Court Opinion

ID: 9544567
Source: CourtListenerOpinion
Date Created: 2023-08-07 16:57:06.865886+00
Date Added: 2024-06-11T15:13:13.940696
License: Public Domain

BISTLINE, Justice,
dissenting.
The first question is whether admissions of medical malpractice by a defendant physician can constitute the direct expert testimony needed to show malpractice. If the answer to this question is negative, then the inquiry in this case is at an end. If the answer is affirmative, however, then a second question is whether the alleged statements in this case are sufficient to constitute admissions of medical malpractice. If sufficient, then the trial court erred in granting summary judgment.1
I.
The overwhelming weight of authority holds that extrajudicial admissions can supply the necessary expert testimony in malpractice cases.2 The court in Jarboe v. Harting, 397 S.W.2d 775 (Ky.App.1965), after noting the general rule “that expert testimony is required in a malpractice case to show that the defendant failed to conform to the required standard,” noted that “it is a generally accepted proposition that *57the necessary expert testimony may consist of admissions by the defendant doctor.” Id. at 778. Similarly, the court in Robertson v. LaCroix, 534 P.2d 17 (Okl.App.1975), stated that “[i]t is well settled in Oklahoma and elsewhere that the extra-judicial admission of a party opponent has the same legal competency as direct expert testimony to establish the requisite elements of a prima facie case of negligence in a medical malpractice action.” Id. at 21. Accord, Lashley v. Koerber, 26 Cal.2d 83, 156 P.2d 441, 444 (1945) (“extrajudicial admissions of defendant [in a malpractice case] have the same legal competency as direct expert testimony to establish the critical averments of the complaint”); Sheffield v. Runner, 163 Cal.App.2d 48, 328 P.2d 828, 830 (1958) (“[w]hile expert testimony is required in a case of this sort to establish the standard of medical practice in the community, this evidence may be found in the testimony of the defendant physician, and his extrajudicial admissions have the same affect as direct expert testimony”); Wickoff v. James, 159 Cal.App.2d 664, 324 P.2d 661, 664 (1958) (“[t]he expert testimony which will establish plaintiff’s prima facie case [in a medical malpractice action] may be that of the defendant, and an extrajudicial admission is sufficient to do this”); Greenwood v. Harris, 362 P.2d 85, 88 (Okl.1961) (“the extrajudicial admissions of a defendant physician are competent to supply the expert testimony required to make out a prima facie case as against a demurrer to the evidence”); 70 C.J.S. Physicians & Surgeons § 62 at 1008 (1951) (“[t]he expert testimony which establishes plaintiff’s prima facie case [in a malpractice action] may be that of defendant, and extrajudicial admissions of defendant have the same legal competency as direct expert testimony to establish the critical averments of the complaint”). See also Tully v. Mandell, 269 Mass. 307, 168 N.E. 923 (1929); Zettler v. Reich, 256 A.D. 631, 11 N.Y.S.2d 85 (S.Ct.), affirmed, 281 N.Y. 729, 23 N.E.2d 548 (1939); 1 Washburn L.J. 615 (1962).
The Court first holds, however, that “the alleged admission of the defendant doctor, equivocal at best, does not satisfy the standards set out in I.C. §§ 6-1012 and 6-1013.” This Court in LePelley v. Grefenson, 101 Idaho 422, 425, 614 P.2d 962, 965 (1980), held, with regard to the requirement of expert testimony, that “the legislature codified already existing case law,” as “[t]he need for expert testimony in a medical malpractice case was well established prior to enactment of this legislation.” Case law from other jurisdictions shows that extrajudicial admissions are considered to be direct expert testimony.
As for the requirements for direct expert testimony set out in I.C. § 6-1013, these do no more than set forth the foundation for expert testimony. To testify for a plaintiff as an expert one must have an opinion to a reasonable medical certainty and one must have the required expertise and knowledge of the community standard. Again, this does no more than codify existing case law. Obviously a statement by a doctor practicing in the community that he was negligent qualifies as direct expert testimony of negligence, both under the statute and case law.
It should also be noted that one of the two medical experts mentioned by the Court as stating that this injury was an inherent and unavoidable risk is none other than defendant Stromberg himself. Stromberg’s affidavit establishes his qualifications and that he knows the community standard, thus his alleged admission definitely constitutes direct expert testimony of malpractice. The only question is whether the alleged statement sufficiently shows that Stromberg failed to meet the applicable standard of health care practice in the community.
II.
The Court further states that this alleged statement does not show that “Stromberg negligently failed to meet the applicable standard of health care practice of the community.” 3
