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Kronfol v. Johnson

Court of Appeals of Mississippi

April 30, 2019

NED O. KRONFOL, M.D. APPELLANT
v.
BARBARA S. JOHNSON APPELLEE

          DATE OF JUDGMENT: 12/21/2016

          LEFLORE COUNTY CIRCUIT COURT TRIAL JUDGE: HON. CAROL L. WHITE-RICHARD

          ATTORNEYS FOR APPELLANT: R.E. PARKER JR. CLIFFORD C. WHITNEY III PENNY B. LAWSON

          ATTORNEY FOR APPELLEE: CHYNEE ALLEN BAILEY

         EN BANC.

          CARLTON, P.J.

         ¶1. Barbara Johnson brought a medical malpractice suit against Dr. Ned Kronfol for injuries she suffered from an infected catheter in her dialysis port. After a trial on the matter, the jury found Dr. Ned Kronfol one-hundred percent responsible for Barbara Johnson's injuries and awarded Johnson a total of $271, 000 in damages.

         ¶2. Dr. Kronfol now appeals the Leflore County Circuit Court's final judgment and jury verdict. Dr. Kronfol also appeals the trial court's order denying his motion for summary judgment. Finding no error, we affirm.

         FACTS

         ¶3. In 2007, Johnson was diagnosed with kidney failure. As a result of her diagnosis, Dr. John Lucas III, a surgeon at Greenwood-Leflore Hospital (GLH) who specializes in dialysis-access surgeries, performed a surgical procedure in which he created a fistula on Johnson's right arm at her wrist. Dr. Lucas explained that a fistula is a "high-flow vein . . . close to the skin [and] connected directly to [an] artery that has a lot of flow," which allows the vein to tolerate kidney dialysis three times a week. In 2010, due to clotting issues, Dr. Lucas performed another surgical procedure, placing a fistula in Johnson's left arm at her elbow. ¶4. From 2007 through May 2013, Johnson received dialysis through a port in her right arm, and later left arm, approximately three times a week at Fresenius Clinic. Dr. Ned Kronfol, a nephrologist who treated Johnson at the Fresenius Clinic, was in charge of her dialysis and kidney care.[1]

         ¶5. On April 12, 2013, Johnson was unable to receive dialysis due to access issues with the dialysis port in her left arm. Staff members from the Fresenius Clinic referred her to GLH. Dr. Donald Russell, an interventional radiologist at GLH, attempted to perform a de-clot of Johnson's dialysis port, but he was unable to do so. Dr. Russell then placed a temporary[2] dialysis port in Johnson's internal jugular (neck) to allow her to be dialyzed. Johnson continued to receive dialysis through the temporary port in her neck.

         ¶6. On April 16, 2013, Dr. Lucas performed a surgical procedure on Johnson to try to restore flow in her fistula in her left arm. Dr. Lucas testified that he was not able to restore the flow to his satisfaction. As a result, Dr. Russell performed a fistulogram procedure that same day, where he attempted to open and stretch areas of Johnson's fistula. Dr. Lucas testified that this procedure was also unsuccessful.

         ¶7. On April 30, 2013, Dr. Lucas surgically created a new fistula for Johnson in her right arm. Dr. Lucas explained that since most fistulas require around six weeks to mature, Johnson was unable to immediately utilize that fistula.[3]

         ¶8. On May 6, 2013, after receiving dialysis at the Fresenius Clinic, Johnson presented to the emergency room (ER) at Delta Regional Medical Center complaining of severe pain and swelling in her face. Johnson was treated by Dr. Xander Buenafe, a nephrologist, who diagnosed her with sepsis with tachycardia arising from an infected hemodialysis[4] catheter in her internal jugular (neck). Johnson received treatment at the hospital and was released on May 15, 2013.

