Holcomb v. CarrawayHolcomb v. Carraway
Joseph L. Reese, Jr., and Randal H. Sellers of Starnes & Atchison, LLP, Birmingham, for appellee Robert P. Carraway, M.D.
Robert E. Cooper, Deborah Alley Smith, and Jennifer M. Thompson of Christian & Small, LLP, Birmingham, for appellees H. Chaney Aderholt, M.D., Randy Finley, M.D., and Steven Manzi, M.D.
STUART, Justice.
Charles D. Holcomb, individually and in his capacity as the administrator of the estate of Carolyn Holcomb, appeals from summary judgments entered in favor of Dr. Robert P. Carraway, Dr. H. Chaney Aderholt, Dr. Randy Finley, and Dr. Steven Manzi. We affirm.
Facts
This is a medical-malpractice action. Because Holcomb is the nonmovant, we construe all disputed facts in his favor. In 1984, Carolyn Holcomb became a patient of Dr. Carraway, a board-certified general surgeon. Carolyn, who had a family history of breast cancer, was first referred to Dr. Carraway in 1984 for surgical evaluation of a palpable cyst on her left breast. Dr. Carraway performed an aspiration of the cyst and determined that the cyst was benign but that it contained atypical cells. Dr. Carraway diagnosed Carolyn as having fibrocystic breast disease, also referred to as “dysplasia,” which, according to Dr. Carraway, can create breast “nodularity” and fullness. Carolyn then began seeing Dr. Carraway regularly to monitor her fibrocystic breast disease.
In the years following her diagnosis, Carolyn had several cysts come and go, and, at various times, she complained of fullness, pain, and tenderness in her breasts. Carolyn regularly underwent mammograms, which were read and the results reported to Dr. Carraway by various radiologists. The radiology reports frequently indicated that Carolyn‘s films were difficult to evaluate. Carolyn also underwent mammograms at least once a year, sometimes every six months, and sometimes more frequently. Those mammograms were read by Dr. Aderholt, Dr. Finley, or Dr. Manzi (hereinafter referred to collectively as “the defendant radiologists“).
On June 30, 1997, Dr. Carraway examined Carolyn and requested a mammogram. Dr. Aderholt interpreted the X-ray
Dr. Carraway received this June 4, 1998, report from Dr. Aderholt. However, he could not locate a physical mass during his physical examination of Carolyn. Dr. Aderholt‘s report also indicated that no physical mass could be located. Dr. Carraway testified that he could not perform an aspiration or a biopsy unless a mass could be located. Therefore, he performed neither of those procedures at that time.
In December 1998, Dr. Carraway and Dr. Aderholt again saw Carolyn. She was complaining of pain and stinging in the area of her left breast. A mammogram was performed and Dr. Aderholt‘s interpretation of the mammogram indicated that the “previously noted opacity is less apparent. . . . Six month study advised.” Dr. Carraway did not perform a biopsy or an aspiration during or as a result of the December 1998 visit.
In June 1999, Dr. Carraway again examined Carolyn. She again was complaining of pain in the same area. After a mammogram was performed, Dr. Manzi interpreted the films; in his report he stated “[n]o mammographic evidence of malignancy. Recommend bilateral study in 1 year.” Dr. Carraway did not perform a biopsy.
On October 27, 1999, Carolyn reported pain, thickening, and the presence of a lump in her left breast. The next day, a mammogram was performed. Dr. Aderholt read it and saw “multiple benign appearing cysts.” Dr. Aderholt ordered a repeat mammogram. On his interpretative report of this second mammogram, he indicated “[m]ultiple rounded lesions seen to be cystic in nature on ultrasound. Repeat ultrasound study advised in 3 months time.” Dr. Carraway did not perform a biopsy.
In December 1999, Carolyn suffered an unrelated injury that caused pain in her hip. She consulted an orthopedist about the pain. During this examination and following workup, the orthopedist identified a lesion on Carolyn‘s right femur. Upon learning of this lesion, Carolyn informed her orthopedist of the lump in her left breast. Carolyn underwent another mammogram; Dr. Finley interpreted this mammogram. He indicated that the area of concern was a “probably benign finding.”
