In a case decided by the Supreme Court of Alabama (“Alabama Supreme Court”) on August 2, 2013, the Alabama Supreme Court stated the general rule that expert testimony is normally required in a medical malpractice case but the Court further stated, “A narrow exception to this rule exists in a case where want of skill or lack of care is so apparent as to be understood by a layman, and requires only common knowledge and experience to understand it.”
The Underlying Facts
On September 12, 2008, the medical malpractice plaintiff was admitted to the hospital for an outpatient procedure for a left-shoulder arthroscopy, a subacromial decompression, and a distal clavicle resection. The plaintiff was placed under general anaesthesia before the surgery and an immobilizer was used to hold the plaintiff’s left arm in place during the surgery that consisted of a metal bar strapped onto the plaintiff’s arm and the bar strapped to a coupler that immobilized her shoulder.
Before the surgery, the circulating registered nurse had noticed that the metal bar had not been sterilized and he placed the metal bar in a sterile basket and then placed the basket in an autoclave that heats objects to the sterilization temperature of 270 degrees Fahrenheit. The operating-room technician began to place the equipment needed for the procedure on a sterile table and he transferred the metal bar from the sterile basket to the sterile table with a glove or a towel because he knew that the metal bar was “very hot” from having been recently sterilized. Soon thereafter, a physician’s assistant placed the metal bar in a foam sleeve and then attached the metal bar to the plaintiff’s left arm and hand.
After the surgery was completed, the plaintiff was transported to the recovery room. When the plaintiff awoke from anesthesia, she complained of pain in the little finger of her left hand and the recovery room nurse noted a blister on her finger. The plaintiff subsequently filed a medical malpractice claim in which she alleged that she had suffered a severe burn on the little finger of her left hand as a result of the defendants’ actions and that the burn had caused permanent disfigurement and impaired mobility in her hand.
The medical malpractice defendants filed a motion for summary judgment, claiming that the plaintiff failed to provide expert testimony as required by the Alabama medical malpractice law, which the trial judge granted. The plaintiff appealed.
The Alabama Supreme Court’s Decision
The Alabama Supreme Court stated that to maintain a medical malpractice action, the plaintiff ordinarily must present expert testimony from a similarly situated health-care provider as to (1) the appropriate standard of care, (2) a deviation from that standard [of care], and (3) a proximate causal connection between the [defendant’s] act or omission constituting the breach and the injury sustained by the plaintiff. However, the Alabama Supreme Court further stated that the need for expert testimony is dependent upon whether the average person is able to decide without expert testimony whether or not the procedure followed in any given case falls below the acceptable standard.
The Alabama Supreme Court held in this case that expert testimony was not necessary to establish that there was a breach in the standard of care owed to the plaintiff that resulted in her hand and arm being burned by a metal bar during surgery because such matters can be easily understood and determined by the average person without the aid of a medical expert: “we conclude that [the plaintiff] produced substantial evidence creating a genuine issue of material fact as to whether a [hospital] employee violated the applicable standard of care by failing to ensure that a hot medical device was sufficiently cool before it was attached to the patient’s arm and hand. Expert testimony was not required.”
Source McGathey v. Brookwood Health Services, Inc., No. 1110760.
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