# National Bank of Commerce v. Dow Chemical Co.

> District Court, E.D. Arkansas · December 30, 1996 · 965 F. Supp. 1490

URL: https://www.frixlaw.com/law-library/cases/2139332

## Case

- **Full name:** NATIONAL BANK OF COMMERCE (OF EL DORADO, ARKANSAS), Guardian of the Estate (Only) of Ashley Marie Smits, a Minor, and William J. Smits, Jr., Individually, Plaintiffs, v. DOW CHEMICAL CO. Et Al., Defendants
- **Court:** District Court, E.D. Arkansas
- **Decided:** December 30, 1996
- **Citations:** 965 F. Supp. 1490; 1996 U.S. Dist. LEXIS 21034; 1996 WL 897619
- **Precedential status:** Published
- **Opinion:** Opinion by Eisele
- **Judges:** Eisele
- **Cited by:** 19 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/2139332

## How later opinions describe it (automated extraction)

- finding expert unreliable after noting that her testimony was tainted by “litigation animus”

## Opinion text

MEMORANDUM AND ORDER
EISELE, Senior District Judge.
Before the Court is the Pesticide Defendants’
1
Motion to Exclude Opinion Testimony of Plaintiffs’ Expert Witnesses; the Pesticide Defendants’ Motion for Summary Judgment; and the Plaintiffs’
Daubert
Mo-ti°n and their response to all of the above, This Order will address the admissibility of plaintiffs’ expert testimony as it relates to the pesticide known as Dursban LO.
The Pesticide Defendants seek to strike the causation testimony of the following plaintiffs’ expert witnesses: Morris Cranmer, Gunnar Heuser, Robert Laird, Jesse Bidanset, Janette Sherman, and Jane Miers.
2
The Court will attempt to evaluate each of said experts and his or her contested testimony but only to the extent necessary to determine if their proffered testimony meets the standards set forth in
Daubert v. Merrell Dow Pharmaceuticals, Inc.,
509 U.S. 579 , 113 S.Ct. 2786 , 125 L.Ed.2d 469 (1993), which focuses primarily on Federal Rules of Evidence 702 and 703. From the pre-September 12, 1996, submissions of the plaintiffs the Court has prepared a rough summary of the key testimony expected of these witnesses, which summary is attached hereto as Appendix A. The Court will separately deal with the “live” testimony of Dr. Sherman at the September 12, 1996, hearing.
When a serious challenge is made to the admissibility of expert scientific evidence, the Court will ordinarily hold an
in limine
hearing or conference to consider the disputed evidence and then make the findings required by
Daubert .
Here, the Pesticide Defendants, through their filings and submissions, have raised such a challenge to plaintiffs’ expert causation evidence. Therefore, an on-the-record conference and argument was held on March 27, 1996. A second hearing was held on September 12, 1996, at which the plaintiffs put on the testimony of Dr. Sherman. After the testimony of Dr. Sherman, further oral arguments were made by the parties. This Memorandum and Order will deal with the issues raised by the pending motions and by the
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arguments made by the parties orally and in their written submissions.
On May 16, 1996, this Court entered a written order granting separate defendant Steam Services’ Motion to Strike Plaintiffs’ Expert Witnesses and for Summary judgment. That order reviewed at some length the
Daubert
decision and its progeny.
3
Much of what was said there will be repeated here (with very few changes) so that this opinion can better stand on its own.
I. FACTS
According to the plaintiffs’ submissions, Mrs. Maria Smits was employed at the Eagle Bank in Sherwood, Arkansas, during the early months of 1991. The date of conception of Ashley Smits was on or about January 16, 1991. Ashley was born on September 20, 1991, with multiple birth defects. On October 4, 1993, Maria Smits and her husband, William Smits, had a son who is perfectly normal.
On February 5, 1991, Maria Smits first learned that she was pregnant. On February 6, 1991, the Adams Pest Control Company made a “crack and crevice” application of a 0.5%
4
solution of Dursban LO in water around the baseboards in the interior of the Eagle Bank Building. This work began around 4:00 p.m. Mrs. Smits states that she worked there that day until 6:00 p.m.
On February 11, 1991, there was a small electrical fire at the Bank. On the same day (after the fire was put out) Steam Services applied Firefog 404, a reorderant. Mrs. Smits worked that day from 12:00 noon until 6:30 p.m. and, indeed, continued to work at the Eagle Bank in Sherwood until the first part of April, 1991, a period of approximately two months.
Plaintiffs allege that Mrs. Smits was continuously exposed to Firefog and Dursban while she worked at the bank since those chemical agents remained in the Bank and continued to be volatilized into the air and inhaled by her and that she was also exposed to the chemicals through skin exposure since those chemicals were left on the various surfaces in the Bank.
Plaintiffs state that Maria Smits became nauseated after her exposure to Dursban LO on February 6, 1991, and that she vomited that night. It is also claimed that after exposure to the Firefog 404 Mrs. Smits could taste the chemicals (a sweet taste) in her mouth and that she could smell the odor of the chemicals.
Plaintiffs allege that Mrs. Maria Smits was a young and healthy, woman, well-nourished, a non-smoker, a non-user of alcohol and that she did not take any known teratogenic drugs during her pregnancy. Plaintiffs also allege that Mrs. Smits had no family history of birth defects and had no detectible genetic defects and that Ashley’s blood lead was normal at birth. Plaintiffs allege that Maria Smits was exposed to Dursban LO during a critical time in Ashley’s development — that is, during the period of time when her nervous and other developing systems were most sensitive to such chemical agents. It is important, in the evaluation of plaintiffs’ expert testimony, to have some knowledge of Dursban’s ingredients. Although defendants’ experts do not fully agree, the Court will accept the plaintiffs’ expert’s description of the Dursban
5
Ingredients:
6
* Chlorpyrifos
7
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(NOTE: The formula and ingredients are filed with this opinion Under Seal because of defendants’ assertion that same constitutes a trade secret or confidential proprietary information. The footnotes to same are not deleted.)
II. STANDARD OF ADMISSIBILITY
We start with Justice Blackmun’s opinion in
Daubert .
After concluding that the
Frye
Rule
11
(“that austere standard”) should not be applied in federal trials,
Daubert,
509 U.S. at 589 , 113 S.Ct. at 2794 , Justice Blackmun went on to discuss the proper test for admissibility of scientific evidence. He pointed out that Rule 702 nowhere refers to the “general acceptance” test of
Frye.
He then explained as follows:
That the
Frye
test was displaced by the Rules of Evidence does not mean, however, that the Rules themselves place no limits on the admissibility of purportedly scientific evidence. Nor is the trial judge disabled from screening such evidence. To the contrary, under the Rules the trial judge must ensure that any and all scientific testimony or evidence admitted is not only relevant, but reliable.
The primary locus of this obligation is Rule 702, which clearly contemplates some degree of regulation of the subjects and theories about which an expert may testify.
“If scientific,
technical, or other specialized
knowledge will assist the trier of fact
to understand the evidence or to determine a fact in issue” an expert “may testify
thereto.”
The subject of an expert’s testimony must be “scientific ... knowledge.” The adjective “scientific” implies a grounding in the methods and procedures of science. Similarly, the word “knowledge” connotes more than subjective belief or unsupported speculation. The term “applies to any body of known facts or to any body of ideas inferred from such facts or accepted as truths on good grounds.” Webster’s Third New International Dictionary 1252 (1986). Of course, it would be unreasonable to conclude that the subject of scientific testimony must be “known” to a certainty; arguably, there are no certainties in science.
* * * * * *
But, in order to qualify as “scientific knowledge,” an inference or assertion must be derived by the scientific method. Proposed testimony must be supported by appropriate
validation
— i.e., “good grounds,” based on what is known. In short, the requirement that an expert’s testimony pertain to “scientific knowledge” establishes a standard of evidentiary reliability.
Daubert,
509 U.S. at 589-90 , 113 S.Ct. at 2794-95 (emphasis in original). It is important also to consider Justice Blackmun’s footnote to this observation:
We note that scientists typically distinguish between “validity” (does the principle support what it purports to show?) and “reliability” (does application of the principle produce consistent results?).
******
... our reference here is to
evidentiary
reliability — that is, trustworthiness.
******
In a ease involving scientific evidence,
evidentiary reliability
will be based upon
scientific validity.
Id.,
at n. 9. The majority opinion then goes on to state that:
Rule 702 further requires that the evidence or testimony “assist the trier of fact to understand the evidence or to determine a fact in issue.” This condition goes pri
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marily to relevance. “Expert testimony which does not relate to any issue in the case is not relevant and, ergo, non-helpful.”
* Hs * * * *
Rule 702’s “helpfulness” standard requires a valid scientific connection to the pertinent inquiry as a precondition to admissibility.
That these requirements are embodied in Rule 702 is not surprising. Unlike an ordinary witness, see Rule 701, an expert is permitted wide latitude to offer opinions, including those that are not based on firsthand knowledge or observation. See Rules 702 and 703. Presumably, this relaxation of the usual requirement of firsthand knowledge — a rule which represents “a ‘most pervasive manifestation’ of the common law insistence upon ‘the most reliable sources of information,’” Advisory Committee’s Notes on Fed.Rule Evid. 602 (citation omitted) — is premised on an assumption that the expert’s opinion will have a reliable basis in the knowledge and experience of his discipline.
Dcmbert,
509 U.S. at 591-92 , 113 S.Ct. at 2796 .
With this doctrinal background in mind, Justice Blackmun then provides the trial judge with practical instructions on how to proceed when expert scientific testimony is challenged:
Faced with a proffer of expert scientific testimony, then,, the trial judge must determine at the outset, pursuant to Rule 104(a), whether the expert is proposing to testify to (1) scientific knowledge that (2) will assist the trier of fact to understand or determine a fact in issue. This entails a preliminary assessment of whether the reasoning or methodology underlying the testimony is scientifically valid and of whether that reasoning or methodology properly can be applied to the facts in issue. We are confident that federal judges possess the capacity to undertake this review. Many factors will bear on the inquiry, and we do not presume to set out a definitive checklist or test. But some general observations are appropriate.
Ordinarily, a key question to be answered in determining whether a theory or technique is scientific knowledge that will assist the trier to fact will be whether it can be (and has been) tested. “Scientific methodology today is based on generating hypotheses and testing them to see if they can be falsified; indeed, this methodology is what distinguishes science from other fields of human inquiry.”
Green
at 645. See also C. Hempel,
Philosophy of Natural Science
49 (1966) (“[T]he statements constituting a scientific explanation must be capable of empirical test”); K. Popper,
Conjectures and Refutations: The Growth of Scientific Knowledge
37 (5th ed. 1989) (“[T]he criterion of the scientific status of a theory is its falsifiability, or refutability, or testability”).
Another pertinent consideration is whether the theory or technique has been subjected to peer review and publication. Publication (which is but one element of peer review) is not a
sine qua non
of admissibility; it does not necessarily correlate with reliability, see S. Jasanoff,
The Fifth Branch: Science Advisors as Policymakers
61-76 (1990), and in some instances well-grounded but innovative theories will not. have been published, see Horrobin, The
Philosophical Basis of Peer Review and the Suppression of Innovation,
263
J.Am. Med.Assn.
1438 (1990). Some propositions, moreover, are too particular, too new, or of too limited interest to be published. But submission to the scrutiny of the scientific community is a component of “good science,” in part because it increases the likelihood that substantive flaws in methodology will be detected. See J. Ziman,
Reliable Knowledge: An Exploration of the Grounds of Belief in Science
130-133 (1978); Reiman and Angelí,
How Good Is Peer Review?,
321
New Eng. J.Med.
827 (1989). The fact of publication (or lack thereof) in a peer-reviewed journal thus will be a relevant, though not dispositive, consideration in assessing the scientific validity of a particular technique or methodology on which an opinion is premised. Additionally, in the case of a particular scientific technique, the court ordinarily should consider the known or potential
*1495
rate of error, see,
e.g., United States v. Smith,
869 F.2d 348, 353-354 (7th Cir.1989) (surveying studies of the error rate of spectrographic voice identification technique), and the existence and maintenance of standards controlling the technique’s operation. See
United States v. Williams,
583 F.2d 1194, 1198 (2d Cir.1978) (noting professional organization’s standard governing spectrographic analysis),
cert. denied,
439 U.S. 1117 , 99 S.Ct. 1025 , 59 L.Ed.2d 77 (1979).
Finally, “general acceptance” can yet have a bearing on the inquiry. A “reliability assessment does not require, although it does permit, explicit identification of a relevant scientific community and an express determination of a particular degree of acceptance within that community.”
