Linda Newton died at Harford Memorial Hospital (“Hospital”) after falling into septic shock. Her estate (“Estate”) alleged that she died as a result of medical malpractice on the part of a radiologist, Haleema Javid, M.D., who read an x-ray taken when she presented to the Hospital with abdominal pain. The Estate filed a Maryland medical malpractice claim against Dr. Javid and the Hospital in the Circuit Court for Harford County and, after discovery, sought to offer an expert opinion on the issue of causation, i.e., that Dr. Javid’s failure to refer Ms. Newton immediately for surgery caused her to develop sepsis that increased her risk of death. After a hearing, the circuit court granted the Hospital’s and Dr. Javid’s motions to exclude the expert’s testimony and, as a result, their motions for summary judgment. The Estate appealed these rulings.
The 66-year-old decedent died on October 21, 2020. She had been diagnosed a few months earlier with Stage IV uterine cancer. She died from sepsis that appears to have resulted from a perforation in her descending colon. Surgeons repaired the perforation after it was identified, but the question was whether that perforation, or at least the possibility of a perforation, should have been identified earlier and, if it had, whether earlier surgery might have prevented her from developing sepsis.
The Appellate Court of Maryland stated in its unpublished Opinion filed on May 22, 2025: “this appeal turns on the circuit court’s decision to grant Dr. Javid’s and the Hospital’s motions to exclude the testimony of the Estate’s proffered expert, Dr. Karen Jubanyik, [a board-certified emergency medicine physician], and for summary judgment. In addition, there does not appear to be any dispute about the standard of care or whether it was violated. The only question is whether Dr. Jubanyik should have been permitted to testify on the issue of causation, and specifically the causal link between Dr. Javid’s delay in discovering free air on the x-ray—and, in turn, the initiation of surgery—and the onset of sepsis and septic shock.”
The Maryland Appellate Court stated that Dr. Jubanyik is not a radiologist or a surgeon, and she acknowledged that a surgeon would make decisions about treatment and interventions and that she would have to defer to a surgeon on the question of when surgery should have occurred had a perforation been identified earlier. The Estate offered Dr. Jubanyik as an expert to opine on causation, specifically that the decedent’s death was caused by undergoing surgery for a bowel perforation while in a state of septic shock. Had Dr. Javid read the second x-ray at 10:07 a.m. to indicate a potential bowel perforation, Dr. Jubanyik opined, the decedent would have gone into surgery before developing sepsis. Thus, according to Dr. Jubanyik, the ninety-minute delay was a cause of the decedent’s death: she opined that the time that elapsed between the reading of the second x-ray (at 10:07 a.m.) and the third (at 11:33 a.m.) caused the decedent to go into septic shock before she underwent surgery.
Dr. Jubanyik admitted that she couldn’t say what a surgeon would or would not have done if notified ninety minutes earlier about the possible perforation. She recognized that there likely would be disagreements among surgeons and acknowledged that her role as an emergency physician would be to get a surgeon involved as soon as possible and, importantly, that the surgeon would decide whether and how to intervene. She also acknowledged that the mortality rate for each person depends on a number of variables.
The Maryland Appellate Court stated: “the circuit court, after considering Rule 5-702(1)–(3) and the Daubert factors, found that the facts, principles, and methodologies grounding Dr. Jubanyik’s opinions were too attenuated from the opinion itself. And on this record, we agree … Dr. Jubanyik isn’t a radiologist, but also wasn’t asked to opine on any radiology failures … Dr. Jubanyik couldn’t testify to an appropriate degree of medical certainty, from her own experience or expertise or any data she produced, that involving a surgeon ninety minutes earlier would have made any difference in Ms. Newton’s condition. Dr. Jubanyik conceded that a surgeon, not the emergency medicine physician, would have made any decisions about whether or when or how to intervene and that surgeons could well disagree about whether and when to intervene, even with earlier notice of a possible bowel perforation.”
The Maryland Appellate Court held: “Dr. Jubanyik’s opinions about the causal effect of any delay were too attenuated from her experience, expertise, or data. And although Dr. Jubanyik’s theory may well have been plausible, the circuit court didn’t abuse its discretion in concluding, on this record and with the acknowledged limitations of Dr. Jubanyik’s testimony, that her expert opinion failed to satisfy Rule 5-702 and was not sufficiently reliable when measured against the Rochkind/Daubert factors. We affirm the court’s decisions to exclude the expert testimony and, as a result, to grant summary judgment in favor of the Hospital and Dr. Javid.”
Source Estate of Linda Kay Newton v. Haleema Javid, M.D., No. 2218 September Term, 2023.
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