Schachtman Law

TORTINI

For your delectation and delight, desultory dicta on the law of delicts.

Government Secrecy That Denies Defendant A Fair Trial – Because of Reasons

June 20th, 2015

In Davis v. Ayala, defendant Hector Ayala challenged the prosecutor’s use of preemptory challenges in an apparently racially motivated fashion. The trial judge allowed the prosecutor to disclose his reasons in an ex parte session, without the defense present. Under the Supreme Court’s decision in Batson, the defendant should have had the opportunity to inquiry into the bona fides of the prosecutor’s claimed motivations. Based upon the prosecutor’s one-sided presentation, the trial judge ruled that the prosecutor had valid, race-neutral grounds for the contested strikes. After a trial, the empanelled jury convicted Ayala of murder, and sentenced him to death. In a 5-4 decision, the Supreme Court held that the trial court’s error was harmless. Davis v. Ayala, Supreme Court, No. 13–1428 (June 18, 2015). Justice Kennedy issued a concurrence. His conscience was curiously not troubled by the Star Chamber proceedings, but the facts of Ayala’s post-conviction incarceration, which has taken place largely in solitary confinement.

Remarkably, the New York Times weighed in on the Ayala case, but not to castigate the Court for rubber-stamping Kafkaesque Rules of Procedure that permits the defense to be excluded and prevented from exercising its Constitutionally protected role. The Times chose to spill ink instead on Justice Kennedy’s concurrence on the length of solitary confinement. Editorial, “Justice Kennedy on Solitary Confinement,” N.Y. Times (June 19, 2015).

What is curious about Justice Kennedy’s focus, and the Times’ cheerleading, is that they run roughshod over a procedural error that excused prosecutorial secrecy and that affected the adjudication of guilt or innocence, only to obsess about whether a man, taken to be guilty, has been treated inhumanely by the California prison system. Even more curious is the willingness to the Times to castigate, on bogus legal grounds, Justice Thomas for responding to Justice Kennedy:

“In a brief, sour retort that read more like a comment to a blog post, Justice Clarence Thomas quipped that however small Mr. Ayala’s current accommodations may be, they are ‘a far sight more spacious than those in which his victims, Ernesto Dominguez Mendez, Marcos Antonio Zamora, and Jose Luis Rositas, now rest’. It was a bizarre and unseemly objection. The Eighth Amendment does not operate on a sliding scale depending on the gravity of a prisoner’s crime.”

Id. (emphasis added). Except, of course, the Eight Amendment’s requirement of proportionality does operate on a sliding scale[1]. In Kennedy v. Louisiana, 554 U.S. 407 (2008), for instance, the Court held that the Eighth Amendment’s Cruel and Unusual Punishments Clause prohibited a state from imposing the death penalty to punish a child rapist because of the sanction’s disproportionality[2].

Perhaps the New York Times could hire a struggling young lawyer to fact check its legal pronouncements? Both Justice Kennedy and Justice Thomas were in the same majority that would tolerate denying the defendant of his constitutional right to examine prosecutor’s motivation for striking black and Hispanic jurors. What a “sour note” for the Times to sound over Justice Thomas’s empathy for the victims of the defendant’s crimes.

[1] William W. Berry III, “Eighth Amendment Differentness,” 78 Missouri L. Rev. 1053 (2013); Charles Walter Schwartz, “Eighth Amendment Proportionality Analysis and the Compelling Case of William Rummel,” 71 J. Crim. L. & Criminology 378 (1980); John F. Stinneford, “Rethinking Proportionality Under the Cruel and Unusual Punishments Clause,” 97 Va. L. Rev. 899 (2011).

[2] Also curious was that then Senator Barack Obama criticized the Supreme Court for its decision in the Kennedy case. See Sara Kugler “Obama Disagrees With High Court on Child Rape Case,” ABC News (June 25, 2008) (archived from the original).

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Daubert’s Error Rate

June 16th, 2015

In Daubert, the Supreme Court came to the realization that expert witness opinion testimony was allowed under the governing statute, Federal Rule of Evidence 702, only when that witness’s “scientific, technical, or other specialized knowledge” would help the fact finder. Knowledge clearly connotes epistemic warrant, and some of the Court’s “factors” speak directly to this warrant, such as whether the claim has been tested, and whether the opinion has an acceptable rate of error. The Court, however, continued to allow some proxies for that warrant, in the form of “general acceptance,” or “peer review.”

The “rate of error” factor has befuddled some courts in their attempt to apply the statutory requirements of Rule 702, especially when statistical evidence is involved. Some litigants have tried to suggest that a statistically significant result suffices alone to meet the demands of Rule 702, but this argument is clearly wrong. See, e.g., United States v. Vitek Supply Corp., 144 F.3d 476, 480, 485–86 (7th Cir. 1998) (stating that the purpose of the inquiry into rate of error is to determine whether tests are “accurate and reliable”) (emphasis added). See also “Judicial Control of the Rate of Error in Expert Witness Testimony” (May 28, 2015). The magnitude of tolerable actual or potential error rate remains, however, a judicial mystery[1].

Sir Austin Bradford Hill described ruling out bias, confounding, and chance (or random error) as essential prerequisites to considering his nine factors used to assess whether an association is causal:

“Disregarding then any such problem in semantics we have this situation. Our observations reveal an association between two variables, perfectly clear-cut and beyond what we would care to attribute to the play of chance. What aspects of that association should we especially consider before deciding that the most likely interpretation of it is causation.”

Austin Bradford Hill, “The Environment and Disease: Association or Causation?” 58 Proc. Royal Soc’y Med. 295, 295 (1965). The better reasoned cases agree. See, e.g., Frischhertz v. SmithKline Beecham Corp., 2012 U.S. Dist. LEXIS 181507, *6 (E.D.La. 2012) (“The Bradford-Hill criteria can only be applied after a statistically significant association has been identified.”) (citing and quoting among other sources, Federal Judicial Center, Reference Manual on Scientific Evidence, 599 & n.141 (3d. ed. 2011)).

Citing the dictum in Matrixx Initiatives[2] as though it were a holding is not only ethically dubious, but also ignores the legal and judicial context of the Court’s statements[3]. There are, after all, some circumstances such as cases of death by blunt-force trauma, or bullet wounds, when epidemiological and statistical evidence is not needed. The Court did not purport to speak to all causation assessments; nor did it claim that it was addressing only instances in which there were “expected cases,” and “base-line risks,” in diseases that have an accepted occurrence and incidence among unexposed persons. It is, of course, in exactly those cases that statistical consideration of bias, confounding, and chance are essential before Bradford Hill’s factors can be parsed.

Lord Rutherford[4] is often quoted as having said that “[i]f your experiment needs statistics, you ought to have done a better experiment.” Today, physics and chemistry have dropped their haughty disdain for statistics in the face of their recognition that some processes can be understood only as stochastic and rate driven. In biology, we are a long way from being able to describe the most common disease outcomes as mechanistic genetic or epigenetic events. Statistical analyses, with considerations of random and systematic error, will be with us for a long time, whether the federal judiciary acknowledges this fact or not.

* * * * * * * * * * * * *

Cases Discussing Error Rates in Rule 702 Decisions

SCOTUS

Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579, 593 (1993) (specifying the “the known or potential rate of error” as one of several factors in assessing the scientific reliability or validity of proffered expert witness’s opinion)

Kumho Tire Co. v. Carmichael, 526 U.S. 137, 151 (1999) (suggesting that reliability in the form of a known and an acceptable error rate is an important consideration for admissibility)

US Court of Appeals

FIRST CIRCUIT

United States v. Shea, 957 F. Supp. 331, 334–45 (D.N.H. 1997) (rejecting criminal defendant’s objection to government witness’s providing separate match and error probability rates)

SECOND CIRCUIT

Rabozzi v. Bombardier, Inc., No. 5:03-CV-1397 (NAM/DEP), 2007 U.S. Dist. LEXIS 21724, at *7, *8, *20 (N.D.N.Y. Mar. 27, 2007) (excluding testimony from civil engineer about boat design, in part because witness failed to provide rate of error)

Sorto-Romero v. Delta Int’l Mach. Corp., No. 05-CV-5172 (SJF) (AKT), 2007 U.S. Dist. LEXIS 71588, at *22–23 (E.D.N.Y. Sept. 24, 2007) (excluding engineering opinion that defective wood-carving tool caused injury because of lack of error rate)

In re Ephedra Products Liability Litigation, 393 F. Supp. 2d 181, 184 (S.D.N.Y. 2005) (confusing assessment of random error with probability that statistical estimate of true risk ratio was correct)

Roane v. Greenwich Swim Comm., 330 F. Supp. 2d 306, 309, 319 (S.D.N.Y. 2004) (excluding mechanical engineer, in part because witness failed to provide rate of error)

Nook v. Long Island R.R., 190 F. Supp. 2d 639, 641–42 (S.D.N.Y. 2002) (excluding industrial hygienist’s opinion in part because witness was unable to provide a known rate of error).

United States v. Towns, 19 F. Supp. 2d 67, 70–72 (W.D.N.Y. 1998) (permitting clinical psychologist to opine about defendant’s mens rea and claimed mental illness causing his attempted bank robbery, in part because the proffer of opinion maintained that the psychologist would provide an error rate)

Meyers v. Arcudi, 947 F. Supp. 581 (D. Conn. 1996) (excluding polygraph in civil action in part because of error rate)

THIRD CIRCUIT

United States v. Ewell, 252 F. Supp. 2d 104, 113–14 (D.N.J. 2003) (rejecting criminal defendant’s objection to government’s failure to quantify laboratory error rate)

Soldo v. Sandoz Pharmaceuticals Corp., 244 F. Supp. 2d 434, 568 (W.D. Pa. 2003) (excluding plaintiffs’ expert witnesses in part because court, and court-appointed expert witnesses, were unable to determine error rate).

Pharmacia Corp. v. Alcon Labs., Inc., 201 F. Supp. 2d 335, 360 (D.N.J. 2002) (excluding ; error too high).

