Bartlett v. Mutual Pharm. Co.
Bartlett v. Mutual Pharm. Co.
Opinion
Bartlett v. Mutual Pharm. Co. CV-08-358-JL 07/22/10 P UNITED STATES DISTRICT COURT DISTRICT OF NEW HAMPSHIRE
Karen L. Bartlett
v. Civil No. 08-cv-358-JL Opinion No.
2010 DNH 123Mutual Pharmaceutical Company, Inc.
MEMORANDUM ORDER
This products liability case presents numerous disputes over
the admissibility of expert testimony. Plaintiff Karen Bartlett,
who took the generic drug Sulindac and suffered severe side
effects, brought suit against the drug's manufacturer. Mutual
Pharmaceutical Company, asserting state-law claims of strict
products liability and negligence based on defective design. She
alleges, in particular, that Sulindac's safety risks outweigh its
medical benefits, making it an unreasonably dangerous product.
This court has subject-matter jurisdiction under
28 U.S.C. § 1332(a)(1) (diversity), because Bartlett is a New Hampshire
citizen and Mutual is located in Pennsylvania.
Earlier in the case, this court denied Mutual's motion for
judgment on the pleadings, see Fed. R. Civ. P. 12(c), rejecting
the argument that Bartlett's claims were pre-empted by federal
law. Bartlett v. M u t . Pharm. Co.,
659 F. Supp. 2d 279(D.N.H.
2009). After discovery, both parties moved for summary judgment.
See Fed. R. Civ. P. 56. This court recently granted each of
1 their motions in part, eliminating several claims and defenses,
but allowing Bartlett to proceed to trial on her defective design
claims. Bartlett v. Mut. Pharm. Co.,
2010 DNH 112.
Both parties have now moved to exclude or limit the
testimony of each other's expert witnesses at the upcoming trial.
See Fed. R. Evid. 702. After reviewing their submissions, this
court grants the motions in part and denies them in part. The
parties' experts have sufficient qualifications and a sufficient
foundation to support most of their proffered opinions. But they
may not offer legal opinions that impinge upon the roles of the
judge and jury, nor may they speculate about what the Food & Drug
Administration ("FDA") would have done in hypothetical
circumstances.
I. Applicable legal standard
"The touchstone for the admission of expert testimony in
federal court litigation is Federal Rule of Evidence 702." Crowe
v. Marchand,
506 F.3d 13, 17(1st Cir. 2007). Rule 702 provides:
If scientific, technical, or other specialized knowledge 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, 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.
2 Fed. R. Evid. 702. As the structure of this rule suggests,
before the jury can consider expert testimony over the adverse
party's objection, the trial judge, serving as "gatekeeper," must
determine whether the testimony has a proper foundation. See,
e.g., Daubert v. Merrell Dow Pharms., Inc.,
509 U.S. 579, 597(1993). The party introducing the testimony bears the burden of
proving its admissibility. I d . at 592. "Rule 702 has been
interpreted liberally in favor of the admission of expert
testimony." Levin v. Dalva Bros., Inc.,
459 F.3d 68, 78(1st
C i r . 2006) .
While presented as Rule 702 challenges, many of the parties'
requests would be more accurately described as motions in limine,
since they seek to exclude testimony for lack of relevance rather
than lack of foundation. Like all evidence, expert testimony
must be relevant to the issues in the case. See, e.g.. United
States v. Pena,
586 F.3d 105, 110(1st Cir. 2009). Evidence is
relevant if it has "any tendency to make the existence of any
fact that is of consequence to the determination of the action
more probable or less probable than it would be without the
evidence." Fed. R. Evid. 401. The relevance standard is also
interpreted liberally. See, e.g., Mitchell v. United States,
141 F.3d 8, 14(1st Cir. 1998).
3 II. Background
The factual and procedural background of this case is set
forth in the recent summary judgment ruling, Bartlett,
2010 DNH 112, at 3-8, and need not be repeated here.
Ill. Analysis
A. Bartlett's motion
Bartlett has made 37 requests to exclude or limit testimony
by Mutual's experts. Some of her requests will be analyzed
together, since they involve closely related issues.
i. Generic drug labeling (Requests 1-8, 22, 29-30)
The first issue raised by Bartlett's motion is whether
Mutual's experts may testify about federal law, FDA policy and
procedure, or industry practice with regard to generic drug
labeling.1 This court has already ruled that federal law allows
generic drug manufacturers to strengthen a generic drug's safety
warning unilaterally. See Bartlett,
659 F. Supp. 2d at 302. But
■'■Although this court recently granted summary judgment to Mutual on Bartlett's failure-to-warn claims, Sulindac's label is still relevant to this case in at least one respect, which is that Mutual's "comment k" defense depends on the adequacy of the product's warning, among other things. See Bartlett,
2010 DNH 122, at 26 (discussing Restatement (Second) of Torts § 402A, c m t . k (1965)). This court will therefore resolve all of the expert challenges relating to Sulindac's label, without prejudice to any trial objections challenging the relevance of such evidence in light of this court's summary judgment ruling.
4 Mutual's experts intend to testify that such changes would be
inconsistent with the "real-life" FDA policy and industry
practice, which is for only the manufacturer of the brand-name or
"reference listed" drug to make such changes. Bartlett argues
that this testimony must be excluded from trial because it would
be contrary to this court's legal ruling and thus confusing to
the jury.
Since "it is the judge's role, not a witness's, to instruct
the jury on the law," this court "has broad discretion to exclude
expert opinion evidence about the law that would impinge on the
roles of the judge and the jury" or would cause "jury confusion."
