No. 13212
I N THE SUPREME COURT O THE STATE O M N A A
F F OTN
1976
R O B I N B A n O R and SARAH J. BAYLOR,
Husband and Wife,
P l a i n t i f f s and A p p e l l a n t s ,
DR. DAVID P, JACOBSON,
Defendant and Respondent.
Appeal from: D i s t r i c t Court o f t h e F o u r t h J u d i c i a l D i s t r i c t ,
Hon. E. Gardner Brownlee, Judge p r e s i d i n g .
Counsel o f Record:
For Appellants :
Moore and Lyrnpus, K a l i s p e l l , Montana
James D. Moore a r g u e d , K a l i s p e l l , Montana
F o r Respondent :
G a r l i n g t o n , Lohn and Robinson, M i s s o u l a , Montana
L a r r y E, R i l e y a r g u e d , M i s s o u l a , Montana
Submitted: May 27, 1976
F i l e d : ,BtjE45.3 j p t j
Mr. J u s t i c e Frank I. H a s w e l l d e l i v e r e d t h e Opinion of t h e C o u r t .
The d i s t r i c t c o u r t o f Missoula County g r a n t e d summary
judgment t o d e f e n d a n t d o c t o r i n a m e d i c a l m a l p r a c t i c e a c t i o n .
P l a i n t i f f s appeal.
P l a i n t i f f s a r e Robin Baylor and S a r a h J. B a y l o r , hus-
band and w i f e , o f M i s s o u l a , Montana. On December 13, 1970
S a r a h Baylor s l i p p e d on t h e driveway a t h e r home w h i l e g e t t i n g
o u t o f h e r c a r and f r a c t u r e d h e r l e g . She w a s t a k e n by ambu-
l a n c e t o S t . P a t r i c k ' s H o s p i t a l where h e r i n j u r i e s w e r e d i a g n o s e d
a s a s p i r a l f r a c t u r e o f t h e t i b i a and a comminuted f r a c t u r e o f
t h e f i b u l a of her r i g h t l e g .
Defendant, D r . David 0 . J a c o b s o n , a m e d i c a l s p e c i a l i s t
i n o r t h o p e d i c s u r g e r y , performed a c l o s e d r e d u c t i o n and p l a c e d
the leg in a cast. S a r a h Baylor w a s c o n f i n e d t o t h e h o s p i t a l
f o r f o u r d a y s and w a s s e e n d a i l y by D r . Jacobson. Following
h e r r e l e a s e from t h e h o s p i t a l , s h e was s e e n by D r . Jacobson a t
h i s o f f i c e on f i v e o c c a s i o n s : December 24, 1970, J a n u a r y 21,
1971, F e b r u a r y 1 8 , 1971, March 1 7 , 1971, and May 2 1 , 1971. Her
c a s t was c o m p l e t e l y removed on March 1 7 , 1971. When D r . Jacob-
son l a s t s a w S a r a h Baylor on May 21, he made t h e f o l l o w i n g
notation i n h i s records:
" S t i l l with pain about t h e t i b i a . No g r o s s
movement w i t h m a n i p u l a t i o n b u t new x - r a y s show
a r e m a r k a b l e p a u c i t y of c a l l u s f o r m a t i o n con-
s i d e r i n g t h e f i v e months t h a t have e l a p s e d
since her f r a c t u r e . I would have a n t i c i p a t e d
f u r t h e r c a l l u s f o r m a t i o n o r some a t t e m p t a t
h e a l i n g which h a s n o t o c c u r r e d . W i l l r e e v a l u a t e
i n one month and g e t new f i l m s and a t t h a t t i m e
p e r h a p s m a n i p u l a t e under f l u o r o s c o p e t o d e t e r -
mine any m o t i o n . "
According t o t h e d e p o s i t i o n o f S a r a h B a y l o r , D r . Jacob-
son t o l d h e r a t t h i s t i m e t h a t h e r l e g w a s c o m p l e t e l y h e a l e d ;
t h a t f u r t h e r t r e a t m e n t w a s u n n e c e s s a r y ; t o q u i t babying h e r s e l f
and i g n o r e t h e p a i n ; t h a t s h e might even jump up and down on
h e r l e g ; and d i d n o t a d v i s e h e r t h a t t h e bone i n h e r l e g w a s
slow i n h e a l i n g ; t h a t t h e r e was some q u e s t i o n a b o u t nonunion;
o r anything along t h a t l i n e .