*58In his deposition, Mr. Maxwell stated that Dr. Stromberg said “I obviously messed up on the first one, and another surgery has to be done to repair the damage.” Plaintiffs in answering interrogatory no. 39 stated “[t]hat after performing said surgery, Defendant Stromberg stated to Plaintiff Bobby Maxwell that he had obviously made a mistake in the performance of the tubal ligation in that he thought he had burned a hole in Plaintiff Marciena Maxwell’s intestine and that Dr. Lung was going to perform an operation to correct said burn hole.” These statements, when construed in a light most favorable to the Maxwells, present a question for the jury as to whether Stromberg negligently failed to meet the applicable standard of health care practice of the community. Cases from other jurisdictions support this conclusion.
The court reversed a judgment of nonsuit in a very similar case in Wickoff v. James, 159 Cal.App.2d 664, 324 P.2d 661 (1958). Because of the similarity of the issue, I quote at length:
“In considering whether or not a judgment of nonsuit was proper, an appellate court must ‘resolve every conflict in their testimonies in favor of plaintiff, consider every inference which can reasonably be drawn and every presumption which can fairly be deemed to arise in support of plaintiff, and accept as true all evidence adduced direct and indirect, which tends to sustain plaintiff’s case.’ Lashley v. Koerber, 26 Cal.2d 83, 84, 156 P.2d 441, 442. In any malpractice case negligence on the part of the doctor will not be presumed, it must be proved except in those cases where res ipsa loquitur is applicable. The expert testimony which will establish plaintiff’s prima facie case may be that of the defendant, and an extra judicial admission is sufficient to do this. However, in order for an extra judicial admission to be sufficient it must be an admission of negligence or lack of skill ordinarily required for the performance of the work undertaken. Lashley v. Koerber, supra.
“The only statement of Dr. James’ which could be construed as an admission of negligence is the statement, ‘Boy, I sure made a mess of things. * * * ’ Webster’s New International Dictionary (2d ed.) gives one of the definitions of the word mess as ‘A confused or disagreeable mixture of things; a hodgepodge. Hence, a situation resulting from blundering or from misunderstanding; a muddle; a botch.’ Roget’s Thesaurus (Crowel Publishing Co., 1946), under the heading ‘unskillfulness,’ gives the phrase ‘make a mess of.’ Partridge, a dictionary of slang and unconventional English (4th ed. 1951), states the phrase ‘make a mess of’ means bungle. The Oxford English Dictionary' defines the phrase ‘to make a mess of’ as bungle. All these definitions indicate that one of the meanings of the phrase is bungle or botch, which in turn connotates a job done in an unskillful manner.
“Respondents argue that even if the admissions of Dr. James were significant they were not sufficient to prevent a nonsuit in the instant case, and that these admissions do not support an inference of negligence. They state further that even if they are wrong in this respect, appellant still cannot prevail because such evidence has been characterized as the most unreliable and uncertain evidence that can be produced. However, we are here concerned with the question of whether or not a nonsuit should have been granted, and in such a case a plaintiff is entitled to every favorable inference that may reasonably be drawn from the evidence. What inferences were to be drawn from said statements of Dr. James in the light of the facts and circumstances shown by the evidence was a question of fact to be determined by the jury and we believe that the court erred in determining as a matter of law that no inference of negligence could be drawn from the evidence. We think that the jury could infer from the statement of Dr. James that in inserting the scope he did *59not use the degree of care ordinarily exercised by other doctors of good standing in the community, and, as a result of the lack of care, Mrs. Wickoff’s bowel was torn. Under such circumstances it was error to grant a nonsuit.” 159 Cal.App.2d 664, 324 P.2d at 663-64 (emphasis added).
In Greenwood v. Harris, 362 P.2d 85 (Okl.1961), the doctor misdiagnosed the plaintiff as having a tumor instead of being pregnant. The plaintiff’s husband testified that the doctor came out of the operating room and said “[y]our wife is approximately three to three and a half months pregnant, this is a terrible thing I have done, I wasn’t satisfied with the lab report, she did have signs of being pregnant. I should have had tests run again, I should have made some other tests.... I am sorry.” Id. at 88. The court held as follows:
“The only question remaining in connection with such admissions is the sufficiency thereof to establish negligence. These admissions as shown by the record are quoted above. We can interpret these statements in no other way than as an admission that a faulty diagnosis had been made due to the failure of the defendant to use and apply the customary and usual degree of skill exercised by physicians in the community.”
The court held that the trial court erred in sustaining a demurrer at the conclusion of plaintiff’s evidence.
