An Emergency Medicine Expert Can Be Qualified to Offer Opinions as to Deviations by Emergency Room Nurses

Posted in Legal Updates, Medical Malpractice

By way of a decision by the Superior Court of New Jersey, Appellate Division in October 2015, a case was remanded for a new trial following the Trial Court’s granting of Motions under N.J.R.E. 702 and determining that the Emergency Medicine expert was “not qualified to render opinions as to the standards of care applicable to either defendant nurse.”

This arises out of the matter of Lauckhardt v. Jeges, 2015 N.J. Super. Unpub. LEXIS 2393. Plaintiff’s emergency medicine expert, Dr. James Bagnell, was offered to provide testimony as to the emergency room doctors and nurses. Even after Dr. Bagnell had substantially completed his testimony, both as to the doctor and the nurses, there was a Motion to bar his testimony as to the accepted standards of emergency nursing care. The Court granted the Motion pursuant to 702 based on the determination that plaintiff’s expert was “not qualified to render opinions of standards of care applicable to either defendant nurse.” The Court did not just strike the expert’s testimony regarding the nursing care, instead provided an instruction that read in substance:

Dr. Bagnell was qualified as an expert in the field of Emergency Medicine and in that regard he can render and did render opinions as to the deviations from the standards of care with regard to Dr. Jeges, but he cannot as a matter of law do that for either of the nurses…

This led to the granting of a Motion for Involuntary Dismissal as to the nurses and instruction to the jury that the two nurses were no longer parties to the lawsuit and the jury was not to speculate as to why. Ultimately, the trial concluded against the emergency room doctor, Dr. Jeges with a jury returning a 7-2 verdict in favor of the doctor on liability.”

Dr. Bagnell had received an Undergraduate Medical Degrees from Georgetown University and began practicing in 1979 as an Attending ER Physician at Atlantic City Medical Center. He became Board Certified in 1986 and also served as Chairman of Emergency Services and Director of Medical Education. In that position, he was “responsible for overseeing the care provided to the patients in the Emergency Department.”

Dr. Bagnell had also participated in the development of Nursing Care Standards, as well as “Critical Treatment Protocols with a Physician component and a nursing component.” He also instructed nursing staff regarding nursing care for trauma patients and participated in developing training modules for nursing staff. In his position, he also instructed physicians with the diagnosis and treatment of traumatic chest injuries, which was relevant in this case, and gave lectures to emergency department nurses on the triage process of evaluating patients.

Dr. Bagnell was offered by plaintiff’s counsel as an expert in the field of Emergency Medicine and Emergency Nursing Standard of Care. Oddly, the Judge only qualified Dr. Bagnell as an expert in the field of Emergency Medicine without addressing his qualifications as to Emergency Nursing Standard of Care.

The Appellate Division determined that the case involved the standard of care required in treating a chest trauma patient undergoing evaluation in an emergency room. They also determined that Dr. Bagnell had addressed such situations on a regular basis as an ER physician, and that his criticisms and opinions regarding inadequate monitoring and failure to expedite a patient’s x-ray and CT scans all fell within his area of expertise. Further, this area of expertise encompassed standards of nursing practice in an emergency room.

Given that Dr. Bagnell had participated in developing and setting out nursing care standards as well as “clinical treatment protocols with a physician component and a nursing component,” this qualified Dr. Bagnell to provide such testimony.

It was ultimately determined that the Trial Court’s decision to strike such testimony and to dismiss the nurses involuntarily was an error which was “clearly capable of producing an unjust result.” It was determined that the exclusion of portions of Dr. Bagnell’s testimony adversely impacted the jury’s assessment of this expert’s opinions as to Dr. Jeges. Precluding Dr. Bagnell or striking Dr. Bagnell’s testimony regarding the care provided by the ER nurses was deemed to be reversible error.