Court: District Court, D. Puerto Rico; October 19, 2016; Federal District Court
Plaintiff Martin Torres-Rivera has filed a malpractice suit against Defendants Dr. Luis A. Aponte and Centro Medico Del Turabo Inc. (doing business as San Pablo HIMA-Caguas), alleging violations of Puerto Rico's Civil Code (Articles 1802 and 1803) and the Emergency Medical Treatment and Active Labor Act (EMTALA). The Court is considering three motions in limine filed by the Defendants. HIMA seeks to exclude references to EMTALA violations, testimony from Plaintiff’s treating physician Dr. Pranay Ramdev, evidence regarding corporate responsibility, and any mention of hospital staff direct liability. Dr. Aponte aims to limit Dr. Ramdev's testimony and exclude testimony from expert witness Dr. Ralph De Natale. The Plaintiff opposes these motions. After reviewing the relevant submissions and applicable laws, the Court denies all motions by both Defendants.
Background facts indicate that on September 26, 2012, Dr. Aponte examined the Plaintiff, diagnosed an abdominal aortic aneurysm, and performed surgery on October 11, 2012. Subsequent complications led to multiple hospital visits and surgeries, including a second surgery on December 11, 2012. The Plaintiff later consulted Dr. Ramdev in Florida, who performed a leg amputation in July 2013.
The Court addresses the Defendants' arguments regarding the exclusion of testimonies. Defendants contend that the Plaintiff did not meet expert disclosure requirements for Dr. Ramdev and that Dr. De Natale’s testimony should be excluded due to lack of notice and insufficient reliability. These arguments are examined as part of the Court's discussion on the motions.
Plaintiffs' treating physician, Dr. Ramdev, is at the center of a motion to exclude or limit his testimony due to alleged non-compliance with expert disclosure requirements. HIMA seeks complete exclusion of Dr. Ramdev, while Dr. Aponte argues for limiting his testimony to factual matters only. Both motions are denied. Under Rule 26 of the Federal Rules of Civil Procedure, parties must disclose individuals likely to have discoverable information, with specific requirements for expert witnesses. However, treating physicians are not categorized as expert witnesses simply due to their expertise; rather, their testimony is based on their direct involvement in the case, allowing them to testify without a written report. Dr. Ramdev, who treated the Plaintiff and performed a leg amputation, will provide relevant testimony as a fact witness regarding the causal connection between the Plaintiff’s treatment and alleged injuries. His professional background may inform his understanding of these injuries, but this does not unfairly prejudice the Defendants. The Plaintiff had disclosed Dr. Ramdev’s status as a treating physician in various documents, and the Defendants had the opportunity to depose him but chose not to do so. Consequently, the Court denies both motions to exclude or limit Dr. Ramdev's testimony.
Both defendants, HIMA and Dr. Aponte, seek to exclude the testimony of Plaintiff's expert witness, Dr. De Natale, but for distinct reasons. HIMA contends that the expert testimony regarding the EMTALA claim was not properly noticed, arguing for exclusion based on a failure to produce evidence during discovery and asserting that a motion in limine is not proper for seeking judgment on a claim. HIMA's broader argument claims a lack of evidence for an EMTALA violation, but this is countered by the record, as they did not file a dispositive motion by the deadline of October 1, 2015. More specifically, HIMA argues insufficient notice under Rule 26 of the Federal Rules of Civil Procedure, despite Dr. De Natale providing an expert report in December 2013 and being deposed in November 2014, with the trial date yet to be set. The court finds HIMA had adequate notice and deems Dr. De Natale’s testimony relevant to the EMTALA claim, particularly regarding the duty of hospitals to screen and stabilize medical emergencies, as established in relevant case law. Consequently, the court denies HIMA's motion to exclude Dr. De Natale's testimony.
Dr. Aponte argues for exclusion based on a lack of reliability, asserting Dr. De Natale only reviewed part of the medical records. Federal Rule of Evidence 702 requires that expert testimony be based on sufficient facts, utilize reliable methods, and apply these methods appropriately to the case's facts. Aponte's motion emphasizes the need for comprehensive review, which he claims is lacking.
The trial court plays a gatekeeping role to ensure that a witness's specialized knowledge aids the jury in understanding evidence or resolving factual issues. Dr. Aponte does not dispute Dr. De Natale's qualifications as an expert but argues that his methodology is unreliable due to a limited review of the plaintiff's medical records. The plaintiff contends that this limited review was necessary given the specific circumstances surrounding the potential to reverse the plaintiff's paralysis after surgery. The court recognizes that questions regarding the persuasiveness and credibility of Dr. De Natale's opinions are for the jury to determine. Thus, the court concludes that Dr. De Natale’s testimony will assist the jury in understanding the standard of care and causation in the medical malpractice claim, denying Dr. Aponte’s motion to exclude his testimony.
Additionally, HIMA's motion to exclude evidence regarding corporate responsibility and principal-agent relationships is denied. The court reinforces that a motion in limine cannot be used as a substitute for summary judgment and allows the plaintiff to present relevant evidence related to the medical malpractice claim and EMTALA claim. HIMA failed to specify the evidence it wished to exclude, focusing instead on tort liability theories, which the court finds admissible if they aid the plaintiff's case. Consequently, all motions in limine by Dr. Aponte and HIMA are denied, and the case is referred to Magistrate Judge Camille Vélez-Rivé for a final pretrial settlement conference before proceeding to trial.
