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STATE OF MICHIGAN 

COURT OF APPEALS 

ROY RUSHA, 

 Plaintiff-Appellant, 

UNPUBLISHED 

October 4, 2016 

v No. 326745 

Wayne Circuit Court 

ADAM M EDELMAN MD, BADAI 

ABDELATIF MD, RAMESH KILARU MD, 

LISA REEVES MD, CORIZON HEALTH OF 

MICHIGAN a/k/a CORIZON HEALTH INC f/k/a 

PRISON HEALTH SERVICES (PHS), and 

CORIZON INC d/b/a CORRECTIONAL 

MEDICAL SYSTEMS, 

LC No. 13-006487-NH 

 Defendant-Appellees, 

and 

JEFFREY STIEVE MD, VASILIOS POZIOS MD, 

and PATRICK GEML PA, 

 Defendants. 

Before: SHAPIRO, P.J., and HOEKSTRA and RONAYNE KRAUSE, JJ. 

PER CURIAM. 

 Plaintiff appeals by right the trial court’s grant of summary disposition in favor of the 

defendants who remained in the case after various dismissals not at issue in this appeal.1

 The 

trial court accurately summarized that “[t] he gravamen of plaintiff’s claim is that he was 

diagnosed with multiple sclerosis (‘MS’) and that he had a seizure disorder and that he was not 

given proper treatment [by defendants] while incarcerated. As a result, plaintiff contends, the 

conditions were allowed to progress when they could have been effectively controlled with 

proper medical treatment.” The trial court disallowed plaintiff’s treating physician from 

presenting evidence as an expert, and it therefore concluded that plaintiff’s remaining experts 

 

1

 For convenience, “defendants” will refer only to the defendants presently at issue. 
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could not “quantify loss or probability that plaintiff’s result would have been different had 

plaintiff been referred to a neurologist [as plaintiff contended].” The trial court further 

characterized the matter as a “lost opportunity to achieve a better result” claim and, because 

plaintiff could not establish the statutorily required “greater than 50%” loss of opportunity under 

MCL 600.2912a(2), granted summary disposition in favor of defendants. We do not find the 

trial court’s exclusion of the expert to be error under the circumstances, but the trial court 

incorrectly found this to be a “lost opportunity” case. Rather than attempt to evaluate 

defendants’ alternate ground for affirmance on the existing record, we vacate and remand for 

further proceedings. 

I. OVERVIEW 

 Plaintiff was incarcerated in a facility that contracted with defendants to provide medical 

services to inmates. Plaintiff contends that he suffered from multiple sclerosis. It is undisputed 

that he saw defendants numerous times for a variety of ailments. It is also undisputed that 

defendants did not, inter alia, refer plaintiff to a neurologist, treat him for MS, or, apparently, 

believe that he had MS. Plaintiff contends that defendants improperly treated him. Whether or 

not defendants actually improperly treated him is not at issue in this appeal. The evidence, 

chaotic as it is, appears to indicate, insofar as we can determine, that plaintiff did consistently tell 

defendants that he had a history of MS during his treatment with them. Furthermore, the 

evidence indicates that defendants did actually take plaintiff’s reports seriously enough to review 

the records available to him and perform some diagnostic tests, and they concluded that he did 

not have MS. Plaintiff was diagnosed with MS after his release. Some medical records indicate 

that he may have received a diagnosis earlier, but defendants seemingly did not receive those 

records until after plaintiff’s discharge. 

II. PROCEDURAL HISTORY 

 The tortuous procedural history of this case is, unfortunately, relevant to one of the issues 

on appeal. Plaintiff filed his complaint on May 17, 2013. The trial court entered a scheduling 

order on October 29, 2013, requiring witnesses to be exchanged by January 24, 2014, and cutting 

off discovery on March 28, 2014. A settlement conference was scheduled for the “Case 

Evaluation date Plus 42 days”; although case evaluation was not specified more narrowly than 

“May, 2014.” Defendants filed a motion for partial summary disposition on July 30, 2013, and a 

motion to limit the affidavits of merit on August 9, 2013. The trial court entered a scheduling 

order on July 30, 2013, setting a hearing on the motion for partial summary disposition for 

December 20, 2013; however, the lower court register of actions indicates that it was reset to 

January 31, 2014, and then to January 23, 2014, although we can find no orders obviously doing 

so in the lower court record. The trial court subsequently entered several substantively identical 

orders on November 11, 2013, December 19, 2013, and December 20, 2013; one of which 

referenced the motion to limit affidavits of merit and the others did not reference any motion 

whatsoever, stating that oral argument was scheduled for January 31, 2014, and that responses to 

the motion were due by January 17, 2014. 

