The United States Court of Appeals for the Fourth Circuit (“Federal Appellate Court”) in its unpublished opinion dated January 15, 2020 upheld summary judgment for the defendant nursing home in a nursing home negligence case out of North Carolina that alleged that the defendant nursing home negligently maintained a resident on a thin liquid diet, causing her to aspirate thin liquids, develop aspiration pneumonia, become septic, and die.
The Federal Appellate court stated: “Under binding Fourth Circuit precedent, for the question of causation to reach the jury in a medical malpractice case, a medical expert’s causation opinion must “rise to the level of a ‘reasonable degree of medical certainty’ that it was more likely that the defendant’s negligence was the cause than any other cause.””
In the case it was deciding, the Federal Appellate Court stated: “The parties do not dispute that Dr. Rupe’s testimony [the plaintiff’s expert’s testimony] meets the first prong, and the record shows she consistently opined that Ms. Riggins [the nursing home resident] more likely than not aspirated thin liquids. However, a reading of the entire record shows Dr. Rupe did not hold this opinion to a reasonable degree of medical certainty,” explaining: “Dr. Rupe acknowledged at deposition that she could not single out a particular cause of aspiration with a reasonable degree of medical certainty. Instead, she twice affirmatively declined to adopt this standard when prompted … Dr. Rupe repeatedly acknowledged that she was unsure what substance Ms. Riggins aspirated, instead candidly admitting that Ms. Riggins could have aspirated food, thickened liquids, or her own secretions. When asked about those alternative causes, Dr. Rupe could not articulate any reason why thin liquids would have been the most likely culprit, again offering conclusory statements that they were.”
The Federal Appellate Court stated that in this case, “Dr. Rupe affirmatively disclaimed the appropriate certainty standard and declined to stand by or explain her opinion that thin liquids were the most likely item aspirated. Her testimony therefore cannot satisfy the second inquiry.”
The Federal Appellate Court concluded: “this is a case where the expert demonstrated that she was not sure of her opinions, declined to consistently and confidently support or explain them, and, when confronted, expressly rejected the required standard of certainty. See id. Dr. Rupe’s causation testimony was thus insufficient to reach the jury.”
The Federal Appellate Court held: “In sum, taken together and considered in the light most favorable to Plaintiff, Dr. Rupe’s explicit refusal to state her opinion to a reasonable degree of medical certainty, her wavering answers as to whether and why thin liquids were the most likely culprit, and her failure to demonstrate what degree of certainty she actually possessed in her causation opinions are insufficient to ensure that if her “expert opinion is taken as fact by the jury, it is relying on legally competent evidence.” … Dr Rupe’s expert testimony on causation is thus insufficient to withstand summary judgment.”
Source Riggins v. SSC Yanceyville Operating Company, LLC, No. 18-2191.
If you or a loved one suffered injuries (or worse) while a resident of a nursing home in North Carolina or in another U.S. state due to a nursing home fall, nursing home aspiration, nursing home neglect, nursing home negligence, nursing home abuse, nursing home under-staffing, or the nursing home failing to properly care for a vulnerable adult, you should promptly find a North Carolina nursing home claim lawyer, or a nursing home claim lawyer in your state, who may investigate your nursing home claim for you and file a nursing home claim on your behalf or behalf of your loved one, if appropriate.
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