Hernandez v. Union Pacific Railroad Company
Filing
62
MEMORANDUM AND ORDER - Defendant's Motion to Exclude Dr. Landolph (Filing No. 45 ) is granted. Defendant's Motion to Exclude Dr. Gale (Filing No. 43 ) is granted as it relates to specific causation, and denied as moot as it relates to gen eral causation. Defendant's Motion for Summary Judgment (Filing No. 48 ) is granted. The parties' Joint Motion to Stay (Filing No. 61 ) is denied as moot. A separate judgment will be entered. Ordered by Magistrate Judge Cheryl R. Zwart. (LKO)
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IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF NEBRASKA
BRIAN HERNANDEZ, Personal
Representative for the Estate of Saul
Hernandez;
8:18CV62
Plaintiff,
MEMORANDUM AND ORDER
vs.
UNION PACIFIC RAILROAD
COMPANY,
Defendant.
Brian Hernandez, as personal representative of the Estate of Saul
Hernandez (Plaintiff) is suing the Union Pacific Railroad Co. (UPRR or Defendant),
under the Federal Employers Liability Act (FELA) 45 U.S.C. § 51 et seq., alleging
workplace exposure to toxic substances caused or contributed to Saul
Hernandez’s development of lung, stomach and bone cancer1 and his resulting
death. (Filing No. 1, at CM/ECF p. 2, ¶ 11). On July 25, 2019, Plaintiff designated
Dr. Robert P. Gale (Dr. Gale) and Dr. Joseph R. Landolph, Jr. (D r. Landolph) to
testify as Plaintiff’s expert witnesses.
Defendant UPRR moves to exclude the expert reports and testimony of Dr.
Gale and Dr. Landolph. (Filing Nos. 43 and 45). UPRR also moves for summary
judgment claiming there are no genuine issues of material fact regarding exposure
and causation. (Filing No. 48). For the reasons discussed below, the motion s to
exclude the testimony of Dr. Gale and Dr. Landolph , and UPRR’s related motion
for summary judgment, will be granted.
Saul Hernandez was diagnosed with gastric, or “stomach,” cancer in 2013 – which is the f ocus on the
expert opinions at issue. The gastric cancer metastasized to his lungs and bones but Drs. Gale and
Landolph were asked to opine only as to causation of his primary cancer, not its metastasis.
1
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MOTIONS TO STRIKE EXPERT OPINIONS
A. Statement of Facts
Consistent with the court’s local rules, only those facts cited, by page, in the
parties’ briefs were considered by the court in evaluating Defendant’s pending
motions. See NECivR 7.1(a)(2)(A) & (b)(2)(A). Those facts, assumed to be true for
the purposes of this motion, are as follows:
Saul Hernandez (Saul) worked for UPRR from approximately 1980 to 1990
as a laborer and trackman. (Filing No. 1 at CM/ECF p. 2, ¶ 7). The Complaint
alleges that during Saul’s employment, he was exposed to “various toxic
substances and carcinogens including but not limited to diesel fuel/exhaust,
benzene, heavy metals, creosote, manganese and rock/mineral dust and asbestos
fibers.” (Filing No. 1 at CM/ECF p. 2, ¶ 8). Plaintiff later stipulated that he is
pursuing claims related to Saul’s purported workplace exposure to only diesel
exhaust, asbestos, and silica dust. (Filing No. 49 at CM/ECF p. 3, ¶ 4); (Filing No.
54 at CM/ECF p. 4, ¶ 4); (Filing No. 52 at CM/ECF p. 3, fn. 1).
Saul smoked cigarettes for at least 40 years, before quitting in September
2013. (Filing No. 47-2). Twice – in 2007 and 2010 – Saul was discovered to have
infections caused by the heliobacter pylori bacterium after he underwent medical
procedures related to abdominal pain. (Filing No. 47-3 at CM/ECF p. 3, ¶ 8). Saul
was diagnosed with gastric cancer in 2013 and passed away on October 9, 2014.
(Filing No. 1 at CM/ECF p. 3, ¶ 3).
Plaintiff designated Drs. Gale and Landolph to testify as Plaintiff’s expert
witnesses. Plaintiff designated Dr. Gale as a medical causation expert, “who will
testify as to general and specific causation of [Saul’s] injuries.” (Filing No. 47-6 at
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CM/ECF p. 1). Plaintiff designated Dr. Landolph as a liability expert, who “will
testify, generally, as to the hazards associated with [Saul’s] crafts, including
exposure to carcinogens. Specifically, Dr. Landolph will opine as to the nature of
[Saul’s] exposures to various toxins present on the railroad.” (Id). Plaintiff clarifies
in his briefing that Dr. Landolph’s opinion is confined to general causation. (Filing
No. 52 at CM/ECF p. 16) (“As stated in his report, and indicated in the introductory
statement, supra, Professor Landolph’s opinions are on general causation in this
matter.”) (emphasis in original).
I.
Dr. Gale
Dr. Gale is a well-qualified, highly credentialed expert in multiple areas of
the medical field. He has postgraduate medical training in internal medicine,
hematology, and oncology, and holds PhDs in microbiology and immunology.
(Filing No. 47-6 at CM/ECF p. 3). Dr. Gale bases his expert opinion on a review of
scientific studies and textbooks, a review of Dr. Landolph’s findings, a review of a
“one-page summary” of the case provided to him by Plaintiff’s counsel, and on
independent research he conducted online. (Filing No. 47-4 at CM/ECF pp. 5-8)
(Gale Dep. 20:11-28:21); (Filing No. 56 at CM/ECF p. 13). He additionally relied
upon data from the International Agency for the Research on Cancer (“IARC”),
which performs studies regarding diesel exposure and reviews diesel exhaust
exposure among railroad workers. (Id).
Dr. Gale also reviewed Saul’s medical records but did not recall if the records
he reviewed were limited to oncology treatment or if he also reviewed records
related to Saul’s previous medical history. (Filing No. 47-4 at CM/ECF p. 7) (Gale
Dep. 26:6-18).
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He did not review Saul’s employment records. Dr. Gale testified that he “had
no access to other [employment] documents so I have only the description that is
provided [by Plaintiff’s counsel].” (Filing No. 47-4 at CM/ECF p. 20) (Gale Dep.
80:8-10). The summary provided to Dr. Gale of Saul’s employment with Union
Pacific indicates only his approximate start and stop dates, his total years served,
his job title(s) and his approximate age at the time of employment. (Filing No. 472). The summary also lists Saul’s “exposure” as “diesel exhaust, benzene, heavy
metals, creosote, silica dust, and gasoline vapor.” (Id). The summary does not
indicate the purported level of exposure or from where this list of exposures was
derived. (Id). Dr. Gale did not know at which job site or sites Saul worked nor did
he have any knowledge of Saul’s specific job du ties and responsibilities. (Filing
No. 47-4 at C/ECF p. 17) (Gale Dep. 66:19-20). He did not speak to any of Saul’s
coworkers or to Saul’s wife. (Filing No. 47-4 at C/ECF p. 9) (Gale Dep. 35:7-25).
He did not review Saul’s son’s deposition testimony in this case. (Filing No. 47-4
at C/ECF p. 9) (Gale Dep. 35:4-6).
In evaluating general causation, Dr. Gale testified that he used a “more
sophisticated evolution” of the Bradford Hill 2 causation methodology. (Filing No.
47-4 at C/ECF p. 15) (Gale Dep. 55:2-5). As described by Dr. Gale, his
process is to consider all of the evidence in favor and contrary to the
opinion that an exposure was more likely than not a cause, to a
reasonable degree of medical probability, a cause of cancer, first at
the level of [general causation] and then at the level of whether the
The Federal Judicial Center (“FJC”) Ref erence Manual sets out the “Bradf ord Hill” f actors that
epidemiologists consider in assessing general causation. FJC, Reference Manual on Scientific Evidence
(“Ref erence Manual”) at 375-76 (2d ed. 2000); see also King v. Burlington N. Santa Fe Ry Co., 762 N.W.2d
24, 40-41 (Neb. 2009). The f actors include (1) temporal relationship, (2) strength of the association, (3)
dose-response relationship, (4) replication of the findings, (5) biological plausibility, (6) consideration of
alternative explanations, (7) cessation of exposure, (8) specificity of the association, and (9) consistency
with other knowledge. See Reference Manual at 375-76. The Ref erence Manual explains that one or more
causation f actors may be absent even when a true causal relationship exists. Id. at 376. Dr. Gale’s
testimony and report do not individually address the foregoing factors.
2
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specific type of cancer under consideration could be caused or
contributed to by exposure to the agents we're discussing.
(Filing No. 47-4 at C/ECF p. 15) (Gale Dep. 55:8-22).
As to specific causation, Dr. Gale utilized the Bayesian Approach and
performed a differential diagnosis.3 As required by the differential diagnosis
technique, Dr. Gale considered other potential causes of Saul’s stomach cancer,
ruling in all causes, before ruling out the least plausible causes of the injury. Bland
v. Verizon Wireless, (VAW) L.L.C., 538 F.3d 893, 897 (8th Cir. 2008). The potential
causes considered by Dr. Gale included the following:
[Saul] had a colon polyp several years before his stomach cancer
diagnosis. A 1st degree relative had colon cancer but there is no
family history of stomach cancer, hereditary diffuse gastric cancer,
hereditary non-polyposis colo-rectal cancer, familial adenomatous
polyposis, Li-Fraumeni syndrome, stomach polyps, Epstein-Barr virus
(EBV)-infection or common variable immune deficiency. I am unaware
whether he was Tested for a somatic mutation in BRCA1 or BRCA2.
He smoked an estimated 3 cigarettes per day for 40 years and had
social exposure to alcohol. Mr. Hernandez is a Hispanic American.
There is no history of stomach ulcers, chronic idiopathic gastritis,
hypertrophic gastroscopy Heliobacter pylori-infection or a mucosaassociated lymphoid tissue lymphoma. His diet was not especially rich
in smoked foods, salted fish and meat or pickled vegetables. He was
not obese and had no prior stomach surgery.
(Filing No. 56 at CM/ECF pp. 19-20).
