the relev ant pro c ed u ral histo ry, “ if w e hav e m issed so m ething in the

rec o rd

. . . the r esp o nsibility rests w ith a p p ellant[’ s] c o u nsel. ” P n eu mo Ab e

x , LLC v

. Lo n g , 357 Ga. A p p

. 1 7 , 1 8 n. 3 (849 SE2d 7 46 ) (2020) (p unc t u atio n o mitted ).

8 Bo one also named def

end ants who are no t p arties to t h i s a p p e al. All o f the ap p ellees f

iled resp onses to eac h o f

B o one’ s p lead ings.

6W h en a j u r y retu r ns a v erd ic t, it mu st be af f irmed o n ap peal “if there i s an y

ev id enc e to su pp o rt it, a nd the e v id enc e is t o be c o nstru ed in a light mo st f av o rable to
the p rev ailing p arty w ith ev ery p resu m p tio n and inf erenc e in f

av o r o f su staining the

v erd ic t. ” 9 Pu t ano ther w ay, a j u ry v erd ic t, “af t er ap pro val by the trial c o u r t, and the
j u d gment thereo n w ill no t be d istu rbed o n ap p eal if su p p o rted by any ev id enc e, in the

absenc e o f any material e rro r o f law

. ” 1 0 And w e rev iew a d enial o f a mo tio n f o r a new

trial “ ac c o rd ing to t his same stand ard .” 1 1 W ith this d ef erential stand ard o f rev iew in

mind , w e tu rn no w to B o o ne’ s sp ec if ic argu ments.

1

. B o o ne f

irst argu e s the trial c o urt erred in allo wing D r. K aren Qu irk

— a

v a sc u lar su rgeo n a nd d ef ense exp e rt—to t estif

y as to the s tand ard o f c a r e f o r

9 Ya s h S o ls

. , LLC v

. N

ew Yo rk G lo b

. Co n s u lta n ts C o rp

. , 352 Ga. A p p

. 1 27 , 1 32 (1 ) (834 SE2d 1 26 ) (201 9 ) ( p u nc tu atio n o mitted ); acco rd Green v

. Key C u s t om H o mes , In c. , 302 Ga. A p p

. 800, 802 (1 ) (6 9 2 SE2d 56 ) (201 0).

1 0 Ya s h S o ls

. , LLC , 352 Ga. A p p

. at 1 32 (1 ) (p unc tu atio n o mitted ); a cco rd Green , 302 Ga. A p p

. at 802- 03 (1 ).

1 1 Ya s h S o ls

. , LLC , 352 Ga. A p p

. a t 1 32 ( 1 ) ( p u nc t uatio n o m itted ); a cco rd Green , 302 Ga. A p p

. at 802 (1 )

.

7ad ministering med ic ine f or p atients p rio r to a TCA R p ro c ed u re bec au se sh e w a s

u nqu alif ied to d o so

. 1 2 W e d isagree.

OCGA § 24- 7- 7 0 2 (“ Ru le 7 02” ) c o n c e r n s the “ a d missibility o f o p inio n

testimo ny by exp ert w itnesses in c iv il cases. ” 1 3 A nd the u su al stand a rd f o r the

ad missibility o f su c h t estimo ny is “ f o u nd in R ule 7 02 (b)

. . . . ” 1 4 The v e r sio n o f Ru le

7 02 (b) ap p lic able in this c ase p ro v id es as f o llo w s:

I f sc ientif ic , t ec hnic al, o r o ther sp ec ializ ed kno w led ge w ill assist t he trier

o f f ac t to u nd erstand the ev id enc e o r to d eterm i ne a f ac t in issu e, a

w itness qu alif

ied as an exp ert by k no w led ge, sk ill, exp e rienc e, training,

o r ed u c atio n may testif

y thereto in the f

o rm o f an o p inio n o r o therw ise, if :

(1 ) The testimo ny is based u p o n su f f ic ient f a c ts o r d ata;

(2) The testimo ny is the p ro d u c t o f reliable princ ip les and metho d s; a nd

1 2 D r. Qu irk ’ s testimo ny had no bearing o n B o o ne’ s negligenc e c laims against D r. M c Gaf

f i g a n

. As exp lained i

n fra , Qu irk testif

ied abo u t t he stand ard o f c are f o r med ic ating a p atient prio r to a TCA R p ro c ed u re, and M cGaf f igan w a s no t inv o lv ed in any d ec isio ns regard ing Thac k er’ s med ic atio n.

1 3 D u b o i s v

. Bra n tley , 29 7 Ga. 57 5 , 580 (2) (7 7 5 SE2d 51 2) (201 5).

1 4 Id.

8(3 ) T h e w itness has a p p lied the p r inc ip les a nd metho d s reliably to the

f ac ts o f the c a s e w hic h hav e been o r will b e ad mitted into ev id enc e bef o re the trier o f

f ac t. 1 5

I m p o rtantly, the issu e o f the ad missibility o r exc lu sio n of exp ert testimo ny “ rests in

t he bro ad d isc retio n o f the c o u rt, and c o nsequ ently, the trial c o urt’ s ru lin g t h e r e o n

c anno t be rev ersed absent an abu se o f d isc retio n. ” 1 6 I nd eed , the Su p reme C o u rt o f

Geo rgia has exp lained that “ [t]he w ho le p remise o f Ru le 7 02 is that a trial c o u rt mu st

ac t a s a ‘ gatek eep er’ to ensu re the relev anc e and reliability o f exp ert te s t i m o ny. ” 1 7

N ev ertheless, o u r Su p reme Co urt has held that “ d isp utes as to an exp e rt’ s c red entials

are p ro p e rly exp lo red thro ugh c ro ss- examinatio n at trial and go to t h e w eight and

c red ibility o f

the testimo ny, no t its ad missibility. ” 1 8

1 5 Fo r mer OCGA § 24- 7

- 7 02 (2022) (ef f ec tiv e fro m J a nu ary 1, 201 3 t o J u ne 30, 2022). The trial u nd erlying this c ase o c c u rred in early M a y 2022.

