Rodriguez-Valentin v. Doctors' Center Hosp. (Manati), Inc. ( 2022 )

United States Court of Appeals
For the First Circuit
No. 20-2093
JEANNETTE RODRÍGUEZ-VALENTIN, in representation of her minor
son, D.A.L.R.,
Plaintiff, Appellee,
v.
DOCTORS' CENTER HOSPITAL (MANATI), INC.,
Defendant, Appellant.
APPEAL FROM THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF PUERTO RICO
[Hon. Bruce J. McGiverin, U.S. Magistrate Judge]
Before
Lynch and Selya, Circuit Judges,
and McCafferty,* District Judge.
Roberto E. Ruiz-Comas, with whom RC Legal & Litigation
Services, PSC was on brief, for appellant.
David Efron, with whom Law Offices of David Efron, P.C. was
on brief, for appellee.
February 24, 2022
* Of the District of New Hampshire, sitting by designation.
MCCAFFERTY, District Judge. This medical malpractice
suit arises from obstetric care provided to the plaintiff-
appellee, Jeannette Rodríguez-Valentin in connection with the
birth of her minor son, DALR. A jury found appellant Doctors'
Center Hospital (Manati), Inc. ("Doctors' Center") liable for 8
percent of a $14,296,000 total award. Doctors' Center appeals the
denial of its post-verdict motions for judgment as a matter of
law, for a new trial, and for remittitur under Federal Rules of
Civil Procedure 50 and 59. We affirm.
BACKGROUND
I. Complications During DALR's Birth
Rodríguez-Valentin gave birth to DALR by caesarean
section at Doctors' Center in Puerto Rico in late September 2008.
A few months after his birth, DALR was diagnosed with cerebral
palsy. Rodríguez-Valentin alleged that DALR's cerebral palsy
resulted from, or was exacerbated by, medical malpractice by
treating physicians and nurses during the late stages of her
pregnancy and DALR's delivery. This appeal by Doctors' Center is
pertinent only to the medical care provided by treating nurses
employed by Doctors' Center.
The nurses' alleged malpractice occurred during DALR's
birth. Doctors' Center's nurses, per a physician's order, began
administering the pharmaceutical drug Pitocin to Rodríguez-
Valentin at about 9:31 A.M. on September 25 while she was in labor.
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The Pitocin was intended to aid delivery by reducing the time
between Rodríguez-Valentin's contractions.
Soon after the nurses administered Pitocin, however,
DALR's "heart rate variability," as documented by a monitor placed
on Rodríguez-Valentin's abdomen, dropped to a "very minimal
level." At trial, Rodríguez-Valentin's expert witness, Dr. Bruce
Halbridge, testified that DALR's heart rate variability had been
within an appropriate range before the nurses administered
Pitocin. Dr. Halbridge explained that the drop in heart rate
variability from that appropriate range showed that DALR was not
receiving enough oxygen, glucose, or blood through the placenta.
Dr. Halbridge noted that such a loss of heart rate variability is
the most important signal that a soon-to-be-born baby lacks
sufficient oxygen.
Dr. Halbridge identified where and when the nurses
should have seen the changes in heart rate variability.
Specifically, according to Dr. Halbridge, DALR's heart rate
variability issues occurred in several, sometimes prolonged,
"episodes" throughout Rodríguez-Valentin's labor. Dr. Halbridge
testified that, in his opinion, by the third "episode" of decreased
heart rate variability, the treating nurses should have stopped
administering Pitocin, placed Rodríguez-Valentin on her left side,
increased her IV fluid intake, provided her with an oxygen mask,
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and notified a physician about the drop in DALR's heart rate
variability.
Rodríguez-Valentin's labor continued for eight hours
after the nurses began administering Pitocin. During this time
the treating nurses failed to recognize or act on the drop in
DALR's heart rate variability, failed to stop administering
Pitocin, and failed to notify any physician about the change in
DALR's heart rate variability.
