# S.F. v. Denton County

> District Court, E.D. Texas · May 27, 2025

URL: https://www.frixlaw.com/law-library/cases/11059873

## Case

- **Court:** District Court, E.D. Texas
- **Decided:** May 27, 2025
- **Opinion:** 100trialcourt
- **Cited by:** 0 later opinions in the Frix Law Library

## Citator (automated)

- No negative treatment found by the automated citator. That is not the same as a confirmation that the case is good law; read the citing cases.
- Full citator and citing cases: https://www.frixlaw.com/law-library/cases/11059873

## How later opinions describe it (automated extraction)

- explaining that a “plaintiff must demonstrate that a municipal decision reflects deliberate indifference to the risk that a violation of a particular constitutional or statutory right will follow the decision” (quoting Bd. of the Cnty. Comm’rs v. Brown, 520 U.S. 397, 411 (1997)
- explaining that, “[a]lthough the Daubert analysis is applied to ensure expert witnesses have employed reliable principles and methods in reaching their conclusions, the test does not judge the expert conclusions themselves”
- stating that a pretrial detainee has a right to medical care

## Opinion text

IN THE UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRICT OF TEXAS
SHERMAN DIVISION

S.F. §
§
v. § NO. 4:23-CV-00864-ALM-BD
§
DENTON COUNTY, TEXAS, et al. §

MEMORANDUM OPINION AND ORDER
Plaintiff S.F. filed a motion to strike defense expert Dr. Nicholas Longnecker, MD. Dkt. 56; see
Dkts. 62 (response), 65 (reply), 69 (sur-reply); see also Dkt. 70 (response to sur-reply filed without
leave of court). The motion will be granted in part and denied in part.
BACKGROUND
According to her operative complaint, S.F. was on deferred adjudication community
supervision when the terms of her supervision were modified to recommend inpatient substance-
use treatment at a residential facility called Christian Farms Treehouse. Dkt. 36 at 3. S.F. was
permitted to seek immediate treatment for her addiction, which included an addiction to fentanyl,
from Denton Treatment Services and then to surrender to the Denton County Jail to await transfer
to Christian Farms.
At Denton Treatment Services, which offers a supervised substance-use rehabilitation
program that provides medication to people with opioid-use disorder (“OUD”), S.F. was
diagnosed with that disorder and prescribed methadone. That type of medication is sometimes
called an “MOUD,” short for medication for opioid-use disorder. Its use is also sometimes called
“MAT,” short for medically assisted treatment.
For approximately one week, S.F. received a daily dose of methadone until she self-surrendered
to the Denton County Jail. The next day, a counselor from Denton Treatment Services emailed a
copy of S.F.’s treatment plan and assessments, including her MAT dosage, to defendant John
Kissinger, the Correctional Health Administrator for defendant Denton County Public Health, the
department that provides healthcare at the Denton County Jail. The counselor received no
response from Kissinger, and S.F. did not receive her daily dose of methadone that day. S.F.
immediately began to feel opioid withdrawal symptoms. Three days later, the counselor again
emailed Kissinger, who told the counselor that the jail would not provide S.F. with methadone.
S.F. remained in the Denton County Jail for three months before being transferred to Christian
Farms. During that time, the jail did not provide her any methadone.
About a month after her transfer to Christian Farms, S.F. was medically discharged. But she
failed to comply with a term of her supervision, so the government moved for an adjudication of
guilt. She later self-surrendered to the Denton County Jail. Again, the jail did not give her
methadone, and she experienced withdrawal symptoms for 12 days before she was transferred to a
different facility.
S.F. sued defendants Denton County, Texas; Public Health; Matt Richardson, in his official
capacity as Director of Public Health; and Kissinger in his official capacity. Dkt. 36 (operative
complaint). She complains of violations of Title II of the Americans with Disabilities Act
(“ADA”); the Rehabilitation Act; the Patient Protection and Affordable Care Act; the Fifth,
Eighth, and Fourteenth Amendments; and article 16.22 of the Texas Code of Criminal Procedure.
The county designated Dr. Longnecker as an expert. See Dkt. 53 (designation); 56-2 at 19–24
(curriculum vitae and expert report). After reviewing several documents, including a Department
of Justice (“DOJ”) handout about the ADA, Longnecker drafted a report summarizing facts and
stating several of his opinions. Dkt. 56-2 at 20–24.
In particular, Longnecker opined that (1) S.F. was not compliantly or actively on methadone at
the time of either of her incarcerations, so there was no indication to the jail to provide MAT;
(2) even if S.F. had been on methadone before intake, her self-reported use of illicit substances
removed her ADA protection and any requirement to continue that treatment in the jail; (3) there
