Santos-Arrieta v. Hospital Del Maestro, Inc.

14 F.4th 1
Court of Appeals for the First Circuit·Decided September 15, 2021·No. 19-1935P·Published·Cited by 7 cases

Opinion

United States Court of Appeals For the First Circuit

No. 19-1935

DAMARIS SANTOS-ARRIETA, in representation of her minor son G.Q.S.; GUSTAVO QUERALES-SALCEDO, in representation of his minor son G.Q.S.; G.Q.S., minor represented by his parents Damaris Santos-Arrieta and Gustavo Querales-Salcedo,

Plaintiffs, Appellants,

v.

HOSPITAL DEL MAESTRO, or alternatively, John Doe Corporation, d/b/a Hospital Del Maestro; CONTINENTAL INSURANCE COMPANY,

Defendants, Appellees,

DR. FELIX VILLAR-ROBLES, in representation of his conjugal partnership; JANE DOE, in representation of her conjugal partnership; JOHN DOES 1, 2 AND 3; CONJUGAL PARTNERSHIP VILLAR-

DOE; PUERTO RICO MEDICAL DEFENSE INSURANCE COMPANY,

Defendants.

APPEAL FROM THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF PUERTO RICO

[Hon. Marcos E. López, Magistrate Judge]

Before

Thompson and Lipez, Circuit Judges, and Laplante,* District Judge.

David Efron, with whom Etienne Totti del Toro and Law Offices of David Efron, PC were on brief, for appellants.

Jeannette López de Victoria, with whom Nuyen Marrero Bonilla

* Of the District of New Hampshire, sitting by designation.

and Sánchez Betances, Sifre & Muñoz Noya, P.S.C. were on brief, for appellees.

September 15, 2021

THOMPSON, Circuit Judge. After a less-than-typical six-

day trial in this medical-malpractice case, Plaintiffs Damaris Santos-Arrieta, Gustavo Querales-Salcedo, and their minor child G.Q.S. (altogether the "Plaintiffs") walked away with a jury verdict of just under $5 million, compensating them for the brain damage that Hospital del Maestro ("the Hospital" for short) and Dr. Felix Villar-Robles ("Dr. Villar") negligently caused G.Q.S. at his birth. The Hospital, convinced that it's now on the hook for damages it didn't cause, filed post-trial motions to knock that number down (or out completely). The district court took up the Hospital's request and used the post-trial motions as an opportunity to reconsider its in-trial ruling on the admissibility of the life-care-planning expert's testimony--even though the Hospital had ditched that argument pre-verdict. Reversing course from its ruling at trial, the district court struck the testimony of the only expert on future costs, deemed a new trial unnecessary, and accordingly entered an amended judgment wiping out just over $3 million (about 60%) of the verdict (i.e., the jury's calculation of the future costs of G.Q.S.'s care). Plaintiffs, rattled by the post-trial maneuver, ask us to revive the judgment or, in the alternative, remand for a new trial on only future costs. Spying legal error in the district court's grant of judgment as a matter of law, we vacate the entry of amended judgment and remand for further proceedings.

BACKGROUND

This dispute arises out of the birth of G.Q.S. at the Hospital in San Juan, Puerto Rico.1 In 2009, G.Q.S.'s mother, Damaris Santos-Arrieta ("Santos"), was under the care of Dr. Villar.2 Dr. Villar scheduled Santos for a Cesarean section, commonly known as a C-section, at the Hospital. According to Plaintiffs, the defendants engaged in a series of gaffes related to G.Q.S.'s delivery, all resulting in his now having varied physical and cognitive health care issues. And, Plaintiffs say, these issues are all symptoms of brain damage, which the negligent care from the Hospital caused.

The Hospital steadfastly disagrees.3 The Hospital's theory of the case has been consistent throughout: Based on the record evidence, G.Q.S. has autism, not brain damage and accordingly, all of G.Q.S.'s physical, developmental, and behavioral symptoms are attributable to that alone. And, because there is no scientifically valid evidence to prove a link between the Hospital's care and G.Q.S.'s autism, it cannot be held liable here.

