Cartledge v. Montano
| Decision Date | 20 November 2013 |
| Docket Number | No. A13A1580.,A13A1580. |
| Citation | 750 S.E.2d 772,325 Ga.App. 322 |
| Parties | CARTLEDGE v. MONTANO et al. |
| Court | Georgia Court of Appeals |
James W. Howard, Sharon Effatt Howard, Tucker, for Appellant.
Fulcher Hagler, Susan Carter Mulherin, Andrew Wayne Holliday, Augusta, for Appellees.
In this medical-malpractice action, Emma Cartledge sued Jolene Montano, M.D. and her practice group, Obstetrics and Gynecology Associates of Augusta, P.C. (collectively "Montano"), alleging that she suffered serious injuries as a result of Dr. Montano's negligent performance of an intrauterine surgical procedure. On interlocutory appeal, Cartledge contends that the trial court erred in (1) granting Montano's motion in limine to exclude the testimony of Cartledge's medical expert; and (2) denying her motion in limine to exclude evidence regarding the fact that she had previously undergone abortion procedures. For the reasons set forth infra, we reverse the trial court's grant of Montano's motion in limine but affirm its denial of Cartledge's motion in limine.
The record shows that in March 2005, Cartledge was experiencing abnormal uterine bleeding and irregular menstrual cycles and, thus, sought treatment from Dr. Montano, an obstetrician/gynecologist. After an ultrasound indicated a possible polyp or fibroid on the interior lining of Cartledge's uterus, Dr. Montano recommended that Cartledge undergo a surgical procedure known as a cervical dilation and uterine curettage ("D & C") with a hysteroscopy. As Dr. Montano explained to Cartledge during an April 2005 appointment, these procedures entail dilating the cervix, distending the uterus with a laparoscopic solution such as Sorbitol, inserting a small scope into the uterus to evaluate its lining, and then scraping the lining to remove the abnormal growth.
On May 4, 2005, Dr. Montano performed the D & C and hysteroscopy and removed what she believed to be a fibroid from the lining of Cartledge's uterus. At the conclusion of this procedure, Dr. Montano noted that approximately 1,500 milliliters of the Sorbitol fluid used during the surgery had not been reclaimed after suctioning. And although Dr. Montano was aware that such a deficit between the amount of Sorbitol used during surgery and the amount reclaimed following the procedure could indicate a perforation, in this instance, she believed that the discrepancy was due to the fact that a significant amount of the fluid saturated the drapes covering Cartledge and spilled onto the operating room floor.
After the surgery, Cartledge was discharged from the hospital; however, over the course of the next couple of days she suffered some bleeding and abdominal pain. On May 7, 2005, after experiencing nausea and severe pain in her abdominal area during a bowel movement, Cartledge returned to the hospital emergency room. And following a series of diagnostic tests, two surgeons performed a laparotomy and determined that Cartledge's uterus and bowel had been perforated. In addition, the surgeons discovered necrosed tissue, blood, and nearly two liters of fluid in Cartledge's abdominal area. Consequently, the surgeons repaired the perforations and performed a temporary colostomy to bypass the damaged portion of Cartledge's bowel. Ultimately, Cartledge underwent three additional surgical procedures to reverse the colostomy and completely treat the perforations to her bowel and uterus.
On April 27, 2007, Cartledge filed a medical-malpractice action against Dr. Montano and her practice group, alleging that Dr. Montano's negligent performance of the D & C and hysteroscopy procedures resulted in the perforation of Cartledge's uterus and bowel. With her complaint, Cartledge included the affidavit of Dr. Bruce Halbridge, a medical expert in gynecology and gynecological surgery. And in his affidavit, Dr. Halbridge averred that he was currently licensed as a practicing obstetrician/gynecologist and opined that Dr. Montano breached the standard of care by, inter alia, failing to perform a bimanual examination of Cartledge to determine the position of her uterus before dilating her cervix; failing to sound the uterus to determine its depth prior to dilation; failing to recognize that she perforated Cartledge's uterus; failing to rule out perforation after more than 1,000 milliliters of hysteroscopic fluid could not be accounted for at the conclusion of the surgery; and failing to monitor Cartledge for signs of uterine perforation.
