P went to her physician D complaining of ankle pain.
D operated on P, placing a screw in her ankle. P did not see D for seven years.
P went to D again complaining that her ankle was giving her considerable pain. D looked at it and wrapped it.
P's ankle continued to worsen; she eventually went to a different doctor 2 years later. The other doctor took an X-ray and found necrosis of the bone around the screw.
P sued D in negligence.
Procedural History:
Trial court found for D.
AZ Supreme Court affirmed, found for D.
Issues:
What is the standard of care required by doctors to avoid claims in negligence?
Holding/Rule:
The standard of care required by doctors to avoid claims in negligence is to exercise ordinary care and skill as an ordinary member of the medical community.
Reasoning:
Rules of medical malpractice…
One licensed to practice medicine is presumed to possess the degree of skill and learning which is possessed by the average member of the medical profession in good standing in the community in which he practices, and to apply that skill and learning, with ordinary and reasonable care, to cases which come to him for treatment. Failure to do this is malpractice.
To be liable in malpractice, a doctor must have done something in his treatment of the patient which the recognized standard of good medical practice in the community in which he is practicing forbids in such cases, or he must have neglected to do something which such standard requires.
The standard of medical practice must be shown by affirmative evidence in order to sustain a verdict.
Negligence on the party of the doctor is never presumed, but must be affirmatively proven, and no presumption of negligence or want of skill arises from the mere fact that a treatment was unsuccessful or failed to bring the best results.
Negligence on the part of a doctor by reason of his departure from the proper standard of practice must be established by expert medical testimony.
The testimony of other physicians that they would have acted differently is not sufficient to establish malpractice alone.
The expert testified that the method used by the D was a standard one and that screws are not typically removed unless they cause trouble for the patient.
He also stated that he would have suspected arthritis in the P but would have taken an X-ray.
This does not establish a community standard, however, and does not make D liable.
Also, it is not clear to a layperson that failure to take an X-ray is negligent since this would be required without proof of the community medical standard.
Dissent:
None.
Notes:
Expert testimony is not required if the departure from the norm is so elementary that a layperson can understand it.
