Nephrology Expert Permitted to Lean on Academic Literature When Discussing Dangers of Dialysis Fluid

Court: United States District Court for the District of ColoradoJurisdiction: FederalCase Name: Morris v. DaVita Healthcare Partners, Inc.Citation: 2015 U.S. Dist. LEXIS 69046

Because a nephrology expert witness can’t easily test a theory regarding how a dialysate can cause serious adverse health effects to patients, showing a consensus in academic literature is enough to support the validity of an expert’s theory.

Facts

The plaintiffs, in this case, received hemodialysis at DaVita clinics. The plaintiffs brought a product liability claim against the defendant alleging that an ingredient in the defendant’s dialysis fluid caused certain chemical reactions which disrupted the metabolic pH balance in the plaintiffs causing serious injuries or death. The defendant did not manufacture these ingredients, so the product liability claim was dismissed.

The plaintiffs further alleged the defendant committed fraud against them, claiming that the defendant was negligent in failing to monitor changing pH levels and failed to disclose this information to the patients when it was noticed. The plaintiffs retained a nephrology expert witness to support their arguments. The defendant challenged the nephrology expert’s testimony in this motion.

The Nephrology Expert

The plaintiffs’ nephrology expert was an attending physician in the renal unit of a large medical center with 20+ years of experience working with the National Institutes of Health (NIH) as a principal investigator. He also served as an associate professor in the medicine department of Boston University. The nephrology expert’s primary areas of focus were educating students and staff at the university, undertaking research on the cellular mechanisms of ischemic acute renal failure, and caring for patients with general medical and renal diseases. The nephrology expert authored 40+ peer-reviewed articles and received multiple awards for his contributions to the field of medical science in general and nephrology.

Expert’s Findings

The expert submitted that the contested products benefited dialysis patients by increasing the level of bicarbonate in serum. He also stated, however, that the products had a tendency to increase the risk of high pH in certain kinds of dialysis patients, thus, leaving them vulnerable to adverse health effects. He did not express any opinion on whether the products should have been withdrawn from the market. However, the nephrology expert suggested that there was a need for more research to determine the kind of patients for whom the benefits of the product would outweigh the toxicity. He identified certain types of patients in whom the pH disbalance caused increased mortality and morbidity.

Discussion

The court noted that the expert’s proffered opinion was relevant as the guidance and expertise of a dialysis and nephrology expert was required. It was noted that his testimony would help the jury understand the pharmacology of the renal area and form opinions about the kind of adverse effects the products in question could have had on the bodies and excretory system of some kinds of dialysis patients.

The defendant asserted that the nephrology expert’s opinion was merely a hypothesis based on debilitating relations between numerous theories and without any merit based on data analysis. The court rejected this claim, noting that even though the nephrology expert’s theory could not be tested (as it was difficult to rigorously test a physician’s hypothesis), his theory was widely accepted in academic circles.

Held

The court held that the nephrology expert witness was qualified to offer his opinion in this case, and that his opinion was relevant and reliable.