Kolln v. Saint Luke's Regional Medical Center

*335SILAK, Justice,

dissenting in part.

I must dissent from part IV(B)(3) of the Court’s opinion, which reverses the district court’s ruling that Katz’s third affidavit was insufficient to withstand summary judgment as to Henbest. I agree with the majority that the affidavit adequately set forth Katz’s experience and education, thus qualifying him to give expert testimony regarding neurosurgeons. Further, the affidavit clearly and expressly stated what the standard of care was, and stated that Katz held his opinion to a reasonable degree of medical certainty. Therefore, the affidavit meets the threshold requirements of I.C. § 6-1013 and I.R.C.P. 56(e), as set forth in Rhodehouse and Dunlap, in that Katz demonstrated that he was competent to testify to the matters stated in his affidavit.

However, that is not the end of the inquiry into whether the district court erred in granting summary judgment to Dr. Henbest. Because I.R.C.P. 56(e) requires that the affidavit set forth such facts as would be admissible into evidence, the Idaho Rules of Evidence regarding expert testimony must also be considered. I.R.E. 702 states that “[i]f scientific, technical, or other specialized knowledge will assist the trier of fact to understand the evidence or to determine a fact in issue, a witness qualified as an expert by knowledge, skill, experience, training, or education, may testify thereto in the form of an opinion or otherwise.” I.R.E. 703 provides that

[t]he facts or data in the particular case upon which an expert bases an opinion or inference may be those perceived by or made known to the expert at or before the hearing. If of a type reasonably relied upon by experts in the particular field in forming opinions or inferences upon the subject, the facts or data need not be admissible in evidence.

We have stated that there must be some factual basis for the opinions an expert expresses in his or her affidavit. Oats v. Nissan Motor Corp. in the U.S.A., 126 Idaho 162, 166, 879 P.2d 1095, 1099 (1994). One of the issues in Oats was whether the body panels of the car in question were defectively weak. In opposition to a defense motion for summary judgment, the plaintiff produced the affidavit of an expert who stated that he reviewed accident scene photos and photos of the vehicle in question, police reports, and the plaintiffs medical record. The expert then stated that in his opinion, the body of the car in question “was ‘not designed to withstand any significant impact affecting the roof structure.’ ” Id. However, the expert’s affidavit did not state a specific factual basis from his review of the records for his opinion, and the expert further acknowledged that there were some records he had not reviewed.

We stated that:

it was incumbent on Oats to' set forth specific facts showing there was a genuine issue whether the 280Z 2 + 2’s body panels were defectively weak. [The expert’s] opinion that the 280Z 2 + 2’s body was defectively weak was wholly conclusory, and merely repeated allegations contained in Oat’s complaint. It did not set forth any specific facts showing that the 280Z 2 + 2 had defectively weak body panels, as required by I.R.C.P. 56(e).

Id. (citing Corbridge v. Clark Equip. Co., 112 Idaho 85, 87, 730 P.2d 1005, 1007 (1986)) (stating that if an affidavit is merely conclu-sory, does not set forth specific facts, and simply repeats the allegations in the complaint, it is just the type of affidavit prohibited by I.R.C.P. 56(e)) (emphasis added). On review of another case dismissed on summary judgment, our Court of Appeals stated that “[bjecause a verdict cannot rest on speculation or conjecture, expert opinion which is speculative, conclusory, or unsubstantiated by facts in the record is of no assistance to the jury in rendering its verdict, and therefore is inadmissible as evidence under Rule 702.” Ryan v. Beisner, 123 Idaho 42, 46, 844 P.2d 24, 28 (Ct.App.1992) (citation omitted).

