Opinion ID: 2794084
Heading Depth: 1
Heading Rank: 2

Heading: The Ruling on Call/D’s Motion In Limine

Text: Russell contends that Judge Combs Greene also abused her discretion in excluding Dr. Zimmet‘s testimony, arguing that Dr. Zimmet‘s ―training and experience provided a sufficient foundation to permit his expert opinion testimony 9 Judge Combs Greene also told counsel at the outset of the hearing that her reason for not calling counsel and saying ―don‘t come in‖ was that she thought that one or both of the parties had ―wanted to make [her] aware of something‖ and thus would have objected to a postponement. 10 Russell complains that Dr. Zimmet could have testified regarding his experience with previous patients and his knowledge concerning the sources of their infections. But Dr. Zimmet had an opportunity to do that at his deposition (including during the questioning by Russell‘s counsel, when he simply agreed with counsel‘s vague leading question that ―what [he] did in this case‖ was ―tr[y] to figure out all of the possibilities that . . . might explain the illness . . . that [he is] trying to treat the patient for‖), and did not do so. 14 on the issue of the source of [Russell‘s] exposure to Legionella bacteria.‖ We review a trial court‘s decision about whether to admit expert testimony for abuse of discretion. District of Columbia v. Anderson, 597 A.2d 1295, 1299 (D.C. 1991). That means that our review is deferential, as ―deference . . . is the hallmark of abuse of discretion review.‖ General Elec. Co. v. Joiner, 522 U.S. 136, 143 (1997); see also Girardot v. United States, 92 A.3d 1107, 1113 (D.C. 2014) (―The concept of ‗exercise of discretion‘ is a review-restraining one.‖ (quoting Johnson v. United States, 398 A.2d 354, 362 (D.C. 1979))). Accordingly, the trial court‘s decision will be ―sustained unless it is manifestly erroneous.‖ Coates v. United States, 558 A.2d 1148, 1152 (D.C. 1989). To be permitted to testify as an expert, a witness ―must have sufficient skill, knowledge, or experience in that field or calling as to make it appear that his opinion or inference will probably aid the trier in his search for truth[.]‖ Dyas v. United States, 376 A.2d 827, 832 (D.C. 1977) (citation omitted). ―Implicit in that requirement is that the expert [must] have a reliable basis for [his] theory steeped in fact or adequate data, as opposed to offering a mere guess or conjecture.‖ Perkins v. Hansen, 79 A.3d 342, 345 (D.C. 2013) (citation and internal quotation marks omitted). ―The purpose of expert opinion testimony is to avoid jury findings based on mere speculation or conjecture[,]‖ and thus the court must weigh the 15 ―sufficiency of the foundation for those opinions . . . with this purpose in mind.‖ Washington v. Washington Hosp. Ctr., 579 A.2d 177, 181 (D.C. 1990). ―Without more than credentials and a subjective opinion, an expert‘s testimony that ‗it is so‘ is not admissible.‖ Wilson Sporting Goods Co. v. Hickox, 59 A.3d 1267, 1273 (D.C. 2013) (quoting Viterbo v. Dow Chem. Co., 826 F.2d 420, 424 (5th Cir. 1987)). ―Expert testimony may be excluded when the expert is unable to show a reliable basis for their theory.‖ Haidak v. Corso, 841 A.2d 316, 327 (D.C. 2004). In this case, Judge Combs Greene articulated many reasons for her ruling that Dr. Zimmet was ―not qualified to testify as to the source of [Russell‘s] disease,‖ among them that Dr. Zimmet had never been trained in or ―involved with the identification of the source of exposure‖ of Legionnaires‘ disease, was ―not aware of any specific type of bacteria present in sewage water[,]‖ ―did not indicate any literature to support his belief that Legionella bacteria could exist in sewage water[,]‖ had ―never had responsibility for determining the source of a person‘s Legionella bacterial exposure as part of his clinical practice[,]‖ did not know ―what strains of Legionella bacteria are most commonly associated with Legionnaire‘s [sic] Disease in humans[,]‖ was not familiar with the temperatures at which or the conditions under which Legionella bacteria amplify, and had ―no data to support his opinion that Legionella bacteria [were] at sufficient levels [in Apartment 1] to 16 cause [Russell‘s] Legionnaire‘s [sic] disease.‖ Dr. Zimmet‘s deposition answers support these findings as well as Judge Combs Greene‘s finding that his opinion testimony on causation was ―without factual basis.‖ It is true that, as Russell emphasizes, an expert witness may rely upon his experience alone when providing an opinion, see Perkins, 79 A.3d at 345 (―[A] physician‘s experience may provide a reliable basis for his or her expert opinion.‖), and that an expert witness need not cite a peer-reviewed journal article as the basis for every opinion he provides and need not use the ―data that will provide the highest degree of certainty[.]‖ Id. at 346. In addition, ―[w]here 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.‖ Knight v. Kirby Inland Marine Inc., 482 F.3d 347, 354 (5th Cir. 2007). But, as Judge Combs Greene recognized, Dr. Zimmet relied on neither experience in investigating the source of a Legionella infection, nor knowledge about what had been determined to be the source of his other Legionnaires‘ disease patients‘ exposures, nor peer-reviewed journal articles, nor data from testing at the apartment building, and he did not utilize a scientific method to conclude that 17 Legionella bacteria were present in the Fitch Street apartment building.11 Instead, as he acknowledged during his deposition, he ―essentially ma[de] the assumption . . . that the water in the apartment [building] contained amplified levels of Legionella bacteria.‖ He acknowledged that the same logic by which he eliminated the environment at the Bryce Resort as a source of Russell‘s infection — that ―[n]obody else got sick‖ there — was equally applicable to the Fitch Street apartment building (since no one else living in the apartment building got sick), and he offered only the ―belie[fs]‖ that ―taking a couple of showers‖ at Bryce would not be enough to make the previously healthy Russell sick and that Russell ―really had no other source of Legionella disease.‖12 Further, Dr. Zimmet invoked ―common sense‖ and ―intuiti[on]‖ as his basis for saying that the Bryce Resort was not a probable source of Russell‘s infection 11 ―Scientific method‖ refers to ―[t]he process of generating hypotheses and testing them through experimentation, publication, and replication.‖ BLACK‘S LAW DICTIONARY 1547 (10th ed. 2014). 12 Dr. Zimmet did not need to rule out every possible alternative source of exposure. See Westberry v. Gislaved Gummi AB, 178 F.3d 257, 265 (4th Cir. 1999). But, to offer an opinion to a reasonable degree of medical certainty, he needed — and, in Judge Combs Greene‘s reasonable estimation, he lacked — ―an objectively well founded conviction that the likelihood of one cause [of Russell‘s exposure was] greater than any other[.]‖ Robinson v. Group Health Ass’n, Inc., 691 A.2d 1147, 1150 (D.C. 1997) (quoting Clifford v. United States, 532 A.2d 628, 640 n.10 (D.C.1987)). 18 and that Russell‘s ―walk[ing] through . . . sewer water‖ at the apartment building was the likely culprit.13 And, when asked at his deposition about his ―training, knowledge and experience with respect to being able to connect a diagnosis of Legionnaire‘s [sic] disease to a suspected source[,]‖ Dr. Zimmet answered that the basis of his opinion in this case was that ―[y]ou know it when you see it.‖ That response — I know it when I see it — was the ―quintessential ipse dixit justification.‖ TASER Int’l, Inc. v. Karbon Arms, LLC, No. 11–426, 2013 WL 6773663, at  (D. Del. Dec. 19, 2013). Judge Combs Greene was not required to admit opinion evidence that was ―connected to existing data only by the ipse dixit of the expert.‖ Kumho Tire Co., Ltd. v. Carmichael, 526 U.S. 137, 157 (1999) (quoting Joiner, 522 U.S. at 146); cf. Brown v. Bray & Gillespie III Mgmt., LLC, No. 6:06-cv-661-Orl-22GJK, 2008 WL 2397601, at  (M.D. Fla. June 10, 2008) (concluding that an internist‘s opinion that plaintiffs ―contract[ed] an acute Legionella infection as a result of [their] hotel stay . . . at the Sea Garden Inn in 13 We note, too, that although Russell testified that he sometimes checked on an elderly woman who was living on the basement level of the apartment building, the deposition testimony contains no evidence that Russell actually ―crossed through‖ or ―walked through‖ any water or did so ―twice a day,‖ as Dr. Zimmet assumed. Russell‘s testimony indicated that, upon entering the apartment building on the ground floor, he needed to walk up to his apartment rather than down to the basement level. He also testified that he at no time entered Apartment 1. Judge Combs Greene could reasonably ―conclude that there [was] simply too great an analytical gap between the data and the opinion [Dr. Zimmet] proffered.‖ Joiner, 522 U.S. at 146. 19 Florida‖ ―lack[ed] a substantial basis,‖ and explaining that ―[t]he opinions of an expert will not be accepted if based on merely the ipse dixit of the expert‖).14 Russell further contends that Judge Combs Greene ―impermissibly demanded that [he] adduce direct (rather than circumstantial) evidence of the presence of Legionella bacteria in the building before permitting Dr. Zimmet to testify.‖ While we agree that the source of a plaintiff‘s Legionnaires‘ infection can be proven by (and perhaps can be proven only by) circumstantial evidence,15 we 14 We also defer to Judge Combs Greene‘s reasoning that, in light of the facts that the sewage-contaminated water in the apartment building had not been tested for Legionella bacteria and that Dr. Zimmet had cited no basis in the scientific literature for his conclusion that the sewage water was the most likely source of exposure, to allow his speculative testimony to that effect would have been more prejudicial than probative. 15 Epidemiological evidence, which typically is used to prove the source of a Legionnaires‘ outbreak, see Brown v. Bray, 2008 WL 2695230 at  (―[E]pidemiologic data indicated that the source of the outbreak was the hotel.‖), is circumstantial evidence. See In re Hanford Nuclear Reservation Litig., 1998 WL 775340, at  (E.D. Wash. Aug. 21, 1998) (―[P]laintiffs here are forced to rely on experts who present circumstantial proof of causation, in particular, epidemiological proof.‖); Land v. United States, 37 Fed. Cl. 231, 235 (Fed. Cl. 1997) (―[T]he two primary forms of circumstantial evidence in a toxic tort case are etiological evidence and epidemiological evidence.‖) (citing Renaud v. Martin Marietta Corp., 749 F. Supp. 1545, 1553 (D. Colo. 1990)); see also Silivanch v. Celebrity Cruises, Inc., 171 F. Supp. 2d 241, 255 (S.D.N.Y. 2001) (describing circumstantial evidence that sufficed to prove causation: the Legionella bacteria recovered from the sand filters of a cruise ship spa system ―were indistinguishable from organisms found in the respiratory system of one of the victims of the outbreak‖). 20 reject Russell‘s claim of error, because we do not agree that Judge Combs Greene excluded Dr. Zimmet‘s testimony on the ground that he had no direct evidence of the presence of Legionella in the building. Judge Combs Greene found it ―significant[]‖ that Dr. Zimmet ―did not indicate any literature to support his belief that Legionella bacteria could exist in sewage water.‖ She reasoned that Dr. Zimmet‘s opinion that sewage water was the most likely source of Russell‘s exposure was ―not supported by published scholarly data‖ and that Dr. Zimmet was ―unfamiliar with several areas of scientific scholarship or clinical work that might provide a substantive basis for the conclusion offered‖ (emphasis added). She also cited portions of Dr. Zimmet‘s deposition in which he testified that he did not regularly read ―published medical or scientific or hygiene literature with respect to Legionnaire[s‘] disease‖; that he had formed his opinions in this case before seeing, just prior to his deposition, an article Russell‘s counsel had given him entitled ―Health Effects of Sewage Aerosols: Additional Serological Surveys and Search for Legionella Pneumophila in Sewage‖; that the article would not play a role in the opinions he would render in the case; and that he had not reviewed any peer-reviewed and published literature discussing the prevalence of Legionella in sewage-contaminated water. In addition, Judge Combs Greene explicitly recognized that case law has held that ―it is not an abuse of discretion for courts to allow expert testimony when the expert did not conduct independent testing‖ and 21 that ―[a]s long as the expert relied on published data generated by another expert in the pertinent field, the opinion is admissible.‖ We read all these statements in the Omnibus Order as indicating that even though Dr. Zimmet had no direct evidence that Legionella bacteria were in water at the apartment building, Judge Combs Greene would likely have permitted him to testify if he had had a basis in the scientific literature to say that the sewage-contaminated water in the basement of the apartment building was a more likely source of Russell‘s exposure than a shower at Bryce Resort or any of the scores of locations Russell had visited through his work and other activities during the incubation period. We next address Russell‘s contention that Judge Combs Greene applied a legally erroneous standard in ruling on the motion in limine. He argues that the judge held Dr. Zimmet ―to a burden of proof greater than the preponderance of evidence (more likely than not) standard[.]‖16 The evidence of this error, he asserts, is the following statement on page 9 of Combs Greene‘s Omibus Order: ―Dr. Zimmet concludes that he ‗believes‘ that the sewage water was the most likely source of exposure as compared to the other possible sources because it looked like a ‗cesspool‘‖ (bold font in the original). We note that Judge Combs 16 A trial court erroneously exercises its discretion if it applies an incorrect legal standard. See Herbin v. United States, 683 A.2d 437, 443 (D.C. 1996). 22 Greene made a similar statement in footnote 6 of the Omnibus Order: ―Dr. Zimmet does not, in his deposition, states [sic] that he believes the sewage was the actual source of the Legionella bacteria. Rather, . . . he ‗believes‘ the apartment complex was the most likely source‖ (bold font in the original). Russell is correct that his burden was to prove the ―most likely‖ source of his exposure. See Snyder v. George Washington Univ., 890 A.2d 237, 248 (D.C. 2006) (―We require only that a causation expert state an opinion, based on a reasonable degree of medical certainty, that the defendant‘s conduct was a likely cause of the plaintiff‘s injuries.‖). Because it is not clear to us what Judge Combs Greene intended to convey through her emphasis on the words ―believes,‖ ―actual,‖ and ―most likely,‖17 we are skeptical of Russell‘s claim that she misapprehended the legal standard or incorrectly applied it. We are, however, satisfied that even if Judge Combs Greene erroneously held Russell to a heightened standard of proof, the basis for her ruling that Dr. Zimmet was not qualified to 17 At one point, Judge Combs Greene appeared to be distinguishing between Dr. Zimmet‘s opinion that the apartment building ―was the actual and only source of [Russell‘s] Legionnaire‘s [sic] Disease‖ and his not opining that the sewage ―was the actual source of the Legionella bacteria‖ (emphasis in original). At another point, however, she characterized Dr. Zimmet‘s view as an opinion that the building ―was the most likely source of exposure as compared to other possible sources ([Russell‘s] job and Bryce Resort)‖ because of the contaminated sewer water. 23 testify as an expert on causation was that Dr. Zimmet did not provide ―any real basis (based on facts or science) for his opinions.‖ That was a sufficient basis for precluding him from testifying as a causation expert regardless of the degree of certainty that was required. For that and all the foregoing reasons, we will not disturb Judge Combs Greene‘s ruling on the motion in limine. Russell argues in the alternative that Dr. Zimmet was entitled to testify about the source of Russell‘s exposure to Legionella as a fact witness rather than as an expert witness. It is true that ―[i]nsofar as a physician obtains and develops his information and opinions in the course of his treatment of a patient, he becomes an ‗actor or viewer‘ who should be treated as an ordinary witness rather than as an expert covered under Rule 26 (b) (4).