Vargas, M.D. v. Gutierrez
176 So. 3d 315
| Fla. Dist. Ct. App. | 2015Background
- Monica Gutierrez saw pediatrician Dr. Vargas during her first six years; multiple urinalyses in early childhood showed repeated proteinuria but Dr. Vargas attributed results to contamination and did not follow up.
- At age ~6 Monica presented to Miami Children’s Hospital (MCH) in renal failure, underwent biopsy, dialysis, and later kidney transplant; removed kidneys were pathologically severely scarred.
- Plaintiffs alleged chronic C1q nephropathy (slow, years-long progression) that should have been detected and treated earlier; Dr. Vargas contended the injury was RPGN (rapid onset) or untreatable C1q, so earlier detection would not have prevented failure.
- At trial both sides presented pathologists and nephrologists; court’s pretrial order limited each side to one expert per specialty, and barred treating physicians from giving expert timing opinions.
- Plaintiffs nonetheless called four pathologists (including two who had been treating/examining pathologists) to opine on disease type/timing; Dr. Vargas presented one pathology expert and one nephrologist. Plaintiffs’ counsel also misstated expert testimony in closing (claiming steroids/ACE inhibitors would have cured Monica).
- Jury returned a >$4M verdict for plaintiffs; trial court denied defendant’s directed verdict and new trial motions. On appeal the court affirmed the directed verdict denial but reversed the denial of a new trial, concluding the one-expert rule and improper closing argument deprived Dr. Vargas of a fair trial.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether directed verdict should have been granted on causation | Evidence showed chronic C1q and that earlier diagnosis/treatment would likely have improved outcome | Disease may have been RPGN or untreatable C1q, so earlier care would not have averted renal failure | Denied — conflicting expert evidence meant jury question remained (motion properly denied) |
| Whether plaintiffs violated pretrial “one expert per specialty” order | Multiple pathologists offered corroborating opinions on timing/diagnosis (supporting plaintiffs’ theory) | Allowing four pathologists to opine on timing unfairly prejudiced Vargas, who had only one pathology expert | Held for defendant — error to permit cumulative expert testimony; new trial required |
| Whether treating pathologists’ testimony crossed into expert opinion | Plaintiffs: treating pathologists’ testimony about slides and opinions was admissible | Vargas: Drs. Pardo and Ruiz testified beyond factual findings into expert timing/opinion, violating rule | Held for defendant — their testimony constituted expert opinion and was cumulative/improper |
| Whether plaintiffs’ closing misstatements required relief | Plaintiffs argued treatment (steroids/ACE inhibitors) would have cured Monica and urged jurors to trust treating doctors as unbiased | Vargas objected that counsel misrepresented Dr. Kaplan and bolstered improperly admitted experts; court failed to give curative instruction | Held for defendant — counsel’s misstatements materially prejudiced Vargas; contributed to need for new trial |
Key Cases Cited
- Tricam Indus. v. Coba, 100 So. 3d 105 (Fla. 3d DCA) (standard for directed verdict review — view evidence for nonmovant)
- Posner v. Walker, 930 So. 2d 659 (Fla. 3d DCA) (appellate limits on overturning jury on sufficiency of evidence)
- Friederich v. Fetterman & Assocs., 137 So. 3d 362 (Fla.) (conflicting causation evidence for jury)
- Gold, Vann & White, P.A. v. DeBerry ex rel. DeBerry, 639 So. 2d 47 (Fla. 4th DCA) (trial court authority to manage witnesses and avoid cumulative expert proof)
- Frantz v. Golebiewski, 407 So. 2d 283 (Fla. 3d DCA) (distinguishing treating physician fact witnesses from retained expert witnesses)
- Tetrault v. Fairchild, 799 So. 2d 226 (Fla. 5th DCA) (error where a treating ‘‘fact witness’’ gave untimely expert opinions)
- Murphy v. Int’l Robotic Sys., Inc., 766 So. 2d 1010 (Fla.) (limits on closing argument — must be confined to evidence and reasonable inferences)
- Hurst v. State, 18 So. 3d 975 (Fla.) (cumulative-error doctrine applicable to denial of fair trial)