dismissing a differential diagnosis based only on an expert’s review of medical records as a “meek attempt” to prove a comprehensive differential diagnosis
How later courts described this case
- dismissing a differential diagnosis based only on an expert’s review of medical records as a “meek attempt” to prove a comprehensive differential diagnosis
Written by the judges who cited it.
The opinion
Southern District of Texas
ENTERED
IN THE UNITED STATES DISTRICT COURT June 08, 2021
FOR THE SOUTHERN DISTRICT OF TEXAS Nathan Ochsner, Clerk
HOUSTON DIVISION
CHARLES CONN, ef al, §
Plaintiffs, :
VS. § CIVIL ACTION NO. 4:14-CV-298
C.R. BARD, INC, et al, :
Defendants. :
ORDER
Pending before the Court is a Motion to Exclude or Limit Opinions and Testimony of
Robert P. Allen, M.D. filed by Defendants C.R. Bard, Inc., and Bard Peripheral Vascular, Inc.
(collectively, “Bard”). (Doc. No. 63), Plaintiff Charles Conn (“Conn”) responded (Doc. No. 94),
and Bard replied (Doc. No. 108). After considering the motion, response, record, and applicable
law, the Court GRANTS IN PART and DENIES IN PART the motion.
I. Background
This is a products liability action involving the G2 Filter (the “Filter”), a medical device
manufactured and distributed by Bard. Conn was implanted with the Filter on August 24, 2006
and claims it “fractured and a strut migrated to the right ventricle causing [ ] significant injuries.”
(Doc. No. 1 at 23-24). Conn sued Bard alleging negligence, failure to warn, design defects,
manufacturing defect, breach of implied warranty of merchantability, negligent representation, and
loss of consortium on behalf of Plaintiff Alyssa Conn, his wife. He also sought punitive damages.
Conn has identified Dr. Robert Allen, an interventional radiologist, as a case specific expert
witness. (Doc. No. 94 at 6). Dr. Allen is the Director of Interventional Radiology at Radiology
Specialists of Denver, Chief of Interventional Radiology at Denver Health Medical Center, and a
Board-Certified practicing diagnostic and interventional radiologist of more than two decades.
(/d.). Dr. Allen used to implant IVC filters regularly as part of his practice. (Doc. No. 117-38 at
2~3). Based on his concerns about the effectiveness of filters, his experience with IVC filters now
consists of consulting with patients who have had IVC filters implanted that require removal and
retrieving them. (/d@.). Dr. Allen offers opinions about, among other things, an alleged failure of
informed consent and failure to warn, the adequacy of the G2 filter instructions for use (“IFU”),
the efficacy of the G2 filter, medical device complaints, and the failure of Conn’s filter. (Doc. No.
63 at 7).
Bard asks the Court to exclude 15 “case specific” opinions and conclusions offered by Dr.
Allen:
* whether the IFU associated with the filter [sic] “inadequate for use by physicians
in medical decision making and in informed consent of patients”;
* whether the IFU “provides inadequate warnings and information about the very
serious risks of tilt, fracture, perforation, migration, and embolization associated
with the G2 filter’;
* whether the IFU fails to provide “adequate recommendations for imaging follow-
up and [] timeline for removal”;
* whether the IFU “failed to meet the reasonable expectations of physicians like Dr.
Gunlock and [Dr. Allen], who implant or recommend implantation of [VC filters”;
* that Bard did not “adequately warn physicians . . . of important safety risks and
specific device failure risks associated with its ‘retrievable’ G2 [VC filter”;
* whether Bard’s alleged failure to warn of “safety risks and problems associated
with the G2 filter... prevented Dr. Gunlock from making an informed decision as
to whether to implant a G2 filter into [Plaintiff], and also prevented him from
explaining the risks to [Plaintiff], and in turn prevented [Plaintiff] from providing
Dr. Gunlock informed consent.”;
* that Bard “failed to notify” treating physicians and patients of “the much higher
complication rates of fracture, embolization of fractured components, caval
perforation, filter migration, and death associated with the G2 and Recovery filters
in comparison to the original predicate device . . . and competitor filters”;
* that Bard “failed to accurately notify regarding the specific complication of
perforation”;
* medical device complaints and: underreporting;
* that there is “no proven efficacy of any IVC filter including the G2 in reducing
the risk of mortality;
* that the G2 “is a filter with great risk but no proven benefit”;
* design defects;
* that the “defective design of the G2 filter caused [Plaintiff]’s injuries, including
tilt and apex embedment, multiple strut fractures, fragment embolization to the
patient’s heart, caval perforation into the retroperitoneum, liver, uncinate process
of pancreas and direct impingement on the crossing right renal artery”;
* that the “strut perforations and fractures associated with [Plaintiff]’s G2 filter were
and are the result of the filter design itself”; and
¢ any and all opinions of Dr. Hurst, Dr. McMeeking, and Dr. Garcia, adopted by
Dr. Allen, that the MDL excluded.
(Doc. No. 63 at 9-10). Conn opposes the motion. (Doc. No. 94). The Court will address each
objection by category.
If. Legal Standard
Under Rule 702, a qualified expert may testify on the basis of “scientific, technical, or other
specialized knowledge” if it “will assist the trier of fact to understand the evidence,” provided the
testimony rests on “sufficient facts or data” and “reliable principles and methods,” and “the witness
has reliably applied the principles and methods to the facts of the case.” Fed. R. Evid. 702(a)-(d).
An expert may be qualified to testify based on his or her “knowledge, skill, experience, training,
or education.” Id.
The proponent of expert testimony must prove by a preponderance of the evidence that the
testimony is reliable. See Moore v. Ashland Chem. Inc., 151 F.3d 269, 276 (Sth Cir. 1998). The
Supreme Court has clarified in Daubert and Kumho Tire that it is the gatekeeping role of the Court
to determine whether an expert’s proffered testimony conforms with Rule 702. Daubert v. Merrell
Dow Pharm., Inc., 509 U.S. 579 (1993); Kumho Tire Co., Ltd. v. Carmichael, 526 U.S. 137 (1999).
The Court is to “ensure the reliability and relevancy of expert testimony,” Kumho Tire, 526 U.S.
at 152, and is not required to “admit opinion evidence that is connected to existing data only by
the ipse dixit of the expert.” /d. at 157 (quoting Gen. Elec. Co. v. Joiner, 522 U.S. 136, 146 (1997)).
IiI.. Discussion
A. The IFU
Bard argues that Dr. Allen is not qualified to give testimony and offer opinions as to the
sufficiency of the Filter’s IFU. (Doc. No. 63 at 12). Bard contends that Dr. Allen has not
established that he has the sufficient knowledge or experience to opine on the content requirements
or adequacy of an IFU, because Dr. Allen has testified that he is not an expert in drafting IFUs.
(Doc. No. 63 at 13-14).
Conn argues that Dr. Allen is the most reliable expert to offer expert opinions regarding
the Filter’s IFU. (Doc. No. 94 at 10). According to Conn, the learned intermediary doctrine requires
him to prove that Bard failed to warn Conn’s implanting physician. (Doc. No. 94 at 10). Therefore,
Conn contends that because Dr. Allen has “extensive experience implanting and retrieving IVC
filters,” he is qualified to testify about the sufficiency of and warnings in the IFU. U/d.). Conn
concedes that Dr. Allen is not offering opinions as a regulatory expert, but rather “from the
perspective of the adequacy for use by physicians in medical decision making and the consent of
the patient.” (U/d.).
