Overqualified Medical Malpractice Expert Witnesses

It is common knowledge that hiring an underqualified medical malpractice expert witness is detrimental to a case. It might come as a surprise that hiring an overqualified expert could be just as harmful. I once heard a trial lawyer say, "why would anyone want to crack a walnut with a sledgehammer?" This often applies to medical negligence cases. Attorneys sometime assume that the better qualified and more famous an expert is, the better it will be for their case. A few years ago I was a designated Emergency Medicine expert on a case in rural Texas. The defendants were an Emergency Physician and a General Practitioner. The case had to do with a missed ectopic pregnancy, its rupture, and the unfortunate death of a young woman. My opinion was that when the patient presented to the Emergency Physician her evaluation and treatment met the standard of medical practice. The Emergency Physician referred her in follow-up to her GP. The GP failed to follow serial beta HCG labs even though the patient was pregnant but had a normal sized uterus. More importantly, he also failed to obtain a repeat ultrasound and failed to refer her to the local Ob-Gyn. The plaintiff attorney knew that the General Practitioner committed gross negligence in his care of this patient but he wanted to make sure that there would be no doubt in the minds of the jurors. Consequently, he hired a professor of Ob-Gyn from Harvard University to be his standard of care expert. The defense, on the other hand, used a local Family Physician who also practiced basic Ob-Gyn. After all was said and done, the jury, feeling sympathy for their local beloved GP, were clearly swayed by the testimony of another local well-respected physician who discussed the unique nature of rural medicine. The jury, when queried later, felt that the Harvard professor was overly arrogant and pompous and did not understand the environment in which medicine is practiced in rural Texas. The jury exonerated the GP. The verdict was unanimous for the defense, despite a clear fact pattern indicating gross deviation from the standard of care. The attorney would have been better served by providing a rural based well-educated and well-qualified primary care physician who also practiced Ob-Gyn, not one of the top academics in the U.S.

Another common scenario is this one: a family physician and a cardiologist are named defendants in a case where a patient was experiencing chest pain and shortness of breath, and an acute myocardial infarction was missed. The patient was first seen by the family physician who delayed referral to a cardiologist for a long period of time. Once seen by the cardiologist it was already too late, the patient had already infarcted his anterior wall. Soon thereafter he developed end stage congestive heart failure and within half a year passed away despite aggressive medical and surgical management. Why not just obtain a cardiology expert to address both the breach of standard of care and proximate cause? The answer is that if you do, then the delay issue by the family physician will also have to be addressed by the cardiologist. The problem with this is that the relevant standard of care is different for each of those two specialties. The standards of care ascribed to a family physician are not the same as those expected from a cardiologist. There is the risk that if the plaintiff attorney has the cardiologist opine with respect to the family practitioner's care, he may be attacked by defense counsel for applying inappropriately high standards of care. This could be the death knell of the plaintiff's case.

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