Willey v. Phoenix Rehabilitation and Health Services - Summary Judgment Order

IN THE SUPERIOR COU RT OF THE STATE OF DELAWARE JAME S WILLEY, Plain tiff, v. P HOENIX REHABIL ITATION AND HEALTH SERVICES, I NC., Defen dant.)))))))))) C.A. No: N 2 3C- 09 - 033 KMM Submit ted: January 1 6, 202 6 Decid ed: February 19, 202 6 ORD ER ON MOTIONS F OR SU MMARY JU DGMENT U pon Pho enix Rehabi litatio n’s Mo tion for S ummar y Judgm ent on Pun itive Damage s – GRANTED Up on Wi lley ’s M otion f or Su mmary J udg ment on P hoen ix Reh abili tati on’ s fourt h sixt h, and e igh th affirmati ve defe nse – GRANTED A. I n trodu ct ion Near ly fo ur week s af ter un dergo ing a m icr odis cecto my a t L4 -5, p laint iff Jame s Wille y (“Wi lle y”) sou ght the servic es of P hoen ix Reha bili tati on and Hea lth Serv ices, Inc. (“P hoe nix Re habi lita tio n”), a physic al ther apy provide r. At the ti me of his f irst a ppoi ntme nt wi th Ph oeni x Reha bili tati on, W ille y was under a phys icia n’s restr ict ion that c aut ione d again st bend ing a t the wai st. Des pite Willey i nfor min g Phoenix Rehabi litation of t his restr icti on, d ur ing a n initial evalua tion the th erapist

2 instr ucte d Willey to bend. Wille y did so and imme diate ly fel t a sharp p ain. A n MRI later revea led t hat th e dis k that re quired h is fir st sur gery ha d re- her niate d, and as a result, Willey nee ded a second sur gery. Each pa rty m oved f or summar y judgm ent. P hoen ix Reha bilitat ion seeks summa ry ju dgme nt on Willey ’s cla im for punit ive dam age s, asserti ng that ther e is no factua l bas is to subm it th e issu e to a jur y. Puni tive da mages are availa ble when a defe nda nt’s c onduct i s wi llful or wa nton, describe d as a “ cons cious indiff erence ” to the rig hts of othe rs. He re, t he re cord do es not suppo rt a fin ding that a reason able jury m ight fin d willf ul or wanton co ndu ct, acc ordingl y Phoen ix Reha bil itat ion’ s Moti on is GRA NTED. Separ ate ly, W illey seeks s ummar y judgmen t on three of Phoen ix Reha bilita tion’s a ffir mative def enses. P hoeni x Reha bilitat ion c onte sts the dism issal of two. 0F 1 A t issue are the affirma t ive defenses of com parativ e negl igence an d super seding ca use. Wille y conte nds that Pho enix R ehabilita tion faile d to supp ort these de fen ses with medic al e xper t tes timony and t herefor e, P hoe nix Re habi lita tio n is bar red from asse rti ng the m at t rial. A defend ant bears the b urden of pro ving i ts affirmative defense s. T hus, t o surviv e a motion for summ ary judgme nt, the defe ndan t mus t po int to adm issibl e evi denc e in the recor d sup porting the defense. 1 Phoenix Rehabilitation does not contest Willey’s motion as to the Sixth Affirma tive defense (negligence by a third party), and therefore, the motion is GRANTED on that defense.

3 Phoenix Rehabi litation fail ed to proffer any exper t testimo ny on plai ntif f’s all eged negl igenc e or of a s upe rsedi ng ca use, whic h is r equ ired fo r it to s usta in its burden of proof. Accord ingl y, Wille y’s Mo tion is GR ANTE D. B. B ackg roun d 1F 2 On Aug ust 23, 20 21, Dr. Jus tin Tor tolani (“Dr. Tor tolan i”) p er for med a Right L4 -L 5 m icrodis cectomy on Wille y to repa ir dis k hernia tion. The surger y was large ly a success. Shortly ther eafter, Willey was diagno sed wit h Dee p Vei n T hrombosis (“DVT”). 2F 3 On Se ptember 7, 202 1, at Wille y ’s post - op appoint m ent, D r. To rtolani “[r] eco mmen ded that [Will ey] cont inue t o be min dful of wais t bendin g and h eavy lifti ng or t wisti ng.” 3F 4 He was re lease d to resume wor k the fo llowi ng week, w ith th e cauti on to “avoi d twi sting e special ly at w ork” an d a lift ing res triction of 15 pound s. 4F 5 Wille y was als o referred to physica l thera py. 5F 6 The physic al the rapy pres cription refle cts a r eferr al for “Core stab iliz ation, LE stre ngtheni ng, m odal itie s…Ev al an d trea t.” 6F 7 It did n ot ind icate an y restr ictions. 2 T he facts are d erived f rom t he undisputed facts in the pleadings and exhi bits submitted by the partie s. Citations in the form of [Name] Dep. refer to witness testimony from a de position transcri pt submitted as an exhibit by the parties. 3 D.I. 105, Ex. B at 1. 4 Id. at 2; D. I. 102, Ex. A (“ Tortolani Dep. ”) 18. 5 D.I. 105, Ex. B. 6 D.I. 105, Ex. D. 7 Id.

4 On Sept ember 16, 2021, Wille y present ed to P hoenix Re habi lita tion for an initia l evalu atio n an d trea tment pla n. 7F 8 Domin ick P olicare, DPT (“ Dr. Pol icare ”), a Phoen ix Rehabi lita tion p hysica l therapi st, c onduc ted th e init ial eva luation. 8F 9 Dr. Polica re discus sed wi th Wille y his back gro und, pa in and discom fort leve ls, and his curre nt ac tivity le vel. This di scus sio n led Dr. P olic are to conclude th at Wille y prese nte d with “pa in and stif fnes s in the l ow bac k, tender ness to palpatio n, decreased [rang e of motion,] ” an ant algic gai t, an d was re lative ly seden tary po st - sur gery. 9F 10 Dr. Polica re also di scus sed W ille y ’s DVT with him. 10F 11 Dr. Policare did no t disc uss a ny restr ictions impose d by Dr. Tort olani. Wille y did not pr ovide Dr. Po licar e with the physic al thera py p rescrip tion, docume nts r elati ng to any restr ictions, or any ot her paper s rela ting to his sur gery. 11F 12 In con ducting the i nitia l evalua tion, Dr. Polic are u tilized t he Axis Sp ine Proto col (th e “Axi s Pro toco l”). 12F 13 Phase 2 of the Axis Protocol applied be cause Wille y was 3.5 wee ks post - op, 13F 14 the ob jecti ve of which i s to “re - establish neuro muscula r recr uitment… with d ynamic lumbar s tabilit y exer cise. ” 14F 15 The Axis 8 S ee D.I. 94, Ex. C (“ Poli care Dep. ”) 16, 30, 54. 9 Id. at 52. 10 Id. at 61–62. 11 Id. at 62. 12 Id. at 11, 52. 13 Id. at 40. 14 D. I. 94, Ex. B (Deposition of Willey’s expert, Dr. Michelle Wolpov (“Wolpov Dep.”) 30, Ex. D (“Axis Protocol”). 15 Axis Protocol at 2.

