Case Name: Stephen GAINES, Appellant, v. COMANCHE COUNTY MEDICAL HOSPITAL and Nursefinders, Inc., Appellees
Court: Oklahoma Supreme Court
Jurisdiction: Oklahoma
Decision Date: 2006-06-13
Citations: 143 P.3d 203
Docket Number: No. 100,598
Parties: Stephen GAINES, Appellant, v. COMANCHE COUNTY MEDICAL HOSPITAL and Nursefinders, Inc., Appellees.
Judges: WATT, C.J., LAVENDER, OPALA, EDMONDSON, COLBERT, JJ., concur.
Reporter: Pacific Reporter 3d
Volume: 143
Pages: 203–217

Head Matter:
2006 OK 39
Stephen GAINES, Appellant, v. COMANCHE COUNTY MEDICAL HOSPITAL and Nursefinders, Inc., Appellees.
No. 100,598.
Supreme Court of Oklahoma.
June 13, 2006.
As Corrected June 20, 2006.
Rehearing Denied Sept. 11, 2006.
Mike Markey, Wichita Falls, TX, for appellant, Stephen Gaines.
Inona Jane Harness, Leslie D. Guajardo, Pierce Couch Hendrickson Baysinger & Green, L.L.P., Oklahoma City, OK, for appel-lee, Comanche County Memorial Hospital.
Monty B. Bottom, Jason T. Rogers, Fol-iart, Huff, Ottoway & Bottom, Oklahoma City, OK, for appellee, Nursefinders, Inc.
Stephen Peterson, Michael McMillin, Fen-ton, Fenton, Smith, Reneau & Moon, Oklahoma City, OK, for amici curiae, Oklahoma State Medical Association & Oklahoma Hospital Association.

Opinion:
WATT, C.J.
¶ 1 The cause presents a question of first impression in Oklahoma law: whether a registered nurse — with eighteen years of experience, who is familiar with the standards of nursing care for the elderly and critically ill and who has a certification for wound care— may offer expert testimony concerning the practices of other nurses and the standard of care in the avoidance, treatment and cause of bedsores. Under the facts presented, we determine that the registered nurse's expertise makes her qualified to give such expert testimony and express her opinion.
¶ 2 In allowing the nurse-expert's testimony as to the practices of other nurses, we align Oklahoma jurisprudence with all other jurisdictions considering whether a nurse may offer expert opinion testimony concerning decubitus ulcers. Our determination is also consistent with the legislative directive in 12 O.S.2001 2702 providing that witnesses may qualify as experts "by knowledge, skill, experience, training or education."
¶ 3 The second question requires that we consider whether a material issue of fact exists militating against the entrance of summary judgment. Here, the only physician testimony contained in the record indicates that the doctor does not consider himself an expert on decubitus ulcers. In contrast, the patient's nurse expert has eighteen years of experience, is familiar with the standard of nursing care for the elderly and critically ill and is certified for wound care practice. Furthermore, her affidavit provides that: 1) the standard of care for the critically ill patient was not carried out by the hospital's nurses; 2) the failure to reposition the patient was a direct contributor to the development of severe decubitus ulcers; 3) the nurses failed to meet the standard of care when they did not place heel protectors on Gaines' heels or feet and that this negligence was a direct and foreseeable cause of the development of decubitus ulcers; and 4) the decubi-tus ulcers could have been avoided if the standard of care had been followed.
¶4 When presented with the review of summary judgment, all inferences and conclusions to be drawn from the underlying faets contained in the record are considered in the light most favorable to the patient. Summary judgment is improper if, under the evidentiary materials, reasonable individuals could reach different factual conclusions. We are constrained to reverse summary judgment when it appears there are disputed facts.
¶ 5 Here, genuine issues of material fact exist concerning whether the patient received appropriate treatment and, if not, whether the patient's bedsores were avoidable. Therefore, we determine that the judgment should be reversed and the cause remanded for a resolution of these issues by the trier of fact.
RELEVANT FACTS
¶ 6 On December 1, 2000, following injuries from multiple gunshot wounds, the appellant, Stephen Gaines (Gaines/patient), was admitted to Comanche County Memorial Hospital (hospital), an appellee herein. Gaines was a large man, approximately six feet four inches tall and weighing three hundred and eighty pounds. Following his initial surgery, Gaines suffered two abdominal evis-cerations requiring surgical repair. The repairing physician, Kelly Means, M.D. (Means), instructed that Gaines not be moved for forty-eight hours following the second procedure.
¶ 7 Gaines left the Hospital on January 17, 2001, when he was transferred to another facility. Before his transfer and while in the hospital, Gaines developed bedsores on his sacral area, feet, heels and head.
¶ 8 The doctor who was originally a defendant in the cause testified that he did not consider himself any kind of an expert on bedsores and that he would find it difficult to identify the stage of the ulcers. The nurse's affidavit offered as plaintiffs evidentiary material provides that: 1) the standard of care for the critically ill patient was not carried out by the hospital's nurses; 2) the failure to reposition the patient was a direct contributor to the development of severe decubitus ulcers; 3) the nurses failed to meet the standard of care when they did not place heel protectors on Gaines' heels or feet and that this negligence was a direct and foreseeable cause of the development of decubitus ulcers; and 4) the decubitus ulcers could have been avoided if the standard of care had been followed.
¶ 9 The patient filed a malpractice suit against Means, the hospital and the appellee, Nursefinders, Inc. (Nursefinders), in October of 2002. Subsequently, the doctor was dismissed from the malpractice cause leaving only the hospital and Nursefinders as defendants. The hospital and Nursefinders filed a motion for summary judgment on February 17, 2004, on grounds that Gaines had not come forward with any expert physician testimony to support his malpractice claims. Gaines opposed the motion and requested additional time to provide a more detailed vitae on the nurse's qualifications. Nevertheless, on April 1, 2004, the trial court sustained the motion. Recognizing the management of pressure sores is the responsibility of nurses, the Court of Civil Appeals reversed.
DISCUSSION
¶ 10 a. The registered nurse's expertise makes her an appropriate professional to offer expert testimony concerning the practices of other nurses and the standard of care in the avoidance, treatment and cause of bedsores.
¶ 11 The patient argues that a registered nurse with the experience of his nurse-expert should be allowed to offer an expert opinion as to the practices of other nurses and the standards of care in the avoidance, treatment and cause of bedsores. The hospital and Nursefinders assert that the nurse is not qualified to give an expert opinion in a medical malpractice action. Their assertion is supported by the amici curiae, Oklahoma State Medical Association and the Oklahoma Hospital Association (collectively, Associations), who submitted their statement in support of granting certiorari. We disagree with the hospital, Nursefinders and the Associations.
¶ 12 It is a rarity when all courts addressing any particular question are in agreement. Nevertheless, our research reveals that, in all causes in which the issue of a nurse's expert testimony arose in response to inquiries concerning a patient's development of and the treatment for bedsores, all jurisdictions having addressed the issue allow the testimony.
¶ 13 The Kansas Court did so in Mellies v. National Heritage, 6 Kan.App.2d 910, 636 P.2d 215 (1981). Mellies shares two important and persuasive factors with this cause. In Mellies, the testimony was offered by nurses who had special training in wound care. Here, the nurse had eighteen years of experience, worked in an area where she treated the elderly and critically ill and was certified for wound care practice. In Mel-lies, the testimony was offered to demonstrate the negligence of the nursing staff. Here, after the physician had been dismissed from the cause, the nurse's testimony was offered as evidence of substandard care administered by the hospital's staff.
¶ 14 The Mellies Court concluded that the trial judge abused his discretion in disallow-tag the nurse's testimony as expert on decu-bitus ulcers. It concluded that, with the proper foundation, nurses should be qualified as experts as to causation and as to treatment and cure of bedsores. In doing so, it recognized that such skin eruptions are "primarily a nursing problem . nurses are experts . ".
¶ 15 Mellies represents the position taken by all deciding tribunals concerning nurse-expert testimony in relation to bedsores. Research reveals no decision, turning on the issue of whether a nurse may offer expert testimony relating to bedsores, which has disallowed such evidence.
