Opinion

Thomsen v. NaphCare, Inc.

Court
District Court, D. Oregon
Filed
Dec 15, 2023
Cited by
0 cases
Authority
More cited than 28.8%

excluding Roscoe’s testimony about standard of care for physician’s interactions with patient, but declining to establish “a bright line rule that a nurse practitioner may never offer an opinion on a physician’s conduct”

How later courts described this case

  • excluding Roscoe’s testimony about standard of care for physician’s interactions with patient, but declining to establish “a bright line rule that a nurse practitioner may never offer an opinion on a physician’s conduct”
  • “Federal Rule of Evidence 403 objections are unnecessary at the summary judgment stage because there is no jury that can be misled and no danger of confusing the issues.”
  • holding that challenges to expert’s assumptions went to credibility, not admissibility, explaining that a court “is supposed to screen the jury from unreliable nonsense opinions, but not exclude opinions merely because they are Page 17 – OPINION AND ORDER impeachable”
  • holding that expert testimony cannot be based “merely on assumptions and speculation”

Written by the judges who cited it.

The opinion

UNITED STATES DISTRICT COURT

DISTRICT OF OREGON

TAMMY L. THOMSEN, personal Ca se No. 3:19-cv-00969-AR

representative of the Estate of DALE L.

THOMSEN, deceased, OPINION AND ORDER

Plaintiff,

v.

NAPHCARE, INC., an Alabama

corporation; WASHINGTON COUNTY, a

government body in the State of Oregon;

PAT GARRETT, in his capacity as Sheriff

for Washington County; ROBERT DAVIS,

an individual; DON BOHN, an individual;

JULIE RADOSTITZ, MD, an individual;

MELANIE MENEAR, an individual;

KATHY DEMENT, an individual; RACHEL

ECLEVIA, an individual; KATIE BLACK,

an individual; ANDREA JILLETE, also

known as ANDREA GILLETTE, an

individual; MORGAN HINTHORNE, an

individual; RACHEL STICKNEY, an

individual; and JOHN/JANE DOES 1-10,

Defendants.

_____________________________________

ARMISTEAD, Magistrate Judge

Dale Thomsen (Thomsen) died while in the custody of Washington County Jail. During

his detention, NaphCare, Inc., provided the jail’s medical care. Thomsen’s widow, plaintiff

Tammy Thomsen, brings this action against Washington County, NaphCare, and NaphCare

Page 1 – OPINION AND ORDER

employees for failure to provide Thomsen adequate medical care while he was in custody from

June 25, 2017, until his death three days later. She alleges that Thomsen was an alcoholic, that he

died from untreated alcohol withdrawal, and that had defendants given him the appropriate

medical care, he would not have died. Plaintiff brings claims under Oregon law and 42 U.S.C.

§ 1983, alleging that defendants were negligent, grossly negligent, and deliberately indifferent to

Thomsen’s medical needs. (First Am. Compl. ¶¶ 27-53.)

In their motion to exclude plaintiffs’ expert opinions under Federal Rule of Evidence 702,

defendants see this as a case where Thomsen died of a heart attack and challenge the

admissibility of plaintiff’s experts’ opinions that say otherwise. Specifically, NaphCare,1 joined

by Washington County, moves under Rule 702 to exclude the expert opinions of plaintiff’s

proffered experts Michael Freeman, Stuart Graham, Vincent Reyes, Michel Sucher, Samuel

Freedman, Gregory Whitman, Amarprit Bains, Reed Paulson, Lori Roscoe, and Bradford

Hansen. Naphcare asserts that plaintiff’s experts (1) base their opinions on insufficient facts and

data; (2) use unreliable methodologies; (3) are unqualified; and (4) make impermissible legal

conclusions. (NaphCare Mot. to Exclude, ECF No. 232.)

Washington County, joined by NaphCare, further moves to exclude the expert testimony

of Bains, Freedman, Sucher, Reyes, Paulson, and Roscoe, arguing that those experts (1) are

unqualified to offer opinions related to Washington County; (2) base their opinions related to the

County on incomplete information; and (3) make impermissible legal conclusions. Washington

1 The court refers only to NaphCare when describing motions and arguments made by

NaphCare and its employee-codefendants Julie Radostitz, Melanie Menear, Kathy Dement, Katie

Black, Andrea Gillette, Morgan Hinthorne, and Rachel Stickney.

Page 2 – OPINION AND ORDER

County also moves for exclusion of plaintiff’s expert reports under Federal Rule of Evidence

403. (Wash. Cnty. Mot. to Exclude at 5-13, ECF No. 237.)

Plaintiff responds that defendants read too much into Rule 702’s requirements. In her

view, the experts are qualified, reach their opinions using sound science and relevant expert

knowledge, and base their opinions on sufficient information in the record. She disagrees that the

alleged shortcomings in her experts’ qualifications, methodologies, or factual assumptions justify

exclusion of their opinions, arguing that such shortcomings instead go to the weight of the

experts’ testimony. (Pl.’s Resp., ECF No. 246.) For the reasons explained below, defendants’

Motions to Exclude are granted in part and denied in part.2

LEGAL STANDARD

Rule 702 governs the admissibility of expert testimony. The Rule provides that expert

opinion evidence is admissible if (1) the witness is sufficiently qualified as an expert by

knowledge, skill, experience, training, or education; (2) the expert’s specialized knowledge will

help the trier of fact to understand the evidence or to determine a fact in issue; (3) the testimony

is based on sufficient facts or data; (4) the testimony is the product of reliable principles and

methods; and (5) the expert has reliably applied those principles and methods to the facts of the

case. FED. R. EVID. 702; Siring v. Or. State Bd. of Higher Educ., 927 F. Supp. 2d 1069, 1072 (D.

Or. 2013).

2 Although the parties have not consented to magistrate judge jurisdiction under 28 U.S.C.

§ 636(c)(1), the court issues this opinion and order on defendants’ nondispositive motions to

exclude plaintiff’s expert witnesses for the limited purpose of addressing the parties’ anticipated

motions for summary judgment.

Page 3 – OPINION AND ORDER

The proponent of expert testimony has the burden of showing, by a preponderance of the

evidence, that the proposed testimony is admissible under Rule 702. See Cooper v. Brown, 510

F.3d 870, 942 (9th Cir. 2007). In evaluating proffered expert testimony, the trial court is “a

gatekeeper, not a fact finder.” Primiano v. Cook, 598 F.3d 558, 565 (9th Cir. 2010). The inquiry

into the admissibility of an expert opinion is a “flexible one,” where “[s]haky but admissible

evidence is to be attacked by cross examination, contrary evidence, and attention to the burden of

proof, not exclusion.” Id. at 564.

DISCUSSION

A. Sufficiency of Facts and Data

Rule 702(b) requires that an expert opinion be “based on sufficient facts and data.” As the

advisory committee note to the Rule explains:

Subpart [b] of Rule 702 calls for a quantitative rather than

qualitative analysis. The amendment requires that expert testimony

be based on sufficient underlying “facts or data.” The term “data”

is intended to encompass the reliable opinions of other experts.

