Professional Documents
Culture Documents
-o0o-
Defendants.
Page 3 Page 5
2 (Pages 2 to 5)
Page 6 Page
1 Stretesky and I'm the first assistant attorney general with 1 Mr. Bath's law firm from May 1 2007, to present.
2 the State of Colorado, and I represent Fred Joseph in the 2 Have you brought anything responsive to that
3 matter of Fred Joseph versus Life Partners Inc., Et al. 3 request?
4 You've come -- appeared here today under subpoena 4 A There hasn't been any communications.
5 and you're represented by counsel who has taken notice of the 5 Q Request number three asks that you produce all
6 requests for production that were attached to the subpoena 6 communications between you and all the defendants from May
7 and has stated an objection to producing items that were 7 1st, 2007, to the present.
8 requested under numbers four, six and seven. And if I 8 Have you brought anything responsive to request
9 understand correctly, the basis of that is that these are 9 number three?
10 medical records. 10 A Only the contract.
11 MS. STRETESKY: And if you could clarify, counsel, 11 MR. MURPHY: And, again, I guess I should
12 is it your contention that these are medical records in the 12 interject. To the extent that it could be interpreted
13 possession of Dr. Cassidy as he is the physician for the 13 paragraph three -- or that the request number three could
14 people listed? 14 include any medical records, the same objection applies. The
15 MR. MURPHY: He need not be the physician for the 15 requests are quite broad in that regard.
16 people. He has been requested to evaluate the medical 16 BY M.S. STRETESKY:
17 records of each one of those patients, urn, and the privilege 17 Q Are you prepared to state that you have had no
18 extends to those patients and may be asserted by Dr. Cassidy, 18 communications with anybody from either Life Partners
19 That includes any hard copies or electronic form. 19 Holdings, Inc. or Life Partners, Inc. since May 1, 2007?
20 MS. STRETESKY: Okay. 20 A There are phone calls but there's no way to bring
2 1BY MS. STRETESKY: 21 those.
22 Q Dr. Cassidy, I don't know if you have a copy of the 22 Q Okay. You didn't make notes during those phone
2 3 request in front of you, but let's just go through. 23 calls?
24 Have you brought with you today all communications 24 A No.
2 5 between you and Life Partners, urn, the Life Partners 25 Q Request Number five asks you to produce all
Page Page
1 defendants from January 1, 2004, to the present? contracts between you and the Life Partners defendants.
2 MR. MURPHY: Let me clarify one thing: To the 2 Is what you've already provided us the only
3 extent that that could be interpreted to mean any 3 contract before -- between you and any of the Life Partners
4 communication regarding the patients identified on Appendix 4 defendants?
5 1.1 believe, and that information includes any medical 5 A It is.
6 history or diagnosis or evaluation, then the same objection 6 Q Are there any addendums that you did not bring
7 that we made would apply to number one. 7 today?
8 BY MS. STRETESKY: 8 A No.
9 Q Have you brought any responsive documents to number 9 Q I guess before we begin with the deposition, have
10 one? 10 you ever been deposed?
11 A I have a contract that I signed outlining my 11 A Yes, I have.
12 responsibilities. 12 Q Okay. Under what circumstances?
13 Q Okay. Can 1 please see that contract. 13 A Divorce.
4 A (Witness complies.) 14 Q I'm just gonna go over some ground rules for you.
15 MR. KLEIN: Just to clarify, is this copy for us or 1 5 This is being transcribed by a court reporter. She's not
16 is this your only copy? 1 don't want to mark it up if it's 16 going to be able to accurately reflect your answer if you
17 gonna go back to — I can't remember if we have another copy 17 answer with a nod of your head or an "uh-huh" or "uh-uh." If
18 or not. 18 you could please answer with an actual word and as clearly as
19 MR. MURPHY: We can ask the court repotter to have 19 you possibly can.
20 a copy made. 20 I'm not out to see how long you can sit in that
21 MS. STRETESKY: Yes. chair so, if you do need a break, please let me know and I'd
22 BY MS. STRETESKY: 22 be happy to accommodate that break. But understand that I
23 Q Number two asks that you produce all communications 23 will not allow a break while a question is pending and I
24 between you and any of the defendants' law firms which would 24 would ask that you answer the question that's on the table
25 include Mr. Hilbert's law firm, Mr. Tenenbaum's law firm and 25 and then we can go ahead and break.
3 (Pages 6 to 9)
Page 10 Page 12
1 Do you understand? 1 Q Sure.
2 A I do. 2 A There is an open complaint that has not been heard
3 Q Are you under any medications that would alter your 3 and that currently is in front of the board of medical
4 ability to answer truthfully today? 4 examiners.
5 A I am not. 5 Q For the State of Nevada?
6 Q Could you describe your educational background? 6 A That is correct,
7 A I attended medical school at the University of 7 Q And what's the nature of that complaint?
8 Texas Medical Branch in Galveston. I did a straight internal 8 A Urn, although we don't know who the plaintiff is,
9 medicine internship at the University of Texas Health Science 9 the complaint was that I ordered an excessive dose of a
10 Center at Houston. I then did an internal medicine residency 10 chemotherapy agent.
11 at the same institution. And then I did a fellowship in 11 Q Have you responded to that complaint?
