Creekmore v. Maryview Hospital
662 F.3d 686
4th Cir.2011Background
- Creekmore sued Maryview for medical malpractice following a high‑risk C‑section and postpartum care.
- The district court found Maryview liable and awarded Creekmore $900,000 after a three‑day bench trial.
- Maryview challenged the admission of Dr. Stokes, an OB‑GYN, as an expert on nursing postpartum monitoring for preeclampsia.
- Virginia law requires experts to satisfy knowledge and active clinical practice requirements to testify on standard of care.
- Dr. Stokes testified he performs postpartum monitoring of high‑risk preeclampsia patients and that nurses should detect bleeding and monitor vital signs.
- Creekmore’s evidence, including rebuttal from a nurse, supported a prima facie case of negligence.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the district court abused its discretion admitting Stokes as an expert | Creekmore argues Stokes was qualified under Va. §8.01-581.20 | Maryview argues Stokes lacked active clinical nursing practice | No abuse; Stokes qualified under Virginia law |
| Whether Stokes satisfied the knowledge requirement | Stokes's knowledge of postpartum monitoring applied to the case | Nurses' standard cannot be testified to by an OB‑GYN | Satisfied; overlap in standards supported admissibility |
| Whether Stokes satisfied the active clinical practice requirement | Stokes regularly performs the relevant procedure in the same context | Active practice in nursing, not OB‑GYN, is required | Satisfied; related‑field practice permitted testimony |
| Whether Creekmore established a prima facie case of negligence | Evidence showed failure to monitor and to escalate care | Challenged sufficiency of proof of standard of care | Creekmore established prima facie case; evidence viewed cumulatively supports verdict |
Key Cases Cited
- Sami v. Varn, 260 Va. 280 (Va. Sup. Ct. 2000) (related‑field and same‑procedure standard; sufficiency of expert testimony)
- Hinkley v. Koehler, 269 Va. 82 (Va. Sup. Ct. 2005) (active clinical practice requirement; context of care)
- Jackson v. Qureshi, 277 Va. 114 (Va. Sup. Ct. 2009) (knowledge of standard of care across related specialties)
- Perdieu v. Blackstone Family Practice Ctr., Inc., 264 Va. 408 (Va. Sup. Ct. 2002) (recent practice of procedures over title)
- Griffett v. Ryan, 247 Va. 465 (Va. Sup. Ct. 1994) (interim practitioner qualified when standard of care overlaps)
- Kadala v. Amoco Oil Co., 820 F.2d 1355 (4th Cir. 1987) (admissibility of evidence; holistic view of record)