Defendant Wins Reversal of Ruling After Court Bars Impeachment Evidence
Moore v. Mandell: Illinois Appellate Court Orders New Trial After Limits on Medical Expert Cross-Examination
An Illinois personal injury case shows why both causation evidence and a party’s ability to challenge an opposing medical expert can be critical at trial.
In Moore v. Mandell, 2023 IL App (5th) 220289, the Illinois Appellate Court for the Fifth District reviewed a personal injury verdict following a five-day jury trial. The defendant had admitted negligence, so the primary disputes at trial concerned the plaintiff’s injuries, causation, permanency, and damages.
The plaintiff, Etta Moore, was born with spina bifida that left her unable to walk. She used a wheelchair, crawled inside her home when necessary, and used a motorized scooter outside the home. On September 30, 2015, Teresa Mandell’s vehicle struck Moore while she was riding her motorized scooter across a public roadway.
Moore later underwent surgery to repair a right shoulder rotator cuff tear. At trial, the defense argued that the tear and some of Moore’s claimed ongoing symptoms were not caused by the 2015 accident. The defense also sought to question one of Moore’s medical experts about potential bias, prior disciplinary matters, paid expert work, and communications with plaintiff’s counsel.
The jury awarded Moore $818,655.03. The Fifth District later determined that the trial court improperly restricted the defense’s cross-examination of Dr. Blair Rhode and that the error was prejudicial. The appellate court therefore reversed the judgment and remanded the case for a new trial.
Important:
The appellate court did not decide that Moore’s injuries were caused by the accident or that Mandell was ultimately liable for all claimed damages. The ruling addressed whether the defense received a fair opportunity to cross-examine a key medical expert and concluded that the evidentiary restriction was prejudicial.
Background of the Accident
Moore was born with spina bifida that paralyzed her legs from the knees down. Although she could not walk, she had developed ways to move around her home, including crawling and using a manual wheelchair. Outside her home, she frequently used a motorized scooter.
On September 30, 2015, Moore was traveling on her motorized scooter and attempting to cross a public roadway when Mandell’s vehicle struck her.
Moore was taken to the hospital, where she was diagnosed with a dislocated right shoulder and experienced significant pain. She remained hospitalized until October 2, 2015.
After returning home, Moore underwent physical therapy. Because she made limited progress, she was eventually referred to orthopedic surgeon Dr. Treg Brown. An MRI later showed a rotator cuff tear in the right shoulder, and Moore underwent rotator cuff repair surgery on March 25, 2016.
The Shoulder Injury Became the Central Causation Issue
The parties agreed that Moore suffered a right shoulder dislocation in the 2015 collision. They also agreed that a right shoulder rotator cuff tear was later discovered and surgically repaired.
The dispute concerned what caused the rotator cuff tear and whether Moore continued to experience permanent limitations after the surgery.
The defense argued that the rotator cuff tear could have resulted from an earlier shoulder injury, degenerative changes, or the extensive use Moore placed on her arms because of her pre-existing mobility limitations.
Moore argued that the 2015 collision caused the tear and that she continued to experience pain and functional limitations afterward.
2015 Collision
Moore’s motorized scooter was struck by Mandell’s vehicle, causing a right shoulder dislocation and significant pain.
Rotator Cuff Tear
An MRI later identified a right shoulder rotator cuff tear that required surgery.
Permanent Injury Dispute
The parties disputed whether Moore had permanent pain and functional limitations attributable to the accident.
The 2009 Shoulder Injury
During discovery, the defense located medical records showing that Moore had injured her right shoulder in 2009 while moving her wheelchair out of a vehicle.
Moore’s 2009 medical records indicated that she had reported right shoulder pain. An X-ray showed no acute fracture or dislocation but did show mild hypertrophy of one joint. The records described the condition as right shoulder pain that was possibly a rotator cuff injury or strain.
The record indicated that the 2009 visit was the only documented medical visit concerning Moore’s right shoulder before the 2015 accident.
During her discovery deposition, Moore testified that she had not experienced prior problems with her right shoulder. The defense therefore sought to use the 2009 medical records not only as evidence concerning causation, but also to challenge the accuracy of her prior testimony.
Why the 2009 Records Mattered
The defense argued that the earlier shoulder injury was relevant to whether the 2015 accident caused the later rotator cuff tear.
The records also created a potential impeachment issue because Moore had previously testified that she had not experienced prior shoulder problems.
Mandell Admitted Negligence
The case ultimately proceeded to trial on damages after Mandell admitted negligence.
That meant the jury did not need to determine whether Mandell was negligent in causing the accident. Instead, the important questions included the nature and extent of Moore’s injuries, whether those injuries were caused by the collision, whether the injuries were permanent, and what damages Moore sustained.
