United States District Court, D. Colorado
ESTATE OF BARTON GRUBBS and TANYA SMITH, individually and as the personal representative of the Estate of Barton Grubbs, Plaintiffs,
v.
THE WELD COUNTY SHERIFF'S OFFICE, BOARD OF COUNTY COMMISSIONERS OF THE COUNTY OF WELD, CORRECT CARE SOLUTIONS, LLC, and CHRISTIN HERNANDEZ, in her Individual and Official Capacity, Defendants.
ORDER
PHILIP
A. BRIMMER UNITED STATES DISTRICT JUDGE
This
matter is before the Court on the Rule 702 Motion to Exclude
Dr. Metzner's Testimony [Docket No. 138] filed by
defendants Correct Care Solutions, LLC and Christin
Hernandez, Defendants the Weld County Sheriff's Office
and the Board of County Commissioners of the County of
Weld's Motion for Summary Judgment [Docket No. 139], and
CCS and Nurse Hernandez's Motion for Summary Judgment
[Docket No. 144]. The Court has jurisdiction pursuant to 28
U.S.C. §§ 1331 and 1367.
I.
BACKGROUND[1]
Shortly
after midnight on March 27, 2014, Colorado State Patrol
Trooper Travis Tyndall arrested Barton Grubbs for failing to
drive in a single lane and driving while under the influence
of alcohol or drugs. Docket No. 139 at 2, ¶ 1; Docket
No. 144 at 2, ¶ 1. At Mr. Grubbs' request, Trooper
Tyndall retrieved Mr. Grubbs' medications - a bottle of
Valium and a bottle of Percocet - from the back seat of Mr.
Grubbs' vehicle. Docket No. 139 at 2-3, ¶¶ 2-3;
Docket No. 144 at 2, ¶¶ 4, 6. The generic name for
Valium is diazepam, while Percocet consists of both oxycodone
and acetaminophen. Docket No. 144 at 9, ¶
65.[2]
Mr. Grubbs subsequently requested medical assistance for
pain. Docket No. 139 at 3, ¶ 4; Docket No. 144 at 2,
¶ 7. Mountain View Fire Paramedics met Trooper Tyndall
and Mr. Grubbs at a Colorado State Patrol substation, where
they cleared Mr. Grubbs for transport to the Weld County
Jail. Docket No. 139 at 3, ¶ 6; Docket No. 144 at 2,
¶ 8. After the paramedics confirmed that there was no
indication Mr. Grubbs was abusing his prescriptions, Docket
No. 144 at 2, ¶ 9; Docket No. 144-1 at 4, Mr. Grubbs was
permitted to take one Valium and one Percocet in the presence
of Trooper Tyndall and the paramedics. Docket No. 139 at 3,
¶ 7; Docket No. 144 at 2, ¶ 10. In preparation for
transport to the Weld County Jail, Trooper Tyndall had Mr.
Grubbs put on his coat and place his medications in his coat
pocket. Docket No. 139 at 3, ¶ 8; Docket No. 144 at 3,
¶¶ 12-13. Mr. Grubbs was then transported to the
jail with his hands cuffed behind his back. Docket No. 139 at
3, ¶ 9; Docket No. 144 at 3, ¶¶ 15-16.
Once
they had arrived at the Weld County Jail, Trooper Tyndall
escorted Mr. Grubbs from the sally port into the booking
vestibule. Docket No. 139 at 3, ¶ 10; Docket No. 144 at
3, ¶ 17. A sign on the door between the sally port and
the booking vestibule stated: “STOP ALL ARRESTEES
WILL NOT BE ACCEPTED UNLESS THEY ARE RESTRAINED
BEHIND THEIR BACK OR BELLY BELTED.” Docket No. 139 at
4, ¶ 11; Docket No. 144 at 3, ¶ 18; Docket No.