5 Proto col cauti on s phys ical thera pists to “keep l umbar spin e in neu tral – avoid bend ing and t wisti ng belo w the knee s.” 15F 16 Dr. P olicar e wante d to ev alua t e Willey’s ra nge of motion and “in struc ted [Wil ley] t o ben d for ward [un til it hur ts] as if he wa s goin g to touc h his toe s.” 16F 17 In respons e, Wi lley in formed Dr. Polica re “tha t’s one of the things the y told me – the word s BLT ma y never ha ve c [o ] me out of m y mo uth, b ut I to ld hi m I was n ot suppo sed to bend, lif t or twis t. ” 17F 18 Dr. Polic are repea ted th e ins truction, stati ng he “jus t wan t[ed] t o evalua te ho w [W ille y was] m oving,” to get a sense of Willey ’s range of moti on. 18F 19 Wille y complie d and bent forwa rd. 19F 20 U po n bend ing for war d, Wille y felt im mediate pain and repo rted i t to Dr. Pol icare. 0F 21 After the appoint ment, Dr. Pol icar e conta cte d Dr. Tor tola ni’s o ffic e to discuss cl earanc e to treat Wil ley give n his DVT 21F 22 (whi ch he receiv ed), bu t he di d no t disc uss any r estric tions impos ed by Dr. Tor tola ni. 22F 23 16 Id. 17 Policare Dep. 69; D. I. 102, Ex. C (“ Willey Dep. ”) 47 (“[Dr. Policare] said bend over until it hurts”). 18 Willey Dep. 46. 19 Poli care Dep. 69. 20 Id. 21 Willey Dep. 49; see also Pol icare Dep. 69, 71. 22 Policare Dep. 63. 23 Id. at 64.

6 A Septe mber 17, 2021, MRI revealed that the same disk (L4 - L5) h erni at ed again. 23F 24 As a resu lt, Wil ley under went an other surge ry on Septe mber 27, 2021, eleve n days aft er his appointme nt with P hoenix Re habilita tion. 24F 25 C. S tand ard of rev iew “The C ourt w ill gr ant sum mar y judgm ent if ‘the re is no ge nuine iss ue as to any ma terial fa ct a nd…the m oving par ty is en tit led to judgment as a mat ter of law. ’” 25F 26 The movin g part y bear s the in itia l burde n of sho wing the abse nce of genu ine is sues o f mate rial f act. 26F 27 “If the m ovin g party m ake s such a show ing, ‘ the burde n shifts to the n on - mo ving pa rty t o demons trate that th ere are mater ial iss ues of fact.” 27F 28 The Cour t must vie w the evi den ce and a ll rea sonable inf erence s there of in the l ight m ost fa vorab le to the non - m oving party. 8F 29 “‘ If the facts p ermit reas onab le pers ons to draw bu t one inf er ence, t he questio n is ripe for sum mary judgm ent. ’” 29F 30 24 D.I. 94, Ex. G at 3. 25 D.I. 94, Ex. E at 2. 26 Marcolini v. Horizon Servs., Inc., 2023 WL 111060, at * 2 (Del. Super. Jan. 5, 2023) (quoting Super. Ct. Civ. R. 56(c)). 27 Id. 28 Davis v. Wayne Crosse, 2023 WL 7140169, at *4 (D el. Super. Oct. 31, 2023) (quoting Moore v. Sizemore, 405 A.2d 679, 681 (Del. 1979)). 29 Id. 30 Marcolini, 2023 WL 111060, at * 2 (quoting Brzoska v. Olson, 668 A.2d 1355, 1364 (De l. 1995)).

7 D. A nalysis 1. Phoen ix Rehab ilitatio n i s entitl ed to s umma ry j udg ment on punitive d amages. “P uni tive d amage s in medica l neg ligenc e ca ses are gover ned by 18 Del. C. § 6855 w hich stat es, ‘ punitive dama ges may be awa rde d onl y if i t is fou nd that t he injur y comp laine d of was malici ously inte nde d or was the resul t of will ful or wa nton misco nduct by the he alth - care p rovider.’” 30F 31 Willfu l or wa nton con duct is co nduc t that re flects a “ co nscio us ind iffe renc e or I don’t care at titud e.” 31F 32 In other w ords, “[w] ithout ‘ evi dence of egreg ious conduc t of an intenti onal or reckle ss nat ure ’ in the recor d, a cla im for puni tive d ama ges ca nnot sur vive.” 32F 33 And wher e the co nduc t “ is based o n an error of judgme nt…the pla in tiff’s bu rden is subst antia l. It must b e shown that the pr eci se har m wh ich e ventuate d must ha ve bee n reasonab ly ap pare nt but co nsci ousl y ign ored i n the for mulati on of the ju dgme nt.” 33F 34 Therefore, “[i]t i s not e nough that a de ci sion be wrong. I t mu st re sult fr om a con scious in diffe rence to the dec ision ’s fore seeable effect.” 34F 35 31 Mil ton v. A lfred I. DuPont Hosp. for Children, 2025 WL 428070, a t *4 (Del. Super. Feb 5, 2025) (quoting 18 Del. C. § 6855). 32 Porter v. Turner, 954 A.2d 308, 312 (Del. 2008) (internal quotations marks omitted). 33 Marydale Pres. Assocs., LLC v. Leon N. Weiner & Assocs., Inc., 2022 WL 4446275, at *16 (D el. Super. Sept. 23, 2022) (quoting Jardel Co., Inc. v. Hughes, 523 A.2d 518, 529 (Del. 1987)). 34 Jardel, 523 A.2d at 531. 35 Id. at 529.

8 Puni tive dam age s s erve to both “pun ish wr ongdoer s and de ter other s from simi lar co nduc t.” 35F 36 Because puni tive dam ages im plicate o ther societ al policie s, “ [a]n a ward of puni tive dama ges m ust theref ore sub sist on gr ounds ot her t han makin g the plai ntiff ‘wh ole.’ ” 36F 37 W hile “the que stio n of puni tive dam age s…i s ordi naril y for the trie r of fac t[,]” 37F 38 “very hi gh level s of ina ppro priate a cti ons are requir ed to warra nt such a s ubmi ssion o f punitive d amages t o a jur y.” 38F 39 I f the evide nce vie wed m ost favora bly for the plai ntiff doe s not pe rmit a re asona ble infer ence that def en dant’ s co nduc t wa s suf ficie ntly egr egi ous to warra nt a n impos ition o f punitiv e damag es, summar y judgm ent in de fenda nt’s favor is appro pria te. 39F 40 Wille y argues th at Dr. Policare ’s re quest t o bend dow n as if he wa s going t o touc h his toes, de spi te Wille y inform ing Dr. Po licar e of the bendin g restr iction, cons titute s consc ious ind iffer ence. 40F 41 Under Will ey’s vi ew, Dr. Poli care ign ored a surge on’s order and subs titute d his own i nferio r judg ment, the reby p utt ing his patie nt’s safet y in je opardy. Further, Dr. Policare knew, o r shoul d hav e know n, this movem ent could easily r e - inj ure W illey gi ven h is rece nt sur gery. 41F 42 36 Id. 37 Id. at 528. 38 Dav is, 2023 WL 7140169, at *5 (internal citations and quotation marks omitted). 39 Vick v. Kha n, 2019 WL 2177114, at *8 (Del. Super. May 17, 2019) (quoting Hartman v. Orthopaedic Assocs. of S. Delaware, 2015 WL 995767, at *2 (Del. Super. Feb. 27, 2015)). 40 Davis, 2023 WL 714016 9, at *5. 41 D.I. 102 (“ Willey’ s AB ”) at 5. 42 Id.