On January 19, 2000, Carolyn underwent biopsies of her leg and her left breast. The following day, she was diagnosed with cancer. Carolyn began extensive treatment for her cancer.
On October 30, 2000, Carolyn Holcomb and Charles D. Holcomb sued Dr. Carraway, Dr. Aderholt, Dr. Finley, and Dr. Manzi. Carolyn Holcomb alleged that the defendants negligently failed to detect and diagnose her breast cancer in a timely manner. Charles Holcomb alleged a loss of consortium as a result of the defendants’ negligence. All of the defendants filed motions for a summary judgment. Carolyn died on January 17, 2005, as a result of her cancer, and Charles was named as the administrator of her estate.
In March and April 2005, the trial court heard arguments on the summary-judgment motions. On May 11, 2005, the trial court held that no genuine issues of material fact existed, and it entered summary
On June 17, 2005, 37 days after the entry of the summary judgments, Charles Holcomb filed a motion to substitute Carolyn‘s estate as a plaintiff in place of Carolyn.2 On June 21, 2005, the trial court granted this motion; this motion was granted on the same date the notice of appeal was filed.
On appeal, Holcomb raises the following issues:
“I. Whether the trial court erred in holding that Holcombs’ expert, Dr. Murray Bern, a board certified oncologist, was not competent to testify against Carraway, a general surgeon, regarding the negligent failure to detect or diagnose breast cancer, when no surgical procedure was performed.
“II. Whether the trial court erred in holding there was no genuine issue of material fact as to whether there was a breach of the standard of care by Carraway in the failure to detect or diagnose breast cancer in Carolyn Holcomb.
“III. Whether the trial court erred in holding that Holcombs’ radiology expert, Dr. Karl Dockray, was not a `similarly situated health care provider,’ under the Alabama Medical Liability Act because he was not actively certified under the Mammogram Quality Standards Act (MQSA).
“IV. Whether the trial court erred in holding there is no genuine issue of material fact as to whether there was a breach of the standard of care by Aderholt, Manzi, and Finley in the failure to detect or diagnose breast cancer on the breast imaging mammograms of Carolyn Holcomb.”
Standard of Review
“In determining whether the summary judgment was properly entered, the reviewing court must view the evidence in a light most favorable to the nonmovant. Rule 56[, Ala. R. Civ. P.,] is read in conjunction with the `substantial evidence rule’ (§ 12-21-12, Ala.Code 1975), for actions filed after June 11, 1987. In order to defeat a properly supported motion for summary judgment, the plaintiff must present `substantial evidence,’ i.e., `evidence of such weight and quality that fair-minded persons in the exercise of impartial judgment can reasonably infer the existence of the fact sought to be proved.‘”
Rodgers v. Adams, 657 So.2d 838, 839-40 (Ala.1995) (citations omitted).
Applicable Law
The plaintiff in a medical-malpractice action must prove by substantial evidence that the defendant health-care provider “failed to exercise such reasonable care, skill, and diligence as other similarly situated health care providers in the same general line of practice ordinarily have and exercise in a like case.”
Section 6-5-548, a provision of the Alabama Medical Liability Act, § 6-5-504 et seq., Ala.Code 1975 (“the AMLA“), provides two definitions of a “similarly situated
“(1) Is licensed by the appropriate regulatory board or agency of this or some other state.
“(2) Is trained and experienced in the same discipline or school of practice.
“(3) Has practiced in the same discipline or school of practice during the year preceding the date that the alleged breach of the standard of care occurred.”
If the defendant is a specialist, subsection (c) defines a “similarly situated health care provider” as one who meets all of the following qualifications:
“(1) Is licensed by the appropriate regulatory board or agency of this or some other state.
“(2) Is trained and experienced in the same specialty.
“(3) Is certified by an appropriate American board in the same specialty.
“(4) Has practiced in this specialty during the year preceding the date that the alleged breach of the standard of care occurred.”