144-4.[3] When they were inside the booking
vestibule, Trooper Tyndall removed Mr. Grubbs' handcuffs
and had him take a seat on a bench. Docket No. 139 at 4,
¶ 12; Docket No. 144 at 4, ¶ 21. T rooper Tyndall
then turned his back to Mr. Grubbs and began preparing Mr.
Grubbs' arrest paperwork. Docket No. 139 at 4, ¶ 13;
Docket No. 144 at 4, ¶ 23. W hile Trooper Tyndall's
back was turned, Mr. Grubbs took the pill bottles out of his
pocket and ingested all of the Valium and all but 11/2 of his
Percocet pills. Docket No. 139 at 4, ¶ 14; Docket No.
144 at 4, ¶ 25.
Deputy
Eric Sutherland, of the Weld County Sheriff's Department,
arrived in the booking vestibule and informed Trooper Tyndall
that arrestees must remain restrained until uncuffed by a
Weld County Sheriff Deputy. Docket No. 139 at 4, ¶ 15;
Docket No. 144 at 4, ¶ 26.[4] Trooper Tyndall advised Deputy
Sutherland that Mr. Grubbs had medications on his person.
Docket No. 139 at 4, ¶ 16; Docket No. 144 at 4, ¶
28. Deputy Sutherland called Nurse Christin Hernandez, an
employee of CCS, to check Mr. Grubbs' medication into the
jail. Docket No. 139 at 5, ¶¶ 19, 21; Docket No.
144 at 4, 7, ¶¶ 29, 44; Docket No. 169 at 3, ¶
19; Docket No. 145-2 at 1. W hile he was waiting for Nurse
Hernandez to arrive, Deputy Sutherland searched Mr. Grubbs
and found the medication bottles. Docket No. 139 at 5, ¶
17; Docket No. 144 at 5, ¶ 30. Af ter seeing the
bottles, Trooper Tyndall told Deputy Sutherland and Nurse
Hernandez that there was a possibility that an unknown number
of pills were missing or that he could be mistaken as to what
the bottles originally contained. Docket No. 139 at 6, ¶
26; Docket No. 144 at 5, ¶ 36.[5] Trooper Tyndall and Deputy
Sutherland both asked Mr. Grubbs if he had taken any
additional medication; Mr. Grubbs responded “no.”
Docket No. 139 at 6, ¶¶ 25, 27; Docket No. 144 at
5, ¶¶ 33-34. Deputy Sutherland asked Mr. Grubbs if
he had ever attempted suicide or if he would tell Deputy
Sutherland if he had thoughts of suicide. Docket No. 139 at
6, ¶ 30; Docket No. 144 at 6, ¶ 40. Mr. Grubbs
responded “no” to both questions. Docket No. 139
at 6, ¶ 30; Docket No. 144 at 6, ¶ 40. Deputy
Sutherland requested a suicide staffing for Mr. Grubbs.
Docket No. 139 at 7, ¶ 36; Docket No. 144 at 7, ¶
45. Nurse Hernandez also took Mr. Grubbs' vital signs.
Docket No. 139 at 7, ¶ 32; Docket No. 144 at 6, ¶
42.[6]
Nurse
Hernandez and Deputy Jennifer Lenderink then conducted Mr.
Grubbs' suicide staffing. Docket No. 139 at 8, ¶ 41;
Docket No. 144 at 7, ¶ 46.[7] During the staffing, Mr. Grubbs
indicated that he had had thoughts of suicide in the past but
was not currently suicidal. Docket No. 139 at 8-9, ¶ 42;
Docket No. 144 at 7, ¶ 48; Docket No. 139-8 at
2-3.[8]
After initially denying that he took any extra medications,
Mr. Grubbs admitted to Nurse Hernandez and Deputy Lenderink
that he had taken approximately 70 Valium pills in the
booking vestibule. Docket No. 139 at 9, ¶¶ 44-45;
Docket No. 144 at 7-8, ¶¶ 51-53.[9] After taking Mr.