FOURTH CIRCUIT

United States v. Moreland, 437 F.3d 424, 427–28, 430–31 (4th Cir. 2006) (affirming district court’s allowance of forensic chemist’s testimony that could not provide error rate because reviews of witness’s work found it to be free of error)

Buckman v. Bombardier Corp., 893 F. Supp. 547, 556–57 (E.D.N.C. 1995) (ruling that an expert witness may opine about comparisons between boat engines in rough water but only as a lay witness, because the comparison tests were unreliable, with a high estimated rate of error)

FIFTH CIRCUIT

Albert v. Jordan, Nos. 05CV516, 05CV517, 05CV518, 05CV519, 2007 U.S. Dist. LEXIS 92025, at *2–3 (W.D. La. Dec. 14, 2007) (allowing testimony of vocational rehabilitation expert witness, over objection, because witness provided “reliable” information, with known rate of error)

SIXTH CIRCUIT

United States v. Leblanc, 45 F. App’x 393, 398, 400 (6th Cir. 2002) (affirming exclusion of child psychologist, whose testimony about children’s susceptibility to coercive interrogation was based upon “‘soft science’ . . . in which ‘error is . . . rampant’.” (quoting the district court))

United States v. Sullivan, 246 F. Supp. 2d 696, 698–99 (E.D. Ky. 2003) (admitting expert witness’s opinion on the unreliability of eyewitness identification; confusing error rate of witness’s opinion with accuracy of observations made based upon order of presentation of photographs of suspect)

SEVENTH CIRCUIT

United States v. Vitek Supply Corp., 144 F.3d 476, 480, 485–86 (7th Cir. 1998) (affirming denial of defendant’s Rule 702 challenge based in part upon error rates; the purpose of the inquiry into rate of error is to determine whether tests are “accurate and reliable”; here the government’s expert witnesses used adequate controls and replication to ensure an acceptably low rate of error)

Phillips v. Raymond Corp., 364 F. Supp. 2d 730, 732–33, 740-41 (N.D. Ill. 2005) (excluding biomechanics expert witness who had not reliably tested his claims in a way to produce an accurate rate of error)

EIGHTH CIRCUIT

Bone Shirt v. Hazeltine, 461 F.3d 1011, 1020 (8th Cir. 2006) (affirming district court’s ruling to admit testimony of expert witness’s regression analysis in vote redistricting case); see id. at 1026 (Gruender, J., concurring) (expressing concern with the questioned testimony’s potential rate of error because it is “difficult to weigh this factor in Daubert’s analysis if ‘the effect of that error is unknown’.” (quoting court below, Bone Shirt v. Hazeltine, 336 F. Supp. 2d 976, 1002 (D.S.D. 2004))

United States v. Beasley, 102 F.3d 1440, 1444, 1446–48 (8th Cir. 1996) (confusing random error with general error rate) (affirming admissibility of expert witness testimony based upon DNA testing, because such testing followed acceptable standards in testing for contamination and “double reading”)

NINTH CIRCUIT

United States v. Chischilly, 30 F.3d 1144, 1148, 1152, 1154–55 (9th Cir. 1994) (affirming admissibility of testimony based upon DNA match in sex crime, noting that although error rate of error was unquantified, the government had made a sufficient showing of rarity of false positives to support an inference of low error rate)

Cascade Yarns, Inc. v. Knitting Fever, Inc., No. C10–861RSM, 2012 WL 5194085, at *7 (W.D. Wash. Oct. 18. 2012) (excluding expert witness opinion because error rate was too high)

United States v. Microtek Int’l Dev. Sys. Div., Inc., No. 99-298-KI, 2000 U.S. Dist. LEXIS 2771, at *2, *10–13, *15 (D. Or. Mar. 10, 2000) (excluding polygraph data based upon showing that claimed error rate came from highly controlled situations, and that “real world” situations led to much higher error (10%) false positive error rates)

TENTH CIRCUIT

Miller v. Pfizer, Inc., 356 F.3d 1326, 1330, 1334 (10th Cir. 2004) (affirming exclusion of plaintiffs’ expert witness, Dr. David Healy, based upon district court’s findings, made with the assistance of court-appointed expert witnesses, that Healy’s opinion was based upon studies that lacked sufficient sample size, adequate controls, and freedom from study bias, and thus prone to unacceptable error rate)

ELEVENTH CIRCUIT

Quiet Tech. DC-8, Inc. v. Hurel-Duboi U.K., Ltd., 326 F.3d 1333, 1343–45 (11th Cir. 2003) (affirming trial court’s admission of defendant’s aerospace engineer’s testimony, when the lower court had found that the error rate involved was “relatively low”; rejecting plaintiff’s argument that the witness had entered data incorrectly on ground that the asserted error would not affect the validity of the witness’s opinions)

Wright v. Case Corp., No. 1:03-CV-1618-JEC, 2006 U.S. Dist. LEXIS 7683, at *14 (N.D. Ga. Feb. 1, 2006) (granting defendant’s motion to exclude plaintiff’s mechanical engineering expert, because the expert’s alternative designs for the seat safety bar were not reliable due to potential feasibility issues, and because the associated error rate was therefore unquantifiable but potentially very high)

Benkwith v. Matrixx Initiatives, Inc., 467 F. Supp. 2d 1316, 1326, 1330, 1332 (M.D. Ala. 2006) (granting defendant’s motion to exclude testimony of an expert in the field of epidemiology regarding Zicam nasal spray’s causing plaintiff’s anosmia, because the opinions had not been tested and a rate of error could not be provided).

D.C. CIRCUIT

Ambrosini v. Upjohn Co., No. 84-3483 (NHJ), 1995 U.S. Dist. LEXIS 21318, at *16, *22–24 (D.D.C. Oct. 18, 1995) (finding that plaintiff’s teratology expert was not permitted to testify, because the methodology used was found to be unreliable and could not yield an accurate error rate)

[1] Jed S. Rakoff, “Science and the Law: Uncomfortable Bedfellows,” 38 Seton Hall L. Rev. 1379, 1382–83 (2008) (observing that an error rate of 13 percent in polygraph interpretation would likely be insufficiently reliable to support admissibility of testimony based upon polygraph results).

[2] Matrixx Initiatives, Inc. v. Siracusano, 131 S. Ct. 1309, 1319 (2011) (suggesting that courts “frequently permit expert testimony on causation based on evidence other than statistical significance”).

[3] See, e.g., WLF Legal Backgrounder on Matrixx Initiatives (June 20, 2011); “The Matrixx – A Comedy of Errors”; Matrixx Unloaded (Mar. 29, 2011)”; “The Matrixx Oversold” (April 4, 2011); “De-Zincing the Matrixx.”

[4] Ernest Rutherford, a British chemist, investigated radioactivity. He won the Nobel Prize in chemistry, in 1908.

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How to Fake a Moon Landing

June 8th, 2015

“The meaning of the world is the separation of wish and fact.”
Kurt Gödel

Everyone loves science except when science defeats wishes for a world not known. Coming to accept the world based upon evidence requires separating wish from fact. And when the evidence is lacking in quality or quantity, then science requires us to have the discipline to live with uncertainty rather than wallow in potentially incorrect beliefs.

Darryl Cunningham has written an engaging comic graphics book about science and the scientific worldview. Darryl Cunningham, How to Fake a Moon Landing: Exposing the Myths of Science Denial (2013). Through pictorial vignettes, taken from current controversies, Cunningham has created a delightful introduction to scientific methodology and thinking. Cunningham has provided chapters on several modern scandalous deviations from the evidence-based understanding of the world, including:

The Moon Hoax
Homeopathy
Chiropractic
The MMR Vaccination Scandal
Evolution
Fracking
Climate Change, and
Science Denial

Most people will love this book. Lawyers will love the easy-to-understand captions. Physicians will love the debunking of chiropractic. Republicans will love the book’s poking fun at (former Dr.) Andrew Wakefield and his contrived MMR vaccination-autism scare, and the liberal media’s unthinking complicity in his fraud. Democrats will love the unraveling of the glib, evasive assertions of the fracking industry. New Agers will love the book because of its neat pictures, and they probably won’t read the words anyway, and so they will likely miss the wonderful deconstruction of homeopathy and other fashionable hokum. Religious people, however, will probably hate the fun poked at all attempts to replace evidence with superstitions.Roblox Hack Bigo Live Beans Hack YUGIOH DUEL LINKS HACK Pokemon Duel Hack Roblox Hack Pixel Gun 3d Hack Growtopia Hack Clash Royale Hack my cafe recipes stories hack Mobile Legends Hack Mobile Strike Hack

Without rancor, Cunningham pillories all true believers who think that they can wish the facts of the world. At $16.95, the book is therapeutic and a bargain.

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The Eleventh Circuit Confuses Adversarial and Methodological Bias, Manifestly Erroneously

June 6th, 2015

The Eleventh Circuit’s decision in Adams v. Laboratory Corporation of America, is disturbing on many levels. Adams v. Lab. Corp. of Am., 760 F.3d 1322 (11th Cir. 2014). Professor David Bernstein has already taken the Circuit judges to task for their failure to heed the statutory requirements of Federal Rule of Evidence 702. See David Bernstein, “A regrettable Eleventh Circuit expert testimony ruling, Adams v. Lab. Corp. of America,” Wash. Post (May 26, 2015). Sadly, the courts’ strident refusal to acknowledge the statutory nature of Rule 702, and the Congressional ratification of the 2000 amendments to Rule 702, have become commonplace in the federal courts. Ironically, the holding of the Supreme Court’s decision in Daubert itself was that the lower courts were not free to follow common law that had not been incorporated into the first version of the Rule 702.

There is much more wrong with the Adams case than just a recalcitrant disregard for the law: the Circuit displayed an equally distressing disregard for science. The case started as a negligent failure to diagnose cervical cancer claim against defendant Laboratory Corporation of America. Plaintiffs claimed that the failure to diagnose cancer led to delays in treatment, which eroded Mrs. Adam’s chance for a cure.

Before the Adams case arose, two professional organizations, the College of American Pathologists (CAP) and the American Society of Cytopathology (ASC) issued guidelines about how an appropriate retrospective review should be conducted. Both organizations were motivated by two concerns: protecting their members from exaggerated, over-extended, and bogus litigation claims, as well as by a scientific understanding that a false-negative finding by a cytopathologist does not necessarily reflect a negligent interpretation of a Pap smear[1]. Both organizations called for a standard of blinded review in litigation to protect against hind-sight bias. The Adams retained a highly qualified pathologist, Dr. Dorothy Rosenthal, who with full knowledge of the later diagnosis and the professional guidelines, reviewed the earlier Pap smears that were allegedly misdiagnosed as non-malignant. 760 F.3d at 1326. Rosenthal’s approach violated the CAP and ASC guidelines, as well as common sense.

The district judge ruled that Rosenthal’s approach was little more than an ipse dixit, and a subjective method that could not be reviewed objectively. Adams v. Lab. Corp. of Am., No. 1:10-CV-3309-WSD, 2012 WL 370262, at *15 (N.D. Ga. Feb. 3, 2012). In a published per curiam opinion, the Eleventh Circuit reversed, holding that the district judge’s analysis of Rosenthal’s opinion was “manifestly erroneous.” 760 F.3d at 1328. Judge Garza, of the Fifth Circuit, sitting by designation, concurred to emphasize his opinion that Rosenthal did not need a methodology, as long as she showed up with her qualifications and experience to review the contested Pap smears.

The Circuit opinion is a model of conceptual confusion. The judges refer to the professional society guidelines, but never provide citations. (See note 1, infra.). The Circuit judges are obviously concerned that the professional societies are promulgating standards to be used in judging claims against their own members for negligent false-negative interpretations of cytology or pathology. What the appellate judges failed to recognize, however, is that the professional societies had a strong methodological basis for insisting upon “blinded” review of the slides in controversy. Knowledge of the outcome must of necessity bias any subsequent review, such as plaintiffs’ expert witness, Rosenthal. Even a cursory reading of the two guidelines would have made clear that they had been based on more than simply a desire to protect members; they were designed to protect members against bogus claims, and cited data in support of their position[2]. Subsequent to the guidelines, several publications have corroborated the evidence-based need for blinded review[3].

The concepts of sensitivity, specificity, and positive predictive value are inherent in any screening procedure; they are very much part of the methodology of screening. These measures, along with statistical analyses of concordance and discordance among experienced cytopathologists, can be measured and assessed for accuracy and reliability. The Circuit judges in Adams, however, were blinded (in a bad way) to the scientific scruples that govern screenings. The per curiam opinion suggests that:

“[t]he only arguably appreciable differences between Dr. Rosenthal’s method and the review method for LabCorp’s cytotechnologists is that Dr. Rosenthal (1) already knew that the patient whose slides she was reviewing had developed cancer and (2) reviewed slides from just one patient. Those differences relate to the lack of blinded review, which we address later.”

