AMFS is the nation's leading provider of medical expert witnesses. We maintain a network of thousands of actively practicing, board-certified physician medical experts as well as expert witnesses in all other health care related fields. Since 1990 we have provided medical expert witnesses to thousands of attorneys in thousands of cases, including medical malpractice, personal injury, wrongful death, criminal and other matters. Contact AMFS now for a free case analysis with our team of U.S. based Medical Directors.
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Infectious diseases are among the most common conditions for which patients seek medical care, and potentially the most serious. Fortunately, since the discovery of penicillin over 70 years ago, antibiotics have made the treatment of serious infections highly successful. Nevertheless, physicians and advanced practioners such as nurse practitioners and physician's assistants must use caution in administering antimicrobial medications, both to ensure effectiveness and to prevent side effects. Careful prescribing will help minimize the legal risks resulting from antibiotic treatment.
Over the past two decades, there has been a growing trend for the care of the hospitalized patient to be assumed by physicians who care only for patients in the inpatient setting, and who do not have an outpatient medical practice. These physicians have come to be known as "hospitalists", and their area of practice as "hospital medicine". Hospitalists are a departure from the old style of practice, in which the primary care physician (PCP) cared for their seriously ill patients in the hospital while still maintaining a busy outpatient practice. Because of the increasing complexity of modern medicine, and due to a variety of economic pressures, the trend now is for physicians in primary care specialties to focus their practice on either outpatient or inpatient care, but not both.
Congestive heart failure can be simply described as the inability of the heart to meet the metabolic demands of the body. The heart functions as a pump to deliver oxygen and nutrients to the tissues. Failure of the pump to deliver nutrition to the tissues stimulates a number of compensatory responses in an effort to improve tissue perfusion. These responses result in the clinical symptoms and signs associated with the heart failure syndromes-shortness of breath, rapid heartbeat, and fluid retention.
Acute respiratory distress syndrome (ARDS) was first described in 1967 by Ashbaugh, who described a syndrome of severe respiratory failure associated with pulmonary infiltrates, similar to infant hyaline membrane disease.
Anterior Cruciate Ligament Injury (ACLI) is most often a result of low-velocity, noncontact, deceleration injuries and contact injuries with a rotational component. Contact sports also may produce injury to the anterior cruciate ligament (ACL) secondary to twisting, valgus stress, or hyperextension all directly related to contact or collision.
Some of the most abstract medical occurrences that may also prove to be legally challenging are transient disorders of awareness. The very nature of their transient occurrence often results in an absence of objective laboratory or examination abnormalities. Since these conditions result in an alteration of the patient's awareness, there may also be inadequate historical information to assist in diagnosis. Yet, these disorders can have very significant consequences that range from a loss of one's driving privileges or job to the participation in a criminal event. The two most common causes of altered awareness are seizures and reduced blood flow to the brain.
There are many wrist and hand symptoms related to the multiple tunnels that tendons, nerves, and blood vessels pass through. Wherever there is a "crease" in one's wrist, palm, or fingers on the flexor/volar side, there is a tunnel that these structures must pass through. These tunnels are usually soft transverse tissue bands that keep the tendons from bowstringing as they pass from forearm to fingers, as we use our hands in grasp and function.
Almost every American from eighteen to eighty years of age has heard enough about LASIK to understand on a basic level what it is and how it works. On average approximately 1,000,000 LASIK procedures are performed annually in the United States. The vast majority of these procedures are successful, but unwanted side effects and/or suboptimal results can occur in a small percentage of patients. Below is a discussion of the essential elements in the pre-operative evaluation of a patient being considered for LASIK.
There is an epidemic of diabetes in the United States. In the last ten years, the number of American diagnosed with diabetes has increased 40 percent. The number has risen from 4.9% to 6.9%. It is estimated that the number will increase buy another 16.5% by 2050. A woman born in 2000 has a 39% risk of developing diabeteso. The epidemic of obesity is responsible for the current epidemic of diabetes in pregnancy. The incidence of diabetes complicating pregnancy has increased 40% between 1989 and 2004.
