COURT OF APPEALS OF VIRGINIA
Record No. 0383-25-2
PATRICK CLANCY v. MATTHEW PEARMAN, ET AL.
Present: Chief Judge Decker, Judges Malveaux and Duffan Argued at Richmond, Virginia Opinion Issued April 21, 2026*
FROM THE CIRCUIT COURT OF ALBEMARLE COUNTY Cheryl V. Higgins, Judge
J. Lloyd Snook, III (Snook & Haughey, P.C., on briefs), for appellant.
Melissa Y. York (Jennifer D. Royer; Royer Law Firm, P.C., on brief), for appellees.
MEMORANDUM OPINION BY CHIEF JUDGE MARLA GRAFF DECKER
Patrick Clancy alleges that during a high-school soccer conditioning session, he sustained
an exertional heat injury due to the gross negligence of School Athletic Director Matthew
Pearman and Coach Stuart Pierson. Clancy appeals the trial court’s grant of summary judgment
against him based on rulings that he assumed the risk of injury and was contributorily negligent
as a matter of law. Clancy also claims that the trial court erred by ruling that testimony from his
expert witness is inadmissible on the ground that the witness is not a medical doctor. We hold
the trial court erred by granting summary judgment because the record does not establish that no
material facts remain in dispute. But we conclude that it did not err by ruling that the challenged
* This opinion is not designated for publication. See Code § 17.1-413(A). expert testimony is inadmissible. As a result, we affirm in part, reverse in part, and remand for
further proceedings.
BACKGROUND1
On the morning of July 21, 2017, Clancy attended an off-season conditioning session for the
boys soccer team at Monticello High School (MHS) in Albemarle County. He was sixteen years
old, and he played for the team during the prior season.
The day before the session, the National Weather Service announced a heat advisory for
Albemarle County. The advisory was scheduled to take effect at 10:00 a.m. on the day of the
session. The session began at 8:00 a.m. and ended around 10:00 a.m.
That morning, before the session began, Matthew Pearman, the school’s athletic director,
checked the heat index calculator of the Oregon School Activities Association (OSAA) and
determined that conditions were safe enough to allow the session to take place. Stuart Pierson, the
team’s head coach, conducted and supervised the session, which, like all of the team’s conditioning
sessions, was characterized as “optional.” Pierson was licensed by the United States Soccer
Federation. Both men were employed by Albemarle County Public Schools (ACPS).
Although Pierson provided the players with breaks, he did not provide water, and the field
had no shade in which the players could rest. Despite drinking sixty-four ounces of water during
the conditioning session, Clancy became “seriously ill” before it ended. He stopped sweating,
developed a bad headache, felt nauseous, and had difficulty walking and thinking. Pierson did not
notice that Clancy had stopped perspiring and was feeling sick. He did notice, however, that Clancy
was out of water at the end of the session and “ridiculed” him in front of the team. Clancy
1 On review, the appellate court states the facts, and all reasonable inferences flowing from those facts, in the light most favorable to Clancy as the non-moving party on the motion for summary judgment. See Thurmond v. Prince William Pro. Baseball Club, 265 Va. 59, 61 (2003). The facts are derived from the pleadings, as supplemented or altered by any relevant admissions and pretrial orders. See Rule 3:20. -2- mentioned a sunburn to Pierson, who responded with “attitude.” Clancy did not tell Pierson that he
had become sick and needed assistance. Instead, he followed Pierson’s instructions to the team to
pick up equipment on the field. That chore kept them there “well after” the heat advisory began at
10 a.m. Although “nothing” “physically” “prevented [Clancy] from requesting to sit out a few
minutes” during the session, Clancy believed that Pierson “ma[de] . . . clear that [he] was being
judged” for expressing concerns about continuing to participate that day.
When Clancy’s brother drove him home, he had a severe headache and nausea. He could
not walk or talk, he was still not perspiring, and his fingers and toes began to turn blue. His mother
put him in a cold shower, where he collapsed and vomited. She then submerged him in a cold bath
to reduce his body temperature more rapidly. He continued to vomit and gasp for air, and the blue
discoloration worsened, so his family drove him to the hospital.
