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Multi-Plaintiffs and Toxic Tort Cases

Expert Witness: Sanjay Adhia, MD
Each plaintiff’s damages are assessed separately and damages are distinct and different. In multi-plaintiff cases, it would be advisable to retain an expert witness who has experience with such cases.

Multi-Plaintiff Tort Cases

The multi-plaintiff case is unique in civil litigation. I have served as an Expert Witness in several such cases and discuss a few below. I also address the role of a Board-Certified Forensic Psychiatrist when plaintiffs constitute a group.

Case Studies

I describe two very different civil cases and the questions they posed.

• Chemical exposure is alleged to cause cancer with potential associated psychiatric illness
• Multiple plaintiffs allege sexual assault

The first case is a toxic tort where multiple plaintiffs claimed their risk of cancer was related
to exposure to a chemical spill.

In the second case, 3 separate women accused a single defendant of serial sexual assault using “date rape drugs.”

Toxic Tort

This case involved a chemical exposure that may have caused late-onset cancers. I was retained by counsel for 2 of the 3 plaintiffs.

It was part of a BELO series (Back End Litigation Option). One plaintiff I examined developed anxiety symptoms from an ENT cancer. After my Independent Medical Evaluation (IME) and review of records, I diagnosed him with Anxiety Disorder Due to Another Medical Condition. This condition includes symptoms of intense anxiety or panic that are directly caused by a physical illness. Approximately 10% to 29% of Individuals with head and neck cancer experience symptoms of anxiety.[1] This diagnosis established a causal link between the chemical exposure and the anxiety if, in fact, the spill caused the cancer.

Consideration for the Mass Tort Attorney: Hiring an Expert Witness

In establishing a team of experts to opine in mass torts involving emotional distress or other psychiatric illness, it is advisable to consult with a forensic psychiatrist.

Causation and Damages

In toxic torts, the opinions of toxicologists, neurologists, medical toxicologists and other experts are important to obtain the causal link and/or assess damages.

Forensic psychiatrists, as physicians, are better suited in cases involving medical issues than psychologists, who are not medical doctors.

It is not unusual for alleged toxic exposure to impact health. Various medical specialists may be involved.

Expert Witness Experienced in Mass Tort Cases

Retaining an expert with experience in mass torts can be helpful to the trier of fact. Mass torts have unique complexities and other nuances.

For example, if plaintiffs reflect a community, like a town or neighborhood, features of mental illness may present differently than if there is a single plaintiff and a single injury.

When there are multiple plaintiffs, I may conduct IMEs of some or all of the individuals.

Evaluation by an Expert Witness Team in Relevant Specialties

Sometimes I team with other specialists including other forensic psychiatrists to assess the plaintiffs. A group of specialists working on a single case provides efficiency and a deeper understanding of findings allow practitioners to approach a question together. This is a considerable benefit to attorneys as they need not find each specialist on their own, or guess about the area of expertise that is relevant.

Case Merit, Damages Insight Early

Experience has led me to recommend that experts be retained earlier in the case to assist the law firm with triaging the plaintiffs who are most suited for IMEs.

[1] Psychological Problems among Head and Neck Cancer Patients in Relation to Utilization of Healthcare and Informal Care and Costs in the First Two Years after Diagnosis; Florie E. van Beek et al; Curr. Oncol. 2022, 29, 3200–3214

Serial Sexual Assault

Multiple women sued for emotional distress after sexual assaults by a single Defendant. Drug Facilitated Sexual Assault (DFSA)* was a related factor.

The defendant was convicted of DFSA and was sued by three plaintiffs for two separate incidents. I was retained by counsel for several plaintiffs In both incidents, the defendant was accused of adding a sedative medication to the respective plaintiff’s beverage, causing them to black out.

The plaintiffs were drinking and in at least one of the incidents, using an illicit drug. Sometime after the plaintiffs had awoken, they realized they had been sexually assaulted.

In my capacity as a retained expert witness forensic psychiatrist, I examined one of the plaintiffs before the case was settled and issued my findings. In that case, the plaintiff developed anxiety, depression, and PTSD symptoms after the sexual assault. It affected her sporting career and caused significant emotional distress which impacted her career trajectory.

In cases involving intoxication and blackouts, it is important to retain a psychiatric physician as opposed to a psychologist. The psychologist does not have the expertise to discuss the psychopharmacology of DFSA, interpreting labs, and discussing blackouts.

“Date Rape Drugs: Weaponized Chemistry” is my article on this site that dives deeper into DFSA.

What is a Medical Review Officer: MRO Certification. In DFSA cases, a Medical Review Officer (I am an MRO) is trained in interpreting drug testing and results. In early reporting of DFSA, the presence or absence of medications might be relevant. The MRO’s training has special applications in this regard.

Sanjay G. Adhia, M.D., MRO

Dr. Adhia is a triple Board-Certified Psychiatrist in Forensic Psychiatry, Psychiatry, and Brain Injury Medicine. He is a practicing clinical psychiatrist. Dr. Adhia is fascinated by the unique interface of neuropsychiatry and the law. His interests led him to obtain experience and Board Certification in Brain Injury Medicine. He treats patients with brain injuries, strokes, spinal cord injuries, and other neurological disorders at TIRR Memorial Hermann, a teaching hospital in Houston and a renowned neurorehabilitation center. Dr. Adhia explains more about Brain Injury Medicine on his website.
Dr. Adhia is also a forensic psychiatrist who works with attorneys and others on a wide variety of cases including personal injury, medical malpractice, probate, and criminal cases along with independent medical exams.

Sanjay Adhia, M.D., MRO, Forensic Psychiatrist
(832) 746-5905

Copyright Sanjay Adhia, MD

Disclaimer: While every effort has been made to ensure the accuracy of this publication, it is not intended to provide legal advice as individual situations will differ and should be discussed with an expert and/or lawyer.For specific technical or legal advice on the information provided and related topics, please contact the author.

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