Attached is a .pdf copy of the class materials for you review prior to Class No.

3, Tuesday,

September 8th. 

In the attached materials you will find the expert report and CV of PLAINTIFF’S EXPERT,

Cameron James.

Attached are also .pdf copies of the expert report and CV of DEFENDANT’S IME EXPERT, Dr.

Ashley Landry.

Please disregard the Class assignment found in the syllabus for Class No. 3; instead, your

assignment is as follows:

All PLAINTIFF COUNSEL should be prepared:

a. to take the expert deposition of Dr. Ashley Landry; and

b. to defend the expert deposition of Cameron James.

All DEFENSE COUNSEL should be prepared:

a. to take the expert deposition of Cameron James; and

b. to defend the expert deposition of Dr. Ashley Landry.

Have a good, long Labor Day weekend. 

https://www.expertinstitute.com/resources/insights/the-ultimate-expert-witness-objection-

checklist/

 Advertising/Marketing/Promotion
 You do advertise that, for a price, you are available to testify, correct?
 You advertise yourself as an expert for hire, is that correct?
 You promote yourself as an expert witness by using a website?
 You are represented by an expert witness referral agency that obtains work for
you through advertising, emails, sponsorships, and bulk mail solicitations, is that
correct?
 How do you promote your expert witness practice?
 Is this a copy of the ad you use to promote your expert witness business
in Trial magazine?
 Do you solicit expert witness work from both plaintiffs and defendants?
“Dr. Schmo, can you please tell the jury the percentage of your medical work, as opposed to legal work?” “About 25
percent of my work is for legal matters.” “What percentage of the legal cases that you work on is for the defense as
opposed to the plaintiffs?” “It varies, but on average, about 90 percent of my cases are for the defense.” “Can you tell
the jury how many open files that you are currently working on?” “My best estimate would be about 50.” “Can you tell
the jury the names of each of the last five cases you worked on for the defense?” “Well, there is the Smith case, the
Jones case, the Rogers case, the Garcia case and the Menendez case.” “Who were the defense attorneys that you
worked for in those cases?” “They were all being handled by the Dewey, Cheatem and Howe defense firm.” “Can you
tell the jury the names of each of the last five cases you worked on for the plaintiff?” “I really cannot remember the
names of the cases right now, I would have to check my files.” “Can you name one?” “As I sit here today, no.” “Dr.
Schmo, have you ever had any of your testimony struck or limited by a court?” “Yes. I was told that I was not allowed
to testify about the biomechanics of an injury.” “What did that case involve?” “The patient claimed that he hurt his
neck in an automobile crash.” “You mean in a case very similar to this one, correct?”A. “Yes.”

Additional important areas of inquiry include what professional organizations does the doctor belong to, what
journals does the doctor receive and read on a regular basis, what treatises and other materials does the doctor
believe are relevant and applicable medical resources, and what areas of practice does the doctor focus on currently.

Expert Depositions You will always achieve more if you have a well thought out, organized plan

for the deposition. Assuming you already have the CV of the expert before the deposition,

confirm it is current. Ask the witness what areas she intends to offer expert testimony in and lock

that as the only area Find out how she got involved the case Find out how much work she has

done for the lawyer she is engaged hrr anrl hor firrrt vI q,rv rrlr rrr rrr What was she asked to do?

What did she do to prepare for the deposition? What did she review? Does she plan to do

anything else? Opinions You have the expert report Ask her to list every opinion she has for this

case Confirm these are all the opinions Then one by one Cet the basis for each opinion What has
she relied upon to reach each opinion? What assumptions has she made? What publications or

other experts does she consider to be an authority in the subject matter? Previous cases for

lawyer that hired her or by that firm? Percentage of work for plaintiff or defendant? This

systematic approach will generally assure that you get the information you want.

Onfte ofterhm{ boft aceilahlm Mrcshavehted, mdfu St dqm@yseal diastases are not particular y

remarkable. She has mild pelvic asymmetry but ftis is difficult to document due to her

anthropomorphic size. Furthermore she does not appear to have my m4ior limb leng& ineryality

uiben u'ri-ng the medial mallmlm regions as Imdmark Allhougfo she does have some limimion

ofmotion, uihd motion Sre does harrc rypeasto be fimdional Shehs sme mrylainF or sitring hfr

dfte sme time her ischial trbercsities are faiity sJmmetrical. I\drs. Temebme also dmonstrdes

antalgic gait wih drut ffice nffid biltrnally in additim b a wide basd gEiL hfr stre does notrequire

my mbul*ory devices- ft isffi,vue$/fu fu does havesore A@Fin as describsd, hS h€r ffigh is

glossly irmct wih fte oroqtim offre rigfut hip abtrrctms (4lr.Additionally, I am rnrable to pinpoint

m identifiable u rywific rodpoblem m fte sornae offtedyseshesia Ovemll, mnsidering the t5pe

offune ftdlvfts. Te,nrebornre srSaid, I would classify ha resrlt as good to excellent even thougfo I

likewise believe &d she has a legitimde hsis for some residual complaints

 What examination results, if any, did you note concerning her condition as it
relates to the automobile accidentthat she told you about?

A. My examination was focused on her cervical spine, neck area. In that

regard her range of motion or ability to bring her chin down, chin up, tilt her
head to the right and left and turn were all slowed and reduced in range. She
had tenderness as well as increased tone or spasticity in her neck muscles
called the trapezius. There was a difference in the height of her shoulders, the
left being lower than the right. Her shoulders, themselves, however, had good
range of motion.

Her upper extremity neurovascular exam, her ability to sensate, feel sensation
of soft touch and provide strength were good, though, in both upper extremity.
There was, when I compressed her spine in the cervical area, reproduction of
her pain in the neck region.

Q. And, Doctor after you noted her complaints, after the examination, did you
then render a diagnosis of her condition initially or did you wait and do some
more diagnostic tests before you did a final impression?

A. I had a report from the chiropractor on her cervical spine suggesting there
was some degeneration between the fifth and sixth cervical vertebrae. So that
entered into my thought process at that time. And my impression following my
visit with her on the 24th of March was that she had a cervical strain brought
on by the rear-end collision and exacerbated pre-existing neck problems she
had.

Q. And your opinion is based upon a reasonable degree of medical certainty

that these conditions that you just described are a result of
the automobile collision?

A. Yes.

Q. And when you say strain, what does that mean?

A. It is a term we use for a soft tissue injury to ligaments or, in this case,
muscles about the neck region. We believe that there is soft tissue damage
and injury to muscles and surrounding soft tissues, in this case, the neck. No
fractures were seen on the X-ray, so it wasn't a bony injury but more the soft
tissues of the areas surrounding the neck.

Q. When you use the term exacerbation of the degenerative conditions, which
is seen in the cervical spine X-ray which is the neck X-ray, what is the
significance of that finding in exacerbation or aggravation of something
degenerative?

A. Well, typically when X-rays do show some signs of degeneration, we feel in

the past sometime, there may have been a previous injury or a problem that
occurred in the neck region so that the bones have changed their
configuration. There may be some spurs. There may be some sclerosis.
There may be some narrowing of spaces consistent with degeneration or
aging.

When that is seen, it is typically something that takes a while to develop. So

an immediate accident, three months prior, would not have caused X-ray
changes. We certainly can note that the problem she has probably did not
cause the bone changes but more in the soft tissue strain region.

Q. Why were her symptoms from the January 19,

1998, automobile accident not resolved when she saw you on that first visit?

A. Sometimes they can remain quite symptomatic from months to years in

situations. Q. Does it depend upon the patient? A. Sometimes depends on the
patient. Sometimes it depends on how violent the injury was. Sometimes it
depends on what soft tissues were injured. If it is mostly muscular, it probably
will resolve. If there is underlying disk and

sort of damage, it may not.

Q.   We agree that this was a head-on collision where a car crossed the center line and hit him on

his driver’s side?

Q.   We agree his car was totaled?

Q.   We agree that he lost consciousness as a result of this auto crash?

Q.   We agree that he had a scalp laceration that required suturing in the hospital?

Q.   We agree he suffered a lateral tibial plateau fracture of the left knee as a result of the auto

crash?

Q.   We agree that Dr. Raymond did surgery repairing the fracture by inserting two screws?

Q.   We agree that Dr. Raymond also did a partial lateral meniscectomy?

Q.   We agree that Dr. Raymond in his surgery found that the lateral meniscus was torn and

removed part of it?

Q.   We also agree that this torn portion of the lateral meniscus was in the same area and the

same side of the knee as the fracture?

Q.   We agree that this fracture involves the knee joint, don’t we?

Q.   And it’s fair to say that fractures that involve the knee joint are worse than those where the

knee cap alone is broken?

Q.   This is because when you have the knee joint involved, it can create an uneven surface that

can cause irritation every time the knee joint is moved. Correct?

Q.   Now, when you have the articulating surface of the knee joint involved in a fracture like this,

it can lead to traumatic arthritis, can’t it?

Q.   Doctor, you certainly don’t disagree that it’s possible that Al’s knee fracture will lead to

traumatic arthritis?

Q.   In fact, you actually expect Al to experience some traumatic arthritis as he gets older, don’t

you?

Q.   And you don’t dispute that this could possibly destroy his knee joint, eventually requiring

him to have a total knee replacement operation?

Q.   You agree with me that Al never had any problems with his left knee before the auto crash?

Q.   And that Al now has pain in his left knee every day?

Q.   Do you agree that Al is experiencing clicking in the left knee?

Q.   Do you agree that clicking often means that a tendon is popping over a bone spur or a screw?

Q.   Al also told you he was having problems with his knee locking?

Q.   And, you would agree that locking, catching, or clicking are all symptoms that suggest a

problem in the knee joint?

Doctor, during your examination you observed that Al was limping. In fact, he was limping even

when his attention was directed to other things?

Q.   Is this one of the things you do during a compulsory medical examination to try to determine

if a limp is real?

Q.   And in his case, it was real?

Q.   You also found in your examination that he had significant swelling of the lower leg?

Q.   You determined this by comparing his injured leg with the one that hadn’t been fractured,

correct?

Q.   You also determined in your examination that he had a bad case of varicose veins that was

contributing to this swelling?

Q.   You would agree with me that his fracture and his torn meniscus could have contributed to

the blood flow problems that you noted in his leg?

Q.   Doctor, you found tenderness on the side of his knee joint?

Q.   You found this tenderness on the side of the knee joint where the fracture had occurred?

Q.   You also found synovitis and that this is consistent with his injury?

Q.   Doctor, what is synovitis?

Q.   Is it a good thing?

Q.   Why not?

Q.   Doctor, you agree with me that the auto crash certainly caused the tibial plateau fracture?

Q.   You agree that Al has continued to have problems related to that fracture and his torn

meniscus?

Q.   You would also agree with me that this type of injury will inhibit his ability to walk long

distances?
Q.   You agree that the way he is today is the way you expect him to remain? And by that, I

mean, that you do not expect his condition to improve from this point?

Q.   In fact, you believe there is a chance that he may actually get worse?

Q.   You would agree with me that the limping that you saw during your exam is consistent with

his injuries?

Q.   Doctor, you also agree that the swelling that you found in his knee is also consistent with

these injuries?

 Doctor, I want to show you a list of medical bills that Al has incurred since this auto crash.

Would you agree with me that all these medical bills are causally related to the auto crash that Al

was in?

Q.   So it’s fair to say, within reasonable medical probability, that Al would not have incurred

$42,567.10 in medical bills but for the crash?

Q.   As a person who is familiar with our medical community, Doctor, is it fair to say that these

medical bills fall within the reasonable and customary charges you would expect for these kinds

of services in our area?

Q.   We have talked about the possibility of a knee replacement. What do you charge for a total

knee replacement?

Q.   What is involved with a total knee operation?

Q.   Is the patient hospitalized?

Q.   For how long?

Q.   Are there office visits afterwards?

Q.   Are there X-rays?

Q.   Is anesthesia involved?

Q.   Are blood, urine and other tests taken?

Q.   Is there physical therapy afterwards?

Q.   What type of physical therapy?

Q.   Doctor, do you have an estimate of what the entire procedure costs?

Q.   You would agree with me, Doctor, that the use of an anti-inflammatory medication is

appropriate for Al’s current problems?

Q.   One of the more popular anti-inflammatories right now, in fact, the one that you, yourself,

prescribe on occasion is Celebrex, correct?

Q.   And Celebrex costs about $100.00 a month, doesn’t it?

Q.   Doctor, it is my understanding that you never actually had an opportunity to see Al’s X-rays.

Is that true?

Q.   They were never sent to you by the defense lawyer?

Q.   Now, when you treat your own patients, don’t you like to look at their X-rays yourself?

Q.   And don’t you prefer to interpret those X-rays yourself?

Q.   But for some reason the defense lawyer didn’t give you that opportunity here with Al, did

he?

Q.   Doctor, I would like to give you a chance to look at Al’s X-rays. Would you take a look at

Exhibit 1? Do you agree with me that it is a May 1, 2001 X-ray of Al’s knee?

Q.   Does it show a tibial plateau fracture?

Q.   Can you show us where that would be?

Q.   Does it involve the articulating knee joint?

Q.   Can you show us?

Q.   Doctor, we have an artist rendition of that fracture. Is that a fair and accurate representation

of what the X-ray shows?

