A late summer decision by the Arizona Supreme Court has drastically changed the way the state perceives medical malpractice cases when they ruled that all medical malpractice lawsuits which involve unclear cases of injury or death cannot proceed without relevant sufficient expert witness testimony delivery guidance for jurors.
The original case was nearly a decade old, originating from a 2012 death of a young boy, age four, who was directed home by a surgery center after being under close supervision for 30 minutes to an hour after a tonsillectomy as well as an additional procedure that included administration of general anesthesia. When he was sent to anesthesia post-operative center he was awake and crying.
After the boy was sent home he went directly to bed. Two hours later he was not breathing.
In the case the plaintiff sued with an expert opinion that the doctor was below the standard of care by releasing the boy too early. The Surgery Center argued that the standard of care expert failed to demonstrate that the surgery center’s actions directly caused the young boy’s death.
The plaintiff argued that the cause of death was obvious and no expert causation testimony was needed.
The court thought differently.
In their summary judgement, the trial court ruled that the expert’s testimony did not establish legal cause and the legal issue of if the young boy could have lived with an extended observation period was above the knowledge base of the average juror, so expert testimony was required.
The Arizona court of appeals reversed the trial court’s ruling, stating that an average jury could find the standard length of observation is usually three hours and the direct time inconsistency would lead to an inference that early discharge was the probable cause of death.
The Supreme Court threw out the court of appeals’ decision and ordered that the initial summary judgement be reinstated. The court cited that in the state of Arizona, medical malpractice cases must have causation established by expert testimony unless the cause is ‘readily apparent.’
They cited that even the plaintiff’s own expert did not say that an extended observation period would have prevented the young boy’s death, and testified that the surgery center would have had an opportunity to resuscitate the child. The court ruled that this statement was not sufficient enough information to prove direct causation.
In their ruling statement, the court said, “In a case where the standard of care or the cause of death is disputed on a matter requiring medical knowledge to resolve, it is difficult, if not impossible, to imagine a situation where lay jurors, untrained in medicine or medical procedure, could properly determine liability absent expert guidance.”
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