Estate of Jacobs by Jacobs v. Princeton Med. Ctr., No. A-5092-18, 2021 WL 4824081 (N.J. Super. Ct. App. Div. Oct. 18, 2021)

Need for competent physician testimony to establish proximate cause in nursing malpractice matters.

The plaintiff argued that her decedent developed pressure sores to her sacrum and heels at the defendant hospital, which worsened there, and later at nursing facilities, causing her pain and suffering and contributing to her death the following year at age 90. 

In support of her case, the plaintiff served an expert report from B. Darlington, RN, who opined that nurses at the defendant hospital and subsequent nursing home facilities deviated from accepted standards of nursing care in failing to plan and implement interventions for the prevention and treatment of pressure sores. 

The plaintiff also offered the testimony of A. Karp, M.D., a Board Certified Internist and Geriatrician, to opine as to the injuries caused or exacerbated by the defendants. However, at his deposition, Dr. Karp conceded that he was never provided with a copy of Nurse Darlington’s report or deposition testimony and was not even aware of what she claimed were the deviations from the standard of care. 

The trial court ultimately granted summary judgment, holding that Dr. Karp was unable as a matter of law to establish causation since he did not even read Nurse Darlington’s report or deposition testimony and as a physician cannot opine as to the standard of care of a nurse. 

The Appellate Division affirmed, reiterating that Dr. Karp did not have knowledge of Nurse Darlington’s allegations of deviations and, therefore, could not possibly link any specific deviation to the decedent’s injury or death. Additionally, the Appellate Division found no factual support in the record which would allow Dr. Karp to opine that the pressure wound either caused the decedent pain or contributed to her death. 

This decision highlights the importance of understanding the qualification requirements for the issuance of standard of care and causation opinions amongst different licensed professionals. 


Case Law Alerts, 1st Quarter, January 2022 is prepared by Marshall Dennehey Warner Coleman & Goggin to provide information on recent developments of interest to our readers. This publication is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. Copyright © 2022 Marshall Dennehey Warner Coleman & Goggin, all rights reserved. This article may not be reprinted without the express written permission of our firm.