Milward v. Rust-Oleum Corp., 1st Cir. (2016)

7/25/2019 Milward v. Rust-Oleum Corp., 1st Cir. (2016)

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United States Court of AppealsFor the First Circuit

No. 13- 2132

BRI AN MI LWARD and LI NDA J . MI LWARD,

Pl ai nt i f f s , Appel l ant s ,

v.

RUST- OLEUM CORPORATI ON,

Def endant , Appel l ee.

APPEAL FROM THE UNI TED STATES DI STRI CT COURTFOR THE DI STRI CT OF MASSACHUSETTS

[ Hon. Dougl as P. Woodl ock, U. S. Di st r i ct J udge]

Bef ore

Howar d, Chi ef J udge,Thompson, Ci r cui t J udge,and Lapl ant e, * Di str i ct J udge.

St eve Baughman J ensen, wi t h whom Al l en St ewar t , P. C. , I anMcCal l i st er , and Kr ei ndl er & Kr ei ndl er , LLP, wer e on br i ef , f orappel l ant s.

Franci s M. Lynch, wi t h whom Cet r ul o LLP, was on br i ef , f orappel l ee.

Apr i l 25, 2016

* Of t he Di st r i ct of New Hampshi r e, si t t i ng by desi gnat i on.


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HOWARD, Chief Judge. I n t hi s t oxi c t or t case, we

pr evi ousl y consi der ed t he admi ssi bi l i t y of t est i mony f r om t he

pl ai nt i f f s' gener al causat i on exper t . At i ssue i n t he pr esent

appeal i s whet her t he di st r i ct cour t abused i t s di scret i on i n

excl udi ng t he t est i mony of t he pl ai nt i f f s' speci f i c causat i on

exper t . We concl ude t hat t he di st r i ct cour t ' s r ul i ng was a

suppor t abl e exer ci se of i t s di scret i on, and we t her ef or e af f i r m

t he gr ant of summary j udgment t o t he def endant f ol l owi ng t hat

evi dent i ar y r ul i ng.

I.

Background

Br i an Mi l war d wor ked as a pi pef i t t er and r ef r i ger at or

t echni ci an f or over t hi r t y year s. Dur i ng t he cour se of hi s

empl oyment , Mi l ward was exposed t o var yi ng l evel s of benzene f r om

pai nt s and ot her pr oduct s manuf act ur ed by ( among others) Rust -

Ol eum Cor por at i on. I n 2004, he was di agnosed wi t h Acut e

Promyel ocyt i c Leukemi a ( "APL") . Thr ee years l at er , Mi l war d and

hi s spouse sued a number of def endant s on t he theor y t hat t hei r

negl i gence caused Mi l war d' s di sease. The onl y r emai ni ng def endant

i s Rust - Ol eum.

To succeed agai nst Rust - Ol eum, t he Mi l war ds had t he

bur den of est abl i shi ng, t hr ough exper t t est i mony, gener al and

speci f i c causat i on. I n ot her wor ds, t hey needed t o show t hat

exposur e to benzene can cause APL ( general causat i on) , and t hat


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exposur e t o benzene was, i n f act , a subst ant i al f act or i n t he

devel opment of Br i an' s APL ( speci f i c causat i on) . The di st r i ct

cour t bi f ur cat ed t he pr oceedi ngs; i t pl anned f i r st t o addr ess t he

admi ssi bi l i t y of exper t t est i mony on gener al causat i on, and t hen

t o consi der t he speci f i c causat i on i ssue.

I n a 2009 r ul i ng, t he di st r i ct cour t excl uded t he

Mi l war ds' gener al causat i on exper t . Accor di ngl y, i t ent er ed

j udgment i n f avor of t he def endant s wi t hout proceedi ng t o t he

second phase of t he case. The Mi l wards appeal ed t hat deci si on

and, f or r easons speci f i c t o t hei r gener al causat i on exper t , we

r ever sed. See Mi l war d v. Acui t y Speci al t y Pr ods. Gr p. , I nc. , 639

F. 3d 11 ( 1st Ci r . 2011) . We r emanded t he case t o t he di st r i ct

cour t t o pr oceed t o t he speci f i c causat i on quest i on.

Under t he super vi si on of a di f f er ent di st r i ct cour t

j udge, t he par t i es engaged i n di scover y on t he subj ect of speci f i c

causat i on. Rel evant her e, t he Mi l war ds r et ai ned occupat i onal

medi ci ne physi ci an Dr . Shei l a But l er t o ser ve as t hei r exper t

wi t ness. 1 The admi ssi bi l i t y of her opi ni on t est i mony i s at t he

1 The Mi l war ds al so engaged i ndust r i al hygi eni st Dr . J amesSt ewar t . Dr . St ewar t eval uat ed Br i an Mi l war d' s exposure t o benzeneat var i ous poi nt s i n hi s car eer and cal cul at ed t he benzene l evel si n var i ous pr oduct s t hat he used. Based on t hose consi der at i ons,Dr . St ewar t est i mated t hat Mi l ward was exposed t o benzene at al evel of 25. 6 par t s per mi l l i on- year s ( t he measur ement of t heamount of benzene equi val ent t o what a person woul d breat he onaver age each day of t he year a per son spent at wor k) . The di st r i ctcour t f ound Dr . St ewar t ' s t est i mony t o be admi ssi bl e, and Rust -


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hear t of t hi s appeal , and t hus addi t i onal backgr ound on her opi ni on

i s i n order .

Dr. Butler

Dr . But l er , an empl oyee of t he Vet er ans Admi ni st r at i on,

speci al i zes i n cl i ni cal assessment s of envi r onment al and

occupat i onal exposur e i n combat - exposed vet erans. I n her pr oposed

t est i mony, Dr . But l er pr esent ed t hr ee t heor i es.

Fi r st , she t est i f i ed t hat al t hough benzene i s nat ur al l y

occur r i ng, t her e i s no saf e l evel of benzene exposur e. Thi s was

her pr edomi nant t heor y, and she consi st ent l y rei t er at ed her

hypothesi s. She emphasi zed t hat she r eached t hi s concl usi on by

exami ni ng " t he bi ol ogy, t he pat hophysi ol ogy, what t he subst ance

does t o t he person and t he di sease pr ocess . " And, she noted, she

was abl e t o do so wi t hout r el yi ng on any of t he r el evant

epi demi ol ogi cal st udi es. Gi ven t hi s no- saf e l evel t heor y, Dr .

But l er mai nt ai ned t hat Mi l war d' s exposur e ( as det ai l ed by Dr .

St ewar t ) was l i kel y t he cause of hi s APL. The di st r i ct cour t

r ej ect ed t hi s hypot hesi s because i t coul d not be pr oper l y t est ed

wi t h any known r at e of er r or . The Mi l war ds do not meani ngf ul l y

chal l enge t he di st r i ct cour t ' s concl usi on on appeal . Accor di ngl y,

we assume that t he rul i ng was cor r ect and bypass f ur t her di scussi on

Ol eum now ar gues t hat t hi s deci si on was er r oneous. Gi ven ourdi sposi t i on of t he case, we do not r each t hi s argument .


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of t he i ssue. See Mi l l s v. U. S. Bank, NA, 753 F. 3d 47, 55 ( 1st

Ci r . 2014) .

Second, Dr . But l er r at her cur sor i l y concl uded t hat even

beyond t he no- saf e l evel hypot hesi s, cer t ai n epi demi ol ogi cal

st udi es have est abl i shed t hat an i ndi vi dual ' s "r el at i ve r i sk" of

devel opi ng APL i ncr eases when exposed t o speci f i ed amount s of

benzene. She t hen compared Mi l ward' s exposur e l evel s t o t hose

t hat had been f ound t o be dangerous i n t hat r esear ch. Si nce

Mi l ward' s exposure was hi gher t han t he amount s f ound t o be

hazardous, Dr . But l er r easoned t hat benzene exposure was l i kel y

t he cause of hi s APL. Not abl y, she di d not expl ai n why she chose

t he st udi es on whi ch she r el i ed, nor di d she addr ess any st udy

wi t h cont r ar y f i ndi ngs. I n f act, dur i ng Dr . But l er ' s deposi t i on,

def endant ' s counsel asked her a number of quest i ons about her

abi l i t y and wi l l i ngness t o engage wi t h t he r el evant

epi demi ol ogi cal r esear ch. For i nst ance, counsel asked, "Ar e you

awar e of any st udi es whi ch f i nd t hat t her e i s no r el at i onshi p

bet ween benzene exposur e and APL, " t o whi ch she answered "Yes . .

. t he l i t er at ur e [ ] has suppor t f or bot h. " Counsel t hen asked,

"Do you i nt end i n t hi s case t o wei gh t he di f f er ent epi demi ol ogi cal

st udi es and of f er an opi ni on as t o whi ch ones we shoul d r el y on

and whi ch ones we shoul d di scount , " t o whi ch she r epl i ed, "No. "

Fi nal l y, Dr . But l er engaged i n a "di f f er ent i al

di agnosi s" t o concl ude t hat benzene exposure l i kel y caused


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Mi l war d' s APL. Thr ough t hi s met hod ( essent i al l y a pr ocess of

el i mi nat i on) Dr . But l er " r ul ed out " some of t he mor e common f act or s

associ ated wi t h APL, among t hem obesi t y and smoki ng. She t hen

determi ned t hat si nce benzene exposur e was a potent i al cause, she

coul d al so "r ul e out " an i di opat hi c di agnosi s ( or , a di agnosi s

wi t hout a known cause) . Thus, si nce benzene exposure was the onl y

si gni f i cant pot ent i al cause r emai ni ng, she concl uded t hat i t was

l i kel y t he cul pr i t .

Procedural History

Back i n cour t , Rust - Ol eum moved bot h t o excl ude Dr .

But l er ' s t est i mony and f or summar y j udgment . The di st r i ct cour t

eval uat ed, and r ej ect ed, each of t he t heor i es t hat Dr . But l er put

f or war d t o est abl i sh speci f i c causat i on. For r easons di scussed

bel ow, t he j udge ul t i mat el y rul ed t hat Dr . But l er ' s t est i mony was

i nadmi ssi bl e under Feder al Rul e of Evi dence 702. Si nce t he

Mi l war ds coul d not est abl i sh speci f i c causat i on wi t hout Dr .

But l er ' s t est i mony, t he di st r i ct cour t gr ant ed summar y j udgment i n

f avor of Rust - Ol eum. Fed. R. Ci v. P. 56. Thi s t i mel y appeal

f ol l owed.

II.

We r evi ew t he di st r i ct cour t ' s deci si on t o admi t or

excl ude exper t t est i mony f or abuse of di scr et i on. See Uni t ed

St at es v. Shay, 57 F. 3d 126, 132 ( 1st Ci r . 1995) ( not i ng t hat we

wi l l onl y "r ever se a deci si on . . . i f ( 1) t he di st r i ct cour t based


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t he deci si on on an i ncor r ect l egal st andar d . . . or ( 2) we have

a def i ni t e and f i r m convi ct i on t hat t he cour t made a cl ear er r or

of j udgment . . . . ") . Pr edi cat e f actual f i ndi ngs ar e r evi ewed f or

cl ear er r or , whi l e pur e quest i ons of l aw engender de novo r evi ew.

Mi l war d, 639 F. 3d at 13- 14. As f or t he di st r i ct cour t ' s ul t i mat e

deci si on t o gr ant Rust - Ol eum summar y j udgment , because t he

Mi l war ds ar e pr oceedi ng under st at e- l aw t heor i es of l i abi l i t y, we

appl y Massachuset t s l aw, see Phi l i bot t e v. Ni sour ce Cor p. Ser vs.

Co. , 793 F. 3d 159, 165 ( 1st Ci r . 2015) , and r evi ew t he deci si on de

novo, see Samaan v. St . J oseph Hosp. , 670 F. 3d 21, 38 ( 1st Ci r .

2012) .

As i n t he di str i ct cour t , our admi ssi bi l i t y i nqui r y i s

gui ded by Feder al Rul e of Evi dence 702, whi ch pr ovi des t hat :

A wi t ness who i s qual i f i ed as an exper t byknowl edge, ski l l , exper i ence, t r ai ni ng, or

educat i on may t est i f y i n t he f or m of anopi ni on or ot her wi se i f :

( a) t he exper t ' s sci ent i f i c, t echni cal , orot her speci al i zed knowl edge wi l l hel p t het r i er of f act t o under st and t he evi dence or t odet er mi ne a f act i n i ssue;( b) t he t est i mony i s based on suf f i ci ent f act sor dat a;( c) t he t est i mony i s t he pr oduct of r el i abl epr i nci pl es and methods; and

( d) t he exper t has r el i abl y appl i ed t hepr i nci pl es and met hods t o t he f act s of t hecase.

Fed. R. Evi d. 702. I n appl yi ng Rul e 702, t he di st r i ct cour t ser ves

as t he gat ekeeper f or exper t t est i mony by "ensur i ng t hat [ i t ] . .


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. bot h r est s on a r el i abl e f oundat i on and i s r el evant t o t he t ask

at hand. " Daubert v. Merr el l Dow Pharm. , 509 U. S. 579, 597 ( 1993) .

The par t y seeki ng t o i nt r oduce t he evi dence has t he bur den of

est abl i shi ng bot h i t s r el i abi l i t y and i t s r el evance. See i d. at

593 n. 10; see al so Fed. R. Evi d. 702, advi sory commi t t ee' s not e.

As not ed above, t he di st r i ct cour t r ej ect ed each t heor y

t hat Dr . But l er put f or war d t o est abl i sh speci f i c causat i on. We

now f ocus on the t wo t heor i es t hat t he Mi l war ds pr ess on appeal :

Dr . But l er ' s r el at i ve r i sk concl usi on and her di f f er ent i al

di agnosi s. 2

Relative Risk

The di st r i ct cour t r ej ect ed Dr . But l er ' s r el at i ve r i sk

t est i mony because she had expr essl y di savowed her i nt ent , and

mi ni mi zed her abi l i t y, t o anal yze conf l i ct i ng epi demi ol ogi cal

st udi es. The di st r i ct cour t r easoned t hat wi t hout such anal ysi s,

2 The Mi l war ds br oadl y al l ege t hat t he di st r i ct cour t appl i edt he wr ong l egal st andar d when eval uat i ng Dr . But l er ' s f i t ness t oserve as an exper t wi t ness. They not e t hat t he cour t "hel d t hatDr . But l er i s unqual i f i ed because she cannot ' eval uat e the r el evantst udi es' wi t h t he ' r i gor ' of an epi demi ol ogi st . " Thi s ar gumentmi sconst r ues the di st r i ct cour t ' s act i on. The cour t di d not , i na vacuum, concl ude t hat Dr . But l er was unqual i f i ed t o pr ovi deexpert t est i mony i n t hi s case because she was not anepi demi ol ogi st . I nst ead, t he cour t st at ed t hat si nce Dr . But l erwas unwi l l i ng t o pr ovi de t est i mony r espect i ng t he epi demi ol ogi call i t er at ur e i n t he cont ext of t he "r el at i ve r i sk" appr oach, t heMi l war ds coul d not r el y on t hat met hod t o pr ove speci f i c causat i on.Whi l e we pr ovi de mor e det ai l about t hat concl usi on bel ow, i tsuf f i ces her e t o say that t he di st r i ct cour t di d not er r as t heMi l war ds al l ege.


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i t was i mpossi bl e t o ensur e t hat t he st udi es she ci t ed wer e

act ual l y based on a r el i abl e met hodol ogy. The Mi l war ds chal l enge

t hi s deci si on i n t hr ee ways.

Fi r st , t hey asser t t hat i n r ej ect i ng t he t est i mony, t he

di st r i ct cour t r el i ed on an i ncor r ect pr emi se: t hat conf l i ct i ng

epi demi ol ogi cal st udi es exi st ed. They not e t hat t her e wer e st udi es

est abl i shi ng an i ncreased r i sk of APL af t er a cer t ai n l evel of

exposure, such as 8 ppm- year s. See, e. g. , Debor ah C. Gl ass et

al . , The Heal t h Watch Case - - Cont r ol St udy of Leukemi a and

Benzene, 1076 Ann. N. Y. Acad. Sci . 80, 85 ( 2006) ; Ri char d B. Hayes

et al . , Benzene and Lymphohematopoi et i c Mal i gnanci es i n Humans, 40

Am. J . I ndus. Med. 117, 120. The Mi l wards al so acknowl edge t hat

ot her st udi es f ound no i ncr eased r i sk of l eukemi a wi t h exposure at

any l evel l ess t han 40 ppm- year s. See, e. g. , Rober t A. Ri nsky et

al . , Benzene and Leukemi a: An Epi demi ol ogi c Ri sk Assessment , 316

New Engl and J . Med. 1044 ( 1987) . They argue, however , t hat si nce

t he Ri nsky st udy di d not af f i r mat i vel y f i nd t he absence of a

r el at i onshi p, t he st udi es wer e not actual l y i n conf l i ct.

Whi l e i t i s cer t ai nl y t r ue t hat , at l east i n some cases,

t he "absence of evi dence" i s not t he same as "evi dence of absence, "

i t i s not si mi l ar l y t r ue t hat t he st udi es must pr esent

di amet r i cal l y opposi ng concl usi ons t o be i n t ensi on wi t h one

anot her . Her e, a number of st udi es have been i dent i f i ed t hat show

a cor r el at i on bet ween APL and benzene exposur e at a speci f i c l evel ,


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whi l e ot her st udi es do not show t hat corr el at i on. I n or der t o

est abl i sh speci f i c causat i on by t he r el at i ve r i sk met hod, Dr .

But l er was r equi r ed t o choose a st udy, or st udi es, t o serve as a

basel i ne t o whi ch she coul d t hen compar e Br i an Mi l war d' s case.

Ther e can be no ser i ous quest i on t hat choosi ng a st udy t hat showed

a cor r el at i on above a speci f i c l evel ( e. g. , t he 8 ppm- year s i n t he

Gl ass st udy) , r at her t han one t hat di d not exhi bi t any such

cor r el at i on ( e. g. , t he 40 ppm- year s i n t he Ri nsky study) , yi el ds

a vast l y di f f er ent compar i son. The di st r i ct cour t di d not cl ear l y

er r i n f i ndi ng t hat t he st udi es wer e suf f i ci ent l y di st i nct f r om

one anot her such t hat ut i l i zi ng one, r at her t han anot her , woul d

necessar i l y l ead t o di f f er ent t est i mony.

The Mi l war ds next ar gue, al bei t summar i l y, t hat Dr .

But l er di d not act ual l y di savow her wi l l i ngness t o consi der t he

di ver gent st udi es. I nst ead, t hey al l ege t hat t he di st r i ct cour t

t ook her st at ement s out of cont ext .

We make qui ck work of t hi s ar gument gi ven t he cl ar i t y of

t he r ecor d. Dr . But l er anchor ed her t est i mony t o her no- saf e

t hr eshol d hypot hesi s, a t heor y t hat di d not t ur n on t he val i di t y

of any of t he epi demi ol ogi cal st udi es. I ndeed, gi ven t hat she

acknowl edged t hat she based t hat t heor y on " t he bi ol ogy, t he

pathophysi ol ogy, [ and] what t he subst ance does t o t he person and

t he di sease pr ocess, " i t was consi st ent f or her t o t hen st at e t hat

she had nei t her t he need nor t he i nt ent t o compare the compet i ng


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epi demi ol ogi cal l i t er at ur e. 3 Ther e was no er r or i n t he di st r i ct

cour t ' s deci si on t o gi ve her st at ement s t hei r pl ai n meani ng.

Fi nal l y, t he Mi l war ds ar gue t hat even i f t he di st r i ct

cour t di d not er r i n t hese r espect s, Dr . But l er ' s t est i mony was

never t hel ess st i l l based on r el i abl e evi dence, and i t was t her ef or e

admi ssi bl e. I n suppor t of t hi s cont ent i on, t he Mi l war ds def end

t he st udi es t hat Dr . But l er i nvoked i n her t est i mony. They al so

ci t e Schul t z v. Akzo Novel Pai nt s, LLC, 721 F. 3d 426 ( 7t h Ci r .

2013) , whi ch t hey mai nt ai n i s cl osel y anal ogous t o t hi s case.

Gener al l y, wher e an exper t ' s medi cal opi ni on i s gr ounded

excl usi vel y on sci ent i f i c l i t er at ur e, a di str i ct cour t acts wi t hi n

i t s di scr et i on t o r equi r e t he exper t t o expl ai n why she r el i ed on

t he st udi es t hat she di d and, si mi l ar l y, why she di sr egar ded ot her ,

i ncompat i bl e r esear ch. See, e. g. , Kuhn v. Wyet h, I nc. , 686 F. 3d

618, 623- 24 & 633 ( 8t h Ci r . 2012) ( permi t t i ng t est i mony where t he

exper t wi t ness r el i ed on met hodol ogi cal l y rel i abl e st udi es and

pr ovi ded an expl anat i on f or why those st udi es wer e chosen) ; Nor r i s

v. Baxter Heal t hcar e Cor p. , 397 F. 3d 878, 886 ( 10t h Ci r . 2005)

( not i ng i n t he cont ext of a gener al causat i on f i ndi ng t hat t he

exper t wi t ness' s i nabi l i t y t o addr ess cont r ar y vi ews made t he

3 Li kewi se, i n di scussi ng t he st at i st i cal si gni f i cance oft he r epor t s, Dr . But l er seemi ngl y mi ni mi zed her abi l i t y t o anal yzet he st udi es when she sai d "and I ' mnot an epi demi ol ogi st i f you' r egoi ng t o go t her e. I ' m j ust sayi ng t hat t o me t hat ' s f ai r l y - -that ' s f ai r l y si gni f i cant . "


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opi ni on unr el i abl e) . I t i s sel f - evi dent t hat , when an exper t

engages i n a r el at i ve r i sk anal ysi s i n t he manner t hat Dr . But l er

di d her e, t he di st r i ct cour t i s on f i r m gr ound i n r equi r i ng such

an expl anat i on, si nce t he val i di t y of t he appr oach depends on t he

r el i abi l i t y of t he st udi es chosen. See 3 Mod. Sci . Evi dence

23: 27 ( 2014- 2015 Ed. ) ( di scussi ng t he use of t he r el at i ve r i sk

appr oach i n est abl i shi ng speci f i c causat i on) . That i s, i f t he

exper t i s compar i ng t he pl ai nt i f f ' s condi t i on t o a st udy, and t he

st udy i s based on an unr el i abl e methodol ogy, t hen t he compar i son

i t sel f i s f ut i l e.