The emergency room physician diagnosed Clancy with heat exhaustion. He was treated
with IV fluids. According to emergency room records, while Clancy reported he took a cold
shower, apparently neither he nor his mother mentioned that he had taken a cooling bath, his
appendages had turned blue, he had collapsed and been unable to walk or talk, or he had stopped
sweating. The notes also stated that he did not report vomiting before he arrived at the hospital and
in fact reported that he had not vomited. No one in the emergency room diagnosed Clancy with
heat stroke. Clancy left the hospital that afternoon with a note stating that he was cleared to return
to sports “after [the next day] as weather temperatures allow[ed].” Later, however, he was
diagnosed with “exertional heat stroke, the most severe form of exertional heat illness.” He suffered
significant permanent health consequences as a result.
-3- Clancy sued, alleging that Pearman and Pierson were liable for gross negligence.2 His
pleaded facts encompassed his history with the team, his own actions on the day of his exertional
heat injury, field conditions during the session, and Pearman and Pierson’s responsibilities and duty
of care.
The July 21 session was the fourth summer conditioning session of the MHS boys soccer
team that Clancy attended that year. He missed at least one session for a family vacation and had
not attended any sessions in a week, which Pierson either knew or should have known. Although
the sessions were optional, Clancy believed that failing to attend meant he “would be less likely to
play” during the regular season.
Clancy knew a heat advisory was in effect the day before the session, and he spent that day
“engaged in indoor activities” at home. Clancy and his mother thought that Pearman and Pierson
would cancel the July 21 session or move it indoors if the heat was excessive, which had happened
on prior occasions. Clancy drank sixty ounces of water before the session, and he took two
additional liters with him as all the players were instructed to do.
ACPS coaches were required to comply with the Virginia High School League (VHSL) heat
guidelines. According to guidance provided to all ACPS coaches, ten to fourteen days are needed
“to acclimate to hot weather conditions,” and “[a]thletes who have not become acclimatized . . . will
be less tolerant of extreme heat[] and at greater risk of exertional heat illness.”
The OSAA heat index calculator was referenced in the VHSL heat guidelines as a resource
for determining the safety of outdoor sessions when heat and humidity might be an issue. The
2 Clancy’s mother originally sued on his behalf. When he turned eighteen, the court granted his motion to file an amended complaint naming himself as the plaintiff. Also, the original complaint alleged both ordinary and gross negligence. Pearman and Pierson filed demurrers, asserting that the allegations were insufficient as a matter of law because they did not owe Clancy a duty of care. The court sustained the demurrers as to the ordinary-negligence count and dismissed it with prejudice but denied it as to the gross-negligence count and granted leave to amend. Clancy amended his complaint, refining his allegations of gross negligence. -4- VHSL heat guidelines, however, “strongly encourage[d]” using the wet bulb globe temperature
(WBGT) method for accurately assessing outdoor conditions in such circumstances. The WBGT
method “t[ook] into account ambient air temperature, relative humidity, and radiant heating from
the sun.” A WBGT thermometer was available on-site, but neither Pearman nor Pierson used it that
morning.
The conditioning session was held on the school’s artificial-turf athletic field, on which “the
air temperature . . . c[ould] be substantially higher than on a grass field”—thirty-five to sixty
degrees higher. The field was in full sun with “little wind” at that time. As alleged in Clancy’s
complaint, when the session began, “the estimated [WBGT] . . . was about 84 degrees” Fahrenheit
with 70% humidity. By the end, it was about 90 degrees with 57% humidity. Those levels were
“right at the borderline between ‘Moderate Risk for Heat Related Illness’ and ‘High Risk,’” at
which additional rests and exertion limits were recommended. No athletic trainer was present
despite a provision in the ACPS Athletics Heat Management Plan requiring a trainer at “every
school-sponsored practice or game.”
Clancy’s complaint alleged that Pearman and Pierson violated the standard of care by,
among other things, conducting the conditioning session outdoors in excessive heat, not having an
athletic trainer present, being insufficiently attentive to the well-being of the players, having no
shade available for the participants or their water, not providing adequate cold water, and not using
a WGBT to accurately gauge the outdoor temperature on the artificial-turf field. Clancy asserted
that Pearman and Pierson’s conduct violated the VHSL guidelines, which they were obligated to
follow under ACPS rules.
Pearman and Pierson demurred to the claim of gross negligence, arguing that they did not
owe a legal duty to Clancy. The court overruled the demurrers.
-5- Before trial, Pearman and Pierson filed a motion in limine to limit the testimony of Douglas
Casa, one of Clancy’s expert witnesses. They argued that Casa, who had a Ph.D. in exercise
physiology, could not testify about Clancy’s diagnosis and treatment or provide any other medical
opinion because he was not a medical doctor. The trial court granted the motion to exclude Casa’s
testimony about Clancy’s “etiology, diagnosis, prognosis, treatment, treatment plan, and disability”
on the ground that he was “not a medical doctor” and his testimony “d[id] not fit into any Virginia
statutory exception to the proscriptions on medical testimony.”3
After Clancy responded to the defense’s requests for admission, Pearman and Pierson made
a motion for summary judgment, arguing that Clancy’s claim was barred by both his assumption of
the risk of heat-related illness and his contributory negligence. They asserted that Clancy
voluntarily participated in the conditioning session knowing that it was hot outside and that a heat
advisory had been in effect the day before and would be in effect again after the morning’s activity.
They noted that Clancy did not take a break or alert anyone when he started feeling ill, despite
seeing another player take a break without immediate repercussions. Clancy countered that he did
not assume the risk that Pearman and Pierson would neglect to take proper precautions to prevent
the players from suffering heat-related illness and that he also was not contributorily negligent by
failing to recognize his symptoms of exertional heat illness.
The trial court granted the motion for summary judgment, based on both assumption of the
risk and contributory negligence. After acknowledging “a certain amount of pressure on kids [who]
want to be on high school teams . . . to put forth effort even when . . . not feeling their best,” the
court noted that “at some point” student athletes “have to say, I am not feeling well, I’m feeling
sick.” It found that Clancy “was aware of the risk of” exertional heat illness from “practicing
3 The court denied the motion to exclude Casa’s testimony regarding the applicable standard of care but noted that the motion could be “renew[ed] . . . at trial as appropriate.” -6- [outside during] a heat advisory” and “exposed himself to that risk.” As to Pearman and Pierson’s
claim that Clancy was contributorily negligent, the court held that he “contributed to his own
injuries by not . . . protect[ing] himself.”
ANALYSIS
I. Summary Judgment
Clancy challenges the trial court’s ruling granting the defendants’ motion for summary
judgment. In ruling on a motion for summary judgment, the trial court considers the facts pleaded,
as well as any relevant admissions and court orders. See Rule 3:20; Llewellyn v. Fechtel, 83
Va. App. 364, 376 (2025) (recognizing that discovery depositions and interrogatory answers may be
used but generally are not binding). It is axiomatic that “[s]ummary judgment is a drastic remedy,
available only when there are no material facts genuinely in dispute.” Llewellyn, 83 Va. App. at 375
(quoting Fultz v. Delhaize Am., Inc., 278 Va. 84, 88 (2009)); see Brown v. Sparks, 262 Va. 567, 571
(2001). “[I]n an appeal of a decision awarding summary judgment, the trial court’s determination
that no genuinely disputed material facts exist[, as well as] its application of law to the facts[,]
present issues of law subject to de novo review.” Shifflett v. Latitude Props., Inc., 294 Va. 476, 480
(2017) (quoting Mount Aldie, LLC v. Land Tr. of Va., Inc., 293 Va. 190, 196-97 (2017)). And the
appellate court “review[s] the record [under] the same standard a[s the] trial court . . . , accepting as
true [the facts and] those inferences from the facts that are most favorable to the nonmoving party,
unless the inferences are forced, strained, or contrary to reason.” Stahl v. Stitt, 301 Va. 1, 8 (2022)
(quoting Fultz, 278 Va. at 88).
Clancy argues that the trial court erred by granting the defendants’ motion for summary
judgment on assumption-of-the-risk and contributory-negligence grounds, both of which are
affirmative defenses. See Colas v. Tyree, 302 Va. 17, 27 (2023) (recognizing these affirmative
defenses). Either defense, if proved, bars the plaintiff’s recovery for ordinary or gross negligence.
-7- See Thurmond v. Prince William Pro. Baseball Club, 265 Va. 59, 64 (2003) (assumption of the
risk); Thomas v. Snow, 162 Va. 654, 660-61 (1934) (contributory negligence), cited with approval
in Griffin v. Shively, 227 Va. 317, 322 (1984). We address these defenses in turn, in the context of
this case, “mindful not to invade the province of the fact finder, whose role it is to resolve ‘any
inconsistencies and discrepancies’” in the evidence in a trial on the merits. Llewellyn, 83 Va. App.
at 375 (quoting W. Refin. Yorktown v. County of York, 292 Va. 804, 826 (2016)).
