Case Name: CRODA v. SARNACKI
Court: Michigan Court of Appeals
Jurisdiction: Michigan
Decision Date: 1981-05-05
Citations: 106 Mich. App. 51
Docket Number: Docket No. 43276
Parties: CRODA v SARNACKI
Judges: Before: Bronson, P.J., and J. H. Gillis and Bashara, JJ.
Reporter: Michigan appeals reports; cases decided in the Michigan Court of Appeals.
Volume: 106
Pages: 51–69

Head Matter:
CRODA v SARNACKI
Docket No. 43276.
Submitted January 14, 1981, at Detroit. —
Decided May 5, 1981.
Leave to appeal applied for.
Josepha P. Croda and Antonio Croda brought a medical malpractice action in Wayne Circuit Court against Carl J. Sarnacki, M.D., Graciano F. Singson, M.D., South Macomb Gynecologists, P.C., Theodore G. Pantos, M.D., and Detroit-Macomb Hospitals Association, jointly and severally. During the first week of trial, defendant Detroit-Macomb Hospitals Association settled with plaintiff for $4,000. The jury returned a verdict of no cause of action as to the remaining defendants and judgment was entered accordingly, William L. Cahalan, J. Plaintiffs appeal, raising the following issues: (1) plaintiffs contend that the trial court erred by restricting the cross-examination of Dr. Pantos after he had been asked by plaintiffs’ counsel whether he agreed with statements in the deposition of defendants’ expert witness, Dr. Urwiller. Defendants objected to the questioning and the trial court ruled that, because Dr. Urwiller’s deposition had not been admitted into evidence and he had not been called as a witness, plaintiffs’ attorney could not specifically refer to the deposition. The court also ruled that plaintiffs’ counsel could not inquire as to why Dr. Urwiller had not been called as a witness. Plaintiffs’ counsel was allowed, however, to ask Dr. Pantos his frame of reference in forming his opinion that Mrs. Croda had not suffered permanent kidney damage as a result of treatment by defendants and as to the applicable standard of care; (2) plaintiffs allege that the trial court erred in giving a jury instruction which informed the jury of the amount of the settlement between plaintiffs and Detroit-Ma-comb Hospitals Association and told the jurors that they must deduct that amount from any judgment rendered against the remaining defendants. Plaintiffs argue that the giving of the instruction violated the rule of evidence which makes evidence of compromises or offers to compromise inadmissible at trial and that the trial court should have deducted the $4,000 from whatever judgment the jury may have reached rather than advising the jury to make the deduction themselvés. They claim that telling the jury of the $4,000 settlement allowed the jury to speculate that plaintiffs’ claims were without merit; (3) plaintiffs challenge an instruction on the apportionment of damages among the defendants; and (4) plaintiffs contend that the inclusion of the word "learned” in a jury instruction used in connection with explaining the requisite qualifications necessary for an expert witness would have misled the jury into concluding that, contrary to established law, the expert must be a specialist in the specific fields at issue in order to be a competent witness. Held:
References for Points in Headnotes
29 Am Jur 2d, Evidence §§ 629-632.
[3, 5, 6] 31 Am Jur 2d, Expert and Opinion Evidence §§ 26-28, 30, 31.
Necessity and sufficiency of showing of medical witness’ familiarity with particular medical or surgical technique involved in suit. 46 ALR3d 275.
Competency of general practitioner to testify as expert witness in action against specialist for medical malpractice. 31 ALR3d 1163.
75 Am Jur 2d, Trial §§ 30, 87.
75 Am Jur 2d, Trial §§ 668, 691.
1. A record of plaintiffs’ attempt to impeach Dr. Pantos fails to show any contradiction between Dr. Urwiller’s deposition and Dr. Pantos’ testimony. Therefore, the deposition was not relevant as impeachment evidence, there being no significant difference between the opinions of the two doctors. There was no error in the court’s ruling as it did.
2. The fact that plaintiffs had reached a settlement with Detroit-Macomb Hospitals Association was not introduced into evidence in order to prove the liability of the remaining defendants and the rule relied on by plaintiffs does not require exclusion when the evidence is offered for another purpose. Furthermore, the information pertaining to the settlement was not admitted into evidence at all. Even if it had been, admission of proof of a prior settlement agreement is a matter of judicial discretion. In view of the fact that the hospital association was an active party during the initial days of trial, the court’s instruction was proper in order to inform the jury of the party’s dismissal from the suit. The trial court’s instruction was the only noted mention of the settlement to the jury. There is no reason to assume that, based upon this instruction, the jury concluded that plaintiffs’ claims were without merit. There was no abuse of discretion in the trial court’s ruling.