Pelletier v. Main St. Textiles, L P ,
470 F.3d 48, 54-55(1st Cir.
2006). Indeed, "[e]xpert testimony proffered solely to establish
the meaning of a law is presumptively improper." United States
v. Mikutowicz,
365 F.3d 65, 73(1st Cir. 2004); see also Nieves-
Villanueva v. Soto-Rivera,
133 F.3d 92, 99(1st Cir. 1997). And
even if such testimony has independent factual significance,
i.e., aside from the content of the law, it still may be excluded
"if its probative value is substantially outweighed by the danger
of unfair prejudice, confusion of the issues, or misleading the
jury." Fed. R. Evid. 403; see also United States v. Ahrendt,
560 F.3d 69, 76(1st Cir. 2009).
As an initial matter. Mutual concedes that its experts
cannot and will not "provide testimony that interprets any
5 statutes or regulations." This concession is well taken. Again,
such testimony would be presumptively improper. See Mikutowicz,
365 F.3d at 73. It would also be unfairly prejudicial to
Bartlett and confusing to the jury, because it would conflict
with this court's legal rulings and, presumably, its jury
instructions. Since Mutual has not opposed that part of
Bartlett's request, it is granted. No defense experts may
testify about the meaning or applicability of the law. See Fed.
R. Evid. 403; Pelletier,
470 F.3d at 54-55(affirming exclusion
of expert testimony regarding applicability of federal workplace
safety regulations).
Mutual argues that, so long as its experts steer clear of
the actual statutes and regulations, they should be allowed to
testify about FDA policy and procedure. But such testimony
raises many of the same concerns, because it is based largely on
FDA documents that analyze or parrot the language of the relevant
statutes and regulations. Indeed, they are some of the very same
documents that this court interpreted in its earlier ruling.
See, e.g., Bartlett,
659 F. Supp. 2d at 293n.19 (rejecting
Mutual's interpretation of 2004 industry guidance); i d . at 294
n.21 (rejecting Mutual's interpretation of "the FDA's remarks in
proposing and promulgating these regulations"). The testimony is
thus a roundabout way of challenging this court's ruling. As
such, it creates the same danger of undue prejudice and confusion
6 as testimony about the statutes and regulations themselves. See
Fed. R. Evid. 403.
Moreover, Mutual's experts have not pointed to any evidence
of the supposed policy in action, so their testimony about it
amounts to little more than "speculation as to what FDA might
have done in hypothetical circumstances." In re Rezulin Prods.
Liab. Litiq.,
309 F. Supp. 2d 531, 550(S.D.N.Y. 2004) (excluding
such speculation). Both parties seem to agree that there is no
historical evidence, at least in this record, that the FDA has
either accepted or rejected previous attempts by generic drug
manufacturers to unilaterally strengthen a drug warning. So the
policy is not based on what the FDA has actually done; rather, it
is based on what the FDA purportedly believed or would have done,
according to former FDA officials. Such testimony is not
sufficiently reliable to satisfy Rule 702(2) .
If Mutual had "simply no other practical means to prove the
point," then this court might be more inclined to admit the
testimony about FDA policy and procedure, despite its problems.
United States v. Fields,
871 F.2d 188, 198(1st Cir. 1989); see
also United States v. Scott,
270 F.3d 30, 51(1st Cir. 2001)
(noting that the "availability of other means of proof" is an
"appropriate factor" to consider in determining whether evidence
should be excluded). But that is not the case. Mutual can make
its point effectively through testimony about industry practice.
7 without needing to try to cast it as a matter of FDA policy and
procedure. Specifically, Mutual's experts can testify that the
longstanding industry practice is for the manufacturer of the
brand-name or "referenced listed" drug to make changes to the
drug's label, and for generic manufacturers simply to parrot any
such changes.
Bartlett argues that testimony about industry practice is
also unduly prejudicial and confusing to the jury. But this
court disagrees. "[I]n general, the customs and practices of an
industry are proper subjects for expert testimony." Pelletier,
470 F.3d at 55. The jury is fully capable of understanding that
there may be a gap between what the law requires and what
industry members actually do. Indeed, conformity with industry
practice is not an absolute defense to liability under New
Hampshire law, because "entire industries may lag behind" the
standard of care. Heath v. Sears, Roebuck & Co.,
123 N.H. 512, 530(1983). But it is nonetheless a factor that the jury may
consider in evaluating strict liability claims, see, e.g.,
Thibault v. Sears, Roebuck & Co.,
118 N.H. 802, 814(1978), and
negligence claims, see, e.g., 8 Richard B. McNamara, New
Hampshire Practice § 4.74, at 4-107 (3d ed. 2003) .
In sum, this court concludes that Mutual's experts may not
testify about federal law (whether directly or under the guise of
FDA policy and procedure) on the issue of whether a generic manufacturer has the ability or responsibility to strengthen a
generic drug's safety warning. The probative value of such
testimony is substantially outweighed by the danger of unfair
prejudice and jury confusion. See Fed. R. Evid. 403. Witnesses
may, however, testify about industry practice in that regard.
ii. Late production of prior transcript (Request 9)
The next issue is whether Dr. Stewart Ehrreich, designated
by Mutual as a pharmacological expert, should be precluded from
testifying altogether because Mutual failed to produce (until the
day of his deposition) a transcript from a deposition he gave in
another case, where he testified that the label for ibuprofen was
inadequate because it did not mention the possibility of death.
According to Bartlett, the parties had agreed that any such
transcripts would be produced at least seven days before Dr.
Ehrreich's deposition. Mutual, however, denies that any such
agreement existed (or that Bartlett complied with it for her own
experts, see Part III.B.i, infra) . According to Mutual, Dr.
Ehrreich "simply forgot" about that prior deposition, and
Bartlett suffered no prejudice because Dr. Ehrreich testified
about it anyway.
Whether an agreement actually existed between the parties is
unclear from the record. Mutual proposed a schedule in which
transcripts of Dr. Ehrreich's prior depositions would be produced
9 seven days in advance of his deposition in this case, but the
record contains no written acceptance of this proposal by
Bartlett, and Mutual denies reaching agreement. In any event,
even if an agreement existed, Bartlett has not suffered any
prejudice from the late production. At his deposition in this
case. Dr. Ehrreich testified in detail about the earlier case and
the specific opinions that he gave there. Bartlett's counsel
thus had an adequate opportunity to explore that issue. Under
the circumstances, it would be inappropriate to exclude Dr.
Ehrreich from testifying. See Fed. R. Civ. P. 37( c ) (1)
(providing for exclusion of expert witness due to untimely
disclosures "unless the failure was substantially justified or
harmless").
iii. References to "bad luck" (Request 10)
Bartlett argues that no defense expert should be allowed to
characterize her injuries as "bad luck," "luck of the draw," or
any similar description, which in her view is an "advanced"
expert opinion that lacks a proper foundation. It is true that
the word "luck" could have a more advanced connotation in this
context, with more specific implications (i.e., that Bartlett's
injuries were entirely random side effects of Sulindac, unrelated
to her physical traits or any other nonrandom factors). But
Mutual's experts seem to be using it in a less advanced way, as a
10 shorthand for saying that only a very small percentage of the
people who have taken Sulindac have suffered SJS/TEN as a side
effect. That is a probative fact for which, on the record before
the court, it appears that a proper foundation has been laid
under Rule 7 02.
Nevertheless, there is some risk that the jury, upon hearing
an expert describe Bartlett's injuries as "bad luck" or "luck of
the draw," might be misled into thinking that the expert intends
the more advanced, implicative meaning, for which a proper
foundation appears not to have been laid under Rule 702. While
that risk is not very high, the probative value of the word
"luck" is even lower. Mutual's experts can make the same point
using other words that avoid any risk of unfair prejudice.
Bartlett's request to exclude defense experts from using the word
"luck" in reference to her injuries is therefore granted.2 See
Fed. R. Evid. 403.
iv. Filling of prescription (Requests 11-13)
Next, Bartlett challenges three of Dr. Ehrreich's opinions
2This ruling is limited to expert testimony. Depending on the context, such language may be permissible in closing argument, where counsel is generally given "some leeway to comment on the evidence." Gomes v. Bradv,
564 F.3d 532, 538 (1st Cir. 2009); see also Lewis v. City of Chicago Police Dep't,
590 F.3d 427, 444(7th Cir. 2009). Coming from an attorney rather than an expert, the word "luck" does not carry the same risk of unfair prejudice.
11 about the filling of her Sulindac prescription: (1) that the
pharmacy could have filled the prescription with another
manufacturer's version of the drug; (2) that the pharmacy
"likely" filled the prescription with Mutual's version because it
was the cheapest; and (3) that Bartlett would have suffered the
same injuries if she took one of theother versions, since they
all had the same active ingredients. Bartlett argues that all of
these opinions are speculative. She is right as to the second
one; Dr. Ehrreich admitted in his expert report that the
pharmacy's reason for choosing Mutual's version "is not known."
Bartlett's request to exclude that opinion is therefore granted.
See Fed. R. Evid. 702(1).
But the other two opinions have a sufficient foundation.
Indeed, the first one is consistent with the testimony of
Bartlett's doctor, who wrote the prescription. And the third one
is based on the fact that the FDA requires all versions of a drug
to have the same active ingredients. Bartlett notes that it is
theoretically possible that her injuries were caused by
Sulindac's inactive ingredients, which need not be identical.
But Dr. Ehrreich made clear that his opinion was based on the
assumption that the active ingredients caused Bartlett's
injuries, which he understood to be one of her allegations.
Bartlett has not disclaimed that understanding of her claims or
identified any evidence to the contrary. See Levin,
459 F.3d at 1279 ("an expert may offer opinions based on assumptions that are
not contrary to the evidence at trial") . Bartlett's request to
exclude those opinions is therefore denied.3
v. Number of NSAID users (Request 14)
Bartlett requests that another defense expert, dermatologist
Robert Stern, be precluded from testifying about the number of
people in the United States who have used NSAIDs. She argues
that such testimony, which Dr. Stern derived from FDA materials,
is hearsay and is not relevant. But "expert opinions based on
otherwise inadmissible hearsay" may be admitted if the underlying
"facts or data are 'of a type reasonably relied upon by experts
in the particular field in forming opinions or inferences upon
the subject.'" Daubert,
509 U.S. at 595(quoting Fed. R. Evid.
703); see also United States v. Corev,
207 F.3d 84, 89(1st Cir.
2000) . The underlying "facts or data need not be admissible in
order for the opinion or inference to be admitted." Fed. R.
Evid. 703.
Experts in the field of medicine reasonably and routinely
rely on FDA materials in forming their opinions on prescription
drugs and their use in the United States. Thus, Dr. Stern's
3Bartlett's challenge to the relevance of such evidence will be considered in connection with her first motion in limine (document no. 185). The court expresses no opinion on that issue he r e .
13 opinion may be admitted even if it is based on hearsay.
Furthermore, the number of NSAID users is relevant contextual
evidence for evaluating whether Sulindac is unreasonably
dangerous. See, e.g.. First Marblehead Corp. v. House,
541 F.3d 36, 42(1st Cir. 2008) ("Testimony that provides a necessary
context and framework ... can be appropriate for expert
testimony."); see also Fed. R. Evid. 401, 402. Bartlett's
request to exclude such testimony is denied.
vi. FDA awareness of SJS/TEN risks (Request 15)
Bartlett argues that Dr. Ehrreich should be precluded from
testifying about the FDA's awareness of the SJS/TEN risks posed
by NSAIDs because he left the agency many years ago, rendering
any such opinion speculative. Actually, Dr. Ehrreich worked for
the FDA from 1979 to 1986, and his opinion is that the FDA has
been aware of the risks since the early 1980s, so his time at the
agency overlaps with the period on which he is opining. But that
is ultimately immaterial, because his testimony is based on
express statements in FDA documents from the time period in
question, not on mere extrapolation from his personal experience
in an earlier era. On this record, his opinion appears to have a
sufficient foundation under Rule 702(1) . Bartlett's request to
exclude the testimony is denied.