The language “facts or data” is broad enough to allow an expert to

rely on hypothetical facts that are supported by the evidence.

When facts are in dispute, experts sometimes reach different

conclusions based on competing versions of the facts. The

emphasis in the amendment on “sufficient facts or data” is not

intended to authorize a trial court to exclude an expert’s testimony

on the ground that the court believes one version of the facts and

not the other.

FED. R. EVID. 702 Advisory Committee Notes (2000 Amendment) (citations omitted).

“Rule 702’s ‘sufficient facts or data’ element requires foundation, not corroboration.”

Elosu v. Middlefork Ranch Inc., 26 F.4th 1017, 1026 (9th Cir. 2022). It is not the court’s role “to

determine whether an expert’s hypothesis is correct, or to evaluate whether it is corroborated by

Page 4 – OPINION AND ORDER

other evidence on the record.” Id. (citing Daubert v. Merrell Dow Pharms., Inc., 509 U.S. 579,

594-95 (1993)). Instead, “the question is whether the expert considered enough information to

make the proffered opinion reliable.” Jerid Enterprises, LLC v. Lloyd’s London, Case No. 3:10-

CV-435 JD, 2012 WL 6115673, at *4 (N.D. Ind. Dec. 10, 2012) (citing CHARLES ALAN WRIGHT

& VICTOR JAMES GOLD, FED. PRAC. & PROC. § 6266, at 41 (Supp. 2004)). “Rule 702 does not

license a court to engage in freeform factfinding, to select between competing versions of the

evidence, or to determine the veracity of the expert’s conclusions at the admissibility stage.”

Elosu, 26 F.4th at 1027 (citation and quotation marks omitted).

Expert testimony should be excluded, however, when a court “conclude[s] that there is

simply too great an analytical gap between the data and the opinion proffered.” Elosu, 26 F.4th at

1026 (quoting Gen. Elec. Co. v. Joiner, 522 U.S. 136, 146 (1997)). Courts properly exclude

expert opinions that are “based on assumptions which are speculative and are not supported by

the record.” Morrison v. Quest Diagnostics Inc., Case No. 2:14-cv-01207-RFB-PAL, 2016 WL

3457725 (D. Nev. June 23, 2016); see also McLean v. 988011 Ontario, Ltd., 224 F.3d 797, 801

(6th Cir. 2000) (“An expert’s opinion, where based on assumed facts, must find some support for

those assumptions in the record.”).

In this case, many of plaintiff’s experts opining that Thomsen died from untreated alcohol

withdrawal rely on Thomsen having had his last drink within a specific time period before

entering the jail, that Thomsen was going through alcohol withdrawal while at the jail, and that

Thomsen had a history of alcohol withdrawal seizures. NaphCare argues that plaintiff’s experts’

assumptions are speculative because (1) no one knows exactly when Thomsen had his last drink;

(2) his documented symptoms do not match the typical presentation of alcohol withdrawal;

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(3) Thomsen was never diagnosed with withdrawal seizures or delirium tremens before his

death; and (4) there is no physical evidence that Thomsen experienced alcohol withdrawal while

in custody. (Id. at 42-47.) Plaintiff responds that NaphCare improperly asks the court to resolve

issues of fact and that her experts’ opinions are sufficiently supported by the record. (Pl.’s Resp.

at 17-20.)

1. Thomsen’s last drink

NaphCare asserts that “[n]o one knows when Thomsen had his last drink.” (NaphCare

Mot. at 42.) Without that information, NaphCare argues, no expert can “opine on the timeline for

Thomsen’s supposed alcohol withdrawal.” (Id.) Thomsen’s widow testified at her deposition

that, before he was arrested, her husband drank four to six 16-ounce beers each day. (Thomsen

Dep., 22:22-23:3, ECF No. 247-6.) She also called the jail while Thomsen was in custody,

warning that her husband would go through alcohol withdrawal. (Adams Dep., 35:3-13, ECF No.

247-2.) Thomsen’s medical record further documents that he was an alcoholic. (See Thomsen’s

Tuality Health Care Record, ECF No. 233-14.) Based on the information in the record, plaintiff’s

experts can reasonably assume that Thomsen had four to six drinks the day before he was

arrested and could permissibly base their expert opinions on that hypothetical fact. Additionally,

although Thomsen, when he entered the jail’s custody, denied having drunk alcohol in the

previous day or two, an alcoholic’s denial of drinking is not enough to establish that the experts’

assumptions about when he last had alcohol are speculative.

2. Thomsen’s symptoms

The symptoms of alcohol withdrawal include audio, visual, or tactile disturbances, and

NaphCare argues that plaintiff’s experts have insufficient data to conclude that Thomsen

Page 6 – OPINION AND ORDER

experienced those symptoms. According to Naphcare, it is “unclear” that Thomsen “calling

Deputy Jeff Smith by the name ‘Jim’ and referring to ‘Debbie’ represented any [such]

disturbances.” (NaphCare Mot. at 45.) But an expert may properly “rely on hypothetical facts

that are supported by the evidence.” FED. R. EVID. 702 Advisory Committee Notes (2000

Amendment). Thomsen’s nonsensical statements, combined with Deputy Smith’s report that

Thomsen was experiencing “hallucinations” (NaphCare Medical Records at 48, ECF No. 233-5),

provide sufficient support for plaintiff’s experts to conclude that Thomsen was suffering from

audio, visual, or tactile disturbances while in custody. That NaphCare interprets the facts

differently is not grounds for exclusion.

NaphCare further argues that plaintiff’s experts lack sufficient facts to conclude that

Thomsen experienced alcohol withdrawal, because “Thomsen’s documented symptoms did not

match the typical presentation of alcohol withdrawal.” (NaphCare Mot. at 44.) NaphCare points

out that there are many common symptoms of alcohol withdrawal—such as nausea, vomiting,

sweating, tremors, and headaches—that are not documented in Thomsen’s medical records from

his incarceration. But as NaphCare acknowledges, Thomsen did have some symptoms of alcohol

withdrawal. (Id. at 45 (noting that Thomsen experienced confusion and agitation).) Further,

Thomsen experienced tachycardia and hypertension, both symptoms of delirium tremens.

(NaphCare Medical Records at 6.) Plaintiff’s experts therefore had sufficient facts from which to

conclude that Thomsen suffered from alcohol withdrawal. Rule 702 does not permit the court to

choose between competing interpretations of the evidence. See Elosu, 26 F.4th at 1027.

NaphCare relies on Goomar v. Centennial Life Ins. Co., 855 F. Supp. 319 (S.D. Cal.

1994), to argue that “[r]etrospective expert testimony regarding the existence or onset of a

Page 7 – OPINION AND ORDER

medical condition is inadmissible speculation.” (NaphCare Mot at 46 (quoting Goomar, 855 F.

