Court Opinion

ID: 9627168
Source: CourtListenerOpinion
Date Created: 2023-08-22 08:36:59.968407+00
Date Added: 2024-06-11T15:31:17.964596
License: Public Domain

John Robbins, Judge, concurring. I agree with the prevail-udge, trial court erred in granting summary judgment to appellee and that this appeal should be reversed and remanded. I write only to express my disagreement with the opinion’s resolution of one point on appeal, which is whether expert testimony was required to be presented on the issue of negligence. I believe that such evidence was necessary and was provided in this case sufficient to survive the motion for summary judgment. The prevailing opinion states that whether a non-specialist physician should follow the instructions of a specialist in these circumstances is no more complicated than leaving gauze in a surgical patient or severing a ureter during ovarian surgery. I disagree. The issue is whether not following a specialist’s recommendations constitutes medical negligence. I cannot hold this issue is so simple that laypersons could reach such a conclusion without the aid of expert testimony. See Haase v. Starnes, supra; Robson v. Tinnin, 322 Ark. 605, 911 S.W.2d 246 (1995). This is especially true where, as here, the defense provided expert opinion from a pathologist that failure to abide by those recommendations was not negligent and did not cause or contribute in any way to Mr. Mitchell’s death. Because appellee filed a motion for summary judgment with a supportive affidavit, it was incumbent upon appellant to meet proof with proof on both the existence of negligence and proximate cause. See Rice v. Tanner, supra. To that end, appellant provided-such proof in the form of expert testimony from Dr. Singer, whose affidavit is set forth in the majority opinion. The only fault that the trial court found with the affidavit was its failure to state explicitly that Dr. Singer was familiar with the standard of care for a physician in Dr. Lincoln’s locality. A subsequent supplemental affidavit put in those “magic words,” but it was struck by the trial court. It must be remembered that this case came for consideration on a motion for summary judgment, where all doubts should be resolved and any reasonable inferences should be drawn in favor of the non-movant. See Adams v. Arthur, 333 Ark. 53, 969 S.W.2d 598 (1998). In that light, Dr. Singer’s affidavit meets the threshold requirement on standard of care. The affidavit, without reciting the entirety of it, sets forth that Dr. Singer is a board certified specialist in hematology/oncology from Pennsylvania, that he knew of the specific details of the patient’s care both in Texas under Dr. Gajewski and in Arkansas under Dr. Lincoln, that he knew of the recommendations in the letter sent by Dr. Gajewski to Dr. Lincoln, and that he had reviewed the medical records concerning the patient’s chronic myelogenous leukemia. The affidavit then goes on to state that: [T]he standard of care would require a primary care physician, such as Dr. Lincoln, to follow the recommendations of a specialist, such as Dr. Gajewski. Transfusing Mr. Mitchell with A positive red cells, as was done in this case, was a violation of the standard of care. In my opinion, within a reasonable degree of medical certainty, the failure to transfuse Mr. Mitchell with O positive red cells and B positive platelets was a significant contributing factor in the recrudescence1 of his disease and ultimate demise. This affidavit sets forth the standard of care for Dr. Lincoln and others like him, a primary care physician practicing in Mountain Home, Arkansas. The trial court found the defense expert’s opinion viable when he stated a familiarity with the standard of care for primary care doctors that applied to the entire state of Arkansas, which would include Baxter County, where Dr. Lincoln practices. Interestingly, the trial court approved of a state-wide standard, although the purpose of the locality rule is to prevent higher standards ordinarily found in the more urban areas from being applied where less demanding standards tend to prevail. See Gambill v. Stroud, 258 Ark. 766, 531 S.W.2d 945 (1976). Nonetheless, when viewing the affidavit provided by appellant’s expert under the proper standard, it meets with the statutory requirements of Ark. Code Ann. § 16-14-206(a)(1) (1987) and was sufficient to allow the case to go forward. As to causation, I agree with the prevailing opinion that appellant’s expert testimony provided evidence of causation sufficient to withstand the motion for summary judgment. I add my recognition of The Medical Malpractice Act, which applies to all causes of action for “medical injury.” The Act defines “medical injury” in Ark. Code Ann. § 16-114-201, which provides in relevant part that it means: any adverse consequences arising out of or sustained in the course of the professional services being rendered by a medical care provider, whether resulting from negligence, error, or omission in the performance of such services [.] Id. at subsection (3). Breaching the standard of care thereby causing a deadly disease to recur and hasten the patient’s death is an adverse consequence. For the foregoing reasons, I concur. Baker, J., joins in this opinion.   “Recrudescence” is defined in IWebster's Dictionary as “a new outbreak after a period of abatement or inactivity: Renewal.” It is synonymous with “return.”