¶ 16 The Kansas Court's stance is consis tent with 12 O.S.2001 2702's legislative directive providing that witnesses may qualify as experts "by knowledge, skill, experience, training or education." Also instructive on the impact of the statute on nurse-expert testimony is Grover v. Isom, 137 Idaho 770, 53 P.3d 821, rehearing denied (2002).
¶ 17 In Grover, the Idaho Supreme Court considered the impact a statute similar to § 2702 had on recognition of an individual as an "expert." The Grover Court determined that a certified registered nurse anesthesiologist with twenty years of experience was qualified to give expert testimony in a patient's action against an oral surgeon. The Idaho Court found it immaterial that the nurse had never administered anesthesia in an oral surgeon's office.
¶ 18 Here, the registered nurse has almost twenty years of experience. She is a specialist in wound care nursing and she has practiced with patients who are prone to develop decubitus ulcers — the elderly and critically ill. She is qualified as an expert witness under 12 O.S.2001 2702 by her knowledge, her skill, her experience, her training and her education.
¶ 19 This cause presents unique facts — a nurse offering her expertise as a standard from which to judge the standard of care of other nurses in a restricted and specific area, the care, treatment and avoidance of bedsores. Under the unique facts presented, we determine a registered nurse — with eighteen years of experience, who is familiar with the standards of nursing care for the elderly and critically ill and who has a certification for wound care practice — may offer expert testimony concerning the practices of other nurses and the standards of care in the avoidance, care, prevention and origin of bedsores. In so doing, we emphasize that this cause does not present the issue of whether a nurse would be an appropriate expert witness in a malpractice cause filed against a physician. We also express no opinion on what appears to be a trend towards allowing a nurse's testimony to be treated as expert in an ever increasing number of arenas. To hold otherwise would place Oklahoma in the position of being a minority of one on the issue of nurse-expert testimony relating to decubitus ulcers and require us to ignore the clear legislative mandate of 12 O.S.2001 2702.
¶ 20 b. The existence of material fact issues concerning whether the patient received appropriate treatment and, if not, whether the patient's bedsores were avoidable requires that the cause be reversed and remanded for a resolution of these issues by the trier of fact.
¶ 21 Summary judgment is proper only when the pleadings, affidavits, depositions, admissions or other evidentiary material establish that there is no genuine issue as to any material fact, and that the moving party is entitled to judgment as a matter of law. All evidentiary materials submitted to the trial court are viewed in the light most favorable to the party opposing the motion. Even when the basic facts are undisputed, motions for summary judgment should be denied, if under the evidence, reasonable persons might draw different inferences from the undisputed facts.
¶ 22 Here, neither the hospital nor Nurse-finders presented any expert testimony indicating that only a doctor is qualified to testify concerning the practices of nurses and the standards of care in the prevention, avoid-anee, care and cause of bedsores. They did not provide an affidavit from an individual on the nursing staff stating that Gaines received the kind of care which normally would avoid the forming of decubitus ulcers. Furthermore, statements by Means and the patient's nurse-expert, Susan Fuller (Fuller/nurse), on their relative experiences with decubitus ulcers were markedly different. When the doctor was questioned about his experience with decubitus ulcers, he stated that he did not consider himself any kind of an expert on bedsores and that he would find it difficult to identify the stage of the ulcers.
¶23 In contrast, the nurse outlined her qualifications arising from eighteen years of nursing practice, her certification for wound care and her knowledge of the standard of care for nurses to critically ill and/or bedridden patients. Based on her training and experience, the nurse stated in an affidavit signed on February 24, 2004, that; 1) the standard of care for a critically ill patient was not carried out by the Hospital's nurses— Gaines' chart revealed that the nurses did not turn him every two hours as is standard practice to avoid bedsores either before the time his doctor ordered him not to be moved for forty-eight hours or following the rescission of that order; 2) the failure to reposition the patient in required intervals was a direct contributor to the development of severe de-cubitus ulcers on Gaines' coccyx, heels and head region; 3) the nurses failed to meet the standards of care when they did not place heel protectors on Games' heels or feet and that this negligence was a direct and foreseeable cause of the development of decubitus ulcers; and 4) Gaines' development of decu-bitus ulcers could have been avoided if the standards of care had been followed despite his weight, any nutritional deficits, and/or immobility due to trauma and surgical complications.
