01/17/2019 - US News: Delaware: A lower court judge improperly excluded expert testimony

The Supreme Court of Delaware has revived medical negligence claims against a women’s health clinic and a doctor, finding a lower court judge improperly excluded expert testimony regarding a procedure gone wrong.

The ruling negated a November 2017 order that found the testimony of an expert witness was unreliable because it was not based on medical literature or peer-reviewed publications.

A high court three judge panel ruled Tuesday that Superior Court Judge William L. Witham Jr. misinterpreted Delaware precedent for establishing the reliability of expert testimony, and ordered the judge to revisit a ruling that granted summary judgment in favor of All About Women and Dr. Christine W. Maynard, who practices gynecology for the Newark-based clinic.

The ruling wiped out a November 2017 order from Witham, which found the testimony of plaintiff Amanda Norman’s expert witness unreliable because it was not based on medical literature or peer-reviewed publications.

State Supreme Court Justice James T. Vaughn Jr., who wrote for the court, said Dr. Jeffrey Soffer’s more than 20 years of experience in obstetrics and gynecology had qualified him to testify that Maynard and the clinic had been negligent in conducting a 2013 procedure, which allegedly left Norman hospitalized with a ruptured bladder.

“In this case, the information relied on by Dr. Soffer are Ms. Norman’s medical records and the depositions of Ms. Norman and Dr. Maynard. He arrives at his opinions by applying his training and experience to the facts of this case,” Vaughn wrote in a 12-page opinion.

“Medical literature or peer-reviewed publications may be useful factors in an appropriate case, and may be relevant to the defense in this case, but they have no bearing on the admissibility of Dr. Soffer’s opinions,” the panel ruled.

Norman’s lawsuit, filed in December 2014, seeks compensatory damages stemming from a diagnostic laparoscopy—a surgical procedure that allows doctors to examine a woman’s reproductive organs. According to court documents, surgical reports did not indicate any complications, but Norman immediately experienced intense pain in her lower abdomen and reported her symptoms to Maynard.

Still in pain, Norman was rushed to the hospital three days later, where doctors discovered that her bladder had ruptured, and attributed the injury to the laparoscopy. Norman later sued in Superior Court, claiming that Maynard was negligent in perforating her bladder and failing to recognize the problem. The lawsuit alleged Norman has racked up more than $42,000 in medical bills and nearly $4,800 in lost earnings due to the “disabling nature of her injuries.”

Maynard and All About Women have denied allegations of negligence, saying the injury is a known complication of the laparoscopy. According to court documents, Maynard discussed the risks and alternatives with Norman before the procedure.

The defendants also attacked Soffer’s testimony that Maynard had provided substandard care, saying that his opinion was not supported by any medical literature, and was based solely on the fact that an injury occurred.

“Adopting Dr. Soffer’s reasoning, any time a bladder injury occurs during this procedure, it is a violation of the standard of care,” attorneys from Wharton Levin Ehrmantraut & Klein argued in court papers last year.

Tuesday’s ruling from the Supreme Court cited a similar case in which the justices found the testimony of a plaintiff’s expert was based on an analysis of the circumstances of the case, and “not mere speculation over the cause of a bad result.”

“The same can be said of Dr. Soffer’s analysis in this case,” Vaughn said. “Dr. Soffer’s deposition testimony, considered as a whole, is sufficient to establish the applicable standards of care, Dr. Maynard’s deviations from those standards, and injury to Ms. Norman caused by those deviations. His testimony is admissible.”

The case will be remanded to Witham for further proceedings. Vaughn was joined in the opinion by Justices Karen L. Valihura and Collins J. Seitz Jr.