Maryland Appeals Court Hears Malpractice Case Where Medical Expert May Not Be Qualified

Plaintiff Ronald Cecil brought a medical malpractice case in the Wicomico County Circuit Court on behalf of his wife Elsie Cecil. The defendants were Mark Treuth, M.D. & Delmarva Heart, LLC. The defendants were alleged to have demonstrated a failure to detect and treat Mrs. Cecil for mesenteric ischemia after she had undergone a significant heart procedure. In accordance with Maryland law, the plaintiff submitted a Certificate of Qualified Expert that had been completed by Carl W. Adams, M.D.

Dr. Adams believed that the defendant failed to adhere to the current standards of care when treating Mrs. Cecil. The defense challenged this assertion by filing a motion for dismissal because Dr. Adams was not board certified in the same medical specialty that Dr. Treuth is. They stated that the dismissal is appropriate based on the provisions of the Maryland Courts & Judicial Proceedings. The court dismissed the case.

Case Background

Mrs. Cecil was evaluated by cardiologist Dr. Mark Treuth after she complained of nausea, vomiting, and other symptoms. Dr. Treuth discontinued her usage of three medications and scheduled her for a follow-up visit in two weeks. In the subsequent weeks, Mrs. Cecil was hospitalized for congestive heart failure and underwent another procedure at Johns Hopkins Hospital. She died shortly after from problems related to sepsis.

Mesenteric Ischemia

• The condition occurs when the arteries become narrow or blocked and obstruct flow to the small intestine
• When this occurs suddenly, it is considered to be acute mesenteric ischemia and requires immediate medical attention
• Chronic mesenteric ischemia occurs when the condition develops more slowly
• Typically, those suffering from the condition will experience significant abdominal pain and feelings of needing to have a bowel movement
• Other symptoms include nausea, fever, and vomiting

Expert Qualifications

The ruling was next heard by an appeals court. They sought to determine if state statute would allow for a cardiothoracic surgeon to determine whether Dr. Treuth, a cardiologist, had met the standards of medical care. The court ultimately determined that Dr. Adams was not qualified based on the statutory requirements. This medical malpractice case progressed to an appellate court without ever reaching a point where medical negligence in the care provided was discussed.

Defense Argument

The defense insisted that the state’s “related specialty” provision did not extend based on Dr. Adams’ qualifications. The defense outlined the differences between the two medical specialties. The appeals court found that the plaintiff did not present appropriate evidence that showed a considerable “overlap” between the two areas of medical practice.

Maryland Expert Requirements

According to Maryland’s rules, the expert is to have relevant clinical experience that is sufficient to evaluate the defendant’s care. This may be from recent experience in consulting, in providing education, or actual providing care in a related field. The expert must have performed these duties within a prior five-year period. Lawmakers were clear that they would prefer that the expert be certified in the same specialty; however, they enacted the “related specialty” provision for instances where someone in the same specialty could not be