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Thursday, September 19, 2019

Advance Registered Nurse Practitioners can offer expert testimony in Wash. med-mal cases

By Laura Halleman | May 2, 2017

OLYMPIA, Wash. (Legal Newsline) – The Washington Supreme Court has ruled that medical malpractice litigants can offer the expert testimony of advanced registered nurse practitioners.

On April 27, the court ruled for Rudy Frausto, a 70-year-old quadriplegic man who allegedly developed pressure ulcers after entering a medical center and offered an ARNP for expert testimony during his lawsuit against the facility.

Frausto entered the Yakima HMA LLC for pneumonia. He alleges that the nurses there did not give him the right care and he developed pressure ulcers due to lack of moving and turning him. He then filed a lawsuit.

Frausto provided an affidavit of Karen Wilkinson, an ARNP with more than 30 years’ experience.

Wilkinson said it was more probable than not that the treating nurses breached the applicable standard of care, causing the pressure ulcers. 

Yakima HMA argued that Wilkinson’s affidavit was not expert testimony.

The trial court found that Wilkinson was a qualified expert in her field, but under state law she could not comment on what caused Frausto’s injuries.

Yakima HMA argued that most states do not allow nurses to chime in on medial causation in medical malpractices lawsuits. However, eight states permit it and only seven forbid it. In Washington, ARNPs can hold independent practices and make medical diagnoses. 

The Supreme Court's Rules of Evidence state, “If scientific, technical, or other specialized knowledge will assist the trier of fact to understand the evidence or to determine a fact in issue, a witness qualified as an expert by knowledge, skill, experience, training, or education, may testify thereto in the form of an opinion or otherwise.”

The conclusion of the Supreme Court is to reverse the trial court’s decision that nurses cannot speak on proximate cause in a medical malpractice case. Rather, in line with the state’s rules, ARNPs shall be permitted to “independently diagnose some conditions within the scope of their certification.”

Determining whether an ARNP is knowledgeable enough and has the scope of practice to qualify as an expert will be determined by the trial court.

Wilkinson’s affidavit will be admissible in this case.

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