is a grave risk of severe overdose when using both fentanyl and methadone, and that risk was
another reason the jail should not have administered methadone to S.F.; (4) the jail’s decision to
provide medically assisted detox, rather than MAT, to S.F. during her first incarceration was
medically appropriate because she would not have been able to continue MAT once transferred to
Christian Farms; (5) the jail’s treatment of S.F., including its treatment of her withdrawals, during
both of her incarcerations was within the acceptable standard of care; (6) the jail’s treatment of
S.F. was consistent with the ADA and DOJ expectations; (7) no evidence exists that the jail had a
blanket policy prohibiting MAT, as reflected by the jail’s administration of MAT when the
appropriate conditions are met; and (8) S.F. did not suffer from severe withdrawal. S.F. asks the
court to exclude or limit that testimony.
LAW
Federal Rule of Evidence 702 governs the admissibility of expert testimony. It was amended a
couple of years ago to provide:
A witness who is qualified as an expert by knowledge, skill, experience, training, or
education may testify in the form of an opinion or otherwise if the proponent
demonstrates to the court that it is more likely than not that:
(a) the expert’s scientific, technical, or other specialized knowledge will help
the trier of fact to understand the evidence or to determine a fact in issue;
(b) the testimony is based on sufficient facts or data;
(c) the testimony is the product of reliable principles and methods; and
(d) the expert’s opinion reflects a reliable application of the principles and
methods to the facts of the case.
The 2023 advisory committee note explains that the amendment was meant to (1) “clarify and
emphasize that expert testimony may not be admitted unless the proponent demonstrates to the
court that it is more likely than not that the proffered testimony meets the admissibility
requirements set forth in the rule” and (2) “emphasize that each expert opinion must stay within
the bounds of what can be concluded from a reliable application of the expert’s basis and
methodology.”
In Daubert v. Merrell Dow Pharmaceuticals, the Supreme Court instructed courts to serve as
gatekeepers when applying Rule 702 to determine whether expert testimony should be presented
to the jury. 509 U.S. 579, 589–95 (1993). Courts must “make certain that an expert, whether basing
testimony upon professional studies or personal experience, employs in the courtroom the same
level of intellectual rigor that characterizes the practice of an expert in the relevant field.” Kumho
Tire Co. v. Carmichael, 526 U.S. 137, 152 (1999). That “gate-keeping obligation applies to all types
of expert testimony, not just scientific testimony.” Pipitone v. Biomatrix, Inc., 288 F.3d 239, 244
(5th Cir. 2002).
Under the Daubert test, which examines the underlying theory on which an expert opinion is
based, “[t]he proponent need not prove to the judge that the expert’s testimony is correct, but she
must prove by a preponderance of the evidence that the testimony is reliable.” Moore v. Ashland
Chem., Inc., 151 F.3d 269, 276 (5th Cir. 1998). The court’s inquiry is flexible, in that “[t]he
relevance and reliability of expert testimony turns upon its nature and the purpose for which its
proponent offers it.” United States v. Valencia, 600 F.3d 389, 424 (5th Cir. 2010).
The Fifth Circuit explained several decades ago that, “[a]s a general rule, questions relating to
the bases and sources of an expert’s opinion affect the weight to be assigned that opinion rather
than its admissibility and should be left for the [factfinder’s] consideration.” Viterbo v. Dow Chem.
Co., 826 F.2d 420, 422 (5th Cir. 1987). And although the 2023 advisory committee note to Rule
702 criticized unspecified judicial decisions concluding that “critical questions of the sufficiency
of an expert’s basis, and the application of the expert’s methodology, are questions of weight and
not admissibility,” it also acknowledged that “[s]ome challenges to expert testimony will raise
matters of weight rather than admissibility even under the [Federal] Rule 104(a) standard,” which
is less permissive than Rule 104(b). Compare Fed. R. Evid. 104(a) (providing that “[t]he court must
decide any preliminary question about whether a witness is qualified, a privilege exists, or evidence
is admissible”) with id. R. 104(b) (providing that “[w]hen the relevance of evidence depends on
whether a fact exists, proof must be introduced sufficient to support a finding that the fact does
exist” and that “[t]he court may admit the proposed evidence on the condition that the proof be
introduced later”). In other words, “once the court has found it more likely than not that the
admissibility requirement has been met, any attack by the opponent will go only to the weight of
the evidence.” Fed. R. Evid. 702, advisory cmte. n. to 2023 amendment.
It remains the case that “[v]igorous cross-examination, presentation of contrary evidence, and
