111 Ill. 2d 229, 489 N.E.2d 867, 95 Ill. Dec. 305 (1986)
Carol L. Purtill instituted this medical malpractice action against George Elfers, M.D., J. H. Hess, M.D., and Gibson Community Hospital for damages from alleged negligence in the care, diagnosis, and treatment during and following the birth of her child.1
The circuit court of Champaign County granted summary judgment in favor of Elfers and Gibson Community Hospital on statute of limitations grounds and in favor of Hess for failure to affirmatively demonstrate the ability to offer competent expert testimony.2 The appellate court affirmed in an unpublished Rule 23 order.3 The Supreme Court granted leave to appeal.4 This appeal concerns only defendant Hess.5
On July 3, 1979, plaintiff gave birth to a child at Gibson Community Hospital in Gibson City, where Dr. Elfers performed a midline episiotomy during delivery that allegedly lacerated the tissue between the rectum and vagina.6 Dr. Hess examined plaintiff on July 9, August 9, and August 19 of 1979, noting in his records that the episiotomy scar seemed to be healing satisfactorily.7
Beginning approximately four months after delivery, plaintiff experienced passing of fecal matter and flatulence from her vaginal opening.8 Plaintiff consulted Dr. Hess multiple times between October 1979 and February 1981 for vaginal irritation and discharge, which he treated as a yeast infection.9 On February 12, 1981, after plaintiff reported the fecal symptoms, Dr. Hess diagnosed a rectovaginal fistula.10 Dr. Hess referred her to Dr. Lewis Trupin.11 Plaintiff underwent repair surgery in July 1981.12
On February 14, 1983, plaintiff filed her complaint.13 Dr. Hess supported his September 8, 1983, motion for summary judgment with his own affidavit describing his examinations and treatment and stating that his care conformed to the standard of care in Rantoul.14 Plaintiff opposed the motion with a counteraffidavit from Dr. William D. Matviuw stating he was familiar with the minimal standards of acceptable medical care, diagnosis, and treatment for Carol L. Purtill’s condition of ill-being as it existed and that those minimal standards were uniform throughout the United States wherever patients similar to Carol L. Purtill were examined, cared for and treated for the condition of ill-being similar to that suffered by Carol L. Purtill.1516
The circuit court struck Dr. Matviuw’s counteraffidavit for failing to show familiarity with the standard in Rantoul or similar communities.17 The circuit court denied reconsideration.18 The circuit court granted summary judgment to Dr. Hess.19 The appellate court affirmed.20
Whether Dr. Matviuw’s counteraffidavit affirmatively demonstrated the plaintiff’s ability to offer competent expert testimony concerning the standard of care required of Dr. Hess?21
An expert medical witness seeking to express an opinion in an affidavit as to the proper standards of diagnosis, care, and treatment must lay a foundation which affirmatively establishes his qualifications and competency to testify by showing that he is familiar with the methods, procedures, and treatments ordinarily observed by other physicians in either the defendant physician’s community or a similar community.22 When the standards to which he proposes to testify are minimum standards applicable wherever medicine is practiced, the lack of familiarity with the practice in a particular locality will not disqualify the expert.23
Yes. Dr. Matviuw’s counteraffidavit stated that he was familiar with the minimal standards of acceptable medical care, diagnosis, and treatment for Carol L. Purtill’s condition of ill-being as it existed. Those minimal standards were uniform throughout the United States wherever patients similar to Carol L. Purtill were examined, cared for and treated for the condition of ill-being similar to that suffered by Carol L. Purtill.
After indicating that he had reviewed plaintiff’s medical records pertaining to the diagnosis, care, and treatment plaintiff received from Dr. Hess between 1979 and 1981, the affidavit offered Dr. Matviuw’s expert opinion to a reasonable degree of medical certainty that such diagnosis, care, and treatment were not in accordance with these uniform minimum standards and that this deviation from the accepted standard of care resulted in injury to the plaintiff.24 The affidavit set forth specific instances in which Dr. Matviuw contended that Dr. Hess was negligent in the diagnosis and treatment of Carol Purtill, including failure to refer the plaintiff to a properly qualified gynecological specialist, failure to take proper diagnostic steps, and failure to diagnose the presence of rectovaginal fistulae.25
Construing Dr. Matviuw’s counteraffidavit strictly against Dr. Hess and liberally in favor of the plaintiff, the affidavit is sufficient to withstand Dr. Hess’ motion for summary judgment.26 When Dr. Matviuw stated in his affidavit that he was familiar with the minimum standards of medical practice in relation to the diagnosis and treatment of rectovaginal fistulae and that those minimum standards were uniform throughout the country, localities similar to Rantoul were included within his scope of knowledge.27
Dr. Matviuw’s counteraffidavit affirmatively demonstrated the plaintiff’s ability to offer competent expert testimony concerning the standard of care required of Dr. Hess.28
Whether the similar locality rule bars an expert from testifying to uniform minimum standards of care applicable throughout the country?29
The similar locality rule requires a physician to possess and to apply that degree of knowledge, skill, and care which a reasonably well-qualified physician in the same or similar community would bring to a similar case under similar circumstances.30 An expert may testify concerning uniform minimum standards for certain types of procedures or treatment without demonstrating a familiarity with the standard of practice in the transaction community or a similar community.31
No. The court refuses to abolish the similar locality rule because the availability of medical facilities for examination and treatment, the presence or absence of specialists and other medical personnel for consultation and assistance, and numerous other variables that may be present or absent in different localities dictate the method in which a physician’s education and skills may be applied.32
Nevertheless, the court is persuaded by the reasoning of reviewing courts in other jurisdictions that have allowed expert medical testimony concerning uniform minimum standards for certain types of procedures or treatment.33 When Dr. Matviuw stated in his affidavit that he was familiar with the minimum standards of medical practice in relation to the diagnosis and treatment of rectovaginal fistulae and that those minimum standards were uniform throughout the country, the similar locality rule does not bar his testimony.34
The similar locality rule does not bar an expert from testifying to uniform minimum standards of care applicable throughout the country.35