DONALD M. MIDDLEBROOKS, District Judge.
THIS CAUSE comes before the Court upon Defendants' (hereinafter, collectively, "Bayer's") Motion for Summary Judgment ("Motion") (DE 12395 in 08-1928 & DE 33 in 09-81262). Plaintiffs filed a Response (DE 12568 in 08-1928 & DE 35 in 09-81262), to which Bayer replied (12660 in 08-1928 & DE 36 in 09-81262). The Court has reviewed the pertinent parts of the record and is advised in the premises. For the reasons stated below I find that the Motion is due to be granted as to all Counts.
In this case Plaintiffs are husband and wife, Alan and Vicki Miller. They are and were at all times relevant to the facts herein, citizens of the State of Illinois.
After his surgery, Mr. Miller experienced a "small acute left hemispheric stroke . . . probably due to a small cardiac embolus." Id. at 40 (consult of David Gelber, M.D.). His neurological deficits from the stroke were "relatively mild [and] his overall neurological prognosis [was] excellent." Id. He also experienced a transient rise in his serum creatinine which peaked at 2.4 on postoperative day 8 and which returned to nearly his pre-surgery baseline by his discharge date without any need for dialysis.
On August 31, 2009, the Plaintiffs filed the instant case alleging claims for: (I) Strict Liability — Failure to Warn; (II) Strict Liability — Design Defect; (III) Negligence; (IV) Negligence Per Se; (V) Fraud, Misrepresentation, and Suppression; (VI) Constructive Fraud; (VII) Breach of Implied Warranties; (VIII) Unfair and Deceptive Trade Practices; (IX) Unjust Enrichment; (X) Loss of Consortium; (XII) Survival Action; (XIII) Gross Negligence/Malice; and (XIV) Punitive Damages.
Bayer argues that summary judgment should be granted as to each of Plaintiffs' claims because (1) under Illinois law, causation is an element of each of Plaintiff's claims, and Plaintiffs' expert's causation testimony is inadmissible;
Plaintiffs argue that summary judgment should be denied because (1) Plaintiffs are not seeking damages due to Mr. Miller's stroke, but for his "acute renal failure"; (2) Dr. Blond is qualified to testify; and (3) "the temporal connection between Mr. Miller's acute renal failure and the injection of Trasylol, together with the absence of renal disease or issues prior to the surgery and the fact that Trasylol is known to be a nephrotoxic agent, standing alone leads to the conclusion that Trasylol was a substantial contributing factor in causing Mr. Miller's injuries and his increased risk of mortality from the use of Trasylol." (DE 35 at 1-2).
Summary judgment is appropriate when "there is no genuine issue as to any material fact" and "the movant is entitled to judgment as a matter of law."
The party seeking summary judgment "always bears the initial responsibility of informing the district court of the basis for its motion, and identifying those portions of `the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any,' which it believes demonstrate the absence of a genuine issue of material fact." Celotex, 477 U.S. at 323 (citing FED.R.CIV.P. 56(c)); Modrowski v. Pigatto; 712 F.3d 1166 (7th Cir. 2013). The movant can meet this burden by presenting evidence showing there is no dispute of material fact, or by pointing out to the district court that the nonmoving party has failed to make a sufficient showing on an essential element of its case with respect to which it has the burden of proof. Celotex, 477 U.S. at 322-23.
Once the moving party has met its burden, the non-moving party bears the burden of coming forward with evidence of each essential element of its claim, such that a reasonable jury could find in its favor. See Earley, 907 F.2d at 1080 (11th Cir. 1990); Lindemann v. Mobil Oil Corp., 141 F.3d 290, 293 (7th Cir. 1998). Rule 56(e) "requires the nonmoving party to go beyond the pleadings and by [its] own affidavits, or by the `depositions, answers to interrogatories, and admissions on file,' designate `specific facts showing that there is a genuine issue for trial.'" Celotex, 477 U.S. at 324; Modrowski, 712 F.3d at 1167. "The mere existence of a scintilla of evidence in support of the [non-movant's] position will be insufficient; there must be evidence on which the jury could reasonably find for the [non-movant]."
Bayer asserts that each of Plaintiffs' claims are due to be dismissed due to a lack of causation — a required element of each claim. Plaintiffs' claims for fraud and consumer fraud are due to be dismissed for the additional reason that they are barred by this Court's previous orders. Lastly, Plaintiffs' unjust enrichment and punitive damages claims are derivative and must fail where the substantive counts they are premised upon are dismissed.