United States v. Downing,
753 F.2d [1224] at 1238 [(3d Cir.1985)] See also 3 Weinstein & Berger ¶ 702[03], pp. 702-41 to 702-42. Widespread acceptance can be an important factor, in ruling particular evidence admissible, and “a known technique that has been able to attract only minimal support within the community,”
Downing, supra,
at 1238, may properly be viewed with skepticism.
The inquiry envisioned by Rule 702 is, we emphasize, a flexible one. Its overarching subject is the scientific validity — and thus the evidentiary relevance and reliability— of the principles that underlie a proposed submission. The focus, of course, must be solely on principles and methodology, not on the conclusions that they generate.
Daubert,
509 U.S. at 592-95 , 113 S.Ct. at 2796-97 . The
Daubert
opinion also instructs the trial judge to be mindful of the provisions of Rules 703, 706 and 403. Finally, the trial judge is admonished that if she or he con-eludes that a scintilla of evidence supporting a position is insufficient to allow a reasonable jury to conclude that the position is more likely than not true, the court remains free to direct a judgment,
see
Fed. Rule Civ. Proc. 50(a), and likewise to grant summary judgment, Fed. Rule Civ. Proc. 56. This is to remind us that scientific evidence may raise questions not only as to admissibility but also as to sufficiency. It is interesting to note that Justice Blackmun cites the case of
Brock v. Merrell Dow Pharmaceuticals, Inc.,
874 F.2d 307 (5th Cir.1989),
modified,
884 F.2d 166 (5th Cir.1989), in support of this proposition. In summary, Justice Blackmun states that the rules of evidence (especially Rule 702),
... do assign to the trial judge the task of ensuring that an expert’s testimony both rests on a reliable foundation and is relevant to the task at hand. Pertinent evidence based on scientifically valid principles will satisfy those demands.
Daubert,
509 U.S. at 597 , 113 S.Ct. at 2799 .
Daubert
holds that admissibility under Rule 702 is governed by Rule 104(a), which requires the judge to conduct “preliminary fact-finding, to make a preliminary assessment of whether the reasoning or methodology underlying the testimony is scientifically valid and whether that reasoning or methodology properly can be applied to the facts in issue.”
12
Id.,
at 592-93 , 113 S.Ct. at 2796 . Thus, before admitting scientific evidence, the Court must,
inter alia,
determine whether the theory advanced by the expert has been subjected to the “scientific method.”
Id.
at 590, 593-95 , 113 S.Ct. at 2795, 2797 .
13
And the focus of this inquiry must be on “principles and methodology, not on the con
*1496
elusions that they generate.”
Daubert ,
at 595, 113 S.Ct. at 2797 .
“Scientific validity” and “fit” inquiries may overlap. For example, if published theories and studies purport to prove A, yet from those studies an expert concludes B, it may be that the expert’s reasoning process is not valid, although the studies or theories she relies upon are. In sum, there may be a lack of “fit” between the studies and theories and the conclusion the expert draws from them.
Each step of the experts’ methodology must be scientifically valid.
See In re Paoli R.R. Yard PCB Litigation,
35 F.3d 717, 745 (3d Cir.1994). For example, in a situation where an expert relies on studies of the effects of animal exposure to a particular chemical to prove similar effects in humans, “[cjourts must assess the scientific validity of the hypothesis proffered to justify such an extrapolation.”
Developments in the
Law—
Confronting the New Challenges of Scientific Evidence,
108 Harv. L. Rev. 1481 , 1536 (1995).
When
Daubert
was remanded back to the Ninth Circuit by the Supreme Court, it became necessary for the judges of the Ninth Circuit to apply the new standard for the admissibility of expert scientific testimony. Circuit Judge Kozinski wrote the opinion for the panel and introduced his analysis with the following background:
Two minors brought suit against Merrell Dow Pharmaceuticals, claiming they suffered limb reduction birth defects because their mothers had taken Bendectin, a drug prescribed for morning sickness to about 17.5 million pregnant women in the United States between 1957 and 1982.
See
Rsp’t’s Br. on Writ of Cert. at 2;
Turpin v. Merrell Dow Pharmaceuticals, Inc.,
959 F.2d 1349, 1350 (6th Cir.1992). This appeal deals with an evidentiary question: whether certain expert scientific testimony is admissible to prove that Bendectin caused the plaintiffs’ birth defects.
For the most part, we don’t know how birth defects come about. We do know they occur in 2-3% of births, whether or not the expectant mother has taken Bendectin.
See
Jose F. Cordero & Godfrey P. Oakley, Jr.,
Drug Exposure During Pregnancy: Some Epidemiologic Considerations,
26 Clinical Obstetrics & Gynecology 418, 424-25 (June 1983). Limb defects are even rarer, occurring in fewer than one birth out of every 1000.
Turpin,
959 F.2d at 1353 . But scientists simply do not know how teratogens (chemicals known to cause limb reduction defects) do their damage: They cannot reconstruct the biological chain of events that leads from an expectant mother’s ingestion of a teratogenic substance to the stunted development of a baby’s limbs. Nor do they know what it is about teratogens that causes them to have this effect. No doubt, someday we will have this knowledge, and then we will be able to tell precisely whether and how Bendectin (or any other suspected teratogen) interferes with limb development; in the current state of scientific knowledge, however, we are ignorant.
Not knowing the mechanism whereby a particular agent causes a particular effect is not always fatal to a plaintiffs claim. Causation can be proved even when we don’t know precisely
how
the damage occurred, if there is sufficiently compelling proof that the agent must have caused the damage
somehow.
One method of proving causation in these circumstances is to use statistical evidence. If 50 people who eat at a restaurant one evening come down with food poisoning during the night, we can infer that the restaurant’s food probably contained something unwholesome, even if none of the dishes is available for analysis. This inference is based on the fact that, in our health-conscious society, it is highly unlikely that 50 people who have nothing in common except that they ate at the same restaurant would get food poisoning from independent sources.
It is by such means that plaintiffs here seek to establish that Bendectin is responsible for their injuries. They rely on the testimony of three groups of scientific experts. One group proposes to testify that there is a statistical link between the ingestion of Bendectin during pregnancy and limb reduction defects. These experts have not themselves conducted epidemiological (human statistical) studies on the
*1497
effects of Bendectin; rather, they have reanalyzed studies published by other scientists, none of whom reported a statistical association between Bendectin and birth defects. Other experts proffered by plaintiffs propose to testify that Bendectin causes limb reduction defects in humans because it causes such defects in laboratory animals. A third group of experts sees a link between Bendectin and birth defects because Bendectin has a chemical structure that is similar to other drugs suspected of causing birth defects.
The opinions proffered by plaintiffs’ experts do not, to understate the point, reflect the consensus within the scientific community. The FDA — an agency not known for its promiscuity in approving drugs — continues to approve Bendectin for use by pregnant women because “available data do not demonstrate an association between birth defects and Bendectin.” U.S. Department of Health and Human Services News, No. P. 80-45 (Oct. 7,1980). Every published study here and abroad— and there have been many — concludes that Bendectin is not a teratogen.
Turpin,
959 F.2d at 1353-56 . In fact, apart from the small but determined group of scientists testifying on behalf of the Bendectin plaintiffs in this and many other cases, there doesn’t appear to be a single scientist who has concluded that Bendectin causes limb reduction defects.
Daubert v. Merrell Dow Pharmaceuticals, Inc.,
43 F.3d 1311, 1313-1314 (9th Cir.1995). After reexamining the challenged expert opinions under the Supreme Court’s new standards, the Ninth Circuit concluded that the plaintiffs had not met that standard.
In the context of the
Smits
case, the plaintiffs must establish by a preponderance of the evidence that their expert testimony meets the
Daubert
standards of scientific reliability. This issue is different from the one that will be submitted to the jury if the plaintiffs’ evidence satisfies those standards. In the latter case, the plaintiffs will have to establish by a preponderance of the evidence to the jury’s satisfaction that Dursban LO caused the birth defects sustained by Ashley Smits. By contrast, the trial judge, when passing upon the admissibility of testimony under
Daubert,
does not deal directly with the causation issue. Rather the judge asks whether it is more likely true than not true that plaintiffs’ expert testimony meets the
Daubert
standard of admissibility,
i.e.
evidentiary reliability based upon scientific validity.
Justice Blaekmun concluded his opinion in
Daubert
by pointing out that the law’s interest in ascertaining the truth differs from that in the scientific community. “Scientific conclusions are subject to perpetual revisions” whereas the need to “resolve disputes fairly and quickly” in a courtroom “inevitably on occasion will prevent the jury from learning from authentic insight and innovation.” The law simply cannot wait upon the results of future scientific investigation and research. Cases pending in our courts must be resolved on the basis of scientific knowledge currently available.
III. DURSBAN LO — DEFENDANTS’ CHALLENGE
The Pesticide Defendants move the Court to exclude from evidence plaintiffs’ expert opinion testimony on general and specific causation. The ultimate opinions of these plaintiffs’ experts are (1) that Dursban LO is capable of causing birth defects in humans (general causation) and (2) that Maria Smits’ exposure to Dursban during her pregnancy caused Ashley Smits’ birth defects (specific causation). Of course, adequate satisfactory proof of the latter proposition would also establish the former.
The Pesticide Defendants make the following main points:
1. The Pesticide Defendants assert that none of the challenged experts has the “education, experience, or expertise in the fields of science dealing with determination of causes of birth defects (teratology and medical genetics) ... [and] they are not qualified to give expert opinions on this subject.” Pesticide Defendants’ Motion to Exclude, p. 2.
2. The Pesticide Defendants argue that plaintiffs’ experts have not done any independent research in an effort to determine if Dursban LO is capable of causing human
*1498
birth defects. Indeed, the Pesticide Defendants assert that four of plaintiffs’ six experts have not, heretofore, been involved in the field of birth defects, while the other two have done no research in such field independent of litigation.
3. The methodologies used by plaintiffs’ experts are not reliable and are not used by experts in the relevant scientific field. The Pesticide Defendants argue that the methodology that should be utilized is that which teratologists use to determine whether a substance is a teratogen.
14
4. Dr. Sherman’s published case report of four birth defect cases allegedly due to Dursban is unreliable because
1. case reports are not relied on by the scientific community to establish general causation;
2. the article stems from, and arises out of, litigation;
3. Dr. Sherman was plaintiffs’ expert in all three cases (one case involved brother/sister);
4. the article does not reveal the litigation connection or her personal financial interest in such litigation;
5. the children’s defects were diagnosed as being genetic in origin;
6. the defects in two cases have been diagnosed as COFS/Micro syndrome and one case has been identified as CHARGE association;
7. the fourth case is distinguishable because exposure occurred in the second trimester; and
8.seventy to eighty percent of all birth defect cases are due to unknown causes.
IV. PLAINTIFFS’RESPONSE
Plaintiffs assert that they have presented reliable and relevant evidence. They point to evidence which they assert demonstrates that Dursban LO and/or its components and metabolites are known teratogens. They rely,
inter alia,
on the Hanley study
15
which reported that
Administration of Triehloropyridinol, to pregnant rabbits was considered teratogenic at a dose level of 250 mg/kg/day, a level which also depressed maternal weight gain. Indications of a teratogenic potential were also observed at 100 mg/kg/day in the absence of any measured maternal toxicity. No adverse effects were observed in either maternal or fetal rabbits at 25 mg/kg/day.
They also cite a letter from Dow to the EPA dated July 24, 1992, which summarized the Hanley study as follows: the incidence of central nervous system (CNS) anomalies (hydrocephaly and severely dilated cerebral ventricles) has increased in both the 100 and 250 mg/kg day base groups.
And the plaintiffs point to the MSDS for tricholorpyridinol (“TCP”), the active ingredient of Dursban LO, which states as follows:
Teratology (Birth Defects): Has been reported to cause birth defects in laboratory animals at doses non-toxic to the mother.
The plaintiffs argue:
The Court should know that Dr. Chris Cunniff, former geneticist at Arkansas Children’s Hospital, now at the University of Arizona Medical Center, told Dr. Miers,
*1499
a pediatrician, that he did not know what caused Ashley’s constellation of defects but that he did not think it was a genetic disorder. Also Dr. Barbara Crandall, geneticist at the U.C.L.A. Medical Center, ruled out several syndromes that she considered, including: Craniosynostosis, Antley-Bixler syndrome, Crouzon syndrome, and she also considered an association of defects called CHARGE (which is not a syndrome at all). Her final diagnosis was that Ashley’s symptoms are suggestive of CHARGE association b.ut that was not a definite diagnosis, and she went on further, and stated that she could not rule out a teratogen as the etiologie cause of Ashley’s birth defects. Only Defense witness, Dr. John Graham, geneticist at the Cedars-Sinai Medical Center in Los Angeles, California, a former witness for the Dow defendants in another Dursban case
(Burke),
stated in his report that Ashley’s problems
appear
to be CHARGE association, a pattern of birth defects which is
thought
to be due to a fresh dominant genetic mutation, a limited transmission to offspring due to the associated hypogonadotropie hypogonadis. These statements' by Dr. Graham are speculative and should carry no weight in this court’s decision regarding the Defendants’ Motions for Summary Judgement.