 Defendants filed a witness list on January 22, 2014. We can find no order specifying a 

hearing date of January 23, 2014. Nevertheless, on January 23, 2014, the trial court entered an 

order granting partial summary disposition in favor of defendants and dispensing with oral 
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argument because plaintiff had not filed a timely response. Plaintiff filed a response to the 

motion for partial summary disposition the next day. Apparently, a hearing was in fact held on 

January 31, 2014, where plaintiff contends he first learned of the order and the untimeliness of 

his response. Plaintiff admitted that he had, however, received the scheduling order specifying a 

January 17, 2014, deadline and had overlooked it. On February 18, 2014, defendants filed a 

motion to dismiss and/or for discovery sanctions based on plaintiff’s failure to file a witness list 

and otherwise comply with discovery orders. The lower court register of actions reflects a 

motion hearing held on March 12, 2014, no transcript of which has been provided. On the same 

day, the trial court entered an order requiring plaintiff to file his witness list within ten days and 

keeping discovery “open to the settlement conference date.” The trial court otherwise denied 

plaintiff’s motion for reconsideration, stating that plaintiff had received the scheduling order but 

failed to open it. 

 Plaintiff filed his 43-page witness list the same day, on March 12, 2014. In relevant part, 

Dr. David Mathis, M.D., was listed as plaintiff’s expert “in the field of Primary Care/Family 

Practice,” and Dr. Neil J. Farber, M.D., was listed as plaintiff’s expert “in the field of Internal 

Medicine.” Several other doctors were noted as potential “standard of care and/or proximate 

cause” witnesses. Notably, however, Dr. Omar Ahmad, M.D., the expert witness at issue, was 

not named anywhere on that list, in any capacity. Although the witness list included “Any and 

all physicians, nurses, therapists, technicians, assistants, aides, agents and/or employees, 

involved in the case and treatment of Roy Rusha at [various institutions], including, but not 

limited to” the individually named persons; according to his CV, Dr. Ahmad is associated with 

the Michigan Neuroscience Clinic, which was not among the institutions named. 

 However, defendants were actually aware of Dr. Ahmad and that Dr. Ahmad was one of 

plaintiff’s post-incarceration treating physicians.2

 Defendants do not dispute that on August 19, 

2014, they served notice on Dr. Ahmad for taking his deposition and to produce records on 

August 29, 2014. Just over a week later, defendants re-noticed Dr. Ahmad’s deposition for a 

different date. Defendants subsequently cancelled the deposition altogether. 

 On April 14, 2014, the parties stipulated to adjourn case evaluation. The trial court 

entered an order setting case evaluation for July of 2014 and holding “[d]iscovery open to new 

evaluation date.” In the meantime, defendants moved to compel discovery, arguing that they had 

served various discovery requests on plaintiff, responses to which had been due in October of 

2013 but most of which remained outstanding. Almost two months later, the trial court entered 

an order requiring plaintiff to “provide the remaining discovery within 14 days” and “provide 

available dates for his deposition within 7 days.” The trial court subsequently granted what was 

apparently a unanimous request by all parties to further extend discovery by handwriting on a 

 

2

 As will be discussed, the trial court’s ruling expressly permitted plaintiff to offer testimony 

from Dr. Ahmad as a factual witness as one of plaintiff’s treating physicians, but not as an expert

witness. 
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faxed letter3

 that the settlement conference would be pushed back by a month and discovery 

would remain open to that date. 

 In October, plaintiff filed a motion seeking to extend discovery. Plaintiff stated that by 

then, the settlement conference was set for October 4, 2014. Plaintiff did not specifically name 

Dr. Ahmad, but did assert that defense counsel had unilaterally cancelled a number of 

depositions without any consultation with plaintiff’s counsel. Defendants responded by arguing 

that discovery had been extended multiple times already due to various failures on plaintiff’s part 

and that defendants had been entirely cooperative. In support of the latter assertion, defendants 

attached a tome of printouts of various email correspondences between counsels. The trial court 

ultimately granted plaintiff a small measure of relief and ordered that “Plaintiff may depose 

Defendants’ standard of care experts (only) within 30 days (on or before November 30, 2014).” 

 Defendants had, in the meantime, also filed a motion for summary disposition arguing 

that on the basis of the testimony from plaintiff’s expert witnesses, plaintiff was unable to 

establish a prima facie case of medical malpractice. In relevant part, defendants argued that 

plaintiff’s malpractice claim was based on “[lost] opportunity to achieve a better result.” 

