Seisinger v. SiebelSeisinger v. Siebel
Lead Opinion
OPINION
¶ 1 The issue before us is whether
I.
¶ 2 Scott Siebel, M.D., an anesthesiologist, administered a spinal epidural to Laura Seis-inger in 2002. Two years later, Seisinger filed a complaint against Siebel alleging malpractice. Seisinger subsequently disclosed that J. Antonio Aldrete, M.D., would testify as an expert about the appropriate standard of care.
¶ 3 When the defendant in a medical malpractice action is a specialist,
¶ 4 The superior court rejected Seisinger’s constitutional argument and granted the motion in limine. The court gave Seisinger additional time to disclose a new expert qualified under
¶ 5 The court of appeals reversed. Seisinger v. Siebel,
¶ 6 We granted review because the case involves the constitutionality of a statute and the issues presented are of statewide importance. See ARCAP 23(c). We have jurisdiction under Article 6, Section 5(3) of the Arizona Constitution and
II.
A.
¶ 7 The Arizona Constitutiоn commands that the legislative, executive, and judicial departments “shall be separate and distinct, and no one of such departments shall exercise the powers properly belonging to either of the others.”
¶ 8 Although we have occasionally said that procedural rulemaking power is vested “exclusively” in this Court, State v. Hansen,
¶ 9 The legislature thus cannot repeal a rule of procedure or evidence. Seidel,
¶ 10 Determining whether a statute unduly infringes on our rulemaking power requires analysis of the particular rule and statute said to be in conflict. Our cases provide some guidance on purported conflicts between statutes and rules of evidence. In Readenour, this Court upheld against a separation of powers attack
1111 We began from the proposition that “it is our duty to save a statute, if possible, by construing it so that it does not violate the constitution.” Id. (citing Ariz. Downs v. Ariz. Horsemen’s Found.,
¶ 12 We then concluded that the statute’s application to pre-injury but post-sale changes' did not conflict with the Rule. Id. The Rule is silent on the admissibility of post-sale, pre-injury changes, so the statute did not expressly abrogate the Rule. Nor did the statute undermine the purposes of Rule 407. We concluded that the policy of the Rule is to encourage remedial measures, the probative value of the evidence excluded is not high, and the extension of the prohibition to this period fosters the policy embоdied in the Rule. Id. at 445-46,
¶ 13 In contrast, in Barsema we found that a statute unconstitutionally conflicted with a rule of evidence. There, the statute at issue,
B.
¶ 15 In this case, the court of appeals held that
¶ 16 Rule 702 permits expert testimony to “assist the trier of fact to understand the evidence or to determine a fact in issue” when a witness is “qualified as an expert by knowledge, skill, experience, training, or education.” “The test оf whether a person is an expert is whether a jury can receive help on a particular subject from the witness. The degree of qualification goes to the weight given the testimony, not its admissibility.” State v. Davolt,
¶ 17 Dr. Siebel argues that there is no conflict between the statute and the Rule because
¶ 18 Thus, as the court of appeals noted,
¶ 19 Consequently, we agree with the court of appeals that
¶ 20 Several federal cases have held that state statutes similar to
¶ 21 The federal cases interpret
¶22 In contrast to the federal rule, Arizona Rule of Evidence 601 states: “Every person is competent to be a witness except as otherwise provided in these rules or by statute.” The Arizona Rule is silent as to the effect of a conflict between a rule and a statute. Thus, even assuming that
¶23 Our prior cases illustrate the point. For example, Rule 402 provides that “[a]ll relevant evidence is admissible, except as otherwise provided by the Constitution of the United States, by the Constitution of Arizona or by applicable statutes or rules.” But in Readenour, we stated that we “cannot let the legislature define what is relevant.”
III.
A.
¶ 24 As the court of appeals recognized, a determination that a statute and court rule cannot be harmonized is but the first step in a separation of powers analysis. Seisinger,
¶ 25 The court of appeals concluded that § 12-2604(A) is not substantive because “the legislative history of the enactment of § 12-2604(A) does not establish that the Arizona Legislature had concerns regarding the right
¶ 26 This legal inquiry, like the determination of whether a rule and a statute conflict, is mandated by fundamental concepts of separation of powers. Article 4, Part 1, Section 1 of the Arizona Constitution vests the legislature (and the people through ballot measure) with the “legislative authority” of the State. The legislature has plenary power to deal with any topic unless otherwise restrained by the Constitution. Giss v. Jordan,
¶ 27 Just as the primacy of the courts in promulgating procedural rules does not exclude a supplementary legislative role, our Constitution does not prohibit the judiciary from developing substantive law. An obvious example of this role is in the area of the common law. The legislature has expressly provided that the “common law ... is adopted and shall be the rule of decision in all courts of this state.”
