Opinion
Civil Action CV-18-354
10-07-2020
CHRISTOPHER TOTO, Plaintiff, v. RAELYN KNOWLES, Defendant
ORDER ON DEFENDANT'S MOTION FOR RECONSIDERATION
MaryGay Kennedy, Justice.
Before the Court is Defendant's Motion for Reconsideration of Defendant's Motion in Limine and Motion for Summary Judgment. After due consideration, the Defendant's Motion for Reconsideration is granted with regard to Defendant's Motion for Summary Judgment and denied as moot with regard to Defendant's Motion in Limine.
I. Factual Background:
This is a negligence case that arises out of a motor vehicle accident between the Plaintiff and Defendant. (Pl.'s Compl. ¶ 4.) Plaintiff alleges that the accident caused certain "visual injuries" that have negatively impacted his balance, depth perception, and ability to read. (Supp.'g S.M.F. ¶ 1.) The damages sought by the Plaintiff are limited to those suffered as a result of these visual injures. (Supp.'g SM.RJ 2.)
Dr, Colin Robinson, a Neuro Optometrist, specifically diagnosed the Plaintiff with "visual midline shift," which can be caused by concussion or various other medical conditions, including; multiple-sclerosis; Parkinson's; autism; and, Lyme disease. (Add. S.M.F. ¶ 7; Robinson Dep. 24.) Because Dr. Robinson allowed that visual midline shift, a neurological phenomenon, is not yet generally accepted by the scientific community,' this Court ruled previously that Dr. Robinson cannot testify as an expert or give an opinion as to whether the vehicle accident caused the Plaintiff's visual injuries. (Order on Def, 's Mot in Limine at 1-3.) This ruling did not affect Dr. Robinson's ability to testify as a fact witness as the Plaintiff's treating physician. (Id.) However, this Court denied the Defendant's Motion for Summary Judgment, concluding that: "Dr. Robinson's testimony is not necessary for a jury to find that the accident caused Plaintiff's injuries" because the Plaintiff has established that "his visual injuries and associated symptoms did not exist prior to the accident." (Order on Def, 's Mot Sum. Judg. at 5, 6.) The Defendant's Motion for Reconsideration challenges the legal basis of this conclusion.
Robinson Dep. 25-27.
II. Summary Judgment Standard
A party is entitled to summary judgment when review of the parties' statements of material facts and the record to which the statements refer, demonstrates that there is no genuine issue as to any material fact in dispute. Dyer v. Dep't of Transp., 2008 ME 106, J 14, 951 A.2d 821; M.R. Civ. P. 56(c). A contested fact is "material" if it could potentially affect the outcome of the case. Id. A "genuine issue" of material fact exists if the claimed fact would require a factfinder to "choose between competing versions of the truth." Id. (quotations omitted). The court reviews the evidence in the light most favorable to the non-moving party. Id.
To prevail against summary judgment, a plaintiff must establish a prima face case for each element of the claim they allege. Tri-Town Marine, Inc. v. J.C. Milliken Agency, Inc., 2007 ME 67, ¶ 7, 924 A.2d 1066. Proximate cause is a necessary element of negligence. Walter v. Wal-Mart Stores, Inc., 2000 ME 63, ¶ 17, 748 A.2d 961.
III. Discussion:
The Defendant argues that the Plaintiff's injuries are medically complex and thus the Plaintiff is required to present expert medical testimony to support his claim as a matter of law. The Defendant reasons that without this expert testimony, a reasonable jury could not conclude, without resorting to improper speculation, that the Plaintiff's complex medical injuries were caused by the accident. The Defendant concludes that because the Plaintiff has not presented such testimony there is no genuine issue of material fact as to whether the accident was the proximate cause of the Plaintiff's injury and thus the Plaintiff's claim fails as a matter of law.
A. Motion for Reconsideration:
A motion for reconsideration "shall not be filed unless required to bring to the court's attention an error, omission, or new material that could not previously have been presented." M.R.Civ.P. 7(b)(5). This rule is intended to "deter disappointed litigants from seeking to reargue points that were or could have been presented to the court on the underlying motion." Shaw v. Shaw, 2003 ME 153, ¶ 8, 839 A.2d 714.
