The issue on appeal concerned the qualification of Ms. Cárdenas' medical expert, Philippe Girard, M.D. ("Dr. Girard"). At trial, Judge Alprin permitted Dr. Girard to testify about the national standard of care for late-term abortions, and the jury returned a verdict for the plaintiff. Afterwards, the defense moved for judgment as a matter of law, taking issue with Dr. Girard's testimony. The trial court sided with the defense, and concluded that Dr. Girard should not have testified as to the national standard of care for late-term abortions. Consequently, the trial court set aside the jury verdict and entered judgment in favor of the defense.

On appeal, Judge Ruiz from the District of Columbia Court of Appeals disagreed with the trial court, and held that Dr. Girard was qualified to testify as to the standard of care in the abortion procedure. According to the appellate court, when Judge Alprin excluded Dr. Girard's testimony, he abused his discretion. The main problem with the trial court's decision was that it muddled two standards that should have been examined separately: 1) admissibility and 2) sufficiency.

The Court of Appeals looked to Hawes v. Chua, 769 A.2d 797 (D.C. 2001), for guidance on the minimum standard for an expert witness to testify on the national standard of care, which is "admissibility." To satisfy this relatively low threshold, both Plaintiffs' and Defendants' expert witnesses must do more than merely recite the words "national standard of care." The expert's opinion must be based on something other than personal experience or speculation. Finally, the expert must present some evidence of a national standard. The Court held that Dr. Girard satisfied the admissibility requirement.

Next, Plaintiffs' expert witnesses, and only Plaintiffs' expert witnesses, must satisfy a "sufficiency" standard. This means that Plaintiffs' experts in medical malpractice cases must prove the national standard of care by a preponderance of the evidence, which is the Plaintiff's burden of proof in a civil suit. The Court again turned to Hawes for guidance, identifying several questions and principles that were important in assessing the sufficiency of an expert's testimony as to the national standard of care. First, what is the course of action that a reasonably prudent doctor would have taken under the same or similar circumstances? Second, is this course of action followed nationally? Third, can the expert refer to national publications that support his or her proposed course of action? Fourth, has he or she discussed the course of action with doctors outside the jurisdiction at seminars or conventions? Fifth, do other doctors agree with the expert's course of action? Finally, the expert's personal opinion does not constitute the national standard of care, and the expert's testimony as to the national standard of care cannot be based on mere speculation or conjecture.

Here, the Court determined that Dr. Girard's testimony as to the national standard of care was sufficient. Dr. Girard fulfilled Hawes' criteria because his testimony as to the national standard of care for late-term abortions was based on: 1) medical literature, specifically, Obstetrics & Gynecology, the official publication of the American College of Obstetricians and Gynecologists ("ACOG"); 2) textbooks; 3) attendance at grand rounds at the Medical College of Virginia, where he was a faculty-member; and, 4) attendance at international and national meetings such as the annual ACOG meeting.

Ultimately, the Court held that Dr. Girard's testimony was both admissible at trial and sufficient to permit the jury to find by a preponderance of the evidence that the course of conduct he suggested should have been used during the abortion represented the national standard of care. Therefore, the Court reversed the judgment as a matter of law for the Defendant and reinstated the jury verdict for the Plaintiff.