1 6 C lev ela n d v

. S en ti

n el In s

. C o

. , Ltd. , 354 Ga. A p p

. 7 9 5, 79 6

- 9 7 (1 ) (a) (840 SE2d 7 38) ( 2020) (p u nc tu atio n o mitted ); a cco rd Agri

- Cycle LLC v

. Co u c

h , 284 Ga. 9 0, 9 3 (5) (6 6 3 SE2d 1 7 5) (2008).

1 7 D u b oi s , 29 7 Ga. at 585 ( 2); s ee Ho well v

. C o chra n , 36 5 Ga. A p p

. 80, 84 (a) (87 7 SE2d 6 25) (2022) ( “ Und er Ru le 7 02, it is the ro le o f the trial c o u r t t o ac t as a gatek eep e r o f

exp ert testimo ny. ” (p u nc tu atio n o m itted )).

1 8 Agri

- C ycle LLC , 284 G a. at 9 3 ( 5) (p u nc tu atio n o m itted ); a c c o r d S a v a n n a h C emetery Grp. , In c. v

. D ePu e- W i lb ert Va u lt C

o. , 307 G a. A p p

. 206 , 21 1 (3) (7 04 SE2d

9Tu rning to the instant c ase, B o o ne argu es that D r. Qu irk w a s no t qu alif i e d to

testif y as to the s tand a r d of c are ap p lic a ble to med ic a ting a p atient p rio r t o a TCA R

p ro c ed ure. A nd B oo ne c orrec tly no tes that, at the time o f trial, Qu irk had o nly

p erf o rmed eight o r nine TCA R p ro c ed u res, all o f w hic h to o k p lac e af ter B o o ne’ s 201 8

TCA R

. U n d o u bted ly, the e asiest w ay t o d emo nstrate that an exp ert “ has an

ap p ro p riate lev el of k no wled ge in p erf o rming a p ro c ed u r e o r teac hing o thers ho w to

p erf o rm a p ro c e d u re is by p ro o f that the exp ert ac tu ally has d o ne these things

. . . . ” 1 9

B ut ou r Su p reme Co u rt has e xp lained that Ru le 702 “ d o[es] n o t requ ire that an exp ert

ac tu ally hav e perf

o rmed o r t au ght the v ery pro c ed u re at issu e ” to be qu a lif ied to

testif y. 2 0

A nd here, p rio r to trial, B o o ne f iled a mo tio n t o exc lu d e “ c erta i n o p i n i o n s o f

K aren Qu irk , M

. D

. [ ,]” c o ntend ing that she w as no t qu alif ied t o testif

y regard ing the

858) (201 0).

1 9 D u b o i s , 29 7 Ga. at 585 (2) (p u nc tu atio n o mitted ) ; a cco r d M e k oy a v

. C l an c y , 3 6 0 Ga. A p p

. 452, 459 (1 ) (86 1 SE2d 409 ) (2021 ).

2 0 D u b oi s , 2 9 7 G a

. at 584 (2) (p u nc t uatio n o mitted ) (emp hasis s u p p lied ); s ee Meko ya , 36 0 Ga. A p p

. at 459 (1 ). “ [ B ] y t h e p l ain terms o f [Ru le 7 02], the p ertinent qu estio n is w hether an e xp ert has an ap p ro p riate lev el o f k no w led ge in p erf o rming the p ro c ed ure o r teac hing others ho w to p erf o rm the p ro c ed u re, no t whether the exp ert himself has ac tu ally p erf

o rmed o r tau ght it. ” Id. (p u nc tu atio n o mitted )).

10stand ard o f care fo r med ic ating p atients p rio r to a TCA R p ro c ed u re. B u t t he trial

c o u rt d e n i ed t h e mo tio n sho rtly thereaf ter. I n d o ing so , t he trial c o u rt exp ressed

c o nc e rn that Qu irk might no t be as k no wled geable o r exp erienc ed as p la i n t i f f ’ s

exp erts, bu t it nev ertheless f o u nd she w as qu a lif

ied to testif

y as to t he ad ministratio n

o f m ed ic ine p rio r to a v asc ular o r arterial p ro c ed u re. The c o u rt f urther no ted that the
j u ry w o u ld d e c id e w hic h of the exp erts they f o und mo re exp erienc ed and

k no w led geable.

A t trial, B o o ne reasserted her o bj ec tio n to D r. Qu irk t e stif ying to the s tand ard

o f c are fo r the ad ministratio n of med ic ine p rio r to the p ro c ed u re at issu e. A nd d u ring

the d isc u ssio n o f

the issu e, the trial c o u rt stated the f ollo w ing:

I think it really go es— I d o n’ t remember w hat w a s ask ed o f her, b u t —I

mean it go es to a fa ct qu es ti o n fo r the j u ry o f whether o r n o t s

he i s qu a li fi ed.
I t ap p eared that s he is and to w hat extent there [may be] testimo ny f ro m

o ther peo p le w ho p erf

o rmed mo re o f these [TCA R pro c ed u res], [the j u ro r s] can c ertainly co nsid er that. So that’ s ju st p art o f the j u ry’ s j o b. 2 1

Su f f ic e it to say, t he trial c o u rt misstated the law in asserting that it is the p ro v inc e o f

th e j u r y to d etermine w hether an exp ert is qu a l i fi ed t o tes t i fy

. I nd eed , w hether an

2 1 (Emp hasis su p p lied ).

11exp ert is qu alif ied to t estif

y o n a p artic u lar su bj ec t is w ithin the trial c o urt’ s d isc retio n,

and the co u rt

serv es a s the gatek eep er in mak ing su c h a d ec isio n. 2 2 B u t o n ap p eal, an

ap p ellant mu st sho w harm a s w e l l a s e r ro r; 2 3 and in this c ase, the trial c o u rt mad e it

c lear bo th bef

o re a n d af t e r trial, that it had ind ep end ently mad e the d eterminatio n that

D r. Qu irk w as qu alif

ied and it w as f

o r the j u ry to d etermine w hic h exp erts w ere mo re

k no w led geable and exp erienc ed

. 2 4

2 2 S ee s u p ra no tes 1 6

- 1 7 & ac c o mp anying text.

2 3 See Ma di

s o n v

. S t a t e , 281 Ga. 6 40, 642 (2) (b) (6 41 SE2d 7 89 ) (2007 ) (“ [ H ] arm a s w e ll as erro r mu st b e sho w n to au t ho riz e a rev ersal b y this [C]o u rt. W hen

a plaintif f in erro r brings a c ase here, he mu st s h o w e r r o r w hic h has hu rt him. This

c o u rt is no t an exp o u nd er o f theo r etic al law , b u t it ad ministers p rac tic al l a w , and

c o rrec t s o nly su c h erro rs as hav e p rac tic ally wro nged the c o mp laining p arty. ” (p u nc tu atio n o mitted )); a cco rd Is b ell v

. C redi t N a ti o n L e n d i n g Se r v

. , L L C , 3 19 G a

. A p p

. 1 9 , 22 ( 735 SE2d 46 ) (201 2). Signif ic antly, Dr. Cherv u a dmi tted that he dev iated f ro m the ap p lic able stand ard o f c are by f ailing to giv e Thac k e r d u al- p latelet therap y.

2 4 I n d enying B o o ne’ s p re- trial mo tio n to e x c lu d e D r

. Qu irk ’s testimo ny, the trial c o urt f

o u nd Qu irk w a s q u alif

ied to testif

y regard ing the stand ard o f c are f o r ad ministering m ed ic ine to p atients prio r to T C A R su rgery and that the j u ry w o u ld d ec id e w hic h o f t h e e x p erts t hey f o u nd mo re exp e rienc ed and k no w led geable. A nd

a g ain, in d enying Bo o ne’ s mo tio n f or a new trial, the c o u rt no ted t hat B o o ne’ s argu ment that it shif

ted the d u ty to d e termine w hether Qu irk w a s qu alif ied w as

“ inc orrec t and tak en o u t o f c o ntext. ” So , d esp i t e t h e t rial c o u rt’ s statements regard ing the j u ry a t trial, the c ou rt mad e c lear that it mad e the qu alif ic atio n d ec isio n.

12Tu rning to D r. Qu irk ’ s qu alif ic atio ns , 2 5 she—lik e D r. Cherv u— is a v asc u lar

su rgeo n, 2 6 and is b o ard c ertif ied in general and v asc u lar su rgery. Fu rthermo re, w hile

Qu irk had no t p erf

o rmed any TCA R p ro c ed u res at the t ime o f Thac k er’ s su r gery, her

p rac tic e is o ne hu nd red perc ent v asc u lar s u rgery. She is also e xp erienc ed in treating

c aro tid artery d isease, seeing ap p ro ximately 1 5 p atients a mo nth du r ing her eight- year

resid enc y and aro u nd 1 0 p atients p er mo nth sinc e the c onc lu s io n o f her training. A nd

thro u gho u t her c areer, Qu irk r egu larly treated p atients w ho tak e anti- p latelet

med ic atio n—the t

yp e o f med ic atio n at issu e in t his c a se—f o r p u rp o ses o f stro k e risk

red u ctio n. So , Qu irk is familiar w ith t he r i s k s o f this med ic ine, inc lu d ing

hemo r rhaging o r bleed ing.

2 5 B o o ne c o mp lains that D r. Qu irk ’ s t r ial testimo ny regard ing her qu a lif ic atio ns

w as inc o nsistent w ith her d e p o sitio n t e st i mo ny d u ring d isc ov ery. B u t t o the extent Qu irk ’ s testimo ny w as inc onsistent in this regard , it w a s w ithin the trial c o u rt’ s bro ad d isc r etio n t o d etermine w hic h te s t i m o n y w a s c red ible. S ee D a b d o ub v

. Glo b

. Ho me Ima ge , LLC , 29 1 Ga. A pp

. 29 8, 29 9 (6 6 1 SE2d 6 6 9 ) ( 2008) (no ting t hat, w hen the trial

c o u rt is t he f

ac t f ind er, “ [ t]he trial c o u rt—no t this Co u rt—reso lv es issu es o f w itness

c red ibility, and c o nf

lic ting ev id enc e in the rec o rd

. . . . ” ).

2 6 I n its o rd er d enying B o o ne’ s mo tio n f o r a new trial, t he trial co u rt stated that D r. Qu irk w a s no t a v asc u lar su rgeo n, bu t it is u nd isp u ted thro u gho u t t he rec o rd and the p arties’ brief

s that she w a s ind eed a v asc u lar su rgeo n.

13D r. Qu irk testif ied that she p erf

o rme d o v e r 2 0 0 su rgeries inv o lv ing c aro tid

artery d isease d u ring her training u nd er s u p erv isio n and betw een 1 6 0 and 1 80

s u r g e r i es f

o llo w ing that training. Signif ic antly, a TCA R p ro ced u re inv o lv es

end o v asc u lar stenting, a nd Qu irk regu larly p e rf o r m s end o vasc u lar stenting

p ro c ed ures. A nd ac c o r d i n g t o Qu irk , she is e xp erienc ed in mak ing d ec isio ns abo u t

m ed ic atio ns f

o r p atients who are abo u t to hav e su rgery f o r c aro tid artery d isease t o

minimiz e the risk o f a stro k e o r blo o d c lo t

.
Relev a nt here, D r. Qu irk testif ied she w a s f

a miliar w ith D r. Cherv u ’ s c o nc erns

abo u t ad ministering DA PT to Thac k er p rio r t o su r gery. A nd in this c a s e , D A PT

w o u ld o nly hav e e ntailed ad ding Plav ix to the m ed ic a tio ns Thac k er w a s a l r e a d y t a k ing.

Qu irk believ e d it w as reaso nable u nd e r the ap p lic able stand ard o f c are f o r a su rgeo n

to be c o nc e rned a b ou t ad d ing Plav ix to t h o se med ic atio ns. B u t Qu irk testif ied that

ano t h e r , s af

er w ay to ad minister D A PT w o u ld hav e been t o su bstitu te Plav ix f o r
hep arin. N ev ertheless, Qu irk believ ed Cherv u ’ s “ p lan w a s in c o mp lianc e w ith the

med ic al s tan d ar d o f c are. ” A nd Qu irk ac k no w led ged that D A PT w a s the u su al

treatment fo r TCA R p a t i en t s , bu t she testif ied there are alw ays exc ep tio ns to “ the

ru le in med ic ine. ”

14Giv en the fo rego ing, altho u gh D r. Qu irk had no t p erf o rmed a TCA R p r o c ed u re

bef o re 201 8, s he w as a lo ng- time v asc u lar s u rg e o n e xp e rienc ed in p erf o rming the same

type o f p ro c ed u re— i

. e

. , p r o ce d u r e s i n v o l v i n g e n d o v a s cu l a r s t e n t i n g

— o n p a t i e n ts w ho ,
lik e T hac k er, w ere d iagno sed w ith c aro tid artery disease. She also regu larly m anaged

the med ic a t i o n ad ministered to tho se p atients. A gain, u nd e r Geo rgia law , to be

qu alif ied as a med ic al exp ert, the exp ert is no t requ ired to hav e p erf o rmed o r tau ght

the exac t su rgery as the o ne at issu e. 2 7 A nd signif ic antly, as to the imp ac t o f Qu irk ’ s

testimo ny, altho u gh D r

. C h er v u exp lained his r e aso ns f o r d o ing so , he a dmi tted to

d ev iating f

ro m the ap p lic able stand ard o f c are in his treatment o f Thac k er. Simp ly p u t,
giv en the f

o rego ing, w e c a n n o t say t he trial c ou rt abu sed its d isc retio n in qu alif ying

Qu irk as an exp ert to testif y as t o t he ap p lic able stand a rd o f care w hen m ed ic ating

p atients p rio r to TCA R p ro c e d u res. 2 8

2 7 S ee s u pra no te 20 & ac c o mp anying text.

2 8 S ee Ro b les v

. Yu

gu ero s , 343 Ga. A p p

. 37 7 , 384- 85 (2) ( a) (807 SE2d 1 1 0) (201 7 ) (“ G iv en [the exp ert’ s] med ic al bac k gro u nd and exp erienc e , w hic h inc lu d ed read ing the exac t typ e o f x- ray a t issu e here—and d o ing s o in c ollabo ratio n w i th e m e r g e nc y med ic ine p hysic ians, the trial c o u rt did no t abu se its d isc r et io n in rej ec ting [the ap p ellant’ s] c o ntentio n t hat, bec au se [the exp ert] w as a rad io lo gist w ho had nev er p rac tic ed emergenc y med ic ine, he w as no t qu alif ied u nd er OCGA § 24- 7

- 7 02

. . . to rend e r o pinio ns regard ing [a d o c to r’ s] interp reta t io n o f [the ap p ellant’ s w if e’ s abd o minal x- ray]. ”); Gra h a m v. Reyn o l ds , 343 Ga. A p p

. 27 4, 27 8- 7 9 (2) (a)- (b) ( 807

152. N e xt, B o o ne c o ntend s the t rial co u rt gav e tw o no n- p attern j u ry instru c tio ns

that imp ro p erly p lac ed “ a thu mb o n the s c ale” in f av or o f t he a p p ellees. 2 9 A gain, w e

d isagree.

W e rev iew de n o v o an alleged ly erro neo u s j u ry instru c tio n, whic h is “ a l e g a l

qu estio n. ” 3 0 And in as s e s sing the assertio n that a j ury instru c tio n w as e rro neo u s, it

SE2d 39 ) (201 7 ) (ho ld ing that a d o c to r was c omp etent t o testif y as an exp e rt regard ing the stand a rd o f c a re ap p lic able to a d o c to r in ano ther sp ec ialty w hen the exp ert had the requ isite k no w led ge and e xp e r i e n ce u n d e r R u l e 7 0 2 t o giv e exp ert testimo ny regard ing the ac ts or o missio ns o f a d o c t o r in ano ther sp ec ialty); C o tten v

. Phi

lli ps , 280 Ga. A p p

. 280, 282- 83 (6 33 SE2d 6 55) (2006 ) (ho ld ing that trial co u rt d id no t abu se d isc retio n in f ind ing t hat v asc u lar su rge o n w as qu alif ied to testif

y as to o rtho p ed ic su rgeo n’ s f ailu re to p ro p erly assess, mo nito r, and resp o nd to patient’ s v asc u lar c ond itio n d u ring

o rtho p ed ic treatment and su rgery).