“Bayesian” is def ined as “being, relating to, or involving statistical methods that assign probabilities or
distributions to events (such as rain tomorrow) or parameters (such as a population mean) based on
experience or best guesses before experimentation and data collection and that apply Bayes’ theorem to
revise the probabilities and distributions af ter obtaining experimental data.” See “Bayesian.” MerriamWebster.com Dictionary, Merriam-Webster, https://www.merriam-webster.com/dictionary/Bayesian.
Accessed 27 May. 2020.
3
A “dif ferential diagnosis [is] a technique that identifies the cause of a medical condition by eliminating the
likely causes until the most probable cause is isolated.” Bland v. Verizon Wireless, (VAW) L.L.C., 538 F.3d
893, 897 (8th Cir. 2008).
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Based on the data he reviewed and considered, Dr. Gale opines that the
alleged toxins have the capacity to cause stomach cancer in persons with the
same exposure as Saul and that “it is more likely than not, to a reasonable degree
of medical probability, the occupational exposures of Mr. Saul Hernandez to silica
dust and diesel engine exhaust particles and exposure to other carcinogens were
more likely than not a cause of his developing stomach cancer.” (Filing No. 47-6
at CM/ECF p. 6).
II.
Dr. Landolph
Dr. Landolph is also a qualified, highly credentialed scientist who is a
tenured associate professor – teaching microbiology, pathology, toxicology, and
chemical carcinogenesis. (Filing No. 47-9 at CM/ECF p. 5). He is a member of the
University of Southern California/Norris Comprehensive Cancer Center at USC’s
Keck School of Medicine. (Filing No. 47-9 at CM/ECF p. 7). In addition, Dr.
Landolph is an active researcher – working as a chemist, biochemist, genetic
toxicologist, cell and molecular toxicologist, and molecular carcinogenesis
researcher. (Filing No. 47-9 at CM/ECF p. 5). He has Bachelor of Science degree
in Chemistry and a PhD in Chemistry. (Filing No. 47-9 at CM/ECF pp. 5-6). Dr.
Landolph lists a litany of other achievements in cluding “scientific publications,
teaching activities, consultation activities, and administrative activities” related to
his work in toxicology, molecular biology, carcinogenesis, and related disciplines.
(Filing No. 47-9 at CM/ECF p. 13).
According to his report, Dr. Landolph used “conventional methodologies of
science” in forming his opinion. (Filing No. 47-9 at CM/ECF p. 17). He based his
opinion on a review of scientific studies, textbooks, and his own previous studies
and writings. (Filing No. 47-8 at CM/ECF pp. 17-18) (Landolph Dep. 68:9 - 71:7).
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Like Dr. Gale, he relied on IARC studies regarding diesel exposure and reviews
diesel exhaust exposure among railroad workers. (Filing No. 47-9 at CM/ECF p.
26). He also reviewed Saul’s medical records. (Filing No. 47-9 at CM/ECF p. 19).
Dr. Landolph has never worked for or visited a railyard and has no
knowledge of working conditions in the railyards where Saul worked. (Filing No.
47-8 at CM/ECF p. 4) (Landolph Dep. 16:3-10). Also, like Dr. Gale, he did not have
Saul’s employment records but reviewed a limited summary that includes Saul’s
dates of employment, job title(s), approximate age at employment, and his
purported “exposures.” (Filing No. 47-2); see also (Filing No. 47-8 at CM/ECF p.
2) (Landolph Dep. 7:11-18).
Dr. Landolph opines
…to a reasonable scientific probability that diesel particulate matter
and silica dust are capable of causing and/or contributing to the
development of cancers in human s, including gastric caner, [sic]
because diesel exhaust contains many carcinogens [BaP, benzene,
carcinogenic PAHs, nitrated PAHs, formaldehyde, acrolein, and
TCDD]. It is my opinion that when Mr. Saul Hernandez, a brakeman
and laborer, inhaled diesel exh aust and silica dust present at the
railroad workers’ work sites, this allowed the diesel exhaust and its
benzene, BaP, other PAHs, nitrated PAHs, and 2,3,7,8-TCDD
(dioxin), and crystalline silica and silica dust, and gasoline (containing
benzene) to penetrate to his respiratory system, oral cavity, nasal
cavity, pharyngeal area, stomach, and circulatory system[.]
(Filing No. 47-6 at CM/ECF p. 73, ¶ G). Dr. Landolph’s findings are premised on
combining data from a study of Canadian railroad workers with an equation created
by the California Office of Environmental Health Hazard Assessment (OEHHA).
(Filing No. 47-8 at CM/ECF p. 33) (Landolph Dep. at 132:8-15); see also (Filing
No. 49 at CM/ECF p. 5, ¶ 18); (Filing No. 54 at CM/ECF p. 5, ¶ 18). Dr. Landolph
took the estimated diesel exhaust exposure of the Canadian workers and placed
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it within the framework of “default factors” created by the OEHHA. (Filing No. 47-8
at CM/ECF p. 33) (Landolph Dep. at 131:10-25). That allowed Dr. Landolph to
calculate “general” exposure of a hypothetical railroad worker. (Filing No. 47-8 at
CM/ECF p. 33) (Landolph Dep. at 131:24-25). Dr. Landolph then considered the
OEHHA’s “cancer potency factor” which is “telling you how potent [the alleged
toxins are] in causing cancer…[.]” (Filing No. 47-8 at CM/ECF p. 116:1-2). Dr.
