Managed Care Liability Expert Witnesses

Paul M. Adler, DO, FACEP, MBA, Medical Director for the Ventura County, California, Department of Corrections, has worked in Correctional / Jail/ Prison Medicine since 1995. He has overseen the care of inmates in Jails in California and New York, as well as Prison inmates who have been transferred to county facilities to serve their terms for years in county jails in California. He has also overseen Correctional health car in locked units in Hospitals .

Dr. Adler is the President-Elect of The American Correctional Health Services Association of California / Nevada, which represents all clinicians and administrators in Jails/Prisons in California and Nevada. He previously oversaw a County Hospital, County Nursing Home and ran a County Health Department and oversaw Correctional healthcare for the Westchester, New York Jail.

Litigation Support - Dr. Adler has defended Jails and Prisons in Southern California, Idaho, Texas, North Carolina, New York, Pennsylvania, etc. He has been involved in Plaintiff litigation in many states including against Rikers Island, NY and Cook County Jail.

Dr. Adler still works as a full-time practicing physician and has helped attorneys and insurance companies in Emergency Medicine, Nursing Home Medicine, Public Health and Hospital Administration since 1985. Dr. Adler is available to review and consult on clinical Correctional/Jail/Prison cases for attorneys for both Plaintiff and Defense.

Services:

• Screen Cases for Merit
• Review, Analyze and interpret Medical Records
• Provide Basic or Comprehensive Written Reports
• Interpret Standards of Care, Deviation and Adherences as they Relate to Correctional Health Care
• Develop Chronological Time Lines
• Policy and Procedure Development

Yolanda Anderson, RN, BSN, CEN, CLNC is a Registered Nurse and has been working in the Emergency Department for more than 25 years. A Certified Legal Nurse Consultant with a detail-oriented approach, Ms. Anderson is knowledgeable about all aspects of Hospital Care and Standards of Care for Physicians, Nurses and Ancillary Personnel.

Ms. Anderson's background experience includes work in the Emergency Department of Los Angeles County, USC Medical Center, a level I Trauma Center and in the Emergency Department at Saint Anthony Hospital Central in Denver, Colorado, a level I Trauma Center where she helped initiate the Hyperbaric Medicine program. For 15 years, she worked as a staff RN, Charge RN and Assistant Nurse Manager in the Emergency Department at Littleton Adventist Hospital - Littleton, Colorado, a level II Trauma Center. There, she helped with the expansion and reconstruction of the current Emergency Department facility.

Ms. Anderson has been retained as an Expert 27 times. Her litigation support services include chart review for merit, chronologies, medical care research, Independent Medical Assessments, and more. Ms. Anderson's services are available to attorneys for both Plaintiff and Defense.

Areas of Expertise:

Emergency Department Care Inpatient Hospital Care Trauma, Cardiac, Neurological Emergency Adult, Pediatric, and Infant Care

Triage & Documentation Nursing Home Care Electronic Medical Records Worker's Compensation

View Yolanda Anderson's Consulting Profile.

Constance J. Paine CCRN, LNC, is a Legal Nurse Consultant with over 40 years of nursing experience. Ms. Paine offers comprehensive services to the legal community in cases involving Critical Care, Interventional Radiology, Medical Surgical, and Discharge Planning. She is currently the Principal at CP LegalMed Consulting and a Staff Nurse in ICU at UC San Diego Health System.

Ms. Paine has been retained as a nursing expert over 70 times for actions involving Medical Malpractice, Personal Injury, and Product Liability. She provides non-biased opinions for attorneys representing both Plaintiff and Defense. Ms. Paine is available to identify causation and damages issues and attend IME's. Her services also include assessment, review, analysis, and research of medical cases, and education of nursing standard of care issues.

Areas of Specialization:

Hospital Policy & Procedure Open Heart Surgery Patients Pacemaker / Implantable Defibrillator Management Intra-aortic Balloon Pumps Continuous Dialysis Advanced Cardiac Life Support Ventilated Patients - acute and chronic

Stroke Care Conscious Sedation Intravenous Therapy Epidural Catheters Skull Base Surgery Wound Care Fall Risk Management

View Constance Paine's Consulting Profile.

Dawn Cook Consulting is based out of Las Vegas, Nevada but provides services nation wide. Services include life care plans, life care plan rebuttals, past medical bill reviews and future medical cost projections for plaintiff and defense attorneys. Life care plans are developed for individuals with injuries or chronic conditions requiring complex long-term healthcare intervention and management. The report provides an organized, concise plan that estimates the reasonable and necessary current and future healthcare needs with the associated costs.