760 F.3d at 1329 n. 10. And when the judges addressed the lack of blinded review, they treated hindsight bias, a cognitive bias and methodological flaw in the same way as they would have trial courts and litigants treat Dr. Rosenthal’s “philosophical bent” in favor of cancer patients — as “a credibility issue for the jury.” Id. at 1326-27, 1332. This conflation of methodological bias with adversarial bias, however, is a prescription for eviscerating judicial gatekeeping of flawed opinion testimony. Judge Garza, in a concurring opinion, would have gone further and declared that plaintiffs’ expert witness Rosenthal had no methodology and thus she was free to opine ad libitum.

Although Rosenthal’s “philosophical bent” might perhaps be left to the crucible of cross-examination, hindsight review bias could and should have been eliminated by insisting that Rosenthal wear the same “veil of ignorance” of Mrs. Adam’s future clinical course, which the defendant wore when historically evaluating the plaintiff’s Pap smears. Here Rosenthal’s adversarial bias was very probably exacerbated by her hindsight bias, and the Circuit missed a valuable opportunity to rein in both kinds of bias.

Certainly in other areas of medicine, such as radiology, physicians are blinded to the correct interpretation and evaluated on their ability to line up with a gold standard. The NIOSH B-reader examination, for all its problems, at least tries to qualify physicians in the use of the International Labor Organization’s pneumoconiosis scales for interpreting plain-film radiographs for pulmonary dust diseases, by having them read and interpret films blinded to the NIOSH/ILO consensus interpretation.

[1] See Patrick L. Fitzgibbons & R. Marshall Austin, “Expert review of histologic slides and Papanicolaou tests in the context of litigation or potential litigation — Surgical Pathology Committee and Cytopathology Committee of the College of American Pathologists,” 124 Arch. Pathol. Lab. Med. 1717 (2000); American Society of Cytopathology, “Guidelines for Review of Gyn Cytology Samples in the Context of Litigation or Potential Litigation” (2000).

[2] The CAP guideline, for instance, cited R. Marshall Austin, “Results of blinded rescreening of Papanicolaou smears versus biased retrospective review,” 121 Arch. Pathol. Lab. Med. 311 (1997).

[3] Andrew A. Renshaw, K.M Lezon, and D.C. Wilbur, “The human false-negative rate of rescreening Pap tests: Measured in a two-arm prospective clinical trial,” 93 Cancer (Cancer Cytopathol.) 106 (2001); Andrew A. Renshaw, Mary L. Young, and E. Blair Holladay, “Blinded review of Papanicolaou smears in the context of litigation: Using statistical analysis to define appropriate thresholds,” 102 Cancer Cytopathology 136 (2004) (showing that data from blinded reviews can be interpreted in a statistically appropriate way, and defining standards to improve the accuracy and utility of blinded reviews); D. V. Coleman & J. J. R. Poznansky, “Review of cervical smears from 76 women with invasive cervical cancer: cytological findings and medicolegal implications,” 17 Cytopathology 127 (2006); Andrew A. Renshaw, “Comparing Methods to Measure Error in Gynecologic Cytology and Surgical Pathology,” 130 Arch. Path. & Lab. Med. 626 (2009).

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Judicial Control of the Rate of Error in Expert Witness Testimony

May 28th, 2015

In Daubert, the Supreme Court set out several criteria or factors for evaluating the “reliability” of expert witness opinion testimony. The third factor in the Court’s enumeration was whether the trial court had considered “the known or potential rate of error” in assessing the scientific reliability of the proffered expert witness’s opinion. Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579, 593 (1993). The Court, speaking through Justice Blackmun, failed to provide much guidance on the nature of the errors subject to gatekeeping, on how to quantify the errors, and on to know how much error was too much. Rather than provide a taxonomy of error, the Court lumped “accuracy, validity, and reliability” together with a grand pronouncement that these measures were distinguished by no more than a “hen’s kick.” Id. at 590 n.9 (1993) (citing and quoting James E. Starrs, “Frye v. United States Restructured and Revitalized: A Proposal to Amend Federal Evidence Rule 702,” 26 Jurimetrics J. 249, 256 (1986)).

The Supreme Court’s failure to elucidate its “rate of error” factor has caused a great deal of mischief in the lower courts. In practice, trial courts have rejected engineering opinions on stated grounds of their lacking an error rate as a way of noting that the opinions were bereft of experimental and empirical evidential support[1]. For polygraph evidence, courts have used the error rate factor to obscure their policy prejudices against polygraphs, and to exclude test data even when the error rate is known, and rather low compared to what passes for expert witness opinion testimony in many other fields[2]. In the context of forensic evidence, the courts have rebuffed objections to random-match probabilities that would require that such probabilities be modified by the probability of laboratory or other error[3].

When it comes to epidemiologic and other studies that require statistical analyses, lawyers on both sides of the “v” frequently misunderstand p-values or confidence intervals to provide complete measures of error, and ignore the larger errors that result from bias, confounding, study validity (internal and external), inappropriate data synthesis, and the like[4]. Not surprisingly, parties fallaciously argue that the Daubert criterion of “rate of error” is satisfied by expert witness’s reliance upon studies that in turn use conventional 95% confidence intervals and measures of statistical significance in p-values below 0.05[5].

The lawyers who embrace confidence intervals and p-values as their sole measure of error rate fail to recognize that confidence intervals and p-values are means of assessing only one kind of error: random sampling error. Given the carelessness of the Supreme Court’s use of technical terms in Daubert, and its failure to engage in the actual evidence at issue in the case, it is difficult to know whether the Court intended to suggest that random error was the error rate it had in mind[6]. The statistics chapter in the Reference Manual on Scientific Evidence helpfully points out that the inferences that can be drawn from data turn on p-values and confidence intervals, as well as on study design, data quality, and the presence or absence of systematic errors, such as bias or confounding. Reference Manual on Scientific Evidence at 240 (3d 2011) [Manual]. Random errors are reflected in the size of p-values or the width of confidence intervals, but these measures of random sampling error ignore systematic errors such as confounding and study biases. Id. at 249 & n.96.

The Manual’s chapter on epidemiology takes an even stronger stance: the p-value for a given study does not provide a rate of error or even a probability of error for an epidemiologic study:

“Epidemiology, however, unlike some other methodologies—fingerprint identification, for example—does not permit an assessment of its accuracy by testing with a known reference standard. A p-value provides information only about the plausibility of random error given the study result, but the true relationship between agent and outcome remains unknown. Moreover, a p-value provides no information about whether other sources of error – bias and confounding – exist and, if so, their magnitude. In short, for epidemiology, there is no way to determine a rate of error.”

Manual at 575. This stance seems not entirely justified given that there are Bayesian approaches that would produce credibility intervals accounting for sampling and systematic biases. To be sure, such approaches have their own problems and they have received little to no attention in courtroom proceedings to date.

The authors of the Manual’s epidemiology chapter, who are usually forgiving of judicial error in interpreting epidemiologic studies, point to one United States Court of Appeals case that fallaciously interpreted confidence intervals magically to quantify bias and confounding in a Bendectin birth defects case. Id. at 575 n. 96[7]. The Manual could have gone further to point out that, in the context of multiple studies, of different designs and analyses, cognitive biases involved in evaluating, assessing, and synthesizing the studies are also ignored by statistical measures such as p-values and confidence intervals. Although the Manual notes that assessing the role of chance in producing a particular set of sample data is “often viewed as essential when making inferences from data,” the Manual never suggests that random sampling error is the only kind of error that must be assessed when interpreting data. The Daubert criterion would appear to encompass all varieties or error, not just random error.

The Manual’s suggestion that epidemiology does not permit an assessment of the accuracy of epidemiologic findings misrepresents the capabilities of modern epidemiologic methods. Courts can, and do, invoke gatekeeping approaches to weed out confounded study findings. See “Sorting Out Confounded Research – Required by Rule 702” (June 10, 2012). The “reverse Cornfield inequality” was an important analysis that helped establish the causal connection between tobacco smoke and lung cancer[8]. Olav Axelson studied and quantified the role of smoking as a confounder in epidemiologic analyses of other putative lung carcinogens.[9] Quantitative methods for identifying confounders have been widely deployed[10].

A recent study in birth defects epidemiology demonstrates the power of sibling cohorts in addressing the problem of residual confounding from observational population studies with limited information about confounding variables. Researchers looking at various birth defect outcomes among offspring of women who used certain antidepressants in early pregnancy generally found no associations in pooled data from Iceland, Norway, Sweden, Finland, and Denmark. A putative association between maternal antidepressant use and a specific kind of cardiac defect (right ventricular outflow tract obstruction or RVOTO) did appear in the overall analysis, but was reversed when the analysis was limited to the sibling subcohort. The study found an apparent association between RVOTO defects and first trimester maternal exposure to selective serotonin reuptake inhibitors, with an adjusted odds ratio of 1.48 (95% C.I., 1.15, 1.89). In the adjusted analysis for siblings, the study found an OR of 0.56 (95% C.I., 0.21, 1.49) in an adjusted sibling analysis[11]. This study and many others show how creative analyses can elucidate and quantify the direction and magnitude of confounding effects in observational epidemiology.

Systematic bias has also begun to succumb to more quantitative approaches. A recent guidance paper by well-known authors encourages the use of quantitative bias analysis to provide estimates of uncertainty due to systematic errors[12].

Although the courts have failed to articulate the nature and consequences of erroneous inference, some authors would reduce all of Rule 702 (and perhaps 704, 403 as well) to a requirement that proffered expert witnesses “account” for the known and potential errors in their opinions:

“If an expert can account for the measurement error, the random error, and the systematic error in his evidence, then he ought to be permitted to testify. On the other hand, if he should fail to account for any one or more of these three types of error, then his testimony ought not be admitted.”

Mark Haug & Emily Baird, “Finding the Error in Daubert,” 62 Hastings L.J. 737, 739 (2011).

Like most antic proposals to revise Rule 702, this reform vision shuts out the full range of Rule 702’s remedial scope. Scientists certainly try to identify potential sources of error, but they are not necessarily very good at it. See Richard Horton, “Offline: What is medicine’s 5 sigma?” 385 Lancet 1380 (2015) (“much of the scientific literature, perhaps half, may simply be untrue”). And as Holmes pointed out[13], certitude is not certainty, and expert witnesses are not likely to be good judges of their own inferential errors[14]. Courts continue to say and do wildly inconsistent things in the course of gatekeeping. Compare In re Zoloft (Setraline Hydrochloride) Products, 26 F. Supp. 3d 449, 452 (E.D. Pa. 2014) (excluding expert witness) (“The experts must use good grounds to reach their conclusions, but not necessarily the best grounds or unflawed methods.”), with Gutierrez v. Johnson & Johnson, 2006 WL 3246605, at *2 (D.N.J. November 6, 2006) (denying motions to exclude expert witnesses) (“The Daubert inquiry was designed to shield the fact finder from flawed evidence.”).