         ¶9. On August 21, 2014, Johnson filed a medical malpractice suit against Dr. Lucas and Dr. Russell, alleging negligence in their care, treatment, and usage of Johnson's hemodialysis catheter. On September 17, 2014, Johnson amended her complaint to include GLH as a defendant. On May 8, 2015, Johnson sent Dr. Kronfol a notice of intent to sue, and on July 8, 2015, she amended her complaint to add Dr. Kronfol as a defendant.[5]

         ¶10. On November 4, 2015, Dr. Kronfol filed a motion for summary judgment and argued that Johnson failed to file her medical malpractice claim within the two-year statute of limitations as prescribed by Mississippi Code Annotated section 15-1-36(2) (Rev. 2012). In his motion, Dr. Kronfol also argued that summary judgment was proper on the grounds of judicial estoppel and lack of an expert. Dr. Kronfol claimed that Johnson knew or should have known of his alleged negligence on May 6, 2013, the day Johnson was diagnosed with sepsis, because he had been her nephrologist since 2007 and had referred her to GLH, where she was seen by Dr. Lucas and Dr. Russell. Dr. Kronfol therefore argues that Johnson's May 8, 2015 notice of intent to sue and July 8, 2015 amended complaint adding Dr. Kronfol as a defendant were untimely and should be barred.

         ¶11. On January 20, 2016, the trial court entered an order denying Dr. Kronfol's motion for summary judgment. In its order, the trial court stated that "Johnson gave deposition testimony that she saw Dr. Kronfol or his nurses twice a week for dialysis." The trial court also acknowledged that when Johnson was asked if Dr. Kronfol sent her to GLH because his staff was having problems dialyzing her, she answered, "[y]es, that's it." However, the trial court opined that "reasonable minds can differ" as to whether Johnson's deposition testimony showed that she knew or should have known of Dr. Kronfol's alleged negligence in her injuries. The trial court explained that "[a] full reading of the deposition supports [Johnson's] contention that she thought that only Dr. Lucas and Dr. Russell were involved in the installation of her temporary catheter." The trial court therefore ruled that since a genuine issue of material fact existed as to when Johnson knew of Dr. Kronfol's alleged negligence, summary judgment was improper.

         ¶12. A jury trial was held on December 12, 2016. After the trial, the jury returned a verdict for Johnson and awarded her $225, 000 in noneconomic damages and $46, 000 in economic damages. The jury found that Dr. Kronfol was 100% responsible for Johnson's injuries. The trial court entered a final judgment and jury verdict on December 21, 2016. Dr. Kronfol then timely filed a motion for a judgment notwithstanding the verdict (JNOV) or, in the alternative, for a new trial, which the trial court denied. Dr. Kronfol now appeals.

         ¶13. On appeal, Dr. Kronfol asserts sixteen assignments of error, which we quote as follows:

1. Whether the trial court erred in denying summary judgment on the statute of limitations grounds.
2. Whether the trial court erred in failing to grant the Defendant's Daubert[6] challenge to Johnson's expert's reliance upon "guidelines," which were not the standard of care, were outdated and were not scientifically valid.
3. Whether the trial court abused its discretion by allowing Johnson's expert to testify about undisclosed opinions.
4. Whether the trial court erred in allowing a treating physician to offer expert opinions about a temporary catheter causing infection, when he was not designated to so testify.
5. Whether the trial court erred in preventing defense counsel from informing the jury that Johnson had alleged that Dr. Lucas and Dr. Russell were negligent and grossly negligent in the treatment of Johnson, which caused or contributed to her injuries.
6. Whether the trial court erred in excluding the testimony of Dr. Lucas regarding the length of time to leave a temporary catheter in place.
7. Whether the trial court erred in excluding deposition testimony of Dr. Russell, which deposition was noticed by counsel for Johnson.
8. Whether the trial court erred in allowing Johnson's counsel to cross examine witnesses and parties with statements made by other witnesses in their depositions.
9. Whether the trial court erred in not allowing into evidence the package insert of the temporary catheter used on Ms. Johnson.
10. Whether the trial court erred in sustaining Johnson's objection to Dr. Kronfol's response to a cross examination question regarding medical authorities and granting a curative instruction.
11. Whether the trial court erred in allowing into evidence a hospital bill as the proper predicate had not been laid for its for its introduction.
12. Whether the trial court erred in failing to grant Defendant's instruction on equally probable causes.
13. Whether the trial court erred in denying Dr. Kronfol's motion to summons a new jury panel.
14. Whether the trial court erroneously denied Dr. Kronfol's Batson[7]challenge to the all-African American jury and improperly refused to quash the jury panel.
15. Whether the trial court erred in not granting a directed verdict/JNOV for Dr. Kronfol.
16. Whether the verdict was against the overwhelming weight of the evidence, thus entitling Dr. Kronfol to a new trial.

