Hegarty v. Hudson
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Daniel Ernest Hegarty, M.D., and the Monroeville Medical Clinic appealed a circuit court judgment entered in favor of Dixie Hudson in her medical-malpractice action. Dr. Hegarty delivered Hudson's baby via cesarian-section ("C-section") in 2004. During the operation, but after the baby had been delivered, the placenta became detached from the baby's umbilical cord. Dr. Hegarty searched within and beyond Hudson's uterus but was unable to locate the placenta. Dr. Hegarty requested assistance from his partner at the time, who also tried to locate the placenta but was unsuccessful. Following the operation, Hudson experienced severe pain in her abdomen and dramatic weight loss. Dr. Hegarty eventually ordered a CT scan to be performed and at that time, a mass was located in Hudson's abdomen. Dr. Hegarty then referred Hudson to Dr. Fahy, who subsequently referred her to a doctor in Mobile, who identified and surgically removed the retained placenta from Hudson's abdomen. Hudson sued in 2006 alleging medical negligence. The defendants contended on appeal that the trial court erred in allowing Hudson's expert witness to testify as an expert regarding the applicable standard of care and Dr. Hegarty's alleged breach of it. Defendants also argued that the trial court's charge to the jury was improper and that the judgment against Dr. Hegarty violated public policy. Upon review, the Supreme Court concluded that the trial court exceeded its discretion in allowing Hudson's expert to testify, and as such, erred in denying the doctor's motions for judgment as a matter of law. Accordingly, the Supreme Court reversed the trial court and rendered judgment in favor of Dr. Hegarty.
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R e l : 4/5/13 Notice: T h i s o p i n i o n i s s u b j e c t t o f o r m a l r e v i s i o n b e f o r e p u b l i c a t i o n i n t h e advance sheets o f Southern Reporter. R e a d e r s a r e r e q u e s t e d t o n o t i f y t h e Reporter o f D e c i s i o n s , A l a b a m a A p p e l l a t e C o u r t s , 300 D e x t e r A v e n u e , M o n t g o m e r y , A l a b a m a 3 6 1 0 4 - 3 7 4 1 ( ( 3 3 4 ) 2 2 9 - 0 6 4 9 ) , o f any t y p o g r a p h i c a l o r o t h e r e r r o r s , i n o r d e r t h a t c o r r e c t i o n s may b e made b e f o r e t h e o p i n i o n i s p r i n t e d i n Southern Reporter. SUPREME COURT OF ALABAMA OCTOBER TERM, 2012-2013 1110578 D a n i e l E r n e s t Hegarty, M.D., and M o n r o e v i l l e Medical C l i n i c v. D i x i e Hudson Appeal from Monroe C i r c u i t Court (CV-06-86) BRYAN, J u s t i c e . D a n i e l E r n e s t H e g a r t y , M.D., a n d t h e M o n r o e v i l l e M e d i c a l Clinic ("the C l i n i c " ) Monroe C i r c u i t C o u r t appeal f r o m a judgment e n t e r e d by t h e i n f a v o r o f D i x i e Hudson i n h e r m e d i c a l - 1110578 malpractice action. H e g a r t y and t h e We r e v e r s e and r e n d e r a judgment f o r Dr. Clinic. F a c t s and P r o c e d u r a l H i s t o r y In 2004, Hudson moved from Montgomery s h o r t l y b e f o r e she was t o g i v e b i r t h , to Monroeville and Dr. H e g a r t y , a b o a r d - certified f a m i l y p r a c t i t i o n e r working at the C l i n i c , treat her. 1 section but Dr. H e g a r t y d e l i v e r e d Hudson's baby v i a c e s a r i a n - ( " C - s e c t i o n " ) on June 23, 2004. after agreed to t h e baby had been During the o p e r a t i o n , delivered, t h e p l a c e n t a became detached from the baby's u m b i l i c a l c o r d . Dr. H e g a r t y s e a r c h e d w i t h i n and b e y o n d Hudson's u t e r u s b u t was u n a b l e t o l o c a t e t h e placenta. at Dr. H e g a r t y r e q u e s t e d a s s i s t a n c e t h e t i m e , Dr. A n g e l a P o w e l l , who p l a c e n t a b u t was call to Dr. gynecologist unsuccessful. Jeff Fahy, from h i s p a r t n e r also tried to locate the Dr. P o w e l l p l a c e d a t e l e p h o n e a board-certified obstetrician- ("Ob-Gyn"), f o r a d v i c e and g u i d a n c e r e g a r d i n g t h e missing placenta. B a s e d on Dr. Fahy's r e c o m m e n d a t i o n s t o Dr. D r . H e g a r t y had been c e r t i f i e d i n f a m i l y p r a c t i c e by t h e A m e r i c a n B o a r d o f F a m i l y P r a c t i c e , w h i c h i s now known as t h e American Board of Family Medicine. Family p r a c t i c e i s a d e f i n e d m e d i c a l s p e c i a l t y t h a t , Dr. H e g a r t y t e s t i f i e d , i n c l u d e s t r a i n i n g i n various p r a c t i c e areas, including geriatrics, p e d i a t r i c s , pulmonology, c a r d i o l o g y , o b s t e t r i c s , gynecology, and emergency m e d i c i n e . 1 2 1110578 P o w e l l , w h i c h were r e l a y e d t o Dr. H e g a r t y , Dr. H e g a r t y closed Hudson's i n c i s i o n w i t h o u t r e t r i e v i n g t h e p l a c e n t a , w i t h a p l a n f o r f o l l o w - u p c a r e . F o l l o w i n g t h e o p e r a t i o n , Hudson e x p e r i e n c e d severe pain i n h e r abdomen and d r a m a t i c w e i g h t loss. H e g a r t y e v e n t u a l l y o r d e r e d a CT s c a n t o be p e r f o r m e d 15, 2004, and, a t t h a t abdomen. t i m e , a mass was Dr. H e g a r t y then r e f e r r e d located surgically abdomen. In Monroe Hudson t o Dr. Fahy, the r e t a i n e d 2006, Hudson sued County H o s p i t a l negligence placenta Clinic, identified p l a c e n t a from Dr. H e g a r t y , the C l i n i c , ("the H o s p i t a l " ) , named d e f e n d a n t s , a l l e g i n g related t o Dr. f r o m Hudson. Hegarty's Hudson a l l e g e d along with one c o u n t Hudson's failure that and t h e several of medical t o remove the Dr. H e g a r t y , t h e and t h e H o s p i t a l h a d b r e a c h e d t h e a p p l i c a b l e s t a n d a r d c a r e i n a number o f ways. Dr. H e g a r t y , t h e C l i n i c , Hospital who 2 fictitiously of removed July i n Hudson's s u b s e q u e n t l y r e f e r r e d h e r t o a d o c t o r i n M o b i l e , who and on Dr. each filed an answer denying the and t h e allegation of n e g l i g e n c e and d e n y i n g any b r e a c h o f t h e s t a n d a r d o f c a r e . A " r e t a i n e d p l a c e n t a " i s an " i n c o m p l e t e s e p a r a t i o n o f t h e p [ l a c e n t a ] and i t s f a i l u r e t o be e x p e l l e d a t t h e u s u a l t i m e a f t e r d e l i v e r y o f t h e c h i l d . " Stedman's M e d i c a l D i c t i o n a r y 1389 (27th ed. 2000). 2 3 1110578 In 2010, t h e t r i a l court entered a summary judgment d i s m i s s i n g t h e c l a i m a g a i n s t t h e H o s p i t a l , w h i c h judgment was made f i n a l P., certification. Hegarty as on A u g u s t 17, 2011, b y a R u l e The c a s e and t h e C l i n i c "the defendants"). proceeded Before b e h a l f as t o Dr. H e g a r t y ' s trial, Hudson identified Dr. who w o u l d t e s t i f y on h e r a l l e g e d breach of the standard of moved t h e c o u r t t o p r e c l u d e Dr. Banks f r o m t e s t i f y i n g a t t r i a l and strike his affidavit defendants Dr. a g a i n s t Dr. A f t e r Dr. Banks was d e p o s e d , t h e d e f e n d a n t s trial to to t r i a l (hereinafter referred to collectively G r e g o r y Banks as an e x p e r t w i t n e s s care. 5 4 ( b ) , A l a . R. C i v . argued t h a t , pursuant Banks, similarly therefore, Hegarty and who was situated a deposition testimony. t o § 6-5-548, A l a . Code 1 9 7 5 , board-certified Ob-Gyn, 4 was c o u l d n o t t e s t i f y as t o t h e s t a n d a r d and, o f c a r e Dr. s h o u l d have e x e r c i s e d w i t h r e g a r d t o t h e r e m o v a l o f t h e The t r i a l defendants t h e n f i l e d a m o t i o n i n l i m i n e s e e k i n g , among 3 3 not a h e a l t h - c a r e p r o v i d e r t o Dr. H e g a r t y placenta. things, The to preclude court denied the defendants' Dr. Banks from t e s t i f y i n g motion. The other as an e x p e r t . T h e p e r t i n e n t p a r t s o f § 6-5-548 a r e q u o t e d i n f r a . D r . Banks h a d been b o a r d - c e r t i f i e d as an Ob-Gyn b y t h e A m e r i c a n C o l l e g e o f O b s t e t r i c s and G y n e c o l o g y . 