Infectious Disease Expert’s Statements on Employer Liability Excluded
Posted on May 13, 2025 by Expert Witness Profiler
Plaintiffs, former employees of a local government public health agency, each filed suit against Rock Island County Health Department (“RICHD”) and Rock Island County, Illinois (“the County”) alleging that their previous employer, RICHD, violated Title VII of the Civil Rights Act of 1964.
The purported violations stem from their employer’s failure to accommodate their religious beliefs, first, when it denied their exemptions from a COVID-19 vaccination requirement, and later when Plaintiffs were terminated for failing to get vaccinated.
RICHD disclosed an expert witness, Dr. F. Ramzi Asfour. Asfour was asked to “provide his opinion concerning the proper approach of a public health entity to evaluating requests from employees to be exempted from” vaccination requirements and to provide epidemiological evidence related to vaccine efficacy compared to other mitigation methods.
Plaintiffs filed the instant motion to bar Asfour, arguing that his opinion violated the standards of Federal Rules of Evidence 702 and 704.
Infectious Disease Expert Witness
F. Ramzi Asfour, MD, is board certified in Infectious Diseases and Internal Medicine, having attended a fellowship specializing in infectious
diseases and having worked for the World Health Organization.
His experience practicing medicine in the area of infectious diseases spans seventeen years, with over 72,000 patient encounters. Moreover, he has recent experience in consulting hospitals and other healthcare facilities on “policies, procedures and protocols relating to COVID-19.”
Discussion by the Court
Whether the Statements Fall Outside of Asfour’s Expertise
Plaintiffs state that Asfour is a medical doctor with an expertise in public health who “is not qualified to render opinions regarding religion or religious exemptions.”
The Court held that Asfour did not purport to opine about the sincerity of anyone’s religious beliefs. Instead, he highlighted various reasons that it was important from a public health perspective that healthcare workers be vaccinated, and based on those factors, opined that healthcare entities should carefully scrutinize requests for religious exemptions from COVID-19 vaccination requirements. Further, he opined that the scrutiny should be accomplished by identifying whether there was a “clear and specific doctrinal basis for objecti[ng]” to getting the vaccine. This is not a religious opinion, so Plaintiffs’ argument that Asfour should be barred from testifying that “religious exemptions should generally be denied unless there is a clear and specific doctrinal basis for objection” on the basis that it is outside his expertise is denied.
Whether the Opinion Contains Legal Conclusions
Asfour opined on how “employer liability” is affected by a potential COVID-19-
related illness or death. And, while Plaintiffs do not take issue with
this part of the opinion, Asfour recounts, verbatim, the definition of religion under Title VII.
While allowing Asfour to opine as to the definition of religion under Title VII and interpret an employer’s liability related to COVID-19 illness or death would run the risk of confusing a jury with multiple presentations of the law, the Court held that Asfour’s statements also offer his perspective on public health matters and provide background for RICHD to make its arguments related to whether granting religious exemptions constituted an undue burden.
Therefore, the Court will limit Asfour’s opinion as to his statement on employer liability related to COVID-19 illness or death, and the definition of religion under Title VII. Those are matters designated for the Court to instruct on; all other statements do not constitute legal conclusions.
Whether the Opinion Meets the Standards of Reliability
From what the Court can decipher from Plaintiffs’ motion, they did not challenge that the underlying data or methodologies used to formulate Asfour’s opinion were unreliable; however, they seemingly did contend that his opinion cannot meet the requirements under Rule 702(d).
Asfour began his expert report by outlining “[a] meta-analysis with seven studies with 21,618,297 COVID-19 patients,” and explained how “unvaccinated patients were 2.46 times more likely to die from COVID-19.”
He analyzed the drop in the death rate after the introduction of the vaccine, specifying how the weekly deaths in Rock Island County decreased from five to one from late 2021 to early 2022.
Asfour then discussed how religious groups generally did not object to vaccinations from a public health standpoint.
The Court held that Asfour’s application of data to the facts at hand did not run afoul of what was required under Rule 702(d).
Whether the Opinion is Relevant
Plaintiffs argued that much of Asfour’s opinion consisted of mere “facts which appear solely intended to justify the vaccine mandate itself which is not the issue for this jury.”
However, the Court held that Asfour’s opinion will aid the factfinder by providing a better understanding of how the rates of infection during the COVID-19 pandemic changed based on the availability and use of the vaccine, which connects to the analysis of whether RICHD faced an undue burden in granting exemption requests.
Plaintiffs next argue that the opinion is too vague due to Asfour’s use of words like “most,” “many,” and “generally.”
Since RICHD has met its burden in establishing how the expert opinion will aid the finder of fact, the Court held that Asfour’s opinion is not too vague to provide this background.
Held
The Court granted in part and denied in part the Plaintiffs’ motion to bar or exclude Defendant Rock Island County Health Department’s expert F. Ramzi Asfour.
Key Takeaway:
Asfour has over seventeen years of experience in treating infectious diseases and has recently shifted his career to consulting healthcare entities specifically on COVID-19 responses—expertise that he pulls from to formulate his opinion. Moreover, his expert opinion meets the relevant standards; he is qualified to opine on matters of public health, his methodology was reliable, and the testimony is relevant.
However, Asfour cannot opine on the definition of religion under
Title VII or employer liability related to COVID-19 illness or death.
Case Details:
| Case Caption: | Sanchez V. Rock Island County Health Department |
| Docket Number: | 4:23cv4007 |
| Court Name: | United States District Court for the Central District of Illinois, Rock Island Division |
| Order Date: | May 12, 2025 |
