Justia Arizona Supreme Court Opinion Summaries

A patient with a history of aortic valve replacement visited an urgent care facility with symptoms including fever, headache, and chills. The urgent care doctor suspected bacterial endocarditis, a potentially fatal infection, and referred the patient to the emergency department at a hospital, providing a note and calling ahead. At the emergency department, the attending physician reviewed the note but dismissed the suspicion of endocarditis, diagnosing the patient with a viral syndrome and discharging him. The patient later saw his primary care provider, who also suspected endocarditis, but he died two days later. An autopsy confirmed death from complications of sepsis due to acute bacterial endocarditis. The patient’s family filed a wrongful death lawsuit, alleging that the hospital and emergency physician’s failure to diagnose and treat endocarditis caused his death.The Superior Court in Maricopa County granted summary judgment for the defendants, finding that the plaintiff’s expert testimony did not meet the clear and convincing evidence standard required by Arizona Revised Statutes § 12-572 for emergency department malpractice claims. The court reasoned that the experts did not state causation to a high degree of medical probability. The Arizona Court of Appeals affirmed, holding that the expert opinions were insufficient to meet the heightened standard and that summary judgment was appropriate.The Supreme Court of the State of Arizona reversed and remanded. It held that the clear and convincing evidence standard in § 12-572 is a standard of proof, not a prima facie element of the claim. The Court clarified that a plaintiff’s expert testimony that negligence “likely” caused the injury is sufficient to establish causation for purposes of surviving summary judgment. The factfinder must consider all relevant, admissible evidence—not just expert testimony—when determining whether causation has been proven by clear and convincing evidence. The Court vacated the court of appeals’ decision and remanded for further proceedings. View "HENKE v. HOSPITAL" on Justia Law

Robin Roebuck, who had previously undergone a heart transplant, was hospitalized at the Mayo Clinic in Arizona in April 2020 for COVID-19. During his stay, an arterial blood gas test was performed as part of his treatment, which led to complications requiring surgery and resulting in significant scarring and reduced function in his right arm and hand. In January 2021, Roebuck filed a medical negligence lawsuit against the Mayo Clinic and two of its medical professionals, alleging that the test was negligently performed. He did not claim gross negligence.The Superior Court of Maricopa County initially denied Mayo Clinic’s motion to dismiss, finding that Roebuck had sufficiently alleged the test was part of his heart treatment rather than COVID-19 care. After discovery, the court determined the test was related to COVID-19 treatment and granted summary judgment for Mayo Clinic, holding that Arizona Revised Statutes § 12-516 provided immunity from ordinary negligence claims during the pandemic, requiring proof of gross negligence or willful misconduct instead. The Arizona Court of Appeals reversed, concluding that § 12-516’s bar on ordinary negligence claims for pandemic-related medical care violated the Arizona Constitution’s anti-abrogation clause.The Supreme Court of the State of Arizona reviewed the case and held that § 12-516(A) unconstitutionally abrogates the right to recover damages for injuries caused by ordinary negligence by health care providers during a public health emergency. The Court found that gross negligence is not a reasonable alternative to ordinary negligence and that the statute’s limitation impermissibly abolishes a protected right of action. The Supreme Court reversed the superior court’s summary judgment and remanded for further proceedings, while vacating part of the court of appeals’ reasoning and replacing it with its own. View "ROEBUCK v MAYO CLINIC" on Justia Law