Schul t z, t he case on whi ch t he Mi l war ds r el y, i s

consi st ent wi t h t hi s vi ew. I n t hat case, t he Sevent h Ci r cui t

r ever sed a di st r i ct cour t ' s deci si on t o excl ude speci f i c causat i on

exper t t est i mony about an i ndi vi dual ' s exposur e l evel t o benzene.

721 F. 3d at 428. The Sevent h Ci r cui t f ound t hat t he t est i mony was

r el i abl e because t he exper t " f ocused speci f i cal l y on t he amount of

benzene t o whi ch [ t he pl ai nt i f f ] had been exposed and r el at ed t hi s

amount t o t he sci ent i f i c l i t er at ur e. " I d. at 432. I mpor t ant l y,

t he exper t i n Schul t z di d not si mpl y poi nt t o f avor abl e st udi es

showi ng an i ncr eased r i sk of l eukemi a at l ow l evel s of exposur e.

I nst ead, t he exper t i n t hat case expl ai ned why he bel i eved t hat a

conf l i ct i ng st udy was unr el i abl e and why, based on hi s knowl edge

of t he l i t er at ur e, he chose t o r el y on t he st udi es t hat he di d.

I d. at 432- 33.


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Her e, t he r el evant st udi es wer e not onl y i n t ensi on

wi t h one anot her , but expr essl y cast each ot her i nt o doubt . See,

e. g. , EPA Of f i ce of Resear ch and Devel opment , Car ci nogeni c Ef f ect s

of Benzene: An Updat e, at 14 ( Apr i l 1998) . Gi ven t hat , t he

di st r i ct cour t r easonabl y r ul ed t hat t her e needed t o be some

i ndi cat i on of why Dr . But l er ut i l i zed t he st udi es t hat she di d.

I ndeed, her compl et e unwi l l i ngness t o engage wi t h t he conf l i ct i ng

st udi es ( i r r espect i ve of whet her she was abl e t o or not ) made i t

i mpossi bl e f or t he di st r i ct cour t t o ensur e t hat her opi ni on was

actual l y based on sci ent i f i cal l y rel i abl e evi dence and,

cor r espondi ngl y, t hat i t comport ed wi t h Rul e 702. Not onl y does

t hi s render t hi s case r eadi l y di st i ngui shabl e f r omSchul t z, but i t

al so j ust i f i es t he di s tr i ct court ' s deci s i on. 4

Differential Diagnosis

The di st r i ct cour t al so r ej ect ed Dr . But l er ' s

"di f f er ent i al di agnosi s. " Al t hough t he j udge di d not quest i on Dr .

4 We al so not e t hat t he Mi l war ds' posi t i on yi el ds a f ur t herpr obl em. Absent Dr . But l er ' s t est i mony wei ghi ng t he st udi es, t heonl y suppor t f or t hei r r el i abi l i t y i s t he f act t hat t hey wer e peer -r evi ewed, publ i shed wor ks. As we have not ed t hough, "an ar t i cl edoes not r each t he di gni t y of a ' r el i abl e aut hor i t y' mer el y becausesome edi t or , even a most r eput abl e one, sees f i t t o ci r cul at e i t. . . [ and] [ m] er e publ i cat i on cannot make t hem aut omat i cal l yr el i abl e aut hor i t y. " Meschi no v. N. Am. Dr ager , I nc. , 841 F. 2d429, 434 ( 1st Ci r . 1988) . Gi ven t he need f or some evi denceest abl i shi ng t he r el i abi l i t y of t he st udi es i nvoked, t he cour tl i kewi se di d not er r i n r ef usi ng t o t ake j udi ci al not i ce of t hei rr el i abi l i t y.


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But l er ' s deci si on t o " r ul e out " obesi t y and smoki ng as causes of

Br i an Mi l war d' s APL, t he cour t was concer ned about t he ut i l i t y of

t he appr oach gi ven t he hi gh percent age of APL cases t hat are

i di opat hi c ( accor di ng t o t he r ecor d, r oughl y 70- 80% of al l APL

di agnoses) . The j udge al so st at ed t hat Dr . But l er ' s reasoni ng was

ci r cul ar ; she " r ul ed out " an i di opat hi c APL by " r ul i ng i n" benzene

as a cause, but she had f ai l ed t o pr ovi de a sci ent i f i cal l y rel i abl e

met hod of " r ul i ng i n" benzene i n t he f i r st i nst ance. The Mi l war ds

cont end t hat i n maki ng t hi s deci si on, t he di st r i ct cour t i gnor ed

our case l aw t hat has bl essed an exper t ' s use of a di f f er ent i al

di agnosi s t o est abl i sh causat i on.

Even i f t he Mi l war ds' scant y ar gument i n thei r openi ng

br i ef wer e suf f i ci ent l y devel oped as t o avoi d a wai ver f i ndi ng,

see Uni t ed St at es v. Ol adosu, 744 F. 3d 36, 39 ( 1st Ci r . 2014)

( " [ b] ecause t he ar gument i s under devel oped, i t i s wai ved") , we

nonet hel ess see no abuse of di scret i on i n t he di st r i ct cour t ' s

deci si on. The Mi l war ds ar e cer t ai nl y cor r ect t hat a "di f f er ent i al

di agnosi s" can be a " r el i abl e met hod of medi cal di agnosi s. "

Mi l war d, 639 F. 3d at 18; see al so Gr anf i el d v. CSX Tr ansp. , I nc. ,

597 F. 3d 474, 486 ( 1st Ci r . 2010) . But , t hey st i l l must show t hat

t he st eps t aken as par t of t hat anal ysi s - - t he " r ul i ng out " and

t he "r ul i ng i n" of causes - - wer e accompl i shed ut i l i zi ng

sci ent i f i cal l y val i d met hods. See Ruggi er o v. War ner - Lamber t Co. ,

424 F. 3d 249, 254 ( 2d Ci r . 2005) .


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Si nce Dr . But l er was onl y abl e t o " r ul e out " an

i di opathi c APL because she had " r ul ed i n" benzene as a cause, t he

val i di t y of her di f f er ent i al di agnosi s t ur ns on t he r el i abi l i t y of

t hat l at t er concl usi on. See Ruggi er o, 424 F. 3d at 254 ( not i ng

t hat an exper t must use r el i abl e sci ent i f i c met hods t o " r ul e i n"

causes) ; see al so Best v. Lowe' s Home Ct r s. , I nc. , 563 F. 3d 171,

179 ( 6t h Ci r . 2009) ; Gl ast et t er v. Novar t i s Phar m. Cor p. , 252 F. 3d

986, 989 ( 8t h Ci r . 2001) . I ndeed, t he r el i abi l i t y of t hat deci si on

i s par t i cul ar l y cr i t i cal her e gi ven t he ext ensi ve number of APL

cases t hat ar e i di opat hi c. Under such ci r cumst ances, el i mi nat i ng

a number of pot ent i al causes - - wi t hout pr oper l y and expl i ci t l y

"r ul i ng i n" a cause - - i s s i mpl y "of l i t t l e assi stance. "

Rest at ement ( Thi r d) of Tor t s; Phys. & Emot . Har m 28, cmt .

c( 4) ( 2010) .

Dr . But l er appear s t o have " r ul ed i n" benzene exposure

sol el y by r el yi ng on her t wo ot her t heor i es. But , as expl ai ned

above, t he di st r i ct cour t f ound bot h of t hese t heor i es t o be

unr el i abl e. As we agr ee wi t h t he di st r i ct cour t ' s concl usi on

r egar di ng t he r el at i ve r i sk met hodol ogy, and si nce t he Mi l war ds

have not chal l enged t he di st r i ct cour t ' s no- saf e t hr eshol d

det er mi nat i on, t hey have f ai l ed t o show how Dr . But l er coul d have

r el i abl y ut i l i zed ei t her met hod t o " r ul e i n" benzene exposur e.

