Opinion ID: 2145524
Heading Depth: 1
Heading Rank: 6

Heading: expert testimonyinformed consent

Text: After Bryan Memorial was dismissed, the sole issue became whether Drs. Bleicher and Eakins failed to obtain informed consent for the surgery. On the issue of informed consent, the Robinsons proffered testimony of one expert who was board certified, but who had no experience in Lincoln, or in Nebraska. Drs. Bleicher and Eakins properly objected. See Paulsen v. State, 249 Neb. 112, 541 N.W.2d 636 (1996). The trial court refused to allow the expert to testify. In Nebraska, a physician's duty to disclose the risks of a particular procedure or treatment, allowing for informed consent, is established by the professional theory. The professional theory `holds that the duty is measured by the standard of the reasonable medical practitioner under the same or similar circumstances, and must be determined by expert medical testimony establishing the prevailing standard and the defendant practitioner's departure therefrom....' Eccleston v. Chait, 241 Neb. 961, 967, 492 N.W.2d 860, 865 (1992) (quoting Smith v. Weaver, 225 Neb. 569, 407 N.W.2d 174 (1987)). This is a locality standard and is the correct standard to be applied in this case. The Robinsons cite Capps v. Manhart, 236 Neb. 16, 458 N.W.2d 742 (1990), for the proposition that a medical expert from one community is competent to testify as an expert witness in a medical negligence case as to the standard of care or skill required in another community if the expert has knowledge of or familiarity with the practice and standard of the locality in question or of a similar or like community. We agree that the proposition of law in Capps v. Manhart, supra , is applicable in a straight medical malpractice action; however, this action is based upon a lack of informed consent or inadequate information for Robinson's consent to a surgical procedure. As we expressly stated in Eccleston v. Chait, supra , in an informed consent case, a locality standard is applicable. Therefore, the Capps rule is not applicable in this case. In determining whether an expert's testimony is admissible, a court considers four preliminary and interrelated questions: (1) whether the witness qualifies as an expert pursuant to Neb. Evid. R. 702, Neb. Rev.Stat. § 27-702 (Reissue 1995); (2) whether the expert's testimony is relevant; (3) whether the expert's testimony assists the trier of fact to understand the evidence or determine a controverted factual issue; and (4) whether the expert's testimony, even though relevant and admissible, should be excluded under Neb. Evid. R. 403, Neb.Rev. Stat. § 27-403 (Reissue 1995) because its probative value is substantially outweighed by the danger of unfair prejudice or other considerations. Anderson/Couvillon v. Nebraska Dept. of Soc. Servs., 248 Neb. 651, 538 N.W.2d 732 (1995). Further, the soundness of a trial court's ruling regarding an expert's qualifications depends upon the particular facts of the case. McArthur v. Papio-Missouri River NRD, 250 Neb. 96, 547 N.W.2d 716 (1996); McIntosh v. Omaha Public Schools, 249 Neb. 529, 544 N.W.2d 502 (1996); Floyd v. Worobec, 248 Neb. 605, 537 N.W.2d 512 (1995). Finally, a witness may qualify as an expert by virtue of either formal training or actual practical experience in the field. Crawford v. Department of Motor Vehicles, 246 Neb. 319, 518 N.W.2d 148 (1994); § 27-702. In determining whether the district court abused its discretion, this court has held that expert testimony should not be received into evidence if it is evident that the witness does not possess such facts that enable him to express a reasonable, accurate conclusion as distinguished from a mere guess; without an adequate basis of facts, the witness should not be allowed to give an opinion. Menkens v. Finley, ante p. 84, 251 Neb. 84, 555 N.W.2d 47 (1996). In this case, Dr. Breitenbach clearly had no knowledge with respect to the standard of informed consent in Lincoln on March 24, 1988. The fact that Drs. Bleicher and Eakins may have testified about the standard in Iowa City, Iowa, and other cities vis-a-vis Lincoln does not establish foundation for Dr. Breitenbach to testify about the standard on informed consent in Lincoln on March 24. Because Dr. Breitenbach was not in possession of facts which would enable him to express a reasonable, accurate conclusion, it was not an abuse of discretion for the district court to exclude his testimony.