Correctional Healthcare Expert’s Testimony About the Risk of Overdose Admitted
Posted on May 28, 2025 by Expert Witness Profiler
S.F., a former detainee in the Denton County Jail, asserted claims for alleged violations of her constitutional rights on account of the jail’s treatment of her withdrawal from opioids during two separate incarcerations and the alleged denial by the jail of medication for Opioid Use Disorder (“OUD”).
Plaintiff filed a motion to strike or limit the expert testimony of Dr.
Nicholas Longnecker, contending that he is not qualified to opine on addiction medicine, the ADA (Americans with Disabilities Act), Denton County policies, and Department of Justice (“DOJ”) policies.
Correctional Healthcare Expert Witness
Nicholas Longnecker obtained a Bachelor of Science in Microbiology and Immunology from the University of Miami with minors in Chemistry and Religious Studies and his Doctor of Medicine from the University of Miami Miller School of Medicine. He completed his residency at The Washington Hospital Family Medicine Residency Program in Washington, Pennsylvania, and is licensed to practice medicine in the states of Texas, New Mexico, Colorado, and Wyoming.
Longnecker is also a certified correctional health professional (CCHP), and he obtained his DEAX licensure, which allowed him to prescribe buprenorphine before this required waiver was eventually removed.
Discussion by the Court
A. Longnecker’s Qualification to Opine on Addiction Medicine
To begin with, S.F. argued that Longnecker is not qualified to offer an expert medical opinion on addiction medicine.
She asserted that Longnecker might be qualified to talk about the administration of some medications in a correctional setting for general ailments but lacks certification or advanced training in addiction medicine and lacks training in psychiatry and addiction psychiatry.
However, Longnecker gained experience in addiction medicine through his work at several facilities over the course of many years.
Longnecker worked at Greenbriar Treatment Center and the Washington County Jail for two years. He evaluated and treated patients suffering from addiction there. And at the Washington County Jail, he managed patients with addiction disorders. For the next six-and-a-half years, he worked at the University of Pittsburgh Medical Center, where he regularly treated patients suffering from addiction and managed their addiction medications.
For a year-and-a-half after that, he worked at WellPath, where he oversaw the MAT program for Albion Prison. And since 2022, he has worked at CorrHealth, where he is responsible for directing inmate medical care. He also developed and manages its MAT program for sites across four States.
The Court found Longnecker qualified to opine on addiction medicine.
B. Improper Topics of Expert Testimony
I. The ADA
S.F. argued that Longnecker is not qualified to testify as to his legal conclusions about whether illicit substance abuse removes ADA protection.
The Court held that Longnecker is qualified to draw that conclusion because he cited DOJ guidance and because he is experienced both in determining whether to offer Medication-Assisted Treatment (“MAT”) for OUD in a correctional setting and in drafting policies and procedures addressing that issue.
II. County Policies
S.F. argued that Longnecker is not qualified to testify that the Denton County Jail does not have a blanket policy prohibiting MAT. She said that the record did not show that Longnecker has worked at the jail, that his employer has performed services there, or that he has reviewed the jail’s or Public Health’s policies.
The entirety of Longnecker’s opinion about the jail’s policies reads as follows: “No evidence exists that the Denton County Jail had a blanket policy prohibiting MAT. Conversely, there is evidence of MAT administration at the jail when the appropriate conditions were met (i.e. pregnancy).”
Since the jury did not need expert testimony to determine what evidence is in the record, the Court held that Longnecker’s opinion about the jail’s policies constituted improper expert testimony.
III. DOJ Policies
S.F. argued that, in the absence of any evidence or training showing otherwise, Longnecker is not qualified to opine as an expert that the jail provided treatment consistent with DOJ policies.
Longnecker stated that the jail’s treatment of S.F. was “consistent with . . . DOJ expectations.” He did not, however, specify what expectations he had in mind. And his report mentioned only one DOJ report: a document that “provides informal guidance” to the public, the contents of which “do not have the force and effect of law and are not meant to bind the public in any way.”
The Court held that the jury did not need an expert to opine on a document that was drafted for the public. Longnecker was expressing a prohibited legal conclusion if he meant to convey his opinion that, based on his understanding of the ADA’s requirements described in that document, the jail complied with the ADA.
C. Relevance
S.F. argued that Longnecker’s testimony about whether the jail treated her withdrawals is irrelevant. In her view, the issue is whether the jail treated her alleged disability—that is, her OUD—as opposed to her withdrawal symptoms.
The Court held that Longnecker’s opinion about whether it was medically reasonable for S.F. to be treated for her withdrawals rather than being given MAT is relevant to showing deliberate indifference as to her constitutional right to medical care.
D. Reliability
I. County policies
S.F. argued that Longnecker’s opinion about the county’s policies is unreliable because it is not based on any instances of the jail actually providing MAT. As already noted, the county refutes that assertion based on Longnecker’s review of county records.
But even if Longnecker reached his conclusions about the county’s policies after reviewing relevant records, the Court held that he did not identify which facts in the record he relied on or what method he used to reach his conclusion.
II. Standard of Care
S.F. argued that the scientific and medical community regards methadone, buprenorphine, or naltrexone as the standard of care for treating OUD.
In her view, Longnecker’s opinion that forced withdrawal, followed by treatment of withdrawal symptoms, constitutes effective treatment for Opioid Use Disorder “is so far outside the established medical community as to be unreliable, unsupportable, and viewed with extreme skepticism.”
Longnecker did not opine, as S.F. argued, that forced withdrawal would be within the acceptable medical standard of care in all circumstances. And even if he did, S.F.’s argument that Longnecker’s opinion is “far outside the established medical community,” would still fail. The “general acceptance” factor from Daubert questions whether a theory or technique is reliable. It does not matter, at this stage, whether Longnecker is correct in finding forced
withdraw reasonable. What matters is how he reached that conclusion, and his report makes that sufficiently clear.
The Court held that Longnecker supported his opinion that MAT was not appropriate during S.F.’s first incarceration with sufficient facts and data. He opined that it was medically appropriate to provide “medically-assisted detox” because S.F. would not have been able to continue MAT after her transfer to Christian Farms, a facility that does not provide MAT.
Further, Longnecker cited the “grave risk of severe overdose when using both fentanyl and methadone” as another reason the jail should not have administered methadone.
Held
The Court granted in part and denied in part the Plaintiff S.F’s motion to strike defense expert Dr. Nicholas Longnecker.
Key Takeaway:
Longnecker was allowed opine on whether the jail’s treatment of S.F. during both incarcerations, including its treatment of her withdrawals, was within the acceptable standard of care; and the severity of S.F.’s withdrawal.
Case Details:
| Case Caption: | S.F. V. Denton County, Et Al. |
| Docket Number: | 4:23cv864 |
| Court Name: | United States District Court, Texas Eastern |
| Order Date: | May 27, 2025 |
