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No.

13212

I N THE SUPREME COURT O THE STATE O M N A A F F OTN 1976

R O B I N B A n O R and SARAH J. BAYLOR, Husband and Wife,

P l a i n t i f f s and A p p e l l a n t s ,

DR. DAVID P, JACOBSON,

Defendant and Respondent.

Appeal from:

D i s t r i c t Court o f t h e F o u r t h J u d i c i a l D i s t r i c t , Hon. E. Gardner Brownlee, Judge p r e s i d i n g .

Counsel o f Record: For Appellants : Moore and Lyrnpus, K a l i s p e l l , Montana James D. Moore a r g u e d , K a l i s p e l l , Montana F o r Respondent : G a r l i n g t o n , Lohn and Robinson, M i s s o u l a , Montana L a r r y E, R i l e y a r g u e d , M i s s o u l a , Montana

Submitted:

May 27, 1976

F i l e d : ,BtjE45.3 j p t j

Mr.

J u s t i c e Frank I. H a s w e l l d e l i v e r e d t h e Opinion of t h e C o u r t . The d i s t r i c t c o u r t o f Missoula County g r a n t e d summary

judgment t o d e f e n d a n t d o c t o r i n a m e d i c a l m a l p r a c t i c e a c t i o n . P l a i n t i f f s appeal. P l a i n t i f f s a r e Robin Baylor and S a r a h J. B a y l o r , husband and w i f e , o f M i s s o u l a , Montana. On December 13, 1970

S a r a h Baylor s l i p p e d on t h e driveway a t h e r home w h i l e g e t t i n g o u t o f h e r c a r and f r a c t u r e d h e r l e g . She w a s t a k e n by ambu-

l a n c e t o S t . P a t r i c k ' s H o s p i t a l where h e r i n j u r i e s w e r e d i a g n o s e d a s a s p i r a l f r a c t u r e o f t h e t i b i a and a comminuted f r a c t u r e o f t h e f i b u l a of her r i g h t l e g . Defendant, D r . David 0 . J a c o b s o n , a m e d i c a l s p e c i a l i s t i n o r t h o p e d i c s u r g e r y , performed a c l o s e d r e d u c t i o n and p l a c e d the leg in a cast. S a r a h Baylor w a s c o n f i n e d t o t h e h o s p i t a l Following

f o r f o u r d a y s and w a s s e e n d a i l y by D r . Jacobson.

h e r r e l e a s e from t h e h o s p i t a l , s h e was s e e n by D r . Jacobson a t h i s o f f i c e on f i v e o c c a s i o n s : December 24, 1970, J a n u a r y 21,
Her

1971, F e b r u a r y 1 8 , 1971, March 1 7 , 1971, and May 2 1 , 1971. c a s t was c o m p l e t e l y removed on March 1 7 , 1971.

When D r . Jacob-

son l a s t s a w S a r a h Baylor on May 21, he made t h e f o l l o w i n g notation i n h i s records: " S t i l l with pain about t h e t i b i a . No g r o s s movement w i t h m a n i p u l a t i o n b u t new x - r a y s show a r e m a r k a b l e p a u c i t y of c a l l u s f o r m a t i o n cons i d e r i n g t h e f i v e months t h a t have e l a p s e d I would have a n t i c i p a t e d since her f r a c t u r e . f u r t h e r c a l l u s f o r m a t i o n o r some a t t e m p t a t h e a l i n g which h a s n o t o c c u r r e d . W i l l r e e v a l u a t e i n one month and g e t new f i l m s and a t t h a t t i m e p e r h a p s m a n i p u l a t e under f l u o r o s c o p e t o d e t e r mine any m o t i o n . " According t o t h e d e p o s i t i o n o f S a r a h B a y l o r , D r . Jacob-

son t o l d h e r a t t h i s t i m e t h a t h e r l e g w a s c o m p l e t e l y h e a l e d ; t h a t f u r t h e r t r e a t m e n t w a s u n n e c e s s a r y ; t o q u i t babying h e r s e l f and i g n o r e t h e p a i n ; t h a t s h e might even jump up and down on

h e r l e g ; and d i d n o t a d v i s e h e r t h a t t h e bone i n h e r l e g w a s slow i n h e a l i n g ; t h a t t h e r e was some q u e s t i o n a b o u t nonunion; o r anything along t h a t l i n e . S a r a h B a y l o r was s c h e d u l e d t o see D r . i n a month b u t s h e n e v e r r e t u r n e d . Jacobson a g a i n

