Category Archives: Expert Opinions

Expert Allowed to Testify About Standard of Care Despite His Belief that the Standard Is Mythical

Pamela Scholl underwent lumbar fusion surgery in Indiana. Scholl alleged that the surgeon, Dr. Mohammed Majd, placed a screw too close to an iliac artery, causing nerve damage. She later had a second corrective surgery.

Scholl sued Dr. Majd for malpractice. Indiana law requires complaints of medical malpractice to be submitted to a medical review panel. The medical and insurance industries view those panels as discouraging malpractice lawsuits that have no merit. Plaintiffs’ lawyers regard panel members as having a pro-doctor bias and typically view them as an obstacle that adds a layer of delay and expense to litigation that is meant to benefit doctors and their insurers.

The panel concluded that Dr. Majd did not breach the applicable standard of care. Scholl then filed suit. She relied on the expert testimony of Dr. Robert Sexton to prove her claim.

After Scholl rested her case, Dr. Majd moved to dismiss on the ground that Dr. Sexton’s testimony failed to establish that Dr. Sexton was familiar with the applicable standard of care. That motion was based on Dr. Sexton’s testimony that the standard of care is whatever a physician thinks it is. Scholl appealed from the trial court’s decision to grant that motion.

Dr. Sexton’s Testimony

Dr. Sexton is a board-eligible neurosurgeon who has performed more than 12,000 spine surgeries during his career, including 150 fusions. Dr. Sexton retired from surgical practice but maintains an active medical license and complies with continuing medical education requirements.

A medical review panel determined that Dr. Majd’s surgery did not fall below the standard of care. Dr. Sexton testified that he disagreed with that conclusion. When he was asked about the panel’s findings, Dr. Sexton referred to the panel’s reliance on a “mythical” standard of care.

Dr. Sexton explained that there is no published standard of care. The review panel defined the standard of care generically as “what a reasonably skilled doctor . . . would do in a given situation.” Dr. Sexton suggested that the generic definition does not identify specific things a doctor should do but leaves it up to each doctor to invent his or her own standard of care.

Dr. Sexton testified that Dr. Majd’s surgery fell below the standard of care because his workup of Scholl before the surgery was “sparse.” He opined that a prudent spine surgeon would have performed a bone density test before deciding whether a spinal fusion was appropriate. He also testified that using a spinal fusion to correct Scholl’s condition as “very controversial.”

Dr. Sexton concluded that placing a screw too close to Scholl’s iliac artery caused her injury. He testified that the standard of care required a surgeon in Dr. Majd’s position to do one of two things: perform a bone graft without using screws or perform a decompressive laminectomy as an alternative to spinal fusion.

When he was asked whether Dr. Majd’s decision to perform a spinal fusion using screws fell below the standard of care, Dr. Sexton replied, “Based on the outcome, yes, I think it was.” On cross-examination, Dr. Sexton repeated that “there is no such thing as a standard of care except what the individual doctor thinks it is.”

After Scholl rested her case, Dr. Majd moved for judgment on the basis that Dr. Sexton did not demonstrate a familiarity with the applicable standard of care. The court granted Dr. Majd’s motion. Scholl appealed.

Appellate Analysis

Indiana follows the customary rule that a medical standard of care and its breach must be established by an expert opinion. The question before the court was whether Dr. Sexton’s opinion adequately conveyed the standard of care to the jury.

The court noted that Dr. Sexton quoted a doctor from the medical review panel who stated that the standard of care is “what a reasonably skilled doctor with reasonably skilled training would do in a given situation.” That is a correct paraphrasing of the standard of care. The fact that Dr. Sexton referred to it demonstrated his familiarity with the standard. His criticism that the standard is mythical in the abstract did not alter his understanding of the standard.

As the court noted, Dr. Sexton explained his reference to the “mythical” standard by noting that no textbook or other authoritative source clearly defines how a spinal surgeon should have treated Scholl’s condition. The court viewed his testimony as explaining that the standard of care was open to interpretation, as is often the case in medical malpractice lawsuits.

Of course, the abstract standard — doctors have a duty to do what reasonably skilled doctors would do — says nothing about what reasonably skilled doctors would do in a given situation. Dr. Sexton filled that gap by testifying that a prudent spine surgeon should perform a bone density test before surgery. He also testified that the standard of care required Dr. Majd to perform a laminectomy rather than a fusion with hardware, a procedure that would have eliminated the risk of causing the injury that resulted from placing a screw too close to the iliac artery.

Dr. Sexton’s extensive history as a spinal surgeon qualified him to express opinions about the applicable standard of care and its breach. The court held that Dr. Sexton’s characterization of the standard of review as “mythical” was “imprecise,” but those comments did not reveal a lack of understanding of the standard of care. The trial court accordingly erred by dismissing the lawsuit rather than submitting it to the jury.

Lessons Learned

The intersection of law and medicine can lead to collisions. Doctors think in terms of medical concepts. The standard of care is a legal concept. Dr. Sexton viewed the standard of care as “whatever a doctor thinks it is” because the medical panel used the language of the law to describe the standard.

What a reasonable doctor would do in a given situation is intended to be an objective standard but differing opinions of whether a doctor’s actions were “reasonable” reveal its subjective nature. Dr. Sexton identified the subjective nature of the standard of care when he defined the standard as whatever “a doctor thinks it is.”

Scholl’s case ended with a dismissal and an appeal because Dr. Sexton referred to the standard of care as “mythical.” That testimony honestly identified the difficulty of defining a precise standard that has not been identified in medical texts. Unfortunately, the testimony was also problematic. An expert’s reference to a legal standard as “mythical” is likely to wave a red flag in front of opposing counsel.

The case illustrates the need for plaintiffs’ lawyers to take the time to explain legal standards to expert witnesses and to caution experts not to editorialize about those standards. How the expert feels about a legal standard has no bearing on the case. The appeal could have been avoided if Dr. Sexton had simply testified that “the standard of care is what a reasonable spinal surgeon would do and, in my opinion, a reasonable spinal surgeon would do the following.”



Judge Rules Gender Equality Expert’s Opinion is Credible and Reliable

An Iowa federal judge has ruled that a gender equality expert’s opinion is both credible and reliable and has temporarily blocked the University of Iowa from cutting its women’s swimming and diving program.

The Dispute

On August 21, 2020, the University of Iowa announced its decision to eliminate women’s swimming and diving as a varsity intercollegiate sport for the 2021-22 academic year.  Six students, Sage Ohlensehlen, Christina Kaufman, Alexa Puccini, Kelsey Drake, Miranda Vermeer, and Abbie Lyman, who are female student-athletes on the women’s swimming and diving team, were torn between remaining at the school and pursuing their athletic careers elsewhere.

The students filed a class-action lawsuit against the University of Iowa, its president, and its athletic director, claiming that the University failed to provide equal participation, equal treatment, and equal scholarship opportunities for female athletes as required under Title IX of the Education Amendments of 1972, 20 U.S.C. § 1681 et seq.

District Court

The students filed their lawsuit in the U.S. District Court for the Southern District of Iowa. On December 3, 2020, the plaintiffs filed a motion for a temporary restraining order and preliminary injunction. The court denied emergency injunctive relief, but ordered that the matter proceed on an expedited basis. The court reviewed each party’s written briefs, affidavits, and documentary evidence and held a hearing on the matter.

The Equity in Athletics Disclosure Act requires universities that receive federal funding to submit an annual report detailing the total number of full-time male and female undergraduate students enrolled at the university, the varsity intercollegiate athletic teams it sponsors, and the number of participants on each team on the date of that team’s first competition.

According to the information that the University provided in response to the Equity in Athletics Disclosure Act, the University of Iowa has been increasing its percentage of women undergraduate students over the past 10 years. Currently, the University offers 24 intercollegiate athletic programs; 13 are women’s teams and 11 are men’s teams.

At issue is whether the University of Iowa will comply with Title IX after eliminating the women’s swimming and diving team alongside three men’s teams. The students retained Dr. Donna Lopiano, Ph.D., to testify on their behalf. Dr. Lopiano reviewed the participation data and compared it with University-sponsored website rosters and raw competition data. She opined that she was confident to a high degree of certainty that women’s intercollegiate athletics at the University of Iowa would not be proportional to female student enrollment.

The University dismissed Dr. Lopiano’s opinions as “unduly speculative” and characterized them as “conspiracy theories.” The University made a motion that Dr. Lopiano’s opinions should be stricken from the record.

Upon review, U.S. District Court Judge Stephanie Rose determined that Dr. Lopiano was a highly credible expert and that her opinion was “exceedingly reliable.” Judge Rose noted that Dr. Lopiano is a highly accomplished expert on gender equity in intercollegiate athletics and Title IX compliance. Her opinion demonstrated that the students had a fair chance of demonstrating that the University is not in compliance with Title IX by providing its female athletes with athletic participation opportunities substantially proportionate to their representation in the student body.

Judge Rose granted the motion for a preliminary injunction, which prevents the University of Iowa from eliminating the women’s swimming and diving team or any other women’s intercollegiate athletic team until there is a full trial on the merits.

Election Experts Testify in Virginia Voter ID Case

Virginia Supreme Court Allows in Evidence of Expert’s History of Testifying as an Expert

The Supreme Court of Virginia has ruled that evidence of an expert witness’ past testimony as an expert is admissible evidence.

The Accident

In December 2015, Deborah Graves was driving her vehicle when she was hit from behind by Samantha Shoemaker. Graves experienced back, hip, and neck pain, along with increased depression and anxiety in the months following the crash. Graves sought medical care and physical therapy that cost over $26,000. Graves filed a lawsuit against Shoemaker seeking $150,000 in damages.

The Expert Witness

Shoemaker’s insurer, State Farm, hired attorney John P. Cattano to represent her in the lawsuit. Cattano retained Dr. William C. Andrews, an orthopedic surgeon who specializes in medicolegal work to testify as a defense expert witness.

Dr. Andrews reviewed Graves’ medical records and prepared an expert report. Dr. Andrews opined that much of the pain that Graves complained of after the crash was caused by preexisting conditions. Dr. Andrews also found that most of the treatment that Graves received was not medically necessary or reasonable to treat her minor injuries. State Farm paid Dr. Andrews $3,362 to issue this report.

Shoemaker’s attorney deposed Dr. Andrews and discovered that Dr. Andrews had been hired by Cattano or his firm 30 to 35 times over the past 10 to 12 years and that he only testified on behalf of a plaintiff one of those times. Dr. Andrews admitted that State Farm had paid him $793,198 for testimony he provided for their insureds from 2012 to 2018. However, he claimed that he was not aware that State Farm was the insurer until he was told at the deposition.

Trial Court

Shoemaker admitted her fault, so the case went to trial on the issue of damages only. Graves made a motion to introduce evidence of Dr. Andrews’ previous relationship with Cattano’s firm and State Farm.  After hearing arguments on the issue, the trial court allowed in evidence that Dr. Andrews had testified on behalf of Cattano’s clients 30 to 35 times in the past. She was not allowed to ask about prior work for State Farm because they were not in a “direct relationship.”

The jury returned a verdict in favor of Graves for $3,000 plus interest. Graves moved for a new trial based upon the ruling that prevented her from introducing evidence of Dr. Andrews’ previous relationship with State Farm. The court denied her motion and she appealed.

The Supreme Court of Virginia

On appeal, Graves argued that the trial court’s ruling went against the Supreme Court of Virginia’s ruling in Lombard v. Rohrbaugh, 262 Va. 484 (2001) by interpreting it to mean that a party must demonstrate a “direct relationship” between an expert and an insurance company before cross-examining the expert on previous payments from that insurance company.  The Supreme Court of Virginia agreed.

The court emphasized that its decision in Lombard only required that there be a “substantial relationship” between an insurer and an expert. The court emphasized that the central issue is not “artificial labels.” Instead, the focus should be on the potential for bias because of the witness’ interest in the case.

