Obstetrics and Gynecology Expert Witness’ Testimony About Medical Necessity of Certain Procedures Performed Admitted
Posted on August 26, 2024 by Expert Witness Profiler
In this defamation lawsuit, Plaintiff Mahendra Amin (“Amin”), a doctor, alleged that Defendant Nbcuniversal Media, LLC aired several broadcast segments on MSNBC which included multiple false and defamatory statements about Amin and his medical treatment of detainees at Irwin County Detention Center (ICDC). To support his case, Amin retained Eldridge Bills to review the medical records of the Plaintiff’s patients and provided opinions on the medical necessity of various procedures Amin had performed.
The Defendant filed a motion to exclude Eldridge Bills’ testimony as it was claimed to be unreliable and inconsistent with the Daubert Standard and Rule 702.
Obstetrics and Gynecology Expert Witness
Elbridge Frederick Bills II, M.D., F.A.C.O.G., is an expert in obstetrics and gynecology based in Georgia. He holds medical licenses in both Florida and Georgia and was certified by the American Board of Obstetrics and Gynecology. He earned his medical degree from Emory University School of Medicine in 1989. Afterwards, he completed his residency at the University of South Florida Morsani College of Medicine in 2001. He also finished a fellowship at Emory University School of Medicine. At present, he practices in Alpharetta, Georgia.
Discussion by the Court
Bills’ Medical Knowledge and Experience Support His Opinions
Defendant challenged Bills’ methodology, arguing it lacked reliability. They contended that Bills failed to apply his specific experience to this case or support his opinions with medical records.
Moreover, they noted that Bills did not reference medical literature or guidelines in his report or deposition. They argued that his opinions were merely assertions without supporting evidence.
In contrast, Plaintiff asserted that Bills’ methodology was reliable due to his 30 years of experience as an OB/GYN. His previous experience as an expert witness in five trials was also highlighted.
To establish reliability, Bills needed to demonstrate a clear connection between his experience and his opinions. He did so by explaining how his OB/GYN background informed his analysis. His report listed his qualifications and detailed his review of 69 patient records, focusing on the medical appropriateness of procedures.
Defendant’s objections to Bills’ methodology did not justify excluding his testimony. They argued that Bills’ opinions lacked data, methodology, or study, characterizing them as mere assertions. However, Bills utilized his OB/GYN experience and medical knowledge to review patient records and link his expertise to his opinions. He referenced relevant medical literature and studies during his deposition. The Court found that Defendant’s issues were about the weight of the testimony, not its admissibility. As such, challenges to expert testimony should be addressed through cross-examination, not exclusion. Bills’ opinions were deemed to be based on a reliable methodology.
Bills’ Opinions Are Based on Sufficient Facts and Data
Bills’ expert report claimed that every procedure by Amin was “medically indicated as documented by various modalities including the history and physical, preoperative ultrasound evaluation, intraoperative surgical images documentation, and final pathology.” Defendant argued that Bills did not specify which modalities he considered in his review of each of the 69 patient records. Defendant also pointed to Bills’ deposition testimony, in which he acknowledged some ultrasound images and surgical images were either low resolution or not clear enough for him to conduct an independent evaluation.
The Court found Bills’ opinions are based on a reliable methodology, in that they are based on sufficient data and the “modalities” he considered are sufficiently discernible. He provided sufficient detail about how he applied his experience to his medical records review and he discussed individual patient considerations and modalities throughout his deposition testimony.
Additionally, in Bills’ supplemental chart, he lists each patient chart reviewed, relevant preoperative notes for each patient, and the corresponding treatment and procedure for each patient and notes any missing documentation for each patient chart.
Bills Provides Sufficient Analysis to Support His Opinions
Defendant argued Bills provided no analysis supporting his opinion every surgery Amin performed was “medically indicated” and, therefore, his methodology is unreliable. Defendant argued Bills included generalized statements about why a doctor could perform these surgeries in his expert report, but he does not explain how each patient’s medical records led him to conclude the surgery Amin performed was medically indicated.
The Court held that Bills reviewed a collection of patient medical records and offered a categorical opinion about all of the procedures on those patients. Bills explained how (i.e., the methodology) he formed that opinion. Defendant has failed to show anything unreliable about that methodology. Defendant, instead, contended Bills was required to explain how he assessed each and every procedure in order for Bills’ overall methodology to be deemed reliable.
Bills’ Presumptions Do Not Warrant Exclusion
Defendant argued that Bills’ methodology was unreliable due to several inadequately explained assumptions. Specifically, Defendant noted Bills’ presumptions about Plaintiff’s patients being high-risk and indigent, consenting to surgery, and facing possible deportation without notice. Defendant also contended that Bills presumed cysts were removed because they caused pain, despite some patients’ cysts being undocumented.
In response, Plaintiff argued that these assumptions were reasonable given Bills’ experience and the medical records reviewed. Plaintiff asserted that reasonable inferences are acceptable in expert testimony and that Defendant could address these issues through cross-examination.
The Court found that Bills’ assumptions were based on reasonable inferences drawn from available data and personal experience. Although the assumptions might not be entirely correct, they provided a reasonable factual basis for Bills’ opinions. Therefore, the Court concluded that Bills’ methodology was reliable and did not warrant exclusion.
Held
The Court denied Defendant’s motion to exclude the opinions of Plaintiff’s obstetrics and gynecology expert witness, Eldridge Bills.
Key Takeaway:
The Court denied Defendant’s motion to exclude Eldridge Bills’ testimony, finding it reliable under the Daubert standard. Although Defendant argued Bills’ methodology lacked specificity and relied on inadequate assumptions, the Court determined his expert opinions were supported by his extensive OB/GYN experience and medical records review.
Bills had categorized patient cases and provided explanations in his reports and deposition, despite some generalizations. The Court viewed the Defendant’s concerns as issues of weight rather than admissibility, suitable for cross-examination rather than exclusion. Bills’ reasonable inferences and thorough analysis were deemed sufficient to support his opinions.
Case Details:
| Case Caption: | Amin V. Nbcuniversal Media, Llc |
| Docket Number: | 5:21cv56 |
| Court: | United States District Court for the Southern District of Georgia, Waycross Division |
| Order Date: | July 11, 2024 |
