Certficate of Merit as Required Under MO Stat. 538.225

A certificate of merit must be filed within 90 days of the Petition for medical malpractice.  The circuit judge may extend that for no longer than an additional 90 days for good cause shown.  However, it is best to practice with filing the certificate of merit at the time of the Petition to avoid any problems.  Below is a sample Certificate of Merit I used in a recent case that I believe conforms to all the requirements of 2005 tort reform, the only thing I left out was the identity of the doctors and parties for confidentiality purposes, however, identification of the medical expert is now required.

CERTIFICATE OF MERIT - MISSOURI MED MALPRACTICE
Negligent Administration of Pain Injection & Res Ipsa Loquitor Claim

I, (EXPERT WITNESS DOCTOR, MD), am a medical doctor specializing in radiology and licensed to practice medicine in the State of Missouri.  I am actively practicing medicine in the State of Missouri, as a radiologist.  The opinions which I am rendering in this Certificate of Merit related to substantially the same area of medicine in which I practice.

I have reviewed the medical records and imaging studies and films regarding the cervical nerve root injection and treatment to PLAINTIFF by DEFENDANT DOCTOR, MD and other providers at DEFENDANT HOSPITAL. 

It is my opinion to a reasonable degree of medical certainty that, more likely than not, DEFENDANT DOCTOR failed to use such care as a reasonably prudent and careful health care provider would have used under similar or same circumstances, as he was negligent (he failed to use that level of skill and learning which is ordinarily used under the same or similar circumstances by members of DEFENDANT DOCTOR'S profession) in the method and manner of administration of the depo medrol injection into the area of the patient’s spine.

It is my opinion that the injection of depo medrol entered into the arterial system, and this is the cause of her damages and her immediate adverse reaction to the injection procedure.    The dosage of depo medrol was negligent as well.  There are no other reasonable explanations, other than this injection of depo medrol, for her immediate adverse reaction followed by her ongoing symptoms, neurological deficits and permanent damages.  The nerve root pain injection was a medical procedure which was under the exclusive control of  DEFENDANT DOCTOR and such immediate adverse reaction does not ordinarily occur in the absence of negligence.  Therefore it is my opinion that the injection was the cause of her damages, symptoms and injuries.  

That such failure to use reasonable care directly caused or directly contributed to cause damages and permanent injury to PLAINTIFF, including injury to her spinal cord, neurological deficits, nervous system, and infarcts. 

SIGNED:   EXPERT WITNESS DOCTOR       DATE: ____________