Here, State Farm’s past payments of nearly $800,000 to Dr. Andrews over the course of 7 years created a substantial relationship that had potential to create bias in the witness. The court ruled that Graves should have been able to introduce this evidence to the jury. The court vacated the trial court’s verdict and remanded the case for further proceedings.


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Expert Witnesses Have Failed to Offer Convincing Opinions in Support of 2020 Election Challenges

Challenges to the 2020 presidential election have been based on a variety of legal claims. Some lawsuits have argued that states followed incorrect election procedures or that state legislatures failed to authorize changes that permitted voters to cast ballots more easily and safely during the pandemic. Others have alleged that ballots or counting procedures were fraudulent.

No challenge to date has altered the election outcome in any state. As judges have repeatedly commented, it is not the function of the courts to choose the president. Only convincing evidence coupled with a sound legal theory will convince a court to review election results after votes have been cast.

In several cases, expert witnesses have weighed in on the election. The expert evidence presented by election challengers has not been viewed with favor.

Nevada Experts

An election contest in Nevada was based largely on the assertion that voting machines did not accurately tabulate the votes that were cast. The challenge relied in part on the opinions of three expert witnesses. The court ruled that the expert testimony was insufficient to prove that the results were inaccurate.

To prove that votes were cast illegally, Michael Baselice conducted a telephone survey of voters. Surveys are only valid if participants consist of a sufficiently large group of randomly chosen voters who are representative of all voters. Since Baselice failed to identify the source of his survey data and “conducted no quality control of the data he received,” the court rejected his conclusions.

Jesse Kamzol concluded that votes were cast illegally based on his analysis of commercial databases of voters. Kamzol did not collect or verify the data, did not know how it was collected, and could not say whether his methodology accounted for false positives. The court concluded that the analysis was unreliable.

Scott Gessler concluded that mail voting was fraudulent. The court rejected that opinion because it was based on a small number of affidavits that Gessler made no effort to corroborate. The court faulted Gessler for failing to support his conclusions with verified facts.

Matthew Braynard

A Georgia election challenge relied on a telephone survey of absentee voters conducted by Matthew Braynard, a former employee of the Trump campaign. After the election, Braynard was hired as an expert witness and paid $40,000 to prepare an expert report. Braynard claims expertise in “the voter data and election administration field.”

Braynard alleged that his staff telephoned people chosen at random and asked them whether they requested and returned an absentee ballot. The answers were then compared to names in a statewide database of voters. Braynard extrapolated his comparisons and concluded that more than 200,000 absentee ballot were cast that were not requested by the voter or that the voter did not return.

Journalist Spenser Mestel explains why election surveys like Braynard’s are often based on bad science. More to the point, when Braynard was confronted with evidence that people he identified as illegal voters had in fact cast legal ballots, he admitted he made no effort to verify whether people listed in the database as having voted were the same people who told him that they had not voted. The election challenge was voluntarily dismissed soon after Braynard’s expert report was filed.

Braynard’s reports were filed in other election challenges, as well. A response to Braynard’s report filed in federal court by Stephen Ansolabehere, a professor of government at Harvard, contended that there was “no scientific basis for drawing any inferences or conclusions from the data presented.” His response identifies errors in Braynard’s data collection methodology and in his survey design and concludes that Braynard’s undescribed “list matching” technique was likely riddled with error.

Russell J. Ramsland Jr.

Attorney Lin Wood Jr. filed a lawsuit challenging the Georgia election. He relied in part on the expert opinions of Russell J. Ramsland Jr., a cybersecurity worker. Ramsland filed an affidavit that purported to identify inconsistencies in electronic voting machines. The New York Times reported that the alleged inconsistencies occurred in Michigan, not Georgia.

Nor were the claims accurate as to Michigan. The same Times report found that the “affidavit also listed a number of towns and counties in which Mr. Ramsland’s analysis ostensibly showed that the number of votes cast exceeded the number of eligible voters. But most, if not all, of the places Mr. Ramsland listed appeared to be townships and counties in Minnesota, not Michigan.

Ramsland filed a subsequent affidavit in a Michigan lawsuit that managed to focus on Michigan jurisdictions. Ramsland claimed that voter turnout in six Michigan precincts exceeded 100%. An investigation of those assertions judged them to be “wildly inaccurate.”

A federal judge who was appointed by President Trump rejected the Georgia challenge. The judge questioned the absence of reliable evidence to support the claim of fraud but ultimately decided that the plaintiff lacked standing to bring the suit. The Michigan lawsuit was dismissed because it was based on “theories, conjecture and speculation” rather than evidence.

Joshua Merritt

Sidney Powell has filed multiple election challenge lawsuits. Before filing in Michigan and Arizona, Powell famously told the media that she would “release the Kraken.” Her lawsuits in those states, as well as her lawsuits in Wisconsin and Georgia, were quickly dismissed.

Powell identified an expert witness in her complaints by the code name “Spyder” (sometimes “Spider”). Powell described Spyder as a former Military Intelligence expert. In a declaration filed in four states, Spyder opined that server traffic data proved that voting systems in the United States were “certainly compromised by rogue actors, such as Iran and China.”

The Washington Post reported that Spyder is Joshua Merritt, an information technology consultant. While he is an Army veteran who once enrolled in an entry-level military intelligence training program, he failed to complete the program. The military denies that he ever served as an intelligence analyst. Records show that he spent most of his military career as a truck mechanic.

Whether the judges who dismissed Powell’s lawsuits were aware that Merritt’s credentials have been stated incorrectly is unclear. The judges were likely unimpressed by a “secret expert witness” whose opinions were speculative and unsupported by reliable facts.

Terpsichore “Tore” Maras-Lindeman

Another secret witness for Powell claimed expertise as a “trained cryptolinguist.” That witness was recently identified as Terpsichore “Tore” Maras-Lindeman, a pro-Trump podcaster whose Navy experience lasted less than a year. Maras-Lindeman has a history of overstating her military credentials. Three years ago, she was fined for soliciting funds for a concert to benefit three homeless shelters and diverting those funds for her own purposes.

