Two-Step Gatekeeping for “Claimed Board-Certified” Specialties and Alleged Care-at-Issue Under A.R.S. § 12-2604

1. Introduction

AROJOJOYE v. ALLEN is an Arizona Supreme Court decision addressing recurring disputes in medical-malpractice litigation: when a defendant physician claims a specialty (and board certification), what expert qualifications does A.R.S. § 12-2604 require for standard-of-care testimony?

The case arises from treatment rendered to Crystal Allen after she developed a pressure ulcer in a skilled nursing facility. After Dr. Oyesiji A. Arojojoye evaluated her and performed a debridement, Crystal later developed infection, sepsis, and died. Crystal’s mother, Vickie Allen, sued and retained an internal-medicine expert (Andrew Marc Meillier, M.D.).

The central issue became whether Allen’s expert was disqualified because Dr. Arojojoye claimed he was board certified in wound care, which—if applicable—could require a wound-care board-certified expert under § 12-2604 as interpreted in Baker v. University Physicians Healthcare, 231 Ariz. 379 (2013).

2. Summary of the Opinion

The Supreme Court vacated the court of appeals’ memorandum decision and vacated the trial court’s order denying summary judgment, remanding for reconsideration under the correct framework.

The Court held that the court of appeals misapplied § 12-2604 (as construed in Baker) because it:

  • failed to correctly identify the care or treatment at issue as alleged by the plaintiff (the alleged omission in recognizing/evaluating/treating systemic infection), and
  • did not conduct the required analysis of whether the defendant’s claimed board-certified wound care specialty qualifies as a “specialty” under § 12-2604.

Although not strictly necessary to decide the remand, the Court provided additional guidance on how trial courts must evaluate “claimed board-certified specialty” assertions (including non-ABMS certifications) and reaffirmed the statute’s “comparable training and experience” purpose.

3. Analysis

3.1. Precedents Cited

Baker v. University Physicians Healthcare, 231 Ariz. 379 (2013)

Baker is the controlling interpretation of § 12-2604. It established that the “same specialty” requirement applies only when the care or treatment at issue was within the defendant’s specialty. It also adopted a workable definition of “specialty” as “a limited area of medicine in which a physician is or may become board certified,” while rejecting a rigid limitation to ABMS-recognized specialties.

This Opinion does not retreat from Baker; instead, it tightens compliance with Baker’s sequencing: a court must first identify the alleged care/treatment at issue, then determine whether that care falls within the claimed specialty, and only then reach whether board certification triggers a matching board-certified expert.

Francisco v. Affiliated Urologists Ltd., 258 Ariz. 95 (2024)

The Court cited Francisco for the rule that Arizona generally requires expert testimony to prove standard of care and causation in malpractice, with a limited exception: res ipsa loquitur. This situates § 12-2604 disputes as often case-dispositive—if the plaintiff’s expert is excluded, the claim may fail as a matter of law.

Glazer v. State, 237 Ariz. 160 (2015) and Windhurst v. Ariz. Dep't of Corr., 256 Ariz. 186 (2023)

These cases supplied the familiar appellate framework for summary judgment: de novo review, viewing facts in the light most favorable to the nonmoving party. The Court used them to frame how expert-qualification rulings intersect with summary judgment posture.

Rasor v. Nw. Hosp., LLC, 243 Ariz. 160 (2017)

Rasor reinforced that the Baker standard of review applies even when expert admissibility is addressed in summary judgment proceedings. This Opinion relied on that continuity to resolve the parties’ dispute over “de novo vs. abuse of discretion.”

City of Phoenix v. Geyler, 144 Ariz. 323 (1985) and McAlister v. Loeb & Loeb, LLP, 260 Ariz. 97 (2025)

These cases reflect appellate restraint—affirming if any reasonable view supports the trial court—but the Court declined to apply that principle here because the superior court’s reasoning was too unclear to permit meaningful review.

Higdon v. Evergreen Int'l Airlines, Inc., 138 Ariz. 163 (1983)

Higdon supported remand where findings are “infirm because of an erroneous view of the law,” unless the record permits only one factual resolution. The Court invoked this to justify sending the matter back rather than deciding specialty/treatment questions itself.

State v. Strong, 258 Ariz. 184 (2024) and State v. Romero, 239 Ariz. 6 (2016)

These cases were cited to analogize the trial court’s role as a “gatekeeper” for expert testimony. The Court used that concept to reject the argument that courts should not “second guess” certification processes: courts are not policing medicine; they are enforcing statutory thresholds for admissibility.

Gulf Homes, Inc. v. Goubeaux, 136 Ariz. 33 (1983); Jimenez v. Wal-Mart Stores, Inc., 206 Ariz. 424 (App. 2003); United States v. Tham, 960 F.2d 1391 (9th Cir. 1992)

These cases were cited on remand procedure: when reversal/remand occurs without directions to enter judgment, parties may raise additional arguments and develop the record. The Court used them to indicate that both sides may litigate § 12-2604 issues anew under the guidance provided.

Arojojoye v. Allen, No. 1 CA-SA 24-0270, 2025 WL 1135746 (Ariz. App. Apr. 17, 2025) (mem. decision)

The Supreme Court vacated this decision, primarily because it analyzed the wrong “care at issue” (the wound debridement) rather than the allegedly omitted follow-up infection/sepsis evaluation and treatment. The vacatur signals that appellate courts must not reframe the malpractice theory when applying § 12-2604.