2 9 Trial c o u r ts a r e no t legally bo u nd to u se t he e xac t langu age in G eo rgia’ s
s u g g e s t e d p attern j u ry instru c t io ns w hen c harging a j u ry. S ee Ba i ley v

. E dmu n ds o n , 280 G a

. 5 2 8 , 5 3 4 (7 ) (6 30 SE2d 39 6 ) (2006 ), s u pers eded b y s ta tu te o n other gro u n ds a s
a ckn o wledged b

y C hrys l e r G r p ., LLC v

. W

a lden , 303 Ga. 358 (81 2 SE2d 244) (201 8) (“ T here is no requ ire m e n t that o nly v erbatim p attern charges a re p ermissible. ” ); S ho wers v

. S ta t

e , 353 G a. A p p

. 7 54, 7 6 0 (2) (b) (ii) (839 SE2d 245) ( 2020) (“ I t is

w ell- established t h a t j u ry instru c tio ns d o no t need to t r ac k , exac tly, the langu age o f p attern j u ry instru c tio ns. ” (p unc tu atio n o mitted ) ). I n fac t, in so me c a ses, this Co urt has d isap p ro v ed of langu age in a p attern instru c tio n. S e e , e

. g

. , Whi te v

. Sta n ley , 36 9 Ga. A p p

. 330, 337

- 38 (1 ) (89 3 SE2d 46 6 ) (2023) (ho ld ing that the trial c o u rt erred in giv ing Geo rgia’ s then- c u rrent p attern j u r y i n s t r u ct i o n o n “ p r e p o n d e r a n ce o f the ev id enc e” ).

3 0 W ri ght v

. S ta te , 36 5 Ga. A p p

. 288, 2 8 9 ( 1 ) ( 8 7 8 SE2d 1 37 ) (2022) (p u nc tu atio n o m itted ); s ee W a lker v

. S ta te , 31 1 Ga. 7 1 9 , 722 (2) (859 SE2d 25) (2021 ) (“ Whether the ev id enc e w a s su f f ic ient to w arrant t he requ ested [j ury] instru c tio n is

16mu st be ev alu ated in “the c o ntext o f t he trial co u rt’ s j u ry instru ctio ns as a who le. ” 3 1

I nd eed , the o nly requ irement regard ing j ury c harges is t h a t t hey w ere, as giv en,

“ co rrec t statements o f the law and , as a w ho le, w o u ld no t mislead a j u ry o f o rd inary
intelligenc e. ” 3 2 A n erro neo us c harge, then, “ d o es no t w arrant a rev ersal u nless it w as

harmf u l and , in d etermining harm, the e ntirety o f the j u r y i n s t r u c tio ns mu st be

c o nsid ered

. ” 3 3 Ev en s o , erro neo u s c harges are “ p resu med t o b e p rej u d ic ial and

harmf u l, bu t this is no t c o nc lu siv e bec au se t he p resu mp t io n o f harm whic h arises f ro m

a legal qu estio n, w hic h w e rev iew de n o v o

. ” (p u nc tu a tio n o mitted )).

3 1 W ri ght , 36 5 Ga. A p p

. at 289 (1 ) (p u nc tu atio n omitted ); see W alker , 31 1 Ga. at 7 24 (3) (“ W hen w e a re p resented w ith a clai m t h a t a p a rtic u lar instru c tio n is mislead ing, w e d o no t ev alu ate j u ry c harges in iso latio n, bu t rather c o nsid er them as
a w ho le to d etermine whether there is a reaso nable lik eliho od the j u ry imp ro p erly ap p l i e d a ch a l l e n g e d i nstru c t io n. ” (p u nc tu atio n o mitted ) ); Fa s s na cht v

. Mo l

er , 358 Ga. A p p

. 46 3, 47 5 (1 ) (b) ( 855 SE2d 6 9 2) (2021 ) (exp laining t hat j ury c h arges and

rec harges mu st be read as a w ho le).

3 2 W ri ght , 36 5 Ga. A pp

. at 2 89 ( 1 ) (p u nc tu atio n o mitted ); a cco rd Pye v

. S ta te , 322 Ga. A p p

. 1 25, 1 29 (2) (7 42 SE2d 7 7 0) (201 3).

3 3 W ri ght , 36 5 G a. Ap p

. at 289 (1 ) (p u nc tu atio n o mitted ); a cco rd W i l l i a m s v

. S ta te , 26 7 Ga. 7 71 , 7 7 3 ( 2) (a) (482 SE2d 288) (1 9 9 7 ); Mu b a ra k v

. S ta te , 305 G a. A p p

. 41 9, 421 (2) (6 99 SE2d 7 88) (201 0).

17a c harging e rro r m ay be o v erc o me by a rev iew o f the rec o rd as a w ho le. ” 3 4 W ith these

gu id ing p rinc ip les in mind , w e tu rn to the sp ec if ic c harges being c hallenged

. (a) B o o ne c laims the trial c o u r t erred in giv ing t he j u ry a “ no

- gu arantee”

instru c tio n.

A s an initial matter, it is u nd isp u ted t h a t the v ersio n o f the no -gu arantee

instru c tio n sho w n to the j u ry o n a Po w erPo int p resentatio n d if f ers slightly f

ro m the

v ersio n c ontained in the trial transc rip t. Sp ec if ic ally, the instru c tio n sho w n to the j u ry

in w riting w a s as f

o llo w s:
Physic ians d o no t gu arantee the resu lts o f treatment, a nd in the absenc e

o f a breac h o f t he stand a r d o f c are, pro o f that t he o u tc o me o f treatment

w as dif f erent than that e xp ec ted neither establishes [ n ] o r s up po rts a n inf erenc e that the stand ard o f c a r e w as v io lated

. 3 5

.

3 4 Pa

yn e v

. T h om p son , 234 G a. A p p

. 533, 5 33 (507 SE2d 257 ) (1 9 9 8) (p u nc tu atio n
o mitted ) ; s ee McC

o rkle v

. D e p’ t o f Tra n s p. , 257 Ga. A p p

. 39 7 , 404 ( 4) (57 1 SE2d 1 6 0) (2002) (“ W hen an e rro r in the c harge of the co u rt is sho w n to exist, it is p resu med to be p rej u d ic ial and harmf

u l, a nd this c o u rt w ill so ho ld unless it ap p ears f ro m the entire

rec o rd that the erro r is harmless. ” (p u nc t uatio n o mitted )).

