Opinion ID: 1986013
Heading Depth: 1
Heading Rank: 4

Heading: Qualification of an Expert Medical Witness

Text: The qualification of an expert medical witness is controlled by 18 Del.C. § 6854. That statute has two subsections. The first states the general rule that: (a) No person shall be competent to give expert medical testimony as to applicable standards of skill and care unless such person is familiar with that degree of skill ordinarily employed in the community or locality where the alleged malpractice occurred, under similar circumstances, by members of the profession practiced by the health care provider; provided, however, that any such expert witness need not be licensed in the State. Subsection (a) originally constituted the entire 18 Del.C. § 6854. It was enacted to remedy the problem of wandering witnesses and itinerant medicine men. Butler v. Alatur, Del.Supr., 419 A.2d 938, 939 (1980). In 1980, the statute was amended to add subsection (b), which states: (b) Any physician who has been in the active practice of medicine or surgery for at least the past 5 years and who currently practices in the State or within a state contiguous to the State and within a radius of 75 miles of the Capitol of the State shall be presumed to be competent to give expert medical testimony as to applicable standards of skill and care, if it shall be established that the degree of skill and care required of the expert in the locality where the expert practices or teaches is of the same or equivalent standard as the skill and care employed in the community or locality where the alleged malpractice occurred. Subsection (b), therefore, creates a presumption of competence for [a]ny physician  who meets the specific criteria set forth in that subsection. The language of 18 Del.C. § 6854(b), however, is clearly limited to the testimony of physicians. In determining the qualifications of putative medical experts who are not physicians, a court must apply 18 Del.C. § 6854(a) rather than (b). This Court has previously recognized the sharp distinction between these two subsections. Baldwin, 606 A.2d at 67. In reviewing Nurse Bachmann's competency to testify as an expert witness, we, therefore, apply 18 Del.C. § 6854(a). [1] In determining the competency of a witness who is not a physician to testify as an expert, the issue, therefore, is the witness' familiarity with that degree of skill ordinarily employed in the community or locality where the alleged malpractice occurred, under similar circumstances, by members of the profession practiced by the health care provider. 18 Del.C. § 6854(a). Familiar, as used in 18 Del.C. § 6854(a), means having more than a fair knowledge of the skill ordinarily employed in the community in question. Loftus v. Hayden, Del.Supr., 391 A.2d 749, 752 (1978). The expert witness should establish that he `knows' what degree of skill is ordinarily employed [in the community or locality] and that he is well acquainted or thoroughly conversant with it. Id. It is also not enough for the expert merely to state that he is familiar with the degree of skill ordinarily employed under usual circumstances in the community where the alleged malpractice occurred. When an objection is made to his qualifications, [he] must present facts from which the Court can reasonably conclude that the witness has the foundation essential to the expertise which he claims. Id. at 753. Loftus sets forth a non-exclusive list of means by which a medical expert can demonstrate he has acquired the necessary familiarity with community or locality standards. They include, by way of example: 1) direct observation in Delaware; 2) study in Delaware...; 3) care of Delaware patients referred by Delaware physicians; 4) teaching of students who have dispersed to Delaware; 5) reading of Delaware medical records, reports, journals, and the like; 6) consultations with Delaware physicians; and 7) attendance at meetings with Delaware doctors. Id. [2] Furthermore, [e]ach factor must be considered in light of the relative difficulty or novelty of the medical problem ... Id.