Crude Oil has been pouring into the Gulf of Mexico and is causing numerous and significant health issues for children, pregnant mothers, and adults. Exposure occurs via inhalation, ingestion (of liquid droplets in the air), and direct skin contact. Some of the health effects will be long-term sequelae and may last a lifetime or affect future generations. Crude oil is a known teratogen and can cause birth defects and changes in fetal development. The target organs for crude oil are the hematopoietic (blood forming) system, lymphatic system, nervous system, and reproductive system. The Benzene component is a known carcinogen.
Persistent neuropsychiatric impairment following head injury is a significant public health problem. From 400,000 to 500,000 are hospitalized in the United States every year from head injury; many more people are injured and do not require admission. Head injury is the third most likely cause of dementia, after infection and alcoholism, in people younger than 50 years.
In 1911, Hammond and Sutton of Philadelphia performed the first human-to-human kidney transplant with transient success. Since then the techniques and indications have evolved. The first wholly successful human transplant took place on December 23, 1954, in Boston, Massachusetts. Surgeon Joseph Murray performed a kidney transplant between identical twin brothers. Although this and subsequent twin transplants did little to solve the problem of rejection, these procedures contributed to proving the value of the procedure and to the solution of many technical problems.
Neonatal emergencies are not uncommon problems. They appear either at the time of birth, during the in-hospital post-birth period, or at home within several weeks of discharge. In all instances they present significant diagnostic and treatment challenges to the clinician, and must be taken seriously.
Cardiovascular disease (CVD) is the leading cause of death in the United States, accounting for approximately 500,000 deaths each year. More women in the United States die of heart disease than of any other cause, and one form of heart disease, myocardial infarction, is responsible for the majority of these deaths. In every year since 1984 it has claimed the lives of more women than men.
A large number of reports have been produced on HP and its pathogenetic potential. In fact, although peptic ulcer disease is the most studied disease related to HP infection, this bacterium is seemingly involved in the pathogenesis of several extragastric diseases, such as mucosa-associated lymphoid tissue lymphomas (MALTomas), coronaritis, gastroesophageal reflux disease, iron deficiency anemia, skin disease, and rheumatological conditions.
Abdominal aortic aneurysm (AAA) is a relatively common, potentially life-threatening condition. It has a wide spectrum of presentations and should be considered in the differential diagnosis for a number of symptoms.
Acetaminophen is the most widely used pharmaceutical analgesic and antipyretic agent in the United States and the world; it is contained in more than 100 products. As such, acetaminophen is one of the most common pharmaceuticals associated with both intentional and accidental poisoning. Acetaminophen-induced hepatotoxicity is well recognized.
Salicylates are ubiquitous agents found in hundreds of over-the-counter (OTC) medications and in numerous prescription drugs including topical preparations used for the treatment of pain, warts, and acne.
Peptic ulcer disease (PUD) is one of the most common diseases affecting the GI tract. It causes inflammatory injuries in either the gastric or duodenal mucosa, with extension beyond the submucosa into the muscularis mucosa.
Among suicidal patients who had taken antidepressants, fluoxetine (Prosac) was associated with the lowest risk for causing suicidal tendencies and venlafaxine (Effexor) with the highest risk, according to the results of a cohort study published in the December 2006 issue of the Archives of General Psychiatry.
Dr. Lorne Sheldon Label, MD, MBA, FAAN, is a Board Certified Neurologist who has extensive training in the treatment of all neurological diseases of adults and children. The field deals with brain, spinal cord, nerve and muscle disorders. Dr. Label has been recognized by the court as having the education, experience, training, and knowledge to assist in rendering an opinion on the subject of Adult and Pediatric Neurology and Acupuncture. His ability is in explaining complicated methods and procedures, technical medical matters and data, as well as interpreting and rendering opinions about a certain set of facts to the court.
Dr. Label has offered his Expert Witness testimony to the legal industry for over 35 years. He has been retained as an Expert by attorneys for both Plaintiff and Defense over 200 times. His services are available for Medical Record Review and Testimony, Medical Malpractice Cases, and Insurance Questions Regarding Neurological Issues.CV available on website or by email.
