Court Permits Endocrinology Expert to Opine on Amputation Risks Associated with Diabetes

Wendy Ketner, M.D.

Written by
— Updated on February 19, 2020

Court Permits Endocrinology Expert to Opine on Amputation Risks Associated with Diabetes

Court: United States District Court for the District of South Carolina, Beaufort Division
Jurisdiction: Federal
Case Name: Dykes v. Inmate Servs. Corp.
Citation: 2017 U.S. Dist. LEXIS 17019

Facts

The plaintiffs, a married couple, filed a complaint against the defendant, a prisoner transportation service, alleging negligence, violations of 42 U.S.C. § 1983, and the loss of consortium. The husband and wife plaintiff claimed that while in the defendant’s custody, the diabetic husband’s care, control, and liability were the responsibility of the defendant. As a result of the defendant’s failure to provide medical care, rehabilitation, and adequate medication, the plaintiff suffered significant bodily injury requiring multiple amputations, leaving him permanently disfigured. Among the Daubert motions, the plaintiff moved to exclude the testimony of the endocrinology expert witness retained by the defendant.

The Endocrinology Expert Witness

The endocrinology expert witness was a practicing endocrinologist in Charleston, South Carolina. She specialized in the prevention, diagnosis, and treatment of hormone balance disorders and endocrine glands. In her practice, she was responsible for studying cases, appropriate patient examination, and evaluating methods of treatment.

The expert graduated from the Medical University of South Carolina and completed her residency at the University of California Davis Medical Center. The endocrinology expert was a board certified doctor in internal medicine.

The endocrinology expert testified that the majority of patients with five risk factors (smoking, obesity, lack of appropriate medication, obesity, high blood sugar, and sedentary lifestyle) will suffer either limb amputation or peripheral vascular disease, which can lead to amputation. The endocrinology expert also testified that diabetic people with foot cellulitis would require urgent medical attention, as was the plaintiff’s situation.

She was not able to testify on whether there was data showing the percentage of patients with these five risk factors who underwent amputations. She noted that she did not have research or study experience in that area. She further testified that no evidence was present to show that the plaintiff had a lesion on his toe while in the custody of the defendant.

The plaintiff challenged the endocrinology expert’s testimony on the grounds that “her opinion fails to meet the relevancy and reliability criteria set forth” in Rule 702 of the Federal Rules of Evidence and Daubert. The plaintiff also claimed that the opinion needed in this case would be more suitably given by a vascular surgeon and that her opinion was formed purely for the purpose of litigation.

Discussion

The court noted that the expert witness was a trained endocrinologist with extensive experience in the care of diabetic patients. Thus, they found that her general knowledge would be useful to the jury at the trial. The court further noted that the expert’s knowledge was relevant and reliable since it was based on her experience as a licensed endocrinologist working in an outpatient clinic with a high percentage of diabetic patients. The court also stated that her opinion of diabetic patients with the five risk factors was not a novel concept. According to the court, this testimony was relevant to the causation and comparative liability defense, and a lack of peer-reviewed literature in support affected the weight of her testimony and not its admissibility.

Similarly, the court believed that the plaintiff’s argument for excluding her opinion because it was prepared solely for litigation, also affected its weight and not admissibility.

Held

The court found that the endocrinology expert witness’s testimony was reliable and relevant. Thus, the plaintiff’s motion to exclude her testimony was denied.

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