Opinion ID: 1857408
Heading Depth: 1
Heading Rank: 4

Heading: Qualification of Nurse-Anesthetist as Expert Witness.

Text: Carolan's second argument on appeal is that the district court improperly excluded Oltz from testifying as to the standard of care concerning the proper positioning and padding of the arms during the administration of anesthesia during surgery. This dispute focuses on the wording of Iowa Code section 147.139, which provides: If the standard of care given by a physician and surgeon licensed pursuant to chapter 148, or osteopathic physician and surgeon licensed pursuant to chapter 150A, or a dentist licensed pursuant to chapter 153, is at issue, the court shall only allow a person to qualify as an expert witness and to testify on the issue of the appropriate standard of care if the person's medical or dental qualifications relate directly to the medical problem or problems at issue and the type of treatment administered in the case. Carolan contends that the plain language of the statute does not restrict non-physician medical personnel from testifying as an expert witness and that the rules of statutory construction support his claim. We agree. Rules of statutory construction are to be applied only when the explicit terms of a statute are ambiguous. Marcus v. Young, 538 N.W.2d 285, 289 (Iowa 1995). Precise, unambiguous language will be given its plain and rational meaning in light of the subject matter. Id. A statute is ambiguous if reasonable minds could differ or be uncertain as to the meaning of the statute. Holiday Inns Franchising, Inc. v. Branstad, 537 N.W.2d 724, 728 (Iowa 1995). Ambiguity may arise in two ways: (1) from the meaning of particular words; or (2) from the general scope and meaning of a statute when all its provisions are examined. Id. The ultimate goal of statutory construction is to give effect to the intent of the legislature. Citizens' Aide/Ombudsman v. Miller, 543 N.W.2d 899, 902 (Iowa 1996). We cannot, under the guise of construction, enlarge or otherwise change the terms of the statute as the legislature adopted it. Marcus, 538 N.W.2d at 289. We will not construe a statute in a way that would produce impractical or absurd results, United Fire & Cas. Co. v. Acker, 541 N.W.2d 517, 518 (Iowa 1995), and we should not speculate as to the probable legislative intent apart from the wording used in the statute. State v. Haberer, 532 N.W.2d 757, 759 (Iowa 1995). If a statute is ambiguous, the court, in determining the intention of the legislature, may consider among other matters: (1) the object sought to be attained, (2) the circumstances under which the statute was enacted, (3) the legislative history, (4) the common law or former statutory provisions, including laws upon the same or similar subjects, (5) the consequences of a particular construction, (6) the administrative construction of the statute, [and] (7) the preamble or statement of policy. Iowa Code § 4.6. We are required to interpret the language fairly and sensibly in accordance with the plain meaning of the words used by the legislature. City of Des Moines v. Civil Serv. Comm'n, 540 N.W.2d 52, 57 (Iowa 1995). The key language in the statute is the legislature's use of the word person. Carolan argues that because the legislature used both physician and person at different places in the statute, it is clear the legislature recognized that the two words are not the same. Defendants argue that the very purpose of Iowa Code section 147.139 is to require testimony only from persons who have qualifications equal to the physician or surgeon. Use of the word person is not ambiguous. In our search for legislative intent, we are to be guided by what the legislature actually said, rather than what it should or might have said. Iowa R.App.P. 14(f)(13); Marcus, 538 N.W.2d at 289. Iowa Code chapter 4, which addresses the construction of statutes, defines the word person. See Iowa Code § 4.1(20). Unless otherwise provided by law, `person' means individual, corporation, limited liability company, government or governmental subdivision or agency, business trust, estate, trust, partnership or association, or any other legal entity. Id. (emphasis added). We must presume the legislature intended this definition of person because it is not defined in Iowa Code chapter 147. If the legislature wanted to restrict expert testimony to physicians and dentists, it easily could have done so. However, even if use of the word person is ambiguous, other rules of statutory construction compel the same conclusion. See Iowa Code § 4.6(5) (examine the consequences of a particular construction). If the word person is construed only to include physicians, it would contradict the statutory and case law regarding the admissibility of expert testimony. Our case law does not suggest that all non-physician medical persons are prohibited from testifying as expert witnesses in medical malpractice actions. We are committed to a liberal rule on admissibility of expert testimony, Wick v. Henderson, 485 N.W.2d 645, 648 (Iowa 1992), and the admission of such testimony rests within the sound discretion of the district court. Tappe v. Iowa Methodist Medical Ctr., 477 N.W.2d 396, 402 (Iowa 1991). Iowa Rule of Evidence 702 has codified Iowa's existing liberal rule on the admission of opinion testimony. Hutchison v. American Family Mut. Ins. Co., 514 N.W.2d 882, 885 (Iowa 1994). The United States Supreme Court reaffirmed this approach in Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579, 597-98, 113 S.Ct. 2786, 2799, 125 L.Ed.2d 469, 485 (1993). Rule 702 provides: If scientific, technical, or other specialized knowledge will assist the trier of fact to understand the evidence or to determine a fact in issue, a witness qualified as an expert by knowledge, skill, experience, training, or education may testify thereto in the form of an opinion or otherwise. Further, in its comments to rule 702, the advisory committee stated: If [pursuant to Iowa Rule of Evidence 104(a)] the Court is satisfied that the threshold requirements have been met, the witness should be allowed to testify. All further inquiry regarding the extent of his [or her] qualifications go to the weight that the fact finder can give such testimony under Rule 104(e). (Emphasis added.) Although licensing carries a presumption of qualification to testify in a given field, learning and experience may provide the essential elements of qualification. Hutchison, 514 N.W.2d at 886 (quoting Jones on Evidence § 14.13, at 619 (6th ed. 1972)). In fact, a trial court may commit an abuse of discretion if it refuses to allow an expert qualified by experience. Id. We have stated that knowledge from experience is every bit as good as that acquired academically. Id. at 888 (quoting Hon. Mark McCormick, Opinion Evidence in Iowa, 19 Drake L.Rev. 245, 263 (1970)). Efforts have been made in the past to impose licensure as a requirement for admission of expert testimony. In Hutchison, we explained our reasoning for rejecting such restrictions: we refuse to impose barriers to expert testimony other than the basic requirements of Iowa rule of evidence 702 and those described by the Supreme Court in Daubert. The criteria for qualifications under rule 702knowledge, skill, experience, training, or educationare too broad to allow distinctions based on whether or not a proposed expert belongs to a particular profession or has a particular degree. Id. at 887-88. Under Iowa Code section 147.139, the expert must have qualifications that relate directly to the medical problem at issue and the type of treatment administered. Carolan argues that his expert, nurse Oltz, should have been permitted to testify because his medical qualifications relate directly to the precise issue in the case: the proper positioning and padding of the arms during administration of anesthesia during surgery. Oltz is well qualified to testify about the standard of care pertaining to the administration of anesthesia. In his twenty-seven years of practice, Oltz has delivered anesthesia to approximately 17,000 patients. Further, in regards to anesthesiology training, both Oltz and Dr. Hill (who administered the anesthesia to Carolan) are considered anesthetists. Even though Dr. Hill is a physician, he is not an anesthesiologist because he does not specialize solely in that field. Because Oltz meets the qualifications of Iowa Rule of Evidence 702 to testify as an expert witness, we find the district court abused its discretion in prohibiting his testimony. The exclusion of Oltz's testimony was prejudicial.