Expert Witness Profiler

Tag: Treatment

  • Cardiology Expert Allowed to Opine on the Need for Additional Treatment

    Cardiology Expert Allowed to Opine on the Need for Additional Treatment

    This medical-negligence/wrongful-death case resulting from the tragic death of Formeka Ball. Ms. Ball was admitted to the River Oaks Hospital Emergency Room complaining of chest pain and shortness of breath that started earlier that morning. After she died, Plaintiff Patricia Ball, Ms. Ball’s mother and the administratrix of her estate, sued River Oaks.

    Defendants challenged Plaintiff’s experts, Dr. Todd A. Parker and Dr. Ronald H. Wharton.

    Emergency Medicine Expert Witness

    Todd Allen Parker is a board-certified emergency-medicine physician and an attending physician. He is an editor and chapter author of a major Emergency Medicine board review textbook published by the American Academy of Emergency Medicine.

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

    Cardiology Expert Witness

    Ronald Howard Wharton is board certified in cardiovascular disease, completed a residency in internal medicine and a fellowship in cardiovascular disease, and is an associate professor of cardiology at the Zucker School of Medicine of Hofstra University in New York.

    He is also an attending cardiologist at a hospital in Manhasset, New
    York.

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

    Discussion by the Court

    Defendants mostly accepted their qualifications but said that their testimony is unreliable and thus inadmissible under Federal Rule of Evidence 702.

    Parker and Wharton offered similar core opinions. Though Ball was given a troponin test in the ER to determine whether she was having a heart attack, they believe she should have received a second troponin test after more observation. Had that test been done, they believe it would have detected the need for additional treatment and that she would not have died from cardiac arrest later that night.

    1. Speculative and Conclusory Opinions

    Both Parker and Wharton offered opinions on the standard of care, breach, and causation. According to Defendants, Parker and Wharton failed “to take into account facts established by the family members’ depositions” regarding the onset of symptoms and have “no autopsy, no abnormal EKG, and no abnormal laboratory testing which factually supports the experts’ opinions.”

    Parker’s initial report indicated that Ball “presented to the ED with a history & physical that is a ‘textbook’ case of how cardiac ischemia presents.” He then described that history and those symptoms, including Ball’s score on a clinical guideline (the HEART score and Heart pathway).

    Parker also conducted a differential diagnosis, ruling in cardiac arrest and ruling out other causes of her symptoms. The Court found the methodology sufficiently reliable to meet Plaintiff’s burden under Rule 702.

    According to Defendants, Parker and Wharton missed evidence and had no autopsy to consider. Neither is dispositive. Because Plaintiff met Rule 702’s burden, Defendants’ other factual arguments go to weight.

    2. Wharton’s Qualifications

    According to Wharton, Ball would have survived if given treatment, including “medications and reperfusion therapy (either percutaneous coronary intervention or bypass surgery).”

    Defendants said that Wharton is unqualified to give this opinion because he is neither an interventional cardiologist nor a cardiovascular surgeon.

    Even assuming he did not currently perform the procedures he noted, Defendants have not explained why a cardiologist with his knowledge, skill, experience, training, and education would lack the expertise to explain how heart attacks are treated.

    Defendants next complained that Wharton lacked the qualifications to agree with the coroner’s finding that cardiac arrest caused the death.

    This was a new argument. While Wharton addressed the issue again in his new affidavit, his original report noted the coroner’s finding and stated that “more likely than not, Ball died from complications of an acute myocardial infarction.” Thus, Defendants could have initially argued that Wharton needed to be a pathologist to testify regarding the cause of death. That argument would have allowed Plaintiff an opportunity to respond.

    This qualifications argument is untimely, and the Court will not strike Wharton based on qualifications.

    3. Failure to Identify Specific Life-Saving Treatment

    After arguing that Wharton is unqualified to address the specific procedures he believes would have saved Ball, Defendants fault Plaintiff’s experts for failing to “establish that timely diagnosis would have led to an identified course of treatment and that treatment would more likely than not, have prevented death within the relevant time window.”

