Doctor

93 – Hans Poppe – David vs. Goliath: Winning the Uphill Battle

In this episode of the Trial Lawyer Nation podcast, Michael sits down with Kentucky-based trial attorney, Hans Poppe, to discuss his recent cases, the difficulty of trying med mal cases, and much more.

The episode begins with Hans going into his history as a trial lawyer. Hans began his practice in Louisville, Kentucky, and currently runs a small, 100% referral-based firm, focusing on catastrophic injury cases. He goes on to explain that he started his firm 4 years out of law school and gradually built his practice through the years by focusing on case selection and making sure everybody knew what he was interested in by utilizing marketing methods such as CLEs to maintain relationships and monthly newsletters.

Following a brief discussion on CLEs, Michael inquires on Hans’ trial record on med mal cases, to which Hans responds, “We’ve won 3 of the last 4 med mal trials, [and have] gotten punitive damages in all 3 of [those wins].” He goes on to say that he’s been focused on trying these cases differently.

To this, Michael asks Hans to explain more about his recent wins, adding that med mal cases are tough for plaintiff attorneys. Hans agrees and adds, in Kentucky, the defense win-rate is 80-90%, and how there’s a very small group of attorneys in the state who take these cases to verdict. He goes on to say even the top lawyers who are doing very well are still losing 80% of the time.

“You’ve got to be able to put $100,000 on the line and know there’s an 80% chance that you’re going to lose it.” – Hans Poppe

Continuing the discussion of the difficulty and uphill battle of med mal cases, Hans expresses the importance of being “hyper-focused” on case selection and realizing “every case is actually 3 cases,” (meaning the case you sign up on day one, the case you prepare for, and the case you try; none of which are the same) and how those factors need to be top of mind during case selection.

Building on the topic of trying med mal cases, Hans goes on to explain if you go into the courtroom and try against a physician just based on medicine, you’re going to lose. He outlines how defense lawyers who handle med mal cases are very good lawyers and work those cases hard, and how you need to “find something else” to bring to the table.

“If you can get past the medicine… and find [focus in on] the other angle… the other side is not used to that.” – Hans Poppe

To explain the concept of “getting past the medicine,” Hans goes into detail on his most recent case involving the suicide death of his client. He shares why it was an impossible case, considering his client committed suicide, but he chose to frame the case so it started before the suicide. He describes the business practice of this particular pain management clinic and the unavoidable outcome it produced of patients not receiving the care they need. This was due to patients only seeing doctors on their first visits and mid-level providers in subsequent visits.

In this case, the prescription given to his client was written 4 days before he’d even seen the provider and was for half of his normal dose. “What we focused on were the business decisions that were being made,” Hans says before delving deeper into the unethical business practices of this clinic. This case ultimately resulted in a $7 million verdict and was a zero-offer case, which Hans adds, “the defense had no idea.”

“There were 15 doctors, and the doctors aren’t seeing the patients… each doctor has 4-5 nurses under him, they see a patient every 15 minutes, and so the doctor bills 4-5 doctor’s visits every 15 minutes.” – Hans Poppe

Following this discussion, Michael and Hans go into another of his recent wins, a $21.3 million verdict case involving an unnecessary pacemaker. In this case, Hans and his team focused on the business practices of the hospital, and how it entangled with cardiologists and encouraged them to perform heart procedures; essentially disincentivizing proper care in favor of profit-focused business practices. “You know what the problem is with incentives?” Hans says, “They work.”

He and Michael continue the topic by delving into the ugly side of the medical business, and how it really changes the dynamic of a case when you can focus jury’s attention on something other than “the white coat and the stethoscope,” before moving on to Hans’ 3rd recent case.

In this case, the audit trail (document that hospitals and physician’s offices are required to maintain, tracks every time the chart is logged into, and if any edits are made) revealed several days after the patient died, the PA got into the patient’s chart and modified the history. The PA had no idea during his deposition that Hans had the audit trail, and not only that, but Hans never asked him about it … UNTIL TRIAL!

