Case Title: Montgomery Mutual v. Chesson

Citation: 399 Md. 314

Docket Number: 110/06

State: maryland

Court: Maryland Supreme Court

Date: 2007-05-23T00:00:00Z

Document:
Montgomery Mutual Insurance Company v. Josephine Chesson, et al.
No. 110, September Term, 2006.
EVIDENCE – ADMISSIBILITY OF SCIENTIFIC AND MEDICAL EVIDENCE –
EXPERT MEDICAL TESTIMONY: Where it was unclear whether the medical
community generally accepted the theory and testing methods
underlying a medical expert’s diagnosis that exposure to mold
caused certain ailments described as either sick building syndrome
or bio toxic illness, that testimony should have been the subject
of a Frye-Reed hearing to determine its admissibility.
JUDICIAL REVIEW – LIMITED REMAND: Limited remand ordered.  A
limited remand for the purpose of holding a Frye-Reed hearing is
appropriate where the issue to be resolved is collateral to the
main issues to be resolved at trial.
In the Circuit Court for Howard County
Case No. 13-C-03-56903
IN THE COURT OF APPEALS
OF MARYLAND
No. 110
September Term, 2006
MONTGOMERY MUTUAL
INSURANCE COMPANY
v.
JOSEPHINE CHESSON, ET AL.
Bell, C.J.
Raker
Cathell
Harrell
Battaglia
Greene
Wilner, Alan M.
(Retired, specially assigned),
JJ.
Opinion by Raker, J. 
Filed:   May 23, 2007
1 Sick building syndrome refers to a combination of ailments associated with exposure
to modern buildings that lack proper ventilation.  The World Health Organization has
identified sick building syndrome as an excess of irritation of the skin and mucous
membranes and other symptoms, including headache, fatigue, and difficulty concentrating.
World Health Organization Regional Office for Europe, Indoor air pollutants: exposure and
health effects, EURO Reports and Studies No. 78, p. 23-26 (1983), available at
http://whqlibdoc.who.int/euro/r&s/EURO_R&S_78.pdf.
This appeal arises from a final judgment in a workers’ compensation matter in which
a jury in the Circuit Court for Howard County returned a verdict in favor of respondents and
against the Baltimore Washington Conference of the United Methodist Church and
Montgomery Mutual Insurance Company.  Respondents claimed that they each had sustained
an accidental injury or occupational disease, known as “sick building syndrome,”1 arising out
of and in the course of their employment, due to exposure to toxic mold.  The issue presented
in this case is whether the Circuit Court abused its discretion by not holding a Frye-Reed
hearing pursuant to our holding in Reed v. State, 283 Md. 374, 391 A.2d 364 (1978), to
determine the admissibility of the testimony of respondents’ expert, Ritchie Shoemaker,
M.D., and specifically, to decide whether the doctor’s methodologies used for diagnosis and
theories regarding the causal connection between mold exposure and certain human health
effects are generally accepted in the scientific community for that purpose.  We shall hold
that the expert’s testimony should have been the subject of a Frye-Reed hearing.
I.
Respondents, Josephine Chesson, Martha Knight, Carole Silberhorn, Linda Gamble,
Kenneth Lyons, and Connie Collins, were employees of the Baltimore Washington
2 The Workers’ Compensation Commission found that respondents Connie Collins
and William Lyons suffered neither an accidental injury nor an occupational disease due to
mold exposure.  The Commission found that respondents Josephine Chesson, Martha Knight,
and Carole Silberhorn suffered accidental injury due to mold exposure, and that respondent
Linda Gamble suffered from an occupational disease and not accidental injury due to mold
exposure.
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Conference of the United Methodist Church, and worked at the Church’s offices located at
9720 Patuxent Woods Parkway, Columbia, Maryland.  On November 18, 2002, several
employees working in the office building noticed a foul odor emanating from the walls.  A
maintenance crew broke through an interior wall and discovered two types of mold,
Aspergillus and Stachybotrys.
Respondents each filed a claim with the Maryland Worker’s Compensation
Commission, alleging that they had sustained an accidental injury or occupational disease
known as sick building syndrome due to mold exposure on November 18, 2002.  See Md.
Code (1999, 2006 Cum. Supp.) § 9-101 et seq. of the Labor and Employment Article.  The
Workers’ Compensation Commission held a hearing and disallowed two of respondents’
claims and awarded partial compensation to the remaining respondents after finding
accidental injury or occupational disease due to mold exposure.2  Each respondent filed a
petition for judicial review in the Circuit Court for Howard County, see Md. Code (1999,
2006 Cum. Supp.) § 9-737 et seq. of the Labor and Employment Article, and a joint motion
to consolidate the claims.
3 The following cases were consolidated with the present case: 13-C-03-56904, 13-C-
03-56955, 13-C-03-56956, 13-C-03-57033, 13-C-03-57043, 13-C-04-57483, 13-C-04-57784,
and 13-C-04-60173.