Specifically, Bayer asserts Plaintiffs' claims require expert testimony to establish specific causation, and Plaintiff lacks any competent evidence that Trasylol caused Mr. Miller's injuries.
Expertise is a rational process and a rational process implies expressed reasons for judgment." Mid-State Fertilizer Co. v. Exchange Nat. Bank of Chicago, 877 F.2d 1333, 1339 (7th Cir. 1989). "An expert who supplies nothing but a bottom line supplies nothing of value to the judicial process." Id. (citing to Richardson v. Richardson-Merrell, Inc., 857 F.2d 823, 829-32 (D.C. Cir. 1988) as holding that "an expert's declaration, full of assertion but empty of facts and reasons, won't get a case past a motion for summary judgment, for the judge must `look behind the expert's' ultimate conclusion . . . and analyze the adequacy of its foundation."). According to Bayer, Plaintiffs' only causation expert's testimony is based on speculation and conjecture, and is therefore unreliable and inadmissible. I agree.
The admissibility of expert testimony is governed by the framework set out in Federal Rule of Evidence 702 and Daubert v. Merrell Dow Pharms., Inc., 509 U.S. 579 (1993) Porter v. Whitehall Lab., Inc., 9 F.3d 607 (7th Cir. 1993). The party seeking to have the expert testimony admitted bears the burden of demonstrating its admissibility by a preponderance of proof. See Porter, 9 F.3d at 611. See also United States v. Frazier, 387 F.3d 1244, 1260 (11th Cir. 2004) ("The burden of establishing qualification, reliability, and helpfulness rests on the proponent of the expert opinion.").
According to Rule 702,
FED. R. EVID. 702. According to the Supreme Court, the inquiry envisioned by Rule 702 is a flexible one, in which federal judges perform a "gatekeeping role" to ensure that speculative and unreliable opinions do not reach the jury. Daubert, 509 U.S. at 594-95, 597 ("Its [Rule 702's] overarching subject is the scientific validity and thus the evidentiary relevance and reliability-of the principles that underlie a proposed submission. The focus, of course, must be solely on principles and methodology, not on the conclusions that they generate.").
In Daubert, the Supreme Court listed several factors federal judges may consider in determining whether to admit expert scientific testimony under Rule 702: whether an expert's theory or technique can be and has been tested; whether the theory or technique has been subjected to peer review and publication; whether the known or potential rate of error is acceptable; and whether the expert's theory or technique is generally accepted in the scientific community.
The Supreme Court subsequently held that the Daubert factors "may or may not be pertinent in assessing reliability, depending on the nature of the issue, the expert's particular expertise, and the subject of his testimony. . . . Too much depends upon the particular circumstances of the particular case at issue." Kumho, 526 U.S. at 150 (internal citations and quotations omitted). Accordingly, "the trial judge must have considerable leeway in deciding in a particular case how to go about determining whether particular expert testimony is reliable. . . . [A] trial court should consider the specific factors identified in Daubert where they are reasonable measures of the reliability of expert testimony." Id. at 152. The trial court has the same 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.
Both the Eleventh and Seventh Circuits, when evaluating the admissibility of an expert's testimony under Rule 702, consider whether:
Quiet Tech. v. Hurel-Dubois UK Ltd., 326 F.3d 1333, 1340-41 (11th Cir. 2003) (internal citations omitted); Clark v. Takata Corp., 192 F.3d 750, 757 (7th Cir. 1999). The primary purpose of a Daubert inquiry is to ensure that the expert, "whether basing testimony upon professional studies or personal experience, employs in the courtroom the same level of intellectual rigor that characterizes the practice of an expert in the relevant field." American Honda Motor Co., Inc. v. Allen, 600 F.3d 813, 818 (7th Cir. 2010) (quoting Kumho, 526 U.S. at 152); McClain v. Metabolife Int'l, Inc., 401 F.3d 1233, 1255 (11th Cir. 2005) (same); Fuesting, 421 F.3d at 536; Clark, 192 F.3d at 757.
Plaintiffs proffer Dr. Carl J. Blond, M.D., Ph.D., as their specific causation
Dr. Blond has confined his practice to the areas of nephrology and internal medicine, and his practice primarily involves patient care. A routine part of his practice involves treating post-operative heart surgery patients who suffer renal problems. Specifically, this included patients who encounter renal problems after coronary artery bypass surgery (CABG), heart valve surgery, heart transplants and other cardiac surgeries. Because of his clinical experience, Dr. Blond is familiar with the etiologies of renal dysfunction and renal failure, as well as the mortality and morbidity associated with renal dysfunction and renal failure.
