Opinion ID: 2638642
Heading Depth: 1
Heading Rank: 1

Heading: Dr. Mengert

Text: This Court, as well as the Court of Appeals, has addressed the constraints placed on the plaintiff's expert, noting that the requirements are not intended to be onerous. Frank v. East Shoshone Hosp., 114 Idaho 480, 482, 757 P.2d 1199, 1201 (1988) (noting, Our decision today does not cast an onerous burden on plaintiffs in medical malpractice actions. It is not an overly burdensome requirement to have an expert become familiar with the standard of care in the community where alleged malpractice is committed); Keyser v. Garner, 129 Idaho 112, 117, 922 P.2d 409, 414 (Ct.App.1996). This Court's interpretation of the requirements created by I.C. §§ 6-1012, -1013 was further elaborated in Clarke v. Prenger, 114 Idaho 766, 760 P.2d 1182 (1988). In Clarke, this Court explained: We take this occasion to express our disapproval of what appears to be a growing practice among the trial courts of this state dismissing medical malpractice cases at the summary judgment point on the basis that plaintiffs' expert witnesses are not sufficiently familiar with the standard of care to be expected from defendant-physicians.... We do not view such burden as being onerous on plaintiffs in medical malpractice cases since ordinarily it only requires a positive indication that plaintiffs' expert witnesses possess the requisite knowledge of the local standard of care which has been allegedly violated. Unfortunately, plaintiffs' counsel too often are either unaware of the requirements of the summary judgment process, or fail to take their responsibilities seriously. On the other hand, it appears that some of our trial judges fail to recognize their obligation to construe not only the evidence before the court, but all reasonable inferences that flow therefrom, most favorably to the non-moving party. Id. at 768, 760 P.2d at 1184. This Court has also addressed whether or not the plaintiff's expert must be of the same specialty as the defendant physician. This Court in Clarke expressly rejected this contention: Recognizing the complexity of knowledge required in the various medical specialties, more than a casual familiarity with the specialty of the defendant's physician is required. The witness must demonstrate a knowledge acquired from experience or study of the standards of the specialty of the defendant physician sufficient to enable him to give an expert opinion as to the conformity of the defendant's conduct to those particular standards, and not to the standards of the witness's particular specialty if it differs from that of the defendant. It is the scope of the witness's knowledge and not the artificial classification by title that should govern the threshold question of admissibility. Of the decisions in other jurisdictions which have discussed this issue, this appears to be the decided majority view. Id. at 769, 760 P.2d at 1185 (quoting Fitzmaurice v. Flynn, 167 Conn. 609, 356 A.2d 887 (1975)). In this case, Dr. Mengert testified in his deposition that he was board certified in both Internal Medicine and Emergency Medicine. Dr. Mengert practiced as a full-time attending physician in the Emergency Department at the University of Washington. Dr. Mengert testified that in order to gain familiarity with the local standard of care, he first contacted a physician in Boise. This physician refused to cooperate because of the small community in Boise. Next, Dr. Mengert contacted a personal acquaintance, Dr. Scott Smith, who practices at the Boise Veterans Administration Hospital. Although Dr. Smith is board certified in both Emergency Medicine and Internal Medicine, his current practice is in Internal Medicine. According to Dr. Mengert, he described the symptoms that Dulaney suffered and the treatment Dulaney received at SARMC. He then asked Dr. Smith if, in his opinion as a practicing Boise physician, the treatment Dulaney received was within the standard of care in that environment. Dr. Smith gave his opinion that she should not have been discharged from the Emergency Department if she could not walk. Dr. Mengert stated that in his opinion, the complaints related to this case are applicable to any Emergency Department within the United States of America. Though I don't have practice knowledge from those other environments, I think what took place was outside the standard of care of modern Emergency Medicine practice. Dr. Mengert testified that in his opinion to a reasonable degree of medical certainty, Dr. Holland breached the standard of care applicable to him as an emergency room physician practicing in Boise in August of 1994 with respect to his care of Dulaney. The district court found Dr. Mengert's testimony to be inadmissible because: [H]e failed to adequately familiarize himself with the standards and practices of emergency room physicians in Boise in August of 1994. Dr. Mengert consulted with Dr. Smith, an internist at a Boise hospital, at the VA hospital. There was no evidence that Dr. Smith was himself familiar with the local standard of care for ER physicians practicing in Boise at the relevant time. Dr. Smith is a board certified ER physician, at least he was in April of 1999 when he gave his deposition. There is no evidence in the record that Dr. Smith was a practicing emergency room physician, nor a board certified emergency room physician in August of 1994. The standard to be applied in this Court's review of a grant of summary judgment compels this Court to construe all facts liberally in favor of the nonmoving party. This, together with our examination of I.C. §§ 6-1012, -1013, in the recent case of Grover v. Smith, 37 Idaho 247, 46 P.3d 1105 (2002) does not mandate the conclusion reached by this Court. In this case, Dr. Mengert contacted a physician, Dr. Smith, who shared the same board certification, Emergency Medicine, as the defendant doctor. This indicates that Dr. Smith was a similarly trained and qualified provider of the same class in the same community, with similar training and field of medical specialization as required by statute. Neither I.C. § 6-1012, nor case law, requires that the local physician practice in the same field. Additionally, this Court has recognized at least since 1988 that experts do not need to share the exact same specialty as that of the defendant physician. As noted by the Clarke court, [t]he witness must demonstrate a knowledge acquired from experience or study of the standards of the specialty of the defendant physician sufficient to enable him to give an expert opinion as to the conformity of the defendant's conduct to those particular standards. Dr. Smith's board certification in Emergency Medicine indicates that his training rises to the level of training contemplated in Clarke. The record does not contain any evidence that the local standards applicable to a physician practicing in emergency room medicine would differ significantly from the standards applicable to a physician practicing in internal medicine. This is especially true in this case, where emergency measures were not taken in regard to the treatment of Dulaney. Consequently, Dr. Mengert's affidavit should have been considered as to the standard of care pertaining to emergency room physicians, such as Dr. Holland, in Boise in 1994. Further, Dr. Mengert's affidavit was also sufficient to help establish the standard of care applicable to Dr. Waters, an orthopedic physician called in to consult in the emergency room. Although Dr. Waters is an orthopedic physician, the standard of care for emergency room practice became relevant when he, after being appraised of the emergency, rendered professional services in the emergency room setting. Therefore, Dr. Mengert's testimony should have been considered as to the standard of care applicable to Dr. Waters. This Court noted in Clarke that the applicable statutes were not intended to be overly burdensome. I would find the affidavit of Dr. Mengert admissible and sufficient to create genuine issues of material fact as to whether Dr. Holland and Dr. Waters breached the local standard of care.