         DISCUSSION

         I. Summary Judgment

         ¶14. Dr. Kronfol argues that since Johnson failed to bring her medical-malpractice claim within the two-year statute of limitations, the trial court erred in denying his motion for summary judgment. In his appellate brief, Dr. Kronfol asserts that he was "Johnson's treating nephrologist and saw [her] at least twice per week since 2007." Dr. Kronfol also asserts that at the very latest, Johnson possessed actual notice of her claim against Dr. Kronfol on May 6, 2013, the date that Johnson received her sepsis diagnosis. Dr. Kronfol therefore maintains that the statute of limitations on Johnson's claim against him expired on May 6, 2015, and that as a result, Johnson's May 8, 2015 notice of intent and subsequent amended complaint were not timely filed and therefore are barred.

         ¶15. As a procedural matter, the record shows that on May 8, 2015, Johnson sent Dr. Kronfol a notice of intent to sue. On July 8, 2015, Johnson amended her complaint to add Dr. Kronfol as a defendant. "The medical negligence statute does provide for a sixty-day tolling period once notice has been given." Arceo v. Tolliver, 19 So.3d 67, 73 (¶24) (Miss. 2009) (citing Mississippi Code Annotated section 15-1-36(15)).[8] The supreme court has held that "whenever a plaintiff files the statutorily required sixty days of notice, the time to file an action is effectively extended by sixty days." Scaggs v. GPCH-GP Inc., 931 So.2d 1274, 1277 (¶11) (Miss. 2006). We therefore recognize that Johnson's May 8, 2015 notice of intent to sue extended the time for her to file her complaint against Dr. Kronfol by sixty days.

         ¶16. Johnson denies that she knew she had a claim against Dr. Kronfol on May 6, 2013. Johnson claims that she assumed Dr. Lucas and Dr. Russell were responsible for the temporary catheter, as opposed to Dr. Kronfol. Johnson also maintains that she was diligent in seeking her medical records: she was discharged from the hospital on May 15, 2013 and requested her medical records on June 25, 2013. Johnson argues that after Dr. Russell placed her temporary catheter, she had no contact with Dr. Kronfol regarding the access point to her temporary catheter. Johnson alleges that when she saw Dr. Kronfol at the Fresenius Clinic, he never even looked at the catheter site.

         ¶17. "This Court has held that appeals from the denial of a motion for summary judgment are interlocutory in nature and are rendered moot by a trial on the merits." Franklin Collection Serv. Inc., v. Collins, 206 So.3d 1282, 1284 (¶8) (Miss. Ct. App. 2016) (quoting Britton v. Am. Legion Post 058, 19 So.3d 83, 85 (¶7) (Miss. Ct. App. 2008)); see also Gibson v. Wright, 870 So.2d 1250, 1254 (¶8) (Miss. Ct. App. 2004). However, in Franklin Collection Services, 206 So.3d at 1285 (¶14) (internal quotation marks omitted), we recognized that "some federal courts of appeals have recognized an exception to this rule and will review purely legal issues decided on summary judgment even after a jury trial and verdict."

         ¶18. Turning to the case before us, Mississippi Code Section 15-1-36(1) provides that an action for medical malpractice must be brought "within two (2) years from the date the alleged act, omission or neglect shall or with reasonable diligence might have been first known or discovered." Miss. Code Ann. § 15-1-36(1). The supreme court has clarified that "[a]pplication of the discovery rule [in a medical-malpractice action] is a fact-intensive process." Huss v. Gayden, 991 So.2d 162, 166 (¶6) (Miss. 2008). "Mississippi substantive jurisprudence requires questions of disputed fact to be decided by juries, such as when [a claimant] 'with reasonable diligence might have first known or discovered' the 'alleged act, omission, or neglect'" referenced in section 15-1-36. Huss v. Gayden, 991 So.2d 162, 168 (¶10) (Miss. 2008).

