Summers v. Syptak
801 S.E.2d 422
| Va. | 2017Background
- Summers, with preexisting diagnoses including PTSD, depression, fibromyalgia, and radiculopathy, had prior treatment at Harrisonburg Family Practice starting in 2010.
- In March 2014 she was seen by Dr. J. Michael Syptak (a physician at the same practice and husband of her prior treating doctor) for high blood pressure.
- Summers alleged Syptak made numerous unsolicited sexual comments and innuendo during visits; she recorded some remarks and later said her preexisting conditions worsened after those visits.
- Summers sued for negligence and intentional infliction of emotional distress; she later nonsuited the IIED claim and pursued malpractice/negligence against Syptak.
- Syptak moved for summary judgment arguing Summers failed to designate a medical expert to establish breach and proximate causation; Summers argued those issues were within jurors’ common knowledge.
- The trial court granted summary judgment; the Virginia Supreme Court affirmed, holding Summers was required to present expert causation testimony and failed to do so.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether expert testimony is required to prove what medical records a physician must review under the standard of care | Summers: no expert needed; jury can determine from common knowledge | Syptak: expert required to define physician’s duty to review past records | Court did not decide this question on the merits (affirmed on alternate ground) |
| Whether expert testimony is required to prove whether a physician’s verbal comments violated the medical standard of care | Summers: no expert needed; comments plainly inappropriate and within jury knowledge | Syptak: expert required to opine whether remarks breached medical standard | Court did not resolve this question (affirmed on alternate ground) |
| Whether expert testimony is required to establish proximate causation of aggravation of preexisting mental/physical conditions | Summers: no expert needed; temporal worsening after visits raises jury question | Syptak: expert required because causation of exacerbation of complex conditions is a medical question | Held: Expert testimony required to prove proximate causation of aggravation of complex preexisting conditions; Summers failed to present such an expert; summary judgment proper |
| Whether lay testimony and a treating counselor’s observations suffice for causation in the absence of a "pure" expert | Summers: lay testimony and her counselor’s report show symptoms worsened after visits | Syptak: that evidence is insufficient to link comments as proximate cause of complex conditions | Held: Lay testimony and counselor report alone were insufficient to establish causation without medical expert opinion |
Key Cases Cited
- Perry v. Commonwealth, 280 Va. 572 (Va. 2010) (appellate court may affirm on alternate grounds apparent in record)
- Beverly Enterprises-Virginia, Inc. v. Nichols, 247 Va. 264 (Va. 1994) (rare exception where negligence lies within jury’s common knowledge)
- Webb v. Smith, 276 Va. 305 (Va. 2008) (certain causation issues may be within common knowledge when facts are straightforward)
- Nichols v. Kaiser Found. Health Plan, 257 Va. 491 (Va. 1999) (treating-physician testimony combined with lay testimony can suffice when it links error to injury)
- Singh v. Lyday, 889 N.E.2d 342 (Ind. Ct. App. 2008) (expert required where preexisting conditions complicate causation)
- Hare v. Wendler, 949 P.2d 1141 (Kan. 1997) (expert required to prove causation where patient had preexisting conditions)
- Carmichael v. Carmichael, 597 A.2d 1326 (D.C. 1991) (similar holding that expert testimony is needed to link practitioner misconduct to aggravation of prior psychiatric conditions)