Normand v. United States of America, No. 7:2010cv00551 - Document 29 (W.D. Va. 2012)

Court Description: MEMORANDUM OPINION. Signed by District Judge Glen E. Conrad on 1/17/2012. (ssm)

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etEe .oFFl U' :1 O QRT ee :, R ATR- OKeI VA FI LED I TH E U N I N TED STA TES D I STRI COU RT CT FO R TH E W ESTERN D I STRI O F V I I I CT RG N A ROA N OK E D I I ON V SI J 1? 2 1 AN 22 J D sxULA C. DLEY, ERK E W.. ,LR C. t K RI ARD A LLAN N O RM AN D, CH Pli if antf, Ci lAc i N o.7:0- vvi ton 1 c 00551 M EM O M N D UM O PI I N N O UN I TED STATES OF AM ERI CA, By' Hon. enE.Conr d . Gl a Chi fUnied St t D i ti tJ e e t a es sr c udg D e e nt f nda . Thepli if RihadAla Nor nd(ç r nd'o t aitf ',i tae t scvi antf, c r ln ma ç ma ' r d nif) niitd hi i l No pl aci o De embe 1 201 undert Fe r TorsCli Ac ($ ton n c r 0, 0 he deal t am t E FTCA' , U. C.jj26 ' 28 S. ) 71 80( 06) al i t tt Unie SttsofAmeia(û fnda t',hr 20 , legng ha he td ae rc i e n' t oughisag nt a de ) t e s nd e pl s neglge l f l t di nos a t e thi pr t t c nce i a tm e y m a r m oyee , i nty aied o ag e nd r a s os a e a r n i l nne , ca i hi t under r dito te t nt whih r nde e hi i usng m o go a ai n r a me s c e r d m mpot nt Theca ei c r nty e . s s ure l b fr t ec u t nt ed fn a tsmoinf rs mmayj d me t i wh c t ed fn n ag e e oe h o r o h e e d n ' to o u l u g n ,n ih h ee da t r u s t tt pl i ifhaspr s nt d i uf i e e de e t s ha he a ntf e e e ns fci nt vi nc o uppor fndi r ga di t a i a e t i ngs e r ng he pplc bl s a r ofca e, e h oft s a r ofca e a c us ton, le s ntale e e s o t t nda d r br ac he t nda d r , nd a a i al s e i l m nt f he pl i ifsneg i ncec am .1 Fort r as a antf ' lge li he e ons nnou d fom t benc a t c l i oft nce r he h t he oncuson he J nua y 1 201 he r ng on t sm o i a ass tf wa d i t s opi on,t cour w ilgr nt a r 2, 2 a i hi ton, nd e or r n hi ni he t l a i pat n d n i pathed fn n ' moin frs mmayj d me t n r a d e y n r t ee da ts to o u r u g n . i l teo iia bifi s p o t fi moinfrs mmayj d me tDo k t .1 )ted fn a t n h rgn l re n u p r o t to o u r u g n ( c e No 8 ,h ee d n s rq etdsmmayj d me t nl o teis eo c uain Howe e,h panifsrs n ieb ifa de sdte e u se u r u g n o y n h su f a sto . v rte litf' epo sv re d rse h iseo c u aina das teis e o tea pl a l sa d r o cr a dof ra ho ta sa d r .( c e No. su f a st n lo h su s fh p i be tn ad f ae n b e c fh t tn ad Do k t o c 2 . Th d fn n rs o d dwi a oh rb ifi whc irq etds mmayj d me t nteis e rg r ig 0) e ee da te p n e t n te re n ih t e u se u r u g n o h su s e adn h t a i bl sa d ofc r a ofbr ac oft sa dad,i addii t ispr vi r ques f s m m a y he pplca e tndar a e nd e h he tn r n ton o t e ous e t or u r j d me to t is eo c u ain ( c e No 2 . u g n n he su f a sto . Do k t . 3) 1. Fact and ProceduralBackzround ual Ther l va f c soft sc e, f t mos pa t a eno i diput 2 A lhough t Unie e e nt a t hi as or he he t d t r, r t n s e. t St t s i t nn e de e nti t s c e N or a a l ge t tt neglgenc a os f om t a e s he m d f nda n hi as , m nd le s ha he i e r e r he a soft heat c r pr vi r a t VeeansAd nitai M e c lCentrC: ct wo lh ae o des t he tr mi srton dia e VAMC' i 'n ) Sae Vigi a sha lm, r ni- nnonCohe ($ n')afmiynureprcii r a Dr W ale W a n$ Cohe ', a l s a ttone, nd . tr de ($ . a e' au oogs. $ W d ' r l it Dr ) Nor ndbe nr ei ngteamen fom t VAMC i 1 ma ga ec vi r t t r he n 996.( ke No.20a 1 ) Doc t t -2. Ree ntt t sc ei t tNor ' Pr tt Spe ii Antge (TSA'3l l r ese diy lva o hi as s ha mand s osae cfc i n ( ' eves os ta l ) e c ye a trhi 2000 r s t 4 a h ar fe s e uls. On Se e be 27, 2005,t pl i tf m e w ih Co 5t r vi w t r uls ofhi l t t pt m r s a es he a n if t t hen o e e he es t PSA ts.( ke No.18a 3. Noi ngars i Nor nd' PSA, e t Doc t t ) tci ie n ma s Cohenrfredhi t t eer m o he VAM C ur og de rme f ac ulai (#. OnOcobe 6,2005 Nor ol y pa t nt or ons tton. J ) t r , mandme wih t t VAM C ur ogs Dr RamaVama(t .Vama'.(4a Abnor r ulsfom adiia r tl ol it . r $ Dr r ' L ) ) mal es t r gtl eca e m i to c bi d w ih N or a s rs ng PSA , om pt Dr V a m a t r c m e a xn na i n, om ne t m nd' i i pr ed . r o e om nd ta rca ulrs undbi y.(#z Thebi ywasshe uld,butwasc ele byNor nd rnse tl ta o ops J . ) ops c d e anc ld ma on Ocobe 20, t r 2005.( Docke No.1 5a 3. t 8- t ) 2 Theco tpr e st f t i t lgh mos fvor et No mand t no ur es nt he acs n he i t t a abl o r he nmovi pa t . Te a ' Fl ng ry r s oor Faho s lc v. lln tnld s.n .7 3F.d6 4, 0(t Ci.1 8 ) s in -n . Bt ico n u .lc, 6 2 0 61 4h r 9 5. r 3 4 PSA i am a ke f dignosng pr tt c e . s r r or a i osae anc r Nor a sPSA r ulsf t tm ei que to we easf l : m nd' es t or he i n sin r olows 8/ 00: 26/ 2/ 01: 20/ 22102: / / l / 03: 06/ 79/ / 04: 9 25/ / 05: 4/ 3/ 1 06: 1 3/ / 07: 8 22/ / 07: 14 . 16 . 1. 7 2. 3 3. 3 4. 8 5. 9 7. 6 11. 1 ( c e No. 0a 2 3. Do k t 2 t - ) 5 Co n te t d N onna durng t tm e f a er e ntt t s c e, b g n i gi 20 0 ( c e No 2 he r a e nd i he i r m elva o hi as e i n n n 0 . Do k t . 0 1 a 20) t . 2 Thene dae ofno ewasa xt t t boutsx m o hslt r on Aprl1 2006, n at s r ve e i nt ae , i 3, whe e t e ald t t r nd' PSA ha rsnt 5. ( ke No. a 3. No ma as ha hi frtmeei ha Noma s d ie o 9. Doc t 20 t ) r nd lo d s is tng wihDr W a o t tda ( ke No.1 a 3. Ba e ont co i t . de n ha y. Doc t 8 t ) s d he ntnuousrs ofNor nd' ie ma s PSA a on t ve oc t oft rs ,D r W a s he ed a bi y, hi w a per or e on M ay nd he l iy he i e . de c dul ops w ch s f m d 1 , 0 6 ( c e No 2 a 3) Th bo s r v ae t a n n o t esx smplsc nan d 8 2 0 . Do k t . 0 t . e ip y e e ld h t o e f h i a e o tie c e ousm a e i ;howe r ac or ngt t bi yr po t ones mpl diplye a S i l anc r t ral ve , c di o he ops e r, a e s a d i ng e s f usofat ca ga s pii frmaina y.'( oc ypi l lnds us cous o lg nc ' Docke No.1 7. Dr W a dic s d t 8- ) . de suse t r s t wiht pli ifonM a 30,2006.( ke No.20a 3. Thepli ifa s t t t he euls t he antf y Doc t t ) antf sers ha Dr W a f l d t r . de aie o evea t hi t tone oft s m pl di pl d a s pi on f t algna y'; l o m ha he a es s aye us ci or t i nc ' m i t d, hepl ntf a r ,Dr W a advie hi onl t tt t s r t ne Cs pi o -ooki nsea t ai if ve s . de s d m y ha he e t e ur d 'us ciusl ng rs t.'( ke No.1 1 a 3;Doc tNo. 1a 61. Att c l i oft me i Dr e uls' Doc t 8- 4 t ke 20- t ) he oncuson he etng, . W a i t uc e N or a t r t n t t V AM C i one ye r on M a 31 2007,f a f l de ns r t d m nd o e ur o he n a, y , or olow up viian f a he PSA ts.( ketNo.1 a 4;Do ketNo.20a 3. Dr W adedi not st d or not r et Doc 8t c t ) . d she ul arp a b o s a t t i .( c e No. 8 8) c d e e e t i p y tha tme Do k t 1 - . N o nd di notw a tt i t M a 31 2007 a nt e t r t n t t V A M C . nna d i mtl he y , ppoi m nt o e ur o he l t d, rt nedo Jnuay3,2007,c ai ngofnocura(rque yofurnai a nsea he eur n a r ompl ni t i fe nc i ton t ni t.( ke No.1 9a 2. A ts o t sdaerveaedt thi PSA ha rs nt 7. gh) Doc t 8- t ) et n hi t e l ha s d ie o 6. ( ke No. a 3. Cohe wr et Nonnandt i or hi oft t trs t a f rhe Doc t 20 t ) n ot o o nf m m he es e uls nd u t r advied t tno f t re ua i w a r uie a t ttm e, e o t pe ng a nt e t s ha urhe val ton s eq r d t ha i bas d n he ndi ppoi m n sh d ldfrM a 31 20 7 ( c t .1 - a 7)No ma dt nv stdDr W a eo c e u e o y , 0 . Do ke No 8 9 t . r n he iie . d n Fe ua y 27,2007,a a t rr vi wi t l t tt tr uls D r W ade s he e a he br r nd, f e e e ng he a es es es t , . c dul d not r bi y f t u omi M a 31vii.( ke No.1 1 )Howe r Nor ops or he pc ng y st Doc t 8- 0. ve , mandc nc l t s a eled hi bi y, ii aconfi i hi s dul ( ke No.1 1 a 5 ) ops ctng ld n s che e. Doc t 8-4 t -6. The e tr t VAM C t mi t d Dr W a i J 2007 a Nor a r e ve anonr afe , he er na e . de n une nd m nd ec i d VAM C r fra t Dr Da dKa e (i . g y', t oo iti Au u t 0 .( c e No 1 e erl o . vi g y ç Ka e ' a l lg s,n g s 20 7 Do k t . 8 Dr ) r a 5. A Se e r28,2007bips rveae t tNor t ) ptmbe o y e ld ha mandwast n s f i fom pr tt he uferng r osae c e .( ke No.20a 3. Afe undegoi abre r i nofhor anc r Doc t t ) tr r ng if egme monet rpy,hepli if hea t antf u d r n ar dc l r sae tmyp ro me b DrKa e o J n a y3 , 0 8 (I)Fo mo t n e we t a ia p o ttco ef r d y . g y n a u r 0 2 0 . Ll r s , of2008, ma sPSA r m ane undee a ea f rhe mor Nor a wasabl t obt i Nor nd' e i d tctbl nd, u t r e, m nd e o an eeci f l ngt s gey.(d. t3 ) Ho ve,hi PSA be nrsnga nt r t r tons olowi he ur r I a -4. we r s ga ii gai owads he e of2008and Dr Kage r f r e Nor ndt Dr Robe t He t ar a i onc ogit nd . y e e r d ma o . r C. a h, aditon ol s. (1. t4. Nor ndbega rc vi t frtoft ry- nerditonte t nt i J uay20 1 a ) ma n e ei ng he is hit ni a ai r ame s n an r 09. (d. Alho ht pl ntf sc nc i i rmison,healge t thei now i tnta ar s t I ) t ug he ai if a er s n e si le s ha s mpoe s eul oft rditont rpy.