Trial lawyer here. I've taken a number of depositions. Experts, if prepared well, can be devastating. If they're a practitioner in their field and not yet tainted by the law, then they need to be prepared extensively before deposition and trial.
I can absolutely sympathize. I've never had to appear in court, thankfully, but I have had several lawyers ask for a "professional opinion" for IT issues-a field that can be just as broad as medicine in its own way. Sometimes you just have to say "That's not an area I specialize in." There's a good analogy you can give them "Well, you're a lawyer in X field, right? Have you considered giving law advice to someone in Y field?"
@@verybarebones I mean the same way that a doctor who hasn’t studied something in years would have more familiarity than someone who hasn’t studied it at all right?
Welll technically they don’t need to with a low pH and high CO2; even if bicarbonate was also low, this would metabolic or some kind of mixed acid-base disorder
@@ImitationKrab99 although very uncommon, it is possible to have concomitant respiratory and metabolic acidosis. In this case, I would agree this is respiratory, however, I would still like to have the bicarb for completeness sake.
@@humski9 it would just rule out the additional component of metabolic acidosis driving the pH to be this low. Although uncommon, it is not impossible to have both metabolic and respiratory acidosis. DKA patient can still go into respiratory failure
@@swimfan3588 Ah, I know but from a legal point of view, mixed respiratory and metabolic acidosis does NOT equal respiratory acidosis; two separate identities in a medical deposition
Maybe it’s those “greater than” and “lesser than” arrows. From the time I got out of nursing school until the time I started working with “newer” grads I felt like I didn’t know anything about nursing. It was unbelievable the difference between what I was taught and what they’re being taught now!
@@user-vm5ud4xw6n I think it might be the arrows on the ABG results showing the pCO2 is high and pH low. Most lab results will show when a result is out of norm. I wasn't taught respiratory opposite metobolic equal when I trained just after the last ice age; those crazy kids come up with the wildest things!
As one who has been an expert witness for both plaintiffs and defendants but never on the losing side, I can say that the greatest liability either party has is most often their attorneys. It's amazing how frequently they fail to understand the medical records and the significance of the data they contain. They also have a propensity for hiring "experts" who simply aren't, at least not in the relevant areas. The video is entertaining, of course, but not entirely inaccurate, esp. when the attorney has not properly prepared the witness.
…and that’s why poor penmanship a) gets people killed (literally) and b) why they are more easily sured. Notes (and accurate legible ones) matter. 🤷♀️. But in saying that, I’ll make the, I think, reasonable assumption that you’re joking 😊
@@masterofdesaster8 oh I’m absolutely with you!!! Plus notes in different departments use different acronyms and arghhh! I must say though this and simply bad charting isn’t only limited to doctors but it has been something I have gone on and on and on about for two decades!! So yep!! (My best friend who HAS heard my rants, is finishing her degree in social work…. I think for the majority of our friendship she assumed I was exaggerating and simply humoured me….. then she did placement and now she understands!) 😊
@@tellem372 Physically writing notes is archaic and should have been phased out like 30 years ago, along with fax machines. Even written prescriptions have other options that keep fonts consistent and legible. Handwriting can't be blamed, it's the system at fault
@@EveTater hmm, okay now see I was the very first person in my health centre to get permission to type notes. I can type much faster then write but two things… 1. Since how does the at actually not impact the fact that almost all health professionals I know cannot “write” (or type) accurate notes (and hey I can go on about more then notes but this is the point)… secondly, what are you gonna do when the EMS systems OR they’re in use or unhelpful or not working that day or you’re in a setting that does not currently use them (often for good reason)…. But that’s fine you can blame the system instead the individuals who don’t get why this important and are happy to harm while thinking they’re helping while patting themselves on the back. Im not saying there aren’t systemic issues as there absolutely are. Gosh five minutes ago I wrote one out that is going to a commissioner. But that does NOT detract from personal responsibility. Shifting the blame doesn’t help anyone. And there are somethings that are nearly impossible to win (although it doesn’t automatically mean we shouldn’t try) but handwriting? That’ll be your hill for this conversation? Not accurate and readable (in any form) note taking? Not being good communicators and listeners which result in good notes and good treatment with intervention/non-intervention. You think handwriting is archaic? And yes, that is the argument you’re trying to make. I do hope at least now, you’re thinking about it differently then when you left your other comment. Think about what your actual argument is, because handwriting and good notes aren’t archaic and and EMS won’t solve either issue for you (actually in many instances it can cause problems but I’m in no way opposed to them). I could seem harsh and I get that. I have been on both sides of this as clinician and patient and I’ve seen the harm done and it’s bad and it IS deadly. Remember a “machine” (software in that case) only gives out what clinicians put in. So my issue remains the same, especially as the very initial comment and my response to that was about penmanship.
Remember ER? When Dr. Corday was sued by the patient whose back surgery she may've rushed (because she wanted to go on a romantic weekend with Mark), and he ended up paralyzed? During a break in her deposition, her attorney asked her if she knew what time it was. She looked at her watch, & told him the exact time. He told her, no, the answer is, "yes." Never elaborate, never say more than the bare minimum to answer the question, make them ask you a follow up, to get further details - lawyer - 'do you know what time it is?' witness - (looks at watch/clock/device) 'yes' lawyer - 'what time is it?' witness - '2:54 pm' words to live by, in any deposition, or court testimony situation
Nothing like getting expert testimony and then asking them about stuff that they're not actually experts in but are enough that the judge thinks they should be! (Oh god this leads to so much utter garbage being allowed in as fact in other fields, and I'd assume medicine as well)
Only if the witness is too reluctant to say "I don't know". If the attorney is so foolish as to ask why the witness doesn't know, his line of questioning can be exposed as weak.
Just say "dude, am I going to your office asking about obscure and technical questions about the probate process? It's not simple and I would need to look something up to answer your questions: I can't do it on top of my head and almost nobody can."
Hopefully, the attorney calling you to the stand will talk to you and actually make sure you are the relevant doctor to talk about the stuff you actually know and can comment on or stuff you did.
Just say yes. A pH of 7.19 with a CO2 of 68 is a respiratory acidosis. Any non surgeon should know that. Even GI needs to have a basic grasp of acid base disorders.
The patient might normally have a raised CO2 due to something like COPD and his bicarb or chloride could be way out, meaning it could be more likely to be metabolic. Or it could be a combination.
that is the most non compensated respiratory acidosis you can see. what do you even learn in med school in US if you don't know to interpret basic labs? the krebs cycle? the radial artery?
Just because you wrote the note, does not mean anything. Not sure why they questioned you. They should have asked the correct doctor for this court case. That is like asking a transmission shop to fix a problem on your engine.
I don’t work as a physician but don’t rotations involve multiple specialties and wouldn’t that involve charting? So at the time most likely they were familiar with the topic but 3 years after that specialization has ended you no longer recall the subject matter that well.
Trial lawyer here. I've taken a number of depositions. Experts, if prepared well, can be devastating. If they're a practitioner in their field and not yet tainted by the law, then they need to be prepared extensively before deposition and trial.
I can absolutely sympathize. I've never had to appear in court, thankfully, but I have had several lawyers ask for a "professional opinion" for IT issues-a field that can be just as broad as medicine in its own way. Sometimes you just have to say "That's not an area I specialize in."
There's a good analogy you can give them "Well, you're a lawyer in X field, right? Have you considered giving law advice to someone in Y field?"
Not quite a good analogy, a criminal lawyer will still be able to advise you on contracts better than just about anyone that hasnt studied law
@@verybarebones They wouldn't, though (wouldn't give advice). They wouldn't have the case knowledge or familiarity with the precedents in that field.
@@verybarebones I agree with @ConstantlyDamaged. They wouldn't give advice even though they could, also to save their own ass.
@@verybarebones I mean the same way that a doctor who hasn’t studied something in years would have more familiarity than someone who hasn’t studied it at all right?
