This decision handed down today (June 5, 2013) by the Arkansas Court of Appeals affirmed a trial court’s order granting summary judgment in a malpractice case.  The plaintiff developed an infection at an epidural site.  She alleged the infection would not have occurred but for negligence in prepping and sterilizing the site.  There was also a claim that there was no informed consent for a student to administer the epidural.   The defense submitted affidavits in support of summary judgment.  The plaintiff submitted counter-affidavits from experts (an anesthesiologist, a CRNA, and a registered nurse).  The trial court ruled in favor of the defense, holding that the plaintiff’s expert affidavits did not satisfy the “locality rule” or meet their burden on proximate cause:

The circuit court granted the appellees’ motion for summary judgment, finding that the Quattlebaums’ experts’ affidavits failed to properly establish the standard of care required of the appellees. Specifically, regarding the failure-to-sterilize claim, the circuit court found that the “conclusory statements of familiarity” with local standards did not satisfy the locality rule found in Arkansas Code Annotated section 16-114-106(b). Moreover, the court found that the affidavits did not provide evidence of a breach of the requisite standard of care. Finally, the court determined that the Quattlebaums’ experts did not provide evidence of proximate cause, and the Quattlebaums had not proven the elements necessary to apply the doctrine of res ipsa loquitur. As to the claim of lack of informed consent, the circuit court again found that the affidavits did not satisfy the locality rule; in addition, the court concluded that there was no evidence of proximate cause of any damages resulting from the performance of the procedures by the student nurse-anesthetist rather than by the anesthesiologist.

The plaintiff filed a motion to reconsider, arguing that the defense expert affidavits were conclusory, contained no admissible evidence, no facts about the plaintiff’s treatment, no mention of their familiarity with the standard of care in Little Rock, and were not stated to a reasonable degree of medical certainty.   (But see Muccio v. Hunt, 2012 Ark. 416 on use of the “motion for reconsideration”).  On appeal, the Court refused to address those arguments, holding:

These arguments, however, were made for the first time in the Quattlebaums’ motion
for reconsideration. It is well settled that our appellate courts will not consider an argument
made for the first time in a posttrial motion. See Lee v. Daniel, 350 Ark. 466, 91 S.W.3d 464
(2002); Wal-Mart Stores, Inc. v. Lee, 348 Ark. 707, 74 S.W.3d 634 (2002); Rose v. Rose, 2013
Ark. App. 256, ___ S.W.3d ___. An issue must be presented to the trial court at the earliest
opportunity in order to preserve it for appeal. Plymate v. Martinelli, 2013 Ark. 194 (refusing
to address an argument concerning the constitutionality of section 16-114-206 where it was
not raised until the plaintiff’s motion for new trial or for reconsideration). Stated another
way, a party may not wait until the outcome of a case to bring an error to the trial court’s
attention. LaFont v. Mooney Mixon, 2010 Ark. 450, 374 S.W.3d 668. The Quattlebaums did
not raise the specific arguments they make on appeal until their motion for reconsideration.
They were not timely raised and are not preserved for our review on appeal, and we
therefore affirm.

The case is Quattlebaum v. McCarver, et al., 2013 Ark. App. 376.  Here is the link: