Court: United States District Court for the Northern District of Georgia, Rome Division
Case Name: Wint v. Neurosurgical Group of Chattanooga, P.C.
Citation: 2013 U.S. Dist. LEXIS 189393
In this case of medical negligence, the plaintiff claimed the defendant violated the standard of care. Since the burden of proof was on the plaintiff, she retained a neurosurgery expert witness. The defendant questioned the reliability and relevance of the expert’s opinion.
The court held that the defendant’s objections affected the weight but not the admissibility of the expert’s testimony.
The plaintiff claimed the defendant’s agent was professionally negligent in implanting a spinal cord stimulator in her thoracic spine. According to the complaint, the defendant’s agent knew her history of spinal stenosis but failed to discover thoracic spine hernias. Allegedly, this caused the plaintiff to suffer incomplete paralysis.
The Neurosurgery Expert Witness
The neurosurgery expert witness was a practicing orthopedic surgeon. The expert witness attended Harvard Medical School after graduating from John Hopkins University. Then, he went on to complete his orthopedic residency and spinal surgery fellowship from John Hopkins Hospital and Medical Institutions. He has over 16 years of experience practicing in general orthopedics, spinal surgery, and pain management.
The plaintiff had the burden to prove the defendant violated the medical standards of care. The plaintiff had to prove the defendant failed to follow procedure. This is a procedure another medical professional with the same information at the time of the operation could be reasonably expected to follow. The plaintiff hired the neurosurgery expert witness to satisfy that burden. The defendant filed this motion to exclude the expert witness. The defendant argued the plaintiff failed the burden of proof. They claimed the plaintiff failed because the expert witness based his opinion on scientific literature published after the operation.
The defendant’s argument was that the neurosurgery expert used a manual published almost a year after the surgery date. The defendant claimed the opinion wasn’t reliable. The defendant explained the opinion was based on scientific literature not available at the time of the plaintiff’s surgery. Furthermore, the defendant asserted the opinion was not relevant. Per Georgia law, the time of determination of standard of care is when the alleged breach of that standard occurred.
The plaintiff argued the defendant’s attack of a document in the expert’s opinion lacked scientific and legal basis. Thus, according to the plaintiff, the defendant’s argument was unsustainable. The plaintiff asserted the expert relied on the plaintiff’s medical history, documents of her treatment, and other documents. Moreover, the expert witness relied on his own experience in spinal surgery. All of the material the expert used, the plaintiff claimed, was enough to satisfy the reliability prong.
The plaintiff also pointed out the treating doctor admitted that implanting the spinal cord stimulator in a herniated area was below the standard of care. Furthermore, imaging the region could detect spinal stenosis. In addition, the plaintiff argued the manual was relevant. Although the manual’s publication happened after the events in question, it could corroborate the prevailing opinions at the time. The manual also illustrated what the defendant should have done. It provided a historical context on what doctors knew or should have known at the time.
The court found the expert’s testimony to be reliable. The expert witness depended on other independent sources and his experience to form his opinions. The neurosurgery expert witness depended on the manual to opine on what the treating doctor should have done. However, the court noted that a previous version of the manual also advised that procedure. The court was convinced by the plaintiff’s reliance on non-binding cases where expert testimony based on irrelevant literature along with other relevant sources was held to be reliable. They found the defendant’s objections to be valid but they affected the weight and not the admissibility of the opinion.
The court further observed that the expert’s testimony was reliable and helpful for the trier of fact, and thus relevant. The defendant’s objections to the expert’s reliance on the later manual affected the weight but not its reliability or relevance.
The court denied the defendant’s motion to exclude the testimony of the plaintiff’s neurosurgery expert witness.
Key Takeaways for Experts
This case demonstrates the importance of relying on multiple pieces of literature, as well as on professional experience. In this case, the expert witness depended not only on the manual but also on his own experience and independent sources. Professional experience is always helpful in cases but using multiple sources of scientific literature builds a stronger methodology.