Dawn Cook is licensed Registered Nurse (RN) who has worked with serious and catastrophic illness and injury for over 30 years including clinical settings and home care. Dawn is an experienced life care planner who holds the certified life care planner (CLCP) and certified nurse life care planner (CNLCP) designations.

Dawn has completed over 600 medical damage reports in 28 states in life care planning and has testified as an expert witness at deposition or trial over 70 times since 2012. Dawn has testified at Federal Court in Illinois and New Mexico and at State Court in California, Nevada and New Mexico as an expert in life care planning. Dawn has also testified in Nevada State Court as an expert in past medical bill reviews.

Dawn enjoys working both plaintiff and defense cases; from complex birth or brain injuries to trucking and motor vehicle accidents, each case requires attention to detail and consistent methodology.

View my CV.

John H. Fullerton, MD, MRO, CMD, CFP, FACP, AGSF, FAAHPM, FASAM is Board Certified in Internal Medicine, Geriatric Medicine, Addiction Medicine and Hospice & Palliative Medicine.

Dr. Fullerton maintains active medical licenses in both California and Florida and holds additional national certificates of added qualifications as a Certified Medical Director (CMD) at multiple levels of care locally and in Home Care (AAHCP).

Dr. Fullerton is a certified Clinical Forensics Expert, who has participated in nationally recognized Elder Abuse Cases, including the cases of "lay caregivers" misguidedly criminally charged with homicide or manslaughter after caring for a loved one at home with advanced dementias. He has been vetted by the Department of Homeland Security, the Department of Justice, the Office of The Inspector General, and the FBI to perform the duties of a government expert in cases of Criminal Healthcare Fraud. He has served as a key expert witness in the continuing efforts of 'Operation HEAT' and been on the winning side of three criminal convictions.

Over roughly the past 14 years, Dr. Fullerton has provided independent medical expert testimony and clinical forensic medical testimony in more than 200 cases and reviewed over 1,500 files (including Medicare Audits for the Government). He has focused his medical expertise in mostly Personal Injury, Medical Malpractice, Determinations of Medicare Medical Necessity matters, and Civil & Criminal cases alleging Elder Abuse (including homicide) at either discovery, deposition or at trial testifying for both plaintiff and defense cases, respectively.

Areas of Expertise:

Adult Hospital Medicine Ambulatory Care - Internal Medicine & Geriatrics Geriatric Approaches to Gero-Psychiatry Immuno-Compromised Host 1 Treatment Long Term Care - SNF Sub-Acute Rehabilitation Assisted Living - Secured Dementia Units

LTC / Hospice Medical Directorships Hospice & Palliative Care Units Home Care Elder Abuse Defense Cases Preventable Falls Pressure Wounds / Pain Management Addiction Medicine - Forensic Toxicology / DUI Defense Cases

View Consulting Profile.

Expert Witness: Retained in Washington, D.C., and over 20 states as an expert in hospital administration who could render opinion after assessing medical records, hospital policies and procedures, medical staff bylaws and regulations, JCAHO standards, depositions, etc. Served as Expert Witness for Plaintiff and Defense.

Consultant: Has assisted hospitals and health systems with accelerating their performance improvement efforts. Speaks, writes and consults on ethical issues in health care.

Background Highlights:

• Consultant, Executive Vice President and Chief Operating Officer of health system.
• Executive Director of two academic medical centers: Emory University Hospital in Atlanta, Georgia, Stanford University Hospital and Clinics at Stanford.
• Past chairman of the national advisory board for the University of Chicago’s Center for Clinical Medical Ethics.
• An author of over 175 publications, he has written articles for USA Today, Health Management Quarterly, Trustee, Health Progress, the Journal of Health Administration Education, Frontiers of Health Services Management, Bioethics Forum, Modern Healthcare, the Cambridge Quarterly of Healthcare Ethics, Stanford Medicine, and Healthcare Executive among others.
• Co-editor of Management Mistakes in Healthcare: Identification, Correction and Prevention, published by Cambridge University Press in 2005.
• Co-editor of Managing Ethically: An Executive's Guide, published by Health Administration Press in 2001, and a second edition, Managing Healthcare Ethically: An Executive's Guide was published in 2010.
• Fellow of the American College of Healthcare Executives, a past member of its Leadership Advisory Committee, and a consultant on health care management ethics since 1994.
• Served as Distinguished Visiting Scholar at Stanford University’s Center for Biomedical Ethics.
• Recipient of American Hospital Association's Award of Honor in 2009 and an Albert Schweitzer Leadership Award in 2012.
• Faculty appointments held at Harvard, UCLA, Stanford, Emory, the University of California, and Seton Hall University.
• Bachelor of Science, Master of Public Health, and Doctor of Public Health degrees are from the University of California, Berkeley.

Dr. John Shershow is a nationally known expert in all aspects of Hospital and Clinic Administration. In his nearly 20 years of experience as a Senior Hospital Executive and Healthcare Consultant, Dr. Shershow has surveyed or consulted to hundreds of hospitals, both as an accreditation surveyor for JCAHO and as a private consultant for hospitals nationwide.

Dr. Shershow has been Medical Director of two prestigious hospitals and an Associate Dean of a nationally known medical school. He is Board Certified and was educated at Harvard, Yale and the University of Southern California.

Areas Of Expertise Include:

Hospital Administration Staffing Quality of Care JCAHO Accreditation Medical Quality Assessment and Review Medical Staff Affairs Hospital And Ambulatory Standards of Care

Patient Rights Health Care Risk Management Medical Quality Assurance Administrative Medicine Peer Review JCAHO Standards Physician Credentialing & Privileging

Lynn M. Shaffer, RN, CLNC®, is Registered Nurse with certification in Legal Nurse Consulting and the founder and managing member of Legal Nurse Consultants of CNY, LLC. Ms. Shaffer's 20 years of nursing experience includes clinical practice in hospitals, outpatient clinics and physician offices, and supervisory roles. She has specialized in Long Term Care / Rehabilitation for most of her nursing career.

Litigation Support - Ms. Shaffer provides consulting and expert witness services for attorneys’ cases including criminal, disability, personal liability, toxic tort, and medical malpractice (specializing in long term care). As a Certified Legal Nurse Consultant, she assists insurance companies and attorneys with screening cases for merit, locating medical and nursing experts, and analyzing and interpreting medical records for both plaintiff and defense.

Ms. Shaffer's CLNC® services also include: development of reports, timelines and chronologies to highlight the significant medical events, identify adherences to and deviations from applicable standards of care, and assess injuries and identify causation issues and pre-existing contributing factors. She also attends and reports on Independent Medical Exams in the Central New York areas.

Areas of Expertise:

Geriatrics Independent Medical Examinations Long Term Care / Rehabilitation Managed Care Medical Malpractice Medical Records Review Nursing Home Malpractice Nursing Home Medical Malpractice Nursing Home Safety

Nursing Home Staffing / Training Nursing Homes Standards of Care Nursing Malpractice Nursing Policy & Procedures Personal Injury Disability Wrongful Death

Mary Wickens, JD, CFE, CHC has over 35 years experience in the Healthcare Insurance, Managed Care, and Compliance Industry. Her experience includes advising and counseling health care providers, insurers, government contractors, and others in compliance, ethics, fraud and abuse, Medicare, Medicaid and Federal Employees Plan, managed care, and other matters. Background Experience - Ms. Wickens is a former compliance officer for a major health insurer and former legal and compliance specialist for a CMS Medicare Program Safeguard Contractor. Also a former operations director for government programs (Medicare Part C, Medi-gap, and FEHBP) for a major HMO, she is experienced with government audits and investigations, commercial audits, as well as self-reporting and internal investigations. Ms. Wickens has decades of experience as in house counsel to HMOs and health insurers. She has drafted, developed, negotiated, and implemented numerous healthcare provider-payor contracts, and developed and implemented codes of conduct, ethics programs, compliance programs and numerous corrective action plans. Litigation Support - Mary Wickens provides litigation support, including skilled expert services, reports and testimony in federal False Claims Act cases, arbitrations, and provider-payer disputes. She is an experienced testifying expert, responsive to the needs of counsel, with excellent report writing skills. Ms. Wickens' services are available to counsel representing both plaintiff and defendant. Areas of Expertise:

Medicare False Claims Act (FCA) Health Insurance HMO Medicare Advantage Provider / Payor Disputes Claims Audits and Appeals Federal Employees Health Benefits Plans (FEHBP)

Medicare Part D Government Audits DME Home Health Care Hospice Managed Care Contracting Anti-Kickback Compliance Self-disclosures

View Mary Wickens' Consulting Profile.