12 medical oncology at M.D. Anderson Hospital and Tumor 12 A Yes, I have.
13 Institute, also in Houston. 13 Q It's still being investigated, then, by --
14 Q When did you go through your, um — when were you 14 A Right.
1 5 at University of Texas, Galveston? 15 Q -- the board? When was it that you were made aware
16 A Graduated 1974. 16 of this complaint?
7 Q And when did you do your fellowship in oncology? 17 A April of this year.
18 A 1976 through 1978. 18 Q When do you anticipate the board determining --
19 Q Where are you licensed to practice medicine? 19 A February of next year.
20 A Texas, Nevada and California, 20 Q Will there be a hearing in front of the board on
21 Q When did you get your license to practice in Texas? 21 that or you're not sure yet?
22 A 1974. 22 A I don't know.
23 Q Is it currently active? 23 Q Okay. Are you board-certified in any certain
24 A Yes, it is. 24 areas?
25 Q How about Nevada? 25 A Internal medicine and medical oncology.
Page 11 Page
1 A The date when I got it? 1 Q When did you receive your certifications?
2 Q Or year. 2 A Urn, you know, I can't remember. It seems -- I'd be
3 A 1 think '81. I'm not entirely sure. 3 guessing. Early '80s for both of them.
4 Q And you're currently active in Nevada? 4 Q Have you been continually practicing as a medical
5 A Yes, I am. 5 doctor since 1974?
6 Q When did you get your Californiamedical license? 6 A Yes.
7 A 1978, I'm pretty sure. 7 Q And what type of practice do you have?
8 Q Is that currently active? 8 A Internal medical and medical oncology.
9 A Yes, it is. 9 Q Do you see A.I.D.S. patients?
10 Q Have you ever been disciplined by either the State 10 A I'm sorry?
11 of Texas, Nevada or California? 11 Q Do you see A.I.D.S. patients?
12 A No, I have not. 12 A Occasionally.
13 Q Okay. Have you ever had a complaint against you 13 Q What would you say your percentage of your practice
14 filed with the boards of medical examiners for any of those 14 would be seeing A.I.D.S. patients?
1 5 states? 15 A Less than 1 percent.
16 A Um, several years ago 1 think a complaint was filed 16 Q Have you taken any continuing education courses on
17 by a patient but there was no action taken and it was closed. 7 A.I.D.S.?
18 Q Did you have to respond to the complaint? 18 MR. HILBERT: Object to form.
19 A I think 1 produced records. 19 THE WITNESS; Yes, 1 have. I just sat for my
20 Q What was the nature of the complaint? 20 second recertification, so I've taken thousands of hours.
21 A I believe he felt that I let some of his medical 21 BY MS. STRETESKY:
22 records get out without his permission. 22 Q In what areas?
23 Q Do you hold any board certifications? 23 A Well, A.I.D.S. and A.I.D.S. malignancies, part of
24 A I'm -- can I add something to the last question, 24 the medical oncologist's ...
25 though? 25 Q What percentage of your practice is seeing
4 (Pages 10 to 13)
Page 14 I Page 16
Page 1 Page 17
1 A That's correct. 1 BY MS. STRETESKY:
2 Q How long were you partners for? 2 Q Within that oral contract were there numerical
3 A We had practiced, you know, sharing expenses four 3 amounts of how many you would be expected to do in a given
4 years, I guess, something like that. 4 month, let's say?
5 Q And when did that partnership start? 5 A No.
6 A Again, this is an estimation. 1996. 6 Q It was unlimited?
7 Q And when did Mr. Kelly excuse me -- Dr. Kelly -- 7 MR. HILBERT: Object to form.
8 die? 8 THE WITNESS: There was -- nothing was said.
9 A I think it was at the end of 1999 but, again, I'm 9 BY MS. STRE I ESKY:
10 not --it's been some time ago. 10 Q At that time, when you first started preparing
11 Q When did you start working for Life Partners? 11 expert opinions on life expectancies for Life Partners,
12 A Basically within a few days of his death. When 1 12 approximately how many did you prepare in a given month?
13 spoke to Brian, records began to be delivered within a day o 13 MR. MURPHY: If you recall.
14 two. 14 THE WITNESS: Fifty to eighty per week initially.
Q In your thinking, that's late 1999? 15 BY MS. STRETESKY:
16 A Late 1999 or late 1998. I'm not sure. 16 Q Did that number go up or down?
17 Q At that time did you have a contract with Life 17 A It went up.
18 Partners? Q How many are you currently preparing within a week?
19 A No, I did not. Only verbal. 19 A It varies from a hundred to as high as two hundred.
20 Q And what were the terms of that oral contract? 20 Q How are the medical records transmitted to you?
21 A For each insurance policy that Life Partners 21 A Two ways, either a computer disk or they are
22 purchased, I was to be paid 5500. 22 downloaded from Life Partners's website, I guess.
23 Q Would Life Partners have already purchased a life 23 Q And is the computer disk sent to you, mailed to
24 insurance policy before sending you the medical information 2 4 you?
25 to review? 25 A If that is the way that they're sending it, If
5 (Pages 14 to 17)
Page 18 Page 20
1 it's directly downloaded, there's no disk involved. 1 I may be paid for four or five and then the next month I
2 Q And the website is only something you have access 2 could be paid for 20 of them. It was very variable.
3 to? 3 Q What was the least amount that you ever got paid
4 A The fellow that understands computers has access to 4 for in a month?
5 it. I am not that computer knowledgeable. My office 5 MR. HILBERT: Object to form,
6 manager, I guess I'd say. Are you asking whether I'm the 6 THE WITNESS: I -- I'd be guessing. $2,000. 3
7 only one that it goes to? 7 BY MS. STRETESKY:
8 Q (Counsel nods.) B Q And what is the most you've gotten paid in a month?
9 A That, I don't know. 9 MR. HILBERT: Object to form.
10 Q But in your office you would say the office manager 10 THE WITNESS: Since the new --
11 is the one who downloads the records or prints them off for BY MS. STRETESKY:
12 you? 12 Q No. Let's start -- let's first -- prior to the
•3 A Yes. 13 retainer.
14 Q And you don't know what safeguards Life Partners 14 A $10,000.
15 ensures so that medical records aren't be sent out on the 15 Q And now how much is the retainer a month?
16 Internet for anyone to view? 16 A $15,000.
17 A I'm not -- 17 Q Okay. And that's -- the retainer is $15,000?
18 MR. HILBERT: Object to form. 18 A (Witness nods.)
19 THE WITNESS: I know nothing about their computer 19 Q And then do you get additional payments --
20 setup. 20 A (Witness nods.)
21 BY MS. STRETESKY: 21 Q -- on top of that?
22 Q Do you know if you are the only physician who is 22 A Yes.
23 currently preparing life expectancy determinations for Life 23 Q And what's the additional payment?
24 Partners? 24 A The same $500 for each policy that was purchased.
25 A No, 1 do not. 25 Q And, again, how do you know whether or not Life
Page 19 Page 21
1 Q When you get a medical -- strike that. Sorry. 1 Partners has purchased a policy?
2 Is this medical consulting agreement dated the 10th 2 MR. FIILBERT: Object to form.
3 day of February 2008 the first written agreement you've had 3 THE WITNESS: Strictly speaking, I don't.
4 with Life Partners? 4 BY MS. STRETESKY:
5 A Yes, it is. 5 Q It's an honor system, then.
6 Q After so many years what precipitated a written 6 MR. HILBERT: Object to form.
7 aueement? 7 BY MS. STRETESKY:
8 MR. HILBERT: Object to form. 8 Q Would you agree?
9 THE WITNESS: There was a change in the financial 9 MR. MURPHY: Well, that's -- I'm gonna object on
10 -- how I was being paid. 10 the basis that that's asking for somewhat of a moral
1 BY MS. STRETESKY; 11 conclusion.
12 Q What was the change? 12 MR. HILBERT: And speculation.
13 A A retainer was begun that would be paid regardless 13 BY MS. STRETESKY:
14 of how many policies were purchased or not. 14 Q You can go ahead and answer.
15 Q Up until this point in February of 2008 when the 15 A 1 trust Mr, Pardo.
16 payment structure changed, what was the difference between 16 Q Who was your contact person at Life Partners?
17 the amount you reviewed and the amount you got paid for? 17 A Most of the contacts are made by my office manager.
18 MR. MURPHY: Do you understand the question? 18 The occasions that I have had to call in a lady named -- her
19 MR. FIILBERT: Object to form. 19 name is LaDonna. I cannot recall her last name.
20 THE WITNESS: Not -- 20 Q And you're unsure of who your office manager
21 BY MS. STRETESKY: 21 communicates with at Life Partners?
22 Q So you were reviewing policies, and say they gave 22 A I'm sorry?
23 you 50 to review in a week. Would you then the next week get 23 MR. HILBERT: Object to form.
24 paid for 25? 24 BY MS. STRETESKY:
25 A It was very variable. There would be months where 25 Q You're not sure who it is at Life Partners that
6 (Pages 18 to 21)
Page 22 Page 24
Page 23 Page 2
7 (Pages 22 to 25)
Page 26 Page 28
1 me. 1 A No.
2 BY MS. STRETESKY: 2 Q Did you develop the different sets of ranges that
3 Q Have you ever had an occasion where you had sent an 3 the left expectancy determinations usually fall within?
4 insured's medical records back to Life Partners stating that 4 A This is my clinical opinion. The -- any
5 you couldn't make a life expectancy determination based on 5 development stems from the 34 years of clinical experience.
6 the information provided? 6 Q Do you have anybody in your office that assists you
7 A Yes. 7 with making the life expectancy determinations?
8 Q How often has that occurred? 8 A No.
9 A Rarely. 9 Q Do you have a medical assistant who reviews the
0 Q What were those occasions? 10 medical records and summarizes them for you?
11 MR. MURPHY: If you recall. 11 A No.
12 THE WITNESS: Yeah. I -- the only one I recall 12 Q Are you the only person in your office that reviews
13 specifically was a notation in the chart concerning a mass in 13 the information that Life Partners sends to you regarding
14 the lung and a biopsy had been planned and there was no 14 each of the insureds?
