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Nurse anesthetist not competent to provide expert opinion on neurosurgical treatment decisions.

March 27, 2026

San Antonio Regional Hospital v. Superior Court (Musharbash) (May 3, 2024, E082481) ___Cal.App.5th ___ [2024 WL 2720256], certified for publication May 28, 2024

Joseph Musharbash sued San Antonio Regional Hospital after his adult son (Michael) died at the hospital while being treated for a traumatic brain injury.  Musharbash alleged the hospital’s surgical delay caused Michael’s death.  He also alleged the hospital’s nursing staff negligently failed to monitor Michael, to inform his doctors of his deteriorating status, and to advocate for earlier surgery.  The hospital moved for summary judgment, based in part on the declarations of two doctors who opined that Michael had received adequate treatment.  In opposition, Musharbash submitted an expert declaration from a nurse anesthetist who opined there was a negligent delay in Michael’s medical treatment, which caused his death.  The trial court denied the hospital’s summary judgment motion, finding that the nurse’s declaration created triable issues regarding standard of care and causation.  The hospital filed a writ petition challenging the superior court’s denial of summary judgment.

The Court of Appeal granted the hospital’s petition and directed the trial court to enter a new order granting summary judgment in the hospital’s favor.  The court held that the nurse anesthetist was unqualified to provide expert testimony on the standard of care and causation issues.  The court explained that nothing in the nurse’s declaration “establishe[d] that her experience as a nurse anesthetist or trauma unit nurse gave her the specialized knowledge required to opine on the standard of care applicable to an intensive care unit neurosurgeon deciding whether a severe traumatic brain injury requires immediate surgical intervention, or whether the standard of care was breached.”  Similarly, her declaration did not show she was competent to opine on causation.  While she might have been qualified to testify whether the hospital’s nursing staff properly monitored and reported on Michael’s status, she was not competent to testify regarding whether the nurse’s alleged negligence affected the neurosurgeon’s treatment decisions.

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