Cella v. U.S.

• Decision Date: 06 August 1993
• Docket Number: Nos. 92-1826,92-1842,s. 92-1826
• Citation: 998 F.2d 418
• Parties: , 37 Fed. R. Evid. Serv. 1229 Edward C. CELLA, II, Plaintiff-Appellee and Cross-Appellant, v. UNITED STATES of America, Defendant-Appellant and Cross-Appellee.
• Court: U.S. Court of Appeals — Seventh Circuit

Page 418

998 F.2d 418

1994 A.M.C. 1212, 37 Fed. R. Evid. Serv. 1229

Edward C. CELLA, II, Plaintiff-Appellee and Cross-Appellant, v. UNITED STATES of America, Defendant-Appellant and Cross-Appellee.

Nos. 92-1826, 92-1842.

United States Court of Appeals, Seventh Circuit.

Argued Feb. 16, 1993.

Decided June 23, 1993.

Rehearing and Suggestion for Rehearing En Banc Denied Aug.

6, 1993. ^*

Dennis H. Geisleman, Myers & Geisleman, Fort Wayne, IN and Terry A. Bell (argued), Belle Chasse, LA, for Edward C. Cella, II, Plaintiff.

John F. Hoehner, U.S. Atty., Office of the U.S. Atty., Dyer, IN; David H. Miller, Asst. U.S. Atty., Office of the U.S. Atty.; Thomas M. Moorhead (argued), Douglas Dormire Powers, Baker & Daniels, Fort Wayne, IN; David V. Hutchinson, Dept. of Justice, Torts Branch, Civ. Div., Washington, DC; and Cary Wiener, Kirlin, Campbell & Keating, New York City, for the U.S. defendant.

Before BAUER, Chief Judge, FLAUM, Circuit Judge, and WILL, Senior District Judge. ^**

WILL, Senior District Judge.

This case involves an appeal by defendant United States from the district court's judgment finding liability based on negligence under the Jones Act, 46 U.S.C.App. § 688, and awarding damages in the amount of $858,654.00 to plaintiff Edward C. Cella, II. Plaintiff Cella also cross-appeals from the district court's determination of damages. According to the defendant, "[t]his appeal presents an opportunity to forestall the 'junk science' litigation in this circuit." Appellant's Br. at 9. Because we regard that as a mischaracterization of this case and for the reasons stated below, we respectfully decline the defendant's invitation and affirm the ruling of the district court.

I. BACKGROUND

In April 1987, plaintiff Edward C. Cella, II was hired through the Seafarers International Union to work aboard the U.S.N.S. Hess ("Hess"), a Navy vessel, for thirty days as the chief cook in the steward's department. Although Cella was fit for duty at the time that he boarded the Hess, he suffered four separate incidents of physical injury during the trip: (1) Cella injured his lower back during the downloading of approximately four pallets of stores from the dock onto the ship; (2) Cella burned his hand when he lifted a twenty-quart pot filled with spaghetti sauce and the simmering sauce spilled onto his hand (because the pot's handle was coated with melted butter); (3) Cella struck his head twice and fell on his buttocks when the vessel under her own power broke the mooring lines tied to the dock; and (4) Cella injured his lumbar spine while lifting approximately ninety pounds of pot roast out of the oven after other crew members refused to help him.

Cella did not seek professional medical treatment for certain of these injuries and treated himself for others. Following the fourth incident, however, Cella claimed that he experienced excruciating pain throughout his body and was confined to the ship's sick bay until the end of the trip.

In addition to these incidents of physical injury, Cella also experienced emotional stress arising out of racial tensions on the Hess and received from other crew members threats of physical violence. For example, certain black members of the crew refused to take orders from Cella, called him names, refused generally to cooperate with him, allegedly burglarized his room, and repeatedly threatened his life.

Upon disembarkment from the Hess in May 1987, Cella consulted several doctors regarding his chronic back pain and fatigue, then returned home to Fort Wayne, and was eventually referred to Dr. Louis Romain, a licensed medical physician who had specialized in neurology since 1971. After taking a complete medical history of the plaintiff, Dr. Romain performed a full neurological examination, conducted a series of tests to rule out various possible diagnoses, and directed two muscle biopsies to be taken and sent out for laboratory analysis. Repeated testing revealed that certain of Cella's muscle enzymes were greatly elevated. The biopsy results suggested that the plaintiff suffered from focal chronic interstitial myositis. After reviewing these test results in light of his examination and history of Cella, Dr. Romain became convinced that Cella suffered from an inflammatory process of the muscles, a type of myositis involving both the upper and lower extremities--that is, polymyositis. ¹

