The cited to report raised an issue of fact

Defendants’ Expert Report Creates Fact Issues in Serious Injury Case

In New York no-fault insurance cases, defendants often retain medical experts to challenge whether a plaintiff sustained serious injuries that meet the statutory threshold. However, when these expert reports rely on the plaintiff’s own medical records that document accident-related injuries, defendants may inadvertently create fact issues rather than resolve them.

The Fourth Department’s decision in James v Thomas demonstrates how defendants can undermine their own summary judgment motion when their expert’s conclusions conflict with the underlying medical evidence they cite. This situation is reminiscent of cases where defendants essentially defeat their own arguments by presenting contradictory evidence. This case illustrates a fundamental principle of New York summary judgment practice: the moving party must eliminate all triable issues of fact, and courts will examine not just the expert’s ultimate conclusions but the foundation upon which those conclusions rest.

Case Background

The James v Thomas case arose from a motor vehicle collision in which the plaintiff claimed to have sustained serious injuries to her cervical and lumbar spine. The defendants moved for summary judgment, seeking dismissal of the plaintiff’s claims on the grounds that she failed to meet the serious injury threshold required under New York Insurance Law Section 5102(d). To support their motion, defendants submitted an expert medical report intended to demonstrate that the plaintiff’s injuries were neither causally related to the accident nor sufficiently severe to constitute serious injury under the statute.

The defendants’ strategy—common in serious injury litigation—was to have their expert review the plaintiff’s medical records and render an opinion that would negate the plaintiff’s claims. However, the execution of this strategy proved fatal to their motion. The medical records the defense expert relied upon contained objective findings and physician assessments that actually supported the plaintiff’s position, creating an internal contradiction within the defense’s own evidence.

Jason Tenenbaum’s Analysis:

James v Thomas, 2017 NY Slip Op 09025 (4th Dept. 2017)

“Although defendants’ expert ultimately opined in his report that plaintiff’s injuries were not causally related to the accident, that report relies on plaintiff’s medical records, which conclude that plaintiff sustained injuries that were causally related to the collision. The report also noted the quantitative assessments of plaintiff’s physicians with respect to her limited range of motion in her cervical and lumbar spine after the accident. Thus, defendants failed to eliminate all issues of fact with respect to whether plaintiff sustained serious injuries that were causally related to the accident under those two categories”

Legal Significance

This decision reinforces several important principles governing summary judgment practice in serious injury cases. First, courts will not simply accept an expert’s conclusory opinion when the underlying materials relied upon by that expert contradict the stated conclusions. The Fourth Department’s analysis demonstrates that appellate courts scrutinize the evidentiary foundation of expert reports, not merely their ultimate pronouncements.

Second, the decision highlights the danger of relying on an opponent’s medical records without carefully vetting their content. When plaintiff’s treating physicians document causally related injuries and quantifiable limitations in range of motion, a defense expert cannot simply dismiss these findings without adequately explaining why they should be disregarded. The presence of objective medical findings—particularly quantitative assessments of limited range of motion—creates fact issues that preclude summary judgment.

Third, the case underscores that defendants bear the burden of establishing their entitlement to summary judgment as a matter of law. This requires more than simply offering contrary expert testimony; defendants must affirmatively eliminate all triable issues of fact. When their own evidence creates or reinforces such issues, summary judgment must be denied regardless of their expert’s ultimate opinion.

Practical Implications

For defense attorneys handling serious injury cases, this decision serves as a cautionary tale about the importance of thoroughly reviewing all medical records before incorporating them into expert reports. Defense experts should be instructed to address any contrary findings in the plaintiff’s medical records rather than simply acknowledging their existence while reaching opposite conclusions. When treating physician records contain objective evidence supporting the plaintiff’s claims, defense counsel must either explain why those findings are unreliable or concede that fact issues exist.

For plaintiff’s attorneys, this case provides a roadmap for defeating defense summary judgment motions. Close examination of defense expert reports may reveal that they rely on medical records containing evidence favorable to the plaintiff. When such contradictions exist, plaintiff’s opposition papers should highlight them prominently, demonstrating that the defendants have failed to meet their burden of eliminating all triable issues of fact.

Key Takeaway

When defendants’ medical experts rely on plaintiff’s medical records that document accident-related injuries and objective signs of continuing disability like limited range of motion, they create fact issues that prevent summary judgment dismissal. Courts will not grant summary judgment when the expert’s opinion conflicts with the underlying medical evidence cited in their own report. Defense counsel must ensure their experts adequately address—rather than merely acknowledge—contrary findings in plaintiff’s medical records, or risk having their summary judgment motions denied due to fact issues created by their own evidence.

Related Articles

• A Plaintiff’s own hospital records defeated his own threshold summary judgment motion
• A Prima facie showing of lack of serious injury does not require a review of plaintiff’s records
• The absence of an expert is fatal to prove causation