{ "id": 1083965, "name": "STEPHEN GARLEY, Indiv. and as Special Adm'r of the Estate of Pauline Garley, Deceased, Plaintiff-Appellee, v. COLUMBIA LaGRANGE MEMORIAL HOSPITAL, Defendant-Appellant (Scott Multack et al., Defendants)", "name_abbreviation": "Garley v. Columbia LaGrange Memorial Hospital", "decision_date": "2004-06-30", "docket_number": "No. 1\u201402\u20142012", "first_page": "398", "last_page": "416", "citations": [ { "type": "official", "cite": "351 Ill. App. 3d 398" } ], "court": { "name_abbreviation": "Ill. App. Ct.", "id": 8837, "name": "Illinois Appellate Court" }, "jurisdiction": { "id": 29, "name_long": "Illinois", "name": "Ill." }, "cites_to": [ { "cite": "381 N.E.2d 279", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1978, "opinion_index": 0 }, { "cite": "72 Ill. 2d 249", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 5443658 ], "year": 1978, "opinion_index": 0, "case_paths": [ "/ill-2d/72/0249-01" ] }, { "cite": "698 N.E.2d 611", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1998, "opinion_index": 0 }, { "cite": "298 Ill. App. 3d 316", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 1073566 ], "year": 1998, "pin_cites": [ { "page": "321" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/298/0316-01" ] }, { "cite": "686 N.E.2d 722", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1997, "opinion_index": 0 }, { "cite": "292 Ill. App. 3d 896", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 1725109 ], "weight": 10, "year": 1997, "pin_cites": [ { "page": "904-07" }, { "page": "900-01" }, { "page": "903" }, { "page": "904" }, { "page": "906" }, { "page": "906" }, { "page": "906" }, { "page": "907" }, { "page": "906" }, { "page": "905-06", "parenthetical": "and cases cited therein" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/292/0896-01" ] }, { "cite": "697 N.E.2d 868", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1998, "pin_cites": [ { "parenthetical": "stating that \"the doctrine of stare decisis requires courts to follow the decisions of higher courts\"" } ], "opinion_index": 0 }, { "cite": "297 Ill. App. 3d 1099", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 910265 ], "year": 1998, "pin_cites": [ { "page": "1102", "parenthetical": "stating that \"the doctrine of stare decisis requires courts to follow the decisions of higher courts\"" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/297/1099-01" ] }, { "cite": "346 Ill. 2d 895", "category": "reporters:state", "reporter": "Ill. 2d", "year": 2003, "pin_cites": [ { "page": "907" } ], "opinion_index": 0 }, { "cite": "347 Ill. App. 3d 828", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 3948781 ], "year": 2004, "pin_cites": [ { "page": "836" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/347/0828-01" ] }, { "cite": "23 J. Health & Hosp. L. 363", "category": "journals:journal", "reporter": "J. Health & Hosp. L.", "year": 1990, "pin_cites": [ { "page": "365" } ], "opinion_index": 0 }, { "cite": "607 N.E.2d 224", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1992, "opinion_index": 0 }, { "cite": "154 Ill. 2d 39", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 4821058 ], "weight": 9, "year": 1992, "pin_cites": [ { "page": "43" }, { "page": "43" }, { "page": "43-44" }, { "page": "44" }, { "page": "43" }, { "page": "44" }, { "page": "43" }, { "page": "43-44" }, { "page": "43-44" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/154/0039-01" ] }, { "cite": "396 N.E.2d 13", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1979, "opinion_index": 0 }, { "cite": "77 Ill. 2d 279", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 5490810 ], "weight": 8, "year": 1979, "pin_cites": [ { "page": "285" }, { "page": "285" }, { "page": "283" }, { "page": "283" }, { "page": "284" }, { "page": "285" }, { "page": "285" }, { "page": "285" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/77/0279-01" ] }, { "cite": "209 Ill. 2d 100", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 5462131 ], "weight": 17, "year": 2004, "pin_cites": [ { "page": "111-16" }, { "page": "112" }, { "page": "113-14" }, { "page": "114" }, { "page": "114-15" }, { "page": "112-13" }, { "page": "115" }, { "page": "119" }, { "page": "120" }, { "page": "120-21" }, { "page": "122-23" }, { "page": "119", "parenthetical": "\"Clearly, this exact issue [whether the licensure requirement includes the nursing profession] was contemplated by this court in Dolan, which unequivocally required that a health-care expert witness must be a licensed member of the school of medicine about which the expert testifies\"" }, { "page": "123" }, { "page": "123-24", "parenthetical": "upholding the trial court's ruling that a doctor was not competent to testify as to the standard of care for the nursing profession and granting a directed verdict for the hospital" }, { "page": "123-24" }, { "page": "123", "parenthetical": "\"We expressly reaffirm the license requirement of Dolan and its progeny and decline plaintiffs invitation to deviate therefrom\"" }, { "page": "119" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/209/0100-01" ] }, { "cite": "489 N.E.2d 867", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1986, "opinion_index": 0 }, { "cite": "111 Ill. 2d 229", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 3166688 ], "weight": 9, "year": 1986, "pin_cites": [ { "page": "241-42" }, { "page": "242" }, { "page": "243" }, { "page": "244" }, { "page": "243" }, { "page": "244" }, { "page": "243" }, { "page": "243" }, { "page": "244" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/111/0229-01" ] }, { "cite": "720 N.E.2d 242", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1999, "opinion_index": 0 }, { "cite": "188 Ill. 2d 102", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 536152 ], "year": 1999, "pin_cites": [ { "page": "132" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/188/0102-01" ] }, { "cite": "787 N.E.2d 796", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2003, "opinion_index": 0 }, { "cite": "204 Ill. 2d 1", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 609707 ], "year": 2003, "pin_cites": [ { "page": "42" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/204/0001-01" ] }, { "cite": "208 Ill. 2d 259", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 2463034 ], "year": 2003, "pin_cites": [ { "page": "274" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/208/0259-01" ] }, { "cite": "229 N.E.2d 504", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1967, "opinion_index": 0 }, { "cite": "37 Ill. 2d 494", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 2866138 ], "year": 1967, "pin_cites": [ { "page": "510" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/37/0494-01" ] }, { "cite": "347 Ill. App. 3d 243", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 3948705 ], "year": 2004, "pin_cites": [ { "page": "248" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/347/0243-01" ] }, { "cite": "292 Ill. App. 3d 896", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 1725109 ], "year": 1997, "opinion_index": 1, "case_paths": [ "/ill-app-3d/292/0896-01" ] }, { "cite": "154 Ill. 2d 39", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 4821058 ], "year": 1992, "opinion_index": 1, "case_paths": [ "/ill-2d/154/0039-01" ] }, { "cite": "77 Ill. 2d 279", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 5490810 ], "year": 1979, "opinion_index": 1, "case_paths": [ "/ill-2d/77/0279-01" ] }, { "cite": "209 Ill. 2d 100", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 5462131 ], "weight": 4, "year": 2004, "pin_cites": [ { "page": "118" }, { "page": "118" }, { "page": "119" } ], "opinion_index": 1, "case_paths": [ "/ill-2d/209/0100-01" ] }, { "cite": "111 Ill. 2d 229", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 3166688 ], "year": 1986, "opinion_index": 1, "case_paths": [ "/ill-2d/111/0229-01" ] }, { "cite": "323 S.E.2d 430", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1984, "opinion_index": 2 }, { "cite": "71 N.C. App. 731", "category": "reporters:state", "reporter": "N.C. App.", "case_ids": [ 8526323 ], "year": 1984, "opinion_index": 2, "case_paths": [ "/nc-app/71/0731-01" ] }, { "cite": "957 S.W.2d 90", "category": "reporters:state_regional", "reporter": "S.W.2d", "case_ids": [ 11874905 ], "year": 1997, "opinion_index": 2, "case_paths": [ "/sw2d/957/0090-01" ] }, { "cite": "995 P.2d 621", "category": "reporters:state_regional", "reporter": "P.2d", "year": 2000, "opinion_index": 2 }, { "cite": "100 Wash. App. 53", "category": "reporters:state", "reporter": "Wash. App.", "case_ids": [ 1363248 ], "year": 2000, "opinion_index": 2, "case_paths": [ "/wash-app/100/0053-01" ] }, { "cite": "272 Kan. 87", "category": "reporters:state", "reporter": "Kan.", "case_ids": [ 701729 ], "weight": 2, "year": 2001, "opinion_index": 2, "case_paths": [ "/kan/272/0087-01" ] }, { "cite": "806 N.E.2d 645", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2004, "pin_cites": [ { "parenthetical": "Sullivan" } ], "opinion_index": 2 }, { "cite": "686 N.E.2d 722", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1997, "pin_cites": [ { "parenthetical": "Wingo" } ], "opinion_index": 2 }, { "cite": "292 Ill. App. 3d 896", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 1725109 ], "year": 1997, "pin_cites": [ { "parenthetical": "Wingo" } ], "opinion_index": 2, "case_paths": [ "/ill-app-3d/292/0896-01" ] }, { "cite": "209 Ill. 2d 100", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 5462131 ], "year": 2004, "pin_cites": [ { "parenthetical": "Sullivan" } ], "opinion_index": 2, "case_paths": [ "/ill-2d/209/0100-01" ] } ], "analysis": { "cardinality": 1442, "char_count": 46693, "ocr_confidence": 0.743, "pagerank": { "raw": 1.0345557928968188e-07, "percentile": 0.5490906998825028 }, "sha256": "8d48fdcccfe93c80abea00c6c4e682bc933dd88df79c1beff57014f7a5abaaa8", "simhash": "1:9b9c0bf8d6175c23", "word_count": 7613 }, "last_updated": "2023-07-14T15:22:07.473803+00:00", "provenance": { "date_added": "2019-08-29", "source": "Harvard", "batch": "2018" }, "casebody": { "judges": [], "parties": [ "STEPHEN GARLEY, Indiv. and as Special Adm\u2019r of the Estate of Pauline Garley, Deceased, Plaintiff-Appellee, v. COLUMBIA LaGRANGE MEMORIAL HOSPITAL, Defendant-Appellant (Scott Multack et al., Defendants)." ], "opinions": [ { "text": "PRESIDING JUSTICE QUINN\ndelivered the opinion of the court: Pauline Garley died from a pulmonary embolism three days after undergoing several abdominal surgeries at LaGrange Memorial Hospital (Hospital). Her husband, plaintiff Stephen Garley, filed a wrongful death suit against the Hospital, based upon the conduct of its nursing staff in caring for Mrs. Garley both during and after surgery; numerous doctors involved in her surgery and postsurgical care, including Drs. Scott Multack, Carla Mitchell, Joan Cardone, and Joseph Reda; and two healthcare corporations. Prior to trial, Drs. Car-done and Reda, as well as the healthcare corporations, were voluntarily dismissed as defendants. After a jury trial, the Hospital and Dr. Multack were found liable for Mrs. Garley\u2019s death. The Hospital filed a motion for judgment n.o.v., which the circuit court denied. On appeal, the Hospital argues that the circuit court erred in denying its motion for judgment n.o.v. because plaintiff\u2019s experts were not competent to testify as to the applicable nursing standard of care. For the following reasons, we reverse and remand with instructions.\nBACKGROUND\nOn the morning of April 28, 1998, Pauline Garley was admitted to the Hospital, where she was to undergo several abdominal surgeries lasting approximately three hours. The surgeries were to be performed by Dr. Scott Multack, who was to be assisted by Dr. Carla Mitchell and Dr. Joan Cardone. At 9:40 a.m., Nurse Nancy Nowak brought Mrs. Garley into the operating room and, pursuant to Dr. Multack\u2019s request, positioned her in the lithotomy position (on her back with her legs elevated and separated) with the use of knee crutches. Though the length of the surgery, her weight, and her age placed Mrs. Garley at risk for developing a deep vein thrombus (DVT) or blood clot, no anti-clotting device or medication was utilized or suggested during surgery. After surgery was completed at 1:30 p.m., Dr. Multack ordered that Mrs. Garley be \u201cambulated with assistance\u201d to decrease the risk that a DVT might develop. According to hospital records, Nurse Karol Meier unsuccessfully attempted to walk Mrs. Garley at 4:36 p.m., approximately three hours after surgery. Mrs. Garley was not ambulated on April 28.\nAt approximately 11 a.m., on April 29, Mrs. Garley was walked for the first time to a chair in her hospital room. Later, at 2:17 p.m., she was walked an undisclosed distance with the use of a walker. At 7:19 p.m., she was walked a distance of 0 to 10 feet, but could not tolerate any further ambulation.\nOn April 30, at approximately 4 p.m., Mrs. Garley again ambulated from 0 to 10 feet. At 8:33 p.m., while Nurse Linda Trotta was ambulating her, Mrs. Garley collapsed and died shortly thereafter.\nAt trial, Dr. Mitra Kalelkar, a forensic pathologist and assistant medical examiner for Cook County, testified that Mrs. Garley died of a pulmonary embolism. She testified that Mrs. Garley developed a DVT, which dislodged and traveled through her bloodstream, blocking her pulmonary arteries. Based upon her finding that Mrs. Garley\u2019s left thigh and calf were larger than her right thigh and calf, she believed the DVT developed in her lower left extremity. She could not determine, however, when the clot formed or whether the clot formed above or below her knee. She also testified that she did not believe that the DVT formed in Mrs. Garley\u2019s pelvis because \u201cno pelvic veins were thrombosed.\u201d\nDr. Carla Mitchell testified that she examined Mrs. Garley on April 29, the day after the surgery, and that Mrs. Garley exhibited no symptoms of DVT. Mrs. Garley also did not complain of leg pain during the examination. Dr. Mitchell stated that, per Dr. Mutlack\u2019s order, the nurses were supposed to ambulate Mrs. Garley as soon as possible and, at a minimum, 3 times every 24 hours. The nursing staff did not inform her that Mrs. Garley had not yet been ambulated. Dr. Mitchell testified that had Mrs. Garley exhibited symptoms of DVT, there were methods and treatments available to reduce the risk of an embolism.\nDr. Multack testified that he expected the nurses to ambulate Mrs. Garley a few hours after surgery, as soon as she was \u201cup and alert.