Hall v. Hilbun
466 So.2d 856 (1985)
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Rule of Law:
The standard of care for a physician is twofold: (1) a national standard based on the knowledge, skill, and judgment of a minimally competent physician in the same specialty, and (2) a resources-based standard considering the facilities, equipment, and services reasonably available to the physician.
Facts:
- On May 18, 1978, Terry O. Hall was admitted to Singing River Hospital with abdominal discomfort.
- Dr. Glyn R. Hilbun, a general surgeon, diagnosed an obstruction of the small bowel and performed an exploratory laparotomy on Mrs. Hall on May 20, 1978.
- After the surgery, Dr. Hilbun stayed with Mrs. Hall in the recovery room until she was stable at approximately 2:50 p.m.
- Dr. Hilbun had no further contact with Mrs. Hall, made no inquiries about her condition, and did not see her again until he was called to her room around 5:00 a.m. the next morning.
- During the night, Mrs. Hall experienced labored breathing and complained of pain, which her husband reported to the nursing staff.
- Dr. Hilbun's written post-operative orders did not include instructions for the nursing staff to contact him if the patient's vital signs changed beyond specified limits.
- Approximately 14 hours after being moved from the recovery room, Terry O. Hall died from adult respiratory distress syndrome.
Procedural Posture:
- Glenn Hall filed a wrongful death action against Dr. Glyn R. Hilbun and others in the Circuit Court of Jackson County, Mississippi (the trial court).
- All defendants except Dr. Hilbun were dismissed prior to trial.
- At trial, the court excluded the testimony of the plaintiff's two expert medical witnesses from Ohio, ruling they were not qualified under Mississippi's 'locality rule'.
- After the plaintiff presented his case, the trial court granted Dr. Hilbun's motion for a directed verdict on the grounds that the plaintiff had failed to establish a prima facie case without expert testimony.
- The trial court entered a final judgment in favor of Dr. Hilbun.
- Glenn Hall's motion for a new trial was denied, and he, as appellant, appealed the judgment to the Supreme Court of Mississippi.
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Issue:
Did the trial court commit reversible error by excluding the testimony of nationally qualified medical experts based on the traditional locality rule, thereby preventing the plaintiff from establishing a prima facie case of medical malpractice?
Opinions:
Majority - Justice Robertson
Yes. The trial court erred because the traditional locality rule is outdated and no longer serves the interests of justice. The proper standard of care for a physician is a national one, requiring the physician to possess the knowledge and exercise the judgment of a minimally competent practitioner in the same field, but this standard is qualified by the practical realities of the facilities, resources, and equipment reasonably available. The old rule, which restricted expert testimony to local doctors, is abolished. An otherwise qualified medical expert's testimony cannot be excluded solely because the expert does not practice in Mississippi or is unfamiliar with local customs; the expert can be familiarized with the available resources through testimony or hypothetical questions. Given this new standard, the plaintiff's expert witnesses from Ohio were competent to testify about the national standard of post-operative care, and their exclusion was a reversible error.
Concurring - Justice Hawkins
Yes. I concur with the majority's decision. This opinion finally provides a clear expression of the principles I advocated for in my dissent in King v. Murphy, which is that the competency of medical expert testimony should be treated the same as that of any other expert, without geographical restrictions.
Dissenting in part; concurring in part - Chief Justice Patterson
No. I dissent in part because the trial court correctly followed the precedent that existed at the time of the trial, and judges and attorneys are entitled to rely on existing law. However, I concur with the majority's result in overturning the locality rule. I would forthrightly adopt the National Standard of Evidence, which permits a medical expert to testify once their qualifications have been established, just like any other expert witness.
Dissenting in part; concurring in part - Presiding Justice Roy Noble Lee
Yes. I concur in reversing the case for a new trial, but for different reasons than the majority. Sufficient evidence already existed to withstand a directed verdict, even under the old rules, including the fact that a surgical sponge was left in the patient and Dr. Hilbun's clear failure to monitor his patient post-operatively. I dissent from the majority's decision to rework the rule from King v. Murphy, as that expanded locality rule was clear, workable, and sufficient.
Dissenting - Presiding Justice Walker
No. The trial court's decision was correct under the law at the time and should be affirmed. The dissent joins the dissenting part of Chief Justice Patterson's opinion and the dissenting part of Presiding Justice Roy Noble Lee's opinion.
Analysis:
This landmark case abolishes Mississippi's restrictive 'locality rule' for medical malpractice, which tied the standard of care to the practices in the defendant's specific community. By adopting a hybrid national standard, the court aligned Mississippi with the modern trend, recognizing that medical education and knowledge are national in scope. The decision significantly impacts malpractice litigation by broadening the pool of available expert witnesses for plaintiffs and holding physicians to a uniform standard of competence, while still realistically accounting for disparities in local resources and facilities. This new standard prevents a 'conspiracy of silence' among local doctors and ensures that the quality of care is judged by objective, national benchmarks rather than potentially lagging local customs.
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