         ¶19. In denying Dr. Kronfol's motion for summary judgment, the trial court acknowledged that "application of the discovery rule is a fact-intensive process." The trial court determined that "reasonable minds can differ as to when . . . Johnson knew of Dr. Kronfol's alleged negligence" and held that "an issue of material fact" existed. We therefore find that the issue before the trial court on summary judgment was not "purely legal." See Franklin Collection Servs., 2016 So.3d at 1286 (¶14). The record reflects that after the trial judge determined a factual question existed, the factual issue was not submitted to the jury to determine as to when Johnson knew or should have known of the alleged negligence of Dr Kronfol.

         ¶20. After our review, we find that the trial court's "pretrial ruling on [Dr. Kronfol's] motion for summary judgment was rendered moot by the trial on the merits. It is not reviewable on appeal and therefore is not a basis for reversal." Id. at 1285 (¶10).

         II. Daubert Challenge

         ¶21. At trial, Dr. Orlando Gutierrez testified for Johnson as an expert in the field of nephrology. Dr. Kronfol argues that the trial court erred in failing to grant his Daubert challenge to Dr. Gutierrez's reliance upon "guidelines," which were not the standard of care, were outdated, and were not scientifically valid. At trial, Dr. Kronfol moved under Mississippi Rule of Evidence 702 and Daubert to strike Dr. Gutierrez's opinions relying on the National Kidney Foundation's 2006 Updates to Clinical Practice Guidelines and Recommendations ("2006 guidelines"). The trial court ultimately denied Dr. Kronfol's motion to strike, but the trial court stated that "if you have an expert or some article that states that these [guidelines] are no longer applicable or that these are no longer . . . what's used, I guess at that point it will be a question for the jury to determine whether or not what weight they want to give to it." On appeal, Dr. Kronfol argues that Dr. Gutierrez never articulated any national standard of care for nephrologists; rather, he just articulated the recommendation "best practices" contained in 2006 guidelines.

         ¶22. We review the trial court's admission or exclusion of expert testimony for an abuse of discretion. Patterson v. Tibbs, 60 So.3d 742, 748 (¶19) (Miss. 2011). "This Court should find error in the trial court's decision to exclude expert testimony only if the decision was arbitrary or clearly erroneous." Id.

         ¶23. The supreme court has stated that "[i]n addressing Daubert issues, our analysis must be guided by Rule 702, which addresses the admissibility of expert testimony." Id. at (¶20).

         Rule 702 provides as follows:

         A witness who is qualified as an expert by knowledge, skill, experience, training, or education may testify in the form of an opinion or otherwise if:

(a) the expert's scientific, technical, or other specialized knowledge will help the trier of fact to understand the evidence or to determine a fact in issue;
(b) the testimony is based on sufficient facts or data;
(c) the testimony is the product of reliable principles and methods; and
(d) the expert has reliably applied the principles and methods to the facts of the case.

         Expert witnesses must be qualified to render an opinion, and expert witnesses "should be given wide latitude when offering opinions within their expertise." Patterson, 630 So.3d at 748 (¶21). "[E]xpert testimony must be relevant and reliable." Delta Reg'l Med. Ctr. v. Taylor, 112 So.3d 11, 25 (¶41) (Miss. Ct. App. 2012).

         ¶24. In Daubert, the United States Supreme Court provided factors for the trial court to consider when determining the relevance and reliability of expert testimony:

(1) whether the expert's theory can be or has been tested; (2) whether the theory has been subjected to peer review and publication; (3) the known or potential rate of error of a technique or theory when applied; and (4) the general acceptance that the theory has garnered in the relevant expert community.

Daubert, 509 U.S. at 593-94. The Mississippi Supreme Court explained that "[t]hese factors are nonexclusive, and their application depends on the nature of the issue, the expert's expertise, and the subject of the testimony offered by the expert." Patterson, 630 So.3d at 749 (¶21) (citing Miss. Transp. Comm'n v. McLemore, 863 So.2d 31, 37 (Miss. 2003)). Furthermore, "[w]hen determining whether expert testimony is admissible, our trial judges should act as gatekeepers and must determine whether the proposed testimony meets the requirements of Rule 702 and Daubert's relevance and reliability prongs." Id. at (¶22).

