Warden v. Exempla, Inc.

2012 CO 74, 291 P.3d 30, 2012 Colo. LEXIS 952, 2012 WL 6685772
CourtSupreme Court of Colorado
DecidedDecember 20, 2012
DocketNo. 12SA199
StatusPublished
Cited by198 cases

This text of 2012 CO 74 (Warden v. Exempla, Inc.) is published on Counsel Stack Legal Research, covering Supreme Court of Colorado primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Warden v. Exempla, Inc., 2012 CO 74, 291 P.3d 30, 2012 Colo. LEXIS 952, 2012 WL 6685772 (Colo. 2012).

Opinion

Justice RICE

delivered the Opinion of the Court.

1 In this original C.A.R. 21 proceeding, we review the trial court's order striking the testimony of plaintiff's rebuttal expert witness, Dr. Susan Shott. We also consider the trial court's order striking portions of the testimony of two previously disclosed expert witnesses, Dr. Harriet T. Cokely and Dr. Pamela E. Wilson. We hold that the trial court abused its discretion when it exeluded Dr. Shott's rebuttal testimony because her testimony properly refuted a central theory of the defendants' case. The trial court also abused its discretion when it excluded Dr. Cokely's and Dr. Wilson's testimony because the late disclosure of their testimony did not harm the defendants, as required for sanctions under Rule 37. Accordingly, we make the rule absolute and remand for further proceedings consistent with this opinion.

I. Facts

T2 On May 12, 2010, Noah Warden, a minor, and his parents, Stacy Warden and Chris Warden (collectively the "Wardens"), brought medical malpractice claims against Defendants, Exempla, Inc., Exempla Good Samaritan Center, LLC., Dr. Camille S. Calderwood, Nurse Jennifer Dillon, and Nurse Jessica Jenks, (collectively, "Exem-pla"), for alleged breaches of the standards of medical care resulting in extensive injuries to Noah during his birth.

4 3 The Wardens allege that on December 22, 2008, Stacy Warden arrived at Exempla Good Samaritan Medical Center. After nine hours of labor, her son Noah was delivered by emergency cesarean section. At birth, Noah's umbilical cord was wrapped around his neck, he was unresponsive, and had no heartbeat. After several minutes of resuscitation efforts, Exempla personnel restored Noah's heartbeat and placed him on a ventilator.

T4 The Wardens also argue that an MRI of Noah's brain revealed that he suffered from severe acute hypoxic-ischemic encephal-ophy ("HIE"), the extensive death of brain matter resulting from oxygen deprivation. Now three years old, Noah cannot communicate or walk and requires round-the-clock care.

[[ 5 The parties dispute the cause of Noah's injuries. The Wardens maintain that Noah was injured by a preventable intrapartum event: Exempla's failure to properly monitor data generated by the fetal monitoring strip during Noah's birth. With proper monitoring, the Wardens' contend, defendant Dr. Calderwood could have timely diagnosed fetal distress and performed an earlier caesarean section.

T6 Exempla argues that Noah's injuries occurred days, or possibly weeks, before his birth. Exempla relies on the analysis of a placental pathologist, Dr. Weslie Tyson, who examined Noah's umbilical cord shortly after birth and allegedly found significant abnormalities-including muscle death of the umbilical vein wall, clotting of the umbilical vein, and poor blood supply through the umbilical cord-all suggesting Noah's injuries preceded labor.

T 7 The Wardens' petition addresses a discrete portion of this negligence action: the trial court's exclusion of certain expert testimony after the Wardens' rebuttal expert disclosures. We now describe the expert disclosures and the trial court's order striking a portion of the Wardens' expert disclosures.

[33]*33II. Procedural History

18 On June 28, 2011, the Wardens made their initial expert disclosures pursuant to Rule 26(a)(2) and the trial court's case management order. The Wardens included Dr. Cokely and Dr. Wilson among the eight testifying experts. Dr. Cokely opined that the doctors and nurses charged with Noah's care could have prevented Noah's injures had they properly monitored his fetal monitoring strip. Dr. Wilson's expert opinion concerned the expensive rehabilitative care Noah requires.