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The Circuit Court consolidated the claims.3  Each respondent had been examined and
treated by Dr. Ritchie Shoemaker, a licensed medical doctor and board-certified physician
in the field of family medicine.  Prior to trial, petitioner filed a motion in limine seeking to
exclude the testimony of Dr. Shoemaker on the grounds that his theories and methodologies
for diagnosis regarding a causal connection between mold exposure and certain human health
effects had not been generally accepted within the relevant scientific community.  Petitioner
requested a Frye-Reed hearing, addressing the court as follows:
“[DEFENSE COUNSEL]: The diagnosis of sick building
syndrome, or bio toxic illness, assumes the causal relationship
of the symptoms, to the bio toxic illness.  It’s – the diagnosis in
itself, of the bio toxic illness, is that this particular illness exists,
as a legitimate illness.  Unfortunately, the ICD-9 classifications,
which lists all diagnosis, for all illnesses, do not recognize bio
toxic illness as an illness.  It’s also not recognized by the CDC,
the Institute of Medicine, and NIOSH, The National Institute of
Occupational Safety and Health.
Arrival at that diagnosis of bio toxic illness, uses
techniques not generally accepted by the scientific community,
which is the Frye-Reed test.
Dr. Shoemaker focuses on a constellation of symptoms
as being caused by bio toxic illness.  This constellation of
symptoms is not accepted as an illness from mold.  The
fundamental principles of differential diagnosis require that you
rule out other causes of illnesses from symptoms that are
presented from the patient.  The first thing you would do is rule
out known illnesses, not an illness that you happen to have made
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up yourself, and that is not accepted by the ICD-9
classifications.  For example, the symptoms presented by these
claimants could include: allergic rhinitis, sinusitis, stress at the
belief of being ill; those illnesses were not even considered by
Dr. Shoemaker.  He took the constellation –
THE COURT: Excuse me, wouldn’t that go to the weight, rather
than the admissibility of his opinion?
[DEFENSE COUNSEL]: No, because you must base your
opinion on accepted medical and scientific data.  Using a
constellation of symptoms, and concluding that it’s sick building
syndrome, is not a generally accepted method for diagnosis.
The generally accepted method for diagnosis is to rule out
different illnesses that are accepted as illnesses.  In addition,
accepting a patient’s prior medical history just by having them
tell you, without verifying the accuracy of the information, is not
a generally accepted form of diagnosis.  Dr. Shoemaker, by his
own admission, reviewed no medical evidence, whatsoever,
concerning prior illnesses.  In addition, he prescribes a drug,
Cholestyramine, for the treatment of bio toxic illness, and the
FDA has not approved Cholestyramine for the treatment of bio
toxic illness because, of course, they don’t recognize bio toxic
illness as a legitimate illness.
The modifying of the accepted diagnostic tools, also
comes under a Frye-Reed evaluation, and that is exactly what
Dr. Shoemaker is doing.  He’s saying, look there’s five thousand
tests of the visual-contrast sensitivity test.  There’s, you know,
four thousand studies on Cholestyramine, but what he is not
telling you, is that those studies are being modified for his use;
his use is unique, and new, it’s a new scientific technique and it
should be looked at under the Frye-Reed test.
When we look at these issues with diagnosis and
treatment, we haven’t even gotten yet to his expression of
‘causal relationship.’  If he can separate out where he has
diagnosis, and then goes to ‘causal relationship,’ I’d sure like to
see it, because by the time these people even got to him, he had
already diagnosed sick building syndrome.  He sent out the
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questionnaires, they filled them out, and sent them back, or
brought them back and, by that time, he found sick building
syndrome.  He didn’t do any differential diagnosis, even though
he says he did.  He didn’t do any testing that is accepted as – by
the general scientific community for mold related illnesses, such
as: allergy testing, spirometry testing – he decides that blood
work is the way to go with mold.  That visual-contrast
sensitivity tests, which are used to test the vision of pilots, is
what is used for mold.  That – those techniques, though they
may be established for other causes, have been modified for Dr.
Shoemaker’s purposes and, therefore, they should be under the
Frye-Reed evaluation.
His tests, and his methods are completely experimental.
He is the self-proclaimed forerunner in this area of law.  He
admits that he’s the one that developed this –
***
The problem with Dr. Shoemaker’s experience is it’s all
anecdotal.  The anecdotal evidence that he sees from treating
people with Physteria and from what he sees –
THE COURT: Physteria were the fish down in Pocomoke City,
or the Pocomoke River, or something?
[DEFENSE COUNSEL]: That’s correct –
THE COURT: – or the Chesapeake Bay?
[DEFENSE COUNSEL]: That’s correct –
THE COURT: Yeah –
[DEFENSE COUNSEL]: – that’s right.  And he uses that
anecdotal evidence and anecdotal evidence from his treatment
of mold patients.  The problem with that is, it assumes that the
test he uses to get to those diagnoses are, generally accepted and
they’re not the generally accepted way to diagnose a mold
related illness, which is to look at the prior medical records,
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physically look at them, see what these people have been
experiencing prior to the mold exposure.  It’s to do allergy
testing, spirometry testing, and then come up with a differential
diagnosis by excluding known illnesses, not by automatically
assuming that this constellation of symptoms means sick
building syndrome.
