Rochkind v. Stevenson

Citations: 164 A.3d 254; 454 Md. 277; 2017 WL 2952984; 2017 Md. LEXIS 463Docket: 76/16

Court: Court of Appeals of Maryland; July 11, 2017; Maryland; State Supreme Court

Original Court Document: View Document

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In the case of Stanley Rochkind v. Starlena Stevenson, the Court of Appeals of Maryland determined that an expert witness lacked a sufficient factual basis to testify that lead exposure caused the plaintiff’s Attention Deficit Hyperactivity Disorder (ADHD). The expert referenced studies linking lead exposure to general attention deficits, but failed to establish a direct connection to a clinical ADHD diagnosis. Consequently, the trial court made an error in admitting this testimony under Maryland Rule 5-702(3), prompting a remand for a new trial focused on damages. The court did not address the petitioner’s claim regarding the absence of a Frye-Reed hearing, as it was deemed irrelevant to the outcome. 

The factual background revealed that Starlena Stevenson lived in environments with lead paint; her blood lead levels were tested multiple times during early childhood, indicating elevated levels while living at Fairview Avenue. Diagnosed with ADHD at age five, she subsequently received various medications. Throughout her life, Stevenson faced significant mental health challenges, including a suicide attempt and diagnoses of major depressive disorder and generalized anxiety disorder, leading to inconsistent employment and eventual unemployment by 2014.

In December 2011, Stevenson initiated a lawsuit against Rochkind in the Circuit Court for Baltimore City, citing negligence and violations of the Maryland Consumer Protection Act. Lead testing conducted by Arc Environmental, Inc. in July 2012 revealed lead-based paint on multiple surfaces at Fairview. In February 2013, Dr. Cecilia Hall-Carrington, a pediatrician, reported that Stevenson was likely poisoned by lead at Fairview, linking this exposure to her neuropsychological issues, including ADHD. Prior to trial, Rochkind sought to exclude Dr. Hall-Carrington’s testimony regarding the source of Stevenson’s lead exposure and its connection to her cognitive deficits, requesting Frye-Reed hearings, which the court denied.

The jury ultimately ruled in favor of Stevenson, awarding her $829,000 in economic damages and $534,000 in noneconomic damages. Rochkind's motion for a new trial was partially granted, resulting in a retrial focused solely on damages in October 2014. He renewed his motions in limine to exclude Dr. Hall-Carrington’s testimony, which were again denied. The court found her opinions to be based on reliable sources and not new science, admitting her testimony under Maryland Rule 5-702.

During the retrial, Dr. Hall-Carrington testified that lead exposure can lead to ADHD and specifically attributed Stevenson’s ADHD to her lead exposure, referencing the Environmental Protection Agency's publication on the effects of lead. In closing arguments, Stevenson’s counsel suggested a link between her ADHD medication and side effects like depression and hallucinations. The jury awarded Stevenson $753,000 in economic damages and $700,000 in noneconomic damages, which was reduced to $1,103,000 due to a statutory cap. Rochkind’s motion for a new trial was denied, and he filed an appeal. The Court of Special Appeals upheld the trial court's decision, confirming that the Frye-Reed hearing was unnecessary for Dr. Hall-Carrington’s general causation testimony, as the studies she referenced were not novel and utilized accepted methodologies. The court also affirmed the admissibility of her specific causation testimony under Rule 5-702, noting it was based on an adequate factual foundation sufficient for jury consideration.

Rochkind appealed a decision regarding the admissibility of expert testimony related to lead exposure and ADHD. The primary issues addressed include: 

1. Whether the Court of Special Appeals incorrectly determined that lead exposure is "generally accepted" as a cause of ADHD, despite major medical organizations stating that ADHD's causes are unknown, with a strong inclination towards hereditary factors.
2. Whether the Court erred by conducting a non-adversarial Frye-Reed analysis instead of remanding for an evidentiary hearing that could have highlighted the controversial nature and criticism of the EPA publication it relied upon.
3. Whether the Court failed to apply the "reliable methodology" requirement of Maryland Rule 5-702 to Dr. Hall-Carrington's testimony regarding the causation of ADHD and if the trial court erred in admitting this testimony.

The court found that the first question warranted a reversal of the Court of Special Appeals' decision, leading to a remand for a new trial on damages, thus not addressing the second question. 

