Opinion ID: 2169679
Heading Depth: 1
Heading Rank: 5

Heading: Motion in Limine: The Remaining Defendants

Text: The remaining defendants, Dr. Cieniawa, Dr. Sullivan, and St. Joseph Health Services of Rhode Island, appeared before a justice of the Superior Court on a motion in limine to preclude plaintiff's expert, Dr. Nathanson, from testifying about causation. After taking testimony and hearing the arguments of the parties, the court granted the defendants' motion in limine and then, after determining that plaintiff had no further evidence to submit on the issue of causation, entered judgment as a matter of law in favor of defendants pursuant to Rule 50 of the Superior Court Rules of Civil Procedure. [10] The justice's finding that Dr. Nathanson was not competent to testify about causation was based on the witness's concession during his deposition that he would defer on that issue to the opinion of a neurologist. During that deposition on May 26, 2004, the following colloquy took place: Q. [Y]ou do not consider yourself either competent or qualified to give any opinions on causation, is that true? [Counsel]: Objection. [Dr. Nathanson]: On causation? Q. In terms of whether any treatment would have made any difference in this case? A. I'm going to let a neurologist speak to that. Q. So your answer is you're notyou don't consider yourself to be competent and qualified[.] Q. I know what the standard of care would have been at my hospital for somebody who had a stroke, that I can testify to. On November 29, 2004, at the hearing on the motion in limine, Dr. Nathanson acknowledged his deposition testimony, in which he declined to testify as to causation and said he would defer to the opinion of a neurologist. [11] He told the court, however, that since the deposition he had done some reading to prepare for this case as well as for his board examinations, and he testified that the administration of aspirin to Ms. Foley before her stroke, or TPA [12] after it, could have altered the medical result in her case. The justice was clearly troubled by Dr. Nathanson's recently acquired expertise in the area of causation. She noted that based on Dr. Nathanson's own deposition testimony, the appropriate person to testify about causation in a case such as this would be an expert in neurology. The justice explained: [I]t does not matter that he [Dr. Nathanson] does not practice in neurology so long as he has sufficient knowledge, skill, experience, training and education in the field of neurology to offer a competent opinion as to causation. However, she continued, Dr. Nathanson did nothing other than read some literature in the area in question and then comes in here and says I wasn't competent in May, but I'm competent today; that's troubling to me. That's troubling. After considering the testimony that she had heard during the motion in limine and the arguments of counsel, the trial justice ruled that she was not satisfied that the witness was now qualified to testify about causation. She also found his testimony about the administration of aspirin and the benefits of TPA to be speculative. For those reasons, the hearing justice granted the defendants' motion in limine and excluded any testimony from Dr. Nathanson about causation. On appeal, Ms. Foley argues that the motion justice abused her discretion when she found that Dr. Nathanson was not qualified to testify about causation. She also urges us to revisit our decision in Contois v. Town of West Warwick, 865 A.2d 1019, 1023 (R.I.2004), and adopt the so-called loss of chance doctrine. It is well settled that [t]he determination of whether to qualify and permit an expert witness to proffer an expert opinion relative to an issue in dispute is left to the discretion of the trial justice and this Court will not disturb that determination absent clear error or an abuse of discretion. Debar v. Women and Infants Hospital, 762 A.2d 1182, 1185 (R.I.2000). We are also mindful that such deference does not mean that the trial justice's ruling is not reviewable. Id. Rather, we must be satisfied that the trial justice's discretion was soundly and judicially exercised, that is, if it has been exercised in the light of reason applied to all the facts and with a view to the rights of all the parties to the action,    and not arbitrarily or willfully, but with just regard to what is right and equitable under the circumstance and the law. Id. at 1185-86 (quoting DeBartolo v. DiBattista, 117 R.I. 349, 353, 367 A.2d 701, 703 (1976)). The General Assembly has identified the qualifications that a witness must possess to offer an expert opinion. Section 9-19-41 provides in pertinent part: In any legal action    for personal injury or wrongful death filed against a licensed physician, [or] hospital    based on professional negligence, only those persons who by knowledge, skill, experience, training, or education qualify as experts in the field of the alleged malpractice shall be permitted to give expert testimony as to the alleged malpractice. When interpreting this statute we have found nothing in its plain and unambiguous terms that requires an expert in a medical malpractice case to practice in the same specialty as the defendant or have training in the same medical specialty as the defendant. Debar, 762 A.2d at 1186. We have explained that an expert's opinion may be heard to aid the jury in its quest for truth where the subject matter of the testimony is of a mechanical, scientific, professional or like nature, none of which is within the understanding of laymen of ordinary intelligence, and where the witness seeking to testify possesses special knowledge, skill or information about the subject matter acquired by study, observation, practice or experience   . Morgan v. Washington Trust Co., 105 R.I. 13, 17-18, 249 A.2d 48, 51 (1969). Here, Dr. Nathanson admitted in May 2004 that on the issue of causation, he would defer to the opinion of a neurologist. Six months later, however, plaintiff's counsel claimed that Dr. Nathanson had become qualified to offer expert testimony on causation. Given these circumstances, it is our opinion that under § 9-19-41, as well as our established case law in this area, the trial justice did not abuse her discretion, but exercised it soundly and judicially when she ruled that Dr. Nathanson was not qualified to testify as an expert on the issue of causation. Nevertheless, the plaintiff maintains that we should revisit our decision in Contois and adopt a loss of chance approach to causation. [13] It is clear to this Court, however, that even under a loss of chance approach to causation, a plaintiff has the obligation to present evidence that the alleged negligence was a proximate cause of the loss of chance. See Contois, 865 A.2d at 1023. Because the plaintiff's expert in this case was not competent to offer expert testimony on causation, and there was no other evidence tending to prove causation, we decline to accept the plaintiff's invitation to adopt any version of the loss of chance doctrine, since it would not alter our decision to deny the plaintiff's appeal. [14] We are convinced, after a thorough review of the record in this case, that the motion justice did not abuse her discretion when she granted the motion in limine and we uphold the entry of judgment as a matter of law in this case.