IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON

JASMINE HORNBEAK,

Appellant,

v.

KARAMJIT VIRK, D.C. and JANE/JOHN 

DOE VIRK, husband and wife, and the 

marital community composed thereof, 

and VIRK CHIROPRACTIC, P.S., d/b/a 

SOUTHCENTER CHIROPRACTIC, a 

Washington corporation,

Respondents.

DIVISION ONE

No. 84371-1-I

UNPUBLISHED OPINION

DWYER, J. — Jasmine Hornbeak filed a complaint against Karamjit Virk 

and his chiropractic practice for damages sustained due to a stroke Hornbeak 

suffered after receiving a chiropractic adjustment from Virk. The trial court 

granted Virk’s motion in limine to exclude Hornbeak’s primary expert witness and 

subsequently granted Virk’s motion for summary judgment dismissal of the 

complaint. Hornbeak appeals, asserting that the trial court incorrectly applied the 

Frye1 standard to exclude the expert testimony, which, according to Hornbeak,

was admissible pursuant to ER 702. Because summary judgment was 

appropriate regardless of the motion in limine ruling, we affirm.

 

1 Frye v. United States, 293 F. 1013 (D.C. Cir. 1923).
No. 84371-1-I/2

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I

In April 2020, Jasmine Hornbeak sued Karamjit Virk and his practice, Virk 

Chiropractic, Inc., P.S., alleging that his failure to follow the standard of care in 

the course of her treatment caused a basilar artery thrombosis, vertebral artery 

dissection, and an ischemic stroke. Hornbeak disclosed the anticipated 

testimony of two expert witnesses: Dr. Harold Rasmussen, who was expected to 

testify regarding Virk’s negligence in his treatment of Hornbeak, and Dr. David 

Lundin, who was expected to testify regarding the nature of Hornbeak’s injuries, 

treatment, and prognosis. 

After two depositions of Dr. Rasmussen, Virk moved in limine to exclude 

Dr. Rasmussen’s testimony on the grounds that it was speculative and that “his 

methodology, if any, is not generally accepted in the medical or scientific 

community pursuant to Frye and its progeny.” Hornbeak did not file a response

to Virk’s motion in limine, and the court granted the motion. Virk subsequently 

moved for summary judgment, which Hornbeak conceded was appropriate given 

the exclusion of Dr. Rasmussen’s testimony. The trial court granted the motion 

for summary judgment. 

Hornbeak appeals.

II

Hornbeak asserts that the trial court erred by excluding Dr. Rasmussen’s 

testimony and subsequently granting summary judgment dismissal of her 

complaint. Because summary judgment was appropriate regardless of the 

court’s ruling in limine, we affirm.
No. 84371-1-I/3

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We review a ruling on summary judgment de novo, considering all 

inferences in the light most favorable to the nonmoving party. Anderson v. Akzo 

Nobel Coatings, Inc., 172 Wn.2d 593, 600, 260 P.3d 857 (2011). Summary 

judgment is appropriate where there are no genuine issues of material fact and 

the moving party is entitled to a judgment as a matter of law. CR 56(c). 

RCW 7.70.040(1) authorizes a cause of action for injury resulting “from the 

failure of [a] health care provider to follow the accepted standard of care.” The 

necessary elements of this cause of action are:

(a) The health care provider failed to exercise that degree of 

care, skill, and learning expected of a reasonably prudent health 

care provider at that time in the profession or class to which he or 

she belongs, in the state of Washington, acting in the same or 

similar circumstances;

(b) Such failure was a proximate cause of the injury 

complained of.

RCW 7.70.040(1). Proximate cause is defined as a cause “‘that in natural and 

continuous sequence, unbroken by an independent cause, produces the injury 

complained of and without which the ultimate injury would not have occurred.’” 

Mehlert v. Baseball of Seattle, Inc., 1 Wn. App. 2d 115, 118, 404 P.3d 97 (2017) 

(quoting Attwood v. Albertson’s Food Ctrs., Inc., 92 Wn. App. 326, 330, 966 P.2d 

351 (1998)). 

