Martinez v. United States, 33 F.4th 20

Background:

Noel Martínez-Marrero was admitted to the VA Medical Center in San Juan in October 2014 for obstructive jaundice; he received antibiotics (initially Zosyn, later Vancomycin), fell and fractured his femur, and died on October 29, 2014; autopsy showed contusions implying bleeding.
His four children sued the United States under the FTCA (Puerto Rico law governs) alleging negligent care that caused his death; medical-malpractice actions under Puerto Rico law generally require expert testimony to establish standard of care, breach, and causation.
Plaintiffs disclosed surgeon-expert Dr. José Ortiz Feliciano, produced a Rule 26 report, and he was deposed; the government moved to exclude his testimony under Fed. R. Evid. 702, attaching the deposition and literature.
The district court excluded Dr. Ortiz Feliciano under Rule 702 (finding his report lacked relevance and reliability) and also criticized the report under Rule 26(a)(2)(B) for missing required details and supplementation; plaintiffs’ reconsideration was denied.
The district court then granted summary judgment for the United States because plaintiffs had no admissible expert testimony and dismissed with prejudice; plaintiffs appealed.
The First Circuit reversed: it held the district court abused its discretion in excluding the expert under Rule 702 (failed to consider deposition excerpts and the record) and in precluding testimony as a Rule 26 sanction (no showing of surprise or prejudice); it vacated summary judgment and remanded.

Issues:

Issue	Plaintiff's Argument	Defendant's Argument	Held
1) Was exclusion of Dr. Ortiz Feliciano under Rule 702 proper (relevance)?	Ortiz identified national standards (monitor platelets; monitor Vancomycin levels) and explained deviations; deposition + report made testimony helpful to the trier of fact.	Report alone was cursory and did not define standards or explain medical conditions; deposition could not cure defects.	Reversed: district court erred by ignoring deposition and other materials; combined record showed relevance.
2) Was exclusion under Rule 702 proper (reliability)?	Opinions were grounded in hospital records, medical literature, and the expert's clinical experience; criticisms go to weight, not admissibility.	Report contained speculative language and analytical gaps, so opinions were unreliable.	Reversed: record (reports, deposition, literature, experience) provided a sufficiently reliable basis; disputes go to weight.
3) Was preclusion an appropriate sanction under Rule 26(a)(2)(B)/26(e)?	Plaintiffs failed to include some report particulars but produced the expert timely, provided deposition excerpts and literature; government was not surprised or prejudiced.	Plaintiffs’ report omitted required details and failed to supplement, justifying exclusion.	Reversed: harsh sanction improper; court failed to assess surprise/prejudice and improperly ignored deposition testimony when weighing sanctions.
4) Was summary judgment dismissing the case for lack of expert testimony proper?	Dismissal flowed from improper exclusion of the expert; without exclusion, plaintiffs could proceed.	Without admissible expert opinion, plaintiffs cannot maintain malpractice claim.	Vacated: summary judgment rested on the erroneous exclusion; remand for further proceedings.

Key Cases Cited

Daubert v. Merrell Dow Pharm., Inc., 509 U.S. 579 (Sup. Ct. 1993) (trial judge's gatekeeping role for expert admissibility)
Gen. Elec. Co. v. Joiner, 522 U.S. 136 (Sup. Ct. 1997) (courts may exclude expert testimony with an unacceptable analytical gap)
Cortés–Irizarry v. Corporación Insular De Seguros, 111 F.3d 184 (1st Cir. 1997) (Puerto Rico medical-malpractice standard; national standard of care)
Milward v. Acuity Specialty Prods. Grp., Inc., 639 F.3d 11 (1st Cir. 2011) (distinguishing admissibility from weight; expert challenges often affect credibility)
Milward v. Rust-Oleum Corp., 820 F.3d 469 (1st Cir. 2016) (abuse-of-discretion review on Daubert issues)
Lawes v. CSA Architects & Eng'rs LLP, 963 F.3d 72 (1st Cir. 2020) (sanction review and consideration of deposition testimony in Rule 26 disputes)
Esposito v. Home Depot U.S.A., Inc., 590 F.3d 72 (1st Cir. 2009) (severity of Rule 26 sanctions requires robust justification; factors to evaluate)
Santiago-Díaz v. Laboratorio Clínico y de Referencia del Este, 456 F.3d 272 (1st Cir. 2006) (Rule 26 requires explicit and detailed expert disclosures)
Torres-Lazarini v. United States, 523 F.3d 69 (1st Cir. 2008) (FTCA medical malpractice governed by local law)
Crowe v. Marchand, 506 F.3d 13 (1st Cir. 2007) (factual underpinnings objections go to weight, not admissibility)
Payton v. Abbott Labs, 780 F.2d 147 (1st Cir. 1985) (deficiencies in research basis affect credibility, not necessarily admissibility)
Levin v. Dalva Bros., Inc., 459 F.3d 68 (1st Cir. 2006) (Rule 702 interpreted liberally in favor of admission)
Mueller v. Auker, 700 F.3d 1180 (9th Cir. 2012) (clinical judgment can form a reliable basis for expert opinion)