The difference was important because the defense focused heavily on whether the 2015 accident caused Moore’s later rotator cuff tear and continuing pain.
What Did the Plaintiff’s Doctors Say?
Several physicians testified about Moore’s treatment following the accident.
Emergency room physician Dr. Michael Chipman treated Moore immediately after the collision and diagnosed a right shoulder dislocation. Other treating providers described the pain Moore experienced during and after her hospital stay.
Orthopedic surgeon Dr. Treg Brown later diagnosed the rotator cuff tear and performed the repair surgery. He testified that Moore had a large to massive tear and that he believed she was progressing after surgery. At his last visit with her in August 2016, he believed she was doing much better and was likely to continue improving.
Dr. Khalid Sonbol testified that Moore had not reported right shoulder complaints during her visits with SIU Family Medicine before the accident and believed the 2015 accident caused the rotator cuff tear.
Dr. Akshay Vakharia, a pain-management physician, treated Moore once in 2018 for neck and right shoulder pain and recommended an injection. He did not offer opinions regarding her condition at the time of trial or future pain and suffering.
Dr. Rhode’s Testimony Was Especially Important
Dr. Blair Rhode was an orthopedic surgeon who saw Moore once on September 4, 2019, for a second opinion after her rotator cuff surgery.
Dr. Rhode testified that the accident caused Moore’s rotator cuff tear and related neck injury. He also testified that Moore had residual symptoms and functional deficits after surgery and that those problems were permanent.
He further testified that Moore’s left shoulder and cervical pain were compensatory problems resulting from using the left side of her body to compensate for the right shoulder injury.
Dr. Rhode testified that Moore’s injuries were permanent to a reasonable degree of medical certainty. He also testified that large to massive rotator cuff tears could have a high recurrence rate even after surgical repair.
On cross-examination, he acknowledged that he had seen Moore only once and that the visit lasted approximately 10 to 15 minutes.
Why Dr. Rhode Mattered to the Verdict
The Fifth District noted that Dr. Rhode was the only physician who gave firm testimony concerning the permanent nature of Moore’s injuries, future pain and suffering, permanent cervical injury, and compensatory left-side pain. His opinions therefore played an important role in the portions of the damages claim involving future limitations and pain and suffering.
What Did the Defense Want to Ask Dr. Rhode?
Before trial, the circuit court limited the defense’s proposed cross-examination of Dr. Rhode.
The excluded subjects included Dr. Rhode’s professional disciplinary reprimands, his previous work as a paid expert for plaintiffs and claimants, the income he received from that expert work, communications between Dr. Rhode and plaintiff’s counsel, and communications concerning the preparation of a written expert report.
The defense also sought to present communications suggesting that plaintiff’s counsel had asked Dr. Rhode to provide an opinion concerning whether Moore might eventually require placement in a nursing facility because of the accident.
The trial court treated Dr. Rhode as a treating physician and concluded that this classification limited the scope of cross-examination that the defense could conduct.
The Appellate Court Found That Limitation Was Improper
The Fifth District concluded that the trial court applied the wrong legal standard.
The appellate court explained that a treating physician is not entitled to a narrower scope of cross-examination simply because the physician became involved in the case as a treating doctor rather than as a retained expert.
Under Illinois law, the opposing party must have broad latitude to cross-examine an expert concerning potential interest, bias, motive, accuracy, recollection, and credibility.
Bias
The opposing party may explore evidence that could show bias or a particular interest in the case.
Financial Interest
Evidence concerning paid expert work can be relevant to a witness’s credibility and potential financial interest.
Credibility
Prior professional history and other relevant matters can be used to test an expert’s credibility.
Counsel Communications
Relevant communications between counsel and a medical expert may bear on bias or the development of an expert opinion.
Why the Error Was Prejudicial
The plaintiff conceded during oral argument that the circuit court had erred in completely barring the defense from conducting this cross-examination.
The plaintiff nevertheless argued that the error did not matter because the jury had enough other evidence to support the verdict.
The Fifth District rejected that argument. The court recognized that erroneous evidentiary rulings only justify reversal when they are substantially prejudicial and affect the outcome of the trial. In this case, the court concluded that standard was met.
The court emphasized that Dr. Rhode was the only physician who gave firm opinions about the permanence of Moore’s injuries and future pain and suffering. He was also the only physician who attributed the later left shoulder and cervical problems to compensation for the right shoulder injury.
Because his testimony was central to important portions of the damages claim, the defense’s inability to present the excluded impeachment evidence could have affected the jury’s evaluation of his credibility and impartiality.
