Lm, Gal W Dussault, V Laura Hamilton, 76019-0

Background

L.M., a minor, suffered permanent brachial plexus injuries (avulsions/ruptures) at birth and sued midwife Laura Hamilton for professional negligence in King County; venue later changed to Lewis County.
Claims against JUA and Midwifery Support Services were dismissed on summary judgment; trial proceeded against Hamilton; jury returned a defense verdict.
Hamilton sought to admit expert testimony that natural forces of labor (NFOL) — including maternal pushing and intrauterine forces — can cause brachial plexus injuries (BPIs); plaintiff moved to exclude NFOL causation evidence under Frye and ER 702; the trial court initially excluded but, on reconsideration, admitted NFOL and biomechanical testimony with limits.
Defense experts (obstetricians and midwives) and peer-reviewed sources (e.g., ACOG, Williams Obstetrics) supported that NFOL can cause BPIs, including some permanent injuries; plaintiff presented experts who disputed NFOL as a cause of avulsion/rupture.
Trial court limited non-medical expert (biomechanical engineer Dr. Tencer) to biomechanics (not medical causation); excluded a plastic surgeon (Dr. Tse) for lack of a reliable causation opinion based on his limited review.
On appeal, the court affirmed admission of NFOL and biomechanical testimony, affirmed exclusion of Dr. Tse, and affirmed the venue change to Lewis County.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Admissibility of NFOL causation under Frye	NFOL causation for avulsion/rupture is novel/not generally accepted; Frye exclusion required	NFOL theory and underlying methodologies are generally accepted in the relevant medical community; Frye not implicated	Frye not implicated; NFOL testimony admissible and goes to weight, not admissibility
Admissibility under ER 702 (helpfulness)	NFOL evidence not helpful because literature doesn’t tie NFOL to specific avulsion/rupture injuries	Experts applied accepted theories to case-specific facts (video, records); testimony aids jury understanding	ER 702 satisfied; testimony helpful and properly admitted
Qualification and scope of biomechanical engineer (Dr. Tencer)	Not a physician; testimony crosses into medical causation	Qualified by training/experience to address forces; limited to biomechanics, not causation	Qualified for biomechanical opinion; trial court properly limited testimony; no abuse of discretion
Exclusion of plastic surgeon (Dr. Tse)	Trial court erred in excluding his testimony	Tse lacked a reliable, case-specific causation opinion and had not reviewed obstetric literature	Exclusion affirmed: Tse not qualified to offer relevant expert causation and testimony would not assist jury
Change of venue to Lewis County	Bias/unfairness in small community; inconvenience to plaintiff’s counsel and out-of-state witnesses	Convenience of parties and witnesses, events occurred in Lewis County; principals reside there	Venue change proper under RCW; no abuse of discretion

Key Cases Cited

Lake v. Puget Sound Energy, 176 Wn.2d 909 (2013) (Frye and ER 702 standards explained)
Anderson v. Akzo Nobel Coatings, Inc., 172 Wn.2d 593 (2011) (scientific methods generally accepted suffice; need not show consensus on specific causal link)
Eakins v. Huber, 154 Wn. App. 592 (2010) (courts may consider peer-reviewed literature on admissibility)
Colley v. PeaceHealth, 177 Wn. App. 717 (2013) (defense experts may present alternative causation to attack plaintiff’s premise)
Taber v. Roush, 316 S.W.3d 139 (Tex. App. 2010) (NFOL admissible despite retrospective studies and ethical limits on prospective testing)
Luster v. Brinkman, 205 P.3d 410 (Colo. App. 2008) (recognizing literature that intrauterine forces can cause BPIs)
Ruffin ex rel. Sanders v. Boler, 890 N.E.2d 1174 (Ill. App. Ct. 2008) (admission of NFOL causation supported by obstetric authorities)
Salvant v. State, 935 So.2d 646 (La. 2006) (same conclusion supporting NFOL causation)