Michigan Audit

Claims that vote tabulating machines manufactured by Dominion switched votes to favor Biden have been widespread in social media. In response to a lawsuit founded on those claims, a Michigan judge gave an election challenger access to forensic images of logs prepared by the vote tabulation machines. The judge did not endorse those claims, but authorized the audit based on a voter’s claim that a Dominion machine incorrectly counted a vote on a village proposal to allow a marijuana dispensary.

The audit was authorized in Antrim County, where a clerk’s failure to update media drives for certain vote tabulators initially resulted in an incorrect vote count. An AP fact check found that the clerk’s subsequent correction of the error caused election challengers to argue that the error was caused by the Dominion vote tabulators when it was actually caused by human error.

The audit was conducted by Allied Security Operations Group. Its report was signed by Russell Ramsland, the same expert whose opinions were rejected in Georgia and an earlier Michigan case. The report does not identify or provide credentials of the people who prepared it. Whether they are experts is therefore unclear.

The report alleges that Dominion machines are “intentionally and purposefully designed with inherent errors to create systemic fraud and influence election results.” Dominion denies that allegation.

The AP fact check notes that some of the report’s assertions, including the claim that the county had a “68% error rate,” are largely unexplained. According to the AP, the report contains a “slew of other debunked claims about Dominion.”

After the audit was completed, Antrim County completed a hand recount of the presidential ballots. The recount confirmed that Trump won the county by less than 3,800 votes. The difference in the machine count and the hand recount amounted to about a dozen votes, a minor error rate that is common in elections. It is difficult to believe that a court will credit an audit that is undermined by an actual count of the votes.

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Doctors Sued for Malpractice Must Use Expert Witness to Prove that a Different Doctor’s Negligence Caused the Patients Injury

The injury victim in a medical malpractice lawsuit is nearly always required to present expert testimony to establish that a physician breached the applicable standard of care and that the breach caused the victim’s injury. The Maryland Court of Appeals was asked whether the same standard applies to a doctor who defends a malpractice claim by asserting that the negligence of another party caused the victim’s injury. Under the facts of the case, the court decided that expert testimony was required.

Facts of the Case

Martin Reiss suffered from tumors in his kidney. A surgeon made a plan to remove the cancerous kidney as well as an enlarged lymph node that was adjacent to the kidney. The surgeon removed the kidney in 2011 but elected not to remove the lymph node because it was close to a large blood vessel that transports blood to the heart.

After the surgery, Reiss was treated by Dr. Russell DeLuca, an oncologist. Dr. DeLuca suspected that the lymph node was cancerous but agreed that it could not be removed safely. He opted to treat Reiss with chemotherapy. The treatment caused the lymph node to shrink, confirming that it was cancerous.

During a period of five years, Dr. DeLuca ordered periodic CT scans of the lymph node to determine whether it was enlarging. Between 2011 and 2014, Dr. Victor Bracey, a radiologist, interpreted the scans. He noted that a contrast dye was not used to perform scans, making interpretation less than optimal. He nevertheless concluded that the lymph node was not enlarging.

In 2015, a different radiologist, Dr. Elizabeth Kim, interpreted a non-contrast CT scan and found “soft tissue density” in the vicinity of the lymph node. She also concluded that the lymph node had enlarged since 2011. A biopsy confirmed that the lymph node was cancerous. A new oncologist agreed that the condition was inoperable.

Malpractice Lawsuit

Reiss sued Dr. Bracey and the surgeon who removed his kidney. He alleged that the surgeon was negligent for not removing the lymph node. At some point, Reiss dismissed his claim against the surgeon.

Reiss alleged that the lymph node could have been surgically removed at an earlier time. He alleged that by 2015, it had become inoperable. He contended that Dr. Bracey was negligent for failing to diagnose the enlargement of his lymph node at a time when it could have been removed.

Dr. Bracey denied that he was negligent. In his answer to the complaint, Dr. Bracey contended that Reiss’ oncologists were negligent and that their negligence caused Reiss’ injury.

Expert Testimony

Reiss presented the expert testimony of Dr. Paul Collier, a vascular surgeon, to establish that the lymph node could have been safely removed at any time before 2015 but not later. Dr. Bracey called Dr. James Black as an expert in vascular surgery. He agreed that the lymph node could have been removed in 2011 but disagreed with Dr. Collier’s opinion that the lymph node could not have been removed after 2015.

Reiss called Dr. Barry Singer as an expert in oncology. Dr. Singer testified that Reiss would have had a much greater probability of survival if the lymph node had been removed between 2011 and 2014. Dr. Singer opined that a biopsy would have confirmed that the lymph node was cancerous. He testified that surgical removal of cancer is always the best treatment option and that Reiss would have been cured if the lymph node had been removed. He explained that Reiss’ life expectancy is significantly shorter because the cancerous lymph node was not removed.

Alleged Negligence of Non-Parties

Dr. Bracey did not designate an expert to support his claim that Reiss’ oncologists were negligent. He instead made a general reservation of his right to rely on Reiss’ expert witnesses.

The trial judge ruled that the alleged negligence of the oncologists was relevant to Dr. Bracey’s defense. The judge also ruled that Dr. Bracey would not be allowed to cross-examine Reiss’ experts about the alleged negligence of his oncologists. The judge decided that Dr. Bracey needed to rely on his own experts and that disclosing an intent to rely on Reiss’ experts did not comply with expert designation rules. That ruling was not appealed.

Reiss called Dr. DeLuca as a fact witness. Dr. DeLuca testified that he discontinued chemotherapy because Dr. Bracey’s radiological reports convinced him that the cancer was in remission. He explained that he did not order dye to be used in administering the CT scan because he did not want to damage Reiss’ remaining kidney. He also testified that he did not refer Reiss’ case to the tumor board for an opinion on the viability of removing the lymph node because he relied on the surgeon’s opinion that the lymph node could not be removed safely.

