George A. Minster, as executor of the estate of Mary Elizabeth Minster Hattrich, filed a medical malpractice action against Candler General Hospital, Inc. (“the hospital”), and its employee Mary Hines, R.N. The complaint was later amended to add as defendants Stephen Pohl, M.D. and William Hitch, M.D., P.C. The trial court denied motions to dismiss the complaint made by Hines, the hospital, and Pohl on the ground that the expert’s affidavits attached failed to comply with the requirements of OCGA § 9-11-9.1. Pohl then filed a motion for summary judgment, which was granted. In Case No. A92A1601, Minster appeals from the grant of summary judgment to Pohl. In Case No. A92A1602, the hospital and Hines appeal from the denial of their motion to dismiss. Hitch is not involved in this appeal.
The record reveals the following salient facts: Mary Hattrich (“the decedent”) was admitted to the hospital for surgery. After sur *618 gery was performed, the decedent developed respiratory problems, and both a breathing tube and a nasogastric feeding tube were inserted. The decedent apparently pulled out the tubes, and Hines reinserted the feeding tube. She then asked Pohl, who was the emergency room doctor on duty, to view an x-ray to verify that she had properly replaced it. Pohl viewed the x-ray, observed that the tube was incorrectly placed in the decedent’s right lung rather than in her stomach and needed to be replaced, and noted that fact in the decedent’s progress notes. A pneumothorax was later discovered in the decedent’s right lung, which eventually led to her death. In the complaint, Minster alleged that Hines was negligent in failing to properly restrain the decedent to prevent her from extubating herself and in improperly inserting and inadequately verifying the placement of the feeding tube. The hospital’s liability wás premised upon respondeat superior. Minster also alleged that although Pohl correctly noted that the feeding tube was improperly placed, he was negligent in failing to recognize and report the development of the pneumothorax, which was visible on the x-ray.
1. The trial court granted Pohl’s motion for summary judgment on the basis that no doctor-patient relationship existed between Pohl and the decedent. In Case No. A92A1601, Minster contends the trial court’s conclusion was erroneous.
It is well established that “before a plaintiff may recover on the theory that he received negligent treatment from a defendant physician, the plaintiff must show that a doctor-patient relationship existed between them. In such cases, called ‘classic medical malpractice actions’ . . . , doctor-patient privity is essential because it is this ‘relation which exists between physician and patient which is a result of a consensual transaction’ that establishes the legal duty to conform to a standard of conduct. [Cit.]”
Bradley Center v. Wessner,
Minster concedes that no consensual relationship in the usual sense existed between Pohl and the decedent, but argues that, contrary to the trial court’s finding, the affidavit of Dr. Scott Fowler, proffered in opposition to the motion for summary judgment, provides some evidence that a doctor-patient relationship was established, and should have precluded the entry of summary judgment in favor of Pohl. Dr. Fowler averred that he was a medical doctor licensed to practice in Georgia and was familiar with the practice of *619 medicine in emergency departments, and opined that to a reasonable medical certainty, Pohl’s entry on the decedent’s progress notes could be interpreted as a direction or instruction to replace the feeding tube, and as such, was “an affirmative intervention into a patient’s , care, amounting to treatment” that created a “limited doctor-patient relationship.”
Pohl’s averment that he had not communicated with the decedent or her family and had viewed the x-ray merely as a courtesy to a member of the hospital staff was based on his personal knowledge of those facts, while Dr. Fowler’s averment was an opinion. Although “[t]he opinions of experts on any question of science, skill, trade, or like questions shall always be admissible,” OCGA § 24-9-67, “the scope of what is admissible as expert opinion testimony is not unlimited.”
