Appellate Court Considers Whether Urology and Nephrology Are "Related Specialties" Under Maryland Law

A Maryland court dismissed a medical malpractice case, ruling that the plaintiff did not produce a “qualified expert” as required by Maryland law. The Maryland Court of Special Appeals reversed the trial court’s ruling in Nance v. Gordon. State law requires a plaintiff, prior to filing a medical malpractice lawsuit, to produce an expert witness who will state that the defendant violated the standard of care for the defendant’s area of specialization. The expert must have qualifications in the same or similar area of specialization as the defendant. The question for the appellate court was whether the specialty of the plaintiff’s expert witness, nephrology, was sufficiently similar to the defendant’s speciality, urology.

The plaintiff, who was fifteen years old at the time, went to the emergency room of a Baltimore hospital in June 2005 to seek treatment for blood in his urine. The hospital diagnosed him with a urinary tract infection and sent him home with antibiotics. Nearly two months later, he returned to the hospital with the same complaint. A physician assistant examined him and reviewed his case with a urologist, but no medical doctor examined the plaintiff at that time. He was sent home with the same diagnosis and more antibiotics. In May 2007, he went to the hospital because he was vomiting blood and experiencing “flu-like symptoms.” He was diagnosed with late-stage kidney disease, and doctors determined that the progress of the disease had caused irreversible kidney failure.

In April 2009, the plaintiff filed a Statement of Claim with Maryland’s Health Care Alternative Dispute Resolution Office (HCADRO), a requirement prior to filing a lawsuit. He included a board-certified pediatric nephrologist’s statement, offering his opinion that the urologist and physician assistant breached the standard of care in July 2005 by “failing to include nephritis on the differential diagnosis” for the plaintiff. HCADRO approved the transfer of the claim to the circuit court, and the plaintiff filed a lawsuit in May 2009.

The defendants moved to dismiss the lawsuit, claiming that the nephrologist was not qualified under Maryland law to offer an opinion regarding the standard of care for urology. The circuit court granted the defendants’ motion in August 2010 and denied the plaintiff’s motion for reconsideration that November.

The appellate court reversed the circuit court’s order, holding that the Maryland Health Care Malpractice Claims Act does not require the plaintiff’s expert to practice in the exact same field as the defendant, but must be in a “related” field. The court examined the similarities between nephrology, which deals with the kidneys, and urology, which deals with the urinary organs. Resources like Gray’s Anatomy include the kidneys among the “urinary organs,” and the court found enough overlap between the two specialties to conclude that they are “related” within the meaning of Maryland malpractice law.

At Wais, Vogelstein, Forman & Offutt we seldom, if ever, encounter the issues raised in this case as we almost universally have an expert from a “related speciality” execute the Certificate of Qualified Expert and Report. An exception to that is oftentimes in our cases against obstetricians we will have the case certified by an expert board-certified in maternal-fetal medicine. However, obstetrics and maternal-fetal medicine (also known as perinatology) are more than “related” as they overlap with each other in many respects.

Patients who have suffered injuries due to medical negligence, hospital and surgical errors, medication errors, and other breaches of a medical professional’s duty of care to a patient have the right to compensation for their losses. The medical malpractice attorneys at Wais, Vogelstein, Forman & Offutt fight for the rights of Maryland have obtained verdicts and settlements for Maryland clients in the millions of dollars. We are committed to providing you with the best possible legal representation. We are available 24/7 and can visit you in your home or at the hospital. Please contact us online, at (410) 567-0800 in Maryland, or at (888) 952-9669 in DC to schedule a free and confidential consultation.

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