407 A.2d 555 (D.C. 1979).

One-Sentence Takeaway: In medical malpractice cases, the standard of care should be measured by the national standard and not the local standard of care for board-certified physicians, hospitals, medical laboratories, and other health-care providers.

Summaries: Defendant’s medical laboratory in the District of Columbia followed local custom and routinely performed a urethral smear test with the patient standing.  Plaintiff was injured when, while being tested at Defendant’s laboratory, fainted and fell.

At trial, Plaintiff’s expert testified that the national standard of care required that the patient sit or lie down during the test.  The trial court, however, instructed the jury that Defendants’ conduct was to be compared solely with the standard of care prevailing in the District of Columbia.  The jury rendered verdict in favor of Defendant.

The appellate court reversed and held that the trial court committed a reversible error in instructing the jury to follow the local standard of care and disregard the national standard of care.

The court explained that, at least as to board-certified physicians, hospitals, medical laboratories, and other health-care providers, the standard of care is to be measured by the national standard, and an instruction which compares a nationally certified medical professional’s conduct exclusively with the standard of care in the District of Columbia or a similar community is erroneous.

In its ruling, the court explained the rationale for the locality rule — to protect rural doctors who lacked access to the training and experience of urban physicians and to avoid creation of disincentives for physicians to engage in rural practice.  The court ruled, however, that the developments in medicine in recent time have obviated much of the basis for the locality rule.

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