Opinion ID: 1057613
Heading Depth: 1
Heading Rank: 10

Heading: Summary Judgment Based on the Actions of Maddox: the Need for Competent Expert Testimony

Text: We come now to the procedural status of this case. Plaintiff's complaint is one for medical malpractice, a specific type of negligence. The elements of a medical malpractice claim are set forth in Tennessee Code Annotated section 29-26-115, which provides, in pertinent part, as follows: (a) In a malpractice action, the claimant shall have the burden of proving by evidence as provided by subsection (b): (1) The recognized standard of acceptable professional practice in the profession and the specialty thereof, if any, that the defendant practices in the community in which the defendant practices or in a similar community at the time the alleged injury or wrongful action occurred; [22] (2) That the defendant acted with less than or failed to act with ordinary and reasonable care in accordance with such standard; and (3) As a proximate result of the defendant's negligent act or omission, the plaintiff suffered injuries which would not otherwise have occurred. Tenn.Code Ann. § 29-26-115(a) (Supp. 2009). This statute `codifies the common law elements of negligenceduty, breach of duty, causation, proximate cause, and damages. No claim for negligence can succeed in the absence of any one of these elements.' Kelley, 133 S.W.3d at 592 (quoting Kilpatrick v. Bryant, 868 S.W.2d 594, 598 (Tenn. 1993)). Pursuant to this statute, a medical malpractice plaintiff must establish four elements in order to be successful: (1) the applicable standard of care; and (2) a breach of the applicable standard of care that (3) proximately caused (4) injuries to the plaintiff. The medical malpractice statute extends to the acts of non-physicians, such as nurses, when they are involved in the medical treatment of a patient. Gunter v. Lab. Corp. of America, 121 S.W.3d 636, 640 (Tenn.2003). The elements of a medical malpractice claim generally must be established through competent expert testimony. [23] Moon v. St. Thomas Hosp., 983 S.W.2d 225, 229-30 (Tenn.1998); Payne v. Caldwell, 796 S.W.2d 142, 143 (Tenn.1990). Subsection -115(b) sets forth the prerequisites that must be met before an expert witness will be deemed competent to testify about any of the elements of a medical malpractice claim: (b) No person in a health care profession requiring licensure under the laws of this state shall be competent to testify in any court of law to establish the facts required to be established by subsection (a), unless the person was licensed to practice in the state or a contiguous bordering state a profession or specialty which would make the person's expert testimony relevant to the issues in the case and had practiced this profession or specialty in one (1) of these states during the year preceding the date that the alleged injury or wrongful act occurred. This rule shall apply to expert witnesses testifying for the defendant as rebuttal witnesses. The court may waive this subsection (b) when it determines that the appropriate witnesses otherwise would not be available. Tenn.Code Ann. § 29-26-115(b). Where the proffered witness is a medical doctor, this statutory test of competency requires that the doctor be licensed to practice, and had recently practiced, a profession or specialty which would make the person's expert testimony relevant to the issues in the case. Id. That is, the doctor's (licensed) practice must provide her with sufficient experience to make her knowledgeable about the issues which are the subject of her testimony. Our Court of Appeals has recognized that this statutory provision requires the proffered expert to have a sufficient basis on which to establish familiarity with the defendant's field of practice and the standard of care required in dealing with the medical care at issue. Bravo v. Sumner Regional Health Systs., Inc., 148 S.W.3d 357, 367 (Tenn.Ct.App.2003). Thus, before a trial court will admit testimony by a proffered expert witness about the standard of care applicable to a defendant, the trial court must be satisfied that the witness is competent to testify. In the context of the instant case, Plaintiff was required to present expert testimony from a competent witness establishing (1) the standard of care Maddox was required to meet, (2) the manner in which his conduct failed to meet the standard of care, and (3) how Maddox's failure to meet the standard of care proximately caused Plaintiff to suffer injuries she would not have suffered otherwise. White v. Vanderbilt Univ., 21 S.W.3d 215, 226-27 (Tenn.Ct.App.1999). [24] A defendant may put a plaintiff's medical malpractice case to the test by filing a motion for summary judgment. The defendant will be entitled to summary judgment if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law. Tenn. R. Civ. P. 56.04. A defendant moving for summary judgment bears the ultimate burden of demonstrating that there is no genuine issue as to any material fact and that it is entitled to judgment as a matter of law. Hannan v. Alltel Publishing Co., 270 S.W.3d 1, 5 (Tenn.2008). When, however, the moving defendant's motion is properly supported, the burden of production then shifts to the [plaintiff] to show that a genuine issue of material fact exists. Id. A defendant moving for summary judgment shifts the burden of production to the plaintiff by either (1) affirmatively negating an essential element of the plaintiff's claim, or (2) showing that the plaintiff cannot prove an essential element of his or her claim at trial. Id. at 8-9. In this case, Defendants' motion for summary judgment is supported by competent expert proof via affidavits from Maddox and Dr. Adams affirmatively negating that either Maddox or Dr. Adams breached the applicable standards of care. This proof effectively shifted the burden of production to Plaintiff to demonstrate through competent expert proof that there is a genuine issue of material fact about whether Maddox or Dr. Adams breached the applicable standard of care. In response to Defendants' motion for summary judgment, and in support of her allegation that Maddox/Dr. Adams breached the applicable standard of care by misdiagnosing her ailment and thereby proximately causing her injuries, Plaintiff relies solely on the deposition testimony of Dr. Nelson Mangione, the cardiologist who performed her surgery. Dr. Mangione testified that Maddox breached the standard of care applicable to primary care physicians. Dr. Mangione admitted, however, that he was not familiar with the standard of care applicable to physician assistants or with the standard of care which a supervising physician must meet when supervising a physician assistant. On this basis, the trial court determined that Dr. Mangione's testimony did not satisfy Plaintiff's burden of production/proof. In essence, the trial court determined that Dr. Mangione was not competent to testify about Maddox's standard of care. We will overturn a trial court's rulings regarding the admissibility of an expert's proffered testimony only upon an abuse of discretion. See Robinson v. LeCorps, 83 S.W.3d 718, 724-25 (Tenn.2002). In this case, the trial court did not abuse its discretion in determining that Dr. Mangione was not competent to testify about the standard of care actually applicable to Maddox. [25] Dr. Mangione admitted as much himself. Plaintiff presented no other proof on the subject. Plaintiff therefore failed to rebut the proof adduced by Defendants in conjunction with their motion for summary judgment. Accordingly, the trial court was correct in awarding summary judgment to Defendants based on the alleged negligence of Maddox.