Background
In April 2021, David Denby was admitted to McLaren Port Huron Hospital for treatment of left knee arthritis. He presented with signs of infection, was placed on IV antibiotics, and underwent an incision and drainage procedure for septic arthritis. During his hospital stay, nursing staff identified three wounds — on his left knee, coccyx, and buttocks — and a subsequent assessment documented an additional wound on the sole of his right foot. In early May 2021, Denby was transferred to Marwood Manor Nursing Home for surgical aftercare.
At Marwood, assessments throughout May showed continued deterioration of his coccyx and right heel wounds. His coccyx wound was ultimately classified as a Stage III pressure ulcer and required surgical excisional debridement on multiple occasions, with treatment extending through June 2021. Denby subsequently filed a nursing-malpractice lawsuit against both McLaren and Marwood, supported by an affidavit of merit from his sole standard-of-care expert, registered nurse Marissa Marten.
During her January 2025 deposition, Nurse Marten testified that the documented care at both facilities was consistent with the standard of care, but she suspected the records were incomplete or inaccurate because the wounds deteriorated in a manner she did not expect if proper care had been given. She acknowledged that wounds can worsen despite appropriate treatment and that Denby had refused certain interventions on multiple occasions. Plaintiff offered no causation expert or other medical expert qualified to opine on wound progression. Defendants moved for summary disposition under MCR 2.116(C)(10), and the trial court granted the motion. Denby appealed.
The Court’s Holding
The Michigan Court of Appeals affirmed the grant of summary disposition in favor of both defendants. The court agreed with the trial court that Nurse Marten’s criticisms of McLaren’s documentation practices were legally insufficient without a showing that plaintiff’s physical injuries were causally attributable to any documentation failures, consistent with the longstanding rule from Boyd v Wyandotte, 402 Mich 98 (1977), and Zdrojewski v Murphy, 254 Mich App 50 (2002).
As to the broader claim that defendants failed to actually provide the care they documented, the court held that Nurse Marten’s opinion on that point was impermissibly speculative. Although her articulation of the applicable standard of care was adequate, her conclusion that the standard was breached rested solely on the wound’s adverse progression — a bad outcome that she herself conceded can occur even when care is properly delivered. The court found that her bare invocation of “education and experience” to explain why the wound should have healed was insufficient to establish the admissibility of her breach opinion under MRE 702 and MCL 600.2955, citing Edry v Adelman, 486 Mich 634 (2010), Danhoff v Fahim, 513 Mich 427 (2024), and Elher v Misra, 499 Mich 11 (2016).
The court further noted that plaintiff failed to demonstrate that opining on wound progression and the factors affecting it fell within Nurse Marten’s established scope of expertise, and that no other qualified expert was offered to fill those gaps. Because plaintiff could not raise a triable issue on the essential element of breach, summary disposition was proper as a matter of law.
Key Takeaways
- Documentation failures alone cannot sustain a medical-malpractice claim in Michigan; a plaintiff must connect the record-keeping deficiency to an actual physical injury.
- An adverse medical outcome — such as a worsening wound — is not, by itself, sufficient evidence of a breach of the standard of care, particularly where the plaintiff’s own expert concedes that deterioration can occur despite proper treatment.
- A nursing expert’s unsupported inference that care was not provided as documented, based only on wound progression and general appeals to experience, is inadmissible speculation insufficient to survive summary disposition under MCR 2.116(C)(10).
- Plaintiffs bear the burden of demonstrating that their expert’s opinion meets the requirements of MRE 702 and MCL 600.2955, including showing the opinion falls within the expert’s established scope of expertise.
Why It Matters
This decision reinforces how demanding Michigan’s evidentiary standards are for nursing-malpractice plaintiffs at the summary-disposition stage. A registered nurse expert who can articulate the standard of care but cannot independently support a breach opinion with more than inference from a bad result — and whose qualifications to opine on wound pathophysiology are unestablished — will not be sufficient to carry a case past a (C)(10) motion. Defense counsel can use this opinion to sharpen early attacks on plaintiffs’ expert qualifications and the methodological foundation of breach opinions.
The case also underscores that patient non-compliance, documented refusals of treatment, and the inherent unpredictability of wound healing create fact patterns that courts will scrutinize closely. Plaintiffs’ counsel should ensure their standard-of-care experts are prepared to address causation and wound progression with substantive support — or retain a separate, appropriately credentialed expert to do so — before filing suit.