Huss v. Gayden

Citation: 571 F.3d 442Docket: 04-60962

Court: Court of Appeals for the Fifth Circuit; October 16, 2009; Federal Appellate Court

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The Petition for Panel Rehearing in the case of Barbara Huss and Rodney Huss v. John Overton Gayden, M.D., and Memphis Obstetrics and Gynecological Association, PC, was denied by the Fifth Circuit Court of Appeals. Judge Higginbotham dissented from this denial. A poll of the active judges showed that a majority did not support rehearing en banc, leading to a similar denial for that request. Judges Higginbotham and Elrod authored dissenting opinions.

Circuit Judge Priscilla Richman Owen addressed the dissenting opinions, clarifying that the panel majority did not rule that the magistrate judge erred in excluding expert testimony related to specific causation. The disagreement centers on whether the magistrate judge's exclusion of Dr. Reddix's testimony pertained to general or specific causation. The panel majority concluded that Dr. Reddix was not qualified to testify about general causation, despite the dissent's assertion otherwise. The majority's opinion emphasized that Dr. Reddix's testimony was relevant to general causation, which was improperly excluded by the magistrate judge. Dr. Reddix acknowledged a lack of established evidence linking Terbutaline to cardiomyopathy, citing issues with the studies cited by the plaintiffs’ expert, including small sample sizes and potential misinterpretations of pulmonary edema versus cardiomyopathy.

Dr. Reddix was prepared to testify that Terbutaline did not cause Barbara’s cardiomyopathy, citing a study of 9,000 patients who took the drug without developing the condition. He argued that the cause of her cardiomyopathy remained undetermined, labeling it as idiopathic. Reddix critiqued the small sample sizes of studies referenced by the plaintiffs, noting high chances of chance occurrences and confusion between pulmonary edema and cardiomyopathy in those studies. He contended that the existing medical literature does not support a causal link between Terbutaline and cardiomyopathy, thus discrediting the plaintiffs’ claims. The defendants claimed that the exclusion of Reddix’s testimony was prejudicial as it hindered their ability to challenge the plaintiffs’ expert, Dr. Carlton, who is a toxicologist, not a cardiologist. Reddix’s qualifications allowed him to effectively argue that the studies cited by the plaintiffs were unreliable, and he emphasized that Barbara’s condition was likely idiopathic rather than caused by Terbutaline. The magistrate judge’s ruling prevented the defendants from presenting evidence that could undermine the plaintiffs’ position, and the defendants argued that this exclusion was not harmless, as Reddix’s insights could have influenced the jury's decision on causation.

The panel majority's opinion clarifies that it does not hold the magistrate judge erred due to the exclusion of Dr. Reddix's testimony on specific causation. Although some statements could be misinterpreted to suggest the panel was evaluating Reddix's qualifications for specific causation testimony, the opinion emphasizes that Reddix would testify against the reliability of the plaintiffs' experts' opinions on general causation and assert that Terbutaline has not been shown to cause cardiomyopathy. Consequently, if Terbutaline is not reliably linked to cardiomyopathy, it follows that Barbara Huss's condition cannot be attributed to it. However, Dr. Reddix’s general causation testimony does not convert into specific causation testimony nor does it become inadmissible based on his qualifications.

The magistrate judge's ruling and much of the trial record support that Dr. Reddix was the sole defense expert to discuss the medical literature underpinning the plaintiffs' expert opinions on general causation. During voir dire, counsel for the Husses sought to exclude Reddix's testimony by questioning his qualifications, but Reddix confirmed his role as an expert on whether Terbutaline could cause cardiomyopathy, indicating that general causation was at play. Judge Higginbotham's dissent suggests that Reddix had completed his general causation testimony before any objections were raised and that any error in excluding further testimony on general causation was harmless; however, this is not supported by the record.

Reddix was prepared to testify about the scientific reliability of the literature cited by the plaintiffs' expert, which pertains to general rather than specific causation, and this testimony was excluded based on the magistrate judge's conclusion regarding Reddix's qualifications. The dissent misinterprets context in its representation of Reddix's proffered testimony, which was understood as addressing general causation. Furthermore, Judge Higginbotham criticizes the panel for referring a statute of limitations issue to the Mississippi Supreme Court, arguing against the decision of other court members to deny rehearing on this matter. The author of the opinion defends the referral, asserting it was appropriate for a federal court to seek clarification on an unsettled state law issue in a diversity case and concurs with the denial of rehearing en banc.