Grubbs' vital signs a second time, Docket No. 139 at 9,
¶ 47; Docket No. 144 at 8, ¶ 55, Nurse Hernandez
and Deputy Lenderink placed Mr. Grubbs on Level 1 suicide
watch and assigned him to housing Unit 6. Docket No. 139 at
10, ¶ 51; Docket No. 144 at 8, ¶ 56.[10] At some point
between 8:30 a.m. and 8:53 a.m., Mr. Grubbs was found
unresponsive in his cell. Docket No. 139 at 11, ¶ 60;
Docket No. 144 at 9, ¶ 63; Docket No. 164 at 8, ¶
63; Docket No. 144-22 at 2; Docket No. 164-13 at 3. Mr.
Grubbs was transported to Northern Colorado Medical Center
where he died on March 28, 2014. Docket No. 139 at 11, ¶
61; Docket No. 139-13 at 2.[11] The autopsy report lists Mr.
Grubbs' cause of death as “complications of
combined diazepam and oxycodone toxicity” and the
manner of death as “suicide.” Docket No. 139 at
12, ¶ 63; Docket No. 144 at 9, ¶¶ 64, 66.
Plaintiffs
filed this lawsuit on March 25, 2016. Docket No. 1. The
operative complaint, filed on July 26, 2016, asserts six
claims for relief: (1) wrongful death under Colo. Rev. Stat.
§ 13-21-202; (2) a claim for expenses related to Mr.
Grubbs' death under Colo. Rev. Stat. § 13-20-101;
(3) deliberate indifference to medical needs under 42 U.S.C.
§ 1983; (4) adoption of an official policy under 42
U.S.C. § 1983; (5) failure to adequately train or
supervise under 42 U.S.C. § 1983; and (6) common law
negligence. Docket No. 66 at 22-34, ¶¶ 187-285.
Plaintiffs' first through third claims for relief are
asserted against all defendants, whereas plaintiffs'
fourth and fifth claims are asserted only against the Weld
County defendants, and their sixth claim is asserted only
against Nurse Hernandez. See Id. On August 9, 2016,
Magistrate Judge Nina Y. Wang granted defendants' motion
to designate Trooper Tyndall as a non-party at fault under
Colo. Rev. Stat. § 13-21-111.5(3)(b). Docket No.
75.[12] On March 8, 2017, this Court dismissed
plaintiffs' third claim for relief as to CCS and the Weld
County defendants. Docket No. 92 at 21-22. The Court further
dismissed plaintiffs' fourth and fifth claims for relief
in their entirety. Id.
On
January 17, 2018, the CCS defendants filed a motion to
exclude the testimony of plaintiffs' expert, Dr. Jeffrey
L. Metzner, pursuant to Fed.R.Evid. 702. Docket No. 138. On
January 24, 2018, the Weld County defendants filed a motion
for summary judgment on plaintiffs' wrongful death
claims. Docket No. 139. On February 7, 2018, the CCS
defendants filed a motion for summary judgment seeking
dismissal of CCS from the lawsuit and an order declaring
Trooper Tyndall negligent as a matter of law. Docket No. 144.
II.
MOTION TO EXCLUDE PURSUANT TO RULE 702
The
Court will begin by addressing the CCS defendants' Rule
702 motion.
A.
Legal Standard
The
admissibility of expert testimony is governed by Federal Rule
of Evidence 702, which provides:
A witness who is qualified as an expert by knowledge, skill,
experience, training, or education may testify in the form of
an opinion or otherwise if: (a) the expert's scientific,
technical, or other specialized knowledge will help the trier
of fact to understand the evidence or to determine a fact in
issue; (b) the testimony is based on sufficient facts or
data; (c) the testimony is the product of reliable principles
and methods; and (d) the expert has reliably applied the
principles and methods to the facts of the case.
Fed. R. Evid. 702. As the rule makes clear, while required,
it is not sufficient that an expert be qualified based upon
knowledge, skill, experience, training, or education to give
opinions in a particular subject area. Instead, the Court
must “perform[] a two-step analysis.” 103
Investors I, L.P. v. Square D Co., 470 F.3d 985, 990
(10th Cir. 2006). After determining whether the expert is
qualified, the Court must assess whether the specific
proffered opinions are reliable. See id.;
Fed.R.Evid. 702 (requiring that the testimony be “based
on sufficient facts or data, ” be the “product of
reliable principles and methods, ” and reflect a
reliable application of “the principles and methods to
the facts of the case”).
Rule
702 thus imposes on the district court a “gatekeeper
function to ‘ensure that any and all scientific
testimony or evidence admitted is not only relevant, but
reliable.'” United States v. Gabaldon, 389
F.3d 1090, 1098 (10th Cir. 2004) (quoting Daubert v.
Merrell Dow Pharm., Inc., 509 U.S. 579, 589 (1993)). To
perform this role, the Court must “assess the reasoning
and methodology underlying the expert's opinion, and
determine whether it is both scientifically valid and
applicable to a particular set of facts.” Dodge v.
Cotter Corp., 328 F.3d 1212, 1221 (10th Cir. 2003)
(citing Daubert, 509 U.S. at 592-93). In assessing
reliability, “the court may consider several
nondispositive factors: (1) whether the proferred theory can
and has been tested; (2) whether the theory has been subject
to peer review; (3) the known or potential rate of error; and
(4) the general acceptance of a methodology in the relevant
scientific community.” 103 Investors I, L.P. v.
Square D Co., 470 F.3d 985, 990 (10th Cir. 2006). These
factors are not applicable in every case. See Kumho Tire
Co. v. Carmichael, 526 U.S. 137, 141, 150-53 (1999).
Indeed, the trial court has “the sam e kind of latitude
in deciding how to test an expert's reliability
. . . as it enjoys when it decides whether or not
that expert's relevant testimony is reliable.”
Id. at 152. Regardless of the specific factors
applied, however, the objective of Daubert's
gatekeeping requirement remains the same: to ensure that an
expert “employs in the courtroom the same level of
intellectual rigor that characterizes the practice of an
expert in the relevant field.” Id.
Although
the proponent of the challenged testimony has the burden of
establishing admissibility, United States v.
Nacchio, 555 F.3d 1234, 1241 (10th Cir. 2009) (citing
Ralston v. Smith & Nephew Richards, Inc., 275
F.3d 965, 970 n.4 (10th Cir. 2001)), the reliability standard
does not require proof “that the opinion is objectively
correct, but only that the witness has sufficient expertise
to choose and apply a methodology, that the methodology
applied was reliable, that sufficient facts and data as
required by the methodology were used and that the
methodology was otherwise reliably applied.” United
States v. Crabbe, 556 F.Supp.2d 1217, 1221 (D. Colo.
2008) (internal citation omitted).
Assuming
the standard for reliability is met, the Court must also
ensure that the proffered testimony will assist the trier of
fact. See Kumho Tire, 526 U.S. at 156; United
States v. Rodriguez-Felix, 450 F.3d 1117, 1122-23 (10th
Cir. 2006). “Relevant expert testimony must logically
advance[ ] a material aspect of the case and be sufficiently
tied to the facts of the case that it will aid the jury in
resolving a factual dispute.” United States v.
Garcia, 635 F.3d 472, 476 (10th Cir. 2011) (internal
quotation marks and citations omitted). In assessing whether
expert testimony will assist the trier of fact, the Court
should also consider “whether the testimony ‘is
within the juror's common knowledge and experience,'
and ‘whether it will usurp the juror's role of
evaluating a witness's credibility.'”
Id. at 476-77 (quoting Rodriguez-Felix, 450
F.3d at 1123).
B.