Dr. Halbridge testified that oxygen deprivation during
the delivery increased DALR's brain damage and aggravated his
cerebral palsy. Dr. Halbridge noted that, had the nurses notified
a physician, the caesarean section could also have been expedited,
which likely would have reduced the severity of DALR's injuries
because he would have spent less time without sufficient oxygen.
In defense of the nurses' conduct, Doctors' Center
offered the testimony of two expert witnesses in obstetrics, Dr.
Alberto de la Vega Pujol and Dr. Edgar Solis. These physicians
disagreed with Dr. Halbridge, opining that DALR's heart rate
variability was adequate during labor and that there was no
evidence that DALR suffered any oxygen deficiency during delivery.
Dr. Solis also testified that neuroradiological testing conducted
after DALR's birth supported his opinion that DALR did not suffer
from oxygen deficiency during delivery.
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II. Testimony about DALR's Life Care Expenses
Rodríguez-Valentin claimed considerable damages for
DALR's future life care costs. Specifically, Gerri Pennachio
testified for Rodríguez-Valentin as a "life care planning expert,"
opining about the yearly cost of DALR's care and treatment.
According to Pennachio, these costs would include necessary
equipment, doctor visits, testing, and physical therapy, among
other items. Pennachio determined that DALR would require
$278,021.57 per year until age 18. After age 18, Pennachio opined,
DALR would need $379,235.57 per year.
On cross-examination, Doctors' Center dissected
Pennachio's calculations, asking her whether she had offset the
yearly amounts by contributions made by insurance or the government
and whether she had based her calculations on costs in Florida
(where DALR lived at the time of trial) as opposed to Massachusetts
(where DALR had lived before moving to Florida). Pennachio
acknowledged that she had not offset her calculations based on
contributions made by insurance or the government. She did not
dispute that she derived her calculations from cost information in
Massachusetts even though, at the time of trial, Rodríguez-
Valentin and DALR lived in Florida.
Additionally, Pennachio acknowledged on cross-
examination that she did not discount her yearly estimates to
present value. Rather, she opined, the cost increases for DALR's
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medical care and life care over his lifetime would offset any
applicable discount rate.
Per a pre-trial ruling on Doctors' Center's motion in
limine, the court prohibited Pennachio (who lacked requisite
expertise) from opining about DALR's life expectancy given his
medical condition.1 Ultimately, neither Doctors' Center nor
Rodríguez-Valentin presented any expert testimony about DALR's
life expectancy.
III. Jury Instructions and Verdict
Consistent with the parties' proposed instructions, the
court instructed the jury that it could award compensatory damages
to Rodríguez-Valentin and DALR for damages they were "reasonably
likely to suffer in the future." It instructed the jury that it
should be "guided by common sense" in fashioning any award and
that it could not engage in "arbitrary guesswork." The court added
that the law does not require proof of the amount of damages "with
mathematical precision but only with as much definiteness and
accuracy as the circumstances permit." It asked the jury to use
"sound discretion" and to draw "reasonable inferences" where
appropriate from the "facts and circumstances in evidence."
In addition, prior to Pennachio's testimony, the court
1
denied a motion by Doctors' Center to limit Pennachio's testimony
to only one year of expenses.
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With respect to DALR's life expectancy, Doctors' Center
did not seek either a ruling from the judge that life expectancy
must be proved by expert testimony or a suitable modification to
the court's jury instruction on damages. Nor did Doctors' Center
request a special verdict form on DALR’s life expectancy. In the
end, Doctors' Center permitted the case to go to the jury without
making any argument about how the lack of expert testimony on life
expectancy should impact the jury's calculation of DALR's future
life care costs.2
The jury found Doctors' Center liable and awarded
$12,996,000 in future life care costs to Rodríguez-Valentin and
DALR. The jury awarded an additional $1,300,000 for physical and
emotional pain and suffering. The jury apportioned 92 percent of
that liability to two treating physicians with whom Rodríguez-
Valentin settled prior to trial. The jury apportioned to Doctors'
Center the remaining 8 percent, which sums to $1,143,680.
2 During closing arguments, Doctors' Center objected to
Rodríguez-Valentin's observation that there was no evidence
presented by either side about life expectancy on the ground that
Rodríguez-Valentin's counsel was improperly "talking about life
expectancy." The court overruled Doctors' Center's objection.
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IV. Post-Verdict Motions
After the jury's verdict, Doctors' Center renewed3 a
motion for judgment as a matter of law under Rule 50 and moved for
a new trial and/or remittitur of the damages award under Rule 59.4
Doctors' Center argued, as it does on appeal, that Rodríguez-
Valentin's evidence was insufficient to support the jury's verdict
as to liability or, alternatively, that the weight of the evidence
required the jury's verdict to be overturned and a new trial to be
held. As to remittitur of the damages award or a new trial on
damages, Doctors' Center argued that the jury's award for future
life care costs was speculative because Rodríguez-Valentin failed
to submit expert testimony about DALR's life expectancy. Doctors'
Center also argued that Pennachio's calculations were deficient.
The district court denied Doctors' Center's motions. As
to Doctors' Center's motions for judgment as a matter of law and
for a new trial on liability, the district court found that Dr.
Halbridge's testimony supported the jury's verdict. As to the
motion for a new trial on damages and/or remittitur, the district
3As it was required to do to preserve its arguments, Doctors'
Center moved for judgment as a matter of law for the first time
before the matter was submitted to the jury. See Fed. R. Civ. P.
50(a); Santos-Arrieta v. Hospital del Maestro, 14 F.4th 1, 8 (1st
Cir. 2021). The district court deferred ruling on the motion, and
Doctors' Center renewed its motion after the jury's verdict.
4Doctors' Center filed its three motions together as part of
one omnibus legal document.
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court stated that the jury could have determined that DALR's life
expectancy was 46 years5 by dividing the award for future care
costs by the amount that Pennachio testified DALR would require
for care each year. The district court, however, acknowledged
that the life expectancy of a child with cerebral palsy "likely
would be a proper subject for expert testimony." Nonetheless, the
district court concluded that the jury in this case could issue an
award for future costs without expert testimony on life expectancy
because damages in a negligence action need not be shown with
mathematical certainty.
The court also stated that other jurisdictions permit a
jury to infer life expectancy from testimony about the injured
person's medical condition and pain and suffering. While
acknowledging that "the far better practice would have been for
both parties to present competent expert testimony of plaintiff's
life expectancy," the district court found that the jurors could
make a reasonable estimate of DALR's life expectancy based on their
common sense, personal knowledge, and experience. The district
court also reasoned that the jury heard and rejected Doctors'
Center's arguments about errors in Pennachio's calculations for
DALR's future life care costs.
5 DALR was 10 years old at the time of trial, so, under these
calculations, he would be expected to live another 36 years.
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DISCUSSION
Doctors' Center appeals the district court's denial of
its motions for judgment as a matter of law, for a new trial, and
for remittitur of the jury's damages award. We address each matter
in turn, and, in the end, affirm the district court's rulings.
I. Judgment as a Matter of Law
Doctors' Center challenges the district court's denial
of its renewed motion for judgment as a matter of law under Federal
Rule of Civil Procedure 50(b). Doctors' Center contends that the
district court erred by denying the motion because Doctors' Center
presented the expert testimony of Drs. de la Vega and Solis, both
of whom opined, in contention with Dr. Halbridge, that the nurses
acted appropriately under the circumstances.
The court reviews de novo the denial of a renewed, post-
verdict motion for judgment as a matter of law under Rule 50(b).
See Fresenius Med. Care Holdings, Inc. v. United States, 763 F.3d
64, 67 (1st Cir. 2014). "If a party has been fully heard on an
issue during a jury trial and the court finds that a reasonable
jury would not have a legally sufficient evidentiary basis to find
for the party on that issue," the court can order a new trial or
direct the entry of judgment in the moving party's favor as a
matter of law. See Fed. R. Civ. P. 50(a)-(b). A trial court
evaluating a motion for judgment as a matter of law under Rule
50(b) must "view the evidence in the light most flattering to the
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verdict and must draw all reasonable inferences therefrom in favor
of the verdict." Fresenius, 763 F.3d at 67-68.
Under Puerto Rico law,6 to prove medical malpractice the
plaintiff must demonstrate, by a preponderance of the evidence, an
applicable standard of care, that the defendant acted or failed to
act in violation of the applicable standard of care, and a
sufficient causal connection between the defendant's act or
failure to act and the plaintiff's injuries. See Pagés-Ramírez v.
Ramírez-González, 605 F.3d 109, 113 (1st Cir. 2010). Viewing the
evidence in the light most favorable to Rodríguez-Valentin, the
jury's verdict finding Doctors' Center liable for medical
malpractice is supported by the evidence. The district court did
not err in denying Doctors' Center's motion for judgment as a
matter of law.
Doctors' Center's primary argument is that the district
court should have given greater weight to the testimony of its
experts as opposed to that of Dr. Halbridge. But, as the district
court found, Dr. Halbridge's opinion (i.e., that the nurses
breached the applicable standard of care by failing to stop
administering Pitocin and by failing to inform treating physicians
that DALR's heart rate variability had decreased) was sufficient
6The substantive law of Puerto Rico controls in this
diversity suit. See Cortés-Irizarry v. Corporación Insular de
Seguros, 111 F.3d 184, 189 (1st Cir. 1997).
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to support the jury's verdict as to those issues. The jury was
entitled to credit Dr. Halbridge's testimony over that of Drs. de
la Vega or Solis. See Feliciano-Hill v. Principi, 439 F.3d 18, 26
(1st Cir. 2006); Lama v. Borras, 16 F.3d 473, 478 (1st Cir. 1994).
Doctors' Center also argues that the jury could not find
liability based on Dr. Halbridge's testimony because he opined
that the nurses breached a standard of care applicable generally
in the United States as opposed to a standard of care specific to
Puerto Rico. We find no merit to Doctors' Center's argument. The
district court instructed the jury that the standard of care in
this case was "equal to the degree of care exercised by other
nurses in the same or similar localities."7 Dr. Halbridge, having
described what the applicable standard of care for the nurses would
be, added that, as to the nurses in this case, the standard of
care was the same as the standard of care in the United States
generally. For purposes of this case, the jury was entitled to
credit Dr. Halbridge's opinion that the applicable standards of
care in Puerto Rico and the rest of the United States are the same.
See Lama, 16 F.3d at 478.
Doctors' Center's other arguments about the sufficiency
of the evidence are without merit and do not warrant further
7 Since it is not a matter challenged on appeal, we make no
ruling about whether the district court's instruction was the
correct interpretation of Puerto Rico law.
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discussion. The district court correctly denied Doctors' Center's
motion for judgment as a matter of law.
II. Motion for a New Trial as to Liability
Leveraging the same arguments presented in its motion
for judgment as a matter of law under Rule 50, Doctors' Center
contends that the district court erred by denying its motion for
a new trial under Federal Rule of Civil Procedure 59. Under Rule
59, "[t]he court may, on motion, grant a new trial on all or some
of the issues -- and to any party -- . . . after a jury trial, for
any reason for which a new trial has heretofore been granted in an
action at law in federal court." Fed. R. Civ. P. 59(a)(1)(A). "A
district court's power to grant a motion for new trial is much
broader than its power to grant a [Rule 50 motion.]" Jennings v.
Jones, 587 F.3d 430, 436 (1st Cir. 2009).
A trial judge may grant a new trial if the jury's verdict
is "against the weight of the evidence" or if "action is required
in order to prevent injustice." Id. at 436. A district court can
independently weigh the evidence when evaluating a motion for a
new trial under Rule 59 and therefore can determine that a witness
or evidence lacks credibility; in other words, the court need not
take the evidence in the light most favorable to the nonmoving
party. Id.At the same time, trial judges "do not sit as thirteenth
jurors, empowered to reject any verdict with which they disagree."
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Id. Indeed, when reviewing a denial of a motion for new trial
that was, at bottom, based on sufficiency of the evidence, the
standards under Rule 50 and Rule 59 effectively "merge." See
Dimanche v. Mass. Bay Transp. Auth., 893 F.3d 1, 8 n.9 (1st Cir.
2018). Moreover, our review of the district court's denial of
Doctors' Center's motion for a new trial is only for abuse of
discretion. Jennings, 587 F.3d at 435-37.
Considering the deferential abuse-of-discretion
standard alongside the reality that Doctors' Center's arguments
under Rule 59 and Rule 50 are based on the same sufficiency-of-
the-evidence grounds, we affirm the district court's denial of
Doctors' Center's motion for a new trial as to its liability. In
other words, consideration of the same facts that lead us to affirm
the district court's denial of the motion as brought under Rule 50
likewise lead us to affirm as to Rule 59. Dr. Halbridge was a
qualified expert witness who testified that Doctors' Center's
nurses breached the applicable standard of care during Rodríguez-
Valentin's labor and DALR's birth. He explained why that breach
of the standard of care caused or aggravated DALR's injuries. The
jury was entitled to credit Dr. Halbridge's testimony over that of
Doctors' Center's experts. The district court did not abuse its
discretion in deferring to the jury's credibility findings.
Doctors' Center points to no facts that convince us the
jury's verdict as to liability was against the weight of the
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evidence or was otherwise unjust. Indeed, the district court's
analysis of the evidence presented at trial was accurate,
thoughtful, and thorough, leaving us with no doubt that the
decision was within its considerable discretion. See id. at 441.
III. Motions for a New Trial on Damages or Remittitur of
Future Life Care Costs Award
Lastly, Doctors' Center contends that the district court
abused its discretion by denying its motion for a new trial or
remittitur on the ground that the jury's $12,966,000 award for
DALR's future life care costs was excessive and unsupported by the
evidence. Specifically, Doctors' Center argues that the award for
future care costs should be reduced, or a new trial on damages
granted, because Rodríguez-Valentin presented no expert testimony
about DALR's life expectancy and because Pennachio based her
calculations on erroneous assumptions.
As with motions for a new trial on liability, appellate
review for denial of a motion for a new trial on damages or
remittitur under Rule 59 is for abuse of discretion. See id. at
435-36. The denial of such a motion "will be reversed only if
'the jury's verdict exceeds any rational appraisal or estimate of
the damages that could be based on the evidence before the jury.'"
Astro-Med, Inc. v. Nihon Kohden Am., Inc., 591 F.3d 1, 13 (1st
Cir. 2009) (quoting Smith v. Kmart Corp., 177 F.3d 19, 29 (1st
Cir. 1999)). When evaluating a motion for a new trial on damages,
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or for remittitur, the court considers the evidence in the light
most favorable to the prevailing party. Wortley v. Camplin, 333
F.3d 284, 297 (1st Cir. 2003).
Under Rule 59, an award for future life care costs is
rational when it is supported by the evidence, reasonable
inferences from that evidence, and the jury's common sense, as
opposed to speculation or conjecture. See Astro-Med, Inc., 591
F.3d at 13; Climent-García v. Autoridad de Transporte Marítimo y
Las Islas Municipio, 754 F.3d 17, 23-24 (1st Cir. 2014). And a
district court does not abuse its discretion by declining to reduce
a jury's verdict or award a new trial where the grounds for doing
so derive from the movant's speculation about what the jury might
have found or what evidence not presented might have demonstrated.
See Loan Modification Grp., Inc. v. Reed, 694 F.3d 145, 154 (1st
Cir. 2012). Here, the jury's verdict was not beyond "any rational
appraisal or estimate of the damages that could be based upon the
evidence before the jury." See id. Doctors' Center's arguments
fail to convince us otherwise.
First, Doctors' Center contends that the district court
abused its discretion by denying its motion under Rule 59 because
Rodríguez-Valentin did not present expert testimony about DALR's
life expectancy. Specifically, Doctors' Center argues that, under
Puerto Rico law, an award for future care costs is speculative
unless the plaintiff submits expert testimony about his or her
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life expectancy. Given the procedural posture of this case and
waivers by Doctors' Center, as explained below, we do not reach
the legal question of whether Puerto Rico law requires such expert
testimony.
Doctors' Center did not timely argue to the district
court that the jury could consider DALR's future care costs only
by reference to expert testimony. Similarly, Doctors' Center did
not timely argue that the jury had to make an estimate of DALR's
life expectancy, or even that it needed to calculate DALR's future
care costs in any particular way. Indeed, Doctors' Center's life
expectancy argument was not part of its motion for judgment as a
matter of law. It was neither reflected in any of Doctors'
Center's proposed jury instructions nor posed as an objection.
Likewise, Doctors' Center did not ask for a special verdict form
that would have required the jury to decide or agree upon DALR's
life expectancy.
Instead, Doctors' Center first argued that expert
testimony on life expectancy was required after the jury delivered
an adverse verdict, in the context of a motion for a new trial or
remittitur reviewable only for abuse of discretion.8 Because the
district court had, without objection, already instructed the jury
8 In its earlier motion in limine, Doctors' Center argued that
Pennachio should be precluded from testifying about DALR's life
expectancy. Doctors' Center did not argue that the jury could not
award future costs without expert testimony about life expectancy.
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on how to calculate damages for future life care costs, Doctors'
Center's argument that the jury could not, as a matter of law,
return a damages award for future life care costs without expert
testimony on life expectancy came much too late.
In other words, Doctors' Center knew before the jury was
instructed that no expert testimony had been presented on life
expectancy and that none would be. Nonetheless, Doctors' Center
neither moved for judgment as a matter of law on that ground nor
offered a jury instruction asking the jury to estimate and agree
on DALR's life expectancy or to calculate that figure in any
particular way. See Cheshire Med. Ctr. v. W.R. Grace & Co., 49
F.3d 26, 35-36 (1st Cir. 1995) (affirming denial of motion for a
new trial where moving party failed to "object precisely on" the
pertinent ground and failed to "propose[] to the trial judge an
acceptable instruction to the jury"). And, Doctors' Center voiced
no objection to the district court's instruction on calculating
damages, which was, in short, to award Rodríguez-Valentin "fair
compensation" of a "reasonable" amount to compensate her and DALR
for physical, emotional, and economic injuries to whatever extent
Doctors' Center was legally liable.
With no pertinent argument made by Doctors' Center
before the case was submitted to the jury, the district court's
jury instructions are the law of the case. United States v.
Oliver, 19 F.4th 512, 517 (1st Cir. 2021) ("Because the defendant
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neither objected to the district court's instructions below nor
assigns error to them on appeal, we treat the instructions as the
law of the case."); United States v. Kilmartin, 944 F.3d 315, 328-
29 (1st Cir. 2019) (holding that an unobjected-to jury instruction
that is neither patently incorrect nor internally inconsistent
becomes the law of the case); Moore v. Murphy, 47 F.3d 8, 11 (1st
Cir. 1995) ("The failure to object to the instructions at the time,
and in the manner, designated by Rule 51 is treated as a procedural
default, with the result that the jury instructions, even if
erroneous, become the law of that particular case.").
At best, we can review the district court's instructions
on this issue for plain error. See Fed. R. Civ. P. 51(c)-(d)
(stating when objections to jury instructions must be made and
that the consequence for failing to timely object to a jury
instruction is review for "plain error" that "affects substantial
rights"); Sindi v. El-Moslimany, 896 F.3d 1, 19-20 (1st Cir. 2018)
("It is black-letter law that claims of instructional error not
seasonably advanced in the district court can be broached on appeal
only for plain error."); see also P.R. Hosp. Supply, Inc. v. Boston
Sci. Corp., 426 F.3d 503, 505 (1st Cir. 2005) ("In general, 'a
party may not appeal from an error to which he contributed, either
by failing to object or by affirmatively presenting to the court
the wrong law.'"). For Doctors' Center to prevail under plain
error review, we must at least conclude that the claimed error was
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clear or obvious. See Sindi, 896 F.3d at 19-20; Babcock v. Gen.
Motors Corp., 299 F.3d 60, 65 (1st Cir. 2002).9
We cannot do so here. Doctors' Center offers no
authority demonstrating that it is clearly the case under Puerto
Rico law that a plaintiff must present expert testimony about life
expectancy to receive damages for future care costs in a medical
malpractice action. Although we agree with the district court
that presenting expert testimony about life expectancy is the best
practice in a medical malpractice case involving an uncommon and
severe medical condition and a request for future costs, we can
find no authority clearly establishing that such expert testimony
is necessary to recover damages for future care costs as a matter
of law in Puerto Rico. Rather, the only arguably relevant
authorities offered here are the Puerto Rico Supreme Court cases
relied on by the district court in denying Doctors' Center's
motion, Zambrana v. Hospital Santo Asilo de Damas, 9 P.R. Offic.
Trans. 687, 692 (1980), and Suro v. E.L.A, 111 P.R. Dec. 456, 461
(1981), which merely stand for the general principle that damages
need not be computed with mathematical rigor or precision.
9As we conclude that there was no clear or obvious error, we
need not reach the other aspects of plain error, which include
whether the claimed error affected the appellant's substantial
rights and "seriously impaired the fairness, integrity, or public
reputation of judicial proceedings." Fothergill v. United States,
566 F.3d 248, 251-52 (1st Cir. 2009).
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Thus, if there were any error under Puerto Rico law in
the district court's instructions on how to calculate damages, it
was not plain. See Sindi, 896 F.3d at 19-20; Babcock, 299 F.3d at
65. Considering those instructions, the evidence that was
presented, and Doctors' Center's failure to timely raise its legal
argument on the need for expert testimony on life expectancy, the
district court did not abuse its discretion in denying the motion.
Finally, Doctors' Center takes issue with Pennachio's
opinion about DALR's future life care costs because Pennachio did
not discount her calculations to present value, used numbers based
on costs in Massachusetts instead of Florida, and did not offset
her calculations for possible contributions by insurers or the
government. The jury, however, heard extensive evidence about
DALR's condition and the care that he required. The district court
allowed Doctors' Center substantial leeway in cross-examining
Pennachio about the accuracy of her calculations.10 Doctors'
Center's cross-examination of Pennachio included questions about
whether she discounted her numbers to present value, whether she
used accurate regional cost-of-living expenses, and whether she
considered potential offsetting contributions. And Pennachio
10On appeal, Doctors' Center challenges the methodology of
Pennachio's opinions and does so only in the context of a new trial
or remittitur, as opposed to admissibility under the Federal Rules
of Evidence. Doctors' Center does not challenge Pennachio's
expertise.
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explained, as one example, that her methodology did not require
discounting her numbers to present value because the prospect of
inflation offset the discount rate. The jury was therefore able
to assess Pennachio's testimony, including Doctors' Center's
criticisms of her methodology, in fashioning its damages award.
See Casco, Inc. v. John Deere Constr. & Forestry Co., 990 F.3d 1,
13-14 (1st Cir. 2021) (rejecting argument that a new trial or
remittitur was necessary due to claimed methodological errors by
plaintiff's damages expert).
Doctors' Center's other arguments regarding the jury's
damages award -- including its contention that the damages are
excessive in light of comparable cases -- are unpersuasive and do
not merit discussion.
At bottom, the jury's verdict was not beyond "any
rational appraisal or estimate of the damages that could be based
upon the evidence before the jury." Accordingly, the district
court did not abuse its discretion in denying Doctors' Center's
motion for a new trial and, in the alternative, remittitur.
CONCLUSION
In sum, the district court did not err or abuse its
discretion in deferring to the jury's evaluation of the evidence.
Accordingly, the district court's order denying Doctors' Center's
motions for judgment as a matter of law, for a new trial, or for
remittitur is affirmed.
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