Opinion ID: 1153595
Heading Depth: 1
Heading Rank: 8

Heading: the testimony is subject to frye

Text: The Frye test is simple to state, if not always easy to apply: [I]n order to introduce expert testimony deduced from a scientific principle or discovery, the principle or discovery `must be sufficiently established to have gained general acceptance in the particular field in which it belongs.' Flanagan v. State, 625 So.2d 827, 828 (Fla. 1993) (quoting Frye v. United States, 293 F. 1013, 1014 (D.C.Cir.1923)). This standard requires a determination, by the judge, that the basic underlying principles of scientific evidence have been sufficiently tested and accepted by the relevant scientific community. Brim v. State, 695 So.2d 268, 272 (Fla.1997); see also Ramirez v. State, 810 So.2d 836, 843 (Fla.2001) (Evidence based on a novel scientific theory is inherently unreliable and inadmissible in a legal proceeding in Florida unless the theory has been adequately tested and accepted in the relevant scientific community.). The underlying theory of Frye is that a courtroom is not a laboratory, and as such it is not the place to conduct scientific experiments. If the scientific community considers a procedure or process unreliable for its own purposes, then the procedures must be considered less reliable for courtroom use. Stokes v. State, 548 So.2d 188, 193-94 (Fla.1989). A. Novel Scientific Testimony Versus Pure Opinion Courts traditionally have exempted pure opinion testimony from the requirements of Frye on the theory that the testimony is based on the expert's personal experience and training. See, e.g., Hodden v. State, 690 So.2d 573, 580 (Fla.1997); Flanagan, 625 So.2d at 828; State v. Demeniuk, 888 So.2d 655, 659 (Fla. 5th DCA 2004). As we explained in Flanagan: [P]ure opinion testimony, such as an expert's opinion that a defendant is incompetent, does not have to meet Frye, because this type of testimony is based on the expert's personal experience and training. While cloaked with the credibility of the expert, this testimony is analyzed by the jury as it analyzes any other personal opinion or factual testimony by a witness. 625 So.2d at 828. The majority holds that testimony causally linking trauma to fibromyalgia is just such pure opinion testimony. This conclusion broadens this supposedly narrow exception way beyond its limited purpose. Testimony is pure opinion only when it is based solely on experience and training, and does not rely on a novel scientific principle, test, or methodology: Pure opinion refers to expert opinion developed from inductive reasoning based on the experts' own experience, observation, or research, whereas the Frye test applies when an expert witness reaches a conclusion by deduction, from applying new and novel scientific principle, formula, or procedure developed by others. Demeniuk, 888 So.2d at 659 (quoting Holy Cross Hosp., Inc. v. Marrone, 816 So.2d 1113, 1117 (Fla. 4th DCA 2001)). We first recognized that pure opinion testimony is not subject to Frye in Flanagan, 625 So.2d at 828. There, we recognized the distinction between pure opinion testimony derived solely from experience and training and expert testimony that necessarily relies on some scientific principle or test and rejected labeling the pedophile/sex offender profile testimony at issue pure opinion: Profile testimony . . . by its nature necessarily relies on some scientific principle or test, which implies an infallibility not found in pure opinion testimony. The jury will naturally assume that the scientific principles underlying the expert's conclusion are valid. Accordingly, this type of testimony must meet the Frye test, designed to ensure that the jury will not be misled by experimental scientific methods which may ultimately prove to be unsound. Id. Similarly, in Hodden, 690 So.2d at 581, we applied Frye to testimony that an alleged victim of sexual abuse exhibited symptoms consistent with those of a child who has been sexually abused. We explained that the Frye test requires that the scientific principles undergirding this evidence be found by the trial court to be generally accepted by the relevant members of its particular field. Hodden, 690 So.2d at 576. We rejected labeling the evidence pure opinion: We differentiate pure opinion testimony based upon clinical experience from profile and syndrome evidence because profile and syndrome evidence rely on conclusions based upon studies and tests. Further, we find that profile or syndrome evidence is not made admissible by combining such evidence with pure opinion testimony because such a combination is not pure opinion evidence based solely upon the expert's clinical experience. Id. at 580 (emphasis added). Therefore, in both Flanagan and Hadden we recognized that pure opinion is not subject to Frye, but emphasized that the underlying scientific principles are. Flanagan, 625 So.2d at 828; Hodden, 690 So.2d at 576, 580; see also Brim, 695 So.2d at 272 (recognizing that under Frye, the burden is on the proponent of the evidence to prove the general acceptance of both the underlying scientific principle and the testing procedures used to apply, that