Title: Hercules Panayiotou, M.D. v. Johnson Jamie Sullivan, as administratrix of the estate of Mae Sullivan, deceased
Citation: N/A
Docket Number: 1061829
State: Alabama
Issuer: Alabama Supreme Court
Date: May 30, 2008

REL: 05/30/2008
Notice: This opinion is subject to formal revision before publication in the advance
sheets of Southern Reporter.  Readers are requested to notify the Reporter of Decisions,
Alabama Appellate Courts, 300 Dexter Avenue, Montgomery, Alabama 36104-3741 ((334) 229-
0649), of any typographical or other errors, in order that corrections may be made before
the opinion is printed in Southern Reporter.
SUPREME COURT OF ALABAMA
OCTOBER TERM, 2007-2008
____________________
1061829
____________________
Hercules Panayiotou, M.D.
v.
Jamie Sullivan Johnson, as administratrix of the estate of
Mae Sullivan, deceased
Appeal from Mobile Circuit Court 
(CV-04-728)
STUART, Justice.
Dr. Hercules Panayiotou appeals the order of the Mobile
Circuit Court denying his motion for a summary judgment in the
medical-malpractice action filed against him by Jamie Sullivan
1061829
Mobile Infirmary Medical Center and IMC Diagnostic &
1
Medical Clinic, P.C., were later dismissed from the case.
2
Johnson, as administratrix of the estate of Mae Sullivan,
deceased.  We reverse and remand.
I.
On March 7, 2002, Dr. Panayiotou performed a heart-
catheterization procedure on Mae Sullivan at the Mobile
Infirmary Medical Center.  During the course of the procedure,
a coronary artery ruptured.  Emergency coronary artery bypass
surgery was performed; however, Sullivan died on March 9,
2002. 
On March 8, 2004, Johnson sued Dr. Panayiotou, Mobile
Infirmary Medical Center, and Dr. Panayiotou's medical
practice, IMC Diagnostic & Medical Clinic, P.C., in the Mobile
Circuit Court, alleging medical malpractice.   On May 11,
1
2007, Dr. Panayiotou moved for a summary judgment arguing that
Johnson could not establish, by substantial evidence, that he
had breached the appropriate standard of care during his
treatment of Sullivan.  Specifically, Dr. Panayiotou argued
that because Johnson's action was governed by the Alabama
Medical Liability Act, § 6-5-540 et seq., Ala. Code 1975 ("the
AMLA"), Johnson was required to present expert testimony from
1061829
Section 6-5-548(c) provides:
2
"(c) Notwithstanding any provision of the
Alabama Rules of Evidence to the contrary, if the
health care provider whose breach of the standard of
care is claimed to have created the cause of action
is certified by an appropriate American board as a
specialist, is trained and experienced in a medical
specialty, and holds himself or herself out as a
specialist, 
a 
'similarly situated health care
provider' is one who meets all of the following
requirements:
3
a "similarly situated health care provider" to establish a
breach of the standard of care.  See Holcomb v. Carraway, 945
So. 2d 1009, 1012 (Ala. 2006) (stating that a plaintiff
ordinarily must present expert testimony to establish that a
defendant health-care provider failed to meet the standard of
care; however, "such expert testimony is allowed only from a
'similarly situated health care provider'").  Dr. Panayiotou
further argued that the only expert witness identified by
Johnson, Dr. Jay N. Schapira, was not a "similarly situated
health care provider" as that term is defined in § 6-5-548(c)
because, he says, while Dr. Panayiotou was certified by the
American Board of Internal Medicine ("ABIM") in internal
medicine, 
cardiovascular 
disease, 
and 
interventional
cardiology, Dr. Schapira was certified by ABIM in only
internal medicine and cardiovascular disease.   Therefore, Dr.
2
1061829
"(1) Is licensed by the appropriate
regulatory board or agency of this or some
other state.
"(2) Is trained and experienced in the
same specialty.
