The previous opinion of the court, filed on March 27, 1992, is withdrawn and the following is substituted.
Plaintiffs appeal from an order granting Defendants’ motion for summary judgment and dismissing their complaint alleging medical malpractice. The sole issue on appeal is whether the trial court erred in granting Defendants’ motion for summary judgment. We reverse and remand. FACTS
On May 9, 1988, Plaintiff Sharon Blauwkamp, acting individually and on behalf of her daughter, Bria, filed a complaint alleging negligence on the part of Defendants during her pregnancy and the birth of her minor child on June 24, 1981. Plaintiff alleged the child suffered severe brain damage resulting from Defendants’ negligent provision of prenatal care, and their negligent acts and omissions at the time of the child’s birth. Thereafter, on November 2, 1988, Plaintiff moved for voluntary dismissal of the complaint, without prejudice, asserting that she desired to obtain co-counsel and she had not yet obtained an expert medical witness to support her malpractice claims. The motion was granted on November 15, 1988. Less than a month later, on December 12, 1988, Sharon,
On August 11, 1989, Defendants filed a “Motion to Dismiss or, in the Alternative, for Summary Judgment” alleging, among other things, that Plaintiffs’ allegations of malpractice could not be supported by expert medical testimony. Defendants’ motion was accompanied by several attachments, including a copy of the original complaint, a copy of the transcript of the November 15, 1988 hearing on the motion for voluntary dismissal of their initial complaint, the order of dismissal without prejudice entered in the first lawsuit, and a copy of “Interrogatories # 1” served in the second action. The interrogatories sought information regarding the names of any expert witnesses Plaintiffs expected to call at trial, the subject matter upon which the experts would testify, the substance of the facts and opinions to which they would testify, and a summary of the grounds for each opinion. Although Plaintiffs failed to timely respond to the interrogatories, asserting that they were never received, none of the parties have argued on appeal that the basis for the court’s order of dismissal was premised on Plaintiffs’ failure to comply with discovery.
Defendants’ motion for summary judgment was not supported by any affidavits or depositions of medical experts setting forth their opinions negating Plaintiffs’ claims of medical malpractice. However, before requesting summary judgment, Defendants answered the complaint, denying both negligence and proximate cause and raising affirmative defenses, including a defense asserting that if Plaintiffs’ representations to the court at the time they voluntarily dismissed their initial complaint “have not been complied with, dismissal [of the second suit] should be awarded for failure to comply with [those] conditions.”
Plaintiffs responded to the motion and offered affidavits of two physicians, Dr. Stanley M. Warner and Dr. Alexander D. Kovacs. A copy of Dr. Kovacs’ notarized affidavit was not filed until October 20, 1989, one day after the trial court mailed a letter to counsel notifying them that Defendants’ motion for summary judgment would be granted. The affidavit of Dr. Warner set forth his opinion, stating, among other things, that acts and omissions of Defendants fell below the required standard of medical care.
Dr. Warner’s affidavit also recited that the failure of UNM Hospital, through its agents and employees, to perform a timely cesarean section and respond to an emergency situation was a proximate cause of the serious injuries to Bria Blauwkamp. His affidavit further stated that the treatment rendered to Sharon Blauwkamp by the Family Practice Center and Eilene Lujan, M.D., departed from the standard of care in that:
A. According to Dr. Lujan’s office notes of the prenatal visits, on July 24, 1981, Sharon Blauwkamp was 21k to 3 weeks overdue. It is well known in the literature that the placenta can begin deteriorating after term (40 weeks gestation), and that the risk of perinatal and neonatal morbidity increases with the passage of each week past term gestation. It is my opinion that since Sharon Blauwkamp was a high risk pregnancy, she should have had appropriate antenatal testing. Once she had reached term, it is my opinion that her prenatal visits should have increased to at least twice weekly. In addition, more aggressive antenatal monitoring, could have been done besides the non-stress test.
