## Facts

- Chelsea Weekley suffered a skull fracture as an infant; a cyst later formed at the fracture site.
- At age 17, after a head injury with loss of consciousness and dizziness, imaging confirmed the fracture’s extent and the cyst.
- Weekley underwent a cranioplasty at a children’s hospital, performed by Dr. Ann Flannery (neurosurgeon) and Dr. Raghuram Sampath (neurosurgical resident).
- She was discharged the day after surgery and was found dead in bed three days later.
- A forensic pathologist (Dr. Raj Nanduri), after consulting a neuropathologist (Dr. Charles Little), concluded Weekley died from a seizure caused by surgical damage; neither reviewed pre-surgery CT/MRI scans in reaching that conclusion.
- The estate alleged malpractice for failing to prescribe prophylactic anti-seizure medication, claiming a post-surgical seizure caused death.
- Defendants denied a seizure occurred and argued a heart-related ailment likely caused death.
- Defense expert Dr. John Ruge (pediatric neurosurgeon/neurologist) testified Weekley did not die of a seizure and that the likely cause of death was a specific cardiac condition; he lacked cardiology training and researched the condition after encountering it.
- The jury found for defendants.

## Issues

1. Whether the plaintiff forfeited appellate challenges to two defense experts’ cause-of-death opinions by presenting underdeveloped arguments.
2. Whether the district court abused its discretion under Federal Rule of Evidence 702 by permitting Dr. Ruge to testify that a specific cardiac condition was the likely cause of death.
3. Whether erroneous admission of Dr. Ruge’s cardiac-causation testimony was harmless.

## Decision

- The court held the plaintiff forfeited challenges to two experts by presenting perfunctory, underdeveloped arguments on appeal.
- The court held the district court abused its discretion by admitting Dr. Ruge’s opinion that a specific heart ailment was the likely cause of death because he lacked the qualifications for that subject.
- The court held the error was not harmless because there was a significant chance the testimony affected the verdict.
- The judgment was vacated and the case remanded for further proceedings.

## Legal Principles

- Appellate courts may treat perfunctory and underdeveloped arguments as forfeited and decline to address them on the merits.
- Under Federal Rule of Evidence 702, an expert must be qualified for the specific opinion offered; medical credentials in one specialty do not automatically qualify the witness to opine on specialized causation questions in another field.
- In a close, contested causation case, admitting an unqualified expert opinion on an alternative cause of death warrants reversal when there is a significant chance the error influenced the jury’s verdict.

## Conclusion

The Seventh Circuit vacated a defense verdict in a medical-malpractice trial because the district court improperly allowed a neurosurgeon to offer a “likely cause of death” opinion about a specific cardiac condition without the requisite cardiology qualifications, and the erroneous testimony plausibly affected the outcome.


Hall v. Flannery, 840 F.3d 922 (7th Cir. 2016)