In this medical malpractice action we consider whether the Superior Court committed reversible error by denying appellants’ motion for judgment as a matter of law, and by excluding certain evidence. The trial court correctly determined that appellees’ medical expert evidence supported a verdict in their favor. Thus, its denial of the motion for judgment as a matter of law is affirmed. The trial court’s
FACTUAL AND PROCEDURAL BACKGROUND
On April 22, 2010, Dr. Jennifer Barlow performed a Caesarean section on Laura Cooney-Koss to deliver her baby. There were no apparent complications from the delivery, and Laura was discharged from Christiana Hospital three days later. On the morning of May 2, 2010, Laura suffered heavy vaginal bleeding, and she returned to the hospital by ambulance.
In an attempt to slow or stop her bleeding, a hospital physician gave Laura medicine to contract her uterus. The doctor then took an ultrasound of Laura’s uterus, and determined that she would need a procedure known as a dilation and evacuation (“D & E”). Dr. A. Diane McCracken performed the D & E, removing blood clots and debris from Laura’s uterus. During that procedure, McCracken actively massaged Laura’s uterus and gave her additional medicine to try to stop her bleeding. Those efforts were unsuccessful.
McCracken tried to find other possible sources of the bleeding by performing a laparotomy. Throughout that procedure, McCracken again massaged Laura’s uterus. The laparotomy was unrevealing, and Laura continued to bleed. During the 30 minutes that McCracken had been treating her, Laura lost approximately one liter of blood. McCracken decided to perform a hysterectomy, believing that Laura would die otherwise. The doctor removed Laura’s uterus, and Laura eventually stopped bleeding.
On October 22, 2010, Laura and her husband, Jerome Koss, filed a complaint in Superior Court against McCracken, Barlow, their employer, All About Women of Christiana Care, Inc.,
DISCUSSION
McCracken appeals from the trial court’s denial of her motion for judgment as a matter of law, as well as several evidentiary rulings. She argues that the trial court should have granted her motion because the Kosses’ expert agreed with McCracken’s expert that it is appropriate to perform a hysterectomy if vaginal bleeding is not controlled by more conservative measures. As to the evidentiary rulings, McCracken contends that the trial court abused it discretion by: (1) excluding the testimony of Laura’s treating anesthesiologist; (2) excluding medical records and corresponding expert testimony indicating that Laura suffers from a bleeding disorder that predisposes her to significant risk of hemorrhage;
I. Motion for Judgment as a Matter of Law
At trial, Dr. William Spellacy, the Rosses’ standard of care expert, testified on direct examination that McCracken had breached the standard of care by not exhausting appropriate conservative treatment options before performing the hysterectomy.
The record does not support McCracken’s claim. Spellacy did not testify that McCracken exhausted all appropriate conservative treatment options; nor did Spel-lacy testify that McCracken exercised appropriate medical judgment by removing Laura’s uterus. To the contrary, Spellacy testified that McCracken breached the standard of care by failing to attempt more conservative treatment options before resorting to a hysterectomy. Viewing the evidence in the light most favorable to the Rosses, Spellacy’s expert testimony raises an issue of material fact for consideration by the jury.
II. Exclusion of the Treating Anesthesiologist’s Testimony
McCracken attempted to call Dr. Tak Lui, the treating anesthesiologist during Laura’s hysterectomy, as a fact witness. During his deposition, Lui testified that he had no memory of the May 2010 procedure, and that the notes from surgery did not refresh his recollection. Nonetheless, McCracken contends that Lui should have been able to review the notes
McCracken argues that evidence of Lui’s routine practice is admissible under Delaware Rule of Evidence 406, which provides:
Evidence of the habit of a person or of the routine practice of an organization, whether corroborated or not and regardless of the presence of eyewitnesses, is relevant to prove that the conduct of the*1215 person or organization on a particular occasion was in conformity with the habit or routine practice.11
In Brett v. Berkowitz,
Courts in other jurisdictions have allowed medical practitioners to testify about their routine practice as evidence of what the practitioners did on a particular occasion. For example, the Supreme Court of Rhode Island recently held that a plaintiffs treating physician, who had no recollection of treating the plaintiff, could testify about his practice in treating patients with similar symptoms.
We agree that a medical practitioner should be allowed to testify as to what he or she “would have done” in cases where the conduct in question is part of the practitioner’s routine conduct. Here, Lui testified during his deposition that, when he has particular concerns about a patient during a procedure, he communicates those concerns to the operating surgeon.
In sum, Lui’s deposition testimony establishes that, as part of his routine practice, (1) he would have been concerned about “keeping up” with Laura’s rate of
III. Exclusion of Evidence About Laura’s Pm'ported Bleeding Disorder
On May 7, 2012, two years after the hysterectomy, a portion of Laura’s colon was removed in an emergency surgery after conservative measures failed to stop bleeding from her rectum. McCracken received medical records from that surgery before trial in late June 2012 (the “May 2012 Records”).
In his expert report,
The Superior Court excluded Les-sin’s expert testimony because it was irrelevant, and because it was “too late” to introduce this evidence “less than a week before trial.”
TV. Exclusion of Medical Treatises on Cross-Examination
McCracken sought to impeach Spellacy, the Kosses’ standard of care expert, using certain medical treatises (including literature that Spellacy had co-authored). The Superior Court excluded the medical treat
Defendants further reserve the right to introduce rebuttal exhibits and exhibits used for impeachment purposes, including medical literature, the identity of which cannot be known until after the presentation of Plaintiffs’ case at trial.26
The trial court made its mistake because it focused on another section of the pretrial stipulation. Since there was no other basis on which the trial court excluded the evidence, its ruling was an abuse of discretion.
V. Rulings Significantly Prejudiced McCracken
We reviewed the Superior Court’s evidentiary rulings under an abuse of discretion standard.
