Lead Opinion
for the Court:
¶ 1. Thе plaintiffs, Vicki and Fred Worthy, brought this medical-malpractice and wrongful-death action against the defendants, Dr. Robbye D. McNair and the Women’s Clinic of Greenwood, alleging that their unborn child died as a result of Dr. McNair’s negligent provision of prenatal care. The defendants, through a Dau-bert
¶ 2. The plaintiffs appealed to this Court, arguing that: 1) the trial court abused its discretion in excluding the obstetrician-gynecologist’s testimony as to cause of death, and 2) the trial court committed reversible procedural error by issuing an order “granting summary judgment and directed verdict” after a jury had been empaneled. Finding that the trial court committed no error, we affirm.
FACTS AND PROCEDURAL HISTORY
¶ 3. On October 7, 1999, plaintiff Vicki Worthy visited the Women’s Clinic of Greenwood, where she met with defendant Dr. McNair, an obstetrician, who confirmed that she was pregnant. Dr. McNair and the Women’s Clinic provided prenatal care to Worthy throughout her pregnancy. On May 23, 2000, Worthy visited Dr. McNair’s office, reporting that she had experienced decreased fetal movement since the previous evening. Tests performed that day determined that the fetus had died, and Dr. McNair delivered the stillborn baby via cesarean section.
-Slightly immature placenta with increased syncytial knotting of chorionic villi consistent with fetoplacental insufficiency.
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-Fetal hydrops with associated hepa-tomegaly and cardiomegaly
- Oligohydramnios
The “discussion” included at the end of the autopsy report stated:
... The two main findings were: 1. Hydrops fetalis and 2. Oligohydramnios gross features.
The list of disorders associated with hy-drops fetalis is extensive....
Oligohydramnios (decreased amniotic fluid) may be caused by a variety of unrelated maternal, placental, or fetal abnormalities. The features of fetopla-cental insufficiency in the placenta could certainly have contributed [sic] fetal placental insufficiency which in turn has a host of etiologies. Chronic leakage of amniotic fluid due to rupture of amnion, uteroplacental insufficiency from maternal hypertension or severe toxemia, and [sic] are all causes of oligohydramnios. The fetal compression associated with significant oligohydramnios in turn results in the phenotype observed in this fetus. That is, flattened faces, malposi-tioned limbs, and thickened skin membranes. Clinical correlation is suggested.
Thus, the autopsy report stated that the autopsy revealed conditions consistent with placental insufficiency, but suggested that it could not be concluded, one way or the other, whether the fetus died from placental insufficiency. Dr. McNair explained at her deposition that the phrase “clinical correlation” in Dr. Montes’s autopsy reports “usually means he doesn’t have enough information from the findings to say exactly what the cause was ... it means ... how well does this correlate with the clinical scenario to determine what the etiology was.”
¶ 5. On May 23, 2002, Worthy and her husband, Fred Worthy, brought suit against Dr. McNair and the Women’s Clinic, alleging that the defendants were negligent, and that their negligence had led to the dеath of the Worthys’ unborn child. The plaintiffs selected Dr. Bruce Hal-bridge, an obstetrician-gynecologist, and Dr. Carole Vogler, a pediatric pathologist, to testify as expert witnesses. Prior to trial, the plaintiffs took the evidentiary depositions of both experts for use at trial.
¶ 6. On April 29, 2008, the matter proceeded to trial and a jury was selected, duly sworn, and empaneled. After the jury was dismissed for the day and instructed to return the next morning, the trial court took up the defendants’ Daubert motion. The motion challenged the reliability of Dr. Halbridge’s testimony regarding the baby’s cause of death.
Dr. Halbridge’s Testimony
¶ 7. At his deposition, Dr. Halbridge testified that Dr. McNair had been negligent in the care of Worthy. Dr. Halbridge testified that Dr. McNаir had failed to diagnose Worthy with gestational diabetes and chronic hypertension. He proceeded to testify that an obstetrician caring for a pregnant woman with these conditions is required to initiate a program of testing referred to as antenatal surveillance. This consists of non-stress tests, contraction stress tests and/or biophysical profiles — all of which are methods of testing for fetal well-being. Dr. Halbridge testified that, had this program of testing been carried out, Dr. McNair would have learned that
¶ 8. Dr. Halbridge also testified regarding the cause of the baby’s death — linking the alleged breach of the standard of care to the baby’s death. He unequivocally testified that the hydrops,
Dr. Vogler’s Testimony
¶ 9. Dr. Vogler, the pathologist whom the plaintiffs selected as an expert witness, testified that the cause of the hydrops, and thus the baby’s death, was unknown. Dr. Vogler testified that there was no evidence of placental insufficiency. She based her determination on her experience as a pathologist, her review of Worthy’s medical records and the autopsy report, and her study of the Worthy baby’s placental tissues under a microscope.
