Lockart v. MacLean

Badt, C. J.,

concurring:

I agree that under the generally recognized majority rule Dr. Tepper was not competent to testify that the several acts and omissions of respondents were not in accord with good practice in the particular locality. I agree, too, that this is not a proper case in which we should essay a re-examination of that rule. However, in view of the recognized standing of such a hospital as Washoe Medical Center, and in view of the great advancements in communication, publication, and general professional knowledge of medical and surgical science over the many years since the first promulgation of such rule, I feel that this first formal acceptance of such rule by this court should not be taken as precluding *218us, in a proper case in the future, from re-examining said rule and, if necessary for the just determination of any specific case, reconsidering and possibly departing from its general application.

McNamee, J.,

concurring:

I concur in the result.

The primary question involved in this appeal relates to the qualification of Dr. Tepper to give evidence as a medical expert. Dr. Tepper’s affidavit failed to show that he was familiar with the standard of care and practice exercised by members of the medical profession either in Reno, in neighboring towns, or in some other area where conditions were similar to those in Reno. It was because of this omission that the trial court refused to receive Dr. Tepper’s affidavit in evidence in opposition to the motion for summary judgment.

It is to be noted that in the first cause of action contained in appellant’s complaint, appellant alleged: “That the defendants above named, through their agents, servants, and employees, did not exercise that degree of care, skill and learning ordinarily possessed and exercised by hospitals and physicians and surgeons practicing in the same locality during said times and places, to the present date * *

The second cause of action charges respondents with a failure to communicate to appellant the risk and hazard inherent in the treatment given appellant.

The third cause of action charges respondents with negligently failing to call into consultation other specialists and negligently entrusting the performance of the physical examination, diagnosis, care, and treatment of appellant to unskilled and incompetent persons.

With respect to these last two causes of action, Dr. Tepper’s affidavit was silent and no other evidence relating thereto was presented on behalf of appellant.

It appears that primarily because of the aforesaid pleadings the majority opinion herein recognizes the so-called “locality rule” which bases the competency of a medical expert upon his knowledge of the standard of care, prevailing in the particular locality.

*219I reach the conclusion to affirm not by establishing as a law of this state the “locality rule,” but on the basis that the qualification of a medical expert to testify in a malpractice action is a question for the sound discretion of a trial court irrespective of whether he is familiar with the standards of care within the particular community and that its ruling will not be disturbed upon appeal unless a clear abuse of discretion is shown. See Hundley v. St. Francis Hospital, 161 Cal.App.2d 800, 327 P.2d 131. The “locality rule” is meeting more and more with disfavor by the courts due to the improvement of medical and hospital standards and the expansion of the requirements for qualification of medical practitioners.

In commenting upon the “locality rule,” the court in Gist v. French, 136 Cal.App.2d 247, 288 P.2d 1003, after terming it archaic, said:

“It was not without merit in former days when distances were great and the mode of travel was in keeping with muddy lanes, swollen streams and impassable mountains; when the means of communication were restricted to handwritten letters; when medical journals were rare and their contents were largely concerning personalities. Today the discoveries of insulin, iron, quinine, strychnine or the antibiotics is instantly heralded throughout the civilized world and as speedily communicated are the methods of administering them and the symptoms for which they are to be applied. Every great hospital in the land maintains systems for preserving statistical information relative to the treatments of diseases and injuries, much of which is published to the medical world in attractive journals, whereby practitioners are equipped immediately to utilize the new remedies. The same is true with respect to all new methods and devices of the surgical art. The ubiquity of such knowledge, the popularity of ethical standards in every part of the nation and the uniformity of curricula in medical schools have combined to create one community of medical practitioners out of the 48 states and the District of Columbia.”

The various recent decisions which are concerned with the competency of medical experts, although the rules *220resulting therefrom appear to differ in certain cases, establish one principle common to all which is that appellate courts endeavor to uphold the lower courts in the exercise of their discretion in the determination of competency whenever possible.