Court Partially Excludes Emergency Medicine Expert for Opinion on Residency Program Feedback Standard

The plaintiff claimed he was unfairly terminated from his residency program. He retained an emergency medicine expert to opine on the standard of feedback in programs as well as the unprofessional communication from his supervisor. 

    Wendy Ketner, M.D.

    Written by
    — Updated on October 6, 2021

    Court Partially Excludes Emergency Medicine Expert for Opinion on Residency Program Feedback Standard

    Court: United States District Court for the Eastern District of Louisiana
    Jurisdiction: Federal
    Case Name: Greenberg v. Bd. of Supervisors of La. Univ. & Agric. & Mech. Coll.
    Citation: 2019 U.S. Dist. LEXIS 205006

    Facts

    The plaintiff brought charges of retaliation and hostile work environment based on religion. He claimed the defendant violated Title VII of the Civil Rights Act of 1964, 42 U.S.C. § 2000e et seq. The plaintiff argued the defendant violated this Act when the defendant terminated his role in the Emergency Medicine Residency Program. The plaintiff retained an emergency medicine expert to attest to the documentation adequacy and feedback received from the hospital. Furthermore, the expert opined on the correct standard of care for placing a central line in a crashing patient. Additionally, the expert spoke on the professionalism in coordination between the plaintiff and his supervisor. The defendant moved to exclude the expert’s views, arguing that they were unreliable.

    The Plaintiff’s Emergency Medicine Expert

    The board-certified emergency medicine physician practiced emergency medicine in an educational hospital setting. The expert was the Associate Director of the residency program and Director of the interim residency program. Additionally, the expert was the Director of the medical student clerkship. The expert was also an academic consultant to medical students and taught communication skills and professionalism. The emergency medicine expert trained residents at a hospital during clinical hours. The expert also sat on an emergency medicine residency education committee.

    The emergency medicine expert’s opinion provided four general conclusions. First, there was an overall lack of records of the progress of the plaintiff in his first year of residency. Furthermore, the hospital did not provide the plaintiff with adequate feedback. Second, the plaintiff met with the standard of care. He did not prescribe local anesthesia to a crashing patient prior to placing a central line. One of the reasons given for his termination was that he failed to administer an analgesic to a mentally challenged patient.  Third, the supervisor’s text and email correspondence sent to the plaintiff were unprofessional in tone. The supervisor’s texts and emails were also unprofessional in content regarding interactions from the resident program director. Fourth, it did not appear that the hospital offered an atmosphere free of religious prejudice.

    Discussion

    The defendant argued that the expert’s opinion on the adequacy of the defendant’s documentation was unreliable. The defendant claimed she simply judged the program based on her personal career experience in emergency medicine. According to the defendant, the emergency medicine expert did not have a discernible methodology. The defendant indicated the expert didn’t access available information on the medical school’s website regarding the residency program and services. The defendant further argued that she did not refer to any national records. These records include documentation from the Residency Review Committee or the Council of Residency Directors. The plaintiff argued that the expert was qualified to testify as to the quality of the correspondence.

    The court noted the expert’s experience of working for one residency program did not provide her with the requisite insight to determine a national standard of feedback. Furthermore, the court noted the expert couldn’t opine on the documentation for all emergency medicine residency programs because her experience was insufficient. The court observed that the plaintiff could assert at trial that he was given pretextual reasons for termination. Then, the jury would be able to evaluate the validity of those reasons.

    The court further acknowledged that the defendant could provide evidence through other experts. The evidence could show that nothing in the patient’s files showed they had crashed at the time the plaintiff placed the central line. The defendant also could’ve cross-examined the expert as to whether her view would change if the patient had not crashed. The court concluded the jury could determine whether the supervisor’s messages to the plaintiff were inappropriate or unprofessional. The expert could not testify about that. The court also noted that the expert’s hostile work environment opinion amounted to legal conclusion and was not admissible.

    Ruling

    The court granted the defendant’s motion in part and denied it in part.

    Key Takeaways for Experts

    Medical experts should have a sufficient background in the topic they discuss. In this case, the emergency medicine expert didn’t have the requisite insight on the national standard of feedback because they had only worked at one program. It’s important to keep your testimony within the scope of your expertise. For example, if your experience is local, limit your opinion to local practices. Only if your experience is national should you broaden the scope of your opinion.

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