¶ 24 The evidentiary materials reveal material questions of fact as to whether Gaines received appropriate care for the prevention and treatment of bedsores. The registered nurse's testimony regarding the patient's handling by the hospital and Nursefinders might be sufficient for a trier of fact to determine that the care, or lack thereof, that Gaines received caused his de-cubitus ulcers. The trier of fact might be even more inclined to rule in the patient's favor if, as here, there were no evidence to contradict the nurse-expert's opinion.
¶ 25 Although we express no opinion on whether Gaines will or should prevail, all inferences and conclusions to be drawn from the underlying facts favor the patient. Therefore, we must reverse summary judgment. Because genuine issues of material fact exist concerning whether the patient received appropriate treatment and, if not, whether the patient's bedsores were avoidable, we determine that judgment by summary process should be reversed and the cause remanded for a resolution of these issues by the trier of fact.
CONCLUSION
¶ 26 This case does not involve a situation where a nurse is giving expert testimony against a physician. The doctor has been dismissed from the cause and the only remaining defendants are the hospital and Nursefinders. The nurse's affidavit attached to the motion for summary judgment gave expert testimony based on her training and experience while the doctor stated that he would have difficulty identifying what stage a bedsore was in and that he would not consider himself any kind of expert on such wounds.
¶ 27 Under the facts presented, we determine that the registered nurse's expertise qualifies her for expert testimony on the issue of bedsores, their cause, treatment and avoidance. In so holding, we align Oklahoma jurisprudence with all other jurisdictions that have considered whether a nurse may offer expert opinion testimony concerning development or prevention of decubitus ulcers. Our determination is also consistent with the legislative directive in 12 O.S.2001 2702 providing that expert witnesses may qualify as experts "by knowledge, skill, experience, training or education."
¶ 28 The cause presents disputed issues of material fact concerning whether the patient received appropriate treatment and, if not, whether the patient's bedsores were avoidable. Considering all the available evidentia-ry material in favor of the patient submitted in summary process, we determine that summary judgment should be reversed and the cause remanded for a resolution of these issues by the trier of fact. CERTIORARI GRANTED.
COURT OF CIVIL APPEALS OPINION VACATED; REVERSED AND REMANDED.
WATT, C.J., LAVENDER, OPALA, EDMONDSON, COLBERT, JJ., concur.
HARGRAVE, J., concurs in result.
WINCHESTER, V.C.J., TAYLOR, J., JOHNSON, S.J., dissent.
KAUGER, J., recused.
. See ¶ 12 and accompanying footnotes, infra.
. Title 12 O.S.2001 2702 provides in pertinent part:
"If scientific, technical or other specialized knowledge will assist the trier of fact to understand the evidence or to determine a fact in issue, a witness qualified as an expert by knowledge, skill, experience, training or education may testify in the form of an opinion or otherwise."
. See, ¶ 22 and accompanying footnotes, infra.
. See, V 23 and accompanying footnotes, infra.
. Mitchell v. Cox, 1997 OK 139, ¶ 7, 948 P.2d 317.
. Barnthouse v. City of Edmond, 2003 OK 42, ¶ 36, 73 P.3d 840.
. Travel Stop, Inc. v. Alliance General Ins. Co., 1997 OK 138, ¶ 7, 950 P.2d 834; Seitsinger v. Dockum Pontiac, Inc., 1995 OK 29, ¶ 7, 894 P.2d 1077.
. See ¶ 22 and accompanying footnotes, infra.
. See, ¶ 23 and accompanying footnotes, infra.
. Our holding today is narrow. We determine merely that, under the facts presented — where the doctor admitted that he was "no expert" on decubitus ulcers and where the nurse is certified in wound care and has extensive experience in the care of the critically ill and elderly — the nurse may testify as to the standard of care afforded by other nurses. The dissent's assertions that the majority decision is an anathema because there is no supporting Oklahoma authority or extant jurisprudence to support the determination cannot go unanswered.
We agree with the dissent that there is no Oklahoma authority for our decision — that is the nature of an issue of first impression. Nevertheless, the fact that the dissent concedes that to adopt its position would leave Oklahoma jurisprudence as "a minority of one" cannot be reconciled with its statement that there is no extant jurisprudence to support today's holding. The only jurisprudence addressing the issue of the ability of nurses to testify as to the standard of care necessary to avoid bedsores supports the determination of the majority opinion.