principle to the facts at hand) (quoting Ramirez v. State, 651 So.2d 1164, 1168 (Fla. 1995)). These cases dictate that where an expert's opinion is based on an underlying scientific principle, that underlying principle is subject to Frye. See also Hildwin v. State, 951 So.2d 784, 792 (Fla.2006) (The principal inquiry under the Frye test is whether the scientific theory or discovery from which an expert derives an opinion is reliable.) (quoting Ramirez, 651 So.2d at 1167). In this case, the underlying scientific principle is that trauma can cause fibromyalgia. That principle must pass the Frye test. I agree that testimony that a particular patient, such as Marsh, suffers from fibromyalgia, if based on clinical experience, may constitute pure opinion not subject to Frye. In this case, however, the objection was not to testimony that Marsh suffers from fibromyalgia, but to testimony that it was caused by trauma. While the experts may assert that their testimony is based on their experience and training, it is also necessarily based on an underlying (and as yet unproven) scientific principle that trauma can cause fibromyalgia. Marsh, 917 So.2d at 327 (recognizing that the testimony requires an underlying scientific assumption  that trauma can cause fibromyalgia  which is not involved in pure opinion cases); see also Kaelbel Wholesale, Inc. v. Soderstrom, 785 So.2d 539, 547 (Fla. 4th DCA 2001) (rejecting the argument that causation testimony was pure opinion, concluding that it was not based upon personal experience or training but instead was based upon scientific principles to reach the opinions and conclusions drawn). This theory of general causation does not become admissible simply because it is the opinion of some experts that trauma caused Marsh's fibromyalgia. See Hodden, 690 So.2d at 580 (recognizing that evidence is not made admissible by combining it with pure opinion testimony); Marsh, 917 So.2d at 327 ([I]t is counterintuitive to permit an expert to ignore scientific literature accepted by the general scientific community in favor of the expert's personal experience to reach a conclusion not generally recognized in the scientific community and then allow testimony about that conclusion on the basis that it is `pure opinion.'). As we recognized in Hodden: Novel scientific evidence must also be shown to be reliable on some basis other than simply that it is the opinion of the witness who seeks to offer the opinion. In sum, we will not permit factual issues to be resolved on the basis of opinions which have yet to achieve general acceptance in the relevant scientific community; to do otherwise would permit resolutions based upon evidence which has not been demonstrated to be sufficiently reliable and would thereby cast doubt on the reliability of the factual resolutions. 690 So.2d at 578; see also Ramirez, 810 So.2d at 844 (recognizing that Frye requires more than [^] bald assertion by the expert that his deduction is premised upon well-recognized scientific principles). The majority's holding that an opinion about specific causation need not pass the Frye test, even where the underlying theory of general causation is not accepted, in effect renders specific causation testimony always admissible as the pure opinion of the expert. This constitutes a sea change in Florida law, as Florida courts have regularly applied Frye to causation testimony. See, e.g., Shepard v. Barnard, 949 So.2d 232, 233 (Fla. 5th DCA 2007) (applying Frye to testimony that the use of Verteporfin could cause permanent photoallergy); Hawkins v. State, 933 So.2d 1186, 1189 (Fla. 4th DCA 2006) (finding Frye applicable to an opinion about the cause of a silicone embolism), review dismissed, 950 So.2d 414 (Fla.2007); Demeniuk, 888 So.2d at 657, 659 (finding Frye applicable to testimony of a causal connection between selective serotonin reuptake inhibitors and suicide/involuntary alcohol consumption where the opinions were based on a novel scientific theory); David v. Nat'l R.R. Passenger Corp., 801 So.2d 223, 226 (Fla. 2d DCA 2001) (remanding for a determination of whether the theory that repetitive motion can cause carpal tunnel syndrome was generally accepted); Kaelbel Wholesale, Inc., 785 So.2d at 548-50 (rejecting testimony linking ciguatera poisoning to the development of Guillain-Barre Syndrome where the theory of causation was not generally accepted); Poulin v. Fleming, 782 So.2d 452, 452 (Fla. 5th DCA 2001) (applying Frye to testimony that prenatal exposure to radiation caused schizencephaly). As I explain more fully below, we have approved, and have seemingly applied, this approach. See U.S. Sugar Corp. v. Henson, 787 So.2d 3, 5 (Fla. 1st DCA 2000) (applying Frye to testimony that the cumulative effect of pesticide exposure caused phrenetic nerve mononeuropathy and finding both the general causation theory and specific causation methodology to be generally accepted), approved 823 So.2d at 109 (commending and approving the thoughtful analysis performed by the district court below evaluating the general acceptance of the methodologies and scientific principles supporting Henson's experts' opinions). Other courts recognize