The first two rulings — the exclusion of the treating anesthesiologist’s testimony, and the exclusion of evidence related to Laura’s bleeding disorder — go to the heart of Laura’s claim. If Lui were allowed to testify that Laura’s blood loss was alarming, the jury could have concluded that McCracken’s decision to perform the hys-tereetomy was not negligent. Evidence about Laura’s bleeding problems, likewise, could have convinced the jury that McCracken made the right decision. Alternatively, the bleeding disorder evidence could have led the jury to find no damages, because the need for a hysterectomy was inevitable. Finally, although not as prejudicial, the exclusion of medical treatises impaired McCracken’s ability to impeach Laura’s only standard of care expert at trial. Because there is a real possibility that the jury would have reached a different outcome had all of this evidence been introduced, we conclude that McCracken was denied a fair trial.
VI. Cross-Appeal Lacks Merit
The Kosses cross-appealed the grant of summary judgment in favor of Barlow. The trial court held that there was no expert evidence that Barlow’s alleged negligence caused the hemorrhaging that led to the hysterectomy. We agree. Spellacy opined that Barlow breached the standard of care by failing to properly suture Laura’s uterus after the Caesarean section. In addition, Spellacy testified that Barlow’s failure to properly suture Laura’s uterus resulted in a small hole and some bleeding into Laura’s abdomen. But no expert, including Spellacy, testified that the suturing, the hole, or the bleeding, was causally connected to the bleeding condition that led McCracken to perform a hysterectomy. In fact, Spellacy testified to the contrary. When asked whether it was his opinion that the suturing lead to the hemorrhaging, Spellacy replied, “No. No.
CONCLUSION
Based on the foregoing, the judgment of the Superior Court is hereby REVERSED and this matter is REMANDED for a new trial in accordance with this opinion. The entry of Summary Judgment in favor of Barlow is AFFIRMED.
. McCracken and All About Women of Chris-tiana Care, Inc. are referred to collectively as "McCracken,” unless the context requires otherwise.
. Christiana Health Services, Inc. was voluntarily dismissed from the suit on February 7, 2012.
. Cooney-Koss v. Barlow, 2013 WL 1400899 (Del.Super. Feb. 28, 2013).
. McCracken also claims that the Kosses’ statement, in closing argument, that the jury should "hold [her] accountable” caused unfair prejudice. She did not object at trial, and we agree with the trial court that there was
. See, e.g., Appellants’ Appendix at A-0955-57.
. Appellants’ Appendix A-0988; see also A>-0985, A-0997-98.
. Appellants’ Opening Brief at 29.
. See, e.g., Mazda Motor Corp. v. Lindahl, 706 A.2d 526, 530 (Del.1998) (noting that this Court reviews a Superior Court ruling on a motion for judgment as a matter of law to determine “whether the evidence and all reasonable inferences that can be drawn therefrom, taken in a light most favorable to the non-moving party, raise an issue of material fact for consideration by the jury”).
. Although the notes from surgery were mostly written by a nurse anesthetist, Lui had initialed them in multiple places.
. Cooney-Koss v. Barlow, 2013 WL 1400899, at *3 (Del.Super. Feb. 28, 2013).
. D.R.E. Rule 406.
. 706 A.2d 509 (Del. 1998).
. Id. at 516-17.
. Dawkins v. Siwicki, 22 A.3d 1142, 1155 (R.I.2011).
. Id. at 1155-56.
. Jacob v. Kippax, 10 A.3d 1159, 1160 (Me.2011) (holding that the trial court did not abuse its discretion when it allowed the defendant oral surgeon, who lacked memory of the plaintiff patient’s specific treatment, to testify as to his routine practices in his treatment of patients); Thomas v. Hardwick, 231 P.3d 1111, 1116-17 (Nev.2010) (allowing the treating emergency room doctor, who had no recollection of the plaintiff patient, to testify “that he routinely urges patients with chest pain complaints and inconclusive results ... to be admitted”); Rivera v. Anilesh, 8 N.Y.3d 627, 838 N.Y.S.2d 478, 869 N.E.2d 654, 657-58 (2007) (permitting the treating physician to testify about his routine procedure for administering injections of anesthesia); Palinkas v. Bennett, 416 Mass. 273, 620 N.E.2d 775, 777-78 (1993) (holding that the trial court did not abuse its discretion when it allowed a defendant pediatrician to testify that he "followed the same routine when discharging premature infants throughout thirty years of practice as a licensed pediatrician”); Aikman v. Kanda, 975 A.2d 152, 163 (D.C.2009) (allowing a surgeon to testify about a component of a mitral valve operation when the surgeon established that he had performed more than 500 similar operations).
. See, e.g., Appellants' Appendix at A-0090, A-0114-15.
. Appellants’ Appendix at A-0115.
. Appellants' Appendix at A-1562-76.
. Appellants’ Appendix at A-0299-302.
. Appellants’ Appendix at A-301.
. Appellants' Appendix at A-302.
. Appellants’ Appendix at A-0339-41.
. Appellants’ Appendix at A-0270-85.
. The trial court did allow McCracken to ask Spellacy questions that included language from the medical treatises, but McCracken was not allowed to reveal the sources of those questions. Impeaching a witness's credibility with medical treatises is far more effective if the jury actually knows that the cross-examination questions are coming from medical treatises. Thus, the trial court's attempted solution was unhelpful.
. Appellants’ Appendix at A-0261.
. See, e.g., Jones v. State, 940 A.2d 1, 9 (Del.2007).
. Manna v. State, 945 A.2d 1149, 1153 (Del.2008).
. Cooney-Koss v. Barlow, 2012 WL 4097291, at *2 (Del.Super. Aug. 29, 2012).
