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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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2/19/2015 · Medical - Medicine

Infectious Disease

By: AMFS Medical Experts Nationwide

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.

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1/15/2015 · Medical - Medicine

Hospital Medicines and Transitions of Care

By: AMFS Medical Experts Nationwide

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.

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12/5/2014 · Medical - Medicine

Congestive Heart Failure

By: AMFS Medical Experts Nationwide

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.

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10/28/2014 · Medical - Medicine

ARDS (Acute Respiratory Distress Syndrome)

By: AMFS Medical Experts Nationwide

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.

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9/16/2014 · Medical - Medicine

Anterior Cruciate Ligament Injury

By: AMFS Medical Experts Nationwide

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.

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8/14/2014 · Medical - Medicine

Transient Disorders of Awareness

By: AMFS Medical Experts Nationwide - R. Starkey

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.

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7/11/2014 · Medical - Medicine

Carpal Tunnel And Other Tunnel, Tendon And Inflammatory Syndromes

By: AMFS Medical Experts Nationwide - John Toton

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.

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6/5/2014 · Medical - Medicine

Evaluating Patients for LASIK Surgery

By: AMFS Medical Experts Nationwide

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.

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4/29/2014 · Medical - Medicine

Diabetes in Pregnancy

By: AMFS Medical Experts Nationwide - Bruce Halbridge

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.

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3/25/2014 · Medical - Medicine

Effects of Crude Oil Exposure to Children, Adults, and Pregnant Mothers

By: AMFS Medical Experts Nationwide

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.

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2/20/2014 · Medical - Medicine

Skilled Nursing Facility Falls

By: AMFS Medical Experts Nationwide

Falls among patients in Skilled Nursing Facilities (SNF) are an all too common occurrence. Causes can generally be classified into 4 broad groups:

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1/3/2014 · Medical - Medicine

Postconcussive Syndrome

By: AMFS Medical Experts Nationwide

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.

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11/27/2013 · Medical - Medicine

Kidney Transplantation in Medical Malpractice or Personal Injury Lawsuits

By: AMFS Medical Experts Nationwide

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.

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10/24/2013 · Medical - Medicine

Neonatal Emergencies

By: AMFS Medical Experts Nationwide

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.

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10/1/2013 · Medical - Medicine

Heart Attacks in Women

By: AMFS Medical Experts Nationwide

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.

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9/5/2013 · Medical - Medicine

H. Pylori Infection

By: AMFS Medical Experts Nationwide

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.

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8/13/2013 · Medical - Medicine

Abdominal Aortic Aneurysm

By: AMFS Medical Experts Nationwide

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.

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7/9/2013 · Toxicology

Acetaminophen Toxicity

By: AMFS Medical Experts Nationwide

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.

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6/18/2013 · Medical - Medicine

Aspirin Toxicity

By: AMFS Medical Experts Nationwide

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.

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5/21/2013 · Medical - Medicine

Spider Bites

By: AMFS Medical Experts Nationwide

In the United States, reports of severe envenomations by brown spiders began to appear in the late 1800s, and today, in endemic areas, brown spiders continue to be of significant clinical concern.

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4/9/2013 · Medical - Medicine

Cataracts

By: AMFS Medical Experts Nationwide

Cataract is a vision-impairing disease characterized by gradual, progressive thickening of the lens. It is one of the leading causes of blindness in the world today.

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3/7/2013 · Medical - Medicine

Peptic Ulcer Disease

By: AMFS Medical Experts Nationwide

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.

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1/14/2013 · Psychiatry

Antidepressants and Suicide Risk

By: AMFS Medical Experts Nationwide

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.

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Elite Medical Experts is a physician-led team that hand selects nationally recognized Professors of Medicine and Surgery as expert witnesses. Each expert is a board-certified specialist with a busy clinical practice and impeccable credentials. From Stanford to Yale, and from every healthcare specialty and field, Elite aligns leading specialists from top-tier medical universities.

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COMPANY DESCRIPTION:

Expert Witness - Medical malpractice, misadministration, medical event (Radiation Oncology, Radiology, Nuclear Medicine)
Expert Witness - Radiation exposure, radiation dose, radioactivity and radiobiological calculations
Expert Witness – Patent infringement (intellectual property all categories)
Expert Witness – Medical physics, supervision of (medical physicist, dosimetrist, radiation therapist, radiologic technologist)
Expert Witness - Termination of employment

Michael S. Gossman, M.S., DABR, FAAPM, is a Board Certified Qualified Expert Medical Physicist, an honorary Fellow of the American Association of Physicists in Medicine (AAPM), and the Chief Medical Physicist & Radiation Safety Officer (RSO) in Radiation Oncology at a clinic in Indiana. Chief Gossman is directly and ultimately responsible for all technical and scientific aspects of cancer treatment. He directly supervises and oversees efforts from staff medical physicists, dosimetrists, radiation therapists and x-ray technologists.

