Expert Witness Blog
Plaintiff’s expert witness testified on the standard of care in the performance of a cervico-cerebral angiogram. After a challenge, the testimony was said to establish an element of causation.
Facts: This case (Jessica Marie Muniz v. United States of America – United States District Court – Northern District of Alabama – Southern Division – August 3rd, 2015) involves the testimony of a radiology/nuclear medicine expert witnesses. Dr. Ahmed M. Kamel Abdel Aal performed a cervico-cerebral angiogram on Jessica Muniz’s right leg. Ms. Muniz had had prior procedures on her right leg, including a previous angiogram. During this prior procedure, Ms. Muniz’s right femoral artery was dissected, resulting in scar tissue to the right leg.
For the procedure that is at issue in this case, the notes indicated that the angiogram was supposed to be in Ms. Muniz’s left leg and she relayed this to Dr. Kamel. That said, he performed the angiogram on her right leg. After the procedure, Ms. Munitz was experiencing pain in her right leg and was seen by Dr. William Harvey, a vascular surgeon. His procedures to assist the pain were unsuccessful, so he had to amputate her leg.
Ms. Munitz filed a medical malpractice suit against Mr. Kamel and proffered the expert testimony of Dr. Harvey and Dr. Mary Jensen, an interventional radiologist. The defense challenged the testimony of both of these experts on the basis that they are either due to be excluded or that they are insufficient to establish the elements of a claim under the Alabama Medical Liability Act (AMLA).
Discussion: The United States opined that Dr. Jensen’s testimony should be excluded as she did not disclose the reasons of her opinions in her expert report. In addition, the state that even if she is not excluded, her report fails the standard of care part of the AMLA. The court shot down the first claim as there was a prior hearing on the same issue and the court determined then that the report satisfied the disclosures.
The court also opined that Dr. Jensen clearly defined the standard of care in performing a cerebral angiogram and put forth numerous steps that Dr. Kamel should have taken while performing the procedure. In addition, they state that Dr. Jensen did identify the basis of her opinion on the standard of care, by citing her education and more than 25 years of practice as a radiologist.
After opining that Dr. Harvey’s testimony about the procedure causing the amputation was excluded (he will be able testify that the multiple dissections in the femoral artery caused the amputation, the former falling into the category of a temporal relationship), the court moved onto the issue of causation and Dr. Jensen’s testimony.
Under the AMLA, . Munitz must establish causation though an expert witness because these claims are complex and can’t be readily understood by a lay person. The court noted that Dr. Jensen did not testify that the procedure performed by Dr. Kamel caused the leg amputation. However, Dr. Jensen did testify that the procedure did injure Ms. Munitz by causing a dissection of her femoral artery, which satisfies the material fact element of the AMLA.
The defense then stated that Dr. Jensen’s testimony will be excluded because she did not put into her report that her testimony will be one of causation. The court replied that Dr. Jenson indicated in her report that the procedure performed by Dr. Kamel caused the leg to be amputated.
Held: Dr. Jensen’s testimony will be allowed and can establish causation under the AMLA claim.