87 So. 3d 1178
Ala.2011Background
- Critopoulos underwent CABG at Springhill Memorial Hospital; post-surgery care in cardiac-recovery unit included reassessment by Nurse Rushing revealing a stage I decubitus on April 14, 2006.
- Discoloration and pressure ulcers developed; Critopoulos later treated at Mobile Infirmary with local wound care and eventual debridement, then continued treatment through 2009.
- Plaintiff asserted nurses breached standard of care in prevention and management of pressure ulcers; Penny Jones, nurse expert, testified for plaintiff.
- Defense moved to exclude Jones’s testimony as not a similarly situated health care provider under §6-5-548; trial court denied the motion.
- Trial proceeded January 2010; jury verdict found in favor of Critopoulos against Rushing, Ostriechmerer, Fleming, and Springhill; Holcombe found for Critopoulos; post-trial motions denied.
- Court reverses and remands for entry of judgment as a matter of law for defendants; the standard of care issue centers on post-CABG cardiac-recovery nurses and Jones’s qualification.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Jones is a similarly situated provider under §6-5-548(b). | Critopoulos argues Jones is qualified. | Defendants contend Jones is not similarly situated for post-CABG cardiac-recovery care. | Jones not similarly situated; standard of care limited to cardiac-recovery post-CABG context. |
| Whether the trial court abused discretion admitting Jones’s testimony. | Jones’s expertise supports standard-of-care testimony. | Admission was improper because not similarly situated. | Trial court erred in admitting Jones’s testimony; JMOL against defendants appropriate. |
| Whether Jones’s qualification, though not similarly situated, could be admitted as highly qualified expert. | Jones is highly qualified in wound care and pressure ulcers. | High qualification cannot override lack of similar practice area. | Exception does not apply; expert testimony excluded. |
| Whether the evidence shows nurses breached standard of care. | Jones’s testimony supports breach by Rushing, Fleming, Ostriechmerer. | No direct nurse-specific, post-CABG standard-of-care breach proven. | Insufficient basis to uphold verdict; JMOL for defendants proper. |
| Whether Springhill’s liability should be reversed given Jones’s exclusion. | Springhill liable through its nurses. | Without Jones’s testimony, no proof of breach. | Reversed and remanded for entry of judgment as a matter of law for defendants. |
Key Cases Cited
- Medlin v. Crosby, 583 So. 2d 1290 (Ala. 1991) (framework for determining whether expert is qualified under §6-5-548)
- HealthTrust, Inc. v. Cantrell, 689 So. 2d 822 (Ala. 1997) (limitations on expert qualifications for malpractice cases)
- Dowdy v. Lewis, 612 So. 2d 1149 (Ala. 1992) (highly qualified expert exception to same-situated requirement)
- Rodgers v. Adams, 657 So. 2d 838 (Ala. 1995) (does not require identical training to be similarly situated)
- Dempsey v. Phelps, 700 So. 2d 1340 (Ala. 1997) (standard of care issue treated as vascular/post-surgical context)
- Glenlakes Realty Co. v. Norwood, 721 So. 2d 174 (Ala. 1998) (standard for reviewing verdicts in malpractice cases)
- Parker v. Williams, 977 So. 2d 476 (Ala. 2007) (post-verdict/review guidance on evidence sufficiency)