Smaha et al. v. The Medical Center Of Central Georgia, Inc.

Facts

In October 2013, Marie Smaha had surgery at the Medical Center of Central Georgia to remove her left kidney. Several days later, while recovering in the hospital, Smaha suffered from internal bleeding and died. Her three surviving children sued the medical center alleging malpractice by the nurses caring for Smaha. They alleged that the nurses had failed to notify Smaha’s surgeon of the signs and symptoms of her internal bleeding. In support of their complaint was the affidavit of Martin Evans, M. D., who opined that the nurses had breached the accepted standard under similar circumstances by failing to identify and give appropriate notice of the signs and symptoms of Smaha’s post-surgical bleed.

The medical center moved to disqualify Dr. Evans on the basis that he was unqualified to render nursing standard of care opinions because he had not supervised, taught, or instructed nurses as required by O.C.G.A. § 24-7-702 (c) (2) (D); and the medical center also moved for summary judgment. The trial court granted the motion to disqualify and granted summary judgment in favor of the medical center, concluding that without Dr. Evans’ testimony, the Plaintiffs were unable to establish that the nurses had breached the applicable standard of care. 

The Plaintiffs appealed, arguing that it was error for the trial court to disqualify their expert witness and grant summary judgment.

Issue & Holding

Was Dr. Evans’ expert testimony admissible to show the medical center’s nurses had violated the standard of care? The court ruled that the trial court did not err in concluding it was inadmissible.

Reasoning

Under O.C.G.A. § 24-7-702(c)(2)(D), an expert witness physician in a medical malpractice action need not be in the same profession as a defendant non-physician whose conduct is at issue if the expert “has knowledge regarding the relevant standard of care as a result of having supervised, taught, or instructed such non-physician health care providers.” To determine whether an expert is qualified under this provision, Georgia courts examine both the area of specialty at issue and what procedure or treatment was alleged to have been negligently performed, both of which are dictated by the complaint. 

According to the Court of Appeals, the question in this case was “What evidence was before the trial court that Dr. Evans had supervised, taught, or instructed nurses during the five years before Smaha’s death so that he was qualified to opine on the standard of care of nurses pertaining to identifying and reporting signs and symptoms of post-surgical internal bleeding in patients?”

Dr. Evans had testified that, during the pertinent five-year period, he was not on the faculty of, and had not taught at, a nursing school. He also testified that he did not supervise nurses at a hospital on a day-to-day basis. Rather, Plaintiffs cited the doctor’s role as the chair of a medical center’s quality control council, which was an administrative job that included evaluating certain nursing metrics and recommending changes to comply with the standard of care, and several lectures that he gave to nurses. But during his hearing testimony, Dr. Evans conceded that as committee chair he did not personally teach nurses about hospital policies, which instead was the responsibility of nurse managers. With regard to his lectures, he testified that they focused mostly on nursing documentation, but also discussed expectations regarding the standard of care and communicating with doctors. 

The Court of Appeals highlighted that the Plaintiffs had not cited any evidence showing how and when, during at least three of the five years preceding Smaha’s death, Dr. Evans supervised, taught, or instructed nurses such that he was qualified to opine on the standard of care for nurses to identify signs and symptoms of post-surgical internal bleeding and report them to the surgeon. The Court of Appeals further explained that the trial court was afforded deference, as the gatekeeper, to resolve any issue on the sufficiency of the expert’s experience. It thus concluded that the trial court did not abuse its discretion in granting the motion to disqualify. And without any expert testimony to support them, the Plaintiffs could not survive summary judgment on their medical malpractice claims. 

Conclusion

Be certain that your medical malpractice expert witnesses are competent and qualified to testify on the standard of care applicable in your case. For physicians testifying against non-physicians, ensure that the expert has ample experience supervising, teaching, or instructing non-physicians regarding the standing of care pertaining to the procedure or treatment alleged to have been negligently performed.

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Citation: Smaha et al. v. The Medical Center Of Central Georgia, Inc., No. A23A0267 (Ga. Ct. App. June 21, 2023)