Tag: Permanency

  • Psychiatry Experts’ Opinions on Causation and Permanency Admitted

    Psychiatry Experts’ Opinions on Causation and Permanency Admitted

    This action arises from the pled sexual assault of Plaintiff Margaret Betts by a massage therapist during an in-room massage appointment at Sixty LES, a hotel owned and managed by Defendants Sixty Lower East Side, LLC, Sixty Hotels, LLC, and Sixty Hotel Manager, LLC.

    Plaintiff has proffered two expert witnesses, Dr. Steven A. Fayer and Dr. Joseph Otonichar, to testify at trial that the Plaintiff’s assault resulted in lasting psychological injuries, including symptoms of post-traumatic stress disorder (“PTSD”). Defendants, meanwhile, have proposed to offer one expert witness, Dr. Julie C. Medlin, to testify at trial that the Plaintiff’s assault did not significantly impact her pre-existing psychological symptoms.

    The parties have each filed motions in limine seeking to preclude the opposing party’s proposed expert witnesses from testifying at trial.

    Psychiatry Expert Witnesses

    Dr. Steven Alan Fayer is an associate professor of psychiatry at The Icahn School of Medicine at Mount Sinai Hospital and an attending physician at The Mount Sinai Hospital. He received his M.D. from Georgetown School of Medicine and completed his residency in psychiatry at Mount Sinai Medical Center in New York City. He is certified by the National Board of Medical Examiners and the American Board of Psychiatry and Neurology. 

    Get the full story on challenges to Steven A. Fayer’s expert opinions and testimony with an in-depth Challenge Study

    Dr. Joseph Otonichar is a clinical assistant professor in the department of psychiatry at New York University’s Grossman School of Medicine, the medical director of Mental Health at NYC-HHC Correctional Health Services, and a co-partner at Gotham Forensics. He received a master’s degree in biology from Cleveland State University, and he subsequently received his D.O. from Midwestern University — Arizona College of Osteopathic Medicine. He is certified by the American Board of Psychiatry and Neurology in forensic psychiatry and is a diplomat of the American Board of Psychiatry and Neurology in Psychiatry.

    Want to know more about the challenges Joseph Otonichar has faced? Get the full details with our Challenge Study report

    Psychology Expert Witness

    Dr. Julie Christine Medlin is a licensed psychologist and the Director of the Medlin Treatment Center in Marietta, Georgia. She obtained her bachelor’s degree in psychology from Harvard University, and her master’s and doctoral degrees in clinical psychology from the University of Florida. Medlin specializes in assessments and conducts psychological, sexual trauma, psychosexual, and forensic evaluations. 

    Discover more cases with Julie C. Medlin as an expert witness by ordering her comprehensive Expert Witness Profile report.

    Discussion by the Court

    Plaintiff’s Motion to Exclude the Testimony of Medlin

    Plaintiff filed a motion to exclude Medlin’s testimony on the grounds that she: (i) lacked the qualifications to serve as an expert in this case; (ii) is not licensed to practice psychology in New York; and (iii) employed tests and techniques in her examination that were not subject to peer review and have not gained general acceptance in the relevant scientific community.

    Julie C. Medlin

    To begin with, Medlin’s curriculum vitae stated that she founded a private, outpatient counseling center more than twenty-five years ago to offer “specialized evaluation and treatment for sexual and physical trauma victims” and conduct “forensic and clinical evaluations of alleged or confirmed sexual abuse victims and perpetrators, including in criminal and civil cases.” The Court found that such work experience is directly relevant to the issues in this action.

    Moreover, Medlin’s curriculum vitae stated that she is licensed with PSYPACT, an interstate organization that allows licensed psychologists to practice telepsychology and conduct temporary, in-person sessions across state boundaries. Medlin conducted her evaluation of Plaintiff in New Jersey, which is a participant in PSYPACT.

    Medlin conducted the following psychological tests on Plaintiff: the Personality Assessment Inventory (PAI); Minnesota Multiphasic Personality Inventory-3 (MMPI-3); Trauma Symptom Inventory, 2nd Edition (TSI-2); and Inventory of Problems (IOP-29). 

    Although Plaintiff claimed that the validity of each test is disputed, Plaintiff’s motion failed to present sufficient evidence to support this assertion. Rather, a brief internet search suggested that, although some instability is inherent in any tests that involve self-reporting, the tests employed by Medlin were widely used and generally considered to be reliable, including for diagnosing PTSD.

    Finally, Plaintiff requested that Medlin be precluded from testifying about certain commentary concerning Plaintiff’s counsel that is contained in her report. While Medlin’s report certainly suggested that Plaintiff’s counsel exhibited unprofessional behavior during both of Medlin’s examinations of Plaintiff, at this stage the Court agreed that the admission of such information is not directly relevant to the issues to be presented at trial.

    Defendants’ Motion to Exclude the Opinions of Fayer and Otonichar

    Defendants filed a motion to bar the admission of testimony by Fayer and Otonichar under Daubert or, alternatively, requested that the Court order a Daubert hearing to determine the reliability of their testimony. 

    Joseph Otonichar

    First, the Defendants contended that Otonichar’s credentials “simply do not meet the standard” set forth in Rule 702(a). With Otonichar’s advanced education in psychiatry and his work experience, including as Medical Director of Mental Health at NYC-HHC Correctional Health Services and Clinical Assistant Professor in the Department of Psychiatry at New York University School of Medicine, the Court disagreed.

    The Defendants further asserted that Otonichar’s methodology was unsupportable, claiming that he conducted two Zoom interviews of the Plaintiff in January and February 2024 lasting a combined total of four hours and “has not spoken to or engaged in any conversation” with the Plaintiff since that time. However, in preparing his written report, Otonichar reviewed: (i) psychiatric treatment records of Dr. Robert A. Reff, M.D. between July 2016 and January 2024; (ii) psychiatric treatment records of Dr. Wilson between August 2016 and January 2024; (iii) the psychiatric examination report of Fayer dated November 9, 2021; (iv) testimony and exhibits from the deposition of plaintiff on January 8, 2021; and (v) the pleadings and procedural filings in this action.

    Finally, the Defendants asserted that Otonichar’s report contains “no opinion on the issues of causation or permanency,” and that he must be precluded from offering opinions to the jury on those issues. The Court disagreed because Otonichar clearly addressed both causation and permanency in his report. Specifically, he stated that Plaintiff experienced a “new type of anxiety” as a result of the assault, which took the form of a “fear of intimacy and romantic relationships.”

    Steven A. Fayer

    Next, Defendants contended that Fayer must also be precluded from testifying at trial, asserting that his proposed testimony did not meet the requirements of Rule 702(b-d).

    First, Defendants asserted that Fayer’s methodology was insufficient, contending that he: (i) interviewed Plaintiff for a total of four hours via Zoom on September 29, 2021 and October 20, 2021, and has had no further contact with Plaintiff or reviewed any additional medical records since that call; (ii) did not review medical records from Plaintiff’s primary treating psychologist after December 15, 2020 or records from Plaintiff’s primary treating psychiatrist covering the four treatment sessions immediately preceding the assault, and did not review the records of Plaintiff’s second treating psychiatrist, Dr. Wilson, or her other medical providers; and (iii) did not administer any tests in evaluating Plaintiff’s psychological condition. However, a review of Fayer’s report indicated that he based his diagnosis of Plaintiff’s mental health conditions on his own examinations of Plaintiff and a review of her psychiatric treatment records with Robert Reff.

    Defendants further argued that Fayer’s expert report contained “no opinion on the issues of causation or permanency,” and that he must be precluded from offering opinions to the jury on those issues. However, Fayer stated that, as a result of the assault, Plaintiff developed “trauma-induced anxiety with features of posttraumatic stress” including “flashbacks, dreams, negative thoughts, avoidance, and isolation.” As a result, the Court held that Fayer’s report adequately addressed both causation and permanency.

    Rule 403

    Finally, Defendants contended that the testimony of Fayer and Otonichar should be precluded or limited as duplicative under Rule 403, asserting that both witnesses “will present predominantly duplicative testimony.”

    Because the two experts examined Plaintiff three years and five years after the assault, respectively, and are expected to testify regarding their separate conclusions with respect to Plaintiff’s psychological condition at each point in time, the Court held that the proposed testimony is neither cumulative nor duplicative.

    Held

    The Court denied the Plaintiff’s motion to exclude the testimony of defense expert, Dr. Julie C. Medlin as well as the Defendants’ motion to exclude the testimony of Plaintiff’s experts, Dr. Steven A. Fayer and Dr. Joseph Otonichar.

    Key Takeaways:

    • Medlin offers specialized evaluation and treatment for sexual and physical trauma victims. Her work experience is directly relevant to the issues in this action. Moreover, even if it were not, an expert’s training need not narrowly match the point of dispute in the case.
    • Fayer’s opinion is grounded in a reliable methodology commonly accepted in the psychiatric community. Any concerns regarding the depth or form of his evaluation goes to the weight of his testimony, rather than its admissibility, and may be addressed on cross-examination.

    Case Details:

    Case Caption: Betts V. Sixty Lower East Side, LLC Et Al
    Docket Number: 1:20cv4772
    Court Name: United States District Court, New York Southern
    Order Date: June 30, 2025
  • Orthopedic Surgery Expert Witness is Qualified to Diagnose Cervicogenic Headaches

    Orthopedic Surgery Expert Witness is Qualified to Diagnose Cervicogenic Headaches

    This is a dispute regarding uninsured motorist (“UIM”) coverage. Perez was a passenger in a car accident on April 18, 2018, and sought coverage for past and future medical expenses arising from this accident under an Allstate insurance policy. Perez intended to rely on the expert opinion of Dr. David Badger at trial.

    The March 2022 report summarized Perez’s medical treatment after the accident, her current symptoms, notes from the in-person examination, and states four diagnoses, with a treatment plan and estimated cumulative cost. Badger also stated, “All diagnoses listed above are due to the motor vehicle accident of 04/28/2018 on a more probable than not basis.”

    The June 2024 report reiterates Perez’s medical treatments since the accident and ends with Badger discussing specific questions, including whether Perez’s current symptoms relate to a preexisting condition, whether Perez suffered permanent injury, and whether and to what extent Perez will need future treatment.

    Perez then attempted to deliver a third “report” to Allstate in the form of a letter attached to an email on November 22, 2024, but the email and attachments were not received by Allstate until January 14, 2025. Allstate moved to exclude portions of Badger’s opinion. 

    Orthopedic Surgery Expert Witness

    David Badger is a board-certified orthopedic surgeon with over thirty-five years’ experience, including treating trauma-related injuries from motor vehicle accidents and a concentration in sports medicine. He has performed over ten thousand rotator cuff surgeries over the course of his thirty-five year career, and has provided expert medical opinion testimony on thirteen previous occasions in other Superior Court cases in Washington.

    Get the full story on challenges to David Badger’s expert opinions and testimony with an in-depth Challenge Study. 

    Discussion by the Court

    Allstate sought to exclude multiple portions of Badger’s opinion. The Court will address each argument in turn.

    Badger May Testify About Perez’s Headaches

    Allstate avers that Badger’s opinion diagnosing Perez with “posttraumatic cervicogenic pain with headaches” should be excluded because Badger is not qualified, and his opinions are not reliable or relevant. 

    Badger identified various examples in his career when he diagnosed or was exposed to patients with cervicogenic headaches. The evidence showed that Badger did not just “believe he can diagnose” cervicogenic headaches, but that he has done so in his practice. 

    While Allstate’s arguments that Badger has not received specialized training or is unaware of certain diagnostic criteria are areas ripe for cross-examination, the Court held that Allstate has not shown that Badger is unqualified to diagnose cervicogenic headaches such that his testimony is inadmissible. 