"(3) Is certified by an appropriate
American board in the same specialty.
"(4) Has practiced in this specialty
during the year preceding the date that the
alleged breach of the standard of care
occurred."
(Emphasis added.)
4
Panayiotou argued, because it was undisputed that he was
practicing interventional cardiology when he performed the
heart-catheterization procedure on Sullivan, Dr. Schapira was
not a similarly situated health-care provider eligible to
provide expert testimony regarding the standard of care.  In
conjunction with his motion for a summary judgment, Dr.
Panayiotou submitted an excerpt of his own deposition in which
he stated that he received his "interventional cardiology
certification the first time [the examination] was ever given
in 1999" and a copy of his curriculum vitae showing, under a
heading listing the examinations he had passed:
"ABIM: Internal Medicine, 25 September 1991
1061829
5
"ABIM: Cardiovascular Subspecialty, November 1993
"ABIM: Interventional Cardiology, November 1999." 
On June 14, 2007, Johnson filed her response to Dr.
Panayiotou's summary-judgment motion, arguing that § 6-5-
548(c) requires only that an expert witness be certified in
the same "specialty" as the defendant to be considered a
similarly 
situated 
health-care 
provider 
and 
that 
Dr.
Panayiotou and Dr. Schapira are in fact both certified in the
same specialty –– internal medicine.  Cardiovascular disease,
she argues, is actually a "subspecialty" of internal medicine,
and interventional cardiology is, at best, she argues, another
"subspecialty" of internal medicine.  However, she argues,
interventional cardiology is more properly viewed as a
subspecialty of cardiovascular disease and thus a "sub-
subspecialty" of internal medicine.  
Johnson also argued that, although Dr. Panayiotou held an
ABIM-issued 
"certificate 
of 
added 
qualification" 
in
interventional cardiology at the time he performed the heart
catheterization on Sullivan, ABIM did not formally recognize
interventional cardiology as a subspecialty of cardiovascular
disease until July 2006.  In support of her argument, she
1061829
ABMS is an umbrella organization that oversees 24
3
specialty boards, including ABIM, and establishes standards
for specialty certification.  The other boards governed by
ABMS include the American Board of Allergy & Immunology, the
American Board of Anesthesiology, the American Board of Colon
& Rectal Surgery, the American Board of Dermatology, the
American Board of Emergency Medicine, the American Board of
Family Medicine, the American Board of Medical Genetics, the
American Board of Neurological Surgery, the American Board of
Nuclear 
Medicine, the American Board of Obstetrics &
Gynecology, the American Board of Ophthalmology, the American
Board 
of 
Orthopaedic 
Surgery, 
the 
American 
Board 
of
Otolaryngology, the American Board of Pathology, the American
Board of Pediatrics, the American Board of Physical Medicine
& Rehabilitation, the American Board of Plastic Surgery, the
American Board of Preventive Medicine, the American Board of
Psychiatry & Neurology, the American Board of Radiology, the
American Board of Surgery, the American Board of Thoracic
Surgery, and the American Board of Urology.
6
submitted printed copies of pages from the Web sites of both
ABIM and the American Board of Medical Specialties ("ABMS")
indicating that, on July 14, 2006, ABIM, in an attempt to
standardize the way it recognized subspecialties, announced
that 
it 
now 
recognized 
all 
certificates 
of 
added
qualifications as subspecialties of internal medicine.3
Johnson also submitted an affidavit from Dr. Schapira in which
he stated that 
"Dr. Panayiotou was not board certified in the
specialty 
or 
subspecialty 
of 
interventional
cardiology at the time of the incident made the
basis of this suit (March 9, 2002), but rather had
a 'certificate of added qualification' that was not
recognized as either a specialty or a subspecialty
1061829
In court filings contained in the supplemental record,
4
Johnson indicated that, at a June 19, 2007, hearing on Dr.