We recognize that there are differences between nurses and doctors except to the extent that, under the facts presented, the doctor admits that he is incompetent to testify as an expert on bedsores. Furthermore, we will not act as fact finders, as the minority urges. The dissent looks to the facts and determines that, because the doctor does not believe nurse malpractice caused the decubitus ulcers, this cause should not be returned to the trial court. On an appeal of summary judgment, this Court does not act as fact finder — that is left to the province of either the jury or the trial judge sitting as such. Our holding simply demonstrates this well recognized principle.
Today's decision cannot be determined to have "opened the floodgates" for nurses to testify as experts in malpractice causes brought against physicians. It is limited to its facts and expresses no opinion on whether the patient should prevail. Nevertheless, it is abundantly clear that other jurisdictions have allowed nurses to testify as experts in an ever increasing number of causes. Another example of "extant jurisprudence" supporting the majority.
The following jurisdictions hold, as do we, that nurses may offer expert testimony concerning the development or prevention of decubitus ulcers. Lawson v. Dallas County, 112 F.Supp.2d 616, 621 (D.C.Tex.2000), aff'd, 286 F.3d 257 (5th Cir.2002) [Nurse jailor was qualified to give expert testimony regarding a prisoner's development of decubitus ulcers in § 1983 action.]; State v. Bermisa, 104 Hawai'i 387, 90 P.3d 1256, 1264-65 (2004) [Nurses are trained to know that patients are at risk for decubitus and infection. Nurse's training, observations and personal knowledge all contribute to the ability to offer an expert opinion.]; Thomas v. Greenview Hosp., Inc., 127 S.W.3d 663, 672 (Ky.App.2004) [Registered nurse qualified to testify as an expert on the breach of the standard of care by nursing staff in regards to treatment of pressure ulcer. Overruled on other grounds.]; Estate of Youngblood v. Halifax Convalescent Center, Ltd., 874 So.2d 596, 601 (Fla.App.2004), rehearing denied (2004), review dismissed, 912 So.2d 1217 (Fla.2005) [Nurse was qualified to testify on overall care afforded patient who developed pressure sores. Abrogated on other grounds.]; Harlett v. St. Vincent Hosps. & Health Servs., 748 N.E.2d 921, 924 (Ind.App.2001), transfer denied, 761 N.E.2d 422 (2001) [Nurses, as health care providers, were qualified under the Medical Malpractice Act to serve on a medical review panel appointed in medical malpractice claim against hospital after patient developed bedsores.]; State v. Boone Retirement Center, Inc., 26 S.W.3d 265, 274-5 (Mo.App.2000), rehearing/transfer denied (2000), transfer denied (2000) [Nurse who had worked in the nursing field for fifteen years qualified to give testimony concerning bedsores. Left to juiy to determine the weight of that evidence.]; Brown v. DeKalb Medical Center, 225 Ga.App. 4, 482 S.E.2d 511-12, cert. denied (1997) [In absence of any objection, nurse was qualified to testify as to cause of development of pressure sores.]; Parris v. Uni Med. Inc., 861 S.W.2d 694, 697-98 (Mo.App.1993), rehearing/transfer denied (1993), transfer denied (1993) [Nurses were qualified to give expert testimony regarding bedsores, their cause and treatment.]; Mellies v. National Heritage, Inc., 6 Kan.App.2d 910, 636 P.2d 215, 222 (1981) [A nurse, who has had wide experience with bedsores is, in fact, an expert as to decubi-tus ulcers since their prevention, treatment and cure are largely nursing duties.].
. Lawson v. Dallas County, see note 10, supra; State v. Bermisa, see note 10, supra; Thomas v. Greenview Hosp., Inc., see note 10, supra; Estate of Youngblood v. Halifax Convalescent Center, Ltd., see note 10, supra; Harlett v. St. Vincent Hosps. & Health Servs., see note 10, supra; State v. Boone Retirement Center, Inc., see note 10, supra; Brown v. DeKalb Medical Center, see note 10, supra; Parris v. Uni Med. Inc., see note 10, supra; Mellies v. National Heritage, Inc., see note 10, supra.