careful instruction on the burden of proof are the traditional and appropriate means of attacking
shaky but admissible evidence.” Daubert, 509 U.S. at 596; see also Guy v. Crown Equip. Corp., 394
F.3d 320, 325 (5th Cir. 2004) (explaining that, “[a]lthough the Daubert analysis is applied to ensure
expert witnesses have employed reliable principles and methods in reaching their conclusions, the
test does not judge the expert conclusions themselves”). Although “the district court must act as
a gatekeeper to exclude all irrelevant and unreliable expert testimony, ʻthe rejection of expert
testimony is the exception rather than the rule.’” Puga v. RCX Sols., Inc., 922 F.3d 285, 294 (5th
Cir. 2019) (quoting Fed. R. Evid. 702 advisory cmte. n. to 2000 amendment).
SCOPE OF REVIEW
The county argues that S.F.’s reply was untimely and should be struck. Dkt. 69 at 2. It is
mistaken. The court-ordered deadline for S.F. to file her reply was January 22, 2025, Dkt. 61, and
S.F. met that deadline, Dkt. 65. The court will therefore consider the reply. It will not, however,
consider S.F.’s response to the county’s sur-reply, which S.F. did not seek leave of court to file.
Dkt. 70; see Loc. R. CV-7(f). That document will be struck.
In her reply, S.F. objected to two documents attached to the county’s response that were
created to address arguments asserted in S.F.’s motion to strike. See Dkt. 62 at 2, 18–27. S.F.
objects to those documents as untimely but cites no authority supporting her position. The county
responds that it timely satisfied Rule 26(a)(2) when it initially designated Longnecker and provided
S.F. with his curriculum vitae and report. Dkt. 69 at 2. The court will consider the documents.
DISCUSSION
I. Longnecker’s Qualifications to Provide Expert Testimony
S.F. seeks to exclude Longnecker because he is not qualified to opine on addiction medicine,
the ADA, Denton County policies, and DOJ policies. Her argument fails on the first point but
succeeds on the final three.
A. Longnecker’s qualification to opine on addiction medicine
S.F. argues that Longnecker is not qualified to offer an expert medical opinion on addiction
medicine, Dkt. 56 at 1, a medical subspecialty that, according to S.F., “requires knowledge of the
pharmacology and pharmacokinetics of addiction medications” and “an understanding of the
neuroscience and psychiatry of addiction,” id. at 7. She asserts that Longnecker might be qualified
to talk about the administration of some medications in a correctional setting for general ailments
but lacks certification or advanced training in addiction medicine and lacks training in psychiatry
and addiction psychiatry. She notes that Longnecker has not published any articles or edited any
scholarly journals, let alone any on addiction medicine or medications for OUD. Id.
The county responds that, in addition to his education, Longnecker gained experience in
addiction medicine through his work at several facilities over the course of many years. Dkt. 62 at
3–5. In its view, Longnecker is qualified based on his experience, his lack of publication
notwithstanding, and S.F.’s argument goes to the weight rather than the reliability of his testimony.
Id. at 13–14.
The county has the better argument. “Rule 702 does not require a witness to publish articles
or conduct research in order to qualify as an expert”; rather, “such a consideration guides the
court’s evaluation of the reliability of an expert’s opinion, not a determination of whether he is
qualified to offer expert testimony.” EEOC v. Mod. Grp., Ltd., 725 F. Supp. 3d 644, 663 (E.D. Tex.
2024). And Longnecker need not have “specific experience and training matched precisely to the
circumstances at issue.” Id. at 663 (collecting cases). Our neighboring court found Longnecker
qualified to opine on an inmate’s cause of death even though he did “not have precise experience
with autopsies or determining causes of death” because of his “extensive knowledge, skill,
experience, training, and education in healthcare — specifically, as a correctional healthcare
professional.” Douglas v. Potter County, No. 2:24-CV-030-Z-BR, 2025 WL 824582, at *4–5 (N.D.
Tex. Mar. 13, 2025).
As relevant here, Longnecker has years of experience treating addiction, overseeing MAT, and
treating inmates. According to his declaration, Longnecker worked at Greenbriar Treatment
Center and the Washington County Jail for two years. Dkt. 62 at 20. He evaluated and treated
patients suffering from addiction there. And at the Washington County Jail, he managed patients
with addiction disorders. For the next six-and-a-half years, he worked at the University of
Pittsburgh Medical Center, where he regularly treated patients suffering from addiction and
managed their addiction medications. For a year-and-a-half after that, he worked at WellPath,
where he oversaw the MAT program for Albion Prison. And since 2022, he has worked at
CorrHealth, where he is responsible for directing inmate medical care. He also developed and
manages its MAT program for sites across four States.
