Opinion ID: 1495900
Heading Depth: 1
Heading Rank: 4

Heading: APPLICATION OF SECTION 490.065 TO DR. McDONAGH'S EXPERTS

Text: The differences between section 490.065 and FRE 703 as interpreted in Daubert take on great importance here because a key area of disagreement of the parties concerns identification of the relevant scientific field by which Dr. McDonagh's practices are to be judged. This is essential because the statute requires that to be admissible expert opinion must be based on facts or data of a type reasonably relied upon by experts in the field.
Dr. McDonagh argued, and the AHC appeared to determine, that the relevant field for purposes of this inquiry is the universe of medical practitioners who utilize chelation therapy. And, as the record shows that Dr. McDonagh followed the protocol for use of chelation therapy approved by the approximately 1,000 doctors who are organized into ACAM, it concluded that his experts' testimony as to whether his treatments were appropriate was admissible. But, to limit the relevant field to only those doctors who have already expressed their view that the therapy in question is appropriate would make the inquiry into acceptance by experts in the field pointless, for, by definition, only those who had accepted the therapy would be asked for their opinion. The relevant field must be determined not by the approach a particular doctor chooses to take, but by the standards in the field in which the doctor has chosen to practice. As relevant here, Dr. McDonagh chose to treat patients with vascular disease. The Board's claim is that Dr. McDonagh engaged in repeated negligence or misrepresentation and was otherwise in violation of the relevant statutes in his provision of chelation therapy for these patients. Therefore, the relevant field is doctors treating persons with vascular disease. The facts or data on which Dr. McDonagh's experts rely, therefore, must be those perceived by them at trial or must be of a type reasonably relied on by doctors treating vascular disease. [13] By so stating, this Court is not in effect readopting the Frye standard under another name. Nothing in section 490.065 suggests that the conclusions reached in reliance on these facts and data must be in conformity with the general medical consensus or must be generally accepted. As under Daubert and cases applying it, such acceptance is but one factor of the relevant inquiry. Section 490.065.3 simply requires the court to consider whether the facts and data used by the expert are of a type reasonably relied on by experts in that field or if the methodology is otherwise reasonably reliable. If not, then the testimony does not meet the statutory standard and is inadmissible.
The Board argues that, even if Daubert for which section 490.065 [14] is interpolatedprovides the standards for admission of expert testimony, the testimony of Dr. McDonagh's experts should have been excluded because controlled studies supporting use of chelation therapy to treat vascular disease do not exist. Nothing in section 490.065 expressly requires such studies. The Board cites to no case decided under section 490.065 requiring that an expert opinion be supported by controlled studies in order to be admissible. To the contrary, section 490.065.3 states that an expert's opinion is admissible if the facts or data on which the opinion is based are of a type reasonably relied upon by experts in the field in forming opinions or inferences upon the subject and are otherwise reasonably reliable. Controlled studies are a form of data. Therefore, the admissibility of an expert's opinion depends not on some immutable, external standardsuch as the presence of controlled studiesbut on whether experts in the particular field can reasonably rely on other types of data in forming their opinions, or whether in that field controlled studies are required. But, the AMA has suggested that controlled studies must be done before chelation therapy will be generally recognized as effective. See AMA, AMA Policy Compendium H-175.994 (1994) supra. Of course, section 490.065.3 also imposes an independent duty on the court to determine whether the facts and data relied on are otherwise reasonably reliable. The lack of controlled studies presumably would be relevant, but not necessarily dispositive, in making this determination. This is consistent with the approach under Daubert and FRE 703. Daubert says that whether the theory is or can be tested as a controlled study would dois merely one factor, albeit an important one, in determining its admissibility. 509 U.S. at 593-94, 113 S.Ct. 2786. As applied here, it was up to the AHC to consider Dr. McDonagh's experts' testimony, along with the other evidence offered on the issue, and determine whether experts in the field could reasonably rely on the data those experts relied on in reaching their conclusions about the use of chelation therapy. Because of the confusion in the cases in regard to the standard for admission of expert testimony, the AHC did not apply these standards in evaluating the expert testimony offered. On remand, the AHC may permit the parties to supplement the record with additional expert testimony addressing the issues relevant under the statute.