“[W]hen a motion for summary judgment asserts an affirmative defense . . . , the burden of
proof . . . rests solely on the civil defendant.” AlBritton v. Commonwealth, 299 Va. 392, 404
(2021). To meet this burden, the defendant “must demonstrate that no reasonable factfinder
governed by the applicable legal standard could reject the asserted defense on the merits.” Id. In
other words, “[a trial] court can enter summary judgment in the defendant’s favor on [an affirmative
defense] ‘only when reasonable minds could not differ’” in concluding that the defense applies to
bar the plaintiff’s recovery. See id. (quoting Jenkins v. Pyles, 269 Va. 383, 389 (2005)).
It is in the context of these legal parameters that this Court reviews each challenge.
A. Assumption of the Risk
“The doctrine of assumption of risk rests on two premises: (1) that the nature and extent of
the risk are fully appreciated; and (2) that [risk] is voluntarily incurred.” Davis v. Sykes, 202 Va.
952, 954 (1961). Virginia applies a subjective standard when evaluating a claim of assumption of
the risk, assessing “whether a particular plaintiff fully understood the nature and extent of a known
danger and voluntarily exposed [him]self to that danger.” Thurmond, 265 Va. at 64. Significantly,
whether a person assumed the risk of injury from a known danger is a question for the jury “unless
reasonable minds could not differ on the issue.” Id.
The trial court ruled that Clancy assumed the risk of heat-related injury by voluntarily
participating in the conditioning session when he knew a heat advisory was or was about to be in
-8- effect. Clancy counters that the trial court did not adequately consider Pearman and Pierson’s
alleged violation of the standard of care. He argues that “the risk that [he] would have had to . . .
assume[] was not merely the risk associated with playing soccer in the heat, but specifically the risk
that Coach Pierson would . . . violat[e] the standard of care.” He contends that Pierson did so in
several ways. First, Pierson “fail[ed] . . . to accurately measure the temperature” on the athletic field
(which he states should have been done with an available WBGT thermometer). Second, according
to Clancy, Pierson did not provide cool water or shade and failed to monitor the players for “the risk
of exertional heat injury.” Clancy explains that although he was aware of “some risk of an
exertional heat injury” that day, he was “not aware” that the coach would not follow the standard of
care “that would keep him safe from exertional heat injury.” Pearman and Pierson argue that their
claimed negligence would nevertheless have been apparent to Clancy once he arrived at the athletic
field and he thereby assumed the risk of participating in their negligently operated conditioning
session.
We hold that the record supports Clancy’s objection to the grant of summary judgment. The
assumption-of-the-risk defense does not apply where the defendants’ negligence creates risks that
the plaintiff is not aware of and that are beyond the risks ordinarily expected from participating in
the activity. See Thurmond, 265 Va. at 66-67; see also Artrip v. E.E. Berry Equip. Co., 240 Va.
354, 358-59 (1990) (noting that the defense also does not apply to risks that are involuntary, leaving
the plaintiff with no viable alternative course of action). The trial court’s ruling does not address
Clancy’s central claim that Pearman and Pierson’s alleged gross negligence exacerbated the risk of
heat-related illness beyond that inherent in participating in an outdoor soccer conditioning
session during a heat wave.
Issues of material fact therefore remain regarding whether Pearman and Pierson were
grossly negligent in conducting the conditioning session that morning and whether Clancy was
-9- aware that they would conduct the session in the manner in which they did. For example, Clancy
states that they did not provide the players with cold water during the session and that no shade was
available in which they could rest or keep their own water cool. Pearman and Pierson, however,
represent that the players had access to a nearby concessions building, ice machines, water
fountains, and air-conditioning. Clancy argues that Pearman and Pierson violated the VHSL
guidelines, including by failing to utilize an available WBGT thermometer to assess the temperature
risk, but Pearman and Pierson claim that their conduct fell “well within” the guidelines. In fact, the
parties do not even agree whether the VHSL guidelines provide the relevant standard of care for
evaluating Pearman and Pierson’s conduct, and Clancy represents that one of his designated expert
witnesses would testify at a trial to a different standard of care.
