Expert Witness Profiler

Tag: Symptoms

  • Allergy and Immunology Expert’s Causation Opinion Admitted

    Allergy and Immunology Expert’s Causation Opinion Admitted

    This is an employment action brought under state and federal law. Donna Neil (“Plaintiff”) brings this lawsuit against her former employer, KMT Waterjet Systems, Inc. (“KMT”), and Flow International Corporation (“Flow”) (collectively, “Defendants”), both of which are subsidiaries of Shape Technologies, Inc. (“Shape”).

    On January 13, 2023, Neil submitted an ADA Reasonable Accommodation Request Form, alleging that she began to suffer “allergies related to the extreme mold odors” in her office. She claimed these odors caused “acute respiratory symptoms,” “cognitive difficulties,” “digestive problems,” and “rashes.”

    She alleged that she was suffering from “mental disturbances/electric shock,” “paranoia,” “kidney pain,” “heart palpitations,” and “oxygen often dropping into the 80s.”

    Thus, Defendants retained Dr. Ronald H. Saff to evaluate these complex medical claims. Neil, however, filed a motion to exclude the testimony of Saff on the ground that it is irrelevant because the medical cause of her symptoms is not an element of her claims.

    Allergy and Immunology Expert Witness

    Dr. Ronald H. Saff is a board-certified allergist and immunologist and has been retained by many attorneys as an expert witness in mold, sick building, “toxic” mold, drug allergy, food allergy, and asthma litigation. He has also served as an assistant clinical professor of medicine at the Florida State University College of Medicine.

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

    Discussion by the Court

    On September 02, 2025, Saff rendered a 4-page opinion. It boils down to the contention that mold exposure did not cause Plaintiff’s health problems; rather, her problems were caused by a combination of the side effects of medication and psychiatric illnesses.

    To begin with, the Court found that Saff is qualified to testify based on his knowledge, skill, training, experience, and education as indicated in his report and that his opinion is reliable based on the records he has evaluated.

    Moreover, there can be no doubt that Saff’s opinion regarding the medical cause of Plaintiff’s symptoms is relevant and may assist the trier of fact. To be sure, Saff may not opine on ultimate legal issues—such as whether Plaintiff is a “qualified individual” or whether her requested accommodation was “reasonable” as those terms are defined by law. However, the question of what medically caused Plaintiff’s symptoms is a factual predicate that underlies those determinations. Accordingly, the Court denied the motion to exclude Saff’s testimony without prejudice.

    Plaintiff also sought to exclude Saff’s testimony on the grounds that his opinion belongs solely before an administrative law judge (“ALJ”) under the Kansas Workers’ Compensation Act (“KWCA”), because the KWCA provides the exclusive remedy for Plaintiff’s claims.

    The KWCA is a liability scheme, not an evidentiary rule. It provided the exclusive remedy for claims arising from on-the-job injuries. Plaintiff’s ADA claims did not require proof of an on-the-job injury; they require proof of certain elements as defined by the ADA. Moreover, the KWCA’s exclusive-remedy provision has no bearing on whether a federal court adjudicating an ADA discrimination claim may hear medical evidence. As a result, the Court denied Plaintiff’s motion to exclude to the extent it sought to limit Saff’s testimony under the KWCA.

    Held

    The Court denied Plaintiff’s motion to exclude the testimony of Ronald H. Saff, M.D., in part and denied it without prejudice in part.

    Key Takeaway

    If Plaintiff’s symptoms were not caused by mold exposure in her workplace, a jury could reasonably conclude that relocating her to Building 3 (her accommodation request) would not have enabled her to perform the essential functions of her job, rendering her unqualified under the ADA and unable to make a prima facie case. 

    Thus, Saff’s causation opinion is sufficiently tied to the facts at issue in this case, and Plaintiff’s challenges to its weight and credibility are properly addressed through cross-examination.

    Case Details:

    Case Caption: Neil V. KMT Waterjet Systems, Inc.
    Docket Number: 2:24cv2602
    Court Name: United States District Court, Kansas
    Order Date: May 22, 2026
  • Dermatology Expert Not Allowed to Opine on Hair Loss

    Dermatology Expert Not Allowed to Opine on Hair Loss

    On January 19, 2023, Plaintiff Tamie Maddox filed her Complaint against Defendant Conopco, Inc. d/b/a Unilever Home & Personal Care USA, alleging that Defendant, a New York corporation with its principal place of business located at 700 Sylvan Avenue, Englewood Cliffs, New Jersey 07632, caused Plaintiff to suffer from hair loss after she used Defendant’s TRESemmé shampoo containing DMDM hydantoin (“DMDM”).  

