Opinion ID: 66068
Heading Depth: 3
Heading Rank: 1

Heading: Exclusion of Dr. Prellop’s Testimony

Text: “Scientific knowledge of the harmful level of exposure to a chemical, plus knowledge that the plaintiff was exposed to such quantities, are minimal facts necessary to sustain the plaintiffs’ burden in a toxic tort case.” 5 A plaintiff in such a case cannot expect lay fact-finders to understand medical causation; expert testimony is thus required to establish causation.6 1 Knight v. Kirby Inland Marine Inc., 482 F.3d 347, 351 (5th Cir. 2007); see Daubert v. Merrell Dow Pharms., Inc., 509 U.S. 579 (1993). 2 Knight, 482 F.3d at 351 (internal quotation marks omitted). 3 Id. 4 Curtis v. M&S Petrol., Inc., 174 F.3d 661, 668 (5th Cir. 1999). 5 Allen v. Pa. Eng’g Corp., 102 F.3d 194, 199 (5th Cir. 1996). 6 Id. (demanding not just knowledge but scientific knowledge); Atkins v. Ferro Corp., 534 F. Supp. 2d 662, 666 (M.D. La. 2008) (concluding that there was no genuine issue of material fact for trial because “plaintiffs [had] not produced any expert testimony or report to establish that[] plaintiffs: (1) were actually exposed to a harmful level of the chemical, or (2) were physically injured by the [chemical] allegedly released from the plant” (emphasis added)), aff’d No. 08-30295, 2009 WL 605743, at  (5th Cir. Mar. 10, 2009) (per curiam) (unpublished) 3 No. 08-30911 Courts use “a two-step process in examining the admissibility of causation evidence in toxic tort cases. First, the district court must determine whether there is general causation. Second, if it concludes that there is admissible general-causation evidence, the district court must determine whether there is admissible specific-causation evidence.” 7 “General causation is whether a substance is capable of causing a particular injury or condition in the general population, while specific causation is whether a substance caused a particular individual’s injury.”8 Attempting to establish these requisite facts, Seaman proffered the report and deposition testimony of Dr. Perri Prellop, his only medical-causation expert. As the proponent of Dr. Prellop’s testimony, Seaman had the burden of establishing by a preponderance of the evidence that the proffered testimony was admissible. 9 A district court assesses expert testimony under Federal Rule of Evidence 702: If scientific, technical, or other specialized knowledge will assist the trier of 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 (“Because plaintiffs presented no expert testimony in support of causation, there is no error in the summary judgment . . . .” (citing Allen, 102 F.3d at 199)); see Templet v. HydroChem Inc., 367 F.3d 473, 484 n.15 (5th Cir. 2004) (Dennis, J., dissenting) (emphasizing the need for expert testimony to prove a complex toxic tort case); Wills v. Amerada Hess Corp., 379 F.3d 32, 50 (2d Cir. 2004) (“Absent admissible expert testimony on the issue of causation, [a plaintiff is] unable to sustain her burden to prove causation.”). 7 Knight, 482 F.3d at 351 (emphases added). 8 Id. 9 United States v. Fullwood, 342 F.3d 409, 412 (5th Cir. 2003) (citing FED . R. EVID . 104(a), cmt.); Moore v. Ashland Chem. Inc., 151 F.3d 269, 276 (5th Cir. 1998) (en banc). 4 No. 08-30911 principles and methods, and (3) the witness has applied the principles and methods reliably to the facts of the case.10 Rule 702 was most recently amended in 2000 in response to the Supreme Court’s decision in Daubert v. Merrell Dow Pharmaceuticals, Inc., which “charged trial judges with the responsibility of acting as gatekeepers to exclude unreliable expert testimony.” 11 Pursuant to Daubert, a trial court ensures that testimony is “supported by appropriate validation — i.e., ‘good grounds,’ based on what is known.” 12 And, “a district court has broad discretion to determine whether a body of evidence relied upon by an expert is sufficient to support that expert’s opinion.”13 In carrying out its gate-keeping function, the trial court “ensures that the proffered evidence is both ‘reliable’ and ‘relevant.’ Reliability is determined by assessing ‘whether the reasoning or methodology underlying the testimony is scientifically valid.’ Relevance depends upon ‘whether [that] reasoning or methodology properly can be applied to the facts in issue.’”14 “[T]he expert’s testimony must be reliable at each and every step or else it is inadmissible. The reliability analysis applies to all aspects of an expert’s testimony: the methodology, the facts underlying the expert’s opinion, the link between the facts and the conclusion, et alia.”15 “Where an expert’s opinion is 10 FED . R. EVID . 702. 11 Advisory Committee Notes to FED . R. EVID . 702 (2000 Amendments) (citing Daubert, 509 U.S. 579 (1993)). 12 Allen v. Pa. Eng’g Corp., 102 F.3d 194, 196 (5th Cir. 1996) (quotation omitted). 13 Knight, 482 F.3d at 354 (emphasis added) 14 Id. at 352 (quoting Daubert, 509 U.S. at 589, 592–93) (internal citations omitted). 15 Id. at 355 (internal quotation marks omitted). 5 No. 08-30911 based on insufficient information, the analysis is unreliable.” 16 Still, there is no bright-line standard and when an expert “otherwise reliably utilizes scientific methods to reach a conclusion, lack of textual support may go to the weight, not the admissibility of the expert’s testimony.” 17 The Supreme Court has offered a non-exhaustive list of Daubert factors that trial courts should consider: “[1] whether the theory or technique the expert employs is generally accepted; [2] whether the theory has been subjected to peer review and publication; [3] whether the theory can and has been tested; [4] whether the known or potential rate of error is acceptable; and [5] whether there are standards controlling the technique’s operation.” 18
Dr. Prellop, a radiation oncologist who completed her residency in radiation oncology in 2006, has never before provided expert testimony. She does not have a particular expertise in bladder cancer and its causes, and, in her career, has only treated three patients diagnosed with bladder cancer.19 She is also the sister-in-law of Seaman’s trial counsel (who continues to represent Seaman in the instant appeal). Dr. Prellop submitted a two-page report that concluded: 16 Paz v. Brush Engineered Materials, Inc., 555 F.3d 383, 388 (5th Cir. 2009); see Knight, 482 F.3d at 355 (stating that if the data relied on by a party’s expert “fail[s] to provide a ‘relevant’ link with the facts at issue, his expert opinion was not based on ‘good grounds’”). 17 Knight, 482 F.3d at 354 (internal quotation marks omitted). 18 Id. at 351 (citing Daubert, 509 U.S. at 593); see id. at 355 (“District courts must carefully analyze the studies on which experts rely for their opinions before admitting their testimony.”). 19 Although Seacor challenged Dr. Prellop’s qualifications to render an opinion on causation, the district court instead excluded the evidence under the Daubert standard. The district court also noted, however, that “[i]t is clear from Dr. Prellop’s deposition that she has no specific expertise in the causes or diagnosis of bladder cancer.” Seaman v. Seacor Marine LLC, 564 F. Supp. 2d 598, 601 n.2 (E.D. La. 2008). 6 No. 08-30911 Mr. Seaman’s history of occupational exposure to diesel exhaust and chemicals including aromatic hydrocarbons[, particularly a chemical called Ferox,] put him at increased risk for bladder cancer. Of course, we could never be certain that these occupational exposures were the definite cause of Mr. Seaman’s bladder cancer but I have no information suggesting that Mr. Seaman’s cancer was caused by other external agents. Dr. Prellop based her opinion on (1) her “understand[ing] that Mr. Seaman’s occupational history includes regular exposure to diesel exhaust and exposure to Ferox at least once a week, twenty-six weeks per year, over more than a decade” and (2) her determination that Mr. Seaman has no risk factor for bladder cancer, e.g., smoking, family history, or age, other than his male gender. To arrive at her conclusion, Dr. Prellop reviewed Seaman’s deposition and medical records, the material safety data sheet (“MSDS”) for Ferox,20 and two scholarly articles about the risk factors for bladder cancer. She never saw or spoke with Seaman, whose complaint and deposition testimony mentioned nothing about either Ferox or diesel exhaust. Dr. Prellop based her “understanding” of Seaman’s regular exposure to Ferox and diesel exhaust on nothing more than the suggestion to her by Seaman’s counsel that another Seacor employee said that Seaman had been exposed to the substances. The district court determined that Dr. Prellop’s assumption of regular exposure without any “facts upon which Dr. Prellop could have possibly surmised exposure levels, rendered her causation opinion mere guesswork.”21 The court also noted that Dr. Prellop never discussed, in either her report or her deposition testimony, the studies on which her two cited journal articles were 20 According to Dr. Prellop, Ferox contains the aromatic hydrocarbons benzene, xylene, and ethylbenzene. 21 Seaman, 564 F. Supp. 2d at 604. 7 No. 08-30911 based.22 In excluding Dr. Prellop’s testimony, the district court concluded that her “opinion is neither factually supported nor scientifically reliable.” 23 We agree and hold that the district court acted well within its discretion in excluding Dr. Prellop’s testimony. Here is why. First, Dr. Prellop does not establish general causation. Her Ferox-related testimony relies on no scholarly studies and merely recites her opinion that Ferox contains aromatic hydrocarbons, which are known carcinogens. Yet, Dr. Prellop makes no connection between Ferox and bladder cancer specifically.24 And, she provides no clue regarding what would be a harmful level of Ferox exposure.25 Without some showing of a “statistically significant” link between Ferox and bladder cancer, Dr. Prellop’s testimony does not establish general causation for Ferox.26 As for her opinion that diesel exhaust causes bladder cancer, Dr. Prellop cites two articles as support: An Updated Review of the Literature: Risk Factors for Bladder Cancer with Focus on Occupational Exposures (“Updated Review”),27 and Projecting Individualized Probabilities of Developing Bladder Cancer in White Individuals (“Projecting Probabilities”).28 Updated Review is an overview of bladder-cancer literature which notes that one analysis found that “[w]orkers with high exposure to diesel exhaust” (the term “high exposure” is left 22 Id. 23 Id. 24 See Allen v. Pa. Eng’g Corp., 102 F.3d 194, 197 (5th Cir. 1996) (noting that causation evidence of cancer generally — rather than the specific cancer from which the plaintiff suffers — is insufficient). 25 See id. at 199 (making clear that such a showing is required). 26 See id. at 195. 27 Sandra M. Olfert et al., Updated Review, 99 S. MED . J. 1256 (2006). 28 Xifeng Wu et al., Projecting Probabilities, 25 J. CLINICAL ONCOLOGY 4974 (2007). 8 No. 08-30911 undefined) have an increased risk of bladder cancer.29 The article cautions that research of occupational bladder cancer is complicated because smoking is the main risk for bladder cancer and it is difficult to separate bladder cancer caused by smoking from that caused by occupational exposures.30 Updated Review mentions nothing about the level of exposure that over time might increase one’s risk of bladder cancer. The authors of Projecting Probabilities created a model that was “consistent with diesel exhaust exposure . . . having a strong etiologic role in [bladder cancer], with numerous studies showing an excess incidence of [bladder cancer] in truck drivers and those exposed to diesel exhausts.” 31 Like Updated Review, Projecting Possibilities is silent on the level of exposure to diesel exhaust that would be significant. These articles thus do not assist Dr. Prellop in meeting Seaman’s “minimal” burden of establishing by “[s]cientific knowledge . . . the harmful level of exposure to a chemical.”32 Without any facts that would establish the allegedly harmful level of exposure (or even some link to bladder cancer), as with her Ferox opinion, Dr. Prellop’s opinion regarding diesel exhaust does not establish general causation. Neither does Dr. Prellop establish specific causation. Seaman makes the contention — with which we disagree — that our opinion in Bocanegra v. Vicmar 29 Updated Review at 1261. 30 See id. at 1261–62. 31 Projecting Probabilities at 4979. The Projecting Probabilities model, however, still requires “validation . . . in an external population [as] an essential next step towards practical use in the clinical setting.” Id. 32 Allen v. Pa. Eng’g Corp., 102 F.3d 194, 199 (5th Cir. 1996); see also id. (citing Wright v. Willamette Indus., Inc., 91 F.3d 1105, 1107–08 (8th Cir. 1996) (rejecting an expert’s testimony that “was not based on any knowledge about what amounts of [a chemical] involve an appreciable risk of harm to human beings who breathe them”)). But see Knight v. Kirby Inland Marine Inc., 482 F.3d 347, 354 (5th Cir. 2007) (noting that not every expert must back his opinion with published studies that unequivocally support that opinion). 