. Title 12 O.S.2001 2102, see note 2, supra.
. Idaho Rule of Evidence 702 provides:
"If scientific, technical, or other specialized knowledge will assist the trier of fact to understand the evidence or to determine a fact in issue, a witness qualified as an expert by knowledge, skill, experience, training, or education, may testify thereto in the form of an opinion or otherwise."
. Title 12 O.S.2001 2702, see note 2, supra.
. An expert need not have a formal degree to appear and give testimony as an "expert" where training and experience are sufficient to identify the individual as an expert. State v. Billiot, 672 So.2d 361, 373 (La.App.1996), writ denied, 680 So.2d 655 (La.1996). Properly qualified individuals, though not physicians, may be sworn as a medical expert. People v. Scala, 128 Misc.2d 831, 491 N.Y.S.2d 555, 560-61 (1985).
. See, United States v. Noda, 137 Fed.Appx. 856, 863 (6th Cir.2005) [Pediatric nurse practitioner well qualified to give expert testimony regarding ages of children depicted in pornography.]; Griel v. Franklin Medical Center, 71 F.Supp.2d 1, 9, aff'd, 234 F.3d 731 (1st Cir.2000) [Acute care nurses qualified to give expert testimony regarding standard of care of nurses distributing drugs.]; Garcia v. Columbia Medical Center of Sherman, 996 F.Supp. 617, 625 (D.C.Tex.1998) [Although nurse could not give testimony against physicians on standard of care, she would be considered an expert in giving opinion on fellow nurses' actions.]; Broehm v. Mayo Clinic Rochester, 690 N.W.2d 721, 726 (Minn.2005) [Certified geriatric nurse practitioner had sufficient training or practical experience to offer opinion, for purposes of patient's expert witness pretrial disclosure, that hospital breached nursing standard of care.]; Grover v. Isom, 137 Idaho 770, 53 P.3d 821, 825 (2002), rehearing denied (2002) [Nurse who had administered anesthesia qualified to testify in case against dentist although he had never administered anesthesia in an office.]; Velazquez v. Commonwealth, 263 Va. 95, 557 S.E.2d 213, 218 (2002) [Nurse qualified to testify as an expert regarding her medical opinion on causation of alleged victim's injuries — statutes governing practice of medicine would not prohibit testimony as constituting the practice of medicine.]; In re Elba General Hosp. & Nursing Home, Inc., 828 So.2d 308, 312 (Ala.2001) [Use of nurse's affidavit not so prejudicial as to require its striking on appeal.]; Creasy v. Rusk, 730 N.E.2d 659, 669 (Ind.2000) [Licensed practical nurse was qualified to give expert testimony concerning patient's mental state.]; HealthTrust, Inc. v. Cantrell, 689 So.2d 822 (Ala.1997) [Registered nurse qualified to testify as expert concerning standard of care alleged to have been breached by operating room technician.]; Carolan v. Hill, 553 N.W.2d 882 (Iowa 1996) [Exclusion of nurse-anesthetist's testimony as to standard of care was prejudicial error.]; Medical Center of Delaware, Inc. v. Lougheed, 661 A.2d 1055, 1058 (Del.1995) [Nurse was qualified to testify as expert witness in medical malpractice action asserting that hospital's employee deviated from applicable standard of care.]; Harris v. Miller, 335 N.C. 379, 438 S.E.2d 731, 741 (1994) [Nurse qualified to give testimony against physician who had been negligent in supervising anesthetist.]; Koeniguer v. Eckrich, 422 N.W.2d 600 (S.D.1988) [Head of nursing qualified to testify that it is for nurses to determine, on change of condition for the worse, whether doctor's orders of dismissal should be followed.]; Avret v. McCormick, 246 Ga. 401, 271 S.E.2d 832 (1980) [Nurse qualified to testify against physician as to standards of care in keeping sterile a needle used to draw blood.]; Morris v. State, 268 Ga.App. 325, 601 S.E.2d 804, 806 (2004), cert. denied, 543 U.S. 1075, 125 S.Ct. 925, 160 L.Ed.2d 813 (2005) [Pediatric nurse was qualified to provide expert testimony in child abuse case.]; State v. One Marlin Rifle, 319 N.J.Super. 