(d. he a ai hea 1 ) OnDe e e 1 , 01 ,h UntdS ae fldismo inf rs c mb r 6 2 1 te ie tts ie t to o umma yj d me t r u g n. Ha ng be n f l bre ed a a gued, he m oto i now r pe f di pos ton. vi e uly i f nd r t in s i or s ii II. Di scuss on i 1 . Le St gal andar d l c n ie i amoinf rs mmayj d me t d rFe ea Rueo Cii P o e u e5 , n o sd rng to o u r u g n un e d r l l f vl r c d r 6 ç he c t sr uie t vi w t f c sa dr w r a ona e i e e s i a lghtm os f vor bl t our i eq r d o e he a t nd a e s bl nf r nce n i t ta a e t t en n vn p ry' S a v S rud 1 F.d7 , 98( t Ci.1 9 ) Th c u t y o h o mo ig a t. h w . to , 3 3 91 7 4h r 9 4 . e o r ma ' g a ts mmayj d me t nl wh n, e n terc r a awh l a di t lg tmo t rn u r u g n o y e viwig h e o d s oe n n he i h s f vor bl t t nonm ovi pa t t r i no g nui i s ofm a e i f c a t nonm ovi a a e o he ng ry, he e s e ne s ue t ral a t nd he ng p ryi e tte t j d me ta amatro lw.Ceoe Co p v Cart 4 7U.. 1 , 2 - 4 a t s n ild o u g n s te f a ltx r . . tet 7 S 3 7 3 2 2 ( 986) Ter sFl Fas ons I . Buri onI .I , F. 604, 0( h Ci.1 5) 1 ; ry' oor hi .nc v. lnat ndus. nc.763 2d 61 4t r 98 . Fo apat se ie c t rieag n ieis eo maeilfc t t v d s mmayj d me t r ry' vd n e o as e un su f tra a tha a ois u r u g n, 4 tee d n emu tb t u ht a ara o a l j r c udrtr avedc f rt no mo ig h vie c s e t c h t e s n b e u y o l eu n r it o he n vn s pa t ' Andes n v.Li t Lobby.nc.47 U. 242,248( 986) ry.' ro bery I , 7 S. 1 . A nal s ysi I or rt e t bls a neglg nc c ai unde V igi a l w ,6a pl i ifm us s ts y f n de o s a i h ie e l m r r ni a t a i f our a ntf ba i elme sbyaprponde mzeoft e d nce:( )duy,( brac ( c uston, nd( sc e nt e r c he vie 1 t 2) e h, 3) a ai a 4) h n M ur yv. t dS ae , 5F.d46 , 6 ( t Ci. 0 0 .t s n t err c s i a u. ra Uni tts 21 3 0 4 3 4h r 2 0 ) s e t h ae a e n e Ab whih t al d ne i nta to o ison i cla l wihi t c c he lege glge c r m s i s e ry t n he ommon knowl dgeoflyme e a n, txpe t esi on i o di rl ne es a y't esa iht eelme s' Ca pbe lv.Unie e r t tm y s r na iy c s r o t bls hes e nt .' m l td Stt , 11 1 4,2012W L 34445,a *3( h Ci. a 9,201 ( i Pake v.Unie aes No. - 55 t 4t rJ n. 2) quotng r r td Stt , F.Supp. 594,598( D. .2007) seas W e v.Smih,661S. 2d457, 9 aes 475 2d E. Va ); e lo bb t E. 45 ( 2008) To stsyt s elment t ought prs nttonofe r t tmony,t pli if Va. . aif he e e s hr he e e ai xpe tesi he antf s t t debenee s de ii t tmonyo DrNori W . hil k(t . hil k', ubmis he s e poston esi f . rs W toc û W toc ' a Dr ) boar ce tte ur ogit ( cke No.20- . d- rii d ol s. Do t 1) a. Dut ( andar ofCar ) y St d e The du y e e e r quiest pl i ift es a i h t a i bl s a r ofca e t l m nt e r he a ntf o t bls he pplca e t nda d r. Rane v.Luz,3 S. 2d 1 1 ( 1 .Be a equaii to ofsa r ofc r is t 41 E. 94, 96 Va. 986) c us lfcain tndad- -a e expe t i m edi a m a pr c i e c e i a i s ofs t ntve l w ,V igi a 1 w a i t t rs n c l l a tc as s s n s ue ubs a i a r ni a pples o he qualtcai oft e rspr f r d i t sc s . Pec v.Te m e r 834 F. pp.903,90 0 ii ton he xpe t ofe e n hi a e k ct ve , Su 9-1 ( . Va 1 ;s ealoCl ev.Unie Stts Ci lAci No. 1 W D. . 992) e s os td ae , vi ton 7:0CV0007,2011W L 1 230266,a #2( . Va. a . ,2011;W or nv. ke ,Ci lAci No. 09- 41 t W D. M r 31 ) kma Ba r vi ton 7: CV- 5, 201 W L 4054470,a *2( . Va.Oc.1 201 .Specfc ly,Vigi aCodej8. - . 