Analysis
Plaintiffs
have designated Dr. Jeffrey L. Metzner, a licensed forensic
psychiatrist, to testify regarding “the appropriate
protocols in correctional health care, ” Docket No.
151-3 at 1, and specifically, the propriety of Nurse
Hernandez's response to Mr. Grubbs' statement that he
had ingested Valium and the preventability of Mr. Grubbs'
death after that statement. See generally Docket No.
138-5. In his expert report, Dr. Metzner opines that Mr.
Grubbs received inadequate care due to Nurse Hernandez's
failure to contact the on-call physician, Nurse
Hernandez's and Nurse Weatherwax's failure to obtain
an emergency mental health consultation, Nurse
Hernandez's lack of qualifications to perform a suicide
risk assessment, and the insufficiency of the walkthroughs
performed by correctional officers as part of the Level 1
suicide watch (“SUW1”) process. Id. at
10. Dr. Metzner concludes that Mr. Grubbs' death would
have been preventable had he received adequate mental health
and/or medical treatment during his time at the Weld County
Jail. Id.
Defendants
move to exclude Dr. Metzner's testimony on four grounds:
(1) as a forensic psychiatrist, he is not qualified to opine
as to the standard of care for nurses; (2) his testimony is
irrelevant to the issues in this case; (3) he is not
qualified to testify as to whether Mr. Grubbs' death was
preventable following completion of the suicide staffing; and
(4) his opinion regarding preventability is unreliable.
Docket No. 138.[13]
1.
Standard of Care Opinions
Defendants
argue that Dr. Metzner is not qualified to testify as to the
standard of care applicable to licensed practical nurses
because he is a forensic and correctional psychiatrist, has
minimal experience training and supervising other
psychiatrists, and has never directly supervised correctional
nurses. Docket No. 138 at 5, 9. Plaintiffs respond by
highlighting Dr. Metzner's experience “defin[ing]
and set[ting] the standards for mental health medical care in
correctional facilities” and his “numerous
positions, honors, memberships, publications, peered [sic]
reviewed journals, books, and reviewed books”
demonstrating his qualifications as a correctional
psychiatrist. Docket No. 151 at 4. Plaintiffs also argue that
Dr. Metzner “has not been disclosed to testify
regarding nurse standard of care issues.” Id.
at 5. They assert that Dr. Metzner's testimony will be
limited to “Nurse Hernandez's role in correctional
health care, ” “the communication a nurse has
with a physician in the context of correctional health care,
” and “the standard of care in correctional
health care.” Id. at 5-7.
As an
initial matter, defendants' challenge fails to comply
with this Court's Practice Standards, which state that a
Rule 702 motion “shall identify with specificity each
opinion the moving party seeks to
exclude.” Practice Standards (Civil Cases), Judge
Philip A. Brimmer, § III.G. Defendants seek to exclude
any testimony by Dr. Metzner regarding “practical
nursing, ” “Nurse Hernandez' care, ”
and the “nursing standard of care.” See
Docket No. 138 at 5, 9. This formulation is imprecise because
it fails to challenge Dr. Metzner's opinions as they
appear in his expert report. See Docket No. 138 at
5, 9; see also White v. Deere & Co., No.
