Court of Appeals Rules Medical Malpractice Suit Required to Allege Cause of Action for Improper Ambulation of Diabetic Patient Recovering from Knee Surgery As Within Realm of Professionalized Knowledge and Training

The Michigan Court of Appeals has ruled a plaintiff must pursue a cause of action sounding in medical malpractice against a hospital where plaintiff broke her leg when hospital staff were removing her to ambulate as part of her recovery from knee surgery.

In Lukas v. William Beaumont Hospital (1), Plaintiff filed a lawsuit against the hospital for damages alleging ordinary negligence against the hospital staff.  The hospital moved for summary disposition arguing plaintiff was instead to go through the notice and pre-suit procedures required to bring a claim sounding in medical malpractice because ambulation of a post-operative diabetic patient for rehabilitation from knee surgery requires specialized training and knowledge.  The trial court disagreed and allowed plaintiff’s suit to continue.

In this three-page, unpublished opinion, the Court of Appeals reversed.  The Court noted a claim sounds in medical malpractice if an alleged breach occurred within a “professional relationship” and if “the claim raises questions of judgment beyond the realm of common knowledge and experience.”  Slip Op. at 1, citing Bryant v. Oakpointe Villa Nursing Ctr., Inc., 471 Mich. 411, 422 (2004).  The Court stated the only question present in the case was whether the alleged conduct on the part of the hospital staff called for “expert medical judgment” which was “beyond the realm of common knowledge and experience.”

The Court reasoned that while at first glance it may appear to the lay person that it takes no special skill or knowledge to assist a person out of bed, it does take special expertise to appreciate that a diabetic, immediately post-operative patient of plaintiff’s age and weight could be injured if not properly supported while being assisted to her feet.

As the Court puts it:  “We very much doubt that it is within the realm of common knowledge and experience how to assist the ambulation of someone whose entire knee has just been surgically replaced.  The evidence was that plaintiff had a pain pump and immobilizer, and professional knowledge was required to assist the ambulation of a patient, such as plaintiff, in a way that would avoid aggravating her injury. The evidence further indicated that prior to ambulating or transferring a patient such as plaintiff, the patient must undergo a neurovascular assessment, and her pain, heart rate, and mobility must be checked. A registered nurse and a physical therapist both explained that ambulating a patient such as plaintiff required specialized medical knowledge, training, and judgment, including being able to recognize cues and utilize proper techniques that nurses are
expected to possess. Ordinary laypersons, however, would not be expected to possess such expertise.”  Slip Op. at 2.

Essentially, the Court reasoned that because the way in which one should assist a patient such as plaintiff is not within common knowledge or experience, it was not possible for a jury, unassisted my medical expertise, to truly evaluate whether defendant’s employees should have acted differently, let alone what it is they should have done. Consequently, “the reasonableness of the action can be evaluated by a jury only after having been presented the standards of care pertaining to the medical issue before the jury explained by experts.”  Thus, the case presented fundamentally as a claim involving a medical misjudgment. This was therefore a medical malpractice action.

As such, the Court concluded, plaintiff’s claim was one sounding in medical malpractice.  She was required, therefore, to provide a notice of an intent to sue before filing her complaint, and she was required to file an affidavit of merit with her complaint.  Id., citing Lockwood v. Mobile Med. Response Inc., 293 Mich. App. 17, 27-28 (2011).  The plaintiff’s lawsuit was dismissed because the filing of a complaint without the procedural prerequisites does not toll the statute of limitations.  Liggons v. Crittenton Hosp., 490 Mich. 61, 73 (2011).  The untolled two-year statute of limitations period for a medical malpractice action expired before defendant had filed its second motion for summary disposition.

Therefore, plaintiff’s lawsuit was no longer viable.

This case provides helpful guidance to medical service providers and practitioners in assessing the  parameters of medical malpractice actions and what types of treatment and care fall within the realm of those specialized medical services that are not within the realm of common knowledge and experience such that plaintiff’s are expected to clear the higher burdens placed upon them to proceed in a suit alleging medical malpractice.

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