Other physicians have been deemed qualified on addiction medicine without having specific
experience and training matched precisely to the circumstances at issue in the cases at hand. For
example, this court found another physician qualified to opine on the use of methadone and the
interaction between it and Xanax because he specialized in addiction medicine, treated patients
with substance-use disorders, and regularly prescribed opioids. Mod. Grp., Ltd., 725 F. Supp. 3d at
663. The court did not demand that the physician prescribe methadone for the treatment of
addiction, regularly prescribe Xanax, work in an opioid treatment program, or personally observe
the effects of both medications. Id. at 662–64.
Likewise, in Johnson v. Dart, the Northern District of Illinois found a physician qualified “to
discuss the standard of care for health workers and [opioid-treatment programs] in the correctional
setting” because he was licensed to practice in California, had taken and passed the National
Commission on Correctional Health Care examination to become a Certified Correctional
Healthcare Professional, and had over 20 years of experience working as a doctor in correctional
settings. No. 16 CV 144, 2020 WL 8255194, at *3, 8 (Dec. 18, 2020), report and recommendation
adopted, No. 16 C 144, 2021 WL 12302695 (Feb. 18, 2021). The court rejected the plaintiff’s
argument that the physician was unqualified because he was not board certified in addiction
medicine, stating that board certification was not necessary and that he was qualified based on his
years of experience treating inmates struggling with addiction issues. Id. at *8.
Similarly, in Adams v. Hooper, the Northern District of Alabama determined that a physician
was “qualified to provide an expert opinion on the standard of care in methadone maintenance”
because he was “trained in methadone maintenance during his residency” and “helped design and
set up a methadone maintenance clinic.” No. 7:12-CV-1942-LSC, 2013 WL 5777032, at *3 (Oct.
25, 2013). “As part of that work, he prepared written protocols for increasing methadone
dosages.” Id. He also “gave a presentation entitled ʻA Forensic Approach to Death in Methadone
Treatment’ to the American College of Forensic Psychiatrists.” Id. Although the defendant argued
that the physician was unqualified based on his lack of recent experience in methadone
maintenance, the court rejected that argument, finding that he had “knowledge of methadone
maintenance, education in methadone maintenance, and training in methadone maintenance.” Id.
He also had “more recent experience prescribing methadone to patients.” Id. The court added
that the defendant could “adequately expose any deficiencies in [the physician’s] qualifications,
such as his lack of more recent experience in methadone maintenance, to the fact finder through
cross examination.” Id.
Longnecker is likewise qualified to opine on addiction medicine. S.F. can pursue any
deficiencies in his qualifications at trial. See Fed. R. Evid. 702, advisory cmte. n. to 2023
amendment; Daubert, 509 U.S. at 596.
B. Improper topics of expert testimony
1. The ADA
S.F. argues that Longnecker is not qualified to testify as to his legal conclusions about whether
illicit substance abuse removes ADA protection. Dkt. 56 at 10–11. The county responds that
Longnecker is qualified to draw that conclusion because he cited DOJ guidance and because he is
experienced both in determining whether to offer MAT for OUD in a correctional setting and in
drafting policies and procedures addressing that issue. Dkt. 62 at 5–7. The county adds that
Longnecker also regularly encounters inmate-patients who need ADA accommodations.
S.F. is correct on this point. “[A]n expert may never render conclusions of law,” Goodman v.
Harris County, 571 F.3d 388, 399 (5th Cir. 2009), so Longnecker’s conclusions about the
requirements of the ADA should be struck, Mod. Grp., Ltd., 725 F. Supp. 3d at 691–92 (striking
expert opinions offering legal conclusions as to what the ADA requires); EEOC v. MJC, Inc.,
No. 17-00371 SOM-WRP, 2019 WL 2992013, at *3–4 (D. Haw. July 9, 2019) (same); Nat’l Ass’n
of the Deaf v. Dist. Hosp. Partners, L.P., No. CV 14-1122 (RC), 2016 WL 447444, at *3 (D.D.C. Feb.
4, 2016) (same).
2. County policies
S.F. argues that Longnecker is not qualified to testify that the Denton County Jail does not have
a blanket policy prohibiting MAT. Dkt. 56 at 11–12. She says that the record does not show that
Longnecker has worked at the jail, that his employer has performed services there, or that he has
reviewed the jail’s or Public Health’s policies. In response, the county argues that Longnecker’s
opinions about the jail policies are based on his review of materials, including all of the documents
that S.F. produced, showing that the jail did administer MAT in some clinically warranted
situations. Dkt. 62 at 7–8.
The entirety of Longnecker’s opinion about the jail’s policies reads as follows: “[N]o evidence
exists that the Denton County Jail had a blanket policy prohibiting MAT. Conversely, there is
