The State of Minnesota Court of Appeals (“Minnesota Appellate Court”) stated in its nonprecedential opinion filed on August 2, 2021 in a Minnesota medical malpractice case in which the plaintiff alleged that the defendants’ delay in providing appropriate medical care and treatment for her mother during premature labor caused her to suffer severe permanent injuries: “If an expert does not explain why a plausible alternative cause is not the sole cause, the expert’s differential diagnosis is necessarily unreliable. See id. at 695 (observing that expert witnesses provided only conclusory denial of potential alternative causes). Dr. Hillman did not rule out periviability as the cause of Daughter’s morbidities, and his differential diagnosis is therefore unavailing and cannot by itself qualify his opinion as foundationally reliable.”
The Underlying Facts
Pregnant Amber Nelson (“Nelson”) went to the hospital, reporting vaginal discharge. An ultrasound revealed significant cervical dilation, prompting doctors to administer labor-inhibiting and fetal-development medications. Nelson gave birth to a 24-week-old daughter weighing 1.4 pounds, 31 hours after she arrived at the hospital. The child now suffers from significant health issues.
Nelson sued two hospitals and two physicians for medical malpractice on behalf of her daughter, alleging that they failed to administer the labor-inhibiting medication soon enough to forestall delivery and failed to administer the fetal-development medication sufficiently to prevent the child’s health problems. The district court granted summary judgment dismissing Nelson’s claims, refusing to consider her expert-witness testimony and concluding that she failed to identify disputed issues of material fact for trial. The Minnesota Appellate Court concluded that the district court should not have excluded the expert testimony but that the testimony nevertheless falls short of presenting a prima facie case of malpractice and therefore affirmed the summary-judgment decision.
The Minnesota Appellate Court held: “Because these two studies support [the plaintiff’s expert] Dr. Hillman’s conclusion that a full course of ANS would have reduced Daughter’s current morbidities, some of Dr. Hillman’s evidence is reliable as applied here. The district court therefore abused its discretion by excluding the expert testimony on foundational reliability grounds.”
The Minnesota Appellate Court further held, however: “Although we agree with Nelson that Dr. Hillman’s testimony rested on sufficient foundation, we agree with respondents that summary judgment is nonetheless appropriate … Nelson failed to provide sufficient evidence to establish a prima facie case for her theory that an allegedly negligent incomplete ANS course caused Daughter’s morbidities … the two relevant medical studies on which Dr. Hillman relies offer a risk-reduction conclusion that, as a matter of law, cannot establish causation … An incomplete course of ANS cannot have more than likely caused an unfavorable outcome if both an incomplete and a full course of ANS result in less-than-likely-to-occur injuries … Both relevant studies that Dr. Hillman relied on establish only a marginal risk decrease in the context of an overall less-than-likely-to-occur injury. Although Dr. Hillman opined that a full course of ANS would more likely have eliminated Daughter’s morbidities, he based this opinion on medical studies that fail to support the conclusion, on a flawed differential diagnosis, and on personal experience that in turn relies on the unsupportive studies. Nelson therefore fails to establish a traditional prima facie negligence case and summary judgment is appropriate.”
Source Nelson v. Fairview Health Services d/b/a/ Fairview Lakes Regional Medical Center, A20-1134.
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