Opinion ID: 220774
Heading Depth: 4
Heading Rank: 1

Heading: District Court’s Orders

Text: The district court struck portions of the testimony of Huerta’s four experts, Dr. Craig Wong, Dr. Steven Alexander, Dr. Bruce Morgenstern, and Dr. Randall Tackett, as unreliable and therefore inadmissible under Daubert and Federal Rule of Evidence 702.4 4 Federal Rule of Evidence 702 provides the following: If scientific, technical, or other specialized knowledge will assist the trier of -6- First, the district court held that Dr. Wong, Dr. Alexander, and Dr. Morgenstern were all “well qualified to give an opinion stating that, based on (1) the severity, (2) the type, and (3) abruptness of Blanca’s rejection when she had been doing well the month before, (4) the extremely high creatinine4 levels in her blood on May 15, 2006, and the fact that (5) tacrolimus is the most powerful and the most critical immunosuppressant medication Blanca was taking . . . Blanca’s rejection was most likely caused by insufficient levels of tacrolimus and/ or other immunosuppressants in her system.” Aug. 13, 2010 Op. at 10. The district court found, however, that “[w]hat [wa]s not supported by any medical evidence in the record . . . [is] their opinions regarding the cause of the insufficient tacrolimus level.” Id. (emphasis in original). As for Dr. Tackett, the district court held that he could testify to a potential relationship between sloppy pharmaceutical record-keeping and sloppy compounding, as well as to the most common types of compounding errors made when capsules are used to compound a suspension. However, the district court held that Dr. Tackett’s ultimate fact to understand the evidence or to determine a fact in issue, a witness qualified as an expert by knowledge, skill, experience, training, or education, may testify thereto in the form of an opinion or otherwise, if (1) the testimony is based upon sufficient facts or data, (2) the testimony is the product of reliable principles and methods, and (3) the witness has applied the principles and methods reliably to the facts of the case. 4 Creatinine is a metabolic waste product generated by the body. DORLAND’S ILLUSTRATED MEDICAL DICTIONARY 390 (28th ed. 1994). Normally functioning kidneys filter creatinine from the bloodstream and the body then excretes it in urine. Ralph E. Cutler, MD, Kidney Failure, in THE MERCK MANUAL, supra note 1, at 828. When a kidney fails and is therefore unable to filter creatinine, “[a] progressive daily rise in the creatinine indicates acute kidney failure.” Id. at 829. “[T]he higher the level [of creatinine], the more severe the failure is likely to be.” Id. -7- causation testimony that subpotent tacrolimus caused Huerta’s kidney rejection was insufficiently reliable to be admissible. Stated differently, the district court found that the experts were qualified to opine on general causation, or what might cause a kidney rejection. See Norris, 397 F.3d at 881 (“General causation is whether a substance is capable of causing a particular injury or condition in the general population.”). However, the district court held that the experts could not render their specific causation opinions that Bioscrip’s tacrolimus suspension was subpotent or that subpotent tacrolimus caused Huerta’s kidney rejection because their methodologies were insufficiently reliable. See id. (“[S]pecific causation is whether a substance caused a particular individual's injury.”). We address the contentions regarding each of the experts in further detail below.