13-cv-02173-PAB-NYW, 2016 WL 482712, at *2 (D. Colo. Feb. 8,
2016) (defendants failed to identify expert opinions with
specificity where they challenged the opinions as summarized
in defendants' motion to exclude and not as they
originally appeared in the expert's report). To the
extent that defendants urge the Court to categorically bar
any testimony by Dr. Metzner concerning the care provided by
Nurse Hernandez, the Court declines to do so. Neither federal
law governing the admissibility of expert testimony nor
Colorado law governing the competency of medical witnesses
supports a rule that a physician is never qualified
to opine as to the sufficiency of medical care provided by
nursing staff. See Gomez v. Palmer, 2016 WL 212952,
at *4 (N.D. Ill. Jan. 19, 2016) (finding doctor qualified to
opine on treatment provided by nurses in prison setting where
doctor had experience working with licensed practical
nurses); Sanford v. Stewart, 2013 WL 3729175, at *3
(N.D. Ohio July 12, 2013) (holding doctor qualified to opine
on actions of nursing staff where testimony did not address
nursing standards of care but rather basic medical standards
regarding when a nurse must report patient symptoms to a
physician); Hall v. Frankel, 190 P.3d 852, 858
(Colo.App. 2008) (stating rule that “[a] trial court
shall not permit an expert in one medical specialty to
testify against a physician in another specialty unless
the expert demonstrates a substantial familiarity with the
other specialty and a similarity between the standards of
care in the two fields” (emphasis added)).
Although
defendants' argument lacks the requisite level of
specificity under this Court's practice standards,
defendants clearly challenge the opinion, expressed during
Dr. Metzner's deposition, that “Nurse Hernandez
should have believed Mr. Grubbs when Mr. Grubbs said during
the suicide staffing that he took the pills.” Docket
No. 138 at 5 (citing Docket No. 138-9 at 25, 93:4-95:7).
Accordingly, the Court will confine its Rule 702 analysis to
that opinion.[14]
The
admissibility of Dr. Metzner's opinion “hinges on
both state substantive law and federal procedural law.”
Nicholson v. Evangelical Lutheran Good Samaritan Society,
Inc., 2017 WL 3127799, at *29 (D.N.M. July 21, 2017).
While Rule 702 governs the admissibility of expert testimony
in diversity cases, Sims v. Great Am. Life Ins. Co.,
469 F.3d 870, 883 (10th Cir. 2006), a witness's
competency to testify regarding a substantive issue, such as
the medical standard of care, is dictated by state law.
See McDowell v. Brown, 392 F.3d 1283, 1295 (11th
Cir. 2004); see also Fed. R. Evid. 601 (“[I]n
a civil case, state law governs the witness's competency
regarding a claim or defense for which state law supplies the
rule of decision.”).[15]
Under
Colorado law, an expert in one medical specialty may testify
regarding the standard of care applicable to a different
medical speciality if (1) the testifying expert “is, by
reason of knowledge, skill, experience, training, or
education, so substantially familiar with the standard of
care applicable . . . as to render the witness' opinion
testimony as well-informed as would be the opinion of an
expert witness practicing in the same specialty as the
defendant, ” or (2) the “standard of care for the
condition in question is substantially identical for both
specialties.” Melville v. Southward, 791 P.2d
383, 388-89 (Colo. 1990). Courts in this district have
applied these standards in medical malpractice cases
involving non-physician defendants. See, e.g.,
Harvey v. United States, No. 04-cv-188-WYD-CBS, 2006
WL 1980623, at *4, *6 (D. Colo. July 13, 2006) (holding,
under admissibility rules articulated in Melville,
that nurse expert was not qualified to opine regarding
standards of care for physicians or physicians assistants in
Colorado).
The
Court agrees with defendants that Dr. Metzner is not
qualified to opine as to whether Nurse Hernandez breached the
nursing standard of care. Although Dr. Metzner testified that
he has developed mental health trainings for health care
staff and monitored trainings delivered to LPNs, Docket No.
138-9 at 4-5, 25, 12:7-13:10, 95:8-96:6, there is no evidence
that he has directly supervised LPNs, received formal
training in nursing standards of care, or worked in such
close proximity to nursing staff as to become familiar with
the applicable standards.
On the
other hand, the Court finds that the combination of Dr.