B. It is my opinion that Sharon Blauwkamp was far in excess of her due date, perhaps as much as 4 to 6 weeks overdue and that an obstetrical consultation should have been obtained in the two weeks or so preceding Bria Blauwkamp’s birth. It is my opinion that the failure to monitor Sharon Blauwkamp more closely antenatally was a proximate cause of Bria Blauwkamp’s serious injuries, and that this failure by the Family Practice Center constituted a departure from the applicable standard of care.
STANDARD OF REVIEW
In reviewing an appeal from an order granting summary judgment, our purpose is not to rule on issues of fact, but to determine if material disputed issues of fact exist. Pharmaseal Lab., Inc. v. Goffe,
Summary judgment is a drastic remedial tool which demands the exercise of caution in its application. Eavenson v. Lewis Means, Inc.,
DID DEFENDANTS MAKE A PRIMA FACIE SHOWING?
Plaintiffs argue on appeal that the trial court should not have assessed the sufficiency of their experts’ affidavits because Defendants failed to meet their initial burden establishing a prima facie right to summary judgment, and failed to support their motion with documentary or other admissible evidence indicating Plaintiffs’ inability to establish the essential elements of their claims.
Defendants’ motion for summary judgment was predicated in part on Plaintiffs’ statements at the hearing on their motion to voluntarily dismiss their first action, that they did not have an expert witness to corroborate their claim of medical malpractice and needed to obtain additional counsel to assist in prosecuting their claims. Although Defendants filed answers to Plaintiffs’ complaint denying any negligence on their part, they did not accompany their motion for summary judgment with an affidavit or other sworn testimony of a medical expert affirmatively stating that Defendants had rendered the required standard of care to the child and her mother or asserting that any injuries suffered by Plaintiffs were not proximately caused by Defendants. On the face of such record, were Defendants required to submit the affidavit of an expert medical witness negating negligence on their part in order to make a prima facie showing of entitlement to relief? In answering this question, we first examine the elements underlying a claim of medical malpractice.
In order to prove medical malpractice, a plaintiff has the burden of showing that (1) the defendant owed the plaintiff a duty recognized by law; (2) the defendant breached the duty by departing from the proper standard of medical practice recognized in the community; and (3) the acts or omissions1 complained of proximately caused the plaintiff’s injuries. See SCRA 1986, 13-1101 (Repl.1991); see also Cervantes v. Forbis,
A defendant seeking summary judgment in a medical malpractice action bears the initial burden of negating at least one of the essential elements upon, which the plaintiff’s claims are grounded. Perez v. Las Vegas Med. Ctr.,
Since Defendants’ motion relied principally on Plaintiffs’ admissions and statements made to the court at the hearing on their motion to voluntarily dismiss their initial lawsuit, conceding that they had not been able to obtain an expert to support their allegations of medical malpractice, the trial court correctly concluded that Defendants made a prima facie showing of entitlement to summary judgment without the necessity of presenting an affidavit by an expert medical witness. In this case, Defendants’ motion for summary judgment relied on the fact that Plaintiffs at an early stage in the proceedings admitted that they lacked an expert Witness. Defendants contend that under Celotex Corp. v. Catrett,
We agree with Defendants that under Celotex their showing was sufficient to make a prima facie case for summary judgment. See Forbes v. Osteopathic Hosp. of Maine, Inc.,
PLAINTIFFS’ RESPONSE TO THE MOTION FOR SUMMARY JUDGMENT
Once Defendants made a prima facie showing of entitlement to summary judgment, the burden of proving the existence of .genuine material factual issues shifted to Plaintiffs, requiring them to come forward and show by affidavits or other means, admissible evidence indicating material facts tending to establish each required element of their claims. See Gerety v. Demers,
In reviewing Plaintiffs’ appeal, we cannot overlook the particular basis of Defendants’ motion for summary judgment. We must evaluate the sufficiency of Plaintiffs’ response to that motion in light of the missing element on which the motion was premised. See, e.g., Forbes v. Osteopathic Hosp. of Maine, Inc. (when hospital moved for summary judgment on the basis that the plaintiff lacked an expert witness but did not support its motion for summary judgment with a showing that the allegations
In response to Defendants’ motion, Plaintiffs relied upon the affidavit of Dr. Stanley Warner, a nonresident physician who was trained in obstetrics and gynecology. In granting Defendants’ motion, the trial court rejected Dr. Warner’s affidavit on the grounds that it failed to set forth the basis of his familiarity with the requisite standard of care concerning the field of medicine practiced by the Defendant physicians (family practice), failed to adequately set forth the basis of his knowledge of the circumstances giving rise to Defendants’ alleged negligence, or to adequately state facts indicating that he practiced in a related field under circumstances similar to those generally followed in this locality.