15 further information concerning the biopsy. 15 A Yes.
16 BY MS. STRETESKY: 16 Q Do you use anything other than your clinical -- 34
17 Q But you don't recall ever sending them back because 1 7 years of clinical experience to make the life expectancy
18 the medical records were too old? 18 determination?
19 MR. HILBERT: Object to form. 19 A There are life expectancy tables that -- from
20 THE WITNESS: No. 2 0 several sources. I use one from Health and Human Services.
21 BY MS. STRETESKY: 21 They give you a starting point for the person's life
22 Q Does Life Partners send with the -- with this 22 expectancy. That's used. And then depending on their
23 information in here a cover letter with this information? 23 medical record is how their life expectancy is generated.
24 A No. 24 Q The Health and Human Services, is that the State of
25 Q So could you describe what — what exactly it is 25 Nevada or the federal?
Page 2 Page 29
8 (Pages 26 to 29)
Page 30 Page 32
1 smoke, that's not good. And after putting all those 1 — titled "Calculation of Life Expectancy," would you say
2 together, I come to an opinion and give my estimate. 2 this accurately reflects how you go about making your life
3 Q And I may be making this seem more mathematical 3 expectancy determination?
4 than it is, so tell me if I'm wrong. 4 MR. HILBERT: Object to form.
5 But do you kind of go through a mathematical 5 THE WITNESS: I have difficulty defining this
6 equation of minus six months for smoking plus 20 years for 6 paragraph. As I mentioned, I take into consideration all the
7 having good genes? Do you go through that kind of analysis? 7 factors that we talked about. If that's what this paragraph
8 A It's not that precise. I mean, you have to take 8 is saying, then it's an accurate ...
9 everything together, if somebody has longevity in their 9 BY MS. STRETESKY:
10 family but is a heroin addict, that's, you know, going to be 10 Q Did you draft this paragraph?
11 against them, so you have to put everything in the picture 11 A No, I did not.
12 before you make the determination. 12 Q Did you assist in drafting it?
13 Q And your factors for things like being a heroin 13 A No.
14 addict or certain medical ailments, is your amount of life 14 Q If we move down to 5.11. it says ''Representations
15 expectancy placed on those particular circumstances based on 15 and Warranties." There's a handwritten note on the bottom in
16 your 34 years as practicing as a physician? 16 addition to the last sentence. It looks like something got
17 MR. HILBERT: Object to form. 17 cut off and it says, "Cassidy shall make all life expectancy
18 MR. MURPHY: Do you understand? 18 prognostications based on his own independent medical
19 THE WITNESS: I'm not sure. 19 judgment and shall not be influenced by any other
20 BY MS. STRETESKY: 20 considerations." What other considerations could there be?
21 Q Okay. You're starting with a table that gives you 21 A Well, the sentence was not a sentence. That's why
22 sex, age, here's what the life expectancy is. Moving beyond 22 that was added.
23 that table, you're factoring in the circumstances of each 23 Q Uh-huh.
24 individual insured. Correct? 24 A I suppose any other considerations except the
25 A That is correct. 25 medical record.
Page 31 Page 33
1 Q Okay. And you're making either additions, month -- 1 Q Do you receive any -- strike that.
2 in months, additions to the life expectancy on the table or 2 Have you ever received any information other than
3 subtracting months or years from the life expectancy that's 3 the information that is detailed in Section 3.3 with regard
4 found on the table based on individual circumstances unique 4 to an insured?
5 to each insured. 5 A All I receive are the medical records.
6 A It's not necessarily in that fashion. Again, 6 Q And they are medical records from physicians which
7 depending on their medical diagnoses, some diseases have a 7 may include forms filled out by the insured, a health history
e fairly well accepted prognosis, and I mentioned one a moment 8 form, maybe?
9 ago, pancreatic cancer. 9 A Yes.
10 Q Uh-huh. 10 MR. HILBERT: Object to form.
11 A And that aspect of it is stems from my 11 BY MS. STRETESKY:
12 experience. 12 Q How much time on average do you take reviewing the
13 Q And when you say that some diagnoses have a very 13 medical records for an insured in developing your life
14 well established life expectancy diagnosis, are those found 14 expectancy evaluation?
15 in medical journal articles or -- 15 MR. HILBERT: Object to form.
16 A They're found in textbooks and in journal articles. 16 THE WITNESS: Extremely variable. The records vary
17 Q Do you often find yourself reviewing textbooks or 17 from a few pages to more than a thousand.
18 medical journal articles when reviewing the medical history 18 BY MS. STRETESKY:
19 of an insured? 19 Q What would be your average, do you think?
20 A If I am not familiar with whatever diagnosis the 20 A I don't know. It's extremely variable.
21 patient might have. 21 Q Could you turn the page, please, sir.
22 Q How often does that occur, would you say, that 22 A (Witness complies.)
23 you're not familiar with a diagnosis? 23 Q Section 6.2 says -- is titled "Reasonable
24 A Rarely. 24 Precautions." What reasonable precautions have you taken to
25 Q Section 3.4 of the calculation of life expectancy 25 ensure that the documentation, information and materials will
9 (Pages 30 to 33)
Page 34 Page 36
10 (Pages 34 to 37)
Page 38 Page 40
Page 39 Page 41
1 need to look at the entire record to see if this was an 1 able to make a determination based on that old of a record?
2 accurate reflection. 2 MR, HILBERT: Object to form.
3 Q And when you perform your duties for Life Partners, 3 THE WITNESS: Number one, I've never gotten a
4 you are using that degree of skill and attention that a 4 record like that. Number two, it would depend on the
5 reasonable physician would exercise in estimating life 5 person's diagnosis. If they had amyotrophic lateral
6 expectancy? 6 sclerosis, possibly.
7 MR. HILBERT: Object to form. 7 BY MS. STRETESKY:
8 THE WITNESS: I would think so, yes. 8 Q Okay. And in a perfect world how updated would you
9 BY MS. STRETESKY: 9 like the medical records to be?
10 Q And are you making these determinations, urn, with a 10 MR. HILBERT: Object to form.
11 reasonable degree of medical certainty? THE WITNESS: I'm sorry. Could you repeat the --
12 MR, HILBERT: Object to form. 12 BY MS. STRETESKY:
13 MR. MURPHY: Objection, Calls for a legal 13 Q Sure. If it were a perfect world, how updated
14 conclusion. You don't have to answer. 14 would you like the medical records or up to date would you
15 MS. STRETESKY: Yes, he does. 15 like the medical records?
16 BY MS. STRETESKY: 16 MR. HILBERT: Object to form.
17 Q Is it your opinion that you're estimating these 17 THE WITNESS: As up to date as possible.
18 within any reasonable degree of medical certainty? 18 BY MS. STRETESKY:
19 A There is a disclaimer on all of my letters 19 Q Have you ever had an occasion where Life Partners
2 0 indicating that no single source should be depended upon in 20 has transmitted medical records and have made statements like
21 making a life expectancy determination. It points out that 21 we're thinking this one is a four- to five-year life
22 many other things can have an effect on a person's life 22 expectancy range?
23 expectancy. 23 A Never.
24 Q Could you explain that. And by "single source," 24 Q Do you perform any quality control on the life
25 are you talking about the medical history is not a -- 2 5 expectancy determinations that you do?
11 (Pages 38 to 41)
Page 42 Page 44
A I'm not sure what you mean by "quality control." 1 seemingly have a summary of medical history similar to each
2 MR. HILBERT: Object to form. 2 other with vastly different life expectancy determinations,
3 BY MS. STRETESKY: 3 you wouldn't be able to explain that --
4 Q How do you ensure consistency with ranges? And 4 MR. HILBERT: Object to form.
5 what I mean is how do you ensure that like ages, same sex, 5 BY MS. STRETESKY:
6 similar diagnoses end up with the same or similar life 6 Q just by looking at the medical summary?
7 expectancy range? 7 THE WITNESS: Obviously, the explanation is that
8 MR. HILBERT: Object to form. 8 the entire record was different between the two patients,
9 THE WITNESS: The life expectancies are determined 9 BY MS. STRETESKY:
10 on the basis of my clinical experience and the life 10 Q But you can't tell that on a summary of medical
11 expectancy table that we start with. 11 history that Life Partners has provided on the confidential
12 BY MS. STRETESKY: 12 case histories?
13 Q Do you ever go back and ask Life Partners how 13 MR. HILBERT: Object to form.
14 you're doing? 14 THE WITNESS: No.
15 MR. HILBERT: Object to form, 15 BY MS. STRETESKY:
16 THE WITNESS: No. 16 Q How do you determine how much information you put
17 BY MS. STRETESKY: 17 into your letter providing the medical summary and life
18 Q Do you know how accurate your life expectancy 18 expectancy determination to Life Partners?
19 determinations are or have been? 19 MR. HILBERT: Object to form.
20 MR. HILBERT: Object to form. 20 THE WITNESS: As I mentioned before, the age of the
21 THE WITNESS: No. 21 patient, their sex, their medical diagnoses, their lifestyle,
22 MS. STRETESKY: This is gonna take me a minute 22 their family histories. These are taken into consideration
23 because I don't have my assistant with me -- now 1 do. 23 along with their current treatment and then my clinical
24 If 1 can mark, please, this as Exhibit 3. 24 opinion as to how long I think they will live.
25 25
Page 43 Page 45
12 (Pages 42 to 45)
Page 46 Page 48
Page 47 Page 49
9 MR. MURPHY: Asked and answered. 9 A.1.D.S., how much does the T-cell count account for in your
10 THE WITNESS: I did not write this. 10 life expectancy determination?
11 BY MS. STRETESKY: 11 A Its hard to quantify that. Certainly a low T-cell
12 Q Have you ever made a statement like that? 12 count places a person at greater danger of opportunistic
13 A Yes, I have. 13 infections.
14 Q And what did you mean by it when you made that 14 The therapy of A.I.D.S. is changing so quickly that
15 statement? 15 its difficult to quantify a particular number and weight it.
