Opinion ID: 4555860
Heading Depth: 3
Heading Rank: 2

Heading: Coroner Testimony

Text: Davis next argues that the district court wrongly allowed the coroner, Dr. Stephen Evans, to give expert testimony that fentanyl caused Castro-White’s death. Davis asserts that Evans’s failure to order an autopsy rendered his opinion inadmissible under Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579 (1993). Davis did not object at trial, so we again review his claim for plain error. United States v. Johnson, 488 F.3d 690, 697 (6th Cir. 2007). Under Daubert, a district court must “ensur[e] that an expert’s testimony both rests on a reliable foundation and is relevant to the task at hand.” 509 U.S. at 597. Federal Rule of Evidence 702 codifies these standards, imposing four requirements that likewise seek to ensure No. 19-3094 United States v. Davis Page 12 that “scientific testimony” is “both ‘relevant’ and ‘reliable.’” Madej v. Maiden, 951 F.3d 364, 369 (6th Cir. 2020) (citation omitted); Fed. R. Evid. 702(a)–(d). Here, there is no dispute that Dr. Evans’s testimony was relevant because the government needed to prove that Davis’s drugs caused Castro-White’s death. See Burrage, 571 U.S. at 218– 19. This case instead concerns reliability. We have held that experts who give medicalcausation opinions may meet Daubert’s reliability rules through a “differential diagnosis” or “differential etiology.” Tamraz v. Lincoln Elec. Co., 620 F.3d 665, 674 (6th Cir. 2010). That method seeks to “rule in” potential causes of a condition and “rule out” other causes. Id. We have viewed a differential diagnosis as sufficiently reliable when a doctor: “(1) objectively ascertains, to the extent possible, the nature of the patient’s injury”; “(2) ‘rules in’ one or more causes of the injury using a valid methodology”; and “(3) engages in ‘standard diagnostic techniques by which doctors normally rule out alternative causes’ to reach a conclusion as to which cause is most likely.” Best v. Lowe’s Home Ctrs., Inc., 563 F.3d 171, 179 (6th Cir. 2009) (citation omitted). When reviewed for plain error, Dr. Evans’s opinion meets this test. Davis does not dispute that Dr. Evans’s opinion satisfied our framework’s first two elements. Dr. Evans explained that his opinion that fentanyl caused Castro-White’s death rested on his review of the scene, the body’s condition, the police reports, and the lab reports. His investigation of the scene revealed drug paraphernalia that tested positive for heroin and fentanyl. And Castro-White’s mouth had a “foam cone” typical of narcotics overdoses. Dr. Evans also ordered blood and urine screens; the urine screen tested positive for opiates and marijuana, while the blood screen showed a fentanyl level that was “three times the highest therapeutic dose[.]” Davis instead focuses on the third differential-diagnosis element. He says that Dr. Evans’s failure to order an autopsy means that he did not engage in “standard diagnostic techniques” to rule out other causes of death (such as Castro-White’s asthma or steroid use). Davis’s argument contains both legal and factual problems. Legally, we do not typically find plain error where no “binding case law . . . answers the question presented[.]” United States v. Al-Maliki, 787 F.3d 784, 794 (6th Cir. 2015) (citation omitted). And we have found no case No. 19-3094 United States v. Davis Page 13 from our court (or others) holding that an autopsy is always a required “diagnostic technique” before an expert may opine on a cause of death. Factually, Dr. Evans explained that coroners do not always need autopsies. If he can identify the cause of death using other tools, he does so: “We don’t disturb a body if we don’t need to disturb a body.” As far as we can tell on this record, Evans applied “the same level of intellectual rigor that characterizes the practice of an expert in the relevant field.” Best, 563 F.3d at 181 (citation omitted). Evans also explained why “an autopsy was not indicated” in this case, including the clear signs of an overdose, as well as the fact that Castro-White was young and healthy. Although Evans knew that Castro-White used steroids and had asthma, he did not need an autopsy to rule out those factors. A steroid death would be “something completely different than what we saw.” Steroids lead to “long-term problems but not usually acute problems like this.” Similarly, the scene did not indicate that Castro-White had died of an asthma attack. A person having an asthma attack experiences “air hunger” and will “go crazy trying to get air[.]” The person does not “die[] laying in bed calmly.” A “foam cone” also does not usually occur outside narcotics overdoses. None of Davis’s cases suggest the contrary. In Johnson v. Memphis Light Gas & Water Division, 695 F. App’x 131 (6th Cir. 2017), for example, we noted that an expert’s “autopsy report and testimony . . . demonstrate[d] that he sufficiently ruled out alternative causes of death.” Id. at 141 (emphasis added). Johnson says nothing about whether an autopsy is always necessary. Davis thus turns to the facts, attacking Dr. Evans’s reasons for dismissing asthma as a cause of death. Evans relied on a statement from Castro-White’s mother that he only occasionally used an inhaler, but a friend testified that Castro-White had been using his inhaler more often before his death. Davis also questions the basis for Evans’s belief that Castro-White died calmly. Neither argument suggests that Evans’s approach was so unsound as to render his opinion inadmissible. Although the lack of an autopsy may have affected the weight the jury No. 19-3094 United States v. Davis Page 14 should give Evans’s opinion, it did not bar the opinion’s “threshold admissibility” on our plainerror review. Best, 563 F.3d at 182.