Further illustrating the facts in dispute, Pearman and Pierson maintain that the conditioning
session was completely voluntary, Clancy knew the temperature would be extremely hot, and he
could have taken a break. Clancy responds that he felt pressure to attend the session, fearing he
“would be less likely to play” during the regular season and would be judged by Pierson if he asked
to take a break or decided to leave. Clancy also states that he was deterred from “request[ing] to sit
out a few minutes” during the session specifically because of Pierson’s “attitude” when Clancy
mentioned sunburn during the activity. It is unclear on the existing record how much pressure the
players faced to attend and fully participate in the conditioning session despite the morning’s
extreme heat.
Based on the record here, disputed questions of fact remained for a jury to decide to
determine whether the conduct of Pearman and Pierson created risks that Clancy did not know
about or could not fully appreciate. Reasonable minds could disagree about whether Clancy
assumed the risk of heat-related illness by participating in the allegedly voluntary conditioning
- 10 - session under the supervision of Pearman and Pierson. Consequently, the trial court erred by
relying on this ground as a basis for granting the extreme remedy of summary judgment.
B. Contributory Negligence
Contributory negligence “must be proved according to an objective standard [of] whether
the plaintiff failed to act as a reasonable person would have acted for his own safety under the
circumstances.” Jenkins, 269 Va. at 388. “[W]hether a plaintiff is guilty of contributory negligence
is ordinarily a question of fact . . . .” Rascher v. Friend, 279 Va. 370, 375 (2010) (quoting Jenkins,
269 Va. at 389).
The trial court ruled that Clancy “contributed to his own injuries by not taking the necessary
actions to protect himself.” The court based this ruling on the fact that Clancy did not alert anyone
that he was feeling unwell. It reasoned that “at some point” student athletes “have to say, I am not
feeling well, I’m feeling sick.” Clancy contends that the evidence did not prove he was
contributorily negligent as a matter of law and, further, that the trial court’s finding of contributory
negligence “[wa]s really an argument for reduction of damages.” He asserts that material facts
remain in dispute and should be decided by a jury.
Clancy was sixteen years old when he participated in the summer conditioning session.
Minors age fourteen and older are presumed capable of understanding and avoiding danger absent
proof of an inability to do so. Grant v. Mays, 204 Va. 41, 44 (1963). Even so, the conduct of
minors over fourteen is not measured by adult standards but, instead, by the “degree of care [that]
children of the same age, experience, discretion[,] and knowledge would exercise under the same or
similar circumstances.” Id. at 45. As a result, Clancy’s conduct must be evaluated as the conduct of
a sixteen-year-old athlete in his position would be.
Clancy drank sixty ounces of water before the conditioning session, and he took two more
liters of water with him, which he drank during the session to stay hydrated. Clancy and his
- 11 - mother—who, like Pierson, was an athletic coach in the school system—expected that the activity
would be moved indoors if Pearman and Pierson determined that the outside temperature was too
high.4 They believed that the defendants were adequately trained to recognize when excessive heat
would pose a danger to the participants’ safety and would cancel the conditioning session or make
alternative arrangements to ensure that safety. Again, Clancy stated that he felt he would have
fewer opportunities to play during the season if he did not attend the conditioning session and would
be judged negatively if he asked to take a break. Pearman and Pierson, on the other hand, asserted
that Clancy saw another player at the session take a break and that Clancy was aware the other
player did not face any repercussions. Clancy, however, indicated that he “d[id]n’t know the
circumstances” surrounding that player’s “removing himself from play.” As such, that fact does not
compel an inference as a matter of law that the other player’s circumstances were sufficiently
analogous to Clancy’s to be of significance.