After setting forth his qualifications as an expert, Dr. Blond's report provides as follows:
(Blond Report — DEFEX D at 2-6).
In summary, Dr. Blond would opine that "in all medical certainty causation [of Mr. Miller's renal failure] was likely multifactorial, [sic] Significant contributing factors included cardiopulmonary bypass surgery, associated blood pressure fluctuations, and the use of aprotinin as an antifibrinolytic agent. Aprotinin, in all medical certainty, was a significant contributing factor." Additionally "in all certainty," the physicians caring for Mr. Miller "would not have used" this drug had they been aware of the association of mortality and acute kidney injury. Id.
Bayer argues that Dr. Blond's opinions should be excluded as unreliable and unhelpful to the trier of fact because: (a) he is unqualified to render any opinion regarding Mr. Miller's stroke; and (2) his opinions as to renal injury result from a flawed methodology.
Plaintiffs' response first focuses on Dr. Blond's qualifications to testify as an expert. As Dr. Blond's qualifications to testify as an expert in general have not been challenged, no discussion is required. Plaintiff next asserts that Mrs. Miller's testimony that she and Mr. Miller are seeking damages only related to Mr. Miller's stroke, and are not seeking damages related to Mr. Miller's renal failure should be disregarded. Plaintiffs lastly assert that as for Mr. Miller's renal injury, Dr. Blond conducted a legally sufficient differential diagnosis because "[t]he
Bayer, in its Reply asserts that Plaintiffs' Response is insufficient to establish the admissibility of Dr. Blond's opinions.
I must first address Bayers' argument as it relates to Mr. Miller's stroke. When deposed, Mrs. Miller testified that she and Mr. Miller (who was unable to testify, and so has provided no position on this or any other point) were seeking damages only for Mr. Miller's post-operative stroke. (DEFEX A at 7 (13:4-9), 8 (21:14-20), 11 (33:14-21), 13 (37:4-9), 18 (98:1-5). She also testified that she was not aware of whether Mr. Miller had ever had any renal problems. Id. at 19 (101:3-8). Defendants assert that Dr. Blond, as a board certified nephrologist, is unqualified to render an opinion as to the cause of Mr. Miller's stroke. Plaintiffs' counsel asserts that the complaint, medical records, and other filings establish that Plaintiffs are seeking compensation for Mr. Miller's renal injury, and that Mrs. Miller's testimony to the contrary should be disregarded. The issue, however, is Dr. Blond's competence to testify as to Trasylol's role in causing Mr. Miller's stroke. As Dr. Blond in neither his report or his deposition proffers such an opinion, I find no need for discussion.
A differential diagnosis, properly performed, constitutes a reliable methodology for determining medical causation under Daubert. See Guinn v. Astrazeneca Pharms. LP, 602 F.3d 145, 153 (11th Cir. 2010); Ervin v. Johnson & Johnson, Inc., 492 F.3d 901, 904 (7th Cir. 2007). While a differential diagnosis can provide a valid basis for a medical causation opinion, "an expert does not establish the reliability of his techniques or the validity of his conclusions simply by claiming that he performed a differential diagnosis on a patient." McClain, 401 F.3d at 1253; Ervin, 492 F.3d at 904. Instead, a court must examine whether the expert correctly applied the differential diagnosis methodology. 602 F.3d at 1253. The reasonableness of applying this approach, along with the validity of the expert's particular methodology for analyzing the data and drawing conclusions from the data, will determine whether the differential diagnosis is reliable. Hendrix v. Evenflo Co., 609 F.3d 1183, 1195 (11th Cir. 2010).
A differential diagnosis is a "patient-specific process of elimination that medical practitioners use to identify the most likely cause of a set of signs and symptoms from a list of possible causes." Ruggiero v. Warner-Lambert Co., 424 F.3d 249, 254 (2d Cir. 2005). See also Ervin v. Johnson & Johnson, 492 F.3d 901, 903 (7th Cir. 2007); Meyers v. Illinois Central R. Co., 829 F.3d 639, 644 (7th Cir. 2010) (It requires an expert to "rule in all the potential causes of a patient's ailment and then by systematically ruling out causes that would not apply to the patient, the physician arrives at what is the likely cause of the ailment." Guinn, 602 F.3d at 1253 (quoting Westberry v. Gislaved Gummi AB, 178 F.3d 257, 262 (4th Cir. 1999)).
