TORTINI

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

Johnson v. Arkema Inc. – The Fifth Circuit Proves to Be Sophisticated Consumer of Science

June 21st, 2012

Yesterday, in celebration of the first day of summer, the Fifth Circuit handed down a decision in a case that looks like a laundry list of expert witness fallacies.  Fortunately, the district judge and two of the three appellate judges kept their analytical faculties intact.  Johnson v. Arkema Inc., Slip op., 2012 WL ___ (5th Cir. June 20, 2012) (per curiam) (affirming exclusion of expert witnesses).

The plaintiff had worked in a glass bottling plant, where on two occasions in 2007, he was in close proximity to the defendant’s ventilation hood, designed to be used with a chemical, Certincoat, composed of monobutyltin trichloride (MBTC), an organometallic compound.  Plaintiff claimed that the ventilation was inadequate and that as a result he was exposed to MBTC as well as hydrochloric acid.

The plaintiff sustained some acute symptoms and ultimately was diagnosed with a “chemical pneumonia,” by his treating physician.  The plaintiff further claimed that his condition progressively worsened,  and that he was ultimately diagnosed with “pulmonary fibrosis,” a “severe restrictive lung disease.” The plaintiff filed reports from two expert witnesses – Richard Schlesinger, a toxicologist, and Charles Grodzin, a pulmonary physician – in support of his claim that his pulmonary fibrosis was caused by overexposure to MBTC and hydrochloric acid (HCl).

Plaintiff’s claim led to defendant’s Rule 702 challenge, which the trial court sustained, and the appellate court affirmed.

A basic problem faced by plaintiff is that there was virtually no evidence that MBTC or HCl causes pulmonary fibrosis. Undaunted, the plaintiff and his expert witnesses pushed on, but the lack of epidemiologic evidence associating MBTC or HCl with pulmonary fibrosis proved reliably harmful to plaintiff’s case.

General Acceptance

Plaintiff could point to no evidence that MBTC or HCl causes pulmonary fibrosis.  Slip op. at 7. Given the delay in manifestation of the fibrosis after the plaintiff’s rather limited, discrete exposures, the court recognized that epidemiologic evidence was important, if not essential, to plaintiff’s case. Without epidemiology, the plaintiff retreated to generalities – the chemicals cause lung irritation, lung injury, etc.  One concurring judge was taken in, but the majority of the panel saw through the dodge.

Anecdotal Evidence

Without epidemiologic evidence, the plaintiff invoked anecdotal evidence that other employees sustained similar lung injuries. The problem, however, for even this low-level evidence was that other employees experienced only transitory symptoms, which quickly resolved.  Id. at 4 -5, 27.

Post Hoc, Ergo Propter Hoc

Focusing only on himself as an anecdote with n =1, the plaintiff, and his expert witnesses, argued that temporal sequence of his exposure and his pulmonary fibrosis was itself evidence of causality.  Neither the trial court nor the appellate court found this much of an argument.  Id. at 16 n.13, 18.

Mechanism in Search of Data – Schlesinger’s irritant theory

Schlesinger argued that both MBTC and HCl are pulmonary irritants, which can cause inflammation, and pulmonary fibrosis results from inflammation. Id. at 8.  True, but not all irritants cause pulmonary fibrosis.  Chronicity and dose are important considerations.  Whether these chemicals, under exposure conditions experienced by plaintiff, were capable of causing pulmonary fibrosis, cried out for evidence.

The Material Safety Data Sheets (MSDS)

The plaintiff argued that the MSDS for HCl established that this chemical was “severely corrosive to the respiratory system.” Id. at 11-12.  The defendant’s own MSDS for MBTC stated that MBTC “causes respiratory tract irritation.” Id. at 16.  The courts saw these arguments as transparently absent evidence. None of the MSDS identified pulmonary fibrosis; nor did they specify (1) the underlying scientific support, or (2) the relevant duration and exposure needed to induce any particular adverse outcome.

Animal Studies

For both MBTC and HCl, plaintiff adverted to animal studies, but the courts found that the animal studies failed to support the plaintiff’s expert witnesses’ opinions and the plaintiff’s claims.  The studies were readily distinguishable in terms of dose, duration, and disease outcome.  In particular, none of the studies showed that the chemicals caused pulmonary fibrosis. Id. at 7, 12 (baboon study of HCl showed impairment but not fibrosis at 10,000ppm for one year, quite unlike plaintiff’s exposure), 16-17 (rat inhalation study of MBTC, six hrs/day, five days/wk, up to 30 mg/m3, with toxicity but no mention of lung fibrosis).

Regulatory Limits

Plaintiff argued that HCl levels were multiples of the OSHA limits, but the courts would not credit regulatory exposure limits are evidence of harmfulness because of the precautionary nature of many regulations.  Id. at 14.  Furthermore, the disease outcomes of regulatory concern did not appear to be pulmonary fibrosis for the chemicals involved.

Res Ipsa Loquitur

The plaintiff argued that causation was a matter of common sense and general experience.  Even if his expert witnesses did not have valid, reliable evidence, the jury could make the causal determination without scientific evidence. Id. at  26.  Rejected.

