DONALD M. MIDDLEBROOKS, District Judge.
THIS CAUSE comes before the Court upon Defendants' (hereinafter, collectively, "Bayer's") Motion to Exclude Testimony of Plaintiffs' Expert Suzanne Parisian
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, 113 S.Ct. 2786, 125 L.Ed.2d 469 (1993). The party seeking to have the expert testimony admitted bears the burden of demonstrating its admissibility by a preponderance of proof. Davidson v. U.S. Dep't of Health & Human Servs., 2007 WL 3251921, at *2 (E.D.Ky. Nov. 2, 2007) (internal citations omitted). 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, 113 S.Ct. 2786 ("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, 119 S.Ct. 1167 (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, 119 S.Ct. 1167. 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.
The Eleventh Circuit engages in a three part inquiry to determine the admissibility of expert testimony under Rule 702, considering whether:
Quiet Tech. v. Hurel-Dubois UK Ltd., 326 F.3d 1333, 1340-41 (11th Cir.2003) (internal citations omitted). The Eleventh Circuit has noted that "the primary purpose of any Daubert inquiry is for the district court to determine whether that 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.'" McClain v. Metabolife Int'l, Inc., 401 F.3d 1233, 1255 (11th Cir.2005) (quoting Kumho, 526 U.S. at 152, 119 S.Ct. 1167.).
According to Plaintiffs, Dr. Parisian's proffered testimony provides the bases for twelve opinions falling into four general areas: (1) the general nature of the approval and regulatory process; (2) the duties and obligations of drug manufacturers in relation to FDA regulations and industry standards; (3) Bayer's actions in relation to FDA regulations, industry standards and the FDA regulatory process generally; and (4) her opinion as to whether Bayer's actions were reasonable and appropriate. (DE 3841 at 7.)
Bayer moves to exclude Dr. Parisian's expert testimony for the following reasons: (1) she lacks the expertise to offer regulatory, medical, or scientific opinions about Trasylol; (2) her testimony consists of nothing more than factual narratives, legal conclusions, personal opinions, and unsupported speculation—all of which fall outside the purview of proper expert testimony; and (3) she has not applied a sound methodology to the facts of the case to reach reliable conclusions. (DE 3065 at 4.)
As a threshold matter, Bayer argues that Dr. Parisian is not qualified to offer expert testimony on three matters that encompass the vast majority of her proposed testimony: (1) foreign regulatory issues; (2) causation opinions about Trasylol and the implications of studies; and (3) FDA's regulation of prescription pharmaceuticals such as Trasylol. (DE 3065 at 4.)
In regards to foreign regulatory issues, the following testimony is at issue: (1) the findings of two foreign Inspection Reports regarding deficiencies identified in Bayer's Pharmacovigilance and Quality Assurance Procedures; and (2) the May 2006 label change for Trasylol's EU label regarding the risks of renal dysfunction, which was not requested by Bayer to be made for the U.S. label. (Parisian Report at ¶¶ 207-214.)
Bayer contends that this testimony should be excluded because Dr. Parisian seeks to testify about foreign regulatory matters while conceding that she is unqualified to do so. (DE 3065 at 5. (citing Parisian Dep. at 78:19-25, 80:16-19.))
According to Plaintiffs, in coming to her opinion that Bayer had means of awareness of risks associated with Trasylol and problems with its safety signal program, Dr. Parisian reviewed all information available to her, including a foreign inspection report and foreign drug label. (DE 3841 at 18.) Dr. Parisian is not being offered to testify as a foreign regulatory expert; her opinions "touch briefly" on foreign regulatory issues "for the purpose of illuminating what Bayer should have been aware of with regard to Trasylol or what it should have been disclosing to the FDA under FDA requirements and industry standards." (DE 3841 at 17-18.)
Bayer replies that Plaintiffs should not be permitted to end run Daubert's gatekeeping requirements by offering unqualified expert testimony framed as an opinion about what information Bayer should have known.
In regards to Dr. Parisian's opinions on medical causation
As for the discussion of scientific studies related to Trasylol, Plaintiffs state that they are "discussed only as they relate to a manufacturer's duty to test, study, monitor, and communicate with the FDA." (DE 3841 at 18.) While Dr. Parisian acknowledges that an epidemiologist would be better qualified to discuss the statistical significance of the studies, Dr. Parisian is an expert "within the context of discussing the role of the studies in the FDA process and in a responsible manufacturer's pharmacovigilence." (DE 3841 at 18.)
Bayer replies that Plaintiffs should not be permitted to end run Daubert's gatekeeping requirements by offering unqualified expert testimony framed as an opinion about what information Bayer should have known.
Finally, Bayer argues that Dr. Parisian is unqualified to render opinions on FDA's regulation of prescription drugs such as Trasylol because she has "no real-world experience with FDA's regulation of prescription drugs or a company's compliance with FDA prescription drug requirements": her assignment at FDA was in the part of the FDA that regulates medical devices, not prescription drugs.
Plaintiffs respond that Dr. Parisian is qualified to opine on the FDA's regulations and procedures with regard to pharmaceutical products: Dr. Parisian's experience with the FDA is not specific to any one drug or device and qualifies her to offer expert opinions on either drug or device matters. (DE 3841 at 17.) According to Plaintiffs, Bayer's argument ignores: (1) Dr. Parisian's experience and knowledge of
Bayer argues that even if the Court were to deem Dr. Parisian qualified, her testimony should be excluded because it consists of nothing more than factual narratives that do not assist the trier of fact, legal conclusions that invade both the province of the court and jury, and personal, speculative opinions that are irrelevant or otherwise improper subjects for expert testimony. (DE 3065 at 9.)
First, according to Bayer, nearly 150 pages of Dr. Parisian's Report are dedicated to summarizing Trasylol's regulatory history and selected Bayer documents.
Plaintiffs respond that the factual materials considered by Dr. Parisian are not intended to be the subject of Dr. Parisian's testimony in and of themselves: they are "relevant to explaining the regulatory context in which they were created, illustrating the considerations that are relevant at different stages of the regulatory process, and allowing Dr. Parisian to apply her expertise to draw inferences that would not otherwise be apparent." (DE 3841 at 19.)
Bayer replies that Plaintiffs' argument deliberately confuses the issue: there are many instances in which Dr. Parisian does not sufficiently connect the Report's factual assertions to expert analysis or opinion.
Second, according to Bayer, nearly every opinion in Dr. Parisian's Report improperly seeks to opine that Bayer violated the FDCA and FDA regulations in its development and marketing of Trasylol, and thus was not a reasonable pharmaceutical manufacturer. (DE 3065 at 12-13.) Bayer argues that these opinions amount to improper legal conclusions that should
Plaintiffs first respond that Dr. Parisian is not offering a legal conclusion (e.g., that Bayer was negligent): she is "informing the jury of the FDA regulations that form the pharmaceutical industry's standard of care and applying her expertise to offer an opinion on where and whether Bayer complied with those standards." (DE 3841 at 20.) According to Plaintiffs, Dr. Parisian's opinions are admissible because: (1) they are based on her analysis of facts
Plaintiffs also assert that Dr. Parisian's testimony is not preempted by Buckman, which applies only to fraud-on-the-FDA claims and imposes no limitations on Plaintiffs' state-law-based personal injury claims. (DE 3841 at 24.) Plaintiffs cite to Wyeth v. Levine, ___ U.S. ___, 129 S.Ct. 1187, 173 L.Ed.2d 51 (2009), as confirming that state law claims against a drug manufacturer based on failure to warn remain viable in the post-Buckman era; plaintiffs may use evidence of the regulatory process so long as they do not bring an independent claim for relief based on fraud-on-the-FDA. (DE 3841 at 25.)