***
THE COURT: Well, if I were going to – before I could do what
you’re asking me to do, if indeed, this would have to be
submitted to the Frye-Reed analysis, then would I not have to
have a Frye-Reed hearing, as opposed to just say, ‘oh, well, I
agree with you,’ wouldn’t I be entitled to have a Frye-Reed
hearing?
[DEFENSE COUNSEL]: We can bring our experts in, Your
Honor, and Dr. Shoemaker is already on video.”
Respondents maintained that because Dr. Shoemaker’s opinion was a medical opinion,
offered as that of a general practitioner and treating physician, the testimony was admissible
and not the proper subject of a Frye-Reed hearing.
The Circuit Court agreed with respondents and denied petitioner’s request for a Frye-
Reed hearing.  The court reasoned as follows:
“I’m prepared to rule on the motion in limine, and I’m
satisfied, from the evidence.  I’m going to deny the motion in
limine to exclude the testimony of Dr. Ritchie Shoemaker, and
I have reviewed the entire submissions and responses, and the
cases that you’ve cited, and also have reviewed, with interest,
the deposition of Dr. Shoemaker, and I’m satisfied, from the
evidence that, regardless of where he starts, that Dr. Shoemaker
has people fill out a form, which is not an uncommon practice
among physicians, or physician’s offices, but – he then goes on
and he takes a history, and – of the patients, and he physically
4 The jury found that mold exposure on the date of November 18, 2002 caused a
neuro-cognitive condition in Carole Silberhorn, a musculoskeletal and neuro-cognitive
condition in Martha Knight, a musculoskeletal and neuro-cognitive condition in Josephine
Chesson, an accidental injury that resulted in a respiratory condition in William Lyons, an
(continued...)
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examines them, and then does testing, and the particular tests
that he uses are different various and sundry blood tests.
***
And he also indicated that he’s spending, approximately,
seventy-five percent of his professional time, now, dealing with
bio toxic related illness.
His particular entry into this area, and notoriety, came
with the Physteria problem in Maryland, and I noted, in
reviewing his deposition, that he had a particular interest in
wetlands, and causal relationship with that regard.
But we’re talking about a board-certified physician, who
has devoted, apparently, in the last five or six years, more than
fifty percent of his time to this area of specialty, and I’m
satisfied that this is not a Frye-Reed situation, it’s ‘diagnosis by
a medical practitioner,’ and he, while they have not adopted, or
adapted his publications, and things that he has developed; he’s
published widely in this field, he’s gone to law school, and
consulted, and he’s indicated he’s worked with a number of
other doctors in this area; I’m satisfied that he’s qualified to
render opinions in this area, and his opinions would be
admissible in the things you mentioned that go to their weight,
rather than their admissibility.  So I am going to deny the motion
in limine.”
The case proceeded to trial and Dr. Shoemaker’s testimony was admitted on behalf of
respondents.  The jury returned verdicts in favor of each respondent, finding a causal
relationship between mold exposure and certain illnesses claimed by respondents.4
4(...continued)
accidental injury that resulted in a neuro-cognitive condition in Linda Gamble, and an
accidental injury that resulted in a respiratory and neuro-cognitive condition in Connie
Collins.
-8-
Petitioner noted a timely appeal to the Court of Special Appeals.  Before that court,
petitioner raised the argument he raises before this Court: that the Circuit Court erred when
it accepted Dr. Shoemaker as an expert witness without first holding a Frye-Reed hearing to
determine whether his medical opinions and methods of diagnosing patients are generally
accepted within the scientific community.  The intermediate appellate court rejected
petitioner’s argument, stating as follows:
“As in the case sub judice, we have previously held that
expert opinions concerning the cause or origin of an individual’s
condition are not subject to Frye-Reed analysis.  In Myers v.
Celotex Corp., 88 Md.App. 442, 460, 594 A.2d 1248 (1991),
cert. denied, Fibreboard Corp. v. Myers, 325 Md. 249, 600 A.2d
418 (1992), we reversed the trial court’s exclusion of appellant’s
expert causation opinion regarding asbestos exposure and
cancer.  In distinguishing the facts of Myers from a case that
would invoke a Frye-Reed analysis, we explained that the fact
that ‘exposure to asbestos may cause cancer . . . is not a novel or
controversial assertion, nor is it a conclusion personal to Dr.
Schepers.’  Id. at 458, 594 A.2d 1248.  We also stressed that the
Reed holding had ‘not been extended to medical opinion
evidence which [was] not presented as a scientific test [,] the
results of which were controlled by inexorable, physical laws.’
Id. at 458-59, 391 A.2d 364 (citation and quotation marks
omitted).
***
We revisited Myers in the case of CSX Transp., Inc. v.
Miller, 159 Md.App. 123, 858 A.2d 1025 (2004), cert. granted,
384 Md. 581, 865 A.2d 589 (2005), cert. dismissed, 387 Md.
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351, 875 A.2d 702 (2005), in which we affirmed the trial court’s
acceptance of expert medical opinion testimony.  Referring to
our opinion in Myers, Judge Moylan reiterated:
A doctor’s opinion as to the etiology of his
patient’s arthritis is simply not the type of thing
contemplated by the phrase ‘new and novel
scientific technique [required by the Frye-Reed
test].’  What is contemplated are new, and
arguably questionable, techniques such as lie
detector tests, breathalyzer tests, paraffin tests,
DNA identification, voiceprint identification, as
in the Reed case itself, and the use of polarized
light microscopy to identify asbestos fibers . . .
