Rasos v. Ethicon, Inc. et al
Filing
74
MEMORANDUM OPINION AND ORDER (Daubert Motion re: Ezell Autrey, M.D.) The 66 MOTION by Ethicon, Inc., Johnson & Johnson to Exclude the Opinions of Plaintiff's Case-Specific Causation Expert Ezell Autrey, M.D. is GRANTED in part, DENIED in part, and RESERVED in part, as more fully set forth herein. Signed by Judge Joseph R. Goodwin on 3/24/2017. (cc: counsel of record; any unrepresented party) (hkl)
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:
Katherine Rasos v. Ethicon, Inc., et al.
Civil Action No. 2:12-cv-01599
MEMORANDUM OPINION AND ORDER
(Daubert Motion re: Ezell Autrey, M.D.)
Pending before the court is the Motion to Exclude the Opinions of Plaintiff’s
Specific Causation Expert Ezell Autrey, M.D. [ECF No. 66] filed by the defendants.
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. 206, 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. 206, 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 “a reliable differential diagnosis 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). “A differential diagnosis that fails to take serious
account of other potential causes may be so lacking that it cannot provide a reliable
basis for an opinion on causation.” Id. at 265. However, an expert’s causation opinions
will not be excluded “because he or she has failed to rule out every possible alternative
cause of a plaintiff's illness.” Id. “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
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sole cause.’” Id. at 265 (citations omitted).
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, Ethicon argues that I should exclude Dr. Autrey’s testimony regarding
the properties of polypropylene mesh, the adequacy of the information Ethicon
provided regarding its product, and design defects. However, those topics are the
provinces of a general causation expert—not a specific causation expert. In PTO No.
206, I directed the parties to file general causation objections in the main MDL.
Because Ethicon failed to do so here, their Motion on this point is DENIED.
Ethicon next argues that I should exclude Dr. Autrey’s testimony regarding
FDA issues. I have consistently precluded Ethicon’s experts from discussing FDA
compliance issues, and I will similarly preclude the Dr. Autrey from discussing those
issues. See, e.g., Lewis v. Johnson & Johnson, 991 F. Supp. 2d 748, 754 (S.D. W. Va.
2014). Ethicon’s Motion on this point is GRANTED.
Ethicon then argues that I should exclude Dr. Autrey’s testimony regarding
Ethicon’s state of mind. In particular, Ethicon seeks to exclude Dr. Autrey’s testimony
that Ethicon knew its product was unreasonably dangerous. To the extent that
testimony seeks to attribute a state of mind to the implanting surgeon, I agree with
Ethicon. Experts may not testify as to what other parties did or did not know.
However, to the extent Ethicon seeks to exclude Dr. Autrey’s testimony about the
adequacy of warnings and the knowledge of the medical community in general, I
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disagree. Expert witnesses may properly offer opinions on these topics. Ethicon’s
Motion is GRANTED to the extent they seek to exclude evidence regarding what
Ethicon did or did not know about its product.
Ethicon also argues that I should exclude Dr. Autrey’s opinions regarding the
plaintiff’s pain during intercourse because there is insufficient evidence in the record
to support that opinion. However, I find that opinion is sufficiently grounded to move
forward. To the extent Ethicon believes Dr. Autrey’s opinion is lacking, Ethicon may
attack that opinion on cross-examination. Ethicon’s Motion on this point is DENIED.
Finally, Ethicon argues that Dr. Autrey did not conduct a proper differential
diagnosis. I disagree.
Dr. Autrey is a gynecologist who is board-certified in obstetrics and gynecology.
Resp. 3. [ECF No. 70]. Dr. Autrey’s expert report and deposition testimony show that
he conducted a detailed review of the plaintiff’s medical records. Dr. Autrey
considered numerous alternative causes for the plaintiff’s injuries and explained his
reasons for ruling out those alternative causes.
As discussed above, an expert’s causation opinions will not be excluded
“because he or she has failed to rule out every possible alternative cause of a plaintiff's
illness.” Westberry, 178 F.3d. at 265. Ethicon’s suggested other possible alternative
causes affect the weight—not the admissibility—of an expert’s testimony, unless the
expert can provide no explanation for ruling out such alternative causes at trial. See
id. at 265. To the extent that Ethicon believes that Dr. Autrey failed to properly
consider other alternative causes, Ethicon is free to address those issues on cross-
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examination. Ethicon’s Motion on this point is DENIED, and any remaining issues
are RESERVED for trial.
IV.
Conclusion
The court ORDERS that the Motion to Exclude the Opinions of Plaintiff’s
Specific Causation Expert Ezell Autrey, M.D. [ECF No. 66] is GRANTED in part,
DENIED in part, and RESERVED in part.
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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March 24, 2017
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