Opinion ID: 220774
Heading Depth: 4
Heading Rank: 5

Heading: Testimony of Dr. Randall Tackett

Text: Dr. Tackett was prepared to testify that “reduced levels of tacrolimus resulted in Huerta’s kidney rejection and it was caused by a compounding error.” Mem. Order and Op. Granting BioScrip’s Motion to Exclude Proposed Testimony of Randall L. Tackett, PhD, August 18, 2010 (“Aug. 18, 2010 Op.”) at 9. Dr. Tackett was also prepared to testify that “his ‘guess’ was that, when BioScrip pharmacists were compounding the April the appellant’s Daubert motion, “Dr. Morgenstern.” See R., Vol. I at 42. -19- or May 2006 suspension, either ‘the wrong number of capsules were counted or emptied improperly.’” Id. (quoting R., Vol. I at 37). The district court admitted Dr. Tackett’s testimony relating sloppy pharmaceutical record-keeping with sloppy compounding. The district court also found that Dr. Tackett was qualified to testify regarding the most common type of compounding errors when capsules are used as an ingredient in the compound, and that BioScrip’s compounding task was straightforward instead of complicated. Id. at 10. The district court, however, excluded Dr. Tackett’s testimony on the standard of care for keeping pharmacy records, the actual potency or adequacy of the tacrolimus suspension dispensed to Huerta, and the cause of Blanca’s kidney rejection being subpotent tacrolimus compounded by BioScrip. Huerta argues that the district court erred in faulting Dr. Tackett’s reliance on the findings of other experts as hearsay, and insists that Dr. Tackett “was able to conclude, based on all the evidence before him, from a pharmacological and toxicological standpoint . . . that the only cause not completely ruled out was a compounding error.” Aplt’s Br. 24-25. Huerta’s arguments, however, fall short. Huerta is correct to say that experts may offer opinions based on hearsay or other inadmissible evidence if experts in the field reasonably rely on such evidence in forming their opinions. See Fed. R. Evid. 703; United States v. Posey, 647 F.2d 1048, 1051 n.2 (10th Cir. 1981) (“If of a type reasonably relied upon by experts in the particular field in forming opinions or inferences upon the subject, the facts or data [in the particular case upon which an expert bases an opinion or inference] need not be admissible in -20- evidence.”); see also United States v. Mulder, 273 F.3d 91, 102 (2d Cir. 2001). However, in this case, the district court also pointed out inconsistencies in Dr. Tackett’s testimony, Aug. 18, 2010 Op. at 11-12, and Dr. Tackett’s “dodg[ing] the issue” of Huerta’s 2007 kidney rejection where non-compliance was suspected. Id. at 11. Huerta does not address either of these issues, which are alternative grounds upon which we could affirm the district court’s order. See Murrell v. Shalala, 43 F.3d 1388, 1389 (10th Cir. 1994) (stating that an independently sufficient alternative basis for the district court’s holding that is unchallenged forecloses success on appeal). We note that this case presents difficult questions that a different district judge may have resolved differently. As this judge pointed out, all of Huerta’s experts are well- qualified to testify on a variety of the underlying issues in this case. However, “when coupled with [the abuse of discretion] standard of review, Daubert’s efforts to safeguard the reliability of science in the courtroom may produce a counter-intuitive effect: different courts relying on [] essentially the same science may reach different results.” Hollander, 289 F.3d at 1206-07 (citing Federal Judicial Center, Reference Manual on Scientific Evidence 27 (2d ed. 2000)). For the reasons stated above, we find that the district court did not abuse its discretion by excluding the testimony of Dr. Wong, Dr. Alexander, Dr. Morgenstern, and Dr. Tackett as unreliable. B. Whether the District Court Abused its Discretion in Admitting the Opinions of Bioscrip’s Experts -21- Huerta next argues that the district court erred by admitting the testimony of two of BioScrip’s experts. The district court granted summary judgment to BioScrip on the ground that BioScrip had admissible expert testimony that, more likely than not, factors other than subpotent tacrolimus8 caused Huerta’s kidney rejection. Aug. 19, 2010 Op. at 8-9. Because the district court held that Huerta did not have admissible expert testimony on causation, the district court also held that Huerta could not rebut the testimony of BioScrip’s experts. Id. Thus, assuming without deciding that it was necessary for the district court to reach this issue given its exclusion of Huerta’s experts’ testimony, we address Huerta’s arguments and reject them for the reasons stated below. 