Plaintiffs emphasize Dr. Sherman’s “peer reviewed” articles:
Chlorpyrifos (Dursban)
—Associated
Birth Defects: A Proposed Syndrome, Report of Four Cases, and Discussion of the Toxicology,
International Journal of Occupational Medicine and Toxicology, Vol.4, No. 4 (1995); and
Chlorpyrifos (Dursban)
—Associated
Birth Defects: Report of Four Cases,
Archives of Environmental Health, Vol 51, No. 1, (Jan./Feb. 1996). Plaintiffs also note that, since the publication of those articles, Dr. Sherman has “discovered two more children who were exposed to Dursban LO which resulted in birth defects.” Plaintiffs’ Supplement, p. 22-23.
16
V. SUBSEQUENT PROCEEDINGS
As stated above, on March 29, 1996, the Court held an in-court conference on the
Daubert
motions and heard argument from all parties. In addition, the Court was the beneficiary of lengthy and detailed pre-hearing and post-hearing submissions from all parties addressing the
Daubert
issue. On May 16, 1996, the Court issued an Order granting Steam Services’ motion to strike the proffered causation testimony of plaintiffs’ expert witnesses. And,. because plaintiffs then had no evidence which could establish causation with respect to the chemical agent Firefog 404, Steam Services’ motion for summary judgment was also granted.
After summary judgment was entered in favor of Steam Services, the Court scheduled a further hearing and further argument on the
Daubert
issues for September 12, 1996. In anticipation thereof the Court wrote three letters to the parties in an attempt to give some focus and guidance to that proceeding. Two of those letters were sent on August 14 and the third on August 16, 1996. They are attached hereto as Appendices B, C and D to this opinion. ■
The plaintiffs requested that they be permitted to bring the live testimony of Dr. Sherman before the Court at the hearing. At a telephone conference held on September 5,1996, the Court agreed to permit the plaintiffs to put on the testimony of Dr. Sherman. On that same day, the Court mailed to the parties a copy of its “Notes Regarding Major Studies” dealing with the Muto, Hanley and Deacon studies. Those notes are attached hereto as Appendix E. More importantly the Court sent to the parties its “Notes and Comments” setting forth its tentative views on many of the important issues. Those “Notes and Comments” are attached hereto as Appendix F and are incorporated herein in their entirety by reference. It will be seen therefrom that the Court had concluded from the record, prior to the September 12, 1996, hearing, that the defendants were correct in stating that there is a consensus in the relevant scientific community (composed of teratologists and medical geneticists) concerning the protocol and methodology that must be followed in order to establish a
*1500
particular chemical agent as a human teratogen. Through the use of that methodology and the reasoning it adopts, some forty chemical agents have been established as human teratogens. Dursban LO is
not
one of them. The Court stated that the defendants had satisfied it that they are correct on their general causation arguments. But the Court was not ready to agree at that time that that conclusion alone was enough to require it to grant the defendant’s
Daubert
motion by excluding all of the plaintiffs’ causation evidence. The Court stated its view that in some cases a plaintiffs proof would be sufficient to go to a jury without having first established the suspect chemical agent as a human teratogen by the use of the accepted protocol.
The Court concluded its “Notes and Comments” as follows:
From my own examination of Dr. Sherman’s articles, from the critiques thereof by Drs. Graham and Johnson, and from the written and oral arguments of defendants’ counsel, I have come to the tentative conclusion that Dr. Sherman’s analysis and causation opinions are not derived from any accepted scientific methodology (i.e., are not grounded in the methods and procedures of science), are not scientifically valid and, ergo, do not possess the evidentiary reliability required by
Daubert.
This is not to say that Dursban LO is not a teratogen or that it did not cause Ashley’s birth defects. It is to say that Dr. Sherman’s submissions and opinions are not derived from scientific methods and are nothing more than an invitation to the jury to speculate (rather than a reliable basis upon which the jury could find that it is more likely true than not true that Dursban LO caused the birth defects suffered by Ashley.) Therefore the views and opinions expressed would not assist the trier of fact to determine the cause of those defects.
My tentative view is that Dr. Sherman’s case studies do nothing more scientifically than to suggest a causal relation. That hypothesis has not to date been legitimized by further research and studies. In sum, there have been no epidemiological studies, no repeatable dose-response animal studies, no other studies which would connect Dr. Sherman’s speculative hypothesis to a scientific proposition having acceptance in at least a segment of the pertinent scientific community. (Note: Dr. Bidanset’s
in vitro
and
in vivo
studies will be discussed later.)
The defendants state that Dr. Sherman’s article relies, inter alia, on the reasoning that the exposure of each of the mothers to Dursban occurred in the first trimester of pregnancy. In her deposition at pages 689-691 she affirms that her theory requires exposure to the chemical agent during the first trimester which she identifies as “this critical point in development when these key structures are formed ...” Defendants then point out that Sherman’s own report in the case of child # 2 (Daniel Gillespie) and the medical records for that pregnancy confirm that the application of Dursban occurred
after
the first trimester. The Court will ask the plaintiffs at the September 12 conference if they agree or disagree that child # 2 should be eliminated when evaluating Dr. Sherman’s article and, if so, what effect that might have on the remainder of that study.
The defendants then state that the patterns of symptoms described by Dr. Sherman in her article are not really present and that the children do not in fact show any concordance of symptoms. Then defendants state:
Moreover, it is not scientifically acceptable to collectively analyze children with multiple anomalies and recognized birth defect syndromes as Sherman has done because by definition the children have patterns of defects which can only be combined if the defects have the same pathogenetic basis. (Graham Decl. ¶ 23). That is not present here.
To evaluate the legitimacy of Dr. Sherman’s statistical analysis it is necessary for the Court to resolve the issue raised by the defendants’ response. Did the children suffer from the same complex or pattern of defects?
*1501
To give further guidance to the parties with regard to the issues of concern, the Court stated in its August 14, 1996, letter:
The first issue relates to exposure and dosage both of Mrs. Smits and Ashley while
in útero.
After plaintiffs detail all of the evidence in the record on these issues and argue its medical and scientific adequacy, defendants’ attorneys will respond. The second phase of the argument will relate to specific causation. Here again plaintiffs’ attorneys will open and then defendants’ attorneys will respond.
VI. IMPORTANT ADDITIONAL LEGAL AUTHORITY
After hearing the testimony of Dr. Sherman at the September 12, 1996, proceeding, the Court quoted at some length from the article “Scientific Evidence After
Daubert”
by David M. Levy, which appeared in the fall 1995 edition of the ABA journal,
Litigation.
It then brought the parties’ attention to the case of
Wright v. Willamette Industries, Inc.,
91 F.3d 1105 (8th Cir.1996) which was decided by a panel of the Eighth Circuit Court of Appeals on August 2, 1996. The Court, stating that this was an extremely important case, noted that an application for rehearing and a suggestion for rehearing en banc had been made and that, therefore, the final word on
Wright
was not in. The
Wright
case is so important that it should be quoted almost in its entirety. Judge Morris Sheppard Arnold wrote the opinion for the majority of the panel, and Judge Gerald Heaney dissented. The Court will first quote from Judge Arnold’s opinion as follows:
The most significant issue in this toxic tort ease is whether members of the Wright family, plaintiffs who prevailed at trial, produced sufficient evidence to submit their negligence claim to the jury. We find that they did not and therefore reverse the judgment of the district court. Appellant Willamette Industries owns a fiberboard manufacturing plant near the town of Malvern in western Arkansas. Willamette takes pine wood shavings and pulp and refines them into a fiber, which is then dried. A resin of urea formaldehyde is mixed with the fiber just prior to drying. It is undisputed that the plant emits particulate matter, part of which has been treated with formaldehyde, into the air. The Wrights live a short distance from the plant and claim to have suffered from a number of afflictions (e.g., headaches, sore throats, watery eyes, running noses, dizziness, and shortness of breath) which they blame on the emissions from the plant. The Wrights brought suit on a variety of theories and prevailed on their negligence claim. The jury awarded the five plaintiffs a total of $226,250.00 in compensatory damages for their personal injuries.
Willamette made a number of post-verdict motions for judgment as a matter of law, which the district court denied. On appeal, Willamette, emphasizes, among other things, that the Wrights failed to make out a submissible case on the issue of proximate cause.
We review a district court’s denial of a motion for judgment as a matter of law by applying the same standard that the district court applied originally.
Sherbert v. Alcan Aluminum Corp.,
66 F.3d 965, 967 (8th Cir.1995). Willamette’s motion for judgment as a matter of law should not be granted unless all the evidence points its way and is susceptible of no reasonable inferences sustaining the Wrights’ position (citing cases).
The Wrights, of course, had the burden of proving proximate cause in order to recover under their negligence theory (citing cases). Proximate cause in Arkansas is defined as a “ ‘Cause which, in a natural and continuous sequence, produces damage and without which the damage would not have occurred.’”
Rogers v. Armstrong World Indus., Inc.,
744 F.Supp. 901, 904 (E.D.Ark.1990) (quoting Ark.Model Jury Instr. Civil 3d ed. 501).
Willamette contends, among other things, that in order to shift the costs of their injuries to Willamette the Wrights had to demonstrate actual exposure to a toxic substance emitted from Willamette’s plant at levels that are known to produce harms like the ones of which the Wrights complain. Willamette’s emphasis on exposure levels is a reasonable one that is reflected
*1502
in a number of recent toxic tort eases (citing cases). We agree with Willamette that a plaintiff in a toxic tort ease must prove the levels of exposure that are hazardous to human beings generally as well as the plaintiffs actual level of exposure to the defendant’s toxic substance before he or she may recover.
The Wrights cite two Arkansas cases,
Worthington v. Roberts,
304 Ark. 551 , 803 S.W.2d 906 (1991), and
Southwestern Bell Telephone Co. v. Smith,
220 Ark. 223 , 247 S.W.2d 16 (1952), for the proposition that Arkansas does not require proof of the level of exposure in toxic tort cases. In
Smith,
a telephone company sprayed vegetation under its telephone lines, after which Mr. Smith’s cows ate the vegetation and died; and in
Roberts ,
pesticides drifted in a strong wind onto Mr. Roberts’s property after a crop duster sprayed nearby fields, following which Mr. Roberts’s trees and vegetation appeared to have been damaged. We believe that plaintiffs’ reliance on these cases is misplaced. The reports of these cases do not reveal whether the plaintiff offered any proof concerning what levels of the relevant chemical might be expected to produce appreciable harm to animals or plants. The argument that defendants make in this case was simply not advanced in these previous Arkansas eases, and they are therefore of no precedential value on the precise question which concerns us here.
A legislature might well altogether outlaw a substance on the ground that it is known to involve a risk of appreciable harm to human beings, without having precise data on the question of how much harm, or what kind of harm, some specific amount of that substance might reasonably be expected to cause to some particular kinds of persons or even to an average or an ordinary person. Such legislation would presumably, as an ordinary matter, survive judicial scrutiny as a rational exercise of the police power. (Citing case)____
* *
X *
* *
Whatever may be the considerations that ought to guide a legislature in its determination of what the general good requires, courts and juries in deciding eases traditionally make more particularized inquiries into matters of cause and effect. Actions in tort for damages focus on the question of whether to transfer money from one individual to another, and under common-law principles (like the one that Arkansas law recognizes) that transfer can take place only if one individual proves, among other things, that it is more likely than not that another individual has caused him or her harm. It is therefore not enough for a plaintiff to show that a certain chemical agent sometimes causes the kind of harm that he or she is he complaining of. At a minimum, we think that there must be evidence from which the fact finder can conclude that the plaintiff was exposed to levels of that agent that are known to cause the kind of harm that the plaintiff claims to have suffered. See
Abuan v. General Elec. Co.,
3 F.3d [329] at 333 [(9th Cir.1993)]. We do not require a mathematically precise table equating levels of exposure with levels of harm, but there must be evidence from which a reasonable person could conclude that a defendant’s emission has probably caused a particular plaintiff the kind of harm of which he or she complaints before there can be a recovery.
In this case, while the Wrights proved that they were exposed to defendant’s emissions and that wood fibers from defendant’s plant were in their house, their sputum, and their 'urine, they failed to produce evidence that they were exposed to a hazardous level of formaldehyde from the fibers emanating from Willamette’s plant. Their experts’ information on this subject was simply insufficient. Dr. Fred Fowler, an industrial hygienist, and Dr. Jimmie Valentine, a pharmacologist, did offer testimony about the levels of gaseous formaldehyde that might be expected to cause symptoms like the ones that plaintiffs claim to have experienced. But the Wrights do not claim to have been injured from breathing gaseous formaldehyde, and they make no reference to any studies that reveal the levels of exposure to wood fibers impregnated with formaldehyde that are likely to produce adverse consequences.
