Does Where A Doctor Practices Affect The Standard Of Care He Or She Must Use?
Sometimes the black letter law passed by the legislature is unclear. The legislature can’t anticipate every possible fact scenario when they pass a law, so it lay to the courts to interpret the law and give guidance to what it means. This interpretation is called case law. When the court decides a certain meeting to the law it essentially answers a legal question. Lawyers and other courts then can rely on that ruling when they have a similar issue in their case. The following case answers the question above.
Chandler v. Neosho Memorial Hospital, 223 Kan. 1, 574 P.2d 136 (1977).
This case addresses the following issue:
Does where a doctor practices effect the standard of care he or she must use?
A claim for medical malpractice requires a plaintiff to prove that the doctor owed a duty of care to the patient, that the duty was breached, that the patient was injured, and that the injury was caused by the breach. Id. at 3. This case dealt with the first element—which is usually not at issue in such cases. Id. Particularly, this case dealt with whether the location of a doctor’s practice has an effect on the standard of care owed to patients. Id. Ultimately, the court found that location is a relevant factor, but may not have a strong influence on the standard of care. Id. at 6.
Plaintiff was born prematurely in Defendant’s hospital. Id. at 2. Defendant’s doctors decided to administer oxygen to Plaintiff shortly after her birth. Id. However, too much oxygen was forced into Plaintiff’s lungs over an extended period of time, causing permanent blindness. Id. At trial, Plaintiff present testimony of two medical experts: one from Los Angeles and one from Illinois. Id. These experts had never practice in a community of a similar size to Chanute, where Defendant’s hospital was located. Id. In fact, each agreed that they were speaking in terms of nationally recognized standards of care. Id. Defendant thus argues that these experts could not establish the appropriate standard of care, because they lacked knowledge of the types of facilities, equipment, and training available in Chanute, Kansas. Id. The trial court determined that the standard of care must be decided under the “strict locality rule,” which must look at the factors relevant to the location of where the doctor practices medicine. Id. at 3.
The court started by laying out the standard of care to be used in medical malpractice actions: “A physician or surgeon is expected to have and to exercise that reasonable degree of learning and skill ordinarily possessed by members of his profession and of his school of medicine in the community where he practices, or similar communities.” Id. Thus, Kansas courts have never adopted the strict locality rule used by the trial court—and the Kansas Supreme Court was not going to adopt it now. Id. In fact, the court had previously cautioned that, with the development of technology and publications, “the need to emphasize on locality no longer exists.” Id.
While it was still true (and it still true today) that some hospitals or areas are known to have extreme specializations or knowledgeable physicians (e.g., Mayo Clinic, John Hopkins, etc.), medical practices are being held to increasingly regularized standards. Id. at 4. This must also be accounted for in determining what the standard of care is for a particular case. Id. The trial court had clearly misapplied the law in determining what the correct standard of care was, so the case was reversed so that Plaintiff’s experts would be allowed to present their opinion of what the proper standard of care was. Id.