Trials of an Expert Witness: Tales of Clinical Neurology and the Law

Dr. Klawans protected the patients and lawyers in these cases by keeping them anonymous in this very readable book. There is no index. Chapter 1 tells how he became an expert witness when treating a patient as a neurologist. Chapter 2 tells of a sad case on iatrogenic water intoxication. Most malpractice cases involve average doctors who made a mistake (p.38). Chapter 3 tells why you have to ask the right questions to get the right answers. Chapter 4 discusses the EEGs of Jack Ruby. The importance of winning for an expert witness is in Chapter 5. One of the most important chapters is on carotid stenosis in Chapter 6. Chapter 7 explains the importance or reading labels on laundry products and following their instructions. "Therapeutic Misadventure" is explained in Chapter 8; did Dr. Parks refer Mrs. Schwartz to Dr. Cooper by mistake? Sleep drunkenness is explained in Chapter 9, and its consequences (pp.136-137). Chapter 10 tells of a woman who had difficulty falling, she said. The rare third-nerve injury is explained in Chapter 11, and the difference between fiction and a scientific article. Chapter 12 tells of the Trial of Dan White, who shot the San Francisco mayor and another politician. The trial record has been impounded! Chapter 13 explains tardive dyskinesia, an iatrogenic disease caused by long-term exposure to drugs used to treat schizophrenia. No treatment may mean years of psychosis. If you want to know the reason for malpractice suits, read Chapter 13. It has both the good and the bad. Chapter 14 examines the "insanity" of Ezra Pound. Dr. Klawans does not appreciate the reactionary politics of that era. If a woman uses birth control pills, smoking increases the chances of having a stroke. This can create aphasia (Chapter 15). Chapter 16 explains the disease dystonia. Dr. Klawans explained how hysteria could be mistake for this disease when the patient could gain from this disease. Could somebody escape from the police by checking into a hospital room as an AIDS patient (p.245)? The dangers of lead poisoning for children are documented in Chapter 17. Drugs, as well as premature birth, can affect a child's brain permanently. The dangers of smoking too much too long are described in Chapter 18. This is one cause of emphysema. This leads to a buildup of blood CO2 levels. But the real cause of death was human error (p.271)! The last chapter tells of a woman who had an accident in a federal office building, and began to feel tired and sleepy a lot (a common sigh of depression). The clothes worn by Dr. Klawans swayed the federal judge! Is this a warning against an inquisitorial system where the judge is also the jury?

This text is an excellent reference which contains manycases on clinical malpractice . The author details thefacts of each case and presents legal outcomes together withthe individual stories behind each legal complaint. This bookis a goldmine for anyone even considering the formulation ofa legal claim against a doctor or institution. The authorexplains many of the fine legal nuances in plain English.Here is a typical sample:"The jury gave Mrs. Cook over one million dollars. It was thefirst malpractice case in which TD resulted in a million-dollarverdict for the plaintiff. It was not all that much money, considering the outcome. Mrs. Cook has severe contorting movements that she cannot control. There are no medicines that can help her. The standard ones we use reserpine and tetrabenazine, tend to cause severe depression in susceptible individuals. And no one could be more susceptible than Mrs.Cook."

If anyone is interested in reading about a physician(neurologist) who has learned the ropes of the court system and whoentertains the reader with forensic medical tales, this is the book to read and savor. Although Dr. Klawans is a frequent medical expert witness for both sides of the versus, he does not hesitate to use the term "hired gun" for impartial medical experts and minces no words in describing the shortcomings of the tort system. In case after case, Dr. Klawans describes how the system works as he plays the role of expert for both plaintiffs and defendants in medical malpractice cases. I recommend this book particularly for physicians who need a distraction from the present travails of corporate socialized medicine (managed care). It will also help them get through the ropes of the court system, if and when he or she is summoned to participate in courtroom proceedings and chances are, he or she will!Miguel A. Faria, Jr., M.D., Editor-in-Chief of the Medical Sentinel of the Association of American Physicians and Surgeons (AAPS) and author of Medical Warrior: Fighting Corporate Socialized Medicine.

As a newly-trained neurologist, I was fascinated by these tales of neurology and the law, from both plaintiff's and defense's viewpoint. Though the stories are dated, the general principles are all too true, and teach physician and patient alike why lawsuits occur.