ATLANTA (Legal Newsline) - A trial judge was correct to bar two physicians from testifying in a lawsuit over the death of a man who contracted an “ultra-rare” case of severe malaria after visiting Africa, a Georgia appeals court ruled, rejecting arguments the doctors could tell jurors the patient would have lived with different treatment.
Drs. Lisa Fowlkes and Cynthia Cooper are both internal medicine doctors working as hospitalists, or specialists in inpatient care. They were hired to provide expert opinions in a lawsuit by Maisha K. Humphrey over the death of Ronald Glenn Humphrey II.
Ronald Humphrey went to Emory St. Joseph’s Emergency Room on Dec. 8, 2018, shortly after returning from a trip to Benin. He had headache, fever, chills and body aches and suspected malaria, which a test confirmed. The ER consulted by phone with Dr. Juliana da Silva, an infections disease expert, who prescribed an oral antimalaria medicine.
Humphrey was admitted to the hospital in “stable” condition and Dr. da Silva examined him on Dec. 9, diagnosing uncomplicated malaria. She attached the criteria for severe malaria from the CDC in her note. Humphery passed to the care of hospitalist Dr. Laura Booth, who examined Dr. da Silva’s notes and ordered additional tests, which showed worsening kidney and liver function.
Humphrey’s condition worsened and on Dec. 10 he was admitted to the intensive care unit, where another infectious disease doctor noted a plan for severe malaria based on kidney failure. Humphrey died of multi organ failure on Dec. 11, however.
Drs. Fowlkes and Cooper were prepared to testify that the Emory doctors deviated from the standard of care and Humphey’s death more likely than not could have been avoided had he received intravenous malarial drugs. The trial judge allowed them to testify on the standard care but barred their opinion on the vital question of causation. The judge said they lacked knowledge and experience or active practice or teaching as required under Official Code of Georgia Annotated, or OCGA, governing the admissibility of expert opinions.
Neither expert had ever treated severe malaria and Dr. Fowlkes had seen her last case of uncomplicated malaria 30 years before in residency. Had she been treating Humphrey, the court said, she testified she “would have consulted an infectious disease specialist for assistance.”
The Georgia Court of Appeals court affirmed the exclusion of both causation opinions in a Sept. 6 decision. There was no need to get to knowledge and experience, the appeals court ruled, because “Dr. Fowlkes’s and Dr. Cooper’s causation opinions were not the product of a reliable methodology.”
Dr. Fowlkes didn’t review any peer-reviewed literature on the diagnosis and treatment of malaria and admitted she didn’t read any scientific studies to support her opinions. “Rather, she obtained most of her information from Internet searches,” the court said.
Dr. Cooper also admitted she wasn’t familiar with the criteria for the diagnosis of severe malaria before she was hired as an expert in this case and said she would “defer to infectious disease doctors” on the proper treatment. Neither doctor had any meaningful experience in dealing with a case of severe malaria, which is “ultra-rare” in the United States, the court concluded.