Medical Legal Consulting

Medical Exam – Dr. Neurosurgeon

Jane Smith

Debbie Fernando, RN

3/11/2013

Brief notes from the medical exam performed on Jane Smith by Dr. Neurosurgeon of Bristol, TN

RE: Medical Exam Jane Smith 03/11/13

Dr. Neurosurgeon refused to let me observe the exam on Ms. Smith; thus he cancelled

the original exam. These are notes from the exam on the above mentioned date on

which he had a videographer present.

He first told me I was not allowed to take notes.

He asked me to sit across the room in the corner where there was a huge piece

of equipment in the corner obstructing my view 90%. I chose to stand in a

different area where I could view the exam.

When asking Jane to explain the accident, he had a difficult time comprehending

the positioning. He ended up saying, “so you two collided” instead of “so he hit

you”

Jane’s car was totaled.

Her complaints were mainly of headaches, neck pain, and back pain

He tended to ask the same question repeatedly.

He asked what she took for pain which was ibuprophen OTC

When asked to tell him about her pain, she stated that her neck hurts, she gets

headaches, and her back hurts.

When questioned about pain in her arms, she informed him that at times her

fingers were numb and her wrists and hands were stiff and numb, especially in

the mornings. She stated it improved as the day progressed, but still the

numbness came throughout the day. He asked her if she ever heard of carpel

tunnel. She said she has heard of it but didn’t know much about it. I inferred that

he may have been trying to imply that this was her problem.

She stated no shooting pain in her arms, just her wrists and hands. When asked

to show where her back hurt, she addressed thoracic, lumbar, and cervical

(which she described as her neck).

When asked about any pain in her legs, she informed him that she did have pain

in her hips and down her upper legs.

She stated she was not wearing a seatbelt, but the airbags deployed around the

car door and the side airbags as well.

She hit her head on the rearview mirror.

When questioned whether her activities were the same as before the accident,

she informed him that they were different because now she has a baby and does

not perform the same activities as before. She also informed him that the

activities she performed during the day caused her pain, yet she had to perform

them. Again, he repeatedly asked her if she was able to perform the same

activities as before the accident. She told him that she was able to, but it caused

her pain.

He tended to say “good” after every test whether or not she was able to perform

the test to its fullest capacity.

THE EXAM

Dr. Neurosurgeon had Jane disrobe and change into a “paper top and bottom”

which was unnecessary for no more tests than he performed on her. She was

constantly holding onto the so called gown for fear it would fall off. My feelings

were that it was a tactic to humiliate and distract her, especially since she was on

camera and did not know who all would see the video.

He asked her to touch her toes; she could not and told him it caused her back to

hurt.

When testing her reflexes, the ones in her ® arm were good. He tapped her left

arm 7 times before he could get a “jerk”. He said, “good” then went to the right

arm. It took only two taps and I could visualize a reflex. After he tested the

reflexes in her right arm he said to her, “Well, that one works, doesn’t it”. He then

went back to the left and tried it again and then got a “jerk” after approx. 3 taps

I could not visualize her hand reflexes due to his body blocking my view.

Leg reflexes – his body obstructed the video, and partially my sight when I was

there, during this test. Again, her (L) leg’s reflexes were minimal. Her R leg

reflexes were good, the best I could tell.

I could not visualize her ankle reflexes at all due to his body

When checking her hip rotations, she informed him that it caused pain. She

complained of more pain in the left upper leg when he was rotating her hip. She

said the right was not as bad. I could confirm this by her facial expressions during

both rotations.

He had her bend her head back and then right and left which she stated caused

her pain.

He asked her to bend backwards from a standing position; then bend forward.

She stated it hurt her back both ways but more to bend backwards.

When asked to raise her arms over her head, she did so but said it hurt.

He used a tape measure to measure from shoulder to elbow. He made an ink

mark on what appeared to me to be her bicep and said 13cm. He then measured

her bicep and said said 29 and ½. He went to her L arm measured from shoulder

to elbow and said “sounds like rain outside” (while marking her bicep level). He

then measured her L bicep and said “30 and ½” implying that her L bicep was

one cm rounder than her R.

CONCLUSION

Dr. Neurosurgeon’s examination of Jane sounded more like a cross examination

than a true physician question/answer exam.

After he checked her reflexes and they were unequal, he still said, “good” after

everything implying that everything was good.

He questioned her about work (several times) after the accident and she kept

informing him that she did what she had to because she had to have money. She

stated she made certain movements but they caused her pain. When asked if

she received treatment from a physician for any of her pains after the accident,

she informed him that she did not because she could not afford to and had no

health insurance. She informed him that if she had insurance she would have

seen a physician for her problems.

There was no need for her to disrobe and put on the paper. I feel it was only to

humiliate her, especially since it was being videoed. She had to concentrate on

keeping herself covered. She was holding on to the paper clothes a majority of

the time.

After the exam, Jane informed me that when he had her make fists and told her

to push up as he was pushing them down, that he pushed harder with his L

making it appear that her R arm was weaker. This could not been seen by my

eyes or on the video due to his body blocking it.

This is a basic overview of her medical exam, which I reiterate, was not a normal

conversational doctor/patient question/answer examination.

DEPOSITION

Comparing Dr. Neurosurgeon’s deposition to his exam, it appeared that he was 2

different people. He appeared very nice during the exam; during the deposition, he was

colder, would not look at Jane, and stated that he found nothing abnormal. When in fact,

I noticed that he did see abnormalities; he just did not document them or mention them.

Early in the deposition, the attorney asked Dr. Neurosurgeon if his time was valuable.

Dr. Neurosurgeon answered, “Yes”. I do not recall him asking Dr. Chiropractor if his

time was valuable and he did not ask me if my time was valuable. My time and Dr.

Chiropractor’s time is just as valuable as Dr. Neurosurgeons. Dr. Neurosurgeon’s time

is by no stretch of the imagination more valuable that mine or Dr. Chiropractor’s,

regardless of his opinion of himself.

Dr. Neurosurgeon commented several times about chiropractic terminology. He

appeared to be putting little respect or regard on the chiropractic field. Our government

disagrees with Dr. Neurosurgeon. Chiropractors are a nationally recognized medical

discipline. It has been my findings that medical doctors do not appreciate the work of

chiropractors nor DOs (doctors of osteopathic medicine).

CONCLUSION

Many of Dr. Neurosurgeon’s deposition answers did not match what I saw on Ms.

Smith’s exam. He downplayed her statements regarding her pain and stated that he

noticed no abnormalities. I did notice abnormalities and do not see how Dr.

Neurosurgeon could not have noticed them as well.