A federal judge has once again upheld the introduction of diffusion tensor imagining (DTI) in an mTBI case, rejecting defendant’s motion to exclude the DTI findings. In White v. Deere and Co., plaintiff filed a product liability action arising out of an incident that occurred while plaintiff was operating her Deere Model 4600 compact utility tractor and Model 460 loader. Plaintiff asserted that she sustained a traumatic brain injury as a result of a hay bale falling onto her head while she was operating the tractor.

Plaintiff retained Randall Benson, M.D. a board-certified neurologist as one of her medical experts. According to the opinion, Dr. Benson opined plaintiff sustained a traumatic brain injury, basing his opinion, in part, on the results derived from a DTI. Defendants moved to exclude Dr. Benson’s DTI findings, arguing that the DTI finding was unreliable.

The court, after discussing the admissibility standard established by the US Supreme Court in Daubert, Joiner and Kumho Tire, performed an analysis to determine whether Dr. Benson’s use and reliance on DTI was permissible.

Defendants argued that DTI was unreliable as a means for diagnosing individual patients’ injuries. Defendants relied upon a November 2014 research paper by Wintermark et al. that concluded that DTI was only suitable for research and concluded and that there was insufficient evidence to support its routine clinical use at the individual patient level.

Plaintiff opposed the motion, asserting that the Daubert reliability factors were established and Dr. Benson’s opinions based on DTI were admissible. Plaintiff cited numerous articles that supported the conclusion that DTI is a generally accepted diagnostic measure for traumatic brain injury. The trial court noted, one of the papers submitted was a peer-reviewed article that reviewed the last decade of research conducted on DTI, which found “a unifying theme can be deduced from this large body of research; DTI is an extremely useful and robust tool for the detection of TBI-related brain abnormalities. The overwhelming consensus of these studies is that low white matter FA is characteristic of TBI.” M.B.Hulkower et al, A Decade of DTI in Traumatic Brain Injury; 10 Years and 100 Articles Later, 34 am J Neuroadlo 2064, 2071 (2013).

Defendants retained Dr. Hal Wortzel, who criticized the use of DTI in an individual case to support a diagnosis of traumatic brain injury. Regarding Dr. Wortzel, Plaintiff cited to an article by Lipton & Bigler, entitled “Clarifying the Robust Foundation for and Appropriate Use of DTI in mTBI Patients” in AJOB Neuroscience, 2014, the authors commented on Dr. Wortzel, stating: “The misleading and often entirely unsubstantiated opinions and positions of Wortzel, Tsiouris, and Filippi (2014), in opposition to diffusion tensor imaging (DTI) as a useful measure in mTBI, are at odds with the clear consensus of the scientific literature regarding mild traumatic brain injury (mTBI), its clinical assessment, and its natural history. The authors’ critique contains numerous errors.”

The court ruled the affidavit of Dr. Benson satisfied the Daubert criteria. The court also noted that DTI has been found admissible by multiple courts throughout the United States.

In conclusion, the court found that the “Defendants present no basis to exclude Dr. Benson’s causation opinions on the grounds of the alleged unreliability or irrelevance of DTI for identifying a TBI suffered by [Plaintiff].” The motion was denied.

The case is White v. Deere & Co., et al, Civil Case No. 13-cv-02173 (U.S. D.C. CO (2016).