United States District Court, D. Massachusetts
MEMORANDUM OF DECISION AND ORDER ON BOEING'S
MOTION TO AMEND THE JUDGMENT UNDER RULE 59(E),
FOR A NEW TRIAL UNDER RULE 59(A),
AND FOR JUDGMENT AS A MATTER OF LAW UNDER RULE
Gail Dein United States Magistrate Judge
October 26, 2010, the plaintiff, Adriana Guzman, was a
passenger on American Airlines flight 1640 from Costa Rica to
Boston when there was a rapid decompression incident which
caused the aircraft to drop suddenly and the oxygen masks to
be deployed. The plane was brought under control by the pilot
and landed safely in Miami approximately 30 minutes later,
after which Ms. Guzman and others continued to Boston on
another plane. The aircraft was a Boeing 757, and the
defendant The Boeing Company (“Boeing”) agreed to
be responsible for any damages proximately caused by the
decompression incident. Several persons on board brought the
instant case, and all claims were settled prior to trial
except for Ms. Guzman's claims.
Guzman contends that as a result of the decompression
incident, she suffered from PTSD, major depressive disorder
and, to a lesser extent, decompression sickness. On April 12,
2018, after a nine day trial on the issue of damages, the
jury returned a verdict finding that the plaintiff had
suffered $2.2 million in damages, but that she had failed to
mitigate $726, 000 of those damages. (See Docket No.
348). On April 19, 2018, this court entered judgment for the
plaintiff, which included prejudgment interest at the rate of
12%, for a total judgment of $2, 271, 651.60. (See
Docket No. 349).
matter is presently before the court on Boeing's
“Motions to Amend the Judgment under Rule 59(e), New
Trial under Rule 59(a), and JMOL under Rule 50(b)”
(Docket No. 380) (“Motion for a New Trial”).
After extensive briefing on this and other post-trial motions
filed by the parties,  oral argument was heard on August 6, 2018.
Thereafter, the parties requested leave to file post-hearing
briefs. The final brief was filed on October 22, 2018 and the
Motion for a New Trial is now ripe for consideration. For the
reasons detailed herein, Boeing's Motion for a New Trial
AMOUNT OF THE AWARD - GENERALLY
initial matter, Boeing challenges the jury award as excessive
on the grounds that the evidence of pain and suffering did
not support the award, and that Ms. Guzman's failure to
mitigate mandates the conclusion that the award was
excessive. After careful consideration, this court finds
Boeing's arguments to be unpersuasive.
Standard of Review
court “is obliged to review the evidence in the light
most favorable to the prevailing party and to grant
remittitur or a new trial on damages only when the award
‘exceeds any rational appraisal or estimate of the
damages that could be based upon the evidence before
it.'” E. Mountain Platform Tennis, Inc. v.
Sherwin-Williams Co., Inc., 40 F.3d 492, 502 (1st Cir.
1994) (quoting Kolb v. Goldring, Inc., 694 F.2d 869,
872 (1st Cir. 1982)). Under this standard, an award of
damages must stand unless it is “grossly excessive,
inordinate, shocking to the conscience of the court, or so
high that it would be a denial of justice to permit it to
stand.” Correa v. Hosp. S.F., 69 F.3d 1184,
1997 (1st Cir. 1995) (quoting Grunenthal v. Long Island
R.R. Co., 393 U.S. 156, 159, 89 S.Ct. 331 (1968)). The
burden on the party seeking remittitur or a new damages trial
is a heavy one, and the jury's assessment of the
appropriate damages award is entitled to great deference.
Monteagudo v. Asociacion de Empleados del Estado Libre
Asociado, 554 F.3d 164, 174 (1st Cir. 2009) (citation
omitted); Toucet v. Mar. Overseas Corp., 991 F.2d 5,
11 (1st Cir. 1993). It goes without saying that
“converting feelings such as pain, suffering, and
mental anguish into dollars is not an exact science”
and, consequently, the jury's assessment will be upheld
so long as it “‘does not strike such a dissonant
chord that justice would be denied were the judgment
permitted to stand.'” Correa, 69 F.3d at
1198 (quoting Milone v. Moceri Family, Inc., 847
F.2d 35, 37 (1st Cir. 1988) (internal punctuation omitted)).
A jury verdict should not be disturbed merely because it is
extremely generous or because the court thinks that the
damages are considerably less. Diefenbach v. Sheridan
Transp., 229 F.3d 27, 32 (1st Cir. 2000) (internal
quotations omitted). “[M]erely showing that the damage
award is generous in comparison to other (hand-picked) cases
is insufficient to warrant relief.” Correa, 69
F.3d at 1198.
noted above, the jury award was to compensate the plaintiff
for PTSD, major depressive disorder and, to a lesser extent,
decompression sickness. Ms. Guzman's symptoms of
decompression sickness, namely headaches, general malaise,
and fatigue, only lasted a few days, and there was evidence
that any abnormalities in her brain could have been related
to a number of different conditions. (Tr. III:45-48;
VIII:109-11). Moreover, there was evidence that any such
abnormalities did not cause, and were not expected to cause,
Ms. Guzman any continuing problems. (Tr. III:47-48). The
parties agree that virtually all of the award had to be to
compensate Ms. Guzman for her PTSD and major depressive
to the plaintiff, “in a survey of 1, 369 civil jury
verdicts across all jurisdictions, two-thirds of plaintiffs
received compensation for PTSD, and about one-third of those
were awarded $1 million or more.” (Docket No. 390 at 34
& n.5). Similarly, courts have upheld damages in excess
of $1 million for PTSD claims even absent significant
physical injuries. See, e.g., Lloyd v.
Am. Airlines (In re Air Crash at Little Rock Ark.), 291
F.3d 503, 512-13 (8th Cir. 2002) ($6.5 million jury verdict
for severe PTSD but limited physical injuries following plane
crash reduced to $1.5 million by Appeals Court in light of
limitations on recovery imposed by the Warsaw Convention).
“The reported cases reflect a broad range of verdicts
for PTSD[, ]” including many in excess of $1 million.
Webb v. TECO Barge Line, Inc., No. 07-514-DRH, 2012
WL 780851, at *31-32 (S.D. Ill. Mar. 7, 2012) (after bench
trial, judge awards $2, 750, 000 for pain and suffering as a
result of PTSD), and cases cited. This court recognizes that
“[i]ndividual cases can differ from each other
enormously in terms of witness credibility, the quality of
presentation, the nature and extent of the injuries, the
vulnerability of the victim, the reactions of jurors to the
particular circumstances, and hosts of other
variables.” Ibanez v. Velasco, No. 96 C 5990,
2002 WL 731778, at *11 (N.D. Ill. Apr. 25, 2002) (declining
to reduce $2.5 million compensatory damage award in excessive
force case despite fact that plaintiff's physical
injuries were “not severe, ” because of
plaintiff's significant emotional injuries, including
PTSD). In the instant case, $2.2 million was awarded to
compensate the plaintiff for her suffering for almost 8 years
following the plane decompression, which the jury then
reduced by approximately one-third. While the award is probably
higher than what this court would have awarded in a bench
trial, as detailed below, this court finds that there was
ample evidence that the plaintiff suffered severe PTSD and a
major depressive disorder, that the reduction for failure to
mitigate is supported by the record, and that there was no
evidence that the jury acted out of any improper motive in
awarding the damages. This court finds no basis to disturb
the jury's award.
The Evidence Supports the Award
the experts, including Dr. Jhilam Biswas for the plaintiff,
and Dr. Charles Marmar for the defendant, agreed that Ms.
Guzman suffered from PTSD and major depressive disorder as a
result of the decompression incident. (Tr. III:107; Tr.
VII:70-71; 77-78). While Boeing argued that a substantial
portion of Ms. Guzman's symptoms were attributable to the
stress she suffered during her time as a student at MIT years
earlier, and the fact that MIT was suing her for unpaid
student loans, the jury apparently rejected this argument.
There was ample evidence from which the jury could find that
Ms. Guzman suffered from PTSD and a major depressive disorder
as a result of the decompression incident, and that these
conditions lasted through trial.
Boeing's theory focused on Ms. Guzman's time at MIT,
some details are necessary. Ms. Guzman was from Costa Rica.
(Tr. V:27). From 1995 through 2005 she attended MIT in
Massachusetts. (Id. at 42, 67). She obtained a
Master of Science degree in Civil Engineering in June 1998,
and continued in a Ph.D. program in the department of Civil
and Environmental Engineering. (See Tr. VII: 156-57;
Tr. VIII:50). While at MIT, Ms. Guzman borrowed in excess of
$100, 000 from MIT. (See Tr. VII:186).
in a Ph.D. program at MIT have to pass a qualifying general
examination before they are approved to start work on their
Ph.D. thesis. (See id. at 156-57). It was undisputed
that in 2000, Ms. Guzman began receiving official warnings
that she had taken too long to take her general examination,
although the reason for the delay was disputed. (See
Tr. VII:155-60). Ms. Guzman eventually elected to take a
medical leave of absence from MIT. (Tr. V:73-74). There was
evidence in the record that during this period she was
suffering from anxiety and depression that interfered with
her ability to sleep or concentrate. (See Tr.
VII:67-68, 77-78). Ms. Guzman made numerous visits to various
doctors for complaints ranging from stress problems to
concerns about fluctuating weight. (E.g. Tr. VII:65,
69, 78-79, 113). There was an unexplained reference in
passing in her medical records that she was potentially
suffering from PTSD, although she apparently was not
diagnosed with that condition. (Tr. VII:164-68). Ms. Guzman
tried an anti-depressant at the time, but it made her feel
ill and she stopped taking the medication. (See Tr.
IV:32, 119, 162-63). There was also evidence that there were
family situations in Costa Rica that required her attention
at that time, including her mother having suffered a stroke
and her father having been assaulted. (Tr. V:73-76; VII:69,
160). During her leave, she went back to Costa Rica for at
least a period of time. (Tr. V:74-75).
Guzman returned from her medical leave in 2003. (Tr.
VII:111). She continued with her studies, although she did
again receive warnings of her need to take her general
examination. (Tr. VII:173-75). In June 2005, she was denied
further enrollment, as a result of which she could no longer
pursue her Ph.D. at MIT. (Tr. VII:176). Ms. Guzman returned
home. (Tr. V:82). As detailed more fully below, the plaintiff
contends that after returning home she was leading a
productive, social, engaging and happy life until the
decompression incident. Boeing attempted to challenge this
evidence, and contends that the court made evidentiary
rulings which were in error.
leaving MIT, Ms. Guzman's student loans became due.
(Id. at 97). She did not pay them. (See Tr.
VII:184). In 2007, MIT sued Ms. Guzman. (Id. at
182). Ms. Guzman counter-claimed for, inter alia,
MIT's refusal to allow her to finish her Ph.D.
(Id. at 181-82, 185). At the time of the rapid
decompression incident on October 26, 2010, Ms. Guzman was
coming to Boston to be deposed in the MIT litigation. (Tr.
V:98, 120). The deposition went forward as planned on October
27, 2010. (See id. at 120). The MIT trial was held
in Boston in February 2011 and resulted in a verdict against
her in the amount of $177, 000.00. (Tr. VII:186; VIII:27,
36-37). This court made a number of evidentiary rulings in
connection with the admissibility of facts relating to the
MIT litigation and statements made by the plaintiff in
connection with the MIT dispute. Boeing was able to and did
cross-examine Ms. Guzman extensively using statements she
made in connection with the MIT litigation. (See,
e.g., Tr. VII:195; VIII:36).
Boeing's contention that Ms. Guzman's PTSD and major
depressive disorder existed during her time as a student at
MIT, and that her inability to complete her Ph.D. program and
the stress of being sued by MIT were the cause of and/or
exacerbated her continued psychiatric conditions.
(See Tr. II:71-73). It was the plaintiff's
contention that while her failure to complete her Ph.D. was a
setback, it was not a debilitating event in her life. Neither
was the MIT lawsuit. (See Tr. VII:184-86). Ms.
Guzman contended that she was functioning well in Costa Rica
until the decompression incident. (See Tr. V:140).
The jury apparently rejected Boeing's theory. As detailed
herein, there was ample evidence to support the jury's
of Emotional Damages Following the Decompression
was substantial evidence from which the jury could find that
the decompression incident was a harrowing event. Ms. Guzman
testified that there was a big, loud, explosion in the plane
and that she felt like she had been kicked in the stomach or
the chest. (Tr. V:102-103). The plane started falling very
quickly and was shaking and rolling. (Id. at 103).
There seemed to be smoke, and she felt wind coming into the
plane, which indicated to her that there was a hole.
(Id. at 104). Ms. Guzman could not get the oxygen
mask on without assistance, and even with the mask on she
felt like she could not breathe properly. (Id.
105-07). Ms. Guzman thought that she was going to die.
(Id. at 103-04). This court recognizes that experts
for both parties (Dr. Podros for the plaintiff and Dr. Hebben
for the defendant) testified, based on symptom validity
testing they had each conducted, that Ms. Guzman exaggerated
her emotional state, both with respect to positive and
negative emotions. (See Tr. IV:79-81; VII:59-60,
79-81; VIII:158). Nevertheless, Ms. Guzman was a very
sympathetic and credible witness, and her testimony was
corroborated. For example, Kathleen Dalton Shields, a flight
attendant, testified that it sounded like a bomb explosion on
board - there was a hiss, a gust of air, and the oxygen masks
came down. Passengers panicked and were crying and asking if
they were going to die. (Tr. V:13-17). Similarly, the
deposition testimony of fellow passenger Gwendolyn Farrell
and Cheryl Carnevale confirmed that there was panic and that
the passengers were very frightened.
Guzman began seeking help for the stress she was feeling
almost immediately. She called her mother who promptly put
her in telephone contact with Dr. Marilyn Cambronero, a
clinical psychologist in Costa Rica. (Tr. VI:15-17). They
first spoke on the morning of October 27, 2010, and Dr.
Cambronero continued to treat Ms. Guzman up until the time of
trial. Ms. Guzman was in crisis when they first spoke.
(Id. at 20). Boeing has attempted to minimize the
impact of the incident on Ms. Guzman over time, and argues
that her concern was limited to situations where she had to
fly. However, as detailed below, in addition to the
plaintiff's own compelling testimony, her sister's
testimony and the Doctor's treatment notes depicted
someone who continued to suffer from severe stress,
depression, anxiety, and other symptoms of PTSD that impacted
her daily living up until the time of trial.
Guzman clearly had difficulty recounting the decompression
events at trial, and was obviously stressed and disturbed by
having to recount her story. (E.g., Tr. V:108). She
testified to feeling strange and being in a daze after the
plane landed in Miami again, and then during the plane ride
to Boston. (Id. 114-16). When she landed in Boston,
she had “a big headache, ” and “was feeling
very strange, very fatigued. I had the feeling that I was
there but wasn't there completely.” (Id.
at 117). She was crying and nervous and only wanted to call
her mother. (Id.) Her mother put her in touch with
Dr. Cambronero who helped calm her down. (Id. at
Guzman made it through the MIT deposition she had to come to
Boston for, although she had difficulty concentrating.
(Id. at 120-21). However, she found herself unable
to pull herself together to return home as originally
planned, and ended up staying in Boston for approximately
three weeks - much longer than expected. (Id. at
130-31). While in Boston, she met with her fellow passenger,
Miguel Morales, and she found it helpful to discuss the
situation with someone else who had been through the same
event. (Id. at 125-27). When she flew home, Ms.
Guzman felt compelled to discuss her situation with the
pilots of the two flights it took her to get home, to get
reassurance from them. (Id. at 132-33).
Guzman testified, when she returned home, she thought that
things would be fine, but instead she started having
“very terrible memories, flashbacks of what had
hap-pened, ” and she would wake up in the middle of the
night crying and yelling. On occasion she would wake up
gasping for air. She also lacked energy and started feeling
very strange. There were days she could not get out of bed.
(Id. at 134-37). She started seeing Dr. Cambronero
promptly and found her helpful. (Id. at 134-35). She
continued treatment with Dr. Cambronero up until the time of
trial, and still got support and hope from her. (Id.
Guzman testified that even at the time of trial, however, she
still lacked the ability to concentrate and found herself
unable to even get through reading a newspaper. (Id.
at 142). She suffered from debilitating concerns, was very
insecure and afraid, and there were times when the world just
went pitch dark, which scared her. (Id. at 142, 151)
Ms. Guzman testified to still suffering from severe
headaches. (Id. at 143-44). Her social circle has
disappeared, and she finds it difficult to interact normally
with people around her. (Id. at 151). She has cut
herself off from her friends in other countries since
traveling is so difficult for her - she needs to take
medication and has flashbacks when she has to get on a plane.
(Id. at 151-52). Ms. Guzman testified that apart
from when she has to fly, which is still extremely difficult,
there has been some improvement over time, but she is still
suffering. (Id. at 155-56). For example, there are
fewer flashbacks, but they still occur. (Id. at
156). While Boeing has attempted to portray Ms. Guzman's
condition as being limited to when she needs to travel, that
was clearly not her testimony or the testimony of any of the
plaintiff's witnesses. (See, e.g., Tr.
VI:37-38, 47-48, 51-55, 65-68).
Cambronero kept treatment notes that showed she met with Ms.
Guzman frequently from the time of the incident through 2016.
(See Pl. Ex. 4). While some of her symptoms waxed and
waned, Ms. Guzman continued to suffer from nightmares, fears,
insomnia, problems with concentration, crying spells and a
lack of interest in life. (E.g., Tr. VI:22, 28, 34,
48). She continued to suffer from panic attacks, depression
and a great deal of anxiety. Ms. Guzman's symptoms were
not limited to when she was getting on a plane, although that
was a very stressful activity for her. (Id. at 32,
39-41). As Dr. Cambronero's notes indicate, Ms. Guzman
and her family were very concerned about her at numerous
other times as well. (E.g., id. at 48,
54-55). As of August 21, 2013, Dr. Cambronero was reporting
that there were no signs of improvement, so that Ms.
Guzman's symptoms were considered chronic. (Id.
at 51-52). When she learned about the potential lawsuit on
September 5, 2013, Ms. Guzman was relieved that she was not
imagining the seriousness of the incident. (Id. at
52-53). In April 2014, Ms. Guzman's family was very
worried because she did not want to leave the house, was
despondent, and had some phobic-type fears of going out.
(Id. at 54-55). These issues did not resolve up to
the time of trial. (Id. at 43, 57-58, 65-67, 71-76).
She continued to struggle with weight gain and her
self-image. (Id. at 54, 58, 67, 71-72). Dr.
Cambronero's testimony amply supported the conclusion
that Ms. Guzman suffered from PTSD through the time of trial.
plaintiff also presented the testimony of Ms. Guzman's
younger sister, Pabla Guzman. (Tr. V:57-72). In very
compelling testimony, Pabla testified how Ms. Guzman changed
from someone who took care of things for the family to
someone who had to be taken care of.Pabla testified that when Ms.
Guzman came home from the trip to Boston in 2010, she was
withdrawn, quiet, cried a lot and had nightmares. The family
tore down walls in the home to create one big bedroom so that
Ms. Guzman would not have to sleep alone, but could share her
room with her much younger sisters. Ms. Guzman would have
flashbacks and talk about things on the plane, and that the
mask hadn't come down. Pabla further testified that, as
of the time of trial, the family takes Ms. Guzman to the
airport when she flies, and she takes medication to try and
calm herself down. Pabla often flies with the plaintiff, who
remains scared despite taking medication. On at least one
occasion, Ms. Guzman has been unable to get on the plane at
all. There are times when Ms. Guzman spends much of her time
just lying down, and the family knows to leave her alone when
she is feeling bad. According to Pabla, Ms. Guzman is no
longer able to function as a mother figure in her life as she
had before the incident, and Pabla is instead taking care of
plaintiff also presented the testimony of Antonio Copete, who
met Ms. Guzman while they both attended MIT, and they
remained friends. (Tr. IV:49-70). He went on to obtain a
Masters Degree and Ph.D. in physics from Harvard and he works
as a research scientist in in the astronomy department. Dr.
Copete was from Bogota originally, and he met Ms. Guzman when
they were both involved in the Latin American student club at
MIT. Ms. Guzman was very active in the club, and was a lead
organizer of the first Latin American Conference at MIT. Dr.
Copete testified that Ms. Guzman was well respected, happy
and gregarious before the incident. After the incident,
however, she was no longer the same person, and their
relationship became more contentious.
Guzman stayed with Dr. Copete after she arrived in Boston
following the decompression incident. He testified that Ms.
Guzman was distressed, frightened and very distraught. She
stayed longer than expected and was very withdrawn. They
continued to see each other once or twice a year after the
decompression incident. When they saw each other after the
incident, they fought more than they had before, and their
relationship changed. He also noticed that she had gained
weight. This credible witness testified that Ms. Guzman's
personal-ity had changed after the incident. A jury could
reasonably conclude that the changed behavior was consistent
with the symptoms of PTSD and major depressive disorder, as
described by the experts at trial.
plaintiff offered the testimony of Dr. Paul Wayne Buza, a
Board-certified neurologist. (Tr. II:79). Dr. Buza opined
that as a result of the decompression incident, Ms. Guzman
suffered from PTSD with an underlying decompression illness.
(Id. at 88). As noted above, the parties agree that
Ms. Guzman's decompression illness, if any, was not a
major factor in the damage award, and it will not be
discussed further herein.
plaintiff offered the testimony of Dr. Jhilam Biswas, a
Board-certified psychiatrist, who is nationally accredited in
forensic psychiatry. (Tr. III:66-70). Dr. Biswas testified
that it was her understanding that at MIT, Ms. Guzman was
diagnosed with situational anxiety and depression, after
which she returned home. (Id. at 91). Based, in
part, on the fact that there was no evidence that Ms. Guzman
sought any mental health treatment after returning to Costa
Rica (before the decompression incident), Dr. Biswas
concluded that Ms. Guzman rebounded from her situational
anxiety and depression upon her return to Costa Rica, was
functioning on a high level, and was very engaged and
passionate about what she was doing. (Id. at
Biswas opined that Ms. Guzman suffered from PTSD and
co-morbid persistent depressive disorder as a result of the
decompression incident. (Id. at 107-10). Her
symptoms of PTSD included a decreased sense of self and loss
of self-esteem, engagement in avoidance behavior,
i.e., avoiding doing things that might make her relive
the trauma, and hyper-vigilance - constantly worrying that
another bad thing is about to happen again very soon.
(Id. at 101-02). Ms. Guzman reported nightmares,
flashbacks, a sort of “altered sensorium, feeling like
the world was closing in on her, having tunnel vision, not
seeing the world in any kind of way that she used to see it
before the accident occurred.” (Tr. IV:28). She felt
numb, and she sensed her environment differently.
(Id. at 29). Her symptoms of depresssion included
erratic eating issues and sleep disturbance, low mood over
more than 3-4 days at a time in a week, low energy, low
motivation, and a decrease in self-image and self-esteem.
(Tr. III:108-09). Ms. Guzman's distress over the
incident lasted at least from the date of the incident on
October 26, 2010 through the time she met with Dr. Biswas in
2016. (Id. at 105-06). Since the condition had
lasted more than 2 years, it was deemed to be persistent.
(Id. at 108-09).
defendant's expert, Dr. Charles Marmar, a PTSD expert,
concurred in the diagnosis of Ms. Guzman as suffering from
PTSD and chronic depression. (Tr. VII:59). While he
acknowledged that some of her conditions were attributable to
the decompression incident, he put part of the blame on
events at MIT. As discussed in more detail infra,
Dr. Marmar differed from Dr. Biswas in that he was more
skeptical of the truthfulness of Ms. Guzman's testimony
based on the symptom validity testing done by Dr. Podros (for
the plaintiff) and Dr. Hebben (for the defendant).
(Id. at 58-60). Such testing helps evaluate the
accuracy of a patient's reporting about his or her
condition. (Id. at 55). Dr. Marmar testified that
Ms. Guzman had an unusual pattern of uneven self -reporting -
under emphasizing the importance of certain things while
over-emphasizing others - and that she was “actively
managing the impression of her internal emotional
state.” (Id. at 60). Nevertheless, as detailed
infra, even considering the symptom validity
testing, Dr. Marmar opined that Ms. Guzman suffered from PTSD
and chronic depression caused at least in part by the
symptoms of PTSD, as described by Dr. Marmar, were consistent
with the other witnesses' descriptions of Ms. Guzman, as
well as Ms. Guzman's own testimony. For example, Dr.
Marmar testified PTSD can affect a person's ability to
concentrate, or to accomplish the same scope of work as
before. (Id. at 107-08). It frequently makes someone
more irritable in their relationships with others, and it can
impact their sleep. (Id. at 108). Dr. Marmar
summarized the symptoms of PTSD as follows:
The symptoms fall into four broad categories. The first
category is referred to as reliving or re-experiencing
painful aspects of the trauma, so that includes thoughts of
the event, memories of the event, images of the event that
intrude into a person's mind, it includes disturbing
dreams of the event, which may be very realistic or simply
fragmatic disturbing dreams that are associated with the
event, it includes feelings of physical distress when
reminded or triggered by a memory of the event. Those kinds
of symptoms are generally classified as remembering, reliving
or re-experiencing the event in ways that may be painful for
the individual and frequently triggered by reminders.
That's the first class.
The second broad class of symptoms are called avoidance
symptoms, and they generally have to do with the fact that,
when a person has been exposed to trauma, that confronting
reminders of that trauma, whether it's talking about it,
reading about it, visiting the site of the trauma, et cetera,
may trigger back and bring back painful memories. So,
avoidance symptoms are the tendency of the person who's
traumatized to try to wall themselves off and isolate
themselves from triggers that are reminders of the trauma.
The third class of symptoms have to do with alterations in
thinking and feeling and views of the self and others; for
example, seeing the world as a more dangerous and
uncontrollable and unpredictable place and seeing oneself as
weaker and more vulnerable, it may see alterations in mood,
generally a loss of -- or a diminishment of positive
emotions, such as love, affection, playfulness, joy and
happiness, and a heightening of negative emotions, such as
fear, sorrow, guilt, sadness. So, in PTSD, we find a
heightening of negative emotions and a blunting of positive
emotions, and those often occur with disturbances in to how
one thinks and sees the world.
And then the final set of symptoms, which is the fourth
category, are symptoms of abnormal heightened arousal.
That's called hyperarousal. And typically they're
things such as being watchful and on guard when there's
no need to be, that's hypervigilance; being jumpy and
easily startled; having trouble sleeping; being irritable;
having a short fuse; having difficulty concentrating.
(Id. at 108-10). As detailed above, these symptoms
match the testimony of Ms. Guzman and the other witnesses for
Marmar testified further that if someone has persistent and
chronic PTSD, they have a 50% chance of developing a
concurrent major depression at some time in the course of
having PTSD, and that if they have a prior history of
depression, they are more likely to develop recurrent
depression in the context of having PTSD. (Tr. VII:101-02).
As discussed infra, Dr. Marmar also opined that Ms.
Guzman nevertheless has an excellent chance of being fully
recovered in a finite period of time.
Dr. Marmar gave more significance to the evidence of
psychological stress Ms. Guzman experienced at MIT. His main
conclusion was that:
Ms. Guzman experienced a traumatic event onboard this flight
and has developed a post-traumatic stress disorder and that
she has also suffered from chronic depression, both in
relationship to this event and before when she struggled with
depression during her years at MIT and that she also has a
long history, which precedes this flight, of reporting
herself to be physically unwell and reporting somatic
disorders, a condition called somatization disorder.
So, within the limits that we have, given our still reliance
primarily on taking at face value what people tell us about
their symptoms, Ms. Guzman meets the diagnostic criteria
currently, at the time of my assessment in July, 2016, of
PTSD related to the airline incident of October 26th, 2010,
of a chronic waxing and waning depression and somatization
(Id. at 58-59). After testifying about Ms.
Guzman's response to symptom validity tests, Dr. Marmar
further testified as follows:
Well, my conclusion is she did suffer from post-traumatic
stress related to the airline incident and that, that is a
significant factor in her life, but that must be placed in
the context of having very significant problems which
occurred before that event and color her response to it
So, the main -- the diagnoses that I provided are, to a
reasonable degree of medical certainty, true for her. She did
develop post-traumatic stress disorder related to the airline
incident and some secondary depression, but that must be
understood against the background of difficulty she had
before the event and her own tendency to view the narrative
of her life as --the main conclusion is, as she presents it,
she had a wonderful life before the event, and the life was
radically damaged by this incident. And I think a more
accurate representation is she was having very significant
psychological difficulties before this event, and this event
has had an aggravating role.
(Id. at 70-71). On cross-examination, Dr. Marmar did
confirm that the only event in Ms. Guzman's life about
which he was aware that could formally be classified as a
traumatic stressor was the decompression incident.
(Id. at 120).
there was ample expert evidence, both from the
plaintiff's and defendant's expert, that as of the
time of trial Ms. Guzman was suffering from PTSD and chronic
depression as a result of the decompression incident, and
that contrary to Boeing's characterization, the emotional
distress she suffered significantly impacted her life.
Before the Decompression Incident
noted above, it was Boeing's contention that the stress
Ms. Guzman suffered at MIT from not completing her Ph.D. and
being sued by MIT, was the cause of and/or exacerbated her
PTSD and anxiety disorders. The plaintiff countered with
evidence that during the period after MIT but before the
decompression incident Ms. Guzman had an active life, and
that she was social and not depressed. Ms. Guzman testified
that before the incident she “was doing the things that
normal people do, ” she was “happy” and
“excited about life.” (Tr. V: 138). She exercised
regularly, including doing aerobics, or kick-boxing, or
running, or swimming. (Id.) She read a lot and ...