# U ni te d S ta te s Co ur t of A pp ea ls For the Eig hth Circu it

__ __ __ __ __ __ __ __ __ __ __ __ __ _ No. 1 7- 22 28

__ __ __ __ __ __ __ __ __ __ __ __ __ _ Lesl ie Grus si ng
ll ll ll ll ll ll ll ll ll ll l Pla in ti

ff - App el la nt

v.
Orth op ed ic an d S po rts Med ic in e, In c., A Mis so ur i Co rp or at io n; Co rey So lm an , Jr., M.D.

ll ll ll ll ll ll ll ll ll ll l Defe nd

an ts - App el le es

__ __ __ __ __ __ App eal fro m

Uni te d S ta te s Di st ric t Co ur t fo r th e Eas te rn Dis tri ct of M is so ur i - St . Lou is

__ __ __ __ __ __ Su bm it te d: Marc h 1 3, 2 01 8 Fi le d: Ju ne 12 , 20 18

__ __ __ __ __ __ Befo re WOL LMAN, SHEPHERD, and ERICKSON, Ci rcu it Ju dg es

.

__ __ __ __ __ __ W OLLMAN, Circ ui t J ud ge

.

Lesl ie Gru ss in g ap pe al s th e di st ric t co ur t’s de ni al of he r m ot io n fo r a ne w tri al 1

un de r Fed eral Ru le of Ci vi l Pro ced ur e 59 (a)( 1) (A), co nt en di ng th at th e di st ric t co ur t

The Hon or ab le Ch arl es A. Sh aw, Uni te d St at es Dis tri ct Ju dg e fo r th e East ern 1 Dis tri ct of M is so ur i.erro ne ou sl y li m it ed he r cro ss -ex am in at io n of th e de fen da nt s’ ex pe rt wit ne ss an d th at

it fai le d to co rrec t de fen se co un se l’s m is st at em en t of la w du rin g cl os in g arg um en t. W e aff irm.

I. Back gr ou nd

Dr. Co rey So lm an , Jr ., pe rfo rm ed art hr os co pi c su rg ery on Gru ss in g’s kn ee on Ju ne 26 , 20 14

. At he r po st -s ur ge ry fo ll ow- up ap po in tm en t on Ju ly 9, 20 14 , Gru ss in g rep or te d swe ll in g in he r kn ee to Dr. So lm an ’s ph y si ci a n as si st an t, Ja so n Gay

. Gay

reco m m en de d th at sh e at te nd ph y si cal th erap y to tre at he r sym pt om s. Dr. So lm an di d

no t ex am in e Gru ss in g d ur in g t hi s v is it

.

Gru ss in g ret ur ne d to Dr. So lm an ’s of fic e on Ju ly 18 , 20 14 , an d ag ai n rep or te d pa in an d swe ll in g. Dr. So l man as pi rat ed Gru ss in g’s kn ee, dr ai ni ng of f 60 cc of syno vi al flu id

. Dr. So lm an no ti ced th at th e flu id lo ok ed n o r mal as id e fro m a sm al l

am ou nt of b lo od an d t he refo re d eci de d n ot to tes t t he flu id for in fect io n.

Gru ss in g co nt in ue d to ex pe rie nc e pa i n a nd swe ll in g du rin g th e fo ll owi ng

m on th s. Sh e was se en by a di ffer en t ph y si ci an in Octo be r 20 14 , who as pi rat ed Gru ss in g’s k ne e an d sen t th e syno vi al flu id in fo r an al y si s. The te st res ul ts sh owe d th at th e kn ee was ch ro ni cal ly in fect ed , as a res ul t of whi ch Gru ss in g un de rwen t a pe rm an en t t ot al kn ee re pl acement i n F eb ru ary 20 15

.

Gru ss in g th erea fte r fil ed su it in fed eral di st ric t co ur t , w h i c h ha d juri sd ic ti on
ov er th es e di ve rs e pa rti es

. Gru ss in g al le ge d th at Dr. So lm an an d O r th op ed ic an d Sp or ts Med ic in e, In c. (co ll ect iv el y de fen da nt s) co m m it te d m ed ic al m al pr act ic e by fai li ng to di ag no se an d tre at a po st -s ur ge ry in fect io n in he r kn ee. The pr im ary is su e at tri al was wh et he r Dr. So lm an br each ed th e st an da rd of care whe n h e d eci de d n ot to te st th e syno vi al flu id as pi rat ed fro m Gru ss in g’s k ne e du rin g he r Ju ly 18 , 20 14 , ap po in tm en t.