Reiss’ new oncologist testified that he consulted with a general surgeon who advised against surgical removal of the lymph node because there was no clear separation between the lymph node and the vein. In that surgeon’s view, the risk of surgery would have outweighed the anticipated benefit. The oncologist acknowledged, however, that he did not ask a vascular surgeon to review the case.

No expert witness testified that the surgeon who removed Reiss’ kidney breached an applicable standard of care by not removing his enlarged lymph node. Nor did any expert witness testify that the standard of care required Dr. DeLuca or Reiss’ new oncologist to refer Reiss to a surgeon to remove the lymph node or to order a biopsy.

The jury demonstrated its confusion about the verdict form before finally determining that Dr. Bracey was not liable for Reiss’ injury. Reiss appealed.

Appellate Decision

Under Maryland law, “evidence of non-party negligence is relevant and admissible in medical malpractice cases.” The court noted that evidence of negligent acts by other doctors are relevant for three purposes: (1) to prove that the defendant doctor was not negligent; (2) to prove that the defendant doctor’s negligence was not a cause of the patient’s injuries; or (3) to prove that another doctor’s negligence was a superseding cause of the patient’s injuries “that cleaved the chain of causation running from the defendant’s negligence.”

Dr. Bracey was therefore entitled to introduce evidence that other doctors were negligent — for example, by not removing the lymph node during Reiss’ initial surgery, by not ordering dye to be used in the CT scan, by not performing a biopsy, or by not removing the lymph node after its cancerous nature became clear. If the jury decided that Reiss was injured because of mistakes made by other doctors and that Dr. Bracey did not contribute to that injury, it was entitled to find in Dr. Bracey’s favor.

The jury heard evidence about the decisions made by other doctors. The question before the court was whether the jury could find that those doctors were negligent in the absence of expert evidence.

Dr. Bracey made the technical argument that he never asserted the negligence of other doctors as an affirmative defense and therefore had no burden to prove their negligence. Rather, he denied liability and raised non-party negligence as an alternative theory of causation that, in his view, he didn’t need to prove.

The court of appeals concluded that the label attached to the defense is not dispositive. The court held that “expert testimony is required to establish non-party medical negligence without regard to whether a defendant is raising the non-party medical negligence as an affirmative defense or in connection with a general denial of liability.”

That holding is consistent with the general rule that juries require the assistance of expert witnesses to determine whether a physician breached an applicable standard of care. Dr. Bracey’s “alternative theory of causation” could not be advanced without evidence. Expert evidence is required to persuade a jury that medical negligence occurred. Without that evidence, a jury would have no basis for concluding that Dr. Bracey’s “alternative theory” was grounded in fact.

Whether or not Dr. Bracey had the burden of persuasion, he had the burden of producing admissible evidence that non-party doctors were negligent. That burden of production could only be met by introducing expert opinions. Since Dr. Bracey failed to offer expert opinions, it was error for the trial court to submit a jury form that asked whether non-party physicians were negligent. That question sent the message that non-party negligence could relieve Dr. Bracey of liability. In the absence of expert evidence that the other doctors were negligent, the jury should not have considered their conduct in determining whether Dr. Bracey was liable. The court therefore remanded the case for a new trial.



Expert Witness Establishes GEICO’s Failure to Pay Reasonable Cost of Windshield Replacements

A Florida judge in Hillsborough County consolidated eleven lawsuits that Glasso, Inc. filed against GEICO. In each case, Glassco replaced windshields that were damaged in cars insured by GEICO. Glassco took an assignment of the insurance benefits from the car owners and billed GEICO directly for the replacement cost.

The lawsuits alleged that GEICO paid less than the invoiced amount. GEICO admitted that it did not pay the invoices in full. It relied on a clause in its insurance contract that limits its liability to the “prevailing competitive price” for repairs. GEICO contended that Glassco’s billings exceeded the prevailing competitive price for windshield replacements.

To support its claim, Glassco relied on the testimony of owners of businesses that make windshield repairs. Glassco also called an expert witness. The judge agreed with the expert’s opinion and entered judgment in favor of Glassco.

Facts of the Case

At trial, the owner of Glassco and the owners of two competing auto glass companies explained how they determine pricing. They take into account the cost they pay for replacement glass and for the materials (molding, clips, and adhesive) they use to install the glass. They also take into account their labor costs. All of those depend on the make, model, and year of the vehicle that needs a replacement windshield.

To reach a final price, the owners add profit to their costs. To calculate profit, the owners take into account the amounts charged by competitors in their same market. They also consider the charge that most insurance companies will pay without dispute.

The owners of Glassco’s competitors testified that Glassco’s pricing structure was consistent with prevailing market prices. They also testified that 95% of insurance companies pay their bills without dispute. Glassco has a similar rate of undisputed payment.

Expert Testimony

Barrett Smith testified as an expert witness for Glassco. Smith is an expert in the appraisal of collision damage repair. He operated an auto body repair shop before joining the insurance industry. As a claims adjuster, Smith evaluated collision damages and estimated reasonable repair costs. He returned to the collision repair industry before founding a business that provides expert appraisal and mediation services regarding collision damage.

Smith testified that he was hired to “perform comparative market research regarding the products and services provided in windshield replacement service” and to tender an opinion “as to the prevailing competitive price of the goods and services.” He concluded that Glassco’s prices were competitive and prevailing within its market.

Smith surveyed 24 glass repair facilities to determine their pricing structure. Based on that survey and his considerable experience in the collision repair and insurance industries, he found that Glassco’s prices were at the lower end of the prevailing range of prices in the market.

GEICO’s Defense

GEICO did not contest that Glassco performed the windshield repairs competently. GEICO did not disagree that Glassco was conveniently situated to the owners who brought their vehicles in to be repaired.

GEICO offered no expert testimony. It instead relied on the testimony of a corporate representative who handles glass litigation claims. She testified that GEICO paid invoices according to its own determination of the “prevailing competitive price.” She based her opinion of that price on GEICO’s glass pricing agreement with its affiliate SGC/Safelite.