         ¶25. Regarding the provision in Rule 702 that "[a] witness who is qualified as an expert by knowledge, skill, experience, training, or education may testify in the form of an opinion or otherwise if . . . the expert's scientific, technical, or other specialized knowledge will help the trier of fact to understand the evidence or to determine a fact in issue[, ]" Daubert provides as follows:

The subject of an expert's testimony must be "scientific knowledge." The adjective "scientific" implies a grounding in the methods and procedures of science. Similarly, the word "knowledge" connotes more than subjective belief or unsupported speculation. The term "applies to any body of known facts or to any body of ideas inferred from such facts or accepted as truths on good grounds."

Daubert, 509 U.S. at 589-90. Our supreme court has also provided that "[e]xpert testimony admitted at trial must be based on scientific methods and procedures, not on unsupported speculation or subjective belief." McKee v. Bowers Window & Door Co., 64 So.3d 926, 932 (¶18) (Miss. 2011).

         ¶26. In the present case, Johnson designated Dr. Gutierrez, a nephrologist, as her trial expert. In Johnson's Designation of Experts for Dr. Gutierrez, she asserted the following:

[Dr. Gutierrez] is of the opinion that there was a breach of care in connection with the care and treatment provided to Barbara Johnson relative to the temporary catheter. Specifically, there was a breach of care [by Dr. Kronfol] when the temporary catheter was allowed to remain in place for approximately twenty-five (25) days. Current vascular access guidelines provide that internal jugular catheters should be used for no more than seven (7) days. See the article entitled Clinical Practice Guidelines for Vascular Access, 2006, which has been previously produced.
Dr. Gutierrez will further opine that the sepsis suffered by Barbara Johnson, her hospitalization at Delta Regional Medical Center from May 6, 2013, through May 15, 2013, and any other subsequent treatment for the sepsis were proximately caused by Barbara Johnson's retention of the internal jugular catheter for approximately twenty-five (25) days, well beyond current vascular access guidelines.

(Emphasis added). Dr. Gutierrez opined at trial that Dr. Kronfol breached the standard of care in his treatment of Johnson. Specifically, Dr. Gutierrez stated that Dr. Kronfol breached the standard of care by allowing Johnson's temporary catheter to be in for more than one week, which led to Johnson's infection from Methicillin-resistant Staphylococcus aureus (MRSA) and later sepsis. Kronfol maintains that it was inappropriate for Dr. Gutierrez to use the 2006 guidelines to set the standard of care.

         ¶27. At trial, Johnson's attorney asserted that the 2006 guidelines relied on by Dr. Gutierrez set forth "guidance regarding what nephrologists are supposed to do in terms of managing temporary catheters." Dr. Gutierrez informed the trial court that the guidelines were produced by a work group called The Kidney Disease Outcomes Quality Initiative (KDOQI), which was put together by the National Kidney Foundation. Dr. Gutierrez stated that the specific task of the work group "is to review the literature and determine, based upon a review of the literature, what are the best practices for different aspects of nephrology care." Dr. Gutierrez further explained during voir dire that "it's really the sort of guidelines that any nephrologist refers to in terms of understanding what is the standard of care, what is the best practice of care." Dr. Gutierrez stated that the guidelines are generally updated every five to ten years.

         ¶28. Dr. Gutierrez testified that the 2006 guidelines establish that "[t]he rate of infection for internal jugular catheters suggests they should be used for no more than one week." Dr. Gutierrez explained that he relied on the 2006 guidelines in forming his opinion, and he also stated that "this is part of the training that any minimally competent nephrologist gets in terms of how long . . . a temporary catheter should stay in for a patient on dialysis. So I'm also relying on just basic experience and training." Dr. Gutierrez further testified that the primary nephrologist generally bears the responsibility for managing catheters in patients like Johnson, who are suffering from end-stage renal disease.