14 vii. Other NSAID safety warnings (Request 16)
The next issue is whether defense experts may testify about
the safety warnings for NSAIDs other than Sulindac. Bartlett
argues that such testimony should be allowed only if it relates
to NSAIDs that were specifically evaluated by the FDA or removed
from the market, because otherwise it is not relevant. Mutual
argues, in response, that such testimony is relevant to whether
Sulindac had an adequate warning. This court agrees with Mutual.
While conformity with industry practice is not an absolute
defense to liability under New Hampshire law, it is a relevant
consideration in evaluating both products liability and
negligence claims. See Thibault,
118 N.H. at 814; 8 McNamara,
supra, § 4.74, at 4-107; see also Fed. R. Evid. 401, 402.
Bartlett's request to confine such evidence to that which favors
her position is denied.
viii. Undisclosed opinions (Request 17)
Bartlett requests a blanket ruling that no defense expert
may testify at trial to any opinion not already set forth in his
or her expert report. It is true that an expert's report "must
contain ... a complete statement of all opinions the witness will
express and the basis and reasons for them." Fed. R. Civ. P.
15 2 6( a ) (2)(B)(I). And where "a party fails to provide information
... as required by Rule 26(a)," that party "is not allowed to use
that information or witness to supply evidence ... at a trial,
unless the failure was substantially justified or is harmless."
Fed. R. Civ. P. 37(c)(1). But whether an untimely disclosure is
substantially justified or harmless cannot be determined in the
abstract; it depends on the particular circumstances.4 This
court therefore declines to issue a blanket ruling, but rather
will resolve any such issues as they arise at trial in the
context of their specific facts.
ix. Hypersensitivity warning (Requests 18-21)
The next issue is whether D r s . Stern and Ehrreich may
testify that the hypersensitivity warning in the Sulindac label
(quoted in Bartlett,
2010 DNH 112, at 5) served as an adequate
warning of SJS/TEN. Bartlett argues that such testimony is
beyond the scope of their expert reports and their expertise.
Mutual appears to accept that Dr. Ehrreich cannot testify to that
particular opinion, which he never properly disclosed, so
Bartlett's request to exclude his testimony on this subject is
4There is also Rule 703's corollary--pertaining to the informational basis of expert opinion testimony--that such testimony may under some circumstances be based on facts "perceived by or make known to the expert at or before the hearing." Fed. R. Evid. 703 (emphasis added).
16 granted. But Mutual argues that Dr. Stern, as one of the world's
leading experts on SJS/TEN, is well qualified to testify about
the meaning and adequacy of the hypersensitivity warning and that
he properly disclosed his opinion in his expert report.
Contrary to what Bartlett suggests. Dr. Stern's expert
report made clear that, in his opinion, the Sulindac label's
hypersensitivity warning and its reference to "severe skin
reactions," coupled with its cross-reference to a list of adverse
reactions that included SJS/TEN, served as an adequate warning
that SJS/TEN were among the risks of taking Sulindac. Indeed,
one of the headings in his report is: "The warning in the 2004
sulindac labeling was clear and consistent with the knowledge
concerning the risk of severe skin reactions including Stevens-
Johnson Syndrome and Toxic Epidermal Necrolysis." Bartlett's
argument that he failed to disclose that opinion in his report is
unpersuasive.
Equally unpersuasive is Bartlett's argument that Dr. Stern
lacks sufficient expertise to offer that opinion. Dr. Stern
founded an international study of SJS/TEN, wrote some of the
leading articles on their connection to NSAIDs (including one in
the New England Journal of Medicine entitled "Severe adverse
cutaneous reactions to drugs"), is the chief of dermatology at
Beth Israel Deaconess Hospital in Boston, is a full-time
professor of dermatology at Harvard Medical School, and has
17 chaired multiple FDA advisory committees on the safety and
efficacy of drugs. See, e.g., Forrestal v. Maqendantz,
848 F.2d 303, 308(1st Cir. 1988) (affirming admission of doctor's expert
testimony "based on his own knowledge and experience").
Bartlett argues that Dr. Stern should not be allowed to
offer any opinions on Sulindac's label (including the
hypersensitivity warning) because he stated at his deposition
that "I'm not an expert on labeling." But Dr. Stern actually
amended that statement in an errata sheet, adding the word "regs
at the end to clarify that he is not an expert on the FDA
regulations applicable to drug labels. See Fed. R. Civ. P.
30(e)(1)(B) (allowing deponent to make "changes in form or
substance" to his deposition transcript). That is a plausible
interpretation of what he meant. While calling the correction a
"sham," Bartlett has not moved to strike it. She is, of course,
free to explore it on cross-examination. See, e.g., Daroczi v.
V t . Ctr. for the Deaf & Hard of Hearing, Inc., 2 0 04 DNH 02 7
(Muirhead, M.J.) (citing 7 Moore's Federal Practice § 30.63[3]
(3d. ed. 2003)).
In any event, it is Dr. Stern's qualifications, not his
extemporaneous disclaimer, that determine the permissible scope
of his testimony. C f . Pineda v. Ford Motor Co.,
520 F.3d 237, 245(3d Cir. 2008) (allowing expert to testify about certain
aspects of product's safety warning even though he denied being "warnings" expert, because he was an expert on the product in
question). Dr. Stern is sufficiently "qualified to render an
opinion regarding the completeness or accuracy of the [Sulindac]
label based on his knowledge of the risks of [Sulindac] and his
own clinical experience." In re Bavcol Prods. Litiq.,
532 F. Supp. 2d 1029, 1064(D. Minn. 2007); see also In re Rezulin,
309 F. Supp. 2d at 556; In re Diet Drugs Prods. Liab. Litiq., No. MDL
1203,
2000 WL 876900, at *11-12 (E.D. Pa. June 20, 2000) .
Bartlett also argues that Dr. Stern's testimony about the
hypersensitivity warning is unreliable because in 2006, after the
events at issue in this case, the FDA adopted a new label for
Sulindac that included both a hypersensitivity warning and a new
SJS/TEN warning in its "Warnings" section. See Bartlett,
2010 DNH 112, at 15 n.6. She reasons that the FDA would not have
approved "side-by-side redundant and duplicative warnings" and
therefore must believe that -- contrary to Dr. Stern's opinion --
the hypersensitivity language in the earlier label did not
adequately warn of SJS/TEN. But Bartlett has not presented any
authority or evidence to support that proposition (which is just
as speculative as Mutual's excluded testimony about FDA beliefs,
see Part III.A.i, supra) . There is nothing inherently illogical
about repeating a safety warning, especially when one wants to
emphasize a point.
