JOHN E. STEELE, Senior District Judge.
This matter comes before the Court on defendant Lee Memorial's Motions to Exclude Expert Testimony (Doc. #95; Doc. #96) filed on November 5, 2018. Plaintiff Donia Goines filed Responses in Opposition (Doc. #130; Doc. #131) on December 21, 2018, to which Lee Memorial filed Replies (Doc. #135; Doc. #136) on January 10, 2019.
Lee Memorial, a public health care system codified under Florida law, hired defendant Jeovanni Hechavarria as a night nurse for the Cape Coral Hospital in the fall of 2014. (Doc. #31, p. 2; Doc. #120-22, pp. 761-62.) In March of 2015, non-party Brianna Hammer, a patient at the hospital, accused Hechavarria of sexual assault. (Doc. #122-1, pp. 3-5.) Lee Memorial investigated Hammer's allegation and determined it was unsubstantiated. (Doc. #120-29, p. 1889.) In July of 2016, Hechavarria was arrested by the Charlotte County Sheriff's Office for an unrelated battery. (Doc. #120-46, pp. 2849-50.) Seven days after the arrest, plaintiff was admitted to the Cape Coral Hospital and Hechavarria was assigned as her night nurse. (Doc. #120-49, pp. 3011, 3019-20.) Plaintiff alleges she was sexually assaulted by Hechavarria during the evening. (
In April of 2018, plaintiff filed an Amended Complaint asserting a section 1983 claim and several common law negligence claims against Lee Memorial, as well as a common law assault and battery claim against Hechavarria. (Doc. #31.) In support of these claims, plaintiff has retained Barbara Cain, RN, and Tracy Decker, RN. Ms. Cain has been retained to provide opinions regarding hospital risk management standards and investigations, and specifically Lee Memorial's investigations, response, and actions involving Hechavarria's alleged sexual assaults. (Doc. #130, p. 1.) Ms. Decker has been retained to provide opinions regarding nurse management and nurse supervisor standards, including "oversight and supervision of nurses, investigation of nursing misconduct, disciplinary action for nursing misconduct and other appropriate responses to nursing misconduct." (Doc. #131, p. 1.) Lee Memorial now seeks to exclude both Ms. Cain's and Ms. Decker's testimony. (Doc. #95; Doc. #36.)
The admission of expert testimony is governed by Rule 702 of the Federal Rules of Evidence, which provides that:
Fed. R. Evid. 702. Rule 702 contemplates that the district court will serve as gatekeeper to the admission of scientific testimony to ensure that any and all expert testimony is both relevant and reliable.
In determining the admissibility of expert testimony under Rule 702, the Court applies a "rigorous" three-part inquiry.
Ms. Cain has a master's degree in health services administration and a bachelor of science degree in nursing. (Doc. #95-1, p. 21.) She was also a certified healthcare risk manager from 2002 until 2017. (
Ms. Decker has a doctorate in nursing practice in executive leadership, a master's degree in health sciences, a bachelor of science degree in nursing, and a bachelor of arts degree in psychology. (Doc. #96-1, p. 21.) She also holds a certificate in health care risk management. (
Lee Memorial seeks to exclude Ms. Cain from providing the following opinions: (1) Lee Memorial failed to "take seriously" Hammer's sexual assault allegation against Hechavarria; (2) Lee Memorial's legal services department did not immediately refer Hammer's accusation to the risk manager; (3) Lee Memorial failed to secure evidence in connection with Hammer's accusation; (4) Lee Memorial's risk manager failed to "appropriately assess statements" of Hammer in connection with the investigation, and failed to "include a qualified professional" in the investigative process; (5) Lee Memorial failed to provide an adequate investigation, including a "neutral environment" for the interview of Hammer; (6) Lee Memorial failed to consult with employee relations for guidance regarding Hechavarria's unrelated battery arrest and failed to implement a corrective action plan; and (7) Lee Memorial failed to "adequately educate hospital staff" on risk management policies. (Doc. #95, pp. 4-5.)
Additionally, Lee Memorial seeks to exclude Ms. Decker from providing the following opinions: (1) Lee Memorial failed to conduct a "thorough" or "proper" investigation into Hammer's allegation against Hechavarria; (2) Lee Memorial did not properly handle Hechavarria's return to work after Hammer's allegation; (3) Lee Memorial failed to investigate Hechavarria's unrelated battery arrest; (4) Lee Memorial did not have "adequate policies and procedures" regarding prevention of sexual abuse; and (5) Lee Memorial showed "indifference to the rights and safety of future patients" which resulted in the assault of plaintiff by Hechavarria. (Doc. #96, pp. 4-5.) Lee Memorial argues both Ms. Cain and Ms. Ms. Decker lack the knowledge, skill, experience, training, or education to offer opinions on these matters, their opinions on these topics are unreliable, and their opinions would not assist the trier of fact. (Doc. #95, pp. 7-19; Doc. #96, pp. 6-19.) The Court will address these arguments in turn.
As noted, the first inquiry in determining whether an expert's testimony is admissible is determining whether the expert is qualified to testify on the topic at issue.
Lee Memorial offers the same argument regarding the first five of Ms. Cain's opinions. Specifically, Lee Memorial asserts that Ms. Cain is not qualified to offer these opinions because "these are opinions that require the expertise of someone qualified in the area of investigating patient sexual abuse allegations against a nurse or other employee." (Doc. #95, p. 8.) Lee Memorial argues that because Ms. Cain has only participated in two investigations in which a patient made allegations of sexual misconduct, she does not have the requisite experience to be qualified as an expert for purposes of the above opinions. (
Ms. Cain possesses fourteen years of experience in the oversight of risk management and direct clinical risk management. (Doc. #130-2, p. 16.) Ms. Cain was a certified healthcare risk manager and has investigated allegations of inappropriate conduct and/or practices of hospital employees. (
Ms. Cain opines that Lee Memorial's risk manager should have consulted with Lee Memorial's employee relations department after Hechavarria was arrested for an unrelated battery approximately a week before plaintiff was admitted to the Cape Coral Hospital.
Lee Memorial argues that Ms. Cain is not qualified to offer these opinions because they address matters "typically handled by a human resources department," and Ms. Cain does not have human resources experience, education, or training. (Doc. #95, p. 9.) The Court disagrees with this argument. Ms. Cain has stated that "[p]art of a risk manager's job function is to recommend the removal of dangerous employees and/or negligent employees from the workforce prior to a patient injury." (Doc. #130-2, p. 25.) As part of this prevention process, risk management identifies employees and coordinates with hospital management regarding their removal. (
Ms. Cain has opined that Lee Memorial failed to provide adequate education to its non-physician employees, specifically regarding sexual assault prevention. (Doc. #95-1, p. 23; Doc. #130-2, p. 25.) Lee Memorial argues that Ms. Cain is not qualified to offer this opinion because she does not have sufficient experience, education, or training on what constitutes "adequate" education of risk management policies. (Doc. #95, p. 9.) Lee Memorial also argues "[t]he mere fact that Cain has worked as a risk manager herself does not make her an expert in education regarding policies." (
As noted previously, Lee Memorial is seeking to prevent Ms. Decker from testifying to the following opinions: (1) Lee Memorial failed to conduct a "thorough" or "proper" investigation into Hammer's allegation against Hechavarria; (2) Lee Memorial did not properly handle Hechavarria's return to work after Hammer's allegation; (3) Lee Memorial failed to investigate Hechavarria's unrelated battery arrest; (4) Lee Memorial did not have "adequate policies and procedures" regarding prevention of sexual abuse; and (5) Lee Memorial showed "indifference to the rights and safety of future patients" which resulted in the assault of plaintiff by Hechavarria. (Doc. #96, pp. 4-5.)
In her report, Ms. Decker opined that Lee Memorial "failed to conduct a thorough investigation" and "failed to properly investigate" Hammer's complaints of sexual assault. (Doc. #96-1, pp. 22-23.) At a deposition, Ms. Decker testified that Lee Memorial should have sequestered potential physical evidence and waited until the Cape Coral Police Department concluded their investigation.
Lee Memorial first argues that Ms. Decker has insufficient education, training, and experience to offer the above opinions. (Doc. #96, pp. 7-8.) The Court disagrees. Ms. Decker has a certificate in in health care risk management and, as part of her work experience, has held positions requiring her to investigate patient complaints regarding acts of misconduct by nursing staff. (Doc. #96-1, p. 21; Doc. #131-2, p. 20.) As a nursing supervisor, she participated in an investigation of a patient's allegations of sexual misconduct made against a nurse. (Doc. #131-3, p. 123.) As with Ms. Cain, the Court finds this knowledge and experience sufficient to meet the "relatively low threshold for qualification" of expert testimony.
In her report, Ms. Decker opines that "[t]here was an opportunity to more closely observe and supervise Jeovanni Hechavarria's conduct and behavior by changing the shift he worked."
Ms. Decker notes in her declaration that her opinion that Lee Memorial did not properly handle Hechavarria's return to work is based on her "years of training and work experience pertaining to nurse discipline, including additional supervision and termination, nurse management, and appropriate conditions on a nurse's return to the workforce following disciplinary action." (Doc. #131-2, pp. 21-22.) She also testified at her deposition that she has spent the majority of her career working on the night shift, but has worked on the day shift for the last thirteen years. (Doc. #131-3, p. 42.) The Court finds Ms. Decker has sufficient experience and knowledge to offer an opinion regarding whether Hechavarria should have been switched to the day shift in order to be more closely supervised after Hammer's allegation.
In her report, Ms. Decker notes that there is no documentation that Lee Memorial investigated Hechavarria after he was arrested for the unrelated battery. (Doc. #96-1, p. 23.) Ms. Decker states that Hechavarria should have been investigated and, considering his "troubled history," the arrest should have resulted in disciplinary action. (Doc. #131-2, p. 22.) Lee Memorial argues Ms. Decker cannot offer this opinion because she does not have experience in conducting or reviewing background investigations, nor does she know what kind of events would disqualify a person from employment as a nurse. (Doc. #96, pp. 9-10.) Once again, this argument misses the mark.
Ms. Decker is not offering an opinion that a specific type of investigation should have been conducted. Rather, Ms. Decker's opinion relates to whether Lee Memorial should have done some type of investigation in response to Hechavarria's arrest, which is based on her experience as a nurse manager and administrative supervisor. In these roles, Ms. Decker was responsible for implementing "appropriate corrective actions" following "non-employment conduct that could be detrimental to the image of the hospital system — such conduct could range from DUI arrests to domestic battery." (Doc. #131-2, p. 22.) The Court finds this experience sufficient to offer the opinion at issue.
In her report, Ms. Decker opines that Lee Memorial "failed to have adequate policies and procedures that speak to preventing sexual abuse." (Doc. #96-1, p. 23.) Ms. Decker notes that one of Lee Memorial's policies, titled Sexual Abuse and Prevention, fails to include information on how to protect patients. (
Ms. Decker's final opinion in her report is that Lee Memorial's "indifference to the rights and safety of future patients" resulted in the sexual assaults committed by Hechavarria. (Doc. #96-1, p. 23.) Lee Memorial argues this is a generalized restatement of the opinions already set forth above and Ms. Decker lacks the experience, education or training to render it. (Doc. #96, p. 10.) However, even if the Court accepted Lee Memorial's argument that this is a restatement of Ms. Decker's prior opinions, the Court has determined she is qualified to offer those opinions. Therefore, Lee Memorial's argument regarding Ms. Decker's qualifications for this opinion have been rendered moot.
The second inquiry for determining the admissibility of expert testimony is whether the methodology used by the expert is sufficiently reliable.
Lee Memorial argues that even if Ms. Cain and Ms. Decker are qualified to offer opinions on the topics at issue, such opinions are inadmissible because they are unreliable. (Doc. #95, pp. 10-15; Doc. #96, pp. 10-16.) The Court will address these arguments in turn.
Ms. Cain's methodology used to reach her opinions is described in her report and her declaration. Ms. Cain states that she analyzed the documents and depositions from this case based on her years of experience as a certified hospital risk manager and the standards that are accepted amongst hospital accreditation agencies and similar hospital systems. (Doc. #130-2, p. 19.) Her expert report also makes references to the Joint Commission Sentinel Event publication, as well as Florida's risk management statute and various other authoritative texts and publications regarding investigation and analysis. (Doc. #95-1, p. 23.) Ms. Cain states she utilized these sources as part of her methodology for finalizing her opinions. (Doc. #130-2, pp. 19-20). Having reviewed the expert reports, declarations, and deposition testimony, the Court finds the majority of Ms. Cain's opinions are sufficiently reliable to be admissible.
Regarding the second opinion, Ms. Cain believes Lee Memorial should have immediately contacted its risk manager when Hammer's allegation came to light. (Doc. #130-4, pp. 77-78.) However, when asked if it was an industry standard for a risk manager to immediately report to the scene, Ms. Cain responded, "I think it depends on the hospital," and stated she could not answer what Lee Memorial's practice was. (
Turning to Ms. Decker, she states in her declaration that her opinions were formulated by reviewing the relevant facts from the depositions, documents and exhibits, and then applying those facts to the standards of care known to her through her education, training and experience. (Doc. #131-2, p. 20.) Ms. Decker also developed her opinions by comparing Lee Memorial's policies and procedures at the time of the alleged assaults with the manner in which Lee Memorial employees responded. (
The final criteria for the admission of expert testimony is the requirement that the testimony assist the jury.
Ms. Cain's and Ms. Decker's opinions address standard practices for a hospital risk manager and hospital nurse supervisor, respectively, with respect to patient safety. Such opinions go directly to the negligence claims raised by plaintiff and are based on knowledge and experience unlikely to be held by the average citizen. Therefore, the Court concludes plaintiff has satisfied the third criteria for admissibility.
In conclusion, the Court finds both witnesses may offer the opinions at issue, subject to the Court's ruling regarding Ms. Cain's second and fifth opinions.
Accordingly, it is hereby