9 Wille y largely r elie s on Dr. Torto lani’s r estric tions, which according to Wille y, were “s trict ‘ No BL T.’” 42F 43 Dr. Tort olani’s e xpert re port opine s that Dr. Polica re was “gr ossly neg ligent” be cau se he “ com pleted [sic ] disre garded t he restr ict ions an d recomm enda tio ns tha t we had pr ovide d to Mr. W illey a nd co mple ted [sic ] disrega rde d Mr. Wil ley’s verba l expla nation of w hat my physic al t herap y recom me ndat ions we re.” 43F 44 Wille y tes tifie d that he tol d Dr. P olicar e he (Wille y) was unde r a “no be nding” order fro m Dr. Tor tolani. And, h ad Dr. Policare c ontact ed Dr. Tort olan i’s off ice befor e the e valuatio n — just as Dr. Po licar e di d whe n he sou ght clar ity a s to Wi lley’ s DVT — he would have known of the re stri cti on. 44F 45 Even ac cep ting t he recor d in ligh t mos t favor able to Willey, t he facts d o not suppor t the posi tion tha t Will ey was und er a “st rict no B LT.” Dr. Tortola ni ’s conte mporane ous off ice notes re flec t the recommend ation that W ille y “ be mindful of bend ing.” 45F 46 Wille y also reli es on the “hie rarch y of or ders,” which me ans a ph ysic ian’ s order s tak es prec ede nce ove r a ph ysica l therapi sts’ pr otoc ols and the de fense’ s relia nce o n the A xis P rotoc ol fails f or two r eason s. First, Dr. Pol icare used t he Axis Protoc ol wi tho ut Dr. To rtolani’ s consent. Secon d, Dr. P olicar e violat ed the pr otocol, 43 Id. at 2; see also Tortolani Dep. 18. 44 D.I. 107, Ex. B at 3. 45 Willey’s A B at 5. 46 D.I. 105, Ex. B at 2.

10 whic h requir ed the s pine be ke pt in a “ne utral” p osition, wh ich wa s violat ed when Willey “nose - dive[d] ” to the fl oor. Wille y relies on h is expe rt Mic helle W olpov to suppor t these ar gument s. Wille y’s hiera rchy o f orde rs arg ument doe s not sup port a fin ding of consc iou s indif fere nce be cau se W ille y was not un der a stric t no BLT, as he conte nds. Furt her, Dr. T ortola ni testif ied t hat he d oes n ot pr ovide guide lines fo r phy sical t hera pist s’ prot ocol s, rat her, he re lies on the judgm en t of the ther apist. 46F 47 Ms. Wo lpov’s tes timo ny als o doe s not su pport Wil ley’s a rgum ent. She test ified t hat it was r eason able f or Dr. Polic are t o use t he Axi s Proto col. 47F 48 Her opini ons are ba sed o n the prot ocol ’s re quir ement o f keepin g the spine neu tral. Wit h respe ct t o the rem ai nder o f the pr otocol’ s para mete rs (avoi d be nding a nd twist ing belo w the knee s), she tes tifi ed that s he is rel ying on th e “more stri ct, the mor e p reci se restr ict ion.” 48F 49 Dr. P olicar e wa nted to unde rsta nd Wil ley’s ra nge o f mot ion as par t of a n initia l evalu atio n. H e use d an accep table pr otoc ol. Acc epting Will ey ’s testim ony, Dr. Pol icar e aske d Willey to be nd “until i t hurt s,” Willey r esp onde d that he is “no t 47 Tortolani D ep. 26, 65 (his opinions are based on the “ assumption that a physica l therapist is n ot going to as a patient to bend, lift, or twist following a microdiscectomy.”) (emphas is added). 48 Wolpov Dep. 94. 49 Id. at 82. Willey also posits that Ms. Wo lpov test ified th at the def ense e xpert’s calcul ation of the degree to which Willey bent shows that Dr. Policare violated the Axi s Protocol. Willey misconstrue s this testimony. In a series of leading questions by Willey’s counsel, Ms. Wo lp ov merely confirmed that be nding to the degree calculated by the def ense expert failed to keep the spine neutral. Id. at 121.

11 suppo sed to bend, lift or twis t.” 49F 50 W hen Wil ley star ted to ben d, he did n ot get “ very far.” 50F 51 Constru ing the fa cts in fa vor of Wi lley, the e videnc e does not ra ise a quest ion of fact on wheth er Dr. Policar e’s con duct r ose t o the leve l of wil lful or wa nton. Dr. Tort olan i’s re comme ndation was to “a void” bend ing, but no t a stric t “no B LT.” Ms. Wolpov opi nes t hat Dr. Polic are v iola ted the Ax is Protoc ol with respe ct t o keepi ng the s pine neutr al. P hoenix Re habilita tion su bmit s its o wn ex pert w ho opine s tha t Wille y bent forwa rd no m ore than 20 - 30 de grees, whic h is les s tha n “ avoid bendin g belo w the kne es. ” Thus, there is a fac tual d ispute as to the inter preta tion of the Axis P roto col and whe ther it was viol ated. That factua l disp ute does not, howe ver, r aise a ques tion of whe ther Dr. Po licare acted w illf ully or wantonly, in consc ious disre gard for W illey’ s safe ty. 51F 52 Per haps Dr. Polic are’ s reques t wa s neg lige nt (an error of judgment) — tha t is a que stion for a jur y — but t he evide nce do es no t supp ort a reaso nab le infe renc e that Dr. Pol ica re’s c onduc t was “‘ suff iciently outr ageous to warra nt t he imp ositi on of pun itive dama ges. ’” 52F 53 Wille y attempt s to like n Dr. P olicar e’s c onduct to that of the defendan t in Straus s v. Briggs. 53F 54 Th at acti on stemm ed fr om a mi spla ced sur gical inc ision t hat 50 Willey Dep. 46. 51 Id. at 47. 52 Marcolini, 2023 WL 111060, at *3 (rejecting the argument that a dispute of fact requires the issue of punitive damages go to the jury). 53 Id. at *3 n.25 (quoting Greenlee v. I mperial Homes Corp., 1994 WL 46 556, at *9 (Del. Super. July 19, 1994)). That Willey’ s experts’ reports opine that Dr. Policare wa s “grossly negligent” or “reckless” does nothing to meet Willey’s burden here. Conclusory opinions are not sufficient. 54 525 A.2d 992 (Del. 1987); Willey’ s AB at 5 –6.

12 dama ge d a nerve i n the p lain tiff’ s foot. 54F 55 Plaint iff sought (and was awa rded) puniti ve da mages base d on the t heor y that the d octor - def enda nt wa s so moti vated by gree d that he acte d wit h reckles s ind iffere nce. 55F 56 The evidence e stab lishe d that the docto r - defe nda nt submitte d mu ltiple fraud ulent bill s to plai ntif f’s ins urer, starte d work at 9 a.m. and wor k ed continu ously unti l he ope rated on plai ntiff at 1 a.m. the next d ay, and pro pos ed to perf orm an ope ration whi ch would o nly pr ovide part ial relie f to plaintif f ’s s ymptoms, despi te the fact t hat t he do ctor knew or s hou ld have known that a diffe rent opera tion (that he was unable to pe rfor m), was indica ted. 56F 57 T he De lawar e Suprem e Cour t affirmed the award of pun iti ve dama ges. 57F 58 Straus s, instruc tive on the type of condu ct that wa rra nts pu nitive damages, is fact uall y disti ngu ishable. Here, the d isp uted ev idence doe s not tend t o show that Dr. Polica re appr oache d Willey ’s trea tmen t with reckle ss indifference or to ser ve some other ul terior mot ive. Moreover, punitive dama ges w ould no t adva nce any under lying polic y (dete rrence o r punishment). 58F 59 Phoenix Rehabili tation, and other ph ysical th erapy provi ders, a re alrea dy disince ntiv ized from pe rfor min g phy sica l ther apy i n a negl igen t mann er. I njur ed pa tien ts not o nl y may r esult in exp ensive litig ation, “ but 55 Strauss, 525 A.2d at 994. 56 Id. at 999. 57 Id. at 999–1000. 58 Id. at 994. 59 See Jardel, 523 A.2d at 531.