¶ 28 But just as a procedural statute cannot prevail against a procedural rule validly promulgated under Article 6, judge-made substantive law is subordinated to contrary legislative acts validly adopted under Article 4.
1.
¶ 29 Athough the basic constitutional principle of separation of powers is easily stated, the precise dividing line between substance and procedure “has proven elusive.” In re Shane B.,
the substantive law is that part of the law which creates, defines and regulates rights; whereas the adjective, remedial or procedural law is that which prescribes the method of enforcing the right or obtaining redress for its invasion. It is often said the adjective law pertains to and prescribes the practice, method, procedure or legal machinery by which the substantive law is enforced or made effective.
State v. Birmingham,
¶ 30 Even if a litmus test as to what is substantive is not possible, our eases do provide guidance. “Because the legislature is empowered to set burdens of proof as a matter of substantive law, a valid statute specifying the burden of proof prevails over common law or court rules adopting a different standard.” Valerie M.,
¶ 31 Because § 12-2604(A) provides that certain expert testimony cannot be received, Seisinger argues that it must be procedural. But, as Readenour teaсhes, a statute excluding evidence is not inevitably procedural; privilege statutes exclude highly relevant evidence but are nonetheless substantive.
2.
¶ 32 In medical malpractice actions, as in all negligence actions, the plaintiff must prove the existence of a duty, a breach of that duty, causation, and damages. Smethers v. Campion,
¶ 33 Under the common law, breach of duty in malpractice actions required proof that the defendant failed to exercise the “same care in the performing of his duties as was ordinarily possessed and exercised by other physicians of the same class in the community in which he practiced.” Rice v. Tissaw,
¶ 34 Arizona courts have also long held that expert testimony on the standard of care can be presented only by a physician. Rice,
¶ 35 Arizona common law decisions requiring expert testimony from physicians in medical malpractice cases long predated the adoption of the Arizona Rules of Evidence in 1977. Thus, as a purely chronological matter, the requirement of a physician expert cannot be said to have resulted from our promulgation of a procedural rule. More importantly, the common law doctrine is far stricter than
¶ 36 Accordingly, even when the Dean of the College of Nursing at the University of Arizona testified that a registered nurse could, under many circumstances, be qualified both by training and experience to know the applicable standard of care, the court of appeals concluded that summary judgment for the defendant was required when there was no testimony from a medical doctor. Rodriguez,
¶ 37 In short, the requirement of expert physician testimony in a medical malpractice action is not simply the result of
¶ 38 We therefore conclude that the requirement of expert testimony in a medical malpractice action is a substantive component of the common law governing this tort action. The common law requirement reflected a policy decision by the courts that the plaintiffs substantive burdеn of production could only be met by a particular kind of evidence. The common law requirement thus effectively established an element of the cause of action, by specifying the kind of proof necessary to meet the plaintiffs burden of production.
¶ 39 The common law elements of a medical malpractice action have now been partially codified by the legislature in
¶ 40 Our conclusion that § 12-2604(A) is substantive insofar as it requires a certain type of evidence to prove an element of the tort does not, as our concurring colleague suggests, “shift[ ] the established boundaries of judicial and legislative domains.” See ¶ 60, infra. The doctrine of separation of powers does not constrain the legislature from modifying, or even abolishing, the elements of common law causes of action. See ¶ 30, supra. Nor do separation-of-powers principles restrict the legislature’s ability to increase the plaintiffs common law burden of proof. See id. If separation of powers would not prevent the legislature from requiring that all medical malpractice plaintiffs prove claims beyond a reasonable doubt, it is difficult to see why the legislature
¶ 41 Although we maintain plenary power over procedural rules, we do not believe that power precludes the legislature from addressing what it believes to be a serious substantive problem — the effects on public health of increased medical malpractice insurance rates and the reluctance of qualified physicians to practice here — by effectively increasing the plaintiffs burden of production in medical malpractice actions. Given the critical substantive function that our common law decisions have ascribed to expert testimony about the standard of care, § 12-2604(A) is properly viewed as a modification of that substantive common law, not merely as a change in procedure.
B.
¶ 42 We therefore conclude that insofar as § 12-2604(A) specifies the kind of expert testimony necessary to establish medical malpractice, it is substantive in nature and does not offend the separation of pоwers doctrine. Section 12-2604(A) was enacted in 2005. 2005 Ariz. Sess. Laws, ch. 183, § 1 (1st Reg. Sess.). This case was filed in 2004, and concerns conduct occurring in 2002. Therefore, we must decide whether § 12-2604(A) applies retroactively to actions filed before its effective date.
