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Emergency medicine expert witness and Chief Editor of web-based eMedicine Dr. Erik Schraga would like legal professionals and experts to know that eMedicine offers continually updated clinical reference information which may prove useful in cases they are working on. The following excerpt on cardiology provides information on aortic stenosis medicolegal pitfalls.

Medicolegal Pitfalls

* Patients with severe valvular AS should receive appropriate counseling regarding their conditions, including restriction of physical activity and the need for surgery, if appropriate. Physicians should document these points in patients’ records.

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In Tough Question Requires Equally Tough Answers, hospitality expert witness Steven Belmonte, President and C.E.O., Hospitality Solutions LLC, asks the questions: “Are product upgrades and renovations really needed during hard economic times?”

I mentioned earlier that there are two answers to the question, “Is renovation viable in a tough economy, and is it a smart thing to do.” Here’s the second answer, and it differs from the first in that it relates to hotels that do not need to be upgraded.

In my humble opinion, owners and operators whose properties are in order and competitive in their marketplace should defer major improvements until the economic recovery is well under way. In these tough economic times, I advocate taking a hard look at every line item on your profit-and-loss statement. Put everything out for competitive bid, whether it is to technology vendors, linen companies, insurance firms, f&b suppliers, you name it. All too often, managers get comfortable dealing with one company-but you’d be amazed at the money you can save by inviting competitive bidding for services and products on a regular basis. It’s a great way to increase cash flow without affecting customer service.

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In August 2009 the Justice Department accused three men of stealing account information for more than 130 million credit and debit card numbers. Networking expert witness Ivan Zatkovich, principal consultant for the security firm E-Comp Consultants, had this to say on the credit card fraud case.

In this particular case, they hacked in to a payment gateway system, which is actually a central hub for processing millions of credit card transactions specifically for outlets like 7-Eleven and supermarket outlets like Hannaford Brothers supermarkets.

I think it’s a matter of diligence in terms of data security for the companies that run payment gateway systems. In fact, Heartland Payment Systems was cited in 2007 for being out of compliance with data security and were just reinstated last year by Visa after meeting compliance and as recently as this year they’ve been touting themselves as a leader in data security. Which turns out not the be case.

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In Daubert: Very Convoluted, Usually Confusing to Many, Nevertheless Elegant, Armand Rossetti writes that it is the expert witness in the first instance, and not the court as gatekeeper, who is the judge of what resources to choose to assist her in forming an opinion. It is the expert who will initially filter out prejudicial information as being irrelevant. The Court then uses Rule 703 to assure the reliability of evidence by vetting the bases that forms an expert’s testimony.

Let’s take environmental asbestos infiltration an example, the fact that an air sampling study is an associational (or case) study affecting a few subjects, rather than a higher evidence based epidemiological study that affects several hundred subjects should not bar an expert from using the case study to inform her opinion about the dangers of asbestos release in the environment. The fact that a single case study published in a peer reviewed journal fails to establish causation under a Rule 703 review should go to the weight that the jury will give such evidence, but it does not mean that an expert cannot eventually rely upon it in part to form an ultimate opinion.

Of course, if a single case study were the only source of evidence, then the court might be reasonable in immediately performing a Rule 702 analysis to disqualify the entire testimony. However, the fact that an expert has relied upon several case studies to form an opinion, and has not used even one single epidemiological study should not in itself disqualify that expert’s testimony.

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The Vermont State Police said Friday they have no proof a Rutland police officer intentionally downloaded child pornography onto a department computer while on duty last year. The admission was contained in an unusual statement released by the state police that discussed the status of its investigation into the allegation that the officer had more than 150 images of child pornography on his laptop computer. The state police rarely comment about ongoing investigations.

“There is insufficient evidence to indicate that the images were knowingly and intentionally downloaded,” the statement read in part. “Investigators have consulted with a medical expert regarding the possible age of an individual” in the images, the statement said. “The medical expert has indicated that he cannot say that the individual depicted is under the age of 16.”

For more, see BurlingtonFreePress.com.

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Prison authorities expert witness Richard Lichten gives an inside view on the causes of jail and prison riots:

Perhaps one of the best things the staff can do to keep control is to use the single most powerful weapon available to jail or prison staff… I am talking about the jail keys. There must be good, well thought out security procedures and then making sure those procedures are followed for inmate safety and security to be enhanced. Staff must conduct plenty of searches, keep accurate records, keep on top of maintenance, and most importantly, keep doors (which are called “gates” in jail), securely locked at all times to enhance security and safety. Remember the New Mexico State Prison riot in 1980? I learned that a poorly trained prison guard failed to lock the gate that separated the two sides of the prison which allowed the rioters to spread out and take hostages and kill other inmates throughout the entire prison. I will never forget the wording of a sign above the entrance to one of the large jails I was assigned to. It states, “Good security is not convenient.”

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Emergency medicine expert witness and Chief Editor of web-based eMedicine Dr. Erik Schraga would like legal professionals and experts to know that eMedicine offers continually updated clinical reference information which may prove useful in cases they are working on. The following excerpt on cardiology provides information on myocardial infarction medicolegal pitfalls.

Medicolegal Pitfalls

* Failure to diagnosis a myocardial infarction is the leading cause of litigation against emergency department clinicians and cardiologists.

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In Daubert: Very Convoluted, Usually Confusing to Many, Nevertheless Elegant, Armand Rossetti writes:

Daubert also requires that an expert witness has to assist and not to confuse the Trier of fact. If the Jury (Trier of fact) can understand whether a substance in particular is able to cause an injury and whether an injury resulted from that particular substance, an expert opinion would be redundant and unnecessary.

On the other hand, Rule 403 requires a Court to balance the probative value against the prejudicial effects of expert witness testimony. Courts should not confuse Rule 403 with Rule 703.

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Medical expert witness and Chief Editor of web-based eMedicine Dr. Erik Schraga would like legal professionals and experts to know that eMedicine offers continually updated clinical reference information which may prove useful in cases they are working on. The following excerpt on cardiology provides information on sudden cardiac death medicolegal pitfalls.

Medicolegal Pitfalls * Failure to recognize and initiate early management of patients with ischemic heart disease is a pitfall. The importance of this cannot be overestimated because approximately 80% of SCD cases can be attributed to ischemic heart disease.

* Failure to use appropriate medical therapy for ischemic heart disease (eg, beta-blockers) can be a pitfall.

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In Tough Question Requires Equally Tough Answers, hospitality expert witness Steven Belmonte, President and C.E.O., Hospitality Solutions LLC, asks the questions: “Are product upgrades and renovations really needed during hard economic times?”

In short, you can’t afford to defer upgrades because of the poor economy. To put it another way, you can’t afford not to invest in an upgrade, regardless of the economy’s strength (or lack of it). The truth is, your guests don’t care if the economy is in bad shape, as long as your hotel is in good shape-and if it isn’t, they won’t be back.

Now because of the economic downturn and the resultant difficulty in getting a loan, you may be wondering how you could possibly afford to upgrade when business is down and cash-flow has been reduced to a trickle. One thing to consider is repositioning your product in the marketplace. Don’t let your ego get in the way-there’s nothing to be ashamed of in repositioning to a “lower” segment, and there are many economy-focused products available. It may be the right decision, one that keeps guest expectations in check while eliminating the need to invest what could be millions of dollars to upgrade in order to meet high expectations. Granted, this is not an easy choice: Your average daily rate will be negatively affected, but it may be your only viable alternative. After all, isn’t it better to reposition to a lower tier than to have your guests dissatisfied because their expectations are not being met? Think about it.