Landolph assumed that Saul would have worked 50 hours a week, five days per
week during his ten years of employment with UPRR, and was exposed toxins at
a level consistent with Dr. Landolph’s hypothetical OEHHA calculation.4 (Filing No.
47-8 at CM/ECF p. 34) (Landolph Dep. at 133:11-21).
Based on that framework and his assumptions, Dr. Landolph calculated that
if one million people were subjected to the same exposures as Mr. Hernandez,
there would be 197 more instances of cancer than there would in an absence of
those purported exposures. (Filing No. 47-8 at CM/ECF p. 35) (Landolph Dep. at
138:11-16).
B. Standard of Review
Plaintiff alleges a FELA claim against UPRR, claiming his cancer resulted
“in whole or in part from the negligence” of the railroad. 45 U.S.C. § 51. The statute
imposes upon employers a continuous duty to provide a reasonably safe place to
work. Cowden v. BNSF Ry. Co., 690 F.3d 884, 889 (8th Cir. 2012). The FELA is
to be liberally construed, but it is not a workers' compensation statute, and the
basis of liability is “negligence, not the fact that injuries occur.” Consolidated Rail
Corp. v. Gottshall, 512 U.S. 532, 543 (1994). To prevail under the FELA, Plaintiff
Saul’s weekly work schedule is purely speculative. Dr. Landolph testified that had not reviewed anything
specific regarding Saul’s dates or hours worked. He “assumed” f or the purposes of perf orming his
calculation that he worked 50 hours per week, over a f ive-day work week. (Filing No. 47-8 at CM/ECF p.
34) (Landolph Dep. at 133:11-21).
4
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must prove the elements of a negligence claim: duty, breach, foreseeability, and
causation. Crompton v. BNSF Ry. Co., 745 F.3d 292, 296 (7th Cir. 2014); Tufariello
v. Long Island R. Co., 458 F.3d 80, 87 (2d Cir. 2006).
The Court applies a relaxed standard of causation under the FELA. CSX
Transp., Inc. v. McBride, 564 U.S. 685 (2011); The test is simply whether employer
negligence played any part, even the slightest, in producing the injury for which
damages are sought. Id. This modified standard of causation does not, however,
change the Daubert analysis. See McLaughlin v. BNSF Railway Company, 2020
WL 641729, at *4 (D. Neb. Feb. 11, 2020). (“The admissibility of expert testimony
under Rule 702 and Daubert is a distinct inquiry from the relaxed causation
standard applied to FELA cases.”); Steggall v. BNSF Ry. Co., 2019 WL 1492579,
at *3 (D. Neb. Apr. 4, 2019) (“The Daubert standard governs the application of Rule
702 and applies to FELA and non -FELA actions.”); In re Conrail Toxic Tort Fela
Litig., 1998 WL 465897, at *6 (W.D. Pa. Aug. 4, 1998) (holding Daubert is properly
applied in a FELA case); Hose v. Chi. Nw. Transp. Co., 70 F.3d 968, 972 (8th Cir.
1995) (applying Daubert in a FELA action challenging plaintiff’s proposed expert
testimony).
The admissibility of expert testimony is governed by Rule 702 of the Federal
Rules of Evidence which states:
If scientific, technical, or other specialized knowledge will assist the
trier of fact to understand the evidence or to determine a fact in issue,
a witness qualified as an expert by knowledge, skill, experience,
training, or education, may testify thereto in the form of an opinion or
otherwise, if (1) the testimony is based upon sufficient facts or data,
(2) the testimony is the product of reliable principles and methods, and
(3) the witness has applied the principles and methods reliably to the
facts of the case.
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Fed. R. Evid. 702. The court must assume a gatekeeping function to ensure that
“any and all scientific testimony or evidence admitted is not only relevant, but
reliable.” Daubert, 509 U.S. at 589. To carry out this function, the court must “make
certain that an expert, whether basing testimony upon professional studies or
personal experience, employs in the courtroom the same level of intellectual rigor
that characterizes the practice of an expert in the relevant field.” Kumho Tire Co.
v. Carmichael, 526 U.S. 137, 152 (1999); see also Am. Auto Ins. Co. v. Omega
Flex, Inc., 783 F.3d 720, 722 (8th Cir. 2015).
A witness can be qualified as an expert by “knowledge, skill,
experience, training, or education,” Fed.R.Evid. 702, and it is the
responsibility of the trial judge to determine whether a particular expert
has sufficient specialized knowledge to assist jurors in deciding the
specific issues in the case. See Kumho Tire, 526 U.S. at 156, 119
S.Ct. 1167.
Wheeling Pittsburgh Steel Corp. v. Beelman River Terminals, Inc., 254 F.3d 706,
715 (8th Cir. 2001). The party offering the challenged testimony bears the burden
of establishing admissibility by a preponderance of the evidence. Lauzon v. Senco
Prods., Inc., 270 F.3d 681, 686 (8th Cir. 2001) (citing Daubert, 509 U.S. at 592).