4 4 1110578 The trial c o u r t d e n i e d t h e m o t i o n i n s o f a r as i t r e l a t e d t o Dr. Banks's testimony. The c a s e was t r i e d before a jury. Dr. B a n k s testified t h a t , as a b o a r d - c e r t i f i e d Ob-Gyn, he c o u l d d e l i v e r b a b i e s a n d that Dr. H e g a r t y , as a b o a r d - c e r t i f i e d could also d e l i v e r babies. family practitioner, He t e s t i f i e d f u r t h e r t h a t , t h e r e was c o m m o n a l i t y i n how b a b i e s a r e d e l i v e r e d , family practice and that he had never Banks been testified the p r a c t i c e t a k i n g c a r e o f a mom trained, that Dr. applicable He Hegarty Hudson's b a b y . of o b s t e t r i c s or was stated standard board- practicing A c c o r d i n g t o Dr. "primarily ... involves ... up t o t h e t i m e o f h e r d e l i v e r y , care of her through the d e l i v e r y , process." licensed, practitioner. o b s t e t r i c s when he d e l i v e r e d Banks, Ob-Gyn a n d a r e s e p a r a t e and d i s t i n c t m e d i c a l s p e c i a l t i e s c e r t i f i e d as a f a m i l y Dr. although that of care Dr. taking and then a f t e r t h e d e l i v e r y Hegarty when he deviated failed from the t o remove t h e p l a c e n t a f r o m Hudson when he p e r f o r m e d t h e C - s e c t i o n a n d t h a t a second d e v i a t i o n on the f i r s t , " from t h e s t a n d a r d o f c a r e , "which h i n g e [ d ] o c c u r r e d when Dr. H e g a r t y f a i l e d t o p e r f o r m a CT s c a n i m m e d i a t e l y a f t e r t h e c o n c l u s i o n at l e a s t t h e next day. 5 of the C-section, or 1110578 However, obstetrical practice Dr. Banks treatment also testified o f Hudson for a board-certified fell that within family Hudson was a l o w - r i s k o b s t e t r i c p a t i e n t . Dr. Hegarty's the scope p r a c t i t i o n e r because Dr. Banks a l s o stated t h a t , i n p e r f o r m i n g t h e C - s e c t i o n on H u d s o n , Dr. H e g a r t y d o i n g what he was f u l l y a u t h o r i z e d of was t o do b a s e d on h i s t r a i n i n g and e d u c a t i o n as a f a m i l y p r a c t i t i o n e r and t h a t h i s actions were w i t h i n t h e s c o p e o f f a m i l y p r a c t i c e . Hudson a t t e m p t e d t o a r g u e , h o w e v e r , t h a t , i n s p i t e o f h i s f a m i l y - p r a c t i c e c e r t i f i c a t i o n , Dr. H e g a r t y h a d h e l d h i m s e l f o u t as a s p e c i a l i s t i n o b s t e t r i c s . curriculum vitae practiced "complete Hudson r e l i e d on Dr. H e g a r t y ' s ("CV"), i n w h i c h he h a d w r i t t e n t h a t he h a d obstetrics and pediatrics and family m e d i c i n e " w h i l e w o r k i n g a t Atmore C o m p l e t e F a m i l y H e a l t h . Hegarty "from testified that the term ... b i r t h u n t i l o l d age." "complete" Dr. on h i s CV Dr. H e g a r t y ' s CV a l s o meant stated t h a t he h a d done a f e l l o w s h i p i n r u r a l f a m i l y m e d i c i n e , where he h a d r e c e i v e d " i n t e n s i v e t r a i n i n g i n h i g h r i s k and operative obstetrics." Dr. B a n k s t e s t i f i e d t h a t , b a s e d on Dr. H e g a r t y ' s CV and h i s h o s p i t a l c r e d e n t i a l s , Dr. H e g a r t y was a f a m i l y p r a c t i t i o n e r who a l s o p r a c t i c e d o b s t e t r i c s . Dr. B a n k s a l s o t e s t i f i e d 6 that 1110578 performing "complete obstetrics" for a low-risk patient is w i t h i n t h e s c o p e o f t h e f a m i l y - p r a c t i c e s p e c i a l t y , t h a t Hudson was a low-risk patient, and that Dr. Hegarty could care for Hudson w i t h i n h i s e x p e r i e n c e and t r a i n i n g as a b o a r d - c e r t i f i e d family practitioner. At the all the c l o s e o f Hudson's c a s e , and evidence, law, the a g a i n at the d e f e n d a n t s moved of failed to p r o f f e r e x p e r t t e s t i m o n y from a s i m i l a r l y provider, among o t h e r a judgment matter health-care arguing, for close things, p u r s u a n t t o § 6-5-548. that as Hudson The of a had situated trial court denied both motions. The t r i a l court determined that a question as t o w h e t h e r Dr. H e g a r t y had in as o b s t e t r i c s so care expected Banks was of held himself to b r i n g himself obstetricians q u a l i f i e d to testify s i m i l a r l y situated health-care charged the j u r y with and, o b s t e t r i c s t r a i n i n g and participate i n and that the therefore, against Dr. specialist standard whether Hegarty Thus, t h e t r i a l w h e t h e r Dr. "beyond t h a t w h i c h a b o a r d c e r t i f i e d had o u t as a within provider. deciding of f a c t e x i s t e d H e g a r t y had s u c h was r e n d e r e d c a r e t o D i x i e Hudson." 