Guadalupe Moreno v. C'Tara Ingram, 454 S.W.3d 186

Background

On Aug. 1, 2010, C’Tara Ingram sued Guadalupe Moreno for injuries from an automobile collision; a jury found Moreno solely negligent and awarded Ingram $275,372.71 plus interest and costs.
Ingram presented Section 18.001 affidavits and medical records; the trial court admitted the affidavits but redacted statements expressly asserting medical necessity.
Ingram called her chiropractor, Dr. Brian Starry, to testify about her injuries, chiropractic care, prognosis, and the necessity of non-chiropractic treatments (including epidural steroid injections and other care by pain-management physicians).
Moreno objected repeatedly that Dr. Starry was not qualified to opine about non-chiropractic treatment or procedures beyond the scope of chiropractic practice; the trial court overruled those objections and admitted the testimony and demonstrative exhibits.
On appeal Moreno argued the chiropractor’s non-chiropractic testimony was inadmissible and legally insufficient to support the jury’s award for non-chiropractic past medical expenses; the court affirmed as to most damages but reversed and rendered on the non-chiropractic medical-expense item.

Issues

Issue	Plaintiff's Argument (Ingram)	Defendant's Argument (Moreno)	Held
Whether Moreno preserved objection to Dr. Starry’s scope	Objection to jury charge was not made but objections at trial were not required to be repeated before jury	Preserved: Moreno made repeated, specific objections during voir dire and on the record	Preserved: objections outside jury and specific in-court objections preserved error under Tex. R. Evid. 103(a)(1)
Whether a chiropractor may opine on necessity of non-chiropractic medical treatment	Dr. Starry’s training, experience, and practice familiarity qualify him to opine about necessity of treatments he refers	Dr. Starry conceded he cannot perform injections, is not a medical doctor, and does not make those treatment decisions; thus he lacks qualification	Not qualified: trial court abused discretion admitting testimony on non-chiropractic treatment; testimony legally insufficient to support those expense awards
Sufficiency of evidence to support past medical expenses award ($25,372.71)	Dr. Starry’s testimony plus records show expenses resulted from collision	Only $6,025 of the bills were for chiropractic care (within his expertise); remaining $19,347.71 lack qualified expert proof	Reverse as to non-chiropractic past expenses: render judgment reducing past medical expenses to $6,025 and adjust totals and interest
Whether erroneous testimony requires reversal of entire judgment	Admission was harmless in part because jury heard other competent evidence (plaintiff testimony, records) supporting pain, impairment awards	Dr. Starry’s testimony could have tainted all damages; prejudicial expert testimony requires reversal	Affirmed in part: awards for pain, mental anguish, impairment upheld; only non-chiropractic past medical expense award reversed and rendered accordingly

Key Cases Cited

Whirlpool Corp. v. Camacho, 298 S.W.3d 631 (Tex. 2009) (standard for admissibility review and no-evidence legal-sufficiency review of expert testimony)
City of Keller v. Wilson, 168 S.W.3d 802 (Tex. 2005) (framework for factual- and legal-sufficiency review of jury findings)
E.I. du Pont de Nemours & Co. v. Robinson, 923 S.W.2d 549 (Tex. 1995) (proponent bears burden to show expert qualifications and reliable foundation)
Gammill v. Jack Williams Chevrolet, Inc., 972 S.W.2d 713 (Tex. 1998) (limits on experience-based expert testimony and analytical gap doctrine)
Hayhoe v. Henegar, 172 S.W.3d 642 (Tex. App.—Eastland 2005) (chiropractor held qualified in that record to opine causation and need for surgery)
Hong v. Bennett, 209 S.W.3d 795 (Tex. App.—Fort Worth 2006) (chiropractor not qualified to controvert necessity of non-chiropractic medical services)
Watson v. Ward, 423 S.W.2d 457 (Tex. App.—Tyler 1967) (chiropractor competent to testify as expert on matters within chiropractic scope)