1. Risks
The Court finds that Dr. Allen can testify as to the risks associated with the use of the G2
filter. Dr. Allen has demonstrated experience in IVC filter implantation. (Doc. No. 117-38 at □□
3). Based upon that experience, he is qualified to testify about whether generally recognized
medical risks associated with the procedure and device are in fact warned about in the IFU. See
Winebarger v. Boston Sci. Corp., 2:13-CV-28892, 2015 WL 1887222, at *15 (S.D.W. Va. Apr.
24, 2015) (holding practicing urogynecologist qualified to opine as to risks he perceives of surgical
mesh product, and whether instructions conveyed those risks to physicians); Jn re Yasmin & YAZ
(Drospirenone) Mktg., Sales Practices & Products Liab. Litig., 3:09-MD-02100-DRH, 2011 WL
6301625, at *11 (S.D. Ill. Dec. 16, 2011) (“doctors are fully qualified to opine on the medical facts
and science regarding the risks and benefits of [drugs] ... and to compare that knowledge with what
was provided in the text of labeling and warnings for FDA approved drugs.”). He can also testify
as to what is or is not in the IFU, to the extent that it is not otherwise objectionable.
In the same vein, Bard also seeks to exclude Dr. Allen’s opinion that Bard “failed to notify”
treating physicians and patients of “the much higher complication rates of fracture, embolization
of fractured components, caval perforation, filter migration, and death associated with the G2 and
Recovery filters in comparison to the original predicate device . . . and competitor filters.” (Doc.
No. 63 at 9-10). As part of his testimony about what a reasonable physician would expect or want
to know, discussed in detail below, the Court finds that Dr. Allen can testify that a reasonable _
physician would want to know if the G2 device had more known risks than other comparable
filters. As previously stated, he can then testify as to whether those risks appeared in the IFU. Such
an opinion is admissible under Rule 702 because it falls within the area of Dr. Allen’s expertise,
and is based on his years of experience as a physician.
While Dr. Allen can testify about the specific risks and whether those risks appeared on
the IFU, he “must possess additional expertise to offer expert testimony about what information
should or should not-be included in an IFU.” Jn re: Ethicon Inc. Pelvic Repair Sys. Prod. Liab.
Litig., No. MDL 2327, 2016 WL 4556807, at *4 (S.D.W. Va. Aug. 31, 2016). Consequently, Dr.
Allen cannot testify that Bard did not “adequately warn physicians . . . of important safety risks
and specific device failure risks associated with its ‘retrievable’ G2 IVC filter.” (Doc. No. 63 at
9-10).
2. Reasonable Expectations
Dr. Allen can testify as to what a physician reasonably expects to be told about the risk of
IVC filters. As the Ninth Circuit has noted, “despite the importance of evidence-based medicine,
much of medical decision-making relies on judgment—a process that is difficult to quantify or
even to assess qualitatively. A doctor’s experience might be good reason to admit his testimony.”
Primiano vy. Cook, 598 F.3d 558 at 565-66 (9th Cir. 2010) (cleaned up) (citing Dickenson v.
Cardiac & Thoracic Surgery of E. Tenn., 388 F.3d 976, 982 (6th Cir. 2004); Schneider v. Fried,
320 F.3d 396, 406-07 (3d Cir. 2003)). The Court finds that Dr. Allen’s knowledge and experience
in the field of interventional radiology and his use of IVC filters in patients form a sufficient
foundation for voicing an opinion concerning what a doctor reasonably expects to be told by the
manufacturer about the risk of IVC filters. See In re Bard IVC Filters Products Liab. Litig., MDL
15-02641-PHX DGC, 2017 WL 6554163, at *4 (D. Ariz. Dec. 22, 2017) (concluding doctors
should be permitted to testify about disclosures that reasonable radiologists expect to receive from
manufactures of IVC filters after thorough case law analysis); see also In re Bard IVC Filters
Prods. Liab. Litig., 2018 U.S. Dist. LEXIS 9682, at *301 (“As an experienced interventional
radiologist with years of practice, Dr. Hurst clearly is qualified to opine about the information
physicians and patients need and expect when making decisions about the use of IVC filters.”).
Such testimony appears to be well within Dr. Allen’s expertise and experience, and the Court can
identify no basis under Rule 702 for precluding it.
By contrast, Dr. Allen cannot testify as to whether the IFU “failed to meet the reasonable
expectations of physicians like Dr. Gunlock, who implant or recommend implantation of IVC
filters.” (Doc. No. 63 at 9). Initially, Dr. Allen can only testify generally as to what a reasonable
person practicing in the field of interventional radiology would expect. He may not testify as to
what Dr. Gunlock would expect. Dr. Gunlock may, of course, testify as to his own experience, if
designated as an expert witness himself. For the same reason, Dr. Allen cannot testify as to
whether Bard’s alleged failure to warn of “safety risks and problems associated with the G2 filter
... prevented Dr. Gunlock from making an informed decision as to whether to implant a G2 filter
into [Plaintiff], and also prevented him from explaining the risks to [Plaintiff], and in turn
prevented [Plaintiff] from providing Dr. Gunlock informed consent.” (Doc. No. 63 at 9-10).
Again, Dr. Allen may not testify on behalf of Dr. Gunlock and may only testify in terms of the
opinions and expectations of a reasonable physician. See In re Bard IVC Filters, 2018 U.S. Dist.
LEXIS 9682, at *301; see also Inre Bard IVC Filters, 2017 WL 6554163, at *4.
3. Adequacy
Dr. Allen is not qualified to testify about the adequacy of the warnings on the IFU or what
should or should not be included in those warnings.’ Dr. Allen has no expertise or experience
related to the requirements for or the drafting of IFUs or warnings. (Doc. No. 63-6 at 203:22-24).
Dr. Allen does not claim to have been involved in writing or preparing a warning for any medical
device. (Id. at 203:16—21). Moreover, he does not present additional qualifications to testify as to
the adequacy of the warnings on the IFUs. (Doc. No. 63 at 13). Therefore, the Court hereby
excludes Dr. Allen’s opinions and testimony concerning the adequacy of the warnings in the IFU
As previously stated, Dr. Allen is permitted to testify about whether perceived risks are in fact warned about, but
he may not opine as to the adequacy of the warning based upon the risks described or omitted. Judge Goodwin aptly
described this distinction in an MDL opinion:
Based on his experience, I find him qualified to testify about whether the risks he perceives are in fact
warmed about in the IFU. Dr. Hoyte’s opinion testimony on the IFU must stop here, however. A doctor
who has no background in the requirements of an IFU is not qualified to opine that it “adequately and
appropriate” warns of the risk merely because he personally knows about or has observed risks in his
practice.
InreC. R. Bard, Inc., Pelvic Repair Sys. Products Liab. Litig., MDL 2187, 2018 WL 4220618, at *5 (S.D.W. Va.
Sept. 5, 2018).
and what should or should not have been included. See Dorgan v. Ethicon, Inc., 4:20-00529-CV-
RK, 2020 WL 5367063, at *2 (W.D. Mo. Sept. 8, 2020) (finding expert with similar qualifications
unqualified to testify about adequacy of warning); see also Inre C. R. Bard, Inc., WL 4220618, at
*5 (holding that mere personal knowledge or observation of risks by doctor does not qualify him
to opine that IFU adequately and appropriately warned of risks, without a background in the
requirements of an IFU).
B. The Efficacy of the Filter
Bard argues that Dr. Allen should not be permitted to opine that there is “no proven efficacy
of any IVC filter including the G2 in reducing the risk of mortality,” or that “the G2 is a filter with
great risk but no proven benefit.” (Doc. No. 63 at 18). Bard urges both that Dr. Allen is not
qualified to opine as to the efficacy of IVC Filters, and that he impermissibly restates Dr. Garcia’s
general expert opinion. (/d.). Conn contends that Dr. Allen is qualified to testify based upon
“decades of experience in placing and retrieving IVC filters,” and his opinion does not regurgitate
that of Dr. Garcia but rather is based upon his review of the “pertinent medical literature and Bard’s
internal documents.” (Doc. No. 94 at 19).
The Court finds that based upon his training and experience, Dr. Allen is qualified to testify
as to the efficacy of IVC filters, including the G2 filter. In addition to his pedigree, there is
uncontroverted deposition testimony that he has “implanted a large number of them over the
years.” (Doc. No. 63-6 at 208: 17-18). As the Supreme Court has explained, “the relevant
reliability concerns may focus upon personal knowledge or experience. Daubert makes clear that
the factors it mentions do not constitute a definitive checklist or test.” Kumho Tire, 526 U.S. at
150. Dr. Allen is qualified to offer his expert opinion as to what an IVC filter is intended to do.
Given his clinical experience as an interventional radiologist who has implanted and continues to
explant IVC filters, insofar as that experience is relevant, he can opine as to whether he thinks the
IVC filters are effective in achieving their intended function. He can also, given his area of
expertise, opine as to whether he thinks the Filter poses risks or presents benefits, so long as his
opinion is based upon his own training, education, and experiences.
Moreover, the Court finds that Dr. Allen’s opinions about the efficacy of IVC filters,
including the G2 filter, are not merely a restatement of Dr. Garcia’s opinions but are instead based
upon his aforementioned clinical experience, his “literature search, review of the literature,” and
his review of “Bard’s internal documents.” (Doc. No. 117-38 at 17-19) (see also Doc. No. 63-6 at
208:18-25). While the Court hereby holds that Dr. Allen may not parrot, either literally or
metaphorically, the opinions of Dr. Garcia, Jn re Bard IVC Filters Prods. Liab. Litig., 2018 U.S.
Dist. LEXIS 9682, at *302, he may certainly rely upon those opinions to inform his own. Jn re
Bard IVC Filters Products Liab. Litig., 2017 WL 6554163, at *2. In this instance, Dr. Allen has
sufficiently established that his own opinion about the efficacy of IVC filters is based upon both
his own clinical experience and his literature review. (Doc. No. 194-5 at 34). Insofar as his opinions
about the efficacy of IVC filters are based upon his education, training, personal experience and
his literature review, he may also testify that it is his opinion that there is “no proven efficacy of
any IVC filter including the G2 in reducing the risk of mortality,” and that “the G2 is a filter with
great risk but no proven benefit.” (Doc. No. 63 at 18).
C. Design Defect or Defective Design
Dr. Allen seeks to offer several opinions regarding the Filter’s design. Bard seeks to
exclude his opinions as to “design defects,” including that the “defective design of the G2 filter
caused [Plaintiff]’s injuries, including tilt and apex embedment, multiple strut fractures, fragment
embolization to the patient’s heart, caval perforation into the retroperitoneum, liver, uncinate
.
process of pancreas and direct impingement on the crossing right renal artery” and that the “strut
perforations and fractures associated with [Plaintiff]’s G2 filter were and are the result of the filter
design itself.” (Doc. No. 63 at 9-10). Bard argues that Dr. Allen lacks the qualifications to opine
on the design of the Filter, and that such an opinion is an impermissible legal conclusion. (/d. at
16~21).
Under Rule 702, an expert’s testimony must be limited to the bounds of his or her
qualifications. Wilson v. Woods, 163 F.3d 935, 937 (Sth Cir. 1999). Dr. Allen is not an engineer of
any kind. (Doc. No. 63-5 at 2). He has never successfully designed or made a medical device to
be implanted in a human. He is not a metallurgist or any other kind of specialist in designing,
selecting, or crafting materials to be used in human implantation. (/d.). He has never consulted
with a medical device manufacturing company on product development. (Doc. No. 63-6 at 21:19-
22:6). As aresult, Dr. Allen lacks the specialized knowledge, skill, experience, and training to
opine as to whether the filter suffers from a “defective design” or has a “design defect.” (Doc. No.
