## Facts

- Daphyne S. Condra sought treatment at Atlanta Orthopaedic Group in 1998 for neck, arm, and back pain following a prior automobile accident.
- Dr. James L. Chappuis continued an anti-inflammatory medication and prescribed a 30-day course of Tegretol (carbamazepine), which carries a rare risk of aplastic anemia.
- Chappuis did not order baseline or periodic blood-count monitoring during the Tegretol regimen.
- Condra later developed aplastic anemia, resulting in bone marrow failure to produce red blood cells and platelets.
- Plaintiffs’ experts opined that Tegretol caused the condition and that blood monitoring was required by the standard of care and could have prevented the injury.
- Defense experts testified that monitoring was reasonable but not required by the standard of care; at least one expert had testified that his own practice was to monitor blood counts for Tegretol patients.
- The trial court granted a motion in limine preventing cross-examination of defense experts about their personal treatment practices regarding Tegretol monitoring.
- The trial court also instructed the jury not to judge the physician’s conduct with “hindsight.”
- The jury returned a verdict for defendants on malpractice and loss of consortium, and judgment was entered; the Court of Appeals affirmed.

## Issues

1. Whether, in a medical malpractice case, a plaintiff may cross-examine a defendant’s expert about the expert’s own personal medical practices as relevant to credibility and the standard of care.
2. Whether the trial court’s “hindsight” jury instruction was improper under Georgia law governing malpractice charges.

## Decision

- Reversed the Court of Appeals and the judgment entered on the defense verdict.
- Held the trial court erred by barring cross-examination of defense experts regarding their personal medical practices.
- Overruled prior precedent that categorically treated expert personal practices as inadmissible on the standard of care.
- Held the hindsight instruction, as given, was improper under governing limits on such charges.
- Remanded for a new trial consistent with these rulings.

## Legal Principles

- Evidence of a medical expert’s personal practice may be admissible to assess the credibility and weight of the expert’s standard-of-care opinions.
- Although the malpractice standard of care is objective, an expert’s real-world conduct in similar circumstances can be probative and is not categorically irrelevant.
- Trial courts may address the risk that jurors confuse personal practice with the legal standard of care through limiting instructions rather than blanket exclusion.
- “Hindsight” instructions in malpractice cases are disfavored when they risk preventing jurors from considering later-learned information that bears on whether the defendant met the standard of care at the time of treatment; if used, the charge must be narrowly tailored.

## Conclusion

The Supreme Court of Georgia ordered a new trial because the jury was improperly prevented from hearing impeachment and evaluative evidence about defense experts’ own treatment practices and because the hindsight instruction risked misleading the jury’s assessment of negligence at the time of care.


Condra v. Atlanta Orthopaedic Grp., P.C., 285 Ga. 667, 681 S.E.2d 152 (Ga. 2009)