United States Court of Appeals

For the Eighth Circuit

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No. 17-2870

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D. Christian Wise; Cheryl Wise

 Plaintiffs - Appellants

v.

Mayo Clinic Rochester

 Defendant - Appellee

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Appeal from United States District Court

for the District of Minnesota - Minneapolis

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Submitted: October 17, 2018

Filed: December 19, 2018

[Unpublished]

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Before SHEPHERD, KELLY, and STRAS, Circuit Judges.

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PER CURIAM.
D. Christian and Cheryl Wise sued Mayo Clinic Rochester for medical

malpractice and lost. On appeal, they challenge the district court’s decision to 1

exclude the testimony of an expert witness at trial. We affirm.

After months of unexplained joint pain in his hips and shoulders, Christian

sought treatment from Dr. Thomas Osborn, a rheumatologist at Mayo Clinic

Rochester. Dr. Osborn was unable to identify the cause of Christian’s pain and

scheduled him for another visit. In the meantime, Dr. Osborn prescribed prednisone,

a corticosteroid, in increasingly larger doses to treat the pain. Other than telling

Christian to taper his dosage over time if possible, Dr. Osborn did not take any steps

to counteract the potential side effects of prednisone. 

Roughly ten weeks later, Christian again began suffering from pain, this time

in his lower back. Another doctor diagnosed him with four vertebral compression

fractures—possibly caused by steroid-induced osteoporosis, a side effect of

prednisone. He eventually underwent back surgery to fix the damage.

The Wises filed a lawsuit in federal district court against Mayo Clinic

Rochester for medical malpractice. Their theory was that Dr. Osborn should have

done more to counteract the bone-depleting side effects of prednisone. Their only

expert witness on this point was Dr. Harold Rosen, an endocrinologist who

specializes in treating patients with osteoporosis and has researched the risks of

prednisone. He was prepared to testify that Dr. Osborn failed to exercise reasonable

care when he prescribed prednisone without taking additional precautions to combat

its side effects. 

The Honorable Wilhelmina M. Wright, United States District Judge for the

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District of Minnesota.

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Midway through trial, the defense challenged Dr. Rosen’s ability to provide

expert medical testimony in the case. After both sides had a chance to question Dr.

Rosen, the district court ruled that he was “not qualified to testify regarding the

standard of care for prescribing prednisone under these circumstances” because he

did not have “practical training or experience with the specific treatment at issue.” 

Without an expert to testify on the standard of care, the Wises could not prove their

case. See Bigay v. Garvey, 575 N.W.2d 107, 111 n.4 (Minn. 1998) (explaining that

expert testimony on the applicable standard of care is required in a medicalmalpractice case). Accordingly, the district court granted judgment as a matter oflaw

to Mayo Clinic Rochester. 

The Wises argue that the district court abused its discretion when it excluded

Dr. Rosen’s testimony. See Stowell v. Huddleston, 643 F.3d 631, 634 (8th Cir. 2011). 

Because this is a diversity action arising under Minnesota law, Minnesota’s expertwitness rules apply. See id. at 633–34.

To testify about the standard of care, a proposed medical expert must have

“both sufficient scientific knowledge of and some practical experience with the

subject matter of the offered testimony.” Cornfeldt v. Tongen, 262 N.W.2d 684, 692

(Minn. 1977). The dispute here centers on the second requirement, practical

experience, and specifically on whether Dr. Rosen possessed “practical knowledge

of what is usually and customarily done by physicians under circumstances similar

to those which confronted [Dr. Osborn].” Id. (citation omitted); see also Stowell, 643

F.3d at 637 (stating that a court should not define the relevant circumstances so

broadly “that it enables an otherwise unqualified witness to offer expert opinion”). 

Here, the relevant circumstance was having prescribed prednisone to a patient like

Christian who suffered from unexplained joint pain.

Dr. Rosen acknowledged that he did “not see patientsin [this] setting” and that

he did not have “practical knowledge” of how a doctor would “usually and

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customarily” treat a patient like Christian. And he conceded that he prescribed

prednisone to his patients only “[i]nfrequently.” 

To be sure, Dr. Rosen testified that he had theoretical knowledge about the side

effects of prednisone and how to prevent them. This type of knowledge, however,

was not a substitute for practical experience. See Lundgren v. Eustermann, 370

N.W.2d 877, 880–81 (Minn. 1985) (holding that a proposed witness lacked the

requisite practical experience because he admitted that he had never prescribed the

drug at issue and did “not know how physicians themselves customarily use[d] [the

drug] in treatment of their patients”). The district court accordingly did not abuse its

discretion in excluding Dr. Rosen’s testimony. 

We affirm the judgment of the district court.

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