Bravo Ex Rel. Gamboa v. Sumner Regional Health Systems, Inc.

148 S.W.3d 357
CourtCourt of Appeals of Tennessee
DecidedApril 5, 2004
StatusPublished
Cited by20 cases

This text of 148 S.W.3d 357 (Bravo Ex Rel. Gamboa v. Sumner Regional Health Systems, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals of Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bravo Ex Rel. Gamboa v. Sumner Regional Health Systems, Inc., 148 S.W.3d 357 (Tenn. Ct. App. 2004).

Opinion

OPINION

HOLLY M. KIRBY, J.,

delivered the opinion of the court,

in which W. FRANK CRAWFORD, P.J., W.S., and ALAN E. HIGHERS, J., joined.

This is a medical malpractice case. The plaintiff was pregnant and came to the hospital to have labor induced for delivery of her baby. The defendant obstetrician-gynecologist had not previously treated *359 the plaintiff, but was the attending physician for the delivery of her baby. After a lengthy labor, the defendant physician attempted to deliver the baby vaginally. When problems developed, the defendant physician immediately delivered the baby by Cesarean section. The baby suffered injuries from the loss of oxygen during the birthing process. The plaintiffs, the child’s mother and father, individually and on behalf of the child, sued the defendant physician, asserting that he breached the standard of care in underestimating the size of the baby and in the delivery of the baby. The defendant physician moved for summary judgment. In response, the plaintiffs submitted the expert affidavit of an obstetrician-gynecologist from Georgia, whose medical practice had been limited to gynecologic and fertility matters for several years. The defendant physician objected, arguing under Tennessee Code Annotated § 29-26-115 that the plaintiffs’ proffered expert was not competent to testify regarding obstetrics since he had not practiced in that specialty for several years and that he did not satisfy the “locality rule.” The trial court found that the expert was not competent and granted summary judgment in favor of the defendant physician. The plaintiffs now appeal. We reverse and remand, finding that the affidavit of the plaintiffs’ expert indicated that he was competent to testify about obstetrics and satisfied the locality rule.

On November 1, 2000, Plaintiff/Appellant Leonorilda Gamboa (“Mother”), who was pregnant, went to Sumner Regional Medical Center (“Sumner Medical”) in Gallatin, Sumner County, Tennessee and had an obstetric ultrasound test performed. The ultrasound test results described the size of the baby, estimated the gestational age as thirty-nine (39) weeks two (2) days, and estimated a date of delivery the week of November 6, 2000.

Approximately four weeks later, well after the estimated due date, the Sumner County Health Department scheduled Mother for an induced delivery at Sumner Medical. On the morning of December 1, 2000, Mother arrived at Sumner Medical for the scheduled labor induction. Defendant/Appellee Robert Dabney Phillips, M.D. (“Dr.Phillips”), was on call for his medical group at Sumner Medical, and consequently became Mother’s attending physician. Prior to that date, Dr. Phillips had neither treated Mother nor been involved in her prenatal care.

At approximately 8:30 a.m., Dr. Phillips met with Mother. She had reported leaking amniotic fluid, with a history of delivering a nine-pound baby in 1995. Mother was unsure of her last menstrual cycle. Dr. Phillips obtained the November 1, 2000 ultrasound report showing pertinent fetal measurements and an estimated gestational age at that time of thirty-nine (39) weeks two (2) days. From the information in the ultrasound report, Dr. Phillips estimated the fetal weight to be about 4000 to 4500 grams, or approximately 8.8 to 9.9 pounds. No further tests to estimate the size of the baby were done. Dr. Phillips anticipated vaginal delivery of the baby.

Pitocin was administered to Mother and labor progressed slowly. Around 5:45 p.m., Mother began pushing. This continued for about one and a half hours. At approximately 7:39 p.m., Dr. Phillips attempted a vacuum extraction of the baby, and the baby’s head was delivered at about 7:41 p.m. With a shoulder dystocia (also called “stuck shoulders”) identified, the baby’s head was put back into the vagina. A Cesarean section was performed at approximately 7:54 p.m. The child, Plain-tiffiAppellant Brandon Bravo (“child”), was delivered at approximately 8:10 p.m., weighing thirteen pounds seven ounces. The child was hypoxic, or lacking oxygen, *360 and was immediately handed over to the pediatrician for resuscitative measures. He was subsequently transported to Vanderbilt Medical Center, and was diagnosed as having experienced prolonged asphyxia with hypoxic-ischemic encephalopathy, or brain damage due to lack of blood flow.

On October 4, 2001, Mother and the child’s father, Epifano Bravo Hernandez (“Father”), individually and on behalf of the child (collectively, “plaintiffs”), filed this lawsuit against Sumner Medical and Dr. Phillips for medical malpractice, seeking damages for the injuries the child sustained during the birth process. The complaint alleged that Dr. Phillips deviated from the applicable standard of care in failing “to treat, observe, detect, test, diagnose, report and monitor the risk factors and medical conditions which [Mother] exhibited” prior to delivery, and also in failing “to examine [Mother] and perform or cause to be performed such procedures, examinations, tests and treatments as [Mother’s] condition would have dictated to a reasonably careful and competent medical professional.”

On December 10, 2001, Dr. Phillips filed an answer, denying the plaintiffs’ allegations of negligence. Discovery ensued. On February 14, 2002, in response to interrogatories, the plaintiffs identified Joel S. Engel, M.D. (“Dr. Engel”), as an expert expected to give testimony at trial in support of their position.

On April 29, 2002, the trial court entered a scheduling order. February 1, 2003, was established as the deadline for the plaintiffs to designate their expert witnesses for trial, and the trial was set for September 1, 2003.

On July 18, 2002, Dr. Phillips moved for summary judgment. In support of his motion, he submitted his own affidavit, stating that his medical treatment of Mother conformed to the required standard of care. On August 23, 2002, the plaintiffs filed a response in opposition to Dr. Phillips’ motion for summary judgment. The plaintiffs’ response was supported by the affidavit of Dr. Engel.

Dr. Engel’s affidavit stated that he was licensed to practice medicine in Georgia in 1969, and that he had been certified by the American Board of Obstetrics and Gynecology since 1974. Further, he stated that he practiced in obstetrics and gynecology in Georgia from 1972 to 1993. In 1993, however, Dr. Engel eliminated obstetrics from his practice and focused on gynecology and infertility.

To demonstrate that he was qualified to testify about Dr. Phillips’ obstetric care of Mother, Dr. Engel stated that he was “familiar with the recognized standard of care applicable to obstetricians during November and December 2000 in Gallatin and in communities similar in size to Gallatin.” In addition to his private practice, Dr. Engel stated, since 1999, he had served on the State of Tennessee Bureau of Tenn-Care, Medical Service Appeals Board (“TennCare Board”). He said that he was a gynecology-obstetrics expert for Tenn-Care. As part of his service on the Tenn-Care Board, Dr. Engel reviewed gynecological-obstetric medical records from smaller Tennessee communities near major regional medical centers, communities that are similar in size to Gallatin. Through his service on the TennCare Board, Dr. Engel asserted, he had become familiar with the medical resources available to obstetricians in communities similar in size to Gallatin.

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Bluebook (online)
148 S.W.3d 357, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bravo-ex-rel-gamboa-v-sumner-regional-health-systems-inc-tennctapp-2004.