## Facts

- Ilene Robins was treated for many years by Dr. Tilak Garg, a general practitioner operating a walk-in clinic.
- At an initial visit in 1986, Garg noted cardiac risk factors including family history of heart disease, high cholesterol, and prior smoking.
- Garg ordered a stress test, an EKG, and blood testing in 1986, but did not refer Robins to a cardiologist.
- Over subsequent years, Garg treated Robins primarily in a primary-care capacity and did not order further stress tests or similar cardiac-focused evaluations despite ongoing risk factors.
- In 1998, Garg rechecked Robins’s cholesterol for the first time since 1986, found it high, advised dietary changes, and ordered follow-up testing; Garg claimed an undocumented cardiology referral and prescribed Lipitor that was not continued.
- In February 2001, Robins presented with chest and back pain; an ambulance was called, but she suffered cardiac arrest and died before its arrival.
- The estate brought a medical-malpractice action alleging negligent monitoring, diagnosis, and treatment of Robins’s cardiovascular risk and disease.
- Plaintiff offered a board-certified internal-medicine physician as the standard-of-care expert.

## Issues

1. Whether a board-certified internist was qualified under MCL 600.2169 to provide standard-of-care testimony against a general practitioner, applying the “one most relevant specialty” analysis.
2. Whether the trial court erred by striking the expert’s deposition testimony and granting summary disposition for lack of admissible standard-of-care proof.

## Decision

- The Court of Appeals reversed the grant of summary disposition and remanded.
- The court held that plaintiff’s internist expert was qualified under MCL 600.2169 to testify regarding the applicable standard of care.
- Because the expert was qualified, striking the deposition testimony was error.
- With the expert testimony available, summary disposition was improper.

## Legal Principles

- Under MCL 600.2169, expert qualification turns on whether the expert specializes in the same specialty as the defendant physician at the time of the alleged malpractice, and board-certification matching applies only if the defendant is board-certified in the relevant specialty.
- The “one most relevant specialty” is identified by the nature of the clinical services the defendant was providing during the alleged malpractice, rather than by labels alone.
- When the defendant is a general practitioner with no board certification, an internal-medicine specialist may qualify to opine on primary-care standards where the claim concerns primary-care management of conditions such as cholesterol and cardiac-risk monitoring and response to chest-pain complaints.
- A trial court errs by excluding otherwise qualified expert testimony under MCL 600.2169 and then granting summary disposition based on the resulting lack of admissible proof.

## Conclusion

The court held that, for alleged negligence arising from primary-care treatment by a general practitioner, a board-certified internist could satisfy Michigan’s expert-qualification statute because the relevant specialty is defined by the services actually rendered; excluding the expert and granting summary disposition was therefore reversible error.


Robins v. Garg, 741 N.W.2d 49 (Mich. Ct. App. 2007)