649 S.E.2d 246
Hard cases make bad law, and the instant case is no exception to this adage.
Simply stated, the facts of this case are horrific. The conduct of the physicians who treated
Mrs. Fout-Iser and her unborn child was inexcusable, unprofessional, and unquestionably
contributed to the death of the Isers' child. Nevertheless, even when a defendant's conduct
is egregious beyond words, a plaintiff is not excused from adhering to the requirements of
the West Virginia Rules of Civil Procedure when prosecuting a claim. The Rules of Civil
Procedure are “administered to secure the just, speedy, and inexpensive determination of
every action.” W. Va. R. Civ. P. 1. Because the Isers' counsel did not follow the established
rules regarding the designation of expert witnesses and because the majority of the Court has
excused their failure to so comply as to Dr. Rhee, I respectfully dissent.
In a case seeking to establish medical malpractice, a plaintiff is required to
prove two things regarding each defendant: (1) that the defendant's conduct deviated from
the applicable standard of care and (2) that such conduct proximately caused the plaintiff's
injury. W. Va. Code § 55-7B-3 (1986) (See footnote 1) (Repl. Vol. 2000) requires, as follows:
The following are necessary elements of proof that an
injury or death resulted from the failure of a health care provider
to follow the accepted standard of care:
(a) The health care provider failed to exercise the degree
of care, skill and learning required or expected of a reasonable,
prudent health care provider in the profession or class to which
the health care provider belongs acting in the same or similar
circumstances; and
(b) Such failure was a proximate cause of the injury or
death.
Accord Syl. pt. 4, Short v. Appalachian OH-9, Inc., 203 W. Va. 246, 507 S.E.2d 124 (1998)
(“In a malpractice case, the plaintiff must not only prove negligence but must also show that
such negligence was the proximate cause of the injury.”). Thus, a plaintiff needs to present
evidence regarding the standard of care and causation with respect to each defendant.
Additionally, a plaintiff must establish that a defendant has breached the
applicable standard of care and that said breach is a proximate cause of the plaintiff's injury
by expert testimony, where required by the court. (See footnote 2) Specifically, W. Va. Code § 55-7B-7
(1986) (Repl. Vol. 2000) requires, in pertinent part, that “[t]he applicable standard of care
and a defendant's failure to meet said standard, if at issue, shall be established in medical
professional liability cases by the plaintiff by testimony of one or more knowledgeable,
competent expert witnesses if required by the court.” We have also addressed the necessity
of expert testimony to prove a claim of medical malpractice, and have specifically held that
“'“[i]t is the general rule that in medical malpractice cases negligence or want of professional
skill can be proved only by expert witnesses.” Syl. Pt. 2, Roberts v. Gale, 149 W. Va. 166,
139 S.E.2d 272 (1964).' Syllabus point 1, Farley v. Meadows, 185 W. Va. 48, 404 S.E.2d
537 (1991).” Syl. pt. 3, Farley v. Shook, 218 W. Va. 680, 629 S.E.2d 739 (2006) (per
curiam).
Finally, when a plaintiff intends to call an expert witness to testify at trial, the
identity of such expert as well as the subject about which the expert is expected to testify, are
discoverable. Rule 26(b)(4)(A)(i) of the West Virginia Rules of Civil Procedure directs that
[a] party may through interrogatories require any other party to identify each person whom the other party expects to call as an expert witness at trial, to state the subject matter on which the expert is expected to testify, and to state the substance of the facts and opinions to which the expert is expected to testify and a summary of the grounds for each opinion.
(Emphasis added). Furthermore, when a party has disclosed the identity of an expert witness
and the subject matter about which the expert is expected to testify, he/she is bound, also, to
disclose any new information he/she acquires in this regard. In this regard, Rule 26(e)(1)(B)
of the West Virginia Rules of Civil Procedure requires that
(1) [a] party is under a duty seasonably to supplement
that party's response with respect to any question directly
addressed to:
. . . .