    Plaintiff alleged that the DMDM preservative used in Defendant’s products including the TRESemmé Keratin Smooth Shampoo is a chemical that releases a carcinogen known as formaldehyde, which has long been associated with causing hair loss, thinning hair, dermatitis, and other adverse scalp reactions, and has been the subject of numerous complaints and various lawsuits.

    According to Plaintiff’s medical expert, dermatologist Dr. Marc J. Serota, “Defendant’s product caused her hair loss due to an allergic reaction to DMDM.” However, Defendant filed a motion to preclude Serota from testifying at trial.

    Dermatology Expert Witness

    Dr. Marc Jonathan Serota is triple board-certified in dermatology, pediatrics, and allergy and immunology. Serota is recognized as a national expert in dermatology and allergy topics. He also frequently lectures across the country and has published numerous articles in his areas of expertise.

    Want to know more about the challenges Marc Serota has faced? Get the full details with our Challenge Study report.

    Discussion by the Court

    To begin with, Defendant argued that Serota formed his opinion without conducting procedures normally performed by dermatologists outside the litigation context. Moreover, Defendant asserted that Serota’s theory in this case lacked scientific support and that he failed to establish that DMDM or other chemicals could have caused the alleged hair loss at the levels of concentration these chemicals are found in Defendant’s products. Defendant noted that Plaintiff has not consulted with a doctor in several years, that she has been uninsured since 1996, and that she has never been tested for an allergy to DMDM. 

    Serota testified that he essentially relied entirely on Plaintiff’s self-report of her symptoms and some photographs of the affected areas on her body to come to his opinion.

    In this case, because Plaintiff effectively lacked any significant medical records or other medical history that could have informed Serota’s opinion as to her specific condition, Serota would have had to perform some physical examination or laboratory tests to credibly determine whether Plaintiff does in fact have an allergy to DMDM.

    He did not do that here, and as a result, the Court cannot credit his testimony and allow him to present his opinions to a jury as those of a properly informed expert.

    Held

    The Court granted Defendant’s Daubert motion to preclude Marc Serota from testifying at trial.

    Key Takeaway

    A physician who evaluates a patient in preparation for litigation should seek more than a patient’s self-report of symptoms or illness. Therefore, the physician should either examine the patient or review the patient’s medical records.

    Case Details:

    Case Caption: Maddox V. Conopco, Inc.
    Docket Number: 2:23cv293
    Court Name: United States District Court for the District of New Jersey
    Order Date: May 12, 2026
  • Psychiatry Expert Witness’ Opinions Regarding the Clinical Sufficiency of Certain Guidelines Admitted

    Psychiatry Expert Witness’ Opinions Regarding the Clinical Sufficiency of Certain Guidelines Admitted

    Kirsten W. sought payment of benefits for her son C.W.’s treatment at Open Sky Wilderness Therapy (“Open Sky”) and Telos Residential Treatment Center (“Telos”) from Defendants California Physicians’ Service d/b/a Blue Shield of California (“BSC”). C.W. was admitted to Open Sky and Telos for treatment of his depression, anxiety, drug and alcohol use disorders, poor impulse control, and other self-destructive behaviors.

    To evaluate coverage of Residential Treatment Center (“RTC”) level of treatment for children and adolescents, BSC has relied on various different criteria that were in effect during different periods. Of particular relevance, BSC utilized the 2018 MCG 21st Edition Residential Acute Behavioral Health Level of Care Guidelines (“MCG Guidelines”) and Version 20 of The Child and Adolescent Level of Care Utilization System Guidelines (“CALOCUS”). 

    Defendants denied Kirsten’s claims for coverage, relying on statements such as “there was never a significant risk that you would harm yourself or others,”
    and “there is no active suicidal ideation with intent or plan, homicidal ideation, or overt psychosis” to support the decision to deny benefits.

    Plaintiff additionally claimed that Defendants violated the Mental Health Parity and Addiction Equity Act of 2008 (the “Parity Act” or “MHPAEA”) by applying acute requirements to subacute mental health treatment. 