Here, the Defendant argues that the Plaintiffs injuries require such scientific and specialized knowledge to understand that, as a matter of law, expert medical testimony is required to prove whether the accident actually caused those injuries. The Defendant cites Merriam v. Wanger in support of his argument but the Plaintiff objects; arguing that Wanger applies only to cases involving professional negligence. 2000 ME 159, 757 A.2d 778. As such, this Court must first determine whether, as a matter of law, Wanger requires expert medical testimony to support the Plaintiff's general negligence claim.
1. Merriam v. Wanger:
The plaintiff in Wanger underwent a procedure designed to restore her fertility. Wanger, 2000 ME 159, J 2, 757 A.2d 778. The plaintiff knew the procedure carried a risk that the plaintiff might develop Pelvic Inflammatory Disease ("PID"). Id. At some point after the procedure, the plaintiff went to the emergency room complaining of pain in her pelvic area, which was mis- diagnosed by the defendant doctor to be PID. Wanger, 2000 ME 159, ¶ 3, 757 A, 2d 778. It was discovered later that the plaintiff actually had an abdominal abscess. Wanger, 2000 ME 159, ¶f 4, 757 A.2d 778. Treatment for the plaintiff's abscess caused irreversible damage to the plaintiff's reproductive system. Id. At trial, expert testimony clearly established that the defendant doctor was negligent in his misdiagnosis and that irreversible damage to the plaintiff's reproductive system was a reasonably foreseeable result of that misdiagnosis. Wanger, 2000 ME 159, ¶ 12, 757 A.2d 778. However, no expert testified that the plaintiff's damages could have been avoided had the defendant not been negligent. Wanger, 2000 ME 159, J 15, 757 A.2d 778. Despite this, the jury ruled in favor of the plaintiff. Wanger, 2000 ME 159, ¶ 5, 757 A.2d 778.
The Law Court held that although "the jury was properly instructed on proximate cause" the record "contain[ed] no evidence upon which a jury could have found ... that [the plaintiff's] damages were proximately caused by [defendant's] negligence." Wanger, 2000 ME 159, ¶ 16, 757 A.2d 778. The Court reasoned that "[a]llowing a jury to infer causation on complex medical facts without the aid of expert testimony on the subject, and without some showing that [the defendant] was more likely than not the cause of [plaintiff's] injury, stretches the jury's role beyond its capacity." Wanger, 2000 ME 159, ¶ 17, 757 A.2d 778.
Citing Wanger, the Defendant argues that the Plaintiff's visual midline shift is a medically complex injury and expert testimony is thus required to prove a causal link between the accident and alleged injury as a matter of law. (Def, 's Mot. Recon. at 2.) In reply, the Plaintiff argues that Wanger only applies in medical and legal malpractices cases. (Pl.'s Reply to Def.'s Mot. Recon. at 2.) The Plaintiff reasons that because the Law Court has only required expert testimony in medical and legal malpractice cases, there is no such requirement for expert testimony in negligence or car accident cases specifically. (Id.)
The Plaintiff specifically sites the section of the opinion that states:
The Plaintiff's positiou misapprehends, albeit understandably, the Law Court's reasoning in Wanger. Although the Plaintiff is correct that Wanger concerned medical malpractice, the Court's ruling was not based on the fact that the injuries may have been caused by a medical professional. Instead, the Court was concerned that a jury was "allowed to infer causation" from complex medical facts without the aid of expert testimony. Wanger, 2000 ME 159, ¶ 17, 757 A.2d 77S (emphasis added). This speculation was of particular concern because the jury inferred causation simply because the plaintiff suffered a reasonably foreseeable injury subsequent to the doctor's negligent act. Wanger, 2000 ME 159, 5 16, 757 A, 2d 778 (holding that "evidence of negligence and foreseeability of risk does not permit a jury to infer causation"). Wanger's reference to medical and legal negligence does not limit the Court's ruling, but rather reinforces the Court's conclusiou that professionals, just like any other defendant, cannot be "subject to liability absent actual evidence of causation" Wanger, 2000 ME 159, J 17, 757 A, 2d 778. As such, Wane er establishes that if a plaintiff's injuries arise out of complex medical facts, proximate causation must be .supported by expert medical testimony if there is no independent evidence to suggest that the defendant caused the plaintiff's complex medical injury.