The duty of care required of a doctor or other health care provider to a patient is set forth in Uniform Jury Instruction 13-1101 and provides that a doctor has the “duty to possess and apply the knowledge and to use the skill and care ordinarily used by reasonably well-qualified doctors * * * of the same field of medicine * * * as that of the defendant practicing under similar circumstances, giving due consideration to the locality involved.” Id. (emphasis added); see also Smith v. Klebanoff.
Our supreme court reviewed Uniform Jury Instruction 13-1101 in Pharmaseal, and rejected the strict-loeality rule that requires expert medical malpractice witnesses who practice in the same community as the defendant. The Committee Comment to Uniform Jury Instruction 13-1101 states:
The reference in this instruction to locality is not the adoption of a strict rule requiring that a departure from accepted standards of care necessarily be established by testimony from physicians practicing in the same community as the defendant. The court must only be satisfied that, by education, training and experience, the witness is qualified to testify to the knowledge, skill and care ordinarily used by reasonably well-qualified doctors of the same field of medicine as that of the defendant practicing under similar circumstances, giving due consideration to the locality involved. Then, how localities differ, such as the lack of facilities, is merely one consideration for the fact-finder. [Emphasis added.]
Plaintiffs were not required to show that Dr. Warner is a specialist in the identical field of practice as each of the Defendant Physicians to withstand Defendants’ summary judgment motion. Instead, his expertise in a related medical field goes to the weight, not the admissibility, of his testimony. Frederick v. Younger Van Lines,
In Pharmaseal the supreme court has indicated that a physician or surgeon from another locality may be competent to testify regarding the standard of care required of a defendant physician or surgeon practicing in New Mexico. See Alfonso v. Lund,
Defendants contend that the trial court properly granted the motion for summary judgment, because, among other things, the court found that Dr. Warner was not qualified to testify in opposition to the motion for summary judgment. Defendants assert that the decision as to whether a physician is qualified involves a question of law for the court to decide, as opposed to the weight or credibility of the witness. See Palmer v. Biloxi Regional Med. Ctr., Inc.,
Defendants correctly point out that determination of whether a witness is qualified to testify as an expert is entrusted to the discretion of the trial court. City of Santa Fe v. Gonzales,
Examination of the affidavit of Dr. Warnersubmitted by Plaintiffs in opposition to Defendants’ motion indicates it was sufficient to withstand the motion for summary judgment as to each Defendant. The affidavit of Dr. Warner was supplied in response to Defendants’ motion for summary judgment, alleging that Plaintiffs lacked expert witnesses. Thus, the issue for the trial court was whether Plaintiffs’ allegations of medical malpractice were supportable by expert medical testimony. We agree with Plaintiffs that the affidavit of Dr. Warner sufficiently set forth his qualifications as an expert medical witness, and was sufficient to create jury issues bearing upon Plaintiffs' claims of negligence and proximate cause. Issues involving
Defendants also argue that summary judgment was proper because Dr. Warner’s affidavit was conclusionary in nature and failed to adequately explain how he arrived at his opinion determining that Defendants breached their duty of care to Plaintiffs and proximately caused the injuries at issue. See Trujillo v. Treat (affidavit of expert filed in response to summary judgment motion must set forth facts admissible in evidence explaining how he arrived at his opinion); R. 1-056(E).