The prohibition against speculative, conclu-sory, or unsubstantiated expert opinions is especially relevant in the medical malpractice context, since direct expert testimony is required by statute. In a previous medical malpractice action, we stated that:

“[i]f a party resists summary judgment, it is his responsibility to place in the record *336before the trial court the existence of controverted material facts which require resolution by trial. A party may not rely on his pleadings nor merely assert that there are some facts which might or will support his legal theory, but rather he must establish the existence of those facts by deposition, affidavit, or otherwise. Failure to so establish the existence of controverted material facts exposes a party to the risk of a summary judgment.”

Sparks v. St. Luke’s Reg’l. Med. Ctr., 115 Idaho 505, 509, 768 P.2d 768, 772 (1988) (quoting Berg v. Fairman, 107 Idaho 441, 444, 690 P.2d 896, 899 (1984)) (first italics in Sparks, second italics added). This requirement of direct expert testimony sets medical malpractice cases such as the one before us apart from other types of eases such as Petricevich v. Salmon River Canal Co., 92 Idaho 865, 452 P.2d 362 (1969), cited by the majority. While we may permit circumstantial evidence to be used in cases other than medical malpractice to create a genuine issue of material fact, I would hold that the non-moving party must allege facts in the nature of direct evidence in order to withstand summary judgment in a medical malpractice case.

The majority opinion states that Katz’s third affidavit set forth facts which provided a sufficient basis for his conclusion that Hen-best breached the standard of care as to Kolln. Specifically, the majority asserts that Katz provided the following “facts”:

“1. Prior to the surgery performed by Dr. Henbest, Kolln had no signs or symptoms which would be consistent with a rotator cuff tear.
2. The day following the surgery, Kolln exhibited signs and symptoms consistent with a rotator cuff tear.
3. During the surgery performed by Dr. Henbest, Kolln was under general anesthesia and had no control over the instrumentalities capable of injuring her in the operating room.
4. One of two things caused Kolln’s injury, either her arm was hyperextended and rotated posteriorly, or it was forcefully inverted and pulled down.”

It is the final “fact” with which I must take issue, first because it misstates what Katz said in his affidavit, and second, if one looks at what Katz actually said, it is not a fact. In his third affidavit, after stating the standard of care, Katz actually stated the following:

5. The opinions expressed herein are my own and are based upon reasonable degree of medical certainty.
6. I have reviewed the records of the care of Ms. Kolln for St. Luke’s Regional Medical Center, Michael L. Henbest, M.D., James D. Redshaw, M.D., the operative report of Jeffrey Hessing, M.D., the Affidavits of Michael L. Henbest, M.D., Terry J. Keller, M.D., Ron Gilliam, CRNA and Sharon L. Kolln and the deposition of Michael L. Henbest, M.D.
7. Based upon my review of the above records it is my opinion within a reasonable medical certainty, that prior to the surgery performed by Dr. Henbest on September 14, 1992, Ms. Kolln had no signs or symptoms which would be consistent with a rotator cuff tear. However, the day following the surgery, Ms. Kolln did exhibit signs and symptoms consistent with a rotator cuff tear. Based upon these findings and within a reasonable degree of medical certainty the injury to Ms. Kolln’s shoulder occurred during the transfer of Ms. Kolln from the gurney to the operating table or from the operating table to the gurney during the subject surgery of September 14,1992.
8. A torn rotator cuff is the type of injury which in the ordinary course of a C4-C6 decompressive cervical laminecto-my, right C4-C5 and C5-C6 foraminotomy and the transfer of Ms. Kolln would not have occurred had Dr. Henbest and the surgical team (which includes certified surgical technicians, surgical technicians, registered nurses, anesthesiologists and certified nurse anesthetists), used due care.
9. Due to the fact that Ms. Kolln was under general anesthesia during the course of the operation she had no control over the instrumentalities capable of injuring her within the confines of the operating room.
*337 10. There are essentially two possibilities which could have caused Ms. Kolln’s injury. Either her right arm was hype-rextended and rotated posteriorly or forcefully inverted and pulled down. One of these two events must have therefore occurred sometime during the surgery or her transfer. The occurrence of either of these events would be a breach of the standard of care applicable to physicians engaged in the practice of neurosurgery in Boise, Ada County, Idaho in September, 1992.
11. Based upon my analysis and review of the aforementioned medical records, affidavits and deposition it is my opinion and with reasonable medical certainty that Michael L. Henbest, M.D. faded to comply with the standard of care applicable to physicians engaged in the practice of neurosurgery in Boise, Ada County, Idaho in September, 1992. As a proximate cause of Dr. Henbest’s failure to comply with the standard of care Ms. Kolln was injured.

Paragraph ten is not stated as a “fact”, by its very terms. It states that there are two “possibilities” which “could have caused” Kolln’s injury, and that one of those events “must therefore have happened” to cause the injury. However, Katz was unable to state that one of those two events did happen. This is much different than the majority’s statement that Katz stated, as a fact, that “[o]ne of two things caused Kolln’s injury....” That difference clearly sets this case apart from Kessler. The information provided the affidavit at issue in Kessler contained actual facts, statements of what had actually happened. In contrast, paragraph ten contains speculative, conclusory statements of what “must have” or could have happened. Such statements cannot be sufficient to withstand summary judgment.

This affidavit suffers from the very same defects as the affidavit in Oats. Although Katz concluded in paragraph seven of his affidavit that “[bjased upon these findings and within a reasonable degree of medical certainty the injury to Ms. Kolln’s shoulder occurred” during the operation, the affidavit fails to state any specific facts gleaned from” the reviewed records which support the conclusion that Henbest breached the standard of care. The affidavit contains the merely speculative statements that one of two events could have caused the injury during surgery. Thus, the affidavit concludes that one of those two events “must have” occurred during surgery, speculating that since Kolln said her pain and immobility started only after surgery, the injury had to have happened during the operation. However, there is no factual support in the affidavit for that conclusion, and mere conjecture or allegation is not sufficient to withstand summary judgment.

All of the medical records, reports, affidavits and depositions reviewed by Katz in preparing to render his opinion are in the record on appeal, with the exception of a Dr. Redshaw’s records. None of those record offer any facts which provide a basis for Katz’s opinion; indeed, all state that nothing unusual happened during surgery which could have caused a tom rotator cuff. While Katz was entitled to review and consider Kolln’s statements about the onset of her pain, and even her inadmissible opinion regarding the timing of her injury and the cause of her injury, those statements are not sufficient to support Katz’s speculative and conclusory opinion that the injury must have happened during surgery.

Not only is Katz’s opinion speculative and conclusory, but an implicit and necessary assumption, if one is to accept the conclusions in Katz’s affidavit, is that those present before, during and after the surgery were misrepresenting certain facts in their records, affidavits and depositions. That implicit assumption is in and of itself speculative, con-clusory and without any foundation. Further, that sort of assumption would take this case into the realm of the sort of speculative testimony condemned by the United States Supreme Court in Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579, 113 S.Ct. 2786, 125 L.Ed.2d 469 (1993). While that case dealt specifically with expert scientific testimony, as opposed to expert medical testimony of the type at issue in this case, the cautionary words of the Supreme Court bear repeating here, particularly given that Federal Rule of Evidence 702 is virtually identical to I.R.E. 702, and both rules cover *338all types of expert testimony. As the Supreme Court noted, “the word ‘knowledge’ [in Rule 702] connotes more than subjective belief or unsupported speculation. The term ‘applies to any body of known facts or to any body of ideas inferred from such facts or accepted as truths on good grounds.’ ” Id. at 590, 113 S.Ct. at 2795 (emphasis added). The Court held that “[proposed testimony must be supported by appropriate validation — i.e., ‘good grounds,’ based on what is known.” Id.

Thus, based on the foregoing analysis, I would hold that the district court did not abuse its discretion in ruling that Kolln’s expert affidavits did not meet the requirements of I.R.C.P. 56(e), and was therefore inadmissible.

SCHROEDER, J., concurs.