    But the experts’ initial reports did not mention specific treatment, so Defendants could have faulted the experts for this omission in their opening brief. The argument is therefore untimely.

    Held

    The Court denied the Defendants’ motion to strike the testimony of Todd Parker and Ronald Wharton.

    Key Takeaway

    The Court should make certain that an expert, whether basing testimony upon professional studies or personal experience, employs in the courtroom the same level of intellectual rigor that characterizes the practice of an expert in the relevant field.

    Case Details:

    Case Caption: Ball V. River Oaks Hospital, LLC
    Docket Number: 3:24cv632
    Court Name: United States District Court, Mississippi Southern
    Order Date: June 11, 2026
  • Pathology Expert’s Emergency Care Opinions Excluded

    Pathology Expert’s Emergency Care Opinions Excluded

    Plaintiffs Lawrence Lieberman, Linda Lieberman, and the Estate of Myron Lieberman asserted claims for negligence and wrongful death against Defendant Target Corporation.

    This matter involves a slip-and-fall incident that occurred at a Target store on December 9, 2021. The man who fell, Myron Lieberman, fractured his hip in the fall. He was taken to the hospital, where he underwent surgery the next morning and was discharged without complications two days after that. On December 24, 2021, fifteen days after the fall, Lieberman passed away.

    Defendant filed a motion to exclude the testimony of Plaintiffs’ medical causation expert, Dr. Marvin Pietruszka.

    Pathology Expert Witness

    Marvin Pietruszka, M.D., M.Sc., F.C.A.P. is a forensic pathologist and forensic toxicologist who is board certified in anatomic and clinical pathology, occupational medicine, and forensic toxicology.

    He earned his M.D. at the Autonomous University of Guadalajara in 1972, completed his Pathology Residency at the University of Pittsburgh, School of Medicine in 1976, and also received a Masters Degree in Forensic Toxicology in 2004 from the University of Florida.

    Pietruszka has been doing IME’s for the past 11 years and has testified in several cases. He has been doing Med/Legal work since 1997. He is licensed to practice medicine in California, Texas and Pennsylvania. Pietruszka is a Clinical Associate Professor of Pathology, University of Southern California, serves as a Director at both the Psychemedics, a toxicology laboratory and at H.I.B.M. a genetic research laboratory and is a pathologist at Forensic Autopsy Services.

    Discover more cases with Marvin Pietruszka as an expert witness by ordering his comprehensive Expert Witness Profile report.

    Discussion by the Court

    Plaintiffs offered Pietruszka to opine on: (1) the effects of Defendant’s employees’ actions on the date in question; (2) how the employees should have acted in response to Leiberman’s injury; (3) how Lieberman’s risk of injury would have been reduced had his hip been immobilized and had he been immediately transported the hospital; and (4) Lieberman’s chance of survival had Defendant’s employees acted properly.

    However, the Defendant argued that Pietruszka was not qualified to give these opinions under Rule 702(a) and that the opinions lacked a reliable factual basis and methodology under Rule 702(b) and (c).

    A. Qualifications Under 702(a)

    To begin with, Pietruszka lacks specialized experience or training in emergency medicine, trauma medicine, or acute care.

    Plaintiffs’ counsel stated at oral argument that Pietruszka has decades of experience examining mortality rates in elderly individuals after hip fractures. But this expertise is not reflected in his research, publications, or courses taught. Instead, his CV describes research in various other areas such as immunizations, cancer, diabetes, and genetic mutations.

    Therefore, the Court held that Plaintiffs have not shown by a preponderance of the evidence that Pietruszka is qualified as an expert by his “knowledge, skills, experience, training, or education” to opine on the treatment of Lieberman after his fall or the consequences of that treatment.

    B. Factual Basis and Methodology Under Rule 702(b) and (c)

    Pietruszka’s report lists nine conditions that are the most frequent causes of death in hip fracture cases: pneumonia, urinary tract infection, deep wound infection, myocardial infarction, stroke, sepsis, septic shock, pulmonary embolism, and deep vein thrombosis.

