[PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
FILED
________________________ U.S. COURT OF APPEALS
ELEVENTH CIRCUIT
JUNE 24, 2002
No. 01-11965 THOMAS K. KAHN
________________________ CLERK
D. C. Docket No. 95-03068-CV-TWT-1
BONNIE JOYCE RIDER,
WALTER ANTHONY RIDER, her spouse,
Plaintiff-Appellants,
versus
SANDOZ PHARMACEUTICALS CORPORATION,
a Delaware Corporation, SANDOZ LTD., a Swiss Corp.,
SANDOZ PHARMA LTD., a Swiss Corporation,
Defendants-Appellees.
________________________
No. 01-11966
________________________
D. C. Docket No. 95-00965-CV-TWT-1
BRIDGET GUTHRIE SIHARATH,
Plaintiff-Appellant,
versus
SANDOZ PHARMACEUTICALS CORPORATION,
a Delaware Corporation,
Defendant-Appellee.
________________________
Appeals from the United States District Court
for the Northern District of Georgia
_________________________
(June 24, 2002)
Before ANDERSON, HULL and RONEY, Circuit Judges.
RONEY, Circuit Judge:
This case involves an issue that has repeatedly come before federal courts:
whether expert testimony purporting to link the drug Parlodel with hemorrhagic stroke
is admissible to prove causation. Bridget Siharath and Bonnie Rider (plaintiffs)
brought this action, alleging that their postpartum hemorrhagic strokes were caused
by ingestion of Parlodel. Defendant Sandoz Pharmaceuticals Company (Sandoz),
maker of Parlodel, moved to suppress the testimony of the plaintiffs’ expert witnesses
and for summary judgment. The district court held that the plaintiffs’ expert
testimony was not sufficiently reliable to meet the standards established by Daubert
v. Merrell Dow Pharm., 509 U.S. 579 (1993), and granted summary judgment in favor
of Sandoz. Plaintiffs appeal. We affirm.
At the outset, we should point out that this decision does not affirm the
interpretation that the appellants and some of the amici give to the district court’s
opinion at Siharath v. Sandoz Pharm. Corp., 131 F. Supp. 2d 1347 (N.D. Ga. 2001).
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The appellants argue that the district court did not follow the law as prescribed by the
Daubert trilogy, as hereafter set forth, misunderstood the scientific basis for the
opinions sought to be introduced by plaintiffs, and overlooked critical evidence. In
our judgment this is a grossly distorted understanding of the decision of the district
court and is unsupported in the record. This opinion should be read with the
understanding that in our view, with due consideration of alleged incidental problems
with the opinion itself, the district court correctly applied the principles established
in the Daubert trilogy, without modification, and considered all of the voluminous
evidence in the record and all of the evidence taken at a three-day hearing, whether
or not specifically mentioned in the opinion. The district court was unable to find
sufficiently reliable scientific evidence to support a decision that bridged the gap
between the conclusion that Parlodel caused other injuries, which might include
ischemic stroke, and the conclusion that Parlodel was a probable cause of the
hemorrhagic strokes suffered by plaintiffs. We have reviewed the opinion, noted a
problem or two with the opinion itself, considered the arguments in the briefs of both
appellants and amici, and reviewed the record, and conclude that under an unmodified
application of the Daubert trilogy, a proper consideration of every piece of evidence
offered, and a study of the expert opinions themselves, the district court did not abuse
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its discretion in denying the admission of the testimony of the five expert witnesses
offered by the plaintiffs to prove causation in this case.
I. Background
Bridget Siharath and Bonnie Rider both took the drug Parlodel to suppress
lactation after childbirth. The active ingredient in Parlodel is bromocriptine, an ergot
alkaloid compound. Both women subsequently suffered hemorrhagic strokes.
Siharath and Rider filed suit against Sandoz, alleging that Parlodel caused their
hemorrhagic strokes. After discovery, Sandoz moved, in limine, to exclude the
opinions and testimony of the plaintiffs’ experts on causation, and for summary
judgment. Because the motions, documentary evidence, experts, and issues were the
same in both cases, the district court addressed the motions together. The district
court held a Daubert hearing to determine whether the evidence was admissible.
The district court, in a three-day hearing, examined the evidence presented in
great detail and found that the plaintiffs’ claims were based on speculation and
conjecture rather than the scientific method. The court drew a careful distinction
between clinical process, in which conclusions must be extrapolated from incomplete
data, and the scientific method, in which conclusions must be drawn from an accepted
process, and concluded that the plaintiffs’ experts were relying on the former.
Accordingly, the district court excluded the evidence and granted summary judgment
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in favor of Sandoz. A detailed summary of the facts is fully set forth in the published
district court opinion, Siharath v. Sandoz Pharm. Corp., 131 F. Supp. 2d 1347 (N.D.
Ga. 2001). This appeal followed.
II. The Legal Standard
Toxic tort cases, such as this one, are won or lost on the strength of the
scientific evidence presented to prove causation. For many years the standard for
admissibility of such evidence was the “general acceptance” test set forth in Frye v.
United States, 293 F. 1013 (D.C. Cir. 1923). When the Federal Rules of Evidence
were enacted in 1975, a question arose as to whether the “general acceptance” test had
been supplanted by the reliability test articulated in Rule 702. The question was
resolved in three cases decided by the Supreme Court. Daubert v. Merrell Dow
Pharm., 509 U.S. 579 (1993); Gen. Elec. Co. v. Joiner, 522 U.S. 136 (1997); Kumho
Tire Co., Ltd. v. Carmichael, 526 U.S. 137 (1999). These cases are commonly
referred to as the Daubert trilogy.
Since Daubert, courts are charged with determining whether scientific evidence
is sufficiently reliable to be presented to a jury. The Daubert court made it clear that
the requirement of reliability found in Rule 702 was the centerpiece of any
determination of admissibility. 509 U.S. at 589. The Supreme Court identified four
factors used to determine the reliability of scientific evidence: 1) whether the theory
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can and has been tested; 2) whether it has been subjected to peer review; 3) the known
or expected rate of error; and 4) whether the theory or methodology employed is
generally accepted in the relevant scientific community. Id at 593-94.
In Joiner, the Supreme Court established the standard for reviewing trial court
rulings of admissibility, and held that such rulings would be made under an abuse of
discretion standard. 522 U.S. at 517. The Joiner court also established the important
test of analytical “fit” between the methodology used and the conclusions drawn. Id
at 519. The court reasoned that just because a methodology is acceptable for some
purposes, it may not be acceptable for others, and a court may not admit evidence
when there is “simply too great an analytical gap between the data and the opinion
proffered.” Id.
In Kumho Tire, the Supreme Court made it clear that testimony based solely on
the experience of an expert would not be admissible. 526 U.S. at 157. The expert’s
conclusions must be based on sound scientific principles and the discipline itself must
be a reliable one. Id at 156. The key consideration is whether the expert “employs
in the courtroom the same level of intellectual rigor that characterizes the practice of
an expert in the relevant field.” Id. The court emphasized that judges have
considerable leeway in both how to test the reliability of evidence and determining
whether such evidence is reliable. Id at 151-53.
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The Daubert trilogy, in shifting the focus to the kind of empirically supported,
rationally explained reasoning required in science, has greatly improved the quality
of the evidence upon which juries base their verdicts. Although making
determinations of reliability may present a court with the difficult task of ruling on
matters that are outside of its field of expertise, this is “less objectionable than
dumping a barrage of scientific evidence on a jury, who would likely be less equipped
than the judge to make reliability and relevance determinations.” Allison v. McGhan
Med. Corp., 184 F.3d 1300, 1310 (11th Cir. 1999). The district court did not abuse
its discretion in holding that the evidence presented by plaintiffs’ experts does not
meet the standard of reliability.
III. The Plaintiffs’ Theory of Causation
Plaintiffs sought to introduce the testimony of five experts. All five possessed
impressive credentials and were found to be well qualified by the district court, three
over the defendants’ objection. For a summary of the experts’ credentials and
qualifications, see the district court opinion, Siharath, 131 F. Supp. 2d at 1352-54.
Two of the experts, Doctors Kulig and Dukes, testified at the Daubert hearing. The
experts presented a detailed argument for the cause of the plaintiffs’ hemorrhagic
strokes that may be summarized as follows:
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1) The active ingredient in Parlodel is bromocriptine, a member of the class of
drugs known as ergot alkaloids.
2) Other ergot alkaloids can cause vasoconstriction, which suggests that
bromocriptine causes vasoconstriction.
3) Animal studies also suggest that bromocriptine causes vasoconstriction.
4) Vasoconstriction can cause high blood pressure and ischemic stroke (stroke
caused by decreased blood flow to the brain).
5) If vasoconstriction and high blood pressure can cause ischemic stroke, it can
also cause hemorrhagic stroke (stroke caused by a rupturing of a blood vessel).
6) Thus, Parlodel caused the plaintiffs’ hemorrhagic strokes.
IV. The Evidence Presented
The scientific evidence presented by plaintiffs in support of their theory of
causation may be grouped into six categories: 1) epidemiological studies that, on the
whole, may point weakly toward causation; 2) case reports in which injuries were
reported subsequent to the ingestion of Parlodel; 3) dechallenge/rechallenge tests that
implied a relationship between Parlodel and stroke; 4) evidence that ergot alkaloids
(a class of drug that includes bromocriptine) may cause ischemic stroke; 5) animal
studies indicating that under some circumstances, bromocriptine may cause
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vasoconstriction in dogs and other animals; and, 6) the FDA statement withdrawing
approval of Parlodel’s indication for the prevention of lactation.
A. Epidemiology
Epidemiology, a field that concerns itself with finding the causal nexus between
external factors and disease, is generally considered to be the best evidence of
causation in toxic tort actions. Plaintiffs presented four epidemiological studies.
Three of the four appear to have found no relationship or a negative relationship
between Parlodel and stroke. Another may suggest a positive relationship.
Nonetheless, both parties agree that none of the studies present statistically significant
results and that the epidemiological evidence in this case is inconclusive.
Plaintiffs argue that the district court erred by requiring epidemiological studies,
effectively ruling against them because they could not produce sufficient
epidemiological evidence linking Parlodel to stroke. Having carefully reviewed the
record, we conclude that the district court did not require epidemiological studies.
It is well-settled that while epidemiological studies may be powerful evidence
of causation, the lack thereof is not fatal to a plaintiff’s case. In Glastetter v. Novartis
Pharm. Corp., 252 F.3d 986 (8th Cir. 2001) and Hollander v. Sandoz Pharm. Corp.,
289 F.3d 1193 (10th Cir. 2002), cases with facts nearly identical to those presented
here, the Eighth and Tenth Circuits affirmed the respective district courts’ exclusion
9
of evidence that Parlodel had caused a hemorrhagic stroke, concluding that the
plaintiffs’ evidence was not sufficiently reliable to be presented to a jury. Those
appellants argued, as the appellants do here, that epidemiological evidence is not
required to prove causation. Both courts properly ruled that it was not required. This
Court has long held that epidemiology is not required to prove causation in a toxic tort
case. See Wells v. Ortho Pharm. Corp., 788 F.2d 741, 745 (11th Cir. 1986) (holding
that “a cause-effect relationship need not be clearly established by animal or
epidemiological studies.”). Accordingly, this case presents the difficult question of
whether the evidence submitted to prove causation, in the absence of epidemiology,
was sufficient to meet the requirements of Daubert.
B. Case reports.
Much of the plaintiffs’ expert testimony relied on case reports in which patients
suffered injuries subsequent to the ingestion of Parlodel. Although a court may rely
on anecdotal evidence such as case reports, Allison, 184 F.3d at 1312, courts must
consider that case reports are merely accounts of medical events. They reflect only
reported data, not scientific methodology. Some case reports are a very basic form
report of symptoms with little or no patient history, description of course of treatment,
or reasoning to exclude other possible causes. The contents of these case reports were
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inadequate, even under the plaintiffs’ expert’s standards, to demonstrate a relationship
between a drug and a potential side effect.
Some case reports do contain details of the treatment and differential diagnosis.
Even these more detailed case reports, however, are not reliable enough, by
themselves, to demonstrate the causal link the plaintiffs assert that they do because
they report symptoms observed in a single patient in an uncontrolled context. They
may rule out other potential causes of the effect, but they do not rule out the
possibility that the effect manifested in the reported patient’s case is simply
idiosyncratic or the result of unknown confounding factors. As such, while they may
support other proof of causation, case reports alone ordinarily cannot prove causation.
See, e.g., Haggerty v. Upjohn Co., 950 F. Supp. 1160, 1165 (S.D. Fla. 1996) (stating
that “while case reports may provide anecdotal support, they are no substitute for a
scientifically designed and conducted inquiry.” (citation omitted)), aff’d without op.,
158 F.3d 588 (11th Cir. 1998). The record demonstrates that the district court
carefully considered the case reports and properly concluded that the case reports did
not by themselves provide reliable proof of causation.
C. Dechallenge/rechallenge Data
Plaintiffs’ experts provided dechallenge/rechallenge data that they argue
suggests a link between Parlodel and stroke. A test is a “dechallenge” test when a
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drug that is suspected of causing a certain reaction is withheld to see if the reaction
dissipates. The drug may then be reintroduced in a “rechallenge” to see if the reaction
reoccurs. These reports, which may be analogized to controlled studies with one
subject, can be particularly useful in determining whether a causal relationship exists.
Nonetheless, because none of the studies involved a patient with the particular injury
suffered by the plaintiffs, they do not provide data useful in determining whether
Parlodel caused the plaintiffs’ injuries.
On appeal, plaintiffs presented two dechallenge/rechallenge reports that they
assert are particularly convincing evidence of causation. In one, a woman developed
severe headaches and hallucinations while taking bromocriptine. All symptoms
disappeared when the drug was withheld. When bromocriptine was readministered,
she complained of chest pain and tests revealed total occlusion of a coronary artery.
One month later, she was given the drug again and tests revealed a seventy percent
arterial constriction. This report indicates at best a relationship between Parlodel and
localized arterial spasm. Plaintiffs have presented insufficient evidence on which the
district court could have concluded that this report is evidence that Parlodel causes
systemic vasoconstriction, high blood pressure, or hemorrhagic stroke.
The other report presented by the plaintiffs involves a woman who reported
partial paralysis in her left arm and left leg after taking her first dose of Parlodel. Her
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symptoms disappeared shortly thereafter, and she did not take Parlodel again until her
physician was present. Upon taking the drug again, she experienced essentially the
same symptoms. Plaintiffs imply that this report is relevant because the woman’s
symptoms were a result of stroke. A careful review of this report, however, reveals
that it does not provide any evidence that the patient suffered a stroke, let alone
evidence that Parlodel caused a stroke. Both neurologists who examined the patient
questioned whether her symptoms were real and reported that the most likely cause
of her symptoms was psychosomatic. One neurologist opined that if the symptoms
were real, it was possible that her symptoms were a result of hypotension, or decreased
blood pressure. Because the plaintiffs’ causation argument relies on a conclusion that
Parlodel causes high blood pressure, this report does not provide reliable evidence in
support of their theory.
Thus, these dechallenge/rechallenge reports suggest at most a possibility that
Parlodel may cause localized vasoconstriction, and may suggest that it causes
hypotension. They cannot be considered reliable evidence of a relationship between
Parlodel and stroke because neither of them involve stroke. Moreover,
dechallenge/rechallenge tests are still case reports and do not purport to offer
definitive conclusions as to causation.
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Plaintiffs argue that the district court completely ignored the
dechallenge/rechallenge reports before it. This overstates the case. The district court
discussed several of the case reports by way of example, and concluded that they were
unreliable as evidence that Parlodel causes hemorrhagic stroke. The case reports that
discussed dechallenge and rechallenge evidence were not sufficiently related to the
case at hand to merit further discussion. Of the seven such reports emphasized by the
plaintiffs, three did not arise postpartum – a significant fact since risk of stroke is
greatly increased in the postpartum period. Of the four arising postpartum, three did
not discuss dechallenge/rechallenge evidence related to stroke or seizure, but only as
to other suspected effects of Parlodel – hypertension, coronary (not cerebral)
vasospasm and occlusion, hallucinations, and headache. This Court’s discussion of
the dechallenge/rechallenge reports relied upon by the plaintiffs demonstrates that the
district court did not abuse its discretion in holding that they are not reliable evidence
of a link between Parlodel and hemorrhagic stroke.
D. Chemical Analogies
Bromocriptine is one of many drugs in a class known as ergot alkaloids.
Plaintiffs sought to introduce evidence that because other ergot alkaloids cause
vasoconstriction, then it is proper to conclude bromocriptine must do so as well.
There is an insufficient basis in the record for this Court to hold that the district court
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abused its discretion by not drawing such a conclusion. Ergot alkaloids encompass
a broad class of drugs with great chemical diversity, and “[e]ven minor deviations in
chemical structure can radically change a particular substance’s properties and
propensities.” Glastetter, 252 F.3d at 990 (citation omitted). The district court, after
a detailed review of the properties of ergot alkaloids, concluded that plaintiffs failed
to come forward with even a theory as to why the mechanism that causes some ergot
alkaloids to act as vasoconstrictors would more probably than not be the same
mechanism by which bromocriptine acts to cause vasoconstriction. The district court
did not abuse its discretion in doing so.
