Stowell v. Dandade
34,998
N.M. Ct. App.Apr 25, 2017Background
- Plaintiff Heather Stowell sued her prenatal provider, Dr. Tushar Dandade, alleging that Zoloft prescribed during pregnancy caused her daughter R.R.’s progressive neurodegenerative disorder that began around age one.
- R.R. was apparently normal at birth; genetic and metabolic testing had not identified a cause; Plaintiff’s sole causation expert was pharmacologist Dr. Patrick Ronaldson (Ph.D.), not a medical doctor.
- Dr. Ronaldson opined that in utero SSRI exposure can cause fetal hypoxia leading to neurological injury (citing PVL references in records and two scientific articles), but he did not review imaging or lab results and conceded no studies directly support his exact hypothesis.
- Defendant submitted testimony from treating and defense medical experts (geneticists, teratologist, pediatrician, neuroradiologist) who concluded R.R.’s condition is likely genetic and that there was no evidence of hypoxia or PVL; they also testified literature does not link Zoloft to this kind of neurodegeneration.
- The district court excluded Dr. Ronaldson’s causation testimony as unreliable and outside his qualifications, then granted summary judgment for Defendant due to Plaintiff’s lack of an admissible causation expert.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Admissibility of Dr. Ronaldson’s causation testimony | Ronaldson is qualified by pharmacology training to explain biological mechanisms linking Zoloft to R.R.’s injury; exclusion usurps the jury’s role | Ronaldson is not a medical doctor, relied on misread records (PVL), did not review images/results, and his theory lacks reliable scientific support | Court excluded Ronaldson: not qualified to diagnose/contradict medical experts and his causation theory fails reliability (Daubert-Alberico factors) |
| Whether scientific basis for causation was reliable | Evidence and literature (animal/physiologic studies) support a plausible mechanism; exclusion improper under Acosta’s permissive approach | No epidemiological or peer-reviewed literature connects prenatal Zoloft to later neurodegeneration in humans or animals; relied studies do not establish causation | Court held the cited studies do not satisfy reliability factors; opinion was conjectural and inadmissible |
| Whether genetic cause was adequately ruled out | Absence of an identified genetic mutation supports non-genetic (drug) causation | Treating and defense geneticists testified a genetic etiology remains likely and sequencing could reveal it | Court credited medical experts that genetic cause was not ruled out; Ronaldson lacked genetics expertise to refute them |
| Grant of summary judgment after exclusion | Exclusion left factual disputes for jury; summary judgment was premature | Without an admissible medical causation expert, plaintiff cannot meet the burden of proving proximate cause | Court affirmed summary judgment: plaintiff had no expert to establish causation, so malpractice claim failed |
Key Cases Cited
- Sewell v. Wilson, 97 N.M. 523, 641 P.2d 1070 (expert must explain how and why opinion links physician conduct to substandard care)
- State v. Downey, 145 N.M. 232, 195 P.3d 1244 (three admissibility requirements for expert testimony)
- Anderson, 118 N.M. 284, 881 P.2d 29 (Daubert-Alberico factors for scientific reliability)
- Parkhill v. Alderman-Cave Milling & Grain Co. of N.M., 149 N.M. 140, 245 P.3d 585 (external-cause opinions require specialized scientific knowledge)
- Acosta v. Shell W. Expl. & Prod., Inc., 370 P.3d 761 (use of Bradford Hill factors and more permissive analysis for novel toxic-tort causation)
- Alberico, 116 N.M. 156, 861 P.2d 192 (abuse-of-discretion standard and limits on appellate review of expert admission)
- Joiner, Gen. Elec. Co. v. Joiner, 522 U.S. 136 (U.S. Supreme Court rule on analytical gap referenced and discussed)