         ¶29. In Delta Reg'l Med. Ctr. v. Taylor, 112 So.3d 11, 18 (¶14) (Miss. Ct. App. 2012), Dr. Wiggins, an expert witness in the field of emergency medicine, agreed that "the American Stroke Association's (ASA) Guidelines for the Early Management of Patients with Ischemic Stroke: A Scientific Statement from the Stroke Council of the American Stroke Association," constituted "an authority for establishing the standard of care in stroke patients." Upon review, this Court found no abuse of discretion in the trial court's admission of Dr. Wiggins's expert testimony, "since [he] grounded [his] expert opinions and testimony upon [the defendant's] medical records, the methods and scientific principles taught in residency programs, and methods and principles instructed upon by medical texts . . . ." Id. at 28 (¶51). This Court also held that "[Dr. Wiggins's] expert opinion[] [was] supported by and consistent with medical literature, including . . . an American Stroke Association article setting forth the standards of care for stroke patients." Id.

         ¶30. Guidelines alone do not establish the standard of care. However, in the present case, Dr. Gutierrez testified that he did not base his expert opinion solely on the 2006 guidelines-he also relied on his training and experience as a nephrologist. We therefore find the trial court did not abuse its discretion in allowing Dr. Gutierrez to testify as an expert in the field of nephrology.

         III. Undisclosed Opinions

         ¶31. Dr. Kronfol argues that the trial court also erred by allowing Dr. Gutierrez to testify about undisclosed opinions. Specifically, Dr. Kronfol takes issue with Dr. Gutierrez's testimony during redirect examination that a permanent catheter could be placed in the same opening where Johnson's temporary catheter had been placed and that the procedure was a "simple procedure" without risks. Dr. Kronfol objected to the testimony, arguing that Dr. Gutierrez's opinion as to this issue was not brought up in cross-examination or contained in Johnson's designation of experts. The trial court overruled Dr. Kronfol's objection. Dr. Kronfol now claims that this testimony was "egregiously prejudicial" and that such testimony countered the testimony by Dr. Lucas that there are multiple and serious risks associated with installing a temporary catheter and installing a permanent catheter in a patient like Johnson.

         ¶32. Mississippi Rule of Civil Procedure 26 provides as follows:

[U]pon request from the opposing party, a party must provide the name of each expert witness it plans to call at trial along with the subject matter on which the expert is expected to testify, the substance of the facts and opinions to which the expert is expected to testify, and a summary of the grounds for each opinion.

Bailey Lumber & Supply Co. v. Robinson, 98 So.3d 986, 997 (¶30) (Miss. 2012) (internal quotation marks omitted) (quoting Miss. R. Civ. P. 26(b)(4)(A)(i)). The supreme court "has emphasized that it is imperative for parties to disclose more than just the general subject matter on which an expert will testify." Id. The disclosure must be sufficient to put the opposing party "on notice of the proffered testimony and [any] new theory at trial." Robinson v. Corr, 188 So.3d 560, 570 (¶30) (Miss. 2016).

         ¶33. However, Johnson argues that Dr. Kronfol opened the door to questions regarding the risks involved with temporary and permanent catheters by asking Dr. Gutierrez during cross-examination whether he heard Dr. Lucas's testimony that "the risks of placing the central line, which is a permanent catheter-of rupturing the lungs, puncturing the heart or the veins or the arteries-was more risky than the patient perhaps having an infection, which was the least risk . . . ." We recognize that "[t]he scope of redirect examination, while largely within the discretion of the trial court, is limited to matters brought out during cross-examination." McDonald v. Lemon-Mohler Ins. Agency LLC, 183 So.3d 118, 133 (¶52) (Miss. Ct. App. 2015). Upon review, this Court "will not disturb a trial court's ruling on matters pertaining to redirect examination unless there has been a clear abuse of discretion." Id.

         ¶34. During redirect examination, Johnson asked Dr. Gutierrez: "What would be the procedure or would it be possible to convert that temporary catheter to a tunneled [permanent] catheter?" Dr. Kronfol objected, arguing "[T]hat's not in his designation to discuss." During a bench conference on the matter, the trial court stated that during cross-examination, Dr. Kronfol "did talk about the dangers of putting in a permanent catheter, a tunneled catheter." The trial court ultimately overruled Dr. Kronfol's objection, and the following exchange occurred during redirect:

