Title: Wozny v. Godsil
Citation: 474 So. 2d 1078
Docket Number: N/A
State: Alabama
Issuer: Alabama Supreme Court
Date: July 26, 1985

474 So. 2d 1078 (1985)
Mary Ann WOZNY
v.
R.D. GODSIL, M.D.; The East Alabama Health Care Authority d/b/a The East Alabama Medical Center; Orthopaedic Clinic of East Alabama, P.C.; and Marvin Powell, M.D.
84-183.

Supreme Court of Alabama.
July 26, 1985.
*1079 Larry W. Morris of Radney &amp; Morris, Alexander City, for appellant.
Charles A. Stakely of Rushton, Stakely, Johnston &amp; Garrett, Montgomery, and W. Banks Herndon of Walker, Hill, Adams, Umbach, Herndon &amp; Dean, Opelika, for appellee Dr. Raymond Godsil.
John V. Denson of Samford, Denson, Horsley, Pettey, Martin &amp; Barrett, Opelika, for appellee East Alabama Medical Center.
W. Stancil Starnes and Carol A. Smith of Starnes &amp; Atchison, Birmingham, for appellee Dr. Marvin Powell.
BEATTY, Justice.
Plaintiff/appellant Mary Ann Wozny appeals from an order granting summary judgment in favor of R.D. Godsil, M.D.; the East Alabama Health Care Authority d/b/a The East Alabama Medical Center; Orthopaedic Clinic of East Alabama, P.C.; and Marvin Powell, M.D. We affirm in part, reverse in part, and remand.
On November 21, 1981, Wozny injured her left ankle while playing racquetball. Unable to walk, she was taken to the East Alabama Medical Center (Medical Center) where she was examined by Dr. Marvin Powell. After X-rays were taken, Powell diagnosed Wozny's injury as a sprained ankle, although Wozny asserts that she told Powell that she was afraid she had ruptured her Achilles' tendon. Powell wrapped her ankle with an Ace bandage and told her to see an orthopaedic surgeon if her ankle did not improve. It did not improve, and on January 29, 1982, Wozny saw Dr. Raymond Godsil, an orthopaedic surgeon. Godsil diagnosed Wozny's injury as a torn Achilles' tendon, and, on February 8, 1982, Godsil surgically repaired the tendon at the Medical Center.
Two days after surgery, Wozny began experiencing pain caused by the cast that had been put on post-operatively. An employee of Godsil changed the cast, but did not inspect the operative site. Wozny saw Godsil two weeks after being discharged from the hospital. During this follow-up examination, Godsil inspected the operative site and noticed that an infection had developed. The cast was changed and Keflex, an antibiotic drug, was prescribed. When Wozny returned 10 days later, Godsil examined her ankle and told Wozny that, due to the worsening of the infection, she would need further surgery. Wozny refused to allow Godsil to perform the surgery and instead went to the University of Alabama at Birmingham Medical Center, where she underwent extensive remedial surgery. Wozny claims that, as a result of the defendants' treatment of her injury, she is disfigured and so disabled that she has had to discontinue her veterinary practice with large animals.
On July 9, 1982, Wozny filed an action against Godsil,[1] Powell, and the Medical Center, claiming negligence in their individual and collective treatment of her injury. All defendants filed motions for summary judgment supported by affidavits. In response to the motions, Wozny filed her own affidavit as a doctor of veterinary medicine, in which she contended that the defendants failed to exercise the proper standard of care in their treatment of her. Later, after experiencing difficulty in obtaining the affidavit of a physician, Wozny also submitted the affidavit of Dr. Peter E. *1080 Johnston, a doctor of osteopathy, in opposition to the defendants' motions for summary judgment. The trial court granted the defendants' motions, stating:
The primary issue presented by this appeal is whether or not the trial court abused its discretion in determining that, because a doctor of osteopathy is not a "practioner of the same school of medicine as the defendants in this case," he is unqualified, as a matter of law, to render expert testimony with respect to the applicable standards of care owed the plaintiff by any one of the defendants.