In addition to arguing that Dr. Parisian is not qualified to offer testimony on foreign regulatory actions, Bayer claims that such testimony should be excluded as irrelevant and unnecessarily confusing in this Case, where U.S. domestic law provides the only applicable standards for pharmaceutical companies. (DE 3065 at 15.) Bayer argues that the probative value of
Plaintiffs respond that Dr. Parisian's references to foreign regulatory actions will not confuse the jury. (DE 3841 at 26.) According to Plaintiffs, Dr. Parisian is not designated as an expert on foreign regulatory standards: "The limited references in Dr. Parisian's report to foreign occurrences are made in the context of setting forth the facts that were considered in arriving at her opinions." (DE 3841 at 26.) For example, one of Dr. Parisian's opinions
Finally, Bayer makes three arguments for excluding Dr. Parisian's opinions about Bayer's and the FDA's conduct and knowledge. First, Bayer argues that many of Dr. Parisian's opinions are grounded in conclusory assertions that Bayer knew or should have known about alleged safety information at various points in time and conjecture as to why Bayer took or failed to take certain actions.
Second, Bayer argues that Dr. Parisian's personal opinions that Bayer failed to act as a responsible pharmaceutical manufacturer must be excluded because they are based on Dr. Parisian's personal ethical standards rather than specialized knowledge or expertise and are unsupported by any expert analysis based on FDA regulations or other potentially applicable industry standards.
Third, Bayer argues that Dr. Parisian improperly injects personal and unsupported "bad company" opinions about pharmaceutical companies generally and Bayer specifically.
According to Plaintiffs, while Dr. Parisian will not be testifying as to Bayer's intent, she may draw "reasonable inferences from the documentary evidence as to what information was available to [ ] Bayer at a given time, and what [ ] action (if any) the available information would provoke from a reasonable and prudent pharmaceutical company." (DE 3841 at 27.)
Further, Plaintiffs state that expert opinions are excluded as impermissibly personal where they are devoid of expertise or analysis: the opinions that Bayer characterized as personal opinions are actually adequately tied to Dr. Parisian's regulatory expertise. (DE 3841 at 28.) For example, Dr. Parisian's statement, at ¶ 233 of the Report, that underreporting of renal failure events by physicians heightened Bayer's responsibility to test and monitor Trasylol's safety was made in the context of a discussion of what factors a pharmaceutical company would be considering when looking at adverse event reports and how they would be interpreting the information contained therein. (DE 3841 at 28-29.)
Finally, Plaintiffs argue that the opinions that Bayer characterizes as "bad company" opinions are not personal opinions but instead ones involving specialized analysis and expertise. For example, Dr. Parisian's reference, in ¶ 250 of the Report, to an e-mail in which Bayer executives looked to refute the Mangano study, serves as one of the many bases for her opinion that Bayer failed to comply with the disclosure and label requirements of 314.70 and 314.80.
In its Reply, Bayer asserts that despite Plaintiffs' assurances that Dr. Parisian can not say what Bayer knew, she repeatedly pontificates about what Bayer knew and why Bayer took certain actions with respect to Trasylol.
Bayer asserts that Dr. Parisian's conclusions are not based on the sound application of valid scientific methodology to the facts of the case and therefore fail to meet Daubert's reliability requirement. (DE 3065 at 20.) While Dr. Parisian claims to have used the same methodology in forming her opinions in this Case as she used while working as a medical reviewer for the FDA, Bayer stated that she "conducted only a cursory and conclusory look at Trasylol from the perspective of the plaintiffs in this case." (DE 3065 at 21.) Bayer also asserts that many of Dr. Parisian's conclusions are based on speculation and have no reliable basis in expertise.
Plaintiffs claim that Dr. Parisian's testimony is founded on data and is methodologically reliable. (DE 3841 at 30.) According to Plaintiffs, Dr. Parisian considered numerous materials that are the types of materials relied upon by experts in the field, including: the Federal Food, Drug and Cosmetic Act, applicable sections of the Code of Federal Regulations, FDA Guidances, pertinent scientific literature, deposition testimony from Bayer employees and other experts, publicly available documents such as Bayer's New Drug Application, patent office records, and records of FDA communications.
Bayer's Motion to Exclude raised several valid concerns with Dr. Parisian's Report and proposed trial testimony that I felt would be best addressed at a Daubert hearing.