evidence of MAT administration at the jail when the appropriate condition(s) were met (i.e.
pregnancy).” Dkt. 56-2 at 24. That is not proper expert testimony. See Robroy Indus.-Tex., LLC v.
Thomas & Betts Corp., No. 2:15-CV-512-WCB, 2017 WL 1319553, at *9–10 (E.D. Tex. Apr. 10,
2017) (collecting cases). The jury does not need expert testimony to determine what evidence is in
the record when it “can easily reach reliable conclusions based on common sense, common
experience, and [jurors’] own perceptions.” Id. at *9 (quoting 29 Charles Alan Wright, Federal
Practice and Procedure § 6265.2 (2d ed. Supp. 2025)); see Fed. R. Evid. 702(a) (requiring expert
testimony to “help the trier of fact to understand the evidence or to determine a fact in issue”).
3. DOJ policies
S.F. argues that, in the absence of any evidence or training showing otherwise, Longnecker is
not qualified to opine as an expert that the jail provided treatment consistent with DOJ policies. Id.
at 12–13. The county responds that Longnecker is qualified to opine on those policies because of
his experience treating people with addiction and developing and managing a MAT program in a
correctional setting. It adds that S.F.’s arguments go to the weight and not the admissibility of his
opinions.
Longnecker stated that the jail’s treatment of S.F. was “consistent with . . . DOJ
expectations.” Dkt. 56-2 at 24. He did not, however, specify what expectations he had in mind.
And his report mentioned only one DOJ report: a document that “provides informal guidance” to
the public, the contents of which “do not have the force and effect of law and are not meant to bind
the public in any way.” DOJ Civil Rights Division, The Americans with Disabilities Act and the Opioid
Crisis: Combating Discrimination Against People in Treatment or Recovery, https://archive.ada.gov/
opioid_guidance.pdf.
The jury does not need an expert to opine on a document that was drafted for the public. See
Fed. R. Evid. 702(a). And if Longnecker meant to convey his opinion that, based on his
understanding of the ADA’s requirements described in that document, the jail complied with the
ADA, he was expressing a prohibited legal conclusion. See Goodman, 571 F.3d at 399.
II. Relevance
S.F. argues that Longnecker’s testimony about whether the jail treated her withdrawals is
irrelevant. Dkt. 56 at 5–6. In her view, the issue is whether the jail treated her alleged disability—
that is, her OUD—as opposed to her withdrawal symptoms. The county responds that Longnecker
does not opine that withdrawal is a disability but instead that illicit drug use excluded S.F. from
ADA protection, that she received reasonable medical treatment at the Denton County jail, and
that her MAT prescription could not be verified. Dkt. 62 at 10.
As already noted, Longnecker cannot properly opine on the contours of the ADA’s protection.
But he can properly opine on the other points.
To succeed on her § 1983 claim, S.F. must show deliberate indifference as to her constitutional
right to medical care. See, e.g., Garza v. City of Donna, 922 F.3d 626, 632 (5th Cir. 2019) (stating
that a pretrial detainee has a right to medical care); Valle v. City of Houston, 613 F.3d 536 (5th Cir.
2010) (explaining that a “plaintiff must demonstrate that a municipal decision reflects deliberate
indifference to the risk that a violation of a particular constitutional or statutory right will follow
the decision” (quoting Bd. of the Cnty. Comm’rs v. Brown, 520 U.S. 397, 411 (1997)). Longnecker’s
opinion about whether it was medically reasonable for S.F. to be treated for her withdrawals rather
than being given MAT is relevant to that showing. Whether S.F. was “compliantly or actively on
MAT at the time of incarceration,” Dkt. 56-2 at 23, informed that opinion and is therefore
relevant.
III. Reliability
S.F. argues that Longnecker’s opinions regarding county policies and the applicable standard
of care are unreliable. Her argument succeeds on the first point but fails on the second.
A. County policies
S.F. argues that Longnecker’s opinion about the county’s policies is unreliable because it is not
based on any instances of the jail actually providing MAT. As already noted, the county refutes
that assertion based on Longnecker’s review of county records.
But even if Longnecker reached his conclusions about the county’s policies after reviewing
relevant records, he does not identify which facts in the record he relied on or what method he
used to reach his conclusion. See Fed. R. Evid. 702(b) (requiring expert testimony to be “based on
sufficient facts or data”). In addition to being beyond the scope of proper expert testimony, see
supra Part I.B.2, that part of Longnecker’s opinion should also be excluded on reliability grounds.
B. Standard of care
S.F. argues that the scientific and medical community regards methadone, buprenorphine, or
naltrexone as the standard of care for treating OUD. Dkt. 56 at 8. In her view, Longnecker’s
