Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caDC-05-07010/USCOURTS-caDC-05-07010-0/pdf.json

Nature of Suit Code: 360
Nature of Suit: Other Personal Injury
Cause of Action: 

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Notice: This opinion is subject to formal revision before publication in the

Federal Reporter or U.S.App.D.C. Reports. Users are requested to notify the

Clerk of any formal errors in order that corrections may be made before the

bound volumes go to press. 

 United States Court of Appeals

FOR THE DISTRICT OF COLUMBIA CIRCUIT

Argued November 16, 2006 Decided February 9, 2007

No. 05-7010

HUMBERTO ANTONIO GAVIRIA,

APPELLANT

v.

DONALD REYNOLDS, DDS, ATTENDING SURGEON, ET AL.,

APPELLEES

Appeal from the United States District Court

for the District of Columbia

(No. 00cv02350)

Eric Berger, appointed by the court, argued the cause as

amicus curiae in support of appellant. With him on the briefs

were Ian Heath Gershengorn and David W. DeBruin, appointed

by the court.

Humberto A. Gaviria, pro se, filed briefs.

James C. McKay, Jr., Senior Assistant Attorney General,

Office of Attorney General for the District of Columbia, argued

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the cause for appellees. With him on the brief were Robert J.

Spagnoletti, Attorney General, and Todd S. Kim, Solicitor

General. Edward E. Schwab, Deputy Attorney General, entered

an appearance.

Before: GINSBURG, Chief Judge, and ROGERS and

KAVANAUGH, Circuit Judges.

Opinion for the Court filed by Circuit Judge ROGERS.

ROGERS, Circuit Judge: After Humberto A. Gaviria

underwent five surgeries to repair jaw problems resulting from

a 1989 altercation with the police, he filed a medical malpractice

action against nine oral surgeons (“Surgeons”) who participated

in the surgeries. Acting pro se after the withdrawal of his courtappointed attorney, Gaviria was unable to substantiate his claims

with expert testimony as required by District of Columbia law,

and the district court granted summary judgment for the

Surgeons. On appeal, Gaviria contends through court-appointed

amicus curiae that the district court abused its discretion by

refusing to appoint replacement trial counsel after Gaviria’s

appointed counsel withdrew and that the court further erred by

refusing to appoint an expert witness pursuant to FED. R. EVID.

706.

The district court took adequate steps to assist Gaviria in the

development of his claims. Gaviria benefitted from appointed

trial counsel—who explored Gaviria’s claims with the help of an

expert before he withdrew—and appointed mediation counsel,

who worked to negotiate a settlement while helping Gaviria, as

did the district court itself, to collect discovery materials from

third parties. By the time the district court granted summary

judgment for the Surgeons, it knew that neither a recent scan of

Gaviria’s head nor anything Gaviria had presented contributed

toward his burden to show that the Surgeons caused or

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1 The hospital was dismissed as a party by the district court

on jurisdictional grounds and is not a party to this appeal.

exacerbated the injuries to his jaw. Because Gaviria’s claims

were given due consideration and because neither his pro se

brief nor Amicus’s demonstrates error by the district court, we

affirm.

 I.

Gaviria was injured in 1989, when he was struck on the

right side of his face and sustained a fractured jaw during an

arrest in Boston, Massachusetts. In May 1994, while in custody

at the D.C. Jail, he began to complain about “severe headaches”

and “severe problems on [his] right jaw.” Gaviria Decl. at 1.

He was taken to the now-defunct D.C. General Hospital where

he was diagnosed with a deranged right temporomandibular

joint (“TMJ”). A group of four surgeons performed a lengthy

operation to alleviate Gaviria’s pain on May 12, 1994. This

operation failed to resolve Gaviria’s condition, and four more

surgeries were performed: another in 1994 and three more in

1998. When Gaviria’s condition still did not improve, he filed

this lawsuit on September 29, 2000, against D.C. General

Hospital1

 and the Surgeons. After over a year passed, the

district court appointed counsel with Gaviria’s consent,

observing:

Defendants have been unable to resolve the matter on

threshold issues of jurisdiction. Given the nature and

complexity of the claims and the likelihood that [the

case] will need to be resolved on the merits, the Court

finds that appointment of counsel would be in the

interests of justice.

Order of Oct. 9, 2001 (citing D.D.C. CIV. R. 83.11(a)(4)(B)

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(amended 2001)). Patrick A. Malone, Esq., of the law firm

Stein, Mitchell & Mezines entered an appearance as appointed

counsel. Malone requested Gaviria’s medical records from the

Surgeons and forwarded the available records and films to Dr.

