Significance of Expert Testimony in a Medical Malpractice Case wherein causation is disputed

Significance of Expert Testimony in a Medical Malpractice Case wherein causation is disputed

The Supreme Court of Arizona affirmed in Sampson v. Surgery Center of Peoria, LLC CV-20-0024-PR that in Arizona medical malpractice cases, causation must be established by competent expert testimony, except where causation is readily apparent. The Court further held that a jury in a medical malpractice case may not be left to “infer” causation without the guidance of expert testimony where the cause of death is disputed and not obvious to an ordinary person.

In March 2012, plaintiff’s son had undergone a scheduled tonsillectomy and adenoidectomy. The said procedure was considered to be routine procedure which had no complication rate. Physicians performed the procedure by administering general anesthesia. Post the procedure, they observed the child for the next 30 minutes in the operating room and was transferred to a post-operative anesthesia care unit. The boy was awake and crying and was discharged home by the unit in an hour. After two hours of his discharge he was found to be not breathing and was not able to revive by the emergency personnel.

Plaintiff brought a wrongful death action against several healthcare personnel, including the Surgery Center. As required by Ariz. Rev. Stat. 12-2603, Plaintiff also arranged expert witness to establish cause of death, proximate cause, and standard of care.

The trial court granted summary judgment, by stating that the expert’s testimony failed to establish causation that the boy would have survived with longer observation. But the court of appeals of Arizona reversed the trial court’s ruling, by concluding that a reasonable jury could find that the standard of care for observation was three hours, and could thus “infer” that the early discharge was the probable cause of death. The supreme court did not agree with the court of appeals’ decision and therefore ordered summary judgement.

In Arizona medical malpractice cases, causation must be established by competent expert testimony, except where causation is “readily apparent.” The court also cited an example of another case where causation was readily apparent—a dentist leaving a piece of metal imbedded in a patient’s jaw. However, in Sampson, causation was not readily apparent. Thus, the court stated that “given that even the medical experts did not agree on the cause of death, it is unrealistic to conclude, as the court of appeals did, that a jury ‘could properly infer that the early discharge was the probable cause of [the c]hild’s death.’”

Finally, the court held that the plaintiff’s causation regarding the “three-hour observation period could have prevented the death” failed to “connect the dots between the premature discharge and [the c]hild’s death.”  Thus court found this causation insufficient. This ruling emphasizes the need for strong expert testimony on each element of a medical malpractice case.