WINHAM v. REESE
2017 OK CIV APP 18
| Okla. Civ. App. | 2017Background
- Plaintiff Billie Winham underwent an ERCP with endoscopic sphincterotomy performed by gastroenterologist Dr. Thomas Schiller in 2011; complications followed, including possible duodenal perforation, multiple readmissions, abdominal abscesses, malnutrition, and cognitive decline.
- Post-operative care involved Dr. Schiller and internist Dr. Joe Reese; Winham alleged negligence in both the initial procedure and subsequent inpatient care leading to mental deterioration.
- Winham designated Dr. Bernard M. Jaffe, a retired general surgeon with extensive open‑surgery and postoperative care experience, as her medical expert; Jaffe had never performed ERCP/endoscopic sphincterotomy.
- Defendants moved to exclude or limit Jaffe’s testimony (Daubert challenge) and for summary judgment, arguing Jaffe was unqualified to opine on specialist gastroenterology care and that his causation opinions were unreliable.
- The district court limited Jaffe to testifying about the standard of care for a "physician in general," excluded specialist surgical opinions, and later granted summary judgment for Drs. Schiller and Reese, finding Jaffe not qualified to opine on specialist breach and his causation opinions inadequate.
- The Court of Civil Appeals affirmed, holding Jaffe unqualified to assess the specialist surgical standard and that his opinions did not reliably establish causation for Reese’s alleged negligence.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether expert Jaffe was qualified to testify about breach of specialist (gastroenterology) surgical standard | Jaffe's general surgical experience and expertise in post‑op care qualify him to opine on the standard of care for the ERCP/sphincterotomy | Jaffe never performed ERCP/endoscopic sphincterotomy and lacks requisite training/experience to opine on specialist procedural standards | Jaffe not qualified to opine on breach for Dr. Schiller; specialist procedure required a specialist expert |
| Whether Jaffe’s testimony on causation with respect to Dr. Reese’s post‑op care was reliable | Jaffe criticized Reese’s management of mental status and diagnostic timing, implying causation of deterioration | Jaffe’s opinions do not employ a reliable method to link Reese’s treatment to Winham’s cognitive decline; he conceded recommended measures would not have changed outcome | Jaffe’s causation opinion inadequate and unreliable; summary judgment proper for Reese |
| Whether exclusion/limitation of Jaffe’s testimony warranted summary judgment for defendants | Winham argued Lounds supports qualification of non‑specialist experts in some contexts | Defendants argued Lounds is distinguishable; specialist procedural expertise is required and Jaffe’s testimony is speculative | Court distinguished Lounds and found no genuine issue of material fact once specialist opinion and reliable causation were excluded |
| Admissibility standard to apply to medical expert testimony | Apply Oklahoma’s adoption of Daubert/Kumho/Christian reliability and qualification framework | Same; defendants urged strict application to test qualifications and causation method | Court applied Christian (Daubert/Kumho) and excluded/unreliable testimony accordingly |
Key Cases Cited
- Christian v. Gray, 65 P.3d 591 (Okla. 2003) (adopted Daubert/Kumho framework for expert admissibility)
- Daubert v. Merrell Dow Pharmaceuticals, 509 U.S. 579 (U.S. 1993) (trial courts must ensure expert testimony is relevant and reliable)
- Kumho Tire Co. v. Carmichael, 526 U.S. 137 (U.S. 1999) (Daubert gatekeeping applies to all expert testimony)
- Lounds v. State ex rel. Dep’t of Veterans Affairs, 255 P.3d 460 (Okla. Civ. App. 2011) (non‑specialist physician found qualified to testify about nursing‑home care; distinguished here)
- Brown v. Nicholson, 935 P.2d 319 (Okla. 1997) (standard of review for legal questions on summary judgment)