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Negligent Treatment of Cellulitis Ulcer; Qualified Expert Required


Over a period of five months, a man was treated weekly by a doctor for a cellulitis ulcer on the man’s foot. The man’s skin had broken open due to a common, potentially serious, bacterial skin infection. Approximately one month after the man’s last appointment with the doctor, the man underwent an amputation of a bone in the foot because the bone had become infected.

 

The man sued the doctor for medical malpractice. The complaint alleged that the doctor breached the standard of care and was negligent because the doctor failed to apply certain wound evaluation practices to evaluate the lack of progress of ulcer healing commonly used by doctors providing treatment for this type of condition. The complaint also asserted that the doctor failed to diagnose a foot bone infection developed and required the foot bone to be amputated.

 

After a lengthy discovery period, the man identified a registered nurse as his proposed expert witness. The nurse was a certified wound, ostomy, and continence nurse.

 

The doctor filed a motion to preclude the man’s relying upon an expert witness at trial. The motion contended that the man failed to meet a discovery deadline with respect to the disclosure of the expert witness. Additionally, the motion argued that the man’s expert did not possess the necessary qualifications to render opinions regarding the applicable standard of care for a doctor.

 

The Washington County Superior Court granted the doctor’s motion. The trial court held that the nurse lacked the necessary qualifications to provide opinions in the case relative to the man’s allegations of medical negligence against the doctor. The trial court instructed the man to disclose a qualified expert before a particular deadline or be precluded from relying on any expert witnesses in the case. The man failed to meet the deadline. Accordingly, the trial court precluded the man from relying on expert witness testimony.

 

The doctor filed a motion for summary judgment based on the principle that expert testimony in a medical malpractice case was required to establish the standard of care, deviation from the standard of care, and proximate cause. The trial court granted this motion.

 

The Supreme Court of Rhode Island affirmed. The court held that the man’s failure to present testimony from a qualified medical expert precluded the man from establishing a medical malpractice claim and the man’s contention that the trial judge was biased was unavailing.

 

The man’s failure to present testimony from a qualified medical expert precluded the man from establishing a medical malpractice claim. The man’s medical malpractice claim was complex and non-obvious. The claim was that the doctor breached the standard of care for the treatment of a cellulitis ulcer. The doctor’s negligence would not have been obvious to a layperson. The man’s claims could only have been established by expert testimony. Having been precluded from relying on expert testimony, the man was unable to establish an essential element of the case.

 

The man’s contention that the trial judge was biased was unavailing. The man did not move for the judge’s recusal in the trial court. The court’s consideration of the alleged bias of the judge and whether or not that issue was raised on the record was hampered by the fact that the man chose not to submit any transcripts on appeal. After an in-depth review of record before it, the court was unable to perceive any evidence that the trial judge was biased against the man or acted in any way that would be incompatible with the interests of justice.

 

The Supreme Court of Rhode Island affirmed the trial court’s grant of summary judgment in favor of the doctor.

 

See: Bartlett v. Coppe, 2017 WL 2125840 (R.I., May 16, 2017) (not designated for publication).

 

See also Medical Law Perspectives Report: Diabetes and Its Complications: Malpractice and Other Liability Issues

 

See the Medical Law Perspectives Blog: Medical Expert Testimony Not Necessary to Establish Standard of Care for Failure to Communicate Cancer Diagnosis

 

 

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