Causation Expert: Dackman v. Fisher

Kopec Law Firm

Maryland medical malpractice lawyers likely need a causation expert to prove that the doctor’s failure to meet professional standards caused the injuries. This requirement is called causation, and usually, a doctor has to testify in support of it.

On October 30, 2023, the Appellate Court of Maryland discussed medical expert causation testimony. It is an unreported opinion in Dackman v. Fisher. Although it involved a lead paint poisoning case, the holding applies to causation testimony in medical malpractice cases. I will discuss the case and then provide commentary for Maryland medical malpractice lawyers.

Dackman Facts

The plaintiff alleged exposure to flaking lead paint as an infant in his family’s rental house. (Op. at 1). As a result, he claimed he suffered brain damage and other injuries. (Id. at 4).

The plaintiff obtained a medical doctor as an expert witness. He had experience treating children who suffered from lead poisoning and was familiar with medical publications on the topic. (Id.)

The defendants were the landlords and owners of the house. They argued that the Court should have excluded the plaintiff doctor’s opinion testimony on causation under the Daubert standard. Specifically, the defendants argued that the doctor had failed to make a differential diagnosis. He did not determine if the plaintiff’s condition was caused by lead paint or by ADHD and mental illness. (Id. at 12). The defendants also argued that the ADHD and mental illness presence made it impossible to connect the problems to lead paint. (Id. at 12-13).

The Court examined “whether a sufficient factual basis exists to support the expert testimony” under Maryland Rule 5-702. The defense objected to the methodology that the plaintiff’s expert used. It opposed the conclusion that the plaintiff had suffered a brain injury as a result of exposure to lead. (Id. at 20-21).

Assessing the Causation Expert

The Court concluded the plaintiff’s expert properly conducted a differential diagnosis. The plaintiff had a deficit in auditory attention, poor visual-motor integration, and poor working memory. The expert found that these made it likely that lead was the cause. (Id. at 22-23). The doctor then ruled out various other exogenous and endogenous factors. (Id. at 23).

The defendant contended that the plaintiff expert’s differential diagnosis was unreliable. It disregarded the specific alternative causes of ADHD and mental illness. (Id. at 23). The Court noted, however, that ADHD and mental illness are not causes of injuries. They are diagnostic labels assigned to behavior that satisfies specific criteria. (Id.) The Court found that the plaintiff’s expert had met the standard. He showed that lead was, more likely than not, a “substantial factor” in causing the harm. (Id. at 27).

Application to Medical Malpractice Cases

Maryland medical malpractice lawyers need expert doctor testimony. This testimony usually includes an opinion that the defendant’s conduct caused the plaintiff’s injury. The Dackman case is an excellent reminder to the lawyer to be proactive. The lawyer should support the cause of the damage. The lawyer should also anticipate what the defendant will likely argue as an alternative cause of the plaintiff’s injury. Your causation expert may be able to explain why the defendant’s alternative explanations do not defeat the plaintiff’s claim. Alternatively, it can be good to retain an expert in another medical area. 

Mark Kopec is a top-rated Maryland medical malpractice lawyer. You can contact us at 800-604-0704 to speak directly with Attorney Kopec for a free consultation. Thank you for reading the Maryland Medical Malpractice Lawyer Blog.

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