Rasor v. Northwest Hospital, LLC Dba Northwest Medical Center
239 Ariz. 546
| Ariz. Ct. App. | 2016Background
- Karyn Rasor was hospitalized at Northwest Medical Center (NWMC) after open‑heart surgery in July 2011, required femoral intra‑aortic balloon pump (IABP) insertion, and subsequently developed a stage IV pressure (decubitus) ulcer that required extensive debridements.
- Rasor and her husband sued NWMC for medical malpractice, alleging nurses failed to "off‑load" and timely treat the developing pressure ulcer.
- The Rasors disclosed a single expert, Julie Ho, a board‑certified wound‑care nurse, and sought to introduce her opinions on standard of care, causation, and prognosis.
- NWMC moved for summary judgment arguing Ho was not qualified under A.R.S. § 12‑2604 to testify to the standard of care for ICU nurses; the trial court granted summary judgment and denied the Rasors leave to obtain a new expert.
- The trial court permitted some discovery: it denied a premature Rule 30(b)(6) deposition request early on but later ordered NWMC to produce redacted ICU patient records of prior decubitus ulcers for the four years before Rasor’s admission; NWMC cross‑appealed that production order.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Expert qualification under § 12‑2604 | Ho’s wound‑care expertise and testimony from ICU nurses suffice to establish standard of care for pressure‑ulcer prevention | ICU nursing is a specialty; Ho did not practice as an ICU nurse (or as a generalist) in the year before the incident, so she is not qualified under § 12‑2604(A) | Court: Ho not qualified under § 12‑2604(A)(2)/(3); summary judgment appropriate to the extent based on expert disqualification |
| Denial of additional time to secure new expert | If Ho is disqualified, Rasors should be given reasonable time to obtain a qualified expert; statute allows curing deficient affidavits | Court acted within discretion to deny further time | Court: Trial court abused discretion by denying leave to secure a replacement expert; reversed that portion and vacated judgment; remanded for further proceedings |
| Rule 30(b)(6) deposition / protective order | Need to depose NWMC on cause of ulcer and related topics via corporate designee | Deposition was premature given discovery stage and lack of scheduling order; overly broad early on | Court: Protective order denying premature 30(b)(6) deposition was not an abuse of discretion; later narrower 30(b)(6) scope was appropriate |
| Production of prior ICU patient records (cross‑appeal) | Prior similar incidents are relevant to habit/routine practice and notice and reasonably calculated to lead to admissible evidence; non‑party records can be redacted | Production would invade patient confidentiality, possibly implicate Patient Safety Act, and is overly burdensome | Court: Ordered production of redacted ICU records for four years was permissible (statutory confidentiality and PSO privilege not shown); relevancy for routine practice sustained; no demonstrated undue burden |
Key Cases Cited
- Baker v. Univ. Physicians Healthcare, 231 Ariz. 379 (court discusses § 12‑2604 specialty/expert symmetry)
- Cornerstone Hosp. of Se. Ariz., L.L.C. v. Marner, 231 Ariz. 67 (nursing qualifies as a health profession under § 12‑2604)
- Preston v. Amadei, 238 Ariz. 124 (trial court must allow reasonable time to cure expert affidavit deficiencies)
- Gasiorowski v. Hose, 182 Ariz. 376 (other similar incidents admissible to show habit or routine practice)
- Ziegler v. Superior Court, 134 Ariz. 390 (non‑party medical records may be discoverable if redacted and relevant)