¶ 43 “No statute is retroactive unless explicitly declared therein.”
IV.
¶ 44 For the reasons above, we hold that § 12-2604(A) does not violate the constitutional separation of powers doctrine. We therefore vacate the opinion of the court of appeals. This case does not present, and we today express no opinion, as to whether the statute contravenes any other constitutional provision. Because § 12-2604(A) does not apply retroactively, we also vacate the judgment of the superior court and remand for further proceedings consistent with this opinion.
Notes
. Section 12-2604(A) provides:
A. In an action alleging medical malpractice, a person shall not give expert testimony on the appropriate standard of practice or care unless the person is licensed as a health professional in this state or another state and the person meets the following criteria:
1. If the party against whom or on whose behalf the testimony is offered is or claims to be a specialist, specializes at the time of the*88 occurrence that is the basis for the action in the same specialty or claimed specialty as the party against whom or on whose behalf the testimony is offered. If the parly against whom or on whose behalf the ieslimony is offered is or claims to be a specialist who is board certified, the expert witness shall be a specialist who is board certified in that specialty or claimed specialty.
2. During the yeаr immediately preceding the occurrence giving rise to the lawsuit, devoted a majority of the person’s professional time to either or both of the following:
(a) The active clinical practice of the same health profession as the defendant and, if the defendant is or claims to be a specialist, in the same specialty or claimed specialty.
(b) The instruction of students in an accredited health professional school or accredited residency or clinical research program in the same health profession as the defendant and, if the defendant is or claims to be a specialist, in an accredited health professional school or accredited residency or clinical research program in the same specialty or claimed specialty.
3. If the defendant is a general practitioner, the witness has devoted a majority of the witness’s professional time in the year preceding the occurrence giving rise to the lawsuit to either or both of the following:
(a) Active clinical practice as a general practitioner.
(b) Instruction of students in an accredited health professional school or accredited residency or clinical research program in the same health profession as the defendant.
. The accuracy of this statement is at least subject to question. A co-sponsor of the bill that contained § 12-2604(A) staled that his goal was “to improve the malpractice climate in our state,” encourage physicians to practice here, and lower medical malpractice rates. Minutes of Meeting: Hearing on S.B. 1036 Before the H. Comm, on Health, 47th Leg., 1st Reg. Sess. (Ariz. Mar. 23, 2005) (statement of Sen. Robert Can-nell).
. The sentiment expressed in
. The federal courts have also struggled to define the distinction between substance and procedure in developing the Erie doctrine. In arguably the most articulate attempt to resolve this problem, Justice Harlan once wrote that "the proper line of approach in determining whether to apply a state or a federal rule, whether ‘substantive’ or ‘procedural,’ is to stay close to basic principles by inquiring if the choice of rule would substantially affect those primary decisions respecting human conduct which our constitutional system leaves to state regulation.” Hanna,
. Arizona Rule of Evidence 407, for example, codifies the common law rule generally making certain remedial measures inadmissible as proof of prior negligence. The Rule plainly reflects a substantive policy decision — that it is more important to encourage remedy of defects than to allow plaintiffs to use arguably relevant evidence as proof of negligence. Although we need not today address the issue conclusively, it would seem that the legislature would be free to enact a contrary policy decision, allowing use of such evidence when its probative value is not substantially outweighed by potential prejudice. Cf. Readenour,
. For the same reason, we are skeptical that the issue can be resolved, as the concurrence suggests, simply by characterizing § 12-2604(A) as usurping a “core judicial function[j." See 1164, infra. The dividing line between "core” functions and others is no more apparent in difficult cases than that between procedural and substantive enactments. Perhaps more importantly, we have previously stated that
Moreover, although the cases involving
. The Arizona cases mirror the general common law rule. See, e.g., Ewing v. Goode,
. Section 12-2604(A) does not purport to abolish the common-law res ipsa loquitur doctrine. Rather, the statute applies only to those cases in which expert testimony is otherwise required. Sanchez v. Old Pueblo Anesthesia, P.C.,
Concurrence Opinion
ECKERSTROM, Judge,
concurring in part and concurring in the result.
