McDaniel v. Payson Healthcare Mgmt., Inc.
| Decision Date | 08 July 2022 |
| Docket Number | CV-20-0333-PR |
| Parties | Ronnie Anthony MCDANIEL, Conservator of the Estate of Dallas R. Haught; and Roy G. Haught and Marie Haught, Natural Parents of Dallas R. Haught, Plaintiffs/Appellants/Cross-Appellees, v. PAYSON HEALTHCARE MANAGEMENT, INC., an Arizona Corporation, dba Payson Regional Bone & Joint ; 4C Medical Group, P.L.C., an Arizona Corporation; and Amar Parkash Sharma, M.D., Defendants/Appellees/Cross-Appellants. |
| Court | Arizona Supreme Court |
Arthur E. Lloyd (argued), A. Evan Lloyd, Lloyd Law Group of Arizona, P.L.L.C., Payson; Thomas P. McGovern, McGovern Law Offices, Phoenix; and Stanley G. Feldman, Timothy P. Stackhouse, Miller, Pitt, Feldman & McAnally, P.C., Tucson, Attorneys for Ronnie Anthony McDaniel, Estate of Dallas R. Haught, Roy G. Haught, and Marie Haught
Kari B. Zangerle, Mary G. Isban (argued), Campbell, Yost, Clare & Norell, P.C., Phoenix, Attorneys for Payson Healthcare Management, Inc., dba Payson Regional Bone & Joint
J. Arthur Eaves (argued), Brianna M. Jagelski, Sanders & Parks, P.C., Phoenix; and Eileen Dennis GilBride, Jones, Skelton & Hochuli P.L.C., Phoenix, Attorneys for 4C Medical Group, P.L.C. and Amar Parkash Sharma, M.D.
Barry D. Halpern, Ian R. Joyce, Snell & Wilmer L.L.P., Phoenix, Attorneys for Amici Curiae Arizona Medical Association and American Medical Association
David L. Abney, Ahwatukee Legal Office, P.C., Phoenix, Attorney for Amicus Curiae Arizona Association for Justice/Arizona Trial Lawyers Association
¶1 To prove negligence in a medical malpractice case, expert testimony is generally required to establish the separate issues of the applicable standard of care and that the failure to meet it caused harm. See A.R.S. § 12-563 ; Sampson v. Surgery Ctr. of Peoria, LLC , 251 Ariz. 308, 311 ¶¶ 13, 16, 491 P.3d 1115, 1118 (2021). The number of retained or specially employed experts that plaintiffs and defendants may call to testify concerning each issue is addressed by Arizona Rule of Civil Procedure 26(b)(4)(F)(i). Specifically, Rule 26(b)(4)(F)(i) allows each side in a case to presumptively call only one retained or specially employed expert to testify on an issue—hence, the rule is more commonly known as the "One-Expert Rule."
¶2 In this case, we consider whether defendants who present testimony by treating physicians on the standard of care they provided, in addition to the testimony of a retained or specially employed expert on the standard of care issue, violate the One-Expert Rule. We also consider whether a treating physician who was dismissed from the case on summary judgment is an indispensable party to a cross-appeal challenging the denial of a motion to designate him a nonparty at fault.
¶3 We hold that defendants do not violate the One-Expert Rule when offering the testimony of a treating physician on the standard of care, in addition to that of a retained or specially employed expert, when the testimony is based on the treating physician's observations and personal participation in providing treatment to the plaintiff. Also, we hold that a treating physician dismissed on summary judgment is not an indispensable party to an appeal of the denial of a motion to name him a nonparty at fault.
¶4 On July 17, 2011, Dallas Haught cut his knee in a dirt-bike accident. He went to Payson Regional Medical Center (Payson Regional), where Dr. Darnell, a surgeon affiliated with defendant Payson Healthcare Management (PHM), provided initial treatment. After Haught's knee injury
worsened, he returned to Payson Regional on July 18 and again on July 19. On July 19, Dr. Darnell ordered a series of tests, including one to measure Haught's C-Reactive Protein (CRP) level, a marker for infection that measures inflammation. Dr. Darnell incorrectly recorded the CRP test result in Haught's records, reflecting a reading of 45 instead of 138.79 mg/dl.
¶5 Because Haught's condition continued to worsen, Dr. Darnell arranged for his transfer later that same day to Scottsdale Shea Medical Center. Dr. Sharma, an employee of 4C Medical Group (collectively "4CMG") in Scottsdale, saw Haught on his arrival and prepared an initial report that omitted the CRP result. Over the course of Haught's stay, Drs. Burge, Cory, Friedman, Schaub, and Sharma participated in treating his injury. No one ordered another CRP test.
