February 9, 2010
WhiteCoat

The Trial of a WhiteCoat – Part 9

Two months came and went rather quickly.

Once again I took off two weeks of work to attend this second trial. It better not get postponed again.

I caught an early train into the city. While riding the train, I didn’t feel as nervous as I did last time around. I really felt good about the care I provided and about the case in general. Of course, if you asked me that same question a week earlier, I would have told you just the opposite. This whole thing has been a crazy emotional rollercoaster ride and I’m just glad this trial is starting on a “up” note.

I got to court a little earlier than scheduled and was the first one there. Two attorneys were in front of the judge on a different case and the judge was yelling at them because of a delay in getting the depositions of two physicians.
“It’s been six months,” the judge said loudly. “I can get the deposition of the president’s physician in six months. And these doctors aren’t even neurosurgeons. The hierarchy doesn’t even apply. You know – district court judges on top, then God, then neurosurgeons. It’s not that tough. Get the depositions in two weeks or the doctors don’t testify.”
It was like watching kids getting yelled at by their father. The attorneys just hung their heads, walked over to a desk, filled out some papers and gave them to the judge to sign.

I took my seat at the desk and noticed some pre-trial orders sitting there with our case caption on them. I nosed through them and got a little upset about one of the orders. It said that “defendants are barred from eliciting any testimony about, introducing any evidence about, or arguing about medical literature as substantive evidence in the defendant’s case in chief.” What the heck? Isn’t that what the practice of medicine is based upon?
There was also an order that barred the introduction of any evidence of conversations the family had with their regular family physician. It made me wonder. Did this physician ever get deposed? Did the family tell him something that would have hurt their case?

Hitch the bailiff was ornery as ever. When the attorneys walked into to the courtroom, before they even had a chance to shut the door, he yelled “shut the door, counsel.” Then he announced to all of us “don’t use the juror bathroom, only use the staff bathroom.”
“Where is it?” I asked.
Without looking up from his newspaper he says “that way.” Thanks for being so vague.
Then he decides that he has got better things to do than sit and read the paper, so he goes off to the back hallway to talk loudly again. I go through another door to the back hallway to look around. He sees me and suddenly has an interest in my ever expanding bladder. “Right in THERE. I told you.” Oh, you mean the door that looks like a closet with no label or lock on it? I see. How careless of me to think that it was a closet.

I was supposed to take off on a Thursday night and miss one Friday during the trial for a wedding. Today I learned that I can no longer go on my trip. They have me scheduled to testify on the day I’m supposed to be gone. There’s simply no other day I can testify. Oh well. There go the plane tickets. Everyone’s schedules have to be worked around the experts who can only testify one day per week.

I also had a surprise when my attorney asked me how I was going to explain away a bloody wound on the patient’s abdomen.
“What are you talking about? There was no bloody wound on the patient’s abdomen.”
“Well, the paramedics notes stated that there was blood coming from the patient’s abdomen when they were transporting the patient to the hospital.” Supposedly the plaintiffs are going to try to state that the presence of a bloody wound on the patient’s abdomen should have led to the earlier diagnosis of the patient’s disease.
I started to get angry. This is such a game. There was no blood present. Now I am being forced to explain away a physical finding that didn’t exist based on the notes of someone who didn’t even undress the patient. This was apparently the “new” information that the plaintiff’s attorney was trying to introduce during the last trial. Never saw the ambulance report until just now.

So we come up with a different explanation of the patient’s findings on the morning of the second trial. There may have been some blood there, but given the patient’s condition, the presence of blood would not have been unexpected.

The whole concept still ate at me. The patient was sent to the hospital from the physician’s office by ambulance. The family physician didn’t note any blood. How could the patient’s abdomen go from having no bleeding wound in the physician’s office to having a bloody wound 15 minutes later with the paramedics, to having no blood when I evaluated the patient twenty minutes later?

Vinny told me “don’t bring out inconsistencies like that — they can’t help us. If you bring out those inconsistencies, it makes it look like you would have done something different if you had noted the blood and makes you look like a dummy for not noticing the blood.”

“Jurors want to be able to fit the stories into a nice little box,” he continued. “Nothing should be outside the box.”

In other words, a physician is stuck with what is written on the chart. No matter what it says.