Dr. Danny Allen, Consultant Adult Psychiatrist is fully trained and experienced in report writing and regularly appears as an Expert Witness in Family Proceedings. Dr. Allen is an Approved Clinician, approved under Section 12(2) of the Mental Health Act 1983 and a Cardiff University accredited Expert Witness and a member of the Expert Witness Institute, the Academy of Experts and the Society of Expert Witnesses. He holds consultancies with Oxfordshire and Buckinghamshire Mental Health NHS Foundation Trust, Workplace Health (Buckinghamshire Hospitals NHS Trust) The Maidenhead Clinic, Phoenix Mental Health Services/Cardinal Clinic and BMI The Shelburne Hospital.
Dr. Allen appears in court regularly in public law cases. He has undertaken a number of high profile cases for Customs and Excise and the Crown Prosecution Service, including alleged rapes and murders. Dr. Allen provides services for lawyers, social services and businesses. His reports are also available to Employment & Housing Tribunals and Employers and Licensing Authorities.
Larry Fishman, MD, PA, is a Board Certified Neurosurgeon with more than 22 years of experience. A Mayo Clinic-trained neurosurgeon, specializes in minimally invasive surgery, including carpal tunnel, spinal, and cranial procedures.
Litigation Support - Dr. Fishman performs CME's and IME's, disability evaluation, permanent impairment rating, future care costs, and determines medical appropriateness of care to date. He performs medical record review, medical malpractice, as well as other medical legal issues. Dr. Fishman's services are available to counsel for both plaintiff and defendant.
Past President of the Boston Society of Neurology, Neurosurgery, and Psychiatry
Clinical experience in both inpatient and outpatient care. Board Certified. Fellowship training and extensive experience in Behavioral Neurology – that branch of neurology that focuses on brain conditions, including dementia, that change a person's behavior or intellect. Has treated 1,000+ patients with dementia (usually due to Alzheimer's Disease). Former Director of Neurology at Head Injury rehabilitation facility.
Highly experienced expert witness. Has reviewed over 250 cases and testified in dozens of depositions and trials. Expert-witness assignments have involved death, catastrophic injury, personal injury, medical malpractice, testamentary capacity, and criminal cases. Experience includes spine injury, head trauma, seizure disorder, epilepsy, headaches, post-concussion syndrome, Parkinson's Disease, anoxia, hypoxic encephalopathy.
Testimonial – "I found Dr. Cranberg to be very thorough, resourceful, and exceedingly well prepared. He was very precise at his deposition and stood up well against a very seasoned lawyer. He knew the medical records better than either the defense lawyer or I did. The case settled; so I cannot tell you how he did before a jury, but I had complete confidence that he would have presented well. He was very easy to work with and was very accessible. He bills fairly. I would not hesitate to use him again." - Charles J. Muchmore, Esq.; Burch & Cracchiolo, PA (Phoenix, AZ)
MRK Medical Consultants provides Medical-Legal Evaluations to help legal and insurance professionals reach appropriate conclusions about their client's situations. MRK provides a wide array of medical experts that offer objective review and analysis of personal injuries. Each stage of the process—research to review, analysis to opinion—is addressed in a comprehensive manner in order to help legal and insurance professionals reach appropriate conclusions about their client’s situations. MRK's prestigious list of more than forty consultants are active clinicians and surgeons, who are all board-certified or eligible in one or more specialties. MRK provides physician experts to the entire State of California, the Reno/Lake Tahoe area, and Las Vegas, and we travel to many areas of the United States. Physical therapy, registered nurses, physician assistant, and billing review consultants are available services MRK provides. Our office physicians are available for telephone review of the merits of your case before you decide to proceed.
Edward W. Younger, III, M.D., Medical Director of MRK Medical Consultants, specializes in Orthopedic Surgery. He has extensive experience in total joint replacement, as well as reconstructive surgery of the knee, hip, and shoulder. He was instrumental in bringing computer navigation technology to his hospital. He served on the orthopedic trauma staff at Mercy San Juan Medical Center in Carmichael, California, for more than fifteen years and was instrumental in bringing computer navigation technology to that institution. He is a member of Alpha Omega Alpha National Honor Society and is a Diplomate of the American Board of Orthopedic Surgery, a member of the American Medical Association, the American Academy of Orthopedic Surgeons, and the California Orthopedic Association.
Dr. Michael R. Klein, Jr., M.D., specializes in Orthopedic Surgery and is a founding member and the first Medical Director of Northern California Orthopedic Centers. He was involved with the development of the orthopedic section of the Level II Trauma Center at Mercy San Juan Medical Center. He served as a clinical professor at the University of California, Davis, Medical Center for more than thirty years. He has been a member of the North American Spine Society since 2009 and was awarded the David O. Selby Award in 2020 for his contributions. He is a fellow of the American College of Surgeons and American Academy of Orthopedic Surgeons, and a member of the American Medical Association and the California Medical Association. He retired from the USAF in 1998 after being on active duty during the Vietnam War, and he was activated for Operation Desert Storm in 1991.
Dr. Farr Ajir, MD, MBA, FACS, CIME, is a Board Certified Neurosurgeon with more than 35 years of experience in the treatment of disorders of the Brain and Spine. He is also Certified by the American Board of Independent Medical Examiners (CIME).
Dr. Ajir has been staff neurosurgeon at Mayo Clinic and Kaiser Permanente Healthcare Systems.
He is a Fellow of the American College of Surgeons (FACS), Congress of Neurological Surgeons, and California Association of Neurological Surgeons. He is a Certified Physician Executive (CPE) with many years of leadership and administrative experience in healthcare delivery.
Litigation Support - As an expert neurosurgeon with decades of experience, Dr. Ajir offers services to attorneys representing plaintiff and defendant. He performs Independent Medical Exammination, and provides expert reviews and medical-legal opinions. Dr. Ajir holds medical licenses in California, Montana, New York, Pennsylvania, Washington, Wisconsin, and Utah.
Mohan Nair, MD, trained at the University of California (Irvine) and Harvard and is board certified in:
Brain Injury Medicine
Behavioral Neurology / Neuropsychiatry
Dr. Nair brings his extensive training, clinical experience, and formal board certifications to provide in-depth and nuanced medico-legal analysis of cases for both adults and children involving brain injury, frequently and tragically combined with chronic pain and severe psychological trauma (PTSD). He is committed to comprehensive and accurate forensic examinations, quality neuropsychological assessment, and the use of the most up-to-date technology available in the field.
Dr. Nair has provided extensive trial testimony in defense and plaintiffs' cases. He provides and coordinates medical, psychological, neuropsychological, toxicological, and imaging experts for complex civil litigation. Dr. Nair has been on cases involving:
MEDICAL TOXICOLOGY: Lead Exposure, Carbon Monoxide Poisoning, Mold
STANDARD OF CARE: Psychiatric/Psychological / Psychotherapeutic Malpractice, Wrongful Death from Prescribing Psychiatric Medication
1970-75 Doctor of Medicine, University of Bombay
1981-83 Clinical Fellow in Child Psychiatry, Harvard University; McLean Hospital / Massachusetts General Hospital
1978-81 University of California at Irvine: Residency in Psychiatry
Dr. Nair is board certified by the American Board of Medical Specialties in Brain Injury Medicine, Psychiatry, Child Psychiatry, Forensic Psychiatry, and Addiction Medicine. Additionally, he is board-certified in Pain Medicine, Psychopharmacology, and Behavioral Neurology / Neuropsychiatry. He currently holds medical licenses in California and Hawaii.
Elliott M. Stein, MD is a Geriatric Psychiatrist with over 40 years of experience caring for the elderly. Dr. Stein is Board Certified by the American Board of Psychiatry and Neurology in General Psychiatry (October, 1979), and in Geriatric Psychiatry (April, 1991; Re-Certified, December, 2001, and in April, 2011). He is licensed to practice in California and Florida. Dr. Stein was the Director of Psychiatry at the Jewish Home of San Francisco from 2010-2020, and the Medical Director of their Geriatric Psychiatry Hospital. He has treated older individuals, typically people who have complex combination of psychiatric and medical problems. Dr. Stein has been a Member of the Task Force on Testamentary Capacity and Undue Influence, for the International PsychoGeriatric Association.