“(e) The purpose of this section is to establish a relative standard of care for health care providers. A health care provider may testify as an expert witness in any action for injury or damages against another health care provider based on a breach of the standard of care only if he or she is a `similarly situated health care provider’ as defined above. It is the intent of the Legislature that in the event the defendant health care provider is certified by an appropriate American board or in a particular speciality and is practicing that specialty at the time of the alleged breach of the standard of care, a health care provider may testify as an expert witness with respect to an alleged breach of the standard of care in any action for injury, damages, or wrongful death against another health care provider only if he or she is certified by the same American board in the same specialty.”
Thus, to determine whether subsection (b) or (c) is applicable to a plaintiff‘s proffered expert, we must determine whether the defendant health-care provider qualifies as a “specialist.”
In order to determine whether the defendant health-care provider qualifies as a specialist, we must first determine the field of medical practice in which the negligence is alleged to have occurred. If the defendant health-care provider is a specialist in the field of practice in which the alleged negligence occurred, then the proffered expert witness must also be a specialist in that field, under
I. Whether Dr. Murray Bern was a “similarly situated health care provider” to Dr. Carraway.
In his complaint, Holcomb alleges that Dr. Carraway is a surgeon, that he had treated Carolyn since the early 1980s, and that under his care she underwent mammograms at least yearly and often
“14. Defendant Carraway owed [the Holcombs] a duty to exercise such reasonable care, skill and diligence as surgeons in the medical community ordinarily have and exercise in like cases.
“15. Defendant Carraway breached that duty by negligently and/or wantonly:
“a. failing to detect Mrs. Holcomb‘s breast cancer;
“b. failing to perform further tests to detect Mrs. Holcomb‘s breast cancer; [and]
“c. failing to advise [the Holcombs] that Mrs. Holcomb should have such tests.”
(Emphasis added.)
Thus, in general, Holcomb alleges that Dr. Carraway acted negligently in failing to diagnose or discover Carolyn‘s breast cancer. However, more specifically, Dr. Carraway is alleged to have negligently failed to perform a biopsy on Carolyn‘s breasts at the proper time.
A “biopsy” is a surgical procedure. Therefore, Holcomb‘s complaint charges Dr. Carraway with failing to perform a necessary surgical procedure on Carolyn in June 1998. Additionally, Holcomb specifically alleges that Dr. Carraway breached the standard of care as it pertains to the exercise of his judgment as a surgeon.
Dr. Carraway is certified by the American Board of Surgery as a specialist in general surgery. Dr. Carraway testified that in his treatment of Carolyn Holcomb he was practicing his specialty of general surgery. Based on Holcomb‘s allegations and on Dr. Carraway‘s testimony, we conclude that Dr. Carraway was a specialist and that he was engaged in the practice of his specialty of general surgery at the time of the alleged breach of the applicable standard of care. Therefore,
However, Dr. Bern, the expert witness Holcomb proffered against Dr. Carraway, does not meet the requirements of
As to Dr. Carraway, Holcomb offered no other similarly situated health-care provider to testify as to the standard of care and to establish that a breach of that standard of care occurred. Without expert testimony to establish that Dr. Carraway breached the applicable standard of care, Holcomb‘s case against Dr. Carraway fails as a matter of law. We do not know the basis of the trial court‘s summary judgment in favor of Dr. Carraway; however, for the reasons stated we affirm the trial court‘s judgment as to Dr. Carraway.
II. Whether the trial court erred in holding that Holcomb‘s radiology expert, Dr. Karl Dockray, was not competent to testify as an expert witness against the defendant radiologists.
The trial court granted the defendant radiologists’ motion for a summary judgment without stating its reasons for doing so. For the reasons stated below, we affirm that summary judgment.
Holcomb proffered Dr. Karl Dockray as a similarly situated health-care provider to testify to the standard of care applicable to the defendant radiologists, Dr. Aderholt, Dr. Finley, and Dr. Manzi. The defendant radiologists are all board-certified radiologists who, at all times pertinent to this action, were reading mammograms in a nationally certified mammography facility. Holcomb alleges that the defendant radiologists failed to “detect or diagnose breast cancer on Carolyn Holcomb‘s mammograms from June 1998 forward.” (Holcomb‘s brief, p. 27.) During his deposition, Dr. Dockray testified that the earliest breach by any of the defendant radiologists occurred in June 1997.5 Regardless of which date was the date of the earliest alleged breach, it is undisputed that, at all times pertinent to this action, the defendant radiologists were working in the area of their specialty—the practice of radiology and, more specifically, reading and interpreting mammograms. Thus, in our consideration of the defendant radiologists,
The parties do not dispute that Dr. Dockray meets the technical requirements of
However, the defendant radiologists assert that the trial court properly excluded Dr. Dockray from serving as a “similarly situated health care provider” for other reasons. They point out that Dr. Dockray has not performed mammograms since 1994—a three- or four-year period preceding the date of the earliest alleged breach, depending on which date is used to determine the earliest alleged breach.6 They also point out that in addition to not performing mammograms for the three- or four-year period preceding the earliest alleged breach, federal law prohibited Dr. Dockray from interpreting mammograms during that time frame. The Mammogram Quality Standards Act (“the MQSA“),
Therefore, the defendant radiologists argue, Dr. Dockray could not have been familiar with the standard of care applicable to a radiologist performing mammograms during the 12-month period preceding their alleged breaches. The defendant radiologists also argue that, because Dr. Dockray had not performed mammograms during the three or four years preceding their alleged breaches and could not have been familiar with the standard of care applicable to that practice, he is no longer in the “same general line of practice” as the defendant radiologists, as required under
Further, the defendant radiologists argue that the enactment of the AMLA did not displace the applicability of the Alabama Rules of Evidence and the broad discretion granted the trial court under those Rules (see, e.g.,
This Court has previously considered similar issues. In Biggers v. Johnson, 659 So.2d 108 (Ala.1995), this Court recognized the trial court‘s continuing discretion in applying
Although the issue presented in Biggers was similar to the issue before the Court today, it was not identical. In Biggers, the trial court used its discretion in deciding a close question of whether the proffered expert met the requirements of
Even more on point than Biggers is the case of Martin v. Dyas, 896 So.2d 436 (Ala.2004). In Martin, the plaintiff in a medical-malpractice action presented as a proffered expert a physician who met all of the requirements set forth in
On appeal, the plaintiff argued that, if a proffered expert meets the requirements of
In reversing the trial court‘s ruling, the Court in Martin v. Dyas stated:
“[I]t is unnecessary in the present case for this Court to reach the extreme results urged by the parties. . . .
“. . . .
“[The proffered expert witness] was qualified to testify as an expert witness pursuant to any of the standards advanced by the parties. Therefore, the trial court exceeded its discretion in excluding
his testimony, and the trial court‘s order in that regard was in error.”
896 So.2d at 441. Thus, the same issue raised in this case was presented in Martin; however, we did not find that case an appropriate one in which to specifically address the discretion afforded to a trial court when determining whether a proffered witness who meets the requirements of
In determining the meaning of a statute, we must begin by analyzing the language of the statute itself:
“This Court has held that the fundamental rule of statutory construction is to ascertain and give effect to the intent of the Legislature in enacting a statute. If possible, a court should gather the legislative intent from the language of the statute itself. If the statute is ambiguous or uncertain, the court may consider conditions that might arise under the provisions of the statute and examine results that would flow from giving the language in question one particular meaning rather than another. The legislative intent may be gleaned from the language used, the reason and necessity for the act, and the purpose sought to be obtained by its passage.”
Norfolk Southern Ry. v. Johnson, 740 So.2d 392, 396 (Ala.1999) (citations omitted).