Panayiotou's summary-judgment motion, she also proffered as
evidence a printed copy of e-mail correspondence her counsel
had engaged in with Joan Otto, senior credentials manager for
ABIM, on the topic of certificates of added qualifications and
subspecialties.  However, she acknowledged in her motion to
supplement the record that the trial court rejected the
proffer as not being in the proper form, apparently because it
was unauthenticated.
During his deposition, Dr. Schapira testified that
5
interventional cardiology had been a subspecialty of internal
7
by [ABMS] ... until July of 2006 when [ABIM]
reclassified 
the 
'certificate 
of 
added
qualification' in interventional cardiology as a
subspecialty of cardiology."
 
Finally, Johnson also submitted a copy of Dr. Panayiotou's
curriculum vitae and noted that it specifically designated the
examination he passed in November 1993 as being for the
"Cardiovascular Subspecialty" (emphasis added), but the
November 1999 examination was merely listed as being for
"interventional cardiology" with any description of that
practice as a subspecialty conspicuously absent.4
After receiving Johnson's motion opposing his summary-
judgment motion, Dr. Panayiotou filed, on June 18, 2007, a
motion asking the trial court to strike Dr. Schapira's
affidavit on the ground that it contradicted his previous
sworn testimony.   See Wilson v. Teng, 786 So. 2d 485, 497
5
1061829
medicine "[s]ince 1999 or 2000" and that the interventional
cardiology board "started in 1999, 2000."
8
(Ala. 2000) ("This Court has held that 'a party is not allowed
to directly contradict prior sworn testimony to avoid the
entry of a summary judgment.'" (quoting Continental Eagle
Corp. v. Mokrzycki, 611 So. 2d 312, 317 (Ala. 1992))).  The
next day, June 19, 2007, Dr. Panayiotou filed another motion
asking the trial court also to strike the printed copies of
pages taken from ABMS and ABIM's respective Web sites on the
ground 
that 
the 
documents 
were 
unsworn, 
uncertified,
unauthenticated, and, therefore, inadmissible.  See Carter v.
Cantrell Mach. Co., 662 So. 2d 891, 893 (Ala. 1995) ("The
documents were not properly authenticated and, thus, they were
inadmissible hearsay, which cannot be relied on to defeat a
properly supported motion for a summary judgment.").  Dr.
Panayiotou simultaneously submitted a personal affidavit in
which he made the following statements:
"2. I am a physician duly licensed to practice
medicine in the State of Alabama and was so licensed
at the relevant times.  I am certified by [ABIM] as
a specialist in Internal Medicine, Cardiology and
Interventional Cardiology and was so certified at
the relevant times.
1061829
9
"3. [ABIM] formally recognized certification in
the subspecialty of Interventional Cardiology in
1999.  In 1999, as part of the certification process
in Interventional Cardiology, I submitted verified
data to the Board stating that I had successfully
accomplished 
the 
appropriate 
number 
of
interventional cardiology procedures to enable me to
take 
the 
examination 
for 
certification 
in
Interventional Cardiology.
"4. As a result of passing this examination,
[ABIM] 
certified 
me 
as 
a 
specialist 
in 
the
subspecialty of Interventional Cardiology.
"5. By meeting 
the 
certification 
requirements 
of
[ABIM], beginning in 1999 I was allowed to represent
to the public that I am board-certified in the
subspecialty of Interventional Cardiology."
On June 21, 2007, Dr. Panayiotou submitted two additional
affidavits.  In the first, ABIM official Joan Otto swore that
"[ABIM] recognized certification in Interventional Cardiology
in 1999" and that "Dr. Panayiotou was certified by [ABIM] in
Interventional Cardiology in 1999."  In the second, Amy A.
Mosser, vice president of administration and operations for
ABMS, swore as follows:
"5. ABMS approved the certification process for
Interventional 
Cardiology 
in 
1996 
and 
began
recognizing certification in this subspecialty in
1999, when the first certifying examination was
offered by the ABIM.
