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  "name": "JUSTIN GRANTHAM, A minor child, by and through THE TRUST COMPANY OF STERNE, AGEE & LEACH, INC., his Guardian Ad Litem, Plaintiff v. ROBERT C. CRAWFORD, M.D., CAROLINA WOMANCARE, P.A., f/k/a ROBERT C. CRAWFORD, M.D., P.A., JOHN DOE; JOHN DOE, M.D.; HIGH POINT REGIONAL HEALTH SYSTEM, d/b/a HIGH POINT REGIONAL HOSPITAL; JOHN DOE P.C. and JOHN DOE, INC., Defendants",
  "name_abbreviation": "Grantham ex rel. Trust Co. of Sterne, Agee & Leach, Inc. v. Crawford",
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    "judges": [
      "Chief Judge MARTIN and Judge ERVIN concur."
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    "parties": [
      "JUSTIN GRANTHAM, A minor child, by and through THE TRUST COMPANY OF STERNE, AGEE & LEACH, INC., his Guardian Ad Litem, Plaintiff v. ROBERT C. CRAWFORD, M.D., CAROLINA WOMANCARE, P.A., f/k/a ROBERT C. CRAWFORD, M.D., P.A., JOHN DOE; JOHN DOE, M.D.; HIGH POINT REGIONAL HEALTH SYSTEM, d/b/a HIGH POINT REGIONAL HOSPITAL; JOHN DOE P.C. and JOHN DOE, INC., Defendants"
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      {
        "text": "JACKSON, Judge.\nJustin Grantham (\u201cplaintiff\u2019), a minor child, by and through his guardian ad litem, appeals the 31 October 2008 and 6 November 2008 orders granting summary judgment of his medical malpractice claim to Robert C. Crawford, M.D. (\u201cDr. Crawford\u201d); Carolina Womancare, P.A.; and High Point Regional Health System (\u201cHigh Point Regional\u201d) (collectively, \u201cdefendants\u201d). For the reasons stated below, we reverse and remand.\nOn 26 March 2008, plaintiff filed a complaint alleging medical negligence and breach of contract against defendants based upon the allegedly negligent delivery of plaintiff on 22 January 1997 and his subsequent neurological injuries. Although defendants include discussion of an earlier complaint in their briefs, plaintiff voluntarily dismissed that complaint and no information regarding it is included in the current record. Plaintiff offered two experts to satisfy the pleading requirement for a medical malpractice suit \u2014 Edith Gurewitsch, M.D. (\u201cDr. Gurewitsch\u201d), and Certified Nurse-Midwife Pamela Scudder Kelly (\u201cCNM Kelly\u201d) (collectively, \u201cproposed experts\u201d).\nDr. Gurewitsch had spent several rotations during her residency in the early 1990\u2019s at LaGuardia Hospital in Queens, New York, a small community hospital run by an HMO. When Dr. Gurewitsch worked there, LaGuardia had approximately four labor rooms, one obstetrical operation room, and an anesthesiologist whom doctors had to call in from home. In 1996, the year preceding the incident in question, Dr. Gurewitsch was a medical fellow in maternal and fetal medicine at New York Hospital, Cornell University Medical Center. She was a licensed physician at the time but was not yet board-certified. During 1996, Dr. Gurewitsch acted as an attending obstetrics-gynecological (\u201cOB-GYN\u201d) physician, working independently and supervising residents. Also during that time frame, maternal and fetal medicine attending physicians supervised Dr. Gurewitsch with respect to high risk procedures. Dr. Gurewitsch has never visited High Point, North Carolina, nor High Point Regional.\nCNM Kelly was a registered nurse who was certified in midwifery in 1980. She practiced as a CNM in Raleigh, North Carolina, from 1980 through 1990; however, from 1985 through 1990, she did not perform deliveries. CNM Kelly did not maintain her licensure and certification in North Carolina after 1990. From 1990 through 2000, including the year in question, CNM Kelly practiced as a CNM at Bethesda Memorial Hospital in Boynton Beach, Florida. She often delivered babies during her decade at Bethesda Memorial. Bethesda Memorial was a Level 2 hospital at least part of the time during those ten years, had approximately six labor rooms, and had to call in a separate operation room team for Cesarian sections. CNM Kelly has been to High Point and has relatives in the area but was unsure of whether she had visited High Point Regional. Both proposed experts opined that Dr. Crawford and the nursing staff at High Point Regional violated the applicable standards of care during plaintiffs delivery on 22 January 1997.