We find nothing in
Section 6-5-548(b), (c), and (d) each begin with the introductory phrase “Notwithstanding any provision of the Alabama Rules of Evidence to the contrary. . . .” We read the introductory phrase “Notwithstanding any provision of the Alabama Rules of Evidence to the contrary” to mean that, regardless of the other criteria set forth in the Alabama Rules of Evidence that may be used to determine the admissibility of opinion testimony, in order to testify as to the standard of care applicable to a defendant health-care provider, the proffered expert witness must first meet the requirements of a “similarly situated health care provider,” as established in
The converse, however, is not necessarily true. Nothing in
Additionally, the legislature‘s use of permissive language as opposed to mandatory language in
“The word `shall’ has been defined as follows:
“`As used in statutes, contracts, or the like, this word is generally imperative or mandatory. In common or ordinary parlance, and in its ordinary signification, the term “shall” is a word of command, and one which has always [been] or which must be given a compulsory meaning; as denoting obligation. The word in ordinary usage means “must” and is inconsistent with a concept of discretion.‘”
(Quoting Black‘s Law Dictionary 1375 (6th ed.1991).) See also State ex rel. Hartman v. Thompson, 627 So.2d 966, 970 (Ala.Civ. App.1993) (“Moreover, had the legislature intended for service as a holdover to be a mandatory part of the statutory term of office, it would not have used the permissive term `may,’ but would have used the imperative term `shall,’ as it did elsewhere in § 5-2A-3.“).
In
The mandatory term “shall” appears again in
“Notwithstanding any provision of the Alabama Rules of Evidence to the contrary, no evidence shall be admitted or received . . . concerning the medical liability insurance, or medical insurance carrier. . . . The limits of liability insurance coverage available to a health care provider shall not be discoverable. . . . ”
(Emphasis added.) This subsection obviously does not address whether the trial court must or “shall” admit testimony from a witness who meets the requirements set forth in any other subsection of the AMLA. The term “shall” does not appear elsewhere in
The legislature‘s use of the permissive term “may” in
“(e) The purpose of this section is to establish a relative standard of care for health care providers. A health care provider may testify as an expert witness . . . against another health care provider based on a breach of the standard of care only if he or she is a `similarly situated health care provider’ as defined above. It is the intent of the Legislature that in the event the defendant health care provider is certified by an appropriate American board or in a particular specialty and is practicing that specialty at the time of the alleged breach of the standard of care, a health care provider may testify as an expert witness with respect to an alleged breach of the standard of care . . . against another health care provider only if he or she is certified by the same American board in the same specialty.”
(Emphasis added.) Had the legislature wanted to mandate that the trial court admit the testimony of a proffered expert who met the requirements of
However, the fact that the legislature used “shall” in
Our application of another principle of statutory construction further supports the conclusion that the legislature did not intend in enacting
“It is an ingrained principle of statutory construction that `[t]he Legislature is presumed to be aware of existing law and judicial interpretation when it adopts a statute. Ex parte Louisville & N.R.R., 398 So.2d 291, 296 (Ala.1981).’ Carson v. City of Prichard, 709 So.2d 1199, 1206 (Ala.1998). `“It is a settled rule that in the adoption of the Code the Legislature is presumed to have known the fixed judicial construction pre-existing statutes had received, and the substantial re-enactment of such statutes is a legislative adoption of that construction.“’ Wood-Dickerson Supply Co. v. Cocciola, 153 Ala. 555, 557, 45 So. 192, 192 (1907) (quoting Morrison v. Stevenson, 69 Ala. 448, 450 (1881)). `It is a familiar principle of statutory interpretation that the Legislature, in enacting new legislation, is presumed to know the existing law.’ Blue Cross & Blue Shield of Alabama, Inc. v. Nielsen, 714 So.2d 293, 297 (Ala.1998).”
Ex parte Fontaine Trailer Co., 854 So.2d 71, 83 (Ala.2003). When it enacted the AMLA and, more specifically,
Based on the foregoing, we conclude that, in a medical-malpractice action, the Alabama Rules of Evidence continue to apply to the trial court‘s determination of who is allowed to testify as an expert witness. Even when the proffered expert witness meets the requirements of a “similarly situated health care provider,” as that term has been defined in
In this case, we find that the trial court did not exceed its discretion in refusing to allow Dr. Dockray to testify as an expert witness as to the alleged breaches of the standard of care by the defendant radiologists. Although the trial court did not state its reasons for excluding Dr. Dockray‘s
Other than Dr. Dockray, Holcomb produced no witness to establish that the defendant radiologists breached the standard of care. Therefore, the defendant radiologists were entitled to summary judgments as a matter of law. We affirm the summary judgments entered in their favor.