9 No. 08-30911 Services, Inc.33 mandates that any shortcomings in Dr. Prellop’s opinion go to its weight, not its admissibility. In that vehicle-collision case, the plaintiff used a toxicology expert to testify about the effects of marijuana on a motorist’s perception, reaction time, and overall driving ability.34 Stressing that “[t]he real world . . . does not operate like a controlled study,” we held that the expert’s testimony was admissible despite unknown variables related to the potency and quantity of the marijuana ingested by the defendant.35 In Bocanegra, the reason that these unknown variables went to the weight and not to the admissibility of the expert’s testimony is because the record also contained sufficient exposure information: It was undisputed both that (1) being high on marijuana impairs perception, viz., it generally has that effect, and (2) the defendant driver had been high within the relevant twelve-hour window, viz., the specific effect.36 We cautioned that we were “not concluding that a trial court may never exclude testimony in a . . . case based on the fact that unknown variables render the testimony unhelpful to the jury.” 37 Instead, we “simply [held] that in th[at] case, the variables d[id] not undermine the expert’s testimony to the point that it [was] of no assistance to the jury.”38 33 320 F.3d 581 (5th Cir. 2003). 34 Id. at 586. The plaintiff used a separate accident-reconstruction expert to connect impaired driving ability to an increased likelihood of a crash. Id. 35 Id. at 588–90. 36 Id. at 587–89. 37 Id. at 589–90 n.5. 38 Id. 10 No. 08-30911 Unlike in Bocanegra,39 the unknown variables of the instant case do render Dr. Prellop’s testimony unhelpful. Dr. Prellop’s opinion is based on nothing other than counsel for Seaman informing her that Seaman was exposed to Ferox and diesel exhaust “at least once a week, twenty-six weeks per year, over more than a decade.” Even if reliance on counsel’s suggestion were permitted, Dr. Prellop still had no information about the amount of exposure to which Seaman was subjected “at least once a week,” viz., duration, concentration, and other circumstances of the exposure. She provided nothing that would offer the fact-finder a clue as to Seaman’s exposure to the allegedly dangerous chemicals. In short, Dr. Prellop’s “background information concerning [Seaman’s] exposure . . . is so sadly lacking as to be mere guesswork. The expert[] did not rely on data concerning [Seaman’s] exposure that suffices to sustain [her] opinions” under Daubert or Rule 702.40 Dr. Prellop’s testimony does not come close to establishing either general or specific causation. The district court did not abuse its discretion in excluding her testimony.41 39 Our holding in Curtis v. M&S Petroleum, Inc., 174 F.3d 661 (5th Cir. 1999) is consistent with that of Bocanegra. In Curtis, although the precise level of chemical exposure was unknown, there was “sufficient information of the level” of exposure, e.g., (1) abnormally high, albeit imprecise, readings on an exposure measuring device, (2) work practices conducive to high exposure, and (3) inadequate factory design. Curtis, 174 F.3d at 671–72. Determining that the expert’s exposure testimony was supported by more than a mere “paucity of facts,” we held that it was admissible. Id. at 672 (citing Moore v. Ashland Chem., Inc., 151 F.3d 269, 279 n.10 (5th Cir. 1998) (en banc) (questioning as suspect causation testimony based on a “paucity of facts”)). 40 See Allen v. Pa. Eng’g Corp., 102 F.3d 194, 198–99 (5th Cir. 1996) (discussing the shortcoming of an expert opinion under Federal Rule of Evidence 703, which requires that if an expert relies on inadmissible facts, they be of a type “reasonably relied on by other experts in the field” (citing FED . R. EVID . 703)). 41 The reduced burden of establishing proximate cause in Jones Act cases, see, e.g., Landry v. Two R. Drilling Co., 511 F.2d 138, 142 (5th Cir. 1975) (describing the burden as “featherweight”), is irrelevant to our holding. The standards of reliability and credibility to determine the admissibility of expert testimony under Daubert and Rule 702 apply regardless whether a seaman’s burden on proximate causation is reduced. See Wills v. Amerada Hess 11 No. 08-30911