Richardson v. Christiana Care Health Services, Inc.
N18C-10-026 JRJ
| Del. Super. Ct. | Jun 21, 2021Background
- Plaintiff Tameka Richardson, as next friend for minor N.D., sued Christiana Care Health Services (CCHS) for medical negligence after N.D. was born HIV‑positive; mother acquired HIV during pregnancy.
- Allegation: CCHS obstetric agents negligently failed to retest the mother at ~36 weeks, so infection went undiagnosed and was transmitted to N.D.
- Key experts: CCHS designated obstetric experts Dr. Neil Silverman and Dr. Harold Wiesenfeld, and pediatric infectious disease expert Dr. Coleen Cunningham; Plaintiff also has standard‑of‑care expert Dr. Elizabeth Eden.
- Central dispute in limine: whether Silverman and Wiesenfeld may testify that maternal infection during pregnancy makes in utero transmission more likely (they cited a 50–75% figure); Cunningham testified timing of transmission is often indeterminable.
- Court proceedings: Plaintiff moved to exclude/limit multiple categories of evidence and expert testimony; the court issued rulings addressing causation statistics, cumulative experts, standard‑of‑care testimony, and omnibus evidentiary issues.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Exclusion of causation testimony that in utero infection was more likely because mother acquired HIV during pregnancy | Silverman and Wiesenfeld lack reliable literature support; their 50–75%/statistical claim is ipse dixit and conflicts with Dr. Cunningham | Experts are qualified under D.R.E. 702/Daubert; literature not required for admissibility; contradictions go to weight | Granted — court excluded the experts’ statistical causation opinions as unreliable and misleading under Daubert/Rule 702 (and Delaware precedent forbids using such statistics to negate proximate cause) |
| Limiting cumulative expert testimony (two obstetric experts offering similar opinions) | Allowing two identical experts will unfairly prejudice Plaintiff; duplicative testimony should be curtailed under Rule 403 | Delaware law permits multiple experts in same field; each has different experience and may rebut different points | Denied without prejudice — both may testify, but court warned against unnecessary "piling on" and will police cumulative examination under Rule 403 |
| Excluding/limiting Dr. Silverman on standard of care | Silverman is a maternal‑fetal subspecialist who stopped routine obstetrical practice in 1997 and is unqualified to opine about obstetric nurse practitioners’ care | Silverman is board‑certified in OB/GYN, was on ACOG committee (Committee Opinion 752), and is recognized on HIV in pregnancy; ACOG opinion is evidence of the standard | Denied — Silverman may testify about the standard of care and ACOG guidance; disputes with Plaintiff’s expert go to weight not admissibility |
| Limiting Dr. Cunningham on standard of care | Plaintiff sought to limit Cunningham | CCHS represented it would not call Cunningham on standard of care if it uses Silverman/Wiesenfeld for that topic | Moot — CCHS stated it will not call Cunningham on standard of care; motion is moot |
| Omnibus evidentiary requests (comparative negligence, failure to mitigate, expert anecdotes, apologies, vouching, uncalled witnesses, good character) | Exclude comparative negligence of mother/grandmother, evidence suggesting failure to mitigate, experts' anecdotal "what I would do," apologies, vouching, etc., as unfairly prejudicial/misleading | CCHS sought to use some conduct evidence for damages/mitigation and allow impeachment/alternative‑treatment testimony; generally agreed some limits appropriate | Granted in part / Denied in part — court excluded comparative‑negligence and failure‑to‑mitigate evidence not pled as affirmative defense; barred expert anecdotes about how they/partners would have treated the patient (except for impeachment); excluded apologies and vouching; deferred rulings on good character and uncalled‑witness comments |
Key Cases Cited
- Bowen v. E.I. DuPont de Nemours & Co., Inc., 906 A.2d 787 (Del. 2006) (Delaware standards for admissibility of expert testimony under Rule 702/Daubert context)
- Norman v. All About Women, P.A., 193 A.3d 726 (Del. 2018) (expert reliability factors and note that medical literature is not strictly required for admissibility)
- Timblin v. Kent General Hospital, 640 A.2d 1021 (Del. 1994) (statistical evidence cannot be used to negate proximate cause in a particular case)
- Barrow v. Abramowicz, 931 A.2d 424 (Del. 2007) (courts should limit cumulative evidence only sparingly)
- Tumlinson v. Advanced Micro Devices, Inc., 81 A.3d 1264 (Del. 2013) (Daubert factors are not a definitive checklist; trial court has broad gatekeeping discretion)
- Getz v. State, 538 A.2d 726 (Del. 1988) (limits on using prior misconduct to infer character; relevance to predictive inferences)
- Deangelis v. Harrison, 628 A.2d 77 (Del. 1993) (trial courts must act firmly to give curative instructions and prevent jury prejudice)