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Redel v. Capital Region Medical Center

5/10/2005

(2) proof that the act or omission was performed negligently; and (3) a causal connection between the act or omission and the claimed injury sustained by the plaintiff. Delisi v. St. Luke's Episcopal-Presbyterian Hosp., Inc., 701 S.W.2d 170, 173 (Mo. App. 1985).


Specific to Hospital's claim, to make a submissible case on Hospital's failure to satisfy the requisite standard of care, Plaintiffs are required to show that Hospital failed to exercise that degree of skill and learning ordinarily exercised under the same or similar circumstances by members of its profession. Id.; M.W. v. Jewish Hosp. Ass 'n. of St. Louis, 637 S.W.2d 74, 76 (Mo. App. 1982) (applying medical malpractice standard of care to hospitals). The general rule requires that Plaintiffs put forth expert medical testimony establishing the appropriate standard of care. Delisi, 701 S.W.2d at 173. Expert testimony is not required, however, if the defendant's own testimony establishes the standard of care. Id. In addition, no expert testimony is necessary where the basis of a plaintiff's claim of negligence is the nurse's failure to follow a doctor's orders. Daugherty v. N. Kansas City Mem 'l Hosp., 570 S.W.2d 795, 797 (Mo. App. 1978).


In Daugherty, the patient brought a claim against her treating hospital because a nurse failed to switch an ice pack on her throat from side to side every two hours, as ordered by the patient's doctor, resulting in permanent and progressive Bell's Palsy to the patient's face. Id. at 796-97. The hospital argued on appeal that the patient failed to make a submissible case because she produced no expert medical evidence that the nurse's conduct violated any standard of care. Id. at 796. The court held that no expert testimony was necessary because patient's claim was based on the failure of the nurses to follow the doctor's orders. Id. at 797. In making its decision, the court stated that the calling of an expert witness to testify that the failure of a nurse to follow a doctor's orders was a violation of the expected standards of the nurse's profession would be an empty gesture. Id. The court further stated that the rationale for the rule is that there is no peculiar need for expert testimony on any issue within the jury's ordinary lay knowledge and experience. Id.


Like the patient in Daugherty, Plaintiffs' claim of negligence was based on Nurse Mote's failure to follow Dr. Galbraith's orders to administer CPM therapy to only one of Patient's legs at a time and to monitor Patient closely to the extent Patient was disoriented. Thus, it was unnecessary for Plaintiffs to offer expert testimony that it was a violation of the standard of care to use two CPM machines at once or to apply CPM therapy when Patient was disoriented. Accordingly, Plaintiffs presented a submissible case on this basis alone.


Plaintiffs also established the standard of care through various employees of Hospital who testified regarding the appropriateness of placing a patient in two CPM machines at the same time. For instance, when Plaintiffs asked Gorene, "Well, a nurse shouldn't put two CPMs on one person, period, right?," Gorene responded "Correct. We never do that." Rakestraw also testified that it is never appropriate to put a patient in two CPM machines at the same time. Finally, Dr. Woods testified that, as a rehab specialist in medicine familiar with CPM therapy, she does not order bilateral CPMs to be done at the same time and that it would be extremely difficult to do so.


Reviewing this evidence, we find that Delisi also assists in our analysis of Hospital's contention. In Delisi, the plaintiff injured his hand on a rusty knife and claimed that his doctor violated the standard of care by fa

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