S a r a h B a y l o r was s c h e d u l e d t o see D r . Jacobson a g a i n
i n a month b u t s h e n e v e r r e t u r n e d . According t o h e r d e p o s i t i o n
and t h a t o f h e r husband s h e d i d n o t r e t u r n b e c a u s e s h e d i d n o t
f e e l D r . J a c o b s o n c o u l d d o a n y t h i n g f u r t h e r f o r h e r and t h a t
a l l h e would d o was send h e r t o p h y s i c a l t h e r a p y . Instead she
e x e r c i s e d t h e l e g by w a l k i n g back and f o r t h a c r o s s t h e f l o o r
a t home w i t h t h e h e l p o f h e r husband.
I n any e v e n t , S a r a h B a y l o r e v e n t u a l l y c o n s u l t e d D r .
C l i n t o n C r a i g , a n o r t h o p e d i c s u r g e o n i n M i s s o u l a , who t o o k X-rays
and t o l d h e r t h a t h e r l e g had n e v e r h e a l e d and a d v i s e d h e r t o
have s u r g e r y . A month o r two l a t e r s h e c o n s u l t e d D r . Paul
Melvin, a n o r t h o p e d i c s u r g e o n i n G r e a t F a l l s who X-rayed h e r
l e g , t o l d h e r t h e r e was a nonunion and t h a t s h e needed s u r g e r y .
She n e x t went t o D r . W i l l i a m J. McDonald, a M i s s o u l a o r t h o p e d i c
surgeon t o g e t another opinion. H e X-rayed her leg, t o l d her
s h e needed s u r g e r y , and r e f e r r e d h e r t o D r . C a r l o Z . B i s c a r o ,
a Missoula o r t h o p e d i c surgeon. The d a t e s o f t h e s e c o n s u l t a -
tions a r e uncertain.
Dr. B i s c a r o performed a bone g r a f t i n March, 1973 at
t h e Community H o s p i t a l i n M i s s o u l a . I n t h e l a t e summer o f 1973.
Dr. B i s c a r o a d v i s e d t h a t t h e f r a c t u r e had n o t h e a l e d and t h a t
f u r t h e r surgery w a s necessary. I n November, 1973 Dr. Biscaro
performed a bone g r a f t , and i n s e c t e d a m e t a l s c r e w and a Rush
rod. By August, 1974 when S a r a h B a y l o r ' s d e p o s i t i o n w a s t a k e n ,
t h e h e a l i n g o f t h e l e g l o o k e d good a l t h o u g h s h e was s t i l l
s c h e d u l e d f o r p e r i o d i c v i s i t s t o D r . B i s c a r o and h i s a s s o c i a t e .
The B a y l o r s f i l e d s u i t a g a i n s t D r . J a c o b s o n o n A p r i l
2, 1974 a l l e g i n g m e d i c a l m a l p r a c t i c e and s e e k i n g damages o f
$184,000. Defendant f i l e d a n answer which was s u b s t a n t i a l l y
a g e n e r a l d e n i a l on J u l y 11. T h i s was s u b s e q u e n t l y amended
t o i n c l u d e t h e d e f e n s e of c o n t r i b u t o r y n e g l i g e n c e . Inter-
r o g a t o r i e s and answers w e r e f i l e d , d e p o s i t i o n s w e r e t a k e n ,
s u p p l e m e n t a l answers were f i l e d , and a p r e t r i a l c o n f e r e n c e
was h e l d .
When p l a i n t i f f s f a i l e d t o p r o v i d e t h e name o f t h e i r
e x p e r t w i t n e s s and answer d e f e n d a n t ' s i n t e r r o g a t o r i e s concern-
i n g t h i s e x p e r t by A p r i l 11, 1975 a s agreed, t h e d i s t r i c t
c o u r t g r a n t e d d e f e n d a n t ' s motion and d i s m i s s e d t h e e n t i r e
litigation. T h i s was s u b s e q u e n t l y v a c a t e d and t h e c o u r t
g r a n t e d p l a i n t i f f s u n t i l August 1, 1975 t o name t h e i r e x p e r t
and answer d e f e n d a n t ' s p r e v i o u s i n t e r r o g a t o r i e s c o n c e r n i n g him.