1 For the record, this is a diversity-jurisdiction case, because Plaintiffs are now citizens of Florida. 28 U.S.C. § 1332.

2 Dr. Villar and his insurer settled on the morning of trial,

so he's not with us on appeal here.

3 When we talk about the Hospital's legal arguments and

maneuvers, we're also referring to those of its named-defendant insurer, Continental Insurance Company, because they're represented by the same counsel.

The autism-versus-brain-damage debate became the center of three motions in limine before trial.4 Two of those motions in limine are relevant here. The first is the defendants' motion to exclude Plaintiffs' life-care planning expert, Gerri Pennachio. Pennachio's life-care plan was designed to give a reasonable estimate of the costs of caring for G.Q.S. for the rest of his life. The defendants argued that Pennachio's calculations were based on caring for G.Q.S.'s diagnosis of autism, which the court, siding with the defendants on this point, had recently ruled off the table as a source of damages.5 So, they argued, the estimates of the costs were too speculative and would confuse the jury into awarding damages based on autism, not brain damage.

The district court granted the motion to exclude Pennachio's testimony on the same day as jury selection. In its opinion and order, the district court didn't specify which Rule (or Rules) of Evidence it was applying and did not cite any case law in support of its ruling. But it reasoned that Pennachio's testimony was inadmissible because "there is no readily apparent way in which to subdivide the plan into expenses related to autism

4 A magistrate judge presided over both the pre-trial proceedings and the trial, as the parties consented to proceeding before a magistrate judge. See 28 U.S.C. § 636(c)(1).

5 In its ruling on another motion in limine, the district

court concluded there was no scientifically reliable evidence presented showing that the defendants' actions could cause autism, autism spectrum disorder, or autistic-like behaviors. Plaintiffs have not appealed that ruling.

and expenses not related to autism." The district court surveyed the references to autism in the life-care plan, and also concluded that there was no way "to determine if the plaintiff's needs are attributed to his autism exclusively, or if any of his other conditions would require the same expenditures." For that reason, the court precluded Pennachio from testifying. Plaintiffs have not appealed that ruling.

The second relevant motion in limine sought to exclude the testimony of Dr. Richard Katz, the defendants' life-care- planning expert. That motion has its own procedural backdrop. Dr. Katz became the center of attention on appeal because Plaintiffs orally told the court that they intended to call the defendants' life-care-planning expert Dr. Katz in their case-in- chief. Faced with the exclusion of Pennachio, their only expert designated to opine on G.Q.S.'s future costs, Plaintiffs presumably saw Dr. Katz as the next-best thing. Although Dr. Katz was retained by the defendants, his life-care plan calculated G.Q.S.'s future costs to be well over $3 million.6 So, before the Hospital filed its motion in limine, Plaintiffs sought to use Dr. Katz to plug the new void in their case. Over the Hospital's first set of objections, the district court ruled that Plaintiffs could call Dr. Katz. The court noted that Plaintiffs had reserved the

6Plaintiffs' expert Pennachio estimated the cost to be $4,261,047.44.

right in their pre-trial memorandum to call any of the defendants' witnesses as their own.7 So, with that reservation in mind, the district court informed the Hospital that if it didn't make Dr. Katz available, the court would give an adverse instruction to the jury based on his absence.8 Later that evening, the Hospital slapped down the motion in limine. This time, the Hospital said that the testimony of Dr. Katz should also be excluded from trial (the opening arguments of which were set to begin the next morning). The district court denied the motion in a one-sentence order based both on the reasons offered in chambers the day before (i.e., that Plaintiffs reserved the right to call the defense's witnesses) and the motion's untimeliness.

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Santos-Arrieta v. Hospital Del Maestro, Inc., 14 F.4th 1 (1st Cir. 2021).

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