And in any event, an expert's opinion need only be "based
19 upon sufficient facts or data," Fed. R. Evid. 702(1), not
perfectly consistent with every piece of available evidence.
Emphasizing inconsistencies between an expert's opinions and the
evidence, of course, is one of the principal purposes of expert
cross-examination. Bartlett's request to exclude Dr. Stern's
testimony about the warning is denied.
x. Other NSAID side effects (Request 23)
The next issue is whether defense experts may testify about
other NSAID side effects that Bartlett never suffered, such as
gastrointestinal problems. Bartlett argues that such testimony
is not relevant. But it is highly relevant to determining
whether Sulindac's safety risks outweigh its medical benefits,
making it an unreasonably dangerous product. See, e.g.. Price v.
BIG Corp.,
142 N.H. 386, 389(1997) (noting that whether a
product is unreasonably dangerous "is determined by the jury
using a risk-utility balancing test"); see also Fed. R. Evid.
401, 402. The jury is not limited to considering only the side
effects that Bartlett suffered. Bartlett's request to exclude
such testimony is denied.
xi. Impact on FDA and industry (Requests 24-25)
Bartlett seeks to preclude Dr. Ehrreich from testifying that
20 if generic drug manufacturers were each responsible for
monitoring the safety of their drugs or strengthening their
warnings, they would either have to raise prices or go out of
business, and that the FDA would be over-burdened. This court
has already ruled, as a matter of federal law, that generic
manufacturers are indeed responsible for such safety
surveillance, see Bartlett,
2010 DNH 112, at 29-31 (citing
21 C.F.R. § 314.80(b)), and for the content of their drugs'
warnings, see i d . at 9 n.4 (citing
21 C.F.R. § 201.57(e) ) .
Mutual's experts may not suggest otherwise, either expressly or
implicitly. To that extent, Bartlett's request is granted. See
Fed. R. Evid. 403.
xii. Rebuttal of Bartlett's experts (Requests 2 6-2 8)
Bartlett argues that Dr. Ehrreich should not be allowed to
criticize Bartlett's experts without first identifying the
specific opinions with which he is disagreeing. She notes, for
example, that Dr. Ehrreich's report launched a number of
broadsides against her expert Dr. Randall Tackett's report,
calling it "disturbing" and claiming to be "shocked and dismayed"
by the amount of "misinformation." While Dr. Ehrreich's specific
disagreements with Bartlett's experts and the basis of those
disagreements are relevant and admissible evidence (assuming they
have a proper foundation), the extent to which he is "disturbed"
21 or "shocked and dismayed" by Bartlett's expert opinions and his
pejorative characterizations of them are not. See, e.g.. United
States v. Gonzalez-Maldonado,
115 F.3d 9, 16(1st Cir. 1997)
(expert opinion on another witness's credibility "is ordinarily
inadmissible pursuant to Rule 702"); see also Ramirez v. Debs-
Elias,
407 F.3d 444, 447-49(1st Cir. 2005). Bartlett's request
to exclude such comments is granted.
Bartlett also argues that Dr. Ehrreich should be precluded
from expressing two particular opinions that purport to rebut
arguments that Bartlett's expert Dr. Tackett never made: one
relating to so-called "black box" warnings, and the other
relating to "due diligence." In both instances. Dr. Ehrreich's
characterization of Dr. Tackett's opinion is not quite accurate.
Dr. Tackett opined that Mutual should have advocated to the FDA
for a "black-box" warning, not (as Dr. Ehrreich says) that Mutual
should have implemented one unilaterally. And Dr. Tackett opined
that Mutual should have conducted "due diligence" before filing
its initial application to manufacture Sulindac, not afterward
(as Dr. Ehrreich says). Accordingly, this court grants
Bartlett's request to exclude the inaccurate comments.
xiii. Industry standards of care (Request 31)
The next issue is whether Dr. Ehrreich may testify about
22 standards of care within the pharmaceutical industry. Bartlett
argues that such testimony should be prohibited unless her own
experts may also testify about those standards, because Dr.
Ehrreich is no more qualified than they are and because he
provided no foundation for his opinions. But one party's failure
to disclose an expert opinion on a given issue has little or no
bearing on the admissibility of an adverse party's properly
disclosed expert opinion evidence on that issue. C f . Adams v . J .
Myers Builders,
2009 DNH 181, 18 n.7. Whether Dr. Ehrreich's
testimony may be admitted depends on his own qualifications, not
on whether Bartlett's experts would be qualified to opine on the
same issues.
As a pharmacologist who has held high-ranking jobs with the
FDA and three major drug companies. Dr. Ehrreich is sufficiently
qualified to testify about the standards of care within that
industry. The foundation for that testimony is his own
experience. See, e.g., Forrestal,
848 F.2d at 308(affirming
admission of doctor's expert testimony "based on his own
knowledge and experience"); Fed. R. Evid. 702, advisory committee
notes (2000) (noting that "the text of Rule 702 expressly
contemplates that an expert may be qualified on the basis of
experience," which may be "the predominant, if not sole, basis
for a great deal of reliable expert testimony"). Bartlett's
request to exclude the testimony is denied.
23 xiv. Knowledge in medical community (Requests 32-35)
Bartlett argues that Dr. Stern should be precluded from
testifying about what doctors generally know about SJS/TEN and
their link to NSAIDs, because such testimony is speculative.