E. Animal Studies
Plaintiffs offered evidence of animal studies in which bromocriptine
demonstrated vasoconstrictive properties in dogs and certain other animals. Plaintiffs
did not offer any animal studies that suggest that bromocriptine causes stroke, or even
high blood pressure. The district court discussed each of these studies and was within
its discretion in concluding that plaintiffs offered insufficient evidence on which that
court could base a conclusion that the effect of bromocriptine would be the same on
humans as it is on animals.
F. FDA Findings
15
Plaintiffs presented evidence that the FDA issued a statement withdrawing
approval of Parlodel’s indication for the prevention of lactation. The district court
concluded that the language in the FDA statement itself undermined its reliability as
proof of causation. In the statement, the FDA did not purport to have drawn a
conclusion about causation. Instead, the statement merely states that possible risks
outweigh the limited benefits of the drug. This risk-utility analysis involves a much
lower standard than that which is demanded by a court of law. A regulatory agency
such as the FDA may choose to err on the side of caution. Courts, however, are
required by the Daubert trilogy to engage in objective review of evidence to determine
whether it has sufficient scientific basis to be considered reliable. The district court
did not abuse its discretion in concluding that the FDA actions do not, in this case,
provide scientific proof of causation.
V. Applying the Evidence to the Plaintiffs’ Theory of Causation
The deficiencies in the evidence reveal three gaps in the causal argument
advanced by the plaintiffs. First, plaintiffs suggest that because bromocriptine is an
ergot alkaloid, it causes vasoconstriction. Although some other ergot alkaloids do
cause vasoconstriction, plaintiffs offered insufficient evidence for the district court to
find that bromocriptine does so as well. This is not a case where the Court finds the
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evidence offered to be unreliable. In this case the record contains no evidence at all
of this hypothesis. Instead, it contains principally speculation and conjecture.
Because the ergot alkaloid class of drugs has a wide range of effects, it is not
obvious that bromocriptine should have the same effects as other drugs in that class.
Indeed, two widely-reported symptoms associated with bromocriptine are vasodilation
and hypotension, precisely the opposite of what the plaintiffs allege. Plaintiffs did
offer a theory as to why the drug might cause either vasodilation or vasoconstriction,
depending on the vascular characteristics of the patient, a theory that the defendants
concede the district court did not correctly explain in its opinion. This minor error
does not affect the correctness of the district court’s conclusion however, because the
plaintiffs did not offer sufficiently reliable evidence to support their theory.
Second, the plaintiffs urge the Court to extrapolate the results of animal studies
to humans. As with the plaintiffs’ evidence of chemical properties, the district court
did not err in finding no basis for doing so. Plaintiffs’ experts admitted that with
respect to animal studies generally, what happens in an animal would not necessarily
happen in a human being. Accordingly, it is necessary for plaintiffs to offer some
rationale for the suggestion that the vascular structures of humans and animals are
sufficiently similar in this context to conclude that bromocriptine’s effects on animals
may be extrapolated to humans. Plaintiffs have not done so.
17
As the Supreme Court held in Joiner, scientific evidence must “fit” the
plaintiff’s theory of causation. In this case, neither the chemical compound evidence
nor the animal study evidence “fits” as evidence relevant to the cause of plaintiffs’
injuries.
Third, plaintiffs argue that because there is some evidence that bromocriptine
causes ischemic stroke, it also causes hemorrhagic stroke. This is the most untenable
link in the causal chain. Strokes are broadly classified into two categories: ischemic
and hemorrhagic. Ischemic strokes occur as a result of lack of blood flow to the brain.
Hemorrhagic strokes occur as a result of bleeding within the brain. Thus, although the
two conditions share a name, they involve a wholly different biological mechanism.
The evidence that suggests that Parlodel may cause ischemic stroke does not apply to
situations involving hemorrhagic stroke. This is a “leap of faith” supported by little
more than the fact that both conditions are commonly called strokes. Plaintiffs argue
that as a result of the vasoconstriction caused by Parlodel, blood pressure may
increase to the point that blood vessels in the brain rupture. Plaintiffs have offered no
reliable evidence that Parlodel increases blood pressure to such dangerous levels.