“We’re not trying a case about what happened  the exam room … we’re trying a case on what business decisions were made and how those impact patient care [and leads to] a bad outcome.” – Hans Poppe

During trial, the PA had no explanation as to why he was changing the patient chart several days later. Hans had also obtained evidence the PA had a productivity bonus and had been running behind on the day his client was seen; a fact Hans argued was the reason he didn’t do a physical examination of the patient.

This episode also covers the willingness to risk losing and why the ability to recover is so important, the impact of your mindset, appearance, and self-confidence, how incentives can go bad and how to highlight it in your case.

 

Guest Bio

Hans is licensed in Kentucky and Indiana; however, he has a national reputation for handling catastrophic injury and death cases as well as contingency fee business-to-business litigation.

While lots of lawyers hold themselves out as “trial lawyers,” Hans actually is one.  According to the 2020 Kentucky Trial Court Year in Review, only three plaintiff lawyers in Kentucky have tried more cases to verdict than Hans since 2005.

In fact, since 1998, only four lawyers in Kentucky have more verdicts over one million dollars than Hans (2020 Kentucky Trial Court Year in Review.) Hans had the largest Kentucky verdict in 2016 and the second largest Kentucky verdict in 2008. Hans has multiple seven and eight figure verdicts and settlements in medical malpractice, insurance bad faith, and FELA cases.

In 2016, ALM VerdictSearch Top 100 Verdicts of 2016 recognized Hans’ $21,274,786 verdict in Wells v Catholic Health Initiatives, Inc as the 94th largest verdict in the United States.  The Wells case was one of over 400 cased filed by the Poppe Law Firm in London, KY alleging unnecessary cardiac procedures were performed in order to boost profits.  Three more cases went to trial and ultimately all the cases were globally settled the night before the verdict in the Owens v. CHI trial.  The work done by Hans and his team also contributed to a $16,500,000 Medicare qui tam recovery from the hospital and $380,000 from two doctors.  Additionally, the work done by the Poppe Law Firm helped lead to the arrest and federal conviction of two other cardiologists for Medicare fraud.  One was sentenced to 42 months and the other was sentenced to 30 months.

At the same time he was handling the London unnecessary procedure litigation, Hans and his team found a similar fact pattern in Ashland, KY involving King’s Daughter’s hospital.  Hans filed over 500 lawsuits in Ashland also alleging unnecessary cardiac procedures. Two months later the Department of Justice reached a $41,000,000 settlement with King’s Daughers for allegations of unnecessary procedures. The civil suits were settled in a 2019 confidential global settlement.  The work done by Hans and his team also helped lead to the conviction of a third cardiologist who was sentenced to 5 years and $1,000,000 in restitution.

Hans was selected by his peers as the 2020 Lawyer of the Year in Medical Malpractice-Louisville by Best Lawyers®. Only a single lawyer in a specific practice area and location is honored with a “Lawyer of the Year” designation. Additionally, Hans was recognized in the same edition of The Best Lawyers in America for his work in Personal Injury Litigation and Professional Malpractice Law.

Hans was named a 2021 Top 50 Kentucky Super Lawyer by the prestigious Thomson-Reuters Super Lawyer peer review rating system.

Also in 2020, Hans was nominated and elected by his legal peers to be President of the prestigious American Board of Trial Advocates’ Kentucky Chapter.

Hans’ advocacy and professionalism recently led the U.S News & World Report to recognize The Poppe Law Firm as a 2021 Best Law Firms in Kentucky-First Tier Law Firm.

In addition to being a courtroom trial lawyer, Hans has had five cases go before the Supreme Court of Kentucky.

Contact Hans:

E-mail:  hans@poppelawfirm.com
Phone: 502-895-3400
Website: www.poppelawfirm.com

66 – Dorothy Clay Sims & Dr. Oregon Hunter – The Lawyer-Doctor Duo: Exposing Deceptive Defense Doctors

In this Trial Lawyer Nation podcast, Michael sits down with attorney Dorothy Clay Sims and Dr. Oregon Hunter to discuss their research on defense-paid medical witnesses. They’ll discuss how the pair became involved in this research, Dorothy’s book “Exposing Deceptive Defense Doctors,” Dr. Hunter’s published study on the subject, and take an in-depth look at Dorothy’s favorite tactics for exposing deception in defense doctors.