‖ Adkins v. Morton, 494 A.2d 652, 657 (D.C. 1985) (explaining that ―the crucial inquiry is whether the facts and opinions possessed by the expert were obtained for the specific purpose of preparing for the litigation in question‖); Gubbins v. Hurson, 885 A.2d 269, 277 (D.C. 2005) (quoting Adkins and reasoning that ―Dr. Kelly‘s opinion, which he expressed to Gubbins while she still was under his care, that her nerves were injured by the medication she received during her surgery‖ ―clearly fell within this ‗exempt-from24 Rule 26 (b) (4)‘ category‖).18 However, ―a witness may be an ‗expert‘ as to some matters and an ‗actor‘ as to others.‖ Id. (internal quotation marks omitted). The question here is one of timing: When did Dr. Zimmet reach the opinions about which Russell sought to have him opine? If he reached them only ―while preparing for his trial appearance[,]‖ id. at 278, he needed to be qualified as an expert to be permitted to testify. What the record reveals is the following: Dr. Zimmet testified that he had formulated his opinions as of February 5, 2013 (the date of Russell‘s previous Rule 26 (b)(4) statement). There was evidence that, as recently as September 2012, Dr. Zimmet or (much more frequently) his staff had provided care to Russell in connection with a blood clot in his leg that stemmed from his being bedridden for weeks while recovering from Legionnaires‘ disease. However, Russell testified that the last time he went to any doctor for anything relating to the Legionnaires‘ disease itself was in June 2011. In addition, Dr. Zimmet testified that Russell‘s diagnosis of Legionnaires‘ disease was made by other doctors prior to Dr. Zimmet‘s involvement in Russell‘s treatment, and one of those doctors (―the 18 See also Folks v. District of Columbia, 93 A.3d 681, 685 (D.C. 2014) (―[T]he medical records suggest that the treating physicians would be able to testify at trial about their opinions on the issue of causation based on the information that they had obtained in their treatment of Mr. Folks.‖). 25 infectious disease doctor‖) wrote in the medical records (apparently incorrectly) that Russell reported that he had water leakage in his apartment from a ventilation system and attributed the Legionella exposure to that.19 Dr. Zimmet described the ―grilling‖ about ―[w]hat‘s your exposure‖ that ―we‖ doctors conduct when encountering a patient who has Legionnaires‘ disease, but also explained that Russell was asked about exposures ―at the time he came in the hospital in his May admission,‖ clarified that Russell did not answer such questions to Zimmet specifically, and acknowledged he had never ―had the responsibility for determining the source of an individual‘s Legionella bacterial exposure as part of [his] clinical practice.‖ Further, Dr. Zimmett had never visited the Fitch Street apartment building. He relied on what he read in Russell‘s deposition transcript and other depositions and on what he saw in the video of Apartment 1 for his knowledge of the conditions that existed in the building, and, importantly, he did not see the video or any photos of Apartment 1 until the day of his deposition, which was April 19, 2013.20 In short, the record provides no foundation for a 19 Russell stated during his deposition that there were no ventilation ducts in his apartment and that he had never ―spent any time in a residence where a ventilation system leaks,‖ and one of Call/D‘s experts also stated in his expert report that ―[t]here is no vent system, no central air system and no air ducting system that could have dripped water into [Russell‘s] apartment.‖ 20 Russell‘s girlfriend, who made the video of the standing water in Apartment 1, testified that she decided to do this on her own after hearing Russell‘s (continued…) 26 conclusion that Dr. Zimmet ―formulated the opinions in question while he was treating‖ Russell, Gubbins, 885 A.2d at 278, rather than in preparation for his deposition and for trial, such that it was error not to permit him to present the opinions as a fact witness.