\nOn 1 October 2008, defendants moved for summary judgment based upon North Carolina Rules of Evidence, Rule 702; North Carolina Rules of Civil Procedure, Rule 9(j); and North Carolina General Statutes, section 90-21.12. The trial court conducted a hearing on the motions on 27 October 2008. On 31 October 2008, the trial court granted summary judgment in favor of Dr. Crawford and Carolina Womancare, and on 6 November 2008, it granted summary judgment in favor of High Point Regional. Plaintiff appeals.\nPlaintiff contends that he reasonably expected that Dr. Gurewitsch and CNM Kelly would qualify as experts pursuant to Rule 702, thereby satisfying the pleading requirements of Rule 9(j). The trial court, therefore, should not have granted defendants\u2019 motion for summary judgment. We agree.\n\u201cWe review a trial court\u2019s ruling on summary judgment de novo.\u201d Barringer v. Wake Forest Univ. Baptist Med. Ctr., 197 N.C. App. 238, 247, 677 S.E.2d 465, 472 (2009) (citing In re Will of Jones, 362 N.C. 569, 573, 669 S.E.2d 572, 576 (2008)). In addition, \u201c[w]hether the pleader could reasonably expect the witness to qualify as an expert under Rule 702 presents a question of law and is therefore reviewable de novo by this Court.\u201d Trapp v. Maccioli, 129 N.C. App. 237, 241 n.2, 497 S.E.2d 708, 711 n.2 (1998) (citing State v. Chaplin, 122 N.C. App. 659, 664, 471 S.E.2d 653, 656 (1996)).\nRule 9Q) provides, in relevant part:\nAny complaint alleging medical malpractice by a health care provider as defined in G.S. 90-21.11 in failing to comply with the applicable standard of care under G.S. 90-21.12 shall be dismissed unless:\n(1) The pleading specifically asserts that the medical care has been reviewed by a person who is reasonably expected to qualify as an expert witness under Rule 702 of the Rules of Evidence and who is willing to testify that the medical care did not comply with the applicable standard of care[.]\nN.C. Gen. Stat. \u00a7 1A-1, Rule 9(j) (2007). Rule 702(b) sets forth the qualifications for an expert in a medical malpractice case:\nIn a medical malpractice action as defined in G.S. 90-21.11, a person shall not give expert testimony on the appropriate standard of health care as defined in G.S. 90-21.12 unless the person is a licensed health care provider in this State or another state and meets the following criteria:\n(1) If the party against whom or on whose behalf the testimony is offered is a specialist, the expert witness must:\na. Specialize in the same specialty as the party against whom or on whose behalf the testimony is offered; or\nb. Specialize in a similar specialty which includes within its specialty the performance of the procedure that is the subject of the complaint and have prior experience treating similar patients.\n(2) During the year immediately preceding the date of the occurrence that is the basis for the action, the expert witness must have devoted a majority of his or her professional time to either or both of the following:\na. The active clinical practice of the same health profession in which the party against whom or on whose behalf the testimony is offered, and if that party is a specialist, the active clinical practice of the same specialty or a similar specialty which includes within its specialty the performance of the procedure that is the subject of the complaint and have prior experience treating similar patients; or\nb. The instruction of students in an accredited health professional school or accredited residency or clinical research program in the same health profession in which the party against whom or on whose behalf the testimony is offered, and if that party is a specialist, an accredited health professional school or accredited residency or clinical research program in the same specialty.