This conclusion is consistent with this Court's prior interpretation of Wanger. In Bell v. R.C. Mgmt, the Superior Court held that the absence of expert testimony prevented the plaintiff from claiming medical damages in her sexual harassment lawsuit. No. CV-16-377, 2010 Me. Super LEXIS 158 (March 27, 2010). The plaintiff in Bell alleged medical damages stemming from psychiatric treatment she received in the months after the alleged sexual harassment. Id. at *9. However, the plaintiff failed to offer any expert testimony that linked this psychiatric treatment to the harassment. Id. Citing Wanger only, this Court held that "an expert is required to establish complex medical facts" and that failure to designate such an expert precludes a plaintiff from claiming medical damages "as a matter of law." Id. at *11.
Here, the Plaintiff alleges that the head injury he sustained in the accident caused him to suffer a visual midline shift; a neurological phenomenon which has yet to be generally accepted by the scientific community. (Robinson Dep. 25-27.) Additionally, the Plaintiff's treating physician has testified that any insult to the brain could trigger a visual midline shift. (Robinson Dep. 40, ¶¶ 8-12.) As such, visual midline shift is a complex medical condition within the meaning of Wanger because jurors are unable to rely on their common knowledge to understand the phenomenon or accurately determine under what circumstances it might occur. Furthermore, there is no evidence independent of the fact that the visual midline shift developed after the Defendant's negligent act to suggest that the accident actually caused the visual midline shift. Therefore, when there are complex medical facts at issue that are not within the common knowledge of an average juror, Wanger requires, as a matter of law, the Plaintiff to provide expert medical testimony to prove proximate causation. Accordingly, Defendant's Motion for Summary Judgment requires reconsideration by this Court.
B. Proximate Cause:
Generally, proximate cause is a question of fact for the jury and is that cause which, in a natural and continuous sequence, unbroken by an efficient intervening cause, produces the injury, and without which the result would not have occurred." Wanger, 2000 ME 159, ¶¶ 9, 10, 757 A.2d 778. Evidence offered to prove proximate cause "need not be persuasive at that stage, but the evidence must be sufficient to allow a [jury] to make a factual determination without speculating." Estate of Smith v. Cumberland Cry., 2013 ME 13, ¶ 19, 60 A.3d 759. Despite this, jurors may draw "reasonable inferences based on their own experience as to whether a particular act... is a proximate cause of an injury." Tolliver v. DOT, 2008 ME 83, ¶ 42, 948 A.2d 1223. However, if a plaintiff's injuries arise out of a complex set of medical facts, proximate causation must be supported by expert medical testimony if there is no other independent evidence to suggest that the defendant caused the plaintiff's injury. Wanger, 2000 ME 159, ¶ 17, 757 A.2d 758.
As stated above, the Plaintiff's visual midline shift is a complex medical condition that is not within the common knowledge of an average juror. The Plaintiff, however, has not provided admissible expert testimony that can link this complex medical condition to the car accident. Thus, Plaintiff is asking that a jury infer his visual midline shift was proximately caused by the car accident, based solely on fact that his symptoms of the visual midline shift developed subsequent to the car accident. Without the aid of expert testimony, this inference stretches the jury beyond its capacity. Because of this, there is no basis upon which a reasonable jury could find, without resorting to speculation, that the car accident caused the Plaintiff's visual midline shift. Therefore, the Plaintiff has failed to show that there is a genuine issue of material fact as to whether the car accident was the proximate cause of the Plaintiff's damages.