7 his The Dr. as status trial at the a court acted family practitioner d e l i v e r e d babies would of who typically time he court noted that i f 1110578 Dr. H e g a r t y had a c t e d b e y o n d t h e s c o p e o f h i s s p e c i a l t y i n h i s c a r e o f Hudson, Dr. B a n k s c o u l d t e s t i f y as a s i m i l a r l y h e a l t h - c a r e p r o v i d e r as apply. However, t h e to the trial standard [ t h e m ] ... of care." considered, t h a t Dr. The " t h e r e w o u l d be Hegarty defendants On no should t o the jury testimony evidence before breached the a p p l i c a b l e s t a n d a r d and Hudson o b j e c t e d to the trial t h e a d m i s s i b i l i t y o f Dr. testimony. September 16, f a v o r o f Hudson i n t h e entered that t h a t Dr. B a n k s ' s c o u r t ' s a l l o w i n g the j u r y to determine Banks's care court's instructions a l s o s t a t e d t h a t , i f i t determined s h o u l d n o t be of situated a defendants final filed 2011, the jury returned amount o f $150,000. judgment based on that a verdict The trial The a renewed m o t i o n f o r a judgment as a h e a r i n g on t h e p o s t j u d g m e n t m o t i o n , court verdict. o f law and, i n t h e a l t e r n a t i v e , a m o t i o n f o r new the t r i a l trial. matter At the court s t a t e d : " [ T ] h e r e a s o n t h a t I s u b m i t t e d [ t h e q u e s t i o n o f Dr. B a n k s ' s q u a l i f i c a t i o n as an e x p e r t ] t o t h e j u r y was b e c a u s e t h e r e was a c o n t e s t i n the f a c t s about w h e t h e r o r n o t [ D r . H e g a r t y ] d i d go b e y o n d h i s s p e c i a l t y and I t h o u g h t t h a t was a f a c t q u e s t i o n t o be d e t e r m i n e d by t h e j u r y . However, i f I had t o r u l e as a m a t t e r o f l a w , I w o u l d have a l l o w e d Dr. B a n k s t o testify. "So, i f t h e Supreme C o u r t wonders Judge t h i n k t h a t [ D r . H e g a r t y ] s h o u l d 8 in does have this been 1110578 a l l o w e d t o t e s t i f y , and i f we t o l d him, you have g o t t o d e c i d e t h a t , what w o u l d he d e c i d e ? I w o u l d d e c i d e t h a t he c o u l d t e s t i f y , s o , you know, i f I e r r e d i n s u b m i t t i n g t h e i s s u e t o t h e j u r y and i f i t s h o u l d have been d e t e r m i n e d by me, my d e t e r m i n a t i o n w o u l d be t h e same t h a t t h e j u r y ' s was " The trial c o u r t e x p l a i n e d t h a t , by did " c o m p l e t e o b s t e t r i c s and p e d i a t r i c s and Dr. H e g a r t y " h e l d h i m s e l f out t o be more t h a n he was went o u t s i d e of his s t a t i n g i n h i s CV s p e c i a l t y and I so family that medicine," and thus h o l d [ t h a t ] he held h i m s e l f o u t as d o i n g more t h a n a f a m i l y p r a c t i t i o n e r w o u l d i n my o p i n i o n . " could have Therefore, considered he do the t r i a l c o u r t concluded, Banks's Dr. the j u r y similarly testimony as a s i t u a t e d h e a l t h - c a r e p r o v i d e r , p u r s u a n t t o § 6-5-548, as t o t h e a l l e g e d breach of the standard of care. the d e f e n d a n t s ' m o t i o n s , and The t r i a l court denied the defendants appealed. Issues The allowing defendants contend Dr. to Banks applicable standard thereof. The Dr. testify of care defendants c h a r g e t o t h e j u r y was that and also the trial Dr. Hegarty's a l l e g e d breach that the regarding in an i m p r o p e r and trial t h a t t h e judgment Hegarty v i o l a t e s p u b l i c p o l i c y . Standard of Review 9 erred as argue expert court the court's against 1110578 "'"The s t a n d a r d of review a p p l i c a b l e t o w h e t h e r an e x p e r t s h o u l d be p e r m i t t e d t o t e s t i f y i s well settled. The matter is ' l a r g e l y d i s c r e t i o n a r y w i t h the trial c o u r t , and that court's judgment w i l l n o t be d i s t u r b e d a b s e n t an abuse o f d i s c r e t i o n . ' Hannah v. G r e g g , B l a n d & B e r r y , Inc., 840 So. 2d 839, 850 ( A l a . 2002). We now refer to that standard as a trial court's 'exceeding i t s d i s c r e t i o n . ' See, e.g., V e s t a F i r e I n s . C o r p . v. M i l a m & Co. C o n s t r . , I n c . , 901 So. 2d 84, 106 ( A l a . 2004) ('Our review of the r e c o r d supports the c o n c l u s i o n t h a t the t r i a l c o u r t d i d not exceed i t s d i s c r e t i o n i n f i n d i n g t h a t J o n e s was p r o p e r l y q u a l i f i e d as an e x p e r t u n d e r R u l e 702[, A l a . R. Evid.,] and in considering his testimony.'). However, t h e s t a n d a r d i t s e l f has not changed." " ' K y s e r v. H a r r i s o n , (Ala. 2005).' 