R.T. v. Knobeloch
2018 Ohio 2734
Ohio Ct. App.2018Background
- Medical-malpractice/informed-consent appeal arising from claimed Stevens-Johnson Syndrome after prescription of Lamictal to a pediatric patient.
- Defendants (physicians) moved to certify conflict between this court's decision and two other appellate decisions (Hunt and Culp). This motion was decided separately from merits.
- On appeal below, plaintiffs presented two experts: Dr. David Arredondo (pediatric psychiatry expert; board certified; ongoing clinical practice) and Dr. Alan Kaye (pharmacology/anesthesia professor; not a pediatric psychiatrist).
- Trial court limited Dr. Kaye: excluded him from opining on pediatric psychiatric standard of care but allowed pharmacology opinions (dosage, black-box warning, causation of Stevens-Johnson Syndrome). Dr. Arredondo testified as to breach of pediatric standard of care.
- Appellants contended (1) this court’s ruling conflicts with Hunt regarding Evid.R. 601(D) minimum clinical-practice threshold for medical experts; and (2) this court’s ruling conflicts with Culp on whether physician expert testimony is required to establish elements of an informed-consent claim when no disclosure was made.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Evid.R. 601(D) required Dr. Kaye to meet the 50% active clinical-practice threshold to testify at all | Argued experts (Arredondo and Kaye) were competent for their respective opinions; non-standard-of-care pharmacology opinions need not satisfy Evid.R. 601(D) | Argued this court's treatment conflicts with Hunt, which they read to require the 50% clinical-practice rule be shown before any expert testimony | Court: No conflict with Hunt. Trial court correctly limited Kaye from pediatric standard-of-care testimony under Evid.R. 601(D) but properly allowed pharmacology opinions not governed by Evid.R. 601(D); Arredondo met the 50% requirement. |
| Whether an informed-consent claim always requires physician expert testimony on all elements when no disclosure was made | Plaintiffs produced expert proof that Lamictal carries a risk of Stevens-Johnson Syndrome and that it was the proximate cause; expert not required to prove hypothetical content of a non-existent disclosure | Defendants claimed conflict with Culp, asserting Culp held physician testimony is always necessary to prove all informed-consent elements where no consent was given | Court: No conflict with Culp. Culp held lack-of-informed-consent claims generally require expert proof of material risks and causation; here plaintiffs did present expert testimony as to material risk and causation, so no inconsistency. |
Key Cases Cited
- Whitelock v. Gilbane Bldg. Co., 66 Ohio St.3d 594 (1993) (certification of inter-district conflicts requires an actual legal-rule conflict on the same question)
- Celmer v. Rodgers, 114 Ohio St.3d 221 (2007) (purpose of Evid.R. 601(D) is to prevent professional-witness-only physicians from testifying on physician liability)
- White v. Leimbach, 131 Ohio St.3d 21 (2011) (lack of informed consent is a medical claim requiring expert testimony on material risks and that an undisclosed risk caused the injury)
- Daubert v. Merrell Dow Pharm., 509 U.S. 579 (1993) (standards for admissibility of expert scientific testimony)