Carole Horseman was treated in the emergency department of Mercy Regional Medical Center four times in September 2018: once on September 7th, once on September 9th, and twice on September 11th. On September 7th and 9th, Ms. Horseman presented with complaints of neck pain. On September 11th, Ms. Horseman presented with complaints of vomiting, nausea, and continued neck pain. Ms. Horseman was discharged after each visit.
On the morning of September 12, 2018, Ms. Horseman collapsed in her home while getting dressed. EMS transported Ms. Horseman to the hospital, where she died that morning. An autopsy subsequently confirmed that Ms. Horseman died of community-acquired MRSA pneumonia.
Zachary Horseman (individually and in his capacity as the administrator of Ms. Horseman’s estate) sued Mercy Health and Dr. David M. Yin (“Dr. Yin”) for wrongful death and negligence, alleging that Dr. Yin breached the standard of care by failing to order certain tests that would have confirmed that Ms. Horseman had pneumonia and sepsis while she was in the ER on September 11th, which could have been successfully treated with MRSA antibiotics. Dr. Yin argued that he did not breach the standard of care because there was no indication that Ms. Horseman had pneumonia or sepsis (and, therefore, no reason to order certain tests) while she was in the ER on September 11th, and that Ms. Horseman acquired MRSA pneumonia after her discharge from the ER. Additionally, Dr. Yin argued that, even if Ms. Horseman had been diagnosed with pneumonia and sepsis while in the ER, she would not have survived.
Plaintiff’s counsel filed motions in limine two weeks before trial, including a motion in limine to exclude any evidence related to its infectious disease expert, John J. Cascone, M.D.’s, history of substance abuse from 2009. Dr. Yin responded in opposition, arguing that Dr. Cascone’s past unlawful acts of fraud and dishonesty that led to his medical license being put on probation directly related to his credibility and character for truthfulness. Dr. Yin argued that this evidence was admissible under Evid.R. 608(B) and that its probative value was not substantially outweighed by the danger of unfair prejudice. As a result, Dr. Yin argued, he should be allowed to rely on such evidence to impeach Dr. Cascone at trial. Dr. Yin also argued that Plaintiff’s assertions regarding Dr. Cascone’s past substance abuse downplayed Dr. Cascone’s past misconduct, which–per publicly available documents from the Missouri Division of Professional Registration and/or the Missouri State Board of Registration for the Healing Arts–included: (1) possessing and using controlled substances, including cocaine, methamphetamine, and other prescription drugs without a valid prescription; (2) failure to “document the suppliers’ or recipients’ DEA number and date of receipt on his controlled substances receipt records and did not maintain complete controlled substance receipt records[;]” (3) failure to maintain a record of all controlled substances prescriptions; (4) prescribing “controlled substances in the absence of good faith, in the absence of properly established physician-patient relationship;” and (5) discovering in February 2008 that his wife “had been purchasing controlled substances and billing them to his account[,]” but failing to “report the loss or diversion” to the appropriate board. Dr. Yin also asserted that Dr. Cascone violated the terms of his probation by using controlled substances and cocaine, which resulted in further disciplinary action and an additional term of probation. Dr. Yin argued that “Dr. Cascone’s misconduct regarding controlled substances and fraudulent record keeping practices is directly relevant to his credibility, qualifications, and character for truthfulness as a purported medical expert witness.” Dr. Yin also argued that the probative value of such evidence was not substantially outweighed by the danger of unfair prejudice, and that the jury should be permitted to evaluate the impeachment evidence and weigh Dr. Cascone’s testimony accordingly.
The trial court granted the motion in limine regarding Dr. Cascone’s past misconduct and licensure issues prior to trial without explaining its reasoning.
The Ohio Court of Appeals Ninth Judicial District (“Ohio Appellate Court”) stated in its April 22, 2024 Decision and Journal Entry: “an expert’s licensure is a matter that affects the weight of the expert’s testimony. St. Elizabeth Health Ctr. at ¶ 50. This case hinged upon which set of experts the jury chose to believe, yet Dr. Cascone was able to “give the jury the impression that his professional credentials were untarnished when this was not the case.” Id. at ¶ 49. Given the facts of this case, had the trial court allowed defense counsel to cross-examine Dr. Cascone regarding his past licensure issues, this evidence may have affected the weight the jury gave to Dr. Cascone’s medical opinions and–in turn–the outcome of the case … As a result, the trial court committed reversible error by precluding defense counsel from cross-examining Dr. Cascone regarding his past licensure issues.”
Source Horseman v. Mercy Health-Lorain Hosp., 2024-Ohio-1518.
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