3 5 (Emp hasis su p p lied ).

18A nd the trial transc r ip t ref lec ts that the instru ctio n w as as f o llo w s:
Phys i c ians d o no t gu a rantee t he resu lts o f treatment and an absenc e o f

a breac h o f the stand ard of c are pro v es that t he o utc ome o f the treatment

w as d if f erent that exp ec t ed , neither establishes or su p p o rts an inf erenc e that the stand ard o f

c are w a s v io lated

. 3 6

On ap p eal, B oo ne a c k no w led ges the instru c tio n no ted in the t r ansc r ip t “ simp ly

d o es no t mak e any sense” and is “ almo st c e r tainly inc o rrec t [. ]” So , B o o ne fo c u ses her

argu ment instead o n the instru ctio n as “ requ ested o r intend ed [,]” 3 7 rather than “ the

c le a r l y er ro neo u s instru c tio n in the rec o rd

. ” A nd bec au se it is u nc lear w hether the

transc rip t c o ntains a typ o grap hic al erro r (altho ugh B o one certainly s eems to p resu me

it d o es), we ad d res s the written j u ry instru c tio n that was ind isp u tably sho wn to the
j u ry.

3 6 (Emp hasis su p p lied ).

3 7 The instru c t io n as requ ested by the d ef end ants, w hic h is nearly id entic al to the instru c t io n o n the Po w erPo int r ead s, “ I c harge yo u t hat a med ic a l p ro vid er d o es
no t gu a r an t e e t h e resu lts o f treatment and that in an absenc e o f a breac h o f the stand ard o f c are, p ro o f that the o u tc o me o f treatment f ro m that exp e c ted o r w as f o llo w ed by d isastro u s instead o f benef ic ial resu lts neither establishes no r su p p o rts an inf erenc e that the stand ard o f c are w as v io lated

. ”

19Sp ec if ic ally , Bo o n e m a i n t a i n s t h a t t he no

- gu a rantee instru c tio n is “ f u nc tio nally

an argu ment that bad o u tc o m es are no t t o be c o nsid e r ed i n d etermining w hether o r

no t the stand ard o f c a r e was v io lated

. ” 3 8 This is simp ly no t the c ase. I nstead , the

instru c tio n p lainly s t a t e s th a t ev en i f a med ic al d ec isio n has a negativ e o u tc o me, a

p laintif f mu st also e stablish that the ap p lic able s t a n d a rd o f ca re wa s b rea ched

. A nd

need less to say, s u ch a breac h is an essential element o f a m ed ic al- malp r ac tic e c laim. 3 9

Pu t ano ther w ay, t he j u ry c harge instru c ts t hat a bad o u tc o me canno t b e the s o le basis

f o r a malp rac tic e c laim if it is no t sho w n t he med ic al p ro f e ssio na l b r e a c h ed the

r elev ant stand ard o f c are. This c o mp o rts w ith o u r “ w ell- s ettled p rin c i p l e o f

3 8 B o o ne c onten d s t h a t i n c ases (lik e this o ne) inv o lv ing t he la ck of med ic al treatment, the no

- gu a rantee instru c tio n is inap p ro p r iate. B u t she p ro v id e s no legal

au tho rity su ggesting t hat med ic al- malp rac tic e c laims inv o lv ing an af f irmativ e deci

s i o n to ad m inister o r n ot t

o a dmi n is ter c erta i n m e d i c a l t reatment are d if f erent in any material w ay, mu c h less as to a d o c to r ’ s ability t o gu arantee po sitiv e ou tc o m es. I n f ac t, B oo ne’ s e ntire c l a i m i s that Dr. Cherv u ’ s dec isio n n o t t o a dmi n i s ter D A PT p rio r to Thac k er’ s su rgery v io lated the stand ard o f c a re and p ro d u c ed negativ e resu lts.

3 9 See Zwi ren v

. Tho mps o n , 2 7 6 G a. 49 8, 49 9 (57 8 SE2d 86 2) (2003) (“ Three essential elements to establish liability in a med ic a l[- ]malp rac ti c e a c tio n hav e emerged f ro m the statu te: (1 ) the d u ty inh e r e n t in the d o c to r- p atient relatio nship ; (2) the breac h o f that d u ty b y f

ailing to exerc ise the r equ isite d egree o f sk ill and c are; and (3) that this f

a ilu re be t he p ro ximate c au se o f the i n j u r y s ustained

. ” (p u nc tu atio n
o mitted ) ).

20negligenc e law that the o c c u rren c e o f a n u nf o rtu nate ev ent is no t s u f f ic ient to

au tho riz e an inf

e renc e o f negligenc e. ” 4 0
Regard less, this Co u r t ap p ro v ed a nearly id entic al j u ry instru ctio n in Ho dges v

.

E ffi n gha m C ou n ty Ho spi ta l Au tho ri ty : 4 1

[A ] ho sp ital d o e s no t gu arantee the resu lts o f its care and p ro o f alo ne that the o u tc o me o f the c are is d if f erent f ro m that exp ec ted or is f

o llo w ed by d isastro u s instead o f benef ic ial resu lts neither establishes no r su p p orts

an inf e renc e of w ant o f p ro p er care, sk ill o r d iligenc e o n the p art of the ho sp ital nu rses. 4 2

A nd in Hi ll v

. Ho s pi t a l A u tho ri ty o

f C la rke C o un ty , 4 3 this Co u rt ap p ro v ed the f o llo w ing
j u ry instru c tio n:

