865 N.W.2d 125
S.D.2015Background
- This is the third appeal in a medical-malpractice suit by Lita St. John against Dr. Linda Peterson alleging negligent treatment of a vesicovaginal fistula and failure to refer to a specialist. Previous appeals (St. John I and II) addressed admissibility of expert testimony and procedural errors, producing remands.
- Before the third trial, Dr. Peterson moved in limine to exclude evidence of other lawsuits/claims against her and testimony about her treatment of three prior patients (Cheryl, Crystal, Ruth) who developed fistulas while under her care. The court granted the motion and reaffirmed prior redactions to expert Dr. Wharton’s deposition.
- The proffered evidence: Dr. Peterson’s deposition statements about Cheryl, Crystal, and Ruth; and Dr. Wharton’s opinion that multiple failed repairs by Peterson showed she lacked competence and that Peterson failed to inform St. John that fistula repair was not her subspecialty.
- The court excluded testimony about Crystal and Ruth because Peterson did not attempt fistula repairs on them; their subsequent care elsewhere made that evidence irrelevant to Peterson’s competence to repair fistulas.
- The court excluded evidence about Cheryl because although Peterson successfully repaired Cheryl’s first fistula, the outcome of a later surgery was unknown and thus did not make Peterson’s competence to repair St. John’s fistula more or less probable.
- The court also excluded portions of Dr. Wharton’s deposition: (1) his reliance on the excluded patient histories (unreliable and irrelevant), and (2) his statements about lack of informed consent (the court had previously granted summary judgment to Peterson on informed consent). The jury returned a verdict for Dr. Peterson; St. John appeals the evidentiary exclusions.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Admissibility of evidence about Peterson’s treatment of other patients | Evidence of failed repairs on similar patients bears on Peterson’s competence to repair fistulas and is thus relevant | The proffered patient histories either did not involve Peterson performing the same repair or the outcomes were unknown, so they are not relevant | Court did not abuse discretion; evidence was not relevant under Rule 401 and properly excluded |
| Admissibility of Dr. Wharton’s opinion based on other patients | Wharton’s testimony that multiple failed attempts show lack of skill is relevant expert opinion | Wharton relied on irrelevant or incorrect factual bases (deposition statements and mistaken procedure claims), making his opinion unreliable | Exclusion affirmed: opinion was neither relevant nor reliably founded; gatekeeping satisfied |
| Admissibility of Wharton’s testimony that Peterson failed to inform patient repair wasn’t her specialty | Such testimony shows a breach of duty and supports claim Peterson should have referred to a specialist | That testimony addresses informed consent (previously resolved for defendant) rather than the separate duty to refer | Excluded: testimony concerned informed-consent issues resolved by summary judgment and did not opine whether a reasonable physician would have referred; exclusion not prejudicial |
| Whether exclusion was prejudicial and merits reversal | Excluded evidence go to heart of negligence claim and could have affected verdict | Exclusions were proper and not outcome-determinative | No prejudicial error; judgment for Dr. Peterson affirmed |
Key Cases Cited
- St. John v. Peterson, 804 N.W.2d 71 (S.D. 2011) (reversed prior exclusion of expert testimony for misapplying Rule 403)
- St. John v. Peterson, 837 N.W.2d 394 (S.D. 2013) (reversed reinstatement of verdict; remanded for retrial)
- Mousseau v. Schwartz, 756 N.W.2d 345 (S.D. 2008) (abuse of discretion standard for evidentiary rulings)
- Supreme Pork, Inc. v. Master Blaster, Inc., 764 N.W.2d 474 (S.D. 2009) (lenient Rule 401 relevance standard)
- State v. Wright, 593 N.W.2d 792 (S.D. 1999) (burden to show relevance for Rule 404(b) other-acts evidence)
- State v. Medicine Eagle, 835 N.W.2d 886 (S.D. 2013) (balance tips toward admission once other-acts evidence found relevant)
- Reinfeld v. Hutcheson, 783 N.W.2d 284 (S.D. 2010) (trial court’s gatekeeping role for expert testimony)
- Ruschenberg v. Eliason, 850 N.W.2d 810 (S.D. 2014) (exclusion of evidence must be prejudicial to warrant reversal)