Supp. at 326).) In Goomar, however, medical experts opined that a patient had been suffering

from a mental illness in 1980, based on medical records beginning nine years later. 855 F. Supp.

at 326. The court excluded the expert opinions because there was no medical evidence that the

patient had suffered from the illness during the relevant period. Id. (citing Benchmaster, Inc. v.

Kawaelde, 107 F.R.D. 752, 753 (E.D. Mich. 1985) (denying motion to compel plaintiff to submit

to a mental examination because the results of that examination would be unhelpful in

determining whether plaintiff suffered from mental illness 10 years earlier)). Plaintiff’s experts

here, in contrast, base their opinions on medical records from before and during Thomsen’s jail

custody. Those records provide sufficient facts and data to enable plaintiff’s experts to reliably

opine on Thomsen’s medical condition in the days leading up to his death.

3. Thomsen’s previous diagnoses

NaphCare argues that there are insufficient facts to support Graham’s conclusion that

Thomsen had a “known history” of delirium tremens. (Graham Report at 22, ECF No. 233-19.)

The court agrees. As Graham acknowledged in his deposition, Thomsen’s medical record makes

no mention of delirium tremens. (Graham Dep. at 82:15-22, ECF No. 233-13.) Because there is

“too great an analytical gap between the data and the opinion proffered,” Graham’s conclusion

that Thomsen had a known history of delirium tremens must be excluded. Elosu, 26 F.4th at

1027.

NaphCare also contends that there are insufficient facts to support Sucher’s statement that

Thomsen’s seizures were “primarily attributed to alcohol withdrawal.” (Sucher Report at 4, ECF

No. 233-27.) It is true that Thomsen’s medical record reveals no definitive identification of the

Page 8 – OPINION AND ORDER

cause of his seizures. Even so, there is support in the record for the conclusion that Thomsen’s

doctors had attributed his seizures to alcohol withdrawal. (See, e.g., Thomsen’s Tuality Health

Care Record at 17 (describing Thomsen as “56 y/o male with history of alcohol abuse and

withdrawal seizures”); id. at 23 (same); id. at 14 (noting that “the only obvious potential cause of

[Thomsen’s seizures] is ethanol withdrawal,” but concluding “I think it is more likely he has a

primary seizure disorder”); id. at 18 (“Seizures – while they may be [alcohol] withdrawal – he

denies stopping drinking.”).) Sucher acknowledged in his deposition that the medical records

included contradictory opinions about the likely cause of Thomsen’s seizures, but that a review

of all the records led him to believe that Thomsen’s seizures were primarily attributed to alcohol

withdrawal. (Sucher Dep. at 24:24-26:24, ECF No. 233-6.) “Rule 702’s ‘sufficient facts or data’

element requires foundation, not corroboration.” Elosu, 26 F.4th at 1026. Because Thomsen’s

medical records provide sufficient foundation for Sucher’s conclusion that Thomsen’s seizures

were primarily attributed to alcohol withdrawal, the court will not exclude that opinion.

4. Evidence of Thomsen’s alcohol withdrawal

NaphCare argues that there is insufficient data for any expert to conclude that Thomsen

suffered from alcohol withdrawal prior to his death. NaphCare points the court to Graham’s

deposition testimony that, after death, there are no physical signs that a person went through

alcohol withdrawal or delirium tremens. (NaphCare Mot. at 48 (citing Graham Dep. at 14:21-

15:16).) In contrast, NaphCare asserts, “there is objective physical evidence that Thomsen had

coronary artery disease.” (Id.) It argues that the lack of physical evidence precludes plaintiff’s

experts from opining that Thomsen suffered from alcohol withdrawal or that alcohol withdrawal

caused his death. (Id. at 47-49.) NaphCare appears to ask the court to conclude that (1) plaintiff’s

Page 9 – OPINION AND ORDER

experts did not accord proper weight to the physical evidence, and (2) their conclusions are

incorrect. Those arguments are for trial; they are not proper grounds for exclusion of expert

testimony on a Daubert motion. IceMOS Tech. Corp. v. Omron Corp., Case No. CV-17-02575-

PHX-JAT, 2019 WL 4750129, at *9 (D. Ariz. Sept. 30, 2019).

B. Reliability

To be admissible, expert testimony must be “the product of reliable principles and

methods,” and “the expert [must have] reliably applied the principles and methods to the facts of

the case.” FED. R. EVID. 702(c)-(d). “The test of reliability is flexible.” City of Pomona v. SQM

N. Am. Corp., 750 F.3d 1036, 1044 (9th Cir. 2014). Courts have identified four factors that may

be considered in evaluating the reliability of scientific opinions: “(1) whether the theory can be

and has been tested, (2) whether the theory has been peer reviewed and published, (3) what the

theory’s known or potential error rate is, and (4) whether the theory enjoys general acceptance in

the applicable scientific community.” Murray v. S. Route Mar. SA, 870 F.3d 915, 922 (9th Cir.

2017) (citing Daubert, 509 U.S. at 593-94). Those factors, however, are “meant to be helpful, not

definitive, and the trial court has discretion to decide how to test an expert’s reliability as well as

whether the testimony is reliable,” based on the circumstances of each case. Primiano, 598 F.3d

at 564. For nonscientific opinions, the Daubert factors do not apply, and “reliability depends

heavily on the knowledge and experience of the expert rather than the methodology or theory

behind it.” United States v. Hankey, 203 F.3d 1160, 1169 (9th Cir. 2000).

1. Michael Freeman

Freeman, an epidemiologist, wrote a scientific report that assesses the most likely cause

of Thomsen’s death. His report concludes:

Page 10 – OPINION AND ORDER

[I]t is my opinion that Mr. Thomsen was at approximately 17 times

greater risk of [sudden cardiac death] because of the combination

of the emotional and physiologic effects of his alcohol withdrawal

symptoms, combined with the physical exertion he engaged in

during the hours prior to his death.

(Freeman Report at 2, ECF No. 233-18.) NaphCare argues that Freeman’s expert report must be

excluded because it is not the product of reliable principles and methods. (NaphCare Mot. at 51-

54.)

“[T]he party presenting [a scientific] expert must show that the expert’s findings are

based on sound science.” Daubert v. Merrell Dow Pharms., Inc., 43 F.3d 1311, 1316 (9th Cir.

1995) (Daubert II). Plaintiff argues, and Freeman asserts in his report, that Freeman’s methods

are consistent with the Reference Guide on Epidemiology. (Pl.’s Resp. at 22-24; Freeman Report

at 3.) Freeman applies the results of a study of male physicians to Thomsen, stating that those

results are “generally applicable” to Thomsen. (Freeman Report at 8.) In doing so, Freeman does

not consider Thomsen’s individual risk factors, despite the Reference Guide’s admonition that

consideration of individual risk factors is required “[b]efore any causal relative risk from an

epidemiologic study can be used to estimate the probability that the agent in question caused an

individual plaintiff’s disease.” MICHAEL D. GREEN, D. MICHAL FREEDMAN, and LEON GORDIS,

Reference Guide on Epidemiology, in Federal Judicial Center, REFERENCE MANUAL ON

SCIENTIFIC EVIDENCE, 615 (3d ed. 2011) (Reference Guide). Consideration of those factors is

necessary because “the results of [a] study will not provide an accurate basis of the probability of

causation for [an] individual” where the individual’s risk factors differ from the study

participants’ risk factors. Id. at 614.

