U.G. v. United States

Background

U.G. and his mother, Asseta Nanema, sued the United States under the Federal Tort Claims Act, alleging medical negligence and malpractice during U.G.’s birth. They allege that Dr. Sandy Lau Biu, a federal employee and the attending obstetrician, used excessive force on U.G.’s head and shoulders during delivery, causing a permanent brachial plexus injury, also referred to as Erb’s palsy, affecting his right arm.

The government moved under Federal Rule of Evidence 702 to prevent plaintiffs’ two experts—Dr. Richard Luciani, an obstetrics and gynecology specialist, and Dr. Daniel Adler, a pediatric neurology specialist—from offering two causation opinions: that U.G.’s injury could not have occurred without Dr. Biu moving his head, and that maternal forces of labor could not have caused the injury.

Legal Standard

Rule 702 permits qualified experts to testify when their specialized knowledge will help the factfinder, their opinions are based on sufficient facts or data, their methods are reliable, and they reliably applied those methods to the case. The party offering the testimony bears the burden of showing that these requirements are satisfied. The court acts as the gatekeeper by deciding whether expert testimony is relevant and reliable.

Court’s Analysis

The court found that testimony about the cause of U.G.’s injury was relevant, that expert testimony would help resolve that question, and that Dr. Luciani and Dr. Adler were qualified to testify about it. The court nevertheless concluded that their specific causation opinions lacked a reliable foundation.

The government relied on medical literature, including a monograph from the American College of Obstetricians and Gynecologists, stating that permanent or persistent brachial plexus injuries may result solely from the forces of labor. The court noted that the monograph had been endorsed by multiple medical organizations and reaffirmed by the American College of Obstetricians and Gynecologists in 2019. The court also cited a 2020 peer-reviewed article and a guideline from the Royal College of Obstetricians and Gynaecologists reaching similar conclusions.

Plaintiffs argued that the literature supported only the possibility of temporary injuries from maternal forces, and that the monograph’s discussion of permanent injuries relied on an unreliable study. The court rejected those arguments, finding that the monograph did not rely on that study alone and that other literature also supported the government’s position. The court further noted that plaintiffs did not identify a peer-reviewed publication supporting their experts’ central premise: that, absent a condition increasing the risk of nerve injury, maternal forces of labor cannot alone cause permanent brachial plexus injury.

The court also rejected the experts’ reliance on the absence of underlying medical conditions and on testimony about Dr. Biu’s actions. It concluded that the experts’ opinions were based on the unsupported premise that delivery-room traction was the only possible cause of a permanent injury in a healthy newborn.

Disposition

The court granted the government’s motion to preclude plaintiffs’ experts from testifying that U.G.’s injury could not have occurred without the doctor’s movement of his head and that Nanema’s forces of labor could not have caused the injury. The parties were ordered to meet and confer and submit a proposed schedule for the next steps in the case by October 28, 2022. The court also stated that it could refer the parties to Magistrate Judge Willis for a settlement conference upon a joint request.