Kentucky Supreme Court Says Medical Experts May be Needed, Even in Negligence Claims

When a baseball umpire, well-traveled in college baseball conferences, went to a hospital for X-rays on his surgically repaired ankle in 2015, a hospital attendant pushing the ump’s wheelchair accidentally bumped his foot against a desk.

The question that has percolated through Kentucky courts since then is: Does the case require a medical expert to testify on whether the bump caused the repaired ankle bone to be dislocated, resulting in a negligence claim against Saint Elizabeth Medical Center in Florence, Kentucky?

A circuit court in Boone County said that expert testimony was needed, and dismissed umpire Ron Arnsperger’s lawsuit. Then, the state Court of Appeals disagreed, noting that it was a simple matter of negligence by the hospital, no medical expertise was required and the suit could move forward.

On Thursday, the Kentucky Supreme Court reversed the appeals court. The high court found that an expert was indeed necessary, given the long history of Arnsperger’s problems with his ankle, problems that included a surgery that went awry when a drill bit broke and left metal shards inside the incision.

The Supreme Court decision is seen as a win for the hospital and its malpractice insurer.

“Arnsperger has failed to raise a genuine issue of material fact, and this failure means that under no circumstances could his claim succeed,” the Supreme Court justices wrote. “The Court of Appeals is reversed, and we reinstate the summary judgment of the trial court.”

The ruling could give succor to Kentucky hospitals, medical providers and insurers, going forward. The justices said in the opinion that they felt compelled to correct a drift in court decisions in recent years, one that had seen an expanded use of the legal doctrine known as res ipsa loquitur, or “the thing speaks for itself.”

Juries may not need a medical expert to determine causation when cause and effect is obvious, such as when a surgical instrument is left inside a body, the court said. But the justices noted that in this and other cases, the causation of the injury had not been established, and it was beyond the knowledge of a jury to conclude that the umpire’s displaced ankle bone was the result of the wheelchair bump, or if it was from a recent surgery.

Arnsperger had offered no expert witnesses in the litigation and his treating physicians testified that they could not say what the cause was.

“It seems from this case that this doctrine is in danger of becoming unmoored from its foundational principles, necessitating some exposition on its content and application,” the opinion reads. “Indeed, it is not the first time in recent history this Court has felt the need to check an unwarranted expansion of res ipsa loquitur for questions of causation in the medical context.”

The opinion can be seen here.