McCarthy v. Atwood

67 Va. Cir. 237, 2005 Va. Cir. LEXIS 11
CourtPortsmouth County Circuit Court
DecidedApril 18, 2005
DocketCase No. (Law) 04-1219
StatusPublished

This text of 67 Va. Cir. 237 (McCarthy v. Atwood) is published on Counsel Stack Legal Research, covering Portsmouth County Circuit Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
McCarthy v. Atwood, 67 Va. Cir. 237, 2005 Va. Cir. LEXIS 11 (Va. Super. Ct. 2005).

Opinion

By Judge Mark S. Davis

This matter is before the Court on plaintiff’s motion in limine concerning opinions by defense expert witness Scott W. Sautter, Ph. D., as well as a motion in limine addressing numerous items of evidence that plaintiff asserts are more prejudicial than probative. The parties appeared before the Court, by counsel, on March 25,2005, to argue the motions, but the Court re-scheduled argument on the motions to April 8, 2005, because Dr. Sautter’s report was not yet complete.1 The parties appeared before the Court again on April 8, [238]*2382005, for argument. The Court has now received the report of Dr. Sautter, has considered the arguments of counsel from both hearings, as well as the briefs filed by each party, and reaches the following conclusions.

I. Factual and Procedural History

This case arises from a vehicle accident of July 7,2000. Plaintiff alleges he suffered a head injury in this accident. Pursuant to a motion of the defendant, the Court ordered the plaintiff to submit to a medical examination by Scott W. Sautter, Ph. D., a neuropsychologist, pursuant to Rule 4:10 of the Rules of the Supreme Court of Virginia. Defendant designated Dr. Sautter as an expert on or about March 15, 2005, prior to production of his report. The designation indicates Dr. Sautter is expected to testify about the neuropsychological testing he and his staff administered to the plaintiff, and “to apply his knowledge, training, and experience to provide information and opinions on the test results and test interpretations.”

Dr. Sautter subsequently produced his report, which contains numerous opinions and data/test results. At the hearing of April 8,2005, counsel for the defendant indicated that he intended to rely upon the impressions contained in Dr. Sautter ’ s Neuropsychological Assessment produced on or about March 29, 2005. His impressions are as follows:

Overall impressions of neuropsychological and emotional functioning are consistent with generally intact cognitive functions as observed on this current evaluation, with mildly deficient performance in thinking flexibly as task demands change, verbal conceptualization (attributable to a low information subtest score on the» intelligence test), and editing skills requiring spelling, syntax, and grammar knowledge. The rest of the profile was found to be intact. With regard to psychological factors contributing to presenting complaints, there were inconsistencies observed in effort testing, below expected performance on the information subtest of the intelligence test when compared to other areas, and a potential finding of seeking attention in the form of secondary gain on the actuarial and objective personality assessment. The inconsistency on the effort testing was found when he passed the easier and face valid tests, but performed worse on a more comprehensive test, particularly in light of self-reported severe symptoms of memory loss and performing within expectations on the neuropsychological memory testing.
[239]*239Given the history, it is probable that the plaintiff did have a concussion at the time of the accident; however, cognitive deficits that would have been present would have been expected to resolve within a few weeks to a few months according to large controlled studies of brain injury. Any lingering deficits would be due to other factors and, in this case, may include a premature, non-accident related shrinking of the brain that could be related to alcohol abuse or other unknown degenerative disorders. The plaintiff more than likely has an alcohol dependence with abuse, had significant cocaine and heroin abuse within six months of his accident and continuing reportedly for the next 18 months or so, and has significant depression. He does complain of headaches, but this is superimposed on significant alcohol abuse and taking pain medication. He appears to have in addition to the pain complaints a personality disorder with features of being histrionic and passivedependant. Secondary gain in seeking attention for his medical complaints in the context of a lawsuit is possible.
Treatment recommendations are to reassure him that he is actually functional at a higher level than he believes, accepting that he is an alcoholic who is in need of drying out and alcohol rehabilitation. This would require an inpatient stay of at least 30 days. It is not recommended that he attend a brain injury rehabilitation facility, but rather a psychiatric facility for the treatment of alcoholism. A complicating factor is the extent of pain reports and to differentiate this from chronic debilitating pain from annoying pain, without the presence of alcohol and drugs. Finally, he may be encouraged to participate in gainful activity once discharged, if not competitive employment then volunteer activities. Prognosis for this is probably poor as the objective personality assessment indicated that he is not likely to accept a psychological explanation for his behavior.

Dr. Sautter then went on to list seven diagnostic impressions, as follows: probable major depression with anxious features, personality disorder with histrionic and passive-dependent features, alcohol dependence and abuse, cocaine and heroin abuse in remission, self-reported pain complaints, intact cognitive function, possible secondary gain seeking attention for his complaints and in the context of a lawsuit.

[240]*240 II. Contentions of the Parties

The primary thrust of plaintiffs motions in limine is to “move[] the Court to exclude from the trial of this case any opinion by defense expert, Scott W. Sautter, Ph. D., concerning the cause or extent of the plaintiffs brain injury and resulting cognitive dysfunction and memory loss. . . .” Plaintiff relies on John v. Im, 263 Va. 315, 321, 559 S.E.2d 694, 695 (2002), for the proposition that “a psychologist, who is not a medical doctor, [is] not qualified to state an expert medical opinion regarding the cause of [a] plaintiffs traumatic brain injury....”

Defendant has responded by submitting to the Court a copy of the article, “John v. Im: Time for Clarification and Revisiting the Decision by the Supreme Court of Virginia,” Journal of Civil Litigation, vol. XV, no. 2, p. 161 (Summer 2003), by John D. McGavin, Esquire, one of the attorneys in that case. In that article, Mr. McGavin argues that “the [Im] decision is being more broadly interpreted regarding the field of neuropsychology in mild traumatic brain injuries than anticipated by any of the parties or by the Court.” McGavin notes that:

The blanket rule that comes from John v. Im, which states that only a medical doctor may render an opinion on causation, is directly contradictory to the evidence presented by the neuropsychologists and directly contradictory to how medical doctors obtain assessments of individuals with complaints consistent with mild traumatic brain injury. Specifically, medical experts attempting to determine whether a patient suffers from mild traumatic brain injury, in the absence of a loss of consciousness and in the presence of negative diagnostic tests, almost always rely upon neuropsychological assessment. Medical doctors are not trained to render neuropsychological assessments and are not trained to interpret the raw data.

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Bluebook (online)
67 Va. Cir. 237, 2005 Va. Cir. LEXIS 11, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mccarthy-v-atwood-vaccportsmouth-2005.