Court Errs in Excluding Medical Evidence
Recently, in the case of Wright v. Residence Inn, the Pennsylvania Superior Court reversed a trial court’s decision to preclude Wright’s sole medical expert from testifying in court. During Wright’s stay at the Residence Inn, he was walking outside on a paved pathway from one building to another when he slipped on a four to six foot patch of ice and fell. As a result of the fall, Wright injured his left shoulder and bruised his hip and shoulder. He underwent treatment for his shoulder, including arthroscopic surgery. Wright filed suit against Residence Inn seeking damages for his injuries, which resulted in a trial. On the eve of trial, during jury selection, Residence Inn filed a motion in limine seeking to preclude the expert report and video testimony of Wright’s sole medical expert, Paul Sedacca, M.D., an internal medicine specialist, because he was not an orthopedic surgeon; and, therefore was not competent to testify to the cause and extent of Wright’s injuries. The trial court granted Resident Inn’s motion in part, but allowed limited testimony from Dr. Sedacca concerning Wright’s medical bills. The next day, Wright asked the trial court to reconsider this issue, arguing that Resident Inn’s motion in limine was untimely and prejudicial since he did not have time to retain another expert. Nonetheless, the trial court again denied his request. Consequently, Wright could not present his medical records, or any testimony about Dr. Sedacca’s qualifications, or the objective findings of Dr. Sedacca’s physical examination of Wright. He also had no expert testimony regarding the nature of his injuries, the cause of those injuries, or the resulting treatment and prognosis. After presentation of all of the evidence, the jury entered a verdict finding Marriott was negligent and Marriott’s negligence was the sole cause of Wright’s injuries. The jury awarded Wright $8,896.44 for his medical expenses and $55,000 for non-economic damages. Dissatisfied with the amount, Wright filed post-trial motions arguing for a new trial, which the trial court denied. Wright appealed the trial court’s decision on damages only, and raised the following issues for our review:
- Did the trial judge abuse her discretion by precluding the testimony of Paul J. Sedacca, M.D. when he was qualified to render opinions about plaintiff’s shoulder injuries?
- Should Plaintiff be granted a new trial on damages when the trial judge’s order precluding Plaintiff’s only medical expert was prejudicial?
The Superior Court analyzed Pennsylvania Rule of Evidence 702, which provides that an expert may testify, “if scientific, technical or other specialized knowledge beyond that possessed by a layperson will assist the trier of fact to understand the evidence 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.” Pa.R.E. 702. The Court acknowledged that the standard for qualification of an expert witness is a liberal one; and, the test to be applied when qualifying a witness is whether the witness has any reasonable pretension to specialized knowledge on the subject under investigation. The witness need not possess “all of the knowledge in a given field” but must only “possess more knowledge than is otherwise within the ordinary range of training, knowledge, intelligence or experience. If he does, he may testify and the weight to be given to such testimony is for the trier of fact to determine in view of the expert’s particular credentials.” Miller v. Brass Rail Tavern
, 664 A.2d 525, 528 (Pa. 1995) Further, the Court, like many others before it, observed that “experts in one area of medicine may be found to be qualified to address other areas of specialization where the specialties overlap in practice, or where the specialist has had experience in a selected field of medicine.” Chanthavong v. Tran
, 682 A.2d 334, 338 (Pa. Super. 1996). However, the Court recognized that there are times when the subject matter is particularly specialized that a doctor from the field cannot offer opinions about a different field of practice. SeeDambacher by Dambacher v. Mallis
, 485 A.2d 408, 419 (Pa. Super. 1984). In this case, the trial court believed that an internist was simply not qualified to offer any expert opinions regarding the cause and extent of Wright’s musculoskeletal injuries. When ruling on the motion in limine and post-trial motions, the trial court cited Wexler v. Hecht
, 847 A.2d 95, 99-100 (Pa. Super. 2004) aff'd, 928 A.2d 973 (Pa. 2007) (holding podiatrist not qualified to opine regarding standard of care for a malpractice case against an orthopedic surgeon). However, the Superior Court determined that the trial court’s reliance on Wexler
was misplaced because this was not a medical malpractice case wherein Wright’s doctor was prepared to offer expert opinions concerning the standard of care of an orthopedic surgeon. Residence Inn also relied on Kovalev v. Sowell
, 839 A.2d 359 (Pa. Super. 2003), wherein this Court affirmed a trial court’s finding that Kovalev
, who represented himself in his personal injury trial, was not qualified to testify as an expert witness about his own orthopedic injuries because Dr. Kovalev only had general unrelated medical experience in the military and as a psychiatrist in a substance abuse facility. Dr. Kovalev was not able to prescribe medication in the United States as he had not yet completed the requisite training to be able to practice in this country. Moreover, he did not routinely treat accident victims with injuries like his own. The Superior Court determined that Dr. Sedacca had more knowledge than is otherwise within an ordinary layman’s range of training, knowledge, intelligence, or experience. Dr. Sedacca had extensive practice in internal medicine, and was exposed to orthopedics during his residency. His practice involved evaluation of the musculoskeletal system and required him to recognize potential surgical problems with his patients, so he can refer them to an appropriate subspecialist. Dr. Sedacca treated patients who had orthopedic or shoulder-type injuries, and routinely referred patients for diagnostic tests. Thus, the Court found that Dr. Sedacca had reasonable pretension to specialized knowledge in the field of orthopedics and should have been allowed to testify as an expert witness. Finally, the Court needed to address whether Wright demonstrated that the exclusion of Dr. Sedacca’s testimony prejudiced him to the extent that the verdict would have been different. The trial found no prejudice because in its view, the evidence enabled the jury to find causation between the accident and Wright’s injuries as well as the extent of the damages he sustained. The Superior court disagreed, finding that although Wright was successful on his claim, he did not get a fair trial on damages due to the preclusion of Dr. Sedacca’s testimony. Without Dr. Sedacca’s testimony, there was no objective expert medical testimony to corroborate Wright’s subjective testimony. Thus, the court believed that Dr. Sedacca’s testimony was critical to fully explain to the jury what happened to Wright physically, how his injuries affected him and the extent to which they affected him. Morevoer, Wright was not able to present evidence of his prognosis and the impact this injury would have on him into the future. The Court further determined that the trial court’s error was compounded by Resident’s Inn’s emphasis during closing argument on Wright’s failure to produce a medical doctor at trial to tell the jury about Wright’s injuries or the effect on Wright. Accordingly, the Superior Court determined that these errors could have affected the jury’s determination on damages; and therefore, Wright was entitled to a new trial on damages alone.