908 So. " R o b i n s o n v. B a p t i s t H e a l t h S y s . , 1119, 1125 ( A l a . C i v . App. 2 0 0 9 ) . 2d Inc., "'"'The standard of review a p p l i c a b l e to a motion for directed verdict or judgment notwithstanding the v e r d i c t [now r e f e r r e d t o as a p r e v e r d i c t and a p o s t v e r d i c t motion f o r a judgment as a m a t t e r o f law] i s i d e n t i c a l t o t h e standard used by the 10 914, 918 24 So. 3d 1110578 t r i a l court i n granting or denying the motions initially. Thus, when reviewing the trial c o u r t ' s r u l i n g on e i t h e r motion, we determine whether there was s u f f i c i e n t evidence to produce a conflict warranting j u r y c o n s i d e r a t i o n . And, l i k e t h e t r i a l c o u r t , we must v i e w any e v i d e n c e most favorably to the non-movant.'" " ' G l e n l a k e s R e a l t y Co. v. Norwood, 721 So. 2d 174, 177 ( A l a . 1998) ( q u o t i n g B u s s e y v. John Deere Co., 531 So. 2d 860, 863 ( A l a . 1988)).' "Parker 2 00 7)." v. Williams, 977 So. 2d 476, 480 (Ala. S p r i n g h i l l Hosps., I n c . v. C r i t o p o u l o s , 87 So. 3d 1178, (Ala. 1180-81 2011). Discussion The defendants first argue that they are e n t i t l e d to a judgment as a m a t t e r o f l a w b e c a u s e , t h e y a r g u e , Dr. Banks not a s i m i l a r l y under situated health-care p r o v i d e r t o Dr. § 6-5-548, and, t h u s , he s h o u l d n o t have been was Hegarty permitted t o t e s t i f y a g a i n s t Dr. H e g a r t y as t o t h e a l l e g e d b r e a c h o f t h e standard 1012-13 of care. I n Holcomb v. C a r r a w a y , ( A l a . 2006), t h i s Court s t a t e d : 11 945 So. 2d 1009, 1110578 "The p l a i n t i f f i n a m e d i c a l - m a l p r a c t i c e a c t i o n must p r o v e by s u b s t a n t i a l e v i d e n c e t h a t t h e d e f e n d a n t health-care provider 'failed to exercise such reasonable care, s k i l l , and diligence as other s i m i l a r l y s i t u a t e d h e a l t h c a r e p r o v i d e r s i n t h e same g e n e r a l l i n e o f p r a c t i c e o r d i n a r i l y have and e x e r c i s e i n a l i k e c a s e . ' § 6 - 5 - 5 4 8 ( a ) , A l a . Code 1975. To meet t h i s b u r d e n , a p l a i n t i f f o r d i n a r i l y must p r e s e n t expert medical testimony; however, such expert t e s t i m o n y i s a l l o w e d o n l y from a ' s i m i l a r l y s i t u a t e d h e a l t h c a r e p r o v i d e r . ' See § 6 - 5 - 5 4 8 ( e ) , A l a . Code 1975; L e o n a r d v. P r o v i d e n c e Hosp., 590 So. 2d 906 (Ala. 1991). " S e c t i o n 6-5-548, a p r o v i s i o n o f t h e Alabama M e d i c a l L i a b i l i t y A c t , § 6-5-504 e t s e q . , A l a . Code 1975 ('the AMLA'), p r o v i d e s two d e f i n i t i o n s o f a ' s i m i l a r l y s i t u a t e d h e a l t h care p r o v i d e r , ' depending upon w h e t h e r t h e d e f e n d a n t h e a l t h - c a r e p r o v i d e r i s a ' s p e c i a l i s t ' o r a ' n o n s p e c i a l i s t . ' See § 6-5-548(b) and ( c ) , A l a . Code 1975. ... " S e c t i o n 6-5-548(c) p r o v i d e s : "(c) Notwithstanding any p r o v i s i o n of the Alabama R u l e s o f E v i d e n c e t o t h e c o n t r a r y , i f t h e h e a l t h c a r e p r o v i d e r whose b r e a c h o f t h e s t a n d a r d o f c a r e i s c l a i m e d t o have c r e a t e d t h e c a u s e o f a c t i o n i s c e r t i f i e d by an a p p r o p r i a t e A m e r i c a n b o a r d as a s p e c i a l i s t , i s t r a i n e d and e x p e r i e n c e d i n a m e d i c a l s p e c i a l t y , and h o l d s h i m s e l f o r h e r s e l f o u t as a specialist, a 'similarly situated health care p r o v i d e r ' i s one who meets a l l o f t h e following requirements: "(1) I s l i c e n s e d by t h e a p p r o p r i a t e r e g u l a t o r y b o a r d o r a g e n c y o f t h i s o r some other state. "(2) I s t r a i n e d and e x p e r i e n c e d i n t h e same s p e c i a l t y . 