Jeffrey Gittleman, a dentist specializing in oral surgery

including TMJ problems, for his preliminary review. After Dr.

Gittleman reported to Malone that he “did not see anything

unusual” in the medical records of Gaviria’s first two surgeries

and that “problems like [Gaviria’s] are frequently never cured,”

Malone reported these findings in a letter to Gaviria and

withdrew from the case. The district court then granted

Gaviria’s request to proceed pro se.

In subsequent filings, Gaviria reconsidered his decision to

represent himself and sought additional court-appointed counsel.

In September 2002, the district court appointed counsel for the

limited purpose of mediation. One of the two mediation lawyers

spoke Spanish, Gaviria’s native tongue. In March 2003, Gaviria

requested that his mediation counsel be converted to permanent

counsel, but the district court refused because mediation counsel

had not consented. At the same time, the district court declined

to appoint another pro bono attorney pending the outcome of

mediation and discovery. After mediation failed and counsel

withdrew in September 2003, Gaviria renewed his request for

appointed counsel. In December 2003, the district court

“conclude[d] that a reappointment [was] not warranted” because

the court itself had assisted Gaviria in obtaining the records of

his surgeries from the government, mediation counsel also had

assisted with discovery, there was no indication that there were

remaining discovery issues, and a lawyer with whom Gaviria

had communicated had not consented to an appointment. Order

of Dec. 12, 2003.

Meanwhile, Gaviria made several requests for the district

court to appoint an independent expert witness. On each

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occasion, the district court refused. Despite Gaviria’s professed

difficulty with the English language and lack of knowledge of

the law, the district court concluded that Gaviria’s situation and

case “d[id] not present the type of compelling circumstances to

justify the exercise of any such discretionary authority.” Order

of July 10, 2002. In further explanation, the district court

remarked that “the first appointed counsel utilized the services

of an expert, who apparently could not render an opinion in

support of plaintiff’s case,” and that “medical records of recent

tests have been produced by the Bureau of Prisons which do not

appear to support his claims.” Order of Dec. 12, 2003. The

recent tests included a noncontrast enhanced CT scan of

Gaviria’s head at the University of Texas Medical Branch

Hospital in Galveston from which Dr. Harish S. Jhaveri reported

that “[b]oth temporomandibular joints are normal.” Gaviria’s

own attempts to find an expert proved unfruitful. At a March

2004 status conference, he told the district court that he had

consulted “too many” potential experts and “they say, I’m sorry,

they feel [for] my case, but they say it’s impossible.” Discovery

closed on May 30, 2004.

On August 9, 2004, the Surgeons filed a motion for

summary judgment. In granting the motion, the district court

acknowledged that expert testimony is “an essential element” of

a prima facie case of medical malpractice under District of

Columbia law and stated:

Plaintiff has not proffered a sworn statement or any

other evidence from the doctors at the Fort Worth

facility to support his claim pertaining to causation.

Nor does he claim that they can provide expert

testimony on the applicable standard of care.

Plaintiff’s bare representations are insufficient to create

a triable issue.

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2 D.D.C. CIV. R. 83.11(b)(3), as amended in 2001, now

provides:

When leave has been granted pursuant to 28 U.S.C. § 1915

for a pro se litigant to proceed in forma pauperis, the judge to

whom the case is assigned may, on application by the pro se

party or otherwise, appoint an attorney from the [Civil Pro

Bono] Panel to represent such party. The appointment should

be made taking into account:

(i) the nature and complexity of the action;

(ii) the potential merit of the pro se party’s claims;

(iii) the demonstrated inability of the pro se party to

retain counsel by other means; and

(iv) the degree to which the interests of justice will be

served by appointment of counsel, including the

Gaviria v. D.C. Gen. Hosp., Civ. No. 00-2350, mem. op. at 4

(D.D.C. Sept. 16, 2004). Gaviria appeals.

II.

No civil litigant is “guaranteed counsel,” Willis v. FBI, 274

F.3d 531, 532 (D.C. Cir. 2001), but district courts are authorized

by statute to “request an attorney to represent any person unable

to afford counsel,” 28 U.S.C. § 1915(e)(1). This court

concluded in Willis that Local Civil Rule 83.11(a)(4)(B) was the

appropriate metric for evaluating appointment of counsel and

that the district court’s decision would be vacated only for abuse

of discretion. 274 F.3d at 532. The Local Rule underwent a

minor amendment and renumbering in 2001 but is substantively

the same as relevant to this appeal and remains, therefore, an

appropriate framework for our review.2

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benefit the Court may derive from the assistance of

the appointed counsel.