*1503
It is true that Dr. Frank Peretti, after a great deal of prodding, testified that the Wrights’ complaints were more probably than not related to. exposure to formaldehyde, but that opinion was not based on any knowledge about what amounts of wood fibers impregnated with formaldehyde involve an appreciable risk of harm to human beings who breathe them. The trial court should therefore have excluded Dr. Paired’s testimony, as Willamette requested it to do, because it was not based on scientific knowledge. See
Daubert v. Merrell Dow Pharmaceuticals, Inc.,
509 U.S. 579, 589-91 , 113 S.Ct. 2786, 2794-96 , 125 L.Ed.2d 469 (1993); Fed.R.Evid. 702; Federal Judicial Center Reference Manual on Scientific Evidence 47-48 (1994). Dr. Paired’s testimony regarding the probable cause of the Wrights’ claimed injuries was simply speculation.
The jury could therefore only have speculated about whether the amount of formaldehyde from Willamette’s plant to which each plaintiff was exposed was sufficient to cause their injuries or, indeed, any injuries at all ... Without proving hazardous levels of exposure to Willamette’s formaldehyde, the Wrights failed to carry their burden of proof at trial on the issue of causation because the evidence failed to support a reasonable inference in favor of the jury’s implicit finding against Willamette on the causation issue.
Judge Heaney, in his dissenting opinion, disagrees with our characterization of this case as being about money, and expresses the view that this “fails to acknowledge the important human elements regarding the injuries at issue.” But lawsuits, unless they seek only a declaratory judgment, are always either about money or some form of specific relief. Those are the only kinds of relief that a court can give and in this case all the plaintiffs asked for was money. Our characterization of the case is therefore the plaintiffs’ characterization of it. Money, moreover, is not properly to be contrasted with human or humane concerns. To the contrary, the reason that we compensate people (that is, transfer money from defendants to plaintiffs) is because rights that are grounded in considerations of humanity have been violated. We believe that it is humane to monetize welfare losses associated with grief, pain and suffering, humiliation, mental anguish, and other intangible injuries so that we can make plaintiffs whole. What we do not do, again for reasons grounded in humanity, is force a defendant to compensate a plaintiff if the plaintiff does not show that the defendant has probably done something to him.
For the foregoing reasons, we reverse the judgment of the district court.
In his dissent Judge Heaney states:
It is undisputed that the Willamette plant emits minute wood fibers laced with formaldehyde. It is also undisputed that because Willamette failed to install equipment that would have significantly lowered the emissions, the levels of formaldehyde emitted from the plant exceeded levels permitted by industry and state standards. The Wright family lives within three-quarters of a mile of the plant. There is uneontradicted evidence that emissions from the plant fell like “snow” on the Wrights’ property to the extent that overnight emissions could be seen on cars. Fibers from the plant were also found in the Wrights’ air conditioner. The Wright family was examined by physicians and significant levels of toxic emissions from the plant were found in their sputum and urine. The Wright family suffered from headaches, sore throats, watery eyes, runny noses, dizziness and shortness of breath which the treating physician testified were more probably than not related to their exposure to the plant emissions.
‡
%
Jj; *
I do not disagree with the majority’s statement that there must be evidence from which the jury could find that the Wrights were exposed to levels of formaldehyde that are known to cause the harm that the Wright family suffered. In fact, however, the required evidence was produced. The State of Arkansas has determined that no plant shall emit formaldehyde because such emissions are dangerous to the health of persons who ingest them. Willamette
*1504
failed to install available equipment to control the discharge of this particulate matter in either the solid or gaseous form. The formaldehyde emissions found their way to the Wrights’ property. They were found in the family’s air conditioner, and more importantly, in the family’s sputum and urine. Competent medical testimony was presented that stated that it was more probable than not that their illness was caused by the formaldehyde. Thus, the circle was complete and proximate cause established. Dr. Peretti may or may not have been prodded to relate the Wrights’ illnesses to formaldehyde, but he did; and the jury could have rejected his testimony if it did not believe him.
The Court has learned that the plaintiffs application for rehearing and suggestion of rehearing
en banc
was denied on September 19, 1996. Therefore,
Wright
is the latest Eighth Circuit decision in this developing area of the law.
Wright
is useful here also because it reminds us of the Arkansas law on proximate cause. See also
Southern Company, Inc. v. Graham,
271 Ark. 223 , 607 S.W.2d 677, 679 (Ark.1980) (possibility, conjecture or guess not enough).
There are other cases that deal quite directly "with the issues before the Court. The Court will quote at length from one of them, the case of
Cavallo v. Star Enterprise,
892 F.Supp. 756 (E.D.Va.1995), because of its startling relevance to this case. There Judge Ellis discusses eases dealing with the “fit” requirement, the dose-response relationship, and the limits upon extrapolations from known data:
The Third Circuit addressed this problem in
In re Paoli R.R. Yard PCB Litigation,
35 F.3d 717 (3d Cir.1994),
cert. denied,
513 U.S. 1190 , 115 S.Ct. 1253 , 131 L.Ed.2d 134 (1995). There, residents housed near a railcar maintenance facility that had used polychlorinated biphenyls (commonly referred to as PCBs) in its business activities for many years claimed that their continued exposure to the PCBs had caused a variety of illnesses. In reviewing the
Daubert
principles, the Third Circuit panel noted that the scientific knowledge requirement, which mandates that the expert’s conclusions be based on “good grounds,” applies to each step of the expert’s analysis.
Paoli R.R.,
35 F.3d at 745 . Thus, the panel emphasized that
“any
step that renders the analysis unreliable under the
Daubert factors renders the expert’s testimony inadmissible. This is true whether the step completely changes a reliable methodology or merely misapplies that methodology.” Id.
(emphasis in original). Similarly, the
Paoli
panel remarked that “the expert’s view that a particular conclusion ‘fits’ a particular case must itself constitute scientific knowledge — a challenge to ‘fit’ is very close to a challenge to the expert’s ultimate conclusion about the particular ease.”
Id.
at 746 .
Cf. Developments in the Law
— Confronting
the New Challenges of Scientific Evidence,
108 Harv. L.Rev. 1481, 1536 (1995) (stating that where expert relies on studies involving animal exposure to particular chemical to prove similar effect in humans, “[ejourts must assess the scientific validity of the hypothesis proffered to justify such an extrapolation”).
This interrelationship between fit and scientific validity is illustrated by a case involving an alleged correlation between a pregnant woman’s use of Retin-A, a Vitamin A derivative acne medication, and her child’s birth defects.
Chikovsky v. Ortho Pharmaceutical Corp.,
832 F.Supp. 341 (S.D.Fla.1993). Although there were no published studies on the effects of Retin-A on fetal development, the plaintiff’s expert in
Chikovsky
concluded that the Retin-A absorbed by the mother had caused the child’s birth defects. He based this conclusion on studies showing a correlation between birth defects and high doses of Vitamin A and certain other Vitamin A derivatives. In holding that the expert’s opinion was not scientifically valid, the court cited the expert’s ignorance of the amounts of Retin-A absorbed by the plaintiff, noted the absence of any established dose-response relationship for Vitamin A and birth defects, and explicitly found that his “analogies to research concerning Vitamin A and other Vitamin A derivatives is [sic] wanting.”
Id.
at 346 .
*1505
Similarly, in
Schmaltz v. Norfolk & Western Ry. Co.,
878 F.Supp. 1119 (N.D.Ill.1995), the plaintiff claimed that his exposure to certain herbicides containing atrazine caused his chronic respiratory disease. Like the situation in
Chikovsky ,
the plaintiffs expert could not cite any documented cases where exposure to these chemicals caused the alleged illness. Rather, he relied on studies where high doses of atrazine caused eye irritation in rabbits. In excluding the expert’s testimony under
Daubert,
the court observed that the record
Fails to make clear why the incidence of eye irritation in rabbits exposed to high doses of atrazine could reasonably lead a doctor to conclude that an indirect exposure to atrazine could cause pulmonary or respiratory conditions in humans. “The analytical gap between the evidence presented and the inferences to be drawn on the ultimate issue ... is too wide” in the present case.
Schmaltz,
878 F.Supp. at 1122 (quoting
Conde v. Velsicol Chem. Corp.,
24 F.3d 809, 814 (6th Cir.1994)). Thus, it is apparent that a determination regarding the scientific validity of a particular theory requires not only an examination of the trustworthiness of the tested principles on which the expert opinion rests, but also an analysis of the reliability of an expert’s application of the tested principles to the particular set of facts at issue.
Id.
at 762-763.
And while specifically analyzing the proffered testimony of Dr. Monroe, a toxicologist, Judge Ellis observed as follows:
As Dr. Rodricks explains, all chemicals can cause health problems' at some level or concentration of exposure, but they vary widely in the types of harm caused and in the levels of exposure required to trigger those harms. In addition, all chemicals have thresholds-of exposure that must be exceeded before the harms will occur, and these thresholds may be identified through scientific studies and literature. The task of the toxicologist, therefore, is to identify a dose-response relationship for a particular chemical (or chemical mixture) and illness and analyze the results to determine whether the duration and concentration of exposure in a given instance could have caused the alleged harms. (Rodricks Rpt. At 2-3).
Id. at 764.
Footnote 12 of the
Cavallo
opinion states as follows:
Dr. Monroe was not aware of the concentration and duration of exposure in making his initial assessment. It is fairly clear from a review of the record that in many instances, Dr. Monroe did not follow the methodology to form his opinion but rather formed his opinion and then tried to conform it to the methodology. The following dialogue is illustrative:
Q: And it’s your opinion that [a concentration of 61 mg/m
3
] would be sufficient to cause sensitization in Mrs. Cavallo; is that correct?
A: That’s correct.
Q: What concentration — First of all, let me ask you this. What was the duration of her exposure?
A: Well, I’m not sure exactly.
Q: Would that be important to know?
A: I’ve not found that to be essential for my assessment.
******
Q: Why is that, sir:
A: Because the available information is sufficient to indicate that the exposure was of sufficient duration to cause an irritant effect on Mrs. Cavallo.
(Monroe Tr., Vol I, at 50-51).
Judge Ellis next turns to a discussion of the need to establish the dose-response threshold:
The second step in the methodology requires the toxicologist to consult the published literature to ascertain a dose-response relationship for the particular chemicals at issue. Dr. Monroe agreed in his deposition that “there should be a threshold below which irritant effects do not occur,” and he conceded that he did not know the specific threshold for the chemicals to which Ms. Cavallo was exposed. (Monroe Tr., Vol II, at 37). None
*1506
theless, he stated that the literature and studies he reviewed provided ample support for his conclusion that Ms. Cavallo’s one-time exposure to AvJet for a period of 5-30 minutes at a concentration of 61
mg/
m
3
caused her chronic conjunctivitis and her heightened chemical sensitivity.
It is important here to quote a portion of Footnote 13 to this text:
Notably, Dr. Monroe acknowledged that he could find no literature supporting the proposition that exposure to AvJet at a concentration of 61 mg/m
3
for 5-30 minutes could cause Ms. Cavallo’s sinusitis.
Judge Ellis then deals more specifically with the inadequacies and unreliabilities of the plaintiffs proof:
The reliability of Dr. Monroe’s opinion that the AvJet spill caused Ms. Cavallo’s chronic condition is further undermined by the fact that the information that
has
been gathered specifically on AvJet suggests that no ill effects would be expected from exposure to AvJet for the duration and at the concentration alleged in this case. As described by Dr. Rodrieks in his report, Threshold Limit Values (“TLVs”) have been established by the American Conference of Governmental Industrial Hygienists for petroleum compounds related to aviation fuel. These TLVs are based upon “the best available information from” human and animal studies as well as industrial experience, and “represent airborne concentrations of substances to -which nearly all workers may be repeatedly exposed day after day without adverse health effects.” (Rodrieks Rpt., at 7-8). According to Dr. Rodrieks’ unrefuted assessment, the TLVs for aviation fuel, “which are designed to protect workers exposed 8 hours [per] day on a chronic basis,” exceed the worst-case concentration to which Ms. Cavallo may have been exposed (61 mg/m
3
) on one evening by a factor of more than 10. (Rodrieks Rpt., at 8). Furthermore, Dr. Rodrieks explained that he consulted the toxicology literature to determine the “no observed effect levels” (“NOELs”) and “lowest observed effect level” (“LOELs”) in humans for acute exposure to jet fuels, kerosene, diesel, and gasoline. This consultation revealed that “[t]he worst-case air concentration for Mrs. Cavallo’s exposure modeled by plaintiffs expert (61 mg/ m
3
= 9ppm) was at least 15 times lower than the NOELs and LOELs observed in humans.” (Rodrieks Rpt., at 9) While Ms. Cavallo contends that these NOELs, LOELs, and TLVs are heavily biased toward industry, a proposition that may well be true, she has not produced any alternative study, literature, or source that supports her conclusion that exposure to 61 mg/m
3
of AvJet for a relatively short duration could produce the chronic illnesses from which she allegedly suffers.
