Gastroenterology Expert’s Testimony Partially Excluded for Conclusions on Psychiatry Issues

Court: United States District Court for the Southern District of New YorkJurisdiction: FederalCase Name: Stelman v. United StatesCitation: 2016 U.S. Dist. LEXIS 129420

The plaintiff claims prison medical staff inadequately managed her Crohn’s disease. Her gastroenterology expert testifies on how the appropriate standard of care was not met. However, the defendant challenges the expert for overstepping his professional scope.

Here, the court agrees. Though the expert is highly qualified in his field, he errs by offering conclusions on the plaintiff’s psychiatric care. As such, the court partially excludes the expert’s testimony.

Facts

The plaintiff alleged that she received insufficient medical care while in prison. This allegedly caused an avoidable intestinal resection surgery and a postoperative wound infection. The infection eventually required a second surgery. The plaintiff claimed that the defendant violated her constitutional rights. As such, she filed a lawsuit claiming negligence and medical malpractice under the Federal Tort Claims Act. The plaintiff retained a gastroenterology expert witness to help support her case.

The Plaintiff’s Gastroenterology Expert Witness

The plaintiff’s gastroenterology expert witness served as Chief of Gastroenterology at the James J. Peters VA Medical Center. The expert was also a professor at Columbia University College of Physicians and Surgeons. To form his opinions, the expert relied on the plaintiff’s medical records both from the prison and medical center where she was treated. He also consulted related case documents. The expert opined that the plaintiff’s injury was due to a deviation from the standard of care. He stated that inconsistent medication, including anti-anxiety drugs, caused her Crohn’s disease to flare up. He testified that the plaintiff’s infection and surgery were due to insufficient wound care at the medical center. In his report, the expert identified four main deviations from the standard of care.

Discussion

The defendant did not challenge the expert’s credentials. However, they criticized the use of the expert’s own experience as the foundation for his opinion. The defendant argued that the expert had not adequately explained how the medical center’s diagnosis did not meet the standard of care. To this point, the court noted that the expert relied on his personal experience to evaluate the plaintiff’s treatment and did not rely on pure intuition. The court also noted that according to the expert, a doctor would continue treating a Crohn’s disease patient with the same medication that had the condition in remission. The court determined the defendant’s argument affected weight and not admissibility. Further, the court felt the defendant had not proved that the expert’s testimony was outside his expertise or speculative. Accordingly, the court found this evidence was admissible for establishing the adequate standard of care.

The defendant also argued that the expert’s finding pertaining to the plaintiff’s anti-anxiety medication was ambiguous and conclusory. Thus, they claimed it was inadmissible. Insofar as his testimony concerned the plaintiff’s treatment at the medical center, the court agreed. It noted that he was not an expert in psychology or psychiatry and had no justification for assessing treatment decisions in those fields. The court explained the expert failed to provide reliable evidence that the plaintiff’s anxiety treatment fell below the standard of care.

Additionally, the defendant claims the expert’s opinion on the consultation of specialists was speculative and conclusive. They argued the expert did not identify any particular action that would have enhanced the plaintiff’s care. Here, the court agreed. The court noted that the expert had failed to show what a specialist would have done differently from the treating physician.

Ruling

The court granted in part and denied in part the defendant’s motion to exclude the plaintiff’s gastroenterology expert witness.

Key Takeaways for Experts

This case demonstrates the importance of staying in your professional lane. Here, the expert overstepped by opining about psychiatric matters when he was retained for gastroenterology insights. It’s critical to focus on your area of expertise or risk challenges and possible exclusion by the court.