## Facts

- Terry O. Hall was admitted to a Mississippi hospital with abdominal discomfort; her physician suspected a surgical condition and requested a consult from Dr. Glyn R. Hilbun, a general surgeon.
- Dr. Hilbun performed an exploratory laparotomy for suspected small-bowel obstruction; the procedure appeared successful and the patient was stable in recovery.
- After transfer to a private room, the patient repeatedly complained of pain and distress overnight; Dr. Hilbun did not personally monitor her post-operative course and did not provide detailed post-operative instructions to nursing staff.
- Nurses did not contact Dr. Hilbun during the night; the patient’s condition deteriorated rapidly the next morning and she died before effective intervention.
- Autopsy found a retained sponge in the abdomen, but it was determined not to have caused the death; death was attributed to cardiopulmonary failure/adult respiratory distress.
- The decedent’s husband sued for wrongful death/medical malpractice, alleging negligent post-operative management, including failure to follow the patient and failure to instruct and supervise nursing monitoring and reporting.

## Issues

1. What standard of care governs Mississippi physician malpractice claims: a strict local custom standard or a nationally informed professional standard adjusted for available resources.
2. Whether out-of-state physicians may be excluded as experts solely for lack of familiarity with the defendant’s precise local medical practices.
3. Whether exclusion of the plaintiff’s out-of-state experts and the resulting directed verdict for the defendant were erroneous.

## Decision

- The Mississippi Supreme Court (on rehearing) withdrew its prior opinion, vacated the judgment, and remanded for a new trial on all issues.
- The court rejected a strict locality rule and adopted an objective standard tied to minimally competent physicians in the same specialty under similar circumstances, informed by national medical knowledge while accounting for local resource limitations.
- The court held that experts may not be disqualified merely because they are from outside the locality; the key is familiarity with the applicable professional standard for similarly situated physicians.
- Because the trial court excluded the plaintiff’s experts on locality grounds and then directed a verdict for the defendant, the judgment could not stand under the refined rules.

## Legal Principles

- A physician must exercise the care, skill, and diligence ordinarily possessed and exercised by minimally competent physicians in the same specialty acting under the same or similar circumstances.
- The applicable standard is not established by local custom alone; it is informed by generally available medical knowledge and professional expectations, with local conditions relevant primarily to the feasibility of particular measures given available facilities and resources.
- Expert qualification turns on the expert’s knowledge of the relevant standard of care for the defendant’s specialty and circumstances; practice in the same community or state is not required.
- When expert testimony is excluded based on an improper locality requirement, a directed verdict based on the resulting absence of proof is improper if the excluded testimony could create a jury question on breach and causation.

## Conclusion

The court ordered a new trial after reformulating Mississippi medical malpractice law to use a nationally informed, objective specialty-based standard tempered by practical resource constraints, and after holding that out-of-state experts may testify if they are knowledgeable about the care reasonably expected of a minimally competent physician under similar circumstances.


Hall v. Hilbun, 466 So. 2d 856 (Miss. 1985)