Court Opinion

ID: 9690580
Source: CourtListenerOpinion
Date Created: 2023-08-24 19:24:39.94111+00
Date Added: 2024-06-11T18:18:59.907504
License: Public Domain

Dissenting opinion by
Justice JOHNSTONE.
In Kentucky, expert testimony is admitted at trial when it satisfies a four-part analysis set forth in Stringer v. Commonwealth, 956 S.W.2d 883 (Ky.1997), which incorporates, as part of that analysis, the requirements of Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579, 113 S.Ct. 2786, 125 L.Ed.2d 469 (1993). To introduce expert testimony, the testimony must satisfy the following four requirements: (1) the expert witness must be qualified, (2) the subject matter must satisfy the requirements of Daubert, (3) the subject matter must satisfy the test of relevancy set forth in KRE 401, subject to the prejudicial versus probative balancing test required by KRE 403, and (4) the testimony must assist the trier of fact. Stringer, 956 S.W.2d at 891. Because it determines only that the expert testimony in this matter satisfies the requirements of Daubert, without any analysis of or reference to the Stringer requirements, I cannot join the majority opinion. Furthermore, having considered the record in its entirety, and having thoroughly reviewed the proposed testimony that Dr. Rolf delivered at the suppression hearing, I conclude that it fails to satisfy the requirements of Stringer.
During her testimony, Dr. Rolf presented the results of her autopsy of Price’s body and explained that Price had suffered from cardiac disease during his life. She concluded that the medical cause of Price’s death was a fatal cardiac arrhythmia, and that the manner of death was “homicide by heart attack.” In explaining this conclusion, Dr. Rolf testified that she followed the criteria set forth in a 1977 article on “homicide by heart attack,” to which she repeatedly referred during the hearing. The article lists the requirements as follows:
1. The criminal act should be of such severity and have sufficient elements of intent to kill or maim, either in fact or by statute, so as to lead logically to a charge of homicide in the event that physical injury had ensued.
2. The victim should have realized that the threat to personal safety was implicit. A logical corollary would be a feared threatening act against a loved one or friend.
3. The circumstances should be of such a nature as to be commonly accepted as highly emotional.
4. The collapse and death must occur during the emotional response period, even if the criminal act had already ceased.
5. The demonstration of an organic cardiac disease process of a type commonly associated with a predis*321position to lethal cardiac arrhythmia is desirable.
Dr. Rolf testified that she believed all of these criteria had been met in this case, and therefore concluded that Price died as a result of “homicide by heart attack.”
This conclusion rested on several preliminary findings, which Dr. Rolf discussed extensively during her testimony. First, Dr. Rolf determined that Appellant committed a criminal act of such severity and nature so as to fulfill the first requirement of “homicide by heart attack.” In addition to the contusions and abrasions on Price’s body indicating a physical altercation, Dr. Rolf based this belief on information in the police reports and a tape recording of the 911 call contained in the police record. On cross-examination, though, Dr. Rolf acknowledged that Appellant’s behavior might not be considered criminal if Price had initiated the altercation, and that she did not know for certain how the altercation commenced. Second, Dr. Rolf surmised that Price perceived an implicit threat to his personal safety. She testified that this was simply a common sense conclusion based on her understanding of the circumstances. Finally, Dr. Rolf concluded that the confrontation between Price and Appellant had been highly emotional. Again, she drew these conclusions based on information in the police reports indicating that Appellant and Price had been in a heated and physical argument.
Expert testimony is admissible only when it will “assist the trier of fact to understand the evidence or to determine a fact in issue.” KRE 702. Here, Appellant was charged with murder. A person commits murder when “with the intent to cause the death of another person, he causes the death of such person or of a third person.” KRS 507.020(l)(a). Though the fact of Price’s death was not at issue, serious questions remained concerning Appellant’s intent and whether her actions did, in fact, cause Price’s death. In other words, causation was the central and determining issue in this case, and testimony as to whether the death was a homicide, accident, or suicide would assist the jury. Accordingly, the jury would need expert testimony concerning cardiac disease in general, and specifically the conditions under which extreme stress could induce a fatal heart attack so that a juror could determine whether another person caused Price’s death. Thus, Dr. Rolf could properly testify that the autopsy revealed Price’s cardiac disease, that he had died of a sudden cardiac arrhythmia, and that his body had numerous abrasions and contusions indicating a physical struggle.
However, by permitting Dr. Rolf to conclude that the manner of death was “homicide by heart attack” pursuant to the list provided in her journal article, the trial court allowed improper opinions that were beyond Dr. Rolfs area of expertise and that were not needed for the jury’s understanding of the evidence. The jury did not require expert testimony to determine whether the altercation between Price and Appellant was highly emotional; testimony from the investigating officers and the 911 recording would have been sufficient evidence upon which the jury could base an informed decision. Likewise, Dr. Rolfs expert opinion was unnecessary to an intelligent determination as to whether Price did or did not perceive a physical threat that would induce stress. This question does not require specialized knowledge beyond the understanding of the average juror. Finally, Dr. Rolfs testimony that, in her opinion, Appellant’s actions constituted a criminal act upon which to base a charge of homicide was undoubtedly beyond the area of her expertise; in fact, Dr. Rolf stated more than once her belief that this was “a question for the investigating *322officers” and that she “wouldn’t know” if Appellant’s actions during the altercation constituted a criminal act.1 These types of opinions are inadmissible as expert testimony, as they do not assist the jury in understanding the evidence or determining a fact in issue. The majority disregards this fundamental requirement.
