Opinion ID: 1979794
Heading Depth: 1
Heading Rank: 4

Heading: Doctor Ferguson's Opinion Testimony

Text: Doctor Latina urges that the trial justice improperly struck the opinion testimony of Dr. Ferguson in which the defense expert opined that Dr. Latina was not negligent when he did the laparoscopic cholecystectomy. In the course of direct examination, Dr. Ferguson first testified that he object[ed] to the concept of a standard of care. Later, when asked what was the standard of care when performing the infundibular technique in the removal of the gallbladder   , he responded that it would be to identify the cystic duct and the cystic artery, [and] to clip and divide the cystic duct and cystic artery   . On cross-examination, Franco's counsel asked Dr. Ferguson whether he agreed that plaintiff's injury was the result of Dr. Latina's misidentification of the cystic duct, and Dr. Ferguson responded in the affirmative. At that point, plaintiff moved to strike the portions of Dr. Ferguson's testimony that offered the opinion that Dr. Latina acted within the standard of care and was not negligent because Dr. Ferguson's opinion as to negligence did not coincide with an articulated standard of care for the procedure. Doctor Latina countered that Dr. Ferguson was a qualified expert and that his opinion should not be stricken, but rather was entitled to be weighed by the jury. In her decision to strike the testimony, the trial justice delivered a detailed rationale for her ruling: [Dr. Ferguson] has described complications in the procedure that could lead to misidentification but he has not altered the standard of care as eliminating correct identification and therein lies the essential problem with regard to his opinion testimony. When he gives his opinion that Dr. Latina was not negligent in performing plaintiff's surgery, he does not marry that testimony with the standard of care. In essence, his conclusion is misidentification is not negligent because it is evidence of human error. That basis for an opinion as to the non-existence of negligence, or an opinion as to whether there was a deviation from the standard of care, is not responsive to the underpinnings of what the standard of care requires.   . So the motion to strike is granted. On appeal, Dr. Latina urges us to hold that the trial justice's decision to strike Dr. Ferguson's opinion testimony was an abuse of discretion because the shortcomings that the trial justice articulated about Dr. Ferguson's testimony were relevant to the weight it should be afforded, but did not provide grounds to strike it. Although it is certainly true that a qualified expert may offer testimony in the form of opinion, the witness nevertheless must set forth a sufficient basis for that opinion. R.I. Evid. R. 705. Furthermore, the decision to allow an expert opinion is within the sound discretion of the trial justice and will be disturbed only for an abuse of that discretion. D'Alessio, 848 A.2d at 1123. Doctor Latina suggests that our decision in Morra v. Harrop, 791 A.2d 472, 477 (R.I.2002), in which we held that it was error for the trial justice to strike the expert testimony of a medical examiner about cause of death because it was articulated in terms of possibility, supports his argument that Dr. Ferguson's opinion should have been allowed. However, Morra is easily distinguishable. In Morra, the expert witness reviewed the case of a psychiatric patient who was found dead near the grounds of Butler Hospital in order to present expert testimony about the cause of death. Morra, 791 A.2d at 474-76. After eliminating all other potential causes of death, the expert doctor testified that in his opinion the only possibility was suicide by drowning. Id. at 476. The trial justice disallowed the testimony because the expert medical witness used the term possibility when he gave his opinion, reasoning that possibility [was] not enough in medical negligence cases. Id. However, we reversed on appeal, holding that because the expert rendered an opinion that suicide was the only possible cause of death, he had ruled out all other possible causes. Id. at 477. Thus, we held that the expert testimony in that case was proffered with the requisite degree of certainty, and that it was an abuse of discretion to disallow it. Id. at 477-78. In this case, however, the trial justice did not strike Dr. Ferguson's testimony because he failed to express his opinion with sufficient certainty. Rather, the trial justice ruled that Dr. Ferguson's opinion about Dr. Latina's freedom from negligence could not be reconciled with his opinion about the appropriate standard of care for performing laparoscopic cholecystectomies. The defendant also directs our attention to Gallucci v. Humbyrd, 709 A.2d 1059, 1064, 1065 (R.I.1998), in which we reversed the trial justice's decision to strike the expert opinion of a physical therapist regarding causation of an injury because the witness' opinion was based on his mistaken belief that the patient engaged in exercises using a greater amount of weight than actually used. In reaching that holding we noted that it was significant that the expert's opinion, though derived from information that provided an incorrect amount of weight, attributed the cause to the performance of any active exercise, without regard to the amount of weight used. Id. at 1064. We held that because the opinion was based on relevant facts and was tied to an articulated standard of care, it was an abuse of discretion to strike portions of the expert's opinion regarding causation. Id. at 1064-65. Here, however, the trial justice made it absolutely clear that her decision to strike Dr. Ferguson's testimony was not because he was unqualified to testify as an expert, nor was it predicated on incorrect or inadequate materials or facts that he relied upon in reaching his opinion. Instead, the trial justice struck Dr. Ferguson's opinion that Dr. Latina was not negligent because she was unable to see any relationship between his opinion and the standard of care to which he and the other experts testified to during the course of the trial. Undaunted, Dr. Latina presses the argument that the apparent disconnect between Dr. Ferguson's opinion on negligence and the standard of care to which he himself testified does not justify striking the opinion, but rather goes to the weight of the evidence. In making this argument, he points to Owens v. Silvia, 838 A.2d 881, 892 (R.I.2003) (quoting Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579, 596, 113 S.Ct. 2786, 125 L.Ed.2d 469 (1993)), in which we said [v]igorous cross-examination, presentation of contrary evidence, and careful instruction on the burden of proof are the traditional and appropriate means of attacking shaky but admissible evidence. However, Dr. Latina's reliance on this language in Owens overlooks our focus in that case on the importance of the trial justice's gatekeeping role when it comes to admitting expert opinions. Indeed, in Owens, we highlighted the role of the trial justice in ensuring that the opinions provided by experts present a scientifically valid theory because their opinions frequently lack the benefit of first-hand knowledge or observations of the factual circumstances at issue, and because expert opinion testimony can be, by its very nature, both `powerful and quite misleading.' Owens, 838 A.2d at 891 (quoting Daubert, 509 U.S. at 595, 113 S.Ct. 2786). We do not question Dr. Latina's description of Dr. Ferguson as a knowledgeable and respected physician and not a charlatan or a purveyor of junk science. See Gallucci, 709 A.2d at 1064. In her decision to strike Dr. Ferguson's opinion regarding Dr. Latina's negligence, the trial justice did not question Dr. Ferguson's credentials either. But, the trial justice aptly noted that his ultimate opinion with regard to negligence was not logically tied to what he conceded was the proper standard of care for the procedure. In light of Dr. Ferguson's testimony that he object[ed] to the concept of a standard of care, his concession that identification of the correct anatomical feature was required, and his testimony that Dr. Latina's mistake in performing Franco's surgery was human error, we hold that the trial justice was performing her necessary duty as a gatekeeper when she removed this powerful and    misleading evidence from the consideration of the jury. See id.