\u201d He testified that she was to be walked \u201ceven if that meant waking her up\u201d and that he expected her to walk unassisted by April 30. When he saw Mrs. Garley on April 30 at 5:10 p.m., she did not complain of leg pain. He stated that he was never informed that Mrs. Garley had complained of leg pain or that she was having difficulty ambulating. He testified that had she been ambulated in accordance with his order, the likelihood of a DVT forming would have decreased and that the failure to do so increased the risk of a pulmonary embolism. He also testified that a number of treatment options were available had he been informed of Mrs. Garley\u2019s complaints of leg pain.\nNurse Karol Meier testified that she was working the 3 p.m. to 11 p.m. shift on April 28. She testified that she understood Dr. Multack\u2019s order to \u201cambulate with assist\u201d to mean that Mrs. Garley was to be ambulated as soon as possible, but no later than 12 to 18 hours after surgery, i.e., between 1:30 a.m. and 7:30 a.m. on April 29. She testified that if a doctor\u2019s order is not being followed, is unclear, or cannot be carried out, the doctor should be notified. However, according to Mrs. Garley\u2019s chart, she was not exhibiting any symptoms consistent with the presence of a DVT and had not complained of leg pain.\nAnnette Colbert, a patient care technician, testified that she attended to Mrs. Garley on April 29 and 30. She testified that Mrs. Garley complained of leg pain while she was being ambulated and that she (Ms. Colbert) relayed these complaints to Nurse Mary Kiser.\nPlaintiff testified that Ms. Colbert called him at work to tell him that his wife was sick, having trouble walking, and experiencing pain in her legs. When plaintiff arrived at the hospital, his wife complained to him of leg pain. Plaintiff did not remember which day Ms. Colbert called him.\nNurses Mary Baser, Linda Trotta, Jane Shepski, and Shawndra Ferrell testified that they attended to Mrs. Garley during her three-day stay at the Hospital. They testified that she did not exhibit any signs consistent with the presence of a DVT or complain to them about pain in her legs. While hospital records indicated that Mrs. Garley complained of abdominal pain, there was no record of her complaining of pain in her legs. Nurse Kiser also testified that she did not remember Ms. Colbert telling her that Mrs. Garley had complained of leg pain.\nThree experts testified on behalf of plaintiff, none of whom were licensed nurses.\nDr. Charles Bird, a board-certified obstetrician-gynecologist, had practiced medicine for 31 years after graduating from Northwestern University Medical School. Dr. Bird was the chief of gynecology at Evanston Hospital and taught third-year medical students at his alma mater.\nHe testified that Mrs. Garley died as a result of a blood clot. He characterized Mrs. Garley as having a moderate risk of developing such a clot based upon her age and weight and the length of the surgery. Dr. Bird testified that, based upon his experience working with nurses, he was familiar with \u201cthe standard of care applicable to nurses who perform postoperative care on patients who have undergone surgeries\u201d similar to those performed on Mrs. Garley. He stated that, because no anticlotting measures were utilized during surgery, she should have been ambulated within 12 hours of surgery. He testified that the Hospital nursing staff fell below the standard of care when they failed to ambulate Mrs. Garley in a timely fashion and that their failure to do so contributed to her death.\nDuring cross-examination, Dr. Bird stated that he had no opinion as to whether Mrs. Garley would have survived had she been ambulated, but testified on redirect examination that it was more probable than not that anticlotting devices or measures, including ambulation, would have prevented her death. Dr. Bird also testified that the nurses should have followed up Mrs. Garley\u2019s complaints of leg pain to Ms. Colbert by examining her legs, but they were not required to inform her doctor of those complaints.\nDr. Fred Duboe, also an obstetrician-gynecologist, performed his residency at Northwestern after receiving his medical degree from the University of Illinois at Chicago (UIC) in 1980. During his 22 years of continuous practice, Dr. Duboe published several scholarly articles relating to blood clots and taught both residents and nurses. Dr. Duboe had also married a nurse and occasionally read her Nursing Spectrums, a nursing periodical.\nHe testified that Mrs. Garley died as a result of a DVT which developed sometime after surgery. He stated that, based upon his experience working with nurses, the nurses\u2019 conduct in caring for Mrs. Garley did not meet the requisite standard of care because they failed to appropriately and timely ambulate Mrs. Garley. He testified that the nurses should have walked her a distance of about 60 feet within 12 to 18 hours after surgery. Moreover, if the nurses were not able to ambulate her by that time, i.e., by 7:30 a.m. on April 29, the nurses should have called her doctor for further instruction and advice. He testified that the nurses\u2019 failure to ambulate Mrs. Garley in a timely fashion contributed to the formation of the blood clot which led to her death.\nDr. Duboe testified that the nurses also failed to properly respond to Mrs. Garley\u2019s complaints of leg pain, which, he stated, should have been relayed to the doctors. Dr. Duboe testified that the nurses\u2019 failure to properly respond to her complaints of leg pain hindered the possible diagnosis of a DVT, which also contributed to her death.\nDr. Richard Vasquez, a general surgeon, graduated from UIC medical school in 1969. After graduation, he worked as a general surgeon at Northwestern Memorial Hospital, published several articles, and taught residents in general surgery. He stated that he also taught nurses and worked with \u201cnursing vice-presidents\u201d at Northwestern \u201cin the formation of guides as to what nurses are supposed to do.\u201d\nHe testified that Nurse Nowak\u2019s conduct before and during surgery fell below the applicable standard of care because she failed to suggest to Dr. Multack that he utilize anticlotting devices during surgery. He testified that he did not know when the DVT formed, but that the failure to employ anticlotting devices \u201cset the ball rolling toward [the development of a] DVT and pulmonary embolus.\u201d\nDuring cross-examination, Dr. Vasquez testified that Nurse Nowak could defer to Dr. Multack\u2019s request as to how Mrs. Garley was to be positioned for surgery. He testified that, statistically speaking, the blood clot most likely developed in the veins of Mrs. Garley\u2019s pelvis. He also testified that Mrs. Garley might have died even if she had been ambulated on April 28. On redirect examination, Dr. Vasquez stated that it was more probable than not that Mrs. Garley would have survived had some anticlotting device been used during surgery.\nDr. James Schuler, a vascular surgeon, testified on behalf of the Hospital. Dr. Schuler testified, he believed the blood clot formed in Mrs. Garley\u2019s pelvis during surgery. Due to the location of the blood clot, Dr. Schuler testified, no amount of postsurgical ambulation would have prevented Mrs. Garley\u2019s death. Dr. Schuler could not rule out the possibility that the blood clot formed in Mrs. Garley\u2019s legs, however, and he stated that the lack of ambulation after surgery \u201cprobably contributed in a very small degree\u201d to an expansion of the blood clot.