Allstate Insurance Company v. Ayman Tarabishy, MC., PLLC

CourtDistrict Court, E.D. Michigan
DecidedJanuary 31, 2025
Docket2:22-cv-12736
StatusUnknown

This text of Allstate Insurance Company v. Ayman Tarabishy, MC., PLLC (Allstate Insurance Company v. Ayman Tarabishy, MC., PLLC) is published on Counsel Stack Legal Research, covering District Court, E.D. Michigan primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Allstate Insurance Company v. Ayman Tarabishy, MC., PLLC, (E.D. Mich. 2025).

Opinion

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MICHIGAN SOUTHERN DIVISION

ALLSTATE INSURANCE COMPANY et al.,

Plaintiffs, Case No. 2:22-cv-12736

v. Honorable Susan K. DeClercq United States District Judge AYMAN TARABISHY, M.D., PLLC and AYMAN TARABISHY, M.D.,

Defendants. ________________________________/

ORDER GRANTING IN PART AND DENYING IN PART DEFENDANTS’ MOTION TO STRIKE EXPERT REPORT AND SUPPLEMENT OF WILFRED L. HYNES, M.D., AND TO EXCLUDE HIS TESTIMONY AT TRIAL (ECF No. 57)

In this civil RICO case, Plaintiffs Allstate Insurance and its affiliates accuse Defendants Dr. Ayman Tarabishy and his medical clinic, Ayman Tarabishy, M.D., PLLC (doing business as Enhance Center), of running a racketeering scheme to exploit Michigan’s no-fault insurance law, MICH. COMP. LAWS § 500.3101 et seq., by generating and submitting fraudulent medical bills for reimbursement. Defendants now move to strike the expert report and supplement of Allstate’s proposed expert, Dr. Wilfred Hynes, and to exclude his testimony at trial. ECF No. 57. As explained below, Dr. Hynes is qualified to testify as an expert in this case— subject to a few exceptions. Accordingly, the motion will be granted in part and denied in part.

I. BACKGROUND Wilfred Hynes, M.D., is a pain-management physician at Tufts Medical Center in Boston, Massachusetts. He is the Medical Director of the hospital’s Pain

Management Center and Co-Chair of its Pain Management Committee. ECF No. 57- 5 at PageID.4063. Allstate retained Dr. Hynes “to testify regarding the fact, extent, and causation of the alleged services for which Allstate was billed [by the defendants] relative to patients at issue in this action . . . the medical necessity and

reasonableness of the services billed by the defendants; the billing submitted by the defendants; and any other subjects or opinions referenced in his report, supplemental report, or in subsequent deposition testimony, including reasonable inferences and

summaries arising therefrom.” ECF No. 57-5 at PageID.3989–90. Allstate disclosed Dr. Hynes’s initial expert report on September 8, 2023. ECF No. 57-5. The report details Dr. Hynes’s findings and opinions from his review of the defendants’ treatment and billing records for more than 90 patients at issue in

this litigation. Id. at PageID.3994–4060. Eighteen days later, Allstate provided a supplemental report by Dr. Hynes that contains five charts Allstate might “use[] at trial to summarize the opinions set forth in detail in [Dr. Hynes’s] medical expert

report.” ECF No. 57-6. Defendants move to strike Dr. Hynes’s expert report and supplement, and to exclude his testimony at trial, based on several grounds:

(1) Dr. Hynes is not board-certified in the specialties of physical medical rehabilitation or brain injury medicine and is not qualified to render opinions about Defendants’ treatments;

(2) Dr. Hynes is not an expert in CPT coding and is not qualified to render opinions about Defendants’ CPT coding or billing;

(3) Dr. Hynes did not prepare the “Supplemental” expert report served on September 26, 2023;

(4) Dr. Hynes’s opinions regarding “fraud” are beyond his purview and he is not qualified to give an opinion or testify about Defendants’ intent;

(5) Dr. Hynes’s reports contain analysis of patients for whom Plaintiffs are not seeking to recover damages and his findings regarding these patients are irrelevant; and

(6) Dr. Hynes’s testimony will not assist the trier of fact and is significantly more likely to mislead a jury.

ECF No. 57 at PageID.3572–73.

II. LEGAL STANDARDS Federal Evidence Rule 702 governs the admissibility of expert testimony. It permits a witness “who is qualified as an expert by knowledge, skill, experience, training, or education” to testify if: (a) the expert’s scientific, technical, or other specialized knowledge will help the trier of fact to understand the evidence or to determine a fact in issue; (b) the testimony is based on sufficient facts or data; (c) the testimony is the product of reliable principles and methods; and (d) the expert has reliably applied the principles and methods to the facts of the case.

FED. R. EVID. 702.

