David Sutton alleged in a lawsuit that he took acetaminophen that had been manufactured by Advance Pharmaceutical. He claimed that the product had been mislabeled as baby aspirin. He intended to take baby aspirin and contended that he experienced severe health problems as the result of taking acetaminophen.

Advance Pharmaceutical packages over-the-counter medications for distribution to wholesalers. It contended that the medications are intended for sale to hospitals, nursing homes, and pharmacies, and are not packaged for sale to the public. Advance Pharmaceutical admitted that it recalled baby aspirin in 2013 after a pharmacist noticed that a bottle of baby aspirin actually contained acetaminophen.

Sutton represented himself in the lawsuit. He appealed an order that dismissed the suit after he failed to pay a monetary sanction. The Michigan Court of Appeals concluded that the sanction was improper and ordered the trial court to reinstate the lawsuit.

The trial court again dismissed the lawsuit, this time because Sutton refused to sign forms authorizing the release of medical records so that Advance Pharmaceutical could determine whether he was taking other medications that might have caused his symptoms. Sutton again appealed and the court of appeals again reversed the dismissal.

Since Sutton had not produced a treating physician as a witness, the court of appeals concluded that he did not waive physician-patient privilege. The trial court therefore erred in holding that Advance Pharmaceutical had the right to view his medical records.

On remand, the trial court granted summary judgment to Advance Pharmaceutical, effectively dismissing the lawsuit a third time. Sutton brought a third appeal. A key issue on appeal was whether Sutton could prevail in his lawsuit without using an expert witness. The court of appeals agreed with the trial court that he could not.

Proof of Causation

Sutton alleged that he experienced a variety of symptoms from taking acetaminophen when he believed he was taking baby aspirin. His proof that Advance Pharmaceutical caused his harm was hampered by his inability to produce the allegedly mislabeled bottle.

Sutton testified that he destroyed the bottles that contained the pills as well as the pills he did not take. The appellate opinion does not explain how Sutton hoped to prove that the pills he took were manufactured by Advance Pharmaceutical or that the pill bottle (assuming it came from Advance Pharmaceutical) was mislabeled.

The trial court determined that Sutton’s documentary evidence was unverified by a records custodian. The appellate opinion does not make the nature of the records clear, but the court agreed that the records failed to prove he suffered harm caused by the ingestion of acetaminophen.

Lack of Expert Evidence

Sutton admitted that he never saw a doctor for treatment of the symptoms that he attributed to taking mislabeled acetaminophen. Failing to see a doctor allowed him to invoke physician-patient privilege as to his medical records, but it doomed his efforts to prove causation.

Sutton could rely on his own testimony to establish that he took pills he believed to be baby aspirin. He could also rely on his own testimony about the symptoms he experienced after taking the pills. But his own testimony was insufficient to prove that the pills caused those symptoms.

The court of appeals determined that neither Sutton nor his roommate, who would have confirmed that Sutton took the pills, could prove causation. Expert evidence was therefore needed to prove that acetaminophen caused the symptoms Sutton experienced.

The court of appeals concluded that Sutton could testify as a lay witness about his own actions, but his opinion about the cause of the cause of his injuries was speculative. Only a medical expert could give admissible testimony to connect the symptoms Sutton experienced to the acetaminophen he allegedly swallowed.

The decision stands as a reminder that in most cases alleging a physical injury caused by ingestion of a drug, expert medical testimony is needed to prove that the drug caused the injury. Ordinary jurors do not typically understand the potential side effects of taking a common over-the-counter medication. Without an expert witness to educate them, the jury has no basis to determine causation. Plaintiffs who proceed without an expert witness face the risk of a judgment that dismisses their case without a trial.