[1] See, e.g., Rabozzi v. Bombardier, Inc., No. 5:03-CV-1397 (NAM/DEP), 2007 U.S. Dist. LEXIS 21724, at *7, *8, *20 (N.D.N.Y. Mar. 27, 2007) (excluding testimony from civil engineer about boat design, in part because witness failed to provide rate of error); Sorto-Romero v. Delta Int’l Mach. Corp., No. 05-CV-5172 (SJF) (AKT), 2007 U.S. Dist. LEXIS 71588, at *22–23 (E.D.N.Y. Sept. 24, 2007) (excluding engineering opinion that defective wood-carving tool caused injury because of lack of error rate); Phillips v. Raymond Corp., 364 F. Supp. 2d 730, 732–33 (N.D. Ill. 2005) (excluding biomechanics expert witness who had not reliably tested his claims in a way to produce an accurate rate of error); Roane v. Greenwich Swim Comm., 330 F. Supp. 2d 306, 309, 319 (S.D.N.Y. 2004) (excluding mechanical engineer, in part because witness failed to provide rate of error); Nook v. Long Island R.R., 190 F. Supp. 2d 639, 641–42 (S.D.N.Y. 2002) (excluding industrial hygienist’s opinion in part because witness was unable to provide a known rate of error).

[2] See, e.g., United States v. Microtek Int’l Dev. Sys. Div., Inc., No. 99-298-KI, 2000 U.S. Dist. LEXIS 2771, at *2, *10–13, *15 (D. Or. Mar. 10, 2000) (excluding polygraph data based upon showing that claimed error rate came from highly controlled situations, and that “real world” situations led to much higher error (10%) false positive error rates); Meyers v. Arcudi, 947 F. Supp. 581 (D. Conn. 1996) (excluding polygraph in civil action).

[3] See, e.g., United States v. Ewell, 252 F. Supp. 2d 104, 113–14 (D.N.J. 2003) (rejecting defendant’s objection to government’s failure to quantify laboratory error rate); United States v. Shea, 957 F. Supp. 331, 334–45 (D.N.H. 1997) (rejecting objection to government witness’s providing separate match and error probability rates).

[4] For a typical judicial misstatement, see In re Zoloft Products, 26 F. Supp.3d 449, 454 (E.D. Pa. 2014) (“A 95% confidence interval means that there is a 95% chance that the ‘‘true’’ ratio value falls within the confidence interval range.”).

[5] From my experience, this fallacious argument is advanced by both plaintiffs’ and defendants’ counsel and expert witnesses. See also Mark Haug & Emily Baird, “Finding the Error in Daubert,” 62 Hastings L.J. 737, 751 & n.72 (2011).

[6] See David L. Faigman, et al. eds., Modern Scientific Evidence: The Law and Science of Expert Testimony § 6:36, at 359 (2007–08) (“it is easy to mistake the p-value for the probability that there is no difference”)

[7] Brock v. Merrell Dow Pharmaceuticals, Inc., 874 F.2d 307, 311-12 (5^th Cir. 1989), modified, 884 F.2d 166 (5^th Cir. 1989), cert. denied, 494 U.S. 1046 (1990). As with any error of this sort, there is always the question whether the judges were entrapped by the parties or their expert witnesses, or whether the judges came up with the fallacy on their own.

[8] See Joel B Greenhouse, “Commentary: Cornfield, Epidemiology and Causality,” 38 Internat’l J. Epidem. 1199 (2009).

[9] Olav Axelson & Kyle Steenland, “Indirect methods of assessing the effects of tobacco use in occupational studies,” 13 Am. J. Indus. Med. 105 (1988); Olav Axelson, “Confounding from smoking in occupational epidemiology,” 46 Brit. J. Indus. Med. 505 (1989); Olav Axelson, “Aspects on confounding in occupational health epidemiology,” 4 Scand. J. Work Envt’l Health 85 (1978).

[10] See, e.g., David Kriebel, Ariana Zeka1, Ellen A Eisen, and David H. Wegman, “Quantitative evaluation of the effects of uncontrolled confounding by alcohol and tobacco in occupational cancer studies,” 33 Internat’l J. Epidem. 1040 (2004).

[11] Kari Furu, Helle Kieler, Bengt Haglund, Anders Engeland, Randi Selmer, Olof Stephansson, Unnur Anna Valdimarsdottir, Helga Zoega, Miia Artama, Mika Gissler, Heli Malm, and Mette Nørgaard, “Selective serotonin reuptake inhibitors and ventafaxine in early pregnancy and risk of birth defects: population based cohort study and sibling design,” 350 Brit. Med. J. 1798 (2015).

[12] Timothy L.. Lash, Matthew P. Fox, Richard F. MacLehose, George Maldonado, Lawrence C. McCandless, and Sander Greenland, “Good practices for quantitative bias analysis,” 43 Internat’l J. Epidem. 1969 (2014).

[13] Oliver Wendell Holmes, Jr., Collected Legal Papers at 311 (1920) (“Certitude is not the test of certainty. We have been cock-sure of many things that were not so.”).

[14] See, e.g., Daniel Kahneman & Amos Tversky, “Judgment under Uncertainty: Heuristics and Biases,” 185 Science 1124 (1974).

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Can an Expert Witness Be Too Biased to Be Allowed to Testify

May 20th, 2015

The Case of Barry Castleman

Barry Castleman has been a fixture in asbestos litigation for over three decades. By all appearances, he was the creation of the litigation industry. Castleman received a bachelor of science degree in chemical engineering in 1968, and a master’s degree in environmental engineering, in 1972. In 1975, he started as a research assistant to plaintiffs’ counsel in asbestos litigation, and in 1979, he commenced his testimonial adventures as a putative expert witness for plaintiffs’ counsel. Enrolled in a doctoral program, Castleman sent chapters of his thesis to litigation industry mentors for review and edits. In 1985, Castleman received a doctorate degree, with the assistance of a Ron Motley fellowship. See John M. Fitzpatrick, “Digging Deep to Attack Bias of Plaintiff Experts,” DRI Products Liability Seminar (2013).

Castleman candidly testified, on many occasions, that he was not an epidemiologist, a biostatistician, a toxicologist, a physician, a pathologist, or any other kind of healthcare professional. He is not a trained historian. Understandably, courts puzzled over exactly what someone like Castleman should be allowed to testify about. Many courts limited or excluded Castleman from remunerative testimonial roles[1]. Still, in the face of his remarkably inadequate training, education, and experience, Castleman persisted, and often prevailed, in making a living at testifying about the historical “state of the art” of medical knowledge about asbestos over time.

The result was often not pretty. Castleman worked not just as an expert witness, but also as an agent of plaintiffs’ counsel to suppress evidence. “The Selikoff – Castleman Conspiracy” (May 13, 2011). As a would-be historian, Castleman was controlled and directed by the litigation industry to avoid inconvenient evidence. “Discovery into the Origin of Historian Expert Witnesses’ Opinions” (Jan. 30, 2012). Despite his covert operations, and his exploitation of defendants’ internal documents, Castleman complained more than anyone about the scrutiny created by his self-chosen litigation roles. In 1985, pressed for materials he had considered in formulating his “opinions,” Castleman wrote a personal letter to the judge, the Hon. Hugh Gibson of Galveston, Texas, to object to lawful discovery into his activities:

“1. It threatens me ethically through demands that I divulge material submitted in confidence, endangering my good name and reputation.
2. It exposes me to potential liability arising from the release of correspondence and other materials provided to me by others who assumed I would honor their confidence.
3. It jeopardizes my livelihood in that material requested reveals strategies of parties with whom I consult, as well as other materials of a confidential nature.
4. It is far beyond the scope of relevant material to my qualifications and the area of expert testimony offered.
5. It is unprecedented in 49 prior trials and depositions where I have testified, in federal and state courts all over the United States, including many cases in Texas. Never before have I had to produce such voluminous and sensitive material in order to be permitted to testify.
6. It is excessively and unjustifiably intrusive into my personal and business life.
7. I have referenced most of the information I have in my 593-page book, “Asbestos: Medical and Legal Aspects.” The great majority of the information I have on actual knowledge of specific defendants has come from the defendants themselves.
8. All information that I have which is relevant to my testimony and qualifications has been the subject of numerous trials and depositions since 1979.”

Castleman Letter to Hon. Hugh Gibson (Nov. 5, 1985).

Forty years later, Castleman is still working for the litigation industry, and courts are still struggling to figure out what role he should be allowed as a testifying expert witness.

Last year, the Delaware Supreme Court had to order a new trial for R. T. Vanderbilt, in part because Castleman had blurted out non-responsive, scurrilous hearsay statements that:

(1) employees of Johns-Manville (a competitor of R.T. Vanderbilt) had called employees of Vanderbilt “liars;”

(2) R.T. Vanderbilt spent a great amount of money on studies and activities to undermine federal regulatory action on talc; and

(3) R.T. Vanderbilt was “buying senators and lobbying the government.”

The Delaware court held that Castleman’s gratuitous, unsolicited testimony on cross-examination was inadmissible, and that his conduct required a new trial. R.T. Vanderbilt Co. v. Galliher, No. 510, 2013, 2014 WL 3674180 (Del. July 24, 2014).

Late last year, a federal court ruled, pre-trial, that Castleman may testify over Rule 702 objections because he “possesses ‘specialized knowledge’ regarding the literature relating to asbestos available during the relevant time periods,” and that his testimony “could be useful to the jury as a ‘sort of anthology’ of the copious available literature.” Krik v. Crane Co., No. 10-cv-7435, – F. Supp. 2d -, 2014 WL 5350463, *3 (N.D. Ill. Oct. 21, 2014). Because Castleman was little more than a sounding board for citing and reading sections of the historical medical literature, the district court prohibited him from testifying as to the accuracy of any conclusions in the medical literature. Id.

Last week, another federal court took a different approach to keeping Castleman in business. In ruling on defendant’s Rule 702 objections to Castleman, the court held:

“I agree with defendant that plaintiffs have made no showing that Castleman is qualified to explain the meaning and significance of medical literature. Further, there is no suggestion in Krik that Castleman is qualified as an expert in that respect. To the extent that plaintiffs want Castleman simply to read excerpts from medical articles, they do not explain how doing so could be helpful to the jury. Accordingly, I am granting defendant’s motion as it relates to Castleman’s discussion of the medical literature.

***

However, Castleman’s report also includes discussions of articles in trade journals and government publications, which, presumably, would not require medical expertise to understand or summarize.”

Suoja v. Owens-Illinois, Inc., 2015 U.S. Dist. LEXIS 63170, at *3 (W.D.Wisc. May 14, 2015). Judge Barbara Crabb thus disallowed medical state of the art testimony from Castleman, but permitted him to resume his sounding board role for non-medical and other historical documents referenced in his Rule 26 report.

The strange persistence of Barry Castleman, and the inconsistent holdings of dozens of opinions strewn across the asbestos litigation landscape, raise the question whether someone so biased, so entrenched in a litigation role, so lacking in the requisite expertise, should simply be expunged from the judicial process. Rather than struggling to find some benign, acceptable role for Barry Castleman, perhaps courts should just say no. “How Testifying Historians Are Like Lawn-Mowing Dogs” (May 24, 2010).

