The plaintiff in a Virginia medical malpractice case who suffered loss of sight in one eye after eye surgery had an expert in ophthalmology and cataract surgery testify during trial that the defendant eye surgeon stimulated inflammation, eye pressure, and the possibility for a retinal tear in the plaintiff’s eye; that the standard of care would have been for the defendant to refer the plaintiff to a retinal specialist the day after his surgery; and, that a retinal specialist would have seen the plaintiff the same day and would have set the plaintiff up to have urgent surgery to remove the lens material and closely observed the plaintiff with very close follow-up. The Virginia medical malpractice jury returned its verdict in the amount of $1.5 million for the plaintiff, and the defendant appealed.
For a successful medical malpractice claim in Virginia, a claimant must establish three elements: (1) the standard of care applicable to the alleged tortfeasor; (2) that the tortfeasor breached the standard of care; and (3) that the breach was the proximate cause of claimed damages. Expert testimony is ordinarily necessary to establish the appropriate standard of care, to establish a deviation from the standard, and to establish that such a deviation was the proximate cause of the claimed damages. Proximate causation requires a showing that the claimant’s injury would not have occurred but-for the tortfeasor’s negligence (“causation-in-fact”) and that the resulting injury is foreseeable (“causation-in-law”).
The Court of Appeals of Virginia stated in its February 10, 2026 published Opinion: “Here, the trial court erred in holding that the evidence was sufficient to sustain the jury’s verdict. Given that no expert testified to establish the standard of care applicable to a retinal specialist upon referral, the evidence was insufficient as a matter of law to establish causation-in-law. The record contains Dr. Barazi’s testimony about the actions he took once Bartin was referred to him. But, just as in Dixon, the record fails to clarify (1) what courses of treatment a retinal specialist could have taken upon sooner referral, (2) whether any treatment options could have diminished the long-term damages incurred by Bartin, and (3) whether and how the treatment a retinal specialist would have offered would have differed if Bartin had been referred sooner. 295 Va. at 67-68. Likewise, the trial court noted it did not “think [Dr. Etter] [was] a retina specialist.” Combined with the fact that Dr. Etter conceded he was not a retinal specialist and lacked the requisite training and experience to practice as one, his testimony is inadequate to support Bartin’s claim. Without evidence “to establish the nature of the treatment [Bartin] could have undergone” had he been referred sooner and “the probability that such treatment would have” prevented Bartin’s damages, Bartin’s evidence was insufficient as a matter of law.”
Source Loudoun Eye Care, P.C. v. Bartin.
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