927 F.3d 169
4th Cir.2019Background
- On Nov. 19, 2013 WellDyne (under contract with Exactus) mistakenly shipped a California patient’s prescription package to Bertha Small in North Carolina; Small ingested pills from the package.
- The outside package was addressed to Small, but the bottle labels bore the California patient’s name and prescribing doctor; Small was elderly and barely literate and did not read the bottle labels.
- After ingestion Small experienced confusion and hallucinations, fell three days later fracturing her leg, was hospitalized for nearly a month, developed infections and cardiac complications, was discharged, and died about ten days later.
- Small’s son sued WellDyne and Exactus for negligence, negligence per se, and breach of implied warranty; Exactus was also alleged vicariously liable.
- The district court granted summary judgment for both defendants, finding contributory negligence as a matter of law and, alternatively, lack of proximate cause; the court declined to decide Daubert motions as moot.
- The Fourth Circuit reviewed de novo, reversed summary judgment as to contributory negligence and proximate cause, affirmed some other district-court rulings, and remanded for Daubert analysis of plaintiff’s expert testimony.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Contributory negligence (North Carolina) | Small acted reasonably given age, literacy, familiarity with pharmacy, package addressed to her, and similarity of pills; expert testimony creates factual dispute | Small was negligent as a matter of law by not reading bottle labels and ignoring differences in delivery, containers, and lack of advance call | Reversed: jury question; summary judgment inappropriate (analogy to Champs) |
| Proximate causation of injuries and death | Experts trace a chain: hypotensive meds → low BP → confusion → fall → fractures → hospitalization → infection/sepsis → myocardial infarction → death; experts provide causal opinions | Relationship between ingesting some pills in Nov. and death in Jan. is too attenuated; death attributable to other medical conditions | Reversed: expert evidence, if admissible, creates genuine issue of material fact on causation |
| Admissibility of plaintiff’s expert testimony (Daubert/Rule 702) | Expert testimony on causation should be admitted if reliable and fit the facts | Defendants moved to exclude experts; district court found motion moot earlier | Remanded: district court must perform Daubert gatekeeping to assess admissibility; outcome undecided |
| Liability of Exactus and certain warranty claim(s) | Plaintiff sought direct and vicarious liability against Exactus and breach of implied warranty claims | District court granted summary judgment to Exactus and for WellDyne on implied warranty; plaintiff had stipulated to dismiss warranty claim as to Exactus | Affirmed in part: summary judgment for Exactus and for WellDyne on implied-warranty claim affirmed; other issues remanded |
Key Cases Cited
- Variety Stores, Inc. v. Wal-Mart Stores, Inc., 888 F.3d 651 (4th Cir.) (summary-judgment standard)
- Anderson v. Liberty Lobby, Inc., 477 U.S. 242 (U.S. 1986) (summary-judgment legal standard)
- Sawyer v. Food Lion, Inc., 549 S.E.2d 867 (N.C. Ct. App. 2001) (contributory negligence bars recovery if proved)
- Nicholson v. Am. Safety Util. Corp., 488 S.E.2d 240 (N.C. 1997) (objective standard for contributory negligence)
- Smith v. Fiber Controls Corp., 268 S.E.2d 504 (N.C. 1980) (contributory negligence objective test)
- Champs Convenience Stores, Inc. v. United Chemical Co., Inc., 406 S.E.2d 856 (N.C. 1991) (delivery of wrong product; contributory negligence for jury)
- Webb v. Wake Forest Univ. Baptist Med. Ctr., 756 S.E.2d 741 (N.C. Ct. App. 2014) (definition of proximate cause)
- Adams v. Mills, 322 S.E.2d 164 (N.C. 1984) (proximate cause usually for jury)
- Lord v. Beerman, 664 S.E.2d 331 (N.C. Ct. App. 2008) (definition of proximate cause)
- Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579 (U.S. 1993) (expert admissibility/Rule 702 gatekeeping)
- Westberry v. Gislaved Gummi AB, 178 F.3d 257 (4th Cir. 1999) (expert testimony can be powerful and misleading)
- Nease v. Ford Motor Co., 848 F.3d 219 (4th Cir. 2017) (trial judge’s gatekeeping obligation under Rule 702)