1. Dr. Chris Clardy Huerta argues that the testimony of Dr. Chris Clardy should have been stricken because it was based on the wrong legal standard. According to Huerta, Dr. Clardy rendered the opinion that “‘it is not certain that [Huerta’s] low level [of tacrolimus] resulted from using an inadequate preparation of tacrolimus.’” Aplt’s Br. at 34 (quoting R., Vol. I at 36) (emphasis from the appellant’s brief). Because the proper standard under New Mexico law is whether something is true “to a reasonable degree of medical probability” rather than “certainty,” Huerta argues that the district court abused its 8 These causes included the change in Huerta’s prescription from Cellcept to Imuran (a weaker immunosuppressant), Huerta’s vomiting for three days before she was hospitalized and her creatinine levels were checked, that Huerta was vomiting for five days before her tacrolimus levels were checked, and the possibility of non-adherence to her medication regime. Aug. 19, 2010 Op. at 8 (citing R., Vol. II at 392-93). -22- discretion by admitting Dr. Clardy’s testimony. Id. at 35 (quoting Baca v. Bueno Foods, 108 N.M. 98, 100 (N.M. App. 1988)). When Huerta advanced these arguments before the district court, the district court found that they mischaracterized Dr. Clardy’s opinion. The district court explained Dr. Clardy’s actual proffer, citing Dr. Clardy’s written report and his deposition testimony. Finding that Dr. Clardy’s opinions were based upon correct legal standards and methodologies, the district court held that his opinions were admissible. Mem. Order and Op. Granding BioScrip’s Mot. to Exclude Proposed Testimony of Chris Clardy and Lloyd Vernon Allen, August 9, 2010 (“Aug. 9, 2010 Op.”) at 5. Huerta’s brief fails to address the district court’s thorough analysis. Based on our review of the briefing, the record, and the district court’s reasoning, we are unpersuaded that the district court abused its discretion in admitting Dr. Clardy’s testimony. 2. Dr. Lloyd Vernon Allen Huerta sought to exclude the testimony of Dr. Lloyd Vernon Allen on the ground that Dr. Allen’s retention as an expert created a gross conflict of interest because of Huerta’s retention also of Dr. Tom Kupiec. Huerta retained Dr. Kupiec as an expert witness in a prior action and also listed Dr. Kupiec in her initial disclosures in the instant action. Aplt’s Br. 35-36. BioScrip subsequently retained Dr. Allen as an expert pharmacologist. Huerta argues that there is a close personal relationship between Dr. Allen and Dr. Kupiec, that they communicate frequently both in person and by e-mail, that they discussed this case briefly on at least one occasion, that Dr. Allen has worked -23- with Dr. Kupiec on a number of projects, and that Dr. Allen selects Dr. Kupiec’s lab for quality assurance testing for pharmaceutical companies. Id. Thus, Huerta argues that there is an apparent conflict of interest between Dr. Allen and Dr. Kupiec and the failure to exclude Dr. Allen’s testimony is an abuse of discretion. Id. The district court found that Blanca’s arguments mischaracterized Dr. Allen’s testimony. The “frequent communication” between Dr. Allen and Dr. Kupiec was once every week or two, and at the time of Dr. Allen’s deposition, the two doctors did not have any concurrent projects ongoing. Their “discussion” of the instant case was only a single instance when Dr. Allen mentioned to Dr. Kupiec that he had been retained in “a tacrolimus case.” Dr. Kupiec mentioned that he had “a contact about that case,” and immediately the two stopped talking about it. Aug. 9, 2010 Op. at 7-8. Ultimately, the