359, 725 A.2d 144, 147 (1999) [Indicating that nurse might qualify to give expert testimony if evidence had disclosed the length of time she had worked in the field.]; People v. E.H., 837 P.2d 284, 288 (Colo.App.1992), cert. denied (1992) [Nurse qualified to offer expert testimony concerning mother's parenting deficits and issue of termination of parental rights.]; State v. Serebin, 119 Wis.2d 837, 350 N.W.2d 65, 72-3 (1984) [Nurses' testimony on standard of care sufficient to support nursing home administrator's conviction for abuse of inmates of an institution.]; Sun-Bridge Healthcare Corp. v. Penny, 160 S.W.3d 230, 240-41 (Tex.App.2005) [Nurse was qualified to testify as an expert on standard of care where patient was injured in a wheelchair fall while not being supervised.]; People v. Carroll, 300 A.D.2d 911, 753 N.Y.S.2d 148, 151 (2002), appeal denied, 99 N.Y.2d 626, 760 N.Y.S.2d 107, 790 N.E.2d 281 (2003) [Nurse's testimony that there were hymenal tears which could have been caused by digital penetration constituted proof of the crime charged.]; Wiley v. Henry Ford Cottage Hosp., 257 Mich.App. 488, 668 N.W.2d 402 (2003), special panel not convened, 257 Mich. App. 801, 668 N.W.2d 641(2003), appeal denied, 469 Mich. 1019, 678 N.W.2d 439 (2004) [Nurse qualified to testify as to whether actions of other nurses in causing laceration to patient later resulted in amputation of leg.]; Theatre Management Group, Inc. v. Dalgliesh, 765 A.2d 986, 992 (D.C.App.2001) [Nurse qualified to give expert testimony about wheelchair-related items, in-home aide, physical therapy, counseling, and medications that patron would need.]; Gregory v. State, 56 S.W.3d 164, 177 (Tex.App.2001) [Nurse who conducted genital examination of child was qualified to testify as an expert in trial for indecency with a child, even though she was precluded from making a medical diagnosis or otherwise practicing medicine.]; White v. DePuy, Inc., 129 Ohio App.3d 472, 718 N.E.2d 450, 459 (1998) [Indicating that with proper foundation and experience, a nurse might be qualified as an expert witness.]; St. Elizabeth Hospital v. Graham, 883 S.W.2d 433, 441 (Tex.App.1994), rehearing overruled (1995), writ denied (1995), rehearing of writ of error denied (1995) [Nurses could testify as expert concerning severity of fall and injury of patient while hospitalized.]; Berdyck v. Shinde, 1993 Ohio 183, 66 Ohio St.3d 573, 613 N.E.2d 1014 (1993) [Nurse qualified to testify that pregnant patient should have been observed because of possibility of seizure considering her physical condition.]; Gray v. Jefferson Geriatric & Rehabilitation Center, 76 Ohio App.3d 499, 602 N.E.2d 396, 399 (1991) [Nurse qualified to give testimony against hospital for negligence of its nurse— not qualified to give testimony against physician or hospital for medical malpractice.]; Holland v. Riverside Methodist Hospital, 70 Ohio App.3d 112, 590 N.E.2d 430, 433 (1990), jurisdictional motion overruled, 59 Ohio St.3d 701, 571 N.E.2d 134 (1991) [Although nurse would have been competent to testify as to standards of nursing care, she offered no opinion on subject.]; Fountain v. Cobb General Hospital, 167 Ga.App. 36, 306 S.E.2d 37, 38-40 (1983) [Nurse was qualified to express an expert opinion as to administration of anesthesia or when an epidural catheter should be removed.]; McCormick v. Avret, 154 Ga.App. 178, 267 S.E.2d 759-60 (1980), aff'd, 246 Ga. 401, 271 S.E.2d 832 (1980) [Nurse qualified to provide expert testimony as to that which constituted reasonable care in keeping needle sterilized.]; Walter v. Pence, 104 Ind.App. 532, 12 N.E.2d 367-68 (1938) [Nurse was qualified to give expert testimony on value of hospital services.]; Texas Employers' Ins. Ass'n v. Drews, 297 S.W. 630, 632 (1927) [Nurse, who had attended cases of erysipelas but not practiced profession for five years, qualified to give expert testimony.]. See also, "The Nursing Profession in the 1990's: Negligence and Malpractice Liability," 43 Clev.St.L.Rev. 557 (1995) [Physician may not be qualified, in all instances, to testify as to nurses' standards of care.]; R. Hills, "Hewitt v. Kalish: Qualifying as an 'Expert' Under O.C.G.A. SECTION 9-11-9.1," 1995 Mercer L.R. 1537; Note, "Expert Witnesses in Malpractice Cases Against Nps," 2 Health Matrix 325 (1992) [The trend is to recognize that nurses have knowledge peculiar to nursing and to use nurses as expert witnesses in malpractice cases against nurses.].
