Preston v. Amadei
238 Ariz. 124
| Ariz. Ct. App. | 2015Background
- In 2009 Jean Preston suffered a fractured femur, was admitted to Kachina for rehab, experienced severe chest pain and related symptoms on Aug. 11, and died several hours later; autopsy listed cause as complications of congestive heart failure.
- Plaintiffs (her children) sued Dr. Michael Amadei (Kachina’s medical director and treating physician) for medical negligence, alleging his care caused her death.
- Plaintiffs disclosed Dr. David Lapan as their standard-of-care expert; he is board-certified in internal medicine and cardiology but testified his clinical practice during the relevant year was primarily cardiology.
- Defendant moved for summary judgment arguing (1) Lapan was not qualified under A.R.S. § 12-2604 because the relevant specialty was internal medicine and Lapan’s recent practice was cardiology, (2) causation was speculative, and (3) the expert testimony would be inadmissible under Rule 702; defendant also moved in limine and for sanctions over allegedly misleading disclosures about the medical examiner’s expected testimony.
- The trial court granted summary judgment on the expert-qualification ground, granted the motion in limine, sanctioned Plaintiffs for a misleading supplemental disclosure regarding the medical examiner, and denied Plaintiffs’ request to substitute a new expert and to continue trial; Plaintiffs appealed and defendant cross-appealed the causation ruling.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Plaintiffs’ expert met A.R.S. § 12-2604 "same specialty" requirement | Lapan is more qualified on cardiac issues and should be allowed to testify despite practicing cardiology | Lapan’s recent professional time was devoted to cardiology, a distinct subspecialty; he did not devote a majority of time to internal medicine | Court: Lapan not qualified under § 12-2604 because relevant specialty was internal medicine and he did not spend a majority of recent time practicing it (affirmed) |
| Whether Plaintiffs should be allowed to substitute a new expert after disqualification | Plaintiffs sought leave to substitute after summary judgment ruling; argued cure should be permitted | Defendant argued cure was untimely and Plaintiffs should not get another expert | Court: Denial of substitution was error; remand to allow reasonable time to substitute an expert (reversed in part) |
| Whether evidence/argument about duties as medical director (contract) is admissible | Plaintiffs argued medical-director role matters and they may be third-party beneficiaries of contract duties | Defendant argued medical-director duties are contractual and not tort claims; no expert disclosed on medical-director standard | Court: Motion in limine properly granted; negligence claim limited to treating-physician standard, not breach of medical-director contract (affirmed) |
| Whether sanctions were proper for misleading expert disclosure about medical examiner | Plaintiffs argued disclosures were not intentionally false and sanctions were unwarranted | Defendant argued the supplemental disclosure contradicted the death certificate/autopsy, forced extra discovery, and was inaccurate | Court: Sanctions (attorney fees) upheld because Plaintiffs "should have known" disclosure was false and it caused additional discovery (affirmed) |
| Whether causation evidence and expert testimony failed Rule 702 and warranted summary judgment | Plaintiffs relied on Lapan’s experience-based opinions about likely hospitalization and survival if family had intervened | Defendant argued Lapan’s causation opinions lacked sufficient facts/data and peer-reviewed support, making them speculative and inadmissible | Court: Denial of summary judgment on causation affirmed; experience-based expert testimony can satisfy Rule 702 and factual disputes on whether family could have persuaded decedent are for the jury (affirmed) |
Key Cases Cited
- Baker v. Univ. Physicians Healthcare, 231 Ariz. 379 (2013) (statutory "same specialty" expert-qualification analysis; specialty includes subspecialties)
- Awsienko v. Cohen, 227 Ariz. 256 (App. 2011) (expert qualification under statute; distinction between specialties and subspecialties)
- Sanchez v. Old Pueblo Anesthesia, P.C., 218 Ariz. 317 (App. 2008) (procedural framework for curing deficient expert affidavits; dismissal with prejudice not authorized under § 12-2603)
- Sandretto v. Payson Healthcare Mgmt., Inc., 234 Ariz. 351 (App. 2014) (experience-based expert testimony permitted under Rule 702)
- McMurty v. Weatherford Hotel, Inc., 231 Ariz. 244 (App. 2013) (Rule 702 does not preclude experience-based medical opinions; cross-examination tests reliability)
- Barrett v. Harris, 207 Ariz. 374 (App. 2004) (causation in medical malpractice is generally a jury question)
- Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579 (1993) (federal gatekeeping principles for expert reliability)
- Kumho Tire Co. v. Carmichael, 526 U.S. 137 (1999) (Daubert gatekeeping applies to all expert testimony)
- Woodard v. Custer, 719 N.W.2d 842 (Mich. 2006) (physician practicing primarily in a subspecialty not qualified to testify about general internal-medicine standard)