Shortly after Cartledge filed her complaint, Montano answered, and during the ensuing discovery, Dr. Montano, Dr. Halbridge, defendant's expert Dr. Dolan, and several of the other doctors involved in Cartledge's treatment were deposed. On September 8, 2010, Montano filed a motion in limine seeking to exclude portions of Dr. Halbridge's testimony that allegedly exceeded the scope of his expertise. Cartledge responded, and shortly thereafter, she filed a motion in limine seeking to exclude any testimony regarding the fact that she had previously undergone several abortions. But as of September 2012, approximately one month before the matter was scheduled to be tried, the trial court had not ruled on either parties' motions.
Consequently, on September 15, 2012, Cartledge filed a second motion in limine to exclude any evidence of her prior abortions. And less than two weeks later, Montano filed a second motion in limine regarding Cartledge's expert—this time seeking to exclude all of Dr. Halbridge's testimony. Then, on October 24, 2012, the trial court issued an order granting defendant's motion in limine to exclude Dr. Halbridge's testimony. Specifically, the trial court concluded that Dr. Halbridge was not qualified to testify because he stated during his deposition that he does not perform hysteroscopic removal of fibroids and because his testimony did not rely on the evidence in the record.
On the same day, the trial court also issued an order denying Cartledge's motion in limine to exclude evidence of her prior abortions, finding that such evidence was relevant given the testimony of defense witnesses that abortions generally increased the risk of uterine perforation.
Subsequently, the trial court issued certificates of immediate review as to the October 24, 2012 orders, and Cartledge filed an application for interlocutory review, which this Court granted. This appeal follows.
At the outset, we note that any issue regarding the admissibility or exclusion of expert testimony "rests in the broad discretion of the trial court, and consequently, the trial court's ruling thereon cannot be reversed absent an abuse of discretion."1 Furthermore, we similarly review a trial court's ruling on a motion in limine for an abuse of discretion.2 And a motion in limine is properly granted when "there is no circumstance under which the evidence under scrutiny is likely to be admissible at trial."3 With these guiding principles in mind, we turn now to Cartledge's specific claims of error.
1. Cartledge contends that the trial court erred in granting Montano's motion in limine to exclude the testimony of Dr. Halbridge on the grounds that he was not qualified under OCGA § 24–9–67.1(c)4 to provide an expert opinion on hysteroscopic removal of fibroids and that his testimony was speculative and, therefore, unreliable. We agree that the trial court erred.
The relevant portion of Georgia's expert-witness statute, former OCGA § 24–9–67.1(c), provides as follows:
In construing this statute, the Supreme Court of Georgia has held that "the requirement that the expert have actual professional knowledge and experience in the area of practice or specialty in which the opinion is to be given means that the plaintiff's expert does not have to have knowledge and experience in the same area of practice/specialty as the defendant doctor."6 Rather, the issue is whether "the expert has knowledge and experience in the practice or specialty that is relevant to the acts or omissions that the plaintiff alleges constitute malpractice and caused the plaintiff's injuries."7 More generally, under the Supreme Court of the United States's opinion in Daubert v. Merrell Dow Pharmaceuticals, Inc.,8 expert testimony is only admissible if it is both: "(1) relevant and (2) reliable, and an expert opinion is ‘relevant’ if it will assist the trier of fact to understand the evidence or to determine a fact in issue."9 And disputes as to an expert's credentials are "properly explored through cross-examination at trial and go to the weight and credibility of the testimony, not its admissibility."10
In the case sub judice, Cartledge's medical expert, Dr. Halbridge, testified that he has been board certified in...
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