Cf. Conde,
24 F.3d at 814 (stating that while the plaintiffs “cite published critiques of [the defendants’] studies, the critiques only underscore the need for further studies, and do not ... establish causation”).
Id.
at 768-769.
Footnote 27 should also be noted:
At several points in her memoranda, Ms. Cavallo resorts to evidence that AvJet is toxic, and that Star knew it to be so, in an effort to support her experts’ opinions of causation. (Mem. In Opp. To Defs’ Mot. In Lim., at 3-1 (citing EPA Order)) (Supp. Mem. In Opp. Of Mot. For sum. Jud., at 3-5 (citing Texaco Material Safety Data Sheet)). Yet, as noted earlier and as readily conceded by Star, there is no doubt that AvJet, as all chemicals, can be toxic. As Paracelsus taught long ago, toxicity is a function of dose. Thus the question for causation purposes is: At what levels of exposure do what kinds of harm occur?
Next the Court in
Cavallo
takes up the testimony of Dr. Bellanti who relied in forming his causation opinion primarily upon the methodology of differential diagnosis:
Although neither party clearly explains the methodology applied by Dr. Bellanti, it appears from a review of his written report as well as his deposition testimony that he primarily applied a methodology of differential diagnosis. Thus, he determined from a review of Ms. Cavallo’s medical history, from her description of the spill incident, from his initial examination of her, and from the timing of the spill in relation to her development of symptoms,
*1507
that her exposure to the petroleum hydrocarbons could have caused her chronic illnesses. Dr. Bellanti then examined other possible causes of her symptoms (such as her history of smoking 1.5 packs a day for at least 20 and as much as 40 years, possible allergies, possible MSG in the Chinese food eaten on the night of the spill, and Ms. Cavallo’s exposure to a previous spill in 1960), and ruled out each one.
The process of differential diagnosis is undoubtedly important to the question of “specific causation.” If other possible causes of an injury cannot be ruled out, or at least the probability of their contribution to causation minimized, then the “more likely than not” threshold for proving causation may not be met. But, it is also important to recognize that a fundamental assumption underlying this method is that the final, suspected “cause” remaining after this process of elimination must actually be
capable
of causing the injury. That is, the expert must “rule in the suspected cause as well as ‘rule out’ other possible causes. And, of course, expert opinion on the issue of “general causation” must be derived from a scientifically valid methodology.”
Id.
at 770-771 .
The court then commented on Dr. Bellanti’s unawareness of the duration and intensity of Ms. Cavallo to AvJet fumes:
With respect to the level of Ms. Cavallo’s exposure, Dr. Bellanti concluded only that she sustained a “massive exposure.” (Belanti Tr., at 231). He candidly acknowledged that in forming his opinion, he was unaware of the duration and intensity of exposure. In addition, he repeatedly qualified his responses to deposition questions regarding levels of exposure and dose-response relationships with the reminder that he was not a toxicologist.
Even assuming that he was aware of and considered the alleged 61 mg/m
3
level of exposure, Dr. Bellanti could cite no studies or published literature to support adverse effects from that level of exposure to AvJet.
‡ H* ‡ H* ' * ^
Thus, it is clear that Dr. Bellanti did not follow the accepted toxicology methodology in formulating his opinion of causation in this case. At bottom, his opinion is founded primarily on the temporal connection between the spill and the development of Ms. Cavallo’s symptoms, as well as on his subjective, unverified belief that AvJet can cause the types of injuries from which Ms. Cavallo suffers. This is not the method of science.
See Schmaltz,
878 F.Supp. at 1122 (stating that “[i]t is well settled that a causation opinion based solely on a temporal relationship is not derived from the scientific method and is therefore insufficient to satisfy the requirements of [Rule] 702”). Because, like Dr. Monroe, Dr. Bellanti significantly departed from the appropriate methodology, his opinion is not based on the scientific method and is inadmissible under Rule 702.
The pertinence of
Wright
and
Cavallo v. Star
will be obvious as we proceed to discuss the issues in this case. See
infra.
VII. EVIDENCE OF A CAUSAL RELATIONSHIP
To resolve the causation issue, it will be helpful to examine the various types of evidence which might support a causal relationship. As pointed out in the Sanders article, cited and quoted or paraphrased below, such evidence is usually derived from and through some or all of the following five well-established methodologies:
1.
Structure-Activity Relationship.
Substances with similar chemical structures may have similar effects on the human body. If the substance is chemically related to another substance which is a known teratogen, then plaintiffs’ experts may point to this similarity, suggesting that it is reasonable to expect similar results to that obtained from a known teratogen with similar chemical structure. But the eases have pointed out the weakness of this approach. See below.
2.
In vitro Studies.
In vitro research involves analyzing the effects of exposing cells or organs maintained
*1508
in a culture to a particular substance or agent.
3.
Animal Studies.
These are frequently referred to as
in vivo
studies. Such studies examine the effect of a substance or an agent on live animals. If such studies show a relationship between the substance (or one of its ingredients) and some teratogenic effect in the exposed animals, plaintiffs might argue that such studies support their contention that the substance will have a teratogenic effect in humans.
4.
Epidemiological Studies.
Epidemiological studies compare the incidence of birth defects among those exposed to, and those not exposed to, a particular agent or substance. There are two ways of making such a comparison: (a) Cohort studies: cohort studies compare the instance of defects among groups of persons exposed to a substance and groups of persons not so exposed; and (b) Case-control studies: these studies match groups of persons who have the injury (birth defects) with another group that does not have that injury. These studies then compare exposure rates for the two groups.
5.
Secular Trend Data.
Secular trend data, which is similar to epidemiology, compares the total reported incidences of various types of birth defects with the volume of the sales and prescriptions of the substances or agent in question. Such studies may reveal whether increases or decreases in particular birth defects parallel the rapid increase or decrease in the sales (and therefore in the use) of the substance. Here, for instance, if we had studies of the instance of birth defects such as those found in Ashley Smits before the introduction of Dursban LO into the market, we could compare those figures with the instance of such birth defects that occurred after the introduction and wide use of the Dursban LO pesticide. Reverse comparisons can also be used when the substance or agent is taken off the market. See Joseph Sanders,
From Science to Evidence: The Testimony on Causation in the Bendectin Cases,
46 Stan. L.Rev. 2 (1993), which discusses these five methodologies. Each of these methods has its own weaknesses. A combination of their approaches, and repetitive studies producing consistent results can reinforce the scientific validity of the inferences drawn.
Furthermore, as pointed out by Judge Kozinski in
Daubert II
and Judge Ellis in
Cavallo ,
causation can sometimes be proved without the benefit of any such studies. This Court suggested a hypothetical situation which could accomplish this in its “Notes and Comments,” Appendix F, p. 2.
Assume further that 25 of the women met daily thereafter in a room that had on the previous day been treated with organophosphate insecticide “X” and that these women stayed in that room for three hours each morning for the next six week period. Assume the other 25 women met in another room which had not been treated by this insecticide but that otherwise the two rooms were identical. If all 25 of the women exposed to the insecticide (manifested by low blood cholinesterase levels) had children born with the same birth defects and if none of the other 25 women (whose blood cholinesterase levels remained unchanged) had a child born with a birth defect, no one would contend that the circumstance that insecticide “X” had not previously been established as a human teratogen by using the accepted protocol would, or should, prevent the case from going to the jury upon such an evidentiary showing. Of course defendants would probably agree, pointing out that the phenomenon itself, as stated in the hypothetical, would, in effect, be the equivalent of a scientifically valid epidemiological study on human “subjects” which would obviate the need for animal studies, etc. And it is obvious that the trial of the case would not have to await “falsifiability” tests, publication and peer review, or the establishment of error rates. And even if this theory of causation had not received prior “general acceptance” within the pertinent scientific community, the “phenomenal” evidence hypothesized would surely suffice. This is because that evidence satisfies the
Daubert
admissibility standards of scientific validity
*1509
and, thus, evidentiary relevance and reliability.
The Court has concluded that, under the
Daubert
standard, plaintiffs have presented no satisfactory scientific evidence (by any of the five, indirect methods listed above) that Dursban caused or contributed to Ashley Smits’ birth defects. Have they provided any substitute scientific evidence of causation that might meet the
Daubert
standards? After a complete review of the record and the arguments of the parties, the Court has concluded that they have not. See
infra.
VIII. METHODOLOGY
The
Daubert
inquiry requires the Court to examine the scientific methodology utilized and determine if such methodology is valid. It is no surprise that the plaintiffs and defendants differ with respect to what methodology should be utilized to determine whether a chemical agent is capable of causing birth defects.
The defendants argue that the relevant scientific community is teratology and medical genetics, while the plaintiffs assert that toxicologists, pediatricians, physicians and pharmacists are all able to identify a chemical agent as one which is capable of causing birth defects and as, in fact, actually causing such defects as those found in Ashley.
The Court agrees with the defendants on the proper methodology and the relevant scientific community when dealing with the issue of general causation and has previously so ruled. See discussion,
supra.
IX. DISCUSSION OF PORTIONS OF DR. SHERMAN’S TESTIMONY
Much of the testimony of Dr. Sherman before the Court on September 12,1996, consisted simply of a restatement of the position she had taken earlier as reflected in the prior submissions by the plaintiffs. However, some of her September 12, 1996, testimony was new or, at least, tended to clarify her prior assertions or to put those prior assertions in doubt.
A.
The Gillespie Child
It will be recalled that prior to the September 12, 1996, hearing the Court advised the parties of certain issues that it wanted them to address at that hearing, among which was the following:
The defendants. state that Dr. Sherman’s article relies, inter aha, on the reasoning that the exposure of each of the mothers to Dursban occurred in the first trimester of pregnancy. In her deposition at pages 689-691 she affirms that her theory requires exposure to the chemical agent during the first trimester which she identifies as “this critical point in development when these key structures are formed ...” Defendants then point out that Sherman’s own report in the case of child # 2 (Daniel Gillespie) and the medical records for that pregnancy confirm that the application of Dursban occurred
after
the first trimester. The Court will ask the plaintiffs at the September 12 conference if they agree or disagree that child # 2 should be eliminated when evaluating Dr. Sherman’s article and, if so, what effect that might have on the remainder of that study.
17
The manner in which Dr. Sherman addressed this question is rather typical of her approach to the serious causation issues in this case:
THE COURT: Before we leave that, let me ask, there’s been some question raised about one of the four children who had
*1510
birth defects in your first study, when the exposure occurred, and that it was stated by the defendants at least that that exposure was not in the first trimester. Is that so, or do you know?
MR. DAVIDSON: Your Honor, I believe that was the Gillespie child, as I recall.
A. That is the Gillespie child. And, after that was raised by the defense attorney, I again called the attorney representing the family, and I again reviewed the medical records. And it was in the first trimester, at the very end of the first trimester.
THE COURT: So, when you say “end of first trimester,” are you talking about end of the third month of pregnancy?
A Toward the end of the third, toward the end of the first trimester, which would have made it about, let’s see, about 11— I’m doing this in the top of my head, about 9 to 11 weeks, in there.
THE COURT: Is that consistent with your theory about the time at which these changes in the developmental patterns have to occur to produce these anomalies that you found after birth?
A Yes, sir, because these involve the midline structures of the brain. And let me get the paper out. He had absence of the corpus callosum, if I remember correctly. This was found on his autopsy unfortunately. And let me just get the paper.
Yes. He also had absence of the corpus callosum. He had structural defects of the eye, palate abnormality, ear abnormality, heart abnormality and genital abnormality, which are all midline structures that occur, the key development occurring during the first trimester. So he fell into that same pattern. And I also have unfortunately, as I said, the benefit of having the autopsy results, which showed all of these abnormalities.
THE COURT: Well, is it your view of embryology involved with the development of the embryo that these anomalies that you’ve just described could originate from exposure to any drug between 9 and 11 weeks of pregnancy?
A. No, because, if you take an example of thalidomide, which occurred during the first trimester, didn’t produce these kinds of anomalies of the brain. It produced limb bud abnormalities, phoeomelia and absence of limbs. So it has to do with the specific agent, in other words, the chemical or pesticide or drug, and the timing during pregnancy. Those are two very specific things.
THE COURT: So it is your view it doesn’t make any difference if the exposure occurs say at three weeks after pregnancy occurs or 11 weeks after.
