Keister v. Neurology Consultants of Huntsville, P.C., and Kar, SC-2024-0718, ___ So. 3d ___ (Ala. Feb. 6, 2026) The Court (per curiam; Stewart, C.J., and Shaw, Bryan, Mendheim, and McCool, JJ., concur; no dissents) affirms in part, reverses in part, and remands, reversing a summary judgment on medical causation and reiterating that (1) supplemental affidavits may be used to clarify an expert’s opinions if timely submitted before the summary-judgment hearing; (2) expert testimony must be construed as a whole, not by isolating a single unfavorable answer; and (3) in delayed-diagnosis cases, proximate cause turns on whether timely diagnosis and treatment would probably have placed the patient in a “better position” or “better condition.” Ms. *29–31, 33–37, 45–46.
The defendants moved for summary judgment solely on causation, relying on an expert’s statement that although delayed diagnosis and treatment “can” worsen outcomes, he did not “know specifically” whether the delay worsened the patient’s condition. Ms. *18, 35–36.
The Court first holds that the trial court properly struck a post-judgment “clarification” affidavit as untimely under Rule 59(e), Ala. R. Civ. P., because it could have been submitted before the summary-judgment ruling through due diligence. Ms. *29–31. However, the Court reiterates that clarification affidavits are permissible if timely filed before the summary-judgment ruling. Ms. *29–30.
On the merits, the Court reverses, emphasizing that expert testimony must be evaluated in its entirety. Ms. *36–37. When viewed as a whole, the expert testified that earlier diagnosis and treatment would have resulted in a better outcome, identified specific symptoms that worsened during the delay, and relied on medical literature supporting improved outcomes with earlier treatment. Ms. *37–40.
Applying the “better-position” principle, the Court reiterates that a plaintiff need not prove certainty of a different outcome only that timely care probably would have placed the patient in a better condition. Ms. *33–34, 44–45. Viewing the evidence in the light most favorable to the nonmovant, the Court holds that a jury question exists on causation