More specifically, upon review, I found many of Bayer's arguments relating to Dr. Parisian's expertise and the proper scope of expert testimony to be meritorious. For example, I concluded that Dr. Parisian should not be allowed to opine on foreign regulatory matters because: (1) Dr. Parisian conceded that she is not an expert in this area; (2) her Report merely summarizes and restates the findings of the foreign Inspection Reports and the proposed change for Trasylol's EU label, and thus her testimony can not be considered expert testimony that would be helpful to the trier of fact; and (3) such testimony should be excluded under Rule 403. See, e.g., In re Seroquel Prods. Liab. Litig., 601 F.Supp.2d 1313, 1318 (M.D.Fla.2009) (finding that "Plaintiffs may not present evidence of foreign regulatory actions and foreign label changes during their main case" because the probative value of such evidence is "greatly overmatched by the jury confusion, waste of time, and unfair prejudice that would result if the Court were to allow Plaintiffs to introduce this evidence during their main case.").
Also, Dr. Parisian is neither a causation expert nor an epidemiologist. See, e.g., In re Prempro Prods. Liab. Litig., 554 F.Supp.2d at 884 (finding that Dr. Parisian was unqualified to interpret a scientific study by Dr. Kerlikowske on breast cancer because it was epidemiologically based and related to causation, and thus outside her
Further, it was apparent that the majority of Dr. Parisian's opinions fall outside the proper scope of expert testimony because they consist of a narrative of selected regulatory events and a summary of Bayer's internal documents. For example, the statements made in ¶¶ 81-131 regarding FDA's approval of Trasylol are used to support Opinions # 3 and # 4, which relate to Bayer's failure to adequately perform clinical testing. (Parisian Report at 55.) However, in discussing Aprotinin's Investigational New Drug ("IND") application, Bayer's pre-phase III meeting with the FDA, and Bayer's submission of the NDA, Dr. Parisian cites to only three FDA regulations, none of which relates to her opinions on Bayer's clinical testing deficiencies.
Other courts have expressed concerns about the use of narrative testimony by Dr. Parisian. See, e.g., In re Fosamax Prods. Liab. Litig., 645 F.Supp.2d at 192 (finding that to the extent such evidence is admissible, it should be presented to the jury directly) ("Dr. Parisian's commentary on any documents and exhibits in evidence will be limited to explaining the regulatory context in which they were created, defining any complex or specialized terminology, or drawing inferences that would not be apparent without the benefit of experience or specialized knowledge. She will not be permitted to merely read, selectively quote from, or `regurgitate' the evidence."); In re Prempro Prods. Liab. Litig., 554 F.Supp.2d at 879-87 (finding that the court should have struck much of Dr. Parisian's testimony because it consisted of a regurgitation of the evidence devoid of expert analysis or opinion and unconnected to FDA regulations) ("Dr. Parisian, generally, did not `give the jury the tools they need to look at those documents, [to] understand them in the context of a regulatory background'—she simply read the documents to the jury.").
I found that many of the opinions challenged by Bayer fall outside the proper scope of expert testimony because they contain improper references to Bayer's and the FDA's knowledge and intent or
The following are some examples of improper references to knowledge and intent. Opinion # 4 discusses Bayer's motives in the promotion of Trasylol: "Bayer slipped information into its product insert's mechanism of action section to help allow it to promote a benefit for full dose Trasylol to physicians that did not have FDA's approval." (Parisian Report at 55.) Similarly, Opinion # 9 states that Bayer was aware that the FDA changed its risk-benefit profile for Trasylol but "continued to expand the Trasylol sales force and provided training and sales aids designed to help minimize the risks of Trasylol for physicians." (Parisian Report at 100.) Opinion # 10, which relates to Bayer's communication of Trasylol's risk to healthcare providers, contains no reference to any FDA regulation and instead regurgitates Dr. S. Horton's statements and opines on Bayer's intent in using key opinion leaders. (Parisian Report at 207.) The Report also refers to the FDA's "concerns" regarding renal dysfunction and "indications" that certain warnings would be insufficient. (Parisian Report at ¶ 150.) Not only does this paragraph regurgitate Trasylol's regulatory history and omit regulatory expert analysis, it improperly touches upon the FDA's knowledge and intent.
These opinions are inadmissible: courts have held that the question of (corporate) intent or motive is a classic jury question and not one for experts. See, e.g., In re Rezulin Prods. Liab. Litig., 309 F.Supp.2d 531, 546 (S.D.N.Y.2004) (holding that expert testimony on motive or intent of corporations and regulatory agencies is inadmissible because it has no basis in any relevant body of knowledge or expertise and describes lay matters which the jury is capable of understanding without the expert's help); In re: Diet Drugs, 2000 WL 876900, at *9 (E.D.Pa.2000) ("If the witnesses' bases for the opinions concerning improper intent come from other evidence such as letters, admissions of AHP officers or employees, or other admissible evidence, that is what the jury should hear and the question of AHP's intent would flow from such evidence to be determined by the jury.").
The following are some examples of improper references to personal "bad company" opinions not based on any FDA regulation or other applicable standard. Dr. Parisian opines that "SAE reports of renal failure associated with aprotinin in this patient population will be underreported by physicians. This increases the responsibility for Bayer to test and monitor the safety of Trasylol and adequately update physicians about the potential risk." (Parisian Report at ¶ 233.) This opinion must be excluded because it is not based on any standard and amounts to no more than Dr. Parisian's personal opinion. In ¶ 250, Dr. Parisian merely restates an e-mail from Bayer's internal documents to support her opinion that Bayer had an "internal plan to obtain a negative statement against Mangano's findings from FDA." Not only does this statement lack any expert analysis, it improperly touches upon Bayer's motive and must be excluded. Finally, in ¶ 53, Dr. Parisian states "If adverse event reports did start to accumulate, recent public disclosures demonstrate that companies employed ghost-writers to publish contrary published literature so that the company
While finding that many of Bayer's arguments were meritorious, based on the Motion alone, I was of the view that an FDA expert could be helpful to the jury. However, it was difficult to parse Dr. Parisian's 250 page Report on a line by line basis, aided only by the written filings. The Report is broad and unwieldy: while each major opinion is followed by statements that are intended to provide the bases for that opinion, there is generally a striking disconnect between these statements and the major opinions. I felt that a Daubert hearing would best allow the Plaintiffs to establish the admissibility of Dr. Parisian's testimony, opinion by opinion.
Additionally, I thought that a Daubert hearing would best allow me to strictly limit the permissible scope of Dr. Parisian's testimony pretrial and avoid the problems faced by the Judge Wilson in In re Prempro Prods. Liab. Litig. There, the judge outlined the permissible testimony pretrial but came across substantial problems with Dr. Parisian's testimony during trial. 554 F.Supp.2d at 878-79. More specifically, the plaintiff asserted, as Plaintiffs here assert, that Dr. Parisian would opine about the information that the FDA requires and whether or not the defendant-company's response was appropriate under FDA guidelines. Id. at 880-87. However, Dr. Parisian simply summarized documents without referencing FDA requirements or providing any expert analysis; on a motion for JNOV, the court determined that it should not have admitted or should have struck much of Dr. Parisian's testimony. Id. ("Parisian often did nothing, or little, more than read exhibits. . . . [M]ost of Dr. Parisian's punitive damages testimony should have been excluded."). Despite repeated sidebar conferences, Dr. Parisian continued to read lengthy passages from exhibits, offered testimony beyond her expert report, and failed to limit her testimony to any FDA regulations. Id.
I approached the Daubert hearing with these concerns in mind but was also open to the possibility that Plaintiffs could establish the admissibility of some of Dr. Parisian's testimony.
Dr. Parisian's testimony at the six-hour Daubert hearing was problematic in various regards and intensified, rather than alleviated, my concerns. More specifically, when efforts were made to establish the foundation of her opinions, Dr. Parisian retreated into obfuscation and referenced irrelevant FDA regulations while refusing to answer questions. It was also apparent that her opinions were often inconsistent. Moreover, she considered evidence and formed new opinions the night before the Daubert hearing. Much of her testimony was based on her review of internal Bayer documents and lacked any valuable FDA expertise.
