Marcum v. Adventist Health System/West, 345 Or. 237

Summary

The Oregon Supreme Court held that expert medical causation testimony based on a differential diagnosis was scientifically valid and should have been admitted. The court concluded that an expert may rely on the temporal and spatial relationship between a single exposure and immediate, localized symptoms, together with biological plausibility and the exclusion of alternative causes, even without a scientifically established mechanism or high-correlation studies. The court reversed the Court of Appeals' decision concerning the negligence claim and remanded for consideration of alternative arguments regarding the informed-consent claim.

Holdings

1. Expert medical-causation testimony based on a differential diagnosis or differential etiology is admissible when the particular application of that methodology has a scientifically valid basis. Scientific validity does not invariably require a scientifically demonstrable mechanism of causation, epidemiological studies showing a high correlation, or elimination of every alternative cause.
2. The Court of Appeals erred by treating the absence of a scientifically accepted mechanism of causation or independently verified correlation as effectively precluding the expert from ruling in gadolinium extravasation as a potential cause.
3. The directed verdict on plaintiff's negligence claim was improper because the excluded expert testimony should have been admitted and supplied evidence of medical causation.
4. The Supreme Court did not resolve defendants' alternative arguments concerning the directed verdict on the informed-consent claim and remanded that issue to the Court of Appeals for consideration.

Questions Presented

1. Whether plaintiff's expert medical-causation testimony that gadolinium extravasation caused her hand injury satisfied the scientific-validity requirements governing expert scientific evidence under OEC 401, OEC 402, OEC 403, and OEC 702.
2. Whether the trial court properly excluded the expert testimony and directed a verdict for defendants on plaintiff's negligence claim.
3. Whether the directed verdict on plaintiff's informed-consent claim could stand when the Court of Appeals had not considered defendants' alternative arguments supporting that ruling.

Disposition

reversed_and_remanded