July 6th, 2023

Surgery is not Spoliation – Again

If was a dumb argument when I first heard about it: That a defendant in a personal injury case had a right to “independent medical exams” of the bodies of injured plaintiffs before they were operated on. And if they didn’t get it, they demanded a sanction for “spoliation” of the evidence — the evidence being the body of the injured person.

Back in late 2021, that argument was dumped on its head by the Appellate Division (First Department), as was the argument that the defense medical exam was somehow independent (The “Independent” Medical Exam is Dead).

And now the Second Department has likewise dumped on the idea, citing to the First Department’s holding in Gilliam v. UNC Holdings:

While the Court ignored the issue of calling such an exam “independent,” it unequivocally held that injured plaintiffs had every right to undergo surgery without first giving defendants access to their bodies for an exam. Citing from the First Department holding in Gilliam, that Court said that the:

“state of one’s body is fundamentally different from inanimate evidence, and medical treatment, including surgery, is entirely distinct from the destruction of documents or tangible evidence which spoliation sanctions attempt to ameliorate. To find that a person has an ‘obligation,’ to preserve his or her body in an injured state so that a defendant may conduct [a medical examination], is antithetical to our belief in personal liberty and control over our own bodies”

…
“[p]laintiffs must be free to determine when to undergo medical treatments based on personal factors such as doctor’s advice and their specific pain and discomfort level. It would be absurd for courts to require a plaintiff to forgo surgery (or other medical treatment) for an injury so as not to potentially compromise a lawsuit against the party(s) alleged to have caused the injury”

And with these following words, the Second Department, joining the First, which will hopefully put a final nail in this stupidity:

It is not reasonable to require a plaintiff to delay medical treatment, and potentially prolong his or her suffering, solely to allow a defendant to examine the plaintiff’s body in a presurgical state. Under these circumstances, the plaintiff has not “refuse[d] to obey an order for disclosure or wilfully fail[ed] to disclose information which . . . ought to have been disclosed”

The case is Fandeau v. Corona Industries, decided June 28th.

December 13th, 2021

The “Independent” Medical Exam is Dead

This post is a two-parter and I struggle to figure out which part is more important. First, an appellate court in New York has finally stuck a fork in the “independent” medical exam. It is dead and gone.

Second, the same court in the same decision has stated that the human body is not capable of spoliation. I’ll deal with that quirky part first (though each is worthy of a separate post).

It’s been a recent trend by some defense lawyers to claim that a personal injury plaintiff could not get surgery to fix their condition. Unless it was an emergency. They had to first give defendants a chance to have the person examined before the plaintiff’s body was changed, or in the words of the law, “spoliated.” And if there is spoliation, then sanctions can be imposed.

And some lower courts bought that argument.

But in Gilliam v.UNI Holdings, a unanimous panel of the Appellate Division (First Department) said no way, you can’t give spoliation sanctions for people getting their bodies fixed after the defendants broke them:

We now reverse and hold that the condition of one’s body is not the type of evidence that is subject to a spoliation analysis. And, to the extent that these lower court decisions hold that spoliation analysis encompasses the condition of one’s body, they should not be followed… To so hold would improperly subject a plaintiff’s health condition to an unsuitable legal analysis. Instead, a failure to appear for an ME, regardless of whether the failure to appear is preceded by medical treatment for the condition at issue, should be analyzed the same as other failures to comply with court-ordered discovery.

Did you see that “ME” in there? That stands for medical exam. I’ll get to that part in a minute.

But first, as rationale for why you can’t “spoliate” the human body the way you could with the destruction of documents, devices, electronic evidence and a wide variety of equipment ranging from treadmills to chairs, the court held:

The state of one’s body is fundamentally different from inanimate evidence, and medical treatment, including surgery, is entirely distinct from the destruction of documents or tangible evidence which spoliation sanctions attempt to ameliorate. To find that a person has an “obligation,” to preserve his or her body in an injured state so that a defendant may conduct an ME, is antithetical to our belief in personal liberty and control over our own bodies.

People should not be forced into the “absurd” situation of being forced to forego surgery to heal themselves because a lawsuit is pending, says the court:

Plaintiffs must be free to determine when to undergo medical treatments based on personal factors such as doctor’s advice and their specific pain and discomfort level. It would be absurd for courts to require a plaintiff to forego surgery (or other medical treatment) for an injury so as not to potentially compromise a lawsuit against the party(s) alleged to have caused the injury.

Now on to that part about the “ME.” For as long as I have practiced law — and I am coming up on 36 years since I was admitted to the bar — defense lawyers and the courts have insisted on using the phrase “independent” medical exams (IME) to refer to exams that defendants were entitled to in order to assess the damage to the human body or mind after a collision or other mishap. When you place your body in issue in a lawsuit, after all, you waive any confidentiality for those particular body parts and the defendants are entitled to have a doctor examine those parts.

But it was never independent. We all knew this. These were not, after all, doctors hired by the courts. They were hired by the defendants as part of litigation.

Back in 2013 I did a series of posts on Quickie Medical Exams that last, often, no more than a few minutes at most so that a doctor could testify that the injured plaintiff wasn’t really hurt, or had fully recovered. It was, and often continues in my opinion to be, a flat out scam and form of insurance fraud (one that favors the insurance company).

Routinely over the years I have struck the word “independent” from the forms for routine discovery orders, insisting they be called Defense Medical Exams or Medical-Legal Exams. I