Is expert testimony required for common knowledge exception cases?

The Tennessee Court of Appeals recently heard a case questioning whether expert testimony is required in medical malpractice cases that fall into the common knowledge exception.

The Tennessee Court of Appeals recently heard a Health Care Liability Act case that was dismissed by lower courts because the plaintiff failed to file a certificate of good faith. The plaintiff in the case, Jonathan Fitzrandolph Zink v. Rural/Metro of Tennessee, contended that the case does not require the certificate as it falls within an exception.

What is the certificate? The certificate in question is used in medical malpractice cases to confirm that an expert was consulted. Tennessee law requires that medical experts be used for most medical malpractice cases. Tennessee uses a locality rule for expert testimony. Expert testimony is used to establish the standard of acceptable professional practice within the specific or similar community.

However, this case specifically questions whether or not the common knowledge exception applies and, if so, whether expert testimony would be required.

What is the common knowledge exception? This exception is used in certain situations when common knowledge would guide what types of actions are acceptable. This exception was discussed in Seavers v. Methodist Medical Center of Oak Ridge. In that case, the court stated that the exception "allows an inference of negligence where the jury has a common knowledge or understanding that the events which resulted in the plaintiff's injury do not ordinarily occur unless someone was negligent."

Based on this reasoning, the plaintiff argued expert testimony was not required when the common knowledge exception is used. If expert testimony is not required, the certificate is unneeded and his case should not be thrown out.

What led to this medical malpractice lawsuit? There is not much information in the initial complaint. At this point, all that is known is that a person requiring urgent medical attention was strapped to a gurney. While strapped down, an emergency medical responder was responsible for a "violent collision between the defendant's fist [the emergency medical responder] and the plaintiff's face." This resulted in both temporary and permanent injury to the plaintiff's face.

What is the issue in this case? The primary issue at this stage of the case is whether or not the plaintiff requires a certificate of good faith used for expert testimony in medical malpractice cases.

What were the arguments in this case? The lower courts stated that the certificate was required. It ruled in favor of the defendant, finding that the matter required expert testimony to determine if the injuries were permanent and if the action taken by the emergency medical care provider was outside of the accepted standard of care. This was supported by the contention that the standard of care in this area of medicine was such that the average person may not be familiar with.

The plaintiff's counsel countered that the plaintiff was already strapped to the gurney. The victim suffered permanent injuries to his face as a result of this attack. The victim further argued that the extent of injury could be established at a later date with the use of experts, but that this was not needed for the initial stages of the case.

What did the court hold? The Court of Appeals did not agree with the lower courts. They did not find that the plaintiff needed the certificate. However, the plaintiff did fail to meet certain notice requirements. As such, the case was dismissed without prejudice to refile.

What does this mean for similar cases? The holding in this case provides some guidance as to whether or not a certificate is required when the common knowledge exception is invoked. This will aid in future filings that use this legal strategy.