Arizona Court of Appeals Determines Specially Trained Registered Nurses are Qualified as Causation Expert Witnesses
On April 24, 2018, the Arizona Court of Appeals ruled that causation experts in medical malpractice cases do not need to be medical doctors. In Rasor v. Northwest Hospital LLC dba Northwest Medical Center, the court held that the strict statutory standards that apply to standard of care experts do not apply to causation experts. This is a significant development in medical malpractice and vulnerable adult abuse cases.
Until Rasor, causation exclusively depended on physician expert testimony. Now, however, the realm of causation experts has been expanded to include specially trained registered nurses. This decision will almost certainly cause nurse practitioners and physicians’ assistants to be added to the list of professionals who may be qualified as expert witnesses. Because pressure ulcer litigation is a large part of vulnerable adult abuse litigation, wound care nurse experts will play an increasingly important role.
In Rasor, the patient, after undergoing open-heart surgery, spent several days in the intensive care unit and eventually developed a stage IV pressure ulcer on her coccyx. The plaintiff’s sole expert to address standard of care, causation, and prognosis was a wound care nurse. The trial court did not allow the nurse to testify on causation.
The Court of Appeals reversed, finding that a certified wound care nurse had sufficient expertise to meet the standards of Arizona Rules of Evidence 702 and to testify on causation issues related to a pressure ulcer. The court rejected the argument that nurses cannot make medical diagnoses, noting that Arizona law permits nurses to “diagnose and treat human responses to actual or potential health problems.” A.R.S §32-1601(23)(d)
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