WILLIAM TOMPKINS, Appellee, v. ROGER N. BISE, M.D., Appellant.
No. 71,593
Supreme Court of Kansas
January 26, 1996
910 P.2d 185 | 259 Kan. 39
Thomas M. Sutherland, of Holbrook, Heaven & Fay, P.A., of Kansas City, argued the cause, and Brent G. Wright, of the same firm, was with him on the briefs for appellant.
Richard P. Senecal, of Duncan and Senecal, Chartered, of Atchison, and Patrick E. Henderson, of the same firm, argued the cause and were on the brief for appellee.
LOCKETT, J.: Patient filed a medical liability action against a medical doctor for alleged negligent treatment of a jaw injury. The jury found that the doctor was negligent and awarded damages. The medical doctor appealed the district court‘s admission of the expert testimony of a dentist who performed similar operations but was not licensed as a medical doctor. The Court of Appeals found that
Plaintiff William Tompkins was injured in a motorcycle accident on November 5, 1990. He suffered two fractures to his jaw, which were treated by Dr. Roger N. Bise. Bise had completed medical school, 5 years of surgical and plastic surgery training, and a 6-month fellowship in cranial maxillofacial surgery. He also had been a licensed dentist and had practiced dentistry in Kansas while attending medical school. At the time of trial Bise‘s Kansas dental license was inactive, though he was licensed to practice dentistry in Missouri.
Bise performed surgery on Tompkins on November 7, 1990, using a “closed” reduction procedure (without making additional incisions). Tompkins was released from the hospital on November 9, 1990. Tompkins saw Bise for several follow-up visits.
On April 19, 1993, Tompkins initiated this medical liability action against Bise, alleging that Bise‘s treatment of Tompkins’ jaw injury was negligent and below the acceptable standard of care. Tompkins designated Dr. Anthony M. Captline, a certified oral and maxillofacial surgeon, as his expert witness. Captline has a Doctor of Medical Dentistry degree, and he completed an additional 3 years of training in oral and maxillofacial surgery. Bise designated John W. Canady, M.D., Steven L. Thomas, D.D.S., and Paul Manson, M.D., as his expert witnesses.
Bise filed a motion to strike Captline as an expert witness. Bise argued that
At trial, Captline testified that Bise performed oral and maxillofacial surgery, not plastic surgery, on Tompkins: Captline opined that Bise‘s treatment of Tompkins fell below the standard of care of an oral and maxillofacial surgeon. Captline asserted that Bise should have used an open, rather than closed, reduction procedure and that Bise failed to correct problems which developed due to muscle pull. Captline stated that he did not have an opinion as to the standard of care of a plastic and reconstructive surgeon.
Bise testified that his primary concern in treating Tompkins was to treat the entire patient, not just the jaw injury. He opted against an open reduction procedure due to the risks anticipated because Tompkins had a possible head injury and pulmonary contusion. As his expert witnesses, Bise called Dr. Canady, a physician certified in ear, nose, and throat treatment and in plastic surgery, and Dr. Thomas, who is trained as a dentist (D.D.S.) and is a board certified oral and maxillofacial surgeon. Both Canady and Thomas opined that Bise properly used a closed reduction procedure because of the possibility that Tompkins had a closed head injury or pulmonary contusion and because that procedure was the least intrusive and would avoid the potential risks associated with an open reduction procedure. Both experts testified that Bise met the standard of care both in his treatment of the jaw injury and in the follow-up care.
The jury returned a verdict in favor of Tompkins. The jury found that Tompkins’ total damages were $195,390.89 and that Bise was 33.75% at fault. Bise timely appealed.
The dissent observed that
A medical malpractice action for damages for personal injury arising out of the rendering of professional services by a health care provider is governed by
Interpretation of a statute is a question of law. An appellate court‘s review of questions of law is unlimited. State v. Donlay, 253 Kan. 132, Syl. ¶ 1, 853 P.2d 680 (1993). The rules of statutory construction have been often stated. It is a fundamental rule of statutory construction, to which all other rules are subordinate, that the intent of the legislature governs if that intent can be ascertained. City of Wichita v. 200 South Broadway, 253 Kan. 434, 436, 855 P.2d 956 (1993). When a statute is plain and unambiguous, the court must give effect to the intent of the legislature as expressed rather than determine what the law should or should not be. Martindale v. Tenny, 250 Kan. 621, Syl. ¶ 2, 829 P.2d 561 (1992). The legislature is presumed to intend that a statute be given a reasonable construction so as to avoid unreasonable or absurd results. Todd v. Kelly, 251 Kan. 512, 520, 837 P.2d 381 (1992).
