§ 8.01-581.20.Standard of care in proceeding before medical malpractice review panel; expert testimony; determination of standard in action for damages.
Chapter 21.1. Medical Malpractice · Article 2. Miscellaneous Provisions · Last amended 2022 · Last verified July 16, 2026
In one sentenceThis section sets Virginia’s malpractice standard of care as a statewide reasonably-prudent-practitioner benchmark, displaceable by a locality standard on proof it fits better, defines who qualifies as a standard-of-care expert witness, including a one-year active-practice requirement, and caps each side to two expert witnesses per medical discipline absent good cause shown.
A.In any proceeding before a medical malpractice review panel or in any action against a physician, clinical psychologist, clinical social worker, licensed professional counselor, podiatrist, dentist, nurse, hospital, or other health care provider to recover damages alleged to have been caused by medical malpractice where the acts or omissions so complained of are alleged to have occurred in this Commonwealth, the standard of care by which the acts or omissions are to be judged shall be that degree of skill and diligence practiced by a reasonably prudent practitioner in the field of practice or specialty in this Commonwealth and the testimony of an expert witness, otherwise qualified, as to such standard of care, shall be admitted; provided, however, that the standard of care in the locality or in similar localities in which the alleged act or omission occurred shall be applied if any party shall prove by a preponderance of the evidence that the health care services and health care facilities available in the locality and the customary practices in such locality or similar localities give rise to a standard of care which is more appropriate than a statewide standard. Any health care provider who is licensed to practice in Virginia shall be presumed to know the statewide standard of care in the specialty or field of practice in which he is qualified and certified. This presumption shall also apply to any person who, but for the lack of a Virginia license, would be defined as a health care provider under this chapter, provided that such person is licensed in some other state of the United States and meets the educational and examination requirements for licensure in Virginia. An expert witness who is familiar with the statewide standard of care shall not have his testimony excluded on the ground that he does not practice in this Commonwealth. A witness shall be qualified to testify as an expert on the standard of care if he demonstrates expert knowledge of the standards of the defendant's specialty and of what conduct conforms or fails to conform to those standards and if he has had active clinical practice in either the defendant's specialty or a related field of medicine within one year of the date of the alleged act or omission forming the basis of the action.
The provisions of this section shall apply to expert witnesses testifying on the standard of care as it relates to professional services in nursing homes.
B.In any action for damages resulting from medical malpractice, any issue as to the standard of care to be applied shall be determined by the jury, or the court trying the case without a jury.
C.In any action described in this section, each party may designate, identify, or call to testify at trial no more than two expert witnesses per medical discipline on any issue presented. The court may permit a party, for good cause shown, to designate, identify, or call to testify at trial additional expert witnesses. The number of treating health care providers who may serve as expert witnesses pursuant to § 8.01-399 shall not be limited pursuant to this subsection, except for good cause shown. If the court permits a party to designate, identify, or call additional experts, the court may order that party to pay all costs incurred in the discovery of such additional experts. For good cause shown, pursuant to the Rules of Supreme Court of Virginia, the court may limit the number of expert witnesses other than those identified in this subsection whom a party may designate, identify, or call to testify at trial.
Plain-English Summary
Subsection A fixes the default standard of care for malpractice claims — before the review panel or in a lawsuit — at that degree of skill and diligence practiced by a reasonably prudent practitioner in the same field or specialty within Virginia, a statewide standard. A party can displace that statewide standard with a locality-based one instead, but only by proving, by a preponderance of the evidence, that the health care services and customary practices in that locality or similar localities give rise to a standard that fits better. Virginia-licensed providers are presumed to know the statewide standard for their specialty, a presumption that also reaches equivalently qualified providers licensed elsewhere. And an expert witness familiar with the statewide standard can’t be excluded just for not practicing in Virginia — but to qualify as an expert on the standard of care at all, the witness needs expert knowledge of the defendant’s specialty standards and has to have had active clinical practice in that specialty or a related field within one year of the alleged act or omission. These same rules govern expert testimony about the standard of care for professional services in nursing homes.
Subsection B assigns the ultimate call on the standard-of-care issue to the jury, or to the court if the case is tried without one.
Subsection C caps each party at two expert witnesses per medical discipline on any given issue, though the court can permit more for good cause and may shift the cost of discovering those additional experts onto the party who wanted them. Treating health care providers who testify as experts under § 8.01-399 aren’t subject to that two-witness cap, except for good cause shown, and the court retains authority under the Rules of the Supreme Court of Virginia to limit other expert witnesses for good cause as well.
Frequently Asked Questions
What is the default standard of care in a Virginia malpractice case?
That degree of skill and diligence practiced by a reasonably prudent practitioner in the field of practice or specialty in the Commonwealth — a statewide standard.
Can a locality-based standard ever replace the statewide standard?
Yes, if a party proves by a preponderance of the evidence that the health care services, facilities, and customary practices in the locality or similar localities give rise to a standard more appropriate than the statewide one.
Must an expert witness practice in Virginia to testify about the statewide standard of care?
No. An expert familiar with the statewide standard cannot have testimony excluded solely on the ground that he does not practice in the Commonwealth.
What must an expert show to qualify as a standard-of-care witness?
Expert knowledge of the defendant’s specialty standards and of what conduct conforms or fails to conform to them, and active clinical practice in the defendant’s specialty or a related field within one year of the date of the alleged act or omission.
How many expert witnesses can each side call per medical discipline?
No more than two per medical discipline on any issue presented, absent a court order permitting more for good cause shown.
Amendment History
1979, c. 325; 1980, c. 164; 1989, cc. 146, 729; 1992, c. 240; 2003, c. 251; 2008, cc. 125, 169, 205; 2015, cc. 310, 361; 2020, c. 945; 2022, c. 509.
Source & verification. Section text and amendment history are
reproduced verbatim from the Code of Virginia, published by the
Code of Virginia, Virginia Division of Legislative Automated Systems. Last verified July 16, 2026.
· Official source
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