Knee Replacement Leads to Debate of Understanding the Difference Between Fact and Law

Louisiana Woman’s
This latter part of the discussion regarding the McGlothlin v. Christus St. Patrick Hospital case is based upon the difference between issues of fact and law, and to who or whom such issues are to be determined. In this case, the issue gets blended with the difference between a lay person’s opinion and the opinion of an expert. This difference, though most commonly an issue during a jury trial, where the rules of evidence permit certain statements and opinions specific to either a lay person or an expert witness. A lay person may make statements as to observations based upon the common five senses (sight, sound, tough, taste, and smell) and may not make a statement as to one’s opinion regarding a material fact in question, that is the job of the jury. Similarly, an expert is permitted to make statements and observations based upon scientific, scholarly, or professional opinion regarding the facts, but as with lay person testimony, an expert may not make an opinion of the material fact in question, as it is the job of the jury. Thus, the job of the jury is to observe and digest the testimonies and facts presented, scrutinizing and determining whose is most credible, and thus determine, within the parameter of the law, the material fact or facts at issue.

Referencing back to the discussion in Part I regarding the medical review panel, the sole purpose of the medical review panel is to review all evidence and examinations of either party, and then “to express its expert opinion as to whether or not the evidence supports the conclusion that the defendant or defendants acted or failed to act within the appropriate standards of care.” Specifically, the doctors on the panel would determine whether, in their expert opinion as doctors in the field of medicine, and even more specifically orthopedics in this case, if the hospital, doctors, nurses, etc. failed to act according to the proper standard of care owed to patients. Here is where the blur between such an issue between fact and law arises. It appears that the doctors, in their expert opinions, are making a statement to the determination of a material issue of fact, which as discussed is reserved to the jury, however, statutorily, the medical review panel is given the purpose to determine this issue and make its opinion and give reasons, in short, according to whether the evidence supports or does not support the conclusion that the defendant(s) (hospital, etc.) failed to comply with or meet the applicable standard of care. This is very similar to the question a jury would be asked if determining whether a hospital or doctor, etc. committed medical malpractice.

The problem here, and the difference between the ability of the medical review panel to make a decision versus a jury to decide, is in what luxuries each has in examining and analyzing the facts and law to make its decision. The medical review panel, through statute, is allowed only to examine and analyze the facts to make a determination based on an expert opinion, that in its expert opinion, both as a whole and individually, the medical review panel believes that there has, or has not been, an instance or instances of a breach of the duty of care owed to a patient or patients. However, a jury may take into account the mannerisms and demeanor of witnesses, as well as the credibility of those witnesses and testimony, and weigh the facts in accordingly. This ability to utilize judgment in the credibility of witnesses and testimony is not given to the medical review panel. What happened in this case is that the medical review panel came to its unanimous opinion because it did not find the testimony of the injured party (plaintiffs) credible, and thus determined that there was no breach of duty. This, of course, is not an expert opinion then, which violates the statute regarding the medical review panel’s authority and role.

To summarize the result of the appeals in this case, the plaintiffs brought an action against the hospital and the findings of the medical review panel were admitted as evidence, which statutorily they are permitted to be, however, the judge allowed the findings into evidence through testimony and documents, but with the language that involves the credibility of the witnesses out. The Trial Court found for the Hospital (defendants). The Appeals Court however, found that the admittance of the findings of the medical review panel was improper and thus reviewed the case de novo, meaning the appeals court reviewed the case as though it was the first Court to hear the case, and found for the plaintiffs. On appeal to the Louisiana Supreme Court, the Court determined that the Appeals Court erred in vacating the judgment of the Trial Court and reinstated its finding in favor of the Hospital (defendants) stating that, although the medical review panel superseded its authority and thus its findings are not mandatorily admissible, the Appeals Court erred in finding that the admission was tainted and in its de novo review, when the Trial Court fixed this problem by not allowing the credibility information in the findings of the medical review panel into evidence.

If you or a loved one feels as though you are victim to the malpractice of doctors and other health professionals, contact the Berniard Law Firm to determine the validity of your claim.