Estate of Patricia E Leblanc v. Eugene J Agnone Md
330416
| Mich. Ct. App. | Jul 6, 2017

Background

  • Patricia LeBlanc (b. 1940) received 16 doses of Mitoxantrone (Novantrone) from Aug 2008–Nov 2009 for progressive MS; her lifetime total (300 mg) exceeded doses plaintiff alleges were appropriate.
  • Cardiology follow-up by Dr. Romanelli showed an EF decline from 76% (July 2008) to 62% (Jan 2009) and stress-test EF ~50% (Jan 2009); further decline and cardiomyopathy followed, leading to surgery and death in July 2010.
  • Plaintiff sued multiple physicians and entities for malpractice alleging excessive/dense Novantrone dosing and failures in cardiac assessment and communication; appeals concern several in limine orders on expert testimony.
  • Docket No. 330330: trial court disqualified plaintiff’s medical-oncology expert (Dr. Sokol) under MCL 600.2169(1)(b) for failing to show he devoted a majority (>50%) of his time to medical oncology the year before the alleged malpractice.
  • Docket No. 330416: trial court denied motions by cardiologist defendants (Dr. Romanelli and Woods) to strike or limit plaintiff’s cardiology expert (Dr. Meltzer) on qualifications, a 10% EF-drop rule, newly disclosed criticisms, and proximate-cause opinions.

Issues

Issue Plaintiff's Argument Defendant's Argument Held
1. Qualification of oncology expert (Dr. Sokol) under MCL 600.2169(1)(b) Sokol devoted a majority of his time to medical oncology (affidavit asserted majority). Sokol split time across many specialties and could not quantify >50% to medical oncology. Court affirmed disqualification: deposition showed insufficient proof he spent a majority of time in medical oncology.
2. Qualification of cardiology expert (Dr. Meltzer) under MRE 702/MCL 600.2169(2) Meltzer is qualified as a cardiologist with experience assessing cardiotoxic chemo effects. Defendants argued he lacked Novantrone-specific experience and relied on internet research. Court affirmed denial of strike: Meltzer’s cardiology experience and literature review made him qualified to testify on cardiology standard of care.
3. Reliability/admissibility of Meltzer’s opinion that a ≥10% EF drop warrants stopping Novantrone The 10% threshold is supported by FDA labeling and medical literature; Meltzer’s methodology reliable. No peer-reviewed standard establishes an absolute 10% cutoff; FDA label doesn’t expressly state 10% rule. Court affirmed admission: Meltzer’s opinion was reasonably grounded in FDA label and literature (e.g., clinical studies) and not mere speculation.
4. Excluding Meltzer’s allegedly new criticisms and expert causation opinions Meltzer’s trial testimony did not materially add undisclosed theories; his causation opinions were reasonably supported. Defendants claimed new criticisms (failure to report 50% EF, failure to order MUGA) were not timely disclosed and causation was speculative. Court affirmed denial of exclusion: discovery record and complaint sufficiently disclosed criticisms; proximate-cause opinions were reasonably extrapolated from evidence and literature.

Key Cases Cited

  • Woodard v Custer, 476 Mich 545 (Mich. 2006) (interpreting MCL 600.2169: expert must match defendant’s specialty and devote a majority of prior-year professional time to that specialty)
  • Elher v Misra, 499 Mich 11 (Mich. 2016) (expert admissibility requires qualification and reliability under MRE 702 and MCL 600.2955)
  • Craig ex rel Craig v Oakwood Hosp, 471 Mich 67 (Mich. 2004) (requirement that expert be qualified by knowledge, skill, experience, training, or education)
  • People v Unger, 278 Mich App 210 (Mich. Ct. App. 2008) (Daubert/MRE 702 gatekeeping: opinion must be rationally derived from a sound foundation)
  • Kiefer v Markley, 283 Mich App 555 (Mich. Ct. App. 2009) (definition of "majority" as >50% under MCL 600.2169(1)(b))
  • Hamade v Sunoco, Inc, 271 Mich App 145 (Mich. Ct. App. 2006) (conclusory affidavit allegations insufficient to create factual dispute)
  • Teal v Prasad, 283 Mich App 384 (Mich. Ct. App. 2009) (expert testimony required to prove causation in medical malpractice)
  • Wiley v Henry Ford Cottage Hosp, 257 Mich App 488 (Mich. Ct. App. 2003) (specialist standard defined by recognized practice within that specialty)
  • Chapin v A & L Parts, Inc, 274 Mich App 122 (Mich. Ct. App. 2007) (MCL 600.2955 factors guide reliability inquiry)
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