## Facts

- Yvonne Gambill was admitted to a hospital in Jonesboro, Arkansas, for surgery to remove a thyroid cyst.
- Dr. Paul T. Stroud was the surgeon; Dr. E. B. Sparks was the anesthesiologist (claims against Sparks were settled before trial).
- After anesthesia was induced and Sparks advised that the patient was ready, Stroud began the incision but stopped when he observed “very dark” blood, a sign consistent with inadequate oxygenation.
- The operation was not completed; the patient suffered cardiac arrest followed by respiratory arrest, resulting in severe, permanent brain damage.
- Plaintiffs alleged Stroud negligently failed to recognize and respond appropriately to signs of hypoxia and otherwise failed to meet the applicable standard of care.
- Plaintiffs presented expert testimony from physicians who asserted familiarity with standards in Jonesboro or similar communities; testimony indicated the standards in Jonesboro, Little Rock, and Memphis were comparable.

## Issues

1. Whether Arkansas should modify or abandon the “same or similar locality” rule for medical-malpractice standard of care and replace it with a broader (including national) standard.
2. Whether instructing the jury under the “same or similar locality” standard (AMI Civil 2d 1501) was error.

## Decision

- The Arkansas Supreme Court affirmed the defense verdict for Dr. Stroud.
- The court held the “same or similar locality” rule reflected in AMI 1501 was proper, adequate, and viable.
- The court declined to adopt a national standard of care as a matter of law, concluding the existence of such a uniform national standard was not appropriate for judicial notice.
- Justice George Rose Smith dissented, favoring modernization of the locality-based approach.

## Legal Principles

- In Arkansas medical-malpractice cases, a physician is judged by the skill and learning ordinarily possessed and used by members of the profession in the same or similar locality.
- The rule is not confined to a single town; “similar locality” considers medical facilities, practices, and advantages, not merely population size or geography.
- Whether communities are “similar” for standard-of-care purposes is a question of fact subject to proof, including evidence about the opportunities and resources available to practitioners.
- A national standard of care is not imposed as a matter of law absent a basis to treat it as established and judicially noticeable.

## Conclusion

The court upheld the jury instruction applying the same-or-similar-locality standard and affirmed judgment for the surgeon, rejecting the request to replace Arkansas’s locality-based malpractice standard with a nationwide standard.


Gambill v. Stroud, 258 Ark. 766, 531 S.W.2d 945 (Ark. 1976)