Although Dr. Romain recognized that the generally-accepted medical dogma identifies polymyositis as an idiopathic disorder, he had heard of cases of polymyositis being secondary to trauma and believed that Cella's polymyositis-like condition might have been From the medical literature search, Dr. Romain concluded first, that cases of polymyositis are heterogenous in origin; and second, that among the documented cases there was always a consistent but somewhat low percentage of cases in which some type of severe emotional or physical stress seemed to have etiological importance. ² Dr. Romain further believed that an experimental model with marathon runners which revealed a link between physical stress and elevated enzymes supported his conclusion that physical stress and trauma caused Cella's polymyositis condition. ³

                brought on by the events that occurred aboard the Hess.   To test his theory, Dr. Romain conducted an extensive search of medical literature to ascertain whether there were documented cases that would support his belief that Cella's disorder was caused by the trauma and stress to which the plaintiff was subjected while aboard the Hess
                

In addition to citing the occasional incidence of trauma, the medical literature considered by Dr. Romain addressed genetic factors, viral infections, vaccinations, certain tropical diseases, and systemic lupus erythematosus as other possible causes of polymyositis. However, through his physical examination of the plaintiff, extensive neurological testing of the plaintiff, and careful review of the plaintiff's medical history, Dr. Romain was able to exclude each of these factors as the potential cause of Cella's condition. Through his elimination of these other possible causes and his medical literature research revealing a causal relation between trauma and documented polymyositis cases, Dr. Romain concluded that the plaintiff's polymyositis-like condition was caused by the trauma arising from the events aboard the Hess. He prescribed prednisone treatment and physical therapy, which apparently stabilized the plaintiff's condition.

Plaintiff Cella then brought this action against defendants for damages for personal injuries under 28 U.S.C. § 1333, under the Jones Act, 46 U.S.C.App. § 688, under the Suits in Admiralty Act, 46 U.S.C.App. § 741, et seq., and under general maritime law. At trial, Dr. Romain testified that it was his opinion within a reasonable degree of medical certainty that Cella's polymyositis-like condition was caused by the trauma and physical stress that he experienced while aboard the Hess. 9/11/90 Tr. at 36-37, 75. The medical literature relied upon by Dr. Romain to establish the causal connection between trauma and polymyositis was entered into evidence. Several other medical experts testified that polymyositis is an idiopathic disorder and that there is at this time no known definite The district court reviewed all of the medical literature and expert medical testimony introduced at trial and found that "there is no inherent conflict between the general conclusions of these articles regarding the etiology of polymyositis and Dr. Romain's clinical diagnosis in this case, that plaintiff's condition was caused by the events complained of on the Hess." Memorandum Opinion and Order, 825 F.Supp. 1383, 1394 n. 19 (N.D.Ind.1991). Based on this evidence, the district court found "by a preponderance of the evidence that [Cella's] condition was, in fact, caused by the trauma and emotional stress that the plaintiff suffered aboard the Hess." Id. at 1395 (footnote omitted). The district court also noted that evidence regarding Cella's past medical history, including symptoms such as elevated enzymes in the early 1980s, clearly raised the suspicion that he may have been afflicted with polymyositis prior to the trip on the Hess. Id. at 1395 n. 20. The court nonetheless concluded that

                etiology of polymyositis.   9/10/90 Tr. at 188 (testimony of Dr. Pan);  9/13/90 Tr. at 186, 189 (testimony of Dr. Wissman);  9/14/90 Tr. at 8 (testimony of Dr. Kincaid).   At least one of these experts, however, further acknowledged that trauma has been identified as a possible cause of polymyositis.   9/10/90 Tr. at 178 (testimony of Dr. Pan).   The defendant also offered as evidence several medical articles which stated that the etiology of polymyositis is unknown. 4
                

even if the plaintiff was afflicted with polymyositis prior to 1987, he was completely asymptomatic at the time he entered into service upon the Hess; the events complained of upon the Hess clearly aggravated plaintiff's condition, caused him to become symptomatic, and proximately caused his current condition which has deteriorated continuously since his service on the Hess.

Id.

Accordingly, the district court found that Cella's polymyositis was either caused or aggravated by the actual physical injuries and threats of physical violence which he suffered aboard the Hess such that he was entitled to damages under a Jones Act theory of employer negligence. Id. at 1404-05. The court also determined that Cella was contributorily negligent in the amount of 40%, that Cella's life expectancy was reduced by 50%, that he had reached maximum recovery on February 15, 1989, so as not to be entitled to seaman's maintenance and cure, and thus awarded Cella a total of $868,654.00 in its amended judgment issued on February 12, 1992.

II. ANALYSIS

The defendant United States raises three issues on appeal: whether the admission of Dr. Romain's expert opinion testimony violates Federal Rule of Evidence 703; whether...