On J u l y 29, 1975 p l a i n t i f f s s t a t e d t h e y had a n e x p e r t and
answered f u r t h e r a s f o l l o w s :
"Dr. B i s c a r o ' s d e p o s i t i o n w i l l be t a k e n on
J u l y 31, 1975. H e may be t h e o n l y e x p e r t .
I f h i s testimony does n o t r e l a t e t h e negli-
gence t o p l a i n t i f f ' s c o n d i t i o n , a n e x p e r t
w i l l be r e t a i n e d and t h e background i n f o r -
mation s o u g h t h e r e i n immediately f u r n i s h e d . "
The o t h e r i n t e r r o g a t o r i e s were answered "Not a p p l i c a b l e " .
Defendant moved f o r summary judgment. It was briefed
by b o t h d e f e n d a n t and p l a i n t i f f s , and o r a l l y a r g u e d . O Sep-
n
tember 30,1975 t h e d i s t r i c t c o u r t g r a n t e d d e f e n d a n t a summary
judgment. The o r d e r g r a n t i n g summary judgment i s s e t f o r t h i n
full:
" L a r r y E . R i l e y , Esq., c o u n s e l f o r t h e Defendant
i n t h i s a c t i o n , D r . David P. J a c o b s o n , h a s f i l e d
a Motion For Summary Judgment and h a s based h i s
motion upon t h e documents i n t h e c o u r t f i l e , i n -
c l u d i n g d e p o s i t i o n s and Answers t o I n t e r r o g a t o r i e s .
" T h i s a c t i o n i s a m a l p r a c t i c e a c t i o n . The f a c t s
show t h a t t h e P l a i n t i f f , S a r a h J. B a y l o r , s u s t a i n e d
a f r a c t u r e of t h e r i g h t l e g . She was t r e a t e d by
t h e Defendant, and a f t e r a b o u t f i v e and one-half
months r e f u s e d t o r e t u r n f o r a n appointment w i t h
D r . Jacobson. The c o n d i t i o n o f P l a i n t i f f ' s l e g
was such t h a t s u r g i c a l t r e a t m e n t w a s r e q u i r e d
a b o u t t w e n t y - s i x months a f t e r t h e a c c i d e n t .
"The P l a i n t i f f s d e s i g n a t e d C a r l o Z . B i s c a r o , M . D . ,
a s t h e e x p e r t m e d i c a l w i t n e s s t o be c a l l e d on
b e h a l f of t h e P l a i n t i f f s a t t i m e o f t r i a l . D r .
B i s c a r o ' s d e p o s i t i o n was t a k e n and h e r e p e a t e d l y
s t a t e d t h a t i n h i s opinion t h e r e w a s proper c a r e
and t r e a t m e n t of S a r a h J . Baylor by D r . J a c o b s o n .
"The C o u r t f i n d s t h a t S a r a h J . B a y l o r ' s r e f u s a l
t o continue medical treatment i s a proximate
c a u s e o f h e r s u b s e q u e n t problems w i t h h e r l e g .
"The C o u r t f u r t h e r f i n d s t h a t t h e P l a i n t i f f s '
e x p e r t m e d i c a l w i t n e s s h a s n o t t e s t i f i e d t o any
c o n d u c t on t h e p a r t of D r . David P . Jacobson
which c a n be termed m e d i c a l m a l p r a c t i c e . There-
fore,
" I T I S HEREBY ORDERED t h a t t h e D e f e n d a n t ' s Motion
For Summary Judgment be g r a n t e d w i t h o u t c o s t s t o
any p a r t y . "
On October 1 p l a i n t i f f s f i l e d amended answers t o de-
f e n d a n t ' s i n t e r r o g a t o r i e s , i d e n t i f y i n g a N e w York d o c t o r ,
Dr. R o b e r t Tuby, a s t h e i r e x p e r t w i t n e s s and answering t h e
other interrogatories. P l a i n t i f f s ! answer t o i n t e r r o g a t o r y
No. 1 2 s e t s f o r t h t h e s u b s t a n c e of D r . Tuby's t e s t i m o n y :
"Dr. Tuby w i l l t e s t i f y t h a t it was a d e v i a t i o n
from a c c e p t a b l e m e d i c a l p r a c t i c e t o remove t h e
c a s t a t t h e t i m e it was removed and t o p r e s c r i b e
e x e r c i s e t h e r a p y when t h e r e w a s p r a c t i c a l l y no
c a l l u s formation about t h e f r a c t u r e site. H e
w i l l f u r t h e r s t a t e t h a t it was a d e v i a t i o n from
acceptable medical p r a c t i c e t o t e l l t h e p a t i e n t
t h a t t h e i n j u r y was h e a l e d when i t w a s n o t h e a l e d
a s shown by t h e X-ray f i l m s . D r . Tuby w i l l s t a t e
t h a t t h e e x e r c i s e t h e r a p y and removal of t h e c a s t
c a u s e d t h e l a c k o f u n i o n , s u b s e q u e n t development
o f a bone n e c r o s i s , t h e s u b s e q u e n t s u r g i c a l pro-
c e d u r e s , and t h e r e s u l t which h a s [been] o b t a i n e d . "
P l a i n t i f f s f i l e d t h e i r n o t i c e o f a p p e a l from t h e summary
judgment a g a i n s t them on October 1 0 , 1975.