"6. ABIM, like other Member Boards, originally
designated 
its 
board 
certification 
for
subspecialties 
as 
a 
'certificate 
of 
added
1061829
10
qualifications.'  This was in conformity with
general ABMS practice at that time.  Subsequently,
ABMS decided to transition away from such language.
The ABMS Bylaws in effect in 2002 required future
applications for subspecialty certificates to be
designated as subspecialty certificates, but gave
the Member Boards discretion to continue designating
existing subspecialty certificates as certificates
of added qualifications or special qualifications or
to discontinue those terms and simply use the
subspecialty designation.  These differences in
terminology are just that, however, and have no
substantive 
effect 
on 
ABMS's 
recognition 
of
certification.  ABMS has continually recognized ABIM
certification in the subspecialty of Interventional
Cardiology since its inception in 1999."
On 
August 
15, 
2007, 
the 
trial 
court 
denied 
Dr.
Panayiotou's motion for a summary judgment, holding that Dr.
Schapira was a similarly situated health-care provider
"regardless of [his] lack of sub-subspecialty certification"
and without addressing whether Dr. Panayiotou was actually
certified as a specialist in interventional cardiology in
March 2002 when he performed the heart catheterization on
Sullivan.  The trial court simultaneously entered an order
granting 
Dr. 
Panayiotou's 
"motion 
to 
strike" 
without
specifying whether it intended to grant the June 18 motion to
strike, the June 19 motion to strike, or both.  
Dr. Panayiotou subsequently moved the trial court to
certify its order denying his motion for a summary judgment
1061829
11
for a permissive appeal pursuant to Rule 5, Ala. R. App. P.,
and, on September 7, 2007, the trial court did so.  On
September 21, 2007, Dr. Panayiotou petitioned this Court for
permission to appeal.  We granted that petition on November 1,
2007.
II.
"'We apply the same standard of review [in reviewing
the grant or denial of a summary-judgment motion] as
the trial court applied.  Specifically, we must
determine whether the movant has made a prima facie
showing that no genuine issue of material fact
exists and that the movant is entitled to a judgment
as a matter of law.  Rule 56(c), Ala. R. Civ. P.;
Blue Cross & Blue Shield of Alabama v. Hodurski, 899
So. 2d 949, 952-53 (Ala. 2004).  In making such a
determination, we must review the evidence in the
light most favorable to the nonmovant.  Wilson v.
Brown, 496 So. 2d 756, 758 (Ala. 1986).  Once the
movant makes a prima facie showing that there is no
genuine issue of material fact, the burden then
shifts to the nonmovant to produce "substantial
evidence" as to the existence of a genuine issue of
material fact.  Bass v. SouthTrust Bank of Baldwin
County, 538 So. 2d 794, 797-98 (Ala. 1989); Ala.
Code 1975, § 12-21-12.'"
Mutual Assurance, Inc. v. Schulte, 970 So. 2d 292, 295 (Ala.
2007) (quoting Dow v. Alabama Democratic Party, 897 So. 2d
1035, 1038-39 (Ala. 2004)). 
1061829
This presupposes that the defendant health-care provider
6
is certified by an appropriate board as a specialist; if not,
§ 6-5-548(b) governs instead of § 6-5-548(c), and there is no
such requirement.
12
III.
This appeal presents two issue for this Court to
consider: (1) what is the meaning of the term "specialty" as
used in § 6-5-548(c); and (2) was Dr. Panayiotou certified by
ABIM as a specialist in interventional cardiology at the time
he allegedly breached the standard of care in March 2002. 
