Medical malpractice; Proximate cause; MCL 600.2912a(2); Expert causation testimony; Benigni v Alsawah; Kalaj v Khan; Level 1 trauma center; Certified anesthesiology assistant (CAA); Standard of care; Cox v Flint Bd of Hosp Managers; Nonlocal expert’s familiarity with local standard; Decker v Rochowiak; Motion to strike expert

The court held that plaintiff failed to establish a genuine issue of material fact as to proximate causation on the level 1 trauma-center theory, and that the trial court did not abuse its discretion by striking plaintiff’s CAA expert. Plaintiff’s decedent, Elizabeth, suffered cardiac complications during elective eye surgery and died about a month later. The trial court denied the Othman defendants’ motion for summary disposition as to plaintiff’s claim that defendant-cardiologist should have recommended the surgery be performed at a level 1 trauma center, but it struck plaintiff’s CAA expert and granted defendant-Hathaway summary disposition. On appeal, the court first held that plaintiff’s causation proof on the level 1 trauma-center theory was insufficient. Although plaintiff’s cardiology expert initially testified that a larger facility would have provided more resources, he later admitted the outcome “might have been better” and that he could not say so to “a reasonable degree of medical certainty.” The court reasoned that malpractice causation requires proof amounting to “‘a reasonable likelihood of probability rather than a possibility,’” and the expert’s testimony did not meet that standard. The court next held that the trial court properly declined to reconsider its ruling striking plaintiff’s CAA expert. Although the expert testified that the CAA standard of care was national, he admitted he had not researched Southfield, defendant-outpatient surgery center, or the available resources at the outpatient facility. Thus, he failed to show “familiarity with the standard of care in an area similar to the community” where Hathaway practiced. Reversed in Docket No. 370206, affirmed in Docket No. 370778, and remanded.