A man was involved in a car accident and an ambulance transported him to a hospital where he was admitted to its trauma unit. The man was discharged from the hospital. A few weeks later he was readmitted to the hospital and diagnosed with a fractured pelvis.
The man sued the hospital, the doctors, and a practice group for medical malpractice and negligence. The complaint alleged that the defendants’ failed to diagnose his fractured pelvis during his initial stay at the hospital and that their negligence was the cause of his deficient treatment and premature discharge.
During discovery the man failed to specifically identify his expert witness. The hospital, doctors, and practice group moved for dismissal of the man's claim on the grounds that he had failed to disclose his expert witness in accordance with scheduling orders. During a hearing on the issue, the man indicated that he planned to pursue his case based upon the theory of res ipsa loquitur. As a sanction for failing to specifically identify his expert witness, the Providence County Superior Court issued an order barring the man from engaging the services of an expert witness or witnesses to offer testimony at trial, whether through deposition or live testimony.
Subsequently, the hospital, doctors, and practice group filed a motion for summary judgment arguing that the man could not carry his burden of proof without the benefit of expert testimony and the facts would not support the application of the doctrine of res ipsa loquitur. The trial court entered summary judgment in favor of the hospital, doctors, and practice group.
The Supreme Court of Rhode Island affirmed. The court held that the man could not prevail absent expert testimony establishing the applicable standard of care and any causal link between the alleged breach of standard of care and his injuries and the res ipsa loquitur doctrine did not apply.
The man could not prevail absent expert testimony establishing the applicable standard of care and any causal link between the alleged breach of the standard of care and his injuries. In order for a plaintiff to make out a case of medical malpractice, the plaintiff must provide expert testimony to establish deviation from the standard of care when the lack of care is not so evident as to be obvious to a lay person. The man failed to provide expert testimony establishing the standard of care applicable to the hospital, doctors, and practice group. He also failed to provide expert testimony establishing any causal link between the hospital, doctors, and practice group's alleged breach of the standard of care and his injuries. The court found that this was not the type of case in which the defendants' alleged negligence would be obvious to a layperson. The court determined that the question of whether and how the hospital, doctors, and practice group's diagnosis and treatment of the man aggravated his pelvic fracture was one that must be answered with expert testimony.
The res ipsa loquitur doctrine did not apply. The court held that for a plaintiff to utilize the res ipsa loquitur doctrine, three conditions must be met: (1) the accident or injury must be of a kind which does not occur in the absence of someone's negligence; (2) such accident or injury must be caused by an agency or instrumentality in the exclusive control of the defendant; and (3) it must not have been caused by any voluntary act or contribution on the part of the plaintiff. Even where the doctrine of res ipsa loquitor applies to establish negligence, the plaintiff must establish by competent evidence the causal connection between negligence and a plaintiff's injury. The court reasoned that in this case, even if the doctrine of res ipsa loquitor applied to establish the hospital, doctors, and practice group's negligence, the man’s claim still failed because he did not proffer expert testimony regarding the causal connection between the hospital, doctors, and practice group's negligence and the aggravation of his pelvic fracture. The court also noted that the man failed to offer any evidence to exclude the possibility that, in the intervening time between his first and second stays at the hospital, he or a third party undertook some action that caused or aggravated his pelvic fracture. The court reasoned that the man could not demonstrate that the aggravation of his pelvic fracture would not have occurred had the hospital, doctors, and practice group exercised due care without expert testimony.
The Supreme Court of Rhode Island affirmed the trial court’s grant of summary judgment in favor of the hospital, doctors, and practice group.
See: Laplante v. Rhode Island Hosp., 2015 WL 789947 (R.I., February 25, 2015) (not designated for publication).
See also Medical Law Perspectives, December 2012 Report: When Urgency Leads to Errors: Liability for Emergency Care