September 29, 2014

Forensic Expert Witness Association's 2015 Annual Conference

The Forensic Expert Witness Association's Annual Conference will be held in San Diego on April 23-25, 2015.

The Forensic Expert Witness Association's Annual Conference is a national event that brings together a large and diverse group of professionals from across the country who share common goals related to forensic consulting and expert witness services in all fields of discipline. FEWA welcomes new and seasoned forensic consultants, attorneys, legal professionals, exhibitors, and those interested in exploring forensic consulting as a career to attend the 2015 Annual Conference, April 23-25 at the Westin San Diego.

The FEWA Annual Conference offers forensic consultants who often serve as expert witnesses, the opportunity to enhance their knowledge and techniques required to perform in an effective manner. Forensic experts testify in court trials or provide vital information that will be used in a trial. Oftentimes, they must perform highly technical and precise work where one misstep can have an adverse impact on a legal case. In almost every case, the expert's testimony is a necessity and is expected by jurors and judges.

The conference schedule features two days of continuing education sessions for experts and networking with attorneys, judges, arbitrators and trial consultants, plus an optional pre-conference day of training. The optional pre-conference sessions will feature two concurrent educational tracks for those aspiring to become forensic consultants as well as for seasoned forensic consultants seeking advanced interactive education. In addition, the conference offers attendees the opportunity to earn over 15 credit hours of Minimum Continuing Legal Education (MCLE), Continuing Professional Education (CPE) for CPAs, plus Continuing Education Credits towards FEWA’s soon to be announced Certified Forensic Litigation Consultant (CFLC) certification program. Furthermore, the conclusion of the meeting will feature presentation of the FEWA President's National Meritorious Service Awards.

Conference co-chairs Allan Kleiner and Mike Wakshull are collaborating with the FEWA Annual Conference Planning Committee to develop a schedule of courses designed to be of interest to experts of all disciplines and all levels of experience. Attorneys, judges and fellow forensic consultants will share their experiences and expertise on a wide range of topics including, how experts are expected to contribute in all aspects of a trial, effective report writing, the role of technology, cross and direct-examination skills, communication skills to effectively fulfill the needs of jurors, alternative dispute resolution, and much more! This year’s Conference theme “Where Forensic Consultants Learn, Connect, & Grow” empowers attendees and speakers to engage with like-minded professionals who seek advanced interactive education, peer-to-peer networking and referrals, and direct interaction with attorneys.

More info:http://www.forensic.org/

September 27, 2014

Business Valuation Expert Witness Answers FAQ For Attorneys

In Do I need a forensic accountant or valuations expert in my case? business & accounting expert witness Richard Teichner, CPA, CVA, CDFAJ answers frequently asked questions attorneys have regarding forensic accountants and about business valuations.

Certified public accountants who provide litigation support services are often referred to as “forensic accountants”. They normally are used as experts in accounting related matters that are necessary in support of business or family law litigation matters. What makes forensic accountants different is that they are experienced in using multiple methods of financial and economic analysis to provide appropriate and objective conclusions on complex financial issues, often when the facts or data are incomplete. If you are representing a client in a matter that requires financial evaluation, such as a determination of economic damages, tracing funds that have been diverted, personal injury and other matters involving financial issues, then a forensic accountant can be a valuable asset to your case. If a business valuation is needed as a means to measure damages or for other purposes in litigation, in divorce matters, or regarding the purchase or sale of a business (or business interest), then a business valuator can assist in the process.

Forensic accountants often have experience in serving as an expert witness. When explaining complex financial analyses to the trier of fact, it is imperative that your expert witness is skilled at clearly and accurately explaining the details in a manner that can be easily understood. Expert witnesses also must be objective and utilize generally acceptable practices in order for their testimony to be credible and admissible.

How can a forensic accountant help my case?
Forensic accountants can assist throughout the litigation process. During discovery and fact-finding, they can aid your investigation by advising you on what documentation you should obtain. They can also help you identify the accounting and valuation questions pertinent to your case, which includes their assistance with formulating requests for production, interrogatories, and questions to be asked of witnesses at deposition and trial. Thus, this process can help you streamline your trial strategies and the focus of your case. The earlier you hire your forensic accountant in the litigation process, the more assistance and support you will likely receive.
What qualities should I look for in selecting a forensic accountant?

