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Orthopedic expert testimony on causation survives unreliable methodology challenge in Louisiana

Posted on September 14, 2023 by Expert Witness Profiler

This case involved a personal injury lawsuit filed by Plaintiff Darla Lacara and the testimony of the Defendant’s orthopedic expert witness. Lacara alleged that she suffered a labral tear to her hip as a result of an injury sustained while shopping at a Kohl’s department store on December 23, 2020. 

According to Lacara, she was walking through the Kohl’s store when her purse, which was on her right shoulder, got caught on a protruding hook on a shelving unit. This caused the shelving unit to fall onto Lacara’s right side. Lacara twisted her body to the left and used her left hand to push the fallen shelving unit off of her. Lacara claimed that having to brace herself against the shelving unit and twist her body in this manner caused her to suffer a labral tear in her left hip.

Kohl’s disputed Lacara’s version of events and causation theory. Kohl’s retained orthopaedic surgeon Dr. Chad Millet as an orthopedic expert witness. Dr. Millet opined that Lacara’s hip injury was not caused by the incident at Kohl’s. Rather, he opined that her injury was caused by “repeated impingements” resulting from “the aspherical nature of her femoral head.” Dr. Millet formed this opinion after reviewing Lacara’s medical records, but he did not physically examine her. 

Lacara filed a motion to exclude causation expert Dr. Millet’s orthopedic expert witness testimony under Daubert, arguing that his methodology was unreliable because it was based solely on a review of medical records rather than a physical examination. Lacara also argued Dr. Millet’s opinion was unreliable because he mistakenly assumed she had fallen to the ground during the incident, when she did not actually fall. 

Orthopaedic Expert Witness

Dr. Chad Millet is an orthopaedic surgeon specializing in hip and knee replacement surgery, with a particular interest in minimally invasive techniques. He completed orthopaedic residency training at Louisiana State University and a fellowship in joint replacement at Johns Hopkins Hospital. Dr. Millet has served in numerous leadership roles including President of the Greater New Orleans Orthopaedic Society, Chief of Orthopaedics at two hospitals, and Chairman of Surgery. He is recognized nationally for his expertise in joint replacement techniques. Dr. Millet’s leadership experience includes serving as President of the Louisiana Orthopaedic Association and he is currently President of the Society for Arthritic Joint Surgery. He is a member of several prestigious professional associations. With this extensive surgical experience, leadership, teaching appointments, awards, and membership in elite orthopaedic societies, Dr. Millet is highly qualified to provide expert testimony regarding orthopaedic injuries and conditions.

Discussions by the Court

The Court noted that under Daubert, expert testimony must be based on sufficient facts and reliable methodology. However, the Court found that experts are permitted to offer opinions not based on firsthand knowledge or observation, citing Daubert v. Merrell Dow Pharmaceuticals, Inc. The Court stated that numerous Courts have held that an expert witness need not personally examine a Plaintiff to offer an opinion. Rather, review of medical records combined with the expert’s medical experience can sufficiently ensure reliability. The Court concluded Dr. Millet’s methodology of reviewing the medical records informed by his extensive experience as an orthopaedic surgeon was sufficiently reliable under Daubert. The Court ruled Dr. Millet’s reliance on records instead of examining Lacara went to the weight, not admissibility, of his testimony. 

Lacara also argued Dr. Millet’s opinion was unreliable because he mistakenly assumed she had fallen during the incident when she did not actually fall. The Court found Dr. Millet’s understanding of the accident was consistent with Lacara’s deposition testimony – he accurately stated her purse got caught on a protruding hook which caused the rack to fall into her arm as she described. While Dr. Millet mentioned an assumption Lacara fell, the Court found this did not render his opinion inadmissible. The Court reasoned that if anything, an assumption of additional trauma would make Dr. Millet more likely to relate the injury to the incident. However, Dr. Millet testified that his causation opinion was based on Lacara’s chronic condition, not any assumed fall. Again, the Court ruled the dispute over the basis for Dr. Millet’s opinion affected the weight the jury should assign it, not admissibility. 

In conclusion, the Court stated Dr. Millet’s methodology of reviewing the medical records was acceptable and sufficiently reliable under Daubert to allow his testimony and the causation expert’s testimony was admitted. The Court found Lacara’s complaints about Dr. Millet not examining her and assuming she fell went to the weight of his testimony and constituted issues for cross-examination and the jury to consider.


The Court ruled that despite some alleged flaws in his methodology, Dr. Millet could testify and the jury could determine the appropriate weight to give his opinions. Lacara’s motion to exclude the orthopedic expert witness testimony under Daubert was denied. The Court dismissed the case without prejudice on August 29, 2023.

Key takeaway

This case demonstrates that experts are permitted to offer opinions based solely on a review of records, without physically examining the Plaintiff. An expert’s reliance on medical records rather than a firsthand exam goes to the weight, not the admissibility, of the testimony. The Court found that review of records combined with the expert’s professional experience can be a sufficiently reliable methodology under Daubert as a result of which the causation expert’s testimony was admitted.