{9 The Wardens also included in their initial disclosures the financial analysis of Jeffrey Opp estimating Stacy and Chris Wardens' expected costs in light of Noah's condition. Opp's estimate assumed Noah would live for over 70 years, as specified by statute.1 He did not consider the effect of Noah's medical condition on Noah's life expectancy.

1 10 After deposing the Wardens' experts, Exempla disclosed its own experts in the fields of obstetrics, gynecology, maternal-fetal medicine, pathology, pediatric neurology, neonatology, pediatric neuroradiology, nursing, genetics, and damages. Among other things, Exempla's experts opined that Noah's condition at birth was not the consequence of intrapartum events. Exempla's experts' conclusions rested, in large part, on a 2003 American College of Obstetricians and Gynecologists study titled, "Neonatal Encephalopathy and Cerebral Palsy: Defining the Pathogenesis and Pathophysiology" ("NEACP"). The NEACP report outlines four essential criteria for finding that HIE was caused by intrapartum events. Exem-pla's experts concluded that Noah's umbilical cord gas values-a NEACP criterion-belied the Wardens' allegations that Noah's injuries occurred during labor. Exempla also disclosed two experts who expected to testify to Noah's shortened life expectancy.

{11 On October 17, 2011, the Wardens disclosed four new rebuttal experts, including Dr. Shott, a biostatistician. Dr. Shott's testimony varied from the Wardens' initial expert disclosures because-rather than attacking the accuracy of Noah's umbilical cord gas test results-Dr. Shott's testimony questioned the validity of the NEACP criteria, concluding that the report was "junk science." In particular, Dr. Shott reviewed all 72 articles cited by the NEACP report and determined that the NEACP report did not rely upon "properly performed studies"; rather, Dr. Shott described the NEACP criteria as a set of "arbitrary cutoff values" based on a statistically insignificant sample size.

12 In addition to Dr. Shott's testimony questioning the NEACP report, the Wardens' rebuttal disclosures included expanding Dr. Cokely's and Dr. Wilson's testimony to address Noah's life expectancy. These two previously disclosed experts now anticipated testifying that Noah would probably live into his forties.

13 Exempla filed a motion to strike the Wardens' rebuttal disclosures, including the life expectancy opinions of Dr. Cokely and Dr. Wilson. They also filed a motion in limine to exclude the testimony of the Wardens' rebuttal expert, Dr. Shott. On April 3, 2012, after multiple hearings, the Magistrate issued an order pursuant to Rule 87(c)(1) striking the life expectancy opinions of Dr. Cokely and Dr. Wilson, and striking Dr. Shott as a rebuttal witness.

"[ 14 The Wardens moved for an expedited review of the Magistrate's order in Boulder County District Court ("trial court"). On May 7, 2012, the trial court affirmed the Magistrate's order. It agreed with the Magistrate that Dr. Shott's rebuttal testimony was "unresponsive [and not] dependent on any particular opinions expressed by [Exem-pla's] experts." For Dr. Wilson and Dr. Cokely, the trial court reasoned that the rebuttal testimony concerning Noah's life ex-pectaney amounted to an "ambush" and was therefore improper rebuttal disclosure.

[34]*341 15 The Wardens now petition this Court under C.A.R. 21 for a review of the trial court's order limiting Dr. Cokely's and Dr. Wilson's testimony and striking Dr. Shott's testimony regarding the NEACP report. We hold that Dr. Shott's testimony was a proper rebuttal disclosure because it rebutted a specific, important portion of Exempla's expert disclosures. Dr. Cokely's and Dr. Wilson's testimony should also be admitted because its late disclosure did not harm Ex-empla.

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Cite This Page — Counsel Stack

Bluebook (online)
2012 CO 74, 291 P.3d 30, 2012 Colo. LEXIS 952, 2012 WL 6685772, Counsel Stack Legal Research, https://law.counselstack.com/opinion/warden-v-exempla-inc-colo-2012.