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-Gru ss in g op en ed he r c a s e by pr es en ti ng Dr. So lm an ’s de po si ti on te st im on y ,

du rin g whi ch he ack no wled ge d t ha t fl ui d t ha t d oe s n ot ap pe ar t o b e cl ou dy can te st po si ti ve for ba ct eri al in fect io n.

Gru ss in g’s ex pe rt wit ne ss te st ifi ed th at be cau se Gru ss in g ha d su dd en
co m pl ai nt s of on se t pa in an d swe ll in g po s t

- s u r ge ry , th e syno vi al flu id sh ou ld ha ve be en se nt in fo r te st in g, an d th at Dr. So lm an ’s fai lu re to do so br each ed th e st an da rd of care ap pr op ria te to th e ci rcu m st an ces

.

The de fen se ’s ex pe rt wit ne ss , Dr. Mat t h e w M a ta va , di sa gr eed an d in st ead te st ifi ed th at th ere was no way to co nf irm th at Gru ss in g’s kn ee was in fect ed whe n sh e
was ex am in ed by Dr. So lm an on Ju ly 18 , 20 14 , be cau s e G r us si ng di d no t ex hi bi t

co ns ti tu ti on al si gn s of an in fect io n— fev er, red ne ss , swe at s, ch il ls , an d ab no rm al lo ok in g syno vi al flu id

. The fo ll owi ng ex ch an ge oc cu rred du rin g Dr. Mat av a’s cro ss
ex am in at io n:

Gru ss in g’s Co un se l: Oka y

. D i d [ D r

. S o l man ] a c t u a ll y ru le ou t in fect io n b y an y m ean s ot he r th an lo ok in g a t th e fl ui d?

Dr. Mat av a: He lo ok ed at th e flu id , he to ok th e co nt ex t o f th e pa ti en t’s hi st or y or la ck th ereo f in ru li ng ou t an in fect io n.
Gru ss in g’s Co un se l: And ag ai n, th at ’s rel y in g on hi s h i s t o r y, no t
an y bo dy els e’s?

Defen se Co un se l: You r Hon or , ob jecti on . Rep et it io us

. The Co ur t: [ C o u n s e l], y ou ke ep go in g ba ck to wha t a n d whe n on th is flu id

. Yo u n e e d t o qu it it an d
m ov e o n. Yo u k no w, I m ean

. . . Pl eas e.

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-Gru ss in g’s Co un se l: Can pe rfec tl y no rm a l l o o k i n g syno vi al flu id be in fect ed ?

Defen se Co un se l: You r Hon or , th is is rep et it io us as we ll

. The Co ur t: Su st ai ne d.

Gru ss in g’s Co un se l: I ha ve no t as ke d th at qu es ti on b e f o r e , Y o ur Hon or

. The Co ur t: W el l, y ou ’re n o t g o in g to as k it no w. Mo ve on fro m th is . No, m ov e o n.
Gru ss in g’s Co un se l: You r Hon or , th at ’s th e co re o f th e cas e.
The Co ur t: Lis te n, you h av e g on e o ve r th is en ou gh

.
Gru ss in g’s co un se l u lt im at el y m ov ed on to a di ffer en t t op ic

.

In hi s te st im on y du rin g th e de fen da nt s’ cas e-i n- ch ie f, Dr. So lm an ad m it te d th at in fect io n can no t be ru le d ou t ba se d so le ly on th e ap pe aran ce of syno vi al flu id

. Ph y si ci a n a s s is ta nt Gay al so te st ifi ed th at it was “ po ss ib le , bu t no t pr ob ab le ” fo r
no rm al lo ok in g s y no vi al flu id to be in fect ed

.

