Background
Joan Mills entered Evergreen Health and Rehabilitation Center for short-term rehabilitation after a fall at home. Her records documented impaired cognition and balance and a need for assistance with activities such as using the bathroom. On May 20, 2021, Mills fell and struck her head while attempting to use the bathroom without assistance. Although initial assessments raised no concern, her condition deteriorated later that evening, and she died shortly after being transported to a hospital.
At trial, the estate offered Indiana registered nurse Kelly Martin to testify about the applicable standard of care and Evergreen’s alleged breach. Martin had spent most of her 27-year nursing career in hospital pediatrics and had never worked in a nursing home. She acknowledged having virtually no familiarity with nursing-home practices, no knowledge of such practices in Michigan, and no familiarity with the policies and procedures of any nursing home. The trial court declined to qualify her as an expert under Michigan Rule of Evidence 702 and granted Evergreen a directed verdict because the estate lacked expert testimony establishing the standard of care.
The Court’s Holding
The Court of Appeals affirmed. It held that the trial court erred to the extent it treated Martin’s hospital experience, rather than nursing-home experience, as disqualifying by itself. For nurses, the governing common-law standard concerns the skill and care ordinarily exercised by practitioners in the same or similar localities; it does not turn solely on whether the nurse works in a hospital or nursing home.
That error did not require reversal because Martin failed to establish familiarity with the applicable local standard of care. Her general internet research and review of case materials did not show knowledge of nursing practices in Southfield, Michigan, or a comparable community, and she offered no comparison between the Indiana communities where she had worked and Southfield. Excluding her testimony therefore remained within the trial court’s discretion. Because the estate then had no qualified expert to establish the standard of care and breach, the directed verdict for Evergreen was proper.
The court also declined to consider the estate’s arguments that expert testimony was unnecessary for some alleged breaches, that a national standard should apply, and that each claim required separate analysis under Rule 702. Those arguments were waived because they either were not raised below or contradicted the estate’s position at trial.
Key Takeaways
- A nurse’s hospital-based experience does not, by itself, disqualify the nurse from giving standard-of-care testimony concerning care in a nursing home.
- An out-of-state nursing expert must demonstrate knowledge of the applicable local standard of care or familiarity with the standard in a comparable community; generalized research is insufficient.
- Once the estate’s only proposed expert was excluded, the absence of qualified expert testimony required a directed verdict because the nursing standard of care was not within ordinary lay knowledge.
Why It Matters
The decision emphasizes that Michigan medical-malpractice litigants must establish an expert’s concrete familiarity with the relevant locality or a similar community. Professional credentials and broad subject-matter research do not substitute for that foundation.
It also clarifies that courts should not draw a categorical standard-of-care distinction between hospital nurses and nursing-home nurses. The decisive question is whether the proposed expert can reliably address the care ordinarily provided in the relevant or a comparable locality.