12 1110578 "(3) I s c e r t i f i e d b y an a p p r o p r i a t e A m e r i c a n b o a r d i n t h e same s p e c i a l t y . "(4) Has p r a c t i c e d i n t h i s s p e c i a l t y d u r i n g the year p r e c e d i n g the date t h a t the a l l e g e d breach of the standard of care occurred." Regarding the a p p l i c a b i l i t y has o f § 6-5-548(c), this Court stated: "In o r d e r t o determine whether t h e defendant h e a l t h - c a r e p r o v i d e r q u a l i f i e s as a s p e c i a l i s t , we must f i r s t d e t e r m i n e t h e f i e l d o f m e d i c a l p r a c t i c e i n w h i c h t h e n e g l i g e n c e i s a l l e g e d t o have o c c u r r e d . I f the defendant h e a l t h - c a r e p r o v i d e r i s a s p e c i a l i s t i n the f i e l d o f p r a c t i c e i n which t h e a l l e g e d n e g l i g e n c e o c c u r r e d , t h e n t h e p r o f f e r e d e x p e r t w i t n e s s must a l s o be a s p e c i a l i s t i n t h a t f i e l d , u n d e r § 6 - 5 - 5 4 8 ( c ) , A l a . Code 1975. See a l s o M e d l i n v. C r o s b y , 583 So. 2d 1290, 1293 ( A l a . 1 9 9 1 ) . " Holcomb, 945 So. 2d a t 1013. In this certified by case, i t was an A m e r i c a n undisputed that board as a Dr. H e g a r t y specialist was i n family p r a c t i c e , t h a t he was t r a i n e d a n d e x p e r i e n c e d as a specialist in out family practice, and that specialist i n family practice. he held himself as a Hudson a l l e g e d t h a t Dr. H e g a r t y breached the a p p l i c a b l e s t a n d a r d o f care d u r i n g h i s performance o f h e r C - s e c t i o n when he f a i l e d t o remove t h e p l a c e n t a f r o m h e r abdomen. Dr. Banks t e s t i f i e d , a n d i t was n o t d i s p u t e d , that Dr. H e g a r t y ' s p e r f o r m a n c e o f Hudson's C - s e c t i o n f e l l w i t h i n t h e 13 1110578 scope of his family-practice u n d i s p u t e d t h a t Dr. H e g a r t y was specialty standard 548(c) of specialty. occurred, we a l l e g e d breach conclude that subsection H e g a r t y was was of the § 6-5- a s p e c i a l i s t f o r purposes of § 5 - 5 4 8 ( c ) , § 6 - 5 - 5 4 8 ( e ) , A l a . Code 1975, p a r t e W a d d a i l , 827 the i t applied. B e c a u s e Dr. if Because c e r t i f i e d i n and p r a c t i c i n g h i s f a m i l y p r a c t i c e when t h e of care 5 defendant So. 2d 789, health-care 794 ( A l a . 2001) provider under s u b s e c t i o n ( c ) , § 6-5-548(e) o f t h e ...."). 6-5-548(e) Section a l s o a p p l i e s . See " i s not (holding a 6Ex that, specialist [AMLA] does n o t apply provides: "(e) The p u r p o s e o f t h i s s e c t i o n i s t o e s t a b l i s h a relative standard of care for health care p r o v i d e r s . A h e a l t h c a r e p r o v i d e r may t e s t i f y as an e x p e r t w i t n e s s i n any a c t i o n f o r i n j u r y o r damages a g a i n s t a n o t h e r h e a l t h c a r e p r o v i d e r b a s e d on a b r e a c h o f t h e s t a n d a r d o f c a r e o n l y i f he o r she i s a 'similarly situated health care provider' as d e f i n e d above. I t i s t h e i n t e n t o f t h e L e g i s l a t u r e t h a t i n the event the defendant h e a l t h care p r o v i d e r i s c e r t i f i e d by an a p p r o p r i a t e A m e r i c a n b o a r d o r i n a p a r t i c u l a r s p e c i a l t y and is practicing that H u d s o n and t h e t r i a l c o u r t r e l i e d on s t a t e m e n t s i n Dr. H e g a r t y ' s CV t h a t he p r a c t i c e d " c o m p l e t e o b s t e t r i c s " as e v i d e n c e i n d i c a t i n g t h a t he was p r a c t i c i n g o u t s i d e h i s f a m i l y p r a c t i c e s p e c i a l t y . However, s t a t e m e n t s i n a CV as t o t h e s c o p e o f h i s p r a c t i c e a t a p r i o r f a c i l i t y do n o t c o n s t i t u t e e v i d e n c e i n d i c a t i n g t h a t Dr. H e g a r t y a c t e d o u t s i d e h i s s p e c i a l t y a t t h e time of the a l l e g e d b r e a c h of the standard of care i n t h i s case. 5 14 1110578 s p e c i a l t y a t the time of the a l l e g e d breach o f the s t a n d a r d o f c a r e , a h e a l t h c a r e p r o v i d e r may t e s t i f y as an e x p e r t w i t n e s s w i t h r e s p e c t t o an a l l e g e d b r e a c h o f t h e s t a n d a r d o f c a r e i n any a c t i o n f o r i n j u r y , damages, o r w r o n g f u l d e a t h a g a i n s t a n o t h e r h e a l t h c a r e p r o v i d e r o n l y i f he o r she i s c e r t i f i e d by t h e same A m e r i c a n b o a r d i n t h e same s p e c i a l t y . " (Emphasis added.) Dr. H e g a r t y i s c e r t i f i e d b y t h e A m e r i c a n B o a r d o f F a m i l y Medicine; Dr. Banks i s c e r t i f i e d O b s t e t r i c s and Gynecology. are not c e r t i f i e d by t h e