Opinion ID: 2155803
Heading Depth: 1
Heading Rank: 3

Heading: Evidentiary Requirements under the Delaware Medical Malpractice Statute

Text: Under 18 Del. C. § 6853, [4] a party alleging medical malpractice must produce expert medical testimony that specifies (1) the applicable standard of care, (2) the alleged deviation from that standard, and (3) the causal link between the deviation and the alleged injury. [5] A defense motion for summary judgment, by contrast, does not require a supporting expert's affidavit if the parties have adequate time for discovery and if the record unambiguously reflects that the plaintiff's allegations are not and will not be supported by any expert medical testimony. [6] As an initial matter, Dr. Weiner suggested at oral argument that Dr. Kahn's 1997 report should not be used as evidence in deciding his motion for judgment as a matter of law. The Superior Court considered Dr. Kahn's report in ruling on Dr. Weiner's motion when it concluded: The fact is that nowhere in [Dr. Kahn's] report or in his deposition does he say what the standard of care was and how specifically Dr. Weiner breached it.... [7] During his deposition, Dr. Kahn verified his 1997 report and agreed that he would testify consistently with that report if he appeared at trial. In effect, Dr. Kahn's report became part of his deposition although Dr. Kahn did not read the contents of the report into the record of the deposition. [8] In the present case, the parties dispute only whether Dr. Kahn's deposition and his accompanying report provide sufficient evidence from which a jury could reasonably infer the appropriate standard of care and Dr. Weiner's breach of the standard under 18 Del. C. § 6853. [9] Section 6853 does not require medical experts to couch their opinions in legal terms or to articulate the standard of care with a high degree of legal precision or with magic words. [10] Similarly, to survive a motion for judgment as a matter of law, the Greens are not required to provide uncontradicted evidence of the elements of their negligence claim. Instead, the Greens must provide credible evidence of each of these elements from which a reasonable jury could find in their favor. [11] So long as Dr. Kahn's testimony provides this minimal evidence, any inconsistencies in Dr. Kahn's testimony must be resolved by a jury and are thus irrelevant for purposes of ruling on a motion for judgment as a matter of law. We find that Dr. Kahn's 1997 report and his 1998 deposition satisfy this minimum evidentiary requirement. In his report, Dr. Kahn opined that considerable force had to have been used [in removing the guidewire from Green's vein] to cause pain and a rip large enough to result in massive hemorrhage. Based on this fact, Dr. Kahn asserted in his report that this adverse outcome was operator dependent and ... with the exercise of reasonable care, could and should have been avoided. During his deposition, Dr. Kahn also testified that he had no other way of explaining [the rip in Green's vein] other than that an operator dependent vascular injury occurred and in my view should have been recognized or anticipated and as a result possibly and probably avoided. Although Dr. Weiner argues that such inferences would amount to impermissible speculation by Dr. Kahn, [12] we find that Dr. Kahn's opinion was based on his analysis of the circumstances of this case, not mere speculation over the cause of a bad result. [13] Any contention that Dr. Kahn was speculating would go to the weight of the evidence and thus presents a jury question. From this evidence, a jury could reasonably infer that the applicable standard of care requires a treating doctor to withdraw a pacemaker guidewire with a degree of force sufficient to remove the wire without seriously damaging the patient's blood vessel. Although a more straightforward explanation of the applicable standard of care undoubtedly would have simplified matters, Dr. Kahn's testimony provides a sufficient basis for a permissible inference of negligence. [14] The jury could reasonably infer that Dr. Weiner breached this standard of care by applying considerable force to withdraw the guidewire from Green's vein. [15] As a consequence, we find that the Greens produced sufficient expert testimony to raise an issue of material fact with respect to all of the elements of a medical malpractice claim under 18 Del. C. § 6853.