The “Same Specialty” Requirement: Can An Obstetrician / Gynecologist Support Malpractice Allegations against a Midwife?

Wilkins v. Connecticut Childbirth and Women’s Center, — A.3d — (Conn. 2014)

This 4:3 majority decision of the Connecticut Supreme Court examined an important aspect of the state’s “same specialty” requirement for experts supporting medical malpractice suits, Conn. Gen. Stat. Ann. § 52190a (a). Specifically, the Court looked into whether a suit for midwife malpractice can be supported by an opinion letter from a board-certified obstetrician and gynecologist, as opposed to a person trained and experienced in midwifery. The alleged midwife malpractice included failure “to diagnose and repair the fourth degree tear following delivery of the fetus and at the postpartum visits.”

The Court answered this question in the affirmative based on the purpose of the opinion letter requirement, which was to prevent frivolous medical malpractice actions. The Court also relied on the fact that a board-certified obstetrician and gynecologist and a certified nurse-midwife “practice and are certified in the same medical specialty,” and that under the statutory scheme governing nurse-midwives in Connecticut, midwifes can only work in conjunction with a certified obstetrician and gynecologist.

The dissent disagreed with that decision on the following grounds: (1) statutory language; (2) prior precedent, Bennett v. New Milford Hospital, 12 A.3d 865 (Conn. 2011), that gave a strict interpretation to the “similar health care provider” requirement; and (3) the fact that nurse-midwifery is an “entirely separate profession” despite its obvious relationship with the practice of obstetrics.