district court found that “[Huerta] ha[s] failed to allege facts showing any conflict of interest, much less the ‘gross conflict’ that [she] contend[s] exists.” Id. at 8. Without citing a single case in support of her position, or identifying any error in the district court’s reasoning, Huerta reiterates the arguments made before the district court and then insists that the district court abused its discretion. Based on the district court’s thoughtful analysis and the facts found on the record before it (again, none of which Huerta’s brief addresses), we are unpersuaded. See also Habecker v. Town of Estes Park, Colo., 518 F.3d 1217, 1223 n.6 (10th Cir. 2008) (stating on appeal that the trial court erred without advancing reasoned argument as to the grounds for the appeal is -24- insufficient appellate argument). In sum, we find no error in the district judge’s refusing to exclude Dr. Allen’s testimony. C. Whether the District Court Erred in Granting Summary Judgment in Favor of Bioscrip We now turn to the district court’s grant of summary judgment in favor of BioScrip, which we review de novo. Garrison v. Gambro, Inc., 428 F.3d 933, 935 (10th Cir. 2005). We apply de novo review with application of the principle that “we view the evidence and draw reasonable inferences therefrom in the light most favorable to the nonmoving party.” Id. Summary judgment “‘necessarily implicates the substantive evidentiary standard of proof that would apply at the trial on the merits.’” Burlington N. & Santa Fe Ry. Co. v. Grant, 505 F.3d 1013, 1023 (10th Cir. 2007) (quoting Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 253 (1986)). Huerta asserted claims for strict products liability, negligence, negligent misrepresentation, a violation of the New Mexico Unfair Trade Practices Act, breach of express and implied warranty, and for an award of punitive damages. In New Mexico, “a tort plaintiff must demonstrate the defendant’s actions caused the plaintiff’s injury.” Wilcox v. Homestake Mining Co., 619 F.3d 1165, 1166 (10th Cir. 2010). “[F]ailure of proof of an essential element renders all other facts immaterial.” Koch v. Koch Indus., Inc., 203 F.3d 1202, 1212 (10th Cir. 2000). When “the moving party does not bear the ultimate burden of persuasion at trial, it may satisfy its burden at the summary judgment stage by identifying a lack of evidence for the nonmovant on an essential element of the -25- nonmovant’s claim.” Cassara v. DAC Serv., Inc., 276 F.3d 1210, 1212 (10th Cir. 2002) (internal quotation marks omitted). The burden then shifts to the opposing party to come forward with admissible evidence to create a genuine issue of material fact on that element. See Bacchus Indus., Inc. v. Arvin Indus., Inc., 939 F.2d 887 891 (10th Cir. 1991). Accordingly, after excluding Huerta’s experts’ causation testimony, the district court found that “BioScrip has demonstrated that there is no direct evidence that the tacrolimus suspension it compounded for Huerta was subpotent or otherwise defective, and that there were several other undisputed factors that could have contributed to Huerta’s transplant rejection.” Mem. Order and Op. Granting BioScrip’s Motion for Summary Judgment, August 19, 2010 (“Aug. 19, 2010 Op.”) at 7. The district court held that the testimony of BioScrip’s expert, Dr. Chris Clardy, was admissible, which we affirm as discussed above. Dr. Clardy was prepared to testify that while it was theoretically “possible” that BioScrip’s tacrolimus suspension was subpotent and caused Huerta’s kidney rejection, “there was a 75 to 80 percent ‘probability’ that the cause of Blanca’s rejection was a combination of non-adherence or some other reason for insufficient levels of tacrolimus in her system other than subpotency, plus the change from Cellcept to Imuran.” Id. at 8. With Dr. Clardy’s testimony and “the undisputed fact that the other three patients taking BioScrip’s tacrolimus suspension from the same batch as Blanca did not report any issues with the -26- tacrolimus BioScrip compounded,” the district court found that “no reasonable jury could find that the tacrolimus was defective or caused Blanca’s rejection.” Id. at 8-9. The