\nN.C. Gen. Stat. \u00a7 8C-1, Rule 702(b) (2007). Section 90-21.12 further clarifies that the standards an expert must apply are \u201cthe standards of practice among members of the same health care profession with similar training and experience situated in the same or similar communities at the time of the alleged act giving rise to the cause of action.\u201d N.C: Gen. Stat. \u00a7 90-21.12 (2007).\nThis Court inquires as to whether plaintiff reasonably expected Dr. Gurewitsch and CNM Kelly to qualify as expert witnesses pursuant to Rule 702, not whether they ultimately will qualify. Smith v. Serro, 185 N.C. App. 524, 527, 648 S.E.2d 566, 568 (2007) (citing N.C. Gen. Stat. \u00a7 1A-1, Rule 9(j)(1) (2005); Trapp, 129 N.C. App. at 241, 497 S.E.2d at 711). \u201cIn other words, were the facts and circumstances known or those which should have been known to the pleader such as to cause a reasonable person to believe that the witness would qualify as an expert under Rule 702.\u201d Trapp, 129 N.C. App. at 241, 497 S.E.2d at 711 (citing Black\u2019s Law Dictionary 1265 (6th ed. 1990) (defining reasonable belief)).\nAccording to our Supreme Court, \u201c[assuming expert testimony is properly qualified and placed before the trier of fact, section 90-21.12 reserves a role for the jury in determining whether an expert is sufficiently familiar with the prevailing standard of medical care in the community.\u201d Crocker v. Roethling, 363 N.C. 140, 150, 675 S.E.2d 625, 633 (2009) (Martin, J., concurring) (citing N.C. Gen. Stat. \u00a7 90-21.12 (2007)). \u201cOur statutes and case law do not require an expert to have actually practiced in the community in which the alleged malpractice occurred, or even to have practiced in a similar community.\u201d Id. at 151, 675 S.E.2d at 633 (Martin, J., concurring) (citing N.C. Gen. Stat. \u00a7 90-21.12; N.C. Gen. Stat. \u00a7 8C-1, Rule 702(b) (2007)). \u201c[O]ur law does not prescribe any particular method by which a medical doctor must become familiar with a given community. Book or Internet research may be a perfectly acceptable method of educating oneself regarding the standard of medical care applicable in a particular community.\u201d Id. (Martin, J., concurring) (citing Coffman v. Roberson, 153 N.C. App. 618, 624-25, 571 S.E.2d 255, 259 (2002), disc. rev. denied, 356 N.C. 668, 577 S.E.2d 111 (2003)) (internal quotation marks omitted).\nIn the instant case, Dr. Gurewitsch was a licensed physician\u2014 she had received her license in 1992, five years before the incident in question; she worked in the same speciality as Dr. Crawford\u2014 both specialized in obstetrics; and in the year prior to the incident, she spent a majority of her time in either clinical practice or teaching \u2014 she spent all of her time as a medical fellow, practicing obstetrics and gynecology and teaching residents. Therefore, she satisfies the three basic elements of Rule 702(b). We agree with plaintiff that defendants\u2019 arguments concerning Dr. Gurewitsch\u2019s being supervised during the year in question and her lack of board certification at the time go to the weight of her testimony, rather than to her initial qualification.\nCNM Kelly also satisfies Rule 702(b) \u2014 she had been certified as a nurse-midwife in North Carolina in 1980 and became dual-certified as a registered nurse and nurse-midwife in Florida in 1990; she and the nurses in the case sub judice all specialized in obstetrics; and in the year prior to the incident, she spent the majority of her time actively practicing obstetrical nursing at a hospital. The fact that she had not been involved in delivering babies in North Carolina for a decade\u2014 but rather had been a preceptor for medical students and then performed deliveries in Florida- \u2014 again goes to the weight of the testimony, not the threshold qualification.\nThe major concern for both proposed experts is section 90-21.12, which requires that an expert witness apply the standard of practice from \u201cthe same or similar communities[.]