The Reference Guide also explains that, when attempting to identify the cause of an

Page 11 – OPINION AND ORDER

individual’s disease, “an expert first determines other known causes of the disease in question

and then attempts to ascertain whether those competing causes can be ‘ruled out’ as a cause of

[the individual’s] disease.” Id. at 617, 617 n.211; see also Henricksen v. ConocoPhillips Co., 605

F. Supp. 2d 1142, 1162 (E.D. Wash. 2009) (“[T]o result in an admissible conclusion, Gardner’s

analysis should reliably rule out reasonable alternative causes of the alleged harm . . .”). Freeman

asserts that he can rule out alternative causes of Thomsen’s sudden cardiac death simply by

examining the annual incidence of sudden cardiac death in men aged 55-64 years. (Freeman Dep.

at 46:18-47:21, ECF. No. 233-17.) He makes no attempt to either identify or rule out specific

alternative causes for Thomsen’s death. (See Freeman Report at 9-10.) That methodology is

inconsistent with the Reference Guide. Reference Guide at 617 (explaining, for example, that “an

expert attempting to determine whether an individual’s emphysema was caused by occupational

chemical exposure would inquire whether the individual was a smoker”).

Freeman further asserts in his report that his methods are consistent with those described

in a book he co-authored. (Freeman Report at 3.) Plaintiff makes no argument that Freeman’s

book provides evidence that the methods he employs in his report are “practiced by (at least) a

recognized minority of scientists in [the] field.” Domingo ex rel. Domingo v. T.K., 289 F.3d 600,

606 (9th Cir. 2002). Nor does she provide the court with sufficient information to make that

determination. Plaintiff has not met her burden of showing that Freeman’s methods are “based

on sound science.” Daubert II, 43 F.3d at 1316. The court therefore excludes his opinion.3

\ \ \ \ \

\ \ \ \ \

3 Because the court excludes Freeman’s opinion on the basis that it is unreliable, the court

does not address NaphCare’s other arguments for excluding his opinion.

Page 12 – OPINION AND ORDER

2. Stuart Graham

NaphCare contends that Graham is unreliable because he is a “plagiarist” who “perjured

himself.” (NaphCare Mot. at 56.) NaphCare’s argument is based on 13 excerpts from Graham’s

report that use similar or identical phrasing to sections of an article by R.S. Hoffman and G.L.

Weinhouse (Hoffman Article). (See Plagiarism Chart, ECF No. 233-21.) NaphCare asserts that

Graham plagiarized the Hoffman Article by “cop[ying] wholesale” sections of the Hoffman

Article and that he “repeatedly lied under oath” about whether his report reflected his own work.

(NaphCare Mot. at 57, 59.)

“Plagiarism in an expert report does not automatically render the expert’s testimony

inadmissible.” Spiral Direct, Inc. v. Basic Sports Apparel, Inc., Case No. 6:15-cv-641-Orl-

28TBS, 2017 WL 11457208, at *2 (M.D. Fla. Apr. 13, 2017). In some cases, however,

plagiarism may demonstrate the proffered expert’s lack of expertise. In Snyder v. Bank of Am.,

N.A., Case No. 15-cv-04228-KAW, 2020 WL 6462400 (N.D. Cal. Nov. 3, 2020), for example,

the court observed that the proffered expert (who was also the plaintiff) had “almost entirely

copied and pasted from [another expert’s] report, with changes from third-person to first-

person.” 2020 WL 6462400, at *4. Importantly, the plaintiff-expert in Snyder copied her case-

specific analysis from another expert’s report in the same case. See Expert Witness Report of

Pamela Snyder, Snyder, 2020 WL 6462400; Report or Affidavit of Thomas A. Tarter, Snyder,

2020 WL 6462400. Another court that excluded expert testimony on the basis of plagiarism

similarly noted that the proffered expert report copied case-specific conclusions that the expert

claimed as his own. Moore v. BASF Corp., Case No. 11-1001, 2012 WL 6002831, at *7 (E.D.

Page 13 – OPINION AND ORDER

La. Nov. 30, 2012), aff’d sub nom. Moore v. Int’l Paint, L.L.C., 547 F. App’x 513 (5th Cir.

2013).

An expert’s attempt to conceal plagiarism may also undercut his reliability. Reliability is

undermined, for example, when an expert falsely testifies under oath that he has not reviewed

any other expert reports, despite having copied his conclusions from another expert report in the

same case. Id. Courts have also excluded as unreliable experts who gave “deliberately

misleading” answers to questions about their reports or falsely swore under oath that they had

provided all documents relied upon in creating their reports. Raymo v. Sec’y of Health & Hum.

Servs., Case No. 11-0654V, 2014 WL 1092274, at *13 (Fed. Cl. Feb. 24, 2014); Spiral Direct,

2017 WL 11457208, at *2.

The court agrees with NaphCare that whether Graham lied about his reliance on the

Hoffman Article is an important factor in deciding whether his report must be excluded.

(NaphCare Mot. at 60 (“Lying about the plagiarism is key.”).) In NaphCare’s view, “when given

the chance to confess to copying the Hoffman Article, Dr. Graham repeatedly lied under oath.”

(Id. at 59 (citing Graham Dep. at 25:23-27:21).) The court disagrees with that characterization of

Graham’s deposition testimony.4 NaphCare’s representative asked Graham whether his lawyers

4 Q: Dr. Graham, did you write both your initial report and rebuttal report?

A: I did.

Q: Your lawyers didn’t write it for you?

A: No. My experience has been that lawyers write much better than I do.

Q: And your lawyers didn’t write this report; that’s true?

A: They did not.

. . . .

Q: Your assistant didn’t write this report?

A: My assistant?

Q: (Nods head.)

A: No. I’m actually a team of one.

Page 14 – OPINION AND ORDER

or assistant had written the report for him, to which Graham responded that he had written it

himself. (Graham Dep. at 26:1-13.) Graham was not asked whether he copied sections of his

report from other publications, or what sources he relied on in creating his report. (See id.)

Graham’s report is easily distinguished from the reports excluded by other courts based

on plagiarism. Graham did not copy his case-specific opinions. Instead, the copied sections

provide general, broadly applicable information about alcohol withdrawal and delirium tremens.

(See Plagiarism Chart.) Graham also included the Hoffman Article in his list of references. (ECF

No. 233-23, at 3.) The court disagrees with NaphCare’s view that Graham should be excluded as

unreliable either because he listed the Hoffman Article “dead last” in his bibliography or because

he failed to use quotation marks, footnotes, or endnotes. (NaphCare Corrected Reply at 27-28,

ECF No. 251.)

Q: So it’s fair to say that your initial report and your rebuttal report are your work?

A: Entirely.