According t o h e r d e p o s i t i o n

and t h a t o f h e r husband s h e d i d n o t r e t u r n b e c a u s e s h e d i d n o t f e e l D r . J a c o b s o n c o u l d d o a n y t h i n g f u r t h e r f o r h e r and t h a t a l l h e would d o was send h e r t o p h y s i c a l t h e r a p y . Instead she

e x e r c i s e d t h e l e g by w a l k i n g back and f o r t h a c r o s s t h e f l o o r a t home w i t h t h e h e l p o f h e r husband. I n any e v e n t , S a r a h B a y l o r e v e n t u a l l y c o n s u l t e d D r . C l i n t o n C r a i g , a n o r t h o p e d i c s u r g e o n i n M i s s o u l a , who t o o k X-rays and t o l d h e r t h a t h e r l e g had n e v e r h e a l e d and a d v i s e d h e r t o have s u r g e r y .
A month o r two l a t e r s h e c o n s u l t e d D r .

Paul

Melvin, a n o r t h o p e d i c s u r g e o n i n G r e a t F a l l s who X-rayed h e r l e g , t o l d h e r t h e r e was a nonunion and t h a t s h e needed s u r g e r y . She n e x t went t o D r . W i l l i a m J. McDonald, a M i s s o u l a o r t h o p e d i c surgeon t o g e t another opinion.
H e X-rayed

her leg, t o l d her

s h e needed s u r g e r y , and r e f e r r e d h e r t o D r . C a r l o Z . B i s c a r o , a Missoula o r t h o p e d i c surgeon. tions a r e uncertain.
Dr.

The d a t e s o f t h e s e c o n s u l t a -

B i s c a r o performed a bone g r a f t i n March, 1973

at

t h e Community H o s p i t a l i n M i s s o u l a .
Dr.

I n t h e l a t e summer o f 1973.

B i s c a r o a d v i s e d t h a t t h e f r a c t u r e had n o t h e a l e d and t h a t I n November, 1973
Dr.

f u r t h e r surgery w a s necessary.

Biscaro

performed a bone g r a f t , and i n s e c t e d a m e t a l s c r e w and a Rush rod. By August, 1974 when S a r a h B a y l o r ' s d e p o s i t i o n w a s t a k e n ,

t h e h e a l i n g o f t h e l e g l o o k e d good a l t h o u g h s h e was s t i l l s c h e d u l e d f o r p e r i o d i c v i s i t s t o D r . B i s c a r o and h i s a s s o c i a t e . The B a y l o r s f i l e d s u i t a g a i n s t D r . J a c o b s o n o n A p r i l
2,

1974

a l l e g i n g m e d i c a l m a l p r a c t i c e and s e e k i n g damages o f

$184,000.

Defendant f i l e d a n answer which was s u b s t a n t i a l l y T h i s was s u b s e q u e n t l y amended Inter-

a g e n e r a l d e n i a l on J u l y 11.

t o i n c l u d e t h e d e f e n s e of c o n t r i b u t o r y n e g l i g e n c e .

r o g a t o r i e s and answers w e r e f i l e d , d e p o s i t i o n s w e r e t a k e n , s u p p l e m e n t a l answers were f i l e d , and a p r e t r i a l c o n f e r e n c e was h e l d . When p l a i n t i f f s f a i l e d t o p r o v i d e t h e name o f t h e i r e x p e r t w i t n e s s and answer d e f e n d a n t ' s i n t e r r o g a t o r i e s concerni n g t h i s e x p e r t by A p r i l 11, 1975 a s agreed, t h e d i s t r i c t

c o u r t g r a n t e d d e f e n d a n t ' s motion and d i s m i s s e d t h e e n t i r e litigation. T h i s was s u b s e q u e n t l y v a c a t e d and t h e c o u r t t o name t h e i r e x p e r t