Id. at 187, 858 A.2d 1025.”
Montgomery Mutual v. Chesson, 170 Md. App. 551, 569-70, 907 A.2d 873, 884 (2006).  The
Court of Special Appeals concluded that a Frye-Reed hearing was not necessary to address
Dr. Shoemaker’s theory of causation because that was part of his medical diagnosis, and that
the Circuit Court committed no error in denying the motion in limine because Dr. Shoemaker
utilized medical tests that are generally accepted in the scientific community.  Id. at 560, 907
A.2d at 878.
Montgomery Mutual Insurance Company filed a petition for writ of certiorari before
this Court.  We granted that petition to address the following question:
“Whether the Court of Special Appeals erred in holding that Dr.
Ritchie Shoemaker’s own, unsupported, testimony about his
practices and expertise renders his opinions concerning mold
related illnesses admissible without the necessity of a Frye-Reed
analysis.”
Montgomery Mut. v. Chesson, 396 Md. 12, 912 A.2d 648 (2006).
5 Petitioner’s two main contentions in this regard are as follows: (1) although some
of the tests used by Dr. Shoemaker may be accepted in and of themselves for other purposes
in the scientific community as a whole, e.g., visual-contrast sensitivity testing, they are not
accepted as reliable or relevant in the diagnosis of sick building syndrome or all of the
particular symptoms claimed by respondents, and (2) Dr. Shoemaker’s use of patient histories
and administration of a certain drug, Cholestyramine, which he employed in his earlier work
diagnosing human disease allegedly caused by Physteria, is not accepted as either reliable or
relevant to diagnosis of sick building syndrome.
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II.
Before this Court, petitioner argues that the Circuit Court should have held a Frye-
Reed hearing to determine the admissibility of Dr. Shoemaker’s testimony.  Petitioner states
that under a proper Frye-Reed analysis, Dr. Shoemaker’s testimony should have been
excluded from trial because his methodologies, techniques, and tests used to formulate his
opinions regarding mold exposure and sick building syndrome have not been generally
accepted in the scientific community.5  Petitioner argues that it was, at a very minimum,
entitled to demonstrate at an evidentiary hearing before the Circuit Court the basis for its
argument that Dr. Shoemaker should not have been permitted to testify.
Respondents contend that Frye-Reed applies only to the appropriateness of new
scientific techniques, and that there was no need for a Frye-Reed hearing in this case because
Dr. Shoemaker based his diagnosis on techniques which are generally accepted in the
scientific community.  Respondents argue that Dr. Shoemaker’s medical opinion concerning
causation—i.e., that exposure to mold caused sick building syndrome in respondents—was
not a proper topic for a Frye-Reed hearing.
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III.
Maryland Rule 5-702 addresses the testimony of expert witnesses at trial.  The Rule
provides as follows:
“Expert testimony may be admitted, in the form of an opinion or
otherwise, if the court determines that the testimony will assist
the trier of fact to understand the evidence or to determine a fact
in issue.  In making that determination, the court shall determine
(1) whether the witness is qualified as an expert
by knowledge, skill, experience, training, or
education,
(2) the appropriateness of the expert testimony on
the particular subject, and
(3) whether a sufficient factual basis exists to
support the expert testimony.”
A trial judge has wide latitude in determining whether expert testimony is sufficiently
reliable to be admitted into evidence, and his sound discretion will not be disturbed on appeal
unless the decision to admit the expert testimony was clearly erroneous or constituted an
abuse of discretion.  See Wilson v. State, 370 Md. 191, 200, 803 A.2d 1034, 1039 (2002);
Massie v. State, 349 Md. 834, 850-51, 709 A.2d 1316, 1324 (1998).
Maryland adheres to the standard set forth in Frye v. United States, 293 F. 1013 (D.C.
Cir. 1923), for determining the admissibility of scientific evidence and expert scientific
testimony.  Reed, 283 Md. at 389, 391 A.2d at 372 (adopting the Frye standard).  Under the
Frye-Reed test, a party must establish first that any novel scientific method is reliable and
accepted generally in the scientific community before the court will admit expert testimony
based upon the application of the questioned scientific technique.  Wilson, 370 Md. at 201,
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803 A.2d at 1039.  A trial court may take judicial notice of the reliability of scientific
techniques and methodologies that are widely accepted within the scientific community.