Q: The opinions expressed in your initial report and your rebuttal report are your

opinions, right?

A: Completely.

Q: Not the opinions of anybody else?

A: Other people may share these opinions, but these are my opinions.

. . . .

Q: By signing your initial report, you represented that the report is your own work, right?

A: Oh, I did, yes.

. . . .

Q: You stand by the opinions expressed in both your initial report and your rebuttal

report, right?

A: I do.

Q: You intend to represent the thoughts and opinions in these reports as your work when

you testify at trial in this case, right?

A: Without hesitation, yes.

(Graham Dep. at 25:23-27:21.)

Page 15 – OPINION AND ORDER

NaphCare further argues that Graham’s reliability is undercut by his “strategic change” of

the word “hyperthermia” to “hypothermia” in the list of alcohol withdrawal symptoms he copied

from the Hoffman Article. NaphCare asserts that Graham intentionally changed the word to

better match Thomsen’s symptoms. (NaphCare Mot. at 57.) The wording change would create

doubt as to Graham’s reliability had he relied on “hypothermia” as a symptom of alcohol

withdrawal to bolster his conclusions. But Graham never mentions “hypothermia” in his

conclusions. (See Graham Report at 22-25.) Instead, he concludes that “[b]y the early morning of

June 28, 2017, 59 hours following his arrest . . . Dale was exhibiting classic signs of DT; he was

having hallucinations, he was disoriented, and he was hypertensive and tachycardic.” (Id. at 23.)

Lack of reference to “hypothermia” elsewhere in his opinion suggests that Graham’s change of

the word “hyperthermia” to “hypothermia” was not strategic. The court concludes that Graham’s

alleged plagiarism does not undermine the reliability of his ultimate conclusions and therefore

will not exclude his opinion on that basis.

3. Vincent Reyes

NaphCare argues that Reyes’ calculations of Thomsen’s mortality risk from coronary

artery bypass surgery should be excluded because those calculations are the products of an

unreliable methodology. (NaphCare Mot. at 61.) Reyes used the Society of Thoracic Surgeons’

Short-Term Risk Calculator to make his calculations. (Reyes Report at 6-8, 14-16, ECF No. 233-

26.) The Risk Calculator requires input of lab values, including the patient’s renal function,

platelet count, creatine level, and hematocrit level. Because Thomsen’s medical records from

Washington County Jail did not include values for his renal function, platelet count, creatine

level, and hemocrit level, Reyes initially ran the calculation using assumed values for those

Page 16 – OPINION AND ORDER

variables. He later ran the calculation again, using values from Thomsen’s 2011 visit to Oregon

Health and Sciences University.

Because neither Reyes nor plaintiff has explained how Reyes arrived at the values he

used in his first calculation, the assumption of those values amounts to unsupported speculation

and his calculation based on those values is unreliable. See, e.g., Stephens v. Union Pac. R.R.

Co., 935 F.3d 852, 856 (9th Cir. 2019) (holding that expert testimony cannot be based “merely

on assumptions and speculation”). Reyes’ first calculation (Reyes Report at 6-8) must therefore

be excluded.

In contrast, Reyes used Thomsen’s own lab values for his second calculation. Reyes

explained that he assumed Thomsen’s 2011 lab values remained accurate at the time of his death

because “[t]here was no indication anywhere in any record subsequent to that that there was any

anemia, thrombocytopenia, neutropenia, infection, or anything that had changed.” (Reyes Dep. at

71:14-19, ECF No. 233-12.) NaphCare argues that Reyes’ assumption that Thomsen’s 2011 lab

values were accurate in 2017 “is preposterous on its face,” and points to medical records from

2014 and 2015 that show different lab values. (NaphCare Mot. at 62; NaphCare Reply at 37.) To

the extent that NaphCare disagrees with Reyes’ conclusion that the 2011 values provided a

reasonable estimate of Thomsen’s 2017 values, it can attack that conclusion “by cross

examination, contrary evidence, and attention to the burden of proof.” Primiano, 598 F.3d at

564. Exclusion, however, would be improper. Id.; see also Alaska Rent-A-Car, Inc. v. Avis

Budget Grp., Inc., 738 F.3d 960, 969 (9th Cir. 2013) (holding that challenges to expert’s

assumptions went to credibility, not admissibility, explaining that a court “is supposed to screen

the jury from unreliable nonsense opinions, but not exclude opinions merely because they are

Page 17 – OPINION AND ORDER

impeachable”).

C. Expert Qualifications

Rule 702 “contemplates a broad conception of expert qualifications.” Hangarter, 373

F.3d at 1018. In the context of medical experts, “it is well-settled that [they] need not have a

subspecialty in the particular field about which they testify.” Schroeder v. County of San

Bernadino, Case No. ED CV 118-427-DMG (JCx), 2019 WL 3037923, at *3 (C.D. Cal. May 7,

2019) (citing Doe v. Cutter Biological, Inc., 971 F.2d 375, 385 (9th Cir. 1992) (“Ordinarily,

courts impose no requirement that an expert be a specialist in a given field, although there may

be a requirement that he or she be of a certain profession, such as a doctor.”)). “Similarly, it is a

generally accepted principle that courts should not exclude expert testimony simply because ‘the

trial court does not deem the proposed expert to be the best qualified or because the proposed

expert does not have the specialization that the court considers most appropriate.’” Id. (quoting

Holbrook v. Lykes Bros. S.S. Co., 80 F.3d 777, 782 (3d Cir. 1996)).

But the Ninth Circuit has also cautioned that “[a] person qualified to give an opinion on

one subject is not necessarily qualified to opine on others.” Rogers v. Raymark Indus., Inc., 922

F.2d 1426, 1431 (9th Cir. 1991). “[L]ack of specialization may go to weight only as long as an

expert stays within the reasonable confines of his subject area.” Avila v. Willits Envt’l

Remediation Tr., 633 F.3d 828, 839 (9th Cir. 2011) (emphasis added) (quotation marks omitted).

1. Qualifications to opine on policies, procedures, and training at the jail

NaphCare argues that Bains, Freedman, and Sucher are not qualified to opine on

NaphCare’s policies, procedures, and training because they lack experience in correctional

settings. (NaphCare Mot. at 65-67.) Washington County argues that Reyes, Freedman, Bains,

Page 18 – OPINION AND ORDER

Sucher, Paulson, and Roscoe are unqualified to offer opinions on Washington County’s standard

of care or its customs, policies, or practices. (Wash. Cnty. Mot. at 6-7.) Plaintiff does not appear

to disagree that Bains, Freedman, Sucher, Reyes, Paulson, and Roscoe are unqualified to opine

on standards for operating correctional facilities or on the nonmedical customs, policies, and

practices of Washington County. Instead, she argues that her experts are qualified to opine on

medical standards applicable to NaphCare, because the medical standard of care is the same in

correctional facilities as it is in the community. (Pl.’s Resp. at 47.) She further argues that

Paulson and Roscoe are qualified by their correctional experience to opine on issues related to

provision of healthcare in a correctional facility. (Id. at 50-52.)

