On July 29, 2022, a minor, Kamila, represented by her mother Keila Robles Figueroa (“Plaintiff” or “Robles”), filed a medical malpractice lawsuit against Dr. Juan C. Castañer (“Castañer”), Presbyterian Community Hospital, Inc. (“the Hospital”) and the Hospital Pediátrico Universitario (collectively “Defendants”). The allegations of negligence in this lawsuit are centered on the medical care providers’ treatment of Robles and her baby during her pregnancy, delivery, and the neonatal care of her premature infant. Robles claimed that the Defendants deviated from the established standards of care.
Defendants sought to exclude the testimony of Plaintiff’s life care planning expert witness, Jocelyn Holt.
Life Care Planning Expert Witness
Jocelyn Holt is a certified life care planner since 2017. She is also a Licensed Occupational Therapist in the states of Florida and North Carolina. She holds a bachelor’s degree in Science, occupational therapy with a minor in Health Science Education from the University of Florida. In addition, she holds a Life Care Planning Certification Course from the Institute of Rehabilitation Education and Training. Her experience since 2002 has been mainly as an Occupational Therapist, yet since 2018 she is the owner of and life care planner at Planning Hope, LLC in Gainesville, Florida.
Discussion by the Court
Defendant’s Arguments
According to Defendants, Holt’s limited experience with pediatric patients, particularly infants and children with complex medical conditions like autism and brain injury, and her inexperience in preparing a life care plan for a medical malpractice case is a significant factor in disqualifying her testimony. They added that Holt did not collaborate with or consult any medical experts, including neurologists, pediatricians, or other relevant specialists, before rendering her life care plan. Specifically, they maintained that she prepared her life care plan without consulting any of Kamila’s treating physicians. In addition, Defendants argued that since Holt relied on generalized data from the Center for Disease Control and Prevention (“CDC”) as to life expectancy— that is not specific to Kamila’s condition— and did not consult appropriate experts, her testimony does not meet the Daubert standards because it lacked a reliable foundation. Defendants also questioned Holt’s methodology and conclusions as speculative and unreliable.
Plaintiff’s Arguments
In response, Plaintiff submitted that the motion in limine constitutes an untimely dispositive motion disguised as a motion in limine. To this extent, Plaintiff argued that this District has already held that “a motion in limine to exclude the Plaintiff’s expert on grounds that his opinion is unreliable was not the appropriate tool to move for judgment on a particular claim.”
She argued that “an expert witness may base his opinion on reports, writings or observations not in evidence which were made or compiled by others, so long as they are of a type reasonably relied upon by experts in that particular field.”
Analysis
A. Holt’s Qualifications
Based on her credentials and extensive experience, the Court determined that Holt was qualified to testify as a life care planner.
B. Holt’s Life Care Plan for Keila Robles on behalf of Kamila Robles (“Life Care Plan Report”)
Holt’s life care plan report, dated April 18, 2023, indicates that “the recommendations are gathered from information provided by [Kamila’s] medical providers through records and evaluations, Keila Robles, evidenced [sic] base practices, as well as knowledge/experience from this life care planner.”
Moreover, during her deposition, Holt admitted that she did not consult any physician before she rendered the life care plan report. She also stated that the life care plan reflects her opinion, based on her assessment after speaking with Kamila’s mother and reviewing her medical record. To this extent she expressed that she interviewed Kamila’s mother on two different occasions.
Holt used the National Vital Statistic Reports and CDC data and indicated she was not an expert in life expectancy. To that extent, in her life care plan Report, Holt clearly stated that “opinions on the life expectancy tables are deferred to an appropriate expert.”
In addition, in page 15 of her life care plan report, Holt listed a series of references used to prepare her report, which included various website links including the CDC and other publications from the pediatric and medical field.
Foremost, and Plaintiff admitted as much, Holt will only testify as a life care planner, and not as to the applicable medical standards of care; the departures from the medical standards of care by Defendants in the treatment of Kamila; or the causal relationship between the alleged departure from the medical standards of care with Kamila’s damages.
Reliability and Methodology
While Defendants questioned the reliability of Holt’s life care plan because she did not consult Kamila’s physicians and attacked Holt’s conclusion because of her methodology and basis, the Court noted that in the first few pages of his report, Holt employed the standard methodology applied by life care planners which requires consideration of: (a) available medical records; (b) assessment of the individual; (c) assessment of the data and the individual’s needs, and (d) research of the costs within the relevant geographical area of items needed for the proper care of the patient. This appeared to be a sufficiently reasonable and reliable method for formulating a life-care plan.
The Court agreed with the Defendants to the extent that there might be some deficiencies in the strength of support for some of the recommendations in Holt’s life care plan report, but concluded that those issues go to the weight, and not the admissibility, of Holt’s testimony. Holt will be able to testify, and be subject to cross-examination, about her opinions in this case.
Held
The Court denied the Defendant’s motion in limine to exclude the testimony of Plaintiff’s life care planning expert witness, Jocelyn Holt.
Key Takeaway:
Despite challenges to Holt’s qualifications, the Court determined she was qualified to testify, given her extensive experience as a certified life care planner and licensed occupational therapist. Defendants argued that Holt’s failure to consult Kamila’s treating physicians and her reliance on generalized data from the CDC rendered her testimony unreliable. However, the Court noted that life care planners are not required to consult with treating physicians when formulating life care plans. Furthermore, the Court found Holt’s methodology to be reasonable and consistent with standard practices in the field. While the Defendants raised valid concerns about the strength of some of Holt’s conclusions, the Court concluded that these issues affected the weight of her testimony, not its admissibility. As a result, Holt was allowed to testify, and the Court permitted cross-examination regarding her opinions.
Case Details:
| Case Caption: | Robles-Figueroa V. Presbyterian Community Hospital, Inc. Et Al |
| Doket Number: | 3:22cv1361 |
| Court: | United States District Court for the District of Puerto Rico |
| Order Date: | January 27, 2025 |
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