\nJacqueline Medland, a registered nurse, also testified on behalf of the Hospital. Ms. Medland testified that she was employed as an administrator at Northwestern Memorial Hospital and that she taught postsurgical patient care to nurses. She testified that Dr. Multack\u2019s order to ambulate with assistance required the nurses to walk Mrs. Garley as soon as she was able to tolerate it, but no later than 24 hours after surgery. She testified that the nursing staff met the standard of care by walking Mrs. Garley to a chair in her room at approximately 11 a.m. on April 29. She also testified that Mrs. Garley displayed no symptoms consistent with the presence of a DVT.\nBased upon the testimony of plaintiffs experts, the jury was instructed on five theories as to how the Hospital\u2019s nursing staff negligently cared for Mrs. Garley: (1) failing to ambulate her in an appropriate and timely manner; (2) failing to notify her physicians of her complaints of pain; (3) failing to notify her physicians of her lack of ambulation; (4) failing to use Allen stirrups in positioning her for surgery; and (5) failing to suggest the use of anticlotting devices during surgery. The jury returned a general verdict of liability against the Hospital and Dr. Multack.\nSTANDARD OF REVIEW\n\u201c \u2018[V]erdiets ought to be directed and judgments n.o.v. entered only in those cases in which all of the evidence, when viewed in its aspect most favorable to the opponent, so overwhelmingly favors movant that no contrary verdict based on that evidence could ever stand.\u2019 \u201d Zabinsky v. Gelber Group, Inc., 347 Ill. App. 3d 243, 248 (2004), quoting Pedrick v. Peoria & Eastern R.R. Co., 37 Ill. 2d 494, 510, 229 N.E.2d 504 (1967). In ruling on a motion for a judgment notwithstanding the verdict, a court does not weigh the evidence, nor is it concerned with the credibility of the witnesses; rather, it may only consider the evidence and any inferences therefrom in the light most favorable to the party resisting the motion. Board of Trustees of Community College District No. 508 v. Coopers & Lybrand, 208 Ill. 2d 259, 274 (2003). A decision on a motion for judgment n.o.v. is subject to de novo review by this court. Snelson v. Kamm, 204 Ill. 2d 1, 42, 787 N.E.2d 796 (2003), citing McClure v. Owens Corning Fiberglas Corp., 188 Ill. 2d 102, 132, 720 N.E.2d 242 (1999).\nANALYSIS\nIn a negligence medical malpractice action, the burden is on the plaintiff to prove the following: the proper standard of care against which the defendant\u2019s conduct is measured; an unskilled or negligent failure to comply with the applicable standard; and a resulting injury proximately caused by the defendant\u2019s want of skill or care. Purtill v. Hess, 111 Ill. 2d 229, 241-42, 489 N.E.2d 867 (1986). Unless the negligence is so grossly apparent or the treatment so common as to be within the everyday knowledge of a layperson, expert medical testimony is required to establish the standard of care and the defendant\u2019s deviation from that standard. Purtill, 111 Ill. 2d at 242.\nThe Hospital argues that, because none of plaintiffs expert physicians were licensed nurses, they were not competent to testify as to either the applicable standard of care for the nurses attending Mrs. Garley or whether the nursing staff deviated from that standard of care. Plaintiff, on the other hand, contends that his experts were competent based upon their experience working with and, as to Drs. Duboe and Vasquez, teaching nurses.\nRecently, our supreme court addressed the issue of how courts are to determine the competency of an expert witness in a medical malpractice action. See Sullivan v. Edward Hospital, 209 Ill. 2d 100, 111-16 (2004). In doing so, the court discussed the development of \u201cthe test of an expert physician\u2019s competency to testify.\u201d Sullivan, 209 Ill. 2d at 112.\nInitially, in Dolan v. Galluzzo, 77 Ill. 2d 279, 285, 396 N.E.2d 13 (1979), the supreme court held:\n\u201c[I]n order to testify as an expert on the standard of care in a given school of medicine, the witness must be licensed therein.\nOnce the fact of such license has been established, it lies within the sound discretion of the trial court to determine if the witness is qualified to testify as an expert regarding the standard of care.\u201d Dolan, 77 Ill. 2d at 285.\nThe rationale behind this licensure requirement, according to the court, was:\n\u201c \u2018[Tjhere are different schools of medicine with varying tenets and practices, and that inequities would be occasioned by testing the care and skill of a practitioner of one school of medicine by the opinion of a practitioner of another school\u2019 [citation].\u201d Dolan, 77 Ill. 2d at 283.\nSimply put, the \u201cpractitioner of a particular school of medicine is entitled to have his conduct tested by the standards of his school.\u201d Dolan, 77 Ill. 2d at 283.\nDolan\u2019s licensure requirement was next discussed in Purtill, where the court stated:\n\u201cIt must be established that the expert is a licensed member of the school of medicine about which he proposes to express an opinion [citation], and the expert witness must show that he is familiar with the methods, procedures, and treatments ordinarily observed by other physicians, in either the defendant physician\u2019s community or a similar community. [Citations.] Once the former requirement has been satisfied, \u2018it lies within the sound discretion of the trial court to determine if the witness is qualified [and competent] to [state his opinion] as an expert regarding the standard of care.\u2019 [Citation.]\u201d Purtill, 111 Ill. 2d at 243.\nIn Jones v. O\u2019Young, 154 Ill. 2d 39, 43, 607 N.E.2d 224 (1992), the supreme court again addressed the competency requirements for expert witnesses in a medical malpractice action, stating:\n\u201cFirst, the physician must be a licensed member of the school of medicine about which he proposes to testify. [Citation.] Second, \u2018the expert witness must show that he is familiar with the methods, procedures, and treatments ordinarily observed by other physicians, in either the defendant physician\u2019s community or a similar community.\u2019 [Citation.] Once the foundational requirements have been met, the trial court has the discretion to determine whether a physician is qualified and competent to state his opinion as an expert regarding the standard of care.\u201d Jones, 154 Ill. 2d at 43.\nThe court went on to say:\n\u201cThe foundational requirements provide the trial court with the information necessary to determine whether an expert has the expertise in dealing with the plaintiffs medical problem and treatment. ***\nIf the plaintiff fails to satisfy either of the foundational requirements of Purtill, the trial court must disallow the expert\u2019s testimony. [Citation.] The requirements are a threshold beneath which the plaintiff cannot fall without failing to sustain the allegations of his complaint.\u201d Jones, 154 Ill. 2d at 43-44.