Donna Faye Shipley v. Robin Williams
2011 Tenn. LEXIS 749, 350 S.W.3d 527 (2011)
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Rule of Law:
In a Tennessee medical malpractice action, an expert witness is not required to have personal, firsthand knowledge of the defendant's medical community to be qualified under the locality rule. The expert can establish the requisite familiarity with the standard of care in the defendant's community or a similar community by educating themselves through means such as research, professional consultation, or review of demographic and facility data.
Facts:
- In January 2001, Dr. Robin Williams, a general surgeon, performed abdominal surgery on Donna Faye Shipley.
- On Saturday, November 17, 2001, Shipley called Dr. Williams with complaints of abdominal pain and a sore throat. Dr. Williams instructed her to schedule an appointment for the following Tuesday.
- The next day, November 18, 2001, Shipley called Dr. Williams again, reporting worsened pain and a 102-degree fever. Dr. Williams directed her to go to the Summit Medical Center emergency room.
- At the emergency room, Dr. Leonard Walker examined Shipley and found she had an elevated white blood cell count of 21,000, low blood pressure, and a high pulse rate.
- Dr. Walker spoke with Dr. Williams by phone, and they agreed that Shipley would not be admitted to the hospital but would instead receive follow-up care with Dr. Williams.
- Shipley was discharged from the emergency room with instructions to call Dr. Williams' office the next morning to arrange a recheck.
- Shipley alleged that she made several calls to Dr. Williams's office for follow-up care but was informed that Dr. Williams would not see her for a non-surgical matter.
- On the evening of November 21, 2001, Shipley returned to the emergency room in critical condition and was diagnosed with acute sepsis, pneumonia, and acute renal failure, subsequently suffering a debilitating stroke.
Procedural Posture:
- Donna Faye Shipley sued Dr. Robin Williams, Dr. Leonard Walker, and Summit Medical Center in the Circuit Court for Davidson County (trial court) for medical negligence.
- The trial court granted unopposed motions for summary judgment in favor of Dr. Walker and the hospital.
- The trial court then granted Dr. Williams's motion for partial summary judgment on the claim of negligent failure to admit Shipley to the hospital.
- Dr. Williams subsequently filed a motion to disqualify Shipley's expert witnesses, Dr. Rerych and Dr. Shaw, and for full summary judgment.
- The trial court granted Dr. Williams's motion, ruling that the experts did not meet the requirements of the locality rule, and dismissed Shipley's case.
- Shipley, as appellant, appealed the dismissal to the Tennessee Court of Appeals.
- The Court of Appeals affirmed the trial court's disqualification of the experts but reversed the summary judgment, finding that Dr. Williams, as appellee, had failed to negate an essential element of Shipley's remaining claims without the experts' testimony.
- The Supreme Court of Tennessee granted permission to appeal to Dr. Williams, who is the appellant before this court.
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Issue:
Does a trial court err by excluding a plaintiff's medical expert witnesses under Tennessee's locality rule, Tenn. Code Ann. § 29-26-115, where the experts, though not practicing in the defendant's community, establish familiarity with the local standard of care through research on the community's medical resources, prior professional experience in the area, and comparison to their own similar practice communities?
Opinions:
Majority - Justice Lee
Yes, a trial court errs by excluding the expert witnesses under these circumstances. The locality rule in Tenn. Code Ann. § 29-26-115 does not require an expert to have personal, firsthand experience practicing in the defendant’s community; rather, an expert may establish familiarity through various means of self-education. Competency to testify is governed by subsection (b) of the statute (licensure, specialty, recent practice), while subsection (a) sets forth the elements of proof, including the local standard of care. Once an expert is deemed competent, their testimony on the standard of care should be evaluated for admissibility under Tenn. R. Evid. 702 and 703, which does not require firsthand knowledge. An expert can demonstrate sufficient familiarity by reviewing statistical data on the community, consulting with local physicians, or visiting the area. Testimony about a national standard is also permissible to support an opinion, provided the expert first establishes familiarity with the local or a similar community standard. The court explicitly rejected the stricter 'personal, firsthand, direct knowledge' standard previously applied by lower courts, finding that the proffered experts, Dr. Rerych and Dr. Shaw, had presented sufficient evidence of their familiarity to be qualified to testify.
Concurring - Justice Holder
I concur with the majority, writing to emphasize that this decision does not alter the abuse of discretion standard for reviewing evidentiary rulings. The majority is not creating new law but is correctly applying the existing statutory framework of § 29-26-115 and the Tennessee Rules of Evidence. The trial court abused its discretion by applying an incorrect legal standard—conflating the competency requirements for an expert with the substance of their testimony—which improperly precluded the plaintiff from presenting her case to a jury.
Concurring-in-part-and-dissenting-in-part - Justice Koch
I dissent from the majority’s reasoning because it improperly alters the standard of review for summary judgment and significantly weakens the statutory locality rule. The majority errs by requiring courts to view evidence in the light most favorable to the nonmoving party during the initial admissibility determination, a standard that should only apply to the weight of evidence already deemed admissible. Furthermore, the majority improperly dilutes the locality rule by inviting excessive reliance on national or regional standards of care, contrary to the statute's plain language. Under the traditional, correct standard of review, both of the plaintiff's experts failed to demonstrate sufficient familiarity with the standard of care for general surgeons in Nashville, and the trial court did not abuse its discretion in excluding their testimony. Therefore, summary judgment for the defendant on all claims was appropriate.
Analysis:
This decision significantly clarifies and liberalizes Tennessee's locality rule in medical malpractice cases, making it easier for plaintiffs to secure qualified expert testimony. By rejecting the restrictive 'personal, firsthand, direct knowledge' standard, the Court lowered the barrier for out-of-state experts, allowing them to qualify by 'educating' themselves on local standards. This ruling modernizes the application of the locality rule, acknowledging the increasing standardization of medical practices while still requiring a demonstrated link to the specific community. Consequently, defendants may find it more difficult to obtain summary judgment by challenging an expert's qualifications on geographic grounds alone, shifting the focus from admissibility to the weight and credibility of the expert's testimony at trial.