opinion that forced withdrawal, followed by treatment of withdrawal symptoms, constitutes
effective treatment for Opioid Use Disorder “is so far outside the established medical community
as to be unreliable, unsupportable, and viewed with extreme skepticism.” Id. at 9. She cites sources
supporting that view and asserts that Longnecker’s contrary opinion has not been subject to peer
review or published.
The county argues that the evidence does not establish that S.F. was on methadone before
either of her two incarcerations and that it does establish that she was illicitly using controlled
substances before incarceration. Dkt. 62 at 11. It adds that Longnecker did not opine that treating
the withdrawals is the standard of care for treating OUD. According to the county, Longnecker
said that medical withdrawal is appropriate for a person who is actively abusing drugs and not on
MAT. The county also faults the sources that S.F. cites because they do not address treatment in
a correctional setting.
In reply, S.F. points out that Longnecker failed to consider an email in the record showing that
Kissinger knew S.F. was participating in MAT immediately before her first incarceration. Dkt. 65
at 2–3. The county responds that the email does not “show evidence of any dose of Methadone
provided to Plaintiff or otherwise establish that she had actually beg[un] receiving MAT therapy.”
Dkt. 69 at 3.
The county has the better argument. Longnecker states that, because S.F. admitted to ongoing
illicit-substance abuse and did not mention being on MAT, he believed that S.F. was not
“compliantly and actively on MAT” and that “there was no indication for MAT administration
during” either of her incarcerations. Dkt. 56-2 at 22–23. Longnecker opined that, instead of MAT,
“medically assisted withdrawal treatment with close monitoring” was within the acceptable
standard of care. Id. at 23–24.
Longnecker does not opine, as S.F. argues, that forced withdrawal would be within the
acceptable medical standard of care in all circumstances. And even if he did, S.F.’s argument that
Longnecker’s opinion is “far outside the established medical community,” Dkt. 56 at 9, would still
fail. The “general acceptance” factor from Daubert questions whether a theory or technique is
reliable. Daubert, 509 U.S. at 594. “A proponent need not prove to the judge that the expert’s
testimony is correct,” but only that it is based on reliable methods. Moore, 151 F.3d at 276. That
means that it does not matter, at this stage, whether Longnecker is correct in finding forced
withdraw reasonable. What matters is how he reached that conclusion, and his report makes that
sufficiently clear. If S.F. disagrees with Longnecker, she may try to convince the jury of her view
through cross-examination.
As to the sufficiency of the facts and data supporting Longnecker’s opinion, the county again
has the better argument. Regardless of the email to Kissinger or S.F.’s alleged failure to mention
MAT treatment at intake, Longnecker supported his opinion that MAT was not appropriate
during S.F.’s first incarceration with sufficient facts and data. He opined that it was medically
appropriate to provide “medically-assisted detox” because S.F. would not have been able to
continue MAT after her transfer to Christian Farms, a facility that does not provide MAT. Dkt. 56-
2 at 23. Further, Longnecker cited the “grave risk of severe overdose when using both fentanyl and
methadone” as another reason the jail should not have administered methadone. Dkt. 56-2 at 22.
That is enough for the matter to go to the jury.
IV. Unchallenged Opinions
A district court has “considerable leeway in deciding in a particular case how to go about
determining whether particular expert testimony is reliable.” Kumho Tire Co. v. Carmichael, 526
U.S. 137, 152 (1999). That leeway allows the court, acting “within its discretionary gatekeeper
role,” to consider sua sponte whether expert testimony should be excluded. Doucette v. Jacobs, 106
F.4th 156, 171 (1st Cir. 2024). Here, the court will consider two topics of expert opinion to which
S.F. did not object.
The first is Longnecker’s opinion that, because using both fentanyl and methadone creates a
serious risk of overdose, the jail should not have administered methadone under the acceptable
standard of care. Longnecker’s experience qualifies him to testify about the risks of mixing those
substances and whether it was within the reasonable standard of care for the jail not to provide
MAT if it was aware of that risk. The court sees no reason to find that testimony unreliable. But as
already noted, Longnecker may not opine on whether that risk affected the jail’s legal
responsibilities to S.F. under the ADA.
The second topic is Longnecker’s opinion about the severity of S.F.’s withdrawal symptoms.
See Dkt. 56-2 at 24. Longnecker’s education and experience qualify him to opine on that topic. And
the court sees no reason to find that category of his testimony unreliable or otherwise inadmissible.
See United States v. Dixon, 185 F.3d 393, 400 (5th Cir. 1999).

