SULLIVAN, Justice.
The sole issue in this appeal is whether the trial court abused its discretion when it permitted a psychologist to testify on behalf of a plaintiff in a personal injury case
In May, 2004, Henry Bennett, while operating a roll-off container truck for Schupan & Sons, Inc. (referred to collectively as "Bennett"), rear-ended John Richmond's vehicle. Bennett's truck weighed 42,000 pounds; Richmond was driving a van. In December, 2005, Richmond and his wife sued Bennett for injuries Richmond sustained in the collision to his neck and back.
In October, 2006, pursuant to a referral by his attorney, Richmond underwent a neuropsychological evaluation with Dr. Sheridan McCabe, a psychologist. Richmond had been experiencing headaches and memory loss since the accident but had not been diagnosed with a brain injury. Dr. McCabe reviewed Richmond's medical records and Richmond's deposition; he also interviewed Richmond and his wife and administered a battery of neuropsychological tests to Richmond. As a result of the evaluation, Dr. McCabe testified that Richmond had "experienced a traumatic brain injury in the accident." Appellant's App. 105. This testimony forms the basis of this appeal.
Bennett objected to Dr. McCabe as an expert witness on three separate occasions during this litigation, each time challenging the admissibility of Dr. McCabe's testimony that Richmond experienced a traumatic brain injury in the accident. Bennett first filed a pretrial motion to exclude Dr. McCabe as an expert witness. The trial court denied Bennett's motion.
Bennett appealed, contending that the trial court erred when it permitted Dr. McCabe to testify that Richmond had sustained a traumatic brain injury in the accident.
Richmond sought, and we granted, transfer, Bennett v. Richmond, 950 N.E.2d 1209 (Ind.2011) (table), thereby vacating the opinion of the Court of Appeals, Ind. Appellate Rule 58(A).
While there is little dispute that a psychologist may testify as to the existence of
For its part, the Court of Appeals in this case held that psychologists are not per se unqualified to opine on issues of medical causation, but rather, under Indiana Evidence Rule 702, they may be qualified to give such an opinion based on certain knowledge, skill, experience, training, or education. Bennett, 932 N.E.2d at 710 n. 3.
Although we disagree with the result reached by the Court of Appeals, we do agree with its general approach in this case, and in doing so, align ourselves with
Bennett objected to Dr. McCabe's testimony under Rule 702 on the basis that Dr. McCabe was "not qualified to render an opinion regarding a medical diagnosis of a brain injury," Appellant's App. 104, which, as noted in footnote 4, supra, we view as a challenge to Dr. McCabe's testimony as to the cause of Richmond's brain injury. "A trial court's determination regarding the admissibility of expert testimony under Rule 702 is a matter within its broad discretion and will be reversed only for abuse of that discretion." TRW Vehicle Safety Sys., Inc. v. Moore, 936 N.E.2d 201, 216 (Ind.2010) (citations omitted). We presume that the trial court's decision is correct, and the burden is on the party challenging the decision to persuade us that the trial court has abused its discretion. Id.
The trial court is considered the gatekeeper for the admissibility of expert opinion evidence under Rule 702. Doe v. Shults-Lewis Child & Family Servs., Inc., 718 N.E.2d 738, 750 (Ind.1999). With regard to the admissibility of expert testimony, Rule 702 provides:
Ind. Evidence Rule 702. "By requiring trial courts to be satisfied that expert opinions will assist the fact-finder and that the underlying scientific principles are reliable, Rule 702 guides the admission of expert scientific testimony." Sears Roebuck & Co. v. Manuilov, 742 N.E.2d 453, 460 (Ind. 2001) (plurality opinion). Once the admissibility of the expert's opinion is established under Rule 702, "then the accuracy, consistency, and credibility of the expert's opinions may properly be left to vigorous cross-examination, presentation of contrary
With regard to his qualifications, Dr. McCabe obtained a Masters degree in General Psychology in 1956 and a Ph.D. in Counseling Psychology in 1958.
With the assistance of a video, Dr. McCabe testified extensively about the physiological aspects of the brain and how a closed head injury
Id. at 79. Dysfunction, he explained, may result from this rotational motion.
Dr. McCabe also thoroughly described the methodology he used to reach his conclusion that the accident caused Richmond's brain injury. He interviewed both Richmond and his wife, reviewed both Richmond's medical records and deposition, and conducted a series of tests. Dr. McCabe drew conclusions from each of the tests he performed on Richmond. From the Wechsler Adult Intelligence Scale-Ill, which he explained was a "widely used test, almost universal" and "very good from a scientific point of view," id. at 88, he noted a disparity between Richmond's verbal and performance tests that he attributed to "some sort of interference with his cognitive processing that [he called] kind of cognitive inefficiency," id. at 90 (emphasis omitted). From the Wechsler Memory Scale, "another widely used clinical memory test," id. at 90, Dr. McCabe also noted a pattern of discrepancy or inefficiency that led him to conclude that there were "difficulties ... getting in the way of [Richmond's] smooth memory function," id. at 90. Lastly, from the Halstead Neuropsychological Test Battery, again "a very widely used battery," id. at 91, Dr.
Id. at 92.
Over Bennett's objection, Dr. McCabe then testified that it was his opinion that Richmond "experienced a traumatic brain injury in the accident." Id. at 105. He explained that "[g]iven the absence of any of the symptoms of this condition prior to the accident, either in his report, the medical record, or the observations of his wife, it seems evident that the accident produced the brain injury." Id. at 105-06. According to Dr. McCabe, Richmond's experiencing "chronic headaches, a loss of cognitive efficiency, difficulties in information processing, and some adverse personality changes" appeared to be a result of his brain injury. Id. at 106.
The Court of Appeals concluded that Dr. McCabe was not qualified under Rule 702 to offer his opinion as to the cause of Richmond's brain injury. Specifically, it held that a psychologist who is not a medical doctor but is otherwise qualified under Rule 702 to offer expert testimony as to the existence and evaluation of a brain injury is not qualified to offer his or her opinion as its cause without demonstrating some medical expertise in determining the etiology of brain injuries. Bennett, 932 N.E.2d at 709-10. Its basis for requiring medical expertise in etiology apparently stems from prior statements of that court that "questions of medical causation of a particular injury are questions of science generally dependent on the testimony of physicians and surgeons learned in such matters." Id. at 709 (citing Hannan v. Pest Control Servs., Inc., 734 N.E.2d 674, 679 (Ind.Ct.App.2000), trans. denied).
We note here that Dr. McCabe's testimony on causation relates to his opinion as to the existence and evaluation of a brain injury that he in fact was uniquely qualified to offer, especially considering his testimony that brain injuries such as Richmond's often go undiagnosed by medical professionals for various reasons. See Bennett, 932 N.E.2d at 709-10 (noting that the evaluation of a brain injury was within Dr. McCabe's field of expertise and that he had demonstrated his qualifications to opine that Richmond sustained a brain injury from an unknown cause). Moreover, the patterns of impairment that Dr. McCabe observed through his testing were those associated with a traumatic brain injury. Traumatic brain injuries occur in the course of closed head injuries,
In any event, we think that the Court of Appeals imposed more stringent requirements on Dr. McCabe than are required under Rule 702. Rule 702 requires that Dr. McCabe demonstrate his knowledge, skill, experience, training, or education in order to be qualified as an expert, and in fact, only one of these characteristics is necessary. See Kubsch v. State, 784 N.E.2d 905, 921 (Ind.2003) (citing Creasy v. Rusk, 730 N.E.2d 659, 669 (Ind.2000)). Even if we were to conclude that Dr. McCabe had not had any specific "education or training relevant to determining the etiology of brain injuries," Bennett, 932 N.E.2d at 709, he clearly demonstrated his knowledge of how a brain injury might result from the whiplash motion experienced in a rear-ending accident, how such a brain injury results in symptoms similar to those experienced by Richmond, and how psychological and neuropsychological testing reveals the relationship between that brain injury and behavior.