Court Decision

The court decided that Glassco had the initial burden of offering “substantial, competent evidence to establish its prima facie case for what the prevailing competitive price is” because Glassco could not prove a breach of contract without demonstrating that it invoiced the prevailing competitive price. If Glassco succeeded in making a prima facie case, the burden shifted to GEICO to establish that the invoices exceeded the prevailing competitive price.

Glassco met its burden with industry and expert testimony. In particular, the court credited Smith’s expert testimony that Glassco’s pricing was at the low end of the prevailing range of competitive pricing.

To rebut that testimony, GEICO offered only the opinion of its own employee. The court faulted GEICO’s representative for failing to offer any data to support her conclusory opinion. GEICO’s pricing agreement with a single affiliate did not establish a prevailing price within the industry. The court therefore agreed that GEICO breached its insurance contracts by failing to pay the full amount that Glassco billed for its services.

Lesson Learned

Glassco’s lawsuit illustrates the impact that expert evidence can have in litigation. While Glassco may have prevailed by relying only on the testimony of glass company owners, the court might have regarded that testimony as self-serving, given the owners’ interest in maximizing their profits by forcing GEICO to pay their bills.

By calling an expert witness with years of experience in both the collision repair industry and in the insurance industry, Glassco offered important support for its claims. The expert collected a significant amount of survey data to support his opinion, giving the court a strong basis for understanding the prevailing competitive price structure for auto glass repair. The court’s favorable view of that expert evidence clearly contributed to Glassco’s litigation success.


GEICO Expert Cleared to Testify in Insurance Fraud Case

A GEICO expert has been cleared to testify in an insurance fraud case where a physician has been accused of improperly certifying certain healthcare services for payment.

The Alleged False Statements

Dr. Luis Mas is a family medicine specialist with a practice in Coral Gables, Florida. Government Employees Insurance Co., GEICO Indemnity Co., GEICO General Insurance Company, and GEICO Casualty Co. filed a suit against Dr. Mas, alleging violations of the Racketeer Influenced and Corrupt Organizations Act, the Florida Deceptive Unfair Trade Practices Act, the Florida Civil Remedies for Criminal Practices Act, common law fraud, and unjust enrichment.

Specifically, the lawsuit alleged that Dr. Mas submitted thousands of fraudulent insurance charges, misrepresented coding levels on billing statements, and changed which medical provider administered treatment on the examination reports. The lawsuit claimed that unsupervised massage therapists and physical therapist assistants performed services that were billed as doctors.

The Daubert Motion

Government Employees Insurance Co., GEICO Indemnity Co., GEICO General Insurance Company, and GEICO Casualty Co. retained Dr. James Dillard to testify on their behalf.

Dr. Mas’s defense team filed a Daubert motion seeking to exclude Dr. Dillard’s testimony.  They sought to exclude Dr. Dillard because his testimony could not be used to prove that Dr. Mas falsified any medical examinations or billing records.  Instead, Dr. Dillard opined that healthcare providers committed fraud in three ways: (1) that Dr. Mas falsified his clinical judgment on the medical necessity of the treatment protocols, (2) that Dr. Mas and others falsified the examination results for the purpose of inflating medical bills, and (3) that the therapeutic care at each facility was performed without supervision.  Dr. Mas’s attorneys argued that, under Florida law, opinions were not actionable for fraud and Dr. Dillard needed to instead rely on statements of fact to undermine Dr. Mas.

Government Employees Insurance Co., GEICO Indemnity Co., GEICO General Insurance Company, and GEICO Casualty Co. argued that Dr. Mas’s motion had no merit because it contained conclusory arguments and failed to question Dr. Dillard’s qualifications or helpfulness to the jury.

The United States District Court for the Southern District of Florida ruled that even if Dr. Mas only gave a statement of opinion, he was a person with superior knowledge on the subject and he knew or should have known from the facts in his possession that the statement of opinion was false.  Because of this, Dr. Mas fell under the exception to the Florida rule that an action for fraud generally may not be predicated on statements of opinion.

The district court noted that Dr. Mas’s motion had three weaknesses.  First, it made the assumption that Dr. Mas rendered an opinion.  Second, the motion “cherry-picked” portions of cases to support its reasoning. Third, it did not take into account that an exception could apply in this case. Based on the allegations and the evidence in Dr. Dillard’s report, an exception may apply because there is a factual dispute on Dr. Mas’s involvement with how the medical facilities handled treatment and billing records.

Accordingly, the district court denied the motion and allowed Dr. Dillard to testify.

NRA Files Motion to Exclude “Mouse Brain” Expert

The NRA has filed a motion to exclude a developmental neuroscience expert in a gun rights suit, arguing that the expert on “mouse brains” is not qualified to offer testimony in this case.

The Lawsuit

The National Rifle Association (“NRA”) filed a lawsuit against Pam Bondi, the Attorney General of Florida, and Rick Swearingen, Commissioner of the Florida Department of Law Enforcement, based on their administering and enforcing Florida laws relating to the sale of firearms.  The NRA sought declaratory and injunctive relief. The NRA wanted a declaration that Florida’s law banning adult, law-abiding citizens under the age of 21 from purchasing firearms was unconstitutional under the Second and Fourteenth Amendments. It also wanted an injunction that prevented Florida from enforcing that law.

Proposed Expert Testimony

The Florida Department of Law Enforcement retained Dr. Pradeep G. Bhide to testify on its behalf.  Dr. Bhide is a Professor and Jim and Betty Ann Rodgers Eminent Scholar Chair of Developmental Neuroscience and Director of the Center for Brain Repair at Florida State University College of Medicine.

Dr. Bhide’s proposed testimony included the statement that “Modern neuroscience establishes what parents have known for generations, that ‘on average 18-year old individuals are more likely to engage in behaviors that are impulsive, emotional, risky and that offer immediate or short time reward compared to 21-year old individuals, on average.’”

The NRA filed a motion in limine to exclude Dr. Bhide’s testimony.  In its motion, the NRA argued that Dr. Bhide had not offered any hard evidence that young adults from age 18 to 20 are more likely to commit criminal violence with a purchased firearm than other adults. The NRA claimed that Dr. Bhide’s opinion would consist only of “secondhand pseudoscience.”