    Allstate also pointed to conflicting evidence to undermine Badger’s diagnosis, which is proper for cross-examination but does not make Badger’s testimony inadmissible. 

    Lastly, Allstate argued that Badger “provided no information about how he reached [this diagnoses] or what information he relied upon to determine that she had an impaction injury to her greater occipital nerve at the base of her skull.”  However, Badger can “expand or explain information contained in his report during oral testimony.” Thus, while any new opinions would be improper, the Court held that Badger may connect his diagnoses with the facts and assessments provided in his report.

    Badger May Testify About Perez’s Shoulder

    Allstate argued that Badger’s opinion on Perez’s shoulder pain and diagnosis of a right rotator cuff tear should be excluded because it lacks corroborating evidence. Like Allstate’s argument about the reliability of Badger’s opinion on Perez’s headaches, the Court held that the lack of shoulder imaging, other doctors’ corroboration, or fulsome explanation connecting the injury and accident is appropriate for cross-examination, but did not go to admissibility.

    Badger May Testify About Perez’s Pre-Existing Conditions

    Next, Allstate asserted that Badger cannot opine on Perez’s past medical conditions because he did not review any medical records from before the 2018 accident. 

    But Badger’s report included a section entitled “Past Medical History” indicating he obtained some information regarding Perez’s past medical conditions and history. There is some basis for Badger’s opinion. The Court held that whether more reliable or conflicting evidence on any pre-existing conditions exists is a matter appropriate for cross-examination or Allstate’s case-in-chief.

    The Court Limits Badger’s Testimony on the Permanency of Perez’s Injuries

    Badger’s March 2022 report did not state any opinions regarding the permanency of Perez’s injuries or pain. The June 2024 report stated Perez “has not undergone sufficient treatment to determine whether she has permanent injury.”

    Badger’s deposition testimony reiterated this opinion. But during Badger’s deposition, Perez’s counsel attempted to obtain testimony about her ongoing pain and symptoms. Perez then attempted to submit an untimely third expert report in the form of a November 22, 2024 letter stating

    “However, even if she were to undergo some or all of the recommended treatments she will still have some degree of residual symptoms and limitations from her collision related injuries for the remainder of her life. This is on a more probable than not basis, to a reasonable degree of medical certainty.”

    Perez’s efforts to add a new opinion about the permanency of Perez’s injuries to Badger’s report failed when the deposition testimony went beyond, and conflicted, with Badger’s report. The Court held that Badger’s only properly disclosed opinion on the permanency of Perez’s injuries is that he could not opine on the topic.

    Second, the November 2024 letter is untimely, whether sent on November 22, 2024 or January 14, 2025. The deadline to disclose expert reports was July 8, 2024. Perez’s argument that the November 2024 letter was timely because it was delivered on the deadline to complete fact discovery improperly ignores the July 2024 deadline for expert reports. The Court held that Perez did not provide any reason why this untimely disclosure should be accepted.

    Badger May Testify Regarding His Opinion on Perez’s Future Treatment

    Lastly, Allstate argued that Badger’s opinions on Perez’s future treatment were too speculative. Allstate pointed to the lack of imaging, the factors that could impact future treatment, and various other reasons this opinion is uncertain. Again, the Court held that these topics are appropriate for cross-examination and/or rebuttal testimony but did not warrant exclusion.

    Held

    The Court granted in part and denied in part Allstate’s motion to exclude portions of Dr. David Badger’s testimony.

    The Court held that Badger can only testify about his opinions on the permanency of Perez’s injuries that were disclosed in the March and June 2024 reports; any opinion outside those bounds is excluded. The remainder of Allstate’s arguments are denied.

    Key Takeaways:

    • While any new opinions would be improper, Badger may connect his diagnoses with the facts and assessments provided in his report.
    • An expert cannot salvage a deficient report by supplementing it with later deposition testimony.

    Case Details:

    Case Caption: Perez V. Allstate Fire And Casualty Insurance Company
    Docket Number: 2:23cv681
    Court Name: United States District Court, Washington Western
    Order Date: February 25, 2025