¶6 At some point, Haught developed necrotizing fasciitis
, resulting in the surgical removal of all the skin on his right leg. Through his conservator, Ronnie McDaniel, Haught subsequently sued several healthcare providers, including PHM, Dr. Cory, and 4CMG for medical negligence. He alleged that the failure to accurately communicate the CRP test result delayed the diagnosis of necrotizing fasciitis and caused the need for greater surgical intervention leading to permanent injuries and disfigurement.
¶7 Before trial, Dr. Cory moved for summary judgment "due to [Haught's] failure to show that any alleged breach of the standard of care by [him] caused and or contributed to any of Dallas Haught's actual injuries." Neither Haught nor any other party opposed the motion and the trial court granted it, entering judgment in favor of Dr. Cory. PHM thereafter requested the trial court withdraw the order granting summary judgment in favor of Dr. Cory and filed a motion to name him a nonparty at fault.1 The trial court denied the withdrawal motion as untimely and denied the motion to name Dr. Cory a nonparty at fault without explanation. Thereafter, PHM sought special action review of the trial court's ruling on the motion for summary judgment. The court of appeals declined jurisdiction.
¶8 At trial, defendants PHM and 4CMG called Drs. Berge, Cory, Friedman, and Schaub to testify and made clear at the outset of their testimony that each was not a "paid expert." Defendants’ disclosure statements indicated that each of them would testify as a treating physician. Specifically, Drs. Berge and Cory would testify "consistent[ ] with the medical records," their depositions, and their recollection, and about their "care and treatment" of Haught, "including [their] personal observations of and interactions with him." Drs. Friedman and Schaub would likewise testify "consistent with the medical records and [their] recollection."
¶9 Haught argued throughout the trial that the defense elicited expert testimony from the treating physicians, thereby violating the One-Expert Rule. Specifically, Haught argued that by asking questions he characterized as hypothetical concerning the CRP result and infectious disease, the defendants elicited testimony that went beyond the treating physicians’ personal knowledge of the care they provided, rendering them expert witnesses. Therefore, because the treating physicians testified to the same issues as the defendants’ retained experts, the defendants presented more experts than allowed.
¶10 After a sixteen-day trial, the jury returned a verdict for the defendants and the trial court entered judgment on their behalf. Haught moved for a new trial based on three issues: alleged juror misconduct; violation of the One-Expert Rule; and defense presentation of previously undisclosed expert opinions. The trial court denied the motion. The court concluded that how to diagnose necrotizing fasciitis
and what to look for was "relevant" in the testimony of the treating physicians as "factual witnesses" and that the One-Expert Rule was not violated. With respect to undisclosed expert opinions, the court held that the "plaintiffs had plenty of opportunity to cross-examine those witnesses on that to reveal that this isn't what they said originally." And the court found there was no juror misconduct.
¶11 Haught appealed the defense judgment and the denial of his motion for a new trial. PHM cross-appealed the denial of its motion to name Dr. Cory a nonparty at fault.
¶12 With respect to Haught's claims, the court of appeals reversed the trial court and remanded for a new trial. McDaniel v. Payson Healthcare Mgmt., Inc. , 250 Ariz. 199, 203 ¶ 1, 477 P.3d 123, 127 (App. 2020). In a de novo review, id. at 204 ¶ 8, 477 P.3d at 128, the court held that the treating physicians’ testimony addressing the CRP test was expert testimony related to the standard of care and violated the One-Expert Rule, id. at 206 ¶ 16, 477 P.3d at 130. Additionally, the court held that the trial court should have excluded the undisclosed expert opinions presented by the defense. Id. at 208 ¶ 26, 477 P.3d at 132. Because the court determined it was necessary to remand for a new trial, it did not address the alleged juror misconduct. Id. ¶ 27. As for PHM's cross-appeal, the court concluded that Dr. Cory was an indispensable party, and that, because PHM had not notified him of the cross-appeal, the court lacked jurisdiction and dismissed it. Id. at 210 ¶ 35, 477 P.3d at 134.
¶13 We granted review to address whether the court of appeals erred in using a de novo standard of review concerning the One-Expert Rule and in concluding that the presentation of the treating physicians’ testimony on the standard of care violated that rule, and whether the court also erred in determining that it lacked jurisdiction to consider PHM's cross-appeal due to the failure to include Dr. Cory. These are recurring issues of statewide importance. We have jurisdiction pursuant to article 6, section 5(3), of the Arizona Constitution.
¶14 As an initial matter, the parties contest whether the applicable standard of review is abuse of discretion or de novo. 4CMG and PHM argue that determining whether a treating physician testified as a fact or expert witness is a threshold matter subject to an abuse-of-discretion standard. Haught argues...
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