Further, Clancy suggests that “confusion” and “irrational . . . behavior” are “among [the]
symptoms” of exertional heat injury. He argues that this provides yet another reason that
“assess[ing] his behavior to decide whether he was acting ‘reasonably’” or in a contributorily
negligent fashion “should [have] be[en] left to [a] jury.” Pearman and Pierson argue that nothing
in the record indicates “Clancy was experiencing confusion or irrational . . . behavior . . . during
the conditioning session as no such symptoms were pled or established in discovery.” To the
contrary, Clancy specifically pleaded that he “became seriously ill” during the session and had
“difficulty . . . even thinking” “[b]y the end of [it].” (Emphasis added). This allegation supports an
inference that he did, in fact, experience confusion during the session. And his interrogatory
4 Pearman and Pierson correctly note that Clancy’s mother, as a coach, had received training similar to Pierson’s for “prevent[ing] and treat[ing] heat-related illness.” The record, however, contains only limited information about how much of this knowledge Clancy’s mother shared with him, leaving an issue of fact for the jury. - 12 - answers notified Pearman and Pierson that one of his expert witnesses, John Jardine, an emergency
room physician, would testify that confusion and disorientation are symptoms of exertional heat
stroke.
In light of these circumstances, objectively reasonable minds could disagree about whether
sixteen-year-old Clancy was negligent in not removing himself from play after he began to feel ill.
Additionally, the trial court’s ruling may implicate not whether Clancy was contributorily
negligent but, instead, whether he failed to mitigate damages because Pearman and Pierson’s
tortious conduct alone—holding a conditioning session “without proper safety measures in place”—
caused his injury. This Court recently noted the difference between the theories of a plaintiff’s
contributory negligence and his duty to mitigate damages. See Rodrigue v. Butts-Franklin, 79
Va. App. 645, 655-56 (2024). “If the plaintiff’s injury occurs because [he] failed to exercise
reasonable care contemporaneously or concurrently with the negligent act of the defendant, [that
failure] constitutes contributory negligence that bars [his] recovery.” Id. at 655. A “plaintiff’s duty
to mitigate damages,” by contrast, “arises . . . after [a] defendant’s tortious conduct.” Id. (quoting
Kent Sinclair, Sinclair on Remedies § 3-6[A], at 3-62 (5th ed. 2016) (emphasis added)). And unlike
contributory negligence, a failure to mitigate “does not necessarily bar all recovery.” Monahan v.
Obici Med. Mgmt. Servs., 271 Va. 621, 633 (2006).
In light of this rationale, we conclude that a jury could find that the issue of whether Clancy
acted reasonably once he started to feel unwell was one of failure to mitigate damages rather than
contributory negligence. If the jury were to find that Pearman and Pierson were grossly negligent
for holding the session outside in the heat and that Clancy was not at fault for deciding to attend the
conditioning session in the first place but was at fault for not resting when he began to feel ill, the
jury might properly conclude, at most, that Clancy failed to mitigate his damages.
- 13 - Whether Clancy was contributorily negligent or failed to mitigate his damages involves
factual determinations that the parties dispute and, accordingly, should be resolved by a jury at trial.
See Llewellyn, 83 Va. App. at 375 (“‘[I]f the evidence is conflicting on a material point or if
reasonable persons may draw different conclusions from the evidence,’ summary judgment should
not be granted.” (quoting Fultz, 278 Va. at 88)).
Accordingly, we hold that the trial court erred by granting summary judgment in favor of
Pearman and Pierson on the ground that Clancy assumed the risk of exertional heat injury or was
contributorily negligent in sustaining that injury.
II. Exclusion of Dr. Casa’s Testimony
Clancy challenges the trial court’s ruling excluding a portion of Dr. Casa’s proffered
testimony on the ground that Casa is not a medical doctor. He suggests that Casa, an athletic
trainer, was qualified to testify about “the prevention, recognition, evaluation, and treatment of heat-
related injuries” caused by a soccer conditioning session.
As a preliminary matter, the defendants argue that Clancy waived this assignment of error
under Rule 5A:18 by failing to note his objection to the trial court’s order limiting Dr. Casa’s
testimony. Rule 5A:18 provides that “[n]o ruling of the trial court . . . will be considered as a basis
for reversal unless an objection was stated with reasonable certainty at the time of the ruling, except
for good cause shown or to enable this Court to attain the ends of justice.” But as clarified by the
related statute, “it shall be sufficient that a party, at the time the ruling or order of the court is made
or sought, makes known to the court the action which he desires the court to take or his objections to
the action of the court and his grounds therefor.” Code § 8.01-384(A).
Here, Clancy filed a written response to Pearman and Pierson’s motion in limine, in which
he asserted that Dr. Casa should be permitted to testify as an expert witness about Clancy’s injury.