[1] See, e.g., Van Harville v. Johns-Manville Sales Corp., CV-78-642-H (S.D. Ala 1979); In re Related Asbestos Cases, 543 F. Supp. 1142, 1149 (N.D. Cal. 1982) (rejecting Castleman’s bid to be called an “expert”) (holding that the court was “not persuaded that Mr. Castleman, as a layperson, possesses the expertise necessary to read complex, technical medical articles and discern which portions of the articles would best summarize the authors’ conclusions”); Kendrick v. Owens-Corning Fiberglas Corp., No. C-85-178-AAm (E.D. Wash. 1986); In re King County Asbestos Cases of Levinson, Friedman, Vhugen, Duggan, Bland and Horowitz, No. 81-2-08702-7, (Washington St. Super. Ct. for King Cty.1987); Franze v. Celotex Corp., C.A. No. 84-1316 (W.D. Pa.); Dunn v. Hess Oil Virgin Islands Corp., C.A. No. 1987-238 (D.V.I. May 16, 1989) (excluding testimony of Barry Castleman); Rutkowski v. Occidental Chem. Corp., No. 83 C 2339, 1989 WL 32030, at *1 (N.D. Ill. Feb. 16, 1989) (“Castleman lacks the medical background and experience to evaluate and analyze the articles in order to identify which parts of the articles best summarize the authors’ conclusions.”); In re Guam Asbestos Litigation, 61 F.3d 910, 1995 WL 411876 (9th Cir. 1995) (Kozinski, J., dissenting) (“I would also reverse because Barry Castleman was not qualified to testify as an expert witness on the subject of medical state of the art or anything else; he appears to have read a number of articles for the sole purpose of turning himself into an expert witness. Reductio ad absurdum.”); McClure v. Owens Corning Fiberglas Corp. 188 Ill. 2d 102, 720 N.E.2d 242 (1999) (rejecting probativeness of Castleman’s testimony about company conduct).

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Professor Bernstein’s Critique of Regulatory Daubert

May 15th, 2015

In the law of expert witness gatekeeping, the distinction between scientific claims made in support of litigation positions and claims made in support of regulations is fundamental. In re Agent Orange Product Liab. Litig., 597 F. Supp. 740, 781 (E.D.N.Y. 1984) (“The distinction between avoidance of risk through regulation and compensation for injuries after the fact is a fundamental one”), aff’d 818 F.2d 145 (2d Cir. 1987), cert. denied sub nom. Pinkney v. Dow Chemical Co., 487 U.S. 1234 (1988). Although scientists proffer opinions in both litigation and regulatory proceedings, their opinions are usually evaluated by substantially different standards. In federal litigation, civil and criminal, expert witnesses must be qualified and have an epistemic basis for their opinions, to satisfy the statutory requirements of Federal Rule of Evidence 702, and they must have reasonably relied upon otherwise inadmissible evidence (such as the multiple layers of hearsay involved in an epidemiologic study) under Rule 703. In regulatory proceedings, scientists are not subject to admissibility requirements and the sufficiency requirements set by the Administrative Procedures Act are extremely low[1].

Some industry stakeholders are aggrieved by the low standards for scientific decision making in certain federal agencies, and they have urged that the more stringent litigation evidentiary rules be imported into regulatory proceedings. There are several potential problems with such reform proposals. First, the epistemic requirements of science generally, or of Rules 702 and 703 in particular, are not particularly stringent. Scientific method leads to plenty of false positive and false negative conclusions, which are subject to daily challenge and revision. Scientific inference is not necessarily so strict, as much as ordinary reasoning is so flawed, inexact, and careless. Second, the call for “regulatory Daubert” ignores mandates of some federal agency enabling statutes and guiding regulations, which call for precautionary judgments, and which allow agencies to decide issues on evidentiary display that fall short of epistemic warrants for claims of knowledge.

Many lawyers who represent industry stakeholders have pressed for extension of Daubert-type gatekeeping to federal agency decision making. The arguments for constraining agency action find support in the over-extended claims that agencies and so-called public interest science advocates make in support of agency measures. Advocates and agency personnel seem to believe that worst-case scenarios and overstated safety claims are required as “bargaining” positions to achieve the most restrictive and possibly the most protective regulation that can be gotten from the administrative procedure, while trumping industry’s concerns about costs and feasibility. Still, extending Daubert to regulatory proceedings could have the untoward result of lowering the epistemic bar for both regulators and litigation fact finders.

In a recent article, Professor David Bernstein questions the expansion of Daubert into some regulatory realms. David E. Bernstein, “What to Do About Federal Agency Science: Some Doubts About Regulatory Daubert,” 22 Geo. Mason L. Rev. 549 (2015)[cited as Bernstein]. His arguments are an important counterweight to those who insist on changing agency rulemaking and actions at every turn. As an acolyte and a defender of scientific scruples and reasoning in the courts, Bernstein’s arguments are worth taking seriously.

Bernstein reminds us that bad policy, as seen in regulatory agency rulemaking or decisions, is not always a scientific issue. In any event, regulatory actions, unlike jury decisions, are not, or at least should not be, “black boxes.” The agency’s rationale and reasoning are publicly stated, subject to criticism, and open to revision. Jury decisions are opaque, non-transparent, potentially unreasoned, not carefully articulated, and not subject to revision absent remarkable failures of proof.

One line of argument[2] pursued by Professor Bernstein follows from his observation that Daubert procedures are required to curtail litigation expert witness “adversarial bias.” Id. at 555. Bernstein traces adversarial bias to three sources:

(1) conscious bias;

(2) unconscious bias; and

(3) selection bias.

Id. Conscious bias stems from deliberate attempts by “hired guns” to deliver opinions that satisfy the lawyers who retained them. The problem of conscious bias is presented by “hired guns” who will adapt their opinions to the needs of the attorney who hires them. Unconscious biases are the more subtle, but no less potent determinants of expert witness behavior, which are created by financial dependence upon, and allegiance to, the witness’s paymaster. Selection bias results from lawyers’ ability to choose expert witnesses to support their claims, regardless whether those witnesses’ opinions are representative of the scientific community. Id.

Professor Bernstein’s taxonomy of bias is important, but incomplete. First, the biases he identifies operate fulsomely in regulatory settings. Although direct financial remuneration is usually not a significant motivation for a scientist to testify before an agency, or to submit a whitepaper, professional advancement and cause advocacy are often powerful incentives at work. These incentives for self-styled public interest zealots may well create more powerful distortions of scientific judgment than any monetary factors in private litigation settings. As for selection bias, lawyers are ethically responsible for screening their expert witnesses, and there can be little doubt that once expert witnesses are disclosed, their opinions will align with their sponsoring parties’ interests. This systematic bias, however, does not necessarily mean that both side’s expert witnesses will necessarily be unrepresentative or unscientific. In the silicone gel breast implant litigation (MDL 926), Judge Pointer, the presiding judge, insisted that both sides’ witnesses were “too extreme,” and he was stunned when his court-appointed expert witnesses filed reports that vindicated the defendants’ expert witnesses’ positions[3]. The defendants had selected expert witnesses who analyzed the data on sound scientific principles; the plaintiffs had selected expert witnesses who overreached in their interpretation of the evidence. Furthermore, many scientific disputes, which find their way into the courtroom, will not have the public profile of silicone gel breast implants, and for which there may be no body of scientific community opinion from which lawyers could select “outliers,” even if they wished to do so.

Professor Bernstein’s offered taxonomy of bias is incomplete because it does not include the most important biases that jurors (and many judges) struggle to evaluate:

random errors;

systematic biases;

confounding; and

cognitive biases.

These errors and biases, along with their consequential fallacies of reasoning, apply with equal force to agency and litigation science. Bernstein does point out, however, an important institutional difference between jury or judge trials and agency review and decisions based upon scientific evidence: agencies often have extensive in-house expertise. Although agency expertise may sometimes be blinded by its policy agenda, agency procedures usually afford the public and the scientific community to understand what the agency decided, and why, and to respond critically when necessary. In the case of the Food and Drug Administration, agency decisions, whether pro- or contra-industry positions are dissected and critiqued by the scientific and statistical community with great care and relish. Nothing of the same sort is possible in response to a jury verdict.

Professor Bernstein is not a science nihilist, and he would not have reviewing courts give a pass to whatever nonsense federal agencies espouse. He calls for enforcement of available statutory requirements that agency action be based upon the “best available science,” and for requiring agencies to explicitly separate and state their policy and scientific judgments. Bernstein also urges greater use of agency peer review, such as occasionally seen from the Institute of Medicine (soon to be the National Academy of Medicine), and the use of Daubert-like criteria for testimony at agency hearings. Bernstein at 554.

Proponents of regulatory Daubert should take Professor Bernstein’s essay to heart, with a daily dose of atorvastatin. Importing Rule 702 into agency proceedings may well undermine the rule’s import in litigation, civil and criminal, while achieving little in the regulatory arena. Consider the pending OSHA rulemaking for lowering the permissible exposure limit (PEL) of crystalline silica in the workplace. OSHA, and along with some public health organizations, has tried to justify this rulemaking on the basis of many overwrought claims of the hazards of crystalline silica exposure at current levels. Clearly, there are some workers who continue to work in unacceptably hazardous conditions, but the harms sustained by these workers can be tied to violations of the current PEL; they are hardly an argument for lowering that current PEL. Contrary to the OSHA’s parade of horribles, silicosis mortality in the United States has steadily declined over the last several decades. The following chart draws upon NIOSH and other federal governmental data:

Silicosis deaths, crude and age-adjusted death rates, for U.S. residents age 15 and over, 1968–2007

from Susan E. Dudley & Andrew P. Morriss, “Will the Occupational Safety and Health Administration’s Proposed Standards for Occupational Exposure to Respirable Crystalline Silica Reduce Workplace Risk?” 35 Risk Analysis (2015), in press, doi: 10.1111/risa.12341 (NIOSH reference number: 2012F03–01, based upon multiple cause-of-death data from National Center for Health Statistics, National Vital Statistics System, with population estimates from U.S. Census Bureau).

The decline in silicosis mortality is all the more remarkable because it occurred in the presence of stimulated reporting from silicosis litigation, and misclassification of coal workers’ pneumoconiosis in coal-mining states.

The decline in silicosis mortality may be helpfully compared with the steady rise in mortality from accidental falls among men and women 65 years old, or older:

Yahtyng Sheu, Li-Hui Chen, and Holly Hedegaard, “QuickStats: Death Rates* from Unintentional Falls† Among Adults Aged ≥ 65 Years, by Sex — United States, 2000–2013,” 64 CDC MMWR 450 (May 1, 2015). Over the observation period, these death rates roughly doubled in both men and women.

Is there a problem with OSHA rulemaking? Of course. The agency has gone off on a regulatory frolic and detour trying to justify an onerous new PEL, without any commitment to enforcing its current silica PEL. OSHA has invoked the prospect of medical risks, many of which are unproven, speculative, and remote, such as lung cancer, autoimmune disease, and kidney disease. The agency, however, is awash with PhDs, and I fear that Professor Bernstein is correct that the distortions of the science are not likely to be corrected by applying Rule 702 to agency factfinding. Courts, faced with the complex prediction models, with disputed medical claims made by agency and industry scientists, will do what they usually do, shrug and defer. And the blow back of the “judicially approved” agency science in litigation contexts will be a cure worse than the disease. At bottom, the agency twisting of science is driven by policy goals and considerations, which require public debate and scrutiny, sound executive judgment, with careful legislative oversight and guidance.