    After listing these common causes of death, Pietruszka opined that the most probable cause of Lieberman’s death was deep vein thrombosis that resulted in a pulmonary embolism. While these are two of the nine conditions Pietruszka identified as frequent causes of death after hip fractures, he did nothing to rule out the other seven common causes.

    Pietruszka did briefly explain why he settled on deep vein thrombosis and pulmonary embolism as the causes of Lieberman’s death. He states that Lieberman’s “continued lower extremity pain several weeks after undergoing surgical treatment for the hip fracture suggests there was significant tissue injury at the site of the fracture.”

    He attributed this tissue injury to Defendant’s moving of Lieberman from the fall site, an act he asserts “would have caused more extensive tissue damage that would result in clot formation.” But Pietruszka did not explain how the pain experienced by Lieberman in the two weeks after his fracture and surgery, or the tissue damage he assumed, were any different from the pain and tissue damage that would have been caused by the fracture itself and the surgery performed the following day, during which a metal rod was inserted into Lieberman’s femur.

    Stated differently, the Court held that Pietruszka provided no facts or reliable methodology the jury can use to conclude that Lieberman’s death was caused by the actions of Defendant’s employees rather than by the fall, hip fracture, and surgery of an 80-year-old man.

    C. Rule 702 Conclusion

    Plaintiffs have not shown by a preponderance of the evidence that Pietruszka is qualified to give the trauma and emergency care opinions he offers in this case, as required by Rule 702(a). Nor have they shown by a preponderance of the evidence that his opinions are based on sufficient facts and data or reliable principles and methods, as required by Rule 702(b) and (c). The Court accordingly granted Defendant’s motion and excluded Pietruszka’s testimony from the evidence in this case.

    Held

    The Court granted the Defendant’s motion to disqualify Dr. Marvin Pietruszka.

    Key Takeaway:

    In differential diagnosis, the expert “assumes the pertinence of all potential causes, then rules out the ones as to which there is no plausible evidence of causation, and then determines the most likely cause among those that cannot be excluded.”

    When eliminating a potential cause, the “expert must provide reasons for rejecting alternative hypotheses using scientific methods and procedures and the elimination of those hypotheses must be founded on more than subjective beliefs or unsupported speculation.”

    Pietruszka provided no explanation of how, in Lieberman’s case, he eliminated the other seven common causes of mortality following hip fractures.

    Case Details:

    Case Caption: Lieberman V. Target Corporation
    Docket Number: 2:24cv450
    Court Name: United States District Court, Arizona
    Order Date: November 03, 2025
  • Orthopedic Surgery Expert’s Opinion on Future Damages Admitted

    Orthopedic Surgery Expert’s Opinion on Future Damages Admitted

    This case concerns a motor vehicle accident involving the Plaintiffs, Vanessa Rivera and her minor child K.C., and Joseph Giordano, a driver for Defendants Safway Services, LLC and Brand Safway Services, LLC. The Plaintiffs asserted four counts of negligence against the Defendants and sought damages for the physical, emotional, and financial injuries they allegedly suffered from the accident.

    Defendants filed a motion to exclude the opinions of Dr. Nikhil Thakur and Maryanne Cline. Basically, the Defendants contended that Thakur’s opinions are not founded on a satisfactory level of analytical rigor and are not the product of reliable principles and methods.

    Moreover, Defendants added that Thakur’s conclusions regarding future medical treatment were speculative under Massachusetts law governing future damages. Based on these challenges, Defendants argued that excluding the expert testimony would mean Plaintiffs could not establish the necessary amount in controversy, requiring dismissal for lack of subject matter jurisdiction.

    As for Cline, the Defendants’ only justification for moving to exclude her medical cost projections hinges on the preclusion of Thakur’s opinions.