American C l e a r l y , Dr. H e g a r t y a n d Dr. Banks i n t h e same s p e c i a l t y American board. American Board o f F a m i l y M e d i c i n e , because in that Because specialty College of Dr. H e g a r t y by the a p p r o p r i a t e i s certified he was by the practicing a t t h e t i m e he p e r f o r m e d t h e C - s e c t i o n on Hudson, a n d b e c a u s e Dr. Banks was n o t c e r t i f i e d b y t h e same A m e r i c a n b o a r d i n t h e same s p e c i a l t y , p u r s u a n t t o § 6-5-548(e) Dr. Banks was n o t p e r m i t t e d t o t e s t i f y as a s i m i l a r l y health-care provider t o the standard of care H e g a r t y was t o be h e l d . or commonality situated t o w h i c h Dr. The f a c t t h a t t h e r e i s some o v e r l a p i n the p r a c t i c e of a b o a r d - c e r t i f i e d family p r a c t i t i o n e r a n d a b o a r d - c e r t i f i e d Ob-Gyn ( i . e . , t h a t b o t h were t r a i n e d to perform C-sections) i s i r r e l e v a n t . Price, I n J o h n s o n v. 743 So. 2d 436, 438 ( A l a . 1 9 9 9 ) , t h i s C o u r t h e l d : 15 1110578 "The f a c t t h a t [two c e r t i f y i n g b o a r d s ] may have t h e same p u r p o s e , t h a t t h e y may c e r t i f y p r o v i d e r s f o r t h e same p r o c e d u r e s , o r t h a t t h e y may r e q u i r e t h e same qualifications would be irrelevant. Section 6-5-548(e) p l a i n l y s t a t e s t h a t i f t h e two p r o v i d e r s are n o t c e r t i f i e d b y t h e same o r g a n i z a t i o n , t h e n one c a n n o t t e s t i f y as t o t h e s t a n d a r d o f c a r e a p p l i c a b l e t o t h e o t h e r . A l l q u e s t i o n s o f p r o p r i e t y , wisdom, n e c e s s i t y , u t i l i t y , and e x p e d i e n c y o f l e g i s l a t i o n a r e e x c l u s i v e l y f o r t h e L e g i s l a t u r e and a r e q u e s t i o n s w i t h w h i c h t h i s C o u r t has no c o n c e r n . " (Emphasis For added.) these reasons, we conclude that the t r i a l court e x c e e d e d i t s d i s c r e t i o n when i t p e r m i t t e d Dr. Banks t o t e s t i f y as a s i m i l a r l y s i t u a t e d h e a l t h - c a r e p r o v i d e r i n t h i s c a s e . The only the evidence indicating that Dr. Hegarty breached a p p l i c a b l e s t a n d a r d o f c a r e came f r o m Dr. B a n k s . t e s t i m o n y was i m p r o p e r l y a d m i t t e d i n t o Because t h a t evidence and because t h e r e was no o t h e r t e s t i m o n y as t o t h e s t a n d a r d o f c a r e , t h e trial court e r r e d i n denying the defendants' motions for a judgment as a m a t t e r o f l a w . A c c o r d i n g l y , we r e v e r s e t h e t r i a l c o u r t ' s judgment a n d r e n d e r a judgment as a m a t t e r o f l a w i n favor of the defendants. 6 REVERSED AND JUDGMENT RENDERED. O u r d e c i s i o n t o r e v e r s e a n d t o r e n d e r a judgment on t h i s b a s i s p r e t e r m i t s d i s c u s s i o n o f the remaining i s s u e s r a i s e d by t h e d e f e n d a n t s on a p p e a l . 6 16 1110578 Moore, C . J . , and S t u a r t , Bolin, Wise, J J . , concur. Murdock, J . , c o n c u r s specially. 17 P a r k e r , Shaw, M a i n , and 1110578 MURDOCK, J u s t i c e ( c o n c u r r i n g I concur. i s s u e and the I write t o e x p l a i n my specially). separately to address a procedural a g r e e m e n t w i t h t h e m a i n o p i n i o n as to merits. A. Because The questions H e g a r t y , M.D., Jury existed Charges as to whether Daniel Ernest t h e p h y s i c i a n d e f e n d a n t , h e l d h i m s e l f o u t as a s p e c i a l i s t and w h e t h e r t h e p l a i n t i f f ' s p r o f f e r e d e x p e r t was a "similarly situated health care provider," gave i n s t r u c t i o n s t h a t a l l o w e d the whether testimony expert i t could consider witness. Understandably Both the sides the trial j u r y to decide objected of to court for itself the plaintiff's this procedure. so. I t i s fundamental t h a t i t i s the t a s k of the t r i a l not the j u r y , to decide admissible. evidence; Rule 104(a), the A the jury trial whether the testimony does court A l a . R. E v i d . qualifications of not decide makes of a w i t n e s s whether that i t may to be a witness is hear decision. ("Preliminary questions a person court, See concerning ... or the a d m i s s i b i l i t y o f e v i d e n c e s h a l l be d e t e r m i n e d by t h e c o u r t . " ) ; S t a r F r e i g h t , I n c . v. S h e f f i e l d , 587 18 So. 2d 946, 956-57 ( A l a . 