The majority also concludes that Dr. Rolf properly based her testimony on “facts and data ... made known to the expert at or before the hearing,” KRE 703(a), correctly noting that medical examiners regularly receive information from investigating officers that aid their inquiry and influences their medical conclusions. A review of Dr. Rolfs testimony, however, reveals that her testimony was not based solely on such information, but also on non-medical opinion. Dr. Rolf acknowledged that her conclusion that Price’s death was a homicide rested, in part, on her assumption that Appellant had committed a criminal act by initiating the altercation. She even conceded that she might not have classified the death as “homicide by heart attack” if, for example, Price had initiated and escalated the conflict that later resulted in his fatal heart attack. Dr. Rolf then admitted that she had “assumed” Appellant had initiated the altercation but could not identify a single police report or record supporting this assumption, or disproving the possibility that Price had started the conflict. These assumptions, necessary to Dr. Rolfs overall conclusion that Price’s death was a homicide and not merely a heart attack resulting from a stressful situation, were simply expressions of Dr. Rolfs personal opinion and cannot be classified as facts or data regularly relied upon by medical examiners. By identifying the manner of death as “homicide,” Dr. Rolf was implicitly testifying that Appellant had caused the death of Price, despite the fact that this conclusion was not based solely on her expert medical opinion or upon facts and data in police reports.
The most glaring omission in the majority opinion is its failure to consider the “prejudice versus probative” analysis required by Stringer. The classification of Price’s death as a “homicide” is highly prejudicial in this case, especially when introduced in the form of expert testimony. KRE 403. An autopsy conclusion of homicide signifies that some human action caused injury to the victim and that the victim died as a result. See KRS 507.010. (“A person is guilty of criminal homicide when he causes the death of another human being ....”) As the majority notes, Price’s death is unlike a victim who has been shot or stabbed, where it is clear that a human being caused the victim’s death. In such situations, an autopsy conclusion that the manner of death was homicide is not particularly prejudicial and is based solely on medical fact. However, the majority fails to take the analogy to its logical conclusion: in a case where the ultimate issue is whether human action caused a *323death, expert medical testimony that conclusively answers this question but is not based solely on medical opinion is highly improper and prejudicial.
Instead, the majority concludes that this discrepancy renders Dr. Rolfs testimony even more necessary, stating that it is “axiomatic that a determination of the cause and manner which led to a person’s death is generally scientific in origin and outside the common knowledge of layperson jurors.” Op. at 815. The fact that jurors “usually” need the assistance of expert medical testimony in similar cases does not somehow reheve this Court of its duty to examine the specific facts and circumstances of this case or to review the actual proposed testimony. See Op. at 815, citing Stringer v. Commonwealth, 956 S.W.2d 883, 889-90 (Ky.1997). (“[Jurors”] usually do need the assistance of a medical expert in determining the cause of a physical condition ....) Nor does the fact that causation of death is at issue somehow open a floodgate to any and all expert medical testimony of whatever nature.
Here, Dr. Rolfs autopsy findings confirmed only that Price died of a heart attack; her conclusion that the death was a homicide incorporated not only objective data gleaned from police reports, but also her personal interpretation of that information.2 The substantial weight that a jury places on expert medical opinion cannot be ignored, and the potential for prejudice resulting from improper expert testimony is great. Furthermore, this potential prejudice greatly outweighs the probative value of the testimony, precisely because, by her own admission, medical expertise was not needed to reach Dr. Rolfs conclusion that the death was a homicide. Once informed of the circumstances under which severe stress can hypothetically result in a heart attack, a reasonable juror is perfectly capable of determining whether one person’s actions were sufficiently stressful and hostile so as to cause the other to suffer a heart attack.3 The factors that led to Dr. Rolfs conclusion of homicide — the taped 911 call, the police reports — are factors well within the knowledge and understanding of the jury. Dr. Rolfs expert opinion as a forensic pathologist was simply not necessary to reach this conclusion, and to admit testimony that incorporates these types of non-professional opinions as expert is highly prejudicial. Inferences to be drawn from the testimony are a function completely within the jury’s province, and the precise conclusions to be drawn from the evidence should never be presented to the jury in the form of expert testimony.
*324By ignoring the “prejudicial versus probative analysis” required by Stringer, both the majority and concurring opinions fail to fully appreciate the impact of Dr. Rolfs testimony as it pertains to the particular facts of this case. When the entirety of Dr. Rolfs testimony is reviewed, it is evident that her testimony incorporated personal opinion, which is never the proper subject of expert testimony and which carries the danger of great prejudice. I find no error in Dr. Rolfs testimony that fatal heart attacks can be induced by high levels of stress, or in her testimony that Price died of a heart attack. I find it highly prejudicial, however, to permit a forensic pathologist to present expert testimony that Appellant did, in fact, induce this stress when such a conclusion is based on nothing more than her admittedly “personal” and “common sense” opinions of the circumstances preceding Price’s death.
For the foregoing reasons, I respectfully dissent.
LAMBERT, C.J., joins this dissent.

. The majority misconceives Appellant’s argument on appeal that Dr. Rolf’s testimony was improper because it included an opinion that a criminal act was committed in this case. See Op. at 315. The majority responds to this argument: "The term, homicide, of course, does not presuppose the occurrence of a criminal act, but simply refers to when a person causes the death of another human being.” Appellant does not argue that the expert testimony was improper because it in-eluded the opinion that the criminal act of homicide occurred; the majority confirms the obvious that "homicide” is not a crime. The argument is that the expert testimony was improperly based on the opinion that Appellant had committed a criminal act by initiating the altercation with Price. This, according to Dr. Rolf's testimony and referring to the 1977 journal article, is a necessary prerequisite to a conclusion that the manner of death was "homicide by heart attack.”

. See Medlock v. State, 263 Ga. 246, 430 S.E.2d 754, 756-57 (1993). (Where an expert’s findings as to cause of death "would have permitted the jury to find the death-causing injury either accidental or intentional ... it would [be] impermissible for the expert to state his opinion that homicide was the cause of death.”)

. The majority’s reliance on Terry v. Associated Stone Co., 334 S.W.2d 926 (Ky.1960), to support a contrary assertion is curious. In that worker’s compensation case, competing expert testimony as to what extent physical strain caused the claimant's heart attack was presented. Because all of the experts agreed that the physical exertion played some causative role in the heart attack, the Court concluded that the board’s findings were based on substantial evidence and thus addressed only the issue of employer liability. The Court was not asked to determine whether the expert testimony was prejudicial because it incorporated personal opinion, precisely because the circumstances preceding the claimant’s heart attack were not disputed. Here, of course, the circumstances surrounding Price's heart attack were very much in dispute.