There are a number of qualities you should look for when selecting a forensic accountant to work with on your case. The following summarizes some of the factors to consider in selecting a forensic accountant or valuation consultant on a legal matter:
• Experience: How many years of practical accounting experience and expert consulting experience do they have?
• Education: Are they licensed as a Certified Public Accountant? Do they have any professional designations? Do they stay current with continuing education courses, books and publications?
• Ability to communicate: Will they be able to clearly express complex accounting theories and explain financial issues in a manner a jury can understand? Have they given presentations to attorneys and other professionals?
• Impartiality: Will they be objective? Have they served as a consultant both to plaintiffs and the defense in litigation matters?
• Credibility: Do they appear to be honest and believable? How do you think they will be perceived by a judge or jury?
• Support: In the preparation of your case for trial, how much advice and support do you think they will offer? Do they appear to be committed to your case without being biased?
• Confidentiality: Do they understand the importance of the attorney-client relationship? Do they have experience with handling highly sensitive documents?


Read more:
Mr. Richard M. Teichner
Teichner Accounting Forensics & Valuations, PLLC

September 24, 2014

Neurosurgery Expert Witnesses

Neurosurgery expert witnesses may consult on trauma neurosurgery, neurosurgeons, spinal surgery, and related matters. In Rules for Neurosurgical Medical/Legal Expert Opinion Services The American Association of Neurological Surgeons writes that "the American legal system often calls for expert medical testimony."

Proper functioning of this system requires that when such testimony is needed, it be truly expert, impartial and available to all litigants. To that end, the following rules have been adopted by the American Association of Neurological Surgeons. These rules apply to all AANS members providing expert opinion services to attorneys, litigants, or the judiciary in the context of civil or criminal matters and include written expert opinions as well as sworn testimony.

A. Impartial Testimony
1. The neurosurgical expert witness shall be an impartial educator for attorneys, jurors and the court on the subject of neurosurgical practice.
2. The neurosurgical expert witness shall represent and testify as to the practice behavior of a prudent neurological surgeon giving different viewpoints if such there are.
3. The neurosurgical expert witness shall identify as such any personal opinions that vary significantly from generally accepted neurosurgical practice.
4. The neurosurgical expert witness shall recognize and correctly represent the full standard of neurosurgical care and shall with reasonable accuracy state whether a particular action was clearly within, clearly outside of, or close to the margins of the standard of neurosurgical care.
5. The neurosurgical expert witness shall not be evasive for the purpose of favoring one litigant over another. The neurosurgical expert shall answer all properly framed questions pertaining to his or her opinions on the subject matter thereof.

B. Subject Matter Knowledge
1. The neurosurgical expert witness shall have sufficient knowledge of and experience in the specific subject(s) of his or her written expert opinion or sworn oral testimony to warrant designation as an expert.
2. The neurosurgical expert witness shall review all pertinent available medical information about a particular patient prior to rendering an opinion about the appropriateness of medical or surgical management of that patient. Revised 03/22/06
3. The neurosurgical expert witness shall be very familiar with prior and current concepts of standard neurosurgical practices before giving testimony or providing written opinion about such practice standards.

C. Compensation
1. The neurosurgical expert witness shall not accept a contingency fee for providing expert medical opinion services.
2. Charges for medical expert opinion services shall be reasonable and commensurate with the time and effort given to preparing and providing those services.


More information: https://www.aans.org/

September 20, 2014

Automotive Expert Witnesses & Recalls

Automotive expert witnesses may consult on auto defects, auto engines, automotive components, and automotive recalls. In the news, General Motors Co. is recalling some 2011-2014 Chevrolet Express compressed natural gas vehicles. About 3,200 vans may leak natural gas from the CNG high pressure regulator and catch fire.

SUMMARY:
General Motors LLC (GM) is recalling certain model year 2011-2014 Chevrolet Express compressed natural gas (CNG) vehicles manufactured September 10, 2010, to April 28, 2014, and GMC Savana CNG vehicles manufactured May 23, 2011, to April 21, 2014. The affected vehicles may leak natural gas from the CNG high pressure regulator.

