A district judge in West Virginia barred the Correctional Healthcare Expert from opining that there was no evidence of medical malpractice, deliberate indifference, discrimination, or negligence.
Joseph Taylor has struggled with opioid addiction for nearly half his life. He is diagnosed with Opioid Use Disorder (“OUD”) and is treating this chronic brain disease with Medications for Opioid Use Disorder (“MOUD”).
Wexford and the West Virginia Division of Corrections and Rehabilitation (“WVDCR”) denied Taylor access to MOUD while he was detained from January through March at Central Regional Jail. Plaintiff alleged that Defendants had a policy of forced withdrawal from MOUD, which was discriminatory and evinced deliberate indifference to his clear and acute need for MOUD while detained at CRJ.
Wexford provided an expert report from Dr. Grady Bazzel who testified that the Defendants met the standard of care in their treatment of Taylor. Taylor filed a motion to exclude the testimony of Bazzel as an expert in addiction medicine.
Correctional Healthcare Expert Witness
Dr. Grady Judson Bazzel is currently the Patient Safety Officer and Medical Director of Care Management for Wellpath, a company that provides correctional healthcare throughout the United States. He has worked in corrections since 2005 and is licensed to practice medicine in multiple states. In his current role, he investigates patient deaths and other care errors and helps improve quality of care across Wellpath-managed sites. He has familiarity with the Bureau of Prisons (BOP) Clinical Guidelines for the Diagnosis, Evaluation, and Treatment of Opioid Use Disorder (OUD), although he did not review them specifically while compiling his report.
Discussion by the Court
Bazzel explained that there are risks to the use of MOUD in correctional settings that are not present in the outside world, including the risk that other inmates will target a patient to obtain the medication.
Bazzel stated that “proper patient selection is the key to a successful Medication Assisted Treatment (MAT) program.” He stated that the “psychological triggers for relapse are less present and the access to substances of abuse is greatly diminished,” during incarceration, reducing the need for treatment. Bazzel suggested that gaps in Taylor’s treatment record, both before and after his period of incarceration, showed a “pattern of spotty follow-up for this medication that he claims to need so badly.”
He offered the opinion that Taylor was not a good candidate for MAT while incarcerated because of his lack of compliance with Clinical Opiate Withdrawal Scale (COWS) assessments, his urine drug screen results, and his gaps in treatment before and after his incarceration. He further opined that “the medical staff at CRJ were under no obligation to continue [buprenorphine] until such time that it became clear that it was needed. This need never presented itself,” as demonstrated by “the fact that his first drug screen post-incarceration was negative for illicit drugs.”
Bazzel lacks experience and specialized training related to OUD, MOUD, and opioid withdrawal
Taylor conteded that Bazzel lacked the necessary qualifications as per Rule 702. He noted that Bazzel has “never conducted an OUD screening or a Rapid Opioid Dependence Screen and is not sure if he has ever reviewed such a test.”
Plaintiff added that Bazzel’s opinions were contradicted in key areas by the Federal Bureau of Prisons (“BOP”) Guidelines, a resource that he stated he was familiar with and considered authoritative.
Absent full exclusion, the Plaintiff argued that several specific opinions offered by Bazzel are improper. He argued that Bazzel should not be permitted to offer opinions on the legal issues of medical malpractice, deliberate indifference, discrimination, and negligence. In addition, he contended that Bazzel’s opinion on the reduction in psychological triggers in jails and prisons should be excluded because it lacks any scientific support, and he is not a psychiatrist or psychologist with any qualification to offer such testimony.
Since Bazzel’s report did not contain citations or references to medical or scientific sources, the Court looked to his deposition to gain an understanding of how he formed his conclusions.
When asked what relevant medical literature he relied on in formulating his opinions, he replied, “None.” He stated that he did not review any scientific literature or journal articles related to COWS scores. As to his opinion that some patients who would be appropriate candidates for treatment with MOUD in the community are not good candidates in a correctional setting, he stated that he did not know if any literature or reports existed to support that viewpoint. He did not review any medical or scientific literature to formulate his opinion that there are fewer triggers for opioid cravings or relapse in jail, stating, “I’m sure I could find some. But it’s just commonsensical.”
Bazzel’s testimony related to incidents of alleged diversion and urine screen results should be excluded
The Plaintiff next argued that Bazzel’s testimony and conclusions related to incidents of alleged diversion and urine screen results, all occurring after the Plaintiff’s January — March 2023 detention, should be excluded because medical staff could not have considered future events when determining Taylor’s medical treatment at the time. He further argued that Bazzel’s opinions regarding security concerns in a correctional setting related to MOUD are “pure conjecture.” Bazzel admitted in his deposition that he ‘has no experience in correctional security,’” and cited no scientific or medical sources. Finally, he argued that Bazzel’s testimony opining about Taylor’s credibility should be excluded.
The Court held that Bazzel’s opinion that the Defendants met the standard of care in their treatment of Taylor was formed based on the analysis of Taylor’s treatment as discussed above, none of which was based on facts, data, or reliable principles or methods.
Held
The Court granted the Plaintiff’s motion to exclude certain opinions of Grady Bazzel.
Key Takeaway:
Bazzel’s report lacked citations or references to medical or scientific sources. When asked what relevant medical literature he relied on in formulating his opinions, he replied, “None.”
The Court held that Bazzel’s opinion that the Defendants met the standard of care in their treatment of Taylor was formed based on the analysis of Taylor’s treatment, none of which was based on facts, data, or reliable principles or methods.
Case Details:
| Case Caption: | Taylor V. Wexford Health Sources, Incorporated, Et Al |
| Docket Number: | 2:23cv475 |
| Court: | United States District Court, West Virginia Southern |
| Order Date: | June 17, 2024 |
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