Defendants also argued that plaintiff’s experts, not being neurologists, could not actually render 

an opinion whether defendants’ actions proximately caused anything, so a “traditional” medical 

malpractice analysis must also fail. The trial court entered a scheduling order setting a hearing 

date for February 6, 2015, and requiring plaintiff’s response to be filed and served by 4:00 pm on 

January 23, 2015. 

 Plaintiff responded that he had provided evidence showing that he suffered direct harm in 

the form of actual, not speculative, degeneration of his MS condition. He alleged that during his 

incarceration, defendants ignored his medical history and his symptoms of MS, and they refused 

to treat him or permit him to be treated properly. Plaintiff attached, for the first time, an affidavit 

from Dr. Ahmad. The affidavit set forth several opinions held by Dr. Ahmad as well as several 

statements of fact based on Dr. Ahmad’s treatment of plaintiff. Plaintiff’s response was filed at 

4:21:52 pm on January 23. Defendants pointed this tardiness out in their reply, as well as the 33-

page length thereof in violation of MCR 2.119(A)(2). 

 Defendants contended, baldly, that plaintiff had conceded that the case was a “lost 

opportunity” action.4 Defendants also argued that Dr. Ahmad’s affidavit should be struck 

because he had not been on plaintiff’s witness list, that the affidavit was speculative and did not 

support plaintiff’s position in any event, and that plaintiff’s own evidence showed that he had not 

really suffered any harm. The trial court held a brief hearing at which plaintiff reiterated that 

 

3

 We cannot find an independent copy of that document in the record, or indeed any other order 

to that effect. The lower court register of actions reflects nothing on that date. However, it does 

state in a note regarding case evaluation later that its date had been changed “per p/c/ from court 

on 6/12.” 

4

 As we will discuss in greater detail, we find absolutely no such concession anywhere in any 

pleading from plaintiff. 
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defendants had known of Dr. Ahmad and cancelled the deposition themselves, that he was not 

pursuing a lost opportunity claim, and that he had complied with scheduling orders. 

 The trial court ruled that Dr. Ahmad would not be permitted to testify as an expert 

because he had not been listed as one, but that Dr. Ahmad would be permitted to testify as a fact 

witness. The trial court took the remainder of the motion under advisement. The trial court 

subsequently entered an opinion and order that, in relevant part, seemingly assumed without 

analysis that the instant action was, in fact, a “lost opportunity” claim. The trial court concluded 

that even if it took as a given that plaintiff did have MS prior to entering prison, without Dr. 

Ahmad’s affidavit, plaintiff’s remaining experts presented only equivocal testimony and could 

not establish the requisite proximate causation. The trial court therefore granted summary 

disposition in favor of defendants. The trial court subsequently denied plaintiff’s motion for 

reconsideration, clarifying that it found the claim to be a “lost opportunity” one based on 

plaintiff’s assertion that if defendants had treated him properly, plaintiff “lost 100% chance of 

avoiding further progression and advancement of his disease.” This appeal followed. 

III. STANDARD OF REVIEW 

 A grant of summary disposition under MCR 2.116(C)(10) is reviewed de novo on the 

basis of the entire record to determine if the evidence, when viewed in the light most favorable to 

the non-moving party, establishes a genuine issue regarding any material fact. Maiden v 

Rozwood, 461 Mich 109, 118-120; 597 NW2d 817 (1999). The trial court’s decision whether to 

admit evidence is reviewed for an abuse of discretion, but preliminary legal determinations of 

admissibility are reviewed de novo; it is necessarily an abuse of discretion to admit legally 

inadmissible evidence. People v Gursky, 486 Mich 596, 606; 786 NW2d 579 (2010). This Court 

otherwise reviews de novo the trial court’s determinations of law; however, any factual findings 

made by the trial court in support of its decision are reviewed for clear error, and ultimate 

discretionary decisions are reviewed for an abuse of that discretion. Herald Co, Inc v Eastern 

Mich Univ Bd of Regents, 475 Mich 463, 470-472; 719 NW2d 19 (2006). Under the abuse of 

discretion standard, this Court “cannot disturb the trial court’s decision unless it falls outside the 

principled range of outcomes.” Id. at 472. The trial court has the discretion to disallow 

testimony from a witness not properly listed on a witness list, but the trial court must carefully 

consider the circumstances of the case to determine whether such a drastic sanction is truly the 

most appropriate sanction. MCR 2.401(I)(2); Duray Development LLC v Perrin, 288 Mich App 

143, 162, 164-165; 792 NW2d 749 (2010). 