Daubert established a non-exclusive checklist for trial courts to use in
assessing the reliability of expert testimony, including whether the theory or
technique can and has been tested, whether it has been subjected to peer review,
whether there is a high known or potential rate of error, and whether the theory or
technique enjoys general acceptance within a relevant scientific community. See
U.S. v. Holmes, 751 F.3d 846, 850 (8th Cir. 2014) (citing Daubert, 509 U.S. at 59294). And for the purposes of evaluating the relevance of expert testimony, the
Court must determine whether the expert’s reasoning or methodology was applied
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properly to the facts at issue.5 Daubert, 509 U.S. at 580. To that end, expert
testimony that is speculative, unsupported by sufficient facts, or contrary to the
facts of the case, is inadmissible. Marmo v. Tyson Fresh Meats, Inc., 457 F.3d
748, 757 (8th Cir. 2006).
C. Discussion
In general, Dr. Landolph and Dr. Gale opine that the alleged toxin s – diesel
exhaust, silica dust, and asbestos – are capable of causing cancer; however, to
meet the burden of establishing causation, even under the relaxed FELA standard,
Plaintiff “must prove not only that an alleged toxin is capable of causing an injury,
but that the toxin caused this particular injury.” McLaughlin, 439 F. Supp. 3d at
1178 (citing Myers v. Ill. Cent. R.R. Co., 629 F.3d 639, 643-44 (7th Cir. 2010))
(emphasis added).
Put differently, proof of causation in a FELA case requires evidence showing
two types of causation: (1) general causation —that the identified toxins have the
capacity to cause the injury suffered by the decedent in persons subject to the
same exposure level as the decedent—and (2) specific causation—that the toxin
was a cause of this decedent’s injury. Bettisworth v. BNSF Ry. Co., 2020 WL
3498139, at *6 (D. Neb. June 29, 2020) (citing Mattis v. Carlon Elec. Products, 295
F.3d 856, 860-61 (8th Cir. 2002)). Plaintiff must have reliable expert evidence of
both types of causation. Brooks v. Union Pac. R. Co., 620 F.3d 896, 899 (8th Cir.
Here, there is some question as to whether the opinions in Dr. Gale’s report truly represent his reasoning
and methodology. At his deposition, Dr. Gale testified that the document produced by Plaintiff’s counsel as
his expert report was not the same report he prepared and provided to Plaintiff’s counsel. He f urther
indicated that portions of the document purporting to be his “report” were “discordant” with the report he
draf ted. And, shown his signature on the report served by Plaintiff’s counsel, Dr. Gale testified that he had
never signed it: “It’s not that I don’t recall [signing it]. I did not [sign it].” (Filing No. 47-4 at CM/ECF pp. 2-3)
(Gale Dep. 8:17-11:7). Because his report will be excluded f or other reasons, the court will not strike it
based on this testimony. But as to future cases, Plaintiff’s counsel is admonished to serve only those expert
reports unequivocally prepared and signed by the expert.
5
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2010); see also Moody v. Maine Cent. R.R. Co., 823 F.2d 693, 695 (1st Cir.1987);
Claar v. Burlington N.R.R. Co., 29 F.3d 499, 504 (9th Cir.1994).
I.
General Causation
The parties vehemently disagree as to whether either expert opinion reliably
opines on general causation. Defendant argues that neither Dr. Gale nor Dr.
Landolph confined his opinion to gastric cancer, i.e. “the injury suffered by” Saul.
Mattis, 295 F.3d at 860 (general causation requires proof that the toxin at issue
caused the specific type of injury the decedent suffered). Instead, Defendant
asserts, both experts’ opinions are based on a generalized calculation of the risk
of developing any type of cancer – which, Defendant argues, is impermissibly
broad. Defendant further argues that even if the experts had sufficiently limited
their opinions to gastric cancer, they both testified that they did not know Saul’s
specific level of exposure to the toxins at issue and thus could not opine on
exposure risk to a person subject to that same unknown exposure level. Id.
Plaintiff argues that the experts’ general causation opinions are sound. As
to Dr. Landolph, Plaintiff argues that he supports “this opinion that diesel exhaust
is a multi-organ carcinogen” based on a “multitude of peer-reviewed studies which
link diesel exhaust and its subcomponents to the development of cancer in various
other parts of the human body.” (Filing No. 52 at CM/ECF p. 21). In his deposition,
Dr. Landolph testified that diesel exhaust “could damage the stomach and the
colon…[.]” (Id) (citing Landolph Dep. at 42:23-43:13) (emphasis added).
The court agrees with Defendant – Dr. Landolph does not seem to
sufficiently link the alleged toxic exposure to Saul’s specific cancer type cancer
(gastric). As noted above, Dr. Landolph based his opinion on figures derived from
the OEHHA, relying specifically on the OEHHA’s “cancer potency factor” to
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determine whether certain toxin exposures have the potential to cause cancer.
(Filing No. 47-8 at CM/ECF p. 29-30) (Landolph Dep. 116:22-117:3).
Dr. Landolph testified that “I don’t know at the time they did this calculation
of cancer potency factors whether gastric cancer was in there or not. I don't know
that answer.” Filing No. 47-8 at CM/ECF p. 29-30) (Landolph Dep. 116:22-117:3).
He also testified that his calculated 197 instances of cancer per million included all
cancer types, and he did not know how many of those 197 would be gastric. (Filing
No. 47-8 at CM/ECF p. 31) (Landolph Dep. 121:18-122:3).
Still, Dr. Landolph maintains that diesel exhaust causes cancer in a
“multitude of different organs” and that supports an opinion that it causes gastric
cancer. He opined that:
Are we now seeing that, indeed, now that lung cancer was
established and IARC called lung cancer and bladder cancer as
being induced by diesel exhaust, what about these other tumors?
And from what I see, my opinion now is that, yes, diesel exhaust is a
multi-organ carcinogen in humans, and it needs to be controlled
much more carefully, and it is a known human carcinogen.
And it doesn't surprise me because it can cause lung cancer because
of inhalation. It can also, once it gets into the lung, be moved by
what's called mucociliary escalator, which has cilia that are hairs that
beat and mucus, which is sticky, and the diesel will stick to that, and
come back up into the mouth and then be swallowed and go down to
the stomach so that it can damage the esophagus potentially, and it
could damage the stomach and the colon as well. And there is more
and more data to support this, so I believe that diesel has crossed
the line, and this is an observation as much as an opinion. The
observations make my opinion because I have worked on a number
of these cases now, and I see more and more organs being affected
in terms of incurring carcinogenesis by contact with diesel, which is
called a known human carcinogen.
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(Filing No. 47-8 at CM/ECF p. 11) (Landolph Dep. 42:23-43:21). Thus, while Dr.
Landolph appears confident that the research supports diesel exhaust as a cause
of lung cancer, his opinion as to which other organs it may affect is, at best, murky.
Even under the FELA causation standard, that is not enough. See Edmonds
v. Ill. Cent. Gulf R.R. Co., 910 F.2d 1284, 1288 (5th Cir. 1990) (“plaintiff must show
more than a possibility that a causal relation existed”); Mayhew v. Bell S.S. Co.,
917 F.2d 961, 963 (6th Cir. 1990) (quoting Moody v. Me. Cent. R.R. Co., 823 F.2d
693, 695 (1st Cir. 1987)) (“[A]lthough a [FELA] plaintiff need not make a showing
that the employer's negligence was the sole cause, there must be a sufficient
showing (i.e. more than a possibility) that a causal relation existed.”).
Dr. Landolph has not sufficiently tailored his opinion to Saul’s actual injury.
His general causation opinion is insufficiently reliable and will be excluded for
failure to reliably opine as to the injury alleged – gastric cancer.
Whether Dr. Gale sufficiently opined as to general causation is a closer
question. To be sure, there were issues with portions of his report and testimony.
For example, Dr. Gale reviewed and relied upon Dr. Landolph’s report as it
relates “excess cancer risk” related to diesel exhaust exposure and notes that the
findings relate to “all cancers” and not specifically to gastric cancer. (Filing No. 474 at CM/ECF p. 36) (Gale Dep. 141:8-15). He could similarly not say whether
asbestos exposure was a cause of gastric cancer:
MS. O’BRIEN:
Is there a known dose or amount of exposure to
asbestos that is more likely than not to cause
stomach cancer?
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DR. GALE:
It's generally -- well, firstly, I wasn't asked to opine
about more likely than not to be the cause. I was
asked whether something could be a cause. I just
want to clarify that. It's generally assumed that a
fiber of asbestos can cause cancer. And I can't
answer specifically can cause gastric cancer.
(Filing No. 47-4 at CM/ECF p. 27) (Gale Dep. 105:4-13).
However, Dr. Gale did provide and rely upon myriad articles that speak
specifically to gastric cancer and its causation or association with the alleged
toxins. See, e.g., (Filing No. 47-4 at CM/ECF p. 18) (Gale Dep. 70:11-15; 77-7-12).
While Defendant takes issue with Dr. Gale’s scientific articles, (Filing No. 44 at
CM/ECF p. 26), arguing that none definitively assert that diesel exhaust, asbestos ,
or silica dust cause gastric cancer, the court is unwilling to go so far. Dr. Gale
clearly attempted to tailor his opinion to the cancer at issue, and the court will not
exclude his report for failure to specifically address Saul’s alleged injury.
Defendant further argues that Dr. Gale’s opinion on general causation
should be excluded for failure to specifically indicate the level at which the alleged
toxic exposure has the capacity to cause gastric cancer. 6 (Filing No. 44 at CM/ECF
p. 28). More specifically, Defendant claims that Dr. Gale could not sufficiently
identify the level of exposure to asbestos, silica dust, or diesel fuel necessary to
cause stomach cancer. And, Defendant asserts that Dr. Gale did not have
sufficient information about Saul’s exposure to the alleged toxins, either – including
a lack of information related to his actual work site, his actual job description, his
actual hours worked, and the like. (Filing No. 44 at CM/ECF pp. 5-6). Defendant
claims that Dr. Gale could not possibly opine as to the alleged toxins’ capacity to
6
Def endant also made this argument as to Dr. Landolph. However, the court did not reach that argument,
as it excluded Dr. Landolph’s general causation opinion on other grounds.