[1] Even under the very low evidentiary and procedural hurdles, federal agencies still manage to outrun their headlights on occasion. See, e.g., Industrial Union Department v. American Petroleum Institute, 448 U.S. 607 (1980) (The Benzene Case); Gulf South Insulation v. U.S. Consumer Product Safety Comm’n, 701 F.2d 1137 (5th Cir. 1983); Corrosion Proof Fittings v. EPA, 947 F2d 1201 (5th Cir 1991).

[2] See also David E. Bernstein, “The Misbegotten Judicial Resistance to the Daubert Revolution,” 89 Notre Dame L. Rev. 27, 31 (2013); David E. Bernstein, “Expert Witnesses, Adversarial Bias, and the (Partial) Failure of the Daubert Revolution,” 93 Iowa L. Rev. 451, 456–57 (2008).

[3] Judge Pointer was less than enthusiastic about performing any gatekeeping role. Unlike most of today’s MDL judges, he was content to allow trial judges in the transferor districts to decide Rule 702 and other pre-trial issues. See Note, “District Judge Takes Issue With Circuit Courts’ Application of Gatekeeping Role” 3 Federal Discovery News (Aug. 1997) (noting that Chief Judge Pointer had criticized appellate courts for requiring district judges to serve as gatekeepers of expert witness testimony).

Posted in Rule 702, Scientific Evidence, Silica | Comments Off on Professor Bernstein’s Critique of Regulatory Daubert

Sophisticated Intermediary Defense Prevails in New York

May 9th, 2015

Several years ago, the New York Appellate Division, 4th Department, reversed summary judgment for defendants in the cases of two workers who alleged that they had developed silicosis from silica exposure to defendants’ silica, at the Olean, New York, facility of their employer, Dexter Corporation (now Henkel Corporation). The trial court motions were based upon the “sophisticated intermediary” defense, but the Appellate Division reversed, holding that there was a genuine issue of material fact with respect to potential confusion between amorphous and crystalline silica, based upon statements in an affidavit of a plaintiffs’ expert witness, made without personal knowledge. See Pete Brush, “NY Court Revives Workers’ Silica Inhalation Suits” (March 24, 2009).

On remand, further discovery and an amplified evidentiary record led to new motions for summary judgment. In a February 26, 2015, order, the New York Supreme Court for Cattaraugus County granted the motions, noting that “the sophisticated intermediary doctrine was tailor-made” for the facts of the two cases. Rickicki v. Borden Chemical, et al., Index No. 53395, and Crowley v. C-E Minerals, Inc., et al., Index No. 61024, N.Y. Supreme Ct., Cattaraugus Cty. (Feb. 26, 2015) (Patrick H. NeMoyer, J.), Slip op. at 24. See also Casetext, “Summary Judgment Re-entered After Remand from the NY Appellate Division in Rickick v. Borden” (April 2, 2015); HarrisMartin, “N.Y. Trial Court Awards Summary Judgment to Silica Defendant, Recognizes Sophisticated Intermediary Doctrine” (March 27, 2015).

The Rickicki case turned 25 years old in February 2015.

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Science as Adversarial Process versus Group Think

May 7th, 2015

Climate scientists, at least those scientists who believe that climate change is both real and an existential threat to human civilization, have invoked their consensus as an evidentiary ground for political action. These same scientists have also used their claim of a consensus to shame opposing points of view (climate change skeptics) as coming from “climate change deniers.”

Consensus, or “general acceptance” as it is sometimes cast in legal discussions, is rarely more than nose counting. At best, consensus is a proxy for data quality and inferential validity. At worst, consensus is a manifestation of group think and herd mentality. Debates about climate change, as well as most scientific issues, would progress more dependably if there were more data, and less harrumphing about consensus.

Olah’s Nobel Speech

One Nobel laureate, Professor George Olah, explicitly rejected the kumbaya view of science and its misplaced emphasis on consensus and collaboration. In accepting his Nobel Prize in Chemistry, Olah emphasized the value of adversarial challenges in refining and establishing scientific discovery:

“Intensive, critical studies of a controversial topic always help to eliminate the possibility of any errors. One of my favorite quotation is that by George von Bekessy (Nobel Prize in Medicine, 1961).

‘[One] way of dealing with errors is to have friends who are willing to spend the time necessary to carry out a critical examination of the experimental design beforehand and the results after the experiments have been completed. An even better way is to have an enemy. An enemy is willing to devote a vast amount of time and brain power to ferreting out errors both large and small, and this without any compensation. The trouble is that really capable enemies are scarce; most of them are only ordinary. Another trouble with enemies is that they sometimes develop into friends and lose a good deal of their zeal. It was in this way the writer lost his three best enemies. Everyone, not just scientists, needs a few good enemies!’”

George A. Olah, “My Search for Carbocations and Their Role in Chemistry,” Nobel Lecture (Dec. 8, 1994), quoting George von Békésy, Experiments in Hearing 8 (N.Y. 1960); see also McMillan v. Togus Reg’l Office, Dep’t of Veterans Affairs, 294 F. Supp. 2d 305, 317 (E.D.N.Y. 2003) (“As in political controversy, ‘science is, above all, an adversary process.’”) (internal citation omitted).

Carl Sagan expressed similar views about the importance of skepticism in science :

“At the heart of science is an essential balance between two seemingly contradictory attitudes — an openness to new ideas, no matter how bizarre or counterintuitive they may be, and the most ruthless skeptical scrutiny of all ideas, old and new. This is how deep truths are winnowed from deep nonsense.”

Carl Sagan, The Demon-Haunted World: Science as a Candle in the Dark (1995); See also Cary Coglianese, “The Limits of Consensus,” 41 Environment 28 (April 1999).

Michael Crichton, no fan of Sagan, agreed at least on the principle:

“I want to . . . talk about this notion of consensus, and the rise of what has been called consensus science. I regard consensus science as an extremely pernicious development that ought to be stopped cold in its tracks. Historically, the claim of consensus has been the first refuge of scoundrels; it is a way to avoid debate by claiming that the matter is already settled. Whenever you hear the consensus of scientists agrees on something or other, reach for your wallet, because you’re being had.

Let’s be clear: the work of science has nothing whatever to do with consensus. Consensus is the business of politics. Science, on the contrary, requires only one investigator who happens to be right, which means that he or she has results that are verifiable by reference to the real world. In science consensus is irrelevant. What is relevant is [sic] reproducible results. The greatest scientists in history are great precisely because they broke with the consensus. There is no such thing as consensus science. If it’s consensus, it isn’t science. If it’s science, it isn’t consensus. Period.³⁴

Michael Crichton, “Lecture at California Institute of Technology: Aliens Cause Global Warming” (Jan. 17, 2003) (describing many examples of how “consensus” science historically has frustrated scientific progress).

Crystalline Silica, Carcinogenesis, and Faux Consensus

Clearly, there are times when consensus in science works against knowledge and data-driven inferences. Consider the saga of crystalline silica and lung cancer. Suggestions that silica causes lung cancer date back to the 1930s, but the suggestions were dispelled by data. The available data were evaluated by the likes of Wilhelm Heuper[1], Cuyler Hammond[2] (Selikoff’s go-to-epidemiologist), Gerrit Schepers[3], and Hans Weill[4]. Even etiologic fabulists, such as Kaye Kilburn, disclaimed any connection between silica or silicosis and lung cancer[5]. As recently as 1988, august international committees, writing for the National Institute of Occupational Safety and Health, acknowledged the evidentiary insufficiency of any claim that silica caused lung cancer[6].

IARC (1987)

So what happened to the “consensus”? A group of activist scientists, who disagreed with the consensus, sought to establish their own, new consensus. Working through the International Agency for Research on Cancer (IARC), these scientists were able to inject themselves into the IARC working group process, and gradually raise the IARC ranking of crystalline silica. In 1987, the advocate scientists were able to move the IARC to adopt a “limited evidence” classification for crystalline silica.

The term “limited evidence” is defined incoherently by the IARC as evidence that provides for a “credible” causal explanation, even though chance, bias, and confounding have not been adequately excluded. Despite the incoherent definition that giveth and taketh away, the 1987 IARC reclassification[7] into Group 2A had regulatory consequences that saw silica classified as a “regulatory carcinogen,” or a substance that was “reasonably anticipated to be a carcinogen.”

The advocates’ prophecy was self-fulfilling. In 1996, another working group of the IARC met in Lyon, France, to deliberate on the classification of crystalline silica. The 1996 working group agreed, by a close vote, to reclassify crystalline silica as a “known human carcinogen,” or a Group 1 carcinogen. The decision was accepted and reported officially in volume 68 of the IARC monographs, in 1997.

According to participants, the debate was intense and the vote close. Here is the description from one of the combatants;

“When the IARC Working Group met in Lyon in October 1996 to assess the carcinogenicity of crystalline silica, a seemingly interminable debate ensued, only curtailed by a reminder from the Secretariat that the IARC was concerned with the identification of carcinogenic hazards and not the evaluation of risks. The important distinction between the potential to cause disease in certain circumstances, and in what circumstances, is not always appreciated.

* * * * *

Even so, the debate in Lyon continued for some time, finally ending in a narrow vote, reflecting the majority view of the experts present at that particular time.”

See Corbett McDonald, “Silica and Lung Cancer: Hazard or Risk,” 44 Ann. Occup. Hyg. 1, 1 (2000); see also Corbett McDonald & Nicola Cherry, “Crystalline Silica and Lung Cancer: The Problem of Conflicting Evidence,” 8 Indoor Built Env’t 8 (1999).

Although the IARC reclassification hardly put the silica lung cancer debate to rest, it did push the regulatory agencies to walk in lockstep with the IARC and declare crystalline silica to be a “known human carcinogen.” More important, it gave regulators and scientists an excuse to avoid the hard business of evaluating complicated data, and of thinking for themselves.

Post IARC

From a sociology of science perspective, the aftermath of the 1997 IARC monograph is a fascinating natural experiment to view the creation of a sudden, thinly supported, new orthodoxy. To be sure, there were scientists who looked carefully at the IARC’s stated bases and found them inadequate, inconsistent, and incoherent[8]. One well-regarded pulmonary text in particular gives the IARC and regulatory agencies little deference:

“Silica-induced lung cancer

A series of studies suggesting that there might be a link between silica inhalation and lung cancer was reviewed by the International Agency for Research on Cancer in 1987, leading to the conclusion that the evidence for carcinogenicity of crystalline silica in experimental animals was sufficient, while in humans it was limited.¹¹² Subsequent epidemiological publications were reviewed in 1996, when it was concluded that the epidemiological evidence linking exposure to silica to the risk of lung cancer had become somewhat stronger.¹¹³ but that in the absence of lung fibrosis remained scanty.¹¹³ The pathological evidence in humans is also weak in that premalignant changes around silicotic nodules are seldom evident.¹¹⁴ Nevertheless, on this rather insubstantial evidence, lung cancer in the presence of silicosis (but not coal or mixed-dust pneumoconiosis) has been accepted as a prescribed industrial disease in the UK since 1992.¹¹⁵ Some subsequent studies have provided support for this decision.¹¹⁶ In contrast to the sparse data on classic silicosis, the evidence linking carcinoma of the lung to the rare diffuse pattern of fibrosis attributed to silica and mixed dusts is much stronger and appears incontrovertible.^33,92”

Bryan Corrin[9] & Andrew Nicholson, Pathology of the Lungs (3d ed. 2011).

=======================================================

Cognitive biases cause some people to see a glass half full, while others see it half empty. Add a “scientific consensus” to the mix, and many people will see a glass filled 5% as 95% full.

Consider a paper by Centers for Disease Control and NIOSH authors on silica exposure and morality from various diseases. Geoffrey M. Calvert, Faye L. Rice, James M. Boiano, J. W. Sheehy, and Wayne T. Sanderson, “Occupational silica exposure and risk of various diseases: an analysis using death certificates from 27 states of the United States,” 60 Occup. Envt’l Med. 122 (2003). The paper was nominated for the Charles Shepard Award for Best Scientific Publication by a CDC employee, and was published in the British Medical Journal’s publication on occupational medicine. The study analyzed death certificate data from the U.S. National Occupational Mortality Surveillance (NOMS) system, which is based upon the collaboration of NIOSH, the National Center for Health Statistics, the National Cancer Institute, and some state health departments. Id. at 122.

From about 4.8 million death certificates included in their analysis, the authors found a statistically decreased mortality odds ratio (MOR) for lung cancer among those who had silicosis (MOR = 0.70, 95% C.I., 0.55 to 0.89). Of course, with silicosis on the death certificates along with lung cancer, the investigators could be reasonably certain about silica exposure. Given the group-think in occupational medicine about silica and lung cancer, the authors struggled to explain away their finding:

“Although many studies observed that silicotics have an increased risk for lung cancer, a few studies, including ours, found evidence suggesting the lack of such an association. Although this lack of consistency across studies may be related to differences in study design, it suggests that silicosis is not necessary for an increased risk of lung cancer among silica exposed workers.”

Well this statement is at best disingenuous. The authors did not merely find a lack of an association; they found a statistically significance inverse or “negative” association between silicosis and lung cancer. So it is not the case that silicosis is not necessary for an increased risk; silicosis is antithetical to an increased risk.

Looking at only death certificate information, without any data on known or suspected confounders (“diet, hobbies, tobacco use, alcohol use, or medication,” id. at 126, or comorbid diseases or pulmonary impairment, or other occupational or environmental exposures), the authors inferred low, medium, high, and “super high” silica exposure from job categories. Comparing the ever-exposed categories with low exposure yielded absolutely no association between exposure and lung cancer, and subgroup analyses (without any correction for multiple comparisons) found little association, although two subgroups were nominally statistically significantly increased, and one was nominally statistically significantly decreased, at very small deviations from expected:

Lung Cancer Mortality Odds Ratios (p-value for trend < 0.001)

ever vs. low/no exposure:              0.99 (0.98 to 1.00)

medium vs. low/no exposure:         0.88 (0.87 to 0.90)

high vs. low/no exposure:               1.13 (1.11 to 1.15)

super high vs. low/no exposure:      1.13 (1.06 to 1.21)

Id. at Table 4, and 124.

On this weak evidentiary display, the authors declare that their “study corroborates the association between crystalline silica exposure and silicosis, lung cancer.” Id. at 123. In their conclusions, they elaborate:

“Our findings support an association between high level crystalline silica exposure and lung cancer. The statistically significant MORs for high and super high exposures compared with low/no exposure (MORs = 1.13) are consistent with the relative risk of 1.3 reported in a meta-analysis of 16 cohort and case-control studies of lung cancer in crystalline silica exposed workers without silicosis”

Id. at 126. Actually not; Calvert’s reported MORs exclude an OR of 1.3.

The Calvert study thus is a stunning example of authors, prominent in the field of public health, looking at largely exculpatory data and declaring that they have confirmed an important finding of silica carcinogenesis. And to think that United States taxpayers paid for this paper, and that the authors almost received an honorific award for this thing!

[1] Wilhelm Hueper, “Environmental Lung Cancer,” 20 Industrial Medicine & Surgery 49, 55-56 (1951) (“However, the great majority of investigators have come to the conclusion that there does not exist any causal relation between silicosis and pulmonary or laryngeal malignancy”).

[2] Cuyler Hammond & W. Machle, “Environmental and Occupational Factors in the Development of Lung Cancer,” Ch. 3, pp. 41, 50, in E. Mayer & H. Maier, Pulmonary Carcinoma: Pathogenesis, Diagnosis, and Treatment (N.Y. 1956) (“Studies by Vorwald (41) and others agree in the conclusion that pneumoconiosis in general, and silicosis in particular, do not involve any predisposition of lung cancer.”).

[3] Gerrit Schepers, “Occupational Chest Diseases,” Chap. 33, in A. Fleming, et al., eds., Modern Occupational Medicine at 455 (Philadelphia 2d ed. 1960) (“Lung cancer, of course, occurs in silicotics and is on the increase. Thus far, however, statistical studies have failed to reveal a relatively enhanced incidence of pulmonary neoplasia in silicotic subjects.”).

[4] Ziskind, Jones, and Weill, “State of the Art: Silicosis” 113 Am. Rev. Respir. Dis. 643, 653 (1976) (“There is no indication that silicosis is associated with increased risk for the development of cancer of the respiratory or other systems.”); Weill, Jones, and Parkes, “Silicosis and Related Diseases, Chap. 12, in Occupational Lung Disorders (3d ed. 1994) (“It may be reasonably concluded that the evidence to date that occupational exposure to silica results in excess lung cancer risk is not yet persuasive.”).

[5] Kaye Kilburn, Ruth Lilis, Edwin Holstein, “Silicosis,” in Maxcy-Rosenau, Public Health and Preventive Medicine, 11^th ed., at 606 (N.Y. 1980) (“Lung cancer is apparently not a complication of silicosis”).

[6] NIOSH Silicosis and Silicate Disease Committee, “Diseases Associated With Exposure to Silica and Nonfibrous Silicate Minerals,” 112 Arch. Path. & Lab. Med. 673, 711b, ¶ 2 (1988) (“The epidemiological evidence at present is insufficient to permit conclusions regarding the role of silica in the pathogenesis of bronchogenic carcinoma.”)

[7] 42 IARC Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans at 22, 111, § 4.4 (1987).

[8] See, e.g., Patrick A. Hessel, John F. Gamble, J. Bernard L. Gee, Graham Gibbs, Francis H. Y. Green, W. Keith C. Morgan, and Brooke T. Mossman, “Silica, Silicosis, and Lung Cancer: A Response to A Recent Working Group,” 42 J. Occup. Envt’l Med. 704, 718 (2000) (“The data demonstrate a lack of association between lung cancer and exposure to crystalline silica in human studies. Furthermore, silica is not directly genotoxic and has been to be a pulmonary carcinogen in only one animal species, the rat, which seems to be an inappropriate carcinogenesis in humans.”)

[9] Professor of Thoracic Pathology, National Heart and Lung Institute, Imperial College School of Medicine; Honorary Consultant Pathologist, Brompton Hospital, London, UK.

Posted in Causation, Cognitive Biases, Scientific Evidence | Comments Off on Science as Adversarial Process versus Group Think

ALI Reporters Are Snookered by Racette Fallacy

April 27th, 2015

In the Reference Manual on Scientific Evidence, the authors of the epidemiology chapter advance instances of acceleration of onset of disease as an example of a situation in which reliance upon doubling of risk will not provide a reliable probability of causation calculation[1]. In a previous post, I suggested that the authors’ assertion may be unfounded. See “Reference Manual on Scientific Evidence on Relative Risk Greater Than Two For Specific Causation Inference” (April 25, 2014). Several epidemiologic methods would permit the calculation of relative risk within specific time windows from first exposure.

The American Law Institute (ALI) Reporters, for the Restatement of Torts, make similar claims.[2] First, the Reporters, citing the Manual’s second edition, repeat the Manual’s claim that:

“Epidemiologists, however, do not seek to understand causation at the individual level and do not use incidence rates in group to studies to determine the cause of an individual’s disease.”

American Law Institute, Restatement (Third) of Torts: Liability for Physical and Emotional Harm § 28(a) cmt. c(4) & rptrs. notes (2010) [Comment c(4)]. In making this claim, the Reporters ignore an extensive body of epidemiologic studies on genetic associations and on biomarkers, which do address causation implicitly or explicitly, on an individual level.

The Reporters also repeat the Manual’s doubtful claim that acceleration of onset of disease prevents an assessment of attributable risk, although they acknowledge that an average earlier age of onset would form the basis of damages calculations rather than calculations for damages for an injury that would not have occurred but for the tortious exposure. Comment c(4). The Reporters go a step further than the Manual, however, and provide an example of the acceleration-of-onset studies that they have in mind:

“For studies whose results suggest acceleration, see Brad A. Racette, Welding-Related Parkinsonism: Clinical Features, Treatments, and Pathophysiology,” 56 Neurology 8, 12 (2001) (stating that authors “believe that welding acts as an accelerant to cause [Parkinson’s Disease]… .”

The citation to Racette’s 2001 paper[3] is curious, interesting, disturbing, and perhaps revealing. In this 2001 paper, Racette misrepresented the type of study he claimed to have done, and the inferences he drew from his case series are invalid. Any one experienced in the field of epidemiology would have dismissed this study, its conclusions, and its suggested relation between welding and parkinsonism.

Dr. Brad A. Racette teaches and practices neurology at Washington University in St. Louis, across the river from a hotbed of mass tort litigation, Madison County, Illinois. In the 1990s, Racette received referrals from plaintiffs’ attorneys to evaluate their clients in litigation over exposure to welding fumes. Plaintiffs were claiming that their occupational exposures caused them to develop manganism, a distinctive parkinsonism that differs from Parkinson’s disease [PD], but has signs and symptoms that might be confused with PD by unsophisticated physicians unfamiliar with both manganism and PD.

After the publication of his 2001 paper, Racette became the darling of felon Dicky Scruggs and other plaintiffs’ lawyers. The litigation industrialists invited Racette and his team down to Alabama and Mississippi, to conduct screenings of welding tradesmen, recruited by Scruggs and his team, for potential lawsuits for PD and parkinsonism. The result was a paper that helped Scruggs propel a litigation assault against the welding industry.[4]

Racette’s 2001 paper was accompanied by a press release, as have many of his papers, in which he was quoted as stating that “[m]anganism is a very different disease” from PD. Gila Reckess, “Welding, Parkinson’s link suspected” (Feb. 9, 2001)[5].

Racette’s 2001 paper provoked a strongly worded letter that called Racette and his colleagues out for misrepresenting the nature of their work:

“The authors describe their work as a case–control study. Racette et al. ascertained welders with parkinsonism and compared their concurrent clinical features to those of subjects with PD. This is more consistent with a cross-sectional design, as the disease state and factors of interest were ascertained simultaneously. Cross-sectional studies are descriptive and therefore cannot be used to infer causation.”

*****

“The data reported by Racette et al. do not necessarily support any inference about welding as a risk factor in PD. A cohort study would be the best way to evaluate the role of welding in PD.”

Bernard Ravina, Andrew Siderowf, John Farrar, Howard Hurtig, “Welding-related parkinsonism: Clinical features, treatment, and pathophysiology,” 57 Neurology 936, 936 (2001).

As we will see, Dr. Ravina and his colleagues were charitable to suggest that the study was more compatible with a cross-sectional study. Racette had set out to determine “whether welding-related parkinsonism differs from idiopathic PD.” He claimed that he had “performed a case-control study,” with a case group of welders and two control groups. His inferences drawn from his “data” are, however, fallacious because he employed an invalid study design.

In reality, Racette’s paper was nothing more than a chart review, a case series of 15 “welders” in the context of a movement disorder clinic. After his clinical and radiographic evaluation, Racette found that these 15 cases were clinically indistinguishable from PD, and thus unlike manganism. Racette did not reveal whether any of these 15 welders had been referred by plaintiffs’ counsel; nor did he suggest that these welding tradesmen made up a disproportionate number of his patient base in St. Louis, Missouri.

Racette compared his selected 15 career welders with PD to his general movement disorders clinic patient population, for comparison. From the patient population, Racette deployed two “control” groups, one matched for age and sex with the 15 welders, and the other group not matched. The America Law Institute reporters are indeed correct that Racette suggested that the average age of onset for these 15 welders was lower than that for his non-welder patients, but their uncritical embrace overlooked the fact that Racette’s suggestion does not support his claimed inference that in welders, therefore, “welding exposure acts as an accelerant to cause PD.”

Racette’s claimed inference is remarkable because he did not perform an analytical epidemiologic study that was capable of generating causal inferences. His paper incongruously presents odds ratios, although the controls have PD, the disease of interest, which invalidates any analytical inference from his case series. Given the referral and selection biases inherent in tertiary-care specialty practices, this paper can provide no reliable inferences about associations or differences in ages of onset. Even within the confines of a case series misrepresented to be a case-control study, Racette acknowledged that “[s]ubsequent comparisons of the welders with age-matched controls showed no significant differences.”

NOT A CASE-CONTROL STUDY

That Racette wrongly identified his paper as a case-control study is beyond debate. How the journal Neurology accepted the paper for publication is a mystery. The acceptance of the inference by the ALI Reporter, lawyers and judges, is regrettable.

Structurally, Racette’s paper could never quality as a case-control study, or any other analytical epidemiologic study. Here is how a leading textbook on case-control studies defines a case-control study:

“In a case-control study, individuals with a particular condition or disease (the cases) are selected for comparison with a series of individuals in whom the condition or disease is absent (the controls).”

James J. Schlesselman, Case-control Studies. Design, Conduct, Analysis at 14 (N.Y. 1982)[6].

Every patient in Racette’s paper, welders and non-welders, have the outcome of interest, PD. There is no epidemiologic study design that corresponds to what Racette did, and there is no way to draw any useful inference from Racette’s comparisons. Racette’s paper violates the key principle for a proper case-control study; namely, all subjects must be selected independently of the study exposure that is under investigation. Schlesselman stressed that that identifying an eligible case or control must not depend upon that person’s exposure status for any factor under consideration. Id. Racette’s 2001 paper deliberately violated this basic principle.

Racette’s study design, with only cases with the outcome of interest appearing in the analysis, recklessly obscures the underlying association between the exposure (welding) and age in the population. We would, of course, expect self-identified welders to be younger than the average Parkinson’s disease patient because welding is physical work that requires good health. An equally fallacious study could be cobbled together to “show” that the age-of-onset of Parkinson’s disease for sitcom actors (such as Michael J. Fox) is lower than the age-of-onset of Parkinson’s disease for Popes (such as John Paul II). Sitcom actors are generally younger as a group than Popes. Comparing age of onset between disparate groups that have different age distributions generates a biased comparison and an erroneous inference.

The invalidity and fallaciousness of Racette’s approach to studying the age-of-onset issue of PD in welders, and his uncritical inferences, have been extensively commented upon in the general epidemiologic literature. For instance, in studies that compared the age at death for left-handed versus right-handed person, studies reported an observed nine-year earlier death for left handers, leading to (unfounded) speculation that earlier mortality resulted from birth and life stressors and accidents for left handers, living in a world designed to accommodate right-handed person[7]. The inference has been shown to be fallacious and the result of social pressure in the early twentieth century to push left handers to use their right hands, a prejudicial practice that abated over the decades of the last century. Left handers born later in the century were less likely to be “switched,” as opposed to those persons born earlier and now dying, who were less likely to be classified as left-handed, as a result of a birth-cohort effect[8]. When proper prospective cohort studies were conducted, valid data showed that left-handers and right-handers have equivalent mortality rates[9].

Epidemiologist Ken Rothman addressed the fallacy of Racette’s paper at some length in one of his books:

“Suppose we study two groups of people and look at the average age at death among those who die. In group A, the average age of death is 4 years; in group B, it is 28 years. Can we say that being a member of group A is riskier than being a member of group B? We cannot… . Suppose that group A comprises nursery school students and group B comprises military commandos. It would be no surprise that the average age at death of people who are currently military commandos is 28 years or that the average age of people who are currently nursery students is 4 years. …

In a study of factory workers, an investigator inferred that the factory work was dangerous because the average age of onset of a particular kind of cancer was lower in these workers than among the general population. But just as for the nursery school students and military commandos, if these workers were young, the cancers that occurred among them would have to be occurring in young people. Furthermore, the age of onset of a disease does not take into account what proportion of people get the disease.

These examples reflect the fallacy of comparing the average age at which death or disease strikes rather than comparing the risk of death between groups of the same age.”

Kenneth J. Rothman, “Introduction to Epidemiologic Thinking,” in Epidemiology: An Introduction at 5-6 (N.Y. 2002).

And here is how another author of Modern Epidemiology[10] addressed the Racette fallacy in a different context involving PD:

“Valid studies of age-at-onset require no underlying association between the risk factor and aging or birth cohort in the source population. They must also consider whether a sufficient induction time has passed for the risk factor to have an effect. When these criteria and others cannot be satisfied, age-specific or standardized risks or rates, or a population-based case-control design, must be used to study the association between the risk factor and outcome. These designs allow the investigator to disaggregate the relation between aging and the prevalence of the risk factor, using familiar methods to control confounding in the design or analysis. When prior knowledge strongly suggests that the prevalence of the risk factor changes with age in the source population, case-only studies may support a relation between the risk factor and age-at-onset, regardless of whether the inference is justified.”

Jemma B. Wilk & Timothy L. Lash, “Risk factor studies of age-at-onset in a sample ascertained for Parkinson disease affected sibling pairs: a cautionary tale,” 4 Emerging Themes in Epidemiology 1 (2007) (internal citations omitted) (emphasis added).

A properly designed epidemiologic study would have avoided Racette’s fallacy. A relevant cohort study would have enrolled welders in the study at the outset of their careers, and would have continued to follow them even if they changed occupations. A case-control study would have enrolled cases with PD and controls without PD (or more broadly, parkinsonism), with cases and controls selected independently of their exposure to welding fumes. Either method would have determined the rate of PD in both groups, absolutely or relatively. Racette’s paper, which completely lacked non-PD cases, could not have possibly accomplished his stated objectives, and it did not support his claims.

Racette’s questionable work provoked a mass tort litigation and ultimately federal Multi-District Litigation 1535.[11] Ultimately, analytical epidemiologic studies consistently showed no association between welding and PD. A meta-analysis published in 2012 ended the debate[12] as a practical matter, and MDL 1535 is no more. How strange that the ALI reporters chose the Racette work as an example of their claims about acceleration of onset!

[1] Michael D. Green, D. Michal Freedman, and Leon Gordis, “Reference Guide on Epidemiology,” in Federal Judicial Center, Reference Manual on Scientific Evidence 549, 614 (Wash., DC 3d ed. 2011).

[2] Michael D. Green was an ALI Reporter, and of course, an author of the chapter in the Reference Manual.

[3] Brad A. Racette, L. McGee-Minnich, S. M. Moerlein, J. W. Mink, T. O. Videen, and Joel S. Perlmutter, “Welding-related parkinsonism: clinical features, treatment, and pathophysiology,” 56 Neurology 8 (2001).

[4] See Brad A. Racette, S.D. Tabbal, D. Jennings, L. Good, Joel S. Perlmutter, and Brad Evanoff, “Prevalence of parkinsonism and relationship to exposure in a large sample of Alabama welders,” 64 Neurology 230 (2005); Brad A. Racette, et al., “A rapid method for mass screening for parkinsonism,” 27 Neurotoxicology 357 (2006) (duplicate publication of the earlier, 2005, paper).

[5] Previously available at <http://record.wustl.edu/archive/2001/02-09-01/articles/welding.html>, last visited on June 27, 2005.

[6] See also Brian MacMahon & Dimitrios Trichopoulos, Epidemiology. Principles and Methods at 229 (2ed 1996) (“A case-control study is an inquiry in which groups of individuals are selected based on whether they do (the cases) or do not (the controls) have the disease of which the etiology is to be studied.”); Jennifer L. Kelsey, W.D. Thompson, A.S. Evans, Methods in Observational Epidemiology at 148 (N.Y. 1986) (“In a case-control study, persons with a given disease (the cases) and persons without the disease (the controls) are selected … .”).

[7] See, e.g., Diane F. Halpern & Stanley Coren, “Do right-handers live longer?” 333 Nature 213 (1988); Diane F. Halpern & Stanley Coren, “Handedness and life span,” 324 New Engl. J. Med. 998 (1991).

[8] Kenneth J. Rothman, “Left-handedness and life expectancy,” 325 New Engl. J. Med. 1041 (1991) (pointing out that by comparing age of onset method, nursery education would be found more dangerous than paratrooper training, given that the age at death of pres-schoolers wo died would be much lower than that of paratroopers who died); see also Martin Bland & Doug Altman, “Do the left-handed die young?” Significance 166 (Dec. 2005).

[9] See Philip A. Wolf, Ralph B. D’Agostino, Janet L. Cobb, “Left-handedness and life expectancy,” 325 New Engl. J. Med. 1042 (1991); Marcel E. Salive, Jack M. Guralnik & Robert J. Glynn, “Left-handedness and mortality,” 83 Am. J. Public Health 265 (1993); Olga Basso, Jørn Olsen, Niels Holm, Axel Skytthe, James W. Vaupel, and Kaare Christensen, “Handedness and mortality: A follow-up study of Danish twins born between 1900 and 1910,” 11 Epidemiology 576 (2000). See also Martin Wolkewitz, Arthur Allignol, Martin Schumacher, and Jan Beyersmann, “Two Pitfalls in Survival Analyses of Time-Dependent Exposure: A Case Study in a Cohort of Oscar Nominees,” 64 Am. Statistician 205 (2010); Michael F. Picco, Steven Goodman, James Reed, and Theodore M. Bayless, “Methodologic pitfalls in the determination of genetic anticipation: the case of Crohn’s disease,” 134 Ann. Intern. Med. 1124 (2001).

[10] Kenneth J. Rothman, Sander Greenland, Timothy L. Lash, eds., Modern Epidemiology (3d ed. 2008).

[11] Dicky Scruggs served on the Plaintiffs’ Steering Committee until his conviction on criminal charges.

[12] James Mortimer, Amy Borenstein, and Lorene Nelson, “Associations of welding and manganese exposure with Parkinson disease: Review and meta-analysis,” 79 Neurology 1174 (2012).

Posted in Causation, Reference Manual on Scientific Evidence, Rule 702, Rule 703, Scientific Evidence | Comments Off on ALI Reporters Are Snookered by Racette Fallacy

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