¶ 10. The trial court concluded that Dr. Halbridge’s testimony as to cause of death, though relevant, was not reliable and did not meet the criteria required by Rule 702 of the Mississippi Rules of Evidence and Daubert,
¶ 11. The trial court orally announced at trial that it was granting the defendants’ motion to exclude Dr. Halbridge’s testimony as to causation. The trial court reasoned that, without Dr. Halbridge’s testimony, the plaintiffs lacked an expert to testify as to causation (i.e., an expert to link the alleged breach of the standard of care to the harm — in this case, hydrops and death) which is needed to establish negligence. Subsequently, the court prepared a written order excluding Dr. Hal-bridge’s testimony as to causation, and also an order “granting summary judgment and directed verdict.” The plaintiffs timely appealed to this Court.
DISCUSSION
¶ 12. The Worthys raises the following two issues on appeal:
I. Whether the trial court erred in finding Dr. Halbridge’s testimony to be unreliable and, therefore, inad
II. Whether the trial court erred by dismissing the action after a jury had been empaneled.
I.
¶ 13. A trial court’s admission or exclusion of expert testimony is reviewed for abuse of discretion. Miss. Transp. Comm’n v. McLemore,
¶ 14. In Mississippi Transportation Commission v. McLemore, this Court adopted the “Daubert/Kumho” rule — the Supreme Court of the United States’ standard as set forth in Daubert,
If scientific, technical or other specialized knowledge will assist the trier of fact to understand or to determine a fact in issue, a witness qualified as an expert by knowledge, skill, experience, training, or education may testify thereto in the form of an opinion or otherwise, if (1) the testimony is based upon sufficient facts or data, (2) the testimony is the product of reliable principles and methods, and (3) the witness has applied the principles and methods reliably to the facts of the case.
Miss. R. Evid. 702.
¶ 15. Summarizing Daubert and Kumho, the McLemore Court explained the following: “the liberal goals of the [rules] include reducing the traditional barriers to opinion testimony.” McLemore,
¶ 17. The Daubert Court adopted a nonexhaustive, illustrative list of reliability factors for determining the admissibility of expert testimony. McLemore,
¶ 18. The McLemore Court emphasized that “the trial court’s role as gаtekeeper is not intended as a replacement for the adversary system” when the expert’s testimony is both relevant and reliable. McLemore,
¶ 19. Furthermore, to be admissible, the expert’s opinion need not be based on first-hand knowledge. This Court has said, “[ljike the Federal Rules, our rules grant wide latitude for experts to give opinions even when opinions are not based on the expert’s firsthand knowledge or observations.” Id. Rule 703 of the Mississippi Rules of Evidence provides that “[t]he fаcts or data in the particular case upon which an expert bases an opinion or inference may be those perceived by or
¶ 20. This Court has long held that “[t]he general rule as to expert testimony in medical malpractice actions is that ‘a specialist in a particular branch within a profession will not be required.’ ” Causey v. Sanders, 998 So.2d 393, 403 (Miss.2009) (quoting Brown v. Mladineo,
¶21. Dr. Halbridge’s opinions regarding the cause of the baby’s death are based on his experience as an obstetrician-gynecologist and his review of the medical records, autopsy report, and relevant medical literature. Dr. Halbridge is a clinician — not a pathologist — and does not perform autopsies. He does, however, routinely review reports prepared by pathologists.
¶ 22. The autopsy report on whiсh Dr. Halbridge rests his opinion in the present matter reached an inconclusive result. As previously stated, the report noted “[cjlinical correlation is suggested,” and Dr. McNair explained that clinical correlation “usually means that [the pathologist] doesn’t have enough information from the findings to say exactly what the cause [of death] was.”
¶ 23. In Daubert, the United States Supreme Court said:
Unlike an ordinary witness ... an expert is permitted wide latitude to offer opinions, including those that are not based on firsthand knowledge or observation .... Presumably, this relaxation of the usual requirement of firsthand knowledge .... is premised on an assumption that the expert’s opinion will have a reliable basis in the knowledge and experience of his discipline.
Daubert,
¶ 24. It is clear that trial judges are given great discretion in their gatekeeping authority under Daubert. We agree with the trial judge that Dr. Halbridge qualifies under the Daubert/Kumho standard to testify as to the standard of care. We further find that the trial court did not abuse its discretion in finding that Dr. Halbridge’s testimony was unreliable as to the cause of the baby’s death. Such testimony would be outside his discipline or the particular topic in which he possessed scientific, technical, or specializеd knowledge. Not only
¶ 25. The Worthys complain on appeal that “no evidence [was presented to the trial court] that Dr. Halbridge’s opinions were not properly grounded] in scientific knowledge,” and therefore, the trial court was in error for finding his testimony unreliable. However, Dr. Carole Vogler, a pediatric pathologist who also testified as an expert witness for the Worthys, directly contradicted the testimony of Dr. Hal-bridge as to the cause of the baby’s death. Dr. Vogler testified that the cause of the baby’s death was hydrops, but the cause of the hydrops was unknown. She also testified there was no evidence of placental insufficiency. Therefore, although Dr. Vo-gler’s testimony was submitted by the plaintiffs rather than the defendants, sufficient evidence which contradicted the testimony of Dr. Halbridge was properly before the trial court when the court ruled on the defendant’s Daubert motion.