    BSC disclosed Caitlin R. Costello as an expert for the purpose of providing opinions “regarding the clinical sufficiency of certain guidelines that [BSC] consulted when evaluating the medical necessity of the services allegedly provided to [C.W.].”

    Given that Defendants relied on Costello in disputing Plaintiff’s purported MHPAEA violations, the Court first considers whether her report and opinions are admissible under Federal Rule of Evidence 702.

    Psychiatry Expert Witness

    Caitlin Costello is an associate clinical professor in the Division of Child and Adolescent Psychiatry, Department of Psychiatry, at the University of California, San Francisco. She also serves as the chief of child forensic psychiatry in the Psychiatry and Law Program at the University of California, San Francisco. Additionally, she is the medical director for child and adolescent ambulatory psychiatry at UCSF-West Bay. Costello is also the Training Director of the Child and Adolescent Psychiatry Training Program at the University of California, San Francisco.

    She is licensed to practice medicine in the state of California and is certified by the American Board of Psychiatry and Neurology in General Psychiatry, Child and Adolescent Psychiatry, and Forensic Psychiatry.

    Want to know more about the challenges Caitlin Costello has faced? Get the full details with our Challenge Study report. 

    Discussion by the Court

    In her expert report, Costello takes no position on whether the disputed services were “medically necessary.” Instead, she opined that utilization of the MCG Guidelines was “clinically appropriate for Blue Shield to consider” in its medical necessity evaluation.

    Costello further opined that the MCG Guidelines did not focus solely, primarily, or improperly on acute symptomology, and that BSC’s reliance on the guidelines did not show any clinically improper focus on acute symptomology.

    First, Plaintiff argued that Costello’s report did not compare analogous guidelines (such as those of skilled nursing facilities with the MCG Guidelines) and was thus unhelpful to the Court’s analysis. Second, Plaintiff argued that Costello’s report was unreliable because it ignored the language of the Plan and the relevant MCG Guidelines.

    Costello’s Report did not Compare Analogous Guidelines

    Plaintiff’s parity act claim is entirely based on her reading of the terms of the MCG Guidelines as requiring acute symptoms in contrast with treatment in a skilled nursing facility, which requires there be “no acute hospital care needs.”

    Demonstration that the MCG Guidelines did not require “acute” symptoms was sufficient to defeat Plaintiff’s Parity Act argument. The Court held that Costello’s report is directly relevant to this point.

    Costello’s Report was Unreliable because it Ignored the Language of the Plan and the Relevant MCG Guidelines

    Plaintiff essentially argued that Costello’s opinion is incorrect as to whether the MCG Guidelines improperly focus on acute symptomology, based on an alleged lack of “citation to any evidence” and in light of a footnote that mentions “acute” symptoms.

    First, the Court held that Costello did cite to the record—specifically the language of the applicable guidelines she opines on. Any interpretations of these guidelines, particularly as to whether they employ acute symptomology criteria, fell under her training and experience.

    And it was not unreasonable for Costello to not specifically describe every footnote in her report that she did not believe would change her analysis, particularly when Plaintiff did not mention this footnote previously. A threshold showing of reliability did not mean the “expert’s testimony is ‘undisputably correct’ or without uncertainty.”

    Plaintiff also argues that discussion of this footnote in Costello’s supplemental declaration attached to Defendants’ Opposition to Plaintiff’s motion for summary judgment amounts to “untimely” expert testimony because the text of the footnote was available upon review of the MCG Guidelines.

    The meaning attributed to the footnote falls within “the contested issue of whether Blue Shield improperly applied guidelines that were too restrictive or otherwise inappropriate,” which Defendants disclosed Costello would testify regarding in their expert disclosures.

    There was no indication prior to the summary judgment briefing that Plaintiff intended to argue that this single footnote altered the reasonable interpretation of the MCG Guidelines. Plaintiff also chose not to submit an expert report, a rebuttal expert report, or depose Costello.

    Therefore, Costello’s declaration was appropriate to rebut Plaintiff’s new argument. Accordingly, the Court finds Costello’s report and opinions sufficiently reliable for the Court to consider regarding the language and meaning of the MCG Guidelines.

    Held

    The Court denied the Plaintiff’s motion to exclude the opinions of Dr. Caitlin Costello.

