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Barlow v. Methodist Hospitals of Dallas3/13/2000
on Reg'l Med. Ctr. v. La Croix, 947 S.W.2d 941, 950 (Tex. App._Forth Worth 1997, writ dism'd by agr.). Generally, proximate cause issues must be proven by expert testimony in medical malpractice cases. See Lopez v. Carillo, 940 S.W.2d 232, 234 (Tex. App._San Antonio 1997, writ denied) (citing Hart v. Van Zandt, 399 S.W.2d 791, 792 (Tex. 1965)).
Here, appellants complain about the trial court's ruling excluding their designated medical doctor from testifying on the causation issue. They assert the doctor's credentials as a board certified internal medicine specialist and professor of medicine, together with his other knowledge, skill, experience, and training, qualified him to testify on the issue of proximate cause. Appellants also contend the hospital's motion to strike the doctor's testimony never specifically addressed the causation issue.
We review a trial court's ruling on whether a witness is qualified to testify as an expert under an abuse of discretion standard. Broders v. Heise, 924 S.W.2d 148, 151 (Tex. 1996). We will not overturn the ruling unless the trial court acted without reference to any guiding principles or rules. See id. (quoting E.I. du Pont de Nemours and Co. v. Robinson, 923 S.W.2d 549, 558 (Tex. 1995). Because appellants offered the doctor as an expert witness, they had the burden of establishing he was qualified to testify under guidelines set forth in rule 702 of the Texas Rules of Evidence. See id. Specifically, appellants were required to establish the doctor had the knowledge, skill, experience, training, or education that would assist the trier of fact on the issue of whether the alleged negligence of the nurses relative to Tidwell's myasthenia gravis and the administration of Mestinon was the proximate cause of Tidwell's death. See id. at 153; Tex. R. Civ. P. 702.
Based on the record before us, we cannot conclude the trial court abused its discretion in excluding the doctor's testimony on the issue of proximate cause. In his deposition, the doctor testified he is board certified in internal medicine and is an attending nephrologist at a St. Louis hospital. His subspecialty is nephrology, and he spends most of his time addressing kidney problems. Although the doctor stated he was generally familiar with myasthenia gravis and Mestinon, he conceded he would defer to a neurologist for diagnosis and treatment of the disease. He testified he had no specialized knowledge of the disease or the Mestinon used to treat it. Although the doctor has treated patients with myasthenia gravis, he was only involved as a consultant on their kidney problems.
The fact that the doctor was certified in internal medicine and had some experience with myasthenia gravis and some knowledge about Mestinon does not necessarily mean his testimony would have assisted the fact finder in determining whether the nurses' conduct in connection with Tidwell's condition and treatment of myasthenia gravis was a proximate cause of his death. After reviewing the doctor's deposition testimony about his credentials, we perceive the trial court could have reasonably concluded the doctor's testimony would not have assisted the trier of fact in the case. Thus, we cannot conclude the trial court abused its discretion in disallowing his testimony on the issue of causation.
We also reject appellants' contention that the trial court's ruling must be reversed because the hospital's motion to strike did not specifically address the causation issue. Appellants cite no legal authority for a reversal on this basis. In any event, our review of the hospital's motion reveals it sought to exclude appellants' designated doctor from testifying because appellants "have not met their burden
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