The Pennsylvania Supreme Court ruled in in favor of a position that the Pennsylvania Medical Society (PAMED) supported with an amicus curiae brief in a medical professional liability case: Green v. Pennsylvania Hospital.
The issue PAMED briefed involves the qualifications of an expert witness on the standard of care —specifically whether a nurse may testify as to causation when there are physician defendants. Under the Mcare Act, only a physician may testify as an expert witness on causation in an action against a physician, unless the trial court determines that the non-physician expert is otherwise competent to testify on the matter by virtue of education, training, or experience.
In this particular case, both nurses and physicians were alleged to be negligent, resulting in the patient’s death. The plaintiff proffered a nurse to testify as to the cause of the patient’s death, purportedly only as to the link to the nursing care. The trial court, citing the Mcare Act requirement, ruled that the nurse could not testify as to causation at all. PAMED supported the court’s rationale that it would create confusion and an anomalous result to allow the nurse to testify as to causation as to the nursing care but not the physician care, as the care was, in many places, indivisible as to who was providing it.
The trial court further refused to apply the exception to the Mcare basic rule, concluding that testimony as to the cause of the patient’s death would have been outside the nurse’s expertise. PAMED supported that holding as well, arguing that nurses are not qualified to testify as to the cause of a patient’s death given that this requires a diagnosis, especially in the case a medically complex patient. The Supreme Court ruled that it was not an abuse of discretion for the trial court to preclude the nurse from testifying given the potential for confusion.