A. Well, at three weeks it would probably kill the fetus. And you would either have — the mother would either figure she had missed a period or would have spotting and would abort. If the exposure occurs too early, before organogenesis has really begun, then the fetus doesn’t survive, and the mother either is unaware of a missed pregnancy or has spotting and figures, well, she wasn’t pregnant.
THE COURT: What is your understanding as to the date of the exposure of Mrs. Smits.
A. That it was during the first trimester of pregnancy.
THE COURT: Well, can you be any more specific than that? Do you know when during the first trimester, according to her own testimony about when she became pregnant?
A Oh, yes. But I haven’t memorized those data.
THE COURT: Well, I’m trying to interpret what I understand the case to be, the comment you just made, that if she were exposed, as early as I think she says she was, that the fetus would have died. I mean the embryo would have died. We know that didn’t happen. So can you refresh your recollection as to when she was exposed to the Dursban?
A. Well, I don’t have her deposition here. THE COURT: You don’t recall?
A Well, that’s a lot of material to remember.
THE COURT: Well, the plaintiff in this case, the child that we are dealing with here should be, it seems to me, one that
*1511
you might keep — I don’t want to criticize you. But I would like you to check to find out when it was. Can someone help her?
MR. DAVIDSON: Your Honor, as I recall, it was between four and six weeks of the pregnancy, as best we could determine. I will have to get the dates for you.
A. Because she had missed a period, I believe.
Then Mr. Davidson proceeded questioning Dr. Sherman about the Gillespie issue:
BY MR. DAVIDSON:
Q. Dr. Sherman, do you want to look at your deposition and refresh your recollection on that issue?
A. If you would like me to, yes. On the Gillespie it says here—
MR. WHETSTONE: What page number?
A. Page 692. The date of the birth was he was born 9-28-87.
BY MR. DAVIDSON:
Q. Is there anything else in there that you want to use to refresh your memory to explain about the Gillespie child to the Court.
A. It says — I guess that is Mr. MacGill asking when was — when was her last period was. “Have you found it?” “Not yet. Here it is. I’m sorry. It says, ‘last menstrual period indicated in this record is 12-10-86.’ ” “And the date of the application here is I believe Exhibit 100?” It says, “Right. I may have written that incorrectly. I have here 4-10-87. The date of the birth is what — he was born 9-28-87. Is there a date of conception that you can estimate based on these records that you have in front of you? Assuming they are true, the last menstrual period is December 10th, ’86, and the birth date we have as given is correct, then two weeks before the last menstrual- period would be approximately the date of conception. Would it be two weeks before or two weeks after? I beg your pardon? Two weeks after. So two weeks after roughly the two weeks after the last menstrual period would be the date of conception?” And I answered ‘Yes, about Christmas Eve.”
THE COURT: Conception around Christmas Eve?
A. Yes, sir.
THE COURT: And the application of the Dursban was April 10?
A. I believe so, yes.
THE COURT: And the date of birth is 9-28?
A. Right.
THE COURT: And was this a full-term pregnancy?
A. Yes.
THE COURT: So, if the application was about, let’s see, five and a half months before pregnancy — before birth, and let’s see here. I don’t know what information is in the record about the embryological development of a child. But it is obvious to me that there’s a lot going on between a month and six weeks and four months. I mean three months after that the child is developed. And, if there’s been no exposure to the drug at that time, I guess what I’m curious about is what’s the latest date at which the chemical agent that caused these defects could have resulted in these defects?
A. Well, because once the Dursban is put into a milieu, a house or an apartment or a building, the half-life varies between 60 days and 18 years. And that’s based on Dow’s own data. So, once this chemical is put into a house or into a home, it is essentially there for the rest of that woman’s pregnancy. The one exception to the eight cases was Mrs. Smits, who fortunately worked in a bank and then ceased working in the bank. But all the other seven cases unfortunately had the Dursban put in their homes, so they were exposed throughout their full terms of pregnancy.
THE COURT: Well, no, Gillespie was exposed, if the application occurred on 4-10 of ’87, and if it continued until birth, then it continued until 9-28-87, about five and a half months?
A. That’s right.
THE COURT: But the first, looks like almost three and a half months, there was no exposure. And your understanding of embryology is that these defects that you
*1512
found in the Gillespie child could have commenced after this exposure?
A. No. I really have a hard time testifying on the Gillespie case in this courtroom when the Gillespie’s are not being represented. I don’t think that’s correct. I did check the medical records. I did cheek with the attorney. And it was the last part of the first trimester that he was exposed. And his defects are the same pattern as the other seven children. And, as I say, the other thing is I have the dubious benefit of having read his autopsy. And they are definitive. He follows the same pattern of the other children, and he follows the same pattern of the boys in that all the boys had undeseended testicles. This is extremely uncommon to find this pattern of defects in a group of children.
THE COURT: So, let me just ask you, assuming that Dursban or no other chemical administered at the time this was, like 4-10-87, could have produced these defects you found, then something else caused it because the defects were there. The defects were there. You know the child—
A. The child has the defects, right.
THE COURT: They are very much like you say the defects that this child Ashley had.
A. But Ashley’s are less — she has more functional ability than the other seven children because her exposure was much more limited because her mother stopped working in the bank. But it is the same pattern of brain, face, nose, eyes, ears, right down the midline.
THE COURT: Well, I’m really getting-let’s assume the Dursban was applied in the seventh month of pregnancy.
A. Then you would more than likely see a different kind of defect, more likely learning impairment, than you would structural defects because by the seventh month the brain would have formed.
THE COURT: How about at the fourth month?
A. I am saying that the structural development, the actual organogenesis occurs essentially between the third and the ninth to tenth week, ninth to twelfth week, third to twelfth week, when the organs are in place, and because of interference with DNA or interference with enzyme systems or interference with a proptosis, then you get a failure of development of a structure that is scheduled to be developed at that time.
THE COURT: If it should turn out it is scientifically impossible for the Gillespie child to have had these birth defects be caused by a drug applied on 4-10-87, do you know of any other explanation of those defects that could have caused it?
A No, sir, because the mother did not smoke, did not drink. The father did not smoke or drink. There was no other exposure. The chromosomes were normal. There was no birth defects in the family.
THE COURT: Yes. But, if you assume for the moment it is impossible for this child to have suffered these defects by that late exposure, then aren’t you really saying that your effort to exclude other causes has been ineffective in that some thing cause — I mean it has to be caused by something.
A Yes, of course.
THE COURT: So, if it wasn’t the drug that was applied on 4-10-87, and you’ve excluded you say a bunch of other alternatives, then it must be something that you haven’t excluded that caused it, if that’s the case.
A. If that’s the case.
THE COURT: Are you an embryologist? I know you’ve taken embryology, I assume, in medical school.
A I took embryology in medical school, yes, sir.
THE COURT: Beyond that, would you consider yourself an embryologist? Do you know exactly when certain organs begin to differentiate at certain points in development?
A. They are well-established. That schedule of events is well established, well-known whether it is in rats, mice or humans.
18
*1513
THE COURT: You may continue.
Sherman Testimony, p.p. 9-19.
These colloquies reveal some of the problems with Dr. Sherman’s theories. Ashley Smits was exposed to Dursban, according to the plaintiffs’ view, for a period of about two months starting less than three weeks after conception. But the Gillespie child was
first
exposed some three and one half months after conception. Dr. Sherman states that “the actual organogenesis occurs essentially between the third and ninth to tenth week, ... Third to twelfth week ...” and “because of interference with the DNA or interference with enzyme systems or interference with proptosis [assumedly caused by Dursban] then you get a failure of development of a structure that is scheduled to be developed at that time.” But then how does one account for the birth defects of the Gillespie child (which are claimed to be essentially the same as the defects found in Ashley and the Burke children) who, according to the plaintiffs, was first exposed to Dursban three and one half months after conception and, therefore, after the development of the structures involved according to Dr. Sherman? And there are further implications from this because the Gillespie child was one of only four cases submitted by Dr. Sherman to her statistician, Mr. J.M. Gould. See p. 8 of “Notes and Comments,” Appendix F.
19
And it also undercuts Dr. Sherman’s contention that she has ruled out alternative potential causes of the defects she found in the four children.
B.
The Effect of Early Exposure
Another problem with Dr. Sherman’s theory is raised by the following question and answer:
THE COURT: So it is your view that it doesn’t make any difference if the exposure occurs say at three weeks after pregnancy occurs or eleven weeks after.
A. Well, at three weeks it would probably kill the fetus. And you would either have — the mother would either figure she had missed a period or would have spotting and abort. If the exposure occurs too early, before organogenesis has really begun, then the fetus doesn’t survive, and the mother is either unaware of a missed pregnancy or has spotting and figures, well, she wasn’t pregnant.
THE COURT: What is your understanding as to the date of the exposure of Mrs. Smits?
To this last question, Dr. Sherman could only state that it was during the “first trimester.” But the real answer is that it was on February 6, 1991, just three weeks after conception. It appears to be Dr. Sherman’s opinion that, if exposure occurred at three weeks, the chemical would probably kill the fetus. But we know that did not occur here. Ashley Smits was born on September 20,1991.
C.
Signature Disease Theory
There are a few so-called “signature” defects such as the one mentioned by Mr. David Levy in his article “Scientific Evidence After
Daubert,”
(see supra):
How much certainty in ruling out potential confounding factors is enough? The answer should depend on their plausibility. Mesothelioma, a cancer of the chest lining surrounding the lungs, is usually caused by exposure to asbestos fibers. Mesothelioma is a “signature” disease: The injury points directly to the substance that caused it.
See The Columbia University College of Physicians and Surgeons Complete Home Medical Guide
471 (1985). Colon cancer, however, has many risk factors: diet, obesity, exposure to environmental hazards, and genetics. An expert witness who claims that a plaintiff’s colon cancer was caused by asbestos exposure must undertake a thorough “differential diagnosis,” performed by a qualified expert, to rule out other potential causes. In
[In re
Joint]
Eastern & Southern District Asbestos Litigation, supra,
827 F.Supp. [1014] at 1048-49 [(S.D.N.Y.1993) ], the court dismissed a claim for colon cancer for failure to perform an adequate differential diagno
*1514
sis even though the plaintiff was only 40 at his death, had no family history of cancer, suffered from no special disease or syndrome, and did not fact an abnormal risk from his diet.
So the Court questioned Dr. Sherman about this possibility:
THE COURT: Isn’t your view that this is what’s sometimes referred to as a signature defect in the sense that it is one that is caused by Dursban and, if you know— not anything else causes it, you could not have these defects caused by any other chemical agent or by genetics but only by Dursban. Is that your view?
A. Yes, sir. That is my view. And I believe this falls into the same situation as the DES children, who by the way there were only seven that formed the signature eases for the DES cases. The daughters who had the vaginal cancers and vaginal autognoses, that their mothers had been given DES, and this was a birth defect that was not expressed until the girls reached menarche. I believe this is like the signature cases of the vinyl chloride caused hemangiosarcoma of the liver. That was three cases that were reported. I think these are the signature case, and I think there’s a lot more than the eight that I’ve identified so far. But I don’t know how we are going to find them except by reporting some way.
THE COURT: Do you know how long these organophosphates, insecticides or pesticides, whatever they are, have been produced?
A Yes, sir.
THE COURT: How long?
%
* * 4? *. H:
THE COURT: Late thirties?
A. Yes, sir.
* * * * * *
THE COURT: If prior to the 1930s there were children born with these defects, that would make your theory wrong; right? I mean, before there was any production of this signature insecticide, which you say causes this result, there could have been no abnormality or children bom with this kind of a defect.
A. I think perhaps, sure.
THE COURT: There could have been?
A. Sure. But they would never have survived because 1930 was the days before antibiotics. They would never survive much before a few days of life.
THE COURT: What about since the drag has been available and actually used? I gather it has been used fairly heavily for some 30 years, recently more so. If there were similar anomalies and birth defects— for instance, one of the doctors talks about this CHARGE diagnosis of being genetic. Is it your view that those were caused by Dursban, I mean whether you know anything about their exposure or not, you could almost just assume, if they have the same symptoms, that they had been exposed to Dursban; is that correct?
A. I don’t know.
So, while Dr. Sherman first contends that the specific birth defects she found in the children were “signature” responses to exposure to Dursban, she-later equivocates.
20
Further undercutting Dr. Sherman’s opinion that Ashley’s birth defects are a “signature” for Dursban exposure is her testimony about the role of Firefog. She was asked in effect (at page 321 of her deposition) if the applicator had not used Dursban, would the case proceed because of Mrs. Smits exposure to Firefog which the MSDS states is a neurotoxin. Dr. Sherman stated that in her opinion substances that are potentially neurotoxic are also teratogenic.
*1515
It had been plaintiffs theory that Dursban was what caused the birth defects while Fire-fog contributed by facilitating the passage of Dursban across the placental barrier. But under that theory there would be no birth defects
without exposure to Dursban.