David Francisco, a retired endodontist, sought treatment from Dr. Kevin Art of Affiliated Urologists, Ltd. in 2018. Dr. Art performed a urological procedure and prescribed the antibiotic Ciproflaxin (Cipro) without discussing its use with Francisco. The FDA's black box warning for Cipro indicated serious risks, especially for elderly patients with a history of corticosteroid use, which applied to Francisco. After taking Cipro, Francisco experienced severe adverse reactions, including tendon ruptures and peripheral neuropathy.The Superior Court in Maricopa County dismissed the Franciscos' case for failing to provide a preliminary expert opinion affidavit as required by A.R.S. § 12-2603. The Franciscos argued that the FDA warning itself should establish the standard of care, negating the need for expert testimony. The Court of Appeals reversed the dismissal, holding that the FDA warning could be sufficient to establish the standard of care without expert testimony.The Arizona Supreme Court reviewed the case and held that FDA warnings cannot substitute for expert testimony to establish the standard of care in medical malpractice cases. The Court emphasized that medical judgment is required to determine the appropriate standard of care, which must be established by expert testimony. The Court also rejected the Franciscos' argument that the statutory requirements for expert testimony violated the anti-abrogation clause of the Arizona Constitution, finding that the statutes permissibly regulate medical negligence actions.The Arizona Supreme Court vacated the Court of Appeals' decision and affirmed the Superior Court's dismissal of the case. View "FRANCISCO v AFFILIATED UROLOGISTS" on Justia Law

The Supreme Court reversed the decision of the trial court granting summary judgment in favor of Corizon Healthcare Inc. in this medical malpractice action, holding that the requirements of Ariz. Rev. Stat. 12-2604 do not apply to claims against medical institutions not based on vicarious liability.David Windhurst, an inmate, was provided with health care through the Arizona Department of Corrections' contractor Corizon Healthcare Inc. David later died due the infections complications of diabetes mellitus. Plaintiff, David's widow, filed a wrongful death action against Corizon and other defendants, alleging, inter alia, institutional negligence by Corizon and vicarious liability based on the negligence of its medical personnel. The trial court granted summary judgment for Corizon on the medical negligence claim. The Supreme Court reversed, holding (1) when it is unclear which provider breached the standard of care, an expert on institutional standards of care may address an alleged breach by establishing that a class of providers failed to exercise appropriate care; (2) the trial court erroneously granted summary judgment for Corizon; and (3) a registered nurse may testify regarding gate cause of death in a medical malpractice case. View "Windhurst v. Ariz. Dep't of Corrections" on Justia Law

The Supreme Court held that an injury settlement agreement between the married couple in this case and a third party did constitute a valid and binding property settlement or postnuptial agreement, thus reversing the trial court's judgment and remanding the case for further proceedings.Husband and Wife sued the manufacturer of Husband's pacemaker, among other parties, claiming medical malpractice. The couple were awarded $2 million in compensatory damages and $5.4 million in punitive damages. Thereafter, the couple entered into a written settlement agreement with the pacemaker manufacturer requiring, for purposes of this appeal, Husband and Wife to use $5.4 million of the settlement to fund a series of annuity payments. Later, the parties separated, and the trial court entered a dissolution decree finding that the parties had agreed to the allocation of the settlement funds. Wife appealed, arguing that the punitive damages portion of the agreement was a community asset that should have been equitably divided. The court of appeals affirmed. The Supreme Court reversed the trial court's determination that the annuity payments were not community property based on the settlement, holding that the agreement was not a valid postnuptial agreement. View "Sowards v. Sowards" on Justia Law

In this medical malpractice case, the Supreme Court held that defendants do not violate the "One-Expert Rule" when offering the testimony of a treating physician on the standard of care, in addition to that of a retained or specially employed expert, when the testimony is based on the treating physician's personal observations and participation in providing treatment to the plaintiff.At issue was the One-Expert Rule set forth in Ariz. R. Civ. P. 26-(b)(4)(F)(i), which allows each side in a medical malpractice case presumptively to call only one retained or specially-employed expert to testify on the standard of care issue. The Supreme Court remanded this case for a new trial, holding (1) the trial court correctly declined to find a violation of the One-Expert Rule in this case; and (2) a treating physician dismissed on summary judgment is not an indispensable party to an appeal of the denial of a motion to name him a nonparty at fault. View "McDaniel v. Payson Healthcare Management, Inc." on Justia Law

