## Facts

- Denise Crowe injured her right wrist in a rollerblading accident and was evaluated in an emergency room where x-rays were taken.
- Orthopedic surgeon Robert C. Marchand reviewed the x-rays, diagnosed a nondisplaced distal radius fracture, placed Crowe in a splint, and advised follow-up.
- At a later visit, new x-rays suggested possible widening of the scapholunate joint; an MRI soon after showed a scapholunate ligament tear in addition to the fracture.
- Marchand discussed possible ligament reconstruction but recommended conservative treatment, including physical therapy.
- Crowe reported ongoing pain, swelling, and stiffness; her therapist reported symptoms consistent with reflex sympathetic dystrophy (RSD).
- Marchand continued therapy-focused treatment and medications, with attention to RSD symptoms.
- Crowe later treated with a hand surgeon, underwent ligament surgery, and sustained significant functional loss.
- Crowe sued Marchand for medical malpractice in federal court on diversity jurisdiction; a jury returned a verdict for Marchand.
- Crowe moved for a new trial based on the admission of Marchand’s expert testimony; the district court denied the motion.

## Issues

1. Whether the district court abused its discretion by admitting defense expert testimony on the standard of care where the expert relied on medical records and diagnostic reports rather than personally reviewing the original x-ray and MRI films.
2. Whether the district court abused its discretion in denying a new trial based on the claimed erroneous admission of that expert testimony and resulting prejudice.

## Decision

- The First Circuit affirmed the judgment for Marchand.
- The court held the district court did not abuse its discretion in admitting the defense expert’s testimony.
- The court held the expert’s reliance on radiology reports and other medical records was a permissible basis for an expert opinion and that any shortcomings in the basis were for cross-examination and jury evaluation.
- The court held the district court did not abuse its discretion in denying Crowe’s motion for a new trial.

## Legal Principles

- Trial courts have broad discretion over the admission of expert testimony; appellate review is for abuse of discretion.
- Under Federal Rule of Evidence 703, a medical expert may base an opinion on facts or data made known to the expert, including medical records and diagnostic reports, if such materials are reasonably relied upon by experts in the field.
- An expert’s failure to review certain primary materials (such as original imaging films) typically affects the weight of the opinion, not its admissibility, and is addressed through cross-examination and competing expert proof.
- A new trial is an extraordinary remedy; denial is reviewed for abuse of discretion and generally requires a showing that the verdict is against the clear weight of the evidence or that the trial resulted in a miscarriage of justice.

## Conclusion

The First Circuit upheld a defense verdict in a medical malpractice case, ruling that it was within the district court’s discretion to admit standard-of-care testimony from an expert who relied on medical records and radiology reports rather than personally reviewing the imaging films, and that this evidentiary ruling did not justify a new trial.


Crowe v. Marchand, 506 F.3d 13 (1st Cir. 2007)