Doris Gray v. James Strong, ANPAC Louisiana Insurance Company and State Farm Mutual Automobile Insurance Company

Judgment rendered October 1, 2025.
Application for rehearing may be filed
within the delay allowed by Art. 2166,
La. C.C.P.

No. 56,512-CA

COURT OF APPEAL
SECOND CIRCUIT
STATE OF LOUISIANA

*****

DORIS GRAY Plaintiff-Appellant

versus

JAMES STRONG, ANPAC Defendants-Appellees
LOUISIANA INSURANCE
COMPANY AND STATE FARM
MUTUAL AUTOMOBILE
INSURANCE COMPANY

*****

Appealed from the
Fifth Judicial District Court for the
Parish of Richland, Louisiana
Trial Court No. 48870

Honorable John Clay Hamilton, Judge

*****

LUKOV INJURY LAW, LLC Counsel for Appellant
By: Abby Roberts Lukov

LOUISIANA LAW LADY
By: Lauren Renee Pilie

MORRIS BART, LLC
By: Diana Lynn Netterville

DAVENPORT, FILES & KELLY, LLP Counsel for Appellees
By: Martin Shane Craighead

*****

Before COX, ROBINSON, and ELLENDER, JJ.

ELLENDER, J.

Doris Gray (“Gray”) appeals a jury verdict finding her 40% at fault in

a motor vehicle accident and finding she failed to prove any injuries as a

result of the accident. She also contests the district court’s rulings

concerning collateral source evidence and arguments of defense counsel.

Finding any error committed to be harmless, we affirm the jury’s verdict.

FACTS

On March 28, 2022, Gray, age 70, and James Strong (“Strong”), age

77, were both driving north on Broadway Street, a four-lane highway in

Delhi. Strong was behind Gray, who was behind a very slow-moving tractor

that took up both northbound lanes. Though he was in a no-passing zone,

Strong moved to pass Gray and the tractor in the inside southbound lane. As

Strong was passing Gray, she began making a left-hand turn, and the front

left corner of her 2015 Chrysler 200 struck the rear passenger door of

Strong’s 2020 Ford F-150. Gray sued Strong, his insurer, ANPAC

Louisiana Insurance Company (“ANPAC”), and her UM carrier, State Farm

Mutual Insurance Company (“State Farm”), alleging Strong was liable for

serious injuries to her neck, back, head, body, and mind as a result of the

collision; she sought past and future medicals and general damages.1

Prior to trial, Gray filed a motion in limine seeking to exclude or limit

evidence presented at trial of when Gray hired her attorney, and that the

attorney referred her to a healthcare provider, negotiated a discount for her

medical expenses, and paid for her treatment. She contended each of these

1
Gray’s claims against State Farm were dismissed without prejudice by the
consent of both parties prior to trial.

topics involved information that was far more prejudicial than probative.

The trial court denied Gray’s motion, finding no specific evidence was

sought to be excluded and no basis for rendering a blanket ruling based on

generalities. The trial court stated it would consider contemporaneous

objections to evidence at trial. Gray sought supervisory review with this

court; we denied her writ.

Trial Evidence

The parties entered pretrial stipulations as to evidence they would

introduce, with both reserving their rights to object contemporaneously to

any items of evidence if appropriate. Gray also entered a standing objection

to any of the defense’s exhibits pertaining to her medical bills, the payment

of those bills, and any attorney-negotiated discounts. Counsel for Gray did

not state the grounds for her standing objection, merely that she objected to

the publication of those specific exhibits to the jury. Further, the record does

not indicate where the defendants were given an opportunity to respond to

Gray’s standing objection, nor does it appear the trial court made a ruling on

any of the items supposedly covered by Gray’s standing objection.

The plaintiff’s exhibits included a copy of Strong’s ANPAC liability

policy; certified records and bills from Traxler Chiropractic, Northeast

Imaging, Bayonne Injury Clinic, Advanced Surgery Center, Spine Institute,

Spine Center of Excellence, Richardson Medical Center, Delhi Community

Health, and Richland Parish Hospital; property damage photographs of both

vehicles; and deposition testimony with exhibits for Drs. Bayonne, Nunley,

and Domangue. The defendants’ exhibits included a copy of the accident

report; photographs of the accident scene and of both parties’ vehicles

following the accident; and copies of various notes made by Gray’s various
2

treatment providers, health insurance claims forms, itemizations of various

charges by providers, copies of invoices sent to Gray’s counsel by her

treatment providers, and copies of checks sent from Gray’s counsel to her

treatment providers. The defense exhibits also included the curriculum vitae

for Dr. Domangue, as well as his deposition transcript with exhibits.

Gray called Strong on cross as her first witness. He testified that just

prior to the accident, he was traveling in the inside northbound lane on

Broadway Street, behind Gray and a slow-moving tractor. He

acknowledged being in a no-passing zone, but because he did not want to be

behind the tractor for several miles, saw no oncoming traffic in the

southbound lanes, and saw no left-turn signal on Gray’s car in front of him,

he pulled his truck into the inside southbound lane to pass Gray and the

tractor. When he realized Gray was coming into the southbound lanes as

well, he initially believed she was also trying to pass the tractor, so he

moved into the outside southbound lane to allow her to pass. However,

Gray was attempting a left-hand turn, and the left front of her Chrysler 200

collided with the rear passenger door of Strong’s Ford F-150. He described

the collision as fairly minor—two vehicles that just “skinned” each other.

Gray pulled into the bank parking lot near where the collision occurred.

When Strong pulled in, Gray was already standing next to her car, looking

shaken but not injured. Strong stated he was not injured and sought no

medical treatment for anything accident-related. He then drove himself

home.

Gray testified that on the day of the accident, she was going from her

home to the bank to make a deposit. She was also in the inside northbound

lane on Broadway Street, right behind the slow-moving tractor and, as she
3

approached the bank on her left, she put on her left turn signal and made

sure there was no oncoming traffic before starting her turn. As she was

paying attention to oncoming traffic, she did not look behind to see Strong

passing, and they collided. Gray acknowledged she did not look in her side

or rearview mirrors prior to executing the left turn, and she agreed the front

driver’s side corner of her Chrysler 200 sedan hit the rear passenger side

door of Strong’s Ford F-150 truck. After impact, Gray continued on to the

bank, where she parked and got out of her car. When police arrived and

asked if she needed medical attention, Gray said she felt all right and

declined to go to the emergency room. Her Chrysler 200 sedan was

drivable, though her insurance company eventually totaled it, and Gray

drove herself home after making her bank deposit. She did not go to work

the evening of the crash, but she did go the next afternoon. Gray said she

felt fine for three or four days, but then started experiencing back and neck

pain, along with headaches. Rather than going to her primary care

physician, she went to Traxler Chiropractic, which her son recommended.

Gray said she did see her primary care physician for a previously

scheduled visit unrelated to her accident while she was treating with Traxler,

and that physician expressed no concern about her chiropractic treatment.

Because of her limited improvement, Traxler referred her to Dr. Harold

Bayonne (“Dr. Bayonne”), a pain management physician, who proposed

treating her with a series of injections. As the injections only provided some

short-lived relief, Dr. Bayonne referred her to Dr. Pierce Nunley (“Dr.

Nunley”), an orthopedic surgeon, for a consult. Gray testified she and Dr.

Nunley discussed surgery as an option, but they ultimately decided to

continue additional injections for as long as those would help alleviate her
4

pain. At the time of trial, Gray stated she had not been released from the

care of Drs. Bayonne and Nunley. Gray described a history of high blood

pressure, diabetes, chronic kidney disease, arthritis in her hands and feet, and

an enlarged heart; she stated none of these issues ever caused her to

experience back pain.

Dr. Bayonne testified by deposition. Gray was referred to him by

Traxler due to secondary pain in her lower back and in both posterior legs

down to her knees; she reported her lower back pain was between a 3 and a

7 on a scale of 10. Dr. Bayonne testified her MRI was consistent with the

pain she reported but also showed mostly facet hypertrophy, consistent with

her age and work history. Back pain, he stated, would not be unusual for a

person her age whose job involved manual labor. Dr. Bayonne opined

Gray’s injuries were a result of the collision with Strong, diagnosing her

with lumbar spondylosis and some disc bulge. He began treating Gray with

steroid injections in the L4-L5 region of her spine and, while she reported

some relief, the injections did not completely resolve her pain. He next

administered bilateral L5-S1 transforaminal epidural steroid injections

(“ESIs”), which he said did help the radicular pain in her legs. Because

Gray’s back still hurt, he administered medial branch blocks, followed by

radiofrequency ablations (“RFAs”). Ultimately, because of the limited

success of the injections, Dr. Bayonne referred Gray to Dr. Nunley at the

Spine Institute for a surgical evaluation.

Dr. Nunley also testified by deposition. He diagnosed Gray with

lumbar spondylosis with radiculopathy, sacroiliac (“SI”) joint pain, and

lumbar strain. He opined her pain was caused by the collision with Strong,

as the pain she reported to him had never been severe enough to warrant
5

medical treatment prior to the accident. Dr. Nunley stated his treatment plan

for Gray involved steroid joint injections, followed by RFAs if the steroid

injections did not resolve her pain. When the RFAs did not alleviate her

pain, he would administer medial branch blocks. Should Gray reach a point

where the injections were no longer providing any relief, Dr. Nunley opined

Gray would be a good candidate for an SI joint fusion, but he did not

recommend it at the time of his deposition.

Dr. Nunley acknowledged Gray did report a history of arthritis, and

that she had continued working as a custodian in the year following the

accident. He also stated the MRI of Gray’s spine was actually a little better

than he would have expected of someone of her age and work history. Dr.

Nunley acknowledged he was unaware that Gray had a negative Faber’s test

at Dr. Bayonne’s office,2 or that she reported arthritic right hip pain to her

primary care physician as early as 2019. Dr. Nunley agreed he

recommended Gray receive physical therapy, but to the best of his

knowledge, she did not go.

Gray was questioned extensively about her attorney’s role in her

treatment. Gray conceded she consulted with an attorney before initially

seeking treatment with Traxler Chiropractic; the attorney was listed as her

primary insurer on her paperwork at Traxler and Northeast Imaging; and the

attorney paid a great deal of her medical bills because she could not afford

them, including Dr. Bayonne and Dr. Nunley. Gray admitted she was on

Medicare and stated she was not aware if her attorney was negotiating with

various providers for prepayments. She was aware her providers often

2
A Faber’s test is a physical examination maneuver used to assess the function
and stability of the hip and SI joint.

6

declined to give her injections unless the attorney paid first. Gray stated she

believed the doctors required an attorney prepayment because they did not

want to make the taxpayers “foot the bill” for her treatment by billing

Medicare. She also said she signed an acknowledgment that she would be

responsible for all of her medical bills regardless of the outcome of her

lawsuit.

Concerning her ability to work, Gray testified that she was a custodian

employed by Guaranty Bank of Delhi, where she had been working for 14

years. Before the accident, she was responsible for cleaning two bank

locations, but since, though her hours were unchanged, she was able to clean

only one. She worked between 22 and 30 hours per week at a rate of $14

per hour. Her job duties included vacuuming, dusting, cleaning bathrooms,

and taking out trash.

Gray’s children both testified about the impact the accident had on

their mother’s life. Alicia Gray, her daughter, testified Gray could no longer

garden or work in the yard; she was still working because she had to, but

now had pain while doing so. Robert Gray, her son, testified he saw his

mother every day, took her to receive her injections when he was able, and

also noticed the toll the pain took on her after the accident. Neither offered

anything more specific. At one point during her cross-examination, the trial

court gently admonished Gray for looking at her son for what appeared to be

guidance as to some of her answers to defense counsel’s questions, and

asked her to refrain from making eye contact with her son.

The defense played the deposition testimony of its own medical

expert, Dr. Chad Domangue (“Dr. Domangue”), an interventional

neurologist and pain management specialist. Dr. Domangue reviewed
7

Gray’s medical records from 2016 onward; they indicated she had a fairly

high BMI; had reported bilateral shoulder pain in 2017 and 2021, pain in her

hands and in her right hip in 2019, on-and-off swelling in her legs; and

reported what he described as “diffuse orthopedic complaints” commonly

associated with aging and age-related arthritis.

Dr. Domangue found Gray’s records from Traxler Chiropractic

concerning. These records reflected Gray presented with muscle spasms

throughout her entire spine, which are commonly associated with cerebral

palsy and multiple sclerosis. According to Dr. Domangue, if Gray had

presented to Traxler with such a high level of trauma to her spine, her

condition would have required immediate medical evaluation; addressing

those symptoms through chiropractic care would have been out of the

question. Dr. Domangue also noted a lack of vitals taken and reported, no

consistent pain scale ratings, and no quantifiable determination as to Gray’s

range of motion, which made it difficult to measure any improvement.

Dr. Domangue then focused on the treatment provided by Drs.

Bayonne and Nunley, finding that nothing in their records of Gray’s

complaints supported the injections they performed as medically necessary.

Those records included a completely normal neurological examination,

several negative Faber’s tests administered by Dr. Bayonne, and what Dr.

Domangue deemed to be a normal MRI for someone of Gray’s age and work

history. Dr. Domangue viewed the MRI as showing Gray’s neural foramen

was patent, meaning there was no impingement of any neurological structure

at any level of her spine. Regarding the ESIs administered by Dr. Bayonne,

Dr. Domangue testified (over objection) that if Dr. Bayonne had submitted

these to Medicare for approval, they would have been denied as not meeting
8

Medicare’s medical guidelines, which are based on current medical

literature.

Dr. Domangue also reviewed an X-ray of Gray’s spine taken in April

2023, which he said revealed a mass the size of a baseball sitting right on top

of her sacrum and next to her SI joint and the lumbar facet joints. Dr.

Domangue stated each of these areas was a target of the minimally

successful treatment administered by Gray’s various physicians; the

complaints about pain in Gray’s sacral region did not begin until about 10

months after the accident; and the mass could have absolutely caused Gray’s

pain. Dr. Domangue saw no indication any of Gray’s treating physicians

reviewed this X-ray. Dr. Domangue also pointed out what he called chronic

arthritic conditions present in someone over 70 years of age, stating there

was “nothing new” present on the X-ray beyond the mass sitting on her

sacrum.

During her interview and examination with him, Gray told Dr.

Domangue she continued to work throughout her treatment with Drs.

Bayonne and Nunley. She stated her pain was generally worse on her right

side and, of all the procedures, the RFA helped her the most. She told him

the steroid shots helped a couple of days, and the SI joint injections did not

help at all. Gray reported she rarely took the pain medication prescribed to

her.

Dr. Domangue stated his physical examination of Gray revealed she

was neurologically intact, with a range of motion consistent with someone of

her age, work history, arthritis, and facet pain. Based on his physical

examination and view of all her records, he believed if she had any injuries

as a result of the accident, at most they would have been an exacerbation of
9

the severe arthritis already present in her lumbar facet joints. He opined that

any treatment received after February 2023 (about 11 months after the

accident) was either medically unnecessary or related to her other age-

related conditions. Dr. Domangue added he was being generous considering

she had no broken bones, no herniated discs, no bruises, no ER visits, and no

neurological issues. The pain in her sacral area or SI joints was not, in his

opinion, in any way related to the accident, and he did not believe she had

any pinched nerves or herniated discs. His conclusions were based on

Gray’s MRI, X-rays, negative Faber’s tests administered by Dr. Bayonne,

the very narrow focus of her treating physicians following the collision

which caused them to overlook other issues present, the lack of physical

restrictions placed on her, and her statement that the SI injections did

nothing to help her.

Dr. Domangue also discussed the differences in billing practices

between insurance companies and providers versus the way doctors are paid

should they choose to await payment following a personal injury suit. He

also mentioned some three times during his deposition that Gray previously

had renal cancer. When given the opportunity to cross-examine Dr.

Domangue about the cancer statements, the deposition transcript does not

show plaintiff’s counsel did so, and counsel did not insist Dr. Domangue be

physically present at trial for additional cross-examination concerning his

deposition testimony. In fact, she agreed to present his deposition in lieu of

live testimony, fully aware of its contents, and made no objection to any

specific portions of his testimony prior to trial.

In closing arguments, counsel for Strong stressed his belief Gray was

not injured as a result of the accident, and her treatment was orchestrated by
10

her attorney, Morris Bart, who paid all her medical bills. Counsel for Gray

specifically asked the jury to award $81,749.50 for past medicals.

Action of the Trial Court

After deliberating for a little over one hour, the jury found Strong

60% at fault for the accident, casting Gray with the remaining 40% of the

fault. The jury also found Gray was not injured as a result of the collision

with Strong, and awarded no damages. This appeal followed.

DISCUSSION

Standard of Review

Gray asks this court to conduct a de novo review of her case, which

she contends is proper because the trial court gave confusing and misleading

instructions to the jury regarding her duty of care resulting in an erroneous

finding of liability; allowed collateral source evidence, testimony, and

innuendo to be put before the jury; and made improper evidentiary rulings

which allowed the defendants to discuss whether Gray had health insurance

that could have paid her medical bills. Gray also contends portions of the

defense’s medical testimony were so contrary to her own evidence as to

interdict the factfinding process.

Ordinarily, the factual findings of a jury are subject to manifest error

review. Hall v. Bennett, 54,995 (La. App. 2 Cir. 4/5/23), 361 So. 3d 1090.

However, where a finding of fact is interdicted because of some legal error

implicit in the fact finding process or when a mistake of law, such as a

consequential but erroneous ruling on the exclusion or admission of

evidence, forecloses any finding of fact, and the record is otherwise

complete, the appellate court should, if it can, render judgment on the

record. Key v. Monroe City Sch. Bd., 45,096 (La. App. 2 Cir. 3/10/10), 32
11

So. 3d 1144. With that said, de novo review is not appropriate in every such

case. Hicks v. USAA Gen’l Indem. Co., 21-00840 (La. 3/25/22), 339 So. 3d

1106.

The finding of causation is a distinctly factual matter and subject to

manifest error review. Hayes Fund for First United Methodist Church of

Welsh, LLC v. Kerr-McGee Rocky Mountain, LLC, 14-2592 (La. 12/8/15),

193 So. 3d 1110; Davis v. Wheeler, 53,233 (La. App. 2 Cir. 3/4/20), 293 So.

3d 173, writ denied, 20-00781 (La. 10/14/20), 302 So. 3d 1124. Under this

standard, reversal is warranted only if the appellate court finds that a

reasonable factual basis does not exist for the trial court’s finding and the

record establishes that the finding is clearly wrong or manifestly erroneous.

Ryan v. Zurich Amer. Ins. Co., 07-2312 (La. 7/1/08), 988 So. 2d 214; Davis

v. Wheeler, supra.

On thorough review, we find nothing in this record that prevented the

jury from receiving the relevant evidence, analyzing it, and assessing the

competing claims. While we do find some evidence was admitted in error,

we believe the error was harmless for the reasons detailed later in this

opinion, and did not interdict the factfinding process. For those reasons, this

court will apply the manifest error standard in its review.

We now turn to Gray’s four assignments of error.

Fault for the Accident

Gray argues because the collision with Strong would not have

occurred had Strong refrained from passing her in a no-passing zone, and

because the trial court gave a “confusing” jury instruction regarding Gray’s

duty of care as the left-turning motorist, the jury erred in assigning her 40%

of the fault for the accident. She asks we reconsider the jury’s fault
12

allocation, suggesting we are bound by the decision in Stewart v. Barnett,

(La. App. 2 Cir. 11/1/06), 942 So. 2d 211, and should assign her no more

than 15% of the liability.

Louisiana applies a comparative fault system, based on the “degree or

percentage of fault of all persons causing or contributing to the injury[.]”

La. C.C. art. 2323(A). In assessing comparative fault, the courts typically

consider (1) whether the conduct resulted from inadvertence or involved an

awareness of the danger, (2) how great a risk was created by the conduct, (3)

the significance of what was being sought by the conduct, (4) the capacities

of the parties, whether superior or inferior, and (5) any extenuating

circumstances which might require the actor to proceed in haste, without

proper thought. Malta v. Herbert S. Hiller Corp., 21-00209 (La. 10/10/21),

333 So. 3d 384; Watson v. State Farm Fire & Cas. Ins. Co., 469 So. 2d 967

(La. 1985); Criswell v. Kelley, 54,188 (La. App. 2 Cir. 3/9/22), 335 So. 3d

483. The trial court’s allocation of fault is a factual determination, and thus

subject to a manifest error review. Malta v. Herbert S. Hiller Corp., supra;

Duncan v. Kansas City S. Ry. Co., 00-0066 (La. 10/30/00), 773 So. 2d 670.

The allocation of fault is not an exact science or search for one precise ratio,

but rather the search for an acceptable range; an allocation by the factfinder

within that range cannot be clearly wrong. Malta v. Herbert S. Hiller Corp.,

supra, and citations therein.

The appellate court neither assesses the credibility of witnesses nor

reweighs evidence. State v. Kelly, 15-0484 (La. 6/29/16), 195 So. 3d 449;

State v. Galloway, 55,591 (La. App. 2 Cir. 4/10/24), 384 So. 3d 1167. When

considering matters on appeal, the reviewing court affords great deference to

the jury’s decision to accept or reject the testimony of a witness in whole or
13

in part. State v. Galloway, supra. Reversal of a jury’s finding is warranted

only when no reasonable factual basis exists in the record for that finding.

Ryan v. Zurich Am. Ins. Co., supra.

In her original brief, and in her reply, Gray relies heavily on Stewart v.

Barnett, supra, to argue this court must find her no more than 15% liable for

this accident. However, despite Gray’s insistence that the facts in Stewart

are “nearly identical,” they are not. In Stewart, the motorist made a left-

hand turn from a stopped position, where she was waiting to turn onto a

four-lane highway. Several vehicles to her left stopped and waved her on to

pull out, which required her to cross several lanes of traffic before turning

left. As she was turning, she was hit by a motorist who came from behind to

pass the motorists stopped to allow the plaintiff to make her left turn. The

facts in Stewart are such that it seems hard to credit how the plaintiff could

have seen the passing motorist when she began her left turn, while in the

instant case, it does not seem unreasonable for a jury to find a person in

Gray’s position could have easily, and reasonably, made sure no motorists

were attempting to pass the slow-moving tractor prior to attempting her turn.

Jurors heard Strong testify Gray did not use her blinker, while Gray

said she did. Also, while Strong acknowledged being in a no-passing zone,

he said he would not have passed Gray had she been using her blinker. The

jury was free to accept the version of events it found more credible. Gray

testified she was looking for oncoming traffic only, but not behind her,

despite following a slow-moving tractor for a period of time. Jurors saw

photographs of minor damage to Gray’s front bumper and Strong’s rear

passenger door. As the record contains support for finding Gray was at least

14

partially at fault for the collision, we cannot find the jury’s allocation of fault

to be manifestly erroneous.

Turning to Gray’s contention the jury instructions were so misleading

as to constitute reversible error, we first note no objection was made to the

instructions. In fact, after instructions were given to the jury, but before

allowing the jury to recess for deliberations, the trial court asked counsel for

both parties if either had any objections to the jury instructions as given.

Both stated they had none.

A party may not assign as error the giving or the failure to give an

instruction unless he objects thereto either before the jury retires to consider

its verdict or immediately after the jury retires, stating specifically the matter

to which he objects and the grounds of his objection. La. C.C.P. art.

1793(C); Sher v. Lafayette Ins. Co., 07-2441 (La. 4/8/08), 988 So. 2d 186,

on reh’g in part (7/7/08). The complaining party must specifically state on

the record the complaint as to each special charge refused and the grounds

for each objection; a blanket objection with no supporting reasons does not

meet the requirements of La. C.C.P. art. 1793. Sher v. Lafayette Ins. Co.,

supra; Sanders v. Bain, 31,362 (La. App. 2 Cir. 12/9/98), 722 So. 2d 386.

As no objection was made to the jury instructions, Gray failed to

preserve this issue for appeal. However, even if an objection had been

made, when the appellate court reviews a trial court’s instructions to a jury,

it is required to determine whether the trial judge adequately instructed the

jury. The giving of an allegedly erroneous jury instruction will not

constitute grounds for reversal unless the erroneous instruction has injured

or substantially prejudiced the complaining party. Trial courts are given

broad discretion in formulating jury instructions, and a trial-court judgment
15

should not be reversed so long as the charge correctly states the substance of

the law. Barber Bros. Contracting Co. v. Capitol City Prod. Co., 23-00788

(La. 6/28/24), 388 So. 3d 331, on reh’g, 23-00788 (La. 12/19/24), 397 So.

3d 404, reh’g denied, 23-00788 (La. 2/14/25), 400 So. 3d 918.

The jury charge informed the jury of Strong’s obligations as a passing

motorist, addressed Gray’s obligations as a left-turning motorist, and advised

the jury if it found both parties at fault for the accident, then percentages of

fault must be assigned to each party. The instructions given correctly state

the substance of the law.

Gray’s assignment of error concerning allocation of fault in the

accident is without merit.

Injury as a Result of the Accident

Gray strenuously argues the jury erred in finding she was not injured

as a result of her collision with Strong. She claims she adequately proved

her injuries through the testimony of her medical providers and their records,

and no medical testimony proved otherwise. Gray believes she established it

was more likely than not those injuries were caused by the collision with

Strong. She contends when the jury erred in finding she was not injured, it

also erred in failing to award special and general damages.

A person injured through the fault of another is entitled to full

indemnification for the damages caused. La. C.C. art. 2315; State v. La.

Land & Expl. Co., 12-0884 (La. 1/30/13), 110 So. 3d 1038; Wainwright v.

Fontenot, 00-0492 (La. 10/17/00), 774 So. 2d 70. Moreover, a defendant

takes his victim as he finds her and is responsible for all natural and

probable consequences of his tortious conduct. Wainwright v. Fontenot,

supra; Davis v. Wheeler, supra.
16

In a personal injury suit, the plaintiff bears the burden of proving the

existence of the injury as well as the connection between the injury sustained

and the accident that caused the injury. Lewis v. State, 94-2370 (La.

4/21/95), 654 So. 2d 311. A plaintiff proves the causal connection through

medical and lay testimony that it was more probable than not the injury was

caused by the accident. Maranto v. Goodyear Tire & Rubber Co., 94-2603

(La. 2/20/95), 650 So. 2d 757; Davis v. Wheeler, supra.

A claimant’s injury is presumed to have resulted from an accident, if

before the accident the injured person was in good health, but commencing

with the accident the symptoms of the disabling condition appear and

continuously manifest themselves afterward, providing that the medical

evidence shows there to be a reasonable possibility of causal connection

between the accident and the disabling condition. Housley v. Cerise, 579

So. 2d 973 (La. 1991); Davis v. Wheeler, supra.3 If a plaintiff makes this

showing, he is entitled to a presumption of causation, and the burden shifts

to the defendant to prove some other particular incident could have caused

the injury of which the plaintiff complains. Lowery v. St. Francis Med. Ctr.,

54,513 (La. App. 2 Cir. 5/25/22), 339 So. 3d 770, citing Goldsby v. Blocker,

51,584 (La. App. 2 Cir. 9/27/17), 244 So. 3d 703.

Whether an accident caused a person’s injuries is a question of fact,

and an appellate court may not set aside a finding of fact made by a judge or

jury in the absence of manifest error or unless it is completely wrong; if the

3
The Housley presumption was overturned by Act No. 18 of the 2025 Regular
Session of the Louisiana Legislature, contained in La. C.E. 306.1, shifting the burden of
proof in certain personal injury cases to the plaintiff to demonstrate a clear connection
between their claimed injuries and the accident that forms the basis of their suit for
damages. However, these new provisions are to be applied prospectively, with an
effective date of May 28, 2025.
17

factfinder’s conclusion was reasonable and supported by the record, the

findings must stand. Jones v. Mkt. Basket Stores, Inc., 22-00841 (La.

3/17/23), 359 So. 3d 452; Lowery v. St. Francis Med. Ctr., supra. As

previously stated, the appellate court neither assesses the credibility of

witnesses nor reweighs evidence, and the reviewing court affords great

deference to the jury’s decision to accept or reject the testimony of a witness

in whole or in part. State v. Kelly, supra; State v. Galloway, supra.

Dr. Domangue was the defense expert, and Gray argues his testimony

was completely unsupported by any medical evidence submitted in support

of her claims, including the testimony of her own treatment providers, and

she claims a significant misrepresentation made by him (specifically, his

stated belief that Gray previously had renal cancer) misled the jury.

If the jury considered the opinions of any of the expert physicians, it

seems likely they found Dr. Domangue to be more convincing than Gray’s

treating physicians. However, in general, the trier of fact is not bound by

expert testimony, but is to hear and weigh expert testimony in the same

manner as any other evidence. Reasonable and well-founded opinion should

be considered. Kennedy v. Thomas, 34,530 (La. App. 2 Cir. 4/4/01), 784 So.

2d 692. The weight to be given expert testimony is dependent upon the

professional qualifications and experience of the expert and especially on the

facts on which that expert’s opinion is based. Id; Chance v. Chance, 29,591

(La. App. 2d Cir. 5/7/97), 694 So. 2d 613; Goodwin v. Goodwin, 618 So. 2d

579 (La. App. 2 Cir. 1993). If the jury did find Dr. Domangue more credible

than Gray’s experts, then we must give great deference to those credibility

determinations.

18

Gray’s treating physicians both concluded Gray’s neck and back

injuries were caused by the collision with Strong; Dr. Domangue presented a

different perspective. Dr. Domangue opined it was possible some of Gray’s

injuries could have been caused by the collision with Strong, but he limited

this possibility to those injuries treated for approximately 11 months after

the accident. In his opinion, anything after February 2023 could not even

possibly be attributable to the collision. Certainly, his opinion cannot be

interpreted as being in complete agreement with Gray’s treating physicians

as to causation. In fact, the only thing all physicians agreed upon was that

Gray’s MRI revealed a spine in good condition considering her age and

work history.

Gray focuses a great deal on Dr. Domangue’s statements about her

being diagnosed with renal cancer, a point he mentioned three times in

deposition. However, Gray’s counsel did not question Dr. Domangue about

his apparent misunderstanding, despite having the opportunity to do so on

cross-examination, and she agreed Dr. Domangue’s testimony would be

entered into evidence in lieu of his live testimony. Despite Gray’s assertion

to the contrary in her reply brief, Dr. Domangue’s testimony was not

covered by the standing objection given by plaintiff’s counsel, and she

raised no contemporaneous objection when it was presented to the jury.

Finally, in her closing, Gray’s counsel emphatically disputed Dr.

Domangue’s findings, emphasizing Gray was not, and never had been,

diagnosed with renal cancer. As the jury is free to assess the credibility and

reasonableness of expert testimony, and as we do not know every reason for

a jury’s verdict, we cannot say Dr. Domangue’s mistaken comments that

Gray had renal cancer were sufficient to sway the jury.
19

It does not appear Dr. Domangue’s opinion about Gray’s injuries was

based on anything other than his review of her medical records, his physical

examination, his discussion with her, and his own medical training and

experience. Certainly, his opinion does not appear to be baseless.

In addition to Dr. Domangue’s testimony, there is substantial support

in the record for the jury’s conclusion Gray was not injured in the collision

with Strong. Gray told responding officers she was not hurt, ran her planned

errands, and drove herself home after the collision. Neither Gray nor Strong

asked for an ambulance to be called, and photographs of the vehicles showed

very minor damage, even with Gray’s seven-year-old vehicle ultimately

being totaled. Gray missed work the evening of the collision, then resumed

her regular work schedule as a janitor, 5 nights a week on a 4-5 hour shift.

Gray admitted she first sought treatment from a chiropractor several days

after the collision, only after speaking to an attorney. Gray’s MRI, which

was taken after the collision, showed what all expert physicians agreed was a

healthy spine in better condition than expected of someone of Gray’s age

and work history. As there is adequate support in the record for the jury’s

finding, we cannot say the jury erred in finding she was not injured by the

accident with Strong. Because we have found the jury’s determination

supported by the record, we must also find the jury was correct not to award

any damages.

This assignment of error is without merit.

Introduction of Collateral Source Evidence and
Arguments Concerning that Evidence

Gray contends the trial court erred in allowing evidence, testimony,

and argument regarding collateral source matters, specifically attorney

20

payment of medical bills. Gray contends her counsel made a standing

objection to all collateral source material throughout pretrial and trial

proceedings, and she contends the trial court violated the collateral source

rule in two ways: by allowing discussion of “insurance” to go before the

jury, and by allowing discussion of who paid Gray’s medical bills to go

before the jury. In the alternative, she argues if this court finds no violation

of the collateral source rule, then that evidence was inadmissible pursuant to

La. C.E. arts. 403 and 409. She contends the admission of this evidence is

unjustly prejudicial, and she argues the defense introduced those payments

as evidence only to confuse and inflame the jury.

Gray further argues the trial court committed reversible error when it

allowed the defense to make arguments regarding “attorney-orchestrated

medical treatment” because those arguments also violated the collateral

source rule. Further, even if this court finds the collateral source rule does

not apply, then the arguments made by defense counsel were unfairly

prejudicial and so inflammatory as to warrant reversal.

Gray details five specific categories of the evidence, testimony, and

arguments she believes are prohibited by the collateral source rule set forth

in La. R.S. 9:2800.27 and, therefore, the trial court improperly allowed the

jury to consider, (1) Gray’s consultation with an attorney prior to seeking

medical treatment; (2) Gray’s counsel’s payment of her medical bills from

Drs. Bayonne and Nunley, as well as bills from their respective surgery

centers where injections were administered; (3) prepayment from her

attorney was required by Drs. Bayonne and Nunley before they would

administer Gray’s injections; (4) testimony of Dr. Domangue claiming

Medicare guidelines would not have supported or paid for certain treatment
21

Gray received, and how treating physicians can be paid when personal injury

suits are pending; and (5) arguments made at closing by defense counsel

characterizing Gray’s medical treatment following the accident as entirely

orchestrated by her attorney.

La. R.S. 9:2800.27

The Louisiana Supreme Court has considered the collateral source

rule several times. Prior to the enactment of La. R.S. 9:2800.27, in Bozeman

v. State, 03-1016 (La. 7/2/04), 879 So. 2d 692, the court found that from an

evidentiary perspective, the collateral source rule barred the introduction of

evidence that a plaintiff received benefits or payments from a collateral

source independent of the tortfeasor’s procuration or contribution. However,

several years later, in Hoffman v. 21st Century N. Am. Ins. Co., 14-2279 (La.

10/2/15), 209 So. 3d 702, the court considered attorney-negotiated discounts

and payments, plainly stating:

We adopt a bright-line rule that such attorney-negotiated
discounts do not fall within the ambit of the collateral source
rule because to do otherwise would invite a variety of
evidentiary and ethical dilemmas for counsel.

The court in Hoffman found it appropriate to exclude attorney-negotiated

payments from the collateral source rule because the plaintiff did not incur

any additional expenses to receive the attorney-negotiated write-off, nor did

he suffer any diminution in his patrimony. Notably, Hoffman was a judge

trial, and did not address the admissibility of such evidence before a jury.

Six years after the decision in Hoffman, the Louisiana Legislature enacted

La. R.S. 9:2800.27.

At the time of this accident, La. R.S. 9:2800.27(F) provided:

In a jury trial, only after a jury verdict is rendered may the court
receive evidence related to the limitations of recoverable past
22

medical expenses provided by Subsection B or D of this
Section. The jury shall be informed only of the amount billed
by a medical provider for medical treatment. Whether any
person, health insurance issuer, or Medicare has paid or has
agreed to pay, in whole or in part, any of a claimant's medical
expenses, shall not be disclosed to the jury. In trial to the court
alone, the court may consider such evidence.

Gray candidly concedes the medical bills and payments at issue on

appeal are ones negotiated and paid for by her attorneys, with no

requirement that she pay them in order for those services to be rendered.

According to the bright-line rule in Hoffman, supra, those attorney-

negotiated discounts and payments are not collateral source material.

However, La. R.S. 9:2800.27(F) prohibits evidence being submitted to a jury

concerning the identity of any person who paid a plaintiff’s medical bills.

Considering Hoffman was a judge trial, and La. R.S. 9:2800.27 allows such

evidence in a judge trial, this Supreme Court holding and the statute enacted

by the legislature do not seem to contradict each other.

A discussion of the legislative history of the collateral source rule

found in La. R.S. 9:2800.27 supports our conclusion the legislature did not

intend for the identity of who paid medical bills to be placed before the jury,

including attorney-negotiated discounts. The collateral source rule was

originally codified in the Revised Statutes during the 1st Extraordinary

Session of the 2020 Legislature, effective January 1, 2021; it was part of the

Civil Justice Reform Act of 2020. The original bill, while it did not include

what would become La. R.S. 9:2800.27, did include proposed changes to La.

C.E. art. 409, which would have allowed evidence of medical payments on

behalf of a plaintiff to be admissible. The reengrossed version of the bill

attempted to enact La. R.S. 13:3737, which would have required the court, in

any claim for medical expenses, to allow the introduction of all admissible
23

evidence, in accordance with La. C.E. art. 409; the trial court would also be

required to consider that evidence in calculating damages.

The final version of the Civil Justice Reform Act of 2020 omitted the

proposed changes to La. C.E. art. 409, and it did not include the proposed

statute La. R.S. 13:3737. However, it did create La. R.S. 9:2800.27, which

we know as the collateral source rule. It limited the recovery of medical

expenses paid by Medicaid to the amounts paid, and it limited the recovery

of medical expenses paid by Medicare to a point (trial courts were still

directed to award 40% of the difference between the billed amount and the

amount paid by Medicare to the plaintiffs). The 2020 version stated the rule

did not apply to medical malpractice suits (La. R.S. 40:1231.1 et seq.),

malpractice suits for state services (La. R.S. 40:1237.1 et seq.), and suits

brought against the state, state agencies, or political subdivisions (La. R.S.

13:5101 et seq.).

The present version of this statute was passed during the Regular

Session of the 2022 Legislature, effective August 1, 2022. While the initial

bill filed sought more changes limiting recovery for plaintiffs, the final

version that passed repealed only the exception for suits brought against the

state, state agencies, or political subdivisions (La. R.S. 13:5101 et seq.). It

appears no other substantive changes were made, and the current version of

the bill contains the language previously quoted from La. R.S. 9:2800.27(F).

The version most recently passed during the Regular Session of the

2025 Legislature contains sweeping changes to the collateral source rule.

Under the new provisions of La. R.S. 9:2800.27, which will go into effect on

January 1, 2026, the prohibition against juries being presented with

information or evidence as to what party or person is paying a plaintiff’s
24

bills was removed. The stated purposes of these changes include increasing

transparency in medical billing, preventing inflated claims, and contributing

to the reduction of excessive insurance payouts. Additionally, in the

“Editor’s Notes about Prospective Application,” it states: “Section 2. The

provisions of this Act shall have prospective application only and shall not

apply to causes of action filed prior to the effective date of this Act.”

Consequently, the version of La. R.S. 9:2800.27 applicable in this case is the

one previously enacted.

Admissible Evidence

We find the trial court properly allowed testimony, evidence, and

argument to be presented regarding (1) Gray’s choice to consult with an

attorney prior to seeking chiropractic treatment; (2) Dr. Domangue’s

testimony regarding Medicare and insurance billing practices in personal

injury cases; and (3) statements made by defense counsel during closing

arguments characterizing Gray’s treatment as orchestrated by her attorneys.

Gray argues any evidence that she consulted with her attorney prior to

seeking chiropractic treatment is inadmissible as it would violate the

collateral source rule. There is no prohibition stated in the collateral source

rule, or elsewhere, barring defense counsel from attempting to determine

through questioning when a plaintiff first sought counsel following an

automobile accident. While evidence as to the subject matter of any

meetings between the plaintiff and her attorney would be prohibited and a

violation of attorney-client privilege, asking if Gray retained counsel prior to

seeking medical treatment is not prohibited.

As to Gray’s contention the defense elicited prohibited testimony

about insurance in the presence of the jury, presumably she is referring to
25

the testimony given by Dr. Domangue that Medicare would have deemed the

transforaminal ESIs medically unnecessary and declined payment under the

current guidelines, as well as his discussion of how doctors can be paid in a

personal injury case. This discussion, however, did not address who was

paying Gray’s medical bills, and Dr. Domangue did not state Gray filed with

Medicare and was denied for any of her medical care following the accident.

La. R.S. 9:2800.27 does not prohibit this type of testimony; the questions

asked of Dr. Domangue were not directed at who paid medical bills, but

rather the necessity of medical treatment. Allowing this testimony did not

violate the collateral source rule, nor was it in error.

There is also no support for Gray’s claim the collateral source rule

prohibited defense counsel from generally arguing her treatment was

orchestrated by her attorneys. Arguments by counsel are not evidence.