Nor , we not e, have t hey poi nt ed t o ot her evi dence i n t he recor d

t hat Dr . But l er coul d have concei vabl y used t o " r ul e i n" benzene.


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Gi ven t hat t he r ecor d does not cont ai n a sci ent i f i cal l y

r el i abl e basi s t o " r ul e i n" benzene, Dr . But l er needed some ot her

met hod t o " r ul e out " an i di opat hi c di agnosi s. She di d not pr ovi de

one. As such, t he di st r i ct cour t act ed wi t hi n i t s di scret i on t o

concl ude t hat t he ext r aor di nar y number of i di opat hi c APL cases,

coupl ed wi t h t he l ack of a r el i abl e means t o rul e out an i di opat hi c

di agnosi s her e, mut ed Dr . But l er ' s abi l i t y t o r el i abl y appl y t hi s

met hodol ogy. 5

III.

Once t he di st r i ct cour t excl uded Dr . But l er ' s t est i mony,

i t t hen cor r ect l y gr ant ed Rust - Ol eum' s mot i on f or summar y

j udgment . As i s wel l - est abl i shed under Massachuset t s l aw, "exper t

t est i mony i s r equi r ed t o est abl i sh medi cal causat i on. " Recki s v.

J ohnson & J ohnson, 28 N. E. 3d 445, 461 ( Mass . 2015) . Thi s appl i es

t o bot h gener al and speci f i c causat i on. I d. at 461 n. 33. Wi t hout

any ot her medi cal exper t evi dence i n t he recor d pr obat i ve on

speci f i c causat i on, j udgment as a mat t er of l aw was necessar i l y

r equi r ed. Fed. R. Ci v. P. 56.

5 I n t hei r br i ef , t he Mi l war ds al so ar gue t hat Dr . But l er ' sposi t i on on speci f i c causat i on i s consi st ent wi t h t he l at encyper i od i n Br i an Mi l war d' s case. The di st r i ct cour t di d not r esti t s deci si on on t hat pr oposi t i on ( i nst ead, i t j ust not ed a concer nabout t he i ssue) , and we theref ore need not r each the ar gument .


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Accor di ngl y, we affirm t he di str i ct cour t ' s deci s i on t o

excl ude Dr . But l er ' s t est i mony and i t s concomi t ant gr ant of summar y

j udgment i n f avor of Rust - Ol eum.

--Dissenting Opinion Follows--


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THOMPSON, Circuit Judge, dissenting.

Setting the Stage

Dr . But l er has qui t e t he CV. A gr aduat e of Wel l esl ey

Col l ege, she has a medi cal degr ee f r om Howar d Uni ver si t y and a

mast er s of publ i c heal t h f r om Col umbi a Uni ver si t y. Speci al i zi ng

i n occupat i onal medi ci ne, she i s boar d- cer t i f i ed i n pr event i ve

medi ci ne and general publ i c heal t h ( by t he Amer i can Boar d of

Pr event i ve Medi ci ne) and i n anat omi c pat hol ogy, cl i ni cal

pathol ogy, and hematol ogy ( by t he Amer i can Boar d of Pat hol ogy) . 6

Thi s means ( accor di ng t o t he Amer i can Board of Pr event i ve Medi ci ne)

t hat she has " cor e compet enci es" i n, among ot her t hi ngs,

"epi demi ol ogy" and " r esear ch i nt o causes of di sease and i nj ur y i n

popul at i on gr oups. " 7 She has a pr et t y i mpr essi ve j ob t oo, wor ki ng

f ul l t i me as a physi ci an at a VA medi cal cent er t hat deal s wi t h

vet er ans r avaged by di seases af t er bei ng exposed t o toxi ns dur i ng

t hei r ser vi ce. Fi gur i ng out t he causes of chr oni c i l l nesses i n

pat i ent s exposed t o t oxi c subst ances i s what she does day i n and

day out . Al l t ol d, she has ( i n t he di st r i ct j udge' s wor ds) over

a decade' s wor t h of exper i ence "as a pr act i ci ng di agnost i c

6 Pat hol ogy i s a medi cal speci al t y f ocusi ng on t he nat ur e andcauses of di seases. See St edman' s Medi cal Di ct i onar y 1332 ( 27t hed. 2000) ( "St edman' s, " f r omher e on) . And hemat ol ogy i s t he st udyof bl ood- r el at ed di seases. See i d. at 796.

7 Epi demi ol ogy i s t he st udy of t he i nci dence, di st r i but i on,and cont r ol of di sease i n a popul at i on. See i d. at 604.


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hemat opat hol ogi st and as a consul t ant on occupat i onal l y- r el at ed

mal i gnanci es. "

As t he Mi l war ds' speci f i c- causat i on exper t , Dr . But l er

t est i f i ed by r epor t , deposi t i on, and af f i davi t t hat based on her

r evi ew of t he sci ent i f i c evi dence t her e i s no "saf e" l evel of

benzene exposure. 8 I n other words, every benzene exposur e

i ncr eases a per son' s r i sk of l eukemi a. But , she added, gi ven our

di f f er ent genet i c makeups, what mi ght be a saf e exposure l evel f or

some coul d be a l ethal one f or ot hers. Anyway, usi ng t wo accept ed

causat i on met hodol ogi es "r el at i ve ri sk" and "di f f er ent i al

di agnosi s" and zeroi ng i n on Br i an' s benzene- exposur e l evel ( set

by Dr . St ewar t at 25. 6 ppm- year s) Dr . But l er concl uded t hat Br i an' s

"excessi ve" exposur e t o benzene caused hi s l eukemi a. 9

8 Remember t he Mi l war ds had t o show t hat benzene exposur ecan cause l eukemi a (gener al causat i on) and t hat Br i an' s exposurewas a subst ant i al f act or cont r i but i ng t o hi s l eukemi a ( speci f i ccausat i on) . A di f f er ent di st r i ct j udge excl uded t he Mi l war ds'gener al - causat i on exper t as unr el i abl e under Rul e 702. Not i ng( among ot her t hi ngs) t hat t he j udge had t aken "si des on quest i onst hat ar e cur r ent l y the f ocus of ext ensi ve sci ent i f i c r esear ch anddebat e and on whi ch r easonabl e sci ent i st s can cl ear l y di sagr ee" we concl uded t hat t he excl usi on edi ct const i t ut ed an abuse ofdi scr et i on. See Mi l war d, 639 F. 3d at 22, 26.

On a di f f er ent not e, because t her e ar e t wo Mi l war ds Br i anand Li nda i t makes sense t o use a f i r st name where necessary t oavoi d conf usi on. Obvi ousl y I i nt end no di sr espect .

9 As my f r i ends i n t he maj or i t y not e, t he Mi l war ds hi r ed Dr .St ewar t ( an i ndust r i al hygi eni st ) t o assess Br i an' s benzeneexposures.


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A qui ck word about how she appl i ed t hese methodol ogi es.

St ar t i ng wi t h r el at i ve r i sk, Dr . But l er sai d t hat even

i f t here were some thr eshol d l evel of benzene exposur e needed t o

cause l eukemi a, t hat t hr eshol d was exceeded here and by a

consi der abl e amount . Wi t h Br i an' s 25. 6 ppm- year s exposure l evel

f i r ml y i n mi nd, she poi nt ed t o a peer - r evi ewed epi demi ol ogy st udy

f i ndi ng t hat workers exposed t o benzene at or above 8 ppm- years

wer e 7 t i mes mor e l i kel y t han cont r ol s t o devel op l eukemi a. And

she di d not st op t her e. Rat her , she went on t o spot l i ght ot her

st udi es of t he same cal i ber showi ng a st at i st i cal l y si gni f i cant

i ncr eased r i sk of l eukemi a among worker s cumul at i vel y exposed t o

benzene at l evel s bel ow Br i an' s 25. 6 ppm- year s. 10 I n a deposi t i on

she sai d t hat she i s nei t her an epi demi ol ogi st nor a resear cher .

