Court Opinion

ID: 9588770
Source: CourtListenerOpinion
Date Created: 2023-08-21 23:38:29.9143+00
Date Added: 2024-06-11T10:48:48.199801
License: Public Domain

Eldridge, Judge,
concurring specially.
While I concur totally with the majority, I feel compelled to address some of the issues raised in the dissent.
Stedman’s Medical Dictionary, 22d defines pharmacology as “[t]he science that deals with drugs, their sources, appearance, chemistry, actions, and uses.” Pharmacologist is defined as “[o]ne who specializes in pharmacology.” Pharmacist is defined as “[a] druggist; a pharmaceutist; an apothecary; one who prepares and dispenses drugs and has knowledge concerning their properties.” Pharmacy is defined as “[t]he act of preparing and dispensing drugs.” Toxicology is defined as “[t]he science of poisons — their source, chemical composition, action, tests, and antidotes.” Toxicologist is defined as “[o]ne *888who has a special knowledge of poisons and their antidote.” Physiology is defined as “[t]he science that deals with living things, with the normal vital processes of animal and vegetable organisms.” Physiologist is defined as ££[o]ne having special knowledge of, or whose vocation is the study of, physiology.” Anatomy is defined as “1. [t]he structure of an organism; morphology. 2. The science of the morphology of structure of organisms. 3. Dissection. 4. A work describing the form and structure of an organism and its various parts.” Cytology is defined as ££[t]he anatomy, physiology, pathology, and chemistry of the cell.” Biochemistry is defined as ££[p]hysiological chemistry; biological chemistry; the chemistry of living organisms and of the changes occurring therein.” Organic chemistry is defined as “the chemistry of carbon compounds and compounds containing covalent bonds.” Medicine is defined as ££[t]he art of preventing and curing disease; the science that treats of disease in all of its relations. The study and treatment of general diseases or those affecting the internal parts of the body, distinguished from surgery.” Etiology is defined as ££[c]ausation; the doctrine of causes, the study of causes; specifically, the cause of disease.” Pharmacodynamics is defined as ££[t]he study of the actions of drugs on the living organism.” Pharmacodynamic is defined as “[Relating to drug action.” None of the above areas of scientific study and practice requires a medical degree by definition, but all are a limited part of the medical training for a medical degree, usually limited to a semester course on each subject; however, a Ph.D. in pharmacology has more hours of specialized study in such areas than is required of a medical student, who is trained as a generalist with knowledge in all areas of medicine. Essential to the science of pharmacology is the knowledge and understanding of the cause and effect of disease and toxins on the physiology of the body and the effect of drugs not only upon disease but also on the body. The very purpose of the study of pharmacology is the creation of drugs that work, which means that through drug trials on animals and clinical trials on humans that drug’s effect on the disease and humans is determined.
To be a pharmacologist requires that the person know, understand, and have training in pathology, microbiology, mycology, cytology, the disease process, trauma, and toxicology, which are primarily medical specialties, in order to determine the action, contraindication, and use of drugs in treatment of the human; thus, pharmacology and toxicology are overlapping fields of science with medicine, and therefore, pharmacologists and toxicologists have knowledge as experts as to causation. Generally, the pharmacology and toxicology professors in medical schools are Ph.D.s instead of M.D.s, although some rare professors have dual degrees. OCGA § 43-34-20 (3) defines: “ £[t]o practice medicine’ means to hold one’s self out to the public as *889being engaged in the diagnosis or treatment of disease, defects, or injuries of human beings; or the suggestion, recommendation, or prescribing of any form of treatment for internal palliation, relief, or cure of any physical, mental, or functional ailment or defect.” The Code does not exclude a pharmacologist from having training, knowledge, and understanding of the effects of drugs and toxins on the human body; it only excludes the practice of medicine, which is quite a different thing. Thus, an expert is qualified to render an opinion as to causation, “[pjrovided an expert witness is properly qualified in the field in which he offers to testify.” Orkin Exterminating Co. v. McIntosh, 215 Ga. App. 587, 592 (4) (452 SE2d 159) (1994).
Where health care providers overlap in their fields of training and practice, a practitioner in one area has been permitted to testify as to the standard of care in such treatment; however, the areas must overlap in the area of testimony as to such standard of care. Handson v. HCA Health Svcs. of Ga., 264 Ga. 293 (443 SE2d 831) (1994); Hewett v. Kalish, 264 Ga. 183, 186 (1) (422 SE2d 233) (1994); Crook v. Funk, 214 Ga. App. 213, 215 (2) (447 SE2d 60) (1994); Tye v. Wilson, 208 Ga. App. 253, 254-256 (430 SE2d 129) (1993); Milligan v. Manno, 197 Ga. App. 171 (397 SE2d 713) (1990); Shaw v. Hosp. Auth. of Cobb County, 507 F2d 625 (5th Cir. 1975); Sandford v. Howard, 161 Ga. App. 495, 497 (4) (288 SE2d 739) (1982). If an expert in the area of health sciences, which overlaps in another area of health sciences, can qualify as an expert witness to testify as to the standard of care exercised in the area of overlapping treatment, then it also follows that such expert can testify as to his or her opinion as to causation, etiology, even though the expert is not a holder of a medical degree. The issue is training, skill, and experience to give competence to give an opinion as to cause and effect of the deviation from the standard of care. This the foregoing cases permit.