3.2. Legal Reasoning

(a) The “Care or Treatment at Issue” Must Be Identified from the Plaintiff’s Theory

The Court emphasized that § 12-2604’s specialty matching is driven by the specific standard-of-care question actually presented. Here, Allen argued she was not criticizing the debridement itself, but rather Dr. Arojojoye’s alleged failure to recognize, evaluate, and treat a developing systemic infection (e.g., advanced imaging, surgery consultation, hospitalization for sepsis).

By focusing on what Dr. Arojojoye did as part of “wound care team” management—and not on the allegedly omitted sepsis workup—the court of appeals answered the wrong question. The Supreme Court’s remand requires the trial court to determine whether the alleged omission falls within wound care, internal medicine, both, or neither.

(b) Overlapping Competence Does Not Avoid Specialty-Matching Under Baker

The Opinion reiterates a core point from Baker: even if physicians in other specialties could competently provide the treatment, § 12-2604 can still require an expert certified in the defendant’s relevant specialty when the defendant was practicing within it. Thus, if the trial court finds that the alleged omission is within wound care (even if also within internal medicine), Baker may still compel a wound-care matched expert.

(c) Claimed Board Certification Requires Judicial Evaluation Under § 12-2604(A)

The Court provided important guidance where the defendant’s “board certification” is disputed—precisely the situation Baker noted it did not have occasion to decide. The Court stressed that “specialty” is not whatever a physician claims; courts must assess whether the claimed certification satisfies statutory expectations.

The Court drew from Baker to identify indicia relevant to whether a certification qualifies as the kind of “board certification” tied to a “specialty” for § 12-2604:

  • a voluntary certification process administered by a credentialing organization recognizing practice areas;
  • graduation from an accredited medical school;
  • successful completion of residency or other training reflecting distinct training and experience;
  • an exam, and continuing education/practice requirements;
  • potential professional advantages (hospital privileges, insurance rates, compensation) as corroborative indicators.

The Court also reaffirmed that ABMS recognition is not the test. A certification from a non-ABMS body (here, ABWM) may qualify, but only after the trial court conducts the required statutory analysis on an adequate record.

(d) The “Majority of Professional Time” Requirement Applies Symmetrically in Practice

A significant clarification concerns § 12-2604(A)(2). The Court adopted and elevated what had been described as a “suggestion” in Baker: because the statute requires a testifying expert to have devoted a majority of professional time in the relevant specialty during the preceding year, a defendant who seeks to invoke a “claimed specialty” under § 12-2604 must also have devoted a majority of professional time to that specialty in the relevant period.

This matters because a physician cannot devote a “majority” of time to more than one specialty. On remand, the parties may litigate whether Dr. Arojojoye satisfies that timing-and-time-allocation component.

3.3. Impact

  • Sharper framing of malpractice theories at the expert-qualification stage: Courts must identify the “care or treatment at issue” from the plaintiff’s allegations and expert disclosure, not merely from labels in medical records (e.g., “wound care team”) or from the defendant’s preferred characterization.
  • More robust scrutiny of nontraditional “board certifications”: Defendants may still rely on non-ABMS certifications, but only if they can show the certification reflects materially distinct training/experience consistent with § 12-2604’s purpose. This likely increases evidentiary development (certification standards, training prerequisites, maintenance requirements, role in privileging/insurance).
  • Constraint on strategic “specialty claiming”: By emphasizing that “specialty” is objectively determinable and by tying invocation of a claimed specialty to the “majority of professional time” concept, the decision reduces the risk that marginal or marketing-driven credentials will automatically force plaintiffs to locate narrowly credentialed experts.
  • Procedural consequences: Because expert qualification disputes can be dispositive at summary judgment, the requirement for clear trial-court reasoning (and a correct care-at-issue identification) will shape how § 12-2604 motions are litigated and how records are built for appeal.

4. Complex Concepts Simplified

  • Standard of care: the level of care a reasonably prudent health-care provider would provide under similar circumstances.
  • Expert qualification under A.R.S. § 12-2604: Arizona restricts who may testify about the standard of care, often requiring the expert to match the defendant’s specialty and board certification when the alleged negligence involves that specialty.
  • Res ipsa loquitur: a narrow doctrine allowing negligence to be inferred without expert testimony when the nature of the event ordinarily would not occur absent negligence (cited via Francisco v. Affiliated Urologists Ltd., 258 Ariz. 95 (2024)).
  • Summary judgment: a pretrial ruling that ends a claim when there is no genuine dispute of material fact and the moving party is entitled to judgment as a matter of law.
  • Abuse of discretion vs. de novo: trial-court expert-qualification determinations are reviewed for abuse of discretion, but statutory interpretation is reviewed de novo (as reaffirmed through Baker and applied here).
  • Gatekeeping: the court’s role in ensuring expert testimony meets legal reliability/fit requirements—used here to justify judicial scrutiny of claimed specialty certifications (citing State v. Strong, 258 Ariz. 184 (2024) and State v. Romero, 239 Ariz. 6 (2016)).

5. Conclusion

The Arizona Supreme Court’s decision in AROJOJOYE v. ALLEN reinforces and operationalizes Baker v. University Physicians Healthcare, 231 Ariz. 379 (2013) by requiring courts to (1) correctly identify the alleged care/treatment at issue and determine whether it falls within the defendant’s specialty, and (2) meaningfully assess whether a defendant’s claimed board certification qualifies as a “specialty” certification under § 12-2604—without treating certification labels as self-proving.

The Opinion’s added clarification that a defendant invoking a claimed specialty must align with the statute’s “majority of professional time” logic may reshape future expert-qualification battles, particularly where physicians hold multiple credentials or rely on certifications issued outside ABMS structures.