Opinion ID: 1695332
Heading Depth: 1
Heading Rank: 4

Heading: is medical expert testimony needed to establish causal connection in this case?

Text: For a plaintiff to recover in a negligence action the conventional tort elements of duty, breach of duty, proximate causation and injury must be proven by a preponderance of the evidence. Palmer, 564 So.2d at 1355; Phillips v. Hull, 516 So.2d 488, 491-92 (Miss. 1987). The Palmers contend that expert testimony showing a causal connection between the breach of duty and damages is not needed in this case because the issue is within the common knowledge of laymen. Our general rule is that the negligence of a physician may be established only by expert medical testimony with the exception for instances where a layman can observe and understand the negligence as a matter of common sense and practical experience. Walker v. Skiwski, 529 So.2d 184, 187 (Miss. 1988). See also Palmer, 564 So.2d at 1355; Phillips v. Hull, 516 So.2d 488, 491 (Miss. 1987); Cole v. Wiggins, 487 So.2d 203, 205 (Miss. 1986). Lay testimony is sufficient to establish only those things that are purely factual in nature or thought to be in the common knowledge of laymen. Drummond v. Buckley, 627 So.2d 264, 268 (Miss. 1993). An expert is needed to show how a breach of the physician's duty proximately caused the plaintiff's injury. Palmer, 564 So.2d at 1355; Hull, 516 So.2d at 491; Hall v. Hilbun, 466 So.2d 856, 870-73 (Miss. 1985). As the court below stated, [T]he action against Defendant Hospital is based upon the allegation that the hospital failed to require ... two surgeons to be present when the surgery in question was performed and failed to insure that the surgeon who did perform the surgery was competent and qualified to perform the surgery that was needed. We note that the nature of the plaintiff's contentions against the hospital fall within the realm of negligence. Miss. Code Ann. § 41-9-17 provides that the agency responsible for the licensing of hospitals in the State adopt rules, regulations and standards for those hospitals. These rules and regulations are compiled in Minimum Standards of Operation for Mississippi Hospitals. Section 12 of those standards deals with surgery and anesthesia. Rule 1202.3 reads, [i]n any procedure with unusual hazard to life, there shall be present and scrubbed as first assistant a physician designated by the credentials committee as being qualified to assist in major surgery. (emphasis added) For this discussion, we will assume that Anderson Hospital breached its duty of care by not requiring two surgeons to be present during Sonny's first operation (the colostomy) in January 1987, and that Sonny sustained damages because of that operation. With one element of negligence remaining at issue, the Palmers must still show that the breach of duty was the proximate cause of the injury. The Palmers concluded that no expert testimony was needed to show a causal connection because it was logical that had another surgeon been present that the stoma would not have been placed in a skin fold and there would have been no injuries. They argued that this is within a layman's common knowledge. We do not agree that expert testimony was not necessary to establish the causal connection between the alleged breach of duty of the Defendant and the Plaintiff's injuries. Such a determination would be contrary to numerous recent cases in which this Court has set forth the requirement that [t]he person charging negligence must show that the other party, by his act or omission, has violated some duty incumbent upon him and thereby caused the injury complained of. Magnolia Hospital v. Moore, 320 So.2d 793, 800 (Miss. 1975) (quoting DeLaughter v. Womack, 250 Miss. 190, 208, 164 So.2d 762, 769 (1964)). We additionally decline to find that this case falls within the layman exception; although, it may not be difficult for laymen to see a causal connection in this case.