¶ 45 I agree fully with the majority’s conclusions, set forth in part II of the foregoing opinion: (1) that the Arizona Constitution commands that the legislative, executive, and judicial branches shall be “separate and distinct” and that no branch “shall exercise the powers properly belonging to either of the others,”
¶ 46 As Judge Irvine aptly observes in the court of appeals opinion, “the separation of powers doctrine does not require absolute compartmentalization of the branches.” Seisinger v. Siebel,
¶ 47 The Arizonа Constitution endows the judicial department with primary authority to create rules governing the standards for the admissibility of evidence in an Arizona state courtroom — at least when, as here, those rules pursue goals at the core of the judicial function. As the majority acknowledges, Article 6, Section 5(5) of the Arizona Constitution expressly vests this Court with the “[p]ower to make rules relative to all procedural matters in any court.” And, this Court has repeatedly observed that, because the Arizona Rules of Evidence are generally procedural in nature, this Court’s authority to promulgate such rules ordinarily falls within the power granted by that article. See, e.g., Barsema v. Susong,
¶ 48 But the authority of the judicial department over most rules of evidence does not derive exclusively from its express authority to promulgate procedural rules pursuant to Article 6, Section 5(5), but also from the basic content of the “judicial power” given to this department by our constitution in Article 6, Section 1. See Burney v. Lee,
[T]he hearsay rales are at the core of the judicial function: defining what is reliable evidence and establishing judicial processes to test reliability. Under basic separation of powers principles, these judicial functions are separate and different from legislative powers. As Professor Wigmore long ago explained, “the judicial power involves the application of the law to concrete facts and, therefore, the investigation and establishment of the facts. Any statute which prevents the judicial body from ascertaining the [true] facts [in the case before it] ... is ineffective.”
Id. (alterations in original) (citation omitted). In so reasoning, the court also observed that the enhancement of “the truth-finding process” and rules designed to assure the reliability of evidence presеnted stand at “the heart of the judicial process.” Id.
¶ 49 Under the specific evidentiary rule at issue here,
The rules in this article are designed to avoid unnecessary restrictions concerning the admissibility of opinion evidence; however, as this note makes clear, an adverse attorney may, by timely objection, invoke the court’s power to require that before admission of an opinion there be a showing of the traditional evidentiary prerequisites. Generally, it is not intended that evidence which would have been inadmissible under pre-existing law should now become admissible.
Ariz. R. Evid. art. 7 note. Thus, in promulgating
¶ 51 For this reason, I must part ways with the majority’s analytical approach and ultimate conclusion. If
¶ 52 The majority does not directly dispute this fact, see ¶¶ 8-9, supra, but nonetheless performs a supplementary analysis of whether the requirements set forth in § 12-2604(A) may be characterized as “substantive or procedural.” See ¶ 24, supra. In light of the clear answers provided by the text of the Arizona Constitution when applied to
¶ 53 As discussed, this Court has repeatedly addressed the constitutionality of statutes in purported conflict with specific provisions of the Arizona Rules of Evidence. In each of those cases, the Court has simply assumed, with brief reference to the authority provided in Article 6, Section 5(5), that the pertinent evidentiary rule fell squarely within the judicial domain and that the statute would be unconstitutional to the extent it conflicted with thе rule. See Barsema,
¶ 54 Thus, in apparent recognition of the fact that a power cannot simultaneously belong to both branches, this Court has declined to apply the procedural/substantive analysis to a statute when such analysis is not necessary to resolve the separation of powers question before it. Rather, it has answered that question by determining whether the Court’s rule of evidence falls within its grant of exclusive constitutional authority and, if so, whether the statute conflicts with the rule.
¶ 55 The wisdom of this approach is aptly demonstrated by the ease with which a statute setting forth an evidentiary rule may be characterized as both substantive and procedural — and the difficulty of determining which aspect controls. As the majority observes and as this Court has previously acknowledged, statutes relating to the admissibility of evidence “often have both substantive and procedural aspects.” See ¶ 29, supra. Presumably, then, we can only assess the fundamental nature of a statute on this continuum by first identifying its respective substantive and procedural features and then determining which of those features are most relevant to the criteria constitutionally provided for resolving separation of powers problems.
