Expert Causation: Kaylor v. Arrisueno
The Baltimore Medical Malpractice Lawyer Blog discusses Maryland medical malpractice cases. In this post, I examine the issue of expert testimony on causation in the case of Kaylor v. Arrisueno. This case, which was heard in the US District Court for the District of Maryland, Civil No. 21-01164-BAH (May 8, 2024), contributes to the field of medical malpractice law due to its discussion on expert testimony.
Factual Background
The plaintiff brought a medical malpractice case based on a delay in diagnosing necrotizing fasciitis. This soft tissue infection is a medical emergency. The plaintiffs also alleged a delay in performing the necessary surgery. (Op. at 1-2). As a result, the plaintiff had minimal use of her left hand and arm. She had chronic pain and could no longer work or drive a car. She also needed assistance with basic activities. (Id. at 13).
The court meticulously reviewed the plaintiffs’ allegations of negligence. The allegations were against nine individual medical providers and a hospital, and the circumstances occurred over a period of five days, April 7 to 11. (Id. at 3-12).
Certain defendants filed a motion for summary judgment, contending that the plaintiffs’ expert failed to establish that causation injury to the plaintiffs. (Id. at 2, 17). The defendants characterized the breach allegations as failing to get a stat CT scan and surgery consult. They also note that they did these things before the 10th, which they characterize as the plaintiff’s expert identified as the last possible date for surgery to avoid permanent injury. (Id. at 18-19).
US District Court on Expert Causation Testimony
The court unequivocally rejected the defense’s contentions. The plaintiffs’ causation expert testified that the earlier the surgery, the less harm it would result. The expert added that surgery should have occurred on the first day. (Id. at 19-20). This opinion provided a basis for a jury to conclude that the defendants could have acted to prevent degrees of permanent injury on the earlier dates, not that the 10th was the date by which the plaintiffs would have avoided any permanent injury. Under this possible conclusion, the 10th was not a line in the sand to prevent permanent injury but rather part of a sliding scale of severity of permanent injury. (Id. at 20-21).
Additional Arguments
The defendants also argued that an earlier CT scan and surgical consultation would not have changed anything because the surgical consult concluded that no surgery was necessary. (Id. at 21). However, the court found that a reasonable jury could conclude that earlier action could have prompted the consult to consider the necrotizing fasciitis diagnosis. (Id. at 23).
The court also relied on a similar case, Adventist Healthcare v. Mattingly, 223 A.2d 1025 (Md. App. 2020), which you can read about in a Blog post. This case, which involved a similar issue of expert testimony on causation, provided a precedent for the court’s decision in the Kaylor v. Arrisueno case.
The defense also characterized the plaintiffs’ expert testimony as meaningless because he did not apportion how much the necrotizing fasciitis advanced. In other words, the defense argued that the expert’s testimony was not specific enough to determine the extent to which the disease progressed, which they claimed was necessary to establish causation. However, the defense did not cite any cases demonstrating such specificity is required.
The court found sufficient evidence of causation to go to the jury, denying the motion for summary judgment. (Id. at 31-32).
Commentary by Baltimore Medical Malpractice Lawyer Mark Kopec on Expert Causation Testimony
The court did not struggle in denying the defendants’ motion for summary judgment. Plaintiffs’ expert causation testimony was sufficient. Unfortunately, this is a typical case where the defendants take isolated parts of testimony and leave out other testimony that provides the full context. In doing so, they make easily defeated arguments when the court considers the whole evidence.
The result is that the plaintiff’s medical malpractice lawyers are put to a lot of work to set the record straight and provide the whole picture. In addition, the court has to expend a lot of time and effort to review all of these materials and, one by one, show how the defendants’ arguments fail.
It would be nice if all of this wasted effort was not necessary. But this is the defense playbook; unfortunately, we see it very often.
You can also read Blog posts on other medical malpractice case on the topics of causation and expert testimony.
Mark Kopec is a top-rated Baltimore medical malpractice lawyer. Contact us at 800-604-0704 to speak directly with Attorney Kopec in a free consultation. The Kopec Law Firm is in Baltimore and helps clients throughout Maryland and Washington, D.C. Thank you for reading the Baltimore Medical Malpractice Lawyer Blog.