[Counsel]: You were asked about -- going back where we were, you were asked about dangers involved in placing a central line. Do you recall that?
[Dr. Gutierrez]: I do.
[Counsel]: Okay. Are those dangers always present when you're changing a temporary catheter to a tunneled catheter?
[Dr. Gutierrez]: No.
[Counsel]: Explain to the jury why they are not.
[Dr. Gutierrez]: When you have a temporary catheter -- well, let me back up. When you're placing a tunneled catheter for the first time or just from anew, there is certainly risks involved with the needle going into the vein and that catheter having problems getting into the vein and causing damage. When you already have a temporary catheter in the vein, you can exchange the temporary catheter for a new one.
[Dr. Gutierrez]: When you have a temporary catheter, you can exchange that catheter by putting a wire through it and put in a tunneled [(permanent)] catheter in its place, which has many fewer risks involved with it than if you had to place a tunneled catheter fresh or just new.
[Counsel]: And that would have been the procedure since Ms. Johnson already had a temporary catheter. Is that correct?
[Dr. Gutierrez]: That's correct. It's a simple procedure.

(Emphasis added).

         ¶35. After our review, we find no abuse of discretion by the trial court in allowing Dr. Gutierrez to testify as to his opinion that through a simple procedure, a permanent catheter could be placed in the same opening where Johnson's temporary catheter had been placed. Dr. Kronfol opened the door to this line of questioning during cross-examination, and the trial court was within its discretion to allow Dr. Gutierrez to testify on the matter during redirect examination.

         IV. Expert Opinion from a Treating Physician

         ¶36. Dr. Kronfol argues that the trial court erred by allowing Johnson's treating physician, Dr. Xander Buenafe, to offer an expert opinion that the temporary catheter placed in Johnson presented a "very high risk" of infection and that the catheter was the source of the MRSA infection. Dr. Kronfol asserts that the testimony by Dr. Buenafe about the risk of infection from a temporary catheter went well beyond his treatment of the patient and should have been excluded by the trial court. Dr. Kronfol maintains that Johnson's expert designation of Dr. Buenafe simply states "this treating physician is expected to testify in a manner consistent with medical records," yet Johnson's medical records make no mention of the temporary catheter placing Johnson at a high risk for infection. Dr. Kronfol further maintains that the designation does not disclose any opinion by Dr. Buenafe that the catheter caused Johnson's infection, or that Dr. Buanefe knew of the multiple shots, procedures, or frequency of dialysis that Dr. Guiterrez admitted could have precipitated the infection.

         ¶37. In Johnson's designation of experts, she lists Dr. Buenafe and provides the following description:

The physician listed below is the treating physician of [Johnson], and, as such, is not an expert who has been retained or specifically employed to provide testimony in this matter. This treating physician is expected to testify in a manner consistent with his medical records and reports, a copy of which has been previously provided to [Dr. Kronfol].

(Emphasis added).

         ¶38. The supreme court has held that "[a] physician can testify without being accepted as an expert regarding: (1) 'the facts and circumstances surrounding the care and treatment of the patient'; (2) 'what his records about the patient reveal'; and (3) 'what conditions the patient was suffering from if the opinion was acquired during the care and treatment of the patient.'" Chaupette v. State, 136 So.3d 1041, 1046 (¶8) (Miss. 2014) (quoting Griffin v. McKenney, 877 So.2d 425, 439-40 (¶50) (Miss. Ct. App. 2003)). However, the supreme court cautioned that "a physician cannot testify about the significance of a patient's condition or industry standards without first being accepted as an expert." Id. (internal citations omitted); see also M.R.E. 701 and 702. We review "[a] trial court's admission of testimony . . . for an abuse of discretion." Id. at1045 (¶7).

         ¶39. In response to Dr. Kronfol's argument, Johnson maintains that Dr. Buenafe's testimony regarding the temporary catheter and the high risk of infection was consistent with Johnson's medical records from her admission and treatment at Delta Regional Medical Center between May 6-15, 2013. On Johnson's discharge summary prepared by Dr. Buenafe and admitted into evidence, the discharge diagnoses states, among other things, "Bacteremia, MRSA, Catheter-related."

         ¶40. The disputed testimony occurred during Dr. Buenafe's direct examination:

Q: Okay. And you just testified that you took a look at the ...

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