Certificate of Merit Requirements in Malpractice Cases

The Minnesota Court of Appeals decided an interesting medical malpractice case addressing the bar plaintiffs’ malpractice lawyers must clear when presenting a certificate of merit that will survive summary judgment.


The gist of this case is that the plaintiff filed a lawsuit against a few neurologists for failing to diagnose with more exigencies her cauda equina syndrome, a neurological condition caused by compression of the nerves in the lower part of the spinal canal. Plaintiff’s argument was very simple: given the weakness of Plaintiff’s lower extremities and other symptoms, the doctors should have gotten right on the ball instead of ordering an MRI and then waiting for the results to come in the ordinary course. Because if you catch it quickly enough to decompress the nerves within hours after the onset of cauda equina syndrome, there is a chance of reversal of the compression of the nerves, particularly if you get the patient into surgery within twenty-four hours.

I don’t think anyone doubted the severity of the condition. But the neurologist did question whether Plaintiff’s certificate of merit was pled specifically enough to meet Minnesota law. The trial court found, and the appellate court agreed, that Plaintiff’s experts failed to specifically testify beyond the generic, one-size-fits-all “earlier-diagnosis-is-better” theory of treatment. Because the plaintiff’s experts lacked specificity and failed to “advance a particularized and direct causal nexus” between the alleged delay in diagnosis and the Plaintiff’s injuries, the malpractice claim did not survive summary judgment.
The take home message for medical malpractice lawyers in states where some form of certificate of merit is required is that a mere “there was negligence and injury” is not going to make it to a jury.

You can find the full opinion in Hanson v. McNiff here.