Medical Malpractice Podcast

25 – Sonia Rodriguez – Defeating Defense Medical Experts

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In this episode of Trial Lawyer Nation, Michael Cowen sits down with Cowen | Rodriguez | Peacock partner, Sonia Rodriguez, for another installment of TLN Table Talk to answer the questions of our listeners. This episode focuses on defense medical “experts,” or as Michael calls them, “paid opinion witnesses.”

Michael calls this spade a spade right from the get-go, in that the title of “defense medical experts” is a sham. Many times, he says, they are called “independent experts” when they are neither independent nor an expert, not to mention the fact that they are hand-picked by defense lawyers who pay them for their testimony. Michael believes it is a huge fraud being perpetrated on our clients, on the jury, and on the court system. He says, typically “we know what their report is going to say once we hear their name,” further exemplifying this flaw in the system.

So, Michael asks, “what do we do to expose this and show the jurors the truth?” Sonia believes it is critical we expose the relationships experts have with the lawyers who hired them, how often they’ve been used by that firm or the defense industry, as well as how much money they make from that business. She also uncovers what percentage of their business is spent on reviewing files for defense lawyers vs. practicing medicine, in some cases. All of which can go a long way in revealing these witnesses for what they really are, which is “paid opinion witnesses.” Michael also explains how he doesn’t like to even use the word “expert,” which gives them the mantle of that title. He goes on to discuss the harsh reality and his distain for medical professionals who misuse their degrees to go against the very oath they have taken to “do no harm,” while we represent legitimately injured clients, and they do it for money! They both agree how uncovering the financial ties and bias of these witnesses also says a lot about them because they could likely be making much more money by seeing patients, but instead are reviewing cases for a defense lawyer. Michael also talks through a real example of what he’s run into on how these medical witnesses come to find themselves making money in this way and how their path toward testifying can ironically parallel his client’s paths.

Michael and Sonia share a plethora of examples regarding their tactics on utilizing depositions, both past and present, to build their cases, ranging from networking with other attorneys and medical professionals to leveraging amazon.com in the middle of a deposition. Sonia explains how you cannot go into a deposition with a broad brush, but rather be laser-focused and able to drill down on even a single word, in some cases, to make your entire case. And to sum things up, Michael talks through the very polarizing two ends of the spectrum his preparations take him with defense medical experts, where they are likely to either be way “off the deep end” and obviously working as a paid witness, or he will focus his energies on essentially turning them to help his case. The strategies they both describe are pure methodical genius.

The conversation shifts to talk specifically about the tone and demeanor both Michael and Sonia use when deposing paid medical witnesses. They both agree the tone and demeaner you use in a paid medical witness deposition is extremely important, as it will likely be replayed for the jury at some point and jurors will also be watching to see how you handle yourself in this situation, the same way they do in the courtroom. We, as plaintiff attorneys, also need to be cognizant of how we are approaching the deposition so it leads the jury to come to their own conclusions regarding the credibility of the paid medical witness and their testimony. It also becomes reflective for the jury to feel the danger themselves of allowing these paid medical witnesses to get away with using their titles as a form of “expertness” in exchange for being paid by the defense. In other words, if we just “rip into them” it will likely backfire on us and not work at all in our favor. Not to mention, Sonia adds, that today’s juries are tired of the theatrics and enthusiastic approach of some lawyers, where the days of yelling and pounding your fist on the table are now long gone.

All in all, this Table Talk with Michael and Sonia was thorough and filled with an enormous number of real examples from their experiences over the years. As a trial lawyer, you will likely run into paid medical witnesses in trials often, and this table talk could be the one thing that prepares you most for success.

23 – Tom Crosley – TBIs: An invisible, yet very real injury

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In this episode of Trial Lawyer Nation, Michael Cowen sits down with accomplished trial lawyer and national speaker, Tom Crosley, who has been incredibly successful in trying cases involving Traumatic Brain Injuries (TBIs).

Tom’s start in TBI-specialized cases began with a case involving a plumber who had a neck and shoulder injury with seemingly normal readings on his CT and MRI scans. The more he worked on the case, the more he found out through his client’s wife that his client just wasn’t the same as before the incident. It was when the defense lawyer was taking the plaintiff’s deposition that Tom realized his client likely had a TBI. All the things a plaintiff’s attorney cringes at in a depo were happening, from his client flying off the handle at the defense attorney, to forgetting his kid’s birthdays. Basically, all the things you think are going to be bad for your case. By the end of the deposition, Tom went from thinking this was a neck and shoulder injury case worth hundreds of thousands of dollars to thinking this could be a TBI case more than likely worth millions.

