Pulmonologist Deemed Unqualified to Opine on Emergency Room Asthma Treatment

ByWendy Ketner, M.D.

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Updated onFebruary 21, 2020

Pulmonologist Deemed Unqualified to Opine on Emergency Room Asthma Treatment

Court: United States District Court for the Western District of Louisiana, Lake Charles DivisionJurisdiction: FederalCase Name: Carter v. United StatesCitation: 2017 U.S. Dist. LEXIS 207565

Facts

This case involved alleged negligent medical treatment given to the plaintiff, Cornel Becnel, by an emergency room doctor at an army community hospital in Fort Polk, Louisiana. The plaintiff, then a minor, arrived at the emergency room with a severe asthma attack. The plaintiff had suffered from asthma since he was two years old. He had gone to the emergency room for asthma-related reasons previously, and the treating physicians noted that his asthma was poorly controlled.

A motion was brought before the court by the defendant seeking to exclude the testimony of the plaintiff’s emergency medicine expert witness concerning the standard of care of emergency medicine doctors and ER staff. The defendant argued the expert’s opinions on the standard of care for ER staff were beyond the scope of his expertise as a pulmonologist.

The Emergency Medicine Expert Witness

The plaintiff retained the practicing chief of pulmonary medicine at Nemours Children’s Specialty Care in Pensacola to opine on the standard of care during the plaintiff’s ER visit. The expert was also the director of the Cystic Fibrosis Center, and a professor of pediatrics at Florida State University School of Medicine. Although he was offered as an emergency medicine expert witness, he did not have direct experience as a physician working in an emergency department. In his expert report, the expert witness criticized the timing of the treating physician’s decision to intubate the plaintiff. The defendant argued to exclude the expert’s report since he was not an emergency medicine doctor and had never intubated a patient who had a severe asthma attack, thus, making him unqualified to offer such an opinion.

Discussion

The defendant argued that the emergency medicine expert witness did not practice as an emergency medicine doctor at any level. The defendant pointed out that the clinic where the expert worked was a multi-specialty facility that did not provide emergency department services. The emergency medicine expert witness further testified that he does not work in an emergency room and sends patients with urgent medical problems to the local ER. He had never intubated an asthmatic patient, much less during a severe asthmatic attack. Thus, the defendant argued that the expert was not qualified to provide opinions on the time of intubation in the ER or any other standard of care for emergency medicine physicians. Also of concern, in this case, was the fact that vomitus obstructed the patient’s throat.

The court noted that per Lee v. Quinn, emergency medicine is recognized as its own specialty. The court further stated that medical professionals are held in accordance with Louisiana Revised Statute 9:2794(A)(1) to the degree of care ordinarily performed by physicians within his medical specialty. The court noted that the expert did not have the required knowledge of accepted standards of medical care regarding protocols and procedures in the emergency department. The court also found that he lacked the necessary experience and/or training to provide expert testimony on the established standard of care.

Held

The motion to exclude the emergency medicine expert witness’s testimony on the appropriate standard of care for emergency department procedures was granted. The expert was permitted to testify on the treatment of asthma in general.

About the author

Wendy Ketner, M.D.

Wendy Ketner, M.D.

Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.

Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.

Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.

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