¶ 26. Based on the foregoing analysis, the trial court did not abuse its discretion in finding Dr. Halbridge’s testimony unreliable, and therefore inadmissible, under the Daubert standard.
II.
¶27. The plaintiffs also argue that the trial court erred in granting summary judgment after the jury was empaneled. The Worthys cite Hurst v. Southwest Mississippi Legal Services Corp.,
¶ 28. The Hurst Court stated, “commencement of trial closes the season for granting motions for summary judgment,” and went on to say, “[w]here trial has already begun, it is far preferable to allow the plaintiff to present his case in chief and then, if the plaintiff has failed to meet his burden of proof, direct a verdict in favor of the defendant.” Hurst,
¶ 29. The rationale in the Hurst opinion was based on the plaintiff’s right to a trial by jury and concern for judicial economy, finding that the grant of summary judgment in that matter “served few, if any, of the pragmatic rationales for summary judgment.” Id. This Court further stated that, under the facts in Hurst, “[t]he advance in judicial economy resulting from the trial court’s grant of summary judgment was ... minuscule at best.”
¶ 30. However, it cannot be said that conducting a full trial in the present matter would serve the judicial economy or the interests of the litigants. Because the plaintiffs had no expert to testify as to causation, they could not prove the necessary elements of their negligence suit. Conducting a trial on the issue with full knowledge that the defendant must prevail as a matter of law — regardless of what a jury may determine — does not serve any of the purposes set forth in Hurst. Therefore, although a jury had been duly empaneled, the trial court was not in error for granting summary judgment in the present matter.
CONCLUSION
¶ 31. The trial court did not abuse its discretion in determining that Dr. Hal-bridge’s testimony regarding the cause of the infant’s death was unreliable under Daubert, and therefore inadmissible under Mississippi Rule of Evidence 702. Because of the exclusion of Dr. Halbridge’s testimony, the plaintiffs had no еxpert to testify as to causation in this present matter. Furthermore, no purpose would have been served by holding a full trial in this
¶ 32. AFFIRMED.
Notes
. Daubert v. Merrell Dow Pharmaceuticals, Inc.,
. All of the deposed experts agreed hydrops ultimately caused the baby’s death.
. See Daubert,
. Analyzing the language of Rule 702 and the Daubert opinion, the Kumho Tire Court concluded that a trial court’s gatekeeping responsibility applies to the admissibility of expert testimony based not only on "scientific” knowledge, but also on "technical” and "other specialized knowledge.” McLemore,
. Adopted by this Court in Miss. Transp. Comm'n v. McLemore,
Dissenting Opinion
Dissenting:
¶ 33. I disagree with the majority’s finding that the trial court did not abuse its discretion in determining that Dr. Hal-bridge’s testimony regarding the Worthy baby’s cause of death was unreliable and thus inadmissible. I agree with the majority’s summary of the law regarding admissibility of expert testimony, but I conclude that the law was not appropriately applied. Regarding the second issue — whether the trial court erred in granting summary judgment after the jury had been empaneled — I agree, for reasons different than those provided by the majority, that the trial court’s granting of “summary judgment and directed verdict” does not constitute reversible procedural error; however, I disagree with the majority’s finding that it was not error for the trial court to grant summary judgment in this matter. Therefore, I must dissent and would reverse and remand this case for a new trial in which Dr. Halbridge’s testimony regarding the cause of the baby’s death would be deemed rehable and admitted.
¶ 34. The majority provides a thorough summary of the law regarding the admissibility of expert testimony; however, I would add to its summary that “the most important question is not whether one ... expert is more qualified than the [other], but rather, whether an expert’s testimony is reliable.” Huss v. Gayden,
¶ 35. Applying the law laid out in the majority opinion and directly above, I conclude that the trial court abused its discretion in excluding Dr. Halbridge’s testimony as to cause of death. As required by Rule 702 and Daubert v. Merrell Dow Pharmaceuticals, Inc.,
¶ 36. Dr. Halbridge is an experienced obstetrician-gynecologist who cares for women with high-risk pregnancies and is knowledgeable about placental pathology. He has been a board-certified obstetrician-gynecologist since 1978. He has cared for women with high-risk pregnancies for more than thirty-five years, managing thousands of such pregnancies throughout his years of practice. Dr. Halbridge had to become knowledgeable about obstetrical and gynecological pathology in order to become a board-certified obstetrician-gynecologist. Dr. Halbridge had to be trained in placental pathology to be able to care for his patients and understand what has happened to his patients’ fetuses. On a weekly basis, he reviews reports of placental autopsies prepared by pathologists.