In Sheffield v. Runner, 328 P.2d 828 (Cal.App.1958), there was testimony that the defendant doctor before the patient’s death stated “[t]his is a hospital case ... ”, while after her death he stated “I should have put her in the hospital.” Id. at 830. The court held that these two statements were sufficient to take the case to the jury.
In Lashley v. Koerber, 26 Cal.2d 83, 156 P.2d 441 (1945), the plaintiff’s husband stated that the doctor told him “that he should have” had an x-ray taken “in the beginning,” and that the doctor stated that the fault was his. The court held as follows:
“In the present case we are satisfied that a jury, considering the background of all the other evidence, could reasonably conclude that the admissions of defendant physician imported that he had not exercised that reasonable degree of skill and learning and care ordinarily exercised by other doctors of good standing practicing in the community and that as a proximate result of such negligence plaintiff suffered damage. To phrase it differently, in the light of the seeming conflicts in defendant’s testimony and all the other circumstances of the case, his admissions that he ‘should’ have had an X-ray taken ‘in the beginning’ and that he was at ‘fault’ in that regard constitute evidence of a character competent to require that the issue of defendant’s negligence be decided as one of fact rather than of law.” Id. at -, 156 P.2d at 445 — 46 (emphasis added).
The court in Scott v. Sciaroni, 66 Cal.App. 577, 226 P. 827 (1924), held as follows:
“The testimony as to defendant’s admission that he ‘left the radium on too long’ and that ‘it was his fault that she was in the condition she was in,’ when considered in connection with proof of the long-continued intense pain suffered and the failure of the burned part to heal, constitutes sufficient expert evidence to require the submission of the case to the jury. If the defendant had admitted that the injury complained of was caused by his negligence, it would hardly be contended that the evidence was insufficient to go to the jury. In the sense in which the word ‘fault’ was used in the foregoing admissions, it is synonymous with ‘negligence.’” Id. at -, 226 P. at 829.
As a final example, the court in Bungardt v. Younger, 112 Okl. 165, 239 P. 469 (1925), held as follows:
“At the time the demurrer to plaintiff’s evidence was interposed, in addition to the evidence heretofore extracted, plaintiff had proven by several witnesses as a part of his case in chief certain declarations against interest claimed to have *60been made by defendant between the time of the first setting of the tibia and the time of the Lane plate operation. These declarations against interest tended to show that the fracture of the fibula was not discovered by defendant until some three weeks after setting the tibia, that he expressed surprise at finding the fibula fractured, and stated in substance that if he had discovered and treated that fracture in the first instance along with the tibia the leg would have required no further operation and recovery would have been complete. These declarations, if made, were made by an expert assuming to treat plaintiff with ordinary skill and care, and tended to prove a want of ordinary skill and care in such treatment. This was competent evidence for the purpose offered, and, together with all of the other facts and circumstances in evidence, including the testimony of Dr. Freeman, [that another operation will have to be performed if the boy is to have a good leg] made such a case as entitled plaintiff to go to the jury.” Id. at -, 239 P. at 471-72.
The present case cannot be distinguished from the foregoing. The Maxwells have alleged that Stromberg stated that he “messed up" or “made a mistake.” As stated in Wickoff v. James, supra, all of the definitions of “to make a mess of” “indicate that one of the meanings of the phrase is bungle or botch, which in turn connotates a job done in an unskillful manner.” 159 Cal.App.2d 664, 324 P.2d at 664. Here it cannot be said as a matter of law that a jury could not reasonably infer from Stromberg’s alleged statement an admission that he had not met the applicable standard of health care practice in the community. The existence of this factual question precludes the entry of summary judgment. It is important to keep in mind that it is not our function to presuppose that a plaintiff’s case may not persuade a jury. Nor is the trial court to do so. All that is at stake is whether the plaintiff, as a matter of law, is precluded from placing her case before a jury. The case law here is squarely against the granting of defendant’s motion.
McFADDEN, J., concurs.

. The trial court granted summary judgment on the grounds that the Maxwells had failed to introduce any expert testimony of medical malpractice.

. Although Idaho now has a statutory requirement of direct expert testimony, I.C. § 6-1012, the Court observed in LePelley v. Grefenson, 101 Idaho 422, 614 P.2d 962 (1980), that this statute merely codified the existing case law which required such testimony. The case law from other jurisdictions shows that extrajudicial admissions are considered to be direct expert testimony.

. This statement by the Court is totally dicta. Once having held that the alleged statements do not meet the standards of the statute, any further statement is unnecessary.