Lucky no one wrote that the patient had Martian ears.

It’s 10:00 AM and the attorneys are back arguing in the judge’s chambers. I sat in my chair reading through the medical record for the fifteenth time with forty different pairs of eyes staring at me from the spectator seats. I wasn’t as uncomfortable as I was before, but it still felt weird having all these people sitting there looking me up and down. Even though I was bored, I resisted the urge to play games on my phone. I didn’t want to do anything that would cause a bad impression.

I had a two bottles of Gatorade already that morning, so my bladder was on overdrive. Now I saw what Vinny was talking about when he said not to drink too much. I walked to the bathroom again. This time I didn’t even need directions.

Strolling back to my seat, I scanned the room. Many of the jurors’ eyes were on me. I smiled. This crowd seemed somewhat older than the previous crowd. No one was sighing. Darn. Now I can’t count the sighs. Many of the jurors were reading newspapers. A couple were even joking with each other. Seemed like a good crowd.

Suddenly, the judge and the attorneys made their entrance into the courtroom. Just like when a conductor taps on the table, everyone quieted down.

The judge began by thanking everyone for being there and went into a short explanation of how important the jury system is to the American jurisprudence system.

Voir dire, or the interrogation of the potential jurors, had officially begun.

See previous posts in this series here.

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12 Responses to “The Trial of a WhiteCoat – Part 9”

  1. Michael Kirsch, M.D. says:

    My attorney relatives and I, a physician, have had many spirited discussions over the years on the tort reform system. We don’t agree. I don’t regard this as a true controversy as I truly believe that the current system is indefensible from a fairness and justice perspective. See http://www.MDWhistleblower.blogspot.com. I wonder what the attorneys’ views on tort reform would be if they were targeted as we physicians are.

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    • Matt says:

      What do you mean “targeted”? How many suits against physicians are there compared to other professions?

      How exactly would tort reform which allows lobbyists to set the value of cases be more just and fair?

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  2. ERP says:

    Maybe you missed a GSW to the abdomen that was sustained at the primary MD’s office. You should be sued for that.

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  3. Blacksails says:

    Maybe the family physician shot the patient!

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    • Ravensfire says:

      From the grassy knoll?

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    • WhiteCoat says:

      Right. And the wound spontaneously healed on the way to the hospital in the ambulance.

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  4. Dr. W: Why didn’t your lawyer try to exclude the EMS note, after discovery ended?

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    • WhiteCoat says:

      I don’t know if he did or didn’t.
      On the other hand, I can’t imagine that the EMS note wasn’t included somewhere in the discovery materials. It may have just been that no one picked up on what was contained in the note until the plaintiff’s attorney tipped his hand.

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  5. anony says:

    you really need to cut to the chase with this story! how many chapters are there?

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    • WhiteCoat says:

      Lots more – I’m estimating about 25.
      Dragging the posts out is just like being involved in the trial itself, huh?
      Sucks, doesn’t it?
      Want to buy the book?

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  6. SeaSpray says:

    I’d by your books! :)

    Voir dire… I like that. The French language is so beautiful.

    Discovering that kind of misinformation… not being able to defend against it and having to keep the jurors happy would be crazy making. YIKES!

    And WHY could the fam DR not testify???

    I know I am naive about these things… but why can’t people just tell the truth and let the jury decide? I guess because the other side will try to twist and cause the truthful person look bad and discredit them.

    And so the game begins.

    What about… “The truth will set you free”?

    In reading about voir dire… I just had an awful thought and I hope I am wrong.

    In the previous comments I mentioned the same man allegedly accused of murder is also doing something else illegal (not the same scale but not good)and it is beginning to hit the papers. The one case has nothing to do with the other.

    but after reading about voir dire (thanks for the lesson :) ,I am now concerned that perhaps… his defense attorney for the murder trial will use this other case hitting the media as a reason for stating he would have a biased jury, etc and if it could negatively impact the case in such a way… that an guilty man (allegedly) gets off scott free?

    Perish the thought!

    It must’ve been so awful to have this hanging over you for so long. I guess you learn to live with it.

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  7. red rabbit says:

    The record stating there was a bloody wound- quite bizarre indeed. Makes me wonder what precisely was occurring in the ambulance.

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