Source: http://oh.findacase.com/research/wfrmDocViewer.aspx/xq/fac.20180404_0000504.NOH.htm/qx
Timestamp: 2019-04-24 09:58:23+00:00

Document:
MARC J. McNAUGHTON, et al., Defendants.
This matter comes before the Court upon the Motion (ECF DKT #83) of Defendants, Marc J. McNaughton, M.D. and Prime Health, Inc., in Limine to Preclude Testimony or Argument based on Testimony of Dr. Lawrence Mendel. The Court determined that the Motion was in the nature of a Daubert challenge; and therefore, ordered a hearing which was conducted on April 3, 2018.
This civil rights and wrongful death action was initially filed on January 8, 2015, against Lake County, Lake County Sheriff Daniel A. Dunlap, Nita L. Brickman, Marc J. McNaughton, M.D. and Prime Health, Inc. An Amended Complaint was filed on July 27, 2016. On August 16, 2016, Defendants Brickman, Lake County and Dunlap were dismissed with prejudice from the lawsuit pursuant to Stipulation (ECF DKT #54 & #55).
Plaintiff's decedent, Dondrea Carter, was an inmate at the Lake County Adult Detention Facility (“LCADF”) in May of 2014 when she complained of chest pain, jaw pain, dizziness, nausea and anxiety. Nurse Brickman administered an EKG, provided Dondrea with four packets of Pepto Bismol and returned Dondrea to her cell. Brickman informed Dr. McNaughton, the jail physician, when he arrived later, of Dondrea's medical complaints and that the results of the EKG were normal. Dr. McNaughton did not see Dondrea nor did he review the EKG results. A short time afterward, Dondrea was found unresponsive in her cell. She was transported to the local ER where she died on May 26, 2014, from a heart attack due to atherosclerotic coronary artery disease.
Donise Carter, Dondrea's mother and administratrix of her estate, brings this action for wrongful death, malpractice, negligence and violation of the Fourteenth and Eighth Amendments to the United States Constitution under 42 U.S.C. § 1983. Plaintiff alleges that Defendants failed to provide adequate medical care to Dondrea Carter, an inmate in the LCADF. Plaintiff specifically contends that McNaughton's inaction amounted to deliberate indifference to Dondrea's serious medical needs.
Plaintiff's civil rights claim relies upon the Eighth Amendment's cruel and unusual punishment clause which obligates the government to provide medical care for individuals punished by incarceration. Estelle v. Gamble, 429 U.S. 97, 103 (1976). “Treatment of a prisoner violates the Eighth Amendment when it constitutes ‘deliberate indifference to [the] prisoner's serious illness or injury.'” Estelle, 429 at 104-05; Jones, 845 F.Supp.2d at 834. To establish an Eighth Amendment claim, a plaintiff must prove both an objective and a subjective component. Jones v. Muskegon Cty., 625 F.3d 935, 941 (6th Cir. 2010), citing Farmer v. Brennan, 511 U.S. 825, 834 (1994). The objective aspect requires proof of a “sufficiently serious” medical need. Id. To meet the subjective burden, a plaintiff must demonstrate that the official being sued: (1) subjectively knew of a risk to the inmate's health, (2) drew the inference that a substantial risk of harm to the inmate existed, and (3) consciously disregarded that risk. Jones, 625 F.3d at 941, citing Farmer, 511 U.S. at 837. “Deliberate indifference” means more than mere negligence, but less than acting purposefully or with knowledge that harm will result. Farmer, 511 U.S. at 835.
Plaintiff's state law claims of wrongful death and medical malpractice require Plaintiff to demonstrate by a preponderance of the evidence that Defendant McNaughton deviated from the ordinary standard of care exercised by physicians in the relevant medical community and that the deviation was the proximate cause of Plaintiff's injury.
Plaintiff offers the expert testimony of Dr. Lawrence Mendel, who is licensed to practice medicine in Ohio and is certified by the American Osteopathic Board of Family Practice. Mendel is also a Certified Correctional Healthcare Professional, National Commission on Correctional Healthcare and a Fellow, Society of Correctional Physicians.
In their Motion in Limine, Defendants assert that Dr. Mendel does not opine that McNaughton's care exhibited deliberate indifference to a serious medical need. Defendants criticize Dr. Mendel's opinion that physicians in a jail setting must perform a comprehensive evaluation of a patient's chest pain, including reviewing EKG results, within one hour of the patient reporting chest pain. Finally, Defendants argue that Dr. Mendel's opinion on proximate causation is only speculative.
Pursuant to Federal Rule of Evidence 702, an expert by virtue of knowledge, skill, experience, training or education may provide testimony to assist the trier of fact to understand the evidence or to determine a fact in issue if the expert testimony is based on sufficient facts or data; the testimony is the product of reliable principles and methods; and the expert has applied the principles and methods reliably to the facts of the case.
The standard set in Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579 (1993) requires “that an expert's opinion be based on a foundation grounded in the actual facts of the case, that the opinion is valid according to the discipline that furnished the base of special knowledge, and that the expert appropriately “fits” the facts of the case into the theories and methods he or she espouses.” Redmond v. United States, 194 F.Supp.3d 606, 615 (E.D.Mich. 2016) (citing Daubert, 509 U.S. at 591-93). “[E]xpert testimony is not admissible unless it will be helpful to the factfinder.” Redmond, Id. Expert testimony is not helpful when it is unreliable or irrelevant or “when it merely deals with a proposition that is not beyond the ken of common knowledge.” Id. “The proponent of expert testimony must establish all the foundational elements of admissibility by a preponderance of proof.” Nelson v. Tenn. Gas Pipeline Co., 243 F.3d 244, 251 (6th Cir. 2001) (citing Daubert, 509 U.S. at 592 n.10).
“The expert's opinion must be expressed in terms of probability, not possibility; while no “magic words” are required, the opinion must be couched within the reasonable degree of certainty.” Rorick v. Silverman, No. 1:14-cv-312, 2015 WL 9303125, *6 (S.D.Ohio Dec.12, 2015) (quoting Ochletree v. Trumbull Mem. Hosp., No. 2005-T-0015, 2006 WL 533502, *6 (Ohio App. 11th Dist. Mar. 3, 2006)).
(1) the standard of care, (2) defendant's failure to meet that standard, and (3) a direct causal connection between the medically negligent act and the injury suffered. Bruni v. Tatsumi, 46 Ohio St.2d 127, syllabus (1976). “Expert testimony on the standard of care and a defendant's failure to adhere to the standard is typically required, unless the lack of skill in rendering care is so clear and apparent that it is within common knowledge and understanding of a jury.” Rorick, supra; Buerger v. Ohio Dept. of Rehab. & Corr., 64 Ohio App.3d 394, 399 (Ohio App. 1989).
The applicable standards of medical care for patients presenting with chest discomfort at risk of cardiac ischemia require that [sic] an accurate medical history, physical exam, EKG testing, and development of a differential diagnosis. (Preliminary Report, ECF DKT #65 at 4).
The applicable standards of care require a rapid and comprehensive evaluation of chest pain with a goal to initiate therapy within one hour of onset for patients identified with suspected acute myocardial infarction (MI). Id.
The failure to review the EKG of a patient with acute chest pain and known risk factors, and to defer evaluation to a nurse with unknown qualifications is a substantial departure from the standard of care and amounts to gross negligence. (Id. at 5; Updated Summary of Opinions, ECF DKT #83-2 at 3).
The applicable standards of care require a rapid and comprehensive evaluation of chest pain with a goal to initiate therapy within one hour of onset for patients identified with suspected acute myocardial infarction (MI). (ECF DKT #83-2 at 1).

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