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D.P. v. Wrangell General Hospital5/19/2000
he "norm of community standards." He stated:
I don't see in -- in my professional opinion that there was a miscommunication, a negligence, a nursing decision where somebody made it on their own and -- and had some wild idea or -- or did anything different than I would have expected any nurse to do. Sometimes patients walk out.
Dr. Schoettle also testified that the nurses had observed D.P. with adequate frequency. But Dr. Schoettle acknowledged that the "fact that the patient went out implies [negligence]," although he did not believe that the nurses were negligent. Dr. Schoettle explained that an order to stay in the building is actually "an assumed" order for any patient, psychiatric or otherwise. He noted that even in psychiatric wards, doors are often left unlocked or open, and patients are allowed to commingle.
The court concluded that Dr. Schoettle's testimony had established the standard of care but failed to show a breach of duty by either the hospital or Hansen. It therefore directed a verdict for the defendants and dismissed D.P.'s claims.
III. STANDARD OF REVIEW
In reviewing the superior court's decision to grant a directed verdict, we view the evidence in the light most favorable to the nonmoving party. We will affirm a directed verdict only where reasonable jurors could not reach different conclusions.
Whether expert testimony is required to show a breach of a duty of care represents a question of law to which we apply our independent judgment. We will adopt the rule of law most convincing in light of precedent, reason, and policy.
IV. DISCUSSION
A. It Was Error to Require D.P. to Present Expert Testimony as to the Breach of a Duty of Care.
The general rule in medical malpractice actions provides that "the jury ordinarily may find a breach of professional duty only on the basis of expert testimony." "The primary limitation to this rule is that expert testimony is not needed in non-technical situations where negligence is evident to lay people." D.P. relies on this exception.
The defendants rely primarily on cases discussing whether the health care provider failed to recognize the suicidal or elopement tendencies of the patient or failed to order appropriate precautions. These cases, however, are distinguishable from the present situation because D.P. does not allege that defendants failed to appreciate her mental health status, to recognize a risk of harm to her, or to order reasonable precautions. She instead faults the defendants' failure to follow the ordered precautionary measures.
It remains far from clear that D.P.'s case should be viewed as a "medical malpractice" action. Most courts characterize cases in which the plaintiff alleges a failure to adequately supervise and safeguard the patient as involving "ordinary negligence" issues. Further, in Alaska, medical malpractice actions are governed entirely by statute. Alaska Statute 09.55.536(a) sets forth specific procedural requirements for medical malpractice cases. Under this section, either the parties must submit a malpractice claim to arbitration or the court must appoint an expert advisory panel within twenty days of the answer to the complaint. Neither occurred here. Moreover, the superior court recognized that the parties had failed to treat the action as one for medical malpractice.
In Clary Insurance Agency v. Doyle, we distinguished between medical malpractice issues and those involving ordinary negligence:
Not every act of a professional requires an instruction on the professional standard of care. Meier v. Ross General Hospital illustrates the point. Meier in
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