Chief Gossman is the highest ranking scientist in medicine and has been in the field for 24 years. Chief Gossman's expertise involves the safe, effective and precise delivery of radiation to achieve the therapeutic result prescribed in patient care by radiation oncologists striving to treat cancer patients with particle accelerators and radioactive material.

Extra-professionally, Chief Gossman is retired as the Interim Editor-in-Chief and Editorial Board Member for the Medical Dosimetry Journal, Editorial Board Member for the Journal of Applied Clinical Medical Physics, served four years as a Medical Consultant to the U.S. Nuclear Regulatory Commission, and was a veteran Accreditation Site Reviewer for both the American College of Radiology (ACR) and the American College of Radiation Oncology (ACRO). He was a 2-term Ohio River Valley Chapter President of the AAPM, and was also formerly a Graduate School Professor of Clinical Medical Physics at Wright State University.

As an expert in radiation safety, dosimetry, detector measurements, particle accelerator and radioactive material calibrations, and radioactive material handling, Chief Gossman is a highly respected medical physicist by medical physicists nationally. He is also the owner of Regulation Directive Medical Physics, which he created as a consulting company, providing services for medical physics, dosimetry, medical device testing, and expert witness efforts.

Services Provided:

Medical expert witness
Medical consultant
Legal consultant
Review of: medical event, malpractice, and misadministration
Regulatory compliance
Investigation and audits
Independent medical evaluation of the probable deterministic effects of radiation exposures
Facility practice vs. standards review
Accreditation preparation
Shielding calculations
Accelerator acceptance testing & commissioning
Quality assurance
Peer review of the Chief Medical Physicist
Radiation measurements
Radiation calculations
Radiation safety
Dose determination
Dosimetry
Calibration of medical accelerators
Treatment planning
Calculation of time and dose for treatment
Handling, shipping, receiving, and storing radioactive material
Calibrating radioactive material
Regulatory compliance
Interpretation of bioassay results and other data related to radiation exposure
Calculation of internal and external radiation doses, as necessary

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• Read Article About Michael Gossman "Medical Multitasker: Local physicist called on to serve in many roles"

• Partial Publication List

8/6/2013 · Medical - Medicine

Intact Performance of a Cochlear Implant Following Radiotherapy in a Child With Acute LymphobLastic Leukemia

By: Michael Gossman

Cochlear implants, via direct electrical stimulation of the auditory nerve, allow the restoration of hearing and speech recognition in both adults and children having sensorineural deafness. These devices typically contain both extemal components (speech processor, microphone, transmitter) and intemal components (including the cochlear stimulator and electrode array), which are surgically placed under the skin behind the ear and in the cochlea.

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7/18/2013 · Radiology

Evaluation of a Ventricular Assist Device: Stability in a Proton Beam Therapy

By: Michael Gossman

Inadequate research exists regarding testing of a ventricular assist device (VAD) for susceptibility to radiation damage. Specifically, minimal data are available to radiation oncologists prescribing treatment plans for patients with an implanted VAD. As the number of implanted devices increases, patients requiring radiation at tissue sites near or at the device will increase.

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6/28/2013 · Medical - Medicine

Evaluation of a Ventricular Assist Device: Stability Under X-Rays and Therapeutic Beam Attenuation

By: Michael Gossman

Improved outcomes and quality of life of heart failure patients have been reported with the use of left ventricular assist devices (LVADs).

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1/8/2013 · Radiology

Planning Dosimetry Near Vascular Ports

By: Michael Gossman

New research shows the effects of electron beams on implanted vascular access ports composed of plastic, determining how they impair the fluence of radiation around them.

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10/23/2012 · Radiology

Effects on Radiation Oncology Treatments Involving Various Neuromodulation Devices

By: Michael Gossman

Abstract. Object: Where no society-based or manufacturer guidance on radiation limits to neuromodulation devices is available, this research provides the groundwork for neurosurgeons and radiation oncologists who rely on the computerized treatment plan clinically for cancer patients.

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7/25/2012 · Medical Physics

Beam Profile Disturbances From Implantable Pacemakers or Implantable Cardioverter-Defibrillator Interactions

By: Michael Gossman, MS, DABR, RSO

Abstract-The medical community is advocating for progressive improvement in the design of implantable cardioverter-defibrillators and implantable pacemakers to accommodate elevations in dose limitation criteria.

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5/14/2012 · Radiology

Radiation Therapy in Cochlear Implant Recipients

By: Michael Gossman, MS, DABR, RSO

Since the first commercial multichannel cochlear implant was marketed by Cochlear in 1985 (1), use of the device has grown exponentially. As of mid-2010, more than 188,000 people worldwide have received a cochlear implant system (2). Recent developments in the manufacturing of cochlear implants by the market leader, Cochlear Limited (based in Australia), have resulted in an aim to provide electronically stable models (3).

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3/13/2012 · Medical Physics

Providing Solid Angle Formalism for Skyshine Calculation

By: Michael Gossman, MS, DABR, RSO, et al

We detail, derive and correct the technical use of the solid angle variable identified in formal guidance that relates skyshine calculations to dose-equivalent rate.

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12/5/2011 · Radiology

A Novel Phantom Model For Mouse Tumor Dose Assessment Under MV Beams

By: Michael Gossman, MS, DABR, RSO, et al

Abstract -- In order to determine a mouse's dose accurately and prior to engaging in live mouse radiobiological research, a tissue-equivalent tumor-bearing phantom mouse was constructed and bored to accommodate detectors. Comparisons were made among four different types of radiation detectors, each inserted into the mouse phantom for radiation measurement under a 6 MV linear accelerator beam.

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9/9/2011 · Radiology

Radiation Skyshine From A 6 MeV Medical Accelerator

By: Michael Gossman, MS, DABR, RSO, et al

Skyshine radiation emanating from medical accelerator facilities is a phenomenon not well understood.

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7/22/2011 · Medical Physics

Design of Site-Specific Prognostic Morbidity-Mortality Studies and Internal Outcome Focus Studies in Radiation Oncology

By: Michael Gossman, MS, DABR, RSO, et al

In the process of radiation oncology department accreditation, surveyors pay close attention to continuous quality improvement in the clinical section.

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1/3/2010 · Medical Physics

NRC Restrictions On The Packaging Of Radioactive Material Should Be Expressed More Explicitly Than Simply in terms of "Activity"

By: Michael Gossman, MS, DABR, RSO, et al

As promulgated by the Nuclear Regulatory Commission, packaging regulations for radioactive material are confusing (e.g., “activity” vs “contained” activity vs “total” activity). As a consequence, medical physicists are forced to secondguess the intent of the regulations.

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1/2/2010 · Medical Physics

Establishing Radiation Therapy Treatment Planning Effects Involving Implantable Pacemakers And Implantable Cardioverter-Defibrillators

By: Michael Gossman, MS, DABR, RSO, et al

Recent improvements to the functionality and stability of implantable pacemakers and cardioverter-defibrillators involve changes that include efficient battery power consumption and radiation hardened electrical circuits. Manufacturers have also pursued MRI-compatibility for these devices

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12/31/2009 · Medical Physics

Dosimetric Effects Near Implanted Vascular Access Ports: An Examination Of External Photon Beam Dose Calculations

By: Michael Gossman, MS, DABR, RSO, et al

Vascular access ports are used widely in the administering of drugs for radiation oncology patients. Their dosimetric effect on radiation therapy delivery in photon beams has not been rigorously established. In this work, the effects on external beam fields when any of a variety of vascular access ports were included in the path of a high energy beam are studied. This study specifically identifies sidescatter and backscatter consequences as well as attenuation effects.

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Aspects of Pacemakers - Functions and Interactions in Cardiac and Non-Cardiac Indications

Edited by Oliver Vonend & Siegfried Eckert

Michael Gossman is the author of Chapter 9: Clinical Concerns For and Strategies With Pacemakers in Radiation Oncology

Quality Assurance and Safety for Radiotherapy (Imaging in Medical Diagnosis and Therapy)

Authors: Todd Pawlicki, et al; Editors; Michael Gossman (Ch. 19), et al

This comprehensive work highlights benefits of quality techniques, approaches to implementation, and guidelines for specific quality assurance steps related to equipment and procedures used in radiotherapy. After an overview of manufacturing and engineering techniques, the text addresses quality and safety issues in radiotherapy from both the physician and physicist viewpoints.

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Clinton F. Merrill, Jr., MD, has over 35 years of experience in clinical Internal Medicine and 28 years of experience in Medical Oncology and Hematology.

Dr. Merrill is experienced in the diagnosis and treatment of all solid tumors as well as the full range of hematologic malignancies. He has special expertise in benign hematology including: anemias, low blood cell counts, iron overload disorders, bleeding and clotting disorders.

Litigation Support - Dr. Merrill offers expert witness services to counsel representing Plaintiff and Defendant. His services include medical record review, written reports, depositions, and trial testimony. Dr. Merrill takes pride in providing thorough record review, meticulously researched reports reflecting unbiased opinions, and excellent communication skills with the ability to make the complex understandable.

Areas of Expertise: