See how AI medical-record review links every fact to the exact Bates page that proves it — click any citation and jump straight to the record.
See the 60-second demo →In December 2025, the New Jersey Appellate Division affirmed summary judgment in a case involving the MILD spinal procedure. The plaintiff's expert was a Tufts faculty member, a pain-management director, board-certified in anesthesiology and pain management — the kind of credential stack that, in another era, would have been bulletproof. He still got excluded. The reason was on the deposition transcript.
Twice during the deposition, the expert had said he would defer to a neurologist on the cause of the patient's leg and foot pain. Then, in his report, he advanced his own contrary causation opinion. The court treated the deferrals as a built-in concession of insufficient qualifications for the specific opinion he was offering. New Jersey's "net opinion" doctrine — the state's parallel to Daubert's fit and reliability prongs — knocked the report out for failing to provide the anatomical mechanism.
If you are a plaintiff attorney with a case in New Jersey, the federal courts, or any specialty-mismatch-vulnerable jurisdiction, the NJ MILD case is the cleanest 2025 cautionary tale you can hand to your expert at deposition prep.
The plaintiff alleged injury arising from a Minimally Invasive Lumbar Decompression — MILD — procedure. The plaintiff retained as his causation expert an anesthesiologist and pain-management physician with strong academic and clinical credentials. The expert's report opined that the MILD procedure had caused the plaintiff's leg and foot pain.
At deposition, the expert was asked about the cause of the leg and foot pain. Twice, he said he would defer to a neurologist on that question. Then his report — already filed — opined on it directly.
The Appellate Division affirmed the trial court's summary judgment. Three threads of reasoning ran through the decision:
Summary judgment for the defendants. Affirmed.
Specialty mismatch is one of the two or three most common defense lines in 2026 motion practice, and it is a line that has tightened substantially since 2023. The Delaware Supreme Court's Scottoline v. Women First decision earlier in 2025 said the same thing in the birth-injury context: a pediatric neurologist could diagnose HIE and ASD but could not opine on what caused them, because his etiology workup did not survive Daubert. The Eleventh Circuit's Moore v. Intuitive Surgical (2021) — still heavily cited in 2024–2026 motions — pushed back against an over-narrow specialty mismatch in the opposite direction. The doctrinal range exists. What is consistent across the cases is that the gatekeeper looks at whether the expert's specialty fits the precise causation question, not the general field.
For plaintiff attorneys at solo-to-mid-size firms, specialty mismatch is especially dangerous because it is often invisible to the retaining attorney until the deposition. The expert's CV looks impressive. The clinical experience is real. The mismatch only surfaces when the defense asks the right question — and the right question is almost always some form of: "Would you defer to a [different specialty] on this point?" The expert, trying to be honest and intellectually humble, says yes. The case ends.
There is a second, related pattern that is worth flagging here. In the 2024 Maryland brachial-plexus case, both plaintiff experts excluded their causation theory's main alternative — maternal forces — at deposition, then pivoted at the Daubert hearing after the defense cited the relevant literature. The court treated the pivot as evidence of result-driven methodology. The lesson is the same: the deposition transcript is the report's true backstop. What the expert says under oath at deposition is what the gatekeeper will read first.
Four concrete steps:
1. Match the expert's specialty to the precise causation question, not the general field. Spinal-procedure case with a leg-pain causation issue? You need the anatomical-mechanism specialty in the room — neurology if the pain pattern is neuropathic, vascular if it is vascular, orthopedic surgery if it is structural. "Pain management" is a treatment specialty, not a causation specialty for the precise mechanism question. Co-experting is cheaper than re-doing the case.
2. Run a deposition-prep audit on specialty-mismatch language. Before the expert is deposed, walk through every causation opinion in the report and identify the specialty most directly responsible for that opinion. For each one, role-play the cross-examination question: "Would you defer to a [specialty] on this?" If the expert's honest answer is yes, that opinion needs a co-expert from that specialty — or it needs to come out of the report. The deposition is not the time to discover the gap.
3. Build the report's anatomical-mechanism section as if the gatekeeper has never seen the procedure. Net opinion and fit objections both come down to whether the report explains the mechanism in enough detail that the court can evaluate it. Generic anatomical references — "lumbar decompression can affect adjacent nerve roots" — will not survive net-opinion review. The report should walk through the specific anatomy, the specific procedure step, the specific mechanism by which the alleged injury was caused, and the specific evidence in this patient's record corroborating that mechanism.
**4. Treat the Moore v. Intuitive Surgical defense as available — but conditional.** The Eleventh Circuit's reversal in Moore is the leading "specialty mismatch is being read too narrowly" pushback in 2024–2026 motion practice. It works when the gatekeeping question is whether the expert can opine on a category of injury (e.g., gynecologic thermal injury) rather than on a particular instrument (e.g., a specific robotic surgical system). It does not work when the expert has admitted in deposition that he would defer to a different specialty on the precise causation question. Different facts, different result.
MedLegal AI's Daubert workup tool runs a specialty-fit audit against every retained expert's CV and the precise causation question in the case. If the expert's specialty is more than one degree of separation from the question — anesthesiology opining on neurologic causation, for example — the tool flags the gap and offers a list of complementary specialties to consider co-experting. The tool's deposition-prep mode also runs proposed expert testimony against the expert's published prior testimony and prior depositions to surface inconsistencies and specialty-mismatch language before the defense does. And the tool maintains a precedent library that includes Moore-style specialty-mismatch defense citations for use when the defense narrows your expert's specialty too aggressively. The point is to prepare smarter for Daubert challenges — to surface specialty exposure before it lands in a deposition transcript. You can run a free Daubert workup on your expert here.
The NJ MILD decision is the cleanest 2025 specialty-mismatch cautionary tale, and it is being cited approvingly in 2026 motion practice across jurisdictions. The structural fix is small: match the specialty to the precise causation question, audit deposition prep for specialty-mismatch language, and co-expert when in doubt. The cases that survive Daubert in 2026 will be the ones whose deposition transcripts do not contain the words "I would defer to a [different specialty]" — at least not for the opinions that matter.
Run a free Daubert workup on your expert.
MedLegal AI is software, not a law firm. We do not provide legal advice. All AI-generated outputs require independent review by a licensed attorney.
Six-pattern audit on a sample case in 90 seconds. No credit card.
Try the free Daubert workup →