Even in medical malpractice actions we have held that "a physician need not be a specialist in the field of which he [or she] speaks in order to testify as an expert." Ornoff v. Kuhn and Kogan Chartered, 549 A.2d 728, 732 (D.C. 1988) (quoting Baerman v. Reisinger, 363 F.2d 309, 310 (1966)); District of Columbia v. Anderson, 597 A.2d 1295, 1299 (D.C. 1991) ("medical expert need not be a specialist in order to be qualified to offer an opinion"); see Sher v. De Haven, 199 F.2d 777, 782 (1952) (same) cert. denied, 345 U.S. 936, 73 S.Ct. 797, 97 L.Ed. 1363 (1953). "[I]t is the actual qualifications of the witness that count, rather than his [or her] title," Anderson, 597 A.2d at 1299, and thus the "training and specialization of the witness go to the weight rather than the admissibility of the evidence, generally speaking."

The court has also recognized that a medical expert need not be a specialist in order to be qualified to offer an opinion. See, e.g., Ornoff v. Kuhn Kogan, Chartered, 549 A.2d 728, 731 (D.C. 1988); Baerman v. Reisinger, 124 U.S.App.D.C. 180, 363 F.2d 309 (1966) (a general practitioner with "experience in treating patients suffering from hypothyroidism" should have been permitted to give expert opinion even though he was not a specialist). Although our prior decisions have involved medical doctors, and Dr. Gottlieb is a podiatrist, not a medical doctor, the import of our cases is that "it is the actual qualifications of the witness that count, rather than his [or her] title. . . . Just as the wrong title may mean that the witness is nevertheless qualified, the right title will not suffice if the witness does not have the qualifications required by the facts of the case."

In asking us to divide psychiatrists into those who are experts on dangerousness and those who are not, Melton places "too much focus on a [purported] specialty and too little focus upon the [facts] alleged." Ornoff v. Kuhn and Kogan Chartered, 549 A.2d 728, 731 (D.C. 1988); see also Kling v. Peters, 564 A.2d 708, 715-16 (D.C. 1989). Judge Ferren states in his dissenting opinion, post at 912, that even if the psychiatrists were qualified to testify about Melton's dangerousness to himself, they had no expertise on his dangerousness to others.

Dr. Kling's argument on appeal presents the same problem that vexed the trial judge throughout the trial, namely, "too much focus on a specialty and too little focus upon the breach alleged." Ornoff v. Kuhn Kogan, Chartered, 549 A.2d 728, 731 (D.C. 1988). The complaint alleged that Dr. Kling was negligent in failing to use the proper instruments to diagnose retained nuclear material in his patient's eye after the March surgery. Dr. Kling was an ophthalmologist.

Under District of Columbia law, the plaintiff in a medical malpractice action must demonstrate by a preponderance of the evidence three elements: (1) the applicable standard of care; (2) the fact that the defendant, through his or her actions or inactions, deviated from that standard of care; (3) and that a causal relationship exists between the defendant's deviation and the plaintiff's injuries. Flores–Hernandez v. United States, 910 F.Supp.2d 64, 72, (D.D.C.2012) (enumerating tripartite burden in medical malpractice actions) (citing Washington v. Wash. Hosp. Ctr., 579 A.2d 177, 181 (D.C.1990)); Ornoff v. Kuhn & Kogan, Chartered, 549 A.2d 728, 731 (D.C.1998); Psychiatric Inst. of Wash. v. Allen, 509 A.2d 619, 623–24 (D.C.1986)); see also Burton v. United States, 668 F.Supp.2d 86, 98 (D.D.C.2009); Appleton v. United States, 180 F.Supp.2d 177, 182 (D.D.C.2002) (in FTCA negligence suit, the plaintiff “bears the burden of proof, by a preponderance of the evidence, to demonstrate the applicable standard of care, deviation from that standard, and the causal relationship between the deviation and plaintiff's injury”) (citing Messina v. District of Columbia, 663 A.2d 535, 537–38 (D.C.1995)); Giordano v. Sherwood, 968 A.2d 494, 498 (D.C.2009); Nwaneri v. Sandidge, 931 A.2d 466, 470 (D.C.2007).