    Orthopedic Surgery Expert Witness

    Dr. Nikhil Thakur is a Board Certified Orthopaedic Spine Surgeon, who specializes in Adult Reconstructive Spine Surgery. Previously, he was an Assistant Professor at SUNY – Upstate in Syracuse NY, where he performed over 300 elective and traumatic spine surgeries at a Level 1 Trauma Center each year. He also developed and ran the spine program at Upstate University at Community General. He continues to hold an adjunct professorship there and is actively involved in his stem cell lab, which he co-directs.

    Thakur completed his spine fellowship at the prestigious Emory Spine Center in Atlanta, where he was involved in the care of the Atlanta Falcons. He also completed an orthopaedic trauma fellowship at Brown University – Rhode Island Hospital.

    Discover more cases with Nikhil Thakur as an expert witness by ordering his comprehensive Expert Witness Profile report. 

    Life Care Planning Expert Witness

    Maryanne Cline began her career in nursing in 1985 and specifically, rehabilitation nursing in 1991. She worked with traumatically injured clients at St. Anthony’s Medical Center in Crown Point, Indiana and in the Physical Medicine and Rehabilitation Inpatient Unit at The Cleveland Clinic.

    Her varied clinical experience includes cardiology, medical/surgical, oncology and hospice. Cline has nearly ten years’ experience in the field of Life Care Planning, first as a research assistant then becoming a Certified Life Care Planner in 2012.

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

    Discussion by the Court

    Initial Arguments

    Defendants moved to exclude the testimony and opinions of plaintiffs’ experts, Thakur, an orthopedic spine surgeon, and Maryanne Cline, a certified nurse life care planner. They argued Thakur’s opinions were inadmissible under Federal Rule of Evidence 702. Defendants asserted his opinions lacked satisfactory analytical rigor and did not result from reliable methods.

    Methodology

    The Court evaluated Thakur’s methodology for forming his expert opinions. Thakur based his opinions on a physical examination of Rivera. Furthermore, he also took her medical history and interpreted medical records from her other healthcare providers. Ultimately, the Court found this approach constituted a reliable methodology under Federal Rule of Evidence 702.

    The Court addressed the Defendants’ specific challenges to alleged “errors and omissions” in Thakur’s report. Specifically, Defendants argued certain points, like the fact that Thakur described the accident as a slip and fall instead of a motor vehicle accident or that Thakur did not reference any medical records contradicting his description of Rivera’s ongoing complications and his diagnosis of a C4-C5 disc herniation, warranted exclusion. Nevertheless, the Court held that these disputes over the factual underpinnings of the report did not evince a “significant ‘analytical ga[p]’” between Thakur’s opinions and the record evidence.

    The Defendants’ only methodological quibble—that Thakur did not wait until two years after the accident to measure Rivera’s maximum medical improvement—is not a significant enough analytical issue to merit wholesale exclusion of his opinions. 

    The Defendants next argued that Thakur’s conclusions regarding Rivera’s future medical treatment are “speculative and precatory” and must be excluded under Massachusetts law governing recovery for future damages.

    A Plaintiff, however, “is not restricted to compensation for suffering and expense” that “will inevitably follow,” because “suffering and expense following an injury cannot be foretold with exactness.” Instead, a Plaintiff may be compensated for expenses “which by a fair preponderance of the evidence [she] has satisfied the jury reasonably are to be expected to follow.” 

    Relevance

    Under Federal Rule of Evidence 403, the Court determined Thakur’s opinions had significant probative value which was not substantially outweighed by the danger of unfair prejudice or jury confusion. Moreover, the Court rejected the argument that the jury would improperly rely on Thakur’s credentials alone or become confused by the “stark contrast” between Thakur’s report and Rivera’s deposition testimony.

    Since Thakur’s opinions were admissible under Rules 702, 403, and Massachusetts law, the Court likewise found that Maryanne Cline’s medical cost projections should not be excluded. After all, Cline based her opinions on Thakur’s admissible findings and recommendations.

    Held

    The Court denied the Defendants’ motion to exclude the experts, Dr. Nikhil Thakur and Maryanne Cline.