g r a n t e d p l a i n t i f f s u n t i l August 1, 1975

and answer d e f e n d a n t ' s p r e v i o u s i n t e r r o g a t o r i e s c o n c e r n i n g him. On J u l y 29, 1975 p l a i n t i f f s s t a t e d t h e y had a n e x p e r t and answered f u r t h e r a s f o l l o w s : "Dr. B i s c a r o ' s d e p o s i t i o n w i l l be t a k e n on J u l y 31, 1975. H e may be t h e o n l y e x p e r t . I f h i s testimony does n o t r e l a t e t h e negligence t o p l a i n t i f f ' s c o n d i t i o n , a n e x p e r t w i l l be r e t a i n e d and t h e background i n f o r mation s o u g h t h e r e i n immediately f u r n i s h e d . " The o t h e r i n t e r r o g a t o r i e s were answered "Not a p p l i c a b l e " . Defendant moved f o r summary judgment.
It was briefed

by b o t h d e f e n d a n t and p l a i n t i f f s , and o r a l l y a r g u e d .

O Sepn

tember 30,1975 t h e d i s t r i c t c o u r t g r a n t e d d e f e n d a n t a summary judgment. full: " L a r r y E . R i l e y , Esq., c o u n s e l f o r t h e Defendant i n t h i s a c t i o n , D r . David P. J a c o b s o n , h a s f i l e d a Motion For Summary Judgment and h a s based h i s motion upon t h e documents i n t h e c o u r t f i l e , i n c l u d i n g d e p o s i t i o n s and Answers t o I n t e r r o g a t o r i e s . " T h i s a c t i o n i s a m a l p r a c t i c e a c t i o n . The f a c t s show t h a t t h e P l a i n t i f f , S a r a h J. B a y l o r , s u s t a i n e d a f r a c t u r e of t h e r i g h t l e g . She was t r e a t e d by t h e Defendant, and a f t e r a b o u t f i v e and one-half months r e f u s e d t o r e t u r n f o r a n appointment w i t h D r . Jacobson. The c o n d i t i o n o f P l a i n t i f f ' s l e g The o r d e r g r a n t i n g summary judgment i s s e t f o r t h i n

was such t h a t s u r g i c a l t r e a t m e n t w a s r e q u i r e d a b o u t t w e n t y - s i x months a f t e r t h e a c c i d e n t . "The P l a i n t i f f s d e s i g n a t e d C a r l o Z . B i s c a r o , M . D . , a s t h e e x p e r t m e d i c a l w i t n e s s t o be c a l l e d on b e h a l f of t h e P l a i n t i f f s a t t i m e o f t r i a l . D r . B i s c a r o ' s d e p o s i t i o n was t a k e n and h e r e p e a t e d l y s t a t e d t h a t i n h i s opinion t h e r e w a s proper c a r e and t r e a t m e n t of S a r a h J . Baylor by D r . J a c o b s o n . "The C o u r t f i n d s t h a t S a r a h J . B a y l o r ' s r e f u s a l t o continue medical treatment i s a proximate c a u s e o f h e r s u b s e q u e n t problems w i t h h e r l e g . "The C o u r t f u r t h e r f i n d s t h a t t h e P l a i n t i f f s ' e x p e r t m e d i c a l w i t n e s s h a s n o t t e s t i f i e d t o any c o n d u c t on t h e p a r t of D r . David P . Jacobson which c a n be termed m e d i c a l m a l p r a c t i c e . Therefore, " I T I S HEREBY ORDERED t h a t t h e D e f e n d a n t ' s Motion For Summary Judgment be g r a n t e d w i t h o u t c o s t s t o any p a r t y . " On October 1 p l a i n t i f f s f i l e d amended answers t o def e n d a n t ' s i n t e r r o g a t o r i e s , i d e n t i f y i n g a N e w York d o c t o r ,
Dr.

R o b e r t Tuby, a s t h e i r e x p e r t w i t n e s s and answering t h e P l a i n t i f f s ! answer t o i n t e r r o g a t o r y

other interrogatories.
No.