The NRA argued that Dr. Bhide failed to meet the requirements of Daubert.  Specifically, it claimed that while Dr. Bhide may be an expert in the broad area of neuroscience or brain development, this was not a substitute for expertise in the area of adolescent brain development. The NRA argued that even if Dr. Bhide had academic credentials in neuroscience and taught in that area, it did not demonstrate that he was competent to give an expert opinion in every area of neuroscience.

The NRA argued that Dr. Bhide was not qualified to give the opinion that 18-to-20-year-olds were more likely to commit crimes with purchased firearms because he had not personally studied human brain development. iWhen questioned whether he had published any peer-reviewed articles that distinguished between the development of a teenage brain and an adult brain, Dr. Bhide responded that he had not written articles about the human brain, he had only written about mouse brain development.

The NRA also argued that Dr. Bhide should be excluded as an expert because his opinions were not based on any reliable methodology. Dr. Bhide’s opinion was not based on his own research, his opinion was based upon the research of others that did not relate to the risk of firearm purchase by 18-to-20-year-olds.

The motion in limine is currently under advisement in the United States District Court for the Northern District of Florida.


Expert Allowed to Use Statistical Evidence of Plaintiffs’ Damages in FLSA Class Action

Eighth Circuit Discusses Whether an Expert Considered “Sufficient Facts” to Support a Conclusion

Joseph and Cindy Hirchak sued W.W. Grainger, Inc. and its subsidiary for selling and failing to warn about an allegedly defective product. They based their claim that Grainger sold the product on the opinion of an expert witness. A federal judge in Des Moines ruled that the expert’s testimony was inadmissible and granted summary judgment to Grainger. The Court of Appeals for the Eighth Circuit affirmed that decision.

Facts of the Case

Grainger distributes industrial equipment, including web slings. A web sling consists of straps or webbing. The webbing is typically made from polyester or a similar synthetic material. Web slings are wrapped around heavy objects and attached to a lifting device (such as a crane). The sling supports the objects as they are being lifted.

Joseph Hirchak was employed by Weiler Inc. Hirchak was working at Weiler’s plant when a web sling broke. The sling had been holding a load of steel tubing. The tubing fell on Hirchak, causing injuries.

While workers’ compensation is generally an exclusive remedy against an employer, an injured employee can bring injury claims against third parties if their negligence contributed to a work injury. Hirchak’s suit against Grainger alleged that Grainger supplied a defective web sling to Weiler and failed to warn Weiler about the defect.

Grainger distributes a variety of slings, including slings made by Juli Sling Company. Juli is a Chinese company. Hirchak alleged that the Grainger sold the defective Juli sling to Weiler. Grainger admitted that Weiler has an account with Grainger but denied that it supplied the defective sling to Grainger.

Grainger relied on its sales records and on the absence of Weiler purchase records evidencing sling purchases from Weiler. Grainger also argued that the Juli slings it distributes have sewn-in tags that the defective sling lacked. According to Grainger, those tags are sewn in by Juli. Grainger therefore contended that the defective sling was not a Juli sling.

Expert Evidence

To prove that Grainger supplied the defective sling, Hirchak relied on an expert opinion. Hirchak’s expert identified similarities between the defective sling and slings manufactured by Juli and distributed by Grainger. The expert based that comparison on two Juli slings that Grainger distributed, including a sling purchased from Grainger for the purpose of comparison and one furnished by Weiler. How Weiler determined that the sling was acquired from Grainger was unclear to the appellate court.

Grainger challenged the expert report. Grainger argued that virtually all web slings distributed in the United States share the similarities that the expert identified, regardless of their manufacturer. Grainger also argued that the expert failed to establish that it distributed the defective sling.

District Court Opinion

The district court decided that the expert’s opinion was not based on sufficient facts. Assuming that the points of comparison were sufficient to identify the defective sling as a Juli sling, that identification did not prove that Grainger distributed the sling. Weiler could have acquired it from any of Grainger’s competitors.

After excluding the expert opinion, the district court asked whether the remaining evidence established that Grainger distributed the defective sling. Finding none, it granted summary judgment in Grainer’s favor.

Appellate Opinion

The Eighth Circuit noted that experts must base opinions on sufficient facts to assist the jury in deciding factual disputes. When are facts “sufficient”? One measure of sufficiency is whether the facts both support the expert’s opinion and allow the expert to exclude other possibilities.

The court recognized that it isn’t necessary to rule out every possible alternative conclusion. It is, however, necessary to consider enough facts to account for obvious alternatives. The failure to rule out obvious alternatives suggests that the expert either failed to consider sufficient facts or failed to explain why the expert’s reasoning makes the expert’s conclusion more sound than alternative conclusions.

The court decided that the expert failed to consider sufficient facts to rule out the conclusion that a different distributor supplied the defective sling to Weiler. The expert’s focus was on facts tending to show that Juli manufactured the sling. The expert considered only a few facts to prove that Weiler obtained the sling from Grainger.

The expert compared the defective sling to two Juli-manufactured slings that came from Grainger. That comparison supported a conclusion that Grainger sells slings that are similar to the defective sling. Since other distributors also sell Juli-manufactured slings, the facts upon which the expert relied were not sufficient to rule out the alternative conclusion that a different distributor supplied the sling to Weiler.

Hirchak argued that, since Weiler had a Grainger-distributed Juli sling in its plant, it is reasonable to infer that Weiler acquired the defective sling from Grainger. Oddly, the court of appeals held that the expert could not draw that inference because only the jury could do so. Yet by granting summary judgment, the court deprived the jury of the opportunity to draw the inference.

A better analysis might focus on whether the inference is sufficiently reasonable that it would support a jury verdict in Hirchak’s favor. The fact that Weiler had one Juli-sling that was distributed by Grainger does not imply that all of its other slings came from Grainger.