Chemical Analogies

The defendant’s expert witness acknowledged that tin oxide can cause pulmonary fibrosis.  Id. at 28.  This admission, however, came without any qualification about what exposure or duration data might be needed to support a conclusion about specific causation in the plaintiff.  Id.  Furthermore, tin pneumoconiosis, or stannosis, is known as a benign lung disease, unassociated with impairment or disability.  Like simple silicosis, stannosis is a picture change on chest radiograph, without diminution of performance on pulmonary function tests.  Agency for Toxic Substances and Disease Registry, A Toxicological Profile for Tin and Tin Compounds at 30 (2005).

Differential Diagnosis

Plaintiff’s pulmonary expert witness, Dr. Grodzin, tried to bootstrap specific causation by assuming general and putting it in the “differentials” for him to embrace.  Id. at 19.  A fallacious form of reasoning, but the courts here were on top of it.

* * * * *

The panel did reverse the trial court’s grant of summary judgment.  The gate closed a little too fast to permit scrutiny of plaintiff’s claim of acute injuries and symptoms, which were less dependent upon epidemiologic evidence.

 

Expert Witness Guru

June 20th, 2012

In my casting about on the internet, I came across an interesting site dedicated to expert witness issues:  The Expert Witness Guru (EWG).

As you might expect, the Expert Witness Guru is an India-based “expert witness consulting and publishing firm, with a distinct focus on helping experts build a robust practice and providing attorneys with the right tools to locate and engage the right experts.”  The website is a blend of marketing and scholarship, which is designed to be helpful to both expert witnesses and to lawyers who depend so much upon their experts in litigation.  The EWG offers a variety of litigation support services, including preparation of expert witness profiles and deposition summaries.

The website features a blog, the Expert Witness Marketing and News Blog, which is designed with the mixed readership of both expert witnesses and lawyers in mind.  The EWG blog publishes the work of the folks at EWG, as well as invited guest posts.  Expert Witness Guru also publishes an electronic monthly magazine, Expert Witness Chronicle, with coverage of the law, practice, and marketing of expert witness testimony.  To date, two issues have been released, which are available at the EWG website.

The editorial staff of Expert Witness Chronicle includes Ashish Arun (Editor), Shweta Nawani (Co-Editor), and contributors John F. Fielder, Myles Levin, and Gil Zamora.

The second issue of the Expert Witness Chronicle announced the formation of a capable editorial board, of well-respected scholars and practictioners:

Joseph P. Sanders, the A. A. White Professor of Law at University of Houston Law Center

Edward K. Cheng, Professor of Law at Vanderbilt Law School, and

John F. Fielder, clinical and forensic psychologist, and CEO, Daubert Institute of Forensic Psychology

The first two issues feature interesting coverage of the whole range of expert witness issues, from practice issues involving retention to the wide spectrum of types of expert witness testimony (forensic, economic, engineering, scientific, etc.).  The website, blog, magazine, and the outsourced services are all worth a closer look.

 

 

Politics of Expert Witnesses – The Treating Physician

June 7th, 2012

If a party retains an expert witness who has actually conducted research on the issue in controversy, the witnesses’ underlying data and analyses will be sought in discovery.  Of course, litigants are entitled to every man’s (and woman’s) evidence, and independent research, but the involvement of an investigator-author as an expert witness will almost certainly increase the scope of discovery.  Counsel will seek manuscript drafts, emails with co-authors, interim data, protocols and protocol amendments, preliminary analyses, among other documents.  Many would-be expert witnesses are reluctant to put their own research into issue.  The result is that expert witnesses frequently do not have “hands-on” experience with respect to the exact issue raised by the litigation in which they serve.

The combination of these factors creates vulnerabilities for witnesses.  Expert witnesses who have not conducted research or written about the issue end up being more attractive to lawyers.  But even these witnesses will be flawed in the eyes of a jury or trial judge:  they have been paid for their time in reviewing literature, preparing reports, sitting for depositions, traveling, appearing at trial.  The compensation of a highly skilled and experienced professional can lead to large amounts of money, amounts sufficient to make juries skeptical and lawyers’ uncomfortable.

Physicians, who care and treat a claimant, represent a litigation Holy Grail:  the prospect of having a neutral, disinterested, and caring expert witness opine about causation, diagnosis, damages, or prognosis, without the baggage of having been selected and paid by lawyers.  A lot of sharp elbows are thrown in the process of trying to align treating physicians with one side or the other’s litigation positions.

In some litigations, in some states, ex parte interviews by defense counsel are forbidden, but similar interviews by plaintiffs’ counsel are allowed.  Much mischief results.  The practice of trying to turn the treating physician into a “causation” or “damages” witness runs amuck, especially when trial courts do not require full Federal Rules of Civil Procedure Rule 26 disclosures from the treating physicians.

