Opinion ID: 1760760
Heading Depth: 1
Heading Rank: 4

Heading: Qualification of an Expert Witness and Summary Judgment

Text: In her last argument for reversal, appellant urges that the trial court erred in excluding Dr. Williams's testimony and in subsequently granting summary judgment. We conclude that the trial court's exclusion of Dr. Williams constituted an abuse of its discretion and that summary judgment was not appropriate. In its third motion in limine, St. Paul claimed that Dr. Williams's deposition testimony indicated that he was not qualified to testify because he was not familiar with the medical facility in Batesville, Arkansas, nor was he testifying based on the standard of care for nurses in 1992 at the same or similar locality. After a hearing on the motion, the trial court granted St. Paul's motion in limine to exclude Dr. Williams's testimony and entered an order reflecting this decision. The trial court concurrently entered an order granting the St. Paul's motion for summary judgment. The trial court found that St. Paul was entitled to judgment as a matter of law because both parties had stipulated that this was a case that required expert medical testimony and the testimony of appellant's only expert witness had just been excluded. The issue for which expert testimony was required is whether Mr. Wolford, now deceased, had received adequate care from the White River Medical Center's nurses and staff. As her expert witness, appellant offered Dr. Williams, who had been a board-certified surgeon, had remained licensed in New York, and had been licensed to practice medicine for fifty-six years. Dr. Williams had practiced in Warsaw, a farm town in upper New York state. Warsaw was described as a similar locality to Batesville in terms of population, number of physicians, and patient drainage and referral. Also, the hospital, where he practiced and held many positions including chief of staff, was described as similar in size, bed capacity, and equipment to the White River Medical Center. He taught nurses for twenty-five years at a three-year accredited RN school, and he trained nurses for duties in the operating room. While Dr. Williams had not practiced for thirteen years, he never ceased his study of medicine and his license remained current. He had previously testified as a medical expert witness in twelve states, and had reviewed between five hundred and one thousand cases. Our case law requires a plaintiff to present expert testimony to prove an action for medical injury when the asserted negligence does not lie within the jury's comprehension as a matter of common knowledge. Reagan v. City of Piggott, 305 Ark. 77, 80, 805 S.W.2d 636, 637-38 (1991). An expert need not be familiar with the practice in the particular locality, but must demonstrate a familiarity with the standard of practice in a similar locality, either by his testimony or by other evidence showing the similarity of localities. First Commercial Trust Co. v. Rank, 323 Ark. 390, 401, 915 S.W.2d 262, 267 (1996) (holding the trial court abused its discretion in excluding the testimony of an emergency-medicine physician who met Arkansas's similar-locality rule). We look at geographical location, size, and character of the community; however, we base the similarity not on population or area, but on the similarity of the medical facilities, practices, and advantages. Id. We have been presented with cases in which medical specialists from dissimilar fields have testified and stated therein that the physician must merely exhibit knowledge of the subject. Id. at 399, 915 S.W.2d at 266. We stated that [w]here a duly licensed and practicing physician has gained knowledge of the standard of care applicable to a specialty in which he is not directly engaged but as to which he has an opinion based on education, experience, observation or association with that specialty, his opinion is competent. Id. Based on our case law, the foregoing evidence establishes an appropriate foundation that shows that Dr. Williams is familiar with the standard of practice in a locality (Warsaw) similar to Batesville. Although appellee argues that Dr. Williams's reference to a national standard of care should be a basis for exclusion, the argument is without merit. Dr. Williams is not an attorney, and it is the court's province to determine if an appropriate foundation has been made, showing Dr. Williams is familiar with the standard of practice in a locality such as Batesville. As seen from the evidence above, that foundation was shown. In Courteau v. Dodd, 299 Ark. 380, 385, 773 S.W.2d 436, 439 (1989), this court, citing A.R.E. 702, held that, if there is a reasonable basis for saying a witness knows more of the subject at hand than a person of ordinary knowledge, his evidence is admissible. We have also stated that if an expert's opinion is merely weak or questionable, that fact bears on the weight to be given the testimony, and not its admissibility. Ishie v. Kelley, 302 Ark. 112, 116, 788 S.W.2d 225, 226-27 (1990). Here, Dr. Williams's expert testimony touched on Alvie Wolford's medical and physical condition while he was a patient in the Medical Center, and he opined the nursing staff's failure to provide proper care and attention to Mr. Wolford had contributed to his death. Dr. Williams averred Mr. Wolford had been a victim of fluid overload, and essentially drowned in his own juices. He said that, after the doctors started an IV in Mr. Wolford's arm in the emergency room, the IV was never removed. Dr. Williams explained that Mr. Wolford was administered liquids by the gallon over many days, even though there were days when he could only get rid of one quart of urine. Mr. Wolford gained forty pounds from water intake. The doctor went into detail how the nurses' alleged failure of care caused Mr. Wolford's legs, arms, and face to swell, and how the fluid filled Mr. Wolford's lungs and decreased the efficiency of his heart to pump blood. Dr. Williams concluded that several causes contributed to Mr. Wolford's death abscess, peritonitis, a hole in the intestine, sepsis, fluid overloadand all of these causes exhibit symptoms nurses should have recognized and reported. The medical treatment administered (and not administered) to Mr. Wolford is clearly a matter outside a person's ordinary knowledge, and in the circumstances surrounding Mr. Wolford's case, a jury could obviously have benefited from hearing expert testimony. If the fact that Dr. Williams has curtailed hands-on surgery since 1979, or another factor, might be considered a weakness in his medical background, that weakness is a matter for the jury to weigh; it is not reason to exclude his testimony. The determination of an expert witness's qualification to testify is within the sound discretion of the trial court. First Commercial Trust Company v. Rank, 323 Ark. at 398, 915 S.W.2d at 266. However, we have stated that the exercise of this discretion is not absolute, and we will reverse where we find that the trial court has abused its discretion. Id. at 399, 915 S.W.2d at 266. We conclude that Dr. Williams possessed the required credentials and experience to testify in this case, and we hold that excluding Dr. Williams's testimony constituted an abuse of the trial court's discretion. Because we hold that the trial court abused its discretion in excluding Dr. Williams's expert testimony, we also conclude that St. Paul was not entitled to judgment as a matter of law. Our rule states that summary judgment should only be granted where there exists no genuine issue of material fact, and the moving party is entitled to judgment as a matter of law. Ark. R. Civ. P. 56. Here, the testimony of Dr. Williams would have provided the requisite background to support a genuine issue of material fact as to whether the White River Medical Center's nurses and staff provided Mr. Wolford with adequate medical treatment. The resolution of this issue should have been within the province of the jury. Accordingly, we reverse the trial court's decision granting summary judgment in favor of St. Paul, and we remand with instructions for the trial court to accept Dr. Williams as an expert witness in this case. In sum, we affirm in part, as modified, and reverse and remand in part.