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cause gastric cancer in “persons subject to the same exposure level” as Saul
because he knew neither the level generally necessary nor any facts to determine
or estimate the level actually—or even possibly—experienced by the decedent.
Mattis, 295 F.3d at 860.
This court has previously excluded expert opinions for that very reason. See
McLaughlin, 439 F. Supp. 3d at 1181 (expert witness “cannot possibly link” the
plaintiff’s alleged diesel exhaust exposure to his cancer if the expert “does not
know what levels of exposure have been shown to cause [that] cancer”); Byrd v.
Union Pac. R.R. Co., 2020 WL 1848496, at *6 (D. Neb. Apr. 13, 2020) (“an expert
cannot with reasonable certainty or probability link an individual’s alleged diesel
exhaust exposure to his [ ] cancer if the expert does not know what level of
exposure has been shown to cause [that] cancer”); But see Langrell v. Union Pac.
R.R. Co., 2020 WL 3037271, at *8 (D. Neb. June 5, 2020) (allowing expert
testimony of general causation based on “materials furnished by the plaintiff’s
attorney, a review of the literature, and his extensive knowledge, experience, an d
expertise” even where expert did not have access to the specific details of plaintiff’s
job duties, work schedule, or site of employment).
The court need not and will not reach this argument. As will be discussed in
detail below, regardless of whether Dr. Gale’s opinion is sufficient as to general
causation, he has clearly failed to reliably opine as to specific causation. And
because Dr. Landolph’s opinion was confined to general causation, and both
general and specific causation are required, Dr. Gale’s specific causation opinion
was necessary for Plaintiff to prove his case. Thus, regardless of whether the court
were to here adopt the reasoning in McLaughlin and Byrd or the contrary reasoning
Langrell on the above-issue, Plaintiff’s lack of evidence on specific causation
discussed below is alone fatal, and summary judgment will be granted.
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II.
Specific Causation
As noted above, Dr. Gale performed a “differential diagnosis” or “differential
etiology” in order to form his opinion on specific causation in this case. (Filing No.
56 at CM/ECF p. 18). And in general, medical causation opinions based upon
differential diagnoses are sufficiently reliable as to pass muster under Daubert.
Turner v. Iowa Fire Equip. Co., 229 F.3d 1202, 1208 (8th Cir. 2000).
Differential diagnosis required Dr. Gale to “identif[y] the cause of a medical
condition by eliminating the likely causes until the most probable cause is isolated.”
Bland, 538 F.3d at 897 (citing Westberry v. Gislaved Gummi AB, 178 F.3d 257,
262 (4th Cir.1999)). This is achieved by ruling in all scientifically plausible causes
and then ruling out the least plausible until the most likely cause remains.
Kudabeck v. Kroger Co., 338 F.3d 856, 860-61 (8th Cir. 2003).
Under the FELA, an expert need not isolate the “most likely” or “proximate”
cause of a plaintiff or decedent’s injury to establish causation under FELA’s relaxed
standard. McBride, 564 U.S.at 685. However, even though the causation standard
is lower than in other negligence actions, a doctor performing a differential
diagnosis is, at minimum, required to consider all potential causes before opining
as to specific causation in a FELA case. (Filing No. 56 at CM/ECF p. 21) (quoting
Guinn v. AstraZeneca Pharm. LP, 602 F.3d 1245, 1253 (11th Cir. 2010) (“while a
reliable differential diagnosis need not rule out all possible alternative causes, it
must at least consider other factors that could have been the sole cause of the
plaintiff’s injury”) (emphasis added); see also Brown v. Burlington N. Santa Fe Ry.
Co., 765 F.3d 765, 773 (7th Cir. 2014); In re Conrail Toxic Tort Fela Litig., No. CIV.
A 94-11J, 1998 WL 465897, at *6 (W.D. Pa. Aug. 4, 1998); In re Viagra Prod. Liab.
Litig., 658 F. Supp. 2d 950, 959 (D. Minn. 2009) (holding a failure to “rule out” other
possible causes will render the differential diagnosis scientifically unreliable).
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It is undisputed that in both 2007 and 2010, Saul had infections caused by
heliobacter pylori and underwent medical procedures related to abdominal pain,
(Filing No. 47-3 at CM/ECF p. 3-4), and he was diagnosed with gastric cancer in
2013. (Filing No. 1 at CM/ECF p. 3, ¶ 3). And, the parties agree that heliobacter
pylori is a cause of gastric cancer. (Filing No. 47-4 at CM/ECF p. 43) (Gale Dep.