1110578 1991) (holding that the admissibility q u e s t i o n of law f o r the t r i a l A fortiori, malpractice i t was case to our legal should standards have gate-keeping trial heard purposes the trial Crosby, this for 2d 1290 is a this resolve medical- whether an i n the within first place jury was the p r o v i n c e of gate-keeping ( A l a . 1991) under the q u e s t i o n must be i t . expert competent D e c i d i n g whether testimony of performing So. in this o f t h e p a r t i e s was If a factual must jury itself function peculiarly court 583 f o r the to t e s t i f y . court i t s e l f . for not one evidence court to decide). decide w i t n e s s p r o f f e r e d by of See, the resolved function, e.g., a then Medlin ( d i s c u s s i n g the v. standard t o be a p p l i e d by t h e t r i a l c o u r t i n d e c i d i n g t h e competence o f an e x p e r t w i t n e s s i n a m e d i c a l - m a l p r a c t i c e c a s e ) . Because the trial court testimony of the p l a i n t i f f ' s heard that testimony, allowed e x p e r t and decide consider that testimony, Normally, a new trial the for a legal w o u l d be jury hear then, having itself whether error required. to The was the already i t could committed. disposition of t h i s c a s e made by t h e C o u r t t o d a y , h o w e v e r , o b v i a t e s t h e n e e d for a remand and a new trial. 19 1110578 B. The Merits I n M e d l i n , Ex p a r t e W a d d a i l , 827 So. 2d 789 ( A l a . 2001), and H o l l y v. H u n t s v i l l e H o s p i t a l , 865 So. 2d 1177 ( A l a . 2003), this Court appeared to treat the emergency-room p r a c t i c e t h e p h y s i c i a n d e f e n d a n t i n e a c h c a s e as p a r t o f a or s c h o o l of p r a c t i c e beyond family practice See, e.g., i n which Holly, 865 or d i f f e r e n t So. 2d a t 1186 discipline from the f i e l d t h e d e f e n d a n t was that, outside because his ( d i s c u s s i n g the Court's the d e f e n d a n t d o c t o r had been speciality n e g l i g e n c e , he was us"). in of board-certified. e a r l i e r h o l d i n g s i n M e d l i n and W a d d a i l and s t a t i n g t h a t held of committing the "[w]e practicing alleged medical not a ' s p e c i a l i s t ' i n the case then b e f o r e B a s e d on my r e a d i n g o f t h e s e t h r e e c a s e s , t h e manner i n w h i c h t h e l a s t s e n t e n c e o f § 6 - 5 - 4 5 8 ( e ) , A l a . Code 1975, i s worded, sentence and the fact of s u b s e c t i o n Court's decision i n 1 9 9 5 ) , I am If could this the legislature (e) t o t h a t statute added soon the last after this O l s e n v. R i c h , 657 So. 2d 875, 880 ( A l a . c o m p e l l e d t o concur i n the main opinion. were a matter q u e s t i o n the legislature that and of making strictness argue that, 20 of the in a a policy rule case choice, chosen such as by one the this, 1110578 Dr. G r e g o r y B a n k s , a s s u m i n g he c o u l d t a i l o r h i s t e s t i m o n y t o the standard o f care Dr. Hegarty, should f o r a physician be deemed i n the p o s i t i o n of competent t o do s o . This, h o w e v e r , i s n o t t h e p r e s c r i p t i o n f o r competence t h a t h a s b e e n w r i t t e n by o u r l e g i s l a t u r e . H a v i n g been p r e s e n t e d as to the c o n s t i t u t i o n a l i t y of this no a r g u m e n t prescription -- a n d a s s u m i n g f o r t h e s a k e o f t h i s c a s e t h a t t h e r e i s none -- i t i s not our r o l e t o p r e s c r i b e some d i f f e r e n t r u l e . Ex p a r t e T.D.T., 745 So. 2d 899, the duty of t h i s Court to question 102, People v. M c I n t i r e , 109 (1999) ("[A] e.g., 904 ( A l a . 1999) ( " [ I ] t i s n o t t h e wisdom, o r t h e l a c k t h e r e o f , used by t h e L e g i s l a t u r e i n e n a c t i n g State."); See, t h e laws o f t h i s 461 M i c h . 147, 159, 599 N.W.2d legislature is free to make i n e f f i c a c i o u s o r e v e n u n w i s e p o l i c y c h o i c e s . The c o r r e c t i o n o f t h e s e p o l i c y c h o i c e s i s n o t a j u d i c i a l f u n c t i o n as l o n g as t h e legislative choices do n o t o f f e n d t h e r e f o r e must c o n c u r . 21 the c o n s t i t u t i o n . " ) . I
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