Yet, Dr. Sherman was willing to suggest that Firefog, in the absence of Dursban, would cause the defects found in Ashley. Of course, there is no scientific proof in the record to support such an assertion, and it is contrary to the plaintiffs’ theory of the role of Firefog. And, as stated, her testimony contradicts her “signature disease” theory by pointing to another chemical as a possible cause of Ashley’s defects.
D.
The Hanley Studies and the MSDS for TCP
Plaintiffs rely heavily on the MSDS for TCP. Dr. Sherman was questioned about that:
Q. So there’s actually two Hanley studies on TCP. Is that correct?
A That’s correct.
Q. One of them was on TCP with rabbits in 1987. And one was with rats in 1987. A. That’s correct.
Q. You’ve reviewed those?
A. Yes.
Q. Have you reviewed the MSDS sheet for TCP also?
A. Yes, I have.
Q. Does that MSDS sheet say anything about the fact that TCP is a teratogen or can cause birth defects?
A. Yes, it does.
Q. What does it say about it?
A. Let me get it.
Q. What do you recall it says? What do you recall that it says?
A It says that it causes birth defects. And it is teratogenic, yes.
THE COURT: Doesn’t it say it is reported? Why don’t you read it.
A. I have to find it. Just a second. Do you have a copy?
MR. DAVIDSON: Your Honor, we have a copy here that was marked in the past I think. We will make it Plaintiff’s Exhibit Number 2. This is a Material Safety Data Sheet for 3, 5, 6-Trichloro-2 pyridinol, Plaintiffs Exhibit Number 2.
(Plaintiffs Exhibit 2 identified.)
THE COURT: It is short, isn’t it?
MR. DAVIDSON: Well, it is a long one. I can read it to you.
THE COURT: The language that she’s relying on, that’s the part.
MR. DAVIDSON: Your honor, the language she’s relying on is the section I think it says, “Teratology: Birth defects: Has been reported to cause birth defects in laboratory animals at doses nontoxic to the mother.”
THE COURT: Has been reported to.
MR. DAVIDSON: Yes, Your Honor.
THE COURT: All right.
BY MR. DAVIDSON:
Q. Have you also personally looked at the Hanley study, not just the MSDS sheet?
A. Yes, I have.
Q. Have you reviewed that?
A. Yes, I did.
THE COURT: You understand the MSDS is based on the Hanley study, when it says has been reported.
A. I am not sure what it is based on because the Hanley study came out in ’87. This was not issued until 1991, so I don’t know what was going on in those five years. There may be other studies that I’m not aware of. It wasn’t until Wednesday that I was able to get a printout of that rat study because I wasn’t aware that there was a rat study. And the rabbit study was withheld from me after it was given to me in the
Burke
case. And I was required to return it because the attorney had agreed to a confidentiality agreement, and I had not. So I had to wait until I could get a copy under a Freedom of Information Act from EPA That took two and a half months. So I don’t know how many other studies there are out there indicating teratogenicity.
THE COURT: So you don’t know what they are referring to when they say it has been reported.
*1516
A. Well, I assume it has to be the two Hanley studies.
The Court accepts the statements made in Appendix A to the defendants pre-hearing brief captioned “Errors and Misrepresentations in Case Reports Published by Janette Sherman” as a fair summation of such errors. The Court also accepts the explanation of this MSDS found at p.p. 24 — 27 of defendants’ Post-Hearing Memorandum. It also finds persuasive most of the critique of Dr. Sherman’s 1995 article set forth in Subsection C of Appendix F to Dr. Johnson’s Declaration. See Tab C to defendants’ Evidentiary Submission.
Dr. Sherman, in her testimony and even in her written articles, comes across as ah advocate. Of course, good and careful scientists may also end up as strong advocates of their scientific opinions. But candor should be a hallmark of a good scientists. The Court cannot avoid the conclusion on this entire record that Dr. Sherman’s advocacy is based on suspicion and conjecture and litigation animus rather than science.
Other courts have commented on Dr. Sherman or her expert testimony. See
In re Paoli RR Yard PCB Litigation,
1992 WL 323493 (E.D.Pa)
rev’d in part
35 F.3d 717 . She has essentially been a litigation consultant and expert witness for the past twenty years. She estimates that she has participated in some 8,000 cases (many, it must be said, being Workman’s Compensation Cases) in that period and given some 800 depositions. Her research and study on the four cases she has written about was all litigation connected. This is not immaterial in a
Daubert
proceeding because the expert’s motivation for his/her study and research is important. While the usual credibility of an expert is not so important, in a
Daubert
hearing the expert’s scientific credibility cannot be avoided. The Ninth Circuit in
Daubert II
makes the point thusly:
One very significant fact to be considered is whether the experts are proposing to testify about matters growing naturally and directly out of research they have conducted independent of litigation, or whether they have developed their opinions expressly for the purposes of testifying ... [I]n determining whether proposed expert testimony amounts to good science, we may not ignore the fact that a scientist’s normal work place is the lab or field, not the courtroom or the lawyer’s office.
That an expert testifies based on research he has conducted independent of the litigation provides important, objective proof that the research comports with the dictates of good science. See Huber, Galileo’s Revenge at 206-09 (describing how the prevalent practice of expert-shopping leads to bad science). For one thing, experts whose findings flow from existing research are less likely to have been biased toward a particular conclusion by the promise of remuneration; when an expert prepares reports and findings before being hired as a witness, that record will limit the degree to which he can tailor his testimony to serve a party’s interests.
Hs * Hí H* Hí $
If the proffered expert testimony is not based on independent research, the party proffering it must come forward with other objective, verifiable evidence that the testimony is based on “scientifically valid principles.”
Hi Hi Hi Hi Hi Hi
Establishing that an expert’s proffered testimony grows out of prelitigation research or that the expert’s research has been subjected to peer review are the two principal ways the proponent of expert testimony can show that the evidence satisfies the first prong of Rule 702. Where such evidence is unavailable, the proponent of expert scientific testimony may attempt to satisfy its burden through the testimony of its own experts. For . such a showing to be sufficient, the experts must explain precisely how they went about reaching their conclusions and point to some objective source — a learned treatise, the policy statement of a professional association, a published article in a reputable scientific journal or the like-to show that they have followed the scientific method, as it is practiced by (at least) a recognized minority of scientists in their field.
*1517
Plaintiffs claim Dr. Sherman’s articles were peer reviewed. But her potential bias because of her direct involvement in litigation in the four eases on which she reported was not disclosed in her articles. Nor did she disclose the opinion of experts attributing the birth defects to genetic causes. And the opinions she expressed in the articles do not go to the same extent as the opinions she would put before the jury. So the court discounts the value of any peer review that might have occurred with respect to those articles.
Most of plaintiffs expert witnesses are highly respected and highly credentialed doctors and scientists. The Court’s difficulties with Dr. Sherman and to a lesser extent with Dr. Bidanset, see below, should not be interpreted as indicating any such problems with those other experts. Nevertheless, Dr. Sherman has clearly been the plaintiffs’ lead expert and most of plaintiffs’ other experts have relied to some degree upon her studies and opinions in reaching their own conclusions. And to the extent that plaintiffs other experts opine that Ashley Smits’ birth defects were caused by her mother’s exposure to Dursban, such opinions simply do not meet the
Daubert
standards. As stated by Judge Ellis in the
Cavallo
case, supra:
In sum, neither Dr. Monroe nor Dr. Bellanti sufficiently adhered to the established toxicology methodology in forming their conclusions that Ms. Cavallo’s exposure to AvJet vapors from the December 1991 spill caused her various chronic illnesses. Their testimony, therefore is not “supported by appropriate validation” as required by
Daubert,
509 U.S. at 590 , 113 S.Ct. at 2795 , and is ultimately unreliable. In the final analysis, the opinions of Drs. Monroe and Bellanti are based largely on hypothesis and speculation. This is not to say that the doctors are insincere in their opinions, or that their opinions may not some day be validated through scientific research and experiment. It may well be that the AvJet spill forever “sensitized” Ms. Cavallo to petroleum vapors and various other household chemicals. But the published scientific literature and test results simply do not support that conclusion at this time. And the price paid for this seemingly stringent standard of reliability is that, unavoidably, some legitimate injuries will be left unredressed.
See Daubert,
509 U.S. at 597 , 113 S.Ct. at 2798-99 (recognizing that “in practice, a gatekeeping role for the judge, no matter how flexible, inevitably on occasion will prevent the jury from learning of authentic insights and innovations”).
X. THE BIDANSET STUDIES
Dr. Bidanset has a Ph.D. in organic chemistry. Like other of the plaintiffs’ experts he has impressive credentials in certain areas. He is presently a Professor of Pharmaceutical Sciences at St. Johns in New York. He is board certified in forensic toxicology. He has worked in a medical examiner’s office. He has done alcohol, drug abuse and urine drug testing in criminal cases. He has prepared and analyzed tissues and tested for the presence of chemical agents in humans. He does not claim to be an expert in epidemiology, biostatistics or medical genetics. He is not a medical doctor. He is not board certified in any field dealing with the diagnosis or treatment of birth defects such as teratology or dysmorphology. (He has studied in the field of teratology for years but does not claim to be an expert in that field.) He published his first article on reproductive processes in animals in 1988, but that study was not related to birth defects or to the effects of Dursban. He has never been employed to consult on a birth defects case outside of the litigation context.
A summary of Dr. Bidanset’s writings and opinions will be found in Appendix A, attached hereto. He is listed as the author or co-author of what are referred to as the Muto Study, the Cosenza Study, and the Nimphius Study, all 'of which deal with the effects of Dursban on animals.
21
The Muto Study was published in 1992. The Cosenza Study was published in 1995. The Nimphius Study was written in 1995 but is unpublished.
*1518
It appears that Muto, Cosenza and Nimphius were graduate students working with and under the direction of Dr. Bidanset on their master degree theses. Dr. Bidanset provided chlorpyrifos as the topic for those studies. Each of the studies was prepared after Dr. Bidanset was employed as an expert for the plaintiffs in the
Burke
case. In that case it was claimed that the mother of Mary Ellen Burke and Keven Burke had been exposed to Dursban as a component of a flea spray called “Rid-A-Bug” which had been applied by Mr. Burke to the Burke home during Mrs. Burke’s pregnancy, and that this exposure resulted in the birth defects sustained by the children
22
Dr. Bidanset acknowledges that the
Burke
case was the force in directing his research. Dr. Bidanset has done no research on Dursban independent of litigation.
The Court finds persuasive the criticisms of the Muto and Bidanset study (published in 1992) and the-Cosenza-Bidanset Study (1995) as set forth in Appendix F to Dr. Marshall Johnson’s Declaration. See Tab C of the defendants’ Evidentiary Submission. There are no adequate exposure, dose or NOEL predicates for Dr. Bidanset’s causation opinions, and he is not qualified to rule out possible genetic causes of Ashley Smits’ birth defects. See below.
XI. REAFFIRMATION OF PREVIOUS FINDINGS AND THE FINALIZATION OF PRIOR TENTATIVE FINDINGS.
A.
Plaintiffs Have Failed to Establish General Causation
As previously stated the most relevant scientific community to deal with issues related to the cause and/or the prevention of birth defects is teratology and medical genetics. This is not to say that no other fields of scientific study have anything to contribute to an understanding of birth defects. Obviously many do. But it is clear to the court that the parents of a child with a significant birth defect will eventually be referred “up the chain,” so to speak, to a teratologist or a medical geneticist specializing in birth defects. Indeed, that is what happened in this case. It is this specialized medical community which establishes the scientific standards and protocols to determine, inter alia, if a given chemical agent is a human teratogen. The people who train in the areas of teratology and medical genetics may come from a variety of other disciplines such as pediatrics, reproductive toxicology, clinical genetics, embryology, obstetrics, and epidemiology. But to be a teratologist a person from such other discipline must specialize in, study, and/or do research into the causes and prevention of birth defects. Such specialists, although few in number (some 600 in the United States), are well known throughout the medical and scientific community.