    Key Takeaway:

    A threshold showing of reliability does not mean the “expert’s testimony is ‘undisputably correct’ or without uncertainty.

    Costello’s opinion is not incorrect in light of a footnote that mentions “acute” symptoms because it was reasonable for Costello to not specifically describe every footnote in her report that she did not believe would change her analysis, particularly when Plaintiff did not mention this footnote previously. Moreover, Costello does cite to the record—specifically the language of the applicable guidelines she opines on. Any interpretations of these guidelines, particularly as to whether they employ acute symptomology criteria, falls under her training and experience.

    Case Details:

    Case Caption: Kirsten W. V. California Physicians Service Et Al
    Docket Number: 2:19cv710
    Court: United States District Court, Utah
    Order Date: February 10, 2025
  • Testimony of Physical Medicine & Rehabilitation Expert Witness Concerning Plaintiff’s Life Care Plan Is Not Entirely Based on Speculation

    Testimony of Physical Medicine & Rehabilitation Expert Witness Concerning Plaintiff’s Life Care Plan Is Not Entirely Based on Speculation

    Plaintiff Towanda R. Futrell filed this personal injury action on August 28, 2023. The action arises from a motor vehicle accident on Interstate 64 on December 16, 2022, when a tractor-trailer owned by AV Leasing, LLC, leased by Triton Logistics, Inc., and driven by Daniel Cramer, collided with a bus on which Futrell was a passenger. 

    Pursuant to Rule 26(a)(2) of the Federal Rules of Civil Procedure, on May 28, 2024, Futrell disclosed Dallas Lea, II, M.D. (“Dr. Lea”), as an expert witness in the field of orthopedic surgery who may be called to testify at trial. Futrell disclosed that Lea was expected to testify to: (a) Futrell’s injuries, including a broken right ankle, sprained left ankle, broken eye socket, and broken left jaw; (b) Futrell’s ankle surgeries; (c) Futrell’s “extensive physical medicine and rehabilitation”; and (d) his opinion that Futrell’s injuries, medical treatment, hospitalizations, “past and future pain and suffering, past and future medical expenses and medical costs and life care medical costs, and economic or non-economic related damages” are “a proximate cause of Defendant Daniel Cramer’s negligence.” 

    Futrell provided Defendants with a copy of Lea’s curriculum vitae. On or before July 9, 2024, Futrell also provided Defendants with Lea’s expert report-a life care plan for Futrell. The life care plan outlines Futrell’s treatment following the accident, Lea’s opinion that Futrell “will have chronic symptoms and residual disabilities resulting from the accident,” and a table containing Lea’s recommendations for Futrell’s “current and future care needs.” 

    On September 17, 2024, Defendants filed the pending motion in limine to exclude Lea’s opinion because he was not properly designated as an expert in life care planning and the opinions in his life care plan lack the requisite foundation. 

    Lea was not properly designated as an expert in life care planning

    First, the Defendants asserted that Lea was not properly designated as an expert in life care planning. The Defendants noted that Lea was designated as an expert in orthopedic surgery who was expected to testify about Futrell’s injuries, Futrell’s treatment, and his opinion that Futrell’s injuries, treatment, past and future pain and suffering, past and future medical expenses, and life care costs were proximately caused by Defendant Daniel Cramer’s negligence.

    Lea’s opinions lack the proper foundation and are speculative

    Next, Defendants argued that Lea’s opinions lacked the proper foundation and were speculative. Lea never treated Futrell and did not interview her or her treating physicians prior to developing the life care plan. The life care plan was drafted based on Lea’s review of Futrell’s medical records.

    Physical Medicine & Rehabilitation Expert Witness

    Dallas Alexander Lea, II M.D. is an internationally recognized spinal cord injury physician, fellowship-trained, and double-boarded in Physical Medicine and Rehabilitation (PM&R) and Spinal Cord Injury (SCI) Medicine.