The legislature has defined a similarly situated health-
care provider as a health-care provider that is "certified by
an appropriate American board in the same specialty" as the
defendant health-care provider.   § 6-5-548(c)(3) (emphasis
6
added).  Dr. Panayiotou argues that a "specialty" for the
purposes of § 6-5-548(c) is any specialized area of medicine
in which a medical board offers certification and that,
because 
ABIM 
offers 
certification 
in 
interventional
cardiology, that area is therefore a "specialty" for purposes
of § 6-5-548.  Johnson, however, argues that an area of
medicine is a "specialty" only if it is specifically
designated by a medical board as a "specialty"; hence, she
argues, because ABIM officially designates interventional
1061829
Eighteen of the specialty boards governed by ABMS,
7
including ABIM, offer certification in specialized areas of
medicine that they officially designate as "subspecialties."
13
cardiology as a "subspecialty," it is not a "specialty" for §
6-5-548 purposes.  
We agree with Dr. Panayiotou that a specialty is any
specialized area of medicine in which an American medical
board offers certification.  There is no indication in the
AMLA that the legislature intended to define the term
"specialty" based upon the taxonomic scheme used by ABIM,
ABMS, or any other professional medical board.   That any
7
appropriate American medical board offers certification in an
area of medicine is itself evidence that that area of medicine
is a specialty.  
The interpretation of the term "specialty" advocated by
Johnson, if adopted, would be problematic in its application
because it fails to recognize that some areas of medicine may
technically be deemed "subspecialties" by some boards, but
recognized as specialties by others.  For example, in Chapman
v. Smith, 893 So. 2d 293 (Ala. 2004), this Court recognized
that the defendant anesthesiologist was certified in the
specialty field of pain management by the American Academy of
1061829
The defendant physician in Chapman was also board-
8
certified in anesthesiology, although the opinion does not
identify the board that issued that certification.  893 So. 2d
at 296.
14
Pain Management ("AAPM"), a non-ABMS board.   ABMS does not
8
recognize pain management as a "specialty" under its taxonomic
scheme; however, the relevant ABMS board, the American Board
of Anesthesiology, does recognize "pain medicine" as a
"subspecialty."  Thus, applying the argument advanced by
Johnson, 
whether 
a 
board-certified 
anesthesiologist 
practicing
in the pain-management/pain-medicine field was a specialist in
that field would hinge on whether the anesthesiologist's
certificate was issued by AAPM, in which case he would be
recognized by our courts as a specialist, or by the American
Board of Anesthesiology, in which case he would not be
recognized as a specialist –– even though both boards
apparently agree that the field is a unique area of medicine
and recognize it as such.  The only difference is that the
field is deemed a "subspecialty" in the ABMS hierarchy.
Whether an area of medicine is a "specialty" for purposes of
§ 6-5-548 should not change depending on which board has
certified 
the 
particular health-care provider in that
specialty. 
1061829
15
Moreover, if we were to adopt Johnson's argument relying
on the taxonomic designations used by ABIM and ABMS, it would
pave the way for a gastroenterologist, an endocrinologist, or
a nephrologist, all of whom practice in an area recognized as
a "subspecialty" by ABIM, to testify as a similarly situated
health-care provider against a cardiologist merely because
they were all certified by ABIM in the "specialty" of internal
medicine –– regardless of the fact that their expertise is in
the digestive system, the endocrine system, and the kidneys,
respectively, and that they might have had minimal experience
with medical issues related to the heart.  This is precisely
the situation § 6-5-548 was enacted to prevent.  Thus, we now
explicitly hold that if an appropriate American medical board
recognizes an area of medicine as a distinct field and
certifies health-care providers in that field, that area is a
specialty for purposes of § 6-5-548.
We note that the Supreme Court of Michigan reached a
similar conclusion when it considered this issue.  In Woodard
v. Custer, 476 Mich. 545, 719 N.W.2d 842 (2006), that court
considered the definition of "specialty" as the term is used
1061829
16
in Mich. Comp. Laws § 600.2169, which states, in relevant
part:
"(1) In an action alleging medical malpractice, a
person shall not give expert testimony on the
appropriate standard of practice or care unless the
person is licensed as a health professional in this
state or another state and meets the following
criteria: 
"(a) If the party against whom or on whose
behalf the testimony is offered is a specialist,
specializes at the time of the occurrence that is
the basis for the action in the same specialty as
the party against whom or on whose behalf the
testimony is offered.  However, if the party against
whom or on whose behalf the testimony is offered is
a specialist who is board certified, the expert
witness must be a specialist who is board certified
in that specialty."
