Experienced cardiology expert witnesses can be helpful and effective in evaluating and opining from either the plaintiff or defense point of view, whether a physician defendant has complied with the standard of care with respect to diagnosis, recommended or prescribed treatment, and the performance of procedures within the domain of cardiology, including the sub specialized areas such as:
- Interventional cardiology (cardiac catheterization, angioplasty and stenting), electrophysiology (ablation procedures, pacemaker and AICD implantation and management),
- Non-invasive imaging (echocardiography, nuclear cardiology, CT and MRI),
- Preventive cardiology/risk factor management (management of hypertension, hyperlipidemia, diabetes, as well as smoking cessation, weight loss and exercise).
In addition to reviewing and opining on diagnosis and treatment of the usual cardiac problems, such as;
- Coronary Artery Disease,
- Angina Pectoris,
- Myocardial Infarction,
- Congestive Heart Failure,
- Cardiogenic Shock,
- Conduction Disturbances
- Congenital Heart Disease,
- Pre-op evaluation and post-op management of both cardiac and non-cardiac surgery in cardiac patients, etc.
The cardiologist expert witness can opine on whether or not a cardiac symptom (chest pain, shortness of breath, palpitations, dizziness, syncope or edema) has been adequately and appropriately evaluated and “worked up”.
Outside of the strictly medico- legal arena, an experienced cardiology expert is knowledgeable about utilization and appropriateness of diagnostic and therapeutic measures with respect to compliance with the expected standard of care, his opinions supported by the premise of evidence based medicine.
Apart from the above, more usual or standard requests, over the years I’ve been asked, on more than one occasion, to help evaluate the validity of a patient’s (or client’s) “excuse” to be relieved of his or her obligation to testify based on a real or “invented” underlying cardiac problem precluding having to testify, as it would be too “stressful”.
Other less common requests have been to evaluate whether an underlying cardiac problem might have contributed to a defendant’s “lapse” while driving, which then resulted in a fatal automobile collision, or whether or not an underlying cardiac condition might have been contributory to a plaintiff’s death which overtly seemed to result from a different cause.
While depositions and trial testimony provide the more dramatic examples of ways in which an experienced cardiology expert witness can be helpful, perhaps the commoner, less dramatic roles are equally important in the overall system of medico-legal jurisprudence. A relatively brief and therefore inexpensive review of medical records can result in the cardiology expert’s explaining to a plaintiff’s attorney why, despite an adverse outcome or death, the physician‘s performance was actually appropriate and not below the standard of care.
In choosing a cardiology expert witness, import criteria should include:
- Their background,
- Training and Board Certification,
- Record as a practitioner,
- Length and breadth experience as both a cardiologist and an expert witness,
- Their current breadth and depth of knowledge of cardiology and the current standard of care,
- Their ability to articulate and explain complex medical principles and issues in easily understandable ways to non-medically trained individuals,
- Their honesty and ability to convey credibility, and
- Their professional and calm demeanor even when under attack by opposing counsel.
About the author
Philip E. Newman, MD, FACC is a board certified cardiologist with 32 years of practice experience involving non-invasive, invasive and interventional cardiology. My initial position was as an academic cardiologist at a medical school, as Director of the cath lab and Acting Chief of Cardiology at a teaching hospital, with patient care, teaching and publishing responsibilities. Following 3 years in that position I was in fee-for- service practice for 7 years, then in practice combining fee for service and managed care patients for the past 22 years.
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