Opinion ID: 1878709
Heading Depth: 2
Heading Rank: 1

Heading: WHETHER THE TRIAL COURT ERRED IN EXCLUDING DR. ALAN BRAGMAN'S EXPERT TESTIMONY AS TO THE CAUSE OF McCAFFREY'S INJURIES

Text: ¶ 8. At trial, the deposition of Dr. Alan Bragman, a chiropractor, was read into evidence. McCaffrey contends that the trial court erred in refusing to admit into evidence that portion of the deposition in which Dr. Bragman testified that the spinal manipulation performed by Puckett caused McCaffrey's injury. McCaffrey relies upon Mississippi Farm Bureau Ins. Co. v. Garrett, 487 So.2d 1320, 1327 (Miss. 1986), for the proposition that a chiropractor may qualify to give an expert opinion regarding the diagnosis, causation and prognosis of an injury. ¶ 9. The trial court refused to admit into evidence the following exchange which occurred during Dr. Bragman's deposition: Q. Dr. Bragman, do you have an opinion based upon your review of these documents as to a reasonable degree of chiropractic certainty concerning the causation or exacerbation of Mr. McCaffrey's herniated cervical disc? A. I believe within a reasonable degree of medical chiropractic certainty that based upon the records that I have looked at here, prior experience, knowledge, education, that this manipulation that was performed which breached the standard of care, either caused or substantially contributed to the disc injury. Puckett objected to this testimony, arguing that Dr. Bragman was not qualified to express such an opinion. He maintained that it's a question about causation. And I object to that question based on the fact that Dr. Bragman's testifying in his deposition having not seen the plaintiff, and in addition to that he's not familiar with whether there are any standards of care in this local area.... ¶ 10. The trial court sustained Puckett's objection, finding that Dr. Bragman was not qualified to testify as to the cause of McCaffrey's injury. The trial court explained, [t]ruthfully, I don't know enough about chiropractors, but I don't know that it is within their area of expertise as far as diagnosis of a herniated disc, so, yeah, I'm going to take that out. As further support for its decision, the trial court noted that Dr. Bragman based his opinion in part on a study written by a medical doctor rather than a chiropractor. Finally, the trial court relied upon the fact that Dr. Bragman had not examined McCaffrey, noting I know he says he's reviewed the documents, but I don't know that in and of itself without a physical examination. [sic] ¶ 11. When expert opinion evidence is offered, there are three factors which must be considered: (1) whether the subject matter of the proffered testimony is of the sort on which expert opinion evidence will assist the finder of fact; (2) whether the area of expertise is scientifically established so that valid opinion may be produced within that area; and, (3) finally, whether the witness is qualified. West v. Sanders Clinic for Women, P.A., 661 So.2d 714, 719 (Miss.1995) (quoting Hardy v. Brantley, 471 So.2d 358, 365-66 (Miss. 1985)). Chiropractors may give expert opinions the same as would qualified witnesses in any other recognized discipline. Garrett, 487 So.2d at 1327. ¶ 12. In Garrett, the plaintiff was involved in an automobile accident with an uninsured motorist. Id. at 1322. Approximately one year after the accident, the plaintiff stumbled over a branch or twig and fell. He sought treatment from Dr. Harry A. Tillman, a chiropractor. Id. At trial, the plaintiff sought to have Dr. Tillman testify as an expert witness that the injuries were caused by the automobile accident. Id. at 1325. The defendant objected, contending that the chiropractor's opinions were within the field of medicine and thus could only be expressed by persons qualified as medical doctors. Id. at 1327. ¶ 13. On appeal, this Court held that a chiropractor may qualify to give an expert opinion regarding the diagnosis, causation and prognosis of an injury. Id. The Court began its analysis by recognizing that in a personal injury case, expert opinion evidence regarding the nature and extent of the plaintiff's injuries, the cause therefor, and such matters as future disability and courses of treatment will assist the trier of fact to understand the evidence on these important points. Id. at 1326. Moreover, this Court held that the field of chiropractics is one within which expert opinions may generally be given. Id. at 1326. Finally, the Court found that Dr. Tillman qualified as an expert in the field of chiropractics, noting that he has met all of the requirements for licensing in the State of Mississippi and that he is in fact a licensed and practicing chiropractor. Id. at 1326-27. ¶ 14. In Garrett, this Court determined that (1) expert opinion evidence regarding the cause of the plaintiff's