The practice of osteopathy, in conjunction with the practice of medicine, is recognized and generally defined in Code of 1975, § 34-24-50, as follows:
Generally, in order to overcome a defendant/physician's motion for summary judgment in a medical malpractice case, the plaintiff must submit competent expert medical testimony to prove that the defendant violated the standard of care set out in Code of 1975, § 6-5-484:
As a general rule, a physician of one school of medicine is incompetent to testify in a malpractice case against a physician of another school of medicine. This rule is stated at 61 Am.Jur.2d, Physicians and Surgeons, etc., § 353, p. 516 (1981):
At the outset, we note that Wozny makes no arguments with respect to her own affidavit as a doctor of veterinary medicine. She does contend, however, that the affidavit of Dr. Johnston is sufficient to bring this case under the exception set out above, because his affidavit establishes that not only has Dr. Johnston had extensive orthopaedic surgical experience, but also that the methods of diagnosis, treatment, and procedures used in the treatment of an Achilles' tendon rupture, as testified to by Powell and Godsil, are the same as that Dr. Johnston would use. The affidavit of Dr. Johnston is, in pertinent part, set out below:
Wozny cites several cases from other jurisdictions in which either an osteopath was held competent to testify against a medical doctor or vice versa. In Hundley v. St. Francis Hospital, 161 Cal. App. 2d 800, 327 P.2d 131 (1958), the court held that the testimony of an osteopath against a medical doctor was properly admitted into evidence, under the following rationale:
In Harris v. Bales, 459 S.W.2d 742 (Mo. App.1970), the court held that an osteopath was qualified to testify in a malpractice action against a medical doctor for the alleged improper reduction and treatment of a leg bone fracture. The defendant medical doctor in Harris was a general practitioner who practiced all types of surgery, including orthopaedic surgery. The proffered expert was an osteopath with a general practice. The court summarized his testimony as follows:
In holding the osteopath was qualified to testify as an expert, the court explained:
Wozny also cites Fridena v. Evans, 127 Ariz. 516, 622 P.2d 463 (1980), a malpractice case factually similar to the present case. The defendant in Fridena was a doctor of osteopathy (D.O.) and an orthopaedic surgeon, whereas the expert witness was a medical doctor (M.D.) and an orthopaedic surgeon. Thus, although in an opposite factual framework, the competency issue presented and the arguments made in Fridena are the same as those presented here with respect to defendant Godsil. In holding that the medical doctor was a competent expert witness, the court explained as follows:
Godsil and Powell contend that a medical doctor who is charged with malpractice is entitled to have his treatment tested by the rules and principles of his school of medicine, and that only a medical doctor can say what those rules and principles are and when they have been violated. That is, they contend, only a medical doctor can testify as to whether or not another medical doctor failed to exercise the requisite standard of care. Thus, Godsil and Powell maintain that the affidavit of Wozny's expert was properly excluded, as a matter of law, because the affidavit failed to show Dr. Johnston had received any training whatsoever in the school of medicine.
Godsil and Powell also cite cases from other jurisdictions in which, for various reasons, an osteopath was not permitted to testify against a medical doctor or vice versa. In Forthofer v. Arnold, 60 Ohio App. 436, 21 N.E.2d 869 (1938), the Ohio Court of Appeals affirmed the trial court's withdrawal of all of the expert testimony *1085 given by two osteopaths in a malpractice suit brought against a medical doctor. The Court in Forthofer explained that the trial court excluded their testimony "for the reason that the evidence of said osteopaths did not indicate that they possessed any knowledge whatsoever as to the standards of skill, care and diligence exercised by physicians and surgeons of the school of medicine to which the defendant belonged." (Emphasis added.) 60 Ohio App. at 439, 21 N.E.2d  at 871. The Court in Forthofer went on to state the general rule that "the care, skill and diligence exercised by the defendant is to be judged by that standard of ordinary care which ordinarily is exercised by physicians and surgeons of the same school of medicine, "but without stating the widely recognized exception. The Court then held that, absent the testimony of the osteopaths, there was "no evidence from which the jury could determine the standard of care, skill and diligence by which the defendant's conduct was to be judged. On that subject there was accordingly a failure of proof." 60 Ohio App. at 439, 21 N.E.2d  at 871.
Powell cites the case of Bryant v. Biggs, 331 Mich. 64, 49 N.W.2d 63 (1951), in which the Supreme Court of Michigan affirmed verdicts directed in favor of the defendant osteopaths, where the plaintiff's principal witness was a licensed physician and surgeon who testified as follows:
The court in Bryant v. Biggs, supra, quoted the general rule and exception thereto as it is stated at 61 Am.Jur.2d, § 1353, quoted supra, and explained:
The court also quoted from an earlier Michigan case, Janssen v. Mulder, 232 Mich. 183, 190, 205 N.W. 159, 1611 (1925), in which it was said with respect to the plaintiff's burden of proof:
The court in Bryant followed a line of cases including Frothofer v. Arnold, supra, in which it was shown the expert had either insufficient knowledge of the standards and methods of treatment of the defendant's school (Sima v. Wright, 268 Mich. 352, 256 N.W. 349 (1934), or insufficient knowledge upon which to base his (the expert's) opinion that there were no differences in the methods of treatment of the two schools (Bush v. Cress, 181 Minn. 590, 233 N.W. 317 (1930)). The court then concluded:
Powell and Godsil further rely on the case of Caro v. Bumpus, 30 Colo.App. 144, 491 P.2d 606 (1971), involving a malpractice action against an osteopath. In that case, the court briefly discussed the exception to the general rule, but held that plaintiff's proffered expert witnesses failed to qualify under that exception:
Powell and Godsil also cite Whitehurst v. Boehm, 41 N.C.App. 670, 255 S.E.2d 761 (1979), where the court held that an orthopaedic surgeon (medical doctor) was incompetent to testify against a podiatrist, reasoning as follows:
It is clear from the preceding analysis of the authorities cited to us by both sides that the prevalent and the modern view is to recognize the exception to the general rule, provided there is an adequate showing on the relevant criteria; that is, even if the defendant and the witness are of different schools of practice, the witness may nevertheless be competent to testify on those standards as to which the principles of the schools do or should concur, such as matters of diagnosis or the existence of a condition that should be recognized by any physician. Accord Ashburn v. Fox, 233 So. 2d 840 (Fla.Dist.Ct.App. 1970), cert. dismissed, 242 So. 2d 873 (Fla. 1971). The cases discussed above also recognize situations in which an expert witness may be competent to testify where he is knowledgeable (by way of either study and training or experience) of the methods and standards of practice (i.e. skill, care, and diligence) exercised by practitioners of the defendant's school, particularly with respect to the diagnosis, treatment, etc., of the specific injury, illness, or ailment involved. We adopt this view, and we, therefore, cannot affirmatively state, as a matter of abstract law, that an osteopathic doctor can never, ipso facto, offer expert testimony in a malpractice case against a medical doctor, regardless of the experience, expertise, etc., of the osteopath or regardless of whether the two schools concur as to the standards and methods of treatment involved.
The qualifications of a proffered expert and the question of whether the two schools do indeed concur in the standards and methods involved are factual determinations. While we recognize that the ultimate question of whether a witness is qualified to render expert testimony in a given case rests within the sound discretion of the trial court, Burroughs Corporation v. Hall Affiliates, Inc., 423 So. 2d 1348, 1353 (Ala.1982), we do not believe sufficient facts have been adduced in this case to enable the trial court to properly exercise that discretion. In light of the exception recognized herein, it is necessary, especially in the context of a motion for summary judgment, that a more complete and thorough examination be made of the witness's knowledge and experience, as well as the similarity of the standards, methods of treatment and diagnosis, etc., exercised by practitioners of the defendants' school and the witness's school, with respect to the particular injury in question.
Dr. Johnston, the proffered expert, has furnished sufficient evidence by way of affidavit to create a reasonable inference of his competency as an expert witness against both defendant doctors. Not only has he stated that "[t]he standards of skill in diagnosis and treatment by doctors of medicine are identical to those of doctors of osteopathy" with respect to plaintiff's injury, but he has also shown that he has had extensive orthopaedic surgical training and expertise as well as selection, training, and supervisory experience as a doctor on the medical staff of a hospital. The defendants, in turn, claim in their affidavits that they exercised the requisite degree of care, skill, and diligence in treating the plaintiff and that Dr. Johnston is not qualified nor competent to render expert testimony against these defendants because he is not a medical doctor. Otherwise, they have made no factual showing of his incompetency under the criteria relevant to the applicability of the exception recognized herein.
*1088 We preserve, however, the right of the trial court in its discretion to weigh the facts which may be adduced at a later hearing dealing with Dr. Johnston's competency; thus, we do not undertake to rule on that issue at this point. It is yet to be resolved whether, after a further hearing on and examination of the criteria relevant to application of the exception, there is indeed sufficient concurrence between the two schools or whether Dr. Johnston does possess the requisite knowledge.
We next consider the propriety of summary judgment in favor of the Medical Center. In the first amendment to her complaint, Wozny stated a claim against the Medical Center, alleging that it, through its agents, servants, and employees, "negligently allowed and negligently permitted her ankle to become infected, and negligently allowed and negligently permitted the plaintiff to believe she was being properly treated, when in fact, she was not being properly treated and cared for." In the second amendment to her complaint, Wozny added Dr. Powell as a defendant and alleged negligence in his treatment of her while he "was a practicing physician at the Emergency Room of the Medical Center."
The Medical Center contends that it was entitled to summary judgment because Wozny, in opposition to the motion, failed to put forth a scintilla of evidence establishing negligence on the part of the Medical Center or its employees. It further asserts that Powell is not an employee of the Medical Center; rather, that he is an independent contractor hired by the Medical Center to provide emergency room service, but over whom it exercised no control, citing Odess v. Taylor, 282 Ala. 389, 211 So. 2d 805 (1968). We note, however, that in its motion for summary judgment, the Medical Center failed to raise the issue of Powell's status as an independent contractor. Nor was the issue raised in either the Medical Center's or Powell's answers to Wozny's complaint. Indeed, Powell "admits that on or about November 20, 1981, he was a practicing physician at the emergency room of the Medical Center," with no mention of independent contractor status. Consequently, since the issue of Powell's status as either an employee or an independent contractor was not before the trial court, summary judgment in favor of the Medical Center cannot be upheld on that basis.
Nevertheless, in opposition to the motion for summary judgment, Wozny failed to adduce a scintilla of evidence as supporting a claim of negligence against any other agents, employees, or servants of the Medical Center, and to that extent, summary judgment in favor of the Medical Center was proper.
For the foregoing reasons, the judgment is affirmed in part, reversed in part, and remanded for proceedings consistent with this opinion.
AFFIRMED IN PART; REVERSED IN PART AND REMANDED.
FAULKNER,[2] JONES, ALMON and SHORES, JJ., concur.
[1]  Wozny also named as defendant Orthopaedic Clinic of East Alabama, the clinic with which Godsil is associated, but we refer only to defendant Godsil because his alleged negligence is imputed to the Clinic by virtue of his association with it.
[2]  Chief Justice Torbert sat for oral argument of this case, but recused himself after its submission. Justice Faulkner, although not sitting at oral argument, has studied the briefs and listened to the tape of oral argument.