Indeed, most courts have prohibited experts from testifying
"about what all doctors generally consider in making prescription
decisions" or about "what doctors generally think," unless the
testimony is based on something more reliable than simply the
expert's own experience as a doctor. In re Diet Drugs,
2000 WL 876900, at *11-12; see also, e.g.. In re Bavcol,
532 F. Supp. 2d at 1064; Pfizer Inc. v. Teva Pharms. USA, Inc.,
461 F. Supp. 2d 271, 277(D.N.J. 2006); In re Rezulin,
309 F. Supp. 2d at 556.
Since Dr. Stern has not identified a more reliable basis,
Bartlett's request to exclude his testimony about what doctors
generally know is granted. See Fed. R. Civ. P. 2 6 ( a ) (2)(B); Fed.
R . Ev i d . 7 02.
Dr. Stern may, however, testify about what a reasonable
doctor should know about the link between NSAIDs and SJS/TEN and
how a reasonable doctor would interpret Sulindac's safety
warning. Such testimony is properly based on his experience as a
professor of dermatology at Harvard Medical School, the chief of
dermatology at a major Boston hospital, and the author of
frequently cited articles on SJS/TEN and its link to NSAIDs. See
Fed. R. Evid. 702; First Marblehead,
541 F.3d at 42(upholding
24 admission of a financial expert's testimony on how a reasonable
investor would have analyzed stock options).
xv. Dr. Valuck (Request 36)
Bartlett seeks to exclude the testimony of another defense
expert, pharmacology professor Dr. Robert Valuck, on the grounds
that he was allegedly unprepared for his deposition. In
particular, Bartlett emphasizes that Dr. Valuck erroneously
stated that there were no Sulindac cases in a particular SJS/TEN
study on which he opined, when in fact there was one such case.
But this error (assuming it was one) resulted from a discrepancy
between the print and online versions of the study. Dr. Valuck
relied on the print version, which listed no Sulindac cases,
whereas the online version listed one case. At his deposition.
Dr. Valuck made clear that regardless of which version of the
study is correct, it would not change his opinions.
Moreover, Bartlett has the ability to explore Dr. Valuck's
error (if any) and its impact (if any) through cross-examination.
"It is not the job of the court to insure that [expert testimony]
is error-free" -- only that it has a sufficiently reliable
foundation to satisfy Rule 702. Southwire Co. v. J.P. Morgan
Chase & C o .,
528 F. Supp. 2d 908, 928(W.D. Wis. 2007). Because
Dr. Valuck's testimony about the SJS/TEN study appears, on this
25 record, to have a proper foundation, Bartlett's request to
exclude his testimony is denied.
xvi. Dr. Duffy (Request 37)
Finally, Bartlett argues that the testimony of Mutual's
economic expert. Dr. Martin Duffy, should be excluded because he
used the wrong figure for the cost of Bartlett's eye surgeries,
thus rendering all of his computations unreliable. Mutual
concedes that Dr. Duffy accidentally imported the wrong figure
from the report of another defense expert. Dr. Jane Mattson, but
argues that Dr. Duffy's economic methodology is nonetheless
reliable and that he should be allowed to testify using the
corrected figures.
The general rule is that an expert's minor computational
errors go to the weight of his testimony, rather than to its
admissibility. See, e.g.. In re Scrap Metal Antitrust Litiq.,
527 F.3d 517, 530(6th Cir. 2008); see also In re Pharm. Indus.
Avq. Wholesale Price Litiq.,
582 F.3d 156, 198(1st Cir. 2009)
(affirming admission of expert's testimony, even if he made
"small" errors, because they did not affect "the reliability of
his damages calculation"). Indeed, in a case involving this same
expert, our court of appeals ruled that "whatever shortcomings
existed in Duffy's calculations went to the weight, not the
26 admissibility, of the testimony." Cummings v. Std. Register Co.,
265 F.3d 56, 65(1st Cir. 2001). The same reasoning applies
here. Dr. Duffy's error is unrelated to his methodology and easy
for him to correct in his trial testimony (or to expose on cross-
examination if he does no t ) . Bartlett's request to exclude him
from testifying is denied.
B. Mutual's motion
For its part. Mutual seeks to exclude or limit the testimony
of Bartlett's expert witnesses on various grounds and also to
exclude any expert testimony by Bartlett's treating physicians.
This court will address each request in turn (identifying them by
the section of Mutual's motion in which they were raised).
i. Failure to produce prior transcripts (Request A)
The first issue raised by Mutual's motion is whether three
of Bartlett's experts should be precluded from testifying because
Bartlett failed to produce their prior deposition transcripts
from other cases. This is essentially the mirror image of
Bartlett's request to exclude one of Mutual's experts. Dr.
Ehrreich, from testifying due to the late production of such a
transcript. See Part III.A.ii, supra. This court denied
Bartlett's request and, for similar reasons, denies Mutual's
27 request as well. It is not clear from the record that Bartlett
violated any disclosure obligations, and even if she did,
exclusion would be an inappropriate sanction under the
circumstances. See Fed. R. Civ. P. 37( c ) (1) (providing for
exclusion of expert witness for failure to disclose, "unless the
failure was substantially justified or harmless").
ii. Similarity of experts' reports (Request A)
Mutual also argues that two of Bartlett's experts,
pharmacologist Dr. Randall Tackett and burn surgeon Dr. Roger
Salisbury, should be precluded from testifying because their
reports contain such similar language that both reports must have
been prepared by Bartlett's counsel, not by the experts
themselves. Mutual argues that this is a violation of Fed. R.
Civ. P. 26( a ) (2)(B), which requires each party's expert
disclosures to "be accompanied by a written report ... prepared
and signed by the witness." Bartlett argues, in response, that
the reports are "99 percent textually distinct" and contain
similar language in only a few areas where the two experts have
shared experiences and expertise.
It is well established that "Rule 26(a) (2) (B) does not
preclude counsel from providing assistance to experts in
preparing reports, and indeed," in some complex cases, "this
28 assistance may be needed." Fed. R. Civ. P. 26(a) (2) (B) , advisory
committee notes (1993). The report, however, must be based on
the expert's prior substantive input, must reflect the testimony
to be given by the witness, and must be signed by the witness.