Other jurisdictions analyzing this issue under various analogs to our Rule 702 have not required specific qualifications in determining the etiology of brain injuries before allowing psychologists or neuropsychologists to testify in this regard. They have allowed experts to testify as to the cause of a brain injury based on qualifications similar to Dr. McCabe's. In Huntoon, the Supreme Court of Colorado held that a neuropsychologist was qualified to testify that a rear-ending accident caused the plaintiff's brain injury. 969 P.2d at 685, 691. The witness had an "extensive educational background, including three degrees in psychology, master's and doctoral degrees, and further study in neuropsychology including understudy with experienced neuropsychologists," and he had explained "the way in which neuropsychological testing reveals the impact of an injurious event on an individual's ability to carry out every day activities, and the manner in which neuropsychologists use the tests and other clinical data to diagnose brain injury as manifested by cognitive impairment." Id. at 691. The Huntoon court concluded that the expert "had demonstrated the knowledge and experience necessary to render an opinion as a neuropsychologist, and that he did not exceed the scope of his expertise by addressing issues of causation." Id Similarly, in Hutchison, the Supreme Court of Iowa held that a neuropsychologist was qualified to testify that a rear-ending accident did not cause the plaintiff's brain injury, but rather that her injuries were pre-existing. 514 N.W.2d at 884, 886. The witness had a "doctorate in clinical psychology ... [and] extensive postdoctoral training and professional experience." Id. at 888. He had opened a head trauma rehabilitation program and developed a head injury severity scale. Id; see also id. at 887 (declining to adopt Pennsylvania's approach requiring psychologist to establish that his methods expose the cause of the injury and not merely its existence). But cf. Davison, 2006 WL 2129803, at *8, 2006 U.S. Dist. LEXIS 52162, at *23 (requiring specialized knowledge or experience in brain injuries, but then appearing to differentiate between expertise to diagnose brain injury and to state an opinion about its cause).
Lastly, Bennett argues that the proper qualifications to testify as to the cause of a brain injury are those of a "neuropsychologist," and because Dr. McCabe has not claimed to be a neuropsychologist and has not presented any credentials identifying himself as a neuropsychologist, his qualifications are distinguishable from those psychologists that were qualified to testify to the medical cause of brain injuries in other cases. But even if we were to require under Rule 702 qualifications similar to those of a neuropsychologist to testify in this manner, our understanding of "neuropsychology," see footnote 6, supra, as well as the description of that term in cases, leads us to conclude that Dr. McCabe's practice was in fact related to neuropsychology even though he did not describe himself as a neuropsychologist. See Huntoon, 969 P.2d at 685 (providing that "neuropsychologists perform the `study of brain behavior relationships and use a battery of psychological and neuropsychological tests that are standardized in order to elicit observations of relevancy of various aspects of the brain in terms of
We conclude that the trial court did not abuse its discretion in finding that Dr. McCabe was qualified to offer his opinion as to the cause of Richmond's brain injury.
Admissibility under Rule 702 also depends on the reliability of Dr. McCabe's causation testimony. In making this determination, "the trial court must make a preliminary assessment of whether the reasoning or methodology underlying the testimony is scientifically valid and whether that reasoning or methodology properly can be applied to the facts in issue." Shafer & Freeman Lakes Envtl. Conservation Corp. v. Stichnoth, 877 N.E.2d 475, 484 (Ind.Ct.App.2007) (citation omitted), trans. denied. "[T]here is no specific `test' or set of `prongs' which must be considered in order to satisfy ... Rule 702(b)." McGrew v. State, 682 N.E.2d 1289, 1292 (Ind.1997). The proponent of the expert testimony bears the burden of establishing the reliability of the scientific principles on which it is based. Kubsch, 784 N.E.2d at 921 (citation omitted).
