Shively et al v. Johnson & Johnson et al
Filing
290
MEMORANDUM OPINION AND ORDER (Daubert Motion re: Christina Pramudji, M.D.) The 154 MOTION by Teri Key Shively, John Shively to Exclude or Limit Case Specific Expert Testimony of Dr. Christina Pramudji is DENIED in part and RESERVED in part, as more fully set forth herein. Signed by Judge Joseph R. Goodwin on 4/17/2017. (cc: counsel of record; any unrepresented party) (mks)
IN THE UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF WEST VIRGINIA
CHARLESTON DIVISION
IN RE:
ETHICON, INC.
PELVIC REPAIR SYSTEMS
PRODUCT LIABILITY LITIGATION
MDL No. 2327
______________________________________________________________________________
THIS DOCUMENT RELATES TO:
Teri Key Shively, et al. v. Ethicon, Inc., et al.
Civil Action No. 2:12-cv-00379
MEMORANDUM OPINION AND ORDER
(Daubert Motion re: Christina Pramudji, M.D.)
Pending before the court is the Motion to Exclude or Limit Case Specific Expert
Testimony of Dr. Christina Pramudji [ECF No. 154] filed by the plaintiffs. The Motion
is now ripe for consideration because briefing is complete.
I.
Background
This case resides in one of seven MDLs assigned to me by the Judicial Panel
on Multidistrict Litigation concerning the use of transvaginal surgical mesh to treat
pelvic organ prolapse (“POP”) and stress urinary incontinence (“SUI”). In the seven
MDLs, there are more than 60,000 cases currently pending, approximately 28,000 of
which are in this MDL, which involves defendants Johnson & Johnson and Ethicon,
Inc. (collectively “Ethicon”), among others.
In this MDL, the court’s tasks include “resolv[ing] pretrial issues in a timely
and expeditious manner” and “resolv[ing] important evidentiary disputes.” Barbara
J. Rothstein & Catherine R. Borden, Fed. Judicial Ctr., Managing Multidistrict
Litigation in Products Liability Cases 3 (2011). To handle motions to exclude or to
limit expert testimony pursuant to Daubert v. Merrell Dow Pharmaceuticals, Inc.,
509 U.S. 579 (1993), the court developed a specific procedure. In Pretrial Order
(“PTO”) No. 217, the court instructed the parties to file general causation Daubert
motions in the main MDL and specific causation Daubert motions, responses, and
replies in the individual member cases. To the extent that an expert is both a general
and specific causation expert, the parties were advised that that they could file a
general causation motion in the main MDL 2327 and a specific causation motion in
an individual member case. PTO No. 217, at 4.
II.
Legal Standard
By now, the parties should be intimately familiar with Rule 702 of the Federal
Rules of Evidence and Daubert, so the court will not linger for long on these
standards.
Expert testimony is admissible if the expert is qualified and if his or her expert
testimony is reliable and relevant. Fed. R. Evid. 702; see also Daubert, 509 U.S. at
597. An expert may be qualified to offer expert testimony based on his or her
“knowledge, skill, experience, training, or education.” Fed. R. Evid. 702. Reliability
may turn on the consideration of several factors:
(1) whether a theory or technique can be or has been tested;
(2) whether it has been subjected to peer review and
publication; (3) whether a technique has a high known or
potential rate of error and whether there are standards
controlling its operation; and (4) whether the theory or
technique enjoys general acceptance within a relevant
scientific community.
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Cooper v. Smith & Nephew, Inc., 259 F.3d 194, 199 (4th Cir. 2001) (citing Daubert,
509 U.S. at 592–94). But these factors are neither necessary to nor determinative of
reliability in all cases; the inquiry is flexible and puts “principles and methodology”
above conclusions and outcomes. Daubert, 509 U.S. at 595; see also Kumho Tire Co.
v. Carmichael, 525 U.S. 137, 141, 150 (1999). Finally, and simply, relevance turns on
whether the expert testimony relates to any issues in the case. See, e.g., Daubert, 509
U.S. at 591–92 (discussing relevance and helpfulness).
