Lead Opinion
OPINION
¶ 1 Buu Nguyen appeals the district court’s exclusion of his expert and the resulting dismissal of his claims for negligence and failure to obtain informed consent, as well as the court’s grant of summary judgment on his intentional infliction of emotional distress and punitive damages claims. We affirm the district court’s decisions, except as concerns the claim premised on failure to obtain informed consent. With respect to that claim, we reverse and remand.
BACKGROUND
¶ 2 Nguyen was the father of one-year-old Derek Nguyen. Derek was admitted into the pediatric intensive care unit (PICU) at Primary Children’s Medical Center (PCMC) as a result of severe injuries he sustained in a car accident. Dr. Madeline Witte, a University of Utah School of Medicine employee, was responsible for Derek’s care while at PCMC. During Derek’s treatment, Dr. Witte
¶3 PCMC had developed a procedure to test and evaluate equipment it was considering for purchase, such as the ventilator. The process included identifying the type of appropriate test-patient and the need to obtain consent from the patient’s parent before the equipment was used. Dr. Witte acknowledged in her deposition that the ventilator was only supposed to be used on “moderately ill” patients. She also stated that while Derek’s father was told “that there was some risk involved” in transporting Derek, he was not told that the ventilator was a test model. According to Dr. Witte, she used the ventilator not as part of the testing process, but only because the ventilator was the only machine “available that [she] had confidence could deliver the level of support that Derek was requiring.” However, several people accompanied Derek as he was moved to observe the ventilator in action. Significantly, this group included a representative from the ventilator manufacturer.
¶4 Following an investigation regarding the ventilator’s malfunction, Dr. Witte met with Nguyen and told him that the ventilator quit working because “a screw had made contact with the motherboard resulting in shutdown of the ventilator.” Dr. Witte also told Nguyen “that the malfunction of the ventilator clearly played a role in the timing of [Derek]’s death” but that Derek’s severe injuries “could very possibly have resulted in his demise even in the absence of a ventilator malfunction.”
¶ 5 Nguyen filed a complaint against IHC Health Services, Inc., doing business as PCMC; University of Utah Hospitals and Clinics; University of Utah; and the State of Utah (collectively, Defendants) alleging negligence, failure to obtain informed consent, intentional infliction of emotional distress, and recklessness that justified punitive damages.
ISSUES AND STANDARDS OF REVIEW
¶ 6 Nguyen asserts that the trial court incorrectly granted summary judgment on his claims. A court shall grant summary judgment when “there is no genuine issue as to any material fact and ... the moving party is entitled to a judgment as a matter of law.” Utah R. Civ. P. 56(c).
A summary judgment movant, on an issue where the nonmoving party will bear the burden of proof at trial, may satisfy its burden on summary judgment by showing, by reference to the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, that there is no genuine issue of material fact. Upon such a showing, whether or not supported by additional affirmative factual evidence, the burden then shifts to the nonmoving party, who may not rest upon the mere allegations or denials of the pleadings, but must set forth specific facts*533 showing that there is a genuine issue for trial.
Orvis v. Johnson,
¶ 7 Nguyen also argues that the court improperly excluded Dr. Goldenring from testifying as an expert. “District courts generally enjoy considerable latitude in making evidentiary rulings, including rulings concerning the qualifications of expert witnesses under rule 702 of the Utah Rules of Evidence. In most instances, therefore, we ■will disturb such rulings only when the district court has exceeded its discretion.” Carbaugh v. Asbestos Corp.,
ANALYSIS
I. Intentional Infliction of Emotional Distress
¶ 8 The district court properly granted Defendants’ summary judgment motion on Nguyen’s claim for intentional infliction of emotional distress. Nguyen’s complaint alleged that Defendants acted outrageously by “using [Derek] as a test subject for, and as part of a sales demonstration of the Pulmonetic ventilator,” an untested ventilator, without obtaining Nguyen’s consent. In responding to Defendants’ summary judgment motion, Nguyen claimed that Defendants did not follow their own guidelines established for testing the ventilator and that “[n]o emergency existed to justify disregard of the protocols.”