First, Bennett argues that the scientific basis of Dr. McCabe's testimony should have been examined through means of a Daubert hearing and that the trial court erred in not holding such a hearing.
We conclude that the trial court did not abuse its discretion in finding that Dr. McCabe's testimony was based on reliable scientific principles. Rule 702(b) "directs the trial court to consider the underlying reliability of the general principles involved in the subject matter of the testimony, but it does not require the trial court to re-evaluate and micromanage each subsidiary element of an expert's testimony within the subject." Sears Roebuck, 742 N.E.2d at 461. As demonstrated in his testimony at trial, the general principles underlying Dr. McCabe's testimony-that rotational motion or whiplash can cause brain injuries and that brain injuries can be evaluated through the testing he performed-were scientifically valid. Indeed, Bennett does not really challenge the validity of these general principles but more so the specific science underlying Dr. McCabe's conclusion that Richmond experienced a traumatic brain injury in the accident. But we note that Dr. McCabe's methodologies in opining on the cause of Richmond's injury were similar to those employed by other qualified experts. Like Dr. McCabe, the neuropsychologist in Huntoon had administered tests that were "part of a standardized battery described as the most respected and widely documented in the neuropsychology profession" and had "prepared a far-reaching background and case history to use as a backdrop for his analysis of the test results" to reach his conclusion as to the cause of the plaintiff's brain injury. 969 P.2d at 691. Similarly, the neuropsychologist in Cunningham had performed "a battery of cognitive tests including intelligence tests, memory tests, tests for concentration and
Related to the reliability of his testimony, the Court of Appeals concluded that even if Dr. McCabe were qualified to opine as to the cause of Richmond's brain injury, his testimony lacked probative value because he did not testify regarding the mechanics of the accident or describe the force or speed of the impact. Bennett, 932 N.E.2d at 711. We disagree. Dr. McCabe's opinion was based on the undisputed fact that a rear-ending accident occurred in this case. Cf. Clark v. Sporre, 777 N.E.2d 1166, 1170-71 (Ind.Ct.App. 2002) (expert opinion that hypoxic event caused mental impairment was speculative because there was no factual basis that hypoxic event occurred). Richmond himself testified that his one-ton van, which was in a stopped position, was hit by Bennett's truck, which according to Bennett's testimony weighed 42,000 pounds; as a result, Richmond's van was propelled forward 300 feet. Dr. McCabe's testimony was unequivocal that whiplash motion such as that occurring in a rear-ending accident may cause brain injury and that such a brain injury may cause the symptoms experienced by Richmond. And, as discussed supra, Dr. McCabe employed reliable methodologies to reach his conclusion that Richmond sustained a brain injury in the accident. Thus, we disagree with the Court of Appeals that Dr. McCabe's testimony was "`nothing more than "subjective belief" and "unsupported speculation." '" Bennett, 932 N.E.2d at 711 (quoting Ind. Mich. Power Co. v. Runge, 717 N.E.2d 216, 235 (Ind.Ct.App.1999)).
We conclude that the trial court did not abuse its discretion in finding that Dr. McCabe's testimony was based on reliable scientific principles that could be applied to the facts at issue.
Our review of the record, read in conjunction with the requirements of Rule 702, leads us to conclude that the trial court did not abuse its discretion in admitting Dr. McCabe's causation testimony. The trial court extensively and thoughtfully considered the admissibility of Dr. McCabe's testimony on three separate occasions during this litigation. Mindful that the trial court is afforded broad discretion in these matters, we decline to find any abuse of it. The judgment of the trial court is affirmed.
SHEPARD, C.J., and DICKSON, RUCKER, and DAVID, JJ., concur.
Appellant's App. 30 n.3.