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Travis v. Ferraraccio9/19/2005
had discussed with other neurologists the nature of medical care in Tennessee cities and communities similar to Clarksville.
Like the disclosure involving Dr. Krendel, the Tenn. R. Civ. P. 26 disclosure stated that Dr. Abrams would testify that Drs. Ely and Ferraraccio failed to comply with the recognized standard of acceptable professional practice in Clarksville in June 1996. He would testify that Dr. Ely breached the standard of care by failing to order a neurological or neurosurgery consult or an immediate transfer to a spinal cord center. He was prepared to testify that Dr. Ferraraccio breached the standard of care by failing to order or obtain a CT scan or 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. Finally, Dr. Abrams was prepared to testify that had Drs. Ely and Ferraraccio acted consistently with the applicable standard of care, Mr. Travis's spinal cord injury would have been quickly identified, corrective surgery would have been performed immediately, and the surgery would, more likely than not, have prevented Mr. Travis's permanent paralysis.
The defendants deposed Dr. Abrams just as they deposed Dr. Krendel. While Dr. Abrams recited more demographic information about Clarksville than Dr. Krendel had been able to recite, he asserted that none of the demographic information regarding Clarksville that he had reviewed had any influence on his opinions in the case. He stated that "the standard of care for a neurologist in an area like Clarksville either is you have to be able to do it, or you have to be able to refer it." When asked the basis for his opinion that such a standard of care applied in Clarksville, Dr. Abrams admitted that his opinion was based on his understanding of "a national minimum standard." Dr. Abrams was asked if there was any community other than Kansas City, Missouri for which he had independent knowledge of the standard of care. Dr. Abrams named only one community - Clinton, Missouri. He also conceded that the standard of care in Clinton was not substantially similar to the standard of care in Clarksville because Clinton was so much smaller than Clarksville.
Based on Dr. Abrams's deposition, Drs. Ely and Ferraraccio claimed that Dr. Abrams, like Dr. Krendel, was unfamiliar with the standard of care in Clarksville or similar communities and that his opinions were actually based on a national standard of care. Ms. Travis responded that Dr. Abrams had not based his opinions on a national standard and filed an affidavit by Dr. Abrams in support of her argument. Dr. Abrams said in his affidavit that St. Joseph, Missouri - which he had not mentioned at his deposition - was a community similar to Clarksville, that he was familiar with the standard of acceptable professional practice in St. Joseph, and that the conduct of Drs. Ely and Ferraraccio violated the standard of acceptable professional practice in St. Joseph as it existed in 1996. Dr. Abrams attached two exhibits to his affidavit. The first exhibit consisted of demographic information about Clarksville in 1996,and the second contained similar information about St. Joseph in 2000.
In granting Dr. Ely's and Dr. Ferraraccio's summary judgment motion, the trial court decided that Dr. Abrams's testimony, like that of Dr. Krendel, was inadmissible. The court found that the statement in Dr. Abrams's affidavit that St. Joseph was similar to Clarksville was "inherently unreliable" because Dr. Abrams had admitted in his earlier deposition that he had no knowledge of the actual standard of care in Clarksville. The court also determined that demographic information attached to Dr. Ab
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