¶ 9 Defendants argued in their summary judgment memoranda that even if all of Nguyen’s assertions could be proven, the conduct as described did not establish that Defendants acted outrageously, as is required to prove a claim of intentional infliction of emotional distress,
¶ 10 Furthermore, the district court correctly determined that no evidence established that Defendants intended to cause emotional distress. See generally Oman,
II. Punitive Damages
¶ 11 The district court also properly granted PCMC’s summary judgment motion on Nguyen’s punitive damages claim. Nguyen argued that summary judgment on this claim was inappropriate because PCMC acted in “knowing and reckless disregard [of Derek’s] safety” by attaching the critically ill
¶ 12 Utah law has long recognized that “[s]imple negligence will never suffice as a basis upon which [punitive] damages may be awarded. ‘Punitive damages are not awarded for mere inadvertence, mistake, errors of judgment and the like, which constitute ordinary negligence.’ ” Behrens v. Raleigh Hills Hosp., Inc.,
III. Exclusion of Nguyen’s Expert
¶ 13 The district court also properly excluded Dr. Goldenring as an expert on the issues of the applicable standard of care and causation. “Practitioners in one specialty are not ordinarily competent to testify as experts on the standard of care applicable in another specialty.” Arnold v. Curtis,
[A] medical expert witness brought in to testify on the applicable standard of care, and whose specialty differs from that of the allegedly negligent doctor, must show that he or she is knowledgeable about the applicable standard of care or that the standard of care in the expert’s specialty is the same as the standard of care in the alleged negligent doctor’s specialty.
Dikeou v. Osborn,
¶ 14 Dr. Goldenring practiced general pediatrics and had never worked as a critical care physician in a PICU. Although he has provided some emergency care in hospitals as an attending pediatrician, he specified that he always worked in the “team context” with specialists because “[ijt’s not appropriate for a general pediatrician to take on a really bad case ... without getting lots of help.” Since 1994 or 1995, Dr. Goldenring has not used any active hospital privileges and had primarily worked for HMOs and individual practice associations as an administrator or consultant. He also had no experience with the ventilator used in this case, is not an expert on ventilators generally, and had no experience writing test protocols for hospital equipment. In addition, Dr. Goldenring frankly conceded in rendering his causation opinions that he was unable to quantify Derek’s chance of survival absent the ventilator failure. For these reasons, we affirm the district court’s decision to exclude Dr. Gol-denring from testifying as an expert regarding the applicable standard of care and causation.
¶ 15 Because Dr. Goldenring was not qualified to testify about the essential elements of Nguyen’s medical negligence claim, the district court properly granted Defendants summary judgment on the claim.
V. Failure to Obtain Informed Consent
¶ 16 The district court improperly dismissed Nguyen’s claim for failure to obtain informed consent. The court based its dismissal on the fact that Nguyen’s expert could not “expertly address what information should or should not have been conveyed about the overall risks and benefits of the transport.” Nguyen argues on appeal, and we agree, that he did not need an expert to establish Defendants’ failure to obtain informed consent to use the ventilator.
¶ 17 Often, an expert is needed to determine if the information provided in the course of securing informed consent was adequate. See generally Goddard v. Hickman,
¶ 18 “Where the physician fails to disclose to his patient any information concerning a material fact, there is no question of skill and judgment, no question of practice beyond the knowledge of laymen which must be established through expert testimony.” Nixdorf v. Hicken,
CONCLUSION
¶ 19 The district court properly granted summary judgment to Defendants on Nguyen’s claims of intentional infliction of emotional distress, punitive damages, and negligence. And the district court properly excluded Nguyen’s expert. However, the district court erred in relying on the lack of expert testimony in granting summary judgment on Nguyen’s claim for failure to obtain informed consent. That claim is remanded to the trial court. The parties will bear their own costs on appeal.
Notes
. Nguyen’s complaint also included claims of strict product liability, negligence, and breach of warranty against Pulmonetic Systems, Inc., the ventilator’s manufacturer. However, these claims were dismissed after Nguyen reached a settlement with Pulmonetic Systems, Inc.
. "Due to the highly subjective and volatile nature of emotional distress and the variability of its causations, the courts have historically been wary of dangers in opening the door to recovery therefor.” Oman v. Davis Sch. Dist.,
In order to properly state a claim for the tort of intentional infliction of emotional distress, a plaintiff must plead facts that demonstrate that the defendant intentionally engaged in some conduct toward the plaintiff, (a) with the purpose of inflicting emotional distress, or, (b) where any reasonable person would have known that such would result; and his actions are of such a nature as to be considered outrageous and intolerable in that they offend against the generally accepted standards of decency and morality.
Id. (emphasis in original) (citation and internal quotation marks omitted).
