Opinion ID: 2169679
Heading Depth: 1
Heading Rank: 4

Heading: Summary Judgment: The Radiologists

Text: To support their motion for summary judgment in the Superior Court, Dr. Shahinfar and St. Joseph Radiology Associates, Inc. argued that Ms. Foley failed to present expert evidence to establish an applicable standard of care for radiologists. A motion justice of the Superior Court agreed with the defendants, and summary judgment was entered in their favor on May 21, 2004. [7] On appeal, Ms. Foley contends that it was not necessary for her to provide an expert opinion because the negligence of Dr. Shahinfar and St. Joseph Radiology Associates, Inc. was patently obvious. It is well-settled law in this jurisdiction that [i]n any negligence action, such as a medical malpractice case, it is the plaintiff's burden to establish that the defendant had a duty to act or refrain from acting and that there was a causal relation between the act or omission of the defendant and the injury to the plaintiff. Schenck v. Roger Williams General Hospital, 119 R.I. 510, 514, 382 A.2d 514, 516-17 (1977). Time and time again we have required expert testimony    to establish deviation from the standard of care when the lack of care is not so evident as to be obvious to a lay person. Boccasile v. Cajun Music Limited, 694 A.2d 686, 690 (R.I.1997) (quoting Richardson v. Fuchs, 523 A.2d 445, 450 (R.I.1987)). Here, plaintiff's expert, Dr. Andrew Nathanson, unequivocally testified during his deposition that he did not plan to testify at trial about the standard of care that applies to a radiologist such as Dr. Shahinfar. He further commented that I think the standard of care was met by the radiologists, even though I'm not a radiologist. I have no problems withI think radiology should be thrown out of the case. Ms. Foley provided no other expert testimony regarding the appropriate standard of care for radiologists. Her argument on appeal is that the delay of more than five hours from the time she was admitted to the emergency room until the radiology department reported the results of her CT scan qualifies as patent negligence. [8] Therefore, she argues, it was not necessary for her to present an affidavit or other evidence from an expert to establish a standard of care and breach of that standard. We disagree. In Boccasile, 694 A.2d at 689, the plaintiff alleged that a defendant doctor was negligent because she caused a delay in the treatment of the plaintiff's husband. The plaintiff contended that the defendant physician failed to bring any medical equipment with her when she first attended to the plaintiff's husband and therefore negligently delayed the administration of a drug to him that, in part, resulted in his death. Id. The defendant doctor was granted summary judgment, and the plaintiff appealed. Id. When we reviewed the case on appeal, we faulted the plaintiff for failing to present any standard-of-care evidence, any medical affidavits establishing alleged deviations from those standards, or any expert attributions of causation   [,] and affirmed the Superior Court's entry of summary judgment against the plaintiff. Id. at 690. Here, as in Boccasile, we do not believe that the delay was so patently negligent that it alleviated the plaintiff's burden to present expert testimony with respect to a standard of care for radiologists and deviation from that standard by Dr. Shahinfar or St. Joseph Radiology Associates, Inc. Indeed, it is difficult for this Court to comprehend how the alleged negligence in this case could be so evident that it would be obvious to a lay person, when plaintiff's own expert, an emergency room physician, testified that the radiologists met the standard of care. Based on our well-established caselaw in this area and the deposition testimony of plaintiff's expert witness, we hold that the alleged lack of care on the part of Dr. Shahinfar and St. Joseph Radiology Associates, Inc. was not so evident that it would be obvious to lay people. As a result, when she opposed the motion for summary judgment, Ms. Foley had the burden of presenting evidence from an expert regarding the applicable standard of care, deviation from that standard of care, and causation between the act or omission and the injury to plaintiff. In an apparent effort to do just that, counsel for plaintiff also sought to introduce a variety of medical texts to establish a standard of care. However, the motion justice determined that the presentation of medical texts, without more, could not assist plaintiff in establishing a standard of care and deviation from that standard. We agree. General Laws 1956 § 9-19-30 provides that a party to a civil malpractice action may introduce published works on a subject of science insofar as the court shall find that the statements are relevant and that the writer of the statements is recognized in his or her profession or calling as an expert on the subject. We have interpreted this statute and said that [a]lthough under § 9-19-30 statements in a treatise are admissible in a medical-malpractice action as evidence tending to prove the facts or opinions they contain, they cannot be relied upon in the absence of other evidence to establish deviation from the standard of care. Richardson, 523 A.2d at 450. First of all, Ms. Foley did not satisfy § 9-19-30 because she presented no evidence that the authors who wrote the texts upon which she intended to rely were recognized as experts in their fields. In addition, the textbooks were not authenticated. We have said that a learned treatise or an article that is part of a medical journal, but which is not authenticated, should not be used for purposes of cross-examination or for purposes of proof of an issue that is material to the outcome of a case. Flanagan v. Wesselhoeft, 765 A.2d 1203, 1209 (R.I.2001). Under Rule 803(18) [9] of the Rhode Island Rules of Evidence some foundation must be laid before the contents of a published treatise, periodical, or other pamphlet may be admissible. In Flanagan, we explained that the great weight of authority has indicated that a treatise or article must be authenticated as authoritative either by the witness under examination or by another witness who may be the proponent's own expert before it is used on cross-examination. Flanagan, 765 A.2d at 1209. Here, plaintiff's counsel did not offer a scintilla of evidence that the authors of the textbooks that he intended to cite were experts in their fields, nor was there even a scrap of evidence that the texts themselves were reliable. Therefore, we conclude that the motion justice did not err in finding that Ms. Foley could not rely on textbooks to establish a standard of care for Dr. Shahinfar or St. Joseph Radiology Associates, Inc. The alleged negligence was not so evident as to be obvious to a lay person, yet Ms. Foley failed to present any evidence whatsoever to establish a standard of care and breach of that standard by Dr. Shahinfar and St. Joseph Radiology Associates, Inc. After conducting a de novo review of the motion justice's decision to grant summary judgment, we are satisfied that plaintiff has raised no genuine issue of material fact in her case against the radiologists. See East Providence School Committee, 896 A.2d at 51. Therefore, we affirm the decision of the motion justice to grant the defendants' motion for summary judgment.