The admissibility of expert testimony is largely at the trial court's discretion, which is reviewed for abuse of discretion. Dr. Hall-Carrington’s testimony was challenged for not meeting the criteria of Maryland Rule 5-702 or the Frye-Reed standard, which requires that novel scientific methods be generally accepted in the relevant scientific community for admissibility. The trial court must assess the qualifications of the expert, the appropriateness of the testimony, and the factual basis supporting it.

The proponent of expert testimony must demonstrate compliance with specific legal requirements, particularly under the third prong concerning a sufficient factual basis, which consists of two key elements: an adequate supply of data and a reliable methodology. The expert's opinion must be grounded in facts that reflect the use of reliable principles and methodologies, avoiding mere speculation. Data can originate from various sources, including the expert’s own knowledge, testimonies, or hypothetical questions, and must be accessible to the expert before the hearing. While the data does not need to be admissible in evidence, it must be of a type that experts in the field typically rely on.

Additionally, the expert must provide a sound reasoning process for deriving conclusions from the factual data, ensuring that the reasoning is evaluable by the trier of fact. Conclusory statements without a reliable methodology are insufficient. In the case at hand, Rochkind challenges Dr. Hall-Carrington’s testimony regarding the causal relationship between lead exposure and Stevenson’s ADHD, arguing that she failed to rule out other causes and did not utilize a differential diagnosis, which should include epidemiological studies linking lead to ADHD. Conversely, Stevenson defends Dr. Hall-Carrington’s testimony, asserting that her reliance on the EPA-ISA paper, which cites multiple high-quality studies demonstrating a causal relationship between lead exposure and attention deficits, is adequate. Dr. Hall-Carrington indicated that while the EPA-ISA does not explicitly mention ADHD, it lists symptoms associated with the condition, asserting that Stevenson’s ADHD was caused by lead exposure.

Epidemiological studies' role in supporting expert testimony on causation remains undecided. Guidance from other jurisdictions is considered, particularly the U.S. Supreme Court's ruling in General Electric Co. v. Joiner, which found that expert testimony linking PCBs to lung cancer was unsupported by any studies demonstrating a causal relationship. The Court noted that a study indicating higher lung cancer deaths among plant workers failed to establish causation, as the researchers did not attribute the cancer to PCB exposure. This reflects the principle that a court may reject expert opinions if there is a significant analytical gap between the data and the opinion presented.

Additional cases, such as Blackwell v. Wyeth and Mitchell v. Gencorp Inc., highlight similar concerns regarding analytical gaps in expert testimony. A qualified expert may testify if their knowledge aids in understanding the evidence, is based on sufficient data, employs reliable methods, and applies those methods correctly to the case. However, Dr. Hall-Carrington's testimony lacked a solid factual foundation linking EPA-ISA studies on lead exposure to ADHD causation. The studies mentioned do not confirm a causal relationship, as the DSM-V outlines specific criteria for an ADHD diagnosis, which Dr. Hall-Carrington failed to address. While research indicates lead exposure may lead to attention deficits and hyperactivity, these symptoms do not equate to a clinical ADHD diagnosis, as they can arise from various other disorders. Thus, general attention deficits should not be conflated with ADHD.

Dr. Hall-Carrington's testimony linking lead exposure to ADHD lacks sufficient scientific support, leading to its inadmissibility under Rule 5-702(3). The court emphasized that while expert conclusions may appear reasonable, they must be substantiated beyond mere association; without concrete causal evidence, an expert's opinion cannot be accepted. Specifically, studies referenced in the EPA-ISA highlight an association between lead exposure and ADHD but fail to establish a direct causal link, largely due to potential confounding factors such as socioeconomic status and parental history of ADHD. The court noted that Dr. Hall-Carrington did not provide additional studies to corroborate her claims, resulting in an inadequate factual basis for her testimony.

The trial court's failure to identify this "analytical gap" constituted an abuse of discretion, necessitating the exclusion of her testimony. Furthermore, the court decided not to address the request for a Frye-Reed hearing regarding the general acceptance of the causal link in the scientific community, as the testimony's exclusion was sufficient. Consequently, the judgment of the Court of Special Appeals was reversed, and the case was remanded for a new trial focused solely on damages, with costs assigned to the respondent.