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Kindoll v. Southern Health Partners

United States District Court, E.D. Kentucky, Northern Division

March 29, 2019





         This case is a federal civil rights and state-law medical malpractice and negligence action arising from Defendants' alleged failure to provide adequate medical care to Plaintiff Michelle Kindoll after she suffered a stroke while incarcerated at the Grant County Detention Center (GCDC) in May 2016. With discovery complete, four of the eight remaining Defendants-Southern Health Partners, Inc. (SHP), David Watkins, David Ross, and Debbie Preston (collectively the SHP Defendants)-now move to exclude the opinions of two of Plaintiff's expert witnesses, Donald Leach (Doc. # 81) and Lawrence Mendel, DO (Doc. # 82). Neither party has requested a Daubert hearing, and the Court has determined that one is not necessary. The Motions have been fully briefed and are now ripe for review. (Docs. # 87, 88, 93 and 94). For the reasons discussed below, the SHP Defendants' Motion to Exclude the Opinions of Donald Leach (Doc. # 81) is GRANTED IN PART and DENIED IN PART, and the SHP Defendants' Motion to Exclude the Opinions of Lawrence Mendel, DO (Doc. # 82) is DENIED.


         The underlying facts have been discussed in the Court's Memorandum Opinion and Order (Doc. # 103) adjudicating Defendants' dispositive motions, and will not be substantially repeated here. Relevant to the Motions at hand, in the event this matter goes to trial, Plaintiff intends to call Donald Leach and Lawrence Mendel, DO, as expert witnesses.

         Plaintiff's expert disclosure identified Mr. Leach as an expert in corrections, including jail administration, medical care, corrections policies, practices, customs, training, supervision, and incident investigations. (Doc. # 59 at 1). Mr. Leach has a Bachelor of General Studies in Social and Political Theory and a Doctorate in Public Administration. (Doc. # 88-1 at 2). Between 1996 and 2004, Mr. Leach served as the Deputy Director for the Division of Detention at the Fayette County Detention Center in Lexington, Kentucky. (Doc. # 88-1 at 1). With approximately twenty-four years of experience working in the field of corrections, Leach has experience in jail management including issues of security and operations as well as the provision of medical and mental health services. Id. Mr. Leach's testimony will address (1) whether “the Grant County policies, procedures, customs, and practices for delivering medical care and supervising the delivery of medical care to inmates” at the GCDC “in May 2016 [was] consistent with professional correctional standards for the delivery of health care in jails as expected by a reasonable correctional administrator, ” and (2) whether such “policies, procedures, customs, and practices cause[d] any injury to Michelle Kindoll.” (Docs. # 81-2 at 5 and 88-1 at 16).

         Plaintiff's expert disclosure identified Dr. Mendel as an expert in providing medical services within a correctional setting, including the roles of LPNs, RNs, CNPs, and physicians, applicable standards of medical care, and general medicine. (Doc. # 59 at 1-2). Dr. Mendel is board certified in Family Practice, a Fellow of the American College of Correctional Physicians, and a Certified Correctional Healthcare Professional. (Doc. # 82-3 at 1). Dr. Mendel's testimony will address “whether the care and treatment rendered to Michelle Kindoll during her stay at the Grant County Detention Center deviated from acceptable standards of care in recognizing and treating stroke like symptoms and transporting Ms. Kindoll to a hospital where she could receive timely and appropriate treatment.” Id.

         Both Mr. Leach and Dr. Mendel have prepared written reports explaining their opinions in accordance with Rule 26(a)(2)(B) of the Federal Rules of Civil Procedure. (Docs. # 82-3 and 88-1). Likewise, both experts have been deposed. Mr. Leach was deposed on July 24, 2018 (Doc. # 88-3), and Dr. Mendel was deposed on August 16, 2018 (Doc. # 82-2).

         III. ANALYSIS

         A. Standard of Review

         The admissibility of expert testimony is governed by Rule 702 of the Federal Rules of Evidence. Rule 702 provides that “[a] witness who is qualified as an expert by knowledge, skill, experience, training, or education may testify in the form of an opinion or otherwise” if the witness meets four conditions. Fed.R.Evid. 702. First, “the expert's scientific, technical, or other specialized knowledge” must “help the trier of fact to understand the evidence or to determine a fact in issue.” Id. Second, the expert's testimony must be “based on sufficient facts or data.” Id. Third, the expert's testimony must be “the product of reliable principles and methods.” Id. Finally, the expert must have “reliably applied the principles and methods to the facts of the case.” Id. In sum, expert testimony is admissible under Rule 702 if the expert is qualified, the testimony is reliable, and the evidence is relevant and helpful to the jury. Scott v. Deerbrook Ins. Co., 714 F.Supp.2d 670, 673 (E.D. Ky. 2010) (citing United States v. Jones, 107 F.3d 1147, 1156 (6th Cir. 1997)). The decision to admit or exclude expert testimony “ultimately lies in a fact-intensive analysis that is particular to each circumstance and subject to the discretion of the trial court.” Scott, 714 F.Supp.2d at 673 (citing Kumho Tire Co., Ltd. v. Carmichael, 526 U.S. 137, 149-51 (1999)). The proponent of the testimony bears the burden of establishing admissibility, which must be shown by a preponderance of the evidence. See Nelson v. Tenn. Gas Pipeline Co., 243 F.3d 244, 251 (6th Cir. 2001).

         B. Motion to Exclude the Opinions of Donald Leach

         Plaintiff's expert disclosure identified Mr. Leach as an expert in corrections, including jail administration, medical care, corrections policies, practices, customs, training, supervision, and incident investigations. (Doc. # 59 at 1). The SHP Defendants do not challenge Leach's qualifications to offer opinions regarding their co-Defendants, Grant County, the GCDC Jailer Christopher Hankins, and his deputy jailers. (Doc. # 94 at 1). However, as to Leach's opinions regarding the SHP nurses who assessed Plaintiff at the GCDC-Defendants Debbie Preston, David Ross, and David Watkins-the SHP Defendants argue that Plaintiff is trying to bring in medical opinions under the guise of corrections opinions. Id. Defendants assert that, as a corrections expert with a doctoral degree in public administration, Leach is unqualified to provide medical opinions because he “does not know the scope of practice for nurses in Kentucky and has no medical education, training, or experience upon which to evaluate whether the medical decisions made by the nurses involved in this case were reasonable.” (Doc. # 81-1 at 5-6). Defendants argue, therefore, that a portion of Leach's testimony and opinions must be excluded because they are not based on Leach's “knowledge, skill, expertise, training or education” within the scope of Rule 702. Further, the SHP Defendants argue that such opinions are speculative, not helpful to the trier of fact, “or are otherwise inadmissible under Federal Rules of Evidence 401, 402, and 403.” (Doc. # 81-1).

         At his deposition, Leach conceded that he does not have the expertise and training to testify as to the opinions of an expert medical provider and that he has never been qualified as an expert to testify regarding whether a medical professional failed to meet the medical standard of care. Rather, he has only testified as to “that which is expected by a reasonable correctional administrator.” (Doc. # 81-2 at 5). Likewise, Leach admitted that the standard of care in how a nurse should or should not act under a set of particular circumstances is not within his expertise. (Doc. # 81-2 at 6).

         The SHP Defendants therefore conclude that any opinion Leach offered at trial “regarding whether the actions or inactions of Nurses Ross, Preston and Watkins were appropriate under the circumstances” would constitute improper standard-of-care opinion testimony. (Doc. # 81-1 at 5). Defendants argue that Mr. Leach's testimony and written report regarding the nurses' (1) alleged failure to provide an acceptable level of medical care at the GCDC, (2) failure to provide timely access to medical care, and (3) inappropriate nursing practices would also be improper opinion testimony. (Doc. # 81-1 at 2).

         Pointing to pages twenty-nine through thirty-six of Leach's expert report, the SHP Defendants object to six portions of Leach's report that they say contain six opinions that improperly go to the standard of care for the medical staff at GCDC. See (Docs. # 81-1 and 94) (citing Doc. # 81-2). The Court will address each opinion in turn.

         1. Leach's opinion regarding the gatekeeping function of nursing staff at the GCDC is admissible.

         First, the SHP Defendants object to Leach's opinion that the facility nurse practitioner or physician should have been more involved in Plaintiff's evaluation. Specifically, Defendants object to Leach's statements set forth in his report that (1) the Defendant nurses did not “escalate[] their assessment [of Plaintiff] to a more qualified provider . . . for evaluation and medical care decisions, ” and (2) that “with [a] greater primary care practitioner (such as Dr. Amos or [Nurse Practitioner] Roy Washington) on-site[, ] supervision of the nursing staff could have identified the medical crisis Ms. Kindoll was experiencing.” (Doc. # 81-3 at 1). Defendants argue that opinions about what the medical staff should have done-what a reasonable medical professional would do under the same or similar circumstances-are medical opinions that apply to the standard of care of medical staff, not of correctional staff.

         In response, Plaintiff argues that the SHP Defendants' characterization of Leach's opinion is overstated. While Leach discusses the actions of the SHP nurses, Plaintiff asserts that Leach's opinion focuses upon the jail administrator's duty to ensure adequate provision of medical care. Leach's opinion regarding SHP focuses upon whether the medical services provided by SHP met SHP's commitments under its ...

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