The episode begins with a brief overview of what Dorothy and Dr. Hunter each do and how they became involved in it. Dr. Hunter focuses on watching video tapes of defense medical exams and generating charts of everything the “expert” lied about in those statements. In his initial study, he’s sad to say they lied or misrepresented the facts 100% of the time.

Dorothy explains how she used to have a large worker’s comp practice in Florida when she noticed a pattern – 60 of her clients were found to be malingerers by a Harvard-educated, smooth talking defense doctor. He was giving them all the same test, the MMPI (Minnesota Multiphasic Personality Inventory). Dorothy decided to sit down with the doctor who first created the test and found that the defense doctor was completely misrepresenting the results of the test. She even got the doctor who created the test to sign an affidavit saying, “If he was a student, I’d flunk him.”

This sparked a deep interest in the subject, and she began researching other tests to see how they’ve been manipulated to serve the interests of the defense. As her work gained more attention, she began receiving phone calls from David Ball himself telling her, “You’ve got to write a book, dammit. You’ve got to do it!” So, she complied and wrote “Exposing Deceptive Defense Doctors,”which Michael describes as “the Bible” for any case where you have a doctor on the other side.

Dorothy goes on to share some of her more shocking findings, from 40% of defense doctors lying about their degrees, to a doctor who was fired for stealing from a poor patient’s medical fund to pay for prostitutes. She also shares some creative resources she uses to find this information and implores all plaintiff attorneys listening to do their due diligence whenever there’s a doctor on the other side trying to discredit their client.

Dorothy then shares her detailed, organized method for marking up her depo notes, allowing her to go into every defense doctor deposition prepared with the pertinent information (and a record of their lies). She has now compiled 30,000 pages of information on thousands of defense doctors, which she is willing to share with any plaintiff lawyer interested.

The conversation shifts to Dr. Oregon Hunter, whose published study on the subject.  He explains how if you look at the medical exams from defense doctors, they will appear at face value as an exam of a perfectly healthy person. But when he watches the video tape of the exam, all he can say is, “Oh my god.” He goes on to share countless examples of doctors who claimed they conducted a test, but either didn’t conduct the test at all or were so sloppy about it that there’s no way they could actually tell if the client was injured or not. He also shares how they’ll often use templates which contain information that has nothing to do with the person they’re examining. For example, a patient’s ankles were described as “normal,” but there was just one issue – the patient’s legs had both been amputated.

Michael then asks Dorothy, what are some other things we need to look out for when they’re “trying to pull the wool over our eyes?” Dorothy shares her experience with brain scans and the defense doctor showing slices of the scan which do not show damage, when there are other slices which show the damage much clearer. She continues with other examples of similar practices with different injuries and concludes by emphasizing the need to always be on the lookout for “false choices.” For example, the defense will say a client who had preexisting arthritis cannot have a herniated disc from the crash, when in reality you can have both.

Michael continues on this note by sharing a story of a radiologist who attempted to re-define the word “trauma” for the sake of the defense argument. After finding the book the doctor was referencing (MRI of the Brain and Spine by Scott Atlas) Michael uncovered a paragraph which states, “there is no legal or factual basis to date when a herniation happened from looking at an MRI.” After bringing this up in the deposition, he effectively ended the radiologist’s testimony career.

The episode concludes with Dorothy’s final words of advice for deposing defense doctors. She recommends numerous helpful strategies, including having the plaintiff present when the doctor calls them a liar, having your own doctor present to induce what Dr. Hunter calls “the halo effect,” and finally (and most importantly) do your research. Does the doctor say they are board certified? Look into the organization (one even certified a cat). Does their CV say anything about Harvard? Definitely look into that, as she’s found 80% of defense doctors with Harvard on their resume are lying about it. Utilizing this advice and the excellent resources mentioned in this episode will ensure that even if the defense doctor is lying through their teeth, you won’t let them get away with it.

This podcast also covers gaining permission to video record defense doctor exams, sociopathy in defense doctors, what “grossly normal” on a report really means, the importance of reading the literature the defense doctor cites, and so much more.

You can reach Dorothy Clay Sims via email at dcs@dorothyclaysims.com and through her website at https://dorothyclaysims.com/.

 

Bio:

Dorothy Sims and her team combine decades of experience in medical, legal, and research fields.

On a daily basis, Dorothy consults with attorneys throughout the U.S., to provide methods of expert testimony cross-examination. If an attorney requests, Dorothy can depose experts herself. For more information about her consulting, visit the Consultations page .

Dorothy’s practice includes numerous other projects and philanthropic work. She is frequently invited to in-house seminars for lawyers and law firms on researching and cross-examining. She has given over 350 speeches internationally on medical/legal issues throughout the world and is often invited as the state keynote speaker. She has spoken in almost every state in the United States including Hawaii and Alaska. She has also been a featured speaker in Paris, France, Jaipur, India, and twice in Kyoto, Japan.

She has authored chapters in books with individuals such as David Ball and Don Keenan as well as Dr. Michael Freeman. Dorothy donates a percentage of her book profits various organizations including the American Association for Justice and the International Federation for Human Rights. Her book, “Exposing Deceptive Defense Doctors ” was a best seller for 3 years in a row and went into reprint status soon after publication, unheard of in the industry. She has also authored two children’s books for parents who are injured. The books are available for free upon request. She has also authored articles in national publications to include the Champion Magazine, Trial Magazine (The American Association for Justice Journal) most recently on the cover of the December, 2015 issue, and Brain Injury Professional.

About Dorothy Sims

Dorothy received both her undergraduate and law degree from the University of Florida; and studied international law at Oxford University. She is licensed in the state of Florida, US District Court – Northern District of Florida, US District Court and the Middle District of Florida. She has also cross examined experts in many states throughout the US.

Dorothy initially represented miners in Kentucky who were denied black lung benefits. Going down into the bowels of a mine in Eastern Kentucky, she felt vibrations as the miners “shot coal” (exploded portions of the face to loosen the coal). Despite wearing a mask, her trip left her coughing and sneezing coal dust for days; leading to a newfound respect for the dreaded pneumoconiosis suffered by miners who had spent decades in the mines.

After representing coalminers, Dorothy began representing workers who were injured and denied medical care. She co-founded the Florida Workers’ Advocates – the state’s first watchdog over the insurance industry devoted to serving injured – and eventually served as president.

For over a decade, Sims volunteered time to lobby on behalf of the injured and was the first woman to be elected Chair of the Florida Bar Worker’s Compensation Section in its 22-year history. She also served as President of the Marion County Bar Association.

While practicing law, she began to notice an alarming pattern. Forensic experts hired by the other side were reaching conclusions by (1) misrepresenting the science (2) ignoring the science (3) misrepresenting the facts and/or their examination and/or (4) testifying beyond their own training and education.

About Dr. Oregon Hunter

Dorothy’s most recent addition to her team is Dr. Oregon K. Hunter, MD – a medical doctor licensed in Florida – who currently works on cases with Dorothy and other lawyers to determine if misrepresentations are made about the science. If you provide notice to defense counsel, he can attend a deposition as a non-testifying consultant. He can remote in for mediations to explain medical issues to the defense in support of the plaintiff’s case. He watches videotapes of defense exams and provides an analysis for lead counsel explaining what the other side’s expert misrepresented. For an example of an evaluation of a case conducted by Dr. Hunter in which the expert’s exam was videotaped contact us here.

Dr. Hunter is board certified in Physical Medicine and Rehabilitation and practiced medicine in Hawaii, California and Florida. He joined Dorothy’s team in 2015 and is an invaluable asset in reviewing cases.

Dr. Hunter is also available to attend mediations by video and explain weaknesses in defense’s position. Attorneys Evan Lubell (elubell@floridalegalrights.com) and Dan Ramsfeld (dan@ramsdelllaw.com) can be contacted as references for Dr. Hunter’s recent participation in their case.

 

63 – Sonia Rodriguez – “You Got Me”: Discrediting Defense Paid Opinion Witnesses

In this Trial Lawyer Nation podcast, Michael sits down with his law partner Sonia Rodriguez for an overview of deconstructing defense-paid opinion witnesses. They highlight many of their favorite strategies to use when dealing with a witness who won’t answer your questions, their favorite unexpected “gifts” from witnesses, and the importance of why someone becomes a defense-paid opinion witness in the first place. This episode is full of shocking real-life examples you don’t want to miss.

Michael begins the episode by highlighting the defense strategy to hire someone to discredit their client. He asks Sonia, “What do you do to deal with this?” Sonia describes the first action she takes, which is reviewing what organizations they show they are affiliated with on their CV (curriculum vitae). Most professional organizations have ethical guidelines which these witnesses must abide by. She’s found success in displaying these guidelines to the witness during the deposition and using them to prevent the witness from stating biased information.

Michael then describes the common narrative these witnesses all portray which every plaintiff attorney listening is sure to relate to. Any injury from the crash goes away in 6-12 weeks, but any injury from 10 years ago is most certainly the cause of everything today, even if they haven’t been to a doctor for it in 9 years. Sonia has combatted this in medical witnesses by focusing heavily on the client’s description of pain. Most doctors will admit that the patient’s description of pain is a very important part of the diagnosis. She uses this information to put the witness in a position of saying, “the records aren’t adequate,” which does not play well with the jury.

The conversation then shifts to the difficult but highly effective strategy of turning the defense paid opinion witness into your witness. Sonia explains why this is so difficult to do successfully, but has maneuvered these difficulties by focusing her depos on what she knows she can get from them. She shares an example of this where she was able to build up the witness’s credibility, then use it to get some simple, clear concessions.

On the other hand, Michael says his primary goal in every defense paid opinion witness depo is to make them his witness. Instead of fighting with them in an area where he does not have credibility, he spends his time researching the witness, reading prior depositions, and trying to find what they will give you based off those prior experiences.

Michael elaborates further on the importance of reading past testimonies by sharing a shocking example with a biomechanical engineer who claimed his client could not possibly have a herniated disc from the crash. Before trial, Michael read several of his previous depositions and went through all of the literature the witness cited in the case. He then shares an example of how he used those prior depos to discredit the witness, how his voir dire helped him do this while also relating to the jury, and why reading the literature can help your case.

Sonia wholeheartedly agrees and gives her real world experience using the literature to your advantage. She shares an example where a neurosurgeon used a study about the prevalence of herniated discs to claim her client’s pain wasn’t caused by the crash. After reading the article, Sonia found that it only referred to a specific type of herniated disc, which was not the type her client had. After revealing this, all the witness could say was, “You got me.”

Another all too familiar roadblock is the witness who just won’t answer your questions. While Sonia and Michael both agree this will always be a barrier, they both share insightful techniques on how you can overcome this. Sonia does this by always recording the testimony, so she can show the jury the witness was refusing to cooperate or concede to basic things. Michael then offers another strategy he employs with uncooperative witnesses – using basic, fair questions in a true or false format. While you may still need to ask the same question 10 times to get a response, you can always cut out the first 9 asks. The key to this is to never appear mad or frustrated because it doesn’t present well to the jury. Sonia agrees with this strategy and points out how well-suited it is for a Zoom deposition.

On a lighter note, Michael and Sonia share their favorite unexpected “gifts” they’ve received from paid opinion witnesses. Sonia details her experience of utilizing past testimony to prove an orthopedic surgeon was simply touting lies for money and highlights the importance of sharing information with other members of the plaintiff’s bar. Michael’s favorite “gift” was an ex-sheriff providing testimony on a drunk driving case, who made an incredibly racist statement in his deposition. The judge insisted the case not be made about race, which Michael had no issuing agreeing to. But when Michael asked the sheriff the same question at trial (assuming the witness had been prepped not to make the same mistake), he made the SAME racist statement he made in the deposition.

While these unexpected “gifts” are a huge blessing, they’re hard to come by on most cases. Sonia and Michael conclude the conversation by exploring why people become paid opinion witnesses in the first place. He accurately states, “This isn’t why people want to become doctors or engineers.” Michael explains how many of them either just weren’t good at their jobs or experienced an injury that rendered them unable to perform surgery.

This podcast also covers using before and after witnesses, focusing on the symptoms instead of the diagnosis, whether or not to “go in for the kill” in a deposition, verifying the qualifications of a witness, and so much more.