Following her husband’s death from COVID-19 complications, Plaintiff I’Esha Short (I’Esha) brought this action seeking damages for the medical care he received at the St. Charles County Jail.
Defendants sought to exclude the testimony of I’Esha’s lone expert, Joel Blackburn, a former medical director at a jail with extensive experience in emergency medicine.
Emergency Medicine Expert Witness
Joel M. Blackburn has practiced Emergency Medicine for over 24 years. He was the facility medical director for the emergency department at Capital Region Medical Center in Jefferson City for nearly 2 years during the COVID pandemic. Blackburn has treated hundreds of patients with COVID infection.
Discussion by the Court
I. Motion to Exclude Blackburn
a. Blackburn can testify as to medical causation.
Defendants offered three main arguments for why Blackburn cannot provide testimony regarding causation. First, they contended that Blackburn lacked relevant expertise. Second, Defendants argued that Blackburn utilized unreliable principles and methods or that he unreliably applied his methodology to the facts. Third, Defendants suggested that Blackburn’s opinions provide little probative value.
1. Blackburn lacked relevant expertise
Defendants first argued that Blackburn lacked expertise to testify as to causation. In particular, they emphasize that he “did not practice medicine in a correctional setting during the COVID-19 pandemic,” specialize in various relevant fields, or conduct research into COVID.
While the fact that he did not practice medicine in a correctional facility during the COVID pandemic may prove fertile ground for cross-examination, it does not override his relevant expertise. As such, Blackburn’s testimony is not excludable on that basis.
2. Blackburn utilized unreliable principles and methods
First, Defendants contended that Blackburn failed to consider alternative explanations for Timothy’s death, including his decision to “remain unvaccinated,” his “non compliance with his healthcare needs,” and the “substantial intervening medical care that [he] received at a hospital.”
However, Blackburn did consider the bulk of the alternative causes that Defendants highlight.
Second, Defendants contended that Blackburn “cannot reliably conclude under oath that any alleged delay in escalation of care . . . caused Short’s death” because he discounted the possibility that earlier administration of medication could have prevented that outcome.
While Blackburn opined that earlier administration of the drug alone would not have changed the outcome, he indicated that Timothy needed a combination of interventions and that earlier admission to the hospital would have prevented his death.
In any event, “an expert’s contradictions or concessions go toward the weight of the evidence put forth by the expert, not toward its admissibility.”
Third, Defendants claimed that Blackburn offered only impermissible “sooner is better” testimony. In reality, he testified that earlier and more extensive intervention would “more likely than not” have prevented Timothy’s death.
Finally, Defendants claimed that Blackburn’s testimony is not supported by medical literature. But “while published studies tending to support an expert’s opinion often are a hallmark of admissible testimony, . . . there is no requirement that a medical expert must always cite published studies on general causation.” Thus, Defendants failed to show why Blackburn should be excluded on the basis of unreliable methodology.
3. Blackburn’s opinions provide little probative value
Finally, Defendants contended that Blackburn’s testimony is more prejudicial than probative. The Court held that Blackburn’s testimony as to causation is admissible because he has relevant expertise, is sufficiently reliable, and will not create undue prejudice.
b. Blackburn’s opinions as to implicit bias are excludable under Rule 702.
Defendants also argued that Blackburn’s testimony regarding implicit bias should be excluded under Rule 702.
Defendants are right that Blackburn cannot testify as to implicit bias. As an initial matter, it is far from clear how implicit bias testimony would be relevant to the key issues underlying a deliberate-indifference claim, which requires a conscious awareness of a serious medical need.
More importantly, as the proponent of his opinion, I’Esha “must show by a preponderance of the evidence both that Blackburn is qualified to render the opinion and that the methodology underlying his conclusions is scientifically valid.”
But Blackburn’s own testimony reveals that, while he lectured in the area of cognitive bias in prison medicine, he is not otherwise qualified in this area.
c. Blackburn cannot opine on credibility, legal conclusions, or medical bills.
Defendants also noted that Blackburn impermissibly commented on witness credibility in his report and during his deposition, offered opinions as to legal conclusions, and commented on medical bills.
I’Esha agreed that Blackburn cannot offer those kinds of opinions.
II. Motion to Strike Blackburn’s Rebuttal Report
Defendants asked the Court to strike portions of Blackburn’s rebuttal report addressing the Nurse Defendants, claiming that he should have included these opinions in his initial report.
But as I’Esha noted, Blackburn added these opinions only after Defendants designated the four nurses as non-retained experts, which happened well after he issued his original report.
She contended that the rebuttal report does not contain new opinions and, even if so, it would not be procedurally improper.
Defendants’ arguments fall short for multiple reasons. First, given that they seek a discovery sanction under Rule 37(c), the operative case management order required them to first “file a memorandum requesting a video conference with the Court.” But no such request was made, and Defendants also failed to comply with the Court’s good-faith certification requirement.
Nor have Defendants even attempted to show good cause for making this request after the discovery-motion deadline.
The Court held that these procedural deficiencies alone are a sufficient basis for denying relief. But the motion also fails on the merits. After Defendants designated the nurses as experts, I’Esha was free to buttress Blackburn’s opinions to address the expanded categories on which the nurses could testify, and the challenged opinions were limited to the subjects outlined in the nurses’ disclosures.
Thus, these opinions were timely under Rule 26(a)(2)(D)(ii), and even if they were not, any delay was substantially justified.
Held
The Court granted in part and denied in part Defendants’ joint motion to exclude Dr. Joel Blackburn’s testimony and denied Defendants’ joint motion to strike improper portions of Plaintiff’s expert’s rebuttal report.
Key Takeaway
There is no requirement for perfect symmetry between an expert’s experience and the precise subject matter of their testimony so long as the expert’s background equips him to help the jury understand the facts or issues in dispute. Blackburn is a board-certified physician with extensive experience treating COVID.
While Blackburn may lack expertise in some relevant specialties, a doctor’s opinion should not be excluded merely because it involves a field of medicine that he does not specialize in.
Case Details:
| Case Caption: | Short V. St. Charles County |
| Docket Number: | 4:22cv1117 |
| Court Name: | United States District Court, Missouri Eastern |
| Order Date: | July 09, 2026 |
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