The following exchange between Mr. Beck
(Hearing Tr. at 76:8-78:11.)
Instead of answering questions directly, Dr. Parisian often retreated to citing regulations that had marginal relevance to the issues being discussed.
An example of this occurred when Mr. Beck was cross-examining Dr. Parisian about her conclusion that Bayer should have taken actions based upon certain adverse event reports. Mr. Beck attempted to ask her about caveats published by the FDA stating that: (1) for any given report, there is uncertainty that the suspected drug caused the reaction because it could have been caused by the underlying disease, by concurrent drugs being taken, or by chance; (2) accumulated case reports can not be used to calculate incidence or estimates of drug use; and (3) true incidence rates can not be calculated from the Adverse Event Reporting Database. In response to the repeated question of whether it was her expert opinion that "once an adverse event report comes to a drug company and they do whatever review they're supposed to do, that then there is certainty that the suspected drug caused the reaction?" Dr. Parisian simply cited to 314.80(b), which requires the manufacturer to review adverse drug experiences. (Hearing Tr. at 95:1-5.) She cited to that same regulation in response to the question of "Is there any FDA regulation or publication or anything in the world that you can cite to support this opinion that you've been expressing today that somehow the adverse event reports when they're sitting in the database maintained by a manufacturer are a completely different animal from when they're maintained by the FDA?" (Hearing Tr. at 96:22-97:97:2.)
(Hearing Tr. at 100:11-102:17.)
In addition to evading questions about her opinions, Dr. Parisian offered opinions at the Daubert hearing that differed from the opinions she offered at her deposition and from those contained in her Report.
For example, when Mr. Love asked Dr. Parisian whether Bayer should have initiated a "changes being effected" ("CBE") label under regulation 314.70 in response to the findings of the Kress study, she responded, "Yes, because this is a new issue about renal safety." (Hearing Tr. at 40:7-14.) When I asked Dr. Parisian where such an opinion is located in the Report, she cited to page 165, under the heading "Bayer delays in providing FDA with safety studies about Trasylol showing increased risk of mortality." (Hearing Tr. at 41:18-20.) When I pointed out that this was a different opinion, Dr. Parisian finally admitted that her Report only contained the opinion that "they delayed and that they didn't provide it [Kress study] to the FDA," and not that Bayer should have submitted a CBE.
Furthermore, Dr. Parisian offered opinions based on audio from a cardiac team meeting that Dr. Kelly, Mr. Morrill's surgeon, attended, which she first listened to just a day before the Daubert hearing. (Hearing Tr. at 69:1-2.) While Mr. Beck stated that Dr. Parisian had not disclosed
(Hearing Tr. at 65:6-16.) Aside from the major problem that Dr. Parisian only listened to the audio the night before the Daubert hearing and formed new opinions not otherwise disclosed in her Report or deposition, this opinion lacked regulatory analysis and did not require any regulatory expertise.
In fact, much of Dr. Parisian's testimony at the Daubert hearing did not involve any regulatory analysis and instead consisted of conclusions made from a review of the regulatory history and Bayer's internal documents. For example, when asked by Mr. Love "What is your understanding of why it [Kress] was disclosed" for the first time in November of 2006, Dr. Parisian responded
(Hearing Tr. at 55:9-17.) Dr. Parisian proceeded to provide the regulatory history based on her reading of the documents without any significant regulatory analysis, referencing an FDA safety alert as well as the contents of Trasylol's 2006 label.
An instance I found particularly egregious was Dr. Parisian's apparent effort to construct a factual scenario, entirely divorced from any regulatory expertise, to support the Plaintiffs' theory as to Bayer's knowledge. The trial for the Morrill case was set to begin two weeks after this Daubert hearing. Mr. Morrill's surgery had taken place on October 3, 2003, so it was desirable for the Plaintiffs to show that Bayer had knowledge of the results of the Kress study prior to that time.