\nHaving revisited its previous holdings in Dolan, Purtill, and Jones, the court in Sullivan reiterated the requirement that, in order to provide competent standard of care testimony, the plaintiffs proffered expert physician must be licensed in the defendant\u2019s given school of medicine. See Sullivan, 209 Ill. 2d at 113-14. (\u201cIf the expert physician fails to satisfy either of these foundational requirements, \u2018the trial court must disallow the expert\u2019s testimony.\u2019 [Citation.] Dolan established the first requirement, i.e., that a health-care expert witness must be a licensed member of the school of medicine about which the expert proposes to testify. *** Accordingly, the Dolan court held that \u2018in order to testify as an expert on the standard of care in a given school of medicine, the witness must be licensed therein.\u2019 [Citation.]\u201d).\nThe Sullivan court also rejected the plaintiffs argument that, based upon language in Jones, \u201cIllinois law no longer holds that a health professional expert witness must always be a licensed member of the school of medicine about which the expert proposes to testify.\u201d Sullivan, 209 Ill. 2d at 114. The court stated: .\n\u201cWe cannot accept this argument. Jones clearly reaffirms this court\u2019s decision in Purtill describing two foundational requirements: that the health-care expert witness must be a licensed member of the school of medicine about which the expert proposes to testify; and that the expert must be familiar with the methods, procedures, and treatments ordinarily observed by other healthcare providers in either the defendant\u2019s community or a similar community. Indeed, the very next sentences in Jones following the italicized sentence upon which plaintiff relies state: \u2018If the plaintiff fails to satisfy either of the foundational requirements of Purtill, the trial court must disallow the expert\u2019s testimony. [Citation.] The requirements are a threshold beneath which the plaintiff cannot fall without failing to sustain the allegations of his complaint.\u2019 [Citation.] It is only after determining that both foundational requirements are satisfied that the court proceeds to evaluate whether the allegations of negligence concern matters within the expert\u2019s knowledge and observation. Instead of retreating from the license requirement, Jones clearly reaffirms that a plaintiff must satisfy both requirements.\u201d (Emphasis in original.) Sullivan, 209 Ill. 2d at 114-15, citing Jones, 154 Ill. 2d at 44, citing Purtill, 111 Ill. 2d at 244.\nTherefore, in order for an expert physician to be competent to testify, two foundational requirements must be met: (1) the physician must be a licensed member of the school of medicine about which he proposes to testify and (2) the expert witness must show that he is familiar with the methods, procedures, and treatments ordinarily observed by other physicians, in either the defendant physician\u2019s community or a similar community. See Sullivan, 209 Ill. 2d at 112-13, quoting Jones, 154 Ill. 2d at 43. These foundational requirements are \u201c \u2018a threshold beneath which the plaintiff cannot fall without failing to sustain the allegations of his complaint.\u2019 \u201d Sullivan, 209 Ill. 2d at 115, quoting Jones, 154 Ill. 2d at 44. \u201cOnce the foundational requirements have been met, the trial court has the discretion to determine whether a physician is qualified and competent to state his opinion as an expert regarding the standard of care.\u201d Jones, 154 Ill. 2d at 43, citing Purtill, 111 Ill. 2d at 243.\nIt is undisputed that, in this case, plaintiffs experts were well-qualified physicians, whose professional experience and accomplishments were beyond reproach. Equally undisputed, however, is that none of plaintiffs experts were licensed in the school of nursing. The question is whether this one failing renders them incompetent to testify as to the applicable nursing standard of care and deviations therefrom.\nBoth our supreme court and legislature have recognized nursing as a unique school of medicine. See Sullivan, 209 Ill. 2d at 119, citing Dolan, 77 Ill. 2d at 284; see also 225 ILCS 65/5 \u2014 1 et seq. (West 2000) (the Nursing and Advanced Practice Nursing Act, which sets forth a unique licensing and regulatory scheme for the nursing profession). In Sullivan, our supreme court rejected the proposition that \u201c \u2018[tjhere is nothing which a nurse can do which a doctor cannot do\u2019 \u201d because it \u201cpresumes a universal standard of treatment among physicians and nurses.\u201d Sullivan, 209 Ill. 2d at 120. In doing so, the supreme court, quoting from the brief of amicus The American Association of Nurse Attorneys (TAANA), stated:\n\u201cTAANA persuasively reasons:\n\u2018A physician, who is not a nurse, is no more qualified to offer expert, opinion testimony as to the standard of care for nurses than a nurse would be to offer an opinion as to the physician standard of care. *** Certainly, muses are not permitted to offer expert testimony against a physician based on their observances of physicians or their familiarity with the procedures involved. An operating room nurse, who stands shoulder to shoulder with surgeons every day, would not be permitted to testify as to the standard of care of a surgeon. An endoscopy nurse would not be permitted to testify as to the standard of care of a gastroenterologist performing a Colonoscopy. A labor and delivery muse would not be permitted to offer expert, opinion testimony as to the standard of care for an obstetrician or even a midwife. Nor would a nurse be permitted to testify that, in her experience, when she calls a physician, he/she usually responds in a certain manner. Such testimony would be, essentially, expert testimony as to the standard of medical care.\u2019\nScholars share this reasoning:\n\u2018Physicians often have no first-hand knowledge of nursing practice except for observations made in patient care settings. The physician rarely, if ever, teaches in a nursing program nor is a physician responsible for content in nursing texts. In many situations, a physician would not be familiar with the standard of care or with nursing policies and procedures which govern the standard of care. Therefore, a physician\u2019s opinions would not be admissible in jurisdictions which hold the expert must be familiar with the standard of care in order to testify as an expert.\u2019 \u201d Sullivan, 209 Ill. 2d at 120-21, quoting E. Beyer & P. Popp, Nursing Standard of Care in Medical Malpratice Litigation: The Rule of the Nurse Expert Witness, 23 J. Health & Hosp. L. 363, 365 (1990).\nThe plaintiff argues that the testimony of Dr. Duboe and Dr. Vasquez clearly demonstrates that they did teach nurses and were familiar with the standard of care for nurses. Appellee\u2019s argument on this point is well-taken. However, the Sullivan court continued:\n\u201cBy enacting the Nursing and Advanced Practice Nursing Act (225 ILCS 65/5 \u2014 1 et seq. (West 2000)), the legislature has set forth a unique licensing and regulatory scheme for the nursing profession. As TAANA observes, under the nursing act, a person with a medical degree, who is licensed to practice medicine, would not meet the qualification for licensure as a registered nurse, nor would that person be competent to sit for the nursing license examination, unless that person completed an accredited program in nursing. See 225 ILCS 65/5 \u2014 1 et seq. (West 2000). The appellate court in this case correctly reasoned:\n\u2018Dr. Barnhart is not a licensed member of the nursing profession. To allow the doctor to testify as to the standard of care applicable to the nursing profession implicates the risks raised by Dolan, namely, the imposition of a higher standard of care and the muddling and mixing of various tenets and practices unique to each profession.