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Travis v. Ferraraccio9/19/2005
standard, or reached a decision which is against logic or reasoning, that caused an injustice to the party complaining. State v. Stevens, 78 S.W.3d at 832; State v. Shuck, 953 S.W.2d at 669. A trial court's denial of a Tenn. R. Civ. P. 59.04 motion to alter or amend a judgment will also be reversed on appeal only for an abuse of discretion. Stovall v. Clarke, 113 S.W.3d 715, 721 (Tenn. 2003); Chambliss v. Stohler, 124 S.W.3d 116, 120 (Tenn. Ct. App. 2003).
III. The Exclusion of Dr. David A. Krendel's Testimony
We turn first to the exclusion of the testimony of Dr. Krendel, the neurologist in private practice in Lawrenceville, Georgia. The trial court excluded this testimony on two grounds. First, the court determined that the record did not contain evidence that Dalton, the community Dr. Krendel believed to be similar to Clarksville, was in fact similar. Second, the court decided that, even if the record contained evidence establishing similarities between Dalton and Clarksville, "there is nothing in the record to indicate that Dr. Krendel is applying the standard of care for Dalton, in assessing the conduct of Drs. Ely and Ferraraccio." After reviewing Dr. Krendel's deposition testimony and affidavit, we agree with the trial court's conclusion that he did not base his opinions regarding the treatment Drs. Ely and Ferraraccio provided to Mr. Travis on the standard of care applicable to Dalton.
A.
The Tenn. R. Civ. P. 26 disclosure regarding Dr. Krendel stated that he was "familiar with the recognized standard of acceptable professional practice in the field of neurology in Clarksville, Tennessee or similar communities as it applied in June, 1996," as well as "the standard of care for attending physicians such as Dr. Ely." It explained that Dr. Krendel had reviewed demographic information regarding the community of Clarksville and the medical community in particular and that he was aware of the number of licensed beds and active physicians in Clarksville's two hospitals in 1995. It also stated that Dr. Krendel had attended national meetings of neurologists.
With regard to the substance of Dr. Krendel's proposed testimony, the Tenn. R. Civ. P. 26 disclosure stated that Dr. Krendel would testify that Dr. Ferraraccio failed to comply with the recognized standard of professional practice in Clarksville in June 1996 by failing to order or obtain a CT scan or an MRI scan of Mr. Travis's cervical spine, by failing to consider the possibility of spinal cord injury, and by misdiagnosing Mr. Travis with Guillain-Barré Syndrome. He would testify that Dr. Ely breached the applicable standard of care by failing to order a neurological consult earlier. Dr. Krendel was also prepared to testify that had Drs. Ely and Ferraraccio acted properly, Mr. Travis's spinal cord injury would have been quickly identified, Mr. Travis would have undergone corrective surgery immediately, and this surgery would more than likely have prevented his permanent quadriplegia.
When the defendant physicians deposed Dr. Krendel, he admitted that he had never been to Clarksville and that he did not have firsthand knowledge regarding the standard of acceptable professional practice in Clarksville itself. However, he insisted that he was familiar with the standards of professional practice in cities "similar" to Clarksville. When asked to identify the "small towns in the region" he believed to be similar to Clarksville, Dr. Krendel mentioned Anderson, South Carolina; Spartanburg, South Carolina; Cookeville, Tennessee; and Dalton, Georgia. However, he had difficulty explaining how he had concluded that the medical practices in these communities were similar to Clarksville.
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