Clarifying the “Obvious Alternative Cause” Test for Expert Testimony under Rule 702: Faison-Williams v. United States

Introduction

In Faison-Williams v. United States (2d Cir. Apr. 1, 2025; No. 24-1404), the Second Circuit addressed two central issues arising under the Federal Tort Claims Act (FTCA) and Federal Rule of Evidence 702. Plaintiff-appellant Natasha Faison-Williams, a veteran, alleged that her Veterans Affairs (VA) surgeon, Dr. James Stone, was negligent in scheduling and supervising a thoracic microdiscectomy, resulting in an epidural hematoma, spinal cord injury, and long-term neurological deficits. After the district court excluded the plaintiff’s causation expert under Rule 702 and granted summary judgment for the government, Faison-Williams appealed. The Court of Appeals vacated and remanded, holding that (1) the FTCA presentment requirement encompassed both performance and scheduling claims, and (2) the district court abused its discretion by misapplying the “obvious alternative cause” test and excluding the expert’s testimony.

Summary of the Judgment

The Second Circuit’s summary order (non-precedential) accomplished three things:

Subject-Matter Jurisdiction: The court rejected the government’s argument that Faison-Williams failed to exhaust administrative remedies for her scheduling-related negligence theory. It held that an administrative claim alleging deviation from the standard of care in performing the surgery would put the agency on notice to investigate both the decision to operate and the performance of the operation.
Expert Testimony Exclusion: On the merits of the Daubert challenge, the panel concluded the district court abused its discretion by excluding Dr. Martin Zonenshayn’s causation opinion. Although Rule 702 permits courts to consider whether an expert “adequately accounted for obvious alternative explanations,” the court found the lower court had applied too rigid a standard—requiring categorical elimination of every alternative—rather than assessing whether Dr. Zonenshayn provided reasoned, non-conclusory responses to each major alternative cause.
Remand: Because the exclusion of the only causation expert left Faison-Williams without evidence to oppose summary judgment, the court vacated the entry of summary judgment and remanded for further proceedings consistent with the proper application of Rule 702.

Analysis

Precedents Cited

Federal Rule of Evidence 702 (as amended in 2000): Requires that expert testimony rest on reliable methods and a reliable application of those methods to the facts.
Amorgianos v. National Railroad Passenger Corp., 303 F.3d 256 (2d Cir. 2002): Affirms the district court’s gatekeeping role under Daubert and Rule 702.
Kumho Tire Co. v. Carmichael, 526 U.S. 137 (1999): Extends Daubert’s gatekeeping to all expert testimony, reaffirming that reliability, not credentials alone, controls admissibility.
McNeil v. United States, 508 U.S. 106 (1993): Establishes that FTCA plaintiffs must exhaust administrative remedies before filing suit.
Collins v. United States, 996 F.3d 102 (2d Cir. 2021): Articulates the specificity required in an FTCA administrative claim to satisfy the presentment requirement.
Johnson v. United States, 788 F.2d 845 (2d Cir. 1986): Emphasizes that administrative presentment need not use formal pleading standards but must enable the agency to investigate liability and value the claim.

Legal Reasoning

1. FTCA Presentment: Section 2675(a) of the FTCA obliges a claimant to present a “sufficiently specific” administrative claim. The court held that stating Dr. Stone “deviated from the accepted standard of medical care” in performing a thoracic microdiscectomy necessarily puts the VA on notice to investigate whether the surgery was indicated (i.e., scheduling/scope decisions) as well as how it was performed.

2. Rule 702 and “Obvious Alternative Cause”: Under Rule 702, district courts must screen expert testimony for reliability. One recognized reliability factor is whether the expert has “adequately accounted for obvious alternative explanations.” The district court excluded Dr. Zonenshayn’s causation testimony on the ground that he “failed to rule out” competing causes such as cervical spine disease, preexisting bladder issues, or psychological factors.

The Second Circuit found two errors in that analysis:

Overly Rigid Standard: The district court improperly required categorical exclusion of every alternative. Rule 702 only demands that experts engage alternative explanations with reasoned analysis, not that they eliminate each one beyond all doubt.
Record Contradicts Exclusion: Dr. Zonenshayn, a seasoned neurosurgeon, had in fact explained in detail why each alternative was less plausible:
- He differentiated thoracic vs. cervical myelopathy by correlating objective upper‐extremity signs and radiographic findings.
- He contrasted the patient’s intermittent, pre-surgical urinary issues with the continuous, objectively documented neurogenic bladder dysfunction that followed the epidural hematoma.
- He acknowledged potential psychological overlays but pointed out that the MRI evidence of acute cord compression could not be “made up.”

Because the district court’s exclusion was “manifestly erroneous,” the panel held the testimony should have been admitted and the summary judgment vacated.

Impact

This decision reinforces two important principles for future litigation:

District courts must apply the Daubert/Rule 702 “obvious alternative cause” factor with flexibility, ensuring experts provide reasoned discussions of competing explanations rather than enforcing an impossible “rule out everything” standard.
In FTCA cases, a single‐page administrative claim alleging negligent performance of a procedure can suffice to support broader theories—such as negligent scheduling or indication—if a fair investigation would encompass those issues.

Complex Concepts Simplified

FTCA Presentment Requirement: A rule that says you must first give the federal agency a chance to review and possibly settle your claim before suing in court. You need only provide enough detail so the agency knows what happened, what injuries you claim, and how much you want.
Daubert/Rule 702 Gatekeeping: Courts must ensure that any expert witness has used reliable methods and properly applied them to the facts, so their specialized knowledge actually helps the jury or judge understand the evidence.
Obvious Alternative Cause Test: A factor in assessing an expert’s reliability: did the expert meaningfully consider and explain why other likely causes of the plaintiff’s injury are less persuasive?

Conclusion

Faison-Williams v. United States clarifies two key points in federal tort and evidence law. First, FTCA claimants who allege deviation from the standard of care implicitly present related scheduling or indication theories to the agency. Second, in evaluating expert causation testimony under Rule 702, district courts must respect that experts need only provide reasoned, non-conclusory analyses of obvious alternatives—not an unattainable guarantee of having “ruled them all out.” By vacating the exclusion of Dr. Zonenshayn’s testimony and remanding the case, the Second Circuit underscored the flexible, context-driven nature of Daubert gatekeeping and reinforced the FTCA’s policy favoring administrative investigation and early settlement of federal tort claims.