\u2019 335 Ill. App. 3d at 272.\nWe uphold the trial court\u2019s ruling on the competency of Dr. Barn-hart to testify as to the standard of care for the nursing profession. We expressly reaffirm the license requirement of Dolan and its progeny and decline plaintiffs invitation to deviate therefrom.\u201d Sullivan, 209 Ill. 2d at 122-23.\nIn this case, there is little question, based upon their extensive experience observing and working with and, for Drs. Duboe and Vasquez, actually teaching nurses, that all three of plaintiffs expert physicians would have satisfied the second foundational requirement (being familiar with the methods, procedures, and treatments ordinarily observed by the nurses). The fact remains, however, that none were licensed members of the school of nursing, an unequivocal requirement under Dolan and its progeny. See Sullivan, 209 Ill. 2d at 119 (\u201cClearly, this exact issue [whether the licensure requirement includes the nursing profession] was contemplated by this court in Dolan, which unequivocally required that a health-care expert witness must be a licensed member of the school of medicine about which the expert testifies\u201d). As our supreme court has made clear, \u201cWe expressly reaffirm the license requirement of Dolan and its progeny and decline plaintiffs invitation to deviate therefrom.\u201d Sullivan, 209 Ill. 2d at 123; accord Jones, 154 Ill. 2d at 43-44; Purtill, 111 Ill. 2d at 244; Dolan, 77 Ill. 2d at 285.\nRigid and formalistic though this rule may be, it is fundamental to our judicial system that once our supreme court has declared the law on any point, this court must follow that law, as only the supreme court has authority to overrule or modify its own decisions. See Mekertichian v. Mercedes-Benz U.S.A., L.L.C., 347 Ill. App. 3d 828, 836 (2004); Robinson v. Johnson, 346 Ill. 2d 895, 907 (2003); see also Schiffner v. Motorola, Inc., 297 Ill. App. 3d 1099, 1102, 697 N.E.2d 868 (1998) (stating that \u201cthe doctrine of stare decisis requires courts to follow the decisions of higher courts\u201d). Moreover, such a rule is necessary in order to avoid the danger of imposing upon nurses a higher standard of care than society and the law should expect, and the inequities that would result from doing so. Therefore, because only those licensed in the field of nursing may testify as to the nursing standard of care and because plaintiff failed to offer any competent expert testimony to establish the standard of care for the Hospital\u2019s nursing staff, we find that the circuit court erred in denying the Hospital\u2019s motion for judgment notwithstanding the verdict. See Sullivan, 209 Ill. 2d at 123-24 (upholding the trial court\u2019s ruling that a doctor was not competent to testify as to the standard of care for the nursing profession and granting a directed verdict for the hospital).\nPlaintiff relies upon Wingo v. Rockford Memorial Hospital, 292 Ill. App. 3d 896, 904-07, 686 N.E.2d 722 (1997), to support his argument that his experts were competent to testify as to the applicable nursing standard of care. In Wingo, a pregnant patient went to the hospital reporting that her waters had broken and that she was leaking fluid. The doctor who examined the patient the following morning found that the patient was not leaking fluid. After the doctor\u2019s examination, however, a nurse observed the patient leaking fluid, but she failed to communicate this to the doctor. The patient was discharged from the hospital later that night. A few hours after her discharge, she began to have complications and returned to the hospital, where doctors performed an immediate delivery. Her child was born with severe brain damage. Wingo, 292 Ill. App. 3d at 900-01.\nAt trial, the plaintiff introduced the testimony of expert witnesses, one of whom was a \u201cboard-certified obstetrician and gynecologist\u201d who had taught nurses \u201cin programs focusing on the assessment of a fetus during labor\u201d and who \u201croutinely lecture[d] obstetrical nurses in continuing education courses.\u201d Wingo, 292 Ill. App. 3d at 903. The experts each testified that the nurse deviated from the standard of care by not appropriately informing the doctor that the patient continued to leak fluid. After a jury returned a verdict for the plaintiff, the hospital appealed and argued that the \u201ctrial court erred in allowing the plaintiffs to present expert testimony from three doctors to establish the applicable standard of care for the Hospital\u2019s nurse.\u201d Wingo, 292 Ill. App. 3d at 904.\nAfter noting that no Illinois court had ever directly applied the licensing requirement to prevent a physician from establishing the applicable nursing standard of care, or found reversible error in allowing a physician to offer such testimony, the appellate court affirmed, stating:\n\u201cWe find that the facts of the instant case do not fit within the license requirement of Dolan or Jones. Those cases indicate that the reason for the rule is to prevent a higher standard of care being imposed upon the defendant and to ensure that the testifying expert has expertise in dealing with the patient\u2019s medical problem and treatment and that the allegations of negligence are within the expert\u2019s knowledge and observation.\u201d Wingo, 292 Ill. App. 3d at 906.\nThe court, in reviewing the facts before it, stated:\n\u201cThose concerns have not been sacrificed here. In the instant case, the allegations of negligence against [the nurse] did not concern a nursing procedure but, rather, related to what a nurse is required to communicate to a physician about what transpired since the physician last saw the patient. As such the allegations of negligence do not concern an area of medicine about which there would be a different standard between physician and another school of medicine. Furthermore, it was established that the allegations of negligence were well within the testifying doctors\u2019 knowledge and experience. We believe that a physician should be entitled to testify about what he or she is entitled to rely upon in the area of communication from a nurse in the context of an obstetrical team rendering care to a patient in a hospital. Accordingly, we hold that no error occurred in allowing the doctors to testify as to the applicable nursing standard of care in this case.\u201d (Emphasis added.) Wingo, 292 Ill. App. 3d at 906.\nThe court also found that \u201ceven if it was error to admit the physicians\u2019 testimony under Dolan, it was harmless\u201d because \u201c[t]hree nurses testified that the nursing standard of care required [the nurse] affirmatively tell [the doctor] that the patient continued to leak amniotic fluid.\u201d Wingo, 292 Ill. App. 3d at 906. The court stated \u201ceven without the physicians\u2019 testimony there was evidence in the record to establish the standard of care for nurses, and we do not find it likely that the outcome was affected by allowing the testimony.