In reviewing the grant of a motion for summary judgment, we resolve all reasonable doubts in favor of the nonmovant. Pharmaseal Lab., Inc. v. Goffe; Goodman v. Brock,
Dr. Warner’s affidavit specifically stated that Sharon Blauwkamp was in a high-risk pregnancy category and that Defendants’ failure to monitor her more closely prior to Bria’s birth proximately resulted in Bria’s injuries. He explains this opinion, observing that “[i]t is well known in the literature that the placenta can begin deteriorating after term (40 weeks gestation), and that the risk of perinatal and neonatal morbidity increases with the passage of each week past term gestation.” Dr. Warner’s affidavit also indicated that the failure to “perform a timely cesarean section is in my opinion a departure from the applicable standard of care” and proximately caused the injuries to Bria. Dr. Warner’s affidavit further stated that, in his opinion, Defendant Hospital failed to have adequate or available staff necessary to respond to the obstetrical emergency presented on June 24, 1981, resulting in an unreasonable delay in dealing with a medical crisis.
Defendants point to a claimed omission in Dr. Warner’s affidavit, and assert that it fails to set forth an opinion indicating that the alleged negligence of Dr. Lujan proximately caused injury to Bria Blauwkamp. Plaintiffs’ complaint alleged that Dr. Lujan was an employee of Defendant Family Practice Center and that the Family Practice Center was part of the UNM Hospital. Defendants’ answer denied Plaintiffs’ allegation. Their motion for summary judgment, however, did not factually controvert this issue.
Dr. Warner’s affidavit recited in part that “the treatment rendered to Sharon Blauwkamp by the Family Practice Center, and Eilene Lujan, M.D., departed from the standard of care”; that Sharon Blauwkamp had a high-risk pregnancy, “she should have had appropriate antenatal testing,” and once she rendered term, “more aggressive antenatal monitoring could have been done”; and “[ijt is my opinion that the failure. to monitor Sharon Blauwkamp more closely antenatally was a proximate cause of Bria Blauwkamp’s serious injuries, and that this failure by the Family Practice Center constituted a departure from the applicable standard of care.” (Emphasis added.)
Defendants assert the quoted portion of Dr. Warner’s opinion, set out above, fails to set forth any opinion that anything done or not done by Dr. Lujan was a proximate cause of Plaintiffs’ injuries and that the reference in the affidavit concerning Dr. Warner’s opinion as to proximate cause refers to the Family Practice Center, not Dr. Lujan. We think this evidence is susceptible to several different interpretations. First, it can be interpreted as indicating
When the facts before the court are reasonably susceptible to different inferences, summary judgment is improper. See Koenig v. Perez,
Do the matters related above satisfactorily explain “how and why” Dr. Warner reached his conclusion that Defendants allegedly acted in a negligent manner? We hold that the affidavit of Dr. Warner was sufficient to withstand Defendants’ motion for summary judgment and indicated the existence of material issues of fact involving each of Plaintiffs’ claims of negligence against the Defendants. See Pharmaseal Lab., Inc. v. Goffe; see also Sharp v. Kaiser Found. Health Plan of Colo.,
Defendants further argue that Plaintiffs’ docketing statement failed to raise the issue of how and why Plaintiffs’ expert witnesses reached their conclusions, and because this appeal was filed prior to July 1, 1990, this court should not address this issue. See SCRA 1986, 12-213(A)(3). We disagree with this analysis. Defendants concede that Plaintiffs’ docketing statement raised the issue of the sufficiency of their prima facie showing. We think this issue, like the issue of the adequacy of Plaintiffs’ response, is a subsidiary issue of Plaintiffs’ challenge on appeal of the propriety of the trial court’s order granting summary judgment. Cf. Procunier v. Navarette,
CONCLUSION
For the reasons discussed above, we reverse the order granting summary judgment as to each of the Defendants and remand for further proceedings consistent with this opinion.
IT IS SO ORDERED.