She al so agr eed t hat some st udi es f ound no rel at i onshi p between

benzene exposure and l eukemi a. Asked by def ense counsel i f she

"i nt end[ ed] i n t hi s case t o wei gh t he di f f er ent epi demi ol ogi cal

st udi es" and comment on "whi ch ones we shoul d rel y on and whi ch

ones we shoul d di scount , " she r epl i ed, "No" and t hen added:

I ' m r el yi ng on what I know about t he bi ol ogy,t he pathophysi ol ogy, what t he subst ance doest o t he person and t he di sease pr ocess . Now,

10 See Deborah R. Gl ass et al . , The Heal t h Watch Case Cont r olSt udy of Leukemi a and Benzene: The St ory So Far , 1076 Ann. N. Y.Acad. Sci . 80 ( 2006) ; Dusi ca Lazarov et al . , Acut e Myel oi d Leukemi aand Exposure t o Or gani c Sol vent s: A Case- Cont r ol St udy, 16 Eur .J . of Epi demi ol ogy 295 ( 2000) ; Ri char d B. Hayes et al . , Benzeneand t he Dose- Rel ated I nci dence of Hematol ogi c Neopl asms i n Chi na,89 J . of t he Nat ' l Cancer I nst . 1065 ( 1997) .


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i f t her e ar e st udi es t hat suppor t i t t hent hat ' s even bet t er , but wi t hout t he st udi esbased on what I know t her e i s a ver y i t ' smor e l i kel y t han not t hat benzene cont r i but est o t he devel opment of [ t he t ype of l eukemi aBr i an suf f er s f r om] . 11

And she l at er sai d t hat "one doesn' t j ust r el y on l i t er at ur e" i n

f or mul at i ng a speci f i c- causat i on opi ni on.

Turni ng, t hen, t o di f f er ent i al di agnosi s ( apt l y

descr i bed by the maj or i t y as "essent i al l y a pr ocess of

el i mi nat i on") , Dr . But l er "r ul ed out " possi bl e causes of Br i an' s

l eukemi a, l i ke smoki ng and obesi t y, l eavi ng onl y benzene. She

t al ked about "' i di opat hi c' l eukemi a" t oo "i di opat hi c" bei ng

another way of sayi ng medi cal pr of essi onal s do not know why a gi ven

person has t he di sease. " [ E] ver y case of l eukemi a has some

cause[ ] , " she expl ai ned, and onl y " [ t ] hose cases wi t h uni dent i f i ed

causes" get hi t wi t h t he "' i di opat hi c' " tag. But gi ven her

concl usi on t hat Br i an' s " benzene exposur es wer e a subst ant i al

f actor causi ng hi s [ l eukemi a] , " she coul d "al so ' r ul e[ ] out ' t hat

hi s [ l eukemi a] was . . . ' i di opat hi c. ' "

The di st r i ct j udge, however , woul d have none of Dr .

But l er ' s t al k about benzene bei ng t he speci f i c cause of Br i an' s

l eukemi a. Gi ven her concessi on t hat she i s " ' not an

epi demi ol ogi st ' " and " ' not a r esear cher , ' " and gi ven her

11 Pat hophysi ol ogy i s t he st udy of t he f unct i onal changes t hataccompany a part i cul ar di sease. See St edman' s 1333.


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"pr of essed i nabi l i t y t o engage wi t h conf l i ct i ng epi demi ol ogi cal

l i t er at ur e" ( t hese ar e quot es f r omt he j udge' s r escri pt ) , t he j udge

excl uded her r el at i ve- r i sk anal ysi s as unr el i abl e under Rul e 702. 12

That meant t hat Dr . But l er ' s di f f er ent i al - di agnosi s anal ysi s

t hr ough whi ch she " ' r ul ed out ' an i di opat hi c or i gi n of [ Br i an' s]

l eukemi a by ' r ul i ng i n' benzene" ( t hese too ar e quot es f r om t he

j udge' s or der ) was unr el i abl e t oo ( because she i s, t he j udge

concl uded, not qual i f i ed t o say whet her benzene exposure at Br i an' s

l evel coul d have caused hi s l eukemi a) . And wi t h t he Mi l war ds'

speci f i c- causat i on exper t out of t he pi ctur e, al l t hat was l ef t

f or t he j udge t o do was ent er summary j udgment agai nst t hemwhi ch

t he j udge di d.

Fast - f or war d t o t he pr esent , wi t h t he maj or i t y spyi ng no

abused di scr et i on her e because Dr . But l er ' s "compl et e

unwi l l i ngness t o engage wi t h t he conf l i ct i ng st udi es ( i r r espect i ve

of whet her she was abl e to or not ) made i t i mpossi bl e f or t he

[ j udge] t o ensure t hat her opi ni on was act ual l y based on

sci ent i f i cal l y r el i abl e evi dence" as r equi r ed by Rul e 702. Cal l

me unper suaded. As I see t hi ngs, t he compl ai nt s about Dr . But l er ' s

12 The "conf l i ct i ng" st udy t hat ever yone f ocuses on i s Rober tA. Ri nsky et al . , Benzene and Leukemi a: An Epi demi ol ogi c Ri skAssessment , 316 New Eng. J . of Med. 1044 ( 1987) , whi ch f ound noi ncr eased r i sk of l eukemi a i n worker s exposed t o l ess t han 40 ppm-years of benzene.


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speci f i c- causat i on opi ni on go t o wei ght , not admi ssi bi l i t y as I

now expl ai n. 13

My Take on the Matter

(a)The Standar d of Revi ew Expl ai ned

Abuse- of - di scr et i on r evi ew i s "r espectf ul , " cer t ai nl y.

Cor p. Techs. v. Har net t , 731 F. 3d 6, 10 ( 1st Ci r . 2013) . But

" r espect f ul " does not mean we must t hrow up our hands and si mpl y

af f i r m ever y di scret i onar y cal l . See, e. g. , Negr on- Al meda v.

Sant i ago, 528 F. 3d 15, 21 ( 1st Ci r . 2008) . Revi ew under t hi s

st andar d does i nvol ve r evi ew, af t er al l . See, e. g. , Dopp v.

Pr i t zker , 38 F. 3d 1239, 1253 ( 1st Ci r . 1994) . And we wi l l not

hesi t at e t o f i nd abuse wher e, f or exampl e, t he di st r i ct j udge based

hi s deci si on on cl ear l y er r oneous f act s, made a ser i ous l egal

er r or , or suf f er ed a si gni f i cant l apse of j udgment , see, e. g. ,

Cent . Pensi on Fund of t he I nt ' l Uni on of Oper at i ng Eng' r s &

Par t i ci pat i ng Emp' r s v. Ray Hal uch Gr avel Co. , 745 F. 3d 1, 5 ( 1st

Ci r . 2014) ; Ri va v. Fi cco, 615 F. 3d 35, 43 ( 1st Ci r . 2010) ; Rui z-

Tr oche v. Pepsi Col a of P. R. Bot t l i ng Co. , 161 F. 3d 77, 83 ( 1st

Ci r . 1998) a poi nt made each t i me we have r eversed the excl usi on

13 Because the maj or i t y j et t i sons t he case by uphol di ng t hej udge' s deci si on t o excl ude Dr . But l er ' s t est i mony, I ( obvi ousl y)f ocus my ener gy on t hat i ssue. So, l i ke t he maj or i t y, I make nocomment on Rust - Ol eum' s ot her ar gument s i . e. , t hat t he j udgeshoul d have excl uded Dr . St ewar t ' s t est i mony and that t he Mi l war dscannot show t hat t he f ai l ur e to pr ovi de cer t ai n war ni ngs aboutbenzene pr oxi mat el y caused Br i an' s i nj ur i es.