At th e cl os e of ev i d e n c e , a n d be fo re cl os in g arg um en ts to th e jury, th e co ur t read it s i ns tru ct io ns to th e jury, inc lu di ng th e fo ll owi ng :

In th es e in st ru ct io ns , y ou are to ld th at y ou r ve rd i c t d e pe nd s on whe th er or no t y ou be li ev e cert ai n pr op os it io ns of fact su bm it te d to y ou

. The bu rd en is up on th e pa rty who rel ie s u po n an y su ch pr op os it io n to
cau se y ou to be li ev e th at su ch pr op os it io n is m or e li ke ly to be tru e th an no t tru e. In de te rm in in g whe th er or no t y ou be li ev e an y pr op os it io n, y ou m us t con si de r on ly th e ev id en ce an d th e reas on ab le in fere nc es de riv ed fro m th e ev id en ce. I f t he ev id en ce in th e cas e do es no t cau se y ou to

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-be li ev e a pa rti cu la r pr op os it io n su bm it te d, th e n yo u can no t ret ur n a

ve rd ic t re qu iri ng be li ef o f th at pro po si ti on

.
You ha ve pr ob ab ly he ard th e ph ras e “ pr oo f be y on d a reas on ab le do ub t.” Tha t is a st ric te r st an da rd th an “ m or e li ke ly tru e th an no t tru e.” It ap pl ie s in cri m in al cas es , bu t no t in th is ci vi l cas e; so pu t it ou t of y ou r m in d.

D u r i n g cl os in g arg um en ts , Gr us si ng ’s c ou ns el ob jecte d to de fen se co un se l ’s st at em en t re ga rd in g t he bu rd en of p ro of :

Defen se Co un se l: I w a n t t o d i s c u s s b r i e f l y j u s t a f

e w in st ru ct io ns

. One of th os e is th e bu rd en of pr oo f. The pl ai nt iff ha s th e bu rd en of pr oo f in th is cas e. As in di cat ed a m om en t ag o, I be li ev e th e ev id en ce su pp or ts a ve rd ic t fo r Dr. So lm an

. And we do n’t ha ve an ob li ga ti on un de r th e la w to pr ov e an y th in g. I do n’t be li ev e pl ai nt iff ha s m et th ei r bu rd en

. I th in k

– b ut if y ou are jus t si tt in g th ere an d y ou are no t su re, th en th e la w req ui res th at y ou fin d in fav or of t he de fen da nt s.
A few ot he r in st ru ct io ns . One o f th em

. Gru ss in g’s Co un se l: Object io n, You r Hon or , th is is a m is st at em en t of th e la w, “ no t s ur e.”

The Co ur t: Co un se l.

Defen se Co un se l: You r Hon or –
The Co ur t: Fo ll ow t he in st ru ct io ns

. Defen se Co un se l: Yes

. And th e Co ur t wil l gi ve y ou th e b ur de n of pro of , what th at is . Mor e li ke ly tha n n ot

.

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-The Co ur t: W el l, i t’s i n t he in st ru ct io n.

Defen se Co un se l: Yes , You r Hon or

. The Co ur t: Yes

.
The co ur t pr ov id ed th e jury wit h writ t en co pi es of th e in st ru ct io ns pr io r to de li be rat io n, fol lo win g whi ch th e jury retu rn ed a ve rd ic t i n fav or of th e de fen da nt s,
an d t he di st ric t co ur t d en ie d Gru ss in g’s m ot io n fo r a n ew tr ia l.

II. Dis cu ss io n

“ W e rev ie w a di st ric t co ur t’s de ni a l o f a m ot io n fo r a ne w tri al fo r ab us e of di sc ret io n.” PFS Dist rib ut io n Co. v. Rad ue ch el , 57 4 F .3d 58 0, 58 9 (8t h Cir. 20 09 ).

Gru ss in g co nt en ds th at th e di st ric t co ur t co m m it te d rev ers ib le erro r in li m it in g th e cro ss -ex am in at io n of Dr. Mat av a reg ard in g whe th er no rm al loo kin g sy novi al flui d

can no ne th el es s be in fect ed

. Sh e arg ue s th at he r co un se l ha d no t pr ev io us ly as ke d th e qu es ti on th at th e co ur t de em ed r e p e t i t i ou s an d th at ha d co un se l be en al lo wed to

co m pl et e hi s cro ss -ex am in at io n, Dr. Mat av a wou ld ha ve te st ifi ed th at no rm al lo ok in g syno vi al flu id can be in fect ed

.