Conclusion
Because of our resolution of these issues relating to the proffered testimony of the expert witnesses, we need not address the other issues raised on appeal. We affirm the summary judgment entered for Dr. Carraway; we also affirm the summary judgments entered for Dr. Aderholt, Dr. Finley, and Dr. Manzi.
AFFIRMED.
NABERS, C.J., and SEE, HARWOOD, SMITH, and BOLIN, JJ., concur specially.
LYONS, WOODALL, and PARKER, JJ., concur in part and dissent in part.
SEE, Justice (concurring specially).
I concur fully in the main opinion and in Justice Harwood‘s special concurrence. I write specially to explain my understanding of the structure of
Subsection (a) of
Subsections (b) and (c) define who is a “similarly situated health care provider.”10
The term “may” indicates that someone has the option of doing or allowing some action or of not doing or allowing some action. See Black‘s Law Dictionary 1000 (8th ed.2004) (“[t]o be permitted to[;] [t]o be a possibility. . . .“). Thus, the question is who makes the decision whether to allow the expert in a medical-malpractice action to testify: the trial court or the party proffering the expert?
The term “only if,” on the other hand, is a term, not of sufficiency, but of necessity. For example, the shipment will be accepted “only if” it has a moisture content of less than 4%; the team will clinch the pennant “only if” it wins this game. This describes a condition of necessity, not one of sufficiency. Thus, there may be other conditions on the acceptance of the shipment,13 but even if all of those other conditions are met, and more, the shipment will be accepted “only if” the moisture content is less than 4%. There may be other games that the team must win,14 but even if it wins all those other games, the team will clinch the pennant “only if” it wins this game. The fulfillment of condition A is necessary to produce consequence B, although it alone may not be sufficient— there may be other, additional conditions that also must be met.15
Thus, under
The foregoing understanding of
I conclude, for the reasons stated above, that the language of the statute provides minimum necessary conditions a proffered expert witness in a medical-malpractice case must satisfy in order to testify. I also conclude that to construe the statute otherwise not only would violate the letter of the statute, but also would lead to absurd results.
HARWOOD, Justice (concurring specially).
I concur fully in all aspects of the main opinion; I write specially only to discuss further the conclusion expressed in the penultimate paragraph before the “conclusion” of the opinion, that “because Dr. Dockray had not performed mammograms” for several years preceding the alleged misreadings of Carolyn Holcomb‘s mammograms by the defendant radiologists,
Holcomb argues in brief that the Mammogram Quality Standards Act (“the MQSA“) “is merely a quality assurance statute for hospitals and medical facilities” and that its enactment did not cause “board certified diagnostic radiologists in those facilities, who read and interpreted thousands of mammograms over the course of years, [to] become any less qualified.” I do not agree that the MQSA is a quality-assurance statute only for hospitals and medical facilities, and, although I agree that board-certified diagnostic radiologists did not become any less qualified immediately upon the enactment of the MQSA, I believe their qualifications with regard to the specialized area of interpreting mammograms would have subsequently begun to suffer when they were disqualified from performing clinical mammogram interpretations.
Under the MQSA, “[t]he term `facility’ means a hospital, outpatient department, clinic, radiology practice, or mobile unit, an office of a physician, or other facility as determined by the Secretary, that conducts breast cancer screen or diagnosis through mammography activities.”
Under the aforesaid “subsection (f),” standards established by the Secretary include those that require establishment and maintenance of a quality-assurance and quality-control program at each facility that is adequate and appropriate to ensure “accuracy of interpretation of mammograms” and include “a requirement that mammograms be interpreted by a physician who is certified as qualified to interpret radiological procedures, including mammography . . . and who meets training and continuing medical education requirements as established by the secretary.”
The regulations implementing the MQSA are found at
NABERS, C.J., and SEE, SMITH, and BOLIN, JJ., concur.
LYONS, Justice (concurring in part and dissenting in part).
