Stowell v. Huddleston, 643 F.3d 631

Mr. Stowell underwent prolonged prone lumbar spine surgery and awoke legally blind from PION, a rarity linked to spine procedures.
Plaintiffs (Manley and Enid Stowell) sued Dr. Huddleston and Mayo Clinic for negligent nondisclosure of a risk related to the procedure.
Minnesota requires two affidavits under § 145.682: an initial review and a second identifying experts and their proposed testimony.
Plaintiffs offered an amended affidavit by Dr. Steven Robin, alleging standard-of-care warnings about risk of permanent blindness under certain circumstances.
District court granted summary judgment, concluding Dr. Robin was not qualified to testify about orthopedic standard-of-care and that reliance on outside sources did not cure the defect.
Eighth Circuit reviews de novo the state-law issues and for abuse of discretion the competency of an expert witness.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Was Dr. Robin qualified to testify on standard of care?	Robin was qualified as a physician with publications and peer-reviewed sources supporting his opinions.	Robin lacked practical orthopedic surgery experience; not qualified to opine on orthopedic standard of care.	No abuse; Robin not qualified.
Did outside sources cure Robin's lack of qualifications?	Publication articles and Mayo notes show applicable knowledge on risk and disclosure.	Outside sources cannot cure absence of practical orthopedic experience; still insufficient.	Outside sources did not cure qualification gap.
Was there a jury-ready prima facie case for negligent nondisclosure without expert testimony?	There was evidence of knowledge of risk that could support a duty to disclose.	Expert testimony is required to prove what a reasonably prudent surgeon would disclose and the risk's gravity/likelihood.	Expert testimony required; no prima facie case without it.

Reinhardt v. Colton, 337 N.W.2d 88 (Minn.1983) (tests competency by practical knowledge and experience)
Cornfeldt v. Tongen, 262 N.W.2d 684 (Minn.1977) (focus on practical knowledge of customary physician conduct)
Lundgren v. Eustermann, 370 N.W.2d 877 (Minn.1985) (importance of practical experience in expert testimony)
Broehm v. Mayo Clinic Rochester, 690 N.W.2d 721 (Minn.2005) (competency to testify when testify pertains to standard of care)
Kinikin v. Heupel, 305 N.W.2d 589 (Minn.1981) (duty to disclose risks depends on what doctor knows or should know)
Benson v. Benson, 527 N.W.2d 561 (Minn.1995) (categories of risks requiring disclosure)
Reimer v. City of Crookston, 326 F.3d 957 (8th Cir.2003) (state-law questions reviewed de novo by federal court)
Bellecourt v. United States, 994 F.2d 427 (8th Cir.1993) (standard for reviewing state-law questions in federal court)