\u201d Wingo, 292 Ill. App. 3d at 907. Plaintiffs reliance upon Wingo is misplaced.\nFirst, the initial premise on which Wingo\u2019s reasoning was based, i.e., that no Illinois court had directly applied the licensing requirement to prevent a physician from establishing the applicable nursing standard of care, is no longer true. See Sullivan, 209 Ill. 2d at 123-24. While the reach of the license requirement in the context of a physician testifying as to the nursing standard of care was an open question when Wingo was decided, as well as when the trial in this case was held, the supreme court in Sullivan left no doubt that having such a license is \u201cunequivocally required.\u201d Sullivan, 209 Ill. 2d at 123 (\u201cWe expressly reaffirm the license requirement of Dolan and its progeny and decline plaintiffs invitation to deviate therefrom\u201d). Second, in Wingo, three nurses testified that the nurse deviated from the applicable nursing standard of care by failing to communicate the patient\u2019s condition to her doctor. See Wingo, 292 Ill. App. 3d at 906. Here, none of plaintiffs witnesses were competent to establish the applicable nursing standard of care. Therefore, we believe that Wingo is not applicable to the case at bar.\nPlaintiff argues that his experts were competent to testify based upon their years of experience observing, working with, and teaching nurses. While such experience would certainly demonstrate that they were \u201cfamiliar with the methods, procedures, and treatments ordinarily observed by other physicians, in either the defendant physician\u2019s community or a similar community\u201d (Purtill, 111 Ill. 2d at 243), the second foundational requirement for determining the competency of an expert witness, and could be considered by the circuit court in determining, within its sound discretion, whether a physician \u201c \u2018is qualified [and competent] to [state his opinion] as an expert regarding the standard of care\u2019 \u201d (Purtill, 111 Ill. 2d at 243, quoting Dolan, 77 Ill. 2d at 285), the fact remains that they were not licensed in the school of nursing. An expert physician who is not licensed in the particular school of medicine about which he intends to testify is automatically incompetent; his knowledge, experience, and level of expertise, no matter how extensive, are simply irrelevant. See Sullivan, 209 Ill. 2d at 119; Jones, 154 Ill. 2d at 43-44; Purtill, 111 Ill. 2d at 244; Dolan, 77 Ill. 2d at 285.\nPlaintiff also argues that the nursing staffs conduct was \u201cso grossly negligent\u201d that expert testimony was not needed to establish the Hospital\u2019s liability. Plaintiff argues that the nursing staff basically \u201cdisregarded\u201d Dr. Multack\u2019s order by failing to ambulate Mrs. Garley or inform her doctors of her inability to ambulate. \u201cAn exception to the general rule that expert testimony is required in a medical malpractice case has been recognized in those cases where the conduct is so grossly negligent or the treatment so common that a layman may understand the conduct without the necessity of expert testimony to establish the standard of care and its breach.\u201d Prairie v. University of Chicago Hospitals, 298 Ill. App. 3d 316, 321, 698 N.E.2d 611 (1998), citing Walski v. Tiesenga, 72 Ill. 2d 249, 381 N.E.2d 279 (1978).\nIn this case, the defendant nurses did not disregard Dr. Multack\u2019s order. The nurses first attempted to ambulate Mrs. Garley three hours after surgery, but she was unable to tolerate it. Mrs. Garley was walked three times on April 29. She was walked again on April 30. The nurses also testified that additional, \u201cuncharted\u201d attempts to ambulate her were unsuccessful. Besides her complaints to Ms. Colbert and her husband of leg pain, complaints that were not indicated in any medical chart, Mrs. Garley showed no symptoms of a DVT. Moreover, it is doubtful that the layman would understand the importance of ambulating a patient after surgery. Thus, the nurses\u2019 conduct cannot be deemed so grossly negligent that plaintiff was not required to offer expert testimony to establish the Hospital\u2019s liability.\nAt the time of trial and until Sullivan, no Illinois court had held that the license requirement in Dolan prevented a physician from establishing the applicable nursing standard of care and several appellate cases had affirmed circuit courts where physicians \u201ctestified against nurses to establish the nursing standard of care without it being challenged\u201d (Wingo, 292 Ill. App. 3d at 905-06 (and cases cited therein)), and the trial court\u2019s error in allowing Drs. Bird, Duboe, and Vasquez\u2019s testimony was in rebanee upon these cases. However, based upon the clear dictate of our supreme court\u2019s holding in Sullivan, we reverse and remand this matter for a new trial consistent with the views expressed herein.\nReversed and remanded.", "type": "majority", "author": "PRESIDING JUSTICE QUINN" }, { "text": "JUSTICE GREIMAN,\nspecially concurring:\nThe authoring judge thoughtfully announces that he is following Sullivan v. Edward Hospital, 209 Ill. 2d 100 (2004). In that case and its predecessors, Dolan v. Galluzzo, 77 Ill. 2d 279 (1979), Purtill v. Hess, 111 Ill. 2d 229 (1986), and Jones v. O\u2019Young, 154 Ill. 2d 39 (1992), a bright line was imposed which requires that health care experts be licensed in the school of medicine of which the expert proposes to testify.\nIn Wingo v. Rockford Memorial Hospital, 292 Ill. App. 3d 896 (1997), the appellate court distinguished Dolan and its predecessors by suggesting a physician could testify to the standard of care for the nurses relating to communications to a physician about what has transpired since the physician last saw the patient.\nThe authoring judge suggests that Sullivan trumps all of the preceding decisions in imposing the bright line of licensure. However, the Sullivan court is very careful to state \u201cthe precise factual scenario of Wingo is not present.\u201d Sullivan, 209 Ill. 2d at 118. In Sullivan, the expert\u2019s testimony related to nursing procedures rather than communications. Sullivan, 209 Ill. 2d at 118.\nSullivan further states:\n\u201cIn distinguishing Wingo from this case, the appellate court did not discuss the merits of Wingo, and neither do we. The present case falls squarely within the license requirement of Dolan and its progeny.\u201d Sullivan, 209 Ill. 2d at 119.\nIf our supreme court wished to impose a license requirement even on those matters that relate to communications to a physician from a nurse, it could have easily so stated.\nInstead it suggested the facts of Wingo, dealing with communications between a nurse and a physician, were not within the purview of the order in Sullivan.\nAccordingly, we must conclude that Wingo remains an appropriate precedent to follow in the case at bar if it meets the factual requirements. The negligence of the nurse in part is predicated upon the nurse\u2019s failure to communicate to the physician the failure of the plaintiffs decedent to respond to ambulation.