16 A That my range for the patient's life expectancy in 16 You have to look at the entire picture. If someone has a
17 my opinion would be two to four years, 17 high T-cell count but happens to have an unresponsive Kaposi
18 MR. HILBERT: Object to form. 18 sarcoma, that's bad.
19 BY MS. STRETESKY: 19 Someone with a low T-cell count and no signs of an
20 Q Do you ever recall making a statement that 20 opportunistic infection, he has a chance to respond well.
21 someone's life expectancy would be an additional 2.3 years? 21 You have to look at the whole picture.
22 MR. HILBERT: Object to form. 22 BY MS. STRETESKY:
23 THE WITNESS: I do not recall. 23 Q How much does the viral load play into the life
24 BY MS. STRETESKY: expectancy determination?
25 Q Okay. Could it be that the actuarial life 25 MR. HILBERT: Object to form.
13 (Pages 46 to 49)
Page 50 Page 52
1 THE WITNESS: Not as much. You want to see some 1 BY MS. STRETESKY:
2 correlation between the T-cell count recovering and the viral 2 Q Would the majority take 30 minutes to review?
3 load going down, but it's not always that way. 3 MR. HILBERT: Same objection.
4 BY MS. STRETESKY: 4 MR. MURPHY: This is becoming harassing.
5 Q So can you fairly quickly move through the medical 5 BY MS. STRETESKY:
6 record of an A.I.D.S. insured or an insured with A.I.D.S., 6 Q Did you have an answer?
7 rather than maybe an elderly person who's got a longer list 7 A Same answer.
8 of medical diagnoses? S MS. STRETESKY: I'm done with my questions.
9 MR. HILBERT: Object to form. 9 MR. HILBERT: I don't have any questions.
10 THE WITNESS: It depends on the record. If 10 MR. MURPHY: The only thing I'd like the record to
11 someone's lifestyle is extremely dangerous, it -- it depends 11 reflect is as to all the objections that Mr. Hilbert has
12 on the record. 12 made, that I join in on behalf of Dr. Cassidy.
13 BY MS. STRETESKY: 13 MR. HILBERT: Do you want to join in on my
/4 Q And do you always have information on the insured's 14 objections, Tom? Oh, now he's snoozing. He usually joins my
15 lifestyle in the records that you get? 15 objections too. You can put that in the record and he can
16 A Not always. 16 take it out if he wants to.
Q About what percentage of time do you -- 17 MS. STRETESKY: Now these questions are for counsel
18 A I don't know. 18 on the record. Could you direct me to the HIPAA section that
19 MS. STRETESKY: Can we take a five-minute break, 19 you are relying on that these would not be disclosable?
20 because I think I'm ready to wrap up? 20 M.R. MURPHY: I included HIPAA but it's also
21 MR. MURPHY: Okay. 21 specifically NRS Section 49.215.
22 (Recess taken.) 22 MS. STRETESKY: And is that a copy of the Nevada
23 BY MS. STRETESKY: 23 Revised Statutes?
24 Q You'd mentioned that you can't really quantify how 24 MR. MURPHY: Uh-huh.
25 much time you spend on any given file, but are there any 25 MS. STRETESKY: Would you mind if I could just look
Page 51 Page 53
1 files that are small enough or records that are small enough at 49.235.
2 that you take five minutes to review? 2 MR. MURPHY: Certainly. As to who may claim the
3 MR. HILBERT: Object to form. 3 privilege?
4 THE WITNESS: If the record were three pages long 4 MS. STRETESKY: Yes. For the record, we disagree
5 it would probably take me five minutes. 5 that Nevada Revised Statute 49.235, who may claim the
6 BY MS. STRETESKY: 6 privilege, extends to Dr. Cassidy in his capacity as a
Q Would that be long enough to make -- would that 7 physician merely reviewing medical records for a third party
8 contain enough information to make a life expectancy 8 who is not the patient.
9 determination? 9 As sub two says, the person who was the doctor may
10 MR. HILBERT: Object to form. 10 claim the privilege but only on behalf of the patient. His
11 THE WITNESS: It could. 11 authority to do so is presumed in the absence of evidence to
2 BY MS. STRETESKY: 12 the contrary.
13 Q Would you be able to estimate that -- the 13 And we would also like the record to reflect that
14 percentage of files that you receive that would take five 14 our reading of HIPAA, specifically 45 CFR 164.512(e) allows
5 minutes long to review? 15 disclosure of medical records in a judicial proceeding such
16 A No. 16 as this one.
17 MR. HILBERT: Object to form. 17 MR. MURPHY: You may make the appropriate motion
18 BY MS. STRETESKY: 18 before the court.
19 Q Do the majority take five minutes to review? 19 MS. STRETESKY: Yes.
20 MR. HILBERT: Object to form. 20 M.R. HILBERT: Are we all done?
21 THE WITNESS: They're all different. 21 MS. STRETESKY: I think so.
22 BY MS. STRETESKY: 22 MR. MURPHY: Plead send the transcript to me.
23 Q Would the majority take 20 minutes to review? 23 MR. HILBERT: And I want a condensed, whatever you
24 MR. HILBERT: Object to form. 24 call it. Just a condensed.
25 THE WITNESS: They are all different. 25 MR. MURPHY: I'll take the condensed version and
14 (Pages SO to 53)
Page 54 Page 56
1 also send the original to me and I'll proceed with the 1 STATE OF NEVADA )
2 signing. 2 ) ss.
