Opinion ID: 482846
Heading Depth: 2
Heading Rank: 5

Heading: Basis for Expert Opinion

Text: 21 As an alternative basis for introducing Dr. Nirmel's note to prove that the cannula came out during surgery, Ricciardi sought to have an expert witness, Dr. Kay, rely on the statement to form an opinion that this occurred. Dr. Kay testified that there were numerous ways a potentially injurious embolus could have occurred in Ricciardi's situation. The most common way, he said, was if residual air were trapped in the chambers of the heart or in the aorta. He said it also could occur if air were introduced into the heart through a monitoring line, or through the aortic cannula when it was initially inserted, if it leaked or became disconnected, or if it came out during surgery. Dr. Kay told the court that if he could rely on Dr. Nirmel's note, it would be his opinion that the cause of the embolus was that the cannula came out. Otherwise, he would have to conclude, based on probabilities, that the cause was residual air being trapped. The court ruled that the note was too unreliable to be used as the basis of Dr. Kay's opinion and, therefore, Dr. Kay was unable to support Ricciardi's theory of the case. 22 Under the Federal Rules, an expert is not confined to admissible evidence in forming an opinion. Rule 703 provides that an expert may base an opinion on inadmissible facts or data if of a type reasonably relied upon by experts in the particular field in forming opinions or inferences upon the subject. [T]his part of the rule is designed to prevent enlarging the category of permissible data to break down the rules of exclusion unduly. Almonte v. National Union Fire Ins. Co., 787 F.2d 763, 770 (1st Cir.1986). It is especially important when the facts or data on which the expert seeks to rely have obvious characteristics of unreliability. 23 The fact or datum on which Dr. Kay offered to base his opinion was not one medical experts frequently encounter. Dr. Kay said that never before had he seen such a statement in a hospital chart. Although neurological consultation reports may well be the type of records upon which an expert would reasonably rely, there has been absolutely no showing here that unattributed material usually comprises a part of such consultative reports, or that experts in the field would rely on this kind of a statement. The evidence Ricciardi claims meets this requirement falls far short. Dr. Kay's testimony certainly does not establish that experts in the field would rely on such a note. Indeed, his characterization of the note as bizarre suggests the contrary. Ricciardi also refers to the testimony of Dr. Michael Bresnan, a pediatric neurologist at the Hospital, who said that when he examined Ricciardi he read Dr. Nirmel's report. Dr. Bresnan said he did not have any doubt about what was written in the chart and that he accepted what Dr. Nirmel wrote to be the truth as he has reported it to be. Dr. Bresnan was not asked, however, whether he accepted the note about the cannula in particular, or whether he would rely on this type of note in forming an expert opinion. Dr. Bresnan's only specific reference to the contents of Dr. Nirmel's report concerned a description of Ricciardi's difficulties and a differential diagnosis of three possible causes of them. This does not establish that experts reasonably would rely on the note about the cannula. Therefore, we hold that it was within the district court's discretion not to allow Dr. Kay to rely on the note in forming his expert opinion. United States v. Wilson, 798 F.2d 509, 517 (1st Cir.1986) (Under Rule 703, the admission of expert testimony is a matter reserved to the trial court's discretion.). 24 Ricciardi also argues that, in ruling that Dr. Kay could not rely on the note, the district court erroneously took into consideration that his opinion would embrace the ultimate issue in the case. Rule 704 provides that except for testimony as to the mental health or condition of a criminal defendant, testimony in the form of an opinion or inference otherwise admissible is not objectionable because it embraces an ultimate issue to be decided by the trier of fact. According to Ricciardi, at the end of the trial the court implied that it might have ruled differently if the opinion were not being used to prove the decisive fact in the case: that the cannula came out. We disagree. When it considered the basis for Dr. Kay's proffered opinion, the court clearly decided not to allow him to rely on the note because of its unknown origin and consequent unreliability, and we have concluded that this was within the district court's discretion. The discussion to which Ricciardi points was made in the context of the court's decision to direct a verdict for defendant. The court said that given the way the issues had been defined, the cannula coming out was the decisive fact that determines negligence, if there was any. The court was not saying that Dr. Kay could not rely on the note to form an opinion embracing the decisive fact, but that because the note was the only evidence that did embrace the ultimate issue, and it was not admissible as evidence or properly the basis for an expert opinion, a directed verdict was in order.