(B) [t]he identity of each person expected to be called as
an expert witness at trial, the subject matter on which the expert
is expected to testify, and the substance of the expert's
testimony.
Cf. Syl. pt. 3, Prager v. Meckling, 172 W. Va. 785, 310 S.E.2d 852 (1983) (“Rule 26(e)(2)
of the Rules of Civil Procedure imposes a continuing obligation to supplement responses
previously made when, in light of subsequent information, the original response is
incorrect.”).
During the proceedings underlying the instant appeal, the trial court, in the
course of its July 22, 2003, status conference, specifically required the parties to disclose
their expert witnesses to each other. In response thereto, counsel for the Isers served upon
the defendants a “Plaintiffs' Designation of Experts and Supplemental Answers to
Interrogatories” on November 3, 2003, which they described as providing information about
“a. [the] [i]dentity of the expert; b. [the] [s]ubject matter upon which the expert is expected
to testify; c. [t]he substance of the opinions to which the expert is expected to testify; and
d. [t]he basis for the opinions to which the expert is expected to testify.” With respect to Dr.
McLaughlin, the plaintiffs provided the following information:
(1) a. Richard D. McLaughlin, M.D., Medical Arts
Center, 1000 East Primrose, Suite 270, Springfield, Missouri,
65807.
b. Obstetrics and gynecology. See attached C.V. which
is incorporated herein.
c. It is expected that Dr. McLaughlin will testify whether
defendant John L. Hahn, M.D., and/or Hahn Medical Practices,
Inc., deviated from acceptable standards of care and/or
committed negligence in the overall care and treatment of
Maranda Fout-Iser. It is further expected that Dr. McLaughlin
will discuss the overall care and treatment of Maranda Fout-Iser
as revealed in the medical records of Maranda Fout-Iser which
have been provided to defense counsel and all of which are
incorporated herein. It is further expected that Dr. McLaughlin
will testify whether John L. Hahn, M.D., and/or Hahn Medical
Practices, Inc., deviated from acceptable standards of care
and/or carelessly and negligently failed to properly diagnosis
[sic] and, thereafter, properly manage, and/or treat Maranda
Fout-Iser for pre-eclampsia and/or eclampsia and/or placenta
abruptio and/or DIC and/or HELLP Syndrome. It is further
expected that Dr. McLaughlin will testify on the issues of
causation and damages, including permanency and the death of
Alexia Cheree Fout-Iser.
d. It is expected that Dr. McLaughlin's opinions will be
based upon his knowledge, education, training, and experience,
together with his review of the medical records of Maranda
Fout-Iser. All medical records are incorporated in this
disclosure and have been provided to defense counsel. In
addition, Dr. McLaughlin may review the deposition testimony
and discovery materials provided by parties to this litigation.
(Emphasis in original).
Consistent with the above-referenced disclosure, Dr. McLaughlin specifically
stated at his deposition that his testimony was limited to the conduct of Dr. Hahn and Dr.
Schmidt and that he expressly was not providing testimony with respect to Dr. Rhee. During
his deposition, Dr. McLaughlin testified as follows:
Q. [by Attorney Goundry (counsel for Dr. Rhee)] Dr.
McLaughlin, this is Ed Goundry. I represent two physicians in
this case, Dr. Rhee, who did the radiology ultrasound report, and
Dr. Kim, who did the final ultrasound report later. Let me ask
you, Doctor _ and hopefully, I'll just have this one question. I
take it from your testimony that you are not going to be
rendering any opinions as to either of those physicians. Is that
correct?
A. [by Dr. McLaughlin] You take that correctly.
MR. GOUNDRY: All right. No other questions.
May 3, 2004, Dep. of Richard D. McLaughlin, M.D., at 62-63. No other reference to Dr.
Rhee was made in Dr. McLaughlin's deposition.
To summarize, then, in order for the Isers to be permitted to call Dr.
