(PC) Witkin v. Lotersztain

District Court, E.D. California·Decided June 23, 2022·No. 2:19-cv-00406·Unknown

Opinion

MICHAEL WITKIN, No. 2:19-cv-0406 TLN KJN P Plaintiff, v. ORDER MARIANA LOTERSZTAIN, M.D., et al., Defendants. Plaintiff is a state prisoner, proceeding without counsel. Two motions filed by plaintiff are pending: a motion to exclude opinion testimony of expert Dr. Burgar under Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579 (1993) (“Daubert I”); and a motion for discovery. Defendant Lin opposes both motions. As set forth below, plaintiff’s motions are denied, and plaintiff is directed to file his oppositions to defendants’ pending motions for summary judgment. I. Motion to Exclude A. The Parties’ Arguments Plaintiff’s Motion Plaintiff seeks to exclude the opinion testimony of defendant Lin’s expert witness, Alexandra Burgar, “on the basis that the opinion testimony is not based on sufficient facts or data, is not grounded in medical science, is unexplained and unhelpful, and is not sufficiently reliable to withstand scrutiny under Rule 702.” (ECF No. 59 at 1.) He contends Dr. Burgar failed to set forth the standard of care and is therefore not relevant, and failed to explain her methodology or provide any peer consensus or medical literature to support her conclusion that splinting was the appropriate treatment for a comminuted intra-articular fracture of the fourth proximal phalanx. (ECF No. 59 at 3, 5-6.) Plaintiff objects that Dr. Burgar failed to explain the potential severity of the fracture and how it impacted treatment options, the effect of the time lapse on the treatment options, whether the initial treatment was beneficial or harmful, or how the nature and extent of plaintiff’s injury impacted the course of treatment. (ECF No. 59 at 3.) Plaintiff argues that Dr. Burgar’s opinion testimony is not good science and does not advance Dr. Lin’s malpractice defense because her opinion is conclusory and fails to provide any factual basis, simply providing “her bald ‘assurances of reliability. Under Daubert, that’s not enough.’” (ECF No. 59 at 6) (quoting Daubert v. Merrell Dow Pharm., Inc., 43 F.3d 1311, 1319 (9th Cir. 1995) (“Daubert II”). Specifically, plaintiff seeks to strike (id. at 7) paragraphs 4, 7 and 8 of Dr. Burgar’s declaration: 4. It is my opinion that Dr. Lin complied with the standard of care with respect to the care and treatment he provided to Mr. Witkin. Specifically, Dr. Lin’s examination and x-ray images revealed a comminuted and intra-articular fracture of the fourth proximal phalanx, with mild degenerative changes. Given Dr. Lin exam findings, the x-ray report, and the history of the injury, Dr. Lin’s determination at the time that surgery was not more likely to provide a better result than splinting was correct, and consistent with the standard of care. Moreover, surgery on Mr. Witkin’s finger could have resulted in a worse outcome for Mr. Witkin, and therefore splinting was the preferred course. 7. The care and treatment provided to Mr. Witkin by Dr. Lin complied in all respects with the standard of care. 8. Given the location of Mr. Witkin’s fracture, the type of fracture, and his pre-existing arthritis (documented on his x-ray as degenerative changes), the finger deformation, loss of function, and improper healing claimed by Mr. Witkin was, more likely than not, a result of the initial fracture, and not the medical care, or any lack of medical care, on the part of Dr. Lin. (ECF No. 55-2 at 120-21.) Defendant’s Opposition Defendant Lin opposes plaintiff’s motion, arguing that Dr. Burgar’s declaration establishes that she is a physician with extensive experience and knowledge in treating conditions affecting the bones, muscles, nerves and tendons of the hand, and her opinions are based on a review of plaintiff’s pertinent medical records, plaintiff’s deposition, and Dr. Lin’s declaration. (ECF No. 63 at 5-6.) Such review supported Dr. Burgar’s conclusion that Dr. Lin’s care was consistent with the standard of care for treating plaintiff’s fracture. The standard of care is a central issue in this case and is not a matter within the general knowledge of lay people. Thus, Dr. Burgar’s declaration should be admitted because there is sufficient evidence to support its reliability and her testimony will assist the trier of fact to understand the issue. Defendant argues that Dr. Burgar was not required to address potential treatment or findings that Dr. Lin could have made that also would have complied with the standard of care; rather, the issue here is whether the treatment Dr. Lin actually provided complied with the standard of care. If Dr. Burgar had concluded that Dr. Lin did not recommend the appropriate treatment, then Dr. Burgar would have likely needed to state what treatment she would have recommended. But because Dr. Burgar found that Dr. Lin’s decision complied with the standard of care, she was not required to identify all decisions that would have complied with the standard of care. Defendant contends that “[b]y stating that the treatment Dr. Lin provided was one which is in compliance with the standard of care, she has articulated what treatment would comply with the standard.” (ECF No. 63 at 6.) Further, to the extent plaintiff argues that Dr. Burgar failed to consider relevant information or might have been able to obtain more complete information, such facts go to the weight to be given to her opinions, not the admissibility of her opinions. (ECF No. 63 at 6.) (citing see Hangarter v. Provident Life and Acc. Ins. Co., 373 F.3d 998, 1017 n.14 (9th Cir. 2004) (“[T]he factual basis of an expert opinion goes to the credibility of the testimony, not the admissibility, and it is up to the opposing party to examine the factual basis for the opinion in cross-examination.”) Plaintiff’s Reply In reply, plaintiff argues that Dr. Burgar’s opinion is a legal opinion created expressly for purposes of testifying, not a medical opinion. Plaintiff contends that Dr. Burgar’s declaration fails to explain why splinting was the appropriate course of medical treatment rather than a closed or open reduction of plaintiff’s fracture, or explain the facts or clinical circumstances under which splinting would be medically appropriate. (ECF No. 69.) Plaintiff reiterates that Dr. Burgar failed to set forth the applicable standard of care or provide any explanation as to why her experience is a sufficient basis for her conclusory opinion. B. Governing Standards Federal Rule of Evidence 702 allows a qualified expert to testify “in the form of an opinion or otherwise” where: (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. In evaluating expert opinion testimony, federal courts apply a more flexible Daubert standard. Daubert I, 509 U.S. at 579.1 Expert testimony is admissible under Rule 702 if the expert is qualified and if the testimony is both relevant and reliable. See Daubert I, 509 U.S. at 597; see also Messick v. Novartis Pharms. Corp., 747 F.3d 1193 (9th Cir. 2014) (finding expert’s testimony relevant and reliable, but fact issues precluded summary judgment on products liability claims). Rule 702 contemplates a “broad conception of expert qualifications.” Hangarter, 373 F.3d

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