1 2 s e t s f o r t h t h e s u b s t a n c e of D r . Tuby's t e s t i m o n y : "Dr. Tuby w i l l t e s t i f y t h a t it was a d e v i a t i o n from a c c e p t a b l e m e d i c a l p r a c t i c e t o remove t h e c a s t a t t h e t i m e it was removed and t o p r e s c r i b e e x e r c i s e t h e r a p y when t h e r e w a s p r a c t i c a l l y no c a l l u s formation about t h e f r a c t u r e site. H e w i l l f u r t h e r s t a t e t h a t it was a d e v i a t i o n from acceptable medical p r a c t i c e t o t e l l t h e p a t i e n t t h a t t h e i n j u r y was h e a l e d when i t w a s n o t h e a l e d a s shown by t h e X-ray f i l m s . D r . Tuby w i l l s t a t e t h a t t h e e x e r c i s e t h e r a p y and removal of t h e c a s t c a u s e d t h e l a c k o f u n i o n , s u b s e q u e n t development o f a bone n e c r o s i s , t h e s u b s e q u e n t s u r g i c a l proc e d u r e s , and t h e r e s u l t which h a s [been] o b t a i n e d . " P l a i n t i f f s f i l e d t h e i r n o t i c e o f a p p e a l from t h e summary

judgment a g a i n s t them on October 1 0 , 1975. The u l t i m a t e i s s u e on a p p e a l i s whether summary judgment f o r d e f e n d a n t was p r o p e r l y g r a n t e d . lying issues.
(1) Is t h e r e s u f f i c i e n t e x p e r t t e s t i m o n y t o r a i s e a

T h i s t u r n s on two under-

g e n u i n e i s s u e of m a l p r a c t i c e ? ( 2 ) Is t h e r e a g e n u i n e i s s u e of m a t e r i a l f a c t concern-

i n g c o n t r i b u t o r y n e g l i g e n c e on t h e p a r t o f S a r a h B a y l o r ?
A s background f o r o u r a n a l y s i s o f t h e i s s u e s , w e n o t e

s e v e r a l b a s i c r u l e s of l a w a p p l i c a b l e t o medical m a l p r a c t i c e actions. The g i s t of a m a l p r a c t i c e a c t i o n i s n e g l i g e n c e on t h e Negaard v . Feda, 152 Mont. 47, 446 P.2d The mere f a c t of i n j u r y o r t h e

p a r t of defendant.

436, and c a s e s c i t e d t h e r e i n .

o c c u r r e n c e of a bad r e s u l t , s t a n d i n g a l o n e , i s no proof o f negligence i n t h e ordinary malpractice action. 58 Mont. 645, 194 P . 488, 1 2 A.L.R. 1487. Loudon v . S c o t t ,

The law d o e s n o t re-

q u i r e t h a t f o r e v e r y i n j u r y t h e r e must be a r e c o v e r y o f damages, b u t o n l y imposes l i a b i l i t y f o r a b r e a c h of l e g a l d u t y by a doctor proximately causing i n j u r y t o t h e p a t i e n t . Scott, supra. The l e g a l d u t y imposed on a d o c t o r h a s been d e s c r i b e d
by t h i s C o u r t i n t h e f o l l o w i n g l a n g u a g e :

Loudon v .

" * * * The l a w r e q u i r e s a p h y s i c i a n o r s u r g e o n t o p o s s e s s t h e s k i l l and l e a r n i n g which i s poss e s s e d by t h e a v e r a g e member o f t h e m e d i c a l prof e s s i o n i n good s t a n d i n g , and t o a p p l y s u c h s k i l l and l e a r n i n g w i t h o r d i n a r y and r e a s o n a b l e c a r e . He i s n o t a n i n s u r e r , n o r i s a good r e s u l t i m p l i e d l y guaranteed. H i s o b l i g a t i o n i s merely t o e x e r c i s e s u c h r e a s o n a b l e c a r e and s k i l l i n t h e t r e a t m e n t o f t h e p a t i e n t a s i s u s u a l l y e x e r c i s e d by p h y s i c i a n s o r s u r g e o n s o f good s t a n d i n g , of t h e same s c h o o l o f p r a c t i c e i n t h e community i n which he r e s i d e s , w i t h due r e g a r d t o t h e c o n d i t i o n t o t h e p a t i e n t and t h e p r o g r e s s o f m e d i c a l o r s u r g i c a l s c i e n c e a t t h e t i m e . * * * " Dunn v . Beck, 80 Mont. 4 1 4 , 4 2 1 ; 260 P. 1047.
The l e g a l d u t y o r s t a n d a r d o f care imposed upon a m e d i c a l s p e c i a l i s t , such a s t h e o r t h o p e d i c s u r g e o n i n t h i s case, i s s e t f o r t h i n t h e f o l l o w i n g p a s s a g e i n 2 1 ALR3d 953:

" * * * t h e general proposition t h a t a physician o r surgeon who h o l d s h i m s e l f o u t a s having s p e c i a l knowledge and s k i l l i n t h e t r e a t m e n t of some p a r t i c u l a r o r g a n o r d i s e a s e must e x e r c i s e , i n h i s t r e a t m e n t o f one who employs him a s a s p e c i a l i s t , t h a t d e g r e e o f s k i l l and care o r d i n a r i l y p o s s e s s e d and used by s i m i l a r s p e c i a l i s t s , and t h a t h i s d u t y t o h i s p a t i e n t i s a c c o r d i n g l y measured by a h i g h e r standard of s k i l l than t h a t of a general p r a c t i t i o n e r . "

O r d i n a r i l y t h e s t a n d a r d of c a r e t o which a m e d i c a l p r a c t i t i o n e r i s h e l d and t h e b r e a c h t h e r e o f must be e s t a b l i s h e d by e x p e r t m e d i c a l t e s t i m o n y . C o l l i n s v. I t o h , 160 Mont. 461,

503 P.2d 36, 8 1 ALR2d 597, and c a s e s c i t e d t h e r e i n . With t h e s e p r i n c i p l e s i n mind, w e proceed t o c o n s i d e r a t i o n of whether summary judgment f o r d e f e n d a n t w a s p r o p e r l y granted. ment when: Rule 5 6 ( c ) , M.R.Civ.P., a u t h o r i z e s a summary judg-

" * * * t h e pleadings, d e p o s i t i o n s , answers t o i n t e r r o g a t o r i e s , and a d m i s s i o n s on f i l e * * * show t h a t t h e r e i s no g e n u i n e i s s u e a s t o any material f a c t and t h a t t h e moving p a r t y i s e n t i t l e d t o a judgment a s a m a t t e r o f law."
I t i s n o t a s u b s t i t u t e f o r a t r i a l o f d i s p u t e d i s s u e s of f a c t .

Dunjo Land Co. v. Hested S t o r e s , 163 Mont. 87, 515 P.2d 961; Dean v. F i r s t N a t i o n a l Bank, 152 Mont. 474, 452 P.2d 402.
A

p a r t y s e e k i n g a summary judgment h a s t h e burden of e s t a b l i s h i n g t h e a b s e n c e o f any g e n u i n e i s s u e of m a t e r i a l f a c t . Meech

v. Cure, 165 Mont. 49, 525 P.2d 546; B e i e r l e v . T a y l o r , 164 Mont. 436, 524 P.2d 783, and c a s e s c i t e d t h e r e i n . Is t h e r e a g e n u i n e i s s u e o f m a t e r i a l f a c t c o n c e r n i n g malpractice i n t h e i n s t a n t case?
O r s t a t e d a n o t h e r way, i s

t h e r e e x p e r t medical testimony t h a t e s t a b l i s h e s a genuine i s s u e o f m a t e r i a l f a c t c o n c e r n i n g t h e r e q u i r e d s t a n d a r d of c a r e and
Dr.

Jacobson's deviation therefrom? The d i s t r i c t c o u r t h e l d t h e r e w a s n o t . The d i s t r i c t

c o u r t s t a t e d i n i t s o r d e r g r a n t i n g summary judgment t h a t D r . Biscaro, p l a i n t i f f s ! designated expert medical witness, repeatedl y s t a t e d t h a t i n h i s opinion

" * * * t h e r e was p r o p e r c a r e

and t r e a t m e n t of S a r a h J. Baylor by D r . J a c o b s o n " , and t h a t
Dr.

Biscaro

" *

* *

h a s n o t t e s t i f i e d t o any c o n d u c t on t h e

p a r t o f D r . David P. Jacobson which c a n be termed m e d i c a l malpractice.

"

A t t h e o u t s e t we o b s e r v e t h a t p l a i n t i f f s '

intended

t o c a l l D r . Biscaro t o e s t a b l i s h proximate cause, n o t m a l practice. P l a i n t i f f s ' answers t o d e f e n d a n t ' s i n t e r r o g a t o r i e s ,

f i l e d J u l y 29, 1 9 7 5 , p r o v i d e i n p e r t i n e n t p a r t : "INTERROGATORY NO.