CONSEQUENCE:
A natural gas leak in the presence of an ignition source increases the risk of a fire or explosion.

REMEDY:
GM will notify owners, and dealers will replace the high pressure regulator, free of charge. The manufacturer has not yet provided a notification date. Owners may contact Chevrolet customer service at 1-800-222-1020 or GMC customer service at 1-800-462-8782. GM's number for this recall is 14321.

The NHTSA also announced this week that Adrian Steel Company is recalling certain model year 2012 Ford E-150, E-250 and E-350 Commercial Cargo Vans modified by Adrian between September 21, 2012, to September 24, 2012. The affected vehicles are equipped with certain propane fuel system conversion kits with an aluminum fuel line fitting manufactured by Roush CleanTech. Due to a reaction between the different metals, the affected kits may develop a propane leak where the aluminum fuel line fitting contacts the brass supply valve housing.

CONSEQUENCE:
A propane leak in the presence of an ignition source increases the risk of a fire.

REMEDY:
Adrian will notify owners, and dealers will replace the aluminum fuel line fittings with stainless steel fittings, free of charge. The recall is expected to begin in September 2014. Owners may contact Adrian customer service at 1-800-677-2726.

More information: Latest Recalls Announced by Manufacturers.

September 17, 2014

Business Expert Witness On Coming To Grips With Risk

In Coming to Grips with Risk, business expert witness Shelley Lee Boyce writes that "Your tolerance for risk is an important factor in how you allocate your investment portfolio among different investments."

While investments are subject to many different types of risk, risk tolerance typically refers to your ability to hold an investment when the return is either less than you expect or it declines in value. You should only assume a level of risk you are comfortable with, so you aren't tempted to sell an investment when it is at a low point.

There are at least two factors affecting your risk tolerance. One is the level of investment risk appropriate for you based on your personal situation. Key factors to consider include:
• Family situation - If you are married and in good health, you can probably assume more risk than someone going through a divorce or who has health problems.
• Age - Typically, you are less willing to assume risk as you age.
• Employment - Individuals with stable employment or whose spouse also earns an income will typically be able to assume more risk.
• Debt and liquidity - If you have sufficient liquid assets to weather temporary financial problems, you'll typically feel more able to take on risk.
• Insurance - If you have insurance to cover the major risks in life, including life, health, disability, and property insurance, you will probably feel more willing to assume more risk with your investments.
• Other investments - The current composition of your portfolio will affect how much additional risk you want to assume. If your portfolio already contains investments with significant risk, you might want to invest in more conservative investments. On the other hand, if your portfolio is primarily composed of conservative investments, you may want to take on more risk
.
The other element is your emotional tolerance for risk. Even if your personal situation indicates you could assume a high level of risk that may not be prudent if you don't feel comfortable with that risk. How you've reacted to the stock market fluctuations over the past few years should provide an indication of your emotional comfort with risk. Have you taken the fluctuations in stride or were you anxious about your portfolio's value? Did you frequently check your portfolio's value or did you only check occasionally? Were you tempted to sell all your stock investments or did you realize that downturns are just a normal part of the investing process? What would you do if the stock market started to decline substantially again? How long could you withstand a declining market before feeling compelled to see? After answering these questions, you should have a better feel for your emotional tolerance for risk.


September 15, 2014

Cross-examining the Expert Witness by Dean Brett Part 1

In How to prepare to cross-examine an expert witness, attorney Dean Brett writes on what he describes as "one of the trial attorney's most difficult tasks."

Throughout my years as a trial attorney, I have found that one of the most challenging aspects of trial is cross-examining an expert witness. I’ve written an article series describing my experience and the methods I’ve used that have allowed me to gain real advantages through cross-examination of an expert witness. These methods have proven highly successful for me for 40+ years. I will be publishing the article series over the next several days, so keep an eye out for the next installment.

Part 1 - Why cross-examine an expert witness?

