Mikaznaaz Saiyed tragically passed away after giving birth at Swedish Covenant Hospital. She became unconscious during labor, and the delivery team had to perform an emergency C-section. Before long, she went into cardiac arrest, and the medical team rushed her to the intensive care unit. She passed away a few days later from a rare, life-threatening condition that sometimes occurs in pregnant women.
Her husband, Ahzar Saiyed, brought medical negligence claims against three Swedish Covenant entities, plus two members of the medical team. The United States later joined the case in place of the doctor and the midwife, because they worked for federally funded clinics.
Saiyed retained an expert, Dr. Martin Gubernick, to explain what went wrong in the delivery room. He issued a 24-page report that summarized how things unfolded in the hospital that day, including the medical care that Mrs. Saiyed received.
Gubernick addressed the cause of her injuries. He opined that the improper use of medications caused Saiyed to have uterine tachysystole, meaning excessive contractions. Gubernick believed that “her uterus was not given sufficient time to relax.” He also opined that the excessive contractions likely caused Saiyed to experience amniotic fluid embolism.
As Defendants see things, Saiyed cannot prove what caused the amniotic fluid embolism. They believe that the testimony of Gubernick is inadmissible under Daubert. And without his testimony, Saiyed cannot carry his burden of proof.
Obstetrics and Gynecology Expert Witness
Dr. Martin Gubernick is a board-certified obstetrician gynecologist with over forty years of experience in obstetrics and gynecology. Gubernick attended medical school at Northwestern University, and he did his residency at New York Hospital – Weill Cornell Medical Center in obstetrics and gynecology.
Discussion by the Court
A. Qualifications
Defendants argued that Gubernick is unqualified to testify about amniotic fluid embolism. They basically identified a bunch of omissions in his CV. As Defendants pointed out, Gubernick has never published any medical literature on amniotic fluid embolism, and has never lectured on the topic. He has not researched that condition in particular. And he has never managed a labor and delivery involving a mother with amniotic fluid embolism.
However, Gubernick has loads of practical experience in delivery rooms. He has given drugs to induce labor, and is familiar with Cytotec and Pitocin, the two drugs at issue in this case. He has performed C-sections, monitored patients, and “overseen massive transfusions of blood products for conditions like amniotic fluid embolism.”
Gubernick has knowledge about amniotic fluid embolism, too. He is “familiar with amniotic fluid embolism including but limited to its pathophysiology, causes, treatments, and outcomes.” Gubernick is a physician trained in the area of pregnancy and childbirth. He has extensive experience with related drugs, procedures, and conditions. That experience gives him sufficient qualifications to take the witness stand.
Based on his report, Gubernick intended to explain to the jury what amniotic fluid embolism is, and how it happens. “Amniotic fluid embolism is a condition in which amniotic fluid (likely with fetal hairs, cells, and other material, etc.) enter the mother’s blood stream triggering what is akin to an allergic reaction. The amniotic fluid can leak into the mother’s blood stream, prompting mom’s body to ‘reject’, or ‘fight off’ what it senses is an attacker.”
Overall, Gubernick may not be an expert in amniotic fluid embolism per se. But he has substantial expertise in the area of pregnancy and childbirth. He has sufficient background and expertise to explain amniotic fluid embolism to the jury.
B. Methodology
Defendants believed that Gubernick lacked a basis to opine about what caused Saiyed to suffer an amniotic fluid embolism.
At bottom, Gubernick offered an opinion with two links in the causal change. He opined that Cytotec likely caused Saiyed’s uterine tachysystole (again, the excessive contractions). And he opined that the uterine tachysystole likely caused her amniotic fluid embolism.
Basically, the medication caused her uterus to go into overdrive, which led to a rupture. And the rupture caused a mixing of the fluid between the mother and the child.
Defendants took issue with both steps in the causal chain. A chain is only as strong as its weakest link. But here, each of the links is strong enough to get to a jury.
The first link is the connection between the medication and the medical condition. Gubernick opined that it is “well recognized” that Cytotec can lead to uterine tachysystole.” The Court found that Gubernick had a sufficiently reliable basis for reaching that conclusion. After all, the package insert itself warns physicians that a “major adverse effect of the obstetrical use of Cytotec is uterine tachysystole.”
A package insert doesn’t come out of nowhere. A package insert needs to receive the blessing of both the FDA and the drug manufacturer. And that approval comes after rigorous review and testing. Medical professionals kick the tires on anything said in a package insert because it affects how physicians use the medication with patients.
Gubernick based his opinion on the package insert, and the package insert reflected the understanding of the medical community. The whole point of a package insert is its reliability. It’s a go-to source for reliable information about how to use a drug, and what side effects might follow. Maybe a package insert is over-inclusive. But it doesn’t have to provide definitive gospel truth for an expert to rely on it.
The second link is the connection between the two medical conditions. Gubernick opined that the excessive contractions likely caused the amniotic fluid embolism. The Court held that Gubernick relied on the FDA-approved package insert, and he offered an explanation of how excessive contractions can lead to a rupture. That’s a sufficiently reliable basis to get in front of a jury. Any problems with his theory are best left for cross examination.
Held
Overall, the Court found that the opinions of Dr. Martin Gubernick pass muster under Daubert and Rule 702. Gubernick has the qualifications to give his opinions, and the opinions have sufficient indicia of reliability to get to a jury. Beyond that, the jury will have to figure it out.
Key Takeaway
An expert does not have to foreclose other possibilities when it comes to causation. And a Plaintiff doesn’t have to prove that negligence is the only explanation. Instead, an expert simply needs to offer an opinion that is sufficiently reliable to put before the jury. Basically, district courts stand guard and protect juries from unreliable experts. But once an expert offers a sufficiently reliable opinion, it is up to the adversary process to find the truth.
Case Details:
| Case Caption: | Saiyed V. Swedish Convenant Hospital |
| Docket Number: | 1:20cv5524 |
| Court Name: | United States District Court, Illinois Northern |
| Order Date: | March 24, 2026 |
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