Reed, 283 Md. at 380, 391 A.2d at 367.  A trial court also may take notice that certain
scientific theories are viewed as unreliable, bogus, or experimental.  Id.  However, when it
is unclear whether the scientific community accepts the validity of a novel scientific theory
or methodology, we have noted that before testimony based on the questioned technique may
be admitted into evidence, the reliability must be demonstrated.  Wilson, 370 Md. at 201, 803
A.2d at 1039-40.  While the most common practice will include witness testimony, a court
may take judicial notice of journal articles from reliable sources and other publications which
may shed light on the degree of acceptance vel non by recognized experts of a particular
process or view.  Reed, 283 Md. at 380, 391 A.2d at 367.  The opinion of an “expert” witness
should be admitted only if the court finds that “the basis of the opinion is generally accepted
as reliable within the expert’s particular scientific field.”  Wilson, 370 Md. at 201, 803 A.2d
at 1040.
Where evidence is subject to challenge under Frye-Reed, it is the better practice for
a court to address the issue pre-trial and out of the presence of the jury.  Clemons v. State,
392 Md. 339, 347-48 n.6, 896 A.2d 1059, 1064 n.6 (2006).  Frye-Reed hearings are best held
before trial in order to preclude jury members from considering irrelevant evidence and to
ensure that the verdict is derived from evidence which is before the jury properly.  Id. at 348
n.6, 896 A.2d at 1064 n.6.  As we noted in Reed, “Frye was deliberately intended to interpose
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a substantial obstacle to the unrestrained admission of evidence based upon new scientific
principles.”  Reed, 283 Md. at 386, 391 A.2d at 370 (quoting People v. Kelly, 549 P.2d 1240,
1245 (Cal. 1976)).  In addition, Frye-Reed generally involves matters collateral to the
substantive issues at trial, and for that reason alone is better resolved outside of the presence
of the jury.  Clemons, 392 Md. at 348 n.6, 896 A.2d at 1064 n.6.
In the case sub judice, the Court of Special Appeals held that it was unnecessary for
the Circuit Court to hold a Frye-Reed hearing, reasoning (1) that Dr. Shoemaker’s medical
diagnosis was not a proper subject for Frye-Reed analysis, and (2) that the tests Dr.
Shoemaker used in reaching his medical diagnoses are generally accepted in the medical
community, and are therefore not subject to Frye-Reed analysis.  Montgomery Mutual, 170
Md. App. at 560, 907 A.2d at 878.  We disagree and hold that, based on this record, the
Circuit Court should have held a Frye-Reed hearing to determine whether the medical
community generally accepts the theory that mold exposure causes the illnesses that
respondents claimed to have suffered, and the propriety of the tests Dr. Shoemaker employed
to reach his medical conclusions.
This Court has emphasized repeatedly that Frye-Reed is meant to apply to evidence
based on scientific opinion.  See Clemons, 392 Md. at 364, 896 A.2d at 1073; Wilson, 370
Md. at 201, 803 A.2d at 1040; Reed, 283 Md. at 381, 391 A.2d at 368.  The proper test for
determining admissibility under Frye-Reed “is whether the basis of the opinion is generally
accepted as reliable within the expert’s particular scientific field.”  Wilson, 370 Md. at 201,
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803 A.2d at 1040.  Dr. Shoemaker’s testimony was based on scientific opinion regarding the
causal link between mold exposure and sick building syndrome.  As such, both his theories
regarding causation and the tests he employed to diagnose respondents were subject to Frye-
Reed analysis.
Our decision in Wilson helps to demonstrate this point.  In Wilson, we found that the
trial court erred in permitting the State to use statistical data and a product rule computation
to prove the improbability of two Sudden Infant Death Syndrome deaths in a single family.
Id. at 195, 803 A.2d at 1036.  While admitting that Frye-Reed “often will not apply to
statistical calculations because the choice between alternative statistical techniques, although
subjective, is often merely a choice between equally valid methods of describing the same
underlying scientific data,” id. at 202, 803 A.2d at 1040 (quoting Armstead v. State, 342 Md.
38, 80 n.33, 673 A.2d 221, 242 n.33 (1996)), we noted that there are instances where the use
of generally accepted statistical techniques will nonetheless 
be subject to Frye-Reed analysis.
Wilson, 370 Md. at 203, 803 A.2d at 1041.  We used the following example to explain:
“[S]uppose that a new species of flower is discovered.  When it
is discovered, a white-flowered variety and a red-flowered
variety are observed.  It would be incorrect to calculate the
probability of a new plant having white flowers based on a
normal distribution, because this would depend on whether
flower colors varied along a continuum from white to pink to
red, or whether there were only discrete possibilities for the
flower color, i.e., white or red.  Under this scenario, the correct
choice of probability calculations would depend on the
underlying genetics of the plant.”
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Wilson, 370 Md. at 203, 803 A.2d at 1041 (quoting Armstead, 342 Md. at 80 n.33, 673 A.2d
at 242 n.33) (internal citations omitted).  We held that in cases in which the proper choice
of statistical techniques was dependent on an underlying scientific phenomenon or principle,
a court must engage in Frye-Reed analysis to determine whether that phenomenon or
principle is generally accepted in the scientific community and whether the proper scientific
tests were used to reach the expert’s conclusions.  Wilson, 370 Md. at 203, 803 A.2d at 1041.
In the instant case, the expert witness offered a medical opinion that was based on an
underlying scientific principle.  The question before the Circuit Court was whether Dr.
