Medical malpractice litigation in Maryland often hinges on whether a plaintiff has satisfied the statutory prefiling requirements designed to screen claims before they proceed to court. One recurring dispute involves the Certificate of Qualified Expert and whether the expert’s specialty sufficiently aligns with the care at issue. A recent decision from a Maryland court demonstrates how courts must focus on the substance of the medical conduct alleged, rather than rigidly categorizing provider specialties, when evaluating these certificates. If you or a loved one suffered harm due to substandard medical treatment in Maryland, speaking with a knowledgeable Baltimore medical malpractice attorney can help you understand how this decision may affect your potential claim.
Facts and Procedural History
Allegedly, the plaintiff was admitted to the defendant hospital after presenting with altered consciousness and remained hospitalized for approximately two weeks under the care of multiple physicians and nurses employed by or acting as agents of the defendant. During this admission, the plaintiff, who was noted to have significant mobility limitations, did not receive timely preventative measures for pressure injuries, and a specialized bed was not ordered until several days into the hospitalization.
It is alleged that the plaintiff developed a sacral pressure ulcer during the hospital stay, which later required surgical debridement and resulted in prolonged pain, functional limitations, and additional medical treatment after discharge. Medical records contained conflicting documentation regarding whether the ulcer was present upon admission or developed during hospitalization, prompting the plaintiff to assert alternative theories of negligence under both scenarios.
Reportedly, before filing suit in circuit court, the plaintiff initiated proceedings under the Maryland Health Care Malpractice Claims Act and submitted a Certificate of Qualified Expert along with a detailed report authored by a board-certified general surgeon with wound care experience. The certificate asserted that the defendant’s healthcare providers failed to properly monitor, document, prevent, and treat the pressure ulcer, allowing it to progress and cause lasting injury.
It is reported that the defendant moved to dismiss the action, arguing that the certificate was legally deficient because the expert’s surgical specialty did not satisfy the peer-to-peer requirement in relation to providers certified in internal medicine, neurology, pulmonary medicine, infectious disease, and nursing. The circuit court agreed, concluding that any overlap between general surgery and the defendant providers’ specialties was insufficient and dismissed the case. The plaintiff then appealed the dismissal.
Procedural Requirements in Maryland Medical Malpractice Cases
On appeal, the court reviewed the dismissal under a de novo standard, emphasizing that whether a Certificate of Qualified Expert satisfies statutory requirements presents a question of law. The appellate court reiterated that dismissal is appropriate only when, assuming the truth of the assertions in the certificate and report, the statutory prerequisites have not been met.
The court examined the peer-to-peer requirement of the Health Care Malpractice Claims Act, which mandates that an attesting expert share the same or a related specialty with the defendant when the defendant is board-certified. Drawing on prior precedent, the court explained that specialties are considered related when there is an overlap in treatment or procedures and when that overlapping treatment is the subject of the alleged negligence.
Applying this framework, the court rejected the circuit court’s narrow view of specialty overlap. It reasoned that the conduct at issue was not a specialized surgical procedure, but the routine examination, monitoring, documentation, and prevention of pressure ulcers in a hospitalized patient. Those tasks fall within the shared knowledge and training of general surgeons and hospital-based physicians such as internists. Because physical examination and ulcer prevention are common responsibilities across these specialties, the expert’s qualifications satisfied the peer-to-peer requirement as to at least some of the named providers.
The court further held that even if the certificate did not perfectly align with every provider specialty listed, it remained sufficient because it met the requirement as to physicians whose care formed the core of the allegations. The statute does not require a plaintiff to prove the case at the certificate stage; it only requires demonstrating a nonfrivolous claim grounded in expert opinion.
Addressing the standard of care requirement, the court concluded that the certificate and report, read together, adequately identified how the defendant’s providers departed from accepted medical practice. The expert described what should have been done to prevent or address the ulcer and contrasted that with the care actually provided. The court therefore reversed the dismissal and allowed the malpractice action to proceed.
Talk to a Dedicated Baltimore Medical Malpractice Attorney
When hospital negligence leads to preventable injuries such as pressure ulcers, early procedural challenges can determine whether a claim is ever heard on its merits. If you believe substandard medical care caused serious harm to you or a family member, it is in your best interest to talk to an attorney. The experienced Baltimore medical malpractice attorneys at Arfaa Law Group understand how Maryland’s certificate requirements operate and how to present claims that withstand dismissal. Call Arfaa Law Group at (410) 889-1850 or contact us online to schedule a consultation.