In Totten v. Adongay, 175 W. Va. 634, 337 S.E.2d 2 (1985) the plaintiffs (husband and wife) brought a medical malpractice action against a defendant doctor for failing to properly diagnose and treat an arm injury suffered by Mr. Totten. The case proceeded to trial before a jury. At the conclusion of the plaintiffs' case-in-chief, the trial court, in Totten, granted judgment as a matter of law to the defendant on the grounds that the plaintiffs failed to present expert testimony on the standard of care. The Court rejected the trial court's ruling and held in Syllabus point 4 of Totten that: "In medical malpractice cases where lack of care or want of skill is so gross, so as to be apparent, or the alleged breach relates to noncomplex matters of diagnosis and treatment within the understanding of lay jurors by resort to common knowledge and experience, failure to present expert testimony on the accepted standard of care and degree of skill under such circumstances is not fatal to a plaintiff's prima facie showing of negligence." (175 W. Va. 634, 337 S.E.2d 2.)