117-38 at 27).? Since Dr. Allen is not qualified to opine as to a design defect, he similarly cannot
opine that any “design defect” or “defective design” caused the Filter to do anything or caused any
of Conn’s injuries. Therefore, he cannot offer the opinions that the “defective design of the G2
filter caused [Plaintiff]’s injuries, including tilt and apex embedment, multiple strut fractures,
fragment embolization to the patient’s heart, caval perforation into the retroperitoneum, liver,
uncinate process of pancreas and direct impingement on the crossing right renal artery,” or that the
“strut perforations and fractures associated with [Plaintiff]’s G2 filter were and are the result of
the filter design itself.” (Doc. No. 63 at 9-10) (emphasis added).
2 Conn apparently interprets Dr. Allen’s report as not offering any opinions on design: “[Dr. Allen] has not and will
not offer any opinion regarding any design issues with the G2 filter.” (Doc. No. 94 at 16). Regardless of how Conn
perceives Dr. Allen’s expert report, the Court now makes clear that Dr. Allen cannot offer any opinions on the
design defect or defective design of the Filter.
10
Although Dr. Allen is not qualified to testify that the filter’s alleged failure was caused by
the filter’s alleged design defect, he is qualified to testify about the resulting problems or
consequences from the filter’s fragmentation (or failure) in Conn, because he has reviewed Conn’s
medical records. In other words, he can offer the opinion fhat the filter failed but not the reason,
and that there were subsequent strut fractures, fragment embolization, impingements, and
perforations.?
D. Specific Causation
While Dr. Allen cannot opine as to any design defect or defective design, there is a separate
question of whether he can offer his opinion as to specific causation. Apparently, Dr. Allen intends
to offer testimony that the “defective design of the G2 filter caused [Plaintiff]’s injuries, including
tilt and apex embedment, multiple strut fractures, fragment embolization to the patient’s heart,
caval perforation into the retroperitoneum, liver, uncinate process of pancreas and direct
impingement on the crossing right renal artery.” (Doc. No. 117-38 at 27).4 He continues that “the
strut perforations and fractures associated with [Plaintiffs] G2 filter were and are the result of the
filter design itself.” (/d.). As a result of these alleged failures, Dr. Allen opines that Plaintiff
“reported intermittent episodes of chest pain and tightness that may well have been related to his
filter or the fractured and/or embolized components thereof.” (/d. at 26).
According to his expert report, Dr. Allen relied on his “training, education, and experience,
[ ] reviewed the medical records and imaging and the documents cited in [his] report, the other
documents [he] mentioned in reliance, and the expert reports of Dr. McMeeking” for the specific
3 Dr. Allen cannot testify as to any design defect. If, however, other reliable expert testimony is admitted at trial that
offers the opinion that there was a design defect, in response to hypothetical questions Dr. Allen may rely upon that
expert opinion in his own testimony.
‘ The reference to plaintiff's injuries is quite non-specific. The Court is still not clear as to the “injuries” to which
either Dr. Allen is referring to specifically or the Plaintiff is claiming generally.
11
causation opinion. (Doc. No. 117-38 at 27). Bard argues that he should not be permitted to testify
as to specific causation because he cannot rely on Dr. McMeeking’s findings, and his differential
diagnosis is unreliable. (Doc. No. 63 at 19-21).
Initially, the Court finds that Rule 703 permits Dr. Allen to rely upon other expert’s
opinions, including Dr. McMeeking’s, to form his own opinion, assuming the underlying data or
opinion is reliable. State Auto. Mut. Ins. Co. v. Freehold Mgmt., Civil Action No. 3:16-CV-2255-
L, 2019 U.S. Dist. LEXIS 55052, at *27 (N.D. Tex. 2019); see also First National Bank of
Louisville v. Lustig, 96 F.3d 1554, 1576 (Sth Cir. 1996). Therefore, while Dr. Allen cannot testify
as to any specific design defect, he may rely on the admissible testimony of other experts who are
competent to testify that a design defect does exist.