1. Temporal Congruity
This ruling is further supported by the Defendant's argument regarding "temporal congruity." Temporal congruity, as the term is used by the Defendant, refers to the Latin maxim of "post hoc, ergo propter hoc" ("PHEPH"). Traskv. Automobile Ins. Co., CV-94-379, 1997 Me. Super. Lexis 118 (April 7, 1997). The PHEPH maxim is a logical fallacy "that assumes causality from a temporal sequence." McClain v. Metabolife Int'l Inc., 401 F.3d 1233, 1243 (11th Cir. 2005). It is a fallacy because it assumes that a relationship exists between an action and a subsequent event, simply because the event occurs after the original action. Id. Although no Maine court has specifically addressed PHEPH logic in terms of proximate cause, the Superior Court has previously held that temporal congruity alone, without any corroborating evidence, cannot be the basis upon which an expert witness testifies that a causal relationship exists. Trask v. Automobile Ins. Co., CV-94-379, 1997 Me. Super. Lexis 118 (April 7, 1997). Specifically, the court reasoned:
Defined literally as "after this, therefore because of this." Black's Law Dictionary 1186 (7th ed. 1999).
"If we enter a darkened room, and the room is suddenly illuminated after our entrance, we tend to conclude that our entry into the room was somehow connected with the illumination. In fact, these circumstances may - or may not - be related. Additional data must be accumulated before we can draw a reasoned conclusion. But our first natural, intuitive inclination is to assume that events which occur in a temporal sequence are related. Thus, the concept of "temporal congruity" is an intuitive process and not a scientific or medical methodology."Id. at 11-2.
Here, the Plaintiff specifically argues that his "problems related to vision and balance did not exist prior to the accident" and his headaches, eyesight, and balance problems that developed after the accident "are enough injuries ... to hold this matter over for trial." (Pl. Opp. to Def's' Mot. Sum. Judg. at 3.) The Plaintiff is therefore arguing that because the Plaintiff's complications became manifest after the car accident, post hoc, ergo propter hoc, the car accident must have been the cause. In a medically complicated case such as this, a mere temporal relationship between a car accident and development of a condition not recognized by the scientific community is too speculative to find causation. In the absence of other corroborating evidence, a reasonable juror cannot be permitted to assume causation simply because two events are temporally associated.
This is consistent with holdings in other jurisdictions. See e.g. Young v. Hickory Bus. Furniture, 353 N.C. 227, 232, 538 S JE.2d 912 (2000) (holding that "[i]n a case where the threshold question is the cause of a controversial medical condition" temporal congruity is not competent evidence of causation")(emphasis added); Hussung v. Patel, 369 Ill.App.3d 924, 933, 861 N.E.2d 678 (2007) (holding that temporal association alone is insufficient to prove proximate cause in a medical negligence case).
IV. Conclusion:
Visual midline shift is a medically complex condition that falls outside the common knowledge of an average juror. There is no evidence that the Plaintiff's visual midline shift was caused by the Defendant other than the mere temporal relationship between the accident and Plaintiff's development visual midline shift symptoms. In the absence of expert medical testimony, no reasonable juror could conclude, without resorting to speculation, that the accident caused this injury. Mere temporal congruity between the accident and Plaintiff's visual complications does not overcome this requirement. Therefore, because visual midline shift is the sole injury alleged by the Plaintiff, and because he has failed to provide admissible expert testimony linking that injury to the accident, the Plaintiff has failed to establish the element of proximate causation required to sustain his negligence claim and the Defendant is entitled to judgment as a matter of law.
Defendant's Motion for Reconsideration is GRANTED in relation to Defendant's Motion for Summary Judgment and is DENIED as moot in relation to Defendant's Motion in Limine.
The Clerk is directed to incorporate this Order into the docket by reference pursuant to Maine Rule of Civil Procedure 79(a).
"Allowing a jury to infer causation on complex medical facts without the aid of expert testimony on the subject and without some showing that Wanger's conduct was "more likely than not" a cause of Memam's injury, stretches the jury's role beyond its capacity. Standards for demonstrating the elements of professional negligence do not differ from profession lo profession.. An attorney may not be; subject to liability absent actual evidence of causation. Likewise, a medical. professional may not be subject lo liability absent actual evidence of causation." Wanger, 2000 ME 159, J 17, 757 A.2d 77S (citations omitted).