I concur in affirming the summary judgment as to Dr. Robert P. Carraway. I must, however, respectfully dissent from affirming the summary judgments as to defendant radiologists, Dr. H. Chaney Aderholt, Dr. Randy Finley, and Dr. Steven Manzi.
Few areas of the law offer a more fertile field for turning simplicity into complexity than statutory construction. The main opinion is a classic example. The legislature responded to a perceived need to codify the bases upon which an expert witness would be permitted to testify in a medical-malpractice case by enacting
Ҥ 6-5-548. Burden of proof; reasonable care as similarly situated health care provider; no evidence admitted of medical liability insurance.
“(a) In any action for injury or damages or wrongful death, whether in contract or in tort, against a health care provider for breach of the standard of care, the plaintiff shall have the burden of proving by substantial evidence that the health care provider failed to exercise such reasonable care, skill, and diligence as other similarly situated health care providers in the same general line of practice ordinarily have and exercise in a like case.
“(b) Notwithstanding any provision of the Alabama Rules of Evidence to the contrary, if the health care provider whose breach of the standard of care is claimed to have created the cause of action is not certified by an appropriate American board as being a specialist, is not trained and experienced in a medical specialty, or does not hold himself or herself out as a specialist, a `similarly situated health care provider’ is one who meets all of the following qualifications:
“(1) Is licensed by the appropriate regulatory board or agency of this or some other state.
“(2) Is trained and experienced in the same discipline or school of practice.
“(3) Has practiced in the same discipline or school of practice during the year preceding the date that the alleged breach of the standard of care occurred.
“(c) Notwithstanding any provision of the Alabama Rules of Evidence to the contrary, if the health care provider whose breach of the standard of care is claimed to have created the cause of action is certified by an appropriate American board as a specialist, is trained and experienced in a medical
specialty, and holds himself or herself out as a specialist, a `similarly situated health care provider’ is one who meets all of the following requirements: “(1) Is licensed by the appropriate regulatory board or agency of this or some other state.
“(2) Is trained and experienced in the same specialty.
“(3) Is certified by an appropriate American board in the same specialty.
“(4) Has practiced in this specialty during the year preceding the date that the alleged breach of the standard of care occurred.
“(d) Notwithstanding any provision of the Alabama Rules of Evidence to the contrary, no evidence shall be admitted or received, whether of a substantive nature or for impeachment purposes, concerning the medical liability insurance, or medical insurance carrier, or any interest in an insurer that insures medical or other professional liability, of any witness presenting testimony as a `similarly situated health care provider’ under the provisions of this section or of any defendant. The limits of liability insurance coverage available to a health care provider shall not be discoverable in any action for injury or damages or wrongful death, whether in contract or tort, against a health care provider for an alleged breach of the standard of care.
“(e) The purpose of this section is to establish a relative standard of care for health care providers. A health care provider may testify as an expert witness in any action for injury or damages against another health care provider based on a breach of the standard of care only if he or she is a `similarly situated health care provider’ as defined above. It is the intent of the Legislature that in the event the defendant health care provider is certified by an appropriate American board or in a particular specialty and is practicing that specialty at the time of the alleged breach of the standard of care, a health care provider may testify as an expert witness with respect to an alleged breach of the standard of care in any action for injury, damages, or wrongful death against another health care provider only if he or she is certified by the same American board in the same specialty.”
I quote the statute verbatim and then summarize its provisions to show how a rather straightforward enactment of the legislature has been distorted by the main opinion‘s strained interpretation of various provisions of that enactment. Subsections (b) and (c) of
Next, the main opinion parses
Under the circumstances here presented, construing an act of the legislature addressing the problem of establishing criteria for expert witnesses in medical-malpractice actions against health-care providers,
After studying Justice See‘s interesting analogies involving moisture content and baseball championships, I cannot resist the temptation to try to make my point through analogy. While we are handicapped in our construction of
After the statute is enacted, attorney Hawkins20 is denied admission to the courtroom because, although he is wearing a dark business suit and a white shirt, he is not wearing a necktie. In litigation over