Shoemaker’s theory regarding mold exposure and illness, and the techniques he employed
to reach his medical conclusions, were generally accepted in the medical community.
Petitioner’s request for an evidentiary hearing was not a frivolous motion.
Courts across the United States have applied either the Frye test or the test set out in
Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579, 113 S. Ct. 2786, 125 L. Ed.
2d 469 (1993) to determine the admissibility of expert medical testimony that mold exposure
causes illness.  See e.g., Roche v. Lincoln Property Co., 278 F. Supp. 2d 744 (E.D. Va. 2003)
(applying the Daubert test to determine the admissibility of a physician’s testimony that mold
exposure caused various ailments); Flores v. Allstate Texas Lloyd’s Company, 229 F. Supp.
2d 697 (S.D. Tex. 2002) (applying the Daubert test to a medical expert’s testimony regarding
mold exposure and illness); Mondelli v. Kendel Homes Corp., 631 N.W.2d 846 (Neb. 2001)
(applying the Frye test to determine the admissibility of medical expert testimony regarding
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mold exposure and respiratory illness); Geffcken v. D’Andrea, 41 Cal. Rptr. 3d 80 (Cal. App.
2006) (applying California’s Kelly-Frye test, derived from People v. Kelly, 549 P.2d 1240,
to testimony regarding the relationship between mold exposure and sick building syndrome);
Allison v. Fire Ins. Exchange, 98 S.W.3d 227 (Tex. App. 2002) (applying Texas’ Robinson-
Daubert test to address a medical expert’s theory that mold exposure led to adverse health
effects); Centex-Rooney Const. v. Martin County, 706 So. 2d 20 (Fla. App. 1997) (applying
the Frye standard to expert opinion evidence regarding the link between exposure to toxic
mold and certain adverse health effects).  See also DANIEL J. PENOFSKY, Litigating Toxic
Mold Cases, in 92 AM JUR. TRIALS 113 at § 87, p. 325 (2004, 2006 Cum. Supp.) (noting that
“admissibility of expert medical or scientific testimony on the trial of the toxic mold case on
such key issues as exposure to toxic mold and causation of illness . . . will typically be
resolved pursuant to an in limine hearing conducted prior to trial or during trial but out of
hearing by the jury”); KATHLEEN L. DAERR-BANNON, Cause of Action by Residential Owners
and Tenants for Personal Injury and Property Damage Due to Toxic Mold, in 26 CAUSES OF
ACTION 2d 529 at § 20, p. 562 (2006, 2007 Cum. Supp.) (noting that in “toxic mold cases,
the court is likely to serve as gatekeeper and make a threshold determination on admissibility
of scientific or medical testimony.  Courts will usually schedule a separate hearing before or
during trial as to whether the requisite standard for such testimony has been met, often
referred to as a Daubert or Frye hearing.”).  As have the courts that have considered this
6 In Myers v. Celotex Corp., 88 Md. App. 442, 594 A.2d 1248 (1991), the Court of
Special Appeals cited our opinion in State v. Allewalt, 308 Md. 89, 517 A.2d 741 (1986), to
support its position that Frye-Reed has not been extended to medical opinion evidence.
Myers, 88 Md. App. at 458-59, 594 A.2d at 1256-57.  Allewalt differs from the present case
significantly.  In Allewalt, we noted specifically that the medical expert’s opinion was
accepted in the relevant medical community.  Allewalt, 308 Md. at 99, 517 A.2d at 746
(stating that there “is no issue in this case over the fact that psychiatrists and psychologists
recognize PTSD [post-traumatic stress disorder] as an anxiety disorder”).  The primary issue
in the case sub judice is whether the medical expert’s opinion has been generally accepted
in the relevant medical community.
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issue, we think it clear that expert medical testimony, such as that offered by Dr. Shoemaker,
is the proper subject of a Frye-Reed hearing.
The Court of Special Appeals relied upon CSX v. Miller, 159 Md. App. 123, 858 A.2d
1025, and Myers v. Celotex Corp., 88 Md. App. 442, 594 A.2d 1248, to support the
conclusion that Dr. Shoemaker’s medical opinion testimony was not subject to analysis under
Frye-Reed.  In both of those cases, the Court of Special Appeals held that a Frye-Reed
hearing was unnecessary to admit a medical expert’s opinion regarding the origin of a
patient’s illness.  See CSX, 159 Md. App. at 187, 858 A.2d at 1062; Myers, 88 Md. App. at
458-59, 594 A.2d at 1256-57.  Myers involved a medical expert’s testimony that exposure
to asbestos caused cancer.  Similarly, CSX involved a medical opinion regarding the etiology
of a patient’s arthritis.  In both cases, the intermediate appellate court found that Frye-Reed
analysis was unnecessary because “Reed v. State has not been extended to medical opinion
evidence which is not ‘presented as a scientific test the results of which were controlled by
inexorable, physical laws.’”6  CSX, 159 Md. App. at 188, 858 A.2d at 1063 (quoting Myers,
88 Md. App. at 458-59, 594 A.2d at 1256-57) (emphasis in original).
7 While we offer no opinion on the general acceptance of Dr. Shoemaker’s medical
conclusions, we think it clear that his theories are not the proper subject of judicial notice.
The debate on toxic mold and sick building syndrome has become increasingly prevalent in
American courtrooms, and courts across the country have reached differing conclusions
regarding the causal relationship between mold exposure and sick building syndrome.  See
e.g., Mondelli v. Kendel Homes Corporation, 631 N.W.2d 846, 858 (Neb. 2001) (holding that
under the Frye standard, expert testimony was permissible on the subject of mold exposure
and respiratory illness); Geffcken v. D’Andrea, 41 Cal. Rptr. 3d 80, 89 (Cal. App. 2006)
(finding that under California’s Kelly-Frye standard, expert testimony was inadmissible
because appellants failed to show that the relationship between mold exposure and sick
building syndrome has gained general acceptance in the relevant scientific community);
Centex-Rooney Const. v. Martin County, 706 So. 2d 20, 26 (Fla. App. 1997) (finding that
under the Frye standard, the scientific community recognizes the link between exposure to
toxic mold and certain adverse health effects).
The General Assembly has taken notice of the increasing claims linked to toxic mold
exposure, and during the 2001 Session, established a task force on indoor air quality to
address the subject.  See S.B. 283 (2001).  The task force issued a lengthy report on indoor
air quality, reaching the following conclusions:
“Some molds have also been shown to produce toxins (termed mycotoxins)
which have been shown to have significant health effects in animals when
given in high doses.  While there is considerable scientific debate about the
potential for these molds to cause toxic effects in people in concentrations
typically seen in office buildings, there is consensus among the Task Force and
most health professionals that:
(1) Mold growth in buildings can have adverse health
consequences;
(2) Normal background levels of mold can be found in all
buildings;
(3) There is an inadequate base of scientific knowledge at this
time to set health-based mold standards for buildings because
of uncertainties about levels of exposures, the relationship
between exposure and different health effects, and differences in
susceptibility from person to person;
(continued...)
-18-
The instant case differs from both CSX and Myers.  It involves more than a generally
accepted medical opinion and diagnosis.  Dr. Shoemaker employs medical tests to reach a
conclusion that is not so widely accepted as to be subject to judicial notice of reliability.7
7(...continued)
(4) While background levels of mold and mold exposures in
buildings cannot be completely eliminated, exposures due to
indoor mold contamination can and should be minimized; and
(5) Mold growth and contamination in office buildings can and
should be prevented or controlled through the use of adequate
and ongoing maintenance of the building and building systems,
as well as through good housekeeping.”
Maryland State Task Force on Indoor Air Quality, Final Report, p. 11 (2002), available at
http://www.dllr.state.md.us/labor/indoorairfinal/iaqfinalreport.pdf (emphasis added).  Both
the findings of the task force and our analysis of cases across the country lead us to believe
that Dr. Shoemaker’s theories should be subject to a Frye-Reed hearing and not taken as
reliable through judicial notice.
-19-
Further, as we noted in Reed, novel medical theories regarding the causes of medical
conditions have been subject to Frye analysis.  Reed, 283 Md. at 383, 391 A.2d at 369
(noting that the Frye test has been applied to “medical testimony regarding the cause of birth
defects”).  See also Pasteur v. Skevofilax, 396 Md. 405, 431 n.18, 914 A.2d 113, 128-29 n.18
(2007) (noting that an expert’s medical opinion will not be admissible unless it is generally
accepted as reliable in the expert’s particular field).
The Circuit Court erred when it allowed Dr. Shoemaker’s testimony without first
holding a Frye-Reed hearing to determine whether his theories and methodologies are
generally accepted in the medical community.
IV.
The question arises as to the proper remedy for the trial court’s error and whether the
judgment should be vacated and a new trial ordered, or whether this matter is better suited
-20-
to a limited remand pursuant to Maryland Rule 8-604(d), with directions to the trial court to
hold a Frye-Reed hearing.  This case fits well within the Maryland rule permitting and
providing for a limited remand.
Maryland Rule 8-604(d) provides, in pertinent part, as follows:
“(d) Remand.  (1) Generally.  If the Court concludes that the
substantial merits of a case will not be determined by affirming,
reversing or modifying the judgment, or that justice will be
served by permitting further proceedings, the Court may remand
the case to a lower court.  In the order remanding a case, the
appellate court shall state the purpose for the remand.  The order
of remand and the opinion upon which the order is based are
conclusive as to the points decided.  Upon remand, the lower
court shall conduct any further proceedings necessary to
determine the action in accordance with the opinion and order
of the appellate court.”
A limited remand is appropriate in various circumstances, in both civil and criminal cases,
and most notably “when the purposes of justice will be advanced by permitting further
proceedings.”  Southern v. State, 371 Md. 93, 104, 807 A.2d 13, 19-20 (2002).  A remand
may be limited if the error occurred in a proceeding collateral to the trial itself, and the
limited purpose of the remand is to correct the error that occurred during the collateral
proceeding.  Lipinski v. State, 333 Md. 582, 591, 636 A.2d 994, 998 (1994).