Most of Dr. Allen’s specific causation opinion hinges on his “failure analysis, by way of
differential diagnosis.” (Doc. No. 117-38 at 27). A differential diagnosis is “a scientific technique
that essentially involves the process of elimination.” Sims v. Kia Motors of Am., Inc., 839 F.3d
393, 401 (Sth Cir. 2016). Although this methodology may be “reliable under Daubert when used
by medical experts,” the “results of a differential diagnosis are far from reliable per se.” Id “A
reliable differential diagnosis . . . generally is accomplished by determining the possible causes for
the patient's symptoms and then eliminating each of those potential causes until reaching one that
cannot be ruled out or determining which of those that cannot be excluded is the most
likely.” Johnson v. Arkema, Inc., 685 F.3d 452 at 468 (Sth Cir. 2012). An “expert's causation
opinions will not be excluded because he or she has failed to rule out every possible alternative
cause of a plaintiff's illness.” Chrastecky v. C. R. Bard, Inc., 2020 U.S. Dist. LEXIS 25837, 2020
WL 748182, at *6 (W.D. Tex. Feb. 14, 2020). “[O]ther possible alternative causes affect the
12
weight—not the admissibility—of an expert's testimony, unless the expert can
provide no explanation for ruling out such alternative causes at trial.” Jd.
Dr. Allen states that his differential diagnosis considered “the implantation technique and
its result, the patients’ anatomy, size of the vena cava, external forces, external stresses, his medical
history including medical procedures performed between implant and removal, and the design of
the G2 filter itself as outlined by Dr. McMeeking as reasonable possible causes of the failures,
including tilt, embedment, perforation, fractures, and fragment embolization.” (Doc. No. 117-38
at 27). He continues that he reviewed Conn’s records and Dr. Gunlock’s testimony, and from this
information “was able to eliminate the listed causes other than design of the product and found no
other reasonable cause.” (/d.).
Initially the Court notes Dr. Allen may not testify as to the cause of the strut perforations
and fractures associated with Conn’s G2 filter. He is not qualified to opine in this area. He has not
given any basis for such testimony nor has he articulated any reliable principle or method upon
which he relied. To the extent he relies upon a differential diagnosis approach (otherwise known
as a process of elimination), he may opine as to whether he could identify any medical or
anatomical condition caused the fractures, but that is the boundary limit of his expertise.
With regard to Conn’s alleged injuries, the analysis in Dr. Allen’s report fails to establish
any valid scientific methodology for how he ruled out other causes of Conn’s pain. Wooley v. Smith
& Nephew Richards, Inc., 67 F. Supp. 2d 703, 709 (S.D. Tex. 1999) (dismissing a differential
diagnosis based only on an expert’s review of medical records as a “meek attempt” to prove a
comprehensive differential diagnosis). He has not provided an explanation for how he ruled out
other potential causes to arrive at his conclusions that the Filter allegedly failed because of its
design or how the Filter’s alleged failure caused Conn’s pain. See Guillory v. Domtar Indus., Inc.,
13
95 F.3d 1320, 1331 (Sth Cir. 1996) (excluding expert opinion based on mere speculation). Dr.
Allen’s analysis glaringly offers no scientifically reliable explanation whatsoever for how he
excluded Plaintiff's numerous comorbidities, including chronic Crohn’s disease and related
complications, as alternate causes of Conn’s injuries.
The admission of Dr. Allen’s opinion is also refuted by his deposition testimony and
unsupported by facts. When asked if any of Conn’s symptoms could be attributed to the filter, Dr.
