Sitts v. United States

After X-rays and a myelogram, doctors at the Veterans Administration Hospital diagnosed Kenneth Sitts (plaintiff) with a bulging or herniated disk between the last lumbar vertebra, L5, and the first sacral vertebra, S1. The physicians advised a laminectomy to remove the bulging material from the L5-S1 interspace. However, postoperation X-rays and a second myelogram disclosed that Dr. Wayne Eckhart, the orthopedic resident who performed the laminectomy, removed material between the first two sacral vertebrae, S1 and S2, and not between L5 and S1. Sitts sued the United States for medical malpractice under the Federal Tort Claims Act. The United States (defendant) conceded that the operation was performed at the wrong level of the spine. Eckhart testified that he followed the procedure normally used by members of his profession to locate the site of the prescribed laminectomy. The normal procedure involved making incisions to expose the spine, then grasping the vertebrae and using pistoning motions to find the sacrum, where ordinarily no further movement is possible; from that place, the surgeon counts vertebrae until he reaches the desired level. Other orthopedic surgeons also testified that Eckhart followed the normal procedure. The district court granted the United States’ motion for summary judgment because Sitts did not introduce expert medical testimony on the issues of negligence and causation. Sitts appealed, arguing that expert testimony was not required, because the questions to be decided were within the ordinary experience and knowledge of laypersons.