1

"Have you r e t a i n e d , o r d o you i n t e n d t o c a l l , an expert witness, o r expert witnesses, t o t e s t i f y on b e h a l f of t h e P l a i n t i f f s a t t h e t i m e o f t h e t r i a l i n t h e above-captioned c a s e ? "ANSWER:
Yes.

"INTERROGATORY NO.

2:

"If so, a s t o t h a t expert, please s t a t e :

" ( a ) H i s name;
" ( b ) H i s age; " ( c ) H i s r e s i d e n t i a l address;

" (d) H i s business address.
"ANSWER: "Dr. B i s c a r o ' s d e p o s i t i o n w i l l b e t a k e n on J u l y If his 31, 1975. H e may be t h e o n l y e x p e r t . testimony does n o t r e l a t e t h e negligence t o p l a i n t i f f ' s c o n d i t i o n , a n e x p e r t w i l l be r e t a i n e d and t h e background i n f o r m a t i o n s o u g h t h e r e i n immediately f u r n i s h e d . " ( ~ m ~ h a s added. ) isP r i o r t o t h e t i m e D r . B i s c a r o ' s d e p o s i t i o n had been t a k e n , s p e c i f i c a l l y on October 4 , 1974, t h e d e p o s i t i o n o f t h e d e f e n d a n t D r . Jacobson had been t a k e n . mony and t h e m e d i c a l r e c o r d s a t t a c h e d a s I n o u r view h i s t e s t i deposition exhibits

were s u f f i c i e n t t o r a i s e t h e i s s u e o f m e d i c a l m a l p r a c t i c e . The c r u x o f h i s t e s t i m o n y i s c o n t a i n e d i n h i s answer t o a hypothetical question. The assumed f a c t s i n t h e hypo-

t h e t i c a l q u e s t i o n r e p r e s e n t e d t h e f a c t s of t h e c a s e from p l a i n t i f f s ' v i e w p o i n t and D r . Jacobson w a s a s k e d whether it would be a c c e p t a b l e m e d i c a l p r a c t i c e t o a d v i s e t h e p a t i e n t t o q u i t babying t h e l e g and jump up and down on i t . The d o c t o r , a f t e r

c o n s i d e r a b l e r e p a r t e e w i t h d e f e n s e c o u n s e l o v e r whether h e w a s t a l k i n g a b o u t S a r a h Baylor o r n o t , i n d i c a t e d t h a t under t h e

assumed f a c t s it would n o t have been a d v i s a b l e t o have t h e p a t i e n t walk on t h e l e g . T h i s , i n o u r view, i s s u f f i c i e n t

t o e s t a b l i s h a n i s s u e on m e d i c a l m a l p r a c t i c e p r e c l u d i n g summary judgment.
I t i s n o t t h e f u n c t i o n o f summary judg-

ment t o d e c i d e t h a t i s s u e b u t s i m p l y t o e s t a b l i s h w h e t h e r a n i s s u e e x i s t s t h a t r e q u i r e s d e t e r m i n a t i o n and r e s o l u t i o n a t trial. Dean v . F i r s t N a t i o n a l Bank, s u p r a ; M a t t e u c c i ' s Super 158 Mont. 311, 491 P.2d 705.

Save v. Hustad C o r p . ,

W e n o t e i n p a s s i n g t h a t s u b s e q u e n t t o summary judgment

p l a i n t i f f s f i l e d amended a n s w e r s t o i n t e r r o g a t o r i e s i n d i c a t i n g t h a t t h e y i n t e n d e d t o c a l l D r . Tuby t o e s t a b l i s h m a l p r a c t i c e and p r o x i m a t e c a u s e . This was not before t h e d i s t r i c t court nor w a s any a t t e m p t

a t t h e t i m e i t r u l e d on summary judgment,

made t o b r i n g t h i s m a t t e r b e f o r e t h e c o u r t f o r c o n s i d e r a t i o n o r adjudication. The d i s t r i c t c o u r t c a n n o t b e h e l d i n e r r o r on

t h e b a s i s o f documents n o t b e f o r e it a t t h e t i m e it made i t s ruling. The d i s t r i c t c o u r t g r a n t e d summary judgment o n t h e add i t i o n a l ground t h a t it found t h a t

" * *

*

Sarah J. B a y l o r ' s

r e f u s a l t o continue medical treatment i s a proximate cause of h e r s u b s e q u e n t problems w i t h h e r l e g . "