Referring to Dorland's Illustrated Medical Dictionary (28th
ed.), the Woodard court concluded:
"[A] 'specialty' is a particular branch of medicine
or surgery in which one can potentially become board
certified.  
"... Moreover, 'sub' is defined as 'a prefix ...
with the meanings "under," "below," "beneath" ...
"secondary," "at a lower point in a hierarchy[.]"'
Random House Webster's College Dictionary (1997).
Therefore, a 'subspecialty' is a particular branch
of medicine or surgery in which one can potentially
become board certified that falls under a specialty
or within the hierarchy of that specialty.  A
subspecialty, 
although 
a 
more 
particularized
specialty, is nevertheless a specialty.  Therefore,
if 
a 
defendant 
physician 
specializes 
in 
a
subspecialty, the plaintiff's expert witness must
1061829
17
have specialized in the same subspecialty as the
defendant physician at the time of the occurrence
that is the basis for the action."
476 Mich. at 561-62, 719 N.W.2d at 851 (emphasis added).  The
court also noted in a footnote that ABMS had filed an amicus
curiae brief in which it agreed that a subspecialty
constitutes a specialty.  476 Mich. at 562 n.6, 719 N.W.2d at
851 n.6.
IV.
Having 
held 
that 
interventional 
cardiology 
is 
a
recognized specialty, we must now address whether in fact Dr.
Panayiotou was certified in that specialty at the time of the
alleged breach of the standard of care.  Dr. Panayiotou
alleges that he was; Johnson alleges he was not.  In
conjunction with his motion for a summary judgment, Dr.
Panayiotou 
submitted 
evidence, 
summarized 
above, 
sufficient 
to
make a prima facie showing that he was board-certified in
interventional cardiology at the time of the alleged breach of
the standard of care in March 2002; thus, the burden then
shifted to Johnson to produce substantial evidence showing
that Dr. Panayiotou was not board-certified in interventional
1061829
After the trial court denied Dr. Panayiotou's motion for
9
a summary judgment and after we granted his subsequent
petition to file an immediate permissive appeal of that
ruling, Johnson obtained a new affidavit from ABIM official
Joan Otto and moved the trial court to supplement the record
to include that affidavit.  Dr. Panayiotou objected, arguing
that Rule 10(f), Ala. R. App. P., does not allow the record on
appeal to be supplemented to include evidence that was not in
the record at the trial court level.  The trial court
nevertheless granted Johnson's motion to supplement, and the
new affidavit was added to the record.  Dr. Panayiotou has
since moved this Court to strike the supplement to the record,
and that motion has been granted.  See Cowen v. M.S. Enters.,
Inc., 642 So. 2d 453, 455 (Ala. 1994) ("Rule 10(f) provides
for the supplementation of the record only to include matters
that were in evidence in the trial court.  That rule was not
intended to allow the inclusion of material in the record on
appeal that had not been before the trial court.").
18
cardiology in March 2002.  Johnson has failed to meet that
burden.
The evidence Johnson submitted in an attempt to meet her
burden included:  (1) printed copies of pages from the Web
sites of both ABIM and ABMS; (2) an affidavit from Dr.
Schapira; and (3) Dr. Panayiotou's curriculum vitae.   Dr.
9
Panayiotou filed separate motions to strike both the printed
copies of the pages from the Web sites and Dr. Schapira's
affidavit, and the trial court subsequently entered an order
granting a motion to strike without stating which motion to
strike it was granting.  Dr. Panayiotou's position is that the
trial court's order granted both motions to strike, while
1061829
19
Johnson alleges it is unclear what motion or motions the trial
court intended to strike.  Regardless of the trial court's
intent, however, the evidence submitted by Johnson was
insufficient to rebut Dr. Panayiotou's prima facie showing
that he was board-certified in interventional cardiology at
the time he allegedly breached the standard of care in March
2002. 