Id.; see also United States v. Kalvmon,
541 F.3d 624, 637-38(6th
Cir. 2008); Jenkins v. Bartlett,
487 F.3d 482, 488 (7th Cir.
2 0 07); Crowley v. Chait,
322 F. Supp. 2d 530, 543(D.N.J. 2004).
Here, both experts' reports satisfy those requirements. Mutual's
request to exclude their testimony under Rule 2 6 ( a ) (2)(B) is
denied.
iii. FDA regulations (Requests B.l-2)
The next issue raised by Mutual's motion is whether
Bartlett's experts may testify about the meaning or applicability
of FDA regulations and whether Mutual violated them. Such
opinions appear frequently in Dr. Tackett's report and, to a
lesser extent, in Dr. Salisbury's report. As discussed in Part
III.A.i, supra, this court has "broad discretion to exclude
expert opinion evidence about the law that would impinge on the
roles of the judge and the jury." Pelletier,
470 F.3d 48, 54-55.
Indeed, "[e]xpert testimony proffered solely to establish the
meaning of a law is presumptively improper." Mikutowicz, 365
F .3d at 73.
29 Bartlett seems to believe that these principles apply only
when the expert is wrong about the law, but that is not so. They
apply even when the expert is right. See, e.g., Nieves-
Villanueva,
133 F.3d at 100("the judge's expert knowledge of the
law makes any such assistance at best cumulative, and at worst
prejudicial") (emphasis added). Mutual's request to exclude such
testimony is therefore granted. See Fed. R. Evid. 403. If
Bartlett wants the jury to know what relevant FDA regulations
require, she can propose appropriate jury instructions. And if
she wants to show the jury that Mutual violated them, she may do
so by introducing evidence of Mutual's acts or failures to act,
rather than conclusory opinions from her experts.
iv. Calling Mutual "negligent" (Request B.3)
A related issue is whether Bartlett's experts may describe
Mutual's conduct as "negligent," which they repeatedly do in
their expert reports. The general rule is that "testimony in the
form of an opinion or inference otherwise admissible is not
objectionable because it embraces an ultimate issue to be decided
by the trier of fact." Fed. R. Evid. 704(a). But that rule
"does not vitiate the rule against expert opinion on questions of
law." Nieves-Villaneuva,
133 F.3d at 100. Nor is it "a carte
blanche for experts to substitute their views for matters well
within the ken of the jury." Dinco v. Dvlex Ltd., Ill F.3d 964,
30 973 (1st Cir. 1997) .
Courts have generally prohibited experts from using the term
"negligent" to describe the defendant's conduct in a negligence
case where the opposing party objects to it. See 4 Weinstein's
Federal Evidence § 704.04[1], at 704-10 (2d ed. 1997) (citing
Andrews v. Metro N. Commuter R.R.,
882 F.2d 705, 708(2d Cir.
1989), and Owen v. Kerr-McGee Corp.,
698 F.2d 236, 240(5th Cir.
1983) ) ; see also Persinqer v. Norfolk & W. Rv. Co.,
920 F.2d 1185, 1189(4th Cir. 1990); Shahid v. City of Detroit,
889 F.2d 1543, 1547(6th Cir. 1989). In light of Mutual's objection,
Bartlett's experts may not use that term at trial to describe
Mutual's conduct.
v. Qualifications (Request C)
Mutual also argues that D r s . Tackett and Salisbury lack
sufficient expertise to testify about drug labeling and FDA
regulatory procedures, because neither has ever worked for the
FDA or a drug manufacturer, and both misused FDA terminology at
their depositions. "It is not required," however, "that experts
be 'blue-ribbon practitioners' with optimal qualifications."
United States v. Vargas,
471 F.3d 255, 262(1st Cir. 2006)
(affirming admission of fingerprint expert's testimony even
though he could not answer certain questions about fingerprint
31 characteristics). They need only be sufficiently "qualified ...
by knowledge, skill, training, or education" to offer a reliable
opinion. Fed. R. Evid. 702.
Dr. Tackett easily meets that standard. He has been a
pharmacologist for more than 30 years, is a professor of
pharmacology at the University of Georgia (where he has offered
classes on FDA regulations and even conducted workshops for FDA
employees), and has worked as a research investigator for various
drug manufacturers. He also recently received a grant from a
group of state Attorneys General to educate health care
professionals about how to evaluate drug information. As another
federal court recently concluded in allowing Dr. Tackett to
testify, this "extensive experience" is enough to qualify him as
an expert in this area. Lofton v. McNeil Consumer & Specialty
Pharms., 05-cv-1531,
2008 WL 4878066, at *9 (N.D. Tex. July 25,
2008).
Dr. Salisbury's qualifications make for a closer call. He
is certainly well qualified to testify about SJS/TEN by virtue of
his 36 years as a burn surgeon and his treatment of more than 400
patients with the disease. But his experience with drug labeling
and the FDA is less extensive. His most significant credential
is that he served as the lead author of a citizen's petition
filed with the FDA in 2005, after Bartlett's injuries, that
resulted in the addition of a more explicit SJS/TEN warning to
32 NSAID labels. See Bartlett,
2010 DNH 112, at 15 n.6. In his
capacity as a professor of plastic surgery, he also "instructs
his students [on] how to review [drug] labels ... so that they
can appropriately communicate warnings to their patients."
Lofton,
2008 WL 4878066, at *9.
While Dr. Salisbury may not be the optimal witness for this
type of case, another federal court recently concluded that "his
extensive practical experience with SJS/TEN patients and the
efficacy of warning labels in the clinical setting" qualified him
to testify about the adequacy of an NSAID's label.