@@verybarebones We're not comparing them to someone that hasn't studied law or medicine, we're comparing them to someone that does work in that field.
We just went over this in nursing school. I'm going to burn this into my memory.
😂😂😂
But like also they didn’t give you a bicarb level to confirm lol
Welll technically they don’t need to with a low pH and high CO2; even if bicarbonate was also low, this would metabolic or some kind of mixed acid-base disorder
how would a bicarb level confirm it?
@@ImitationKrab99 although very uncommon, it is possible to have concomitant respiratory and metabolic acidosis. In this case, I would agree this is respiratory, however, I would still like to have the bicarb for completeness sake.
@@humski9 it would just rule out the additional component of metabolic acidosis driving the pH to be this low. Although uncommon, it is not impossible to have both metabolic and respiratory acidosis. DKA patient can still go into respiratory failure
@@swimfan3588 Ah, I know but from a legal point of view, mixed respiratory and metabolic acidosis does NOT equal respiratory acidosis; two separate identities in a medical deposition
As a Respiratory Therapist, I'm cracking up over here! Rome? Arrows?
Maybe it’s those “greater than” and “lesser than” arrows. From the time I got out of nursing school until the time I started working with “newer” grads I felt like I didn’t know anything about nursing. It was unbelievable the difference between what I was taught and what they’re being taught now!
@@user-vm5ud4xw6n I think it might be the arrows on the ABG results showing the pCO2 is high and pH low. Most lab results will show when a result is out of norm. I wasn't taught respiratory opposite metobolic equal when I trained just after the last ice age; those crazy kids come up with the wildest things!
We all feel this way court can be confusing
Watching legal side of UA-cam will help with that. Emily D Baker, The lawyer you know, etc are lawyers that help explain it all.
@@Alisha_79
Oh I know
I follow Steve Lehto thanks
As one who has been an expert witness for both plaintiffs and defendants but never on the losing side, I can say that the greatest liability either party has is most often their attorneys. It's amazing how frequently they fail to understand the medical records and the significance of the data they contain. They also have a propensity for hiring "experts" who simply aren't, at least not in the relevant areas. The video is entertaining, of course, but not entirely inaccurate, esp. when the attorney has not properly prepared the witness.
Can’t say without the bicarb and BE. But like also yeah, probably.
how so
@@humski9 bicarb would tell us if there's a metabolic component to the acidosis or not.
@@humski9 and how acute this is, or whether the bicard is starting to compensate.
That's why most MDs have horrible penmanship: So they'll always have wriggle room when the lawyers get involved...
…and that’s why poor penmanship a) gets people killed (literally) and b) why they are more easily sured. Notes (and accurate legible ones) matter. 🤷♀️.
But in saying that, I’ll make the, I think, reasonable assumption that you’re joking 😊
@@tellem372 Yeah, I was. But some doctors out there write their notes in some variant of Sumerian cuneiform, and it's bugging me.
@@masterofdesaster8 oh I’m absolutely with you!!! Plus notes in different departments use different acronyms and arghhh! I must say though this and simply bad charting isn’t only limited to doctors but it has been something I have gone on and on and on about for two decades!! So yep!! (My best friend who HAS heard my rants, is finishing her degree in social work…. I think for the majority of our friendship she assumed I was exaggerating and simply humoured me….. then she did placement and now she understands!) 😊
@@tellem372 Physically writing notes is archaic and should have been phased out like 30 years ago, along with fax machines. Even written prescriptions have other options that keep fonts consistent and legible. Handwriting can't be blamed, it's the system at fault
@@EveTater hmm, okay now see I was the very first person in my health centre to get permission to type notes. I can type much faster then write but two things… 1. Since how does the at actually not impact the fact that almost all health professionals I know cannot “write” (or type) accurate notes (and hey I can go on about more then notes but this is the point)… secondly, what are you gonna do when the EMS systems OR they’re in use or unhelpful or not working that day or you’re in a setting that does not currently use them (often for good reason)…. But that’s fine you can blame the system instead the individuals who don’t get why this important and are happy to harm while thinking they’re helping while patting themselves on the back.