The cross-examination of an expert witness is one of the trial lawyer’s most difficult tasks. The expert must be assumed to be an intelligent person who has focused his intelligence on the particular scientific, technical, or specialized field of inquiry. The rules of evidence allow the expert witness certain unique advantages, including:

the chance to state his opinion (ER 702);
to include conclusions on the ultimate fact to be decided by the jury (ER 704);
to be buttressed by facts or data not in evidence (if of a type reasonably relied upon by other experts in the particular subject matter) (ER 703);
to include facts even if those facts or data would not otherwise be admissible in evidence (ER 703);
to include facts or data which the expert need not disclose in direct examination (ER 705);
allowing the jury to be told the expert was appointed not by your opponent, but by the court (ER 706).

To make matters even more challenging, frequently the expert witness has more courtroom experience and savvy than the cross examiner.

“As a general thing, it is unwise for the cross-examiner to attempt to cope with a specialist in his own field of inquiry. Lengthy cross-examination along lines of the expert’s theory is easily disastrous and should rarely be attempted.” Francis Wellman, The Art of Cross-Examination, 1903.

Why then ever cross-examine an expert witness? Only because you have no alternative.

If you bring a claim of professional negligence or products liability, you are claiming that the defendant made an error in his own field of expertise, and you thereby incur an obligation to your client to prove the standard of conduct in that field of expertise and to cross-examine expert witnesses called to defend on the basis that the standard is not as you allege, or if it is, that it was met.

To fail to cross-examine is to concede the heart of the claim. Even if you try only “simple” negligence claims, you must be prepared to meet witnesses with expertise in engineering, accident reconstruction, medicine, psychology, vocational rehabilitation, and economics, to name a few.

Precisely because they are so difficult to examine, your opponent will insist on presenting the testimony of experts on the critical issues of the case. Those experts, because they are looked up to by the jury and because they are often hired for the specific purpose of destroying a necessary element of your proof, often cause more damage than lay witnesses and thus compel cross-examination. Failure to examine expert witnesses may be viewed by the jury as a surrender on the critical issues they support.

The next installments of this article series will be:

The four main advantages the trial lawyer has against the expert witness defending his home territory;
The four stages of general preparation for cross-examination of a defense expert;
The three conceptual categories of potential lines of questioning;
Final preparation for the cross-examination;
The Ten Commandments of cross-examination, plus four more.
An example cross-examination of a defense economist.

Attorney Dean Brett has been practicing injury and wrongful death law for 40+ years. Learn more about Dean, his practice, and his cases at his biography page. To contact the Brett Murphy attorneys with questions about a potential claim, please call 1-800-925-1875 or complete our simple contact form.

September 13, 2014

Pathology Expert Witness On Learning From Other Experts

In Expert Mistakes, pathology expert witness Dr. Judy Melinek discusses learning from other experts:

"An expert is someone who knows some of the worst mistakes which can be made in a very narrow field."
Niels Bohr

When I review others' reports and find mistakes I always try to learn from them because it is always easier to learn from others' mistakes than to make and learn from your own.

No one is immune to mistakes. It is what makes us human. The question is how do we, as scientists and experts, deal with our errors? Do we ignore them? Deny them? Or do we delve into the reasons why they occurred and make a change? And can we accept that by making a change in policy or procedure we will be opening ourselves up to future attacks by attorneys who will use the change as a basis to invalidate our previous opinions?

What are some of the worst mistakes? The worst I've seen are the result of arrogance. As an expert and legal consultant one needs to be confident and project that confidence when testifying. But knowing the facts of your case and showing proficiency in analyzing and conveying those facts is different from insulting or tearing down an opposing expert, criticizing the person instead of their opinion (ad-hominem attacks). I've been on the receiving end of those with opposing counsel making fun of me for having gone to Harvard or for my dress ("fancy"). Generally I know that if they are attacking me personally it is because they don't know how to attack me based on the facts of the case. I also know that the more obnoxious they get the more they will alienate the decision makers - the jury.