3 MS. STRETESKY: I would prefer a condensed, and can 3 COUNTY OF WASHOE )
4 you do it electronically? 4
5 THE REPORTER: Yes. I, CHRISTINA MARIE HERBERT, a Certified Court Reporter
6 MR. TENENBAUM: Thank you. I would like a 6 in and for the State of Nevada, do hereby certify:
7 condensed E-Tran transcript and if the reporter could send it 7 That f was personally present for the purpose of acting
8 to ATT at Tlawfirm dot-corn. 8 as Certified Court Reporter in the matter entitled herein;
9 (Whereupon, deposition was concluded at 9 that the witness was by me duly sworn;
10 2:59 p.m.) 10 That said transcript which appears hereinbefore was
11 -o0o- 11 taken in verbatim stenotype notes by me and thereafter
12 12 transcribed into typewriting as herein appears to the best of
13 13 my knowledge, skill, and ability and is a true record
14 DONALD CASSIDY, M.D. 14 thereof.
15 15
16 16
17 17 Christina Marie Herbert, CCR #641 (NV), CSR #11883, (CA)
18 18
19 19 -o0o-
20 20
21 21
22 22
23 23
24 24
25 25
Page 55 Page 57
15 (Pages 54 to 57)
------ -------
RECITALS
Therefore, for and in consideration of the mutual benefits and promises herein
described, and for other good and valuable consideration the receipt and sufficiency of which are
hereby acknowledged by the parties hereto, the parties hereto agree as follows:
ARTICLE L CONSTRUCTION
SECTION 1.1 Usage of Terms. The words "hereof," "herein" and "hereunder" and
words of similar import when used in this Agreement shall refer to this Agreement as a whole
and not to any particular provision of this Agreement; Section, subsection and exhibit schedule
references contained in this Agreement are references to sections, subsections, exhibits and
schedules in or to this Agreement unless otherwise specified; with respect to all terms in this
Agreement, the singular includes the plural and the plural the singular; words importing any
gender include the other gender; references to "writing" include printing, typing, lithography and
other means of reproducing words in a visible form; references to agreements and other
contractual instruments include all subsequent amendments, amendments and restatements and
supplements thereto or changes therein entered into in accordance with their respective terms and
not prohibited by this Agreement; references to Persons include their permitted successors and
assigns; references to laws include their amendments and supplements, the rules and regulations
thereunder and any successors thereto; and the term "including" means "including without
limitation."
SECTION 2.1 Appointment. The Company hereby appoints and engages Cassidy as a
life expectancy provider with respect to the insured lives specified to Cassidy by the
Company for the period commencing on the date hereof until the expiration or termination of
this Agreement pursuant to Article VII hereof, subject to the terms and conditions of this
Agreement.
SECTION 3.1 Standard of Care. Cassidy shall perform his duties under this agreement
with reasonable care, using that degree of skill and attention that a reasonable physician would
exercise in estimating the life expectancy of an insured, including compliance with all applicable
state and federal regulations.
SECTION 3.2 Errors and Omissions Policy. Cassidy agrees to maintain an errors and
omissions insurance policy with coverage no less than $1 million per occurance.
SECTION 3.4 Calculation of Life Expectancy. For each insured life, Cassidy will
prognosticate the average life expectancy of the respective insured(s) based on standard
mortality tables and adjusted based on the medical condition of the insured(s) and the clinical
experience and professional medical judgment and opinion of Cassidy. Said opinion and
prognostication shall be made independently and without the undue influence of any person or
entity. Upon request, Cassidy shall provide the Company with a written report documenting
Cassidy's opinion, prognostication and evaluation of an insured.
SECTION 6.1 General Duty. Cassidy and the Company hereby agree that all
documentation, materials and information provided by, or made available by, the Company
and by Cassidy for the performance of Cassidy's obligations hereunder shall be used solely for
the purposes contemplated by this Agreement and that all such documentation, information
and materials shall be deemed proprietary; all information and materials shall be received,
utilized, and maintained in confidence.
SECTION 6.2 Reasonable Precautions. Subject to Section 6.4, the Company and
Cassidy shall take such precautions as may reasonably be necessary to protect such
documentation, information and materials from disclosure to others or from use by itself or
others for any purpose inconsistent with this Agreement.
SECTION 6.3 Dissemination of Certain Information. Cassidy and the Company shall at
all times comply with all laws and regulations affecting insureds whose life expectancies are
being evaluated including but not limited to laws and regulations regarding the privacy of any
insured and the maintenance of all information obtained by the Company and/or Cassidy in
the performance of their duties in accordance with applicable laws and regulations concerning
the dissemination of such information.