Here a g a i n t h e d i s t r i c t

c o u r t h a s made a f a c t u a l d e t e r m i n a t i o n o f t h e c a u s e o f h e r i n j u r i e s i n g r a n t i n g summary judgment.
It ignores her deposi-

t i o n t e s t i m o n y and t h a t o f h e r husband t h a t s h e c o n t i n u e d t o p u t w e i g h t upon h e r l e g and p r a c t i c e d w a l k i n g on it a s a d v i s e d by t h e d o c t o r .
It eliminates her testimony t h a t she d i d n o t

know t h e r e was a nonunion a t t h e s i t e o f t h e f r a c t u r e and t h a t
Dr.

J a c o b s o n d i d n o t t e l l h e r t h e r e w a s a nonunion.

I t rejects

t h e r e a s o n s and j u s t i f i c a t i o n t h a t S a r a h B a y l o r and h e r husband gave f o r d i s c o n t i n u i n g c o n s u l t a t i o n s w i t h D r . J a c o b s o n . These

c o n s i d e r a t i o n s e s t a b l i s h a n i s s u e on p r o x i m a t e c a u s e t h a t p r e c l u d e s

summary judgment. W p a s s no judgment on t h e m e r i t s of t h i s c a s e . e The u l t i m a t e d e t e r m i n a t i o n o f t h e i s s u e s h e r e must be decided a t t r i a l .
W e simply hold t h a t t h e r e a r e genuine i s s u e s

of m a t e r i a l f a c t t h a t p r e c l u d e summary judgment i n advance

of t r i a l . The summary judgment of t h e d i s t r i c t c o u r t i s r e v e r s e d . The c a u s e i s remanded t o t h e d i s t r i c t c o u r t o f M i s s o u l a County f o r f u r t h e r proceedings.

Justice

---;-----LL-;-J----------------

Hon. Bernard Thomas, D i s t r i c t Judge, s i t t i n g i n p l a c e of M r . Chief J u s t i c e James T. H a r r i s o n .

M r . Justice Wesley Castles dissenting:

I respectfully dissent. In my view the determinative question is whether plaintiffs presented sufficient expert testimony to establish an issue of malpractice. In Collins v. Itoh, 160 Mont. 461, 470, 503 P.2d 36, this Court said:

" * * * The well-recognized rule, subject to certain exceptions, is that there must be expert testimony to establish negligence in a malpractice action."
Here, plaintiffs rely on defendant's deposition to supply the required expert testimony. They constructed a hypothetical

question which they maintain is representative of their viewpoint of the facts of this case. Plaintiffs then asked defend-

ant if it would be acceptable medical practice to advise the patient in the hypothetical question to jump up and down on her leg. Defendant said no. Plaintiffs find a contradiction be-

tween this response and the defendant's alleged treatment of plaintiff Sarah Baylor. Upon this premise they contend the

issue of malpractice is raised and summary judgment is precluded. I disagree. The deposition shows the defendant em-

phatically and persistently refused to accept the hypothetical as an accurate statement of this case. It is clear defendant

perceived significant differences between the facts of this case and the assumed facts in the hypothetical. He did not

intend his response to apply to the medical history of plaintiff
Sarah Baylor and he explicitly said so.

There is no other

expert testimony as to the required standard of care or its breach by defendant. There comes a time when the district court must be allowed to enter summary judgment. was filed April 2, 1974. The complaint in this action

The summary judgment which is the

s u b j e c t of t h i s a p p e a l w a s e n t e r e d September 3 0 , 1975.

At

t h a t t i m e p l a i n t i f f s had s t i l l n o t p r e s e n t e d a n e x p e r t w i t n e s s t o t h e d i s t r i c t c o u r t who would t e s t i f y t h a t d e f e n d a n t was n e g l i g e n t i n h i s treatment of p l a i n t i f f Sarah Baylor. I n t h e a b s e n c e of such e x p e r t t e s t i m o n y I would a f f i r m t h e judgment o f t h e d i s t r i c t c o u r t .

Justice

Mr.

J u s t i c e John Conway H a r r i s o n d i s s e n t i n g :
I concur i n t h e f o r e g o i n g d i s s e n t . o f M r .

Justice
V

Wesley C a s t l e s .



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