On direct examination, Mr. Love asked Dr. Parisian when the Kress study was completed, and she responded that "according to the document provided to the FDA from Bayer, it was completed in 2002." (Hearing Tr. at 30:2-3.) She then mentioned that she "saw a seventh draft of the report in 2003." (Hearing Tr. at 30:5.)
On cross-examination, Dr. Parisian repeated her claim that the evidence indicated that the Kress study had been completed
None of this was disclosed in Dr. Parisian's Report, and her conclusion surely does not involve any regulatory expertise. But even more troubling is her willingness, indeed eagerness, to advance the conclusion at all. The number, standing alone, tells us little, if anything, about when the study was completed. It is a basis for beginning an inquiry, not ending one. The most likely explanation for the number, particularly in view of the 2003 draft, is that the number reflects the date the study was initiated. Dr. Parisian's willingness to offer "expert" opinion on such flimsy evidence and withhold any disclosures in advance is simply astonishing.
Instead of providing regulatory analysis, Dr. Parisian repeatedly arrived at conclusions based on her interpretation of Bayer's internal documents. For example, during re-direct examination, Mr. Love showed Dr. Parisian a Bayer e-mail, asked her to read a portion he had highlighted, and then asked:
(Hearing Tr. at 156:25-157:11.) Based on an e-mail between two Bayer employees, Dr. Parisian offered her "takeaway" about another person's state of mind, whether he had reached a final conclusion, and whether Bayer was in possession of his analysis, all in the guise of regulatory expertise.
When Mr. Beck pointed out sections of Dr. Parisian's Report that merely summarized Bayer's documents and testimony, Dr. Parisian refused to admit that these sections did not require regulatory expertise and lacked any regulatory analysis. The following exchange was typical:
(Hearing Tr. at 82:23-83:16.) Similarly:
(Hearing Tr. at 103:10-25.) Dr. Parisian refused to acknowledge that her testimony was not related to any regulatory expertise and that it merely restated and drew conclusions from documentary evidence; she made no efforts to confine her testimony to the area in which she allegedly does have expertise: the FDA regulatory scheme.
Problematic testimony such as that outlined above caused me to have the following impressions at the Daubert hearing:
Based on a thorough review of Dr. Parisian's Report, deposition, and her testimony at the Daubert hearing, I find that Dr. Parisian's expert testimony must be excluded in its entirety pursuant to Rule 702 and the analysis under Daubert. Even assuming that Dr. Parisian is qualified to testify as to the FDCA and the FDA regulatory scheme as it applies to pharmaceuticals, I find that her testimony is due to be excluded for two major, independent reasons.
Most of Dr. Parisian's testimony will not assist the trier of fact because she makes no effort to confine it to her area of expertise: the FDA regulatory scheme. As
(Parisian Report at 55.) This opinion does nothing more than rely on Bayer's internal documents to improperly opine on Bayer's motive.
Dr. Parisian's Report is replete with such improper references to Trasylol's regulatory history and Bayer's internal documents and FDA correspondence. While Plaintiffs argued that the presentation of such facts is necessary, as they are connected to Dr. Parisian's opinions, Dr. Parisian's major role in this litigation appears to be that of Plaintiffs' advocate rather than expert. Her expertise is not required to present the factual narrative to the jury, and she has no expertise that allows her to infer Bayer's and the FDA's knowledge and intent and present those inferences to the jury. Therefore, Dr. Parisian generally does not offer testimony involving "scientific, technical, or other specialized knowledge" that would assist the trier of fact to understand the evidence or to determine a fact in issue. FED. R.EVID. 702.
Based on a thorough review of Dr. Parisian's Report and her Daubert hearing testimony, I find that she generally takes a collection of facts, imputes motive and knowledge, and draws unsupported conclusions unrelated to any regulatory expertise.
Opinion # 10 is a prime example.
(Parisian Report at 207.) At the Daubert hearing, Mr. Beck cross-examined Dr. Parisian on this Opinion.
