Facts
- Lorrie Ardoin underwent coronary artery bypass surgery at Our Lady of Lourdes Hospital in Lafayette, Louisiana, performed by cardiovascular surgeon Dr. James Bozeman.
- The procedure used a heart-lung machine assembled with new tubing manufactured by Bentley Laboratories, Inc.; Bentley’s district manager, Travis Bohannon, attended to assist hospital perfusionists in attaching the tubing.
- During surgery, a tube connected to the patient’s ventricle pumped air rather than suctioning blood, causing a massive air embolism and instantaneous death.
- The decedent’s spouse and children filed a wrongful-death suit against medical personnel, the hospital, Bentley/Bohannon, and insurers; Bentley/Bohannon and their insurers filed a third-party demand against Dr. Bozeman for contribution/indemnity.
- The third-party claim turned on whether the applicable standard of care required a cardiovascular surgeon to personally verify the tubing/lines before inserting them into the heart.
- Dr. Bozeman offered testimony that, in Lafayette practice, perfusionists were responsible for checking the tubing; the third-party plaintiffs sought testimony from an out-of-town cardiovascular surgeon that specialists should check the lines themselves.
- The trial court excluded the non-local specialist’s testimony based on a locality-based standard of care; the jury absolved Dr. Bozeman, defeating the third-party claim.
Issues
- Under La. R.S. 9:2794, is a medical specialist’s standard of care governed by a locality rule or by a specialty-based standard not confined to the defendant’s community?
- Did the lower courts err by excluding expert testimony from a non-local cardiovascular surgeon solely because he lacked familiarity with local medical practices?
Decision
- The Louisiana Supreme Court reversed the court of appeal as to the third-party demand against Dr. Bozeman.
- The court held the locality rule does not apply to medical specialists; specialists are judged by the care, skill, and diligence ordinarily exercised by members of the same specialty under similar circumstances.
- The court ruled that excluding the non-local cardiovascular surgeon’s testimony solely for lack of familiarity with Lafayette standards was legal error.
- The court set aside the jury verdict and district court judgment on the third-party action and remanded for a new trial consistent with the proper specialist standard.
Legal Principles
- La. R.S. 9:2794 distinguishes between general practitioners (whose standard may incorporate community or similar-community considerations) and specialists (whose standard is tied to the specialty under similar circumstances).
- For specialists, the standard of care is not limited by geographic locality; local custom does not control if it conflicts with generally accepted specialty practice.
- Expert testimony on a specialist’s standard of care is admissible when the expert is qualified in the specialty and familiar with specialty standards, even if the expert is not familiar with the defendant’s local practices.
- Excluding competent, relevant expert testimony on the specialist standard of care can require a new trial when the standard-of-care question is central to liability or third-party allocation.
Conclusion
The court required Louisiana malpractice claims against specialists to be evaluated under a specialty-based standard rather than a local community standard, and it ordered a new trial on the third-party claim because the trial court improperly excluded non-local specialist expert testimony on the applicable standard of care.