Allen testified: “I’m saying that the filter certainly could have contributed to some of his
symptomatology, and there’s no way of knowing whether it did or didn’t.” (/d. at 170:2-5). Dr.
Allen’s deposition testimony contradicts any attempt to link the Filter and its alleged failings to
Conn’s abdominal and chest pain symptoms. (Doc. No. 63-3 at 168:14-16). There is no way he
can testify to any specific pain or “symptomatology” to any degree of reasonable medical
probability. The Court determines that Dr. Allen’s specific causation opinions are therefore -
speculative and unsupported, and they warrant exclusion. See Guillory, 95 F.3d at 1331.
E. Opinions Excluded in the MDL
As previously stated, Dr. Allen may rely upon other experts’ opinions to form his own
opinion, assuming the underlying data or opinion is reliable. State Auto. Mut. Ins. Co. v. Freehold
Memt., Civil Action No. 3:16-CV-2255-L, 2019 U.S. Dist. LEXIS 55052, at *27 (N.D. Tex. 2019);
see also First National Bank of Louisville v. Lustig, 96 F.3d 1554, 1576 (5th Cir. 1996). It
follows, then, that Dr. Allen cannot rely upon other expert testimony or opinions that have already
been excluded under Daubert. Insofar as the opinions Dr. Allen intends to offer are based upon
other expert opinions that have already been specifically excluded in the MDL as being
unsupportable and inadmissible, the Court hereby excludes that testimony. The Court also
reiterates that Dr. Allen may not parrot opinions of other experts. This is especially true if he is
14
partroting impermissible hearsay evidence or opinion evidence that has been excluded. Cooper v.
Meritor, Inc., 4:16-CV-52-DMB-JMV, 2019 WL 545271, at *3 (N.D. Miss. Feb. 11, 2019)
expert may not parrot another expert's opinion when the subject relates to an issue in the
case”); Eveler v. Ford Motor Co., CV 16-14776, 2017 WL 3382460, at *9 (E.D. La. Aug. 7, 2017)
(“Unblinking reliance on another expert’s testing also renders [the expert’s] methodology
unreliable.”’).
F. Medical Device Complaints and Underreporting
Finally, Bard seeks to exclude Dr. Allen’s opinions pertaining to “medical device
complaints and underreporting.” (Doc. No. 63 at 9-10). Bard does not support its request with any
argument, and Conn did not respond. The Court hereby excludes Dr. Allen’s testimony pertaining
to “medical device complaints and underreporting” because he is not qualified to offer such an
opinion. An expert’s testimony must be limited to the bounds of his or her qualifications. Wilson,
163 F.3d at 937. Dr. Allen is not an FDA expert, nor is he being offered as one. (Doc. No. 94 at
10) “Dr. Allen does not purport to be and is not offered as a regulatory expert.”). Similarly, he
does not have special training or knowledge of the FDA reporting requirements. (Doc. No. 117-
38 at 2). He is also not an expert in the MAUDE database and has never collected data or conducted
a study on reporting rates of medical devices. While he has reviewed two materials (see Doc. No.
117-38 at 21) on medical device underreporting, he does not purport to have taken any steps to
verify their conclusions, and merely restating those conclusions does not constitute a reliable basis
for rendering an expert opinion under Rule 702. See In re Bard IVC Filters Prods. Liab. Litig.,
2018 U.S. Dist. LEXIS 9682, at *302 (citing In re Matter of Complaint of Ingram Barge Co., 2016
USS. Dist. LEXIS 107984, 2016 WL 4366509, at *4 (N.D. II. Aug. 16, 2016)). These opinions
are, therefore, excluded.
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IV. Conclusion
For the foregoing, the Court grants in part and denies in part Bard’s Motion to Exclude or Limit
Opinions and Testimony of Robert P. Allen, M.D. (Doc. No. 63).
yn
Signed at Houston, Texas, this 3 day of June 2021.
Andrew 8S. Hanen
United States District Judge
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