4 0 W i ls on v

. Gu y , 356 Ga. A p p

. 509 , 5 1 1 (1 ) (848 SE2d 138) (2020) (p u nc tu atio n
o mitted ) ; s ee W

o lfe v

. Ca rter , 31 4 Ga. A p p

. 854, 8 5 9 (2) (b) (7 26 SE2d 122) (201 2) (“ [ I ]t is a w ell settle d p r i n c i p le o f negligenc e law that the o c c urrenc e o f an

u nf o r tu nate ev e nt is no t su f f ic ient to au tho riz e a n inf erenc e of neglig e n c e. ” (p u nc tu atio n o m itted )); Hi ll v. Ho s p. Au th. o f C la rke C n ty

. , 1 37 Ga. Ap p

. 6 33, 6 39

- 40 (I I ) (4) (224 SE2d 7 3 9 ) (1 9 76 ) (no ting that, in regard s to a no

- gu arantee instru c tio n similar to the one at issu e here, “ [t]he langu age o f the c harge is in ac c o r d w ith the general p r inc ip les o f negligenc e law that the o c cu r renc e o f an u nf o rtu nate ev ent is no t

su f fic ient to au tho riz e an inf erenc e o f negligenc e” ).

4 1 1 82 Ga. A p p

. 1 7 3 (355 SE2d 1 04) (1 9 87 )

.

4 2 Id. at 1 7 7 (5) (p u nc tu atio n o m itted ).

4 3 1 37 Ga. A p p. 6 33.

2 1I c harge yo u that a ho sp ital d o es no t gu arantee the resu lts of a treatment

o r o p eratio n, and that in the absenc e o f negligenc e as a matter o f f ac t o r

as a matter o f law o n the p art o f the ho sp ital o r its emp lo y ees o r agents,
p ro o f simp ly that an op e ratio n o r treatment is d i f ferent in its o u tc o m e f ro m that exp ec ted , o r is f o llo w ed b y disastro u s inste ad o f benef ic ial

resu lts neither establishes no r su p p o rts an inf erenc e o f l a c k o f p ro p er

c are, sk ill o r d iligenc e o n the p art o f the emp lo yees o f the ho sp ital. 4 4

Finally, in Bra nn en v. Pri

n ce , 4 5 w e ap p ro v ed the f

o llo w ing j u r y instru c t io n:
[P]ysic ians d o no t gu a r a n t e e the resu lts o f treatment o r o peratio n, a nd that in the absenc e o f negligenc e o n the p art o f the p hysic ia n s, p ro o f simp ly that an o p eratio n o r treatm en t i s d if f erent in its ou tc ome f

ro m that exp ec ted o r is f

o llo w ed by d i s a s t ro u s resu lts instead o f benef ic ial

resu lts neither establishes no r su p p o rts an inf erenc e o f la c k o f p r o p er

c are, sk ill o r d iligenc e o n the p art o f the p hysic ians. 4 6

Simp ly p ut, bec au se w e hav e rep eated ly ap p ro v ed o f j u ry instru c tio ns that are

su bstantiv ely the same as the o ne at issu e here, B o o ne has no t established that the no

4 4 Id. at 6 39 (4).

4 5 204 Ga. A p p

. 86 6 (421 SE2d 7 6 ) (1 9 9 2), o v erru led o n o ther gro u n ds b y Gi lli s v

. C i t y o f W a ycro s s , 247 Ga. A p p

. 1 1 9 (543 SE2d 423) (2000), a n d Smi t h v

. Fi n ch , 285 Ga. 7 09 (6 81 SE2d 1 47 ) (2009 ).

4 6 Id. at 87 1 (8).

22gu arantee j u r y instru c tio n w a s an inc o rrec t statement of law o r had the p o t ential to

c o nf u se the j u r y. A s a resu lt, the trial c ou rt d id no t err in giv ing this j u r y c harge. 4 7
(b) B o o ne also argu es the trial c o u rt erred in giv ing this “ dif f e ring- v iew s” j u ry

instru c tio n: 4 8

Testimo ny sho w ing a d if

f erenc e o f view s betw een physic ians regard ing the m e d i c al j u dgment exerc ise is insu f f ic ient to su p p o rt an ac tio n f o r malp rac tic e w here it is sho w n that the pro c ed u re p ref erred by e ac h o r the j u d gment exerc ised is an a c c ep table and cu s to m ary metho d und er the stand ard o f

c are I hav e giv en yo u

.

4 7 S ee S a go n v

. Pea c

htree C a rdi o v a scu la r & Tho ra ci

c Su rgeo n s, P. A

. , 29 7 Ga. A p p

. 37 9 , 382- 83 (6 7 7 SE2d 351 ) (2009 ) (ho ld ing the trial c o urt d id no t e rr in giv ing a
c ertain ju ry instru ctio n when, “ v iew ed in their entirety, t h e t r ial c o u rt’ s j u ry instru c tio ns gav e a f

u ll and co rrec t statement o f the law regard ing the stand ard o f c are that ap p lied to all o f the pro f essio nal health c are pro v id ers and w ere no t co nf u sing in d ef ining t he p ro f

essio nal negligenc e issu e” ); Wes t v

. Brea s t C a re S peci a li s t s , LLC , 29 0 Ga. A p p

. 521 , 522 (1 ) (6 59 SE2d 89 5) (2008) (ho ld ing a j u ry c harge w as p ro p er w hen it “ gav e a f

u ll and c o r rec t statement of t he law r egard ing the c are a nd s k i l l r e qu ired

o f a p h ysic ian and the p ro o f requ ired at t rial to su p p o rt a c laim of med i c a l

m a l p r a ct i ce ”) ; s e

e a l s o W hi te , 36 9 Ga. A p p. at 332 (“ [T]he o nly requ irement r e g a r d i n g j u ry c harges is that they w e re, as giv en, c orrec t statements of t he law and , as a w ho le,

w o u ld no t mislead a j ury o f o r d inary intelligenc e. ” (p u nc tu atio n o m itted )).

4 8 The ap p e llees and p o rtio ns o f the r ec ord als o r e f er to this instru c tio n as a

“ perso nal- prac tic e s” c harge.