The u l t i m a t e i s s u e on a p p e a l i s whether summary judgment
f o r d e f e n d a n t was p r o p e r l y g r a n t e d . T h i s t u r n s on two under-
lying issues.
(1) Is t h e r e s u f f i c i e n t e x p e r t t e s t i m o n y t o r a i s e a
g e n u i n e i s s u e of m a l p r a c t i c e ?
( 2 ) Is t h e r e a g e n u i n e i s s u e of m a t e r i a l f a c t concern-
i n g c o n t r i b u t o r y n e g l i g e n c e on t h e p a r t o f S a r a h B a y l o r ?
A s background f o r o u r a n a l y s i s o f t h e i s s u e s , w e n o t e
s e v e r a l b a s i c r u l e s of l a w a p p l i c a b l e t o medical m a l p r a c t i c e
actions. The g i s t of a m a l p r a c t i c e a c t i o n i s n e g l i g e n c e on t h e
p a r t of defendant. Negaard v . Feda, 152 Mont. 47, 446 P.2d
436, and c a s e s c i t e d t h e r e i n . The mere f a c t of i n j u r y o r t h e
o c c u r r e n c e of a bad r e s u l t , s t a n d i n g a l o n e , i s no proof o f
negligence i n t h e ordinary malpractice action. Loudon v . S c o t t ,
58 Mont. 645, 194 P . 488, 1 2 A.L.R. 1487. The law d o e s n o t re-
q u i r e t h a t f o r e v e r y i n j u r y t h e r e must be a r e c o v e r y o f damages,
b u t o n l y imposes l i a b i l i t y f o r a b r e a c h of l e g a l d u t y by a
doctor proximately causing i n j u r y t o t h e p a t i e n t . Loudon v .
Scott, supra.
The l e g a l d u t y imposed on a d o c t o r h a s been d e s c r i b e d
by t h i s C o u r t i n t h e f o l l o w i n g l a n g u a g e :
" * * * The l a w r e q u i r e s a p h y s i c i a n o r s u r g e o n
t o p o s s e s s t h e s k i l l and l e a r n i n g which i s pos-
s e s s e d by t h e a v e r a g e member o f t h e m e d i c a l pro-
f e s s i o n i n good s t a n d i n g , and t o a p p l y s u c h s k i l l
and l e a r n i n g w i t h o r d i n a r y and r e a s o n a b l e c a r e .
He i s n o t a n i n s u r e r , n o r i s a good r e s u l t i m p l i e d l y
guaranteed. H i s o b l i g a t i o n i s merely t o e x e r c i s e
s u c h r e a s o n a b l e c a r e and s k i l l i n t h e t r e a t m e n t o f
t h e p a t i e n t a s i s u s u a l l y e x e r c i s e d by p h y s i c i a n s
o r s u r g e o n s o f good s t a n d i n g , of t h e same s c h o o l
o f p r a c t i c e i n t h e community i n which he r e s i d e s ,
w i t h due r e g a r d t o t h e c o n d i t i o n t o t h e p a t i e n t
and t h e p r o g r e s s o f m e d i c a l o r s u r g i c a l s c i e n c e a t
t h e t i m e . * * * " Dunn v . Beck, 80 Mont. 4 1 4 , 4 2 1 ;
