The Court of Special Appeals of Maryland (“Maryland Appellate Court”) held in its unreported opinion dated October 25, 2019 that “a licensed nurse practitioner, even one who is a Certified Clinical Transplant Coordinator, is not “in the same or related specialty” as a board-certified transplant surgeon.”
The Maryland medical malpractice lawsuit alleged that the plaintiff suffered from end-stage renal disease and received a kidney transplant performed by a surgeon board-certified by the American Board of Surgery, who specializes in kidney transplant surgery. The plaintiff alleged that the surgeon deviated from the standard of care by transplanting an unsuitable kidney into her.
As a precondition to suing a board-certified health care provider for medical malpractice in Maryland, a plaintiff must file a certificate from a health care provider “in the same or related specialty as the defendant,” which alleges “that the care given by the health care provider is not in accordance with the standards of practice among members of the same health care profession with similar training and experience situated in the same or similar communities at the time of the alleged act giving rise to the cause of action.” MD. Code, Courts and Judicial Proceedings Article (“CJ”) § 3-2A-02(c)(1); (c)(2)(ii)(1).
In support of her Maryland medical malpractice complaint, the plaintiff filed two documents: (1) a “Certificate of Qualified Expert” prepared by Karen Paolini; and (2) a “Report of Karen Paolini, M.S., ANP-BC, CCTC” [a licensed nurse practitioner and Certified Clinical Transplant Coordinator]. The Circuit Court for Baltimore City found that neither of these documents satisfied the requirements of CJ § 3-2A-02(c) and granted summary judgment for the defendants. The plaintiff then appealed.
Maryland Health Care Malpractice Claims Act
The Maryland Appellate Court discussed the Maryland Health Care Malpractice Claims Act (“Act”) requirement regarding a certificate from a health care provider in the “same or related specialty” as the defendant: “In any action for damages filed under this subtitle, the health care provider is not liable for the payment of damages unless it is established that the care given by the health care provider is not in accordance with the standards of practice among members of the same health care profession with similar training and experience situated in the same or similar communities at the time of the alleged act giving rise to the cause of action.”
The Maryland Appellate Court stated, “The governing law stresses that when determining if one practitioner is qualified under the Act to opine as to the standard of care applicable to another practitioner, we should not focus on the titles of health care practitioners or the names of their fields of practice. Instead, we look to the substance of what the health care practitioners’ respective areas of concern is to discern whether there is sufficient “overlap” to permit the proposed certifying health professional to opine about the applicable standard of care.”
The Maryland Appellate Court held: “While we do not wish to diminish in any way the important and lifesaving work that transplant coordinators perform, it is neither the same, nor comparable to the work of a surgeon. Transplant coordinators act pursuant to instructions given by surgeons. Surgeons, not the transplant coordinators, determine, who is eligible for a transplant, what organs are acceptable, and what treatments are necessary based on the standard of care. Transplant coordinators may be aware of the guidelines that surgeons follow during transplant procedures, but coordinators do not decide what those guidelines are or when it is appropriate to depart from them. There is no “overlap,” and therefore, because Nurse Paolini does not practice in the same or related specialty, her certificate does not satisfy the statutory requirement.”
Source Chaplin v. University of Maryland Medical System Corporation, No. 317 September Term, 2018.
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