While an expert may well have been able to identify the manufacturer of the defective sling, identifying its distributor was probably beyond the realm of expert testimony. Purchases and sales are typically proved by purchase records or the testimony of sellers or buyers. In the absence of that evidence, Hirchak had little hope of proving his case through expert testimony.



Court Relies on Expert Witnesses in Affirming Dismissal of Challenge to Harvard Affirmative Action Policy

The controversy surrounding university admissions policies that consider race has been fueled by lawsuits alleging that the policies discriminate against Asians. In a recent appellate victory for Harvard, the court considered competing expert witness testimony in ruling that Harvard’s admissions policy did not violate the law.

Students for Fair Admissions (SFFA) sued Harvard University, alleging that its admissions policies discriminated against Asian Americans. The SFFA has initiated similar suits against the University of Texas at Austin and the University of North Carolina as part of a national litigation strategy to overturn U.S. Supreme Court rulings that permit a very limited form of affirmative action to promote racial diversity in student populations.

Harvard Admissions

Harvard selects about 1,600 students each year from a pool of about 35,000 applicants. Since it cannot give a position to each applicant who is likely to achieve academic success, academic excellence is only one of several factors that guide its admissions decisions.

Harvard recruits students who have good grades and high college admission test scores without regard to their race. To expand its applicant pool, Harvard also recruits minority students who did not do as well on standardized tests. Whether Harvard recruited a student, however, is not a factor that Harvard considers when it makes admission decisions.

Applications provide Harvard with a wealth of information, including the applicant’s standardized test scores, transcripts, extracurricular and athletic activities, awards, teacher and guidance counselor recommendations, intended field of study, a personal statement, and other information an applicant would like Harvard to consider. Applicants can reveal their race but are not required to do so.

Consideration of Race in Admissions Decisions

Admissions officers give applications a numerical rating in various categories of achievement: academic success, extracurricular pursuits, athletic pursuits, school support (as measured by the strength of teacher and guidance counselor recommendations), and a personal rating that considers the positive effect the student might have on the Harvard community. The personal rating considers the applicant’s perceived leadership, maturity, integrity, personality, ability to overcome setbacks, concern for others, and whether the applicant is “a good person to be around.”

Experiences pertaining to race, such as an applicant’s struggle to overcome discrimination, might inform the personal rating. However, race does not play a direct role in the personal rating and Harvard instructs admissions officers not to consider the race of applicants when assigning a personal rating.

Finally, admissions officers assign an overall rating. They can consider “tip factors” when assigning an overall rating. Tip factors include legacy status and athletic ability. About 30% of Harvard’s students are legacy applicants, the children of donors, the children of faculty members, or recruited athletes. Applicants in those categories have a significantly higher chance of being admitted than applicants outside of those categories.

Other tip factors include race and ethnicity, geographical location, and economic background. Apart from legacy status (which often rewards alumni who contribute to the school) and recruited athletes, one goal of tips is to achieve a racially, ethnically, geographically, and economically diverse student body. Harvard also considers an applicant’s intended field of study to assure adequate student interest in the classes that it offers.

Expert Testimony

A good bit of the trial addressed the legal validity of Harvard’s policy of promoting racial diversity in its student body. Supreme Court precedent prohibits racial quotas or “racial balancing” in admissions. It also prohibits race from being a mechanical factor that gives applicants a decisive advantage. Precedent nevertheless allows schools to consider race as one of many factors for the purpose of promoting diversity, which the Court recognizes as a compelling educational interest. However, race can only be considered if no race-neutral alternative is available that would achieve the same diverse student body.

The trial and appellate courts were persuaded by expert testimony that race was not a decisive factor in Harvard admissions. Even SFFA’s expert witness admitted that Harvard rejects most Hispanic applicants, and almost half of African American applicants, who are “among the top 10% most academically promising applicants to Harvard in terms of standardized test scores and GPA.” Harvard’s admissions process is so competitive that it admits only highly qualified students, regardless of race.

The expert evidence did not suggest that Asians who were rejected were any more likely to succeed at Harvard than black and Hispanic applicants who were accepted. In fact, the evidence established that ancestry enhanced the opportunity of some Asian applicants to be accepted.

The district court rejected SFFA’s racial balancing claim. It determined that Harvard treats every applicant as an individual and that every applicant competes for every seat. The court of appeals accepted that finding after noting that SFFA presented no expert evidence to support its claim that Harvard denies the applications of Asian American applicants in order to promote admissions of non-Asian applicants.

A statistical analysis presented by Harvard’s expert witnesses established that “the share of Asian American applicants admitted to Harvard has increased roughly five-fold since 1980 and roughly two-fold since 1990.” Expert analysis also demonstrated that the annual admission of Asian applicants varies more than the number of applications submitted by Asians, a finding that undercuts the claim that Harvard engaged in racial balancing.

Expert testimony established that the elimination of race as a factor in Harvard’s admissions policy would reduce the African American share of Harvard’s student body from 14% to 6% and would reduce the Hispanic share from 14% to 9%. Experts examined race-neutral alternatives proposed by SFFA, such as strengthening recruiting and financial aid, eliminating standardized testing, and eliminating tip factors. The expert witnesses concluded that none of those alternatives were viable means of assuring racial diversity.

Discriminatory Intent

The SFFA relied on the expert testimony of Peter Arcidiacono, an economics professor at Duke University, in its effort to prove that Harvard intentionally discriminated against Asians. Harvard countered with the expert testimony of David Card, an economics professor at UC-Berkeley. Both experts relied on statistical models that used regression analysis to explain how one variable (race) affected admissions while controlling for all other variables (such as grades and test scores).

The models suggested that Asian applicants tended to receive better scores than other applicants based on academic criteria but slightly worse scores based on personal factors. While the personal rating was correlated with race, the court of appeals agreed with the district court that correlation does not prove causation. In other words, the expert evidence did not establish that race influences the personal rating. The court regarded the statistical evidence of intentional discrimination as inconclusive and therefore held that SFFA failed to prove that Harvard violated the law by intentionally discriminating against Asian applicants.