I have seen world-renowned experts, confronted with inconsistencies between their previous and current testimony, or between their testimony and a recently published article get defensive and even aggressive. They respond to legitimate questions with bluster and arrogance. Nothing turns off a jury more. The best way to deal with a direct attack is to address the specific issues at hand and simplify it for the jury. Explain to them why the case the attorney is asking about is different from the current case and how interpretations in science can vary based on these crucial differences. By the time the expert is done explaining, the jury will have either forgotten the attorney's challenge or gotten so wrapped up in the explanation of the facts of the current case that they will be right back along agreeing with the expert.

But how does an expert learn to keep her ego in check? The best way is to hang around people who know a lot more than you do. By teaching residents and medical students and working alongside staff in a university setting you are constantly barraged with questions that force you to challenge your assumptions and stay up on the scientific advances that drive the peer-reviewed medical literature. Take challenging consult cases: by sparring with attorneys on high-profile cases you are going to be confronted with sharp criticism and you'll find that you can't just rely on your experience and training - you need to stay current and sharp. And finally, go to professional meetings. Nothing humbles me more than attending an AAFS or NAME meeting, and sitting in lectures about the cutting-edge research others are conducting, or the challenging cases that others have successfully investigated. I can't sit for more than 10 minutes before having that "shoulda coulda woulda" feeling about some of my own cases. Yet at the same time, when I leave the conferences, I feel invigorated. Forensic science can be incredibly isolating, especially if you are the only doctor in a small rural Coroner's office. Lunching and dining with colleagues makes you realize that there is camaraderie and support; that we may not always agree on the best way to interpret an injury, or certify a death, but we can come together, break bread and do what scientists do best: collaborate.


Dr. Melinek is a American Board of Pathology board-certified forensic pathologist practicing forensic medicine in San Francisco, California as well as an Assistant Clinical Professor of Pathology at the UCSF Medical Center.

September 11, 2014

Security Management Expert Witness On Hospital Security Programs

In Sustaining Hospital Security Programs in an Environment of Decreasing Reimbursables & Increasing Demand for Services, security management expert witness William H. Nesbitt, CPP, writes that “many hospitals are facing a decrease in reimbursables, and sometimes, in an environment of increasing demand. When budgets get tight, unfortunately, security budgets become a target for belt tightening, sometimes at the expense on increasing liability. There are practical solutions to these challenges, but these solutions must be situationally determined because security is a situational discipline.”

The most logical first step is an objective assessment of your security program. Every security program is unique and should be driven by need. Security is a situational discipline which means that no two security programs are alike, nor should they be. We frequently find relatively good security programs that are none-the less inefficient and lacking in cost-effectiveness. The goal should be to do more, with less. The security assessment becomes the foundational basis for all that follows.

We believe there are two primary opportunities for cost savings for most hospital security programs, along with secondary options to further reduce costs. First, the application of CPTED (Crime Prevention Thought Environmental Design) and the application of technology, such as smart video with outsource monitoring. Applying CPTED strategies helps to ensure that the security program is truly synergistic and supported by all employees. CPTED has been around for many years, but not taken advantage. However the attack of the Alfred P. Murrah Federal Building in 1995 and the 9/11 attack on the World Trade Center caused security professional to look a broader based security strategies. As a result, CPTED principals are more in play than ever before.

Additionally, networked based security systems, especially video have had a substantial favorable impact on security budgets. Second, is the application of emerging technology such as smart video. In recent years technology has gotten better, and at the same time, less costly.
Clearly the security needs of hospitals have evolved since 1755, and continue to evolve to this day. Several years ago we had the privilege of working with Pennsylvania Hospital, one of the most unique challenges and most gratifying experiences we have ever encountered.
In recent years the outsourcing of security management has become an emerging trend. However, hospitals have outsourced departmental management for years for departments such as dietary, housekeeping, pharmacy, and facilities, to name a few. We believe that when it comes to outsourcing security management, the providing contractor should not have any conflicts of interest such as being a contract guard service provider.

Bill Nesbitt, who is a Board Certified Protection Professional (CPP) and the President of Security Management Services International, Inc., has been providing Security Litigation Support Services as a Security Expert Witness to law firms across the United States for more than 35 years.