Amicus contends that the district court erred in refusing to

reappoint counsel for Gaviria by providing “scanty reasoning”

that was “speculative and irrelevant.” Brief of Amicus Curiae

at 38. In particular, Amicus maintains that the district court

should have set forth the four factors of Local Civil Rule

83.11(b)(3) and explained how they were implicated in

Gaviria’s case. However, in light of the record of the

proceedings, the district court’s articulation sufficed to

demonstrate that it did not abuse its discretion.

After acknowledging that Rule 83.11 was controlling, the

district court concluded that a reappointment was unwarranted

because Gaviria had competently prosecuted his case with the

assistance of the district court. The district court noted that

Gaviria had contacted private counsel but that the attorney had

not entered an appearance. Further, the district court noted that

neither the response by the expert consulted by Gaviria’s first

appointed counsel (Malone) nor the recent CT scan results

supported the merits of Gaviria’s claims. Concluding that it had

worked to ensure Gaviria a “full and fair hearing on his

complaint,” the district court denied Gaviria’s request for

reappointment of counsel. Order of Dec. 12, 2003.

Despite its brevity, the district court’s discussion shows that

it considered each of the four factors of Rule 83.11(b)(3) and

does not constitute an abuse of discretion. To the contrary,

considering the factors independently, it is clear that the balance

of factors in the local rule weighs against Gaviria. While the

“nature and complexity of the action” initially favored Gaviria,

leading the district court to appoint counsel, this factor does not

weigh so much in his favor that any malpractice claim requires

a second appointment of counsel after initial counsel withdraws.

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The district court concluded that Gaviria had done an adequate

job prosecuting his case and that the difficulties had been

resolved with the assistance of the district court and prior

counsel. The potential merits of Gaviria’s claims favor the

Surgeons because there is no evidence that Gaviria’s claims

have merit—in the sense that he would be able to meet his

burden to show causation—and a growing body of

circumstantial evidence to suggest otherwise. Gaviria’s ability

to retain counsel by other means is probably a wash—he had

consulted other counsel who did not take his case, leaving this

court unable to distinguish between whether his case was

meritless or whether the attorney was uninterested in a pro bono

assignment. On the final factor, the “interests of justice,” the

district court noted that it “expended significant time and

resources in assuring that [Gaviria] receives a full and fair

hearing on his complaint” and that “[Gaviria] proceeded to

prosecute his case in a competent manner.” Order of Dec. 12,

2003. 

While the district court has a “plain duty . . . to appoint

counsel to assist” the plaintiff “[w]hen necessary to insure that

an indigent prisoner’s allegations receive fair consideration,”

Hudson v. Hardy, 412 F.2d 1091, 1095 (D.C. Cir. 1968),

Gaviria’s claims have been fleshed out, with the assistance of

initially appointed counsel and mediation counsel; his claims

just happen to be unsupported and perhaps unsupportable. In

the end, Gaviria’s claims fail because he has not been able to

produce anything beyond his own allegations to establish that he

has jaw problems, let alone that they were caused by the

Surgeons. Absent at least a preliminary showing of a

meritorious claim, there is no basis, in light of the district court’s

reasonable conclusion that Gaviria had ably handled his case

with the assistance provided, to conclude that the district court

abused its discretion in denying Gaviria’s request for new

counsel after the district court had appointed both initial counsel

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and mediation counsel and assisted him in obtaining discovery.

See Parham v. Johnson, 126 F.3d 454, 457 (3d Cir. 1997). 

III.

Federal Rule of Evidence 706(a) provides:

The court may on its own motion or on the motion of

any party enter an order to show cause why expert

witnesses should not be appointed, and may request the

parties to submit nominations. The court may appoint

any expert witnesses agreed upon by the parties, and

may appoint expert witnesses of its own selection.

Our standard for reviewing the district court’s refusal to

appoint an expert under Rule 706 is a matter of first impression.

Because the rule speaks in permissive terms and requires an

individualized case-specific determination, other circuits review

such denials for abuse of discretion. See Quiet Tech. DC-8, Inc.

v. Hurel-Dubois UK Ltd., 326 F.3d 1333, 1349 n.14 (11th Cir.

2003); Walker v. Am. Home Shield Long Term Disability Plan,

180 F.3d 1065, 1071 (9th Cir. 1999); Ledford v. Sullivan, 105

F.3d 354, 358 (7th Cir. 1997). We join these circuits.