Q.   We also have a drawing of a lateral meniscal tear in the area of the tibial plateau, don’t we?

Q.   Is that accurate?

Q.   Does it show the part of the meniscus that was removed by Al’s treating physician?

Q.   Why do we have a meniscus in our knee?

Q.   Is it better to have a meniscus than not to have one?

Q.   Doctor, would you agree with me that of all the possible causes in the universe, the most

likely cause of Al’s torn meniscus was the auto crash?

Q.   Now, Doctor, you had an opportunity to review all of Al’s past medical records before the

auto crash didn’t you?

Q.   And the truth is, Doctor, you didn’t see any evidence in his previous medical records of

problems with his left knee before the auto crash?

Q.   In fact, in your initial report, it was your conclusion that the meniscal tear was caused by the

auto crash, isn’t that true, Doctor?

Q.   Well, Doctor, I have a blow-up of page two of your independent report, the one you

prepared and sent to the defense counsel. Let’s read it together just to make sure I’m getting this

right. Doesn’t the first sentence of the second paragraph say, “My assessment of this patient is

that he sustained a lateral meniscal tear and a lateral tibial plateau fracture as a result of this

motor vehicle accident?”

Q.   Doctor, I would like to show you another X-ray. This one is of Al’s knee taken

approximately two months after the auto crash. Now, you never had an opportunity to see this X-

ray before today, have you?

Q.   Can you tell us what it shows?

Q.   Can you tell us why there are two screws in his knee?

Q.   We also have an artist’s drawing of his knee. Is it a fair and accurate rendering of what Al’s

knee looks like now?

Q.   Are those screws still in his body?

Q.   Will they remain in his body for the rest of his life?

Q.   Doctor, is there a chance that they may have to come out at some time?

Q.   Why?

Q.   If they did have to be removed, what would be the total cost?

Q.   How long would the recovery period be?

Q.   Doctor, you have told us that it is possible that Al may need a total knee replacement

operation sometime in the future. Would you take a look at Panel #3 and tell me if that artist’s

rendering is a fair and accurate representation of how a total knee replacement is done?

Q.   Can you explain to the jury, using that diagram, how you do a total knee surgery?

Q.   Now, Doctor, you have already told us that a person who has a total knee operation is put

under anesthesia, correct?

Q.   Is there at least some risk that a person will die from the anesthesia?

Q.   Does a person who has a total knee replacement run any risk of infection?

Doctor’s Ongoing Relationship With Defense Counsel

Q.   Doctor, this wasn’t the first time that Attorney Brown has asked you to do a compulsory

medical examination on one of his cases, is it?

Q.   The truth of the matter is that you and Attorney Brown have had an ongoing relationship for

over ten years?

Q.   Your best estimate is that you have been asked to do approximately four or five

examinations by him or members of his law firm each year since you have arrived in our

community?

Q.   So it’s fair to say you have done 40-50 compulsory medical examinations for Attorney

Brown or members of his firm?

§9:96        Economics of Doing Compulsory Medical Examinations

Q.   Now, Doctor, other defense attorneys in our area also hire you to do compulsory medical

examinations?

Q.   In fact, your best estimate is that you do two or three a month on average?

Q.   So if my math is correct, you are doing approximately 24-36 a year?

Q.   Now, when you do these examinations, you usually charge $500.00, correct?

Q.   When your deposition is taken by a lawyer such as myself who represents an injured person,

you charge us $600.00, an hour don’t you?

Q.   When your videotaped deposition is taken in a case like this by Defense Lawyer Brown, you

charge $1500.00?

§9:97        Inconsistencies With Prior Testimony

Q.   Doctor, although you do a lot of compulsory medical examinations for defense lawyers, you

also treat injured victims of car crashes, don’t you?

Q.   In those cases, you are often called by a plaintiff’s attorney such as myself to testify about

your patient’s injuries?

Q.   In fact, several years ago, you testified in the case of Paul Pike?

Q.   Doctor, let me help refresh your memory. I have a copy of your trial transcript. Would you

like to take a look at it?

Q.   Doctor, would you look at page 1, line 6?

Q.   Does that refresh your memory as to what Paul Pike’s injury was?

Q.   Doctor, Paul Pike had a tibial plateau fracture very similar to Al’s, didn’t he?

Q.   In fact, you treated it the same way by using two screws to hold the pieces in place, didn’t

you?

Q.   Doctor, would you now look at page 36, line 8?

Q.   Would you read that line for us?

Q.   Doctor, you testified under oath in the Paul Pike case that more likely than not he would

need a total knee operation sometime in the future because of his tibial plateau fracture, didn’t

you?

Q.   But in this case, where you have been hired to testify for the defense, you believe it is only a

possibility, is that true?

No further questions.