SECTION 6.4 Confidentiality of Reports Any report that the Company receives from
Cassidy is intended for the specific use of the Company or individual signing this Agreement
ONLY, and may be distributed to persons or entities in connection with the transaction in
which the original life expectancy report was requested, but shall not otherwise be distributed to
any other party, without the written consent of Cassidy or as may be required by competent
regulatory authority or judicial fiat.
SECTION 7.1 Term; Termination. This agreement will automatically renew from year
to year unless terminated by the Company or Cassidy by delivery of written notice to the other
party of a change in any applicable law or regulation that causes it to be illegal for such party to
continue performing under this Agreement, (c) terminated by Cassidy or the Company by
thirty (30) days written notice thereof to Cassidy or Company, depending upon whoever is the
initiating party.
SECTION 7.2 Files and Records Upon Termination. Immediately upon termination by
Cassidy or the Company, Cassidy shall destroy all files and records retained by Cassidy in
connection with the performance of its duties and obligations under this Agreement, unless
otherwise required by law.
SECTION 8.1 Evaluation Limitation. Evaluations to determine life expectancy are based
on the understanding of current available medical records provided at the time of evaluation.
Cassidy makes no representation that any individual will expire on or near the time period
indicated on our report. The life expectancy of any individual may be impacted positively or
negatively by factors that change following the date of the evaluation. Every effort is made to
anticipate future favorable or adverse changes in medical conditions, but it is not possible to
make representations, guarantees or assurances after the date of any evaluation.
SECTION 8.2 Release Limitation. Should any life expectancy report that is provided to
the Company by Cassidy be released to any person or entity, and such release is not approved
with the written consent of Cassidy, then Cassidy assumes no liability for the use or content of
any such life expectancy report beyond this Agreement or the disclaimer that is on any such life
expectancy reports other than with respect to such parties listed in Section 6.4. Should Cassidy
consent in writing to the release of a life expectancy report that the Company received, Cassidy
shall have no liability and shall be held harmless for any use for which the approved party uses
the life expectancy report.
SECTION 9.1 Amendment. This Agreement may be amended from time to time only by
the written mutual agreement of the Company and Cassidy.
SECTION 9,3 Notices. All demands, notices and communications hereunder shall be in
writing and shall be deemed to have been duly given if personally delivered at or mailed by
overnight mail using a nationally recognized carrier or by registered mail, return receipt
requested, to:
or at such other address or facsimile number as shall be designated by either such Person in a
written notice to the other.
Notwithstanding the foregoing, notice of breach, service of legal process or other similar
communications shall not be given by electronic mail and will not be deemed duly given under
this Agreement if delivered by such means. Notices, demands and communications hereunder
given by facsimile or electronic mail shall be deemed received upon oral confirmation of receipt
by the addressee or upon the sender's receipt of an affirmative confirmation of receipt thereof by
the addressee.
SECTION 9.5 Assignment. The teuus and provisions of this Agreement shall be binding
upon and inure to the benefit of the Parties hereto and their respective permitted successors and
assigns. Neither of the Parties hereto shall assign this Agreement or any of the rights created
hereunder without receipt of the prior written consent of the other party. Consent shall not be
unreasonably withheld.
SECTION 9.9 No Petition.Each of Cassidy and the Company, by entering into this
Agreement, hereby covenants and agrees that it will not at any time institute against the other
party, or solicit or incite any other Person to institute for the purpose of joining in any such
institution against that party, any bankruptcy, reorganization, arrangement, insolvency or
liquidation proceedings, or other proceedings under any United States federal or state
bankruptcy or similar law. This Section will survive the termination of this Agreement.
SECTION 9.10 Limited Recourse. The obligations of the Company under this
Agreement are solely the obligations of the Company and payable from and recourse only to the
assets of the Company. No recourse shall be had for the payment of any amount owing by
the Company hereunder, or for the payment by the Company of any fee in respect hereof or
any other obligation or claim of or against the Company arising out of or based on this
Agreement or against any partner, owner, beneficiary, officer, director, employee or agent of
the Company; provided, however, that nothing in this Section shall relieve the Company from
any liability which the Company may otherwise have in such capacity for its own gross
negligence or willful misconduct. The agreements in this Section shall survive termination of
this Agreement.
SECTION 9.11 Third-Party Beneficiaries. This Agreement will inure to the benefit of
and be binding upon the parties signatory hereto. Except as otherwise provided in this
Agreement, no other Person will have any right or obligation hereunder.
SECTION 9.12 Merger and Integration. Except as specifically stated otherwise herein,
this Agreement sets forth the entire understanding of the parties relating to the subject matter
hereof, and all prior understandings, written or oral, are superseded by this Agreement. This
Agreement may not be modified, amended, waived or supplemented except as provided herein.
SECTION 9.13 Headings. The headings herein are for purposes of reference only and
shall not otherwise affect the meaning or interpretation of any provision hereof.
SECTION 9.15 Information and Data. Nothing contained in this Agreement shall be
deemed or construed to limit the Company from utilizing any information or data from this or
any other Agreement in furtherance of its underwriting or business processes and to be utilized
or assimilated in any other form for the benefit of the Company, as long as any individual
personal health information continues to be subject to those protections as provided in this
agreement.