Expert Testimony on Orthopedic Injury Admitted

This case arises from a February 17, 2023, collision between motor vehicles operated by Plaintiff Shirley Jordan and Defendant Michelle Marik, a truck driver then employed by Defendant Hirschbach Motor Lines, Inc. ("Hirschbach").

This collision allegedly caused Plaintiff to suffer from myriad injuries to her person. She filed suit to recover general and special damages related to Defendants' alleged negligence, which she claims caused the collision. Plaintiff contended that, because of the collision, she sustained injuries to her body "including, but not limited to," her neck, left shoulder, left hip, back, cervical spine, and lumbar spine. She further alleged that she suffered from headaches because of the crash. She alleged that she underwent a variety of medical treatments for these alleged injuries.

Defendants retained Dr. Douglas W. Pahl and Dr. Patrick G. Hanson to provide their expert opinions concerning the injuries Plaintiff allegedly suffered because of the collision. Plaintiff filed separate motions to exclude their expert testimony and opinions pursuant to the Daubert standard.

Orthopedic Surgery Expert Witnesses

Dr. Douglas Wesley Pahl, MD, is employed as a board-certified orthopedic physician—licensed in Alabama and Georgia—specializing in cervical, thoracic, and lumbar spine disorders. He has received professional training in general surgery, orthopedic surgery, and orthopedic spine surgery. He also holds, and has previously held, several professional positions related to orthopedic practice and prior military assignments related to orthopedic surgery and care.

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

Dr. Patrick Groves Hanson is a board-certified orthopedic surgeon. Hanson has worked as a general orthopedic surgeon since 2018, after five years of residency in an orthopedic surgery department. Further, he has participated in creating original research in the form of presentations and publications on orthopedic subjects.

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

Discussion by the Court

Douglas Pahl

A. Pahl's Qualifications

First, Pahl is qualified to give this testimony. He provided an opinion based on his medical experience and expertise regarding Plaintiff's claimed orthopedic injuries, those injuries' consistency with different potential causes, and the reasonableness and necessity of Plaintiff's medical treatment. Pahl is an orthopedic surgeon. He has practiced medicine since 1995 and routinely treats patients involved in motor vehicle accidents, even though motor vehicle collisions are not "the bulk of" his practice. Pahl testified in his deposition that "maybe 10 to 20 percent" of his practice deals with a combination of motor vehicle collisions, sports injuries, and workers' compensation injuries. Indeed, Plaintiff concedes that Pahl is qualified as a medical expert in orthopedic surgery and attacks only his qualifications as an expert in "the field of biomechanics" or on the "exact measure of forces needed to cause an injury and the extent to which pain from said injury would last in duration."

Eleventh Circuit precedent plainly indicates that an experienced orthopedic surgeon and physician generally has sufficient qualifications to give testimony regarding both an injury's causation and the reasonableness and necessity of medical treatment. The Court agreed; Pahl's testimony is based on his medical experience, not on any assertions about biomechanics broadly or mere unsupported speculation. Thus, Pahl's testimony should not be excluded for lack of qualification.

B. Pahl's Methodology

Next, Pahl's methodology is sufficiently reliable. His testimony is not "scientific" in nature, but rather based on his specialized experience; he is a medical doctor, not an academic.

Plaintiff first argued that Pahl's testimony should be excluded for what appears to be concerns about reproducibility: "testability," lack of an "error rate," lack of evidence of "peer review" or use of "peer-reviewed sources," and a failure to show "the general acceptance of his opinions in a field of study."

Standards for laboratory testing and calculable error rates do not apply here to Pahl's testimony, which is based on clinical judgment and review of medical records, rather than academic inquiry. Instead, the Court must analyze the actual methodology and principles Pahl used in coming to his conclusions. Here, Pahl reviewed Plaintiff's medical records and applied his professional knowledge, experience, and expertise as an orthopedic surgeon. To that end, he reviewed Plaintiff's medical records—both before and after the collision—including imaging studies. He also reviewed the Georgia Motor Vehicle Crash Report for the subject collision. A careful review of medical records is an expected method for an orthopedic surgeon to use when making determinations about the nature and type of injuries. Further, even if Pahl's expert report was prepared in anticipation of litigation, his review and analysis of the records provided to him appears to be carefully considered.