3. The trial court substantially charged the jury with the standard jury instructions on apportionment. Based upon the evidence presented, there was no error in the charge.
4. An expert witness must possess the necessary learning, knowledge, skill or practical experience that would enable him to competently testify concerning the subject at issue. The trial court told the jurors that they could not determine the standard of care on their own knowledge, but that the proper practice would have to be established by one "learned in urology or gynecology”. Viewing the instructions as a whole, there was no reversible error.
Affirmed.
Bronson, P.J., dissented from the majority opinion on two points. First, he would hold that the trial court committed reversible error in giving the jury instruction which informed the jury of the earlier settlement and the amount thereof because a substantial possibility existed that the jury would misuse the information concerning the settlement and conclude that plaintiffs’ claims were of dubious validity given the relatively low amount for which the claim against the hospital was settled. Secondly, he would hold that the jury instruction pertaining to the qualifications of an expert witness was incomplete and erroneous and would lead the average juror to conclude that the plaintiffs’ expert witness’s testimony should be given less weight because he was not a specialist in urology and gynecology and that it was highly-probable that the jury’s verdict was improperly affected by the instruction. He would reverse and remand for a new trial.
Opinion of the Court
1. Evidence — Settlement Agreements — Admissibility of Agreements — Discretion.
Admission of proof of a prior settlement agreement between a defendant and the plaintiff is a matter of judicial discretion.
2. Damages — Evidence — Settlements — Admissibility — Jury.
A trial court in a medical malpractice action against multiple defendants did not abuse its discretion by instructing the jury that the plaintiffs had settled with one defendant for $4,000 and that the jury should deduct that amount from any judgment rendered against the remaining defendants where the instruction was proper in order to inform the jury of the settling party’s dismissal from the suit, the instruction was the only mention of the settlement to the jury, and there was no reason to assume that, based upon the instruction, the jury concluded that the plaintiffs’ claims were without merit.
3. Witnesses — Expert Witnesses — Medical Malpractice — Qualifications of Witness.
An expert witness in a trial for medical malpractice need not be a board-certified specialist in a particular field in order to testify as to the standard of care applicable to that practice but he must possess the necessary learning, knowledge, skill or practical experience that would enable him to competently testify concerning that area of medicine.
Dissent by Bronson, P. J.
4. Trial — Discretion — Failure to Recognize or Exercise Discretion — Error.
It is error for a trial court, where it has the discretion to rule on a matter, to fail to recognize that it has such discretion and, therefore, to fail or to refuse to exercise it.
5. Witnesses — Expert Witnesses — Medical Malpractice — Standard op Care.
A witness need not be of the same school or speciality as the defendant in order to be a qualified medical expert in a medical malpractice case; it is sufficient if the witness has expertise in the standard of care imposed by the defendant’s school or speciality.
6. Trial — Jury — Jury Instructions — Expert Witnesses — Error.
It was error for a trial court to give a jury instruction on the requisite qualifications for an expert witness where the court stated that an expert witness must be "learned” in a particular field or speciality because the jurors could have construed the instruction to mean that a particular witness must be a specialist in that field or speciality, the instruction could lead the average juror to conclude that that witness’s testimony should be given less weight because he was not a specialist in that particular field where a very specific objection to the instruction was made, and the trial court, which easily could have rectified the matter, did not.
Lopatin, Miller, Bindes, Freedman, Bluestone, Erlich & Rosen (by Steven G. Silverman), for plaintiffs.
Kerr, Russell & Weber (by James R. Dashiell), for defendants Sarnacki, Singson and South Ma-comb Gynecologists, P.C.
Sullivan, Ranger, Ward & Bone, P.C., for defendant Pantos.
Before: Bronson, P.J., and J. H. Gillis and Bashara, JJ.

Opinion:
Bashara, J.
Plaintiffs sought recovery of damages incurred as the result of defendants' alleged medical malpractice. During the first week of trial, defendant Detroit-Macomb Hospitals Association settled with plaintiffs. Subsequently, the jury returned a verdict of no cause of action as to the remaining defendants. Plantiffs now appeal the jury's verdict.