this proposition as well. As a federal appellate court has said, The underlying predicates of any cause-and-effect medical testimony are that medical science understands the physiological process by which a particular disease or syndrome develops and knows what factors cause the process to occur. Based on this predicate knowledge, it may then be possible to fasten legal liability for a person's disease or injury. Black v. Food Lion, Inc., 171 F.3d 308, 314 (5th Cir.1999); cf. McClain v. Metabolife Int'l Inc., 401 F.3d 1233, 1239 (11th Cir. 2005) (noting that in toxic tort cases where the medical community does not generally recognize an agent as both toxic and capable of causing the injury alleged, the Daubert analysis covers not only the expert's methodology for the plaintiff-specific questions about individual causation but also the general question of whether the drug or chemical can cause the harm plaintiff alleges). Permitting an expert to testify that X caused Y in a specific case without requiring the general acceptance of the theory that X can ever cause Y expands the pure opinion exception to the point where it swallows the rule. B. U.S. Sugar and Castillo Two of our recent decisions confirm the applicability of Frye to general causation testimony. See U.S. Sugar Corp. v. Henson, 823 So.2d 104 (Fla.2002); Castillo v. E.I. Du Pont De Nemours & Co., 854 So.2d 1264 (Fla.2003). U.S. Sugar involved a Frye challenge to an expert's opinion that the cumulative effect of pesticide exposure caused the claimant's phrenetic nerve mononeuropathy. 823 So.2d at 106. The First District applied Frye to conclude: Because our de novo review establishes that there is general acceptance in the relevant scientific community both (i) for claimant's general causation theory that certain pesticides to which he was repeatedly exposed over a long period of time can cause peripheral neuropathy, and (ii) for the differential diagnosis methodology employed by claimaint's physicians, which they used to exclude other facts that might cause his condition and to determine that his pesticide exposure specifically caused his injury, we affirm. U.S. Sugar Corp., 787 So.2d at 5 (emphasis added). On review, we agreed that it is generally accepted in the scientific community that `organophosphates are neurotoxic' and that [b]ecause of this generally accepted scientific foundation, the `extrapolation' method utilized by these experts in concluding that chronic exposure to these pesticides caused claimant's condition is an acceptable scientific technique in this case. U.S. Sugar, 823 So.2d at 109 (quoting U.S. Sugar, 787 So.2d at 16-17). We went on to highlight (referring to the Third District's decision in E.I. DuPont De Nemours & Co., Inc. v. Castillo, 748 So.2d 1108 (Fla. 3d DCA 2000), quashed, 854 So.2d 1264 (Fla. 2003)) that under Frye, the inquiry must focus only on the general acceptance of the scientific principles and methodologies upon which an expert relies in rendering his or her opinion. U.S. Sugar, 823 So.2d at 110. The other case in which we confirmed Frye's application to general causation was Castillo, 854 So.2d at 1264. That case involved expert testimony that fetal exposure to a fungicide (Benlate) caused a birth defect (microphthalmia). Id. at 1267. The Frye challenge related to the methodology for determining whether, and at what level, Benlate could cause birth defects in humans. Id. The defendants acknowledged that the in vivo tests (animal toxicology) and in vitro tests (analysis of the effects of suspected substances on isolated cell systems) underlying the opinion were generally accepted methods for analyzing toxicology, but they argued that the expert's extrapolation from the tests to conclude that Benlate is a human teratogen was not generally accepted. Castillo, 748 So.2d at 1116, 1118. The district court found that the expert's extrapolation from the tests was subject to and failed to satisfy Frye. Id. at 1120-21 ([W]here, as here, .plaintiffs wish to establish a substance's teratogenicity in human beings based on animal and in vitro studies, the methodology used in the studies, including the method of extrapolating from the achieved results, must be generally accepted in the relevant scientific community.). On review, we disagreed, concluding that the expert conclusions reached through extrapolation fell outside of Frye consideration: By considering the extrapolation of the data from the admittedly acceptable experiments, the Third District went beyond the requirements of Frye, which assesses only the validity of the underlying science. Frye does not require the court to assess the application of the expert's raw data in reaching his or her conclusion. We therefore conclude that the Third District erroneously assessed the Castillos' expert testimony under Frye by considering not just the underlying science, but the application of the data generated from that science in reaching the expert's ultimate conclusion. Castillo, 854 So.2d at 1276 (emphasis added). U.S. Sugar and Castillo confirm that while expert opinions deduced from generally accepted principles are not subject to Frye, the underlying principles