“In any medical malpractice liability action, as defined in
K.S.A. 60-3401 and amendments thereto, in which the standard of care given by a practitioner of the healing arts is at issue, no person shall qualify as an expert witness on such issue unless at least 50% of such person‘s professional time within the two-year period preceding the incident giving rise to the action is devoted to actual clinical practice in the same profession in which the defendant is licensed.”
The Court of Appeals stated that
The primary dispute between the parties concerns the application of the term “profession.” The parties do not dispute that Capt-
Bise points out that he is a physician and a practitioner of the healing arts and that Captline is a dentist and not a practitioner of the healing arts. He asserts that dentists practicing their professions and dentists administering anesthesia to facilitate medical procedures conducted by a person licensed to practice medicine and surgery are not licensed or engaged in the practice of the healing arts. See
Tompkins points out that the medical procedure used by Bise was oral and maxillofacial surgery, not plastic surgery. Tompkins stresses that, although a dentist, Captline routinely performed oral and maxillofacial surgery, the same procedure Bise, a physician, performed on Tompkins. Tompkins also notes that Bise‘s dentist expert witness, Thomas, testified that the standard of care of a dentist performing oral and maxillofacial surgery and of a plastic surgeon performing oral and maxillofacial surgery would be similar if not identical. He concludes that it is the specialty of oral and maxillofacial surgery, not the fact that one is a dentist or a physician, that qualifies both Bise and Captline to perform the procedure on Tompkins.
We agree that under the statutes Captline, a dentist, is not a practitioner of the healing arts. However, does
In Wisker, 244 Kan. 36, the issue was whether a general practitioner of medicine could testify as to the standard of care of a surgeon and vice versa. The Wisker court noted:
”
K.S.A. 1987 Supp. 60-3412 is intended to prevent the use of ‘professional witnesses.’ That is, practitioners of healing arts who spend less than 50 percent of their professional time in actual clinical practice in their profession are considered to be ‘professional witnesses’ rather than practitioners of their profession. The statute was not intended to require that only a surgeon could testify as to the standard of care of another surgeon, etc. The weight afforded the testimony ofphysicians testifying outside their area of professional specialization is a matter to be determined by the jury.” 244 Kan. at 43-44.
Bise points out that the Wisker court used the language “practitioners of healing arts” and “physicians testifying outside their area of professional specialization.” He infers from this that the Wisker court‘s holding that practitioners of different specialties could testify against one another applies only when the proposed expert witness and the defendant are both practitioners of the healing arts.
If one were to follow Bise‘s argument to its conclusion, one would conclude that any physician, surgeon, osteopathic physician, chiropractor, or other practitioner of the healing arts, defined in
In Denton, 731 F. Supp. 1034, the plaintiffs sought to have a doctor of osteopathy who had served only on the staffs of osteopathic hospitals testify concerning the defendant medical hospital‘s treatment of plaintiffs’ decedent. The Denton court concluded that the doctor of osteopathy met the minimum qualifications of
This court‘s discussion in State v. Willis, 256 Kan. 837, 888 P.2d 839 (1995), is informative. Willis involved the testimony of a licensed social worker that the alleged victim of a rape suffered from
The Willis court recognized that to qualify as an expert witness in the field, the witness must have the training in the field and the professional qualifications. Here, unlike in Willis, Captline and Bise were both qualified to diagnose and treat Tompkins’ jaw injury. Their licensure procedure may have differed, but both were trained in and practiced oral and maxillofacial surgery.