Drs. Sarnacki and Singson practiced medicine together as South Macomb Gynecologists, P.C., also a named defendant in the action. On June 8, 1973, plaintiff Josepha Croda consulted with Dr. Sarnacki concerning problems which included a dropped uterus, a herniated rectum, a lacerated cervix, excessive bleeding, pain on intercourse, constipation, and urinary incontinence. Sarnacki informed plaintiff that she needed a hysterectomy and a cystocele-rectocele. She underwent the surgery in the South Macomb Hospital on July 30, 1973. Subsequent to the surgery, plaintiff's bladder did not maintain its proper tone. As a result, catheterization was necessary to evacuate urine from the bladder. Two days after her discharge from the hospital, plaintiff went to the office of South Macomb Gynecologists and Dr. Singson removed the catheter. When Mrs. Croda began to notice urine in her vagina, Sarnacki reinserted a catheter and referred her to defendant Dr. Theodore Pantos, a urologist, who treated her from August 21, 1973, to November 2, 1973. As part of his treatment, Dr. Pantos performed a right ne phrostomy on September 11, 1973, and a reimplantation of the right ureter on November 9, 1973.
Plaintiff alleged that she sustained permanent injuries to her urinary system and right kidney as a result of defendants' negligence. She averred that she had not been properly informed of the dangers inherent in the surgical procedure of July 30, 1973, and that Dr. Sarnacki had breached a contract to cure. Mrs. Croda further contended that Sarnacki departed from the standard of care in cutting her right ureter during surgery and by discharging her from the hospital prematurely. Plaintiff further averred that Dr. Pantos was negligent in failing to perform the right nephrostomy before September 11, 1973, when he knew that plaintiff had problems with her right kidney on September 4, 1973. Mrs. Croda also alleged that the delay resulted in further damage to her right kidney. She also claimed that, instead of a nephrostomy, Dr. Pantos should have performed a reimplantation of the right ureter on September 11, 1973. Plaintiff Antonio Croda's claim was based on loss of consortium.
Plaintiffs initially contend that the trial court erred in restricting the cross-examination of Dr. Pantos. Plaintiffs' counsel began to ask Dr. Pantos whether he agreed with statements in the deposition of defendants' expert witness, Dr. Urwiller.
Upon objection by defendants, the trial court ruled that, since the deposition of Dr. Urwiller had not been admitted into evidence and he had not been called as a witness, plaintiffs' attorney could not specifically refer to the deposition. It was further held that plaintiffs' counsel could not inquire as to why Dr. Urwiller had not been called as a witness. Plaintiffs' counsel was allowed, however, to ask Dr. Pantos his frame of reference in forming his opinion that Mrs. Croda had not suffered permanent kidney damage and the standard of care.
A separate record was made in which plaintiffs attempted to impeach Dr. Pantos. Plaintiffs failed to show any contradiction between Dr. Urwiller's deposition and Dr. Pantos' testimony. Therefore, the deposition was not relevant as impeachment evidence, there being no significant difference between the opinions of the two doctors. We find no abuse of discretion in the court's ruling. Lorenz Supply Co v American Standard, Inc, 100 Mich App 600, 615; 300 NW2d 335 (1980), People v Strickland, 78 Mich App 40, 54; 259 NW2d 232 (1977).
Plaintiffs allege error in the following jury instruction:
"Now there was an additional defendant in this trial which was South Macomb Hospital [sic] Association and as you recall I instructed you that South Macomb Hospital [sic] Association after a particular point in this trial would no longer be considered a defendant. South Macomb Hospital [sic] Association has settled the claim filed against it by the plaintiffs for the amount of four thousand dollars. If you determine to award Mr. and Mrs. Croda any additional money from the remaining defendants, you should first deduct the sum of four thousand dollars from any sum you feel the plaintiffs should receive as damage."
Plaintiffs argue that the instruction violated MRÉ 408, which states:
"Rule 408 Compromise and Offers to Compromise.
"Evidence of (1) furnishing or offering or promising to furnish, or (2) accepting or offering or promising to accept, a valuable consideration in compromising or attempting to compromise a claim which was disputed as to either validity or amount, is not admissible to prove liability for or invalidity of the claim or its amount. Evidence of conduct or statements made in compromise negotiations is likewise not admissible. This rule does not require the exclusion of any evidence otherwise discoverable merely because it is presented in the course of compromise negotiations. This rule also does not require exclusion when the evidence is offered for another purpose, such as proving bias or prejudice of a witness, negativing a contention of undue delay, or proving an effort to obstruct a criminal investigation or prosecution." (Emphasis added.)
We find MRE 408 inapplicable to the controversy at bar. The settlement was not introduced into evidence in order to prove the liability of the remaining defendants. In fact, it was not admitted into evidence at all.
Plaintiffs assert for the first time on appeal that the trial court should have deducted the $4,000 from whatever judgment the jury may have reached rather than advise them to make the deduction themselves. By telling the jury that plaintiffs recovered $4,000 from the hospital, they contend the jury was allowed to speculate that their claim was without merit.