Chandler Exterminators v. Morris, 262 Ga. 257 (416 SE2d 277) (1992), Drake v. LaRue Constr. Co., 215 Ga. App. 453 (451 SE2d 792) (1994), and Handy v. Speth, 210 Ga. App. 155 (435 SE2d 623) (1993) essentially held that a neuropsychologist, who is trained to test for the existence of brain damage, lacks the expertise to give an opinion as to the etiology of such brain damage, because neuropsychology is not an overlapping field of practice with medicine, although it studies brain anatomy, morphology, and physiology.
“ ‘[T]he law in Georgia does not require that only medical doctors be permitted to give testimony regarding a medical issue, but allows others with certain training and experience to testify on issues within the scope of their expertise.’ ” Rainwater v. State, 210 Ga. App. 594, 595 (3) (436 SE2d 772) (1993). Pharmacology and toxicology are such overlapping areas of science/medicine where the expert in either area has the expertise to render an opinion as to the etiology of a *890drug and the effect on the human body.
Hunnicutt v. Hunnicutt, 237 Ga. 497 (228 SE2d 881) (1976) was a divorce case where the wife was allowed to testify that she had recurrent phlebitis with depressive reaction. There was no expert testimony to support this, and the husband appealed. The Supreme Court held regarding such non-expert testimony: “[t]he diagnosis and potential continuance of a disease are medical questions to be established by physicians as expert witnesses and not lay persons. Metropolitan Life Ins. Co. v. Saul, 189 Ga. 1 (5 SE2d 214) (1939); Autry v. General Motors &c. Plant, 85 Ga. App. 500, 502 (69 SE2d 697) (1952).” None of these cases dealt with a medical malpractice causation issue or testimony by an expert qualified in an overlapping science to give his or her opinion on causation.
In Cherokee County Hosp. Auth. v. Beaver, 179 Ga. App. 200 (345 SE2d 904) (1986), this Court dealt with a case in which no expert witness, whether medical or overlapping field of health care, testified as to causation; only the plaintiff testified. However, in Division 2 of the opinion a nurse set forth the standard of care for giving an inter-muscular injection in the buttock and was allowed to do so by this Court; the nurse did not, as a practitioner in an overlapping area of health care, give an opinion as to causation.
In Eberhart v. Morris Brown College, 181 Ga. App. 516, 518 (1) (352 SE2d 832) (1987), this Court held in a contract dispute as to payment for medical treatment for a student-athlete for an alleged football injury that there was no expert testimony showing causation other than the plaintiff’s own opinion. This was not a case of overlapping fields of health care where someone other than a physician sought to testify.
In Goodman v. Lipman, 197 Ga. App. 631, 633 (399 SE2d 255) (1990), this Court held that a pharmacologist was a competent expert in a medical malpractice case to testify regarding pharmacokinetics and pharmacodynamics of drugs, causation. “The law in Georgia does not require that only medical doctors be permitted to give testimony regarding a medical issue, but allows others with certain training and experience to testify on issues within the scope of their expertise. For example, a licensed registered nurse is qualified to testify as an expert witness within the areas of her expertise. (Cit.) Hyde v. State, 189 Ga. App. 727, 728 (377 SE2d 187) (1988).” (Punctuation omitted.) Id. This Court reversed where the non-physician pharmacologist expert opinion was denied admission.
Chandler v. Koenig, 203 Ga. App. 684 (417 SE2d 715) (1992), is distinguishable from this case in that it held that under OCGA § 9-11-9.1 (a) a pharmacologist could not testify as to the standard of care of a physician. “[The pharmacologist] possesses expertise in that area which probably far exceeds that of the average medical doctor. *891However, other than [the pharmacologist’s] bare assertion that he is familiar with the applicable standard of care, nothing in [his] affidavit explains how his pharmacological education or his professional duties ha[ve] provided him with expert knowledge of the standard of care in prescribing of drugs ordinarily employed throughout the general medical profession by physicians who are years removed from the intensive pharmacological training they received in medical school and for whom the prescribing of drugs is but one facet of their practice.” Id. at 687. In this case the expert pharmacologist did not testify as to the standard of care but as to his field of expertise, drug use and causation, i.e., pharmacokinetics and pharmacodynamics, which the physician was supposed to have learned in medical school and which is the area of expertise of the pharmacologist.
I am authorized to state that Presiding Judge McMurray, Presiding Judge Pope, Judge Johnson and Judge Smith join in this special concurrence.