Inappropriate Standard of Care Testimony Mandates Dismissal of Medical Malpractice Claim

The case of St. George vs. Plimpton which was decided by the Arizona Court of Appeals on November 19, 2016, involves a malpractice claim brought, among others, against a nurse midwife.  In this case, the Plaintiff claimed she was injured as a result of the nurse midwife’s “negligently applying pubic pressure during the delivery” of Ms. St. George’s child.  The trial court dismissed the claim without a trial based upon the nurse midwife’s motion due to a lack of qualified expert testimony as is required under Arizona’s medical malpractice statutes.

On appeal, Ms. St. George claimed the trial court was in error for two reasons.  Her first argument was to the effect that there are midwifery statutes which have been adopted by the legislature which control the manner in which registered midwives are to practice and that in this case the nurse midwife violated one or more of those statutes.  The court rejected this argument and stated that to apply Ms. St. George argument would lead to absurd results.  First, the court pointed out that registered midwives and nurse midwives are not the same.  Registered midwives are certified by the Arizona Department of Health Services while nurse midwives are licensed by the Arizona State Board of Nursing.  According to the court, the statutes referred to by St. George apply only to registered midwives because registered nurses are exempt “from the licensure requirements of this section.”  Were the court to require nurse midwives to comport with the registered midwife statutes, “anyone who delivers a baby — including an obstetrician — [would be] subject to the midwifery statutes.”

Next, St George argued that she did provide expert testimony from an obstetrician who testified that he “supervised Certified NurseMidWifes throughout his career,” and, as such, he was familiar with the standard of care applicable to these midwives.  The court rejected this argument by citing the applicable Arizona statute which requires an expert to have an “active clinical practice of the same health profession as the defendant,” or “[t]he instruction of students…in the same health profession as the defendant.”  Under the statute, because the defendant was a certified nurse midwife, only another certified nurse midwife, who was actively engaged in the practice of nurse midwifery or who trained students in that field would qualify to provide the necessary testimony.

The trial court’s holding was upheld.

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