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Comstock v. Nippoldt1/29/2002 ert affidavits must be filed. This rule comports with the legislature's intent, in enacting Minn. Stat. § 145.682, to eliminate nuisance medical malpractice lawsuits by requiring that plaintiffs file affidavits to verify that their allegations are well-founded. Stroud v. Hennepin Cty. Med. Ctr., 556 N.W.2d 552, 555 (Minn. 1996).
Comstock contends that because she alleges only breach of contract, consumer fraud, and breach of warranty claims, this action does not fall within the purview of Minn. Stat. § 145.682. But the key to determining whether this action is akin to one for medical malpractice depends not on the language of the complaint in isolation, but rather on the real-world context of the claim. In this regard, we examine whether the complained-of conduct flowed from the therapeutic relationship and constituted an integral part of the treatment process. See D.A.B. v. Brown, 570 N.W.2d 168, 172 (Minn. App. 1997) (holding that because doctor's duty to disclose kickback scheme was related to medical diagnosis, treatment, and care of patient, it was essentially a malpractice action subject to two-year medical malpractice statute of limitations.) More specifically, we have held that expert affidavits are required when a health care provider is accused of "malpractice, error, mistake, or failure to cure" as a result of giving care or treatment. Canfield v. Grinnell Mut. Reins. Co., 610 N.W.2d 689, 693 (Minn. App. 2000) (emphasis added), review denied (Minn. July 25, 2000).
In this case, the actions giving rise to Comstock's complaint arose exclusively within the context of a doctor-patient relationship. Dr. Nippoldt recommended a treatment plan, referred Comstock to an oral surgeon, and fitted her with dentures. All of these activities involved rendering patient care. Rather than simply purchasing a product, Comstock was relying on Dr. Nippoldt's professional judgment as he performed therapeutic dental services. Therefore, the district court properly found this case to fall within the scope of the affidavit requirement.
In order to establish a prima facie case of medical malpractice, a plaintiff must introduce expert testimony to establish the standard of care, the defendant's departure from that standard, and causation when these elements are not within the common knowledge of laypersons. Reinhardt v. Colton, 337 N.W.2d 88, 94-95 (Minn. 1983). Comstock argues that, even if this action is treated as one for medical malpractice, it is excepted from the requirements of Minn. Stat. § 145.682 because the complained-of acts or omissions lie within the common knowledge of laypersons. See, e.g., Tousignant v. St. Louis Cty., 615 N.W.2d 53, 59 (Minn. 2000) (district court finding that nursing home staff exercised some medical judgment in interpreting how to restrain patient was held insufficient to require expert affidavit, where court failed to find that those medical judgments were not within general knowledge of laypersons).
But the supreme court has allowed a medical malpractice claim to proceed without expert testimony only in "exceptional cases." Sorensen, 457 N.W.2d at 191. This is not such an exceptional case. Defining the applicable standard of care in this case involves the medical question of the suitability of implants, as opposed to removable dentures, for this particular plaintiff. Comstock further admits that expert testimony will be required to establish causation between the denture she received and the physical pain for which damages are sought. Therefore, because expert medical testimony is necessary to establish a prima facie case, the district court did not err in dismissing the action.
Affirmed.
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