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of exper t t est i mony, see, e. g. , Mi l war d, 639 F. 3d at 13- 14, 23-

25; Rui z- Tr oche, 161 F. 3d at 79, 83- 86.

(b)A Short Pr i mer on Expert Opi ni on

Rul e 702 gover ns t he admi ssi on of exper t - opi ni on

t est i mony, wi t h t he of f er i ng par t y requi r ed t o show t hat such

t est i mony i s rel evant and r el i abl e. See, e. g. , Kumho Ti r e Co. v.

Car mi chael , 526 U. S. 137, 149 ( 1999) ( r el yi ng on Dauber t , 509 U. S.

at 592) ; Rui z- Tr oche, 161 F. 3d at 80 ( same) . Exper t - opi ni on

t est i mony i s rel evant i f i t wi l l assi st t he f act f i nder i n

under st andi ng and deci di ng a f act . See, e. g. , Dauber t , 509 U. S.

at 592. And i t i s r el i abl e i f i t has "a r el i abl e basi s i n t he

knowl edge and exper i ence of [ t he per t i nent ] di sci pl i ne. "14 I d.

Basi cal l y t hen, di st r i ct j udges ar e supposed t o weed out

nonsense opi ni ons by j unk sci ent i st s. But i n doi ng so, t hey must

keep a bunch of t hi ngs i n mi nd i ncl udi ng t he f ol l owi ng:

The r ul e on exper t - opi ni on t est i mony i s notabl y " l i ber al , "

wi t h t he evi dence consi der ed pr esumpt i vel y admi ssi bl e. See

4 J ack B. Wei nst ei n & Mar gar et A. Ber ger , Wei nst ei n' s

14 Because ever yone f ocuses on whether Dr . But l er ' s t est i monyi s rel i abl e, I wi l l do l i kewi se.


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Feder al Evi dence 702. 02[ 1] , at 702- 5 ( J oseph M. McLaughl i n

ed. , 2d ed. 2013) ( "Wei nst ei n' s, " t o save some keyst r okes) .

Proponent s of exper t t est i mony must show t hat t he pr oposed

wi t ness i s abl e t hr ough her educat i on, t r ai ni ng, or

exper i ence t o of f er a meani ngf ul opi ni on on t he i ssue i n

pl ay. I d. 702. 04[ 1] [ c] , at 702- 57.

An exper t can r el y, t hen, on "cl i ni cal i nst i nct " i . e. ,

"what exper i ence adds t o sci ent i f i c knowl edge and t r ai ni ng"

whi ch i s a wel l - known and accept ed part of t oday' s medi cal

pr act i ce. Muel l er v. Auker , 700 F. 3d 1180, 1191 ( 9t h Ci r .

2012) ( quot ed appr ovi ngl y i n Wei nst ei n' s 702. 05[ 2] [ c] , at

702- 103 n. 46) .

J udges abuse t hei r di scr et i on i f t hey "excl ude t est i mony

t hat woul d ot her wi se" hel p t he f act f i nder "under st and a

f act i n i ssue, si mpl y because the exper t does not have t he

speci al i zat i on" t hat t he j udges t hi nk "most appr opr i at e. "

Pags- Ram r ez v. Ram r ez- Gonzl ez, 605 F. 3d 109, 114 ( 1st

Ci r . 2010) ( i nt er nal quot at i on mar ks omi t t ed) ; see al so

Ral st on v. Smi t h & Nephew Ri char ds, I nc. , 275 F. 3d 965, 970

( 10t h Ci r . 2001) ( expl ai ni ng t hat so l ong as t he exper t

keeps " wi t hi n t he r easonabl e conf i nes of [ her ] subj ect ar ea,

. . . a l ack of speci al i zat i on does not af f ect t he


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admi ssi bi l i t y of [ her ] opi ni on, but onl y i t s wei ght "

( i nt er nal quot at i on mar ks omi t t ed) ) .

Al so, an exper t need not have epi demi ol ogi cal st udi es at

t he r eady t o get her opi ni on i n. See Mi l war d, 639 F. 3d at

24 ( hol di ng t hat " [ e] pi demi ol ogi cal st udi es ar e not per se

r equi r ed as a condi t i on of admi ssi bi l i t y r egar dl ess of

cont ext " ) ; see al so Dauber t , 509 U. S. at 593 ( expl ai ni ng

t hat "[ p] ubl i cat i on . . . i s not a si ne qua non of

admi ssi bi l i t y" ) .

And an opi ni on, by the way, does not have t o concl usi vel y

pr ove causat i on t o be admi ssi bl e. " [ M] edi cal knowl edge, "

we can al l agr ee, " i s of t en uncer t ai n. The human body i s

compl ex, et i ol ogy i s of t en uncer t ai n, and et hi cal concer ns

of t en pr event doubl e- bl i nd st udi es cal cul at ed t o est abl i sh

st at i st i cal pr oof . " Uni t ed St at es v. Sandoval - Mendoza, 472

F. 3d 645, 655 ( 9t h Ci r . 2006) . But t hat "does not pr ecl ude

t he i nt r oduct i on of medi cal exper t opi ni on t est i mony when

medi cal knowl edge per mi t s t he asser t i on of a r easonabl e

opi ni on. " I d. ( i nt er nal quot at i on mar ks omi t t ed) .

Cr i t i cal l y t oo, deci di ng "whi ch of sever al compet i ng

sci ent i f i c t heor i es has t he best pr ovenance" i s none of t he

j udges' busi ness whi ch i s j ust anot her way of sayi ng t hat


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j udge' s or der ) i s f i l l ed wi t h er r or s. And t hese er r or s r i se t o

t he l evel of an abuse of di scr et i on.

Take t he di st r i ct j udge' s f i xat i on on her sayi ng t hat

she was "not an epi demi ol ogi st " and "not a r esearcher . " Ti me and

agai n we have sai d t hat one "need not be a speci al i st i n a

par t i cul ar medi cal di sci pl i ne t o r ender exper t t est i mony rel at i ng

t o t hat di sci pl i ne. " Gaydar v. Soci edad I nst i t ut o Gi neco

Qui r ur gi co y Pl ani f i caci on Fami l i ar , 345 F. 3d 15, 24 ( 1st Ci r .

2003) ; see al so Pags- Ram r ez, 605 F. 3d at 116- 17. And not onl y

have we t al ked t he tal k, but we have wal ked t he wal k r eversi ng

as an abuse of di scr et i on exper t - excl usi on r ul i ngs premi sed on an

exper t ' s mi ssi ng t he t ype of speci al i zat i on t he j udges t hi nk

necessary, even t hough the t est i mony woul d have hel ped t he j ur y

under st and a di sput ed i ssue. See, e. g. , Pags- Ram r ez, 605 F. 3d

at 116- 17. And gi ven her t r ai ni ng and exper i ence don' t f or get ,

( a) her boar d cer t i f i cat i on i n pr event i ve medi ci ne shows she has

competency i n epi demi ol ogy and r esearch i nt o causes of di sease,

and ( b) she anal yzes speci f i c- causat i on i ssues as a r out i ne par t

of her j ob t he j udge' s r ul i ng f aul t i ng Dr . But l er f or not bei ng

abl e t o "eval uat e t he r el evant st udi es" wi t h t he " r i gor " of an

epi demi ol ogi st f i t s t hat cat egor y of er r or . The maj or i t y t r i es t o

downpl ay t he di st r i ct j udge' s comment s about her not bei ng an

epi demi ol ogi st by pl ayi ng up how concer ned he was wi t h her

"unwi l l i ng[ ness]" t o anal yze t he "conf l i cti ng" l i t er at ur e. But


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t he f act r emai ns t hat t he j udge di d add her non- epi demi ol ogi st

st at us t o hi s deci si onal mi x, whi ch ( f or t he r easons j ust

di scussed) i s an abuse of di scr et i on, pl ai n and si mpl e.

