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Expert Testimony Required in Finger Surgery Resulting in Loose Teeth?

By Edward A. Brutscher, Esq.

The Court of Appeals recently published Green v. Owensboro Medical Health System, Inc., et al., a case involving allegations of medical negligence during an operation to repair a fractured finger. Green emerged from a surgery to repair a fractured finger to find her mouth bloody and her teeth loose and misaligned. She sued for negligence. She did not identify an expert regarding the standard of care. She did, however, present the testimony of a dentist who opined that the post operative damage seen was related to trauma and not her ongoing periodontal disease. The Defendants were granted summary judgment.

Green argued on appeal that expert testimony on the standard of care was unnecessary, because jurors, based upon common knowledge and experience alone, could have inferred negligence from the facts. The Court of Appeals identified two circumstances when expert proof regarding the standard of care was not necessary in medical negligence cases. One of these was in instances when the negligence and injurious results are "so apparent that laymen with general knowledge would have no difficulty in recognizing it." The Court noted;

While it seems unusual for a patient to enter an operating room for hand surgery with teeth intact and emerge with loose, misaligned, and bloody teeth, we do not believe a layman, without medical expert testimony identifying the required standard of care and the breach thereof, could competently determine an anesthesiologist, surgeon, and/or health care facility did something wrong before, during, and/or after Green?s surgery so as to cause damage to her teeth.

According to the Court, it could not say that the average layperson possesses sufficient medical knowledge about intubation procedures, anesthesiology, and orthopedic surgery to determine Green's loose teeth obviously resulted from negligence.

It would appear to me that the average layperson would know that when you go in for finger surgery, you should not come out with a bloody mouth and loose misaligned teeth anymore than you should come out with a concussion or other trauma to the face or head. Green had testimony to show that the damage to her teeth was the result of "trauma" and not her preexisting disease, so that is a nonissue as far as the opinion goes. Even the Court of Appeals noted this trauma was "unusual". I can understand complex issues, involving complex medical complications and results, to require expert testimony but this does not appear to be one of them.

Full post as published by Kentucky Tort Journal on August 23, 2007 (boomark / email).