Testifying Medical Experts Need Not Be Specialists in the Malady: NJ Appellate
An medical expert witness need not be a treating specialist of the malady to explain it on the witness stand, a New Jersey appellate panel has ruled. The ruling upholds the lower court finding that that the doctors were not substantially liable for not detecting the root cause of a young man's chronic ear problems, which caused permanent damage to his hearing.
In Picillo v. West Morris Pediatrics, PA (2018), No. A-1250-16T2, N.J. Super. Ct. App. Div., plaintiff Thomas Picillo came under the care of the defendants West Morris in 1992, from the age of eight suffering from increasing episodes of middle ear infections and fluid in the middle ear.
In May 1999, Picillo failed a school hearing test, but West Morris found only en ear infection and did not refer him to an otolaryngologist (ENT) nor retest his hearing.
In March 2005, Picillo's right ear began bleeding and was taken to an ENT, Dr. Damian Sorvino. On his first examination, Sorvino suspected a cholesteatoma (a cyst-like structure), which was confirmed by a CAT scan and removed by surgery.
In August 2013, Picillo sued West Morris alleging negligent treatment, contending that had they referred him to an ENT, he would have received treatment that would have prevented the cholesteatoma, numerous surgeries and permanent hearing impairment.
Both plaintiffs and defendants presented multiple medical experts. Picillo's ENT expert, Dr. Louis Rondinella, opined that had West Morris referred Picillo to an ENT in 2001, Picillo likely would have had a better outcome.
West Morris' ENT expert witness, Dr. Lee Rowe, testified that the cholesteatoma only started to develop in 2003, finding that the growing cholesteatoma was not visible under normal examination because of its location.
Dr. Harold Raucher, West Morris' Pediatric expert witness, provided a similar opinion, although he acknowledged that he had only seen two cholesteatomas in his lifetime, and had never actually diagnosed one.
Over Picillo's objections, Raucher testified that Picillo's cholesteatom originated in “the attic” of his ear cavity, noting that many nurse practitioners, physicians and a school doctor had examined Picillo for years and saw nothing. That, Raucher said, was consistent with the mass growing in a place where nobody could see it and it not coming down into a visible location until 2005.
The jury found that West Morris did deviate from the applicable standard of care, but that it was not a substantial factor in causing Picillo's injuries.
Picillo moved for a new trial, which the trial court denied, leading Picillo to appeal with a primary issue being the testimony of Raucher. Picillo contended that “only an ENT could properly provide such testimony, arguing the subject matter lies beyond the purview of a pediatrician.”
The appellate panel disagreed finding that “when there is an overlap between practices of disciplines, a licensed medical practitioner who is familiar with the situation in dispute may "possess the requisite training and knowledge to express an opinion as an expert."”, Rosenberg v. Cahill, 99 N.J. 318, 332 (1985).
In many jurisdictions in med-mal cases, testifying expert witnesses on applicable standards of care are often required to be in the same specialty as the defendant physicians, not necessarily in the specialty that normally treats the medical condition.