Dr. Stein is a Clinical Professor in the Department of Psychiatry at the University of California, San Francisco, School of Medicine. He is a Distinguished Life Fellow of the American Psychiatric Association and a Distinguished Fellow of the American Association for Geriatric Psychiatry.
He is available to serve as an Expert Witness, do legal and forensic consultation, record review, and assessments concerning Psychiatric issues in older individuals. Dr. Stein offers his services to attorneys for both Plaintiff or Defense.
Stephen M. Raffle, M.D. is double Board-Certified in Psychiatry and Forensic Psychiatry. Dr. Raffle has over 49 years as a clinical and forensic psychiatrist offering his expert opinion in Federal and State jurisdictions nationwide. In addition to serving as an expert witness, Dr. Raffle consults to attorneys, judges, insurers, and to employers regarding Fitness for Duty and Risk of Violence (Threat) Assessment:
5000+ psychiatric assessments
Expert testimony in 700 depositions and trials
Successful clinical practice
The job of an expert witness is to educate a jury, judge, attorney, and trier of fact about the forensic psychiatrist's conclusions and how those opinions were derived in a manner well-reasoned, skillful, and easily understood by every person, not only another forensic psychiatrist. In short, an educator. Dr. Raffle’s experience as an educator extends well beyond a forensic venue, yet underpins the key to his ability to explain his opinions.
Prof. of Psychiatry, UCSF Medical School, 20 years
U.C. Hastings College of the Law postgraduate course "Trial and Appellate Advocacy" instructing seasoned attorneys about the direct and cross-examination of expert witnesses, with special focus on mental health experts and licensed medical professionals, Psychiatrists (MDs), Psychologists (LCSWs / MFTs), and physicians in other medical specialties, 11 years
Stephen M. Raffle, M.D. & Associates' expertise is well-established in forensic assessment in the areas of:
In order for a medical opinion to be admissible as evidence in civil, criminal and administrative cases, the basis of the opinion must fulfill either the Daubert Criteria or the Frye test, depending on the jurisdiction. The judge of the court rules on the admissibility of the expert opinion. The effect of Daubert has been to limit expert testimony to opinions which are based on a scientific foundation. Daubert specifies that adequate scientific support and method and a known error rate must exist. The testimony of a mental health expert rendering an opinion using criteria which does not meet Daubert standards is weakened by the implication that it is not based on "sound science." In some instances, for example, a mental health expert uses an approach where there are no peer-reviewed studies or methods, such as when psychologists compose their own neuropsychological test batteries. In most cases where an attorney is considering a "Daubert challenge," a contemporaneous and up-to-date literature search is indicated. Also, extensive case law presently exists as to specific issues. Being familiar with the Daubert criteria enhances effectiveness in challenging a mental health expert's opinion, whether on voir dire or cross examination. On direct examination, the strengths of an opinion reached under Daubert criteria become a "teaching moment" for the trier of fact, because it will be founded on the science of mental health assessment.
Undue influence occurs when the testator's freewill and freedom of choice in the disposition of the assets of his or her estate is replaced by the substituted judgment/wishes of another. This can apply to creating a will, codicil to amend a will, trust or other legal instrument.
The medical expert cannot express an opinion about the ultimate question to the trier of fact: how much is the plaintiff's emotional distress (emotional injury) worth in dollars? Yet when the question of these monetary damages is put to a jury, their deliberations are better-served if considered in the context of a Forensic Psychiatrist's knowledgeable findings and testimony.
My teacher and mentor, Dr. Bernard Diamond, pondered the question about the role of the psychiatric expert and other experts in the courtroom. My first public presentation was to the American Criminology Society on this topic, and it has continued to occupy my attention to the present
All psychiatric reports evaluate something, but not always the same thing. For example, eligibility for benefits, or fitness to do a job. To make sense of the report, the reader must determine what is being evaluated and how it is being done
In civil cases where emotional distress is alleged, it often occurs that the plaintiff’s attorney designates the treater as his expert. Usually the argument is that the plaintiff’s own therapist has spent many more hours with the plaintiff than the defense expert and therefore "knows" the plaintiff better. The treater often agrees with this reasoning