## Facts

- Mark Alan Shilkret was born on December 22, 1968, at Anne Arundel General Hospital and allegedly suffered brain damage from negligent delivery and subsequent treatment, requiring continuous institutionalization.
- Defendants included the hospital and several physicians involved in prenatal care, delivery, anesthesia, and neonatal assessment.
- Plaintiffs alleged defendants failed to meet applicable professional standards and offered expert testimony framed in terms of national or similar-locality standards, not a strict community-only standard.
- The trial court treated the governing medical standard of care as the “strict locality” rule and, finding plaintiffs’ proof not tailored to that standard, directed verdicts for the hospital and physicians.

## Issues

1. Whether Maryland medical malpractice claims are governed by a strict locality standard of care or a broader standard based on reasonably competent practitioners in the same class acting in the same or similar circumstances.
2. Whether hospitals, like physicians, are subject to the same broader, non-locality-bound standard of care.

## Decision

- The Court of Appeals of Maryland reversed the intermediate appellate court and rejected the strict locality rule in medical malpractice cases.
- The court adopted a broader standard requiring a health-care provider to exercise the care and skill expected of a reasonably competent practitioner in the same class, acting in the same or similar circumstances.
- The court held that the standard is not confined to the defendant’s immediate community and may be informed by generally accepted professional expectations while accounting for circumstances such as available facilities.
- The case was remanded for a new trial under the correct standard, because the directed verdicts rested on an erroneous locality-based standard that improperly discounted plaintiffs’ expert proof.

## Legal Principles

- In Maryland medical malpractice actions, the standard of care is the degree of care and skill expected of a reasonably competent practitioner in the same class acting in the same or similar circumstances, not the practices of the defendant’s single locality.
- The standard accommodates circumstances (including available resources and facilities) but does not permit geographic isolation to define professional competence.
- Hospitals are held to a comparable, broader standard consistent with professional expectations shaped by state regulation and widely accepted accreditation and operational norms.
- Expert testimony is not inadmissible or insufficient merely because it is framed in national or similar-circumstances terms rather than a strict locality formulation.

## Conclusion

Maryland replaced the strict locality rule with a broader, similar-circumstances standard for physicians and hospitals, requiring a new trial when a case was removed from the jury based on an erroneous, locality-confined view of professional negligence.


Shilkret v. Annapolis Emergency Hosp. Ass’n, 276 Md. 187, 349 A.2d 245 (Md. 1975)