Metzner's psychiatry background and his many years of
experience developing policies and practices for correctional
health care qualifies him to express an opinion as to whether
an individual trained in conducting suicide assessments
should have believed Mr. Grubbs when he said he had ingested
the pills. Dr. Metzner has been working as a licensed
psychiatrist in correctional health care settings for nearly
forty years. See Docket No. 138-9 at 2-3, 4:22-5:16;
Docket No. 138-11 at 1. In 1980, he serv ed as the chief of
psychiatry for the Colorado Department of Corrections
(“CDOC”) and worked to develop policies and
procedures to remedy deficiencies in CDOC's psychiatric
services. Docket No. 138-9 at 3, 7:11-25. Since that time,
Dr. Metzner has served as a clinical professor of psychiatry
at the University of Colorado Health Sciences Center and as a
court-appointed monitor in mental health litigation, ensuring
proper implementation of court-ordered remedial plans at
correctional facilities across the country. Id. at
7-9, 23:4-32:5; Docket No. 138-11 at 1, 5-6; see,
e.g., McClendon v. City of Albuquerque, 2015 WL
13667177, at *2 (D.N.M. Oct. 13, 2015) (discussing
appointment of Dr. Metzner as expert “to evaluate
conditions of confinement” at the Metropolitan
Detention Center).
These
experiences indicate that Dr. Metzner is familiar with the
provision of psychiatric care in a correctional setting. They
also qualify him to state that an individual adequately
trained in conducting suicide assessments should have
believed Mr. Grubbs when Mr. Grubbs said he had ingested the
pills. Such an opinion does not depend on Dr. Metzner's
knowledge of the standard of care applicable to LPNs. Dr.
Metzner cited three bases for his conclusion that Nurse
Hernandez should have believed Mr. Grubbs: (1) people who are
suicidal are often ambivalent about killing themselves; (2)
people will often not tell the truth about being suicidal
because they do not want to be stopped from killing
themselves; and (3) Trooper Tyndall indicated that there
might be pills missing from the two pill bottles. Docket No.
138-9 at 25, 93:4-95:3. Dr. Metzner stated that he would not
“be real critical about [an LPN] not being aware”
of the first two points; however, he indicated that any such
lack of awareness on the part of Nurse Hernandez would
demonstrate that she was not qualified to conduct a suicide
risk assessment. Docket No. 138-9 at 26, 97:12-98:1. This
opinion does not require Dr. Metzner to have knowledge of the
standard of care applicable to LPNs.
An
issue arises as to what claim testimony about Nurse
Hernandez's qualifications to conduct a suicide risk
assessment would support. Because Dr. Metzner is not
qualified to testify about an LPN's standard of care, his
opinions cannot support plaintiffs' negligence claim
against Nurse Hernandez. Plaintiffs' claim against Weld
County for failure to train its employees was dismissed,
Docket No. 92 at 19, and, in any event, did not include
allegations concerning CCS or Nurse Hernandez. Moreover,
plaintiffs deny making a direct claim against CCS for
negligence. See Docket No. 144 at 10, ¶ 75;
Docket No. 164 at 10, ¶ 75. Finally, plaintiffs provide
no explanation of how Dr. Metzner's testimony about the
standards for properly conducting a suicide assessment would
be relevant to whether Nurse Hernandez was deliberately
indifferent under plaintiffs' third claim. As a result,
this testimony, while not subject to exclusion under Rule
702, appears to be irrelevant.
2.
Causation Opinions
Defendants
contend that Dr. Metzner's opinion regarding the
preventability of Mr. Grubbs' death at a particular point
in time is inadmissible on grounds that (1) Dr. Metzner is
not sufficiently knowledgeable about pharmacokinetics,
pharmacodynamics, overdose reversal, and resuscitation
measures to offer such an opinion; and (2) the opinion is
unreliable. Docket No. 138 at 10-15. Plaintiffs' primary
response is that defendants' challenge rests on facts not
in the record. Docket No. 151 at 10, 12-13. They also assert
that Dr. Metzner “testified consistent with the
correctional standard of healthcare” and talked
“at length” about pharmacokinetics and
pharmacodynamics. Id. at 12. Finally, plaintiffs
argue that Dr. Metzner does ...