We first note that the printed copies of pages from the
ABIM and ABMS Web sites submitted by Johnson "were not
properly authenticated and, thus, they were inadmissible
hearsay, which cannot be relied on to defeat a properly
supported motion for a summary judgment."  Carter, 662 So. 2d
at 893.  Accordingly, we will not consider that evidence on
appeal, regardless of whether the trial court actually struck
it.  See Chatham v. CSX Transp., Inc., 613 So. 2d 341, 346
(Ala. 1993) (stating that this Court "may not consider"
inadmissible evidence that a party properly moved to strike).
Citing Wilson, supra, Dr. Panayiotou also urges us not to
consider 
Dr. 
Schapira's 
affidavit, 
which 
directly 
contradicted
his deposition testimony.  However, the so-called "sham
affidavit doctrine" applied by this Court in Wilson, which
1061829
20
prevents 
an 
individual 
from contradicting prior sworn
testimony to avoid the entry of a summary judgment, has, to
date, been applied only against actual parties in Alabama, and
Dr. Schapira is an expert witness, not a party.  See Champ
Lyons, Jr. & Ally W. Howell, Alabama Rules of Civil Procedure
Annotated § 56.7 (4th ed. 2004) ("Strong dictum in Tittle v.
Alabama Power Co., 570 So. 2d 601 (Ala. 1990) suggests that
the rule preventing a party from contradicting an earlier
deposition by affidavit for purposes of avoidance of the entry
of summary judgment does not apply to prevent such activity
when the deponent is a non-party.").  While one law review
article has noted that other courts to consider the issue have
"generally agreed that [the sham-affidavit doctrine] applies
to the contradictory testimony of expert witnesses," Applying
the Sham Affidavit Doctrine in Arizona, 38 Ariz. St. L.J. 995,
1048 (Winter 2006) (footnotes omitted), and one court has
noted that "[it] can think of no reason, however, not to apply
this rule to the present case involving the testimony and
affidavit of the plaintiff's sole expert witness," Adelman-
Tremblay v. Jewel Cos., 859 F.2d 517, 521 (7th Cir. 1988), we
need not address that issue at this time because, even if we
1061829
21
considered the affidavit, we would have to conclude that
Johnson failed to create a genuine issue of fact regarding
whether Dr. Panayiotou was board-certified in interventional
cardiology in March 2002.  
In his affidavit, Dr. Schapira declared that Dr.
Panayiotou 
was 
not 
board 
certified 
in 
interventional
cardiology in March 2002 because, at that time, Dr. Panayiotou
held only a "certificate of added qualification."  Johnson
argues that Dr. Schapira's statement is further supported by
Dr. Panayiotou's own curriculum vitae, which omits the word
"subspecialty" next to "Interventional Cardiology" in the list
of examinations passed by Dr. Panayiotou, but explicitly lists
"Cardiovascular Subspecialty" (emphasis added) in that same
list, thus indicating, Johnson argues, that even Dr.
Panayiotou recognized that interventional cardiology was not
a "subspecialty" in 1999 when he passed the examination.
However, Johnson's argument was directly refuted by an
ABMS official, who, in an affidavit submitted by Dr.
Panayiotou, explained that there was no substantive difference
between a certificate of added qualification and certification
in a subspecialty, and that "ABMS has continually recognized
1061829
22
ABIM certification in the subspecialty of Interventional
Cardiology since its inception in 1999."  In light of this
definitive evidence on this point, we can say as a matter of
law that the certificate of added qualification Dr. Panayiotou
held in interventional cardiology in March 2002 was the
equivalent of subspecialty certification and that he was
accordingly a board-certified specialist in interventional
cardiology at that time.