23Sp ec if ic ally, B o o ne c o ntend s t h e f o r e go ing c harge instru c ted t he j u ry to

p resu me the absenc e o f negligenc e and that the p laintif f ’ s “ e xp erts’ testimo ny o f

stand ard o f c are v io latio ns is insu f f ic ient to s u p p o r t a malp rac tic e claim if there is any

ev id enc e o n the o ther s i d e

. ” B u t this instru c tio n d id no t direc t the j u ry to p resu me

a n ythi n g o r in a ny w ay su ggest it sho u ld d isregard a p l a i n t i f f ’ s exp ert if a d ef

ense

exp ert testif

ies. I nstead , it simp ly ac k no w led ged that there c a n be mo re than o ne w ay

to satisf y the ap p lic abl e st a n d ard o f c are, a nd t he mere f ac t that med ic al exp erts

d isagree o n ho w to d o so d o es no t, in and o f itself , p r o v e med ic al malp rac tic e.

M o reo v e r, the Su p r eme Co u rt o f Geo rgia has ad v ised that a d if f ering- v iew s

instru c tio n s

ho u ld b e giv en w hen m e d i c a l exp e r ts testif y. Sp ec if ic ally, in C

o n dra v

.
Atla n ta Ortho

p a edi c G rp. , P. C

. , 4 9 o u r Su p reme Co u rt ad d ressed an a r g u m ent that

allo w ing exp erts in med ic al- malp rac t ic e c a ses to testif y as to their p e rso nal prac tic es

i s “ l ik ely t o c onf

use the j u ry b y c o nf

lating the s tand ard o f c are w ith an ex p e r t ’ s

p erso nal p ro to c o ls. ” 5 0

4 9 285 Ga. 6 6 7 (6 81 SE2d 1 52) (2009 )

5 0 Id. at 6 72 (1 ).

24I n d o ing so , the C on dra Co u rt exp lained ,

any p o tential c o nf

usio n c reated by the a d missio n o f su c h ev id enc e may be remed ied t hro u gh t h e u s e o f caref u l j u ry instru c tio ns. Su c h instru c t i o n s sho u ld , f

o r examp le, c learly d ef

ine t he legal meaning o f stand ard o f c a re; e nu nc iate the p rinc ip le t h a t a m e re d i fferen ce i n v i ews b etween phys i

ci a n s do es n o t b

y i ts elf pro v e ma lpra cti

ce

. 5 1

A nd here, B o o ne has no t id entif ied any m aterial d istinc t io n betw een the trial c o u rt’ s

d if f ering- v iew s instru c tio n and the langu age o u r Su p reme Co u rt su ggested that trial

c o u rts sho u ld u se in Co n dra

.

B oo ne f u rther c laims the trial c o urt imp r o p erly su ggested it p r o v id ed the j u ry

w ith the ap p lic able stand ard o f c are w hen it is f o r the j u ry to mak e that d e terminatio n.
Sp ec if ic ally, B o o ne c hallenges t he p o rtio n of the instru c tio n no t ing that, “.

. . w here

it is sho w n t hat the pro c ed u r e p ref erred by e a c h o r the j ud gment exerc ised is an

5 1 Id. B o o ne c laims t he trial c o u rt’ s dif fering- v iew s ju ry instru c tio n is similar to

o ne this Co u rt d isp ro v ed of in Byrd v

. Medi ca l C en t er o f C e n tra l G eo rgi a , In c

. , 258 Ga. A p p

. 286 ( 57 4 SE2d 326 ) (2002 ). B ut ev en if t hat w ere argu ably tru e, w e are
nev ertheless bo u nd by o u r S u p r e me Co u rt’ s d ec isio n in Co n d ra

. See Tho mps o n v

. S ta te , 358 Ga. A p p

. 5 53, 557 (1 ) (8 5 5 S E 2d 7 5 6 ) (2021 ) (“ A ltho u gh [the ap p ellant] argu es that this w ell settled au tho rity sho u ld no lo nger be f o llo wed in G eo rgia, w e are bo und b y the o p inio ns of the Su p reme Co u rt. ” ); W ho rto n v

. Sta te , 321 G a. A p p

. 335, 339 (1 ) (7 41 SE2d 653) (201 3) (no ting that “ v ertic al stare d ec isis d i c tates that w e f aithf u lly ad here to the p rec ed ents established by the Su p reme Co u rt o f Geo rgia” ).

25ac c e p table and c u sto mary metho d u nd er the s ta n da rd o f ca re I ha ve gi

ven yo u

. ” 5 2 B u t

this statement c anno t b e read in a v ac u u m

. B o one has no t id entif ied anyw here in the

rec o rd , transc rip t, o r j u ry instru c tio ns w here the trial c o u rt p ro v id ed the j u ry w ith the

sp ec if ic med ic al stand a r d o f c are f o r med ic ating TCA R p atients. A nd ju st p rio r to the
j u ry c harge at issu e , the trial c o urt instru c ted the ju ry o n the gen era l l ega l def initio n o f

“ s tand ard o f

c a re. ” So , c onsid ering the j u ry instru c tio ns as a w ho le (as w e mu st), it

is c lear the trial c o u rt w as r e f e r en c i n g the legal d ef

initio n o f the p hrase, no t the

sp ec if ic med ic al st a n d a r d o f care ap p lic able in thi s c a se. The trial c o u rt did no t e rr,
then, in giv ing a d if

f ering- v iew s instru c tio n nearly id entic al to the o ne a p p ro v ed o f in

C o n dra

. 5 3

Fo r all these reaso ns, w e af f irm the j u ry’ s v erd ic t in f av or o f the ap p ellees.

Ju dgmen t a

ffi rmed. Bro wn a n d Pa dgett, JJ. , co n cu r

.

5 2 (Emp hasis su p p lied ).

5 3 S ee s u pra no te 47

.
26