¶ 37. Dr. Halbridge based his opinions regarding the Worthy baby’s cause of death on his experience as an obstetrician-gynecologist, his review of Worthy’s medical records and the autopsy report, and his review of various medical textbooks and literature. He testified that the literature he referenced and provided at his deposition associates antepartum testing with pregnancy outcome; that the literaturе is reliable in the field of obstetrics-gynecology; that it is relied upon by obstetricians-gynecologists to form opinions and treat their patients; and that it is used as a teaching tool in medical schools throughout the country. Moreover, Dr. Halbridge testified that the diagnoses of gestational diabetes and placental insufficiency — the two conditions he believes caused the baby’s death — are clinical, not pathological, diagnoses.
¶38. Given Dr. Halbridge’s education, training, and experience, and his review of Worthy’s medical records, the autopsy report, and relevant medical literature, it is evident that Dr. Halbridge’s opinions as to cause of death are grоunded in science and not merely a subjective belief or unsupported speculation. See Poole v. Avara,
II39. Furthermore, experts can give opinions not based on firsthand knowledge or observation. Miss. Transp. Comm’n v. McLemore,
¶ 40. In addition, in medical-malpractice actions, a specialist in a particular branch within a profession is not required; it is the expert’s knowledge and experience, not his professional degree or title that governs the threshold question of admissibility. Causey v. Sanders,
¶ 41. The majority is correct that “only if the witness possesses scientific, technical, or specialized knowledge on a particular topic will he qualify as an expert on that topic” (Sheffield,
¶ 42. The determination of admissibility must focus on whether an expert’s testimony is reliable, not on whether another available expert is more qualified. Huss,
¶ 48. Lastly, the majority is in error to find that Dr. Halbridge’s opinion is unreliable because “the [autopsy] report on which he rested his opinion reached an inconclusive result.” Maj. Op. at ¶24. First, Dr. Halbridge did not “rest his opinion” on the autopsy report; rather, it was one of several sources of information upon which he based his opinion. Second, Dr. Halbridge was considering the report and its contents as a whole; i.e., he was considering the conditions listed in the report that the report describes as “consistent with fetоplacental insufficiency,” not merely considering the final, inconclusive conclusion the author of the report reached. Needless to say, an expert can review and consider a report without adopting everything it says.
¶ 44. Therefore, I conclude that the trial court abused its discretion in finding Dr. Halbridge’s testimony as to cause of death unreliable and inadmissible.
¶ 45. Regarding the second issue— whether the trial court erred in granting summary judgment after the jury had been empaneled — I agree, for reasons different than those provided by the majority, that the trial court’s granting of “summary judgment and directed verdict” does not constitute reversible procedural error; however, I disаgree with the majority’s finding that it was not error for the trial court to grant summary judgment in this matter.
¶ 46. The jury for this matter was empaneled on April 29, 2008, then released, with instructions to return the following morning. On April 29, after the jury was released, the trial court heard the defendants’ motion to exclude Dr. Halbridge’s testimony as to cause of death. The next morning, the trial court granted the defendants’ motion, stated that it would be granting summary judgment and/or directed verdict, and excused the jurors from the case. On September 4, 2008, the trial court filed orders with the clerk, granting the defendants’ motion to exclude Dr. Hal-bridge’s testimony as to causation and “granting summary judgment and directed verdict.”
¶ 47. As the plaintiffs point out, Hurst v. Southwest Mississippi Legal Services Corporation states that summary judgment cannot be granted onсe the trial has begun (Hurst v. Sw. Miss. Legal. Servs. Corp.,
¶ 48. Therefore, the trial court did not commit reversible procedural error by styling its order of dismissal as an order “granting summary judgment and directed verdict”; however, the trial court was in error to dismiss the case, because Dr. Hal-bridge’s testimony as to cause of death was rehable, and thus the plaintiffs made
¶ 49. For the foregoing reasons, I must respectfully dissent and would reverse and remand this case for a new trial in which Dr. Halbridge’s testimony regarding the cause of the baby’s death would be deemed reliable and admitted.
KITCHENS and CHANDLER, JJ., join this opinion.
. The case record suggests that the terms "placental insufficiency," "fetal placental insufficiency,” and "fetoplacental insufficiency” have the same or similar meanings.
. If the trial court concludes that the evidence supporting a position is insufficient to allow a reasonable juror to conclude that the position is more likely true than not, the trial court can direct a judgment or grant summary judgment. McLemore,
. Notably, unlike in Hurst, in the instant case, the jury, while having been empaneled, never heard opening arguments of either party.