“ [E]rror whi ch m ig ht ari se fro m th e ex cl us io n of ev id en ce is ha rm le ss whe re th e sa m e fact s are pres en te d to th e jury th ro ug h ot he r ev id en ce.” Po rch ia v. Desi gn Equ ip . C o., 11 3 F.3 d 87 7, 88 1 (8 th C ir. 19 97 ). Dr. So lm an an d ph y si ci an as si st an t Gay bo th te st ifi ed t h a t i t was “ po ss ib le ” bu t “ no t pr ob ab le ” fo r no rm al lo ok in g syno vi al flu id to te st po si ti ve fo r in fect io n. The jury ha d earl ie r he ard Dr. So lm an ’s de po si ti on te st im on y th at flu id th at do es no t ap pe ar to be cl ou dy can te st po si ti ve fo r ba ct eri al in fect io n, whi ch was th e pr eci se ev id en ce th at Gru ss in g was ho pi ng to el ic it fro m Dr. Mat av a. Any erro r in li m it in g c ou ns el ’s q ue st io ni ng on th e gr ou nd th at it

was rep et it io us was t hu s h arm le ss

.
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-W e si m il arl y reject Gru ss in g’s as se rti on th at sh e sh ou ld be gr an te d a ne w tri al

be cau se of t he ob

jecte d- to st at em en t of la w d ur in g cl os in g a rg um en ts . A thr es ho ld is su e is whe th er fed eral or Mi ss ou ri la w co nt ro ls th e pr op rie ty of cl os in g arg um en ts in th is di ve rs it y c a s e

. G ru ss in g arg ue s th at Mi ss ou ri la w ap pl ie s. Our co ur t ha s st at ed , ho wev er, th at whe th er th e di st ric t co ur t e r red in pe rm it ti ng arg um en ts of

co un se l i s a p ro ced ur al qu es ti on th at sh ou ld be go ve rn ed by fed eral la w. See Kos te le c v. St at e Farm Fi re an d Cas

. Co ., 64 F.3 d 12 20 , 12 28 (8 th Ci r. 19 95 ) (li st in g
cas es ); se e al so Ban k of Am ., N.A. v. JB Han n a , LLC, 76 6 F.3 d 84 1, 85 1 (8 th Ci r. 20 14 ) (“Th e g r a n ti ng or de ni al of a ne w tri al is a m at te r of pr oc ed ur e go ve rn ed by fed eral la w.”) (in te rn al m ark s an d ci ta ti on om it te d)

. Fed eral la w gr an ts co ns id erab le di sc ret io n to th e tri al co ur t to co nt ro l arg um en ts

. Van sk ik e v. Uni on Pac. R. Co ., 72 5 F.2 d 1 14 6, 1 14 9 (8 th Cir . 19 84 ). W e wil l re ve rs e o nl y if th e st at em en ts m ad e were

“ pl ai nl y un warra nt ed an d c le arl y

in juri ou s.” Id

.

The di st ric t cou rt d id no t ab us e it s d is cret io n h ere. It co rrec tl y in st ru ct ed th e jury reg ard in g th e bu rd en of pr oo f be fo re an d aft er cl os in g arg um en ts ; it im m ed ia te ly ga ve a cu rat iv e in st ru ct io n du rin g arg um en ts ; an d th e co rrec t bu rd en of pr oo f w as pr op erl y em

ph as iz ed th ro ug ho ut tri al

. W e th us co nc lu de th at de fen se co un se l’s st at em en t was no t so pl ai nl y un warra nt ed or so in juri ou s as to req ui re a ne w tri al

. See Ci ty of Mal de n v. U n i o n El ec. Co ., 88 7 F.2 d 15 7, 16 4- 65 (8 th Ci r. 19 89 ) (h ol di ng t h a t a ne w t ria l is no t warra nt ed whe n th e di st ric t co ur t pr op erl y in st ru ct ed th e jury

co nc ern in g it s du ty an d th ereb y cu red an im pr op er in st ru ct io n th at ha d be en pr ev io us ly gi ve n by de fen se du rin g cl os in g arg um en ts ); se e al so Uni te d St at es v. Voi ce, 62 2 F.3 d 87 0, 87 5 (8 th Ci r. 20 10 ) (h ol di ng th at th e di st ric t co ur t su ffi ci en tl y
co rrec te d a m is st at em en t of go ve rn in g la w in cl os in g arg um en ts whe n i t in st ru ct ed th e jury to “ rel y

on th e jury ins tru ct io ns th at I ga ve y ou for what th e la w m ean s” ).

The jud gm en t i s af

fir m ed

.

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