171:22-25) (transcribing Dr. Gale’s testimony that heliobacter pylori is a known
cause of gastric cancer); (Filing No. 47-3 at CM/ECF p. 4) (Klute Dec. ¶ 11)
(“Helicobacter pylori infection…is a well- established risk factor for gastric cancer,
and in particular for the specific type that Mr. Hernandez suffered from – diffuse
gastric cancer”). Yet here, Dr. Gale either never received for consideration or did
not consider the medical records and information regarding Saul’s heliobacter
pylori infections—a known cause of gastric cancer. Instead, Dr. Gale’s report
indicates that Saul had “no history of stomach ulcers, chronic idiopathic gastritis,
hypertrophic gastroscopy Heliobacter pylori-infection or a mucosa-associated
lymphoid tissue lymphoma.” (Filing No. 47-5 at CM/ECF p. 7). At his deposition,
he testified that he “wasn't asked to opine about Helicobacter [sic]. That's not a
task I was asked. I could consider it. I was unaware of it, but I could consider it if
you ask me.” (Filing No. 47-4 at CM/ECF p. 50) (Gale Dep. 197:6-9).
When a Daubert motion is filed, this court serves as the gatekeeper to
assure the opinions advanced by experts are sufficiently reliable to be admissible.
Daubert, 509 U.S. at 589. Under the current circumstances, the court must
consider whether Dr. Gale approached th e causation issue in this case with “the
same level of intellectual rigor that characterizes” the practice of a medical
professional. Kumho, 526 U.S. at 152. Expert testimony that is based on incorrect
assumptions of facts material to performing a differential diagnosis is inadmissible.
Marmo, 457 F.3d at 757. Here, Dr. Gale not only failed to rule out heliobacter pylori
as the sole cause of Saul’s gastric cancer, his report and testimony indicate that
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he was not even aware of Saul’s heliobacter pylori infections. (Filing No. 47-4 at
CM/ECF p. 48) (Gale Dep. 184:12-16).
Dr. Gale’s failure to even consider
heliobacter pylori precludes the possibility that Dr. Gale performed a proper
differential etiology and renders his causation opinion scientifically unreliable.
Bland, 538 F.3d at 897 (affirming exclusion of expert’s differential diagnosis
testimony under Daubert because the expert failed to properly investigate and
consider other possible causes of injury). Dr. Gale’s opinion will be excluded as it
relates to specific causation.
MOTION FOR SUMMARY JUDGMENT
UPRR moved for summary judgment, arguing Plaintiff cannot make a prima
facie FELA case without proving causation. The railroad argues the plaintiff must
offer expert testimony to support a claim of medical causation, specifically that Dr.
Landolph’s and Dr. Gale’s expert opinions on general causation and Dr. Gale’s
expert opinion on specific causation are unreliable and inadmissible and as such,
UPRR is entitled to summary judgment.
1. Standard of Review
“The court shall grant summary judgment if the movant shows that there is
no genuine dispute as to any material fact and the movant is entitled to judgment
as a matter of law.” Fed. R. Civ. P. 56(c)(2). In ruling on a motion for summary
judgment, the court must view the evidence in the light most favorable to the non moving party, giving that party the benefit of all inferences that may be reasonably
drawn from the evidence. Dancy v. Hyster Co., 127 F.3d 649, 652-53 (8th Cir.
1997). The court does not weigh evidence in the summary judgment record to
determine the truth of any factual issue. It merely determines whether there is
evidence creating a genuine issue for trial. Bell v. Conopco, Inc., 186 F.3d 1099,
1101 (8th Cir. 1999).
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The moving party bears the burden of showing there are no genuine issues
of material fact. Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986). However, “a
party opposing a properly supported motion for summary judgment ‘may not rest
upon the mere allegations or denials of [its] pleading, but must set forth specific
facts showing that there is a genuine issue for trial.’” Anderson v. Liberty Lobby,
Inc., 477 U.S. 242, 248 (1986) (quoting First Nat’l Bank of Ariz. v. Cities Serv. Co.,
391 U.S. 253, 288 (1968)). Credibility determinations, the weighin g of the
evidence, and the drawing of legitimate inferences from the facts are left for trial.
“The evidence of the non -movant is to be believed, and all justifiable inferences
are to be drawn in [its] favor.” Anderson, 477 U.S. at 251-52.
2. Discussion
To be successful on the FELA claim, Plaintiff must prove causation. Expert
testimony is required to establish medical causation in a FELA case. Brooks v.
Union Pac. R. Co., 620 F.3d 896, 899 (8th Cir. 2010). Dr. Landolph has not
provided reliable scientific opinions, as required by Daubert, on general causation.
Dr. Gale has likewise failed to provide reliable scientific opinions, as required by
Daubert, on specific causation. Without a reliable opinion on both general and
specific causation, Plaintiff cannot provide his FELA case. As such, the motion for
summary judgment will be granted.
Accordingly, IT IS ORDERED:
(1)
Defendant’s Motion to Exclude Dr. Landolph (Filing No. 45) is granted.
(2)
Defendant’s Motion to Exclude Dr. Gale (Filing No. 43) is granted as
it relates to specific causation, and denied as moot as it relates to
general causation.
(3)
Defendant’s Motion for Summary Judgment (Filing No. 48) is granted.
(4)
The parties’ Joint Motion to Stay (Filing No. 61) is denied as moot.
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(5)
A separate judgment will be entered.
Dated this 14th day of August, 2020.
BY THE COURT:
s/ Cheryl R. Zwart
United States Magistrate Judge
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