The parties also presented their arguments to the court at a hearing. So Clancy was not required to
- 14 - object again when the court ruled in Pearman and Pierson’s favor. See id. We therefore address the
trial court’s exclusion of Dr. Casa’s expert testimony on the merits.5
The decision whether to admit or exclude expert testimony is one left to the sound discretion
of the trial court, and this Court will reverse only upon a showing that the court abused its exercise
of that discretion. Graydon Manor, LLC v. Bd. of Supervisors, 79 Va. App. 156, 168 (2023). The
“bell-shaped curve of reasonability governing . . . appellate review” under an abuse-of-discretion
standard “rests on the venerable belief that the judge closest to the contest is the judge best able to
discern where the equities lie.” Qiu v. Huang, 77 Va. App. 304, 328 (2023) (alteration in original)
(quoting Sauder v. Ferguson, 289 Va. 449, 459 (2015)). In this context, “we do not substitute our
judgment for that of the trial court. Rather, we consider only whether the record fairly supports
the trial court’s action.” Harris v. Joplin, 304 Va. 338, 347 (2025) (quoting Carter v.
Commonwealth, 293 Va. 537, 543 (2017)). “The abuse-of-discretion standard [also] includes
review to determine that the discretion was not guided by erroneous legal conclusions.” Carter,
293 Va. at 543-44 (alteration in original) (quoting Porter v. Commonwealth, 276 Va. 203, 260
(2008)). “[A trial] court by definition abuses its discretion when it makes an error of law.”
Porter, 276 Va. at 260 (quoting Koon v. United States, 518 U.S. 81, 100 (1996)).
It is settled law in Virginia “that only a medical doctor [is qualified to] testify as to the
causation of a human physical injury.” Fitzgerald v. Commonwealth, 273 Va. 596, 602 (2007); see
5 Pearman and Pierson also suggest that Clancy failed to cite the proper pages in the record showing his preservation of the issue. Under Rule 5A:20(c)(3), a “deficiency in the reference to the page(s) of the record . . . where the alleged error has been preserved” below can be the subject of “a rule to show cause . . . pursuant to Rule 5A:1A.” The rules do not provide a mandatory procedural bar for such a deficiency. See Rule 5A:1A(a) (permitting discretionary dismissal for non-compliance). The Court is authorized to dismiss for noncompliance that is “significant.” See Coward v. Wellmont Health Sys., 295 Va. 351, 367 (2018) (quoting Bartley v. Commonwealth, 67 Va. App. 740, 746 (2017)). But here, the relevant trial court order is almost immediately preceded in the record by Clancy’s forty-five page request to the trial court to “overrule” the motion in limine. So we decline on the specific facts of the case to hold that Clancy’s failure to cite this filing was significant. - 15 - Conley v. Commonwealth, 273 Va. 554, 561 (2007); Combs v. Norfolk & W. Ry., 256 Va. 490,
496-97 (1998). Casa is a licensed athletic trainer and a professor of kinesiology at the University of
Connecticut. It is undisputed that his status as a doctor derives from his Ph.D. in exercise
physiology, not from a degree in medicine.
Having a Ph.D. in a potentially relevant field of study does not render one qualified to give a
medical diagnosis and opinion about causation, and Clancy does not argue otherwise. See generally
Norfolk & W. Ry. v. Keeling, 265 Va. 228, 234-35 (2003) (upholding the exclusion of testimony
from a witness with a Ph.D. in biomechanical engineering); John v. Wong Shik Im, 263 Va. 315,
318, 321 (2002) (upholding the exclusion of testimony from a licensed psychologist with a Ph.D. in
that field). It is undisputed that Dr. Casa is not a medical doctor, so we examine Clancy’s argument
that Casa’s status as an athletic trainer qualifies him to provide an expert opinion on “matters that
make up [his] field of expertise as set out in the statutes.”
In Hollingsworth v. Norfolk Southern Railway, 279 Va. 360, 367-68 (2010), the Supreme
Court held that podiatrists were not qualified to testify as to the cause of the plaintiff’s injuries
because, although the relevant statute allowed podiatrists to treat a physical injury to the foot or
ankle, it did not allow them to diagnose such injuries. The Court focused heavily on the differences
in the statutory definitions of the “practice of medicine” and the “practice of podiatry.” Id. at 366.
Crucial to the Court’s determination was that the “[p]ractice of medicine” definition includes the
term “diagnosis” but the definition of the “[p]ractice of podiatry” does not. Id. (alterations in
original) (quoting Code § 54.1-2900).