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

    Discussion by the Court

    Errors in the Rule 26(a)(2) disclosure are harmless as Dr. Lea’s CV, life care plan, and deposition clarify his expertise and outline his proposed expert testimony

    Futrell asserted that Defendants were provided with a copy of Lea’s CV, which put them on notice that Lea was a life care planner, board certified in physical medicine and rehabilitation, and Defendants were provided with his life care plan on July 5, 2024. During Lea’s deposition, Futrell’s counsel clarified that the designation of Lea as an orthopedic surgeon was due to a “typographical error.” Lea testified that he was not an orthopedic surgeon, but a specialist in spinal cord injury and in physical medicine and rehabilitation. Lea explained that he would not be testifying about causation or negligence, rather he would testify to Futrell’s “injuries and future care and needs,” and that he was asked to “review records, review the case, and produce a life care plan.” 

    The Court found that Futrell’s failure to identify Lea as an expert to testify about Futrell’s life care plan in the Rule 26(a)(2) disclosure served on May 28, 2024, was harmless. The Rule 26(a)(2) disclosure was inaccurate. Futrell’s explanation for the inaccurate disclosure—that it was a “typographical error”—is less than satisfactory. The inaccuracy also goes beyond simply misstating that Lea is an orthopedic surgeon, by wrongfully disclosing that Lea will testify about the cause of Futrell’s injuries. The disclosure did, however, include Lea’s expected testimony about Plaintiffs future medical care and expected costs over her lifetime. The provision of Lea’s CV and life care plan clarified his expertise and proposed testimony and Defendants were further able to clarify this with his deposition taken September 6, 2024. 

    Lea’s proposed testimony concerning Futrell’s life care plan is based on his medical expertise and will be helpful to a jury

    Defendants also challenged several of the line items in Lea’s life care plan table, specifically house cleaning, ophthalmologist evaluations, an ear, nose, and throat evaluation, yearly visits to her primary care physician, and psychological counseling.

    Defendants argued Lea did not know whether Futrell has familial support to take care of house cleaning or to what extent she has suffered emotional injuries and needs counseling. They concluded that the life care plan is speculative and not tailored to Futrell’s unique needs, and Futrell “provides no indication why Lea’s life care plan is more plausible than other possibilities of what she will require in the future.”

    Lea explained that: (1) Futrell’s chronic symptoms and residual disabilities “were evident” in her medical records (2) the monthly housecleaning expense is for deep cleaning (3) the ophthalmologist evaluation and ear, nose, and throat evaluation were a precaution due to her jaw fracture and broken eye socket (4) the yearly visit to her primary care physician would be in addition to a routine yearly physical and would be necessary for pain management and pain management medications and (5) psychological counseling was included because of the mention of Futrell’s anxiety in the medical record.

    The Court held that Lea reviewed and summarized Futrell’s past treatment, current treatment regimen, and future treatment recommended by her physicians. Lea then developed a life care plan projecting Futrell’s future costs based on this review.  A certain amount of speculation is inherent in a life care plan that projects what will be needed in the future and hinges on future events. Permitting cross-examination regarding the facts and data Lea relied on to arrive at the future costs will allow the fact finder to determine the appropriate weight to assign to Lea’s testimony. 

    Held

    • The Court held that permitting Lea to testify about the life care plan he outlined for Futrell would not disrupt the trial. Lea, however, will not be permitted to testify about the cause of Futrell’s injuries and his testimony will be limited to the opinions outlined in his life care plan.
    • The Court found that Lea is qualified to testify as an expert witness and he is proposing to testify to relevant medical knowledge that will assist the trier of fact in understanding a fact in issue. Nor does the Court find that the probative value of such testimony is substantially outweighed by the danger of unfair prejudice, confusion of the issues, or misleading the jury. The Court found that Defendants’ concerns about the reliability of Lea’s testimony may be properly raised during cross-examination, but they are insufficient to persuade the Court to exclude Lea.

    The Court denied Defendants’ motion in limine to exclude the expert opinions of Dallas Lea, II, M.D.

    Key Takeaways:

    • The Rule 26(a)(2) disclosure was inaccurate. Futrell’s explanation for the inaccurate disclosure—that it was a “typographical error”—is less than satisfactory. The inaccuracy also goes beyond simply misstating that Lea is an orthopedic surgeon, by wrongfully disclosing that Lea will testify about the cause of Futrell’s injuries.
    • A certain amount of speculation is inherent in a life care plan that projects what will be needed in the future and hinges on future events.

    Case Details:

    Case Caption: Futtrell V. Av Leasing, LLC
    Docket Number: 4:23cv118
    Court: United States District Court for the Eastern District of Virginia, Newport News Division
    Order Date: October 25, 2024