Opinion ID: 1927099
Heading Depth: 2
Heading Rank: 1

Heading: the exclusion of dr. heller's testimony

Text: The determination of the competency of an expert witness to testify is within the discretion of the trial justice, the exercise of which we shall not disturb in the absence of clear error or abuse. Greco v. Mancini, 476 A.2d 522, 525 (R.I. 1984); Lacey v. Edgewood Home Builders, Inc., 446 A.2d 1017, 1018 (R.I. 1982). In making such a determination, the trial justice must take into account the natural tendency of the jury to place greater weight on the testimony of one qualified as an expert. Morgan v. Washington Trust Co., 105 R.I. 13, 18, 249 A.2d 48, 51 (1969). Accordingly, the expert witness must possess special knowledge, skill or information about the subject matter acquired by study, observation, practice or experience, so that the testimony given will aid the jury in its search for the truth. Id. Evidence concerning the question of whether a physician has used proper skill and diligence in diagnosing or treating a medical condition must be supplied by experts unless the lack of care is so obvious as to be within the layman's common knowledge. Young v. Park, 417 A.2d 889, 893 (R.I. 1980); Wilkinson v. Vesey, 110 R.I. 606, 613, 295 A.2d 676, 682 (1972). The expert must measure the care that was administered against the degree of care and skill ordinarily employed in like cases by physicians in good standing engaged in the same type of practice in similar localities. Schenck v. Roger Williams General Hospital, 119 R.I. 510, 515, 382 A.2d 514, 517 (1977); Wilkinson v. Vesey, 110 R.I. at 613, 295 A.2d at 682. Thus, to have been qualified to testify, Dr. Heller would have had to possess special knowledge about the relevant standard of care, acquired by study, observation, practice or experience. Doctor Heller had never been in private practice, nor did he claim to be an orthopedic specialist. His credentials, all acquired in a university setting, were, however, clearly impressive. In 1946 and 1947 he served in the Department of Pathology at Yale University School of Medicine. In 1948 and 1949 he was an assistant physician and from 1949 through 1954 an associate physician at Yale-New Haven Hospital. In 1951 and 1952 he was an assistant professor of internal medicine at Yale University School of Medicine, which position involved a dual appointment both in physiology and internal medicine. He also served as professor of interdisciplinary studies at the New England Institute until 1981, when he retired as professor emeritus. From 1973 to 1981 he was involved as coinvestigator with a professor of surgery at Yale in the development and clinical trial of new drugs to treat primary cancer of the breast and its metastasis to the bone and other organs. It is evident from the record that Dr. Heller was well versed in the physiology of bone healing, healing been involved over several years in a research project using radioactive calcium to measure the dynamics of bone healing in its earliest stages and the effects upon the process of various stimulants and retardants; having experimented in the use of radiation therapy to spot-treat fractures in patients with metastatic bone disease; and having lectured at the University of Connecticut on various aspects of bone healing. However, when asked specifically upon what basis he claimed to be qualified to testify regarding the standard of care in Connecticut for the orthopedic treatment of fractures  the subject matter of his intended testimony  Dr. Heller testified to no such in-depth experience. [4] He cited discussions that he had had in the previous month with five board-certified orthopedic specialists in Connecticut and New Hampshire, varying in length from one-half hour to one and a half hours, concerning the various ways of treating fractures of the humerus and the pros and cons of each. In addition, he cited his personal experience in the hospital during the relevant period with patients with fractures, in setting approximately twelve fractures similar to Richardson's while in the Navy during World War II, and in setting such fractures suffered by his own family members. According to Dr. Heller's own testimony, however, the patients with fractures with whom he dealt in the course of his research in the hospital were treated orthopedically by other physicians  his area of treatment being the patient who was fracture prone and not the fracture itself. He did not claim to have observed the orthopedic treatment of these patients directly or to have been involved in an assessment of such treatment. The circumstances in which he practiced and the techniques he employed while in the Navy were not necessarily comparable to those in Connecticut approximately thirty years later. Finally, information about techniques used in Connecticut gained from single conversations with individual orthopedists in preparation for trial do not clearly rise to the level of knowledge or information gained from study, observation, practice or experience that a qualified expert is required to possess. In fact, Dr. Heller's perceived need to contact these specialists undercuts his claim of familiarity with the standard of care based on his personal experience. Thus, we cannot find as a matter of law that the trial justice abused his discretion and clearly erred in excluding Dr. Heller's testimony. Cf. Noll v. Rahal, 219 Va. 795, 250 S.E.2d 741 (1979)(no abuse of discretion in excluding testimony of board-certified pediatrician practicing in Falls Church, Virginia, where claim of familiarity with standard of care for pediatricians in Richmond was based on reading a state monthly journal; interacting with physicians from Richmond periodically at monthly meetings; and teaching residents from medical college in Richmond, which allowed for discourse with physicians in the teaching program there); Loftus v. Hayden, 391 A.2d 749 (Del. 1978)(no abuse of discretion where familiarity with community consisted of brief contacts in community, examinations of some medical records, conversations with a number of local practitioners, and some reading of local publications). [5] See generally Annot. 37 A.L.R. 3d 420 (1971). We stress that neither this opinion nor the decision of the trial justice is based upon the fact that Dr. Heller was not an orthopedic specialist. Cf. Schenck, 119 R.I. at 521, 382 A.2d at 520 (fact that cardiologist not an expert in hospital administration or emergency-room care goes to weight of testimony and not competence to testify in negligence action against hospital for failing to equip emergency room with machines to take electrocardiograms). [6] Nor do we mean to suggest that the expert must have performed the particular procedure involved. See generally Annot. 46 A.L.R. 3d 275 (1972). We merely find that the experience testified to by Dr. Heller relative to the critical fact in this case  the standard existing for the practice of orthopedics in Connecticut and similar localities  did not show him to be so clearly qualified as to warrant the conclusion that the trial justice abused his discretion by excluding his testimony relevant to that fact. Richardson also claims that the trial justice erred by refusing to permit Dr. Heller to testify concerning the dynamics of bone healing and the reasons why her fracture failed to unite. It is evident from the record that the trial justice found Dr. Heller incompetent to testify only with regard to Dr. Fuchs's alleged deviation from the standard of care and that Richardson made no further attempt to elicit testimony from Dr. Heller on any other aspect of the case. Richardson clearly cannot claim error in the exclusion of evidence that she did not attempt to introduce.