Clanton v. Von Haam,
The question remains, however, here as in
Clanton,
supra at 696 (2), whether disregarding Dr. Fowler’s opinion, the evidence of record supports Minster’s contention that some form of doctor-patient relationship existed so as to support a claim for malpractice. The only evidence of record bearing on this issue, other than the affidavit of Dr. Fowler, consists of Pohl’s affidavit and the decedent’s medical records containing Pohl’s chart notation, and neither includes a direct reference to this issue. Because on motion for summary judgment all justifiable inferences are to be drawn in the respondent’s favor, however,
Barber v. Perdue,
This court has held repeatedly that a doctor-patient relationship must be consensual. See, e.g.,
Bradley Center,
supra;
Clough v. Lively,
2. Minster also contends that even should this court find no doctor-patient relationship, summary judgment was improperly granted. He argues that although Pohl’s duty to the decedent, a necessary element in establishing a malpractice claim against him, see
Hawkins v. Greenberg,
Although there are exceptions to the requirement that a doctor-patient relationship be shown, see
Clough,
supra at 287, the facts of this case do not support Minster’s argument that this case falls within any of those exceptions. In his affidavit proffered in support of the motion for summary judgment, Pohl averred that he “viewed the x-ray as a courtesy to the staff of [the hospital] and not out of any obligation or duty.” Insofar as Minster’s complaint may be construed as a factual allegation that Pohl was under contractual obligation to attend to a patient in the decedent’s circumstances or that such attendance was the custom at the hospital, Pohl’s affidavit pierced this factual allegation. Minster proffered no evidence rebutting Pohl’s averment. Hence, the trial court properly concluded that the evidence adduced by Minster failed to support such a factual allegation. See generally
Lau’s Corp. v. Haskins,
Further, our review of the applicable law convinces us that the narrow exceptions to the rule that existence of a doctor-patient relationship must be shown before liability may be imposed for medical malpractice do not encompass the situation presented here, and we decline to expand them to do so. The rule is generally followed by most other states,
Peace v. Weisman,
*621 Accordingly, because the doctor-patient relationship was a necessary predicate for Minster’s claim of medical malpractice, and this element was lacking, see Division 1, supra, the trial court properly entered summary judgment in favor of Pohl. See Clanton, supra.
3. We do not address Minster’s argument that a question of fact remains regarding whether Pohl is entitled to immunity under OCGA § 51-1-29, the “Good Samaritan” Statute, compare
Clayton v. Kelly,
4. In Case No. A92A1602, the hospital and Hines contend the trial court erred by denying their motion to dismiss the complaint as to them, because the affidavit of Susan Clarke Case, R.N., attached to the complaint failed to comply with OCGA § 9-11-9.1 in two respects. 1
(a) In her affidavit, Case averred that she was a registered nurse licensed to practice in Georgia and was familiar with the standard of care applicable to the nursing profession generally with regard to the restraint of intubated patients and the proper placement and verification of feeding tubes. She then averred that she had reviewed copies of the decedent’s medical records, and from her review of those records it was her opinion, based upon a reasonable degree of professional certainty, that Hines should have restrained the decedent in order to prevent her from extubating herself; that Hines both improperly placed the feeding tube and failed to properly verify placement of the feeding tube; and that the improper placement of the feeding tube caused the pneumothorax eventually leading to death. The hospital and Hines maintain that Case’s affidavit was insufficient to satisfy OCGA § 9-11-9.1 because it did not include Case’s explicit averment that Hines’ actions violated the applicable standard of care.
We do not agree. The statute does not require that specific language be employed. It requires only that the affidavit “set forth specifically at least one negligent act or omission claimed to exist and the factual basis for each such claim.” OCGA § 9-11-9.1 (a). We find that Case’s affidavit fulfills this requirement unequivocally by listing the appropriate actions in each case; stating that Hines did not take the appropriate actions; and stating specifically that the decedent
“should have
been restrained”; that Hines
“improperly
placed the feeding tube”; and that Hines “did
not properly
verify placement of
*622
the feeding tube.” (Emphasis supplied.) OCGA § 9-11-9.1 establishes “an ‘exception to the general liberality of pleading permitted under (the Civil Practice Act, OCGA § 9-11-1 et seq.),’ [cit.],”
0-1 Doctors &c. v. Moore,
Piedmont Hosp. v. Milton,
(b) The contention of the hospital and Hines that Case’s affidavit was defective because the medical records on which Case averred she relied were not attached to the affidavit is controlled adversely to them by our holding in Division (4) (b) of
HCA Health Svcs. v. Hampshire,
Accordingly, because Case’s affidavit complied with OCGA § 9-11-9.1, the trial court did not err by denying the motion to dismiss the complaint against the hospital and Hines. HCA Health Sues., supra.
Judgments affirmed.
Notes
OCGA § 9-11-9.1 applies to a hospital when it is sued under a theory of respondeat superior for the professional negligence of its employee nurse. See
Dozier v. Clayton County Hosp. Auth.,