IV. DR. AHMAD AS AN EXPERT WITNESS 

 Resolution of this appeal turns in significant part on the second issue raised by plaintiff, 

which we address first: whether the trial court properly excluded Dr. Ahmad from testifying as 

an expert witness. “The purpose of witness lists is to avoid ‘trial by surprise.’” Grubor 

Enterprises Inc v Kortidis, 201 Mich App 625, 628; 506 NW2d 614 (1993). “[T]he mere fact

that a witness list was not timely filed does not, in and of itself, justify the imposition of [barring 

an expert witness or dismissing an action].” Dean v Tucker, 182 Mich App 27, 32; 451 NW2d 

571 (1990). Conversely, the trial court’s failure to ensure that the record reflects the trial court’s 

consideration of the circumstances of the case and the alternatives available does not, in and of 

itself, constitute an abuse of its discretion, unless the record otherwise manifestly shows that 
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such a sanction was appropriate. See id. at 33-34; see also Duray Dev, 288 Mich App at 165. A 

nonexhaustive list of factors that should be considered includes: 

(1) whether the violation was willful or accidental; (2) the party’s history of 

refusing to comply with discovery requests (or refusal to disclose witnesses); (3) 

the prejudice to the defendant; (4) actual notice to the defendant of the witness 

and the length of time prior to trial that the defendant received such actual notice; 

(5) whether there exists a history of plaintiff’s engaging in deliberate delay; (6) 

the degree of compliance by the plaintiff with other provisions of the court’s 

order; (7) an attempt by the plaintiff to timely cure the defect[;] and (8) whether a 

lesser sanction would better serve the interests of justice. [Duray Dev, 288 Mich 

App at 165, quoting Dean, 182 Mich App at 32-33.] 

“In exercising its discretion, the trial court should [also] determine whether the party can prove 

the elements of its position based solely on the parties’ testimony and any other documentary 

evidence.” Grubor Enterprises, 201 Mich App at 629. 

 As an initial matter, the trial court’s stated reasoning for excluding Dr. Ahmad as an 

expert witness is a single sentence that suggests that the trial court did not consider any 

circumstance of the case other than plaintiff’s tardiness, although as noted, the trial court also did 

not impose the most drastic sanction possible. There is no requirement that the trial court 

pontificate ad nauseum. See MCR 2.517(A)(2). However, we find that the trial court’s 

statements do not rise to the level of the “[b]rief, definite, and pertinent findings and 

conclusions” required by the court rule. Consequently, the resolution of this issue turns on 

whether the trial court’s decision was so clearly proper that no other option would have been 

reasonable. 

 It is clear from the record that the trial court did in fact consider more than just plaintiff’s 

tardiness. The trial court permitted plaintiff the opportunity to show that in fact Dr. Ahmad had

been indirectly or impliedly included in the witness list, but there is no evidence in the record 

that plaintiff was able to do so. Defendants point out that plaintiff missed numerous deadlines, 

had in fact only filed his witness list because he was directly ordered to do so, and first disclosed 

Dr. Ahmad as an expert only in response to defendants’ motion for summary disposition. 

Plaintiff focuses on the fact that formalities notwithstanding, defendants had actually been aware 

of Dr. Ahmad for some considerable period of time and even voluntarily gave up their own 

efforts to depose him. 

 We find no abuse of discretion in the trial court’s decision to permit plaintiff to call Dr. 

Ahmad as a factual witness but not as an expert. Defendants were well aware that Dr. Ahmad 

was plaintiff’s treating physician, and they had access to Dr. Ahmad’s records, so they could not 

have been surprised by the content or relevancy of his factual testimony. We are not persuaded 

by defendants’ argument that plaintiff willfully flouted deadlines, but the record amply supports 

defendants’ observation that plaintiff had missed many deadlines and the trial court had been 

generous in extending leeway to plaintiff. Mere untimely disclosure of Dr. Ahmad as an expert

would be an insufficient basis by itself to bar his testimony as an expert, but we find no abuse of 

discretion in finding that disclosure to be egregiously late here, rather than a mere failure to 

comply with a technicality, especially in light of plaintiff’s other tardiness. It was not 
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unreasonable for the trial court to exercise its discretion to impose the limited sanction of 

precluding plaintiff from utilizing Dr. Ahmad as an expert, while permitting him to testify as a 

fact witness, that “late in the game.” The trial court’s decision in this regard is not “outside the 

principled range of outcomes.” Herald Co, 475 Mich at 472. 

