dissenting. I would affirm udgegrant , summary judgment. First, I do not agree that the nature of the alleged negligence here is such that ho expert testimony is needed. The majority concludes that using a different blood type than the one “recommended” in a letter by the deceased’s treating physician in Texas is clear negligence. Without additional expert testimony about the nature or import of the recommendation, dong with the other dtematives recommended in the treating physician’s letter to the appellee, Dr. Lincoln, there is no way that a lay person could even guess that the failure to follow this recommendation was negligence per se. However, the majority concludes that it must be because the letter was from a “specidist” to a “non-specidist,” and that such negligence is no more complicated to comprehend than when a surgeon leaves a foreign object in the surgicd site after an operation or severs a ureter during removd of an ovary. This is ludicrous, and it is certdnly not readily apparent from the ambiguous nature of the letter’s directive whether any harm might result from the failure to follow the “recommendation.” This case is not at all andogous to the facts of the case relied upon in part by the majority, Lanier v. Trammell, 207 Ark. 372, 180 S.W.2d 818 (1944), in which the court in essence held that jurors could make the leap between dirty hands and instruments to a resulting an eye infection without expert testimony. I cannot make such a leap in this case to conclude that there would be “injurious consequences” resulting from the use of a different blood type, and the majority most certainly could not either.
The appellant thus was required to prove, with expert testimony, “the degree of skill and learning ordinarily possessed and used by members of the profession of the medical care provider in good standing, engaged in the same type of practice or specialty in the locality in which he practices or in a similar locdity.” Ark. Code Ann. § 16-114-206(a)(1) (1987). An expert witness need not be one who has practiced in the particular locality, or one who is intimately familiar with the practice in it, in order to be qualified as an expert to testify in a medical malpractice action “if an appropriate foundation is established to demonstrate that the witness is familiar with the standard of practice in a similar locality, either by his testimony or by other evidence showing the similarity of localities.” Grice v. Atkinson, 308 Ark. 637, 826 S.W.2d 810 (1992).
In this instance, because appellant’s expert, Dr. Singer, failed to establish the standard of care in Baxter County, Arkansas, or a similar locality, the trial court granted Dr. Lincoln’s motion for summary judgment. Dr. Singer, a hematology-oncology expert located in Pennsylvania, was silent in his original affidavit as to any community standard, much less the standard of care applicable in Arkansas. There was no evidence in his affidavit that he was familiar with the standard of care in Arkansas, and there was no attempt to compare his locale with Baxter County or anywhere in Arkansas. His original affidavit did not even identify the location of his current practice. His affidavit simply stated that “the standard of care would require a primary care physician, such as Dr. Lincoln, to follow the recommendations of a specialist.” The trial court struck the supplemental affidavit of Dr. Singer in which he asserted familiarity with the standard of care in Arkansas, from the record; appellant does not argue that the trial court erred when it struck this supplemental affidavit from the record. Because Dr. Singer’s original affidavit did not offer any proof as to the applicable standard of care, the appellant failed to meed her burden of proof according to Ark. Code Ann. § 16-114-206(a)(1). See Reagan v. City of Piggott, 305 Ark. 77, 805 S.W.2d 636 (1991) (granting summary judgment when the plaintiff presented no expert proof to establish the standard of care of a violation of the standard of care).
In addition, the trial court granted summary judgment alternatively based upon the appellant’s failure to establish the required element of proximate causation. Proximate cause is defined, for negligence purposes, as that which in a natural and continuous sequence, unbroken by any efficient intervening cause, produces the injury, and without which the result would not have occurred. Kilgore, supra. In other words, Ark. Code Ann. § 16-114-206(a) (1987) implements the traditional tort standard of requiring proof that “but for” the tortfeasor’s negligence, the plaintiff s injury or death would not have occurred. Ford v. St. Paul Fire & Marine Ins. Co., 339 Ark. 434, 5 S.W.3d 460 (1999).
Here, appellee’s expert, Dr. Markland, stated that Dr. Lincoln’s treatment did not cause or contribute to Mr. Mitchell’s death and that his underlying condition, the leukemia, was the cause of his death. Dr. Singer, appellant’s expert, stated that Dr. Lincoln’s action was only “a significant contributing factor” to the ultimate demise of the decedent. This infers that another condition actually caused his death. Thus, even if Dr. Singer’s original affidavit was sufficient to set forth the proper standard of care, it did not establish that, but for any violation of the standard of care on the part of Dr. Lincoln, the decedent would have survived, and such survival surely cannot be inferred from Dr. Singer’s affidavit. While the affidavit may have sufficed in a medical malpractice case to establish that some kind of medical injury to the deceased occurred, Dr. Singer’s affidavit does not establish proximate causation for his death.
I would affirm.
Crabtree, J., joins.