But see, Elswick v. Pikeville United Methodist Hospital of Kentucky, Inc., 50 Fed.Appx. 193-94 (6th Cir.2002) [Finding that nurse not qualified to present expert testimony as to cause of staph infection not clearly erroneous where nurse denied having expertise to give opinion.]; Green v. Charleston Area Medical Center, Inc., 215 W.Va. 628, 600 S.E.2d 340, 344 [Nurse could not present expert testimony on an area outside her expertise.]; Crocker v. Paulyne's Nursing Home, Inc., 95 S.W.3d 416, 421 (Tex.App.2002), rehearing overruled (2003) [Summary judgment affidavits insufficient to establish that nurses were qualified to give expert testimony.]; Stryczek v. Methodist Hosps., Inc., 694 N.E.2d 1186, 1190 (Ind.App.1998), transfer denied, 706 N.E.2d 172 (Ind.1998) [Nurse not qualified to offer expert testimony on standards of care for physician in action against hospital where patient received radiation treatment and chemotherapy.]; Taplin v. Lupin, 700 So.2d 1160, 1162 (La.App.1997) [Registered nurse not qualified to give expert testimony as to whether emergency room physician certified in internal medicine breached applicable standard of care.]; Waatti v. Marquette General Hospital, Inc., 122 Mich.App. 44, 329 N.W.2d 526 (1983) [Nurse's testimony did not establish requisite standard of care of emergency room treatment.]; Saliba v. Uniontown Hosp., 54 Pa. D. & C.4th 202 (2001) [Registered nurse not qualified to testify as expert with regard to whether emergency room physicians deviated from good and acceptable medical standards in diagnosing and treating plaintiff's baby daughter.].
. Title 12 O.S.2001 2702, see note 2, supra.
. Sullivan v. Buckhorn Ranch Partnership, 2005 OK 41, ¶ 23, 119 P.3d 192; Bogart v. CapRock Communications Corp., 2003 OK 38, V 20, 69 P.3d 266; Prichard v. City of Oklahoma City, 1999 OK 5, ¶ 19, 975 P.2d 914.
. Green v. Harris, 2003 OK 55, ¶ 11, 70 P.3d 866; K &K Food Services, Inc. v. S & H, Inc., 2000 OK 31, ¶ 16, 3 P.3d 705; Phelps v. Hotel Management, Inc., 1996 OK 114, ¶ 7, 925 P.2d 891.
. Carris v. John R. Thomas & Associates, 1995 OK 33, ¶ 16, 896 P.2d 522.
. Deposition of Kelly Means, M.D. taken on December 3, 2003, providing in pertinent part at p. 45:
"... Q. Okay. Is it possible to identify, by looking at a decubitus ulcer, what the stage of it is?
A. It's difficult.
Q. Could you do it?
A. I'm not an expert at it but I could—
Q. You don't consider yourself an expert on decubitus ulcers?
A. No. By no means, no.... "
. Mitchell v. Cox, see note 5, supra.
. Travel Stop, Inc. v. Alliance General Ins. Co., see note 7, supra; Seitsinger v. Dockum Pontiac, Inc., see note 7, supra.
. See ¶ 22-3 and accompanying footnotes, supra.
. See ¶ 12 and accompanying footnotes, supra.
. Title 12 O.S.2001 2702, see note 2, supra.