Im not saying there aren’t systemic issues as there absolutely are. Gosh five minutes ago I wrote one out that is going to a commissioner. But that does NOT detract from personal responsibility. Shifting the blame doesn’t help anyone. And there are somethings that are nearly impossible to win (although it doesn’t automatically mean we shouldn’t try) but handwriting? That’ll be your hill for this conversation? Not accurate and readable (in any form) note taking? Not being good communicators and listeners which result in good notes and good treatment with intervention/non-intervention. You think handwriting is archaic? And yes, that is the argument you’re trying to make. I do hope at least now, you’re thinking about it differently then when you left your other comment. Think about what your actual argument is, because handwriting and good notes aren’t archaic and and EMS won’t solve either issue for you (actually in many instances it can cause problems but I’m in no way opposed to them).
I could seem harsh and I get that. I have been on both sides of this as clinician and patient and I’ve seen the harm done and it’s bad and it IS deadly. Remember a “machine” (software in that case) only gives out what clinicians put in. So my issue remains the same, especially as the very initial comment and my response to that was about penmanship.
Btw, yes that is respiratory acidosis lol.
Don't worry. We can get the deposition thrown out.
"pimping" has more than one meaning.....lol
new fear unlocked.
I like the “that is not my area of expertise” answer.
Remember ER? When Dr. Corday was sued by the patient whose back surgery she may've rushed (because she wanted to go on a romantic weekend with Mark), and he ended up paralyzed? During a break in her deposition, her attorney asked her if she knew what time it was. She looked at her watch, & told him the exact time. He told her, no, the answer is, "yes." Never elaborate, never say more than the bare minimum to answer the question, make them ask you a follow up, to get further details -
lawyer - 'do you know what time it is?'
witness - (looks at watch/clock/device) 'yes'
lawyer - 'what time is it?'
witness - '2:54 pm'
words to live by, in any deposition, or court testimony situation
🤣🤣Yeah brushing up on files before a deposition is helpful.
You can't HANDLE the truth!
Oooh man thank you for this new flavor of nightmare 😭
Nothing like getting expert testimony and then asking them about stuff that they're not actually experts in but are enough that the judge thinks they should be! (Oh god this leads to so much utter garbage being allowed in as fact in other fields, and I'd assume medicine as well)
Only if the witness is too reluctant to say "I don't know". If the attorney is so foolish as to ask why the witness doesn't know, his line of questioning can be exposed as weak.
Just say "dude, am I going to your office asking about obscure and technical questions about the probate process? It's not simple and I would need to look something up to answer your questions: I can't do it on top of my head and almost nobody can."
Seriously Doc, you need an agent and head to Hollywood!! ❤. Ingenious and creative!!
So real. This is good
Hopefully, the attorney calling you to the stand will talk to you and actually make sure you are the relevant doctor to talk about the stuff you actually know and can comment on or stuff you did.
Just say yes. A pH of 7.19 with a CO2 of 68 is a respiratory acidosis. Any non surgeon should know that. Even GI needs to have a basic grasp of acid base disorders.
The patient might normally have a raised CO2 due to something like COPD and his bicarb or chloride could be way out, meaning it could be more likely to be metabolic. Or it could be a combination.
that is the most non compensated respiratory acidosis you can see. what do you even learn in med school in US if you don't know to interpret basic labs? the krebs cycle? the radial artery?
Normally I would say just admit you don't know and need more research time, but I guess that's probably how you lose a malpractice case against you...
You should do a collab with Legal Eagle
Scary stuff
More co2 in lungs?
😂😂😂😂
I feel u
LOLOL!
Just because you wrote the note, does not mean anything. Not sure why they questioned you. They should have asked the correct doctor for this court case.
That is like asking a transmission shop to fix a problem on your engine.
I don’t work as a physician but don’t rotations involve multiple specialties and wouldn’t that involve charting? So at the time most likely they were familiar with the topic but 3 years after that specialization has ended you no longer recall the subject matter that well.
😂😂
🤣🤣🤣