Id.This
court agrees. Dr. Salisbury falls in the same camp as Mutual's
corresponding expert Dr. Stern: both of them clearly know more
about SJS/TEN than about drug labeling, but nevertheless have
enough knowledge and experience to testify about the adequacy of
Sulindac's safety warning as it relates to SJS/TEN. See Part
III.A.ix, supra. Mutual's request to exclude Drs. Tackett and
Salisbury from testifying due to a lack of qualifications is
therefore denied.
vi. Mutual's ethics and motives (Requests D.l.a, D.2)
Mutual argues that Drs. Tackett and Salisbury should be
precluded from testifying about the ethics or morality of
Mutual's decisions or about Mutual's motive or state of mind in
making them. Bartlett concedes, in response, that "other than
33 state of mind as might plainly appear on a document or from
deposition testimony," she will not "offer any opinions from Drs.
Tackett or Salisbury on ethical obligations, state of mind,
knowledge or intent." In light of that concession, which the
court interprets to cover motive as well. Mutual's request to
exclude such testimony is moot. Any remaining objections in this
area that Mutual may have can be made at trial.
vii. Generic drug labeling (Requests D.l.a, D.2)
Mutual also seeks to preclude Drs. Tackett and Salisbury
from testifying that if Mutual had attempted to strengthen
Sulindac's safety warning, the FDA would have approved those
changes based on the information in the medical literature. Such
testimony is indeed speculative on this record, for reasons that
this court explained in its recent summary judgment ruling, see
Bartlett,
2010 DNH 112, at 15, and in denying Bartlett's
analogous request to exclude Mutual's experts from speculating
that the FDA would not have allowed such changes. See Part
III.A.i, supra (citing In re Rezulin,
309 F. Supp. 2d at 550,
which excluded an expert's "speculation as to what FDA might have
done in hypothetical circumstances"). As such, it lacks a
sufficient foundation to satisfy Rule 702. Mutual's request to
exclude such testimony is granted.
34 viii. Sulindac's risk of SJS/TEN (Request D.l.b)
Next, Mutual argues that Bartlett's experts should not be
allowed to suggest that Sulindac carries a higher risk of SJS/TEN
than other NSAIDs or other drugs. Mutual argues that such
testimony is speculative, because the available evidence on that
point -- including, in particular, the adverse event data
reported by Maja Mockenhaupt et a l ., The Risk of SJS and TEN
Associated with NSAIDs: A Multinational Perspective, 30 Journal
of Rheumatology 2234-2240 (Oct. 2003)) -- is largely anecdotal
and not statistically significant. But Bartlett's experts
acknowledged the limits of the data at their depositions, so this
is really an issue for cross-examination, as opposed to outright
exclusion. Moreover, a recently discovered draft of the study
suggests that the data might be more extensive than is apparent
from the published article. See document no. 251 (ordering
supplemental depositions regarding that draft). Mutual's request
to exclude testimony on this topic is denied.
Mutual also argues that Dr. Tackett should be prohibited
from using information about Bactrim, another drug that Mutual
manufactures and that has been linked to SJS/TEN, to support his
opinion about what Mutual should have done with respect to
Sulindac. Mutual argues that whether Bactrim creates a risk of
SJS/TEN has no bearing on whether Sulindac creates such a risk
and that, even it did. Mutual acquired Bactrim only one month or
35 so before Bartlett filled her prescription. But those issues
also go to weight, not admissibility. Mutual's request to
exclude such testimony is denied.
ix. Treating physicians (Request E)
Finally, Mutual seeks to exclude Bartlett's treating
physicians from offering any expert testimony at trial, since
they did not prepare expert reports pursuant to Fed. R. Civ. P.
26(a) (2) (B) . Both parties agree, however, that "Rule 26(a) (2) (B)
reports are not required as a prerequisite to a treating
physician expressing opinions as to causation, diagnosis, [and]
prognosis ... where they are based on the [plaintiff's]
treatment," provided, as is the case with each doctor, that the
witness has been properly designated as an expert under Rule
26( a ) (2)(A). Sprague v. Liberty M u t . Ins. Co.,
177 F.R.D. 78, 81(D.N.H. 1998) (Muirhead, M.J.); see also Aumand v. Dartmouth
Hitchcock Med. Ctr.,
611 F. Supp. 2d 78, 87-89(D.N.H. 2009).
Bartlett has disavowed any intent to present testimony that goes
beyond that scope.
To the extent that the parties may disagree about where the
line should be drawn between "treatment" opinions and "non
treatment" opinions (which is not entirely clear from their
briefing), those disagreements can be resolved at trial, in
accordance with the basic principle set forth above. As a
36 general matter, Bartlett's treating physicians may testify about
whether Sulindac caused Bartlett's injuries, provided that they
reached that conclusion in a reliable manner while examining and
treating Bartlett. See Sprague,
177 F.R.D. at 81. But they
should not be asked "hypothetical question[s]" about causation
that "include[] information not learned during the course of
treatment." Vosburqh v. Bourassa,
2008 DNH 133, at 7-8(McAuliffe, C.J.). Such opinions would render them "witness[es]
... retained or specially employed to provide expert testimony in
the case," requiring expert reports under Fed. R. Civ. P.
26( a ) (2)(B), which were not produced.
IV. Conclusion
As set forth above, Bartlett's motion to exclude or limit
Mutual's expert testimony5 is GRANTED in part and DENIED in part.
Mutual's corresponding motion to exclude or limit Bartlett's
expert testimony6 is also GRANTED in part and DENIED in part.
SO ORDERED.
/s/Joseph N. Laplante_____ Joseph N. Laplante United States District Judge
Dated: July 22, 2010
cc: Keith M. Jensen, Esq.
5Document no. 12 8.
6Document no. 142.
37 Bryan Ballew, Esq. Patrick J. O'Neal, Esq. Christine M. Craig, Esq. Eric Roberson, Esq. Timothy P. Beaupre, Esq. Jeffrey D. Geoppinger, Esq. Joseph P. Thomas, Esq. Linda E. Maichl, Esq. Paul J. Cosgrove, Esq. Stephen J. Judge, Esq.
38
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