McLaughlin to testify that Dr. Rhee had breached the applicable standard of care and that
such breach was a proximate cause of their injuries, the Isers first had to either (1) designate
Dr. McLaughlin as an expert testifying to these matters, pursuant to Rule 26(b)(4)(A)(i), or
(2) supplement their expert disclosure to include such information, in accordance with Rule
26(e)(1)(B). The Isers, however, did neither, and, thus, the circuit court did not err by
concluding that they had failed to present evidence as to causation vis-a-vis Dr.
Rhee.
In rendering their decision in this case, the majority of the Court completely
ignores the failure of the Isers' counsel to designate Dr. McLaughlin as an expert to testify
as to standard of care and causation with respect to Dr. Rhee. Rather than recognizing the
Isers' failure to comply with the West Virginia Rules of Civil Procedure, the majority instead
compounds this error by specifically finding that “the appellants' expert witness, Dr. Richard
D. McLaughlin, . . . offered testimony with regard to causation.” Majority op. at 10. The
parties do not dispute that Dr. McLaughlin is qualified to testify as an expert in this case, (See footnote 3) and, as such, he is perfectly capable of rendering an opinion with regard to causation as it
relates to the other defendants about whom he has been designated to testify. Dr.
McLaughlin could not, however, provide testimony with respect to causation as it related to
Dr. Rhee because the Isers neither designated him as an expert in this regard (See footnote 4) nor
supplemented their original expert disclosure list to indicate that Dr. McLaughlin's testimony
also would include an evaluation of Dr. Rhee's conduct. More importantly, though, the
record clearly evidences that Dr. McLaughlin did not provide testimony regarding Dr. Rhee.
Dr. McLaughlin's deposition testimony quite explicitly stated that he would not be testifying
as to Dr. Rhee's conduct and whether or not it contributed to the Isers' injuries. In fact,
nothing in the record submitted for appellate consideration would lead to the conclusion that
Dr. McLaughlin had been designated as an expert to testify regarding Dr. Rhee.
The instant proceeding was appealed to this Court upon the lower court's grant
of summary judgment in favor of Dr. Rhee. As such, this Court, when reviewing the lower
court's summary judgment order, must view all evidence in light most favorable to
nonmoving party. See, e.g., Syl. pt. 2, Williams v. Precision Coil, Inc., 194 W. Va. 52, 459
S.E.2d 329 (1995) (“Summary judgment is appropriate if, from the totality of the evidence
presented, the record could not lead a rational trier of fact to find for the nonmoving party,
such as where the nonmoving party has failed to make a sufficient showing on an essential
element of the case that is has the burden to prove.”); Syl. pt. 4, Painter v. Peavy, 192 W. Va.
189, 451 S.E.2d 755 (1994) (same). See also Williams, 194 W. Va. at 59-60, 459 S.E.2d at
336-37 (commenting that when reviewing a motion for summary judgment, “the underlying
facts and all inferences are viewed in the light most favorable to the nonmoving party”); Painter, 192 W. Va. at 192, 451 S.E.2d at 758 (recognizing that court considering a motion
for summary judgment “must draw any permissible inference from the underlying facts in
the light most favorable to the party opposing the motion” (citations omitted)). In other
words, this Court, in reviewing the circuit court's summary judgment order, must construe
the evidence presented below in the light most favorable to the Isers.
To find in favor of the Isers in this case, the majority determined that the Isers
had provided sufficient causation evidence against Dr. Rhee through Dr. McLaughlin's
testimony. (See footnote 5) However, where the Isers failed to amend their witness disclosure list to include
Dr. Rhee's conduct as a matter upon which Dr. McLaughlin was expected to testify and
where Dr. McLaughlin, himself, clearly stated that he would not testify with respect to Dr.
Rhee and did not testify regarding Dr. Rhee, (See footnote 6) I can reach no other conclusion but that Dr.
McLaughlin did not establish causation regarding Dr. Rhee. Thus, in the absence of other
causation evidence linking Dr. Rhee's conduct to the injuries sustained by the Isers, (See footnote 7) I
respectfully disagree with the majority's decision to the contrary.