0 t W D. t 3, 0) iial r ni 0158120 delneat t s andar f qualf ng asan exper ,pr di i peri i es he t d or iyi t ovi ng n tnentpar : t 6 Be us t alege ne i nceoc re i Vigi a N or a s c pl i i gove ned by Vigi a l w . ca e he l d glge cu rd n r ni, m nd' om a nt s r r ni a S e28U.. j1 46 9()( diai ta FTCA camsaeg v r e b t ta o teplc wh r t a to e SC. 3 0 1 i c t h t n ng li r o en d y heç w fh a e ee he c r l o s in o c re ' . miso c u r d' ) A wines s l be quaii d t t tf a a e r on t sa z ofca e i he t s ha l lfe o esiy s n xpe t he tnda d r f de o ta e e r kno edg o t sa r oft de e nts s i t a m nsrt s xpe t wl e f he t nda ds he f nda ' pecaly nd ofwha c t onduc conf msorf ist c onn t t e sanda dsa i he ha ha t or a l o onf o hos t r nd f s d a tve clni l pr c i i e t r t de e nts s c a t or a r a e f e d o ci i ca a tce n ihe he f nda ' pe i ly el t d i l f m e ci w ihi one ye r o t da e of t a l d a t or om i s on f m i t di ne t n a f he t he lege c s i or ng he ba i oft a i s s he d on. Va Codej8. - 120( ( et2011.Theq si ofwhehe awine sstsist ditts . 0158 . A) W s ) ueton t r t s aife he cae ofj8. - 1. A) a t rbyquaiisa a e r wine s i tageywihi t s 01 58 20( , nd hee lfe s n xpe t t s, s t r l t n he ound l dicei oft tilcour. W orma 201 W L 4054470, t* (ntr lquoai maks s rton he ra t' ' k n, 0 a 2 i ena tton r omitd)( i W rchtv. ye,593S. 2d307,31 ( 2004). te quotng i Ka E. 2 Va. ) Ha ngconsdee t rquie nt ofj8. - 20( a Dr W hil k' t tmony, vi i rd he e r me s 01581. A) nd . toc s esi t co t he ur conc udest tD r W hil l ha . tock,a ur ogit i no qua ii d t r nde a e r opi o as ol s , s t lfe o e r n xpe t ni n t t s a r ofc r a i a e t Cohe s c fc ly, he s a r ofc r i pos d upon a o he t nda d a e pplc bl o n- pe ii a l t t nda d ae m e nur e who tea s a m a whos PSA i t s e on a a s r t n e s etd n nnua bas s7 I D r W hil sde be e s l i. n . tock' ne s e de ii he c e t theha no knowl dgeoft tai ng t tanur epr cii r poston, onc ded ha d e he r ni ha s a ttone undeg s ( ke No.20- at47. The e fe,t e ha bewe ndefns c e a Dr roe . Doc t 1 ) r atr he xc nge t e e e ouns l nd . W hil pr tock oceeded as f l s: olow Q. So,i woul befi t syt ty woul no know,ba e onyou t d ar o a ha ou d t sd r l c oft a ni a e re a a nur e pr c ii ne ,wha t s a r of c r ak r i ng nd xpe i nce s s a tto r t he t nda d ae wo d ha bee f M s Cohe i 2004, ul yo ul ve n or . n n wo d u? A. I a not s e wha s kne ,no,l do t ha a know l e o m ur t he w n' ve ny edg n t hat. (d. I) He ,bas d on D r W hil sow n a i s o he l c e nce e . tock' dm s i n, a ks xper know l dg oft t e e he sa dst tgovenanurepr ttone ' pef ma a t r or,purua t j8. tndar ha r s acii rs ror nce nd,heef e s nt o 01 7 Alhough Dr W hil k aserst the aur ogit woul ha r e r Nor t . toc s t ha ol s, d ve efred mandt t V AM C ur ogy o he ol d p rme t e Noma dsPS b e c e 20i 2 0 ( c e No. 0 1a 2 -21, etee h ra k o e g s e at n wh n r n ' A ra h d . n 0 3 Do k t 2 - t 0 )h h ra e c n wld e t tt pr aii FDA sa d f am a ofNor a sa woul r r alr og r era o yoncet PSA ha he ev lng tndar or n m nd' ge d equie zol y ef r l nl he r a h d4..