district court then reasoned that “the continuing vitality of this case . . . depend[ed] upon a single issue: whether Plaintiffs [sic] have met their [sic] burden to come forward with sufficient, admissible, medical evidence to show that BioScrip compounded and dispensed subpotent tacrolimus that caused Blanca [sic] kidneytransplant rejection such that a reasonable jury could return a verdict in favor of the Plaintiffs [sic].” Id. at 7. Without admissible expert testimony to rebut Dr. Clardy’s testimony on the issue of causation, the district court concluded that Huerta could not establish any of the following facts: (1) [that] the tacrolimus BioScrip marketed and dispensed was subpotent or defective; (2) [that] BioScrip’s compounding of the tacrolimus suspension failed to meet the standard of care [to prove negligence]; (3) [that] BioScrip made any misrepresentations [sic] or concealed any information about the quality and efficacy of the tacrolimus it dispensed; (4) [that] BioScrip’s tacrolimus was not fit for human consumption; (5) [that] Blanca’s low levels of tacrolimus on May 17, 2006 were caused by BioScrip’s marketing or dispensing of a defective product; or (6) [that] Blanca’s transplant rejection and resulting injuries were caused by ingestion of subpotent tacrolimus. Aug. 19, 2010 Op. at 9. Finding that Huerta did not meet her burden to demonstrate a genuine issue of material fact on causation, the district court granted summary judgment in BioScrip’s favor. Id. Huerta argues that genuine issues of material fact exist regarding causation, citing the testimony of her experts which we have held was within the district court’s discretion to exclude. Aplt’s Br. 26; Reply Br. 15. Aside from stating the elements of the strict -27- products liability tort in New Mexico, Huerta offers no argument as to how those elements have been met in this case, Aplt’s Br. 30-31, and we decline to make them for her here. See Fed. R. App. P. 28(a)(9)(A) (“The appellant’s brief must contain . . . appellant’s contentions and the reasons for them, with citations to the authorities and parts of the record on which the appellant relies.”). On her negligence claim, Huerta argues that a jury is entitled to weigh the testimony given by the experts, and that contrary to BioScrip’s arguments, she does not have to show that subpotent tacrolimus was the cause of her kidney rejection to avoid summary judgment. Aplt’s Br. 31-32. Given that we hold that her experts’ testimony was properly excluded, Huerta’s first argument fails. Huerta’s second argument mischaracterizes BioScrip’s position. Nowhere does BioScrip argue that Huerta must show that subpotent tacrolimus must be the sole cause of her injury. Rather, BioScrip argues that given the variety of other potential causes of Huerta’s kidney rejection, without her experts’ testimony, Huerta could not show that more likely than not, the tacrolimus suspension dispensed was subpotent, that it was a but-for cause of Huerta’s kidney rejection, or that it was a proximate cause of Huerta’s kidney rejection. Aplee’s Br. 52-54. To that end, the only case Huerta cites supports BioScrip’s position: to sustain a negligence claim, “[p]laintiff . . . must prove that the act characterized as negligence more probably than not was a contributing cause of the injury.” Tafoya v. Seay Bros. Corp., 119 N.M. 350, 351 (N.M. 1995) (first emphasis added). -28- Next, Huerta summarily argues that BioScrip violated the New Mexico Unfair Trade Practices Act, Section 57-21-1 NMSA (1978), by selling subpotent medication and by failing to warn of the medication’s subpotency. Aplt’s Br. 32. As the district court held, however, Huerta cannot establish to a reasonable degree of medical probability that the BioScrip tacrolimus was subpotent without the testimony of her experts. Huerta’s summary reliance on her experts’ testimony to sustain her failure to warn and unfair trade practices claims, therefore fails. The same is true for her breach of express and implied warranty claims. Because the district court properly granted summary judgment in favor of BioScrip, we need not address Huerta’s claim for punitive damages.