In the context of specific causation expert opinions, the Fourth Circuit has held
that plaintiffs may use “a reliable differential diagnosis[, which] provides a valid
foundation for an expert opinion.” Westberry v. Gislaved Gummi AB, 178 F.3d 257,
263 (4th Cir. 1999).
A reliable differential diagnosis typically, though not invariably, is
performed after ‘physical examinations, the taking of medical histories,
and the review of clinical tests, including laboratory tests,’ and generally
is accomplished by determining the possible causes for the patient’s
symptoms and then eliminating each of these potential causes until
reaching one that cannot be ruled out or determining which of those that
cannot be excluded is the most likely.
Id. at 262 (citations omitted).
Defendants, however, need not conduct a differential diagnosis to identify the
specific cause of an injury because they do not bear the burden of proving causation.
See 3 David Faigman et al. Modern Sci. Evidence § 21:6 (2015-2016 ed.). Indeed, a
defendant’s specific causation expert’s testimony should not be excluded because it
fails to identify the specific cause of a plaintiff’s injury. See Yang v. Smith, 728 S.E.2d
794, 800 (Ga. Ct. App. 2012) (refusing to exclude defendant’s specific causation expert
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testimony where that testimony did not identify an injury’s specific cause because the
defendant had no burden to prove the specific cause of the injury). In lieu of
conducting traditional differential diagnoses, defendants may instead provide expert
testimony suggesting alternative causes for the plaintiff’s injury in order to rebut the
plaintiff’s specific causation testimony. See Westberry, 178 F.3d at 265 (“The
alternative causes suggested by a defendant ‘affect the weight that the jury should
give the expert’s testimony and not the admissibility of that testimony,’ unless the
expert can offer ‘no explanation for why she has concluded [an alternative cause
offered by the opposing party] was not the sole cause.’” (citations omitted)); see also
Faigman, supra, at § 21:4 (“Sometimes, the courts subtly shift the burden of
production onto the defendant when determining whether the [plaintiff’s] expert has
done a sufficient job in ruling out other causes.”).
At bottom, the court has broad discretion to determine whether expert
testimony should be admitted or excluded. Cooper, 259 F.3d at 200.
III.
Discussion
First, the plaintiffs ask that I exclude several portions of Dr. Pramudji’s
testimony because they are speculative or unreliable. However, after reviewing the
record, I determine that Dr. Pramudji’s testimony is sufficiently founded and reliable
to move forward. To the extent the plaintiffs believe that Dr. Pramudji’s testimony is
deficient, they may attack that testimony on cross-examination. The plaintiffs’
Motion on these point is DENIED.
Next, the plaintiffs essentially argue that Dr. Pramudji did not conduct a
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proper differential diagnosis. However, as a defense specific causation witness, Dr.
Pramudji need not conduct a differential diagnosis. Instead, she is tasked with giving
testimony that affects the weight and potentially the admissibility of the plaintiffs’
specific causation expert. So long as the defense specific causation expert’s opinion is
a product of her specialized knowledge or training and is reliably grounded, it should
be admissible to rebut the plaintiffs’ specific causation expert.
Here, Here, Dr. Pramudji is a board-certified urologist who specializes in pelvic
floor medicine. Order, Aug. 5, 2016, at 5 [ECF No. 276]. Dr. Pramudji’s expert report
and deposition testimony show that she conducted a detailed review of Ms. Shively’s
medical records. Dr. Pramudji conducted a thorough, reliably-grounded analysis of
the medical evidence and determined that the plaintiffs’ proffered specific cause was
unlikely. She need not take an additional step and prove that another alternative
cause caused the plaintiffs’ injury; causation is the plaintiffs’ burden. To the extent
the plaintiffs believe that Dr. Pramudji’s testimony is flawed, they may address those
issues on cross-examination and with the testimony of their own specific causation
witness. The plaintiffs’ Motion on this point is DENIED, and any remaining issues
are RESERVED for trial.
IV.
Conclusion
The court ORDERS that the Motion to Exclude or Limit Case Specific Expert
Testimony of Dr. Christina Pramudji [ECF No. 154] is DENIED in part and
RESERVED in part.
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The court DIRECTS the Clerk to send a copy of this Order to counsel of record
and any unrepresented party.
ENTER:
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April 17, 2017
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