Under District of Columbia law, the plaintiff in a medical malpractice action must demonstrate by a preponderance of the evidence three elements: (1) the applicable standard of care; (2) the fact that the defendant, through his or her actions or inactions, deviated from that standard of care; (3) and that a causal relationship exists between the defendant's deviation and the plaintiff's injuries. Flores–Hernandez v. United States, 910 F.Supp.2d 64, 72–73 (D.D.C.2012) (enumerating tripartite burden in medical malpractice actions) (citing Washington v. Wash. Hosp. Ctr., 579 A.2d 177, 181 (D.C.1990); Ornoff v. Kuhn & KoganChartered, 549 A.2d 728, 731 (D.C.1988); Psychiatric Inst. of Wash. v. Allen, 509 A.2d 619, 623–24 (D.C.1986)); see also Burton v. United States, 668 F.Supp.2d 86, 98 (D.D.C.2009); Giordano v. Sherwood, 968 A.2d 494, 498 (D.C.2009); Nwaneri v. Sandidge, 931 A.2d 466, 470 (D.C.2007); Appleton v. United States, 180 F.Supp.2d 177, 182 (D.D.C.2002) (in FTCA negligence suit, plaintiff “bears the burden of proof, by a preponderance of the evidence, to demonstrate the applicable standard of care, deviation from that standard, and the casual [sic] relationship between the deviation and plaintiff's injury”) (citing Messina v. District of Columbia, 663 A.2d 535, 537–38 (D.C.1995)). Each of these elements must usually be proved by expert testimony. Porter v. McHugh, 850 F.Supp.2d 264, 267 (D.D.C.2012) (citing Cleary v. Group Health Ass'n, 691 A.2d 148, 153 (D.C.1997) (“Generally, in a medical malpractice negligence action, the plaintiff must present medical expert testimony to establish the standard of care, expert testimony that th

Consequently, the Court must look to District of Columbia law in resolving Plaintiff's claims under the FTCA. Under District of Columbia law, “[i]n a negligence action predicated on medical malpractice, the plaintiff must carry a tripartite burden, and establish: (1) the applicable standard of care; (2) a deviation from that standard by the defendant; and (3) a causal relationship between that deviation and the plaintiff's injury.” Washington v. Wash. Hosp. Ctr., 579 A.2d 177, 181 (D.C.1990) (citing Ornoff v. Kuhn & Kogan, Chartered, 549 A.2d 728, 731 (D.C.1988); Psychiatric Inst. of Wash. v. Allen, 509 A.2d 619, 623–24 (D.C.1986)). “Each of these elements must usually be proved by expert testimony.”

See Woods v. United States, 720 F.2d 1451, 1453-54 (9th Cir. 1983); Lane v. United States, 225 F. Supp. 850, 852-53 (E.D.Va. 1964). The plaintiff in a medical malpractice suit must establish by a preponderance of the evidence: (1) the applicable standard of care; (2) a deviation from or breach of that standard by the defendant; and (3) a causal relationship between that deviation or breach and the plaintiff's injury. See Randall v. United States, 850 F. Supp. 22, 30 (D.D.C. 1994) (citing Kosberg v. Washington Hosp. Ctr., 394 F.2d 947, 949 (D.C. Cir. 1968)); see also Ornoff v. Kuhn Kogan Chartered, 549 A.2d 728, 731 (D.C. 1988). In order for a plaintiff to meet the required burden of proof, "[the] plaintiff must affirmatively prove the relevant recognized standard of care exercised by other physicians and that defendant departed from that standard when treating the plaintiff."

          As defendants point out, in a negligence action founded on medical malpractice the plaintiff must establish three elements: (1) the applicable standard of care, (2) a violation of that standard of care by the defendant, and (3) a causal relationship between the violation and the plaintiff's injury. Washington v. Washington Hosp. Ctr., 579 A.2d 177, 181 (D.C.1990); Ornoff v. Kuhn and Kogan Chartered, 549 A.2d 728, 731 (D.C.1988). Furthermore, where such a case involves the exercise of professional skill and judgment, a jury usually will not be qualified without the assistance of an expert to determine whether there was negligent treatment and whether it caused injury.

Stager v. Schneider, 494 A.2d 1307, 1311 (D.C.App. 1985). The plaintiff has established by a preponderance of the evidence: (1) the applicable standard of care owed to the plaintiff; (2) a deviation from or breach of that standard by the defendant; and (3) a causal relationship between that deviation or breach and the plaintiff's injury. Ornoff v. Kuhn Kogan Chartered, 549 A.2d 728 (D.C.App. 1988); Fitzgerald v. Manning, 679 F.2d 341 (4th Cir. 1982); Brown v. Koulizakis, 229 Va. 524, 331 S.E.2d 440 (1985). The defendant, in turn, has failed to carry its burden of proving by a preponderance of the evidence that plaintiffs' decedent was contributorily negligent.