(Hearing Tr. at 85:14-87:22.) While Dr. Parisian referenced a regulation that was allegedly included in the general, introductory section of her Report, this regulation is not discussed in the section "Bases for Opinions # 10-# 12"; Dr. Parisian does not analyze the facts under this regulation to arrive at Opinion # 10.
The same can be said of Dr. Parisian's remaining opinions. For example, Opinion # 1 deals with Bayer's failure to "test, monitor, update and warn FDA about the post-operative risks of aprotinin (Trasylol) which included renal failure, thrombosis, and death," while Opinion # 2 deals with Bayer's failure to update its product insert and promotions, warn physicians, and provide adequate large clinical trials. (Parisian Report at 24.) While Dr. Parisian references 21 U.S.C. § 352 and 21 CFR § 201.5 in Opinion # 2, the section "Bases of Opinions # 1 & # 2" does not analyze Bayer's actions under the cited statute and regulation but rather provides a general background on the FDA process and the role of the FDA. Despite the heading, the section in no way provides an adequate basis for the opinions it is intended to support: the section does not even discuss Bayer's actions with respect to Trasylol, and certainly does not discuss how and why Bayer violated its duties under the relevant statute and regulation.
On the rare occasion where Dr. Parisian states that Bayer violated a specific regulation with some specific action, she fails to explain why that regulation was violated. For example, Dr. Parisian opines "There were medical literature reports that Bayer should have been aware of for nephrotoxicity with APROTININ before its 1993 NDA approval. Bayer was required by 21 CFR 314.50 to have provided those reports to FDA in its marketing application. . . . However, instead of providing the information to FDA and physicians, Bayer sought to remove the information from Micromedex and pharmacists." (Parisian Report at ¶¶ 283-284.) While quick to infer Bayer's knowledge and bad motives from internal e-mails, Dr. Parisian fails to explain why Bayer violated 21 C.F.R. § 314.50: the critical link between the existence of the studies and the conclusion that a regulation was violated is missing from Dr. Parisian's Report and testimony. At other times, Dr. Parisian opines that Bayer behaved inappropriately but fails to cite to
(Parisian Report at ¶ 294.) It is difficult to locate the regulatory analysis that Dr. Parisian purports to offer in these statements. See also Parisian Report at ¶ 348 ("Bayer had become aware of the contents of the Mangano manuscript in October 2004. Therefore, it was false and misleading in January 2006, to tell Bayer's sales representatives to convey to physicians that Bayer had `just become aware of this manuscript.' Bayer had first learned about the information . . . from Dr. Rosyton."), ¶ 352 ("The letter also has misleading information about the anti-inflammatory benefits of full dose Trasylol to help justify the beneficial use of full dose when compared to a half-dose."), ¶ 392 ("A reasonable pharmaceutical manufacturer with a concern for patient safety would have pursued studies regarding the renal effects long before March 2006. Bayer's safety study was undertaken to help refute or discredit Dr. Mangano's renal failure and risk findings.").
Furthermore, some of Dr. Parisian's opinions are unreliable because they are purely speculative. According to Opinion #6,
(Parisian Report at 99.) Dr. Parisian was not a percipient witness to these events and is engaging in pure speculation as to the alternative outcome of a certain FDA meeting without providing any regulatory expertise or analysis.
While I have not discussed my concerns with the reliability of each of Dr. Parisian's opinions, the major problem identified— the lack of analysis or connection between the facts and the opinions—persists throughout Dr. Parisian's Report and Daubert testimony. I therefore find that Dr. Parisian's testimony must be excluded in its entirety. Plaintiffs have failed to meet their burden of establishing the reliability of Dr. Parisian's testimony by a preponderance of proof.
Plainly stated, Dr. Parisian is an advocate, presented with the trappings of an expert but with no expectation or intention of abiding by the opinion constraints of Rule 702. She comes armed with a Report designed to be broad enough to allow her to gather and stack inference upon inference in order to offer her "takeaway" or "take home message" with respect to intent, knowledge, or causation in a manner unrelated to any regulatory expertise. Her testimony is unreliable and would not be of assistance to the jury.
Accordingly, it is hereby