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Clark v. HCA8/25/2005
e accepted standards of medical care. See Act of May 1, 1995, 74th Leg., R.S., ch. 140, § 2, sec. 14 .01(a), 1995 Tex.Gen.Laws 985, 988 (repealed 2003). The report itself must establish the expert's qualifications on the basis of training and experience. See In re Windisch, 138 S.W.3d 507, 511 (Tex.App.--Amarillo 2004, orig. proceeding).
In determining if an expert is qualified on the basis of training and experience, the court is to consider whether, at the time the claim arose or the testimony is given, the witness is board certified or has other substantial training or experience in an area of practice relevant to the claim and is actively practicing medicine in rendering medical care services relevant to the claim. See Act of May 1, 1995, 74th Leg., R.S., ch. 140, § 2, sec. 14.01(c), 1995 Tex.Gen.Laws 985, 988 (repealed 2003). Because of the increasing specialization of medicine, "there is no validity, if there ever was, to the notion that every licensed medical doctor should be automatically qualified to testify as an expert on every medical question. . . . he proponent of the testimony has the burden to show that the expert 'possess special knowledge as to the very matter on which he proposes to give an opinion.'" Broders v. Heise, 924 S.W.2d 148, 152-53 (Tex. 1996). Thus, the issue is the specific subject matter and the expert's familiarity with it. Broders, 924 S.W.2d at 153.
Dr. Pacheco's curriculum vitae (CV) reveals that he is board certified in internal medicine, oncology, and nuclear medicine. He completed an internal medicine internship and residency at University District Hospital, Medical Sciences Campus in Rio Pierdas, Puerto Rico from 1981 until 1984. He was on active duty with the United States Army Medical Corps from 1984 until 1988. Between 1988 and 1990, he pursued a medical oncology fellowship at M.D. Anderson Cancer Center in Houston. His nuclear medicine fellowship was obtained at William Beaumont Army Medical Center in El Paso from 1992 until 1994. He remained at Fort Bliss in El Paso until 1996, serving as teaching staff and a staff physician in nuclear medicine and hematology-oncology. He then launched his private practice. His CV indicates he practiced as a physician in Laredo and El Paso, Texas; Sioux Falls, South Dakota; Wausau and Sheboygan, Wisconsin; Grand Junction, Colorado, and Thomasville, Georgia. Most recently he was employed as a " hysician with Pacific Coast Hematology/Oncology." All of the Appellees allege that at the time of Clark's treatment, Dr. Pacheco was engaged in the practice of oncology. Clark has not professed otherwise.
The expert report makes no mention of Dr. Pacheco's training, experience, or familiarity with Lovenox, anticoagulant medications, deep venous thrombosis, diagnosis and treatment of compartment syndrome, or the causes and results of hematoma. Dr. Pacheco merely quotes a few medical reference materials with no supporting information concerning the qualifications or expertise of the authors. We are left then with his CV. Dr. Pacheco's specialty in hematology may well qualify him to render an opinion, but the record is silent as to his current role as a hematologist or his experience with anticoagulation therapy. While the CV lists a one-year membership on the Pharmacy Utilization Committee at Archbold Memorial Hospital in Thomasville, Georgia, the record does not establish his awareness of the common usage of Lovenox, contraindications of its usage, or whether he is familiar with the treatment required in the event of an adverse reaction. See Broders, 924 S.W.2d at 153. Because we cannot conclude that the trial court abused its discretion in finding that Dr. Pacheco was not qualified to testify as an expert, we overrule
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