Plaintiff made two arguments to attack this methodology: first, an argument disputing the evidence Pahl reviewed (or did not review) and resulting disputes about his conclusions, and, second, an argument that Pahl's opinions are unreliable because they do not "grow naturally and directly out of research" independent of litigation.

Plaintiff's arguments that Pahl did not consider certain evidence—that he failed to personally treat Plaintiff, did not independently examine Plaintiff, did not review certain documents, did not review photographs of the vehicles, and did not have access to a pre-collision MRI when making his assessment—and that his interpretations of the evidence he did review are flawed—for example, regarding Plaintiff's history of lower back pain—all go to weight, not admissibility; they are credibility arguments. The same goes for his alleged failure to rule out some alternative explanations for certain medical conditions. A physician witness whose expertise lies in interpreting medical records may testify as to his interpretation of medical records, even if Plaintiff believes his interpretation is flawed or otherwise "defense-tinted."

Further, Plaintiff's argument that Pahl's testimony does not grow naturally and directly out of research he conducted independent of litigation does not provide grounds for exclusion. The law does not require an orthopedic surgeon to conduct independent research on the exact injury presented in a case before he may give admissible testimony on the injury. Similarly, an expert with relevant professional training or experience need not be called to perform a specific type of analysis in his day-to-day practice (or to have "taught on [the] subject") to do so in his testimony.

Here, Pahl testified in his deposition that his professional training included learning and understanding standard healing processes for skin, muscles, tendons, ligaments, and other parts of the body. He stated that his knowledge is based on "well-established" sources including "textbooks like Rockwood and Green." While Plaintiff may certainly cross-examine Pahl on his apparent lack of independent research on recovery timelines or other issues if she so desires, those kinds of alleged deficiencies do not make his testimony inadmissible. Indeed, Plaintiff's methodology arguments all go to weight, not admissibility.

C. Helpfulness of Pahl's Testimony

Finally, Pahl's testimony will help the trier of fact understand evidence or determine a fact in issue: the source and nature of Plaintiff's injuries and the necessity of her medical treatment.

In this motor vehicle collision case, any jury will be called to evaluate both new injuries and the potential aggravation of pre-existing conditions. Issues of disputed medical causation are well outside the purview of an average juror but are familiar to Pahl. He can apply his extensive expertise as an orthopedic surgeon and his professional medical knowledge to help the jury understand this evidence or determine the source of Plaintiff's injuries and whether the medical treatment she received—and claims she will need to receive—is truly medically necessary. And that is exactly what his testimony sets out to do, even if his conclusions are flawed or Plaintiff disagrees. Arguments here against his interpretation of the medical records he was provided and reviewed do not go to the admissibility of his testimony, but rather, to the weight a jury may or may not afford it. Those sorts of objections are for cross-examination.

Patrick Hanson

1. Hanson's Qualifications

Plaintiff's legal argument for excluding Hanson's testimony does not question his qualifications. This Court found that Hanson is qualified to give the sort of testimony contained in his expert opinion. He has experience as a general orthopedic surgeon and physician. This role includes assessing the nature and cause of orthopedic injuries, such as injuries to the knee. Indeed, Hanson has completed original research on knee and ligament injuries in the past. He is sufficiently qualified to opine on the nature and cause of Plaintiff's knee injury for purposes of his testimony's admissibility.

2. Hanson's Methodology

However, Plaintiff did attack the reliability of Hanson's opinion testimony, specifically targeting his methodology. Plaintiff claimed that Hanson's opinion testimony failed on "the reliability prong of Rule 702" for "myriad" reasons. First, Plaintiff attacked the academic rigor of Hanson's opinions: the lack of testability, the lack of a given error rate, the lack of peer review, the lack of citation to peer-reviewed sources, and the lack of "general acceptance" of his opinion in his field. Then, Plaintiff doubles down on this line of attack, arguing that Hanson has not "submitted any medical literature, studies, or other information which suggests that the methods used in reaching his opinions have been subjected to meaningful collegial scrutiny, are generally accepted in the medical community, or have otherwise been established as reliable."

These objections to Hanson's testimony go to weight, not admissibility. Though Plaintiff is certainly welcome to pursue these points on cross-examination (to the degree allowed under the Rules), the Court should not exercise its gatekeeping authority to preclude Hanson's testimony altogether on these grounds.

First, Plaintiff's points are fit more for an expert presenting the results of an academic study or experiment, not an expert relying on professional experience and expertise. Hanson's testimony is not "scientific" in nature, but rather based on his specialized experience; he is a medical doctor, not an academic.

