Opinion ID: 2156142
Heading Depth: 2
Heading Rank: 2

Heading: Deviation from the standard

Text: Even if we accept Dr. Kleinerman's testimony that the applicable standard of care was for a physician to be aware of the correct way to use a Cytobrush, there was no evidence that Dr. Bepko deviated from that standard. In fact, Ms. Derzavis did not present any evidence that Dr. Bepko had never been instructed, or had been instructed incorrectly, in the use of a Cytobrush. Her evidence focused instead on the way he inserted the brush when he conducted the Pap test. Dr. Kleinerman did say that she believed Dr. Bepko violated the standard of care because he engaged in excessive instrumentation. The only basis she offered for that conclusion, however, was the fact that Dr. Bepko inserted the Cytobrush until the last bristle disappeared. But neither Dr. Kleinerman nor anyone else testified that inserting the brush into the cervix until the last bristle disappeared violated the standard of care. At most, the package insert, which said that the Cyobrush should be inserted until only the bristles closest to the handle are exposed, constituted  prima facie proof of proper use, Garvey, 530 A.2d at 1146, but there was no evidence that inserting the Cytobrush one bristle farther amounted to improper use. We therefore hold that Ms. Derzavis did not present sufficient evidence to prove the second element of her malpractice claim: that Dr. Bepko deviated from the applicable standard of care. [16]