Plaintiff, Amaris I Ward, who was seventeen years old during the events of this case, sought medical treatment at Madigan Army Medical Center (“MAMC”) over several weeks in October 2022.
Plaintiff alleged that emergency care providers at MAMC failed to properly evaluate and diagnose her with acute bacterial rhinosinusitis on October 16, 2022, which led to their failure to determine the extent of the sinusitis so it could be treated in a timely fashion. As a result, Plaintiff alleged that the bacterial infection progressed untreated for more than 30 hours, which caused permanent damage to the optic nerve in her left eye, resulting in permanent blindness in the left eye. Plaintiff alleged that these actions amounted to a breach of the standard of care of reasonably prudent emergency care providers when confronted with symptoms such as Plaintiff’s.
Defendants filed a motion to exclude the testimony of Plaintiff’s expert, Dr. Richard O. Cummins.
Emergency Medicine Expert Witness
Richard Oliver Cummins is board-certified in both internal medicine and emergency medicine.
He joined the faculty of the Department of Medicine at the University of Washington in 1981, and was promoted to the rank of full Professor in 1993. As a member of the Department of Emergency Medicine he worked as an attending physician in the UWMC Emergency Department, providing clinical care, supervising medical students and emergency medicine residents in training, as well as providing direct patient care.
Discussion by the Court
1. Cummins is qualified as an expert
Defendants argued that Cummins did not have the clinical experience or educational basis to anchor his causation opinion about the cause of Plaintiff’s infection.
The Court noted that Cummins is qualified to testify because he has been medical physician for several decades and is board-certified in both internal and emergency medicine.
Although he is not an infectious disease specialist, he is a board-certified emergency medicine physician with over 39 years of experience. To the extent there is a challenge to Cummins’ qualifications, the Court is satisfied he has demonstrated at least a “minimal foundation of knowledge, skill, and expertise required” to give expert testimony on the issues in this case.
2. Cummins’ methodology is not reliable
Defendants argued that Cummins opined that the failure to start Plaintiff on either levofloxacin or moxifloxacin on October 16, 2026 caused her permanent loss of vision—and argued that this opinion is unreliable.
According to Cummins, a “causal chain” of failures to comply with the standards of reasonable emergency department care led to Plaintiff’s vision loss. Within the “causal chain” was the failure to timely initiate “appropriate treatment,” otherwise identified as “appropriate intravenous antibiotics.”
Cummins determined from review of available records that Plaintiff’s left eye blindness was caused by “damage to her optic nerve (optic neuropathy) from her infectious sphenoid sinusitis,” which contained fusobacterium necrophorium. But nowhere in Cummins’ expert report or deposition testimony did he explain why or how the failure to diagnose Plaintiff with severe bacterial pan-sinusitis caused damage to her optic nerve.
Simply put, the Court cannot identify the generally accepted methodology Cummins used in arriving at his medical conclusions on causation. When asked how he reached the opinion that if physicians had given Plaintiff antibiotics on October, the antibiotics would have been effective to prevent Plaintiff’s vision loss, Cummins stated, “A general experience that antibiotics often work.” To the extent Cummins’ opinions are based on his general experience, he did not explain “how that experience leads to the conclusion reached, why that experience is a sufficient basis for the opinion, and how that experience is reliably applied to the facts.”
Held
The Court granted Defendants’ motion to exclude the testimony of Dr. Richard Cummins.
Key Takeaway
A medical expert may rely heavily on their experience, but they must still explain their methods. Put differently, the opinion must describe a “methodology that can be challenged in some objective sense” because “a subjective, conclusory approach cannot reasonably be assessed for reliability.”
Case Details:
| Case Caption: | Ward V. United States Of America |
| Docket Number: | 3:24cv5836 |
| Court Name: | United States District Court, Washington Western |
| Order Date: | June 12, 2026 |
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