Council of City of New Orleans v. Washington, 09-1067 (La. 5/29/09), 9 So.

3d 854; Southern v. Servpro D E Invs., 55,874 (La. App. 2 Cir. 8/28/24), 400

So. 3d 974, writ denied, 24-01190 (La. 12/11/24), 396 So. 3d 963.

Additionally, after closing arguments, but prior to deliberations, the trial

court stated to the jury:

What the community expects of you and what I expect of you is
the same thing you would expect if you were a party to this suit,
an impartial deliberation and conclusion based on all the
evidence presented in this case and on nothing else. (Emphasis
supplied.)

The trial judge also stated to the jury:

The evidence which you are to consider consists of the
stipulated facts, the testimony of the witnesses, the documents
if any that have been admitted into evidence and any fair
inferences and reasonable conclusions which you can draw
from the evidence submitted to you. Neither the written
pleadings nor arguments made by the lawyers nor any comment
or ruling which I have made is evidence.
26

The jury was instructed to consider only the evidence presented, and jurors

were explicitly told not to consider the arguments of counsel as evidence.

The jury instructions given negated the potential adverse effect defense

counsel’s argument may have had. Van Buren v. Minor, 51,960 (La. App. 2

Cir. 4/11/18), 247 So. 3d 1040, writ denied, 18-0768 (La. 9/21/18), 252 So.

3d 911. As will be discussed below, defense counsel should not have been

allowed to argue Gray’s attorneys paid for her medical bills, but we find this

error to be harmless.

All three of these categories of evidence are clearly relevant to the

defense’s argument, and Gray fails to show any prejudicial effects

outweighed their probative value.

Inadmissible Evidence/Harmless Error

We turn now to the two categories of evidence we believe would be

prohibited by the collateral source rule. Gray correctly argues that in cases

tried before a jury, La. R.S. 9:2800.27(F) prohibits the presentation of any

evidence as to the identity of any person’s payments of a plaintiff’s medical

bills to the jury prior to its verdict being rendered. For this reason, the

invoices sent to Gray’s attorney, Morris Bart, as well as the payments made

by her attorney, should not have been allowed into evidence before the jury,

nor should counsel have been allowed to include these items in argument.

Further, as the identity of the party who paid Gray’s medical bills is

prohibited under the collateral source rule, we also find the evidence and

testimony that show her providers refused at times to proceed with injections

without prior payment from Gray’s counsel would likely also violate La.

R.S. 9:2800.27(F).

27

In finding La. R.S. 9:2800.27(F) is applicable to this kind of evidence,

we must now determine if the trial court’s error in allowing it requires

reversal of the jury’s verdict, or if it amounts to harmless error. Reversal of

a jury’s verdict is not warranted unless the trial court’s error, when

compared to the record in its entirety, was so substantial as to materially

affect the outcome of the case; the complainant has the burden of proof.

Patterson v. State Farm Mut. Auto. Ins. Co., 51,620 (La. App. 2 Cir.

11/15/17), 244 So. 3d 800; Ryan v. Case New Holland, 51,062 (La. App. 2

Cir. 12/22/16), 211 So. 3d 611.

Considering the record in its entirety, we cannot say the inadmissible

evidence and arguments materially impacted the jury’s decision in this

matter to such an extent as to require reversal as there was substantial

available evidence favorable to the defense’s position that Gray was not

injured as a result of the accident.

The accident itself was a minor collision, with the parties traveling at

a slow rate of speed at impact. Strong testified the vehicles merely

“skinned” each other, and the photographs of the vehicles showed minor

damage. Gray was out of her vehicle when Strong pulled into the bank after

the collision, with Strong saying Gray appeared shaken, but not hurt. Gray

told the police she was not injured and declined medical attention. Both

vehicles were drivable, and Gray completed her bank deposit and drove

home.

Gray did not experience any pain at all for three to four days after the

accident, but then consulted an attorney before seeking medical treatment.

During treatment, she continued to work the same hours as she did before as

28

a custodian with the manual duties described earlier. Gray’s doctors placed

no physical restrictions upon her during treatment.

Dr. Domangue noted Gray previously reported bilateral shoulder pain

in 2017 and 2021, as well as pain in her right hip as early as 2019; she also

disclosed suffering from age-related arthritis. He noted her range of motion

was normal for someone of her age and work history, her pain had not been

consistently documented in her medical records, and any relief she may have

obtained from the many injections she received was not consistently

documented. He pointed out Gray reported to Traxler Chiropractic muscle

spasms all over her entire spine following the accident, which he said would

have warranted immediate medical attention, not chiropractic care. Gray’s

MRI showed her neural foramen was patent, meaning there was no

neurological impingement of her spine, and the X-ray taken in April 2023

showed “nothing new” beyond a mass on top of her sacrum, which no other

physician noted or appeared to have reviewed.

Dr. Domangue, Dr. Bayonne, and Dr. Nunley all agreed Gray’s MRI

reflected her spine was in good shape and consistent with her age and work

history. Further, Dr. Bayonne noted Gray’s MRI reflected “facet

hypertrophy,” which is commonly associated with age-related wear and tear.

Dr. Nunley testified Gray reported a history of arthritis, and she also

reported working during the entirety of her treatment following the accident.

Gray had a negative Faber’s test at Dr. Bayonne’s office approximately one

month prior to having a positive test at Dr. Nunley’s, which Dr. Nunley was

unaware of until defense counsel provided it at the deposition. Dr. Nunley

stated he recommended Gray seek physical therapy, but to his knowledge,

29

she did not do it. While Dr. Domangue claimed it was possible Gray was

injured as a result of the collision, he never said it was probable.

The jury had significant evidence to conclude Gray was not injured as

a result of this minor motor vehicle collision, irrespective of the evidence

allowed in error. Consequently, we find this error to be harmless as it was

not so substantial as to materially affect the outcome of the case.

This assignment of error is without merit.

CONCLUSION

The jury verdict is affirmed. All costs are to be paid by the plaintiff,

Doris Gray.

AFFIRMED.

30