¶ 56 Although the majority opinion cogently highlights what it characterizes as the substantive aspects of § 12-2604(A), see ¶ 39, supra, it fails to identify or analyze the manifest procedural features of that statute. To the extent our jurisprudence has provided a yardstick for distinguishing between substantive and procedural law, it has observed that substantive law “creates, defines and regulates rights,” while procedural law “prescribes the method of enforcing the right or obtaining redress for its invasion.” State v. Birmingham,
¶57 The majority declines to assess the procedural features of § 12-2604(A) under the Birmingham test. But, in my view, such an exercise provides considerable clarity in assessing the essential nature of the statute. As a threshold matter, § 12-2604(A) prescribes an evidentiary rule relating to “an action alleging medical malpractice.” And there is no dispute that the elements of that cause of action, because they define the right to seek redress, are substantive law. But § 12-2604(A) does not create the right to sue when the elements of that cause of action are
¶ 58 Thus, while
¶ 59 The procedural aspеct of § 12-2604(A) is highlighted not only by our traditional approach to characterizing a statute, but also by the function it performs in the context of our evidentiary law. Neither the majority opinion nor any of the litigants dispute that
¶ 60 At a minimum, then, the procedural features of § 12-2604(A) are prominent. At the same time, the arguments for characterizing the statute as substantive law are, in my estimation, less persuasive. In essence, the majority posits that elevated standards for the admission of expert testimony in medical malpractice cases effectively establish an element of the cause of action, “by specifying the kind of proof necessary to meet the plaintiffs burden of production.” See ¶ 38, supra. But there are few, if any, rules of evidence that do not similarly qualify the method by which claimants must meet their burdens of production. Indeed, this is the function of those rules. For example, the hearsay rules play this role in every case— rendering a certain type of information unavailable to claimants to support the elements of their claim. Indeed, if the Court were to apply this analytical approach in every case addressing a conflict between a statute and a rule of evidence, the statute must always prevail — and the legislature, not the judicial department, would possess hegemony over all evidentiary rules. Because such a shift of power stands in direct conflict to the grant of authority to the judicial department found in the text of the Arizona Constitution, I fear the majority’s approach is incorrect and risks shifting the established boundaries of judicial and legislative domains.
¶ 61 Although the majority’s characterization of § 12-2604(A) as a constructive element of a medical malpractice cause of action proves too much, I believe its second argument in support of characterizing the statute as substantive, proves too little. The majori
¶ 62 However, as discussed, our constitutional text expressly empowers the judicial department to “make rules relative to all procedural matters.”
¶ 63 In sum, the power to promulgate
¶ 64 In so concluding, I am cognizant that the judiciary must foster comity between the respective branches and that, in possessing the trust and responsibility to resolve disputes among the branches including our own, we must be careful not to develop self-serving and self-empowering аpproaches in analyzing such questions. But we must also enforce the provisions of our constitution that expressly grant the judiciary the primary authority over those procedural rules that-serve core judicial functions. Because I fear the majority analysis fashions a wholly new framework for addressing separation of powers conflicts between statutes and evidentia-ry rules, and, in so doing, shifts to the legislature power that constitutionally belongs to this department, I can concur only in the result.
Chief Justice Ruth V. McGregor has recused herself from this case. Pursuant to Article 6, Section 3 of the Arizona Constitution, the Honorable Peter J. Eckerstrom, Judge of the Arizona Court of Appeals, Division Two, was designated to sit in this matter.
. As the majority correctly observes, judge-made substantive law does not prevail over conflicting legislation merely because this Court has characterized that law as a rule of evidence. Specific rules of evidence that fall outside the domain of plenary judicial power, as articulated by the Arizona Constitution, are subordinate to conflicting legislation on the same topic. See Valerie M. v. Ariz. Dep't of Econ. Sec.,
. Arizona courts have yet to elaborate on what pursuits, if any, might be characterized as core functions of the judiciary beyond providing an efficient, reliable, and impartial truth-finding process. But, to properly carry out the intent expressed by our constitutional text in granting exclusively to this department "[t]he judicial power,”
. In recognizing the logic of this approach, I do not suggest that the separation of powers inquiry ends upon the discovery of "some conflict between a validly enacted rule of evidence and a statute.” See ¶ 29, supra. Rather, once an evi-dentiary rule has been determined to be an exercise of this Court’s plenary authority as set forth by the various provisions of Article 6 of the Arizona Constitution, then it follows that any conflicting provision in a statute is unconstitutional. As the majority correctly observes, a rule can be validly promulgated but subordinate to any conflicting legislation if its promulgation does not fall within the powers granted to the judicial branch in Article 6. See 1127, supra.
. The majority asks why the legislature may not "require a heightened level of proof of the standard of care," if the legislature maintains the power to set forth the burden of proof in the first instance. See ¶ 40, supra. But there remains an analytical distinction under the Birmingham test between a statute setting forth the quantum of proof necessary to support a cause of action and a statute specifying what potential witnesses may be used in doing so. Indeed, § 12-2604(A) does not so much purport to address the level of proof as the form that proof must take. For example, an experienced but recently retired physician with all of the same academic qualifications and practical experience as the defendant physician might well be able to provide a very high level of proof for the plaintiff on the question of the standard of care but would still be disqualified from doing so by § 12 — 2604(A)(2)(a) and (3)(a), which prohibit expert testimony if the witness no longer maintains “active clinical practice.”
. Although § 12-2604(A) addresses a particular element of a particular cause of action — while