13 it also dama ges the c ompany’ s image and rep utation. ” 59F 60 As explai ned a bove, t his dispu te is over an e rror of judgm ent and t he rec ord lac ks any evide nce risi ng to the level of consc ious in differe nce. Acc ording ly, Pho enix Reh abilitati on’s Mot ion is GRANTED. 2. Willey i s entit led to s ummary j udgm ent on Phoe nix Re habilitati on’s fourth and eigh th Affirma tive Defen ses. The four th affirma tive defen se state s, in relev ant par t, “ [t ] o the e xtent that it is fou nd tha t an y con duct o n the part of [Phoeni x Reh abilitati on] cau se [d] [Wille y] dama ges, [W ille y] wa s compa rati vely negl igen t in caus ing his injur y and h is dama ges s hould b e red uced a ccord ingly.” 60F 61 The eight h affirmative defense state s “[t] he in jurie s allege d by [W illey] were proxim ately ca used by a supe rse ding a nd/o r inter vening act, no t cau sed by [Phoe nix Rehab ilita tio n].” 61F 62 Wille y con tend s tha t Phoen ix Reha bilita tion fa iled t o offer e xpert t esti mon y to suppo rt eithe r affir mative defense. 62F 63 Phoenix R ehabil itati on res pond s that evidence exi st s in the re cor d to suppor t the m. 63F 64 A defe nda nt ass erti ng an af firm ative defe nse bears t he burden of proving it. 64F 65 Where a medical expert opinion is requi red to pr ove ne gligence, th e opi nion 60 Marcolini, 2023 WL 111060, at *3. 61 D.I. 41 at 7. 62 Id. at 8. 63 See gen erally D. I. 95. 64 D.I. 100 at 3. 65 Paragon Metal Holdings, LLC v. Smith, 2025 WL 524265, at *10 (Del. Super. Jan. 28, 2025).

14 proff ered m ust be t o a reaso nabl e degr ee of med ical proba bil ity. 65F 66 This st andard appl ies t o all ele ments, includ ing caus ation. 66F 67 Phoen ix Reha bilita tion con ten ds that if Willey wa s under a str ict “ no bending ” order, the n any acti vity w hich caused him to be nd constitute s negl igence o r a super seding ca use of Wille y’s alle ged injur ies. 67F 68 For sup port, Phoenix Reha bilita tion poi nts to the opini ons offe red by Dr. Br ian G. Leggi n (“D r. Leg gin ”) and Dr. Scot t A. Rusht on (“Dr. R ush ton”), the de fense expe rts. Dr. Leggin opine s that “[t]here are a mul titu de of fa ctor s that c ould have prec ipita ted the rec urrent di sk hernia tion such a s…p ositi ons the patie nt ma y have pu t himse lf into on his own suc h as sit ting f or exten ded pe riods, et c.” 68F 69 Dr. Ru shton opi ned that funct ional ac tivit ies of [] W illey fo llow ing the i nde x opera tive proce dure duri ng his recover y time i ncl uding the abilit y to drive, enter and ex it a ve hicle, a mbu late, get in and o ut of bed, in a nd ou t of a cha ir, on an off t he comm ode, woul d have exc ee ded the p hysiolog ical stress exhi bite d by the initial a ssessm ent of [D r.] Polic are. 69F 70 Phoen ix Reha bilita tion’s a rgume nts fail f or two re aso ns. F irs t, con trary t o Phoen ix Rehab ilita tion’ s po sition, exp ert te stimony i s requir ed t o suppor t contr ibutory ne gli gen ce or supe rsed ing ca use here. Wh ile Phoe nix Rehab ilita tion is 66 Kardos v. Harrison, 980 A.2d 1014, 1018 (Del. 2009). 67 Id. 68 D.I. 100 at 4 (“[Willey] got up and dow n out of a chair, got up and down to use a commode, go t in an out of a car, a nd performed other activities of daily living. In a ddition, [Willey] reporte d to his provider on October 18, 2024, ‘he just bent over to get something and ha d excruciating pain. ’ ”). 69 Id., Ex. H at 8. 70 Id. at 5, Ex. I at 12.