This Court previously has recognized that “one of the purposes of the discovery
process under our Rules of Civil Procedure is to eliminate surprise. Trial by ambush is not
contemplated by the Rules of Civil Procedure.” McDougal v. McCammon, 193 W. Va. 229,
236-37, 455 S.E.2d 788, 795-96 (1995). To this end, this Court also has cautioned that
[t]he fairness and integrity of the fact-finding process is of great concern to this Court; and, when a party fails to acknowledge the existence of evidence that is favorable or adverse to a requesting party, it impedes that process. . . . As a general rule, wrongfully secreting relevant discovery materials makes it inequitable for the withholder to retain the benefit of a favorable verdict.
McDougal, 193 W. Va. at 238, 455 S.E.2d at 797. When a party, such as in the case sub
judice, fails to disclose information, or to amend previously disclosed information, that the
party is required to disclose, or amend, this Court has found sanctions to be appropriate. See,
e.g., Syl. pt. 5, Prager v. Meckling, 172 W. Va. 785, 310 S.E.2d 852 (“Factors to be
considered in determining whether the failure to supplement discovery requests under Rule
26(e)(2) of the Rules of Civil Procedure should require exclusion of evidence related to the
supplementary material include: (1) the prejudice or surprise in fact of the party against
whom the evidence is to be admitted; (2) the ability of that party to cure the prejudice; (3) the
bad faith or willfulness of the party who failed to supplement discovery requests; and (4) the
practical importance of the evidence excluded.”).
Most recently, this Court upheld the imposition of such sanctions in Jenkins
v. CSX Transportation, Inc., ___ W. Va. ___, ___ S.E.2d ___ (No. 33179 May 17, 2007) (per
curiam), by affirming the trial court's exclusion of the plaintiff's sole evidence on causation.
In Jenkins, the plaintiff had disclosed his expert witnesses to the defendant and informed the
defendant of the matters about which said experts would testify. During the deposition of
one of the plaintiff's experts, Dr. Ducatman, the expert was asked whether he had reviewed
the neuropsychological test results of a Dr. Phifer. Dr. Ducatman testified that, “'I do not
recall seeing a report from Dr. Pfeiffer [sic] relating to this patient. It does not mean that I
haven't seen one.'” Jenkins, ___ W. Va. at ___, ___ S.E.2d at ___ , Slip op. at 3. At the
conclusion of this testimony, counsel for the defendant reserved the right to re-depose Dr.
Ducatman if he were to review Dr. Phifer's report. See Nov. 19, 2004, Dep. of Alan
Ducatman, M.D., at 39. Dr. Ducatman was not re-deposed.
During the trial, however, counsel for the plaintiff called Dr. Ducatman as an
expert witness and asked him to testify with respect to his review of Dr. Phifer's report.
Because the plaintiff had neglected to supplement his expert disclosure to inform the
defendant that the scope of Dr. Ducatman's testimony had changed, and because the
defendant had no warning that Dr. Ducatman would be called to testify as to Dr. Phifer's
report, the trial court determined that the plaintiff's failure to earlier disclose this information
to the defendant precluded him from presenting such evidence at trial. This Court affirmed
that ruling. In the instant case, though, the majority, on extraordinarily similar facts, reaches
a completely opposite conclusion by not only ruling in favor of the party who failed to
disclose the allegedly expanded nature of the expert's testimony (See footnote 8) but by also relying upon
such non-disclosed testimony to support its decision in that party's favor. I cannot subscribe
to this inconsistency.
In conclusion, I wish to make it abundantly clear that I appreciate the very
tragic facts of this case, and I emphatically do not condone the utter lack of professionalism
inherent therein. Be that as it may, I am nevertheless bound to follow the law of this State,
and in accordance therewith I believe that the Isers failed to follow the West Virginia Rules
of Civil Procedure by not amending their expert witness disclosure and that the circuit court
properly determined that the Isers had not sustained their burden of proof in this case as to
Dr. Rhee. Because the majority apparently condones this disregard for the West Virginia
Rules of Civil Procedure, I respectfully dissent.