The appellate court’s reasoning:
The error was significant because the excluded evidence went directly to the credibility of the medical expert whose testimony supported permanent injury and future damages, rather than being merely cumulative of other evidence.
What About the Other Evidence the Defense Wanted to Introduce?
The defense also challenged the trial court’s treatment of the 2009 shoulder injury and statements Moore had made before trial concerning functional impairments.
Those issues were important to the defense’s broader argument concerning causation and damages. However, the appellate court did not need to resolve each of those questions after determining that the restriction on cross-examination of Dr. Rhode independently required reversal and a new trial.
Accordingly, it would be inaccurate to say that the Fifth District held that every piece of excluded evidence relating to the 2009 injury or Moore’s earlier statements was necessarily admissible. The dispositive error was the restriction on Dr. Rhode’s cross-examination.
The Defense Also Presented Its Own Medical Expert
The defense called orthopedic surgeon Dr. Gary Klaud Miller.
Dr. Miller agreed that Moore had suffered a painful shoulder dislocation in the 2015 accident, but he disagreed that the collision caused the later rotator cuff tear.
He attributed the tear to degenerative changes associated with Moore’s age and the extensive use of her arms. He also believed Moore’s continuing pain was associated with AC-joint arthritis rather than a continuing problem from the repaired rotator cuff.
The competing medical opinions made the credibility and reliability of the experts particularly important to the jury’s determination of causation and damages.
The Jury Awarded More Than $818,000
After five days of trial, the jury returned a verdict in Moore’s favor totaling $818,655.03.
Loss of Normal Life
Damages for loss of a normal life experienced and reasonably certain to be experienced in the future.
Pain and Suffering
Damages for pain and suffering experienced and reasonably certain to be experienced in the future.
Medical Expenses
Reasonable expenses for necessary medical care, treatment, and services.
The circuit court entered judgment on the jury’s verdict and also awarded prejudgment interest. Mandell then appealed.
What Did the Illinois Appellate Court Decide?
The Fifth District reversed the circuit court’s judgment and remanded the case for a new trial.
The court held that the trial judge abused the court’s discretion by improperly limiting the defense’s cross-examination of Dr. Rhode. The defense was entitled to explore matters bearing on the doctor’s potential bias, financial interest, credibility, prior expert work, professional history, and communications with plaintiff’s counsel.
Because Dr. Rhode’s testimony was central to the plaintiff’s claims for permanent injury and future damages, the appellate court determined that the evidentiary error was prejudicial rather than harmless.
Final Result
The jury’s $818,655.03 judgment was reversed.
The case was remanded to the circuit court for a new trial because the defense was improperly prevented from fully cross-examining a key medical expert.
What Moore v. Mandell Means for Illinois Personal Injury Cases
Moore v. Mandell demonstrates that a personal injury trial can turn on more than whether an accident occurred. Even when negligence is admitted, the parties may still dispute causation, permanency, future medical needs, pain and suffering, and the extent of the plaintiff’s functional limitations.
Medical experts can play an especially important role in those disputes. Illinois law gives opposing counsel broad latitude to challenge an expert’s potential bias, financial interest, credibility, and other matters relevant to the reliability of the expert’s testimony.
The case also demonstrates why pre-existing conditions should be carefully evaluated. A pre-existing condition does not automatically establish that a later injury was unrelated to an accident. Instead, medical evidence and the facts of the case may be used to distinguish injuries caused or aggravated by the accident from conditions that existed before the accident.
Here, Moore’s spina bifida was a significant part of her medical history, and the defense separately relied on the 2009 right shoulder injury and degenerative changes in challenging the claimed cause and extent of the later shoulder problems.
A Pre-Existing Condition Does Not End a Personal Injury Claim
The important legal question is generally how the accident relates to the claimed injury. Medical records, prior symptoms, diagnostic studies, treatment history, expert opinions, and evidence concerning changes after the accident can all become relevant to causation and damages.
Talk to a Champaign, Illinois Personal Injury Lawyer
A vehicle accident can create complicated questions about causation, pre-existing conditions, medical treatment, permanent injuries, and the reliability of competing medical opinions. The evidence used at trial can have a substantial impact on the outcome of a personal injury claim.
Patel Law, PC represents Illinois residents who have been injured in traffic accidents and other personal injury cases. Our attorneys can review the circumstances of an accident, the medical evidence, and the damages involved in a claim.
Contact our Decatur personal injury lawyers to schedule a consultation and discuss your legal options.
Sources
Moore v. Mandell, 2023 IL App (5th) 220289 — Illinois Appellate Court, Fifth District
Moore v. Mandell — Published Illinois Appellate Court Opinion
Illinois Supreme Court Rule 213 — Written Interrogatories to Parties