260 P. 1047.
The l e g a l d u t y o r s t a n d a r d o f care imposed upon a m e d i c a l
s p e c i a l i s t , such a s t h e o r t h o p e d i c s u r g e o n i n t h i s case, i s s e t
f o r t h i n t h e f o l l o w i n g p a s s a g e i n 2 1 ALR3d 953:
" * * * t h e general proposition t h a t a physician
o r surgeon who h o l d s h i m s e l f o u t a s having s p e c i a l
knowledge and s k i l l i n t h e t r e a t m e n t of some p a r -
t i c u l a r o r g a n o r d i s e a s e must e x e r c i s e , i n h i s
t r e a t m e n t o f one who employs him a s a s p e c i a l i s t ,
t h a t d e g r e e o f s k i l l and care o r d i n a r i l y p o s s e s s e d
and used by s i m i l a r s p e c i a l i s t s , and t h a t h i s d u t y
t o h i s p a t i e n t i s a c c o r d i n g l y measured by a h i g h e r
standard of s k i l l than t h a t of a general p r a c t i t i o n e r . "
O r d i n a r i l y t h e s t a n d a r d of c a r e t o which a m e d i c a l
p r a c t i t i o n e r i s h e l d and t h e b r e a c h t h e r e o f must be e s t a b l i s h e d
by e x p e r t m e d i c a l t e s t i m o n y . C o l l i n s v. I t o h , 160 Mont. 461,
503 P.2d 36, 8 1 ALR2d 597, and c a s e s c i t e d t h e r e i n .
With t h e s e p r i n c i p l e s i n mind, w e proceed t o c o n s i d e r -
a t i o n of whether summary judgment f o r d e f e n d a n t w a s p r o p e r l y
granted. Rule 5 6 ( c ) , M.R.Civ.P., a u t h o r i z e s a summary judg-
ment when:
" * * * t h e pleadings, d e p o s i t i o n s , answers t o
i n t e r r o g a t o r i e s , and a d m i s s i o n s on f i l e * * *
show t h a t t h e r e i s no g e n u i n e i s s u e a s t o any
material f a c t and t h a t t h e moving p a r t y i s
e n t i t l e d t o a judgment a s a m a t t e r o f law."
I t i s n o t a s u b s t i t u t e f o r a t r i a l o f d i s p u t e d i s s u e s of f a c t .
Dunjo Land Co. v. Hested S t o r e s , 163 Mont. 87, 515 P.2d 961;
Dean v. F i r s t N a t i o n a l Bank, 152 Mont. 474, 452 P.2d 402. A
p a r t y s e e k i n g a summary judgment h a s t h e burden of e s t a b l i s h -
i n g t h e a b s e n c e o f any g e n u i n e i s s u e of m a t e r i a l f a c t . Meech
v. Cure, 165 Mont. 49, 525 P.2d 546; B e i e r l e v . T a y l o r , 164
Mont. 436, 524 P.2d 783, and c a s e s c i t e d t h e r e i n .
Is t h e r e a g e n u i n e i s s u e o f m a t e r i a l f a c t c o n c e r n i n g
malpractice i n t h e i n s t a n t case? O r s t a t e d a n o t h e r way, i s
t h e r e e x p e r t medical testimony t h a t e s t a b l i s h e s a genuine i s s u e
o f m a t e r i a l f a c t c o n c e r n i n g t h e r e q u i r e d s t a n d a r d of c a r e and
Dr. Jacobson's deviation therefrom?
The d i s t r i c t c o u r t h e l d t h e r e w a s n o t . The d i s t r i c t
c o u r t s t a t e d i n i t s o r d e r g r a n t i n g summary judgment t h a t D r .
Biscaro, p l a i n t i f f s ! designated expert medical witness, repeated-
l y s t a t e d t h a t i n h i s opinion " * * * t h e r e was p r o p e r c a r e
and t r e a t m e n t of S a r a h J. Baylor by D r . J a c o b s o n " , and t h a t
Dr. Biscaro " * * * h a s n o t t e s t i f i e d t o any c o n d u c t on t h e
p a r t o f D r . David P. Jacobson which c a n be termed m e d i c a l mal-
practice. "
A t t h e o u t s e t we o b s e r v e t h a t p l a i n t i f f s ' intended
t o c a l l D r . Biscaro t o e s t a b l i s h proximate cause, n o t m a l -
practice. P l a i n t i f f s ' answers t o d e f e n d a n t ' s i n t e r r o g a t o r i e s ,
f i l e d J u l y 29, 1 9 7 5 , p r o v i d e i n p e r t i n e n t p a r t :
"INTERROGATORY NO. 1
"Have you r e t a i n e d , o r d o you i n t e n d t o c a l l ,
an expert witness, o r expert witnesses, t o
t e s t i f y on b e h a l f of t h e P l a i n t i f f s a t t h e
t i m e o f t h e t r i a l i n t h e above-captioned c a s e ?