A plaintiff must establish the applicable standard of care and proximate 

cause, generally by providing expert medical testimony. Keck v. Collins, 184 

Wn.2d 358, 370, 357 P.3d 1080 (2015). If the plaintiff lacks expert testimony 

regarding one of the required elements, the defendant is generally entitled to 

summary judgment on liability. Reyes v. Yakima Health Dist., 191 Wn.2d 79, 86, 
No. 84371-1-I/4

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419 P.3d 819 (2018). “Expert medical testimony must meet the standard of 

reasonable medical certainty or reasonable medical probability.” Anderson, 172 

Wn.2d at 606-07. Such evidence “must rise above speculation, conjecture, or 

mere possibility.” Reese v. Stroh, 128 Wn.2d 300, 309, 907 P.2d 282 (1995).

Here, Dr. Rasmussen opined that Virk breached the standard of care in 

several ways: by failing to properly document Hornbeak’s care, symptoms, and 

activities of daily living; by failing to perform certain diagnostic tests; by failing to 

create a treatment plan; and by using certain traction techniques. However, Dr. 

Rasmussen would not state that any of these breaches of the standard of care 

were more likely than not to a reasonable medical certainty the cause of

Hornbeak’s injury.

2

 Rather, as to any given breach, Dr. Rasmussen opined only 

that the breach may have possibly contributed to the injury. 

Regarding Virk’s breach of the standard of care in his testing practices, Dr. 

Rasmussen opined that “if you don’t do appropriate tests to rule . . . out [a 

stroke], that can be a direct cause.” However, he acknowledged that he could 

only speculate regarding whether any of the diagnostic testing he recommended 

would have indicated that there was such an injury. Similarly, regarding 

breaches of the standard of care in the documentation of Hornbeak’s treatment, 

Dr. Rasmussen opined that information documented by a practitioner could cue 

the practitioner to perform more diagnostic tests to rule out certain issues. He

acknowledged, however, that he did not know whether any information existed 

 

2 The statement of Dr. Rasmussen most closely approximating an indication of causation 

was his statement that “if you do not do a good job of everything as a practitioner, it’s all directly 

related to the cause.” 
No. 84371-1-I/5

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that could have cued Virk to rule out the possibility of an arterial dissection. 

Ultimately, when questioned regarding whether any of the identified failures to 

document could have prevented Hornbeak’s injury, Dr. Rasmussen stated, “I’m 

not going to say probable. I’m going to say possible.” Additionally, Dr. 

Rasmussen opined that the lack of treatment plan and the traction techniques 

employed by Virk did not cause Hornbeak’s injury. 

Hornbeak’s only other expert witness, Dr. Lundin, was expected to testify 

that the chiropractic manipulation performed by Virk likely caused the injury, but 

he would not be testifying that it was a deviation from the standard of care. Thus, 

this testimony would not establish liability. 

Given the anticipated expert testimony of Dr. Rasmussen and Dr. Lundin, 

summary judgment was appropriate. At most, the testimony would have 

established that Virk breached the standard of care and that his chiropractic 

manipulation caused Hornbeak’s injury. However, no anticipated testimony 

would have established that any of the breaches of the standard of care 

proximately caused that injury. The anticipated testimony regarding proximate 

cause would not “rise above speculation, conjecture, or mere possibility.” Reese, 

128 Wn.2d at 309. Accordingly, Virk was entitled to summary judgment on 

liability. Reyes, 191 Wn.2d at 86.3 

 

3 Hornbeak also claims on appeal that Dr. Rasmussen’s testimony that Virk failed to get 

informed consent was necessary for an informed consent cause of action. However, Hornbeak 

never pleaded such a cause of action, nor was the issue “tried by express or implied consent of 

the parties.” CR 15(b). Even if she had, Dr. Rasmussen acknowledged that “reasonably prudent 

patients” agree to the chiropractic adjustments at issue even with full informed consent. See

RCW 7.70.050(1) (necessary element of a claim for failure to secure informed consent is that “a 

reasonably prudent patient under similar circumstances would not have consented to the 

treatment if informed of” the material facts).
No. 84371-1-I/6

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Because summary judgment was appropriate regardless of the trial court’s 

ruling to exclude Dr. Rasmussen’s testimony, we need not reach that issue.

Affirmed.

WE CONCUR: