916 N.W.2d 151
S.D.2018Background
- Anita Hanson had a right total hip arthroplasty on Sept. 8, 2014; immediate post‑op x‑rays showed no fracture and she participated in initial PT without issue.
- Transferred to Milbank Hospital for rehab on Sept. 11; over Sept. 11–13 PT sessions she reported only mild groin tightness and no new pain; therapists testified she showed no signs of fracture after Sept. 12–13 sessions.
- On Sept. 14 during a PT session with Laurie Batchelor (Big Stone), Anita alleges a geriatric recliner footrest was forced closed, causing her leg to drop, severe pain, and persistent worsening pain that night.
- Hospital staff x‑rayed Anita on Sept. 15; x‑ray revealed a proximal femur fracture and she underwent revision surgery on Sept. 16.
- Plaintiffs sued Big Stone (PT negligence) and Milbank Area Hospital (delayed diagnosis). Plaintiffs designated Dr. Jonathan Reynolds (physical therapist) as expert; he opined PTs breached PT standard of care and that fracture most likely occurred Sept. 14, but defendants challenged his causation competence.
- Circuit court granted summary judgment for both defendants, ruling expert testimony was required for malpractice claims and excluding Dr. Reynolds’ causation as beyond his expertise; Supreme Court affirmed as to the hospital but reversed as to Big Stone.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether expert testimony was required to prove Hospital’s negligence (delayed diagnosis) | Hansons: jury can infer Hospital knew of injury and delayed x‑ray; causation (pain/suffering) is within common experience | Hospital: claims require medical standard and causation proof via expert testimony | Affirmed: expert required; plaintiffs produced no qualified medical expert on Hospital care or causation, so summary judgment proper for Hospital |
| Whether Big Stone deviated from PT standard of care by using a recliner without lever and causing hip flexion >90° | Hansons: Dr. Reynolds opined use of recliner post‑THA was below PT standard and created undue risk | Big Stone: disputes breach; highlights contrary testimony and attacks sufficiency of expert proof | Reversed: disputed facts (use of recliner, chair propping, abrupt closure, immediate increased pain) create triable issue on breach; Dr. Reynolds adequate on PT standard of care |
| Whether expert testimony was required to prove causation between PT conduct and fracture | Hansons: lay evidence + timing/acute symptoms allow jury inference of causation; Dr. Reynolds offered causation opinion | Big Stone: Dr. Reynolds not an MD; not qualified to opine on medical causation; therefore plaintiffs lack admissible causation proof | Split: court held Dr. Reynolds’ causation opinion inadmissible as beyond his expertise, but nonetheless concluded sufficient circumstantial and lay evidence existed to permit jury to infer causation for Big Stone claim; summary judgment for Big Stone reversed |
| Admissibility/timeliness of supplemental expert opinion | Hansons: updated opinion was timely to address depositions and records | Defendants: supplemental opinion untimely and prejudicial | Court considered the supplemental report (no appellate challenge to that consideration) and relied on it in part; defendants did not preserve review on that point |
Key Cases Cited
- Gades v. Meyer Modernizing Co., 865 N.W.2d 155 (S.D. 2015) (summary judgment standard)
- Hamilton v. Sommers, 855 N.W.2d 855 (S.D. 2014) (elements of negligence claim)
- Magbuhat v. Kovarik, 382 N.W.2d 43 (S.D. 1986) (when expert testimony is required in malpractice/negligence cases)
- Lohr v. Watson, 2 N.W.2d 6 (S.D. 1942) (plaintiff must show it is more probable than not that negligence caused harm)
- Koeniguer v. Eckrich, 422 N.W.2d 600 (S.D. 1988) (expert testimony on standard and causation generally required in malpractice)
- Keystone Plaza Condominiums Ass’n v. Eastep, 676 N.W.2d 842 (S.D. 2004) (summary judgment appropriate when issues are unsubstantial or truth is clear)