0:00

So, um, what have I learned

0:03

or gathered from doing expert witness work

0:06

for about 25 years?

0:08

Um, I think it makes me understand

0:11

that when I make a mistake, it's better to just admit it

0:16

and not take it to heart

0:19

and understand that if that mistake led to damages

0:23

to a patient, even if I am 99.99%

0:30

accurate, the patient should be compensated for the damages.

0:34

By my mistake, it's not about my past expertise

0:38

and my, all the correct answers that I've given.

0:42

If I make a wrong answer

0:43

and it harms a patient, I can understand that

0:47

and that patient needs to be compensated

0:51

for the economic losses for the painting suffering.

0:54

So that's my view on the ethics of making mistakes.

0:59

We all make mistakes, and it's just a matter of time

1:01

before one of those mistakes leads to harm to a patient.

1:05

Being negligent on one case does not

1:07

make you a bad physician.

1:10

It's, you know, 99.99% accurate is pretty darn good.

1:14

That makes you a great physician, but

1:16

because you've read 200,000 studies in your career,

1:21

you, it's going to catch up with you.

1:23

It, it's, you know, we all make mistakes

1:26

from the standpoint of the law.

1:27

My insights are that there are a lot of unsavory individuals

1:32

out there, but they're much less common than

1:34

responsible persons.

1:36

And even when I'm arguing over a case with

1:40

the opposing counsel

1:42

or reading an expert witness that I totally disagree with,

1:47

in general, you find that people are ethical

1:50

and that people are trying to do the right thing.

1:54

The jury system, I think, sometimes is a little bit

1:57

of a farce in that you have people

2:00

who are not educated in medicine making

2:03

fine determinations based on, you know,

2:06

how likable an expert witness is.

2:08

Unfortunately, for example, I was in a,

2:10

in a case in which a patient claim

2:13

that they were made paraplegic

2:15

after surgery on their cervical spine

2:20

and post-op, the council

2:24

had a video of the patient riding a

2:29

Harley motorcycle with high handlebar in the street.

2:34

And this was the same patient who was claiming

2:36

that they were paraplegic.

2:38

And despite that video showing that patient

2:42

riding their motorcycle by themselves, the jury

2:47

awarded them money for the damages, which I,

2:52

I just found incredible.

2:54

And one of the reasons why that happened was

2:56

because the defendant

2:59

Was just, uh, a despicable individual on the stand.

3:04

He just was too arrogant.

3:06

He was a neurosurgeon and in this case he was just very

3:09

arrogant and the jury didn't like him

3:11

and they decided to ward it

3:12

to the paraplegic motorcycle rider.

3:14

Who knows? Um, one of the things that you should be aware of

3:19

that I think is a little bit, uh, crazy, is that

3:22

the lawyers will talk about all these economic damages

3:26

that the patient has incurred

3:28

and will require for their life going forward.

3:32

And at the same time, their fee is usually 30 to 40%.

3:36

So even in the best of situations,

3:40

the plaintiff doesn't get the full amount that the legal

3:44

team is asking for.

3:46

Settle cases is the most common scenario

3:48

and the best outcome in most cases.

3:51

And lawyers are, in some cases not knowledgeable,

3:55

especially defense lawyers in medicine, even if

3:58

that's their practice.

4:00

Our role as experts is really to teach the lawyers as well

4:04

as teaching the jury.

4:05

And finally, the business.

4:09

When you are doing this, you get a lot of referrals.

4:12

And I often ask myself, how is it that I was never asked

4:16

to be a medical expert witness?

4:18

Prior to being the division chief

4:19

of neuroradiology at Johns Hopkins for 10 years,

4:22

I practiced neuroradiology.

4:23

No one ever came to me for doing expert witness work.

4:26

And as soon as I became the division chief at Johns Hopkins,

4:30

it was like constant people coming to you.

4:32

So there is this underground referral system.

4:35

If you do it well, you get a little bit of a reputation

4:39

and, um, you know, it ends up

4:42

that you have too many cases to review.

4:44

And that's why I select them based on, you know, being,

4:48

coming to me in a blinded fashion

4:52

and without any bias with regard

4:54

to plaintiff versus defense.

4:56

So some of the cases in which it's sort of at the borderline

4:59

of my expertise, I will refer out if it's a

5:03

interventional case, for example, I don't take them.

5:05

So make sure that you're in your strike zone

5:08

and comfort level in accepting some cases.