Court: Montana Supreme Court; September 4, 2018; Montana; State Supreme Court
Justice Jim Rice issued the Opinion of the Court regarding John Melton's appeal of a summary judgment dismissing his medical malpractice claim against Dr. Steven Speth. The Thirteenth Judicial District Court ruled that Melton's expert witness, Dr. Steven Graboff, was not qualified under Montana Code Annotated 26-2-601(1)(a). Melton's claim arose from spinal surgery performed by Dr. Speth in November 2009, during which a locking screw from a Medtronic device failed, leading to incomplete spinal fusion. Following a second surgery by Dr. Speth in 2012 to address the issue, Melton alleged negligence due to improper securing of the locking screw.
Dr. Graboff, a board-certified orthopedic surgeon with over thirty years of experience, was disclosed as Melton's only expert. Although he had performed spinal fusions in the past, he had not used the TSRH-3D device, which was introduced in 2009, and had not performed surgery since 2004, shifting to non-surgical practice. His opinion on negligence was based on the failure of the hardware immediately after surgery, although he could not specify Dr. Speth's exact actions that constituted negligence. Dr. Speth filed for summary judgment, arguing that Dr. Graboff was unqualified and that his opinion relied on res ipsa loquitur, which is generally insufficient to establish negligence without specific evidence of wrongdoing.
The District Court agreed with Dr. Speth's arguments, leading to the summary judgment. Melton's appeal is reviewed de novo, with particular attention to the qualifications of expert testimony and the underlying determinations made by the District Court. The exclusion of expert testimony is generally reviewed for abuse of discretion, but when based on evidentiary rules, it is reviewed for correctness.
No material facts are in dispute; the focus is on the exclusion of an expert witness based on statutory interpretation, which is reviewed for correctness. The primary aim in interpreting statutes is to fulfill the legislature's intent, relying on the plain meaning of the language used. The judge's role is to clarify the statute's content without adding or omitting terms and to ensure all statutory provisions are effective.
The District Court's decision to exclude Dr. Graboff as an expert witness under 26-2-601(1)(a), MCA, is challenged by Melton. For a medical malpractice claim, expert testimony is required to establish the standard of care and any deviations from it. The statute stipulates that a qualified expert must be a licensed health care provider who has treated the relevant condition within the last five years or has been an instructor in an accredited program related to that condition.
Melton argues Dr. Graboff meets the criteria as he treats orthopedic conditions related to Melton’s claim. However, Dr. Graboff clarified that he does not treat surgical patients and refers them to other physicians. While Melton characterizes the claim as "back pain," the specific issue is the spinal surgery performed by Dr. Speth, which Dr. Graboff does not perform. The District Court found that Melton's claims focus on the surgery, not merely the diagnosis, and concluded Dr. Graboff's practice does not encompass the treatment relevant to Melton's claim. Therefore, the court correctly excluded Dr. Graboff under the statute.
The court upheld its previous decisions regarding the qualifications of medical experts, specifically under 26-2-601(1)(a), MCA. In the case of Beehler, a plaintiff's expert, although not a radiologist, was deemed qualified due to his relevant experience in treating bacterial meningitis and familiarity with infection control during myelograms. However, Dr. Graboff was found unqualified because he did not provide the type of treatment relevant to the claim of spinal surgery. The McColl case illustrated that a naturopathic physician was considered qualified as he regularly treated conditions similar to the case at hand, unlike Dr. Graboff, who referred patients requiring spinal surgery to specialists. In Griffin v. Moseley, although a neuro-ophthalmologist was deemed qualified to discuss informed consent for surgical procedures due to his knowledge of alternative treatments, he was not allowed to opine on the surgical standard of care itself. Similarly, Dr. Graboff was not qualified to comment on the standard of care for spinal fusion surgeries. The District Court's decision to exclude Dr. Graboff's testimony and grant summary judgment favoring Dr. Speth was affirmed. The court noted that Melton did not provide evidence regarding Dr. Graboff's recent treatment history or teaching credentials. Since Dr. Graboff was not qualified as an expert under the relevant statute, the court found it unnecessary to evaluate whether his opinion improperly relied on the doctrine of res ipsa loquitur.
