Opinion ID: 2360326
Heading Depth: 1
Heading Rank: 1

Heading: A. Fact and Procedural History

Text: On December 10, 2000, Wood was driving her car in New Castle County. [3] While she was attempting to merge from Route 7 onto Route 40, Wood stopped at a yield sign and waited for an opening in the traffic on Route 40. Haines's car then struck Wood's car in the rear. Both Haines and Wood agreed that the collision caused minor impact. Haines testified that the impact was a tap and that she felt no jolt of any kind. Wood testified that her car moved less than a foot when Haines's car struck hers. Wood further testified that she had pain instantly going down her neck and into her left arm. Despite her pain, Wood did not seek immediate medical treatment and continued driving after she inspected her car for damage and exchanged information with Haines. [4] About one year before the accident, Rudin surgically treated Wood for a severely degenerative disc in her back. Wood had also reported pain to her shoulder and upper arm sometime before the accident. On January 3, 2001, approximately three weeks after the accident, Wood went to see Rudin again. [5] Wood told Rudin that she was involved in an accident, and complained about neck and arm pain. Rudin conducted a physical examination and reported that Wood was tender to palpation over from C-6 down through T-1, which is the area in her neck where the x-rays were actually abnormal. She didn't have any notable spasm, but was tender over her trapezius muscles as well. Neurologically she was intact. Rudin prescribed pain medication and physical therapy for Wood's symptoms. In March 2001, after Wood continued to report severe pain, Rudin ordered an MRI which revealed abnormalities in Wood's neck at levels C5-6 and C6-7. When crossexamined at trial, Rudin acknowledged that in addition to disc herniations, the MRI revealed disc desiccation over most of Wood's cervical spine, which occurs over a period of time and which pre-existed the accident. [6] In May of 2001, Rudin performed an anterior cervical discectomy and fusion on the disc abnormality at C5-6. Because Wood's pain persisted after the May 2001 surgery, Rudin performed a similar operative procedure at C6-7 in August of 2004. At the August 29, 2005 trial, Rudin was the only medical expert who testified. He testified by videotaped deposition and by live testimony. [7] At the close of all of the evidence, Wood moved for a directed verdict on causation. Wood's counsel cited Amalfitano v. Baker [8] and claimed that Wood had presented uncontradicted, and, therefore, uncontroverted evidence that Haines's negligence caused both the collision and injuries proximately related to the collision. Wood wanted the jury instructed on damages alone because Rubin's uncontradicted medical testimony, confirmed by an objective medical test (an MRI) supporting Wood's subjective complaints, established a causal link between the accident and Wood's injuries. [9] The trial judge responded that he had Amalfitano in mind throughout trial and that he did not see where plaintiff's counsel pointed out to the jury objective signs of injury. The following exchange took place after the trial judge asked Wood's counsel to point to when Rubin specifically testified about objective findings versus subjective complaints of injuries: [Counsel]: I can't sir. I didn't think this was a case where the testifying expert had to be asked if the signs and symptoms of injury were subjective or objective, and the reason that I didn't think that is because you've got a surgery case. So, there's clear signs of objective injury, and if the Court has a question about it, I'd be happy to make a record of it. We have an MRI study taken in February of 2001 that's part of the exhibit package, demonstrating a soft disk herniation at C5-6 and another disk herniation at C6 and 7. [Trial Judge]: So, you're telling me that the Court needs to make the objective determination, not it doesn't come in through expert testimony. [Counsel]: I think that's right, and especially when you look at the decisions that have come out under that line of cases. [Trial Judge]: I can't find one that splits that in that way.... [Counsel]: When the Court looks at these cases, and the Court's analysis has been something as simple as well, the doctor mentioned spasm, and spasm qualifies  at least it usually does in this Court  as an objective sign of injury, and Amalfitano instruction or an Amalfitano ruling applies, and here, we have got tremendously more than that. We [have] two herniated disks. We've got disruption of the vertebral column.... [Trial Judge]: Can you point to a case that tells me, as a matter of law, an MRI is an objective test, a spasm is an objective test? Although we don't have a spasm in this case. [Counsel]: I suppose I can find a case. If the Court wanted me to do some research to find a case that says that a herniated disk is an objective finding or  [Trial Judge]: Yes. I need some guidance along that line, because clearly Amalfitano talks about the unconverted medical evidence, but it has to be confirmed by independent objective testing, and nowhere in the case did the doctor say an MRI was an independent test or an objective test. Nowhere did he say tenderness was objective. He didn't make that distinction for the fact finder or the Court ... Neither did he talk about subjective symptoms of when the plaintiff may have been relating them to a car accident.... And it's not clear, through objective tests, that the operation was related to the accident. After further discussion the trial judge denied Wood's Motion for a Direct Verdict on causation and stated: Amalfitano requires that the medical evidence be confirmed by independent, objective testing. Certainly, there's been no discussion in this case about objective versus subjective. I'm not sure that the doctor has confirmed what objective testing is and what symptoms or findings demonstrate that. So, because of that, I think this case is different from Amalfitano v. Baker . On September 1, 2005, the jury returned a verdict form clearly finding that Haines's negligence caused the accident and that Haines's negligence was not the proximate cause of Wood's injuries. They consequently awarded Wood no damages. After the jury's verdict, Wood filed a Motion for a New Trial. The trial judge denied that motion noting that, based on Amalfitano, jury awards of zero damages are only against the great weight of evidence when uncontradicted expert medical testimony establishes causation. When that expert testimony is based upon the victim's subjective complaints, it must be supported and confirmed by independent objective findings. The trial judge further explained that, despite Rudin's testimony about causation, during cross examination Haines's counsel drew out discrepancies between Rudin's deposition and live testimony: In his videotaped deposition, Dr. Rudin testified that there was a distinction between degenerative disc, which Plaintiff had in her low back prior to the accident, and a herniated disc, which she had in her neck. However, during live testimony Dr. Rudin was cross-examined as to the fact that he had prepared two operative reports relating to the neck. In one report, he called the disc degenerative and in the other report he called it a herniation. During his testimony he stated that there was no distinction between degeneration and herniation. Moreover, when describing Plaintiff's pre-existing neck condition, he admitted that the Plaintiff had pre-existing desiccation of her discs.... Defendant contends that a sufficient evidentiary basis exists to support the jury's verdict because Dr. Rudin's testimony was contradictiory, his conclusions concerning proximate cause were substantially based on Plaintiff's subjective assertions, and he had no understanding as to how the accident occurred. Given these discrepancies in Rudin's testimony and the inference of bias that flowed from Rudin's own financial interest in an outcome that favored Wood, [10] the trial judge concluded that the evidence established a reasonable basis for the jury to conclude that while Haines's negligence caused the accident, the injuries complained of by Wood and her later surgeries were not causally related to that accident. We now address the trial judge's rulings on Wood's Motions. [11]