The defendants rely heavily on the submissions of Dr. Lewis Holmes, Chief of the Genetics and Teratology Unit of the Massachusetts General Hospital in Boston (the expert relied upon by the Court in the
WadeGreaux
ease); Dr. Marshall Johnson, PhD., a reproductive toxicologist specializing in the effects of chemicals on
in útero
development; Dr. John Graham, pediatrician and medical geneticist with 20 years of clinical experience in genetics, dysmorphology and teratology; and Dr. Christopher Cunnif, board certified in pediatrics and clinical genetics. Dr. Cunniff was previously the Director of the teratogen counseling service at the Arkansas Childrens’ Hospital. He treated and provided medical care to Ashley Smits. They also rely on a medical text written by Dr. Schardein, who has 30 years experience as a researcher on the teratogenic potential of drugs and chemical agents. These submissions have contributed to the factual conclusions reached by the Court earlier and conveyed to the parties as part of its “Notes and Comments” (see Appendix F):
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Defendants make the point that there is a consensus in the relevant scientific community (composed of teratologists and medical geneticists) concerning the appropriate protocol and methodology that must be followed in order to establish and classify a particular chemical agent as a human teratogen. The submissions of the parties have persuaded me that they are correct in this regard. Through the use of this protocol and the methodology and reasoning it adopts, some 40 chemical agents have apparently been established as human teratogens. See above. Dursban LO is not on this list. Defendants have essentially satisfied the court that they are correct on their general causation arguments. They would then go on to argue that this conclusion by the Court requires it to grant their
Daubert
motion by excluding all of plaintiffs causation evidence. The Court is not ready to agree. Such a conclusion would have the effect of denying the claims of all plaintiffs who contend that their birth defects were caused by a chemical agent that had not been established as a teratogen through the use of the accepted protocol. While it would undoubtedly be extremely helpful to such plaintiffs to have the challenged chemical agent firmly established (through the use of such protocol) as a human teratogen, the absence of such a determination should not, alone, prove fatal to their claim. Indeed, it is clear to the Court that the facts and circumstances of particular cases might provide evidence of specific causation sufficient to go to a jury.
After having the benefit of further argument on September 12, 1996, the Court reaffirms its general causation conclusion.
B.
The Only Epidemiological Study in This Record Undercuts Plaintiffs’ Causation Opinions
In its “Notes and Comments” (Appendix F, p.p. 3-7) submitted to parties before the September 12, 1996, hearing, the Court also carefully reviewed the “Willis Study” which appears to be the only epidemiological study ever conducted on Dursban. And the Court also reviewed the analysis of that study by Dr. Marshall Johnson which concluded that the study revealed no indication of any developmental defects in the women who were exposed. Then the Court states:
At the last oral argument plaintiffs’ lawyers contended that the Willis study was not reliable and should be given no weight. They pointed out that Dursban was just one of many pesticides to which the subject women might have been exposed. If the plaintiffs believe that the Willis study is subject to other defects or inadequacies which could undermine its validity, they should point same out at the September 12 conference. Of course, it certainly would be better if several, or many, epidemiological studies were done on Dursban LO, its contaminants, impurities and metabolites. But the Willis study is the only such study we have. So it is critical to carefully assess its importance.
Nothing that occurred at the September 12 hearing or thereafter has changed the Court’s view. The Willis study, while it has its inadequacies, clearly supports the defendants’ position. More important, plaintiffs have no epidemiology study supporting their theory of causation, and it is the plaintiffs who have the burden of proof on the
Daubert
issues.
C.
Dr. Sherman’s Articles on Four Cases
In its “Notes and Comments,” the Court discussed Dr. Sherman’s 1995 article on four eases, Appendix F, pp. 7-8, and pointed out that it had also read Dr. John Graham’s and Dr. Marshall Johnson’s critiques thereof. It then stated:
Overall, Dr. Sherman bases her opinion on her analysis of the human case reports, animal studies, biochemistry and the structural activity relationship of the chemical agent.
From my own examination of Dr. Sherman’s articles, from the critiques thereof by Drs. Graham and Johnson, and from the written and oral arguments of defendants’ counsel, I have come to the tentative conclusion that Dr. Sherman’s analysis and causation opinions are not derived from any accepted scientific methodology (i.e., are not grounded in the methods and procedures of science), are not scientifically valid and, ergo, do not possess the eviden
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tiary reliability required by
Dauberb.
This is not to say that Dursban LO is not a teratogen or that it did not cause Ashley’s birth defects. It is to say that Dr. Sherman’s submissions and opinions are not derived from scientific methods and are nothing more than an invitation to the jury to speculate (rather than a reliable basis upon which the jury could find that it is more likely true than not true that Dursban LO caused the birth defects suffered by Ashley.) Therefore the views and opinions expressed would not assist the trier of fact to determine the cause of those defects.
My tentative view is that Dr. Sherman’s case studies do nothing more scientifically than to suggest a causal relation. That hypothesis has not to date been legitimized by further research and studies. In sum, there have been no epidemiological studies, no repeatable dose-response animal studies, no other studies which would connect Dr. Sherman’s speculative hypothesis to a scientific proposition having acceptance in at least a segment of the pertinent scientific community.
Those conclusions are no longer “tentative.” After a thorough review of the record the court adopts that view of Dr. Sherman’s ease studies as final. For further support of this conclusion see Section IX, above, “Discussion of Portions of Dr. Sherman’s Testimony.”
XII. PLAINTIFFS HAVE FAILED TO EXCLUDE OTHER POSSIBLE CAUSES OF ASHLEY’S BIRTH DEFECTS
In determining the cause of birth defects it is necessary not only to rule in a particular possible cause but also to rule out other possible causes. The plaintiffs have failed to do either in this case.
Although the defendants do not have the burden in a
Dauberb
proceeding to prove that the harm (here birth defects) was caused by something other than their product (here Dursban), they have brought forth experts who have opined that Ashley’s birth defects were caused by, probably caused by, or possibly caused by genetic factors. And there is evidence that the treating physicians for the
Burke
children (2 of the 4 dealt with in Dr. Sherman’s article) believed their defects could be genetic in origin. In the face of such suggestions plaintiffs assert they have ruled out possible genetic causes. But defendants contend that none of plaintiffs experts has the skill, experience, training or education to make such a scientific judgment. The Court agrees. During Dr. Sherman’s testimony on September 12,1996, the following occurred:
Q. In the case of Ashley Smits, have you ruled out other causes of birth defects in that child?
A Yes, I did.
Q. How did you go about doing that?
A Taking a history from the parents and reviewing all the medical records and talking to her treating physician and found that the chromosomal studies were normal. Neither parent smoked. Mrs. Smits did not drink. There were not other medications, except for an occasional — where are we here — occasional Tylenol to give any explanation as to why this child is abnormal.
THE COURT: Were you able to rule out genetic possibilities?
A Yes, sir. Neither the mothers nor the fathers had any genetic abnormality. Neither the maternal grandmother had any. The maternal grandfather, his medical history was unknown. The paternal grandmother and grandfather had no genetic abnormalities. There was another child born to the family. As a matter of fact, all of the families, all eight families have other children bom at a time when Dursban was not used, which those children are normal.
THE COURT: When you say there was no genetic abnormality in these various generations of people, how do you know that?
A I asked the families.
THE COURT: Just asked if there was any?
A Any birth defects, any birth defects in your parents’ families or in your grandparents’ families. And the thing is, it has been suggested by the defense that this is a genetic abnormality. But you have to
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look at these kids and realize that they are totally incapable of reproduction short of rape of one of the girls. They are not— the boys are certainly not ever going to reproduce because they all have undeseended testicles. And two out of three have microphallus. The girls, it would be impossible for them to reproduce unless they were raped. I don’t even think that would — I don’t think they could ever carry a child to term. So how in the world anybody in the background could have had this collection of illnesses and reproduce is totally impossible.
THE COURT: So it is your understanding of the science that if there were not a history of similar defective children suffering the same or similar birth defects in the history, that there’s no basis for concluding that this might be due to genetic problems?
A. That’s correct.
•I* ■I'
THE COURT: So let me get a little bit about your background in genetics. You had a course in genetics in college?
A. Yes. In medical school ■ and college, undergraduate school.
THE COURT: Is that the limit of your training in genetics?
A. No.
THE COURT: What else have you had? A, Well, I’ve been in practicing medicine since 1964. I read on a constant basis. My book that I published covers the effects. This is the book, the effects on chemical, the effects of chemicals and radiation on living systems, including how these interact with the DNA and cellular mechanisms, enzymes, embryological effects. I covered all of that in here on how to think about chemicals and their impact on life.
Transcript 9/12/96 hearing, Dr. Sherman, p. 21-24. Dr. Sherman testified she had “no idea” what the COSF syndrome or the CHARGE syndrome are. See her deposition, p. 113.
Dr. Join Grisham who specializes in Dysmorphology, Clinical Genetics, Medical Genetics, Teratology, Developmental Disabilities, Communicative Disorders, Pediatries and Public Health is of the opinion that the most likely diagnosis for Mary Ellen and Kevin Burks is the COFS syndrome or possibly the Micro syndrome both of which are autosomal recessive brain and eye disorders. He concludes:
“To a high degree of medical certainly I believe that the defects in these children recurred on an autosomal recessive genetic basis ...”
Dr. Gunner Heuser referred Ashley Smits to Dr. Barbara Crandall, Professor of Psychiatry and Pediatrics, Division of Medical Genetics, for evaluation concerning prenatal exposure to possible toxic substances. See defendants’ evidentiary submission, Tab E. After taking a history, including family history, and performing a physical examination, Dr. Crandall opined:
Impression: Ashley is a three year old girl who has many of the facial features of a cranio synostosis syndrome. Premature fusion would explain the facial hypoplasia and the prominent eye as well as the nose. Cleft lip and palate are quite commonly associated. Her features are most suggestive of the Antley-Bixler syndrome but also of the Crouzon syndrome. However, her features are different to this or related syndromes because of the degree of asymmetry, facial palsy, deafness and the one-side aortic arch and absence of features such as joint contractures. Since the lip fuses at 5 weeks post conception, it is likely that these abnormalities arose prior to that time. This does not exclude a genetic disorder or some factor acting early on in development affecting both of the brain and the face. Many of the cranio synostosis are inherited as autosomal dominant traits although the Antley-Bixler syndrome is inherited as an autosomal recessive disorder. In the majority of cases there is no family history so these appear to result from new dominant mutations. There is no positive family history, and the only way to be certain of a genetic basis would be to see a recurrence in a succeeding child or a child of Ashley. Although most cases of malformations affecting the brain and face probably occur early in
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pregnancy, most do not have a positive history of any teratogenic exposure, but this certainly cannot be excluded in the case of Ashley Smits. Overall, I would estimate that there is a low likelihood that the exposure described in pregnancy was the cause of Ashley’s problems.
On June 23, 1995, Dr. Crandall did a “follow-up” on the case.
See
Tab E. Therein she states:
I have reviewed the findings in Ashley in some depth and I now believe the abnormalities in her fit within the broad categories of the CHARGE syndrome. This association of abnormalities describes
C coloboma
H congenital heart defect
A choanal atresia
R retardation in growth and or central nervous system and mental retardation
G hypoplastic genitalia
E ear abnormalities and or deafness
My hesitation in using this designation earlier was the absence of the choanal atresia. However, it appears that choanal atresia occurs in about 65% of CHARGE syndrome patients. The type of heart abnormality includes aortic arch malformations would fit within this constellation as would the asymmetry of the face. Aberrant development or migration of neural crest cells has been suggested as a primary etiology. Most cases of CHARGE syndrome have been single ones within a family and no common etiology has been identified. I could find no report to suggest any particular type of teratogen found to be responsible for some of these cases. Nevertheless, the abnormalities would have arisen early on in gestation and certainly within the first 6 to 7 weeks from conception.
23
My conclusion after considerable review and reevaluation suggests but does not confirm the diagnosis of the CHARGE syndrome and confirms that these malformations had their origin early on in pregnancy. I cannot exclude a teratogen as an etiologic agent.
And Dr. Christopher M. Cuniff, M.D., Assistant Professor of Pediatrics at the University of' Arknasas for Medical Science, diplomat of the American Board of Medical Genetics and Director of Teratogen Counseling Services of the Arkansas Genetics Program is also of the opinion that Ashley’s birth defects were caused by a genetic disorder. See p. 34 of his deposition, Tab D. And he also points out that a normal chromosome analysis does not rule out genetic factors as a cause of Ashley’s birth defects:
Q. Does a normal chromosome analysis as done in the case of Ashley eliminate a genetic abnormality as the cause of her birth defects?
A. No, absolutely not. If you look at all the most common genetic disorders, think about conditions like sickle cell anemia in the African-American population or cystic fibrosis in the Caucasian population, and Tay-Sachs in. the Eastern European-Jewish population, very serious genetic disorders, life-threatening, fatal in many cases their chromosomes are completely normal.
The Court has not quoted from defendants’ genetic experts for the purpose of endorsing their views. Rather its purpose is to make clear that genetics is a serious, complex science. One without training or experience cannot exclude possible genetic causes by doing little more than questioning the parents of a child born with defects about the family history. Another way of looking at it is this: If parents of a child with birth defects want to learn if those defects may have been caused by genetic factors, to whom do they go? Obviously one seeks out the most knowledgeable experts on medical genetics. And that is what occurred in this case. But plaintiffs have not found any such qualified geneticist to agree with them that genetic

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/2139332. Public record. Not legal advice.