15 not seeking to es tabl ish ne glige nce by a medica l pro vider, and t heref ore, 18 Del. C. § 6853 (e) do es not appl y, wher e a quest ion of neg ligence or a super sedi ng cause is beyo nd the p urve y of lay jur ors, exp ert tes timony is re quir ed. 70F 71 A lay j uror w ill not be able to de termine whether a ny activi ties Wille y en gage d in co uld h ave co ntribute d to the secon d hernia tion or w hether an other eve nt was a supe rse ding c ause without the as sistance of a me dical ex per t. Second, neithe r of the d efense exp erts offer op inion s on how or when Wil ley alleg edly a cted negl igently or whe n the sup ersedi ng cause 71F 72 occu rred a fter th e initial allege d neglige nt act of Dr. P olic are. Dr. Leg gin offers o pini ons on activities th at coul d have c ontr ibute d to the seco nd rup ture, but he doe s not go a s far to opi ne that Wille y engage d in any of the se ac tivi ties negl ige ntly. Simi lar ly, Dr. Rushton offers no opini on ca u sally li nki ng the rec urre nt her niat ion with an y neglig ent actions taken by Wil ley. Fur thermor e, nei ther ex pert offers an op inion on any eve nt after D r. Polica re’s alle ged negl igence. 72F 73 71 Money v. Manville Corp. Asbestos Disease Comp. Trust Fund, 565 A.2d 1372, 137 7 (Del. 1991) (“ When the issue of causation is presented in a context which is not a matter of common knowledge, such a reasonable probability can only be proven by the testi mony of a competent expert witness.”). 72 Duphily v. Del. Elec. Coop., Inc., 662 A.2d 821, 829 (De l. 1995) (“ A superseding cause is a new and independent act, itself a proximate cause of an injury, which breaks the causal conn ection between the original tortious conduct and the injury.”) 73 Id. (“ An intervening cause is one which come s into active operation in produc ing an injury subsequent to the negligence of the defendant.”) (emphasis in original).

16 As Wi lley reco gniz es, P hoen ix Re habi lita tion m ay presen t evidence of certai n risk fa ctors an d nor mal a cti vitie s to expla in why th e re - her niation occ urred, but th ere is no me dical ex pert t estimony t o suppor t the co nclusio n tha t Wille y was neg lige nt in perf ormi ng suc h acti vities o r tha t some eve nt after hi s Phoenix Reha bilitatio n visit was a superseding cause. Therefor e, Willey’ s motion is GRANT ED. E. C onclu sion Punit ive damage s are avail able only upon a showing of willfu l or wanton cond uct. Th us, a sho wing of e gregio us co nduc t is a prer equisit e to the subm i tt ing punit ive damage s to a jury. Dr. Polic are’s co nduc t, vie wed in the li ght m o st favor abl e to W illey, d oes n ot rise to an eg regious le vel. Acco rdingly, Phoenix Reha bilita tion’s Mo tion is GRAN TED. F or an aff irmative d efense t o surv ive summary judgment, the defe ndant m ust produ ce eviden ce of a genuine issue of m ater ial fa ct. A medical exper t ’s opin ion as to the negl igenc e of W illey or of a s uper seding ca use of his i njurie s i s require d, but none wa s provi ded. Theref ore, Phoe nix Reha bil itati on has n ot produce d evide nce to sur vive summa ry j udgme nt as t o its f our th and e igh t h affir mative defe nse. Thus, Wille y’s Mo tion is GRAN TED. IT IS SO ORDERED. /s/K athle en M. Mill er Kath leen M. Mil ler, Judge