    Key Takeaways:

    • Ultimately, the “errors and omissions” highlighted by the Defendant did not evince a significant analytical gap between Thakur’s opinions and the record evidence.
    • Because the evidentiary value of Thakur’s opinions is not substantially outweighed by the risk of jury confusion or unfair prejudice, exclusion of his report and testimony is unwarranted.

    Case Details:

    Case Caption: Rivera V. Safway Servs., LLC
    Docket Number: 1:23cv12184
    Court Name: United States District Court for the District of Massachusetts
    Order Date: April 23, 2025
  • Gastroenterology Expert Witness’ Testimony Is Not Supported By An Explanation Of the Principles and Methods

    Gastroenterology Expert Witness’ Testimony Is Not Supported By An Explanation Of the Principles and Methods

    Plaintiffs, Kathian Marie López-Concepción and Lenymar López-Concepción sought to recover damages for the alleged wrongful death of their late father, Angel I. López-Diaz in this medical malpractice action.

    Plaintiffs alleged in their complaint that the medical treatment and care provided by CMC, Dr. Benny Nieves Matias, Dr. Iolani Garcia Rosario, and Dr. Cristina I. Ortiz Garcia deviated from the standards of care of the medical professional community and was the cause of the death of Ángel I. López Díaz, after he received treatment and care for what turned out to be ingestion of a toxic substance.

    The Defendants jointly moved in limine to exclude the testimony of Plaintiffs’ expert witness, Dr. Edwin Miranda-Aponte (hereinafter “Dr. Miranda”), pursuant to Rule 702 and Daubert V. Merrell Dow Pharmaceuticals (92-102), 509 U.S. 579 (1993).

    Plaintiffs, in turn, requested the exclusion of two experts announced, respectively, by Co-Defendants Dr. Cristina Ortiz-García and Dr. Iolani García-Rosario: Drs. Wilfredo Nieves-Colomer (“Dr. Nieves”) and Alvaro Reymunde (“Dr. Reymunde”). 

    Emergency Medicine Expert Witnesses

    Edwin Miranda-Aponte is a licensed Specialist in Emergency Medicine with over 36 years of professional experience in Direct Care, Administrative, Operations Management, Aero-Medical Transport, and Academic Medicine. From 1983 through 2019, he held an unrestricted current permanent license to Practice Medicine and Surgery issued by the Puerto Rico Board of Medical Examiners. His Curriculum Vitae shows that he worked as an emergency room physician from 1994 through 2018 at Centro Médico. For a span of 8 years, he was the emergency room director at that same institution (2001-2009). Miranda was also a Professor at the University of Puerto Rico School of Medicine during the years 1983 through 1994.

    Want to know more about the challenges Edwin Miranda-Aponte has faced? Get the full details with our Challenge Study report. 

    Wilfredo Nieves Colomer, MD is an emergency medicine specialist in Carolina and has over 37 years of experience in the medical field. He graduated from Ponce Health Sciences University School of Medicine in 1986.

    Fortify your strategy by reviewing a Challenge Study detailing grounds for excluding Wilfredo Nieves Colomer’s expert testimony. 

    Gastroenterology Expert Witness

    Alvaro Reymunde, MD is a gastroenterologist in Ponce, PR and has over 40 years of experience in the medical field. He graduated from University Central Del Este in 1983. He

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

    Discussion by the Court

    Edwin Miranda-Aponte

    Defendants argued that Miranda is unqualified to render reliable testimony because he is not a toxicology expert and never treated a glyphosate poisoning while working as an emergency room physician.

    Defendants’ contention that he is not qualified because his medical training is limited to the “basic medical training as a General Practitioner” with no academic background or medical experience in toxicology, misses the mark considering his ample experience as an emergency room physician and emergency room director.

    The Court held that Miranda does not need to be an expert in toxicology to render an opinion regarding the treatment of López at CMC’s emergency room for ingesting a poisonous substance. Even more so when the allegations in this case all relate to treatment of López in the emergency room, as he was allegedly never admitted to the regular ward or the intensive care unit.