Plaintiff’s medical experts may properly opine on whether the acts of specific employees

of Washington County or NaphCare were consistent with the medical standard of care and

whether specific employees had adequate training to take medically appropriate action toward

Thomsen. As the court explains below, however, it agrees with NaphCare and Washington

County that medical expertise does not qualify an expert to opine on the adequacy of correctional

healthcare policies, or to opine on Washington County’s nonmedical standards of care, customs,

practices, or policies.5

5 Washington County further argues that the opinions of plaintiff’s experts related to

Washington County’s standards, policies, or customs are unreliable because they are based on

incomplete information. The court excludes, based on lack of expertise, the portions of plaintiff’s

experts’ reports that improperly opine on the operation of correctional facilities or on the

nonmedical standards of care, policies, or customs of Washington County. Accordingly, the

court need not address the County’s further argument that opinions on those topics should be

excluded because they are based on incomplete information. To the extent that Washington

County argues that the experts’ failure to review Washington County’s policy manuals or

training materials justifies further exclusion of their opinions, that argument is rejected.

Plaintiff’s experts’ “fail[ure] to review certain materials goes to weight, not admissibility.”

Arriaga v. Logix Fed. Credit Union, Case No. CV-18-9128-CBM-(AGRx), 2022 WL 3052318,

Page 19 – OPINION AND ORDER

a. Amarprit Bains

Bains is a practicing physician certified in internal medicine. He practices hospital

medicine at the Portland VA Medical Center and teaches at Oregon Health & Science

University. (Bains Report at 1.) Bains has no expertise in providing medical care in correctional

facilities. The court therefore excludes the following sections from Bains’s report: “Washington

County failed to remedy defective training and policies” (Bains Report at 10-11), “NaphCare’s

policies and procedures were inadequate” (id. at 15-18), and the subsection “NaphCare failed to

remedy defective policies” (id. at 18-20) within the “NaphCare failed to remedy defective

training and policies” section.

The court also excludes, based on Bains’s lack of correctional expertise, his opinions

(1) that alcohol withdrawal is common at the jail and that the expected standard of care was that

staff would be appropriately trained to recognize and treat alcohol withdrawal (id. at 4); (2) that

Deputy Adams’ failure to pass along medical information is “representative of a much more

systematic pattern of poor oversight and policies by Washington County leadership” (id. at 8);

(3) regarding lack of formal policy or consistent training for relaying information from loved

ones (id. at 8-10); and (4) that NaphCare and Washington County “failed to monitor the

education provided to jail staff” (id. at 13).

\ \ \ \ \

\ \ \ \ \

at *3 (C.D. Cal. Apr. 22, 2022); see also Rapp v. NaphCare, Case No. 3:21-cv-05800-DGE,

2023 WL 5844724, at *13 (W.D. Wash. Sept. 11, 2023) (holding that expert’s supposed failure

to review policy manual was “not a proper basis for exclusion”); Hangarter, 373 F.3d at 1017

n.14 (holding that expert’s selection of documents to review went to weight of his testimony, not

to reliability of his methodology).

Page 20 – OPINION AND ORDER

b. Samuel Freedman

Freedman is a licensed emergency physician with 35 years of experience in emergency

medicine. He has also worked as a medical director. (Freedman Report at 2.) Like Bains,

Freedman lacks expertise in administration of healthcare in correctional facilities. Accordingly,

the court excludes his opinion to the extent that it opines on systemic shortcomings and

deficiencies in training, policy, and action both before and after Thomsen’s death (Freedman

Report at 8), his opinions about NaphCare’s contractual obligations (id. at 9), his discussion of

the need to train jail staff in alcohol withdrawal (id. at 9-10); his opinions on whether

defendants’ response to the auditor’s report was proper (id. at 11); and his general conclusions

about deficient policies, substandard staffing, and resource deployment at the jail (id. at 12).

From Freedman’s rebuttal report, the court excludes his opinion that “IV high dose Librium is

not a jail procedure” (Freedman Rebuttal Report at 3, ECF No. 233-29) and his discussion of

whether NaphCare took appropriate actions following Thomsen’s death (id).

c. Michel Sucher

Sucher is a practicing physician whose focus areas are crisis addiction medicine, medical

detoxification, and residential treatment. (Sucher Rep. at 2.) He works for a private network of

rehabilitation facilities and previously worked as an emergency physician for over 20 years. (Id.;

Sucher Dep. at 10:10-16, ECF No. 247-14.) Sucher does not, however, have any correctional

experience. The court therefore excludes Sucher’s nonmedical opinions that Washington County

failed properly to monitor NaphCare’s contractual compliance (Sucher Report at 6); that there

was a lack of appropriate training and education as to nonmedical staff (id.); and that there were

“numerous violations in the standard of care by Washington County and Washington County

Page 21 – OPINION AND ORDER

Jail” (id. at 5) to the extent he opines on nonmedical standards of care. The court further

excludes his opinion that defendants failed properly to assess Thomsen at intake and during his

entire jail stay (id.), because the standards for intake and monitoring at the jail are specific to the

correctional setting.

d. Vincent Reyes

Reyes is a licensed cardiologist and has practiced interventional cardiology for 31 years.

(Reyes Report at 2.) He has treated patients suffering from alcohol withdrawal and has diagnosed

delirium tremens. (Reyes Dep. 9:22-10:11.) The court agrees with Washington County that

Reyes’ medical expertise does not qualify him to offer opinions on the County’s nonmedical

standards of care, customs, policies, or practices. Review of his initial and rebuttal reports,

however, reveals that Reyes does not opine on those topics. (See Reyes Report at 1-4; Reyes

Rebuttal Report at 1-4, ECF No. 233-42.) Reyes’ reports are confined to opinions on the medical

standard of care, Thomsen’s medical condition, appropriate treatment, and chances of survival.

Each of those topics is within Reyes’ expertise as a medical doctor with a specialization in

cardiology and experience with alcohol withdrawal. Reyes’ lack of correctional experience does

not justify excluding any portion of his opinion.

e. Reed Paulson

Paulson is a physician with experience in emergency medicine, family medicine, and

correctional medicine. His correctional experience includes providing medical care at the Hopi

Nation Jail and at Oregon Department of Corrections Coffee Creek Intake Facility. (Paulson

Report at 2.) Paulson is qualified by his experience to opine on medical issues unique to

correctional healthcare. He is not, however, qualified to opine on the administrative and

Page 22 – OPINION AND ORDER

operational policies of NaphCare and Washington County. The court therefore excludes his

opinions that failures to properly treat Thomsen result from systemic issues, inadequate training,

and failed oversight, and his discussion of practices and norms within the Jail. (Paulson Report at

2, 5, ECF No. 233-34.)

f. Lori Roscoe

Roscoe is a registered nurse and nurse practitioner. She is a certified correctional health

professional and has worked in a variety of correctional healthcare roles, including as a health

services administrator, executive director of clinical services, and nurse practitioner. She has

graduate degrees in nursing and administration. (Roscoe Report at 2.)