\u201d N.C. Gen. Stat. \u00a7 90-21.12. Our Supreme Court\u2019s decision in Crocker, supra, provides helpful analysis as to whether the proposed experts\u2019 depositions and affidavits reveal sufficient familiarity with High Point Regional as it relates to their experiences in community hospitals. We note that all parties in the instant case argue that Crocker is inapplicable, because unlike Crocker, the current case is not a \u201cclose case.\u201d However, each party contends that these facts clearly are in his or its favor. We disagree.\nAs is true in the case sub judice, in Crocker a discrepancy appeared between the knowledge to which the expert testified in his deposition and the knowledge included in his subsequent affidavit. In Crocker, \u201cDr. Elliott\u2019s [the proposed expert\u2019s] deposition testimony tended not to support the admission of his testimony at trial.\u201d 363 N.C. at 150, 675 S.E.2d at 633 (Martin, J., concurring). He was unsure about significant information, including the level of the hospital at issue, the number of beds it had, and facts about the community in which it was situated. Id. at 150-51, 675 S.E.2d at 633 (Martin, J., concurring).\nDr. Elliott\u2019s affidavit, on the other hand, indicated that he had researched and was knowledgeable about the standard of care in Goldsboro[,] . . . [including] \u201cthe size of the population [of Goldsboro], the level of care available at the hospital, the facilities and the number of health care providers for obstetrics,\u201d and \u201cthe prevailing standard of care for handling shoulder dystocia in the same or similar community to Goldsboro.\u201d\nId. at 151, 675 S.E.2d at 633 (Martin, J., concurring) (quoting Dr. Elliott\u2019s affidavit). Similarly, both Dr. Gurewitsch and CNM Kelly shared knowledge in their affidavits with respect to the community of High Point, its population, the per capita income there, the number of beds in High Point Regional, and the number of beds in the obstetrics unit, including one operating room for Cesarian sections. They both also stated that they had practiced in community hospitals \u201cwith similar equipment and facilities as High Point Regional Hospital and in an area of similar per capita income.\u201d However, their deposition testimonies several months earlier generally had been lacking such specific information.\nEven the depositions, though, contained some evidence of similarities between the hospitals in which the experts had practiced and High Point Regional. For instance, CNM Kelly stated that her hospital was a Level 2 for at least a portion of the time she worked there during the relevant time period; she also knew that, similar to High Point Regional, the staff at her hospital had to call in an operating room team for Cesarian sections. Of particular relevance is CNM Kelly\u2019s reference to the policies and procedures of High Point Regional during her deposition. CNM Kelly specifically quoted the applicable policies of High Point Regional and explained that the nurses did not follow these policies and procedures during plaintiff\u2019s delivery. Clearly, the policies of the specific hospital at issue are relevant evidence of that hospital\u2019s local standard of care. Similarly, Dr. Gurewitsch stated her knowledge that High Point Regional was either a Level 1 or Level 2 hospital in 1997, that it had to call anesthesia from home, and that it had a separate operating room team for Cesarian sections. Although she had not reviewed any bylaws, policies, or procedures of High Point Regional, she did later review that information. Dr. Gurewitsch may have been more explicit than CNM Kelly that she applied a standard of care specific to High Point Regional and to Dr. Crawford when providing her expert opinions. The paper record, therefore, may be ambiguous \u2014 i. e. a close case \u2014 with respect to the extent of these experts\u2019 bases of knowledge.\nWhen this Court previously has interpreted Crocker, we reached a similar conclusion. The expert in Barringer, Dr. Mosca, spoke \u201cin the language of N.C. Gen. Stat. \u00a7 90-21.12\u201d in his affidavit, and yet, his deposition testimony created questions as to whether he had applied a national standard of care when evaluating the defendant\u2019s actions. 