Instead, the Court must analyze the actual methodology and principles Dr. Hanson used in coming to his conclusions. Here, Hanson reviewed Plaintiff's medical records and applied his professional knowledge, experience, and expertise as an orthopedic surgeon. To that end, he reviewed Plaintiff's medical records—both before and after the collision—imaging studies, and the Georgia Motor Vehicle Crash Report for the subject collision. A careful review of medical history is an expected method for an orthopedic surgeon to use when making determinations about the nature and type of injuries. Further, even if Hanson's expert report was prepared in anticipation of litigation, his review and analysis of the records provided to him appear to be carefully considered.

Indeed, Hanson did not appear to have unjustifiably extrapolated from an accepted premise to an unfounded conclusion, and does not appear to have been any less careful than he would be in his regular professional work outside of paid litigation consulting. Finally, Plaintiff made no argument—and the Court found no reason to suggest—that professional knowledge and expertise in orthopedic medicine applied to the review of medical records is not generally known to reach reliable results when identifying the nature of an orthopedic injury or necessity of medical treatment. Focused solely on the reliability of Hanson's apparent principles and methodology, and not on the conclusions his approach generated, the Court found no reason to doubt his opinion is reliable for the limited purposes of admissibility.

3. Helpfulness of Hanson's Testimony

Finally, Hanson's testimony will help the trier of fact understand evidence or determine a fact in issue: the source and nature of Plaintiff's knee injuries and the reasonableness or necessity of her medical treatment. Plaintiff also does not contest the helpfulness of Hanson's testimony, but the Court addresses it here, nonetheless.

In this motor vehicle collision case, any jury will be called to evaluate both new injuries and the potential aggravation of pre-existing conditions. Issues of disputed medical causation are well outside the purview of an average juror but are familiar to Hanson. He can apply his experience and expertise as an orthopedic surgeon and his general professional medical knowledge to help the jury understand this evidence or make determinations based on it, to a degree the jury would not be able to do without his assistance. And that is exactly what his testimony sets out to do, even if Plaintiff disagrees with his opinion. Thus, Hanson's testimony is sufficiently helpful for purposes of admissibility.

4. Rule 37

First, Hanson's testimony is admissible procedurally under Federal Rule 37. Plaintiff asserted that defense counsel timely disclosed their intention to call Hanson and produced an expert file containing "over 3,207 pages of documents." What Plaintiff takes issue with is what Plaintiff calls defense counsel's "inadvertent" omission of a three-page opinion report for Hanson.

However, it is unclear how this accidental slip-up actually harmed Plaintiff. Plaintiff only asked about the missing expert report ten months—almost a year—after Defendants initially produced their expert files. And, when asked where the missing three-page opinion report was, defense counsel provided it the same day. While Plaintiff has not provided the Court with a description of how not having access to it (until the same day Plaintiff first requested access to it) actually prejudiced her, Defendants made no effort to claim the failure was substantially justified, themselves also casting the omission as "inadvertent."

The Court does not see how Defendants' accidental failure to include the opinion report resulted in surprise or prejudice to the Plaintiff. Plaintiff has known that Defendants retained Hanson and intended to introduce his testimony since October 3, 2025. If Plaintiff wished to review his report but was unable to, at any time between October 3, 2025, and August 24, 2026, she has not shown anything to suggest it. And, when Plaintiff finally notified Defendants that the opinion report was not included in their document production, she was provided with it the very same day. Finally, no trial date has been set for this case, and so Hanson's testimony will not disrupt trial.

Indeed, the parties were able to easily cure any surprise Plaintiff experienced and its effects by addressing the omission the same day Plaintiff noticed it, allowing the evidence would not disrupt trial, and both parties agree that Defendants were merely negligent, rather than acting intentionally to obtain an unfair advantage.

For all these reasons, any failure by Defendants to timely disclose Hanson as an expert within the discovery period was harmless.

Held

The Court denied Plaintiff's two motions to exclude the testimony of Douglas Pahl and Patrick Hanson.

Key Takeaway

As the law recognizes by allowing the Court considerable leeway in the factors it considers measuring expert testimony reliability, it would make little practical sense to apply experimental standards like testability, rate of error, or peer review to expert testimony derived from clinical judgment and analysis of medical records.

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