Opinion ID: 1897769
Heading Depth: 1
Heading Rank: 5

Heading: Jury Instruction on Determination of Causation Based Solely on Expert Testimony

Text: Appellant asserts that the trial court made a second error in its instructions to the jury, one of commission rather than omission, and poses the following query: Did the trial court err in twice charging the jury, over plaintiff's objections, that it must make its judgment as to whether plaintiff's claimed injuries were caused by the alleged negligence of defendants only on the basis of expert medical testimony which speaks in terms of reasonable probability or reasonable certainty? The trial court included in its charge to the jury an instruction derived almost verbatim from one proposed by counsel for Appellees, which stated: In considering the question of whether the alleged negligence of the Defendants was the cause of the injuries of which the Plaintiffs now complain, you must form your judgment only on the basis of expert medical testimony which speaks in terms of reasonable probability or reasonable certainty. Your decision may not be based on expert testimony that admits of a mere possibility of negligence, or a mere possibility that such negligence caused the injury. [Emphasis added.] At the close of the court's charge to the jury, counsel for Appellant immediately objected to this particular instruction, arguing: I believe there was an instruction that the jurors should only consider expert testimony that was stated in the form of reasonable medical probability in determining whether or not there was a cause of the injuries. And the problem I'm having with that is that other evidence is certainly appropriate to be considered in addition to expert testimony. Now I don't have a problem with an instruction that expert testimony needs to be stated in order to be evidence to a reasonable degree of medical certainty, but I do have a concern with the Court's instruction on that element there because it's suggesting that the plaintiff has an obligation to produce expert testimony stated within a reasonable degree of medical probability in order to demonstrate causation. And respectfully, we would submit that the evidence to demonstrate that can include non-expert testimony or it can include expert testimony, it's up to the jury to determine whether the evidence that's submitted is sufficient to find causation, whether it be proximate cause or direct cause. So that is my objection to that particular instruction, Your Honor. In response to Appellant's objection, the trial court decided to re-read that instruction, modifying it by deleting that second [sentence].... Thereupon, Appellant reiterated her protest, contending that the court's proposed solution failed to dispel her dissatisfaction with the original instruction: The problem I'm having, even deleting that sentence, it still makes it sound as if they have to form their judgment based only on the basis of expert medical testimony. And my problem is ... that obviously there's a lot of other evidence besides expert medical testimony in the case. And so I think that needs to be clarified, something needs to be added to it, that says ... you should consider only expert medical testimony which speaks in terms of reasonable probability or reasonable certainty, along with any other evidence that is not from an expert that you deem appropriate. With its instruction in the instant case the trial court improperly restricted the jury in its determination of causation to the bare consideration of three witnesses' testimony, thus wiping out all the other voluminous evidence admitted at trialin the form of interrogatories, depositions, live testimony and exhibitsas provided by both Appellant and Appellees. In particular, the testimony of the plaintiff patient and the defendant doctor in the present case might undoubtedly have some evidentiary value relative to causation. To the extent that the court's instruction rendered all non-expert evidence irrelevant to the issue of causation, the jury was misguided in its task, and the court erred. See Singleton v. Roman, 195 Md. 241, 247, 72 A.2d 705, 707 (1950) ([A]n instruction is erroneous if it withdraws from the consideration of the jury any evidence, however weak, tending to establish material facts. (citation omitted)). This is particularly true in light of the oddity that, as to causation, the only evidence left to the jury by the court's single instruction on the issuethe expert opinion testimonynecessarily derived its probative force from the very evidence the court had excised from the jury's review. See State Health Dep't v. Walker, 238 Md. 512, 520, 209 A.2d 555, 559 (1965) (An expert opinion derives its probative force from the facts on which it is predicated, and these must be legally sufficient to sustain the opinion of the expert. (citation omitted)). Because the court's instruction that the jury consider only expert medical testimony in determining the cause of Appellant's injuries misrepresented the law in Maryland, it was error for the trial court to instruct the jury as it did in the present case. See Kennelly v. Burgess, 337 Md. 562, 572, 654 A.2d 1335, 1340 (1995) ([T]he instruction given was an improper statement of the law and was therefore error.).