Jurors will want to know what treating physicians said, and may regard them as disinterested.  Indeed, the supposed neutrality and beneficence of the treating physician is often emphasized by counsel in their addresses to juries.  See, e.g., Simmons v. Novartis Pharm. Corp., 2012 WL 2016246, *2, *7 (6th Cir. 2012)((affirming exclusion of retained expert witness, as well as a treating physician who relied solely upon a limited selection of medical studies given to him by plaintiffs’ counsel); Tamraz v. BOC Group Inc., No. 1:04-CV-18948, 2008 WL 2796726 (N.D.Ohio July 18, 2008)(denying Rule 702 challenge to treating physician’s causation opinion), rev’d sub nom. Tamraz v. Lincoln Elec. Co., 620 F.3d 665 (6th Cir. 2010)(carefully reviewing record of trial testimony of plaintiffs’ treating physician; reversing judgment for plaintiff based in substantial part upon treating physician’s speculative causal assessment created by plaintiffs’ counsel), cert. denied, ___ U.S. ___ , 131 S. Ct. 2454, 2011 WL 863879 (2011).  See generally Robert Ambrogi, “A ‘Masterly’ Opinion on Expert Testimony,” Bullseye: October 2010;   David Walk, “A masterly Daubert opinion” (Sept. 15, 2010);  Ellen Melville, “Comment, Gating the Gatekeeper: Tamraz v. Lincoln Electric Co. and the Expansion of Daubert Reviewing Authority,” 53 B.C. L. Rev. 195 (2012) (student review that mistakenly equates current Rule 702 law with the Supreme Court’s 1993 Daubert decision, while ignoring subsequent precedent and revision of Rule 702).

In the silicone gel breast implant litigation, plaintiffs corralled a herd of rheumatologists who were sympathetic to their claims of connective tissue disease, and who would support their “creative” causation theories.  As a result, defense rheumatologists were not likely to have seen many of the claimants in their practice.  The plaintiffs’ counsel capitalized upon this “deficiency” in their experience, by attacking the defense experts’ expertise and their experience with the newly emergent phenomenon of “silicone-associated disease” (SAD).  The treating physicians were involved early on in the SAD litigation exploit.

In New Jersey, defense counsel have a limited right to ex parte interviews of treating physicians.  Stempler v. Speidell, 100 N.J. 368, 495 A.2d 857 (1985).  Certain New Jersey state trial judges, however, have ignored the Stempler holding in mass tort contexts, and have severely limited defendants’ ability to get information from treating physicians.  Last week, the New Jersey Appellate Division waded into this contentious area, by reversing an aberrant trial judge’s decision that severely restricted defendants’ retention of any physician who had treated a plaintiff in the mass tort.  In Re Pelvic Mesh/Gynecare Litig., No. A-5685-10T4 (N.J. Super. App. Div. June 1, 2012).

The defendants, Johnson & Johnson and Ethicon, Inc., designed, made, marketed, and sold pelvic mesh medical devices for the treatment of pelvic organ prolapse and stress urinary incontinence.  In re Pelvic at 2.  Several hundred personal injury cases against the defendants were assigned to the Atlantic County law division.  In a pretrial order, the trial court barred “defendants from consulting with or retaining as an expert witness any physician who has at any time treated one or more of the plaintiffs.”  Id. Remarkably, the trial court’s order was not limited to attempts to contact a physician for purposes of discussing a particular plaintiff’s case.  The trial court’s order had the effect of severely limiting defendants access to expert witnesses, as well as disqualifying expert witnesses already retained.  Plaintiffs’ counsel, however, were free to line up their clients’ treating physicians, and other treating physicians with substantial clinical experience with the allegedly defective device.

The Appellate Division reversed the trial court’s asymmetrical rules regarding treating physicians as manifestly inconsistent with the New Jersey Supreme Court’s mandate in Stempler and other cases.  The Appellate Division showed little patience for the trial court’s weak attempt to justify the uneven-handed treatment of access to treating physicians.  The trial court had invoked the potential for interference with the doctor-patient privilege as a basis for its pretrial order, but hornbook law, in New Jersey and in virtually every state, treats the filing of a lawsuit as a waiver of the privilege.  Id. at 11.  Similarly, the Appellate Division rejected the trial court’s insistence that a treating physician was obligated to protect and advance patients’ litigation interests by either testifying for patients or refraining from testifying for defendants. Id. at 15.  A treating physician has no “duty of loyalty” to help advance a patient’s litigious goals.  Id. at 26. The trial court had myopically confused a duty to provide medical care and treatment with helping plaintiffs’ counsel advance their view of the patients’ welfare.

The Appellate Division’s reversal is a welcome return of sanity and equity to New Jersey law of expert witnesses.  The over-reaching rationale of the trial court posed some incredible implications.  The appellate court noted, as an example, that “radiologists, orthopedists, and neurologists who routinely testify as experts for the defense in numerous personal injury cases in our courts are likely to be treating or consulting physicians for other patients with similar injuries, and some of those patients may also have filed lawsuits or may do so in the future.”  Id. at 16.  The trial court’s reasoning would strip defendants in virtually all personal injury litigation of access to expert physician opinion.  In asbestos litigation, for instance, the defense would find any and all pulmonary physicians who was treating a worker with asbestos-related disease to be off limits to consulting or testifying.  The Appellate Division’s strong ruling should be seen as a cloud on the validity of the continuing practice of barring defense counsel from ex parte interviews of treating physicians in mass or other tort litigation.