At the first of the two steps, the "rule in" step, the expert must compile a comprehensive list of theories that could explain the patient's symptoms. Ervin, 492 F.3d at 904; Hendrix, 609 F.3d at 1195; McClain, 401 F.3d at 1253; Clausen v. M/V NEW CARISSA, 339 F.3d 1049, 1057 (9th Cir. 2003). "Expert testimony that rules in a potential cause [of a patient's symptoms or mortality] that is not so capable is unreliable." McClain, 401 F.3d at 1253 (quoting Clausen, 339 F.3d at 1158); Ervin, 492 F.3d at 904. This is because "a fundamental assumption underlying [differential diagnosis] is that the final, suspected `cause'. . . must actually be capable of causing the injury." Id. (alteration in original). At the second step of a differential diagnosis, the "rule out" step, the expert must at least consider the other causes that could have solely given rise to Plaintiffs' injury. Guinn, 602 F.3d at 1253. However, the expert "need not rule out all possible alternative causes" for his differential diagnosis to be reliable. Id.; Best v. Lowe's Home Ctrs., Inc., 563 F.3d 171, 181 (6th Cir. 2009); Westberry v. Gislaved Gummi AB, 178 F.3d at 265; Heller v. Shaw Indus., Inc., 167 F.3d 146, 156 (3d Cir. 1999).
"Although a reliable differential diagnosis need not rule out all possible alternative causes, it must at least consider other factors that could have been the sole cause of the plaintiff's injury. .. . [A] `differential diagnosis that fails to take serious account of other potential causes may be so lacking that it cannot provide a reliable basis for an opinion on causation.'" Guinn v. Astrazeneca Pharms. LP, 602 F.3d 1245, 1253 (11th Cir. 2010) (internal citations omitted). "[A]n expert must provide a reasonable explanation as to why he or she has concluded that [any alternative cause suggested by the defense] was not the sole cause of the plaintiff's injury." Id. (internal citations and quotations omitted). The "`temporal connection between exposure to chemicals and an onset of symptoms, standing alone, is entitled to little weight in determining causation.'" McClain v. Metabolife Int'l, Inc., 401 F.3d 1233, 1254 (11th Cir. 2005) (internal citations omitted). Accord Happel v. Walmart Stores, Inc., 602 F.3d 820 (7th Cir. 2010) (relying on "past experience and the temporal proximity of [ a patient's symptoms] . . . does not an expert opinion make."); Ervin, 492 F.3d at 904. Temporal proximity is "especially unreliable" where conditions independent of exposure to the drug could have been the sole cause of the plaintiff's injury, and the expert fails to explain the relative contribution of the drug to the injury. Id.; Guinn, 602 F.3d at 1254-55 (excluding differential diagnosis opinion where evidence "appeared to equally indicate that Guinn may have already developed diabetes before ever taking Seroquel," Guinn's numerous other risk factors for diabetes put her at high risk for diabetes, and opinion failed to explain Seroquel's relative contribution to her diabetes).
An expert must engage in the same level of "intellectual rigor that characterizes the practice of an expert in the relevant field." Guinn, 602 F.3d at 1255 (citing Kumho Tire Co. v. Carmichael, 526 U.S. 137, 152, 119 S.Ct. 1167, 1176 (1999); Rosen v. Ciba-Geigy Corp., 78 F.3d 316, 318 (7th Cir. 1996). An expert engaging in a differential diagnosis must adhere to their standard diagnostic techniques to be considered reliable. Id. Any analytical gap in an expert's methodology can be a sufficient basis to exclude expert testimony under Daubert. See Fuesting v. Zimmer, Inc., 421 F.3d 528, 536 (7th Cir. 2005), rev'd on other grounds by Fuesting v. Zimmer, Inc., 448 F.3d 936 (7th Cir. 2006); Trucks Ins. Exchange v. MagneTek, Inc., 360 F.3d 1206, 1212-13 (10th Cir. 2004); Goebel v. Denver & Rio Grande Western R. Co., 346 F.3d 987, 992 (10th Cir. 2003). Under Daubert, "`any step that renders the analysis unreliable ... renders the expert's testimony inadmissible. This is true whether the step completely changes a reliable methodology or merely misapplies that methodology.'" Mitchell v. Gencorp Inc., 165 F.3d 778, 783 (10th Cir.1999) (citing In re Paoli R.R. Yard PCB Litigation, 35 F.3d 717, 745 (3d Cir.1994)). Where an expert testifies that a particular injury "could have numerous causes and . . . simply picks the cause that is most advantageous to [a plaintiff's] claim, . . . [such testimony ] is not admissible." Viterbo v. Dow Chemical Co., 826 F.2d 420, 423 (5th Cir. 1987). See also In re Paoli R.R. Yard PCB Lit., 35 F.3d 717, 763-65 (3d Cir. 1994).