The statute in this case contains a similarly limited definition of the “[p]ractice of athletic
training.” Code § 54.1-2900. Athletic trainers are qualified in “the prevention, recognition,
evaluation, and treatment of injuries or conditions related to athletic or recreational activity that
requires physical skill and utilizes strength, power, endurance, speed, flexibility, range of motion[,]
- 16 - or agility . . . immediately upon the onset of such injury or condition.” Id. Athletic trainers may
provide “subsequent treatment and rehabilitation of such injuries or conditions . . . under the
direction of the patient’s physician[,] . . . any doctor of medicine,” or another listed specialist. Id.
When analyzing a statute, the appellate court “must presume that the General Assembly
chose, with care, the words that appear in the statute[] and must apply the statute in a manner
faithful to that choice.” Boyd v. Weisberg, 75 Va. App. 725, 740 (2022) (quoting Jones v.
Commonwealth, 296 Va. 412, 415 (2018)). Consequently, “[we] apply the plain meaning . . . unless
the terms are ambiguous or applying the plain language would lead to an absurd result.” City of
Virginia Beach v. Va. Marine Res. Comm’n, 70 Va. App. 68, 74 (2019) (second alteration in
original) (quoting Miller & Rhoads Bldg., LLC v. City of Richmond, 292 Va. 537, 541 (2016)).
Viewed in light of these principles, the definition of “athletic training” in Code § 54.1-2900
supports the trial court’s ruling excluding Dr. Casa’s testimony about the diagnosis, treatment, or
other matters of medical opinion concerning Clancy’s condition for three reasons.
First, like in Hollingsworth, 279 Va. at 366-67, the applicable statute does not include any
form of the word “diagnose” in its description of what “[p]ractic[ing] . . . athletic training” qualifies
a practitioner to do. See Code § 54.1-2900. Contrast Hollingsworth, 279 Va. at 366-67 (holding
Virginia’s applicable statute permits podiatrists to treat foot and ankle issues but not diagnose them),
with Conley, 273 Va. at 561-62 (upholding the admission of testimony that the victim had PTSD
because a statute specifically authorized licensed clinical social workers to “provide . . . diagnostic
. . . and treatment services” regarding such mental disorders (quoting Code § 54.1-3700)).
Second, the statutory limitation in Code § 54.1-2900 provides that athletic trainers are
qualified to prevent athletic injuries as well as to recognize, evaluate, and treat them “immediately
[after] the[ir] onset.” Code § 54.1-2900 (emphasis added). Based on this language, the court did
not err by concluding that Dr. Casa did not qualify as an expert witness on these topics because he
- 17 - did not examine Clancy immediately after the onset of the alleged injury. The statutory limitation
that athletic trainers may treat and rehabilitate patients “subsequent[ly]” only “under the direction”
of a medical doctor or other specifically listed practitioner reinforces this conclusion. See id.
Third, no specific statutory exception allows an athletic trainer to testify as an expert witness
on these topics. Code § 8.01-401.2 allows only chiropractic doctors, physician assistants, advanced-
practice registered nurses, and optometrists to testify as expert witnesses “as to etiology, diagnosis,
prognosis, treatment, treatment plan, and disability” within the scope of their respective practices.
The exclusion of athletic trainers from this section supports the conclusion that the legislature did
not intend for them to be permitted to testify as expert witnesses “as to etiology, diagnosis,
prognosis, treatment, treatment plan, and disability” under the terms set out in Code § 8.01-401.2.
See Turner v. Wexler, 244 Va. 124, 127 (1992) (“[M]ention of a specific item in a statute implies
that omitted items were not intended to be included within the scope of the statute.”).
We conclude the trial court did not abuse its discretion by limiting Dr. Casa’s testimony. He
is not a medical doctor, the statutory definition of athletic trainer does not qualify him to testify
about the prevention, recognition, evaluation, or treatment of injuries or conditions, and no explicit
statutory exception allows for such testimony.
CONCLUSION
For these reasons, we reverse the circuit court’s ruling granting summary judgment. But
we affirm the court’s ruling on Pearman and Pierson’s motion in limine. We remand the case to
the trial court for further proceedings consistent with this opinion.
Affirmed in part, reversed in part, and remanded.
- 18 -