WINHAM v. REESE
2017 OK CIV APP 18
| Okla. Civ. App. | 2017Background
- In 2011 plaintiff Billie Winham underwent an ERCP with endoscopic sphincterotomy performed by gastroenterologist Dr. Thomas Schiller; complications followed including possible duodenal perforation, additional surgery, multiple readmissions, abdominal abscesses, malnutrition, and cognitive decline.
- Plaintiff sued Dr. Schiller (for the procedure) and Dr. Joe Reese (for post‑operative care), alleging breaches of the standard of care causing her injuries and cognitive deterioration.
- Plaintiff proffered Dr. Bernard Jaffe, a retired general surgeon and professor, as her medical expert; Dr. Jaffe had extensive open‑surgery and postoperative care experience but had never performed ERCP/endoscopic sphincterotomy.
- Defendants moved to exclude or limit Dr. Jaffe’s testimony (Daubert motion/similar motions in limine) and sought summary judgment, arguing Jaffe was unqualified to opine on specialist gastroenterological procedure care and that his causation opinion regarding post‑op care was unreliable.
- The trial court limited Jaffe’s testimony to general physician standards, excluded specialist surgical opinions, and later granted summary judgment for Schiller and Reese, finding Jaffe unqualified to prove breach for the specialist and his causation opinions insufficient as to Reese.
- The Court of Civil Appeals affirmed: Jaffe was not qualified to opine on the specialist surgical standard (Schiller), and his causation testimony regarding Reese was unreliable and insufficient to support a jury finding.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Dr. Jaffe was qualified to testify as to the standard of care for the specialist who performed ERCP/sphincterotomy | Jaffe’s general surgical expertise and experience in postoperative care qualify him to opine about the procedure’s standard | Jaffe lacks training/experience performing ERCP or endoscopic sphincterotomy and thus is unqualified to give specialist procedural standard opinions | Not qualified; court excluded Jaffe’s specialist surgical opinions and limited him to a general physician standard |
| Whether Jaffe’s opinions about breach of care for the specialist were reliable under Daubert/Christian | Plaintiff contends Jaffe’s methods/opinion are reliable based on surgical experience | Defendants argue the opinion is conjectural and not based on reliable methodology for an endoscopic specialist procedure | Unreliable for specialist procedure; opinion excluded as insufficient to prove breach |
| Whether Jaffe’s testimony established causation as to Dr. Reese’s post‑op care | Jaffe criticized Reese’s diagnostic/testing choices and suggested different testing might have identified treatable causes | Defendants argue Jaffe could not link Reese’s choices to plaintiff’s cognitive decline and admitted the alternative tests would not have changed outcome | Held insufficient; Jaffe admitted recommended measures would not have altered outcome and provided no reliable causation method |
| Whether summary judgment for defendants was appropriate given exclusion/limitations on Jaffe’s testimony | Plaintiff argues exclusion was erroneous and genuine issues of material fact remain | Defendants argue without admissible expert proof of breach/causation summary judgment is proper | Summary judgment affirmed because plaintiff lacked qualified, reliable expert proof of breach and causation |
Key Cases Cited
- Lounds v. State ex rel. Dep’t of Veterans Affairs, 255 P.3d 460 (Okla. Civ. App. 2011) (expert qualification evaluated by comparability of expert’s practice to defendant’s care setting)
- Christian v. Gray, 65 P.3d 591 (Okla. 2003) (adopted Daubert/Kumho framework; expert must be qualified and reliable)
- Daubert v. Merrell Dow Pharm., 509 U.S. 579 (1993) (trial court gatekeeper must assess relevance and reliability of expert testimony)
- Kumho Tire Co. v. Carmichael, 526 U.S. 137 (1999) (Daubert gatekeeping applies to all expert testimony, not only scientific)
- Carmichael v. Beller, 914 P.2d 1051 (Okla. 1996) (standard for appellate review of summary judgment involves legal de novo review)
- In re Estate of Bell‑Levine, 293 P.3d 964 (Okla. 2012) (de novo review described as plenary, independent examination of trial court’s rulings of law)