rasor/miller v. Northwest Hospital LLC
CV-16-0134-PR
| Ariz. | Oct 18, 2017Background
- Karyn Rasor sued Northwest Hospital (NWMC) for medical malpractice after developing a severe pressure ulcer while in a post‑operative ICU stay, alleging improper repositioning and wound care by ICU nursing staff caused the injury.
- Rasor served a preliminary expert affidavit under A.R.S. § 12-2603 identifying Julie Ho, an R.N. and certified wound‑care nurse, as her expert on standard of care and causation.
- NWMC deposed Ho and then moved for summary judgment under A.R.S. § 12-2604, arguing Ho lacked the statutory qualifications (e.g., ICU/critical‑care experience during the year before the injury) to testify on standard of care and causation.
- The trial court initially indicated Ho would be allowed to testify about wound care but later granted NWMC’s summary judgment motion without explaining its reasoning; Rasor was denied leave to substitute another expert.
- The court of appeals reversed, holding Rasor should have been given an opportunity to substitute an expert under § 12-2603(F); it also held Ho was not qualified under § 12-2604. The Arizona Supreme Court granted review.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether a defendant must first challenge a plaintiff's preliminary expert affidavit under § 12-2603 before moving for summary judgment on expert qualifications under § 12-2604 | Rasor: defendant must invoke § 12-2603(F) to force cure/substitution; failing that, defendant waived later challenge | NWMC: defendant may move for summary judgment under § 12-2604 when expert qualifications are shown deficient, even after disclosure deadline | Court: No. § 12-2603 challenge is not a prerequisite; plaintiff may seek relief under Ariz. R. Civ. P. 56(d) when qualifications are first attacked at summary judgment. |
| Whether Julie Ho met the § 12-2604 statutory qualifications to testify as a standard‑of‑care expert | Rasor: Ho’s wound‑care specialty suffices; ICU specialty not required or Ho is a qualified generalist | NWMC: ICU nurses are a specialty and Ho lacked majority active clinical time in same profession/specialty in the year before the incident | Court: Ho did not meet § 12-2604(A)(2)/(3) because she lacked required majority active clinical practice or teaching in the relevant profession/specialty during the year prior; therefore unqualified as a matter of law. |
| Whether the trial court’s denial of substitution (after indicating Ho would be allowed) required reversal | Rasor: trial court’s prior statements and § 12-2603/Preston require opportunity to substitute | NWMC: no automatic right to substitute once summary judgment is filed; Rule 56(d) governs | Court: Remand appropriate because (1) conflicting appellate precedent made substitution request justifiable and (2) trial court’s statements created ambiguity; but automatic substitution under § 12-2603(F) is not available. |
| Appropriate disposition given unresolved causation and Rule 702 issues | Rasor: even if Ho unqualified on standard of care, causation might not require expert or Ho may be qualified on causation/under Rule 702 | NWMC: if Ho unqualified on causation as well, summary judgment should be affirmed | Court: Remanded to court of appeals to decide whether expert causation testimony was required and whether Ho qualifies to testify on causation or under Rule 702; if not, affirm summary judgment; if yes, remand for Rule 56(d) proceedings. |
Key Cases Cited
- Baker v. Univ. Physicians Healthcare, 231 Ariz. 379 (Ariz. 2013) (interpreting § 12-2604 specialty/qualification requirements for standard‑of‑care experts)
- Seisinger v. Siebel, 220 Ariz. 85 (Ariz. 2009) (expert testimony required unless malpractice is grossly apparent)
- Preston v. Amadei, 238 Ariz. 124 (App. 2015) (held plaintiffs should be allowed to substitute experts when defendants first challenge qualifications after disclosure)
- Sanchez v. Old Pueblo Anesthesia, P.C., 218 Ariz. 317 (App. 2008) (construed § 12-2603 as exclusive remedy to test affidavit sufficiency)
- St. George v. Plimpton, 241 Ariz. 163 (App. 2016) (held summary judgment challenge may proceed and plaintiff must use Rule 56(d) to request additional time to obtain a substitute expert)