\nWhile a physician unlicensed as a nurse might not be competent to testify as to general nursing procedure, nothing in Sullivan suggests that a physician, upon a proper foundation of experience, could not testify as to the standard of care for a failure of communication between nurse and physician.\nIn the case at bar, Dr. DuBoe\u2019s opinion does touch upon the failure to communicate, although he also touches upon the failure to timely ambulate the patient and to properly respond to the patient\u2019s complaints of pain. Similarly, Drs. Bird and Vasquez testified to matters other than communication between nurse and physician. Accordingly, it appears that their testimony here falls within the scope of Sullivan.\nI therefore grudgingly concur with the authoring judge. Grudgingly because I do not believe that a physician\u2019s testimony about a nurse\u2019s standard of care will somehow raise the bar on that standard of care. It is difficult to imagine that physicians with 20 years\u2019 (Dr. DuBoe), 31 years\u2019 (Dr. Bird) and 26 years\u2019 (Dr. Vasquez) experience, two of whom have taught nurses and one who has written a nurses manual, cannot determine a nurse\u2019s standard of care.\nThe majority quotes a learned text that is set forth in Sullivan: E. Beyer & P. Popp, Nursing Standard of Care in Medical Malpratice Litigation: The Role of the Nurse Expert Witness, 23 J. Health & Hospital L. 363, 365 (1990), which provides:\n\u201c \u2018Physicians often have no first-hand knowledge of nursing practice except for observations made in patient care settings. The physician rarely, if ever; teaches in a nursing program nor is a physician responsible for content in nursing texts.\u2019 \u201d (Emphasis added.) 351 Ill. App. 3d at 408.\nOne might wonder why the supreme court in Sullivan felt it necessary to make reference to the physician who teaches in nursing programs or who is responsible for the production of nursing texts.\nIn the instant matter, Dr. Bird testified that he had taught nurses and Dr. Vasquez testified that, in addition to teaching nurses, he had worked with hospital authorities to prepare nursing guidelines.\nThe foundation that these doctors taught or prepared manuals was not in much depth or detail. While this may not be the case for a physician who has been involved in teaching or preparation of a nursing manual to testify, Sullivan does not completely close that door.", "type": "concurrence", "author": "JUSTICE GREIMAN," }, { "text": "JUSTICE HARTMAN,\ndissenting:\nI respectfully dissent from the majority disposition reversing the jury\u2019s decision favoring plaintiffs in this case.\nThe majority author finds that Sullivan v. Edward Hospital, 209 Ill. 2d 100, 806 N.E.2d 645 (2004) (Sullivan), has established a \u201cbright line\u201d requiring, for this case, that a physician may not testify with respect to the nursing standard of care unless the physician also was a licensed nurse. The concurring author disagrees, citing Wingo v. Rockford Memorial Hospital, 292 Ill. App. 3d 896, 686 N.E.2d 722 (1997) (Wingo), to the effect that Sullivan never reached the issue of whether a communication between doctor and nurse, or its absence, could be the subject of the physician\u2019s expert opinion as to the nurse\u2019s failure to meet the standard of care required in such cases. I agree with the concurring opinion with respect to its conclusion that Sullivan does not prevent a doctor from testifying as to a nurse\u2019s failure to communicate to the doctor necessary information concerning fulfillment of the doctor\u2019s orders as it affects his patient.\nThe concurrence goes on to note, however, that the three physicians who testified for plaintiffs did not limit their expert testimony to lack of communication, but also testified to nursing matters other than communications, or lack thereof, contrary to Sullivan, and would concur in the reversal and remandment of this case. Although the concurrence notes that two of the three physicians taught in nursing programs, one of whom assisted in the preparation of a nursing manual, the foundations for their teaching and writing \u201cwas not in much depth or detail.\u201d\nClearly, plaintiffs\u2019 physicians who testified as experts as to adequacies of communications between doctors and nurses concerning the patient\u2019s well-being were qualified to give their expert opinions with respect to this subject. The three doctors had over 76 years of experience in working with nurses in various hospital settings and were well qualified to testify concerning what was expected of nurses by way of communications between doctors and nurses. It is unfathomable to regard a doctor who has had to rely on hospital staff to advise him as to the progress, or lack of progress, of a patient he has placed in the hospital for care and treatment as incompetent to testify as an expert in this regard.\nWith respect to the physicians\u2019 qualifications to testify concerning nursing matters other than communications, dismissed by the concurrence for lack of foundation, no objections to their testimony were timely made at a time when any paucity of foundation could have been cured at th\u00e9 trial level. Doctors who teach or train nurses at nursing schools have been recognized in other jurisdictions as experts with respect to nursing standards of care violations. Nold v. Binyon, 272 Kan. 87, 31 P.3d 274 (2001); Hall v. Sacred Heart Medical Center, 100 Wash. App. 53, 995 P.2d 621 (2000); Hall v. Huff, 957 S.W.2d 90 (Tex. Ct. App. 1997); Haney v. Alexander, 71 N.C. App. 731, 323 S.E.2d 430 (1984). None of the foregoing authorities have questioned the teaching or training experiences of the physicians testifying as to nursing standards. In Wingo, similarly to the instant case, a board-certified obstetrician and gynecologist, who lectured nurses in various programs and courses, was found qualified to testify with respect to deviations in nursing standards of care. There, as here, defendant\u2019s failure to make a contemporaneous objection at trial was found to be waiver, although the appellate court went on to decide the issue on its merits favorably to plaintiffs.\nFor the foregoing reasons, I would affirm the jury\u2019s decision in the present case.", "type": "dissent", "author": "JUSTICE HARTMAN," } ], "attorneys": [ "Hall, Prange & Schoonveld (Michael E. Frangle, of counsel), and Lord, Bissell & Brooks (Hugh C. Griffin and Stevie A. Starnes, of counsel), both of Chicago, for appellant.", "Novoselsky Law Offices (David A. Novoselsky and Leslie J. Rosen, of counsel), and Goldberg & Goldberg (Barry D. Goldberg, of counsel), both of Chicago, for appellee." ], "corrections": "", "head_matter": "STEPHEN GARLEY, Indiv. and as Special Adm\u2019r of the Estate of Pauline Garley, Deceased, Plaintiff-Appellee, v. COLUMBIA LaGRANGE MEMORIAL HOSPITAL, Defendant-Appellant (Scott Multack et al., Defendants).\nFirst District (4th Division)\nNo. 1\u201402\u20142012\nOpinion filed June 30, 2004.\nRehearing denied August 5, 2004.\nHall, Prange & Schoonveld (Michael E. Frangle, of counsel), and Lord, Bissell & Brooks (Hugh C. Griffin and Stevie A. Starnes, of counsel), both of Chicago, for appellant.\nNovoselsky Law Offices (David A. Novoselsky and Leslie J. Rosen, of counsel), and Goldberg & Goldberg (Barry D. Goldberg, of counsel), both of Chicago, for appellee." }, "file_name": "0398-01", "first_page_order": 416, "last_page_order": 434 }