The rule also commands that district courts play a “gatekeeping role” by screening out unsupported, unreliable, and speculative expert opinions. Tamraz v. Lincoln Elec. Co., 620 F.3d 665, 668 (6th Cir. 2010) (quoting Daubert v. Merrell Dow Pharms., Inc., 509 U.S. 579, 597 (1993)). Medical doctors are “generally competent” to testify about matters “within [their] own professional experience.” Gass v. Marriott Hotel Servs., Inc., 558 F.3d 419, 427–28 (6th Cir. 2009) (citing Dickenson v. Cardiac & Thoracic Surgery of E. Tenn., 388 F.3d 976, 982 (6th Cir. 2004)); see also Kumho Tire Co. v. Carmichael,

526 U.S. 137, 156 (1999) (“[N]o one denies that an expert might draw a conclusion from a set of observations based on extensive and specialized experience.”). “When, however, the doctor strays from such professional knowledge, his or her testimony

becomes less reliable, and more likely to be excluded under Rule 702.” Gass, 558 F.3d at 428. Even so, excluding testimony “is rarely justified in cases involving medical experts,” especially when that testimony “is supported by extensive relevant experience.” Dickenson, 388 F.3d at 982 (citation omitted).

Namely, so long as the expert’s opinion has “a reasonable factual basis,” it should not be excluded. United States v. L.E. Cooke Co., 991 F.2d 336, 342 (6th Cir. 1993). “Rather, the testimony should be admitted, and any remaining challenges merely go to the weight, as opposed to the admissibility, of the expert testimony.” United States v. Ramer, 883 F.3d 659, 680 (6th Cir. 2018) (citing In re Scrap Metal

Antitrust Litig., 527 F.3d 517, 530 (6th Cir. 2008)). III. DISCUSSION A. Dr. Hynes’s Opinions on Medical Care

Defendants argue that Dr. Hynes is not qualified to serve as an expert because he has neither the relevant experience nor qualifications to opine on the treatments Dr. Tarabishy provided to patients. Specifically, both Dr. Hynes and Dr. Tarabishy are board-certified pain-management practitioners. But Dr. Tarabishy is also board

certified in two additional specializations which he regularly practices: physical medicine and rehabilitation (“PM&R”) and brain-injury medicine. See ECF No. 54- 2 at PageID.1419.

Except as to certain aspects of brain-injury treatment—which will be addressed at the end of the analysis—Dr. Hynes is qualified to offer expert testimony on the medical care at issue in this case. Like Dr. Tarabishy, Dr. Hynes has had a long career in interventional pain-management: since 2005, Dr. Hynes has been the

Medical Director of the Pain Management Center and Co-Chair of the Pain Management Committee at Tufts Medical Center in Boston, Massachusetts. ECF No. 57-5 at PageID.4063. He currently practices pain management there and is also

board certified in Anesthesiology and Pain Management. Id. Further, Dr. Hynes’s report details his “extensive relevant experience,” Dickenson, 388 F.3d at 982, with the types of patients (mainly auto-accident

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Sedima, S. P. R. L. v. Imrex Co.
473 U.S. 479 (Supreme Court, 1985)
H. J. Inc. v. Northwestern Bell Telephone Co.
492 U.S. 229 (Supreme Court, 1989)
Daubert v. Merrell Dow Pharmaceuticals, Inc.
509 U.S. 579 (Supreme Court, 1993)
Kumho Tire Co. v. Carmichael
526 U.S. 137 (Supreme Court, 1999)
Tamraz v. Lincoln Electric Co.
620 F.3d 665 (Sixth Circuit, 2010)
United States v. L.E. Cooke Company, Inc.
991 F.2d 336 (Sixth Circuit, 1993)
United States v. Ralph M. Daniel, Jr.
329 F.3d 480 (Sixth Circuit, 2003)
United States v. Ronda Nixon
694 F.3d 623 (Sixth Circuit, 2012)
Gass v. Marriott Hotel Services, Inc.
558 F.3d 419 (Sixth Circuit, 2009)
In Re Scrap Metal Antitrust Litigation
527 F.3d 517 (Sixth Circuit, 2008)
Barlow v. General Motors Corp.
595 F. Supp. 2d 929 (S.D. Indiana, 2009)
United States v. Turner
465 F.3d 667 (Sixth Circuit, 2006)
Moon v. Harrison Piping Supply
465 F.3d 719 (Sixth Circuit, 2006)
United States v. Joseph Melcher
672 F. App'x 547 (Sixth Circuit, 2016)

Cite This Page — Counsel Stack

Bluebook (online)
Allstate Insurance Company v. Ayman Tarabishy, MC., PLLC, Counsel Stack Legal Research, https://law.counselstack.com/opinion/allstate-insurance-company-v-ayman-tarabishy-mc-pllc-mied-2025.