Statutory Interpretation – FTCA – Expert Testimony

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7^th Circuit Court of Appeals

Case Name: Billie Vargas Love v. United States of America

Case No.: 20-3534

Officials: EASTERBROOK, MANION, and WOOD, Circuit Judges.

Focus: Statutory Interpretation – FTCA – Expert Testimony

Louis Vargas received extensive medical care from the Veterans Administration. He argues in this suit under the Federal Tort Claims Act, 28 U.S.C. §§ 2671–80, that a nurse employed by the VA was negligent in failing to order additional tests after receiving the results of a urinalysis in October 2015. More testing, Vargas contended, would have revealed that he suffered from a urinary tract infection. He continues: Failure to diagnose that infection led to a heart attack, which led to extended hospitalization, which led to pain and inflammation caused by the catheters inserted into his hands during this stretch in the hospital.

The district court held a bench trial and ruled against Vargas on all of his principal contentions. Vargas v. United States, 430 F. Supp. 3d 500 (N.D. Ill. 2019), motion for a new trial denied, 2020 U.S. Dist. LEXIS 220349 (Nov. 24, 2020). The judge found that further testing to identify a potential urinary tract infection was not required by the appropriate standard of care, given the judge’s finding that no other indication of infection was present. The results that Vargas contended implied a need to search for an infection were consistent with benign prostate hypertrophy (an enlarged prostate), for which Vargas had been treated since 2004.

On appeal Vargas contests some of the important factual findings, but none is clearly erroneous. (Vargas died after the district court’s opinion was issued, and the appeal is being prosecuted by the administrator of his estate. We refer to the appellant as “Vargas” for clarity.) Vargas’s principal appellate arguments concern expert evidence.

The doctrine on which Vargas relies—one under which medical professionals must stay within the scope of their expertise, see, e.g., Sullivan v. Edward Hospital, 209 Ill. 2d 100, 113–15 (2004)—is designed to ensure that judges and juries rely on properly supported testimony. So, for example, a nurse practitioner could not testify in Illinois to the standard of care by a urologist; medical doctors have greater knowledge than nurses on matters within their specialties. Federal courts would reach the same conclusion under Rule 702. But the doctrine need not work in reverse. Coogan testified that even a board-certified urologist would not have seen anything in the October 2015 test result calling for further lab work. If that is a correct statement of the medical standard of care at the highest level—and the district judge found that it is—then a nurse practitioner’s identical decision cannot be negligent. Illinois does not hold nurses to the higher standard of specialists; but when the standard of specialists has been met, a nurse cannot be blamed for a bad outcome. None of Vargas’s remaining arguments requires discussion.

Affirmed

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Derek A Hawkins is Corporate Counsel, at Salesforce.