Following the Court of Appeals’ analysis of Wisker, a general medical practitioner with no training in oral and maxillofacial surgery would be qualified to testify as an expert witness as to Bise‘s performance of oral and maxillofacial surgery on Tompkins. Certainly Captline is better qualified than a general practitioner to testify as to the professional standard of oral and maxillofacial surgery. Unless
It is elementary that if the meaning of a statute is plain, the sole function of the court is to enforce it according to its terms. Where a statute may be of doubtful meaning and is susceptible to two constructions, the court may look at the legislative history of the statute to assist in determining the meaning of the statute. If the legislative history does not assist the court as to which of the two constructions is correct, the court must select the reasonable con-
Prior to the enactment of
Medical malpractice reform occurred in 1985 with the enactment of Substitute S.B. 110. The legislature enacted
“In an action for malpractice against a physician or hospital, no person shall testify as a medical expert as to the standard of care unless that person is licensed to practice medicine and surgery in Kansas or a contiguous state, has current personal experience and practical familiarity with the medical subject forming the basis of the litigation and is actively engaged in direct patient care.” S.B. 110, New Sec. 4(a)(2).
This provision was deleted when the substitute for S.B. 110 was adopted.
An interim committee on medical malpractice studied the need for further reform in 1985. The committee reported the arguments concerning what is now
“The [Kansas Medical Society argued] that Kansas health care providers should be judged by those familiar with standards of practice here and should not be subject to scrutiny from so-called experts from large urban centers or universities far from Kansas. Some such experts were said to make their livelihood from court testimony.” (Emphasis added.) Proposal 47, Medical Malpractice, Report on Kansas Legislative Interim Studies to the 1986 Legislature, pp. 817, 849 (December 1985).
Following the interim committee report, additional medical malpractice reform occurred in 1986. The provisions of
Does
Although the language of
Captline satisfied the minimum requirements of
We need not reach the other issues raised by the parties.
The judgment of the Court of Appeals is reversed, and the judgment of the district court is affirmed.
LARSON, J., not participating.
SIX, J., dissenting: I would affirm the Court of Appeals and reverse the trial court.
The majority identifies the question before us as, “does
By adopting the “performing a similar medical procedure” test, the majority has rewritten
I disagree with a
“Dr. Schlachter [an expert witness] is a general practitioner of medicine. Dr. Lavigne [another expert witness] is a surgeon. The trial court construed
K.S.A. 1987 Supp. 60-3412 to preclude a surgeon from testifying as to the standard of care applicable to general practitioners and vice-versa. Hence, it limited the jury‘s consideration of Dr. Lavigne‘s testimony to the standard of care of defendant Hart, a fellow surgeon, and the jury‘s consideration of Dr. Schlachter‘s testimony to the standard of care of defendant Davis, a fellow general practitioner.“Plaintiff contends this was an erroneous construction of the statute. We agree.
K.S.A. 1987 Supp. 60-3412 is intended to prevent the use of ‘professional witnesses.’ That is, practitioners of healing arts who spend less than 50 percent of their professional time in actual clinical practice in their profession are considered to be ‘professional witnesses’ rather than practitioners of their profession. The statute was not intended to require that only a surgeon could testify as to the standard of care of another surgeon, etc. The weight afforded the testimony of physicians testifying outside their area of professional specialization is a matter to be determined by the jury.” 244 Kan. at 43-44.
The majority, by adopting the “similar or related area of practice” standard, has either overruled or seriously questioned Wisker. The rationale advanced by the majority for permitting Captline to testify against Bise is based on a perceived similarity of specialty, oral and maxillofacial surgery.
The majority overlooks the concept of “profession” placed in
“that branch of dentistry concerning the diagnosis, surgical and adjunctive treatment of disease, injuries and defects of the oral and maxillofacial region.” K.A.R. 71-2-2.
“Nothing in this act shall apply to the following practices, acts and operations:
“(a) To the practice of a person licensed to practice medicine and surgery under the laws of this state, unless such person practices dentistry as a specialty.”
The majority‘s “performing a similar medical procedure” test would appear to permit: (1) a podiatrist to testify as to the standard of care for an orthopedic surgeon; (2) a midwife to testify as to the standard of care for an obstetrician (An obstetrician is a physician licensed by the State Board of Healing Arts. A midwife is a specialty branch of nursing licensed and governed by the State Board of Nursing.
ROBERT H. MILLER, C.J. Retired, assigned, joins the foregoing dissenting opinion.
