Robbins v. Footer
553 F 2d 123, 179 U.S. App. D.C. 389 (1977)
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Rule of Law:
The standard of care for a nationally certified medical specialist is not determined by the practice in their specific geographic locality. Instead, specialists are held to a national standard and must exercise the degree of care and skill expected of a reasonably competent practitioner in their specialty acting under the same or similar circumstances.
Facts:
- Jay H. and Joan Robbins were expecting a child under the care of Dr. Marvin P. Footer, a specialist certified by the American Board of Obstetrics and Gynecology.
- During Mrs. Robbins' labor, Dr. Footer administered the drug 'pitocin' to stimulate the process.
- Following the administration of pitocin, Mrs. Robbins experienced intense and frequent uterine contractions.
- The Robbins' child, James Alan Robbins, was born with a depressed respiratory condition that required emergency resuscitation.
- The child's health deteriorated, and he died within eight hours of his birth.
- The Robbins believed that the contractions induced by pitocin limited their child's oxygen supply, causing his subsequent injury and death.
Procedural Posture:
- Jay and Joan Robbins sued Dr. Footer and George Washington University Hospital for medical malpractice in the United States District Court for the District of Columbia.
- The district court granted a directed verdict for George Washington University Hospital.
- During the trial against Dr. Footer, the court refused to qualify the Robbins' expert witness, Dr. S. Edward Davis, because he was not familiar with the medical standards in the District of Columbia.
- The trial judge instructed the jury to evaluate Dr. Footer's conduct based on the 'same or similar locality' standard of care.
- The jury returned a verdict in favor of the defendant, Dr. Footer.
- The Robbins, as appellants, appealed the judgment to the U.S. Court of Appeals for the D.C. Circuit, arguing the trial court erred in excluding their expert witness.
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Issue:
Does the 'same or similar locality' rule, which measures a physician's conduct against the standards of their local community, apply to a physician who is a nationally certified specialist?
Opinions:
Majority - Tamm, Circuit Judge
No, the 'same or similar locality' rule does not apply to nationally certified specialists. Such specialists are required to exercise the degree of care and skill expected of a reasonably competent practitioner in their specialty acting in the same or similar circumstances. The court reasoned that the historical justifications for the locality rule—such as disparities in medical education, access to information, and facilities between rural and urban areas—are no longer valid in the modern era, especially for specialists. National standards for medical education, board certification, professional journals, and continuing education have created a uniform standard of practice for specialists across the country. To continue applying a locality rule ignores the reality of modern medicine and instead relies on an 'outdated mythology.' Therefore, an expert witness familiar with the national standard of a specialty is qualified to testify, regardless of their familiarity with the defendant's specific locality.
Analysis:
This decision marks a significant departure from the traditional 'locality rule' in medical malpractice, aligning the legal standard of care with the realities of modern medical specialization. By establishing a national standard of care for board-certified specialists, the court makes it easier for plaintiffs to secure expert testimony, as they are no longer restricted to finding experts from a 'similar locality.' This ruling holds specialists to a uniform, higher standard, preventing a defense based on a lower local standard of practice and promoting a consistent quality of specialized medical care across the nation. Future cases involving specialists will now focus on the national standards of the specialty rather than local customs.