Now, as f or t he j udge' s bel i ef shar ed by t he maj or i t y

t hat Dr . But l er "pr of essed [ an] i nabi l i t y t o engage wi t h t he

conf l i ct i ng epi demi ol ogi cal l i t er at ur e, " t her e ar e pr obl ems

gal or e.

For st ar t er s, I espy no conf l i ct . To r epeat a poi nt I

made a f ew paragr aphs ago: The st udi es Dr . But l er r el i ed on show

t hat benzene- exposur e l evel s bel ow t he 25. 6 ppm- years endur ed by

Br i an can cause l eukemi a. The Ri nsky st udy t he supposedl y

"conf l i ct i ng" s t udy al so shows t hat benzene exposur e at cer t ai n

l evel s can cause l eukemi a, t hough t he aut hors f ound no i ncr eased

r i sk of l eukemi a among workers exposed t o l ess t han 40 ppm- years

of benzene. Accor di ng t o t he di st r i ct j udge, because t he Ri nsky

st udy di d not f i nd any i ncr eased r i sk of l eukemi a at l ower exposur e

l evel s, t her e i s a "conf l i ct " and "debat e wi t hi n t he

epi demi ol ogi cal l i t er at ur e" t hat can onl y be put t o r est by someone

wi t h epi demi ol ogi st cr edent i al s. Not onl y di d t he j udge get t he

epi demi ol ogi st - credent i al s par t wr ong ( as I j ust not ed) ; he got

t he "conf l i ct " par t wr ong t oo. For a t r ue conf l i ct t o exi st , t he

Ri nsky st udy woul d have to show t hat benzene- exposur e l evel s of


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25. 6 ppm- year s or l ower cannot cause l eukemi a. And t he Ri nsky

st udy does no such t hi ng.

Anyhow, even assumi ng t her e i s a conf l i ct , t he j udge

st i l l er r ed i n t wo i mpor t ant ways. For one t hi ng, despi t e what

t he j udge sai d, Dr . But l er har dl y copped t o bei ng unabl e to engage

wi t h t he l i t er at ur e. By my l i ght s, t he j udge coul d onl y say what

he sai d by mi sr eadi ng her deposi t i on. Quest i oned ( r ecal l ) by

def ense counsel about whether she " i nt ended i n t hi s case to wei gh

t he di f f er ent epi demi ol ogi cal st udi es and of f er an opi ni on as t o

whi ch ones we shoul d r el y on and whi ch ones we shoul d di scount , "

Dr . But l er sai d, "No. " That i s because, she st r essed, ( a) one

need not r el y j ust "on l i t er at ur e" and ( b) her exper i ence wi t h

"bi ol ogy, " " pat hophysi ol ogy, " and " t he di sease pr ocess" pr ovi ded

t he speci al i zed knowl edge t o suppor t her speci f i c- causat i on

t est i mony. St at ement s ( a) and ( b) squar e wi t h our casel aw. See,

e. g. , Mi l war d, 639 F. 3d at 24 ( emphasi zi ng how " [ e] pi demi ol ogi cal

st udi es ar e not per se r equi r ed as a condi t i on of admi ssi bi l i t y") .

And j ust as i mpor t ant l y, not hi ng she sai d t her e i nt i mat ed even a

possi bl e whi sper of a hi nt of a suggest i on t hat she coul d not t ake

on t he r el evant l i t er at ur e. Put di f f er ent l y, she di d not say t hat

she l acks t he know- how t o assess Rust - Ol eum' s pref er r ed st udi es

onl y t hat she di d not need t o i n f or mul at i ng her exper t opi ni on.


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The wor d " i nt end" I hope we can al l agr ee does not i mpl y

"can' t . "

For anot her t hi ng, despi t e what t he j udge i ndi cat ed,

nei t her Dr . But l er nor t he Mi l war ds had any bur den t o expl ai n why

t he Ri nsky st udy i s wr ong. Thi nk back t o t he pr i mer : The

pr oponent s of exper t t est i mony, I not ed, ar e not r ef l exi vel y

obl i ged t o "di scr edi t " a st udy pushed by t hei r opponent s. Kuhn

a case hi ghl i ght ed by t he maj or i t y says as much. Sur e, t he

pl ai nt i f f s' exper t t her e t r i ed t o poke hol es i n a st udy r el i ed on

by t he def endant s. And, deemi ng t he cr i t i ci sms i nsubst ant i al , t he

j udge excl uded t he exper t f r om t est i f yi ng. Si gni f i cant l y f or

pr esent pur poses, t hough, t he ci r cui t cour t wr ot e t hat t he exper t

di d not have t o debunk t he st udy; he onl y had t o show t hat he

r eached hi s concl usi on vi a a sound methodol ogy. 15 See Kuhn, 686

F. 3d at 626. Dr . But l er di d t hat i n spades, usi ng t wo r ecogni zed

t echni ques f or i dent i f yi ng causes ( r el at i ve r i sk and di f f er ent i al

di agnosi s) and r el yi ng i n par t on st udi es t hat ( as best I can t el l )

nei t her t he di st r i ct j udge nor t he maj or i t y has any pr obl ems wi t h.

15 So i nst ead of suppor t i ng t he maj or i t y' s posi t i on t hat Dr .But l er had t o expl ai n why she di sagr eed wi t h " i ncompat i bl e"st udi es, Kuhn r ej ect s t hat posi t i on. And Nor r i s anot her caseci t ed by the maj or i t y i s not a di f f er ence maker f or t he maj or i t yei t her . The cour t t her e uphel d t he excl usi on of exper t t est i monybecause t he exper t s di d not conf r ont t he r eal i t y t hat t hei ropi ni ons wer e "f l at l y cont r ar y t o al l of t he avai l abl eepi demi ol ogi cal evi dence, " see 397 F. 3d at 885- 86 whi ch i s wor l dsapar t f r om our case.


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And havi ng met her bur den, a j ur y shoul d get t o deci de whi ch

st udi es t o bel i eve ( her s or Rust - Ol eum' s) , i f any, see i d. j ust

l i ke a j ur y woul d get t o do i f f aced wi t h duel i ng exper t s ( i nst ead

of duel i ng st udi es) , see Fel i ci ano- Hi l l , 439 F. 3d at 25.

Summing Up

Because, as di scussed, t he j udge made ser i ous j udgment

er r or s i n excl udi ng Dr . But l er ' s exper t t est i mony a r ul i ng ( i n

my vi ew) i nconsi st ent wi t h t he " l i ber al t hr ust of t he Feder al Rul es

and t hei r gener al appr oach of r el axi ng t he t r adi t i onal bar r i er s t o

' opi ni on' t est i mony, " see Dauber t , 509 U. S. at 588 I woul d

r ever se hi s rul i ng as an abuse of di scr et i on. And because t he

maj or i t y, t hough consci ent i ous, has deci ded ot her wi se, I

r espect f ul l y but unequi vocal l y di ssent .

Documents

Milward v. Rust-Oleum Corp., 1st Cir. (2016)