CONCLUSION
It is ORDERED that S.F.’s response, Dkt. 70, to the county’s sur-reply is STRUCK.
It is FURTHER ORDERED that S.F.’s motion to strike, Dkt. 56, is GRANTED in part and
DENIED in part. Longnecker may not offer expert testimony on whether (1) S.F.’s self-reported
use of illicit substances removed her from the ADA’s protection; (2) the jail had any legal
obligation to continue MAT; (3) the jail’s treatment of S.F. was consistent with ADA and DOJ
expectations; (4) evidence exists that the jail either had a blanket policy prohibiting MAT or had
administered MAT when the appropriate conditions were met.
Longnecker may, however, opine on (1) whether S.F. was compliantly or actively on
methadone at the time of either of her two incarcerations and, if she was not, whether MAT was
appropriate; (2) whether there is a grave risk of severe overdose when using both fentanyl and
methadone and whether that risk was another reason the jail should not have administered
methadone to S.F. under the acceptable standard of care; (3) whether the jail’s decision to provide
medically assisted detox, rather than MAT, to S.F. during her first incarceration was medically
appropriate, considering that S.F. would not have been able to continue MAT once transferred to
Christian Farms; (4) whether the jail’s treatment of S.F. during both incarcerations, including its
treatment of her withdrawals, was within the acceptable standard of care; and (5) the severity of
S.F.’s withdrawal.

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/11059873. Public record. Not legal advice.