Milliman’s Tampa Office provides Health Insurance, Health Care and Employee Benefit Consulting to law firms, insurance companies, hospitals, HMO’s, Blue Cross/Blue Shield plans, employers and government agencies. Our staff is experienced with medical, dental, long-term care, Medicare supplement & critical illness.

We assist clients nationwide with forensic actuarial work, rate filings, regulatory compliance, reserve projections, valuations, employee benefit analysis and design, mergers and acquisitions, demutualizations, claim cost analysis, and utilization management programs.

These health care services are used in litigation relating to:

• Pricing & Underwriting
• Senior Services
• Contract Development and Negotiations
• New Plan Design

William (Bill) C. Mohlenbrock, MD, FACS, has practiced General Orthopedics and Trauma Care, including total joint and arthroscopy surgeries and sports medicine and related injuries for many years at Scripps Memorial Hospital in La Jolla, California. He is senior physician in a group of 8 orthopedic surgeons and 2 Physician Assistants.

In addition to orthopedic experience, Dr. Mohlenbrock is a nationally recognized expert in the objective assessment of hospital medical outcomes, Clinical Quality and Cost Efficiencies for inpatient care. He has consulted for hospitals who have found themselves in potential legal situations where the quality of their clinical care has been called into question.

Dr. Mohlenbrock received his BS degree from the University of Illinois and his MD from the St. Louis University School of Medicine. He holds fellowships in the American Academy of Orthopaedic Surgeons, American College of Surgeons and the American Association of Physician Leadership. He is a noted lecturer and has published numerous articles on measuring and improving the quality and cost efficiency of medical care.

Comprehensive Quality Data used to Defend Hospitals for Med Mal

Litigation Support - Attorneys wishing to take advantage of Dr. Mohlenbrock's orthopedic and quality assessment experience as well as his communication skills, will receive unbiased, evidence-base opinions. He assists the legal profession whose clients are either plaintiffs or defendants.

Areas of Expertise:

Orthopedic Surgery Adult Reconstructive Surgery Total Joint Surgery Scoliosis Surgery Arthroscopy Surgeries

Sports Medicine Sport-related Injuries Hospital Medical Outcome Assessments Medical Care Efficiency Medical Care Quality

View Dr. Mohlenbrock's Consulting Profile.

Managing Partner, Healthcare Practice works with health systems, health IT companies, and health plans. Recent retentions by the U.S. Department of Justice (DOJ). Drug pricing, patent infringement, medical coding and billing and Qui Tam False Claims Act and fraud case specialties. He has in-depth experience in HIPAA mandates, the HITECH Act and Patient Protection and Affordable Care Act (PPACA) and is a published author and regular speaker. He consults to clients including Health IT investors, Health IT companies, and health plans and hospital systems in matters regarding:HIPAA Privacy Rule, HIPAA Security Rule, HIPAA Breaches, Revenue Cycle Management

• Meaningful Use of Electronic Health Care Records
• Quality Measures for Medicare Advantage Hospital Value Based Purchasing
• Medicare Advantage HEDIS 5-Star Ratings for Health Plans Mr. Arrigo was recently quoted in the Wall Street Journal Venture Capital Dispatch regarding medical coding standards and Wall Street Journal Health Blog regarding venture-backed information-technology companies that serve hospitals and health insurers.

Cynthia (Cyndy) Minnery RN, BSN has over 30 years of experience caring for the elderly within Acute Care, Skilled Nursing, and Assisted Living Facilities. Ms. Minnery has worked as a Director of Quality Compliance in Skilled Nursing and Home Health Care. She now owns Residential Care Facilities and is familiar with the Standards of Care expected of caregivers in these settings.

Ms. Minnery has years of experience and training in care of the elderly and common disorders like Alzheimer’s Dementia, Parkinson’s Disease, and other Geriatric Syndromes. She currently serves on the San Diego Dementia Consortium board of directors and Clinical advisory committee.

Cyndy Minnery has been an expert witness for elder abuse cases within Residential Care Facilities for the Elderly (RCFE) since 2012. Her reputation for providing exceptional care as an RCFE owner/administrator is well known within San Diego county, caring for residents with the highest level of compassion. Ms. Minnery provides medical record review and other services to attorneys for Plaintiff and Defense.

Areas of Expertise:

Residential Care for Elderly Assisted Living Nursing Homes Title 22 Regulatory Compliance Standards of Care

Elder Abuse Bedsores Wound Care Falls Medication Management

View Cyndy Minnery's Consulting Profile.