The main flaw in Dr. Blond's methodology is his failure to account for or appropriately address numerous risk factors at both the rule in and rule out stage. Factors which either alone or in combination could explain Mr. Miller's alleged renal injury. These factors include, but are not limited to: pressure stabilizing medications; extended pre-surgical and post-operative hypertension; and pre-surgical chronic renal failure. Even to those factors which Dr. Blond did rule in, he either gives them short shrift at the rule-out stage, or dismisses them without discussion.
In his report Dr. Blond states that many risk factors are "extremely frequent in the general population undergoing cardiopulmonary bypass surgery, such as hypertension . . ., advanced age, ..., prior chronic kidney disease . . ., female sex, congestive heart failure, CODA, tobaccoism, ASPVD,
As for Mr. Miller's individual specific risk factors, Dr Blond stated that
Dr. Blond in his neither his report nor deposition provides any explanation for why he concluded that Mr. Miller's various risk factors other than exposure to Trasylol were not the sole cause of his injuries. In fact, during his deposition, he identified several additional risk factors for Mr. Miller that he had failed to consider in rendering his opinion, and further testified that many of those risk factors, either alone or in concert, could have caused Mr. Miller's transient creatinine rise. (See DEFEX D at 10-11). These risk factors included: the surgery; the associated fluctuations in Mr. Miller's blood pressure; a previously unconsidered transfusion, a previously unconsidered hematoma, a previously unconsidered twenty-pound weight loss resulting from post-surgical diuresis, post-operative congestive heart failure, diastolic dysfunction, and Mr. Miller's extended history of chronic renal disease and hypertension. Dr. Blond specifically testified that Mr. Miller, without Trasylol, "could have had the same postoperative course."
In this case, Dr. Blond concedes that Trasylol was not the sole cause of Mr. Miller's "injury," and in fact, "there's no way [to] determine that one factor had more of an effect than the others. . .. the theory is multiple hits, that the kidney can take one factor and tolerate it well but the more factors involved, the more likely you're going to have an injury." (DEFEX B at 38). In other words, Dr. Blond's opinion is that despite the multiple hits to Mr. Miller's kidneys from other factors, Trasylol somehow tipped the scales causing his renal injury.
After sorting through Dr. Blond's opinions and the Plaintiffs' response to Defendants' Motion, I find that Dr. Blond improperly relies on temporal proximity. As stated previously, the "temporal connection between exposure to chemicals and an onset of symptoms, standing alone, is entitled to little weight in determining causation." McClain v. Metabolife Int'l, Inc., 401 F.3d 1233, 1254 (11th Cir. 2005) (internal citations omitted); Tucker v. SmithKline Beecham Corp., 701 F.Supp.2d 1040; Ervin, 492 F.3d at 904. Temporal proximity is "especially unreliable" in circumstances such as this where a patient's conditions independent of exposure to the drug could have been the sole cause of the plaintiff's injury, and the expert fails to explain the relative contribution of the drug to the injury. See Guinn v. Astrazeneca Pharmaceuticals LP, 602 F.3d 145, 153 (11th Cir. 2010); Porter, 791 F. Supp. 2d at 1349. As with the expert in Guinn, I find exclusion is warranted because the evidence "appear[s] to equally indicate that [Mr. Miller] may have [developed renal injury either] . . . without ever taking [Trasylol]." Id. Also as with Guinn, Mr. Miller had numerous other risk factors which placed him at a high risk for renal failure, and Dr. Blond's opinion fails to explain Trasylol's relative contribution to his transient injury.
Dr. Blond's reliance on temporal proximity in this Case is not a reliable methodology. He fails to provide a reasonable explanation for why he concluded that Mr. Miller's various risk factors other than exposure to Trasylol were not the sole cause of his renal injury. Under Illinois law, a party cannot create a genuine issue of fact merely by presenting an expert witness who is willing to express an unsupported opinion that favors the party's position. See Lewis v. CITGO Petroleum Corp, 561 F.3d 698, 705 (7th Cir. 2009). "Qualifications alone do not suffice. A supremely qualified expert cannot waltz into the courtroom and render opinions unless those opinions are based upon some recognized scientific method and are reliable and relevant under the test set forth by the Supreme Court in Daubert." Id. "Expertise is a rational process and a rational process implies expressed reasons for judgment." Mid-State Fertilizer Co. v. Exchange Nat. Bank of Chicago, 877 F.2d 1333, 1339 (7th Cir. 1989). "An expert who supplies nothing but a bottom line supplies nothing of value to the judicial process." Id. (citing to Richardson v. Richardson-Merrell, Inc., 857 F.2d 823, 829-32 (D.C. Cir. 1988) as holding that "an expert's declaration, full of assertion but empty of facts and reasons, won't get a case past a motion for summary judgment, for the judge must `look behind the expert's' ultimate conclusion . . . and analyze the adequacy of its foundation."). Where an expert testifies that a particular injury "could have numerous causes and . . . simply picks the cause that is most advantageous to [a plaintiff's] claim, . . . [such testimony ] is not admissible." Id.; Viterbo v. Dow Chemical Co., 826 F.2d 420, 423 (5th Cir. 1987). See also In re Paoli R.R. Yard PCB Lit., 35 F.3d 717, 763-65 (3d Cir. 1994).
I note that his report is deficient for additional reasons, some of which I briefly summarize:
(1) Although he lists a history of smoking as a pre-surgical risk factor in the general population, he does not list that as a specific risk factor for Mr. Miller;
Bayer next asserts that Plaintiffs' failure to warn claim is precluded by Illinois's Learned Intermediary Doctrine. Under Illinois law a plaintiff bringing suit against a drug manufacturer based upon a failure to warn, "must demonstrate that the warning was inadequate and that the failure to adequately warn of the dangers of the drug was a proximate cause of his or her injuries. See Walton v. Bayer Corp., 643 F.3d 994, 999-1000 (7th Cir. 2011); Phelps v. Sherwood Medical Industries, 836 F.2d 296, 299 (7th Cir. 1987); Kirk v. Michael Reese Hospital and Med. Ctr., 513 N.E.2d 387 (Ill. 1987). The Plaintiff "bears the burden of proving that a defect exists and that this defect is the proximate cause of [his or her] injury." See Ziliak v. AstraZeneca LP, 324 F.3d 518 (7th Cir. 2003); Haddix v. Playtex Family Products Corp., 138 F.3d 681, 683 (7th Cir. 1998); Moss v. Crosman Corp, 136 F.3d 1169, 1171 (7th Cir. 1998).
I find it unnecessary to decide the applicability of the Learned Intermediary Doctrine to Plaintiffs' Failure to Warn claim because this claim is due to be dismissed for the same reasons discussed relating to Plaintiffs' other claims.
Summary judgment is granted on Plaintiffs' Unjust Enrichment and Punitive Damages claims because they are derivative of their underlying substantive claims each of which have failed. See e.g., Ass'n. Benefit Servs. Inc. v. Caremark Rx, Inc., 493 F.3d 841, 855 (7th Cir. 2007) (loss of consortium); Bayh v. Sonnenburg, 573 N.E.2d 398, 408 (Ind. 1991) (unjust enrichment); Franz v. Calaco Dev. Corp., 818 N.E.2d 357, 367 (Ill. Ct. App. 2004) (punitive damages).
Accordingly, for the reasons set forth above, it is hereby
Accordingly, serum creatinine level is used as a measure of renal function. When its value is elevated, renal dysfunction is indicated. For Creatinine, a normal result falls within the range of 0.7-1.2. The numbers represent the value of mg/dL. Mr. Miller's creatinine level of 1.5 indicates he was suffering from some renal impairment upon admission.
Plaintiffs did not respond to these Orders. Plaintiffs' fraud and misrepresentation claims were accordingly dismissed in part allowing them thirty days to provide specific allegations of fraud and reliance. There is no record evidence that Plaintiffs relied on specific misleading statements that caused the use of Trasylol in the decedent's case, nor does she support her broad claims of fraud with any evidence of reliance, an essential element of these claims. See Teamsters Local 282 Pension Trust Fund v. Angelos, 839 F.2d 366, 370 (7th Cir. 1988) ("Under Illinois law, one essential element [in fraud-based claims] is justifiable on the alleged fraudulent statement). Accordingly, Plaintiffs' misrepresentation and fraud claims are due to be dismissed in full for this additional reason.