September 8, 2014

Internet Legal Research on a Budget Seminar Los Angeles Law Library

Carole Levitt and Judy Davis, co-authors of Internet Legal Research on a Budget (ABA 2014) and Mark Rosch, co-author of The Cybersleuth’s Guide to the Internet (IFL Press 2014) present Internet Legal Research on a Budget on Saturday, September 13th, 10 am-12 pm.

Are you an attorney who didn't pay enough attention in your first year Legal Research class and now realize you should have? Or do you know all about the Internet but want to learn how to use new legal and investigative research sites that are free and low-cost (and even established sites that you have yet to try out)? Or, did you attend law school before computers existed, much less the Internet? Then this seminar is for you!

In partnership with Internet for Lawyers this class will provide instruction and tips from recognized Internet research authorities: Carole Levitt and Judy Davis, co-authors of Internet Legal Research on a Budget (ABA 2014) and Mark Rosch, co-author ofThe Cybersleuth’s Guide to the Internet (IFL Press 2014).

This class will be videotaped. By registering for this class you consent to the use of the videotape by the presenters for future educational or commercial purposes.

Class Covers:

• Quickly find and effectively use reliable free (or low-cost) legal and investigative resources online
• Become less reliant on pay resources (but learn when they are the better option)
• Search expensive databases for free to gather background and investigative information
• Locate missing parties, witnesses, and other people
• Use databases that you might already have free access to (Casemaker and Fastcase)
• Become an expert searcher using Google Scholar, Congress.gov, FDsys, PACER, public records, and more


Two hours general MCLE credit

Fee:
$40 for the class (non-refundable payment reserves spot)
$99 for the class AND a discounted copy of Internet Legal Research on a Budget (the book retails at $89.95 but is available with the seminar for an extra $59)

When
Sat Sep 13, 2014 5pm – 7pm GMT (no daylight saving)
Where
LA Law Library, 301 W 1st St, Los Angeles, CA, United States (map)
More info at Internet For Lawyers and Los Angeles Law Library.

September 7, 2014

Forensic Pathology Expert Witness On Death Investigations

In Cutting Corners, forensic pathology expert witness Dr. Judy Melinek answers the question "Is it common for coroners or forensic pathologists to cut corners in a death investigation if a case does not look like foul play was involved?"

Several visitors to this blog have asked me this question recently, as part of their research into forensic science. Usually those inquiring have had direct contact with a Medical Examiner's or Coroner's Office - and did not find that institution particularly forthcoming. Office policies require death investigators to be careful about divulging information on open cases, and sometimes cases can be "pending" for several months while the pathologist awaits toxicology reports, microscopic slides, scene investigation or incident reports. This can be frustrating and even infuriating to the deceased's family members. They are the ones who have to plan the funeral, and answer inquires while dealing with their own feelings of grief and even guilt about the death while the case is still "pending additional examination." The law allows you to bury a body with a death certificate that says "pending" under "cause of death," but that is cold comfort to the family which has to tackle the inevitable question - "What happened?" - over and over again. A death certificate that says "Hanging" and "Suicide" may not be welcome, but it is an answer.

Coroners and forensic pathologists are two different groups of people. Coroner's deputies are death investigators (often part of a law enforcement agency, like a sheriff's office) while forensic pathologists are the doctors who do the autopsies. Both can "cut corners," yes - but in different ways. A Coroner's deputy might cut corners by not visiting the scene; by not examining the scene thoroughly, either in order to save time or because they are tired (many death investigations are at ungodly hours); by trusting the reports of the people at the scene about what happened without confirming whether those reports are accurate. The death investigation doesn't end when the deputy returns to the office and writes up the case. Frequently they have to complete their investigation, or ask others to, by getting medical records, police reports or questioning other witnesses who were not at the scene when they picked up the body.

A forensic pathologist might "cut corners" by doing an incomplete or partial autopsy; or by rushing through the case and by not following up with police or Coroner's investigators when the story being given does not match up with the injury on the body or the presumed cause of death. This takes time. Coroner's deputies get paid per shift and FP's in a coroner system get paid per case. There is no financial incentive for the doctor or the deputy to invest extra time in investigating a case. Many offices are understaffed due to budget shortfalls, so there is always plenty of work and not enough people to do it. A deputy has to be efficient with his/her time; so if a case looks like something routine, such as an overdose or a suicide, you might see them cut corners in the interest of working speed.

Yet speculation frequently follows an overdose. Generally, people who use drugs and alcohol are on the margins of society, hang out with unsavory or unreliable "friends," some of whom may have criminal pasts. This fuels funeral-parlor rumors that foul play was involved when the person dies of an overdose. Generally, the only way the police or coroner can confirm that foul play was not involved is with a thorough death investigation. But the investigative and autopsy findings also have to be articulated to the family. Coroner's staff are not necessarily medically trained and may not be effective communicators, so families might seek out other sources for answers. That other source is sometimes me - and I am always glad to serve as a consultant, but only after asking the person calling whether they aired their concerns with the Coroner's office or with the police. I also ask whether the family member had spoken to the original pathologist who did the autopsy. Frequently they have not. Sometimes if they go back and speak to those people who were directly involved with the death investigation, they will find out that the investigation was actually more thorough than they initially thought, or was not completely documented in the limited materials that were initially released to them.

Frequently I hear about families finding out about other peoples' suspicions at the time of the funeral. Unless the people fueling the speculation have direct knowledge of what happened, I would be cautious about putting too much faith in rumors. Family and friends often invent or exaggerate the importance of certain events in order to make themselves or others feel better about a death. I have investigated cases that were clear-cut suicides, where the deceased even left a suicide note, the family was understanding and seemed at peace, but then speculation at the funeral made them doubt the coroner's findings and suspect murder by an estranged lover or the roommate who found the body. Denial in the face of a death is a powerful (and expected) reaction - but entrenching that denial by piling doubt upon doubt is harmful to the grieving and healing process. I spend many hours counseling these families and I am grateful for my role in helping them find closure, and while I understand why well-meaning people can sometimes unintentionally cause more grief, it still pains me to watch.

What can be done about this? Well, if you are attending a funeral and have no idea why the person died, don't ask the family "what happened?" You'll find out soon enough. I love the Jewish tradition at a shiva (the equivalent of a wake) to bring food and not speak unless you are spoken to. When my father died the sustenance was appreciated and I was glad not to have to talk to anyone. If you feel really sad and want to share that with the bereaved you can always go with "I'm sorry for your loss," though I personally prefer sharing a happy story about something the deceased did that meant a lot to you or made you smile. That will have resonance and truly give comfort. If you are a family member and have been told things that disturb you about the circumstances surrounding the death of a loved one and are starting to have concerns, start by calling the officer who gave you their card at the death scene or informed you of the death. Tell them what others are saying, and ask them to help you have some closure. They may refer you to the forensic pathologist who did the autopsy, or maybe they will just reassure you that a thorough investigation was already done. If you don't get the answers you need, you can always ask to speak to their supervisor or to the pathologist yourself. In most cases, you will eventually be able to find someone to answer your questions, but please understand that death investigations take time. Just because you haven't heard back from the Coroner's office doesn't mean they have forgotten about you or about the case. The doctor may be waiting for the lab results before proceeding further. The Deputy Coroner may have received no replies when calling people to follow up on your concerns. Find out who the lead investigator is on the case, and what their hours are. If you call the office once every two to three weeks during their shift and always ask to speak to the same person, you will be able to get a progress report on what is going on with the case. I hope this helps you find closure.

Dr. Melinek is a American Board of Pathology board-certified forensic pathologist practicing forensic medicine in San Francisco, California as well as an Assistant Clinical Professor of Pathology at the UCSF Medical Center.

September 2, 2014

Chiropractic Expert Witness On Standard Of Care Part 2

In Defining the Chiropractic Standard Of Care, chiropractic expert witness Richard K. Skala, D.C., writes:

IS THERE A LEGAL DEFINITION OF THE CHIROPRACTIC STANDARD OF CARE?

Based on the definitions above, as well as my medical legal experience, the chiropractic standard of care can be summed up as follows:

"What a prudent, competent state licensed chiropractic physician in the same general region (state) would do under the same or reasonably similar situations or circumstances."

HOW IS THE CHIROPRACTIC STANDARD OF CARE DETERMINED?

Like all health care professions, chiropractic physicians are trained in schools/colleges of chiropractic (43 worldwide)*. In the USA, each of the 17 chiropractic colleges are accredited based on a number of criteria, not the least of which is their respective basic science, and clinical science curriculum. Within these curriculum is contained the foundation for the Chiropractic Standard of Care. In addition to college curricula, the chiropractic profession is supported by established scientific, empirical, and clinical evidence. Over the course of time, a consensus of opinions and conclusions regarding things such as the scope of use of various forms of chiropractic treatment, where these methods are taught, and the clinical utility and proper application for any specific condition(s) for which the treatment is applied are all factors of consideration. In certain cases or jurisdictions Case Law may prove relevant in defining specific aspects of the standard of care on a legal basis.

REAL WORLD OCCURENCES

So what are the more common lapses in standard of care that end up in a law suit or board compliance action? (This list is by no means complete.)

1. Lack of informed consent given to the patient signed by the patient
2. Adverse consequence resulting from treatment
3. Negative side effects of the treatment employed
4. Misdiagnosis
5. Failure to diagnose
6. Failure to reexamine
7. Failure to refer
8. Failure to keep adequate records
9. Altering patient records

SO WAS JUSTICE POTTER CORRECT?

In any case involving breach of “Standard of Care” there are going to be advocates on either side of the question diligently working to advocate their side of the argument. Each case will largely depend on the condition of the chiropractic records, and the impressions, opinions and conclusions of the experts who review those records and eventually give testimony. This article is by no means a treatise on the subject of the “Chiropractic Standard of Care.” It does set forth my experience and the general concepts relating to questions that arise over the “Chiropractic Standard of Care.” Each and every case is unique with its own set of facts. At the end of the day, even with the availability of the outline above, and others like it, the best I can say is not too far afield from Justice Potter (and I in no way compare my intelligence to his intelligence and wisdom when I say this): “I shall not today attempt further to define the kinds of material I understand to be embraced within the medical records reviewed and perhaps I could never succeed in intelligibly doing so. But I know what breach of the Chiropractic Standard of Care looks like when I see it.”

* http://en.wikipedia.org/wiki/List_of_chiropractic_schools

A Doctor of Chiropractic since 1976, Dr. Skala provides consultation and expert witness services for attorneys regarding Personal Injury; Industrial Medical-Legal Cases; Standard of Care involving General Chiropractic, Manipulation Under Anesthesia (MUA), Non-Surgical Spinal Decompression, and Extracorporeal Shockwave (EWST); Chiropractic Licensure Compliance California, and Workers Compensation. Declared an expert witness by the California Workers’ Compensation Appeals Board, he is a California Qualified Medical Evaluator (QME), a Certified Industrial Disability Evaluator, and a certified AMA Impairment rater. www.drskalachiroexpert.com.


August 30, 2014

American Institute of CPAs Expert Witness Skills Workshop

Expert Witness Skills Workshop offered by The American Institute of CPAs

Do you have the confidence and communications skills necessary to serve as an effective expert witness under pressure? Are you often chosen to serve as an expert witness by outside clients? How do you communicate to jurors today that are more technical and have different expectations of testimony and witnesses? Limited to just 36 participants, the AICPA Expert Skills Workshop answers all of these questions and covers the expert witness process from qualifications to depositions to mock trial. In three intensive days, you will:

• experience a real-life courtroom atmosphere

• present to practicing experts and attorneys

• be personally critiqued

• benefit from hands-on training

• testify in a mock trial

This blend of classroom lectures and instant personal feedback will provide the key framework for developing the “real life” skills you need to succeed as an expert witness. Ensure your spot at this interactive workshop, and register today!

WHO SHOULD ATTEND
• Practitioners with minimal to no testifying experience who need a safe environment to develop their skills
• Experienced testifying experts who wish to refine and advance their skills

Date: Sep 11 - Sep 13, 2014
Location: Hotel Palomar
Washington D.C., DC
Recommended CPE Credit: 28
More info.