are. U.S. Sugar, 823 So.2d at 109-10 ([W]hen the expert's opinion is based on generally accepted scientific principles and methodology, it is not necessary that the expert's deductions based thereon and opinion also be generally accepted as well.); Castillo, 854 So.2d at 1269, 1276 (We must consider whether the scientific principles upon which the Castillo's experts based their opinions are generally accepted in the scientific community.). The majority characterizes the challenge in this case as one to the experts' conclusions that trauma caused Marsh's fibromyalgia. Majority op. at 549. But Respondents do not challenge the experts' conclusions. Rather, they challenge the premise behind them  the theory that trauma can ever cause fibromyalgia. If it were generally accepted in the scientific community that trauma can cause fibromyalgia, then I would agree that the experts' deduction from that principle to conclude that trauma caused Marsh's fibromyalgia would not be subject to Frye. See Castillo, 854 So.2d at 1276; U.S. Sugar, 823 So.2d at 110. It is that underlying principle, however, that is contested here. I also disagree with the majority's conclusion that Marsh's experts' testimony is not subject to Frye simply because the methodology used  differential diagnosis  is generally accepted. Majority op. at 549. Differential diagnosis is certainly a generally accepted methodology for determining specific causation. The use of differential diagnosis alone, however, does not exempt causation testimony from Frye. Differential diagnosis is merely a scientific methodology in which the expert eliminates possible causes of a medical condition to arrive at the conclusion as to the actual debilitating factor. U.S. Sugar, 823 So.2d at 106. It is a process of elimination  the patient's condition, call it X, was not caused by A, B, or C; therefore, X must have been caused by D. But before causes A, B, and C can be scientifically excluded as a specific cause (i.e., A did not cause X), they must first be scientifically included as a general cause (i.e., A can cause X). Experts cannot conclude, through a process of elimination, that trauma caused the plaintiffs fibromyalgia without first demonstrating the reliability of the theory that trauma can cause it. To illustrate with an extreme example: a patient suffering from depression sees a doctor because her arm hurts. She does not know why her arm hurts. The doctor diagnoses a broken arm. The patient cannot tell the doctor how she broke her arm. The doctor may, through performing tests and interviewing the patient, conclude that it could not have been a car accident (the patient was not involved in an accident) and it could not have been playing sports (the patient does not play sports), but the doctor cannot then conclude that it must have been the depression that caused the broken arm  unless, of course, the doctor can show that the theory that depression can cause a broken arm is generally accepted in the scientific community. Similarly, only if it is generally accepted that trauma is a potential cause of fibromyalgia may an expert testify that, through differential diagnosis, she has concluded that trauma caused this plaintiffs fibromyalgia. See, e.g., McClain, 401 F.3d at 1253 ([A]n expert does not establish the reliability of his techniques or the validity of his conclusions simply by claiming that he performed a differential diagnosis on a patient.); Clausen v. M/V New Carissa, 339 F.3d 1049, 1057-58 (9th Cir.2003) (The first step in [a differential diagnosis] is to compile a comprehensive list of hypotheses. . . . The issue at this point in the process is which of the competing causes are generally capable of causing the patient's symptoms or mortality. Expert testimony that rules in a potential cause that is not so capable is unreliable.) (citation omitted); Food Lion, 171 F.3d at 314 (recognizing that the causes of fibromyalgia are unknown and [a]bsent these critical scientific predicates . . . no scientifically reliable conclusion on causation can be drawn such that the use of a general methodology cannot vindicate a conclusion for which there is no underlying medical support); Maras v. Avis Rent A Car Sys., Inc., 393 F.Supp.2d 801, 809 (D.Minn.2005) (noting that the plaintiff failed to demonstrate a proper basis for ruling in an accident as the cause of fibromyalgia and thus, use of differential diagnosis did not render the testimony admissible). Differential diagnosis is not a wild card that can be used to introduce novel scientific theories into the courtroom. Any other logic would revert us to the science of the Salem Witch Trials. See, e.g., Laurie Winn Carlson, A Fever in Salem xiv (1999) (With the limited scientific and medical knowledge of the time, physicians who were consulted could only offer witchcraft as an explanation.); cf. Carl Sagan, The Demon-Haunted World 26 (1995) (Science is an attempt, largely successful, to understand the world, to get a grip on things, to get hold of ourselves, to steer a safe course. Microbiology and meteorology now explain what only a few centuries ago was considered sufficient cause to burn women to death.).