(d a 4 ) W he a k d wh tsa d r o c r wo l a pyt t ep ro ma c o an rep a tt n r e c e 0 I . t 6. n s e a tn a d f ae u d p l o h e f r n e f u s r cii e , o a s i t tt gov nm en ' sa d e t ihi aPSA of4. i det m i ngt ne f f rhe te t e w a s um ng ha he er ts tndar sabls ng 0 n er ni he ed or u t r r am nt s ful , . to kfi dt p o iead fnt atr ai sa d r .(d a 4 47) a t DrWhi c al o r vd eii l n t tn ad 1 . t 6. . y l e e e ve 6 58120( ,i no qualfedt ofe ane r opi onont sa r ofc ea iabl t Cohe . A) s t ii o fr xpe t ni he tndad ar pplc e o n i t s c s . I lghtoft sde s on,t co t us g a t govemm e ' m o i f s m a y n hi a e n i hi ci i he ur m t r nt he l nt s ton or um r j d me ta t Co e - wih u aq aiide etoe tbl htesa d r o c r a pia l t u g n s o h n t o t u lfe xp r t sa i h tn ad f a e p lc be o s Cohe t pl i ifi una e t s ts y t ne es a y du y e e e ofhi ne i nc c ai n, he a ntf s bl o a i f he c s r t l m nt s glge e l m ag ns Co n. ai t he Ont eoh rh n ,h c u t o cu e t a, a e o ter q ie n so j801 h te a d te o r c n ld s h tb s d n h e urme t f . 581. A) Dr W hil k,a a tveboa d-ette url s wihe e i clnia e re ei 20( , . toc n ci r c rii d oogit t xtnsve i c l xpeinc n t tfed,i quaiid t r ra expe topi o ast t sa r ofca ea iabl t Dr ha i l s lfe o ende n r ni n o he t nda d r pplc e o . W a ,a he ur ogit (d. t5 7. de not r ol s. I a -1 ) b. Breach Vi wi t f t i a lghtm os f vor bl t Nor nd, henonmovi pa t t cou t e ng he ac s n i t a a e o ma t ng ry, he r c n l d st a t panifh sp e e tds fiin e ie eo ti s mmayj d me tmo in o cu e h the litf a rs ne u tce t vd nc n h s u r u g n to t c ea e a ge ne i s ofm a era f c a t w he he , olow i t M a 30, o r t nui s ue t il a t s o t r f l ng he y 2006 c ula i n ons t to w ih N o m a c t r nd once ni t bi y r s t , r W a e br c t s a r ng he ops e uls D . d ea hed he t ndm' ofc r w he he d ae n f ie t s he e ar pea bi y wihi as re pe i oftm e.Dr W hil k t sii d al d o c dul e t ops t n ho tr rod i . toc e tte e mpha i ly t t knowi oft t us ci ' bi y r ulsa ofNor a sco t n l rsng tcal ha , ng he s pi ous' ops es t nd s m nd' nsa ty ii PSA,t sa r ofc r r quie Dr W ad t s he ear pea bi y no lt rt n sx m o hs he t nda d a e e r d . e o c dul e t ops a e ha i nt f o t tm e oft M a 3 2006 c ula i r m he i he y 0, ons t ton- s e i e a ound t e ofN ove be 2006. om tm r he nd m r td. t24 ) l ta bohpa te a e t tDr W a di notshedul ar pe tbi y, L= a -26. nse d, t ris gre ha . de d c e e a ops but rt r s he e onl ar t nvii f aPSA ts oneye rltr o M a 31 2007.( ke No. ahe, c duld y eur st or et a ae , n y , Doc t 1 a 4; ke No. a 3. Fu t r e,atrNo ma rt ne t t VAM C o Fe u r 8 t Doc t 20 t ) rhemor fe r nd eur d o he n br ay 27,2007,Dr.W ade di notschedul an i m edi e bi d e m at opsy,buti ead,schedul a bi nst ed opsy f or tle mo hsltr ont M a 31a nt nt ( ke No.1 1 ) lre nt ae, he y ppoi me . Doc t 8- 0. 7 C. Caus t on ai Li wie, hec tc l st t vi wi t f c si a lg mos f vo abl t ke s t our onc ude ha , e ng he a t n i ht t a r e o N o m a a r as r nd, e onabl f ti rc d consr e D r W hil k' t s i ony t s a e t ti i m o e e ac fnde oul t u . toc s e tm o t t ha t s r lke y t n no t t i a r a bi y had be n pe f m e l t ri 2006,r a i n w oul notha i l ha t ha , f epe t ops e r or d a e n adi t o d ve bee r q rda tus t pl ntf woul nothav bec i e .( ke No. 1a 30 n e uie nd,h ,he ai if d e ome mpotnt Doc t 20- t - 3 ) W h l t ec u t oe t t h panifsc s c nan s b tn il a n s e o t eis e 6. ie h o r n ts ha t e litf a e o tis u sa ta we k e s s n h su ofc ai ( cai dbyDr W hil k' va iltngtsi nyont sis ) t co t auston oc sone . toc s clai etmo hi sue,he ur none he es m us vi w t f c si a lg m os f vor bl t t pl ntf a t s s a i t c e. t l s t e he a t n i ht t a a e o he ai i f t hi t ge n he as Furhe r t co tr cog z t tt pl i i fne d no pr ca a i t a c r a nt b t nuo e, he ur e ni es ha he a ntf e t ove us ton o e t i y, ut nee o ypr tha t t fnda tsbr a hofdut wasmo elkel t nnot(..pr bl d nl ove l the dee n ' e c t y r i y ha ie, oba y) t c u eo ij r ' nuv 21 F.da 4 3(u tn Hu lyv. ie Sae , 2 F.d 1 91 he a s f nu y.' 'Mu , 5 3 t 6 q o ig re Untd tts 9 3 2 0 , 1 (t Ci.1 ).Thus ad i avi oft e de et ti mos fvorbl t t 094 4h r 991) , optng ew he vi nc ha s t a a e o he pl ntf , nd bea i i m i t tt l w ofc us ton ld l i pr biii ,' ohe t v. l c ai if a rng n nd ha he a a a i t ea s n oba ltes' D r v A e k, 641S. 2d93, ( 2007) t c tsc tane t c l t tt pli ifha prsntd E. 97 Va. , he our i onsri d o oncude ha he antf s ee e s fcen e de t cr a ea g nui is ofma e ilf tast t is ofca a i ufi i t vi nce o e t e ne s ue t ra ac o he s ue us ton. 11 1. Concl on usi Ase pan da o e t ec ur g a t ted f n a ' moin frs mmayj g n i is x lie b v ,h o t rns h e e d nts to o u r ud me t n t e ie y a t Cohe The co ta i s r s e t to y a lm ied po ton oft pl ntf ' c s ntr t s o n. ur ga n t e s s ha nl i t ri he ai if s a e a ans Dr W a es r i e ted fn a tsmoinf rs mmayj g n .S e i c ly t e g i t . d u v v s h e e d n ' to o u r ud me t p ct al,h i pl i if s iss fci nte de e t c e t a ge ne i s ofm a e i f tonl on t i s s a ntf ubm t uf i e vi nc o r a e nui s ue t ral ac y he s ue ofwhe he Dr W a sf iur t s he ear pe tbips wihi as trpe i oftme t r . de' a l e o c dul e a o y t n hore rod i f l i t M a 30,2006 co ula i n br c d t s a r ofc r a f rhe m or , olow ng he y ns t to ea he he t nda d a e nd, u t r e pr xi t l c us d t pli ifsnee f r diton t r py.The c t ni t de e nts o ma ey a e he antf d or a a i he a our de es he f nda ' 8 moinf rsl r j d me to l a t t sd srt is e we e ,h c u t rn ste to o t mma y u g n ny s o hi icee su .Ho v r t e o r g a t h motonwih r s tt t pl i ifsca m a i tDr W a i a1o he r s c s i t e pec o he antf li ga ns . de n l t r e pe t . TheClr i die t d t s nd ce tte c esoft sme or ndum opi on a t ek s rce o e rii d opi hi m a ni nd he a co pa ng or rt a 1c c m nyi de o 1 ouns lofr or e ec d. ENTER:Th s t18 d yo J n ay 2 2 i a f a u r , 01 . . Chi fU nied St t D i ti tJ e t a es s r c udge 9

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