Even if they had, they failed to offer proof of how such an increase in blood pressure
can precipitate a hemorrhagic stroke.
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Since the shortcomings in the evidence render the theory unreliable, the district
court did not abuse its discretion in excluding the plaintiffs’ evidence of causation.
V. Conclusion
In the absence of epidemiology, plaintiffs may still prove medical causation by
other evidence. In the instant case, however, plaintiffs simply have not provided
reliable evidence to support their conclusions. To admit the plaintiffs’ evidence, the
Court would have to make several scientifically unsupported “leaps of faith” in the
causal chain. The Daubert rule requires more. Given time, information, and
resources, courts may only admit the state of science as it is. Courts are cautioned not
to admit speculation, conjecture, or inference that cannot be supported by sound
scientific principles. “The courtroom is not the place for scientific guesswork, even
of the inspired sort. Law lags science; it does not lead it.” Rosen v. Ciba-Geigy
Corp., 78 F.3d 316, 319 (7th Cir. 1996).
Plaintiffs argue that the district court erred in requiring a checklist of types of
evidence to prove causation. This argument misinterprets the district court’s opinion.
The district court, after finding that the plaintiffs’ evidence was unreliable, noted that
certain types of other evidence may have been considered reliable, including peer-
reviewed epidemiological literature, a predictable chemical mechanism, general
acceptance in learned treatises, or a very large number of case reports. In so doing,
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the district court was not compiling a list of required types of evidence. Rather, it was
highlighting the plaintiffs’ failure to present evidence in any of several categories that
would have been persuasive.
Plaintiffs also argue that the district court ignored important evidence. As a
preliminary matter, this Court has considered the evidence the plaintiffs allege was
ignored and has found nothing upon which to base a conclusion that Parlodel causes
hemorrhagic stroke. The Court also notes that it has no reason to believe that the
district court did not examine the entire record in this case. On the contrary, there is
every indication that the district court correctly stated in its opinion that it had
carefully “reviewed the massive volume of documentary evidence (in all, about 575
exhibits, depositions and affidavits) that relates to Plaintiffs’ expert testimony on
medical causation. The Court’s ruling is based on both the testimony from the
Daubert hearing and the substantial documentary evidence in the record.” 131 F.
Supp. 2d at 1350. The district court held a three-day hearing in which two of the
plaintiffs’ experts were allowed to testify and were subjected to cross-examination.
The district court’s twenty-five page published opinion meticulously discusses the
evidence and considers whether it was reliable, concluding after a thorough analysis
that it was not.
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The district court’s conclusion is in conformity with numerous other decisions.
Two circuit court opinions have addressed the issue of Parlodel and hemorrhagic
stroke. See Glastetter v. Novartis Pharm. Corp., 252 F.3d 986 (8th Cir. 2001);
Hollander v. Sandoz Pharm. Corp., 289 F.3d 1193 (10th Cir. 2002). Both courts,
presented with facts and evidence nearly identical to what is presented here, affirmed
the district courts’ exclusion of the plaintiffs’ scientific evidence as unreliable. There
are at least four district court opinions involving Parlodel that, despite slight
differences in facts or evidence, reach the same ultimate result. See Caraker v. Sandoz
Pharm. Corp., 188 F. Supp. 2d 1026 (S.D. Ill. 2001); Douglas v. Sandoz Pharm.
Corp., 2000 WL 33342286 (M.D.N.C. 2000); Brumbaugh v. Sandoz Pharm. Corp.,
77 F. Supp. 2d 1153 (D. Mont. 1999). Two Parlodel cases in which the evidence of
causation of injury was admitted involved injuries different from the hemorrhagic
strokes alleged in the instant case. Brasher v. Sandoz Pharm. Corp., 160 F. Supp. 2d
1291 (N.D. Ala. 2001) (admitting evidence that Parlodel caused ischemic stroke);
Globetti v. Sandoz Pharm. Corp., 111 F. Supp. 2d 1174 (N.D. Ala. 2000) (admitting
evidence that Parlodel caused acute myocardial infarction).
We hold that the district court did not abuse its discretion in concluding that the
Plaintiffs’ scientific proof of causation is legally unreliable and inadmissible under the
standards set by the Daubert trilogy.
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AFFIRMED.
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