This sent Tom off to learn as much as he possibly could about TBIs, all in the face of having normal scan results, which back then were seen more as a barrier to proving TBI cases. His research inevitably led him to finding a case study where war veterans of Iraq and Afghanistan were not displaying outward signs of TBIs, nor were their CT or MRI scans showing any abnormalities, but were found to have TBIs through additional testing. Not to give the whole story away, but Tom tracked down the lead researcher, his client was tested and found to have a mild TBI, the case was won with a verdict over 20X the initial offer given pre-trial, and Tom’s specialty for TBI cases had begun.

Since then Tom attributes his ability to go from never having tried a TBI case to now being one of the country’s top TBI lawyers, to his penchant for reading medical literature and going to legal and medical conferences in order to gain knowledge of the cutting-edge science happening with TBIs. He also admits it’s not all brain science with TBI cases, but it also includes some very human nature elements sometimes overlooked. Things like before-and-after witnesses who can relay their own experiences with a plaintiff in a meaningful and impactful way, having nothing to gain from doing so. This puts the decision on the jury to conclude that this invisible injury (which many defense lawyers will proclaim isn’t real if it can’t be seen) either has a lot of people lying about it for the benefit of the plaintiff, or there is something very real about it given those who have first-hand accounts of seeing the plaintiff’s evolution from pre-injury to their current state. Michael shares his own firm’s experience about the timing of getting other witnesses involved in TBI cases and the hard lessons that experience has brought with it.

Next, Michael explores how Tom transitioned from having success with just one TBI case to building up the number of TBI specific cases to become successful. To which Tom explains that the sequence of your evidence at trial makes a big difference on the outcome of the trial and shares a perfect example based on his experience of the order where he has found the most success over time. Tom discusses the patterns which tend to work for him, although his process is nothing close to being cookie-cutter, and shares “just like no two snowflakes are alike, no two brain injury cases are alike.”

Michael and Tom both reference a shocking study which shows upwards of 56% of TBIs are misdiagnosed or go undiagnosed completely. Tom digs in and goes over some of the reasons WHY they get missed, starting with the most obvious in a traumatic medical situation where other orthopedic injuries tend to get the attention; i.e., someone goes to the ER with a bone sticking out of their leg and a concussion – the doctors focus on the bone first. Another challenge Tom points out is while a TBI is an invisible injury, their symptoms can also be described as things not brain injury related, such as age, depression, PTSD, psychiatric history, which also cause symptoms that mirror those of a TBI. So, the challenge becomes, in these cases, to figure out how those symptoms are related to brain damage and not related to something else. He goes on to discuss the lack of training most physicians receive on what to do with concussion patients, which adds another layer of complexity to many TBI cases.

Michael asks the question on all trial lawyers’ minds who work on TBI cases, and that is “what are some of the things that we should be doing when we get hired on these cases early in order to have the best possible chance of winning the case?” Tom explains the number one piece of advice when trial lawyers run into these types of cases is that as long as the plaintiff/patient is experiencing symptoms, they need to be getting documented in the medical records. You don’t want to go to trial with a gap in records where these life-changing symptoms are occurring, which Michael also points out is likely no different than the advice that you would give to a friend or a family member.

Michael and Tom explore several other nuances of TBI cases; but in the end, Tom explains, we are painting a portrait of a person whose life has been changed forever. Similar to a wrongful death case where the person who existed before is no longer; helping a jury understand the impact a TBI has on a person, their family, and the future and how this person no longer exists as they did before is EXACTLY what can turn a $100k case into a $16M case.

About Tom Crosley

Tom Crosley received his bachelor’s degree from the University of Texas in 1988, and his law degree from the University of Houston in 1992. He was admitted to the bar in the State of Texas in 1992 and is also admitted to practice in the United States District Courts for the Northern, Southern, Eastern and Western Districts of Texas, as well as the United States Court of Appeals for the Fifth Circuit. Prior to forming the Crosley Law Firm, P.C. in 2005, he was a partner with Branton & Hall, P.C. in San Antonio, where he worked for ten years. He began his legal career in Houston as an associate at Brown McCarroll, LLP.

Mr. Crosley is “AV” rated by Martindale-Hubbell, and is Board Certified in Personal Injury Trial Law by the Texas Board of Legal Specialization and is board certified as a Civil Trial Advocate by the National Board of Trial Advocacy. He is a past president of the San Antonio Trial Lawyers Association in 2002. In 2001, he served under appointment by the Bexar County Commissioners Court to the Advisory Board for the Bexar County Dispute Resolution Center and he served in that position until 2006. He is a member of numerous legal organizations, including the American Association for Justice. He has been an active member of the Texas Trial Lawyers Association (Director, 2005-present, Advocates Director, 1999-2001), the San Antonio Trial Lawyers Association (Director, 2000-2001, President, 2002), the American Board of Trial Advocates, San Antonio Chapter (inducted 2004, Secretary, 2014, Treasurer, 2014, Vice President 2015, President-Elect 2016, and President 2017), the American Bar Association, the Texas Young Lawyers Association (Director, 1997-2001), the San Antonio Bar Association (President-Elect, 2018-2019, Vice President, 2017-2018, Secretary, 2016-2017, Treasurer, 2015-2016, Director, 2004-2006 and 2013-2016), the San Antonio Young Lawyers Association (Director, 1997-2001, Vice President, 2000) and the American Inns of Court. Mr. Crosley is a Life Fellow of the Texas and San Antonio Bar Foundation and is a member in good standing of the State Bar of Texas. Mr. Crosley has tried 50 cases as first-chair trial counsel, nearly all of them from the plaintiff’s side of the docket.

Mr. Crosley frequently serves as an author and speaker at legal seminars, usually on topics related to personal injury trial law. Mr. Crosley has been selected as a Texas Super Lawyer each year since 2004 and has been named as one of the Top 50 Lawyers in Central and West Texas by that publication for the last several years.

Mr. Crosley’s docket of cases includes personal injury and wrongful death cases arising from automobile and trucking accidents, defective products, medical malpractice, and related areas. In 2006 ($28,000,000), 2010 ($16,000,000), and 2016 ($11,485,000)

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08 – Chad Roberts – Discovery in the Electronic Age of Documentation

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In this episode of Trial Lawyer Nation, Michael Cowen sits down with 25+ year veteran of the legal industry and founder of eDiscovery CoCounsel, Chad Roberts.

In a legal world where we are document heavy and paperless, eDiscovery sets out to avoid the abundance of obstacles trial lawyers encounter when in search of documents, be it the dump-truck effect of getting volumes of information or the paid search games that are played.

Primarily, people think about documentary evidence which is stored in a digital format, to which the rules have somewhat of a bias toward that type of framework, which tends to be the biggest challenge, explains Chad. He goes on to describe that it is not so much the format by which these documents are held, but rather the sheer volume of content that is available. For those of us who are not experts in e-discovery, not knowing the right questions to ask to receive what is sought after or even what is available to ask for, can make a case challenging. Chad points out one of the biggest “tectonic shifts” in the advantage/disadvantage for discovery really occurred back in December of 2015 with the new Rule 26, pertaining to the proportionality factors that came about under that rule, of which Chad dives deep on along with the ways around it.

Chad continues to reveal the dirty little secret that the more you know about the information structure and how documentation is filed, the easier it is to deconstruct the arguments of it being tremendously difficult for the defense to compile what you are looking for … which, coincidentally, is enormously easy for them to produce. Furthermore, Chad describes the other “human nature” side of the story where attorneys psychologically feel that they are out of their element, mostly because they don’t do excessive amounts of document productions, and are more likely to agree to things that are not best for a case.

Ideally, as Chad describes, his firm is typically brought in at the beginning of a case and start with  Electronic Storage Information (ESI) protocols, where the front-end platform is established through discussions regarding agreement of the mutual expectations of those involved in the case, and this, of course, is the best line of defense in counteracting the diversions played by opposing counsel.

The podcast concludes with Michael and Chad discussing the types of cases that make the most sense to bring in a firm such as eDiscovery; and the description that Chad offers on why even the biggest of firms would likely have a significant flaw in their practice if they had the capacity of his firm is enlightening and makes perfect sense when you hear it.

Background on Chad Roberts

Chad Roberts is a seasoned trial lawyer with a career focused on technology, complex litigation, and multi-district litigation.  He has been a litigation partner at an AmLaw 20 multi-national law firm as well as a small, boutique trial firm, winning multi-million dollar verdicts as lead trial counsel. His focus at eDiscovery CoCounsel, pllc includes predictive coding technology, discovery jurisprudence, and large scale litigation management.  Chad received an Engineering Science degree from the Georgia Institute of Technology and graduated with high honors from the Florida State University College of Law, where he was an Associate Editor of the Florida State University Law Review.

For more info on Chad Roberts visit:  www.edcclaw.com

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