 We therefore need not consider defendants’ alternate asserted bases for affirming the trial 

court’s decision. 

V. NATURE OF PLAINTIFF’S CLAIM 

 Plaintiff also argues on appeal that the trial court erred in concluding that his claim is a 

“lost opportunity” claim. We agree. 

 The gravamen of plaintiff’s claimed injury, as set forth in the complaint, is: 

¶ 98: Due to the lack of medication, Mr. Rusha’s MS advanced prematurely and 

be [sic] began experiencing seizures and other MS symptoms including 

numbness, tingling, and left-sided weakness. 

* * * 

¶ 109: To this day, Plaintiff continues to suffer neurological deficits as a result of 

the progression of his MS due to the failure of the Defendants to properly treat 

him. 

* * * 

¶ 122: As a direct and proximate result of the acts of general negligence, medical 

negligence, gross negligence and/or wanton or reckless misconduct and/or 

reckless disregard for the safety of the Plaintiff, Defendants, either directly or 

through their agents, servants and/or employees caused Plaintiff’s seizures and 

MS to worsen and caused pain, suffering disfigurement [sic], loss of function and 

disability which otherwise would not have occurred. Such acts were a significant 

contributing factor in causing the damages complained of thereof [sic]. 

Consequently, the gravamen of plaintiff’s claim is that he directly suffered a concrete injury as a 

consequence of defendants’ alleged improper care, and that injury was both symptoms of MS he 

suffered during his incarceration because of non-treatment and accelerated degeneration of his 

MS. 

 We note that we are baffled by defendants’ conclusion that this is a “lost opportunity for 

a better result” claim. Both here and in the trial court, defendants simply state it baldly. We are 

further baffled by the trial court’s unexplained adoption of that conclusion with no stated 

analysis or apparent consideration. In so doing, the trial court took one statement from plaintiff 

out of context to justify its conclusion, even though that statement was clearly made by plaintiff 

in response to and disputing defendants’ assertion that he was advancing a “lost opportunity” 

claim. Courts, however, should look to the substance of a claim or transaction, not pure 
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superficial details. See In re Traub Estate, 354 Mich 263, 278-279; 92 NW2d 480 (1958); 

Wilcox v Moore, 354 Mich 499, 504; 93 NW2d 288 (1958). 

 We emphasize that we express no opinion whatsoever as to the substantive merits of 

plaintiff’s claim. Whether or not it can be proven, plaintiff has consistently alleged that he was 

actually harmed by defendants’ alleged malpractice, not that he suffered an increased risk of 

harm due to the alleged malpractice. This is precisely the critical distinction between the two 

theories of medical malpractice. See Compton v Pass, 485 Mich 920, 921; 733 NW2d 664 

(2009); Stone v Williamson, 482 Mich 144, 151-162 (TAYLOR, C.J.), 166-171 (CAVANAGH, J); 

753 NW2d 106 (2008). The only way to arrive at defendants’ and the trial court’s interpretation 

of plaintiff’s claims is to conclude that past pain and suffering and/or actual degeneration in a 

person’s physical condition are not, themselves, cognizable injuries. Such a conclusion has no 

basis in law. Whether or not the proofs will ultimately support it, plaintiff clearly, 

unambiguously, and consistently articulated a traditional medical malpractice action asserting 

that defendant’s alleged malpractice directly caused him an actual injury. 

 Defendants argue in the alternative that plaintiff also cannot prevail under a traditional 

medical malpractice theory. Under the circumstances, we decline to consider that argument at 

this time. Rather, we conclude that the traditional medical malpractice argument is better 

directed at the trial court, which has the discretion, should it wish to use it, to require or permit 

the parties to conduct additional briefing or discovery in light of this Court’s resolution of the 

two issues addressed above. We express no opinion as to the merits of defendants’ alternate 

argument. 

VI. CONCLUSION 

 The trial court’s ruling as to Dr. Ahmad is affirmed. However, the trial court’s finding 

that this case is a “lost opportunity” case was erroneous, and therefore the trial court’s grant of 

summary disposition is vacated. We remand this matter to the trial court for further proceedings 

consistent with this opinion as the trial court deems necessary or proper. We do not retain 

jurisdiction. No costs, neither party having prevailed in full. 

/s/ Douglas B. Shapiro 

/s/ Joel P. Hoekstra 

/s/ Amy Ronayne Krause