Our jurisprudence is replete with examples where a limited remand is proper.  See
e.g., Edmonds v. State, 372 Md. 314, 812 A.2d 1034 (2002) (ordering a limited remand to
hold a new 
Batson hearing to address the credibility of prosecutor’s race-neutral explanations
for the use of peremptory strikes); In re Adoption No. A91-71A, 334 Md. 538, 640 A.2d 1085
-21-
(1994) (ordering a limited remand to appoint independent counsel to represent the interests
of a child involved in a contested adoption proceeding); Patrick v. State, 329 Md. 24, 617
A.2d 215 (1992) (ordering a limited remand to determine whether a criminal defendant was
prejudiced by the State’s failure to disclose polygraph test results); Scheve v. Shudder, 328
Md. 363, 614 A.2d 582 (1992) (ordering a limited remand so that the trial court could
determine whether to dismiss an action pursuant to Maryland Rule 2-506); Warrick v. State,
326 Md. 696, 607 A.2d 24 (1992) (ordering a limited remand to hold an in camera hearing
to determine whether the defendant was entitled to the name of a confidential State
informant, and if so, whether he suffered prejudice due to the State’s failure to provide the
name of that informant); Reid v. State, 305 Md. 9, 501 A.2d 436 (1985) (ordering a limited
remand to hold an evidentiary hearing regarding the authenticity of character letters offered
by defendant during sentencing proceedings); Bailey v. State, 303 Md. 650, 496 A.2d 665
(1985) (ordering a limited remand to permit the State to provide discovery material regarding
statements made by the defendant to an out-of-state police trooper and to allow the trial court
to determine the appropriate sanction for the discovery violation); Wiener v. State, 290 Md.
425, 430 A.2d 588 (1981) (ordering a limited remand to reconsider defendant’s motion for
dismissal of his indictment due to ineffective assistance of counsel).
Other appellate courts addressing Frye or Daubert issues have ordered limited
remands.  For example, in Brim v. State, 695 So. 2d 268 (Fla. 1997), the Florida Supreme
Court ordered a limited remand after determining that DNA population frequency tests were
-22-
subject to analysis under the Frye test.  The court noted that there would be no need to
overturn the verdict if the trial court found that the methods satisfied the Frye test; a new trial
would be necessary only if the trial court reached a contrary conclusion and found the tests
should have been inadmissible.  Id. at 275.  Likewise, in People v. Leahy, 882 P.2d 321 (Cal.
1994), the California Supreme Court ordered a limited remand to hold a Kelly-Frye hearing.
In addressing the propriety of certain field sobriety tests, California’s highest court noted that
retrial of the case might be unnecessary because the questioned scientific evidence could be
found admissible at the hearing.  Id. at 335.  See also State v. Harvey, 699 A.2d 596, 683
(N.J. 1997) (recognizing that an appellate court addressing a Daubert issue may “remand the
matter to the trial court to take additional testimony about the general acceptance of the
scientific evidence”).
In this case, the issue to be resolved, i.e., the threshold question of the admissibility
of Dr. Shoemaker’s testimony, is collateral to the issues to be resolved at trial.  See Clemons,
392 Md. at 348 n.6, 896 A.2d at 1064 n.6 (noting that Frye-Reed hearings generally involve
matters collateral to the substantive issues of a case).  Verdicts should not be vacated
unnecessarily, and in this case, a retrial may not be necessary.  Indeed, it would be a grave
injustice were we to reverse the judgment and vacate the verdict, and then the trial court,
after a Frye-Reed hearing, determined properly that Dr. Shoemaker’s testimony was
generally accepted within the scientific community.  Accordingly, we remand this case for
an evidentiary hearing to ascertain whether Dr. Shoemaker’s methodologies used for
-23-
diagnosis and theories regarding the causal connection between mold exposure and certain
human health effects are generally accepted in the scientific community.  The trial court is
directed to make factual findings and conclusions and then to issue a Frye-Reed
determination.  If the trial court finds that Dr. Shoemaker’s methods and theories satisfy the
Frye-Reed test, the judgment should remain in effect.  If the court finds to the contrary, the
judgment should be vacated.  Our remand is limited solely to this issue.
JUDGMENT OF THE COURT OF
SPECIAL 
APPEALS 
VACATED.
CASE 
REMANDED 
TO 
THAT
COURT WITH DIRECTIONS TO
R E M A N D  
C A S E , 
W I T H O U T
AFFIRMANCE OR REVERSAL, TO
THE 
CIRCUIT 
COURT 
FO R
HOWARD 
COUNTY 
FOR 
THE
P U R P O S E  
O F  
H O LD I N G  
A
HEARING PURSUANT TO THE
MOTION 
IN 
LIMINE. 
 
THE
JUDGMENTS OF THE CIRCUIT
COURT 
REMAIN 
IN 
EFFECT
UNLESS 
VACATED 
BY 
THE
CIRCUIT COURT IN ACCORDANCE
WITH 
THE 
PROCEDURES 
SET
FORTH 
IN 
THE 
FOREGOING
OPINION.  COSTS IN THIS COURT
AND THE COURT OF SPECIAL
APPEALS 
TO 
BE 
PAID 
BY
RESPONDENTS.