injuries will assist the trier of fact in a personal injury case, and (2) chiropractics is a field in which expert opinions may be given. Accordingly, the central issue in the present case is (3) whether Dr. Bragman is qualified to express an expert opinion as to the cause of McCaffrey's herniated disc. The trial court answered this question in the negative, finding that Dr. Bragman did not qualify as an expert because the diagnosis of a herniated disc is not within a chiropractor's area of expertise. ¶ 15. A chiropractor may be competent to give expert testimony within the limited scope of the practice of chiropractics. Garrett, 487 So.2d at 1327 (emphasis added). Miss.Code Ann. § 73-6-1(1) (2000), defines the practice of chiropractic as follows: [t]he practice of chiropractic involves the analysis of any interference with normal nerve transmission and expression, and the procedure preparatory to and complementary to the correction thereof, by adjustment and/or manipulation of the articulations of the vertebral column and its immediate articulations for the restoration and maintenance of health without the use of drugs or surgery. (emphasis added). Articulation is defined as a joining or connecting together loosely so as to allow motion between the parts. STEDMAN'S MEDICAL DICTIONARY (1982). Chiropractics therefore includes manipulation of the joints of the human body and would seem to encompass the spinal manipulation performed by Puckett in the instant case. ¶ 16. Dr. Bragman qualifies as an expert in the field of chiropractics. He testified that he had been practicing chiropractics since graduating from the National College of Chiropractic in 1982. Dr. Bragman is licensed in the state of Georgia where he maintains his offices. Finally, Dr. Bragman confined his testimony to chiropractics, prefacing his opinion I believe within a reasonable degree of medical chiropractic certainty.... ¶ 17. The chiropractor Garrett found to be qualified as an expert witness met all of the requirements for licensing in the State of Mississippi and ... [was] in fact a licensed and practicing chiropractor. Dr. Bragman is not licensed in Mississippi. However, this Court has held that where the expert lives or where he or she practices his or her profession has no relevance per se with respect to whether a person may be qualified and accepted by the court as an expert witness. Hall v. Hilbun, 466 So.2d 856, 874 (Miss.1985). So long as the expert qualifies, i.e., is familiar with the national standard of care, it should not matter that Dr. Bragman practices in Georgia. ¶ 18. Contrary to the trial court's findings, Dr. Bragman's reliance upon an article written by a medical doctor does not prevent him from expressing an opinion regarding the cause of McCaffrey's injury. The fact that a medical doctor may be better qualified to render the same opinion does not preclude the chiropractor from testifying as an expert witness. Garrett, 487 So.2d at 1327. Moreover, in addition to relying upon an article written by a medical doctor, Dr. Bragman also relied upon an article written by a chiropractor, entitled Contraindications and Complications of Spinal Manipulative Therapy. ¶ 19. The fact that Dr. Bragman did not treat McCaffrey is of no moment. Our rules of evidence state that [t]he facts or data in the particular case upon which an expert bases an opinion or inference may be those perceived by or made known to him at or before a hearing. M.R.E. 703. In Sibley v. Unifirst Bank for Sav., 699 So.2d 1214, 1219 (Miss.1997), the plaintiff contended that the Mississippi Workers' Compensation Commission erred in relying upon the testimony of a physician who had not examined her but who had based her evaluation of the plaintiff upon medical records and observation of the trial. This Court held that the fact that the expert witness did not examine the plaintiff goes to the weight to be given the physician's testimony, not its admissibility. Id. ¶ 20. Puckett contends that the trial court correctly found Bragman was not qualified to render an expert opinion as to causation because Bragman was not familiar with the standard of care in Petal, Mississippi. We disagree. In Hall v. Hilbun, 466 So.2d 856 (Miss.1985), this Court abolished the locality rule and adopted the national standard of care which provides each physician has a duty to use his or her knowledge and therewith treat through medical recovery, each patient, with such reasonable diligence, skill, competence, and prudence as are practiced by minimally competent physicians in the same specialty or general field of practice throughout the United States, who have available to them the same general facilities services, equipment and options. Id. at 873. The trial court erred in excluding Dr. Bragman's testimony as to the cause of McCaffrey's injuries.