The Supreme Court held that a jury in a medical malpractice case may not be left to "infer" causation without the guidance of expert testimony where the cause of death is disputed and not obvious to an ordinary person.Plaintiff brought a wrongful death actin against several healthcare defendants, including the Surgery Center of Peoria and Dr. Guido, after her four-year-old son died following a routine tonsillectomy and adenoidectomy. As required by Ariz. Rev. Stat. 12-2603, Plaintiff identified Dr. Greenberg as her expert witness to establish cause of death, proximate cause, and standard of care. After trial, the court granted partial summary judgment for the Surgery Center and Dr. Guido, finding that Dr. Greenberg's testimony failed to state a causal connection between the Surgery Center's actions and omissions and the child's death. The court later entered final judgment against Plaintiff. The court of appeals reversed as to the Surgery Center, concluding that the jury could properly infer proximate cause under the facts presented. The Supreme Court vacated the court of appeals' decision and affirmed the trial court's ruling, holding (1) in this case, expert testimony establishing causation was essential; and (2) the trial court did not err by granting partial summary judgment. View "Sampson v. Surgery Center of Peoria, LLC" on Justia Law

In this case involving the construction of Ariz. R. Civ. P. 4(i), the Supreme Court held that, under Rule 4(i), if a plaintiff shows good cause for failing to serve a defendant within ninety days, a court is required to extend the time for service, but also under the rule, a court in its discretion may extend the period for service without a plaintiff showing good cause.Melissa Langevin filed a complaint against Dr. Steven Sholem. More than ten months after the ninety-day deadline had expired, Langevin filed a motion pursuant to Rule 4(i) seeking to extend the time for service. The trial court determined there was good cause to grant the motion and extended the deadline. After Langevin served Sholem he moved to dismiss, arguing that the complaint did not show good cause for extending the deadline. The trial court denied the motion to dismiss. The Supreme Court affirmed, holding that there was no good cause for an extension under rule 4(i), but there were discretionary grounds in the record to deny Sholem's motion to dismiss. View "Sholem v. Honorable David Gass" on Justia Law

In this medical malpractice action, the Supreme Court held that a stipulated dismissal with prejudice of an agent-surgeon does not preclude a party from asserting a claim against the surgeon’s principal for its own independent negligence, and this is true even when the independent negligence claim requires proof of the surgeon’s negligence.Plaintiffs filed medical malpractice actions against Hospital and Surgeon alleging that Surgeon was negligent in his surgical care and that Hospital was both vicariously liable for Surgeon’s negligence and independently negligent. Plaintiffs subsequently entered into a settlement agreement with Surgeon precluding Plaintiffs from pursuing claims against Hospital based on a theory of vicarious liability, although Plaintiffs could bring independent claims against Hospital. Hospital moved to dismiss the remaining claims on the ground that they were derivative of Surgeon’s negligence. The trial court agreed and dismissed most of Plaintiffs’ remaining claims against Hospital. The Supreme Court reversed, holding (1) Plaintiffs’ claims for negligent credentialing, hiring, and supervision were based on Hospital’s independent negligence and thus were preserved in the settlement agreement with Surgeon; and (2) the holding in DeGraff v. Smith, 62 Ariz. 261 (1945), that a stipulated dismissal with prejudice operates as an adjudication that the dismissed party was not negligent in the treatment of the plaintiff, is disavowed. View "Kopp v. Physician Group of Arizona, Inc." on Justia Law

At issue in this medical malpractice action was Ariz. R. Evid. 615 and the proper remedy for technical Rule 615 violations. Rule 615 generally provides that a trial court, at a party’s request, must order witnesses excluded so that they cannot hear other witnesses’ testimony. The Supreme Court held that Rule 615, when invoked, prohibits a party from providing prospective trial witnesses with transcripts of prior witnesses’ trial testimony. The court further held (1) a violation of this prohibition is not presumptively prejudicial in a civil action, but even when no prejudice is shown, the trial court must take some corrective action by fashioning an appropriate remedy under the circumstances; and (2) although expert witnesses are not automatically exempt from the Rule, a trial court must permit a witness to hear (or read) a prior witness’s testimony if a party shows that such an exception is essential to that party’s claim or defense. View "Spring v. Bradford" on Justia Law