    Even though Miranda affirmed in his deposition that he never treated a patient with glyphosate poisoning, his expertise as an emergency room physician qualifies him to testify on whether the Defendants failed to abide by the accepted standards of care in managing López’s condition at the emergency room.

    The Court added that the admission of Miranda’s testimony does not prevent Defendants from presenting their own expert to refute his opinion at trial, or from confronting him through cross examination with matters that go to credibility or the weight, if any, that the jury will assign to his opinions. Moreover, Plaintiffs also challenged Miranda’s qualifications because his medical license was expired when he rendered his report. Miranda retired from the practice of medicine in 2018 and his license expired in 2022. However, Plaintiffs have not explained how the expiration of Miranda’s license undermines his credibility or makes his testimony unreliable.

    Benny Nieves Matias

    Nieves’ report stated that he was asked to review the medical record of López with particular attention to the care provided by Ortiz at CMC’s emergency department in February 2020.

    Because there was no list of his qualifications; no mention of other cases where he has testified; and no statement of the compensation he received for the study and testimony in the case, the Court held that Nieves’ three-page report did not fulfill the requirements of Rule 26(a)(2)(B). Moreover, Nieves’ report did not reference any additional data, medical literature, or treatises that he reviewed or considered.

    When Nieves stated that the intervention of Cristina Ortiz García with Angel I. López Díaz at the emergency department at Caribbean Hospital on February 27, 2020, was adequate, that Court held that Nieves’ input offered little that could not be obtained from the medical records. The report did not identify a national standard of care, nor did it state how Ortiz adhered to that standard of care. Moreover, Plaintiffs deemed Nieves’ conclusions as ipse dixit.

    In conclusion, the report did not guide the Court through Nieves’ analytical process to reach the conclusion that no standard of care was breached.

    Alvaro Reymunde

    To begin with, Reymunde opined that the mechanism that is triggered with the poison ingestion (“oxidative stress”) was already damaging López’s organs when he was admitted to the emergency room. And that there was nothing the doctors could have done because there’s no antidote for ingesting glyphosates. In fact, he categorically stated that other treatments that could have been attempted, such as dialysis, would have been futile because “the damage was already done.”

    Like Nieves’ expert report, Reymunde’s did not comply with all the requisites of Fed. R. Civ. P. 26(a)(2)(B). Also, the report was also missing any reference to medical literature and standards of care. Reymunde admittedly based his opinion on his vast experience but his report, however, does not delve into how his experience led to the conclusions he reached.

    Regarding García-Rosario’s care, he states that her decisions and medical criteria did not deviate from the standards of medical practice since she was in constant contact with the in-house physicians even when she wasn’t there in person to check on the patient. 

    The Court held that Reymunde’s conclusory opinion that nothing could be done by the medical personnel at CMC is not supported by an explanation of the principles and methods he used to arrive at it. Likewise, the Court is left to guess how he estimated the amount of glyphosate López consumed, and the time elapsed between the ingestion of the poison and the arrival at the emergency room.

    Held

    In conclusion, the Court denied the Defendants’ motion to exclude the testimony of Plaintiffs’ expert witness, Dr. Edwin Miranda-Aponte but granted the motion as to the exclusion of the reports and testimonies of Benny Nieves Matias and Alvaro Reymunde.

    Key Takeaways:

    • If Nieves was relying solely or primarily on his own experience, he was required to “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.”
    • Concerning the standards of care, Reymunde did not enunciate what that standard is or why he understands that García-Rosario’s actions or medical decisions had no bearing on the outcome of López’ health condition. The Court is left to wonder what the reasoning or the methodology are underlying his conclusions and whether they are scientifically valid and applicable to the facts in issue. An expert’s opinion “must be supported by appropriate validation” and rely on “more than subjective belief or unsupported speculation.” 

    Case Details:

    Case Caption: Lopez-Concepcion Et Al V. Caribe Physicians Plaza Corporation Et Al
    Docket Number: 3:21cv1360
    Court: United States District Court, Puerto Rico
    Order Date: August 07, 2024