Washington County argues, and the court agrees, that Roscoe is not qualified to opine on

the County’s nonmedical standards, practices, policies, or customs. Roscoe is, however, qualified

by her experience as a nurse and correctional healthcare administrator to opine on whether

specific actions taken by Washington County employees were consistent with the medical

standard of care and whether NaphCare provided adequate training to Washington County

employees. Roscoe’s report does not address operational standards of correctional facilities or

the nonmedical customs or practices of Washington County. Her opinions related to Washington

County are within her scope of expertise.

2. Qualifications to opine on alcohol withdrawal and cause of death

a. Stuart Graham

Graham is a forensic pathologist. He is licensed to practice medicine and is certified in

anatomic and clinical pathology, with a subspecialty in forensic pathology. (Graham Report at

2.) According to NaphCare, Graham is unqualified to opine that alcohol withdrawal caused

Page 23 – OPINION AND ORDER

Thomsen’s death, because he “has no expertise in alcohol withdrawal.” (NaphCare Mot. at 56-

57). As a forensic pathologist, however, Graham’s expertise is in identifying cause of death.

Opining on Thomsen’s cause of death is therefore “within the reasonable confines of his subject

area.” Avila, 633 F.3d at 839. NaphCare further argues that Graham’s cause-of-death analysis

must be excluded because forensic pathologists perform autopsies and autopsies do not reveal

whether the deceased experienced alcohol withdrawal. (NaphCare Mot. at 31-32.) As Graham

explained, however, forensic pathologists do not base their conclusions solely on autopsies: other

data are considered in analyzing autopsy results and in making cause-of-death determinations.

(Graham Dep. at 13:18-14:1.) NaphCare’s objections to Graham’s qualifications go to the

weight, not the admissibility, of his opinion.

b. Michel Sucher

Because Sucher has never performed an autopsy, is not qualified to perform an autopsy,

and otherwise does not have expertise in identifying cause of death, NaphCare argues that he is

unqualified to opine on Thomsen’s cause of death. As previously noted, however, Sucher is an

addiction specialist and was previously an emergency physician for over 20 years. He has seen

patients die and has diagnosed cause of death. (Sucher Dep. at 11:3-6.) Sucher’s training and

experience qualify him to opine on whether Thomsen died due to alcohol withdrawal.

NaphCare’s argument that Sucher is unqualified to opine on Thomsen’s cause of death because

he is not specialized in identifying cause of death is unavailing.

c. Gregory Whitman

Whitman is a licensed neurologist whose primary focus is on dizziness, balance

disorders, and cognitive impairment. He also has extensive experience treating patients with

Page 24 – OPINION AND ORDER

alcohol withdrawal. (Whitman Dep. 22:8-16, ECF No. 247-15.) NaphCare argues that Whitman

is not qualified to opine that Thomsen died from alcohol withdrawal because his practice does

not focus on alcohol withdrawal, he is neither a pathologist nor qualified to perform autopsies,

and he is not qualified to opine on survival rates of people with severe coronary artery disease.

(NaphCare Mot. at 63-64.) As Whitman explained, however, “alcohol withdrawal is within the

scope of knowledge of neurologists.” (Whitman Dep. at 21:5-6.) Whitman’s training as a

neurologist and his extensive experience treating patients with alcohol withdrawal qualify him to

opine that Thomsen’s death was most likely the result of untreated alcohol withdrawal.

d. Bradford Hansen

Hansen is a retired prison warden with 42 years of experience working in correctional

institutions. (Hansen Report at 2.) Hansen has no medical training. Accordingly, the court agrees

with NaphCare that he is unqualified to opine on either Thomsen’s cause of death or his chances

of survival had defendants acted differently. See, e.g., Garcia v. County of Riverside, Case No.

CV 5:18-00839 SJO (ASx), 2019 WL 4282903, at *13 (C.D. Cal. June 7, 2019) (holding that

expert with no medical training was not qualified to opine on cause of death). Hansen’s report is

excluded to the extent that he opines on Thomsen’s cause of death.

e. Vincent Reyes

NaphCare argues that Reyes, a cardiologist, is unqualified to opine on whether Thomsen

was either suffering from or died due to alcohol withdrawal, because Reyes does not specialize

in alcohol withdrawal. (NaphCare Mot. at 61.) It is true that being a medical doctor does not

qualify Reyes to opine on all medical topics. See, e.g., Montera v. Premier Nutrition Corp., Case

No. 16-cv-06980-RS, 2022 WL 1225031, at *9 (N.D. Cal. Apr. 26, 2022). Reyes, however, has

Page 25 – OPINION AND ORDER

diagnosed and examined patients with both alcohol withdrawal and delirium tremens. (Reyes

Dep. at 9:1-10:11, ECF No. 247-9.) Reyes’ experience and training qualify him to opine on

whether Thomsen experienced alcohol withdrawal and delirium tremens and whether Thomsen’s

heart condition would likely have killed him in the absence of a severe stress event.

3. Qualifications to opine on duties of medical director

In her report, Roscoe opines on the duties of NaphCare’s medical director, Dr. Julie

Radostitz, to supervise nursing staff, provide training, and maintain standards. (Roscoe Report at

10-13, ECF No. 233-38.) NaphCare argues that Roscoe is unqualified to opine on the duties and

standards that apply to Radostitz because Roscoe is not a medical doctor. (NaphCare Mot. at 67.)

As other courts have acknowledged, however, nurses may be qualified by training or experience

to opine on standards applicable to medical doctors. See, e.g., Reece v. Shelby County, Case No.

3:16-cv-00069-GFVT-EBA, 2020 WL 4582410, at *5-6 (E.D. Ky. Aug. 10, 2020) (noting that it

was possible for an APRN to “obtain the knowledge, skill, experience, or training required to

qualify as an expert on the standard of care required of a doctor supervising PAs and APRNs,”

but holding that nurse in that case was not qualified because of limitations in her experience

(quotation marks omitted)); Shipp v. Murphy, 9 F.4th 694, 701, 701 n.3 (8th Cir. 2021)

(excluding Roscoe’s testimony about standard of care for physician’s interactions with patient,

but declining to establish “a bright line rule that a nurse practitioner may never offer an opinion

on a physician’s conduct”).

Roscoe has worked as a correctional-facility health services administrator and as an

executive director of clinical services. (Roscoe Report at 1.) In that work, Roscoe has been

responsible for policy and procedure development, staff supervision, staff education, and

Page 26 – OPINION AND ORDER

continuous quality improvement programs at correctional facilities. (Id. at 2.) Roscoe’s extensive

training and experience in correctional healthcare administration qualify her to opine on the

administrative duties of NaphCare’s medical director.