Barbara Huss and her husband filed a medical malpractice lawsuit over nine years ago, claiming negligence in the administration of Terbutaline during her pregnancy, which allegedly caused her lifelong cardiomyopathy. The Husses secured a jury verdict in their favor in August 2004, but the defendants appealed, resulting in a majority opinion that reversed the verdict on statute of limitations grounds. Following a denied request for en banc rehearing, the panel later certified the limitations issue to the Mississippi Supreme Court, which found the defense meritless. The panel then identified an error in the trial court’s exclusion of defense expert Dr. Reddix’s testimony regarding causation but allowed general causation testimony. The dissenting opinion criticizes the panel for failing to adhere to circuit precedent and for improperly applying a higher standard for evidentiary admissibility. The dissent emphasizes the trial court's discretion in determining admissibility and argues that the panel misapplied the standard of "manifest error." The refusal of the full court to reconsider the case is seen as a troubling endorsement of an aggressive judicial stance that disregards established legal standards.

The qualification of an expert to testify is a legal question assessed based on the lower court's factual findings, particularly regarding excluded evidence. The trial record is clear, with no ambiguity surrounding the objection, ruling, or the defendant’s proffer. The panel majority's attempt to identify uncertainty in the record is misguided, as any factual questions raised would still need to support the trial court's ruling. Overturning the jury's verdict based on the trial judge's ruling would undermine judicial discretion and replace it with a de novo standard for plaintiffs. The panel's task involved applying concepts of general and specific causation, and the dissent emphasized that the court is bound by precedent established in Tanner v. Westbrook regarding expert testimony admissibility, which respects the trial judge's discretion unless a clear error is evident. In Tanner, the court reversed a jury's damage award because an expert with general training was improperly allowed to opine on specific causation. In the current case, Reddix initially discussed general causation but was later restricted from testifying on specific causation after the plaintiffs objected. The magistrate judge clarified that only specific causation testimony was excluded, questioning the witness's qualifications to provide such an opinion. Subsequent inquiries from defense counsel focused solely on specific causation, further underscoring the limitation imposed by the judge.

Reddix testified that the cause of cardiomyopathy is unknown and that Terbutaline's role in causing it was uncertain. However, he was not permitted to assert that Terbutaline was not the cause in this specific case. The defense attempted to explore specific causation through four questions, one posed in front of the jury and three in proffer, but the district court excluded this testimony. No ruling prevented the defense from discussing general causation or critiquing the plaintiffs’ scientific studies. The magistrate determined that Reddix lacked the necessary experience to opine on whether Terbutaline caused or contributed to Barbara Huss's cardiomyopathy, highlighting the distinction between specific and general causation as established in Tanner. Reddix's lack of experience as a treating obstetrician and his inability to connect general principles to Huss's case supported the decision to exclude his opinion on specific causation.

The defendants acknowledged that the case centered on general causation rather than specific causation, thus undermining the argument that Reddix should have been allowed to express an opinion on specific causation. Reddix was permitted to testify on general causation without objection, and the panel's assertion that he could rebut Dr. Tucker’s specific causation testimony contradicted established law, which states that competence in general causation does not automatically confer competence in specific causation. The author argues that this case should have been reviewed en banc to rectify significant errors in federal law regarding expert testimony and emphasizes the importance of trial judges acting as gatekeepers against questionable expert opinions, as outlined in relevant case law. The reluctance of the court to correct the panel's error is criticized as favoring defendants in malpractice cases and undermining the integrity of expert testimony standards.

The use of expert testimony significantly influences litigation dynamics, particularly concerning privilege laws and the role of private attorneys-general. In the highlighted case, the objection was specifically related to causation, and the evidence excluded was solely that supporting specific causation, indicating no blatant disregard for the law. The trial was conducted by skilled lawyers and a competent judge. The panel's frustrations stem from unsuccessful earlier attempts to reverse the ruling based on limitations and Daubert standards, leading to a reliance on a weak argument regarding evidence exclusion. The court's handling of the case suggests a troubling departure from judicial impartiality, prioritizing personal views over legal obligations, thus undermining the integrity of the judicial process. The dissent emphasizes that Ms. Huss had the right to pursue her claim and jury trial, rights seemingly compromised by the court's actions, including suggesting the exclusion of plaintiffs' expert testimony while reversing the trial judge's exclusion of defendants’ evidence. The dissent critiques the court's evolving interpretation of its role, asserting that it lacks the discretion to decline rulings as the Supreme Court does. The dissenters highlight the detrimental impact of the court's decisions on litigants, leading to a decline in civil trials and litigation in federal courts. The dissent argues for en banc reconsideration of the case due to its potential to create conflicting precedents in Daubert jurisprudence, which could confuse trial judges regarding the handling of expert witness qualifications. The lack of resolution on these contradictions represents a failure of the court.