Adrienne Titus, Personal Representative of the Estate of Joel Titus v. State of Alaska, Department of Corrections; John Does 1-6; and Golden Heart Emergency Physicians, PC, Adrienne Titus, Personal Representative of the Estate of Joel Titus v. State of Alaska, Department of Corrections
496 P.3d 412
Alaska2021Background
- Joel Titus was treated twice in an emergency department for alcohol-related problems, discharged to custody at Fairbanks Correctional Center, and later died; autopsy suggested possible alcohol-withdrawal seizure among other causes.
- The estate sued the State (DOC) and Golden Heart Emergency Physicians (ER providers) for medical malpractice related to the ER care and discharge instructions.
- Golden Heart moved for summary judgment supported by an affidavit from a board‑certified emergency-medicine physician asserting no breach of the ER standard of care.
- The estate opposed with an affidavit from Dr. Lisa Lindquist, a board‑certified psychiatrist (not board‑certified in emergency medicine) who testified she was trained and experienced in managing alcohol withdrawal, had ER experience, and that alcohol‑withdrawal treatment is general medical knowledge taught in medical school.
- The superior court granted summary judgment, concluding Lindquist was not qualified to opine on the ER standard of care because she was not board‑certified in emergency medicine; the estate appealed.
- The Alaska Supreme Court reversed, holding AS 09.20.185’s “matter at issue” is flexible and that Lindquist’s credentials and experience could make her qualified to testify about the ER care for alcohol withdrawal; the case was remanded.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether a non‑EM board‑certified physician (Dr. Lindquist) is qualified under AS 09.20.185 to testify about the standard of care for ER physicians treating alcohol withdrawal | Lindquist has medical‑school training, ER rotations, clinical experience treating alcohol withdrawal, and psychiatry board certification; treatment protocols are general knowledge across specialties | Only a board‑certified emergency physician can testify about the ER standard of care because the "field or specialty" at issue is emergency medicine | Reversed: “matter at issue” refers to the underlying circumstances of treatment; qualification depends on relation of expert's training/experience/certification to that matter; Lindquist may be qualified under AS 09.20.185 |
| Whether summary judgment for Golden Heart was proper given the competing affidavits | Lindquist’s affidavit creates a genuine factual dispute about whether ER physicians breached the standard of care | Golden Heart’s EM expert affidavit showed compliance; plaintiff’s expert was unqualified so summary judgment should stand | Reversed: because Lindquist can be qualified, the affidavit raises a material factual dispute and summary judgment was erroneous; remanded |
| Whether the State was estopped from blaming Golden Heart after not opposing summary judgment | Estate: DOC’s failure to oppose summary judgment should estop it from allocating fault to Golden Heart | DOC: permitted to seek fault allocation under comparative‑fault framework | Not reached as moot after reversal of summary judgment |
Key Cases Cited
- Hymes v. DeRamus, 222 P.3d 874 (Alaska 2010) (discussing interplay of AS 09.20.185 and AS 09.55.540 on expert qualification)
- Beistline v. Footit, 485 P.3d 39 (Alaska 2021) (holding sufficiency of expert testimony depends on both AS 09.20.185 and AS 09.55.540; pharmacist affidavit inadequate)
- Kendall v. State, Div. of Corr., 692 P.2d 953 (Alaska 1984) (summary judgment burden‑shifting in malpractice cases and use of expert affidavits)
- Greywolf v. Carroll, 151 P.3d 1234 (Alaska 2007) (evidence admissibility at summary judgment and expert foundation)
- Ayuluk v. Red Oaks Assisted Living, Inc., 201 P.3d 1183 (Alaska 2009) (expert qualification and admissibility in negligence contexts)
- Alaska Spine Ctr., LLC v. Mat‑Su Valley Med. Ctr., LLC, 440 P.3d 176 (Alaska 2019) (statutory construction principle distinguishing different statutory terms)
- Cikan v. ARCO Alaska, Inc., 125 P.3d 335 (Alaska 2005) (procedures for resolving preliminary factual disputes)
- Hall v. Frankel, 190 P.3d 852 (Colo. App. 2008) (illustrative discussion that some general medical knowledge crosses specialties for expert qualification)