197 N.C. App. at 247, 677 S.E.2d at 472-74. Dr. Mosca\u2019s deposition testimony revealed that he was uncertain \u201cwhether Winston-Salem was indeed similar to the communities with which he was familiar.\u201d Id. at 251, 677 S.E.2d at 474. Although neither Dr. Gurewitsch nor CNM Kelly seemed unsure of the standard she applied to the actions of Dr. Crawford and the nurses of High Point Regional, defendants nonetheless question whether the proposed experts\u2019 knowledge with respect to the hospital is sufficient to make their testimonies relevant. Therefore, in accordance with both Crocker and Barringer, we reverse the trial court\u2019s grant of summary judgment and remand to the trial court to conduct a voir dire examination of the proposed experts.\nFor these reasons, we reverse the grant of summary judgment and remand to the trial court for further action consistent with this opinion.\nReversed and remanded.\nChief Judge MARTIN and Judge ERVIN concur.\n. According to Justice Newby in his dissent, \u201cJustice Martin\u2019s opinion, having the narrower directive, is the controlling opinion... and requires the trial court to conduct avoir dire examination of the proffered expert witness.\u201d Crocker, 363 N.C. at 154 n.1, 675 S.E.2d at 635 n.1 (Newby, J., dissenting) (citing Marks v. United States, 430 U.S. 188, 193, 51 L. Ed. 2d 260, 266 (1977) (\u201cWhen a fragmented [Supreme Court of the United States] decides a case and no single rationale explaining the result enjoys the assent of five Justices, \u2018the holding of the Court may be viewed as that position taken by those Members who concurred in the judgments on the narrowest grounds ....\u2019 \u201d)).",
        "type": "majority",
        "author": "JACKSON, Judge."
      }
    ],
    "attorneys": [
      "Ferguson, Stein, Chambers, Gresham & Sumter, P.A., by Adam Stein, William Simpson and James E. Ferguson, II, for plaintiff-appellant.",
      "Smith, Anderson, Blount, Dorsett, Mitchell & Jemigan, L.L.P., by Samuel G. Thompson, Robert E. Desmond and Elizabeth Horton, for Robert C. Crawford, M.D. and Carolina Womancare, PA. f/k/a Robert C. Crawford, M.D., P.A., defendants-appellees.",
      "Carruthers & Bailey, P.A., by Pamela A. Robertson, for High Point Regional Health System d/b/a High Point Regional Hospital, defendant-appellee."
    ],
    "corrections": "",
    "head_matter": "JUSTIN GRANTHAM, A minor child, by and through THE TRUST COMPANY OF STERNE, AGEE & LEACH, INC., his Guardian Ad Litem, Plaintiff v. ROBERT C. CRAWFORD, M.D., CAROLINA WOMANCARE, P.A., f/k/a ROBERT C. CRAWFORD, M.D., P.A., JOHN DOE; JOHN DOE, M.D.; HIGH POINT REGIONAL HEALTH SYSTEM, d/b/a HIGH POINT REGIONAL HOSPITAL; JOHN DOE P.C. and JOHN DOE, INC., Defendants\nNo. COA09-528\n(Filed 18 May 2010)\nMedical Malpractice\u2014 Rule 9(j) certification \u2014 reasonable expectation of qualifications\nThe trial court erred by granting summary judgment on a medical malpractice claim in favor of defendants. Plaintiff reasonably expected that two witnesses would have been qualified under N.C.G.S. \u00a7 8C-1, Rule 702, thus satisfying the pleading requirements of N.C.G.S. \u00a7 1A-1, Rule 9(J).\nAppeal by plaintiff from orders entered 31 October 2008 and 6 November 2008 by Judge John O. Craig, II in Guilford County Superior Court. Heard in the Court of Appeals 26 October 2009.\nFerguson, Stein, Chambers, Gresham & Sumter, P.A., by Adam Stein, William Simpson and James E. Ferguson, II, for plaintiff-appellant.\nSmith, Anderson, Blount, Dorsett, Mitchell & Jemigan, L.L.P., by Samuel G. Thompson, Robert E. Desmond and Elizabeth Horton, for Robert C. Crawford, M.D. and Carolina Womancare, PA. f/k/a Robert C. Crawford, M.D., P.A., defendants-appellees.\nCarruthers & Bailey, P.A., by Pamela A. Robertson, for High Point Regional Health System d/b/a High Point Regional Hospital, defendant-appellee."
  },
  "file_name": "0115-01",
  "first_page_order": 139,
  "last_page_order": 146
}