Admission of proof of a prior settlement agreement between a defendant and the plaintiff is a matter of judicial discretion. Wilson v W A Foote Memorial Hospital, 91 Mich App 90, 97; 284 NW2d 126 (1979), lv to appeal held in abeyance 409 Mich 868 (1980), Reno v Heineman, 56 Mich App 509, 512; 224 NW2d 687 (1974). But see, Brewer v Payless Stations, Inc, 94 Mich App 281; 288 NW2d 352 (1979), lv gtd 409 Mich 871 (1980). Until the Supreme Court holds to the contrary, we agree with the conclusion in Wilson, supra, that plaintiffs' proposal raised only on appeal is a permissible alternative which the trial court is not required to follow. Wilson, supra, 98.
In view of the fact that the hospital association was an active party during the initial days of trial, the court's instruction was proper in order to inform the jury of the party's dismissal from the suit. The trial court's instruction was the only noted mention of the settlement to the jury. There is no reason to assume that, based upon this instruction, the jury concluded that plaintiffs' claims were without merit. We fail to find an abuse of discretion in the trial court's ruling.
The third instruction challenged on appeal concerns the apportionment of damages among the defendants. The trial court substantially charged the jury with the standard jury instructions on apportionment, SJI 41.04 and SJI 41.05. Based upon the evidence presented, we find no error in the charge. Naccarato v Grob, 384 Mich 248, 255-256; 180 NW2d 788 (1970).
Plaintiffs challenge one final jury instruction:
"Now, the question is, 'How do you as jurors determine what the standard of practice is and whether or not it has been observed by the defendants in this case?'
"Jurors and judges do not know and are not permitted arbitrarily to say what are the proper methods of treating a patient under the circumstances in this case. This is a medical question. What is or is not a proper practice by a urologist or a gynecologist, the treatment of a patient or what is or is not standard of practice of the usual practice in the community is a question for experts and can be established only by their testimony. That is, it is only those learned in urology or gynecology who can say what should have been done or what was done or not to have been done and it is only those learned in urology or gynecology who can say what was done was proper."
Plaintiffs contend that the phrase "learned in urology or gynecology" could have misled the jury into concluding that, contrary to established law, the expert must be a specialist in those fields in order to be a competent witness. We agree with plaintiffs' initial premise that an expert need not be a board-certified specialist in the field in order to testify as to the standard of care of that practice. However, it is well-established that the expert witness must possess the necessary learning, knowledge, skill or practical experience that would enable him to competently testify concerning that area of medicine. Siirila v Barrios, 398 Mich 576, 591; 248 NW2d 171 (1976).
It is therefore clear that plaintiffs' expert, Dr. Miller, was not required to be a gynecologist or urologist in order to qualify as an expert witness. He stated that he was learned in those areas due to his medical training, experience and continuing review of the literature in those fields. The trial court properly allowed Dr. Miller to testify as an expert witness. MRE 702, S C Gray, Inc v Ford Motor Co, 92 Mich App 789, 805; 286 NW2d 34 (1979), MCL 600.2912a; MSA 27A.2912(1).
However, plaintiffs argue that by giving the above instruction, Dr. Miller's credibility was diminished by the court. They read the instruction as requiring the expert to be an actual member of one of the named specialties, a greater qualification then established by law.
We disagree with plaintiffs' interpretation of the instruction. The trial court told the jurors that they could not determine the standard of care on their own knowledge. Rather, the proper practice may only be established by one "learned in urology or gynecology". We find the instruction to conform precisely to the requirements of Siirila, supra.
Viewing the instructions as a whole, we find no reversible error. Moore v Foster, 96 Mich App 317, 321; 292 NW2d 535 (1980).
Affirmed. Costs to defendants.
J. H. Gillis, J., concurred.
Consequently, we need not address plaintiffs' novel suggestion that the deposition of one doctor may be introduced into evidence solely for the purpose of impeaching another doctor's testimony. See MRE 707, People v Brown, 13 Mich App 222; 163 NW2d 829 (1968).
An interlocutory appeal was granted in Brewer, where this Court reversed the judge's pretrial ruling that evidence of the settlement of one defendant would go to the jury in order that it could deduct the amount from any judgment rendered. One issue under consideration by the Supreme Court in Brewer is "whether the jury hearing the plaintiffs case against one or more tortfeasors may be informed of a settlement between plaintiff and another tortfeasor responsible for the same injuries where the settlement does not directly relate to an issue of material fact in the case", 409 Mich 871 (1980).