law rights & civil resource

posted by admin on Feb 1

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1 Q I also see that you have authored more than

2 100 — or been part of the authoring of more than 100

3 peer review articles; is that correct?

4 A Right, right.

5 Q In addition, to greater than 50 book

6 chapters, correct?

7 A Right.

8 Q And all of these are on the specialty –

9 within the specialty and/or subspecialty of pediatric

10 neurology, correct?

11 A Correct.

12 Q Within the K.K.Institute, which

13 we got a description of and the volume of conference

14 rooms there, I understand you hold several offices.

15 What offices do you hold?

16 A I’m the medical director and chief medical

17 officer, and then I’m a senior vice president. So I’m

18 part of the management, and I’m the — responsible for

19 the medical care.

20 Q Okay. I want to briefly address your

21 opinions, and I want to make sure that I have an

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1 understanding of your opinions to a medical

2 probability. Okay?

3 A Okay.

4 Q It is my understanding that you hold the

5 opinion, based upon a constellation of things, not any

6 one thing from the review of the records, but

7 specifically including the slow heart rate, the

8 placenta previa and the abruption, that the injury to

9 this child or the threshold for this injury had

10 occurred by the time the ultrasound was taken; is that

11 true?

12 A Yeah, by the time or during the time of

13 that — that the bradycardia was documented. That the

14 blood — that the blood loss had reached the point

15 where it had associated with a bradycardia where it had

16 reached the threshold for injury in a premature infant

17 like this.

18 Q Okay. So when we apply it to this specific

19 patient, in a premature infant between 28 and 31 weeks,

20 based upon the heart rate that was observed on

21 ultrasound, the placenta previa and/or abruption, you

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1 are able to state to a medical probability that the

2 threshold for injury, neurologic injury, had already

3 been surpassed by that time?

4 A Yeah. I think that’s the prominent event

5 that — that was related in this case to the — to the

6 brain injury, to the white matter and to the –

7 Q Let that ambulance go by.

8 A To the brain injury — the injury to the

9 white matter and to the intraventricular hemorrhages.

10 Q Okay. And the time that the ultrasound was

11 taken was actually between 11:38 and 12:06, correct?

12 A Right. That’s what I have down.

13 Q Okay. So to put a time on this for when we

14 explain this to a jury, you believe that the damage to

15 this child — there was neurologic damage to this

16 child, and that being, as you described, the threshold

17 for injury having been surpassed, by some period of

18 time between 11:38 and 12:06, correct?

19 A Yeah. In other words, I think this was the

20 trigger. And often then it takes some time for the

21 injury to evolve later on, but that was the time in the

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1 record where there’s a clear-cut evidence of — of an

2 insult that probably went on to injury.

3 Q Okay. And you aren’t able to say how long

4 before the ultrasound this threshold for neurologic

5 injury had occurred, correct?

6 A Right. In other words, I think this was

7 certainly sufficient to cause the injury, and whether

8 there had been previous episodes associated with

9 abruption, I don’t know.

10 Q Okay. And that opinion is based on all of

11 the training and accomplishments and research you’ve

12 done throughout your practice, correct?

13 A Yeah. And it’s consistent with the — the

14 primary theory for these hemorrhages and injury, which

15 is oscillations or abrupt changes in cerebral blood

16 flow. And based on the idea that I think is pretty

17 well-established that in the premature infant the

18 cerebral circulation is fairly passive and reflects the

19 infant’s heart rate.

20 MR. K.: Dr. J., I thank you very

21 much for your time. I have no further questions.

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1 MR. GERSHON: Anyone else on the defense?

2 MR. C.: No, no questions. Greg C..

3 No questions.

4 MR. GERSHON: Then this is Zeev. I’m just

5 going to follow up on one thing that I didn’t ask

6 beforehand.

7 EXAMINATION BY MR. GERSHON:

8 Q Doctor, did you make any notes upon your

9 review of any of this material?

10 A Yeah. I have a page of notes here. I can

11 give it to the court reporter.

12 Q Perfect. Is that the only page of notes

13 you ever made?

14 A Yes.

15 MR. GERSHON: Okay. We’ll mark that as

16 Plaintiffs’ next exhibit, and I have no other

17 questions.

18 THE WITNESS: Okay.

19 (Examination concluded at 4:36 p.m.)

20 (J. Deposition Exhibits Nos. 1 and

21 2 were marked by the reporter.)

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1 STATE OF M.)

) ss

2 COUNTY OF W.)

3 I, S.M. W., a Notary Public in and

4 for the County and State aforesaid, duly commissioned

5 and qualified, do hereby certify that the above named,

6 M. V. J., M.D., was by me first duly sworn

7 to testify the truth, the whole truth, and nothing but

8 the truth, and that his deposition as set forth above,

9 which was reduced to writing under my direction and

10 control, is a true record of the testimony given and/or

11 as corrected by said witness.

12 I certify that I am not of counsel,

13 attorney, or relative of any party, or otherwise

14 interested in the event of this suit.

15 In witness whereof I have hereunto set my

16 hand and affixed my notarial seal this 19th day of

17 September year.

18 _____________________

S.M. W.

19 Notary Public