We further note that the Michigan Supreme Court, in
Woodard, did not have to directly consider this issue;
however, a concurring Justice nevertheless did so and
similarly concluded that there was no functional difference
between a certificate of added qualification and board
certification, stating:
"As we did above with regard to the 'specialty'
versus 'subspecialty' dispute, it is again necessary
for us to resolve a question that arises in most
cases as a result of nomenclature often used to
distinguish between certifications offered for broad
specialty areas and certifications offered for the
narrower 
subspecialty 
areas. 
 
Specifically,
certifications coinciding with the broader specialty
areas are often referred to by parties and in case
law as board certifications, while certifications
coinciding with the narrower specialty areas are
referred 
to 
as 
'certificates 
of 
special
qualifications' 
or 
'certificates 
of 
added
qualifications.'  The result is that in many cases,
1061829
23
such 
as 
Woodard, 
plaintiffs 
will 
argue 
that
certificates of special qualifications are not board
certifications that need to be matched.  We clarify,
however, that under the above definition of the
phrase 'board certified,' any difference between
what 
are 
traditionally 
referred 
to 
as 
board
certifications and what have commonly been called
certificates of special qualifications is merely one
of semantics.  When a certificate of special
qualifications is a credential bestowed by a
national, 
independent 
medical 
board 
indicating
proficiency in a medical specialty, it is itself a
board certification that must be matched."
476 Mich. 545, 613, 719 N.W.2d 842, 878 (Taylor, C.J.,
concurring in the result) (emphasis added).
V.
Dr. Panayiotou moved the trial court to enter a summary
judgment in his favor in the medical-malpractice action filed
against him by Johnson, alleging that she had failed to
identify a similarly situated health-care provider who would
testify that he had breached the standard of care in his
treatment of Sullivan.  The trial court denied his motion,
holding that the expert identified by Johnson, Dr. Schapira,
was in fact similarly situated to Dr. Panayiotou because they
were both board-certified by ABIM in internal medicine.
However, because Dr. Panayiotou put forth evidence indicating
that he was also board-certified by ABIM in interventional
1061829
24
cardiology when the alleged malpractice occurred and that Dr.
Schapira did not hold that certification, the trial court
erred in holding that Dr. Panayiotou and Dr. Schapira were
similarly situated health-care providers.  Accordingly, the
order of the trial court denying Dr. Panayiotou's motion for
a summary judgment is reversed, and this cause is remanded for
the trial court to enter a summary judgment for Dr.
Panayiotou.  
REVERSED AND REMANDED. 
See, Lyons, Woodall, Smith, Bolin, and Parker, JJ.,
concur.
Cobb, C.J., concurs in part and dissents in part.
Murdock, J., dissents.
1061829
25
COBB, Chief Justice (concurring in part and dissenting in
part).
The majority opinion presents a new rationale for
defining the term "specialty" as applied to similarly situated
health-care providers under Ala. Code 1975, § 6-5-548.
Although I do not disagree with this rationale and I concur in
its adoption, I do not believe that it is appropriate to apply
it to this case.  In this case, and under the state of the law
at the time the trial court found that Dr. Panayiotou and Dr.
Schapira were similarly situated health-care providers, the
trial court was correct.  The record shows that, in the
context of the medical procedure in question, Dr. Schapira had
experience similar to or greater than Dr. Panayiotou.  Under
these circumstances, I believe that it would be more just to
apply the new construction of § 6-5-548 as adopted by the
majority prospectively, rather than retroactively.  See, e.g.,
Ex parte F.P., 857 So. 2d 125 (Ala. 2003);  City of Daphne v.
City of Spanish Fort, 853 So. 2d 933 (Ala. 2003); and Ex parte
Bonner, 676 So. 2d 925 (Ala. 1995)(cases supporting the
general rule that statutes should be construed prospectively
and not retrospectively in the absence of a particular
1061829
26
indication 
of 
legislative 
intent 
to 
apply 
statute
retrospectively).