. Nguyen cites authority for the proposition that the jury, not the court, should determine if conduct is outrageous. See Gulbraa v. Corporation of the Pres, of the Church of Jesus Christ of Latterday Saints,
. There is admittedly limited case law in Utah exploring intentional infliction of emotional distress in a medical setting. The leading case is Sorensen v. Barbuto,
. According to the cited provision,
punitive damages may be awarded only if compensatory or general damages are awarded and it is established by clear and convincing evidence that the acts or omissions of the tort-feasor are the result of willful and malicious or intentionally fraudulent conduct, or conduct that manifests a knowing and reckless indifference toward, and a disregard of, the rights of others.
Utah Code Ann. § 78B-8-201(l)(a) (2008).
. The district court also ruled that punitive damages were inappropriate against the University of Utah based on the Governmental Immunity Act, see Utah Code Ann. § 63G-7-201 (2008). Nguyen does not challenge this ruling on appeal.
. Ordinarily when a defendant moves for summary judgment, the defendant must show that no material facts are in dispute and the defendant is entitled to prevail as a matter of law, See Utah R. Civ. P. 56(c); Eagar v. Burrows,
. For a patient to recover damages from a health care provider in an action based upon the provider's failure to obtain informed consent, the patient must prove the following:
(a) that a provider-patient relationship existed between the patient and health care provider;
(b) the health care provider rendered health care to the patient;
(c) the patient suffered personal injuries arising out of the health care rendered;
(d) the health care rendered carried with it a substantial and significant risk of causing the patient serious harm;
(e) the patient was not informed of the substantial and significant risk;
(f) a reasonable, prudent person in the patient's position would not have consented to the health care rendered after having been fully informed as to all facts relevant to the decision to give consent; and
(g) the unauthorized part of the health care rendered was the proximate cause of personal injuries suffered by the patient.
Utah Code Ann. § 78B-3-406(l) (2008).
. We note that the record shows that some general information was given to Nguyen about the need for Derek to be transported to receive a CT scan and "that there was a risk involved with this process.” However, it appears even from Defendants' account that no information was given to Nguyen regarding the fact that the ventilator was not regular hospital equipment and that it was being tested by PCMC so it could evaluate whether the ventilator should be purchased.
Concurrence Opinion
(concurring in part and dissenting in part):
¶21 I concur in parts III, IV, and V. I respectfully dissent from parts I and II. I disagree with the majority opinion that the district court properly granted Defendants’ summary judgment motions on Nguyen’s claim for intentional infliction of emotional distress and punitive damages claim.
¶ 22 In particular, I disagree with the majority’s conclusion that the district court correctly granted Defendants’ summary judgment motion for intentional infliction of emotional distress because no evidence existed to show, as a matter of law, that Defendants intended to cause emotional distress or that the conduct was outrageous. See supra ¶¶ 9, 10. The evidence in this case is such that a reasonable person might conclude that Defendants’ conduct has been sufficiently extreme and outrageous to result in liability. Under the circumstances of this case, it would be possible for a jury to reasonably find that Defendants acted in an outrageous manner.
¶23 The evidence before the trial court included testimony that at the time of its use on Derek the sales model ventilator had not been tested, attached to, or previously used to transport anyone; a committee was assembled to test, evaluate, and acquire a new life-flight transport ventilator (the CTM committee); a clinical evaluation previously scheduled had not taken place as arranged; Defendants’ agents were subject to rules governing use of the sales model, which prohibited use on any critically-ill or medically unstable child without obtaining parental
¶24 Based on this evidence reasonable minds could differ on whether Defendants’ actions would “evoke outrage or revulsion” sufficient to be considered outrageous conduct. See Oman v. Davis Sch. Dist.,
¶ 25 I also disagree with the majority’s determination that the district court properly granted Defendants’ summary judgment motion on Nguyen’s punitive damages claim. Based on the same facts and conduct summarized above, a reasonable jury could determine that Defendants’ actions to pursue testing of the sales model despite the risks to the critically-ill child were “willful and malicious or intentionally fraudulent conduct, or conduct that manifests a knowing and reckless indifference toward, and a disregard of, the rights of others,” see Utah Code Ann. § 78B-8-201(l)(a) (2008), as required for Nguyen to prove he is entitled to punitive damages. Therefore, I would hold that the grant of summary judgment on the punitive damages claim was also improper.
¶ 26 I would reverse and remand the matter for a trial on the merits of Nguyen’s claims of intentional infliction of emotional distress and punitive damages.