D. Opinions about the Death of Madaline Pitkin

Washington County, joined by NaphCare, argues that Hansen’s opinion must be excluded

under Rule 702 to the extent that he discusses the death of Madaline Pitkin, who died in custody

at Washington County Jail in 2014. The County argues that opinions related to Pitkin must be

excluded because they are unfounded and unsupported, as Hansen was not provided with any

pleadings, depositions, or discovery from the Pitkin case, and instead bases his opinion on “the

limited amount of information” he learned from a newspaper article and deposition testimony of

the Washington County auditor. (Wash. Cnty. Mot. at 11-12.) The court understands the

County’s argument as based in Rule 702(b)’s “sufficient facts or data” requirement.

Ordinarily, an expert’s “fail[ure] to review certain materials goes to weight, not

admissibility.” Arriaga v. Logix Fed. Credit Union, Case No. CV-18-9128-CBM-(AGRx), 2022

WL 3052318, at *3 (C.D. Cal. Apr. 22, 2022). But “[r]eliance on incomplete facts and data may

make an expert opinion unreliable because an expert must know of facts which enable him to

express a reasonably accurate conclusion.” Arjangrad v. JPMorgan Chase Bank, N.A., Case No.

3:10-cv-01157-PK, 2012 WL 1890372, at *6 (D. Or. May 23, 2012).

Plaintiff makes no argument that the documents that Hansen reviewed provide sufficient

information to allow him to reliably opine on Pitkin’s death, nor does she point the court to

evidence in the record providing a foundation for those opinions. Plaintiff has not met her burden

of showing that Hansen’s opinions related to Pitkin’s death are based on enough information to

Page 27 – OPINION AND ORDER

allow him to express reasonably accurate conclusions. Accordingly, the court excludes Hansen’s

opinion to the extent that he opines on the specific circumstances of Pitkin’s death, compares the

deaths of Pitkin and Thomsen, or concludes that Washington County failed to learn from the

Pitkin death. (Hansen Report at 23-24 (Section F, ¶¶ 2, 3).)

E. Roscoe’s Supplemental Report

Plaintiff disclosed Roscoe’s supplemental expert report after expert discovery closed on

December 16, 2022. (Order Granting Motion for Extension of Discovery and PTO Deadlines,

ECF No. 224; Dahab Decl. at 4, ECF No. 247 (stating that supplemental report was produced to

all parties on December 17, 2022).) In the supplemental report, Roscoe states that she has

reviewed NaphCare training materials and that her previous opinions remain unchanged. She

also opines that a blog post in the training materials “almost exactly describes Mr. Thomsen’s

situation.” (Roscoe Supp. Report at 1, ECF No. 247-18.)

Federal Rule of Civil Procedure 26 provides that a party must supplement its disclosure

“in a timely manner if the party learns that in some material respect the disclosure or response is

incomplete or incorrect.” FED. R. CIV. P. 26(e)(1)(A). Under Rule 26, a supplemental report is

proper if it corrects an inaccuracy in a party’s original disclosures, or fills a gap based on

information that was previously unavailable. Luke v. Family Care and Urgent Med. Clinics, 323

F. App’x 496, 500 (9th Cir. 2009).

Plaintiff makes no argument that the supplemental report corrects inaccuracies in a

previous report. And although the report does address information (training materials) that were

not addressed in Roscoe’s initial report, plaintiff makes no argument that those materials were

previously unavailable. The supplemental report is improper.

Page 28 – OPINION AND ORDER

Federal Rule of Civil Procedure 37 requires the court to exclude the improper

supplemental report unless it determines that the improper report was either substantially

justified or harmless. FED. R. CIV. P. 37(c)(1). Plaintiff argues that the report is “both justified

and harmless” because training is within the scope of Roscoe’s initial report. (Pl.’s Resp. at 49.)

The court concludes that, to the extent that Roscoe states that her initial opinion remains

unchanged after reviewing NaphCare’s training materials, her supplemental report is harmless.

Her new opinion comparing the blog post to Thomsen’s situation, however, is neither justified

nor harmless. NaphCare had no opportunity to depose Roscoe about the new opinion or to rebut

the opinion with its own expert report. The new opinion is excluded.

F. Improper Legal Conclusions and Rule 403 Arguments

Defendants ask the court to exclude the opinions of Hansen, Freedman, Paulson, and

Roscoe because those experts offer inadmissible legal conclusions. They further ask that, under

Federal Rule of Evidence 403, the court exclude any mention of Madaline Pitkin and any

medical expert opinions related to Washington County. (NaphCare Resp. at 10, ECF No. 242;

Wash. Cnty. Mot. at 10.)

Objections based on relevance and improper legal conclusions “are moot in the summary

judgment context,” because they are “duplicative of the summary judgment standard itself.” Sec.

& Exch. Comm’n v. Criterion Wealth Mgmt. Servs., Inc., 599 F. Supp. 3d 932, 945 (C.D. Cal.

2022); see also Cherewick v. State Farm Fire & Cas., 578 F. Supp. 3d 1136, 1156 (S.D. Cal.

2022) (overruling objections to improper legal conclusions in expert testimony at summary-

judgment stage as “redundant of the summary judgment standard itself”). The court agrees with

defendants that certain statements in Thomsen’s expert reports may qualify as improper legal

Page 29 – OPINION AND ORDER

conclusions. At this stage, however, the court need not exclude expert opinions on that basis

because legal conclusions will not be considered in determining whether there is a genuine

dispute of material fact. See Burch v. Regents of Univ. of Cal., 433 F. Supp. 2d 1110, 1119 (E.D.

Cal. 2006).

“Further, in the summary judgment context, a court need not exclude evidence for danger

of unfair prejudice, confusion of issues, or any other the other grounds outlined in Federal Rule

of Evidence 403.” Melena v. ASRC Indus. Servs., LLC, Case No. CV 21-6769 PA (Ex), 2022 WL

423493 (C.D. Cal. 2022) (quotation marks omitted); Holt v. Noble House Hotels & Resort, Ltd,

370 F. Supp. 3d 1158, 1164 (S.D. Cal. 2019) (“Federal Rule of Evidence 403 objections are

unnecessary at the summary judgment stage because there is no jury that can be misled and no

danger of confusing the issues.”). The court denies defendants’ Motions to Exclude to the extent

that they are based in arguments about relevance, improper legal conclusions, and Rule 403, as

those arguments are inapplicable in the context of summary judgment.

\ \ \ \ \

\ \ \ \ \

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\ \ \ \ \

\ \ \ \ \

\ \ \ \ \

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Page 30 – OPINION AND ORDER

CONCLUSION

For the above reasons, the court excludes Freeman’s opinion in its entirety and excludes

the opinions of Graham, Bains, Reyes, Freedman, Sucher, Paulson, Roscoe, and Hansen only to

the extent described above. Thomsen has met her burden of showing that the remaining portions

of those opinions are admissible for purposes of summary judgment. NaphCare’s Motion to

Exclude (ECF No. 232) is GRANTED IN PART and DENIED IN PART; and Washington

County’s Motion to Exclude (ECF No. 237) is GRANTED IN PART and DENIED IN PART.

DATED: December 15, 2023

ZA

JEXF ARMISTEAD

United States Magistrate Judge

Page 31 — OPINION AND ORDER

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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