"ANSWER: Yes.
"INTERROGATORY NO. 2:
"If so, a s t o t h a t expert, please s t a t e :
" ( a ) H i s name;
" ( b ) H i s age;
" ( c ) H i s r e s i d e n t i a l address;
" (d) H i s business address.
"ANSWER:
"Dr. B i s c a r o ' s d e p o s i t i o n w i l l b e t a k e n on J u l y
31, 1975. H e may be t h e o n l y e x p e r t . If his
testimony does n o t r e l a t e t h e negligence t o
p l a i n t i f f ' s c o n d i t i o n , a n e x p e r t w i l l be r e t a i n e d
and t h e background i n f o r m a t i o n s o u g h t h e r e i n
immediately f u r n i s h e d . " ( ~ m ~ h a s added. )
is-
P r i o r t o t h e t i m e D r . B i s c a r o ' s d e p o s i t i o n had been
t a k e n , s p e c i f i c a l l y on October 4 , 1974, t h e d e p o s i t i o n o f t h e
d e f e n d a n t D r . Jacobson had been t a k e n . I n o u r view h i s t e s t i -
mony and t h e m e d i c a l r e c o r d s a t t a c h e d a s deposition exhibits
were s u f f i c i e n t t o r a i s e t h e i s s u e o f m e d i c a l m a l p r a c t i c e .
The c r u x o f h i s t e s t i m o n y i s c o n t a i n e d i n h i s answer
t o a hypothetical question. The assumed f a c t s i n t h e hypo-
t h e t i c a l q u e s t i o n r e p r e s e n t e d t h e f a c t s of t h e c a s e from p l a i n -
t i f f s ' v i e w p o i n t and D r . Jacobson w a s a s k e d whether it would
be a c c e p t a b l e m e d i c a l p r a c t i c e t o a d v i s e t h e p a t i e n t t o q u i t
babying t h e l e g and jump up and down on i t . The d o c t o r , a f t e r
c o n s i d e r a b l e r e p a r t e e w i t h d e f e n s e c o u n s e l o v e r whether h e w a s
t a l k i n g a b o u t S a r a h Baylor o r n o t , i n d i c a t e d t h a t under t h e
assumed f a c t s it would n o t have been a d v i s a b l e t o have t h e
p a t i e n t walk on t h e l e g . T h i s , i n o u r view, i s s u f f i c i e n t
t o e s t a b l i s h a n i s s u e on m e d i c a l m a l p r a c t i c e p r e c l u d i n g
summary judgment. I t i s n o t t h e f u n c t i o n o f summary judg-
ment t o d e c i d e t h a t i s s u e b u t s i m p l y t o e s t a b l i s h w h e t h e r a n
i s s u e e x i s t s t h a t r e q u i r e s d e t e r m i n a t i o n and r e s o l u t i o n a t
trial. Dean v . F i r s t N a t i o n a l Bank, s u p r a ; M a t t e u c c i ' s Super
Save v. Hustad C o r p . , 158 Mont. 311, 491 P.2d 705.
W e n o t e i n p a s s i n g t h a t s u b s e q u e n t t o summary judgment
p l a i n t i f f s f i l e d amended a n s w e r s t o i n t e r r o g a t o r i e s i n d i c a t i n g
t h a t t h e y i n t e n d e d t o c a l l D r . Tuby t o e s t a b l i s h m a l p r a c t i c e
and p r o x i m a t e c a u s e . This was not before t h e d i s t r i c t court
a t t h e t i m e i t r u l e d on summary judgment, nor w a s any a t t e m p t
made t o b r i n g t h i s m a t t e r b e f o r e t h e c o u r t f o r c o n s i d e r a t i o n o r
adjudication. The d i s t r i c t c o u r t c a n n o t b e h e l d i n e r r o r on
t h e b a s i s o f documents n o t b e f o r e it a t t h e t i m e it made i t s
ruling.
The d i s t r i c t c o u r t g r a n t e d summary judgment o n t h e ad-
d i t i o n a l ground t h a t it found t h a t " * * * Sarah J. B a y l o r ' s
r e f u s a l t o continue medical treatment i s a proximate cause of
h e r s u b s e q u e n t problems w i t h h e r l e g . " Here a g a i n t h e d i s t r i c t
c o u r t h a s made a f a c t u a l d e t e r m i n a t i o n o f t h e c a u s e o f h e r
i n j u r i e s i n g r a n t i n g summary judgment. It ignores her deposi-
t i o n t e s t i m o n y and t h a t o f h e r husband t h a t s h e c o n t i n u e d t o
p u t w e i g h t upon h e r l e g and p r a c t i c e d w a l k i n g on it a s a d v i s e d
by t h e d o c t o r . It eliminates her testimony t h a t she d i d n o t
know t h e r e was a nonunion a t t h e s i t e o f t h e f r a c t u r e and t h a t
Dr. J a c o b s o n d i d n o t t e l l h e r t h e r e w a s a nonunion. I t rejects
t h e r e a s o n s and j u s t i f i c a t i o n t h a t S a r a h B a y l o r and h e r husband
gave f o r d i s c o n t i n u i n g c o n s u l t a t i o n s w i t h D r . J a c o b s o n . These
c o n s i d e r a t i o n s e s t a b l i s h a n i s s u e on p r o x i m a t e c a u s e t h a t p r e c l u d e s
summary judgment.
W p a s s no judgment on t h e m e r i t s of t h i s c a s e .
e
The u l t i m a t e d e t e r m i n a t i o n o f t h e i s s u e s h e r e must be de-
cided a t t r i a l . W e simply hold t h a t t h e r e a r e genuine i s s u e s
of m a t e r i a l f a c t t h a t p r e c l u d e summary judgment i n advance
of t r i a l .
The summary judgment of t h e d i s t r i c t c o u r t i s r e v e r s e d .
The c a u s e i s remanded t o t h e d i s t r i c t c o u r t o f M i s s o u l a County
f o r f u r t h e r proceedings.
Justice
---;-----LL-;-J----------------
Hon. Bernard Thomas, D i s t r i c t
Judge, s i t t i n g i n p l a c e of M r .
Chief J u s t i c e James T. H a r r i s o n .
M r . Justice Wesley Castles dissenting:
I respectfully dissent.
In my view the determinative question is whether
plaintiffs presented sufficient expert testimony to establish
an issue of malpractice.
In Collins v. Itoh, 160 Mont. 461, 470, 503 P.2d 36,
this Court said:
" * * * The well-recognized rule, subject to
certain exceptions, is that there must be
expert testimony to establish negligence in
a malpractice action."
Here, plaintiffs rely on defendant's deposition to supply the
required expert testimony. They constructed a hypothetical
question which they maintain is representative of their view-
point of the facts of this case. Plaintiffs then asked defend-
ant if it would be acceptable medical practice to advise the
patient in the hypothetical question to jump up and down on her
leg. Defendant said no. Plaintiffs find a contradiction be-
tween this response and the defendant's alleged treatment of
plaintiff Sarah Baylor. Upon this premise they contend the
issue of malpractice is raised and summary judgment is precluded.
I disagree. The deposition shows the defendant em-
phatically and persistently refused to accept the hypothetical
as an accurate statement of this case. It is clear defendant
perceived significant differences between the facts of this
case and the assumed facts in the hypothetical. He did not
intend his response to apply to the medical history of plaintiff
Sarah Baylor and he explicitly said so. There is no other
expert testimony as to the required standard of care or its
breach by defendant.
There comes a time when the district court must be
allowed to enter summary judgment. The complaint in this action
was filed April 2, 1974. The summary judgment which is the
s u b j e c t of t h i s a p p e a l w a s e n t e r e d September 3 0 , 1975. At
t h a t t i m e p l a i n t i f f s had s t i l l n o t p r e s e n t e d a n e x p e r t w i t n e s s
t o t h e d i s t r i c t c o u r t who would t e s t i f y t h a t d e f e n d a n t was
n e g l i g e n t i n h i s treatment of p l a i n t i f f Sarah Baylor.
I n t h e a b s e n c e of such e x p e r t t e s t i m o n y I would a f f i r m
t h e judgment o f t h e d i s t r i c t c o u r t .
Justice
Mr. J u s t i c e John Conway H a r r i s o n d i s s e n t i n g :
I concur i n t h e f o r e g o i n g d i s s e n t . o f M r . Justice
Wesley C a s t l e s . V