Rule 706 provides no instruction as to when an expert

should be appointed except insofar as the district court “may” do

so. As for when the district court should appoint an expert,

Professors Wright and Gold suggest that “[w]hile Rule 706

provides no standard for determining when to appoint an expert,

the policy [of promoting accurate factfinding] underlying the

provision supplies some guidance.” CHARLES ALAN WRIGHT &

VICTOR JAMES GOLD, 29 FEDERAL PRACTICE AND PROCEDURE

§ 6304, at 465 (1997). Courts have hesitated to find any

affirmative obligation to exercise the Rule 706 power. See

Quiet Tech., 326 F.3d at 1348-49; Steele v. Shah, 87 F.3d 1266,

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1271 (11th Cir. 1996); Okla. Natural Gas Co. v. Mahan &

Rowsey, Inc., 786 F.2d 1004, 1007 (10th Cir. 1986); see

also WRIGHT & GOLD, supra, § 6304, at 469. While none of

these cases has involved expert testimony that forms part of a

plaintiff’s prima facie case, other courts to consider Rule 706

have required only that the district court actually exercise its

discretion and expressly articulate a reasoned explanation for its

determination. See Quiet Tech., 326 F.3d at 1348-49; Steele, 87

F.3d at 1270-71.

The district court acknowledged that expert testimony

consistent with Gaviria’s position was imperative to his case, but

it cannot follow that a court must therefore appoint an expert

under Rule 706 whenever there are allegations of medical

malpractice. Here, by relying upon an appointed attorney

specializing in medical malpractice (Malone) who had a

professional obligation (and a financial incentive) to unearth

evidence and by allowing Gaviria repeated opportunities to

come forward with substantiating evidence, the district court

was assured of receiving preliminary information about the

likely merits of Gaviria’s malpractice claims before having to

decide whether a formal appointment of an expert would be

necessary. As it turned out, the district court granted summary

judgment only after Gaviria acknowledged that he had been in

contact with many experts who had been unable or unwilling to

help, after appointed trial counsel consulted an expert who found

no likely fault with Gaviria’s first two surgeries, and after recent

medical tests by the Bureau of Prisons showed no continuing

TMJ problems.

It is difficult to understand what more Amicus would

require of the district court at this preliminary stage of the

proceedings. The district court understood that Gaviria’s claim

entailed possibly difficult medical questions and gave Gaviria

repeated opportunities to show that his claim had substance. In

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so doing, the district court was left, after full discovery, without

even a statement from Gaviria’s current doctors that something

had gone wrong in the prior surgeries and with an unexplained

five-year period between the initial injury to Gaviria’s jaw and

his first surgery. Although Amicus protests any reliance by the

district court on its own interpretation of the medical evidence,

we find no fault in the district court’s reliance at this preliminary

stage of the proceedings on the uncontroverted physician’s

opinions that in plain terms belie the premise of Gaviria’s

complaint. Cf. Daubert v. Merrell Dow Pharms., Inc., 509 U.S.

579, 592-93 (1993).

While it is true that Gaviria cannot prevail under District of

Columbia law without an expert witness, see Gubbins v. Hurson,

885 A.2d 269, 280 n.5 (D.C. 2005), it is fair to say that Gaviria’s

claims fail not because of the district court’s refusal to appoint

an expert witness but because of his broader failure to adduce

any evidence that the claims have merit. The district court and

mediation counsel guided Gaviria through discovery and,

through the efforts of appointed counsel, an expert examined the

medical records from Gaviria’s first two surgeries and found

that there was likely nothing wrong, a conclusion supported by

the subsequent medical tests forwarded to the district court by

the Bureau of Prisons. Under the circumstances, the district

court did not abuse its discretion in refusing to appoint an expert

witness.

IV.

Gaviria’s pro se brief likewise presents no basis for

reversing the grant of summary judgment to the Surgeons. He

contends that the district court erroneously resolved factual

matters on summary judgment that are relevant to his

previously-unmentioned constitutional claims. The thrust of his

argument is that “[t]he facts alleged by the plaintiff are evidence

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that the Surgeons were acting maliciously and sadistically to

cause harm.” Appellant’s Br. at 8. However, this assertion is

not enough for Gaviria to survive summary judgment on his

medical malpractice claims. See generally Anderson v. Liberty

Lobby, Inc., 477 U.S. 242, 247-56 (1986). To the extent that

Gaviria invokes the Constitution, he failed to include such a

claim in his complaint and he has not made allegations of

subjective indifference necessary to pursue this line of

argument. See, e.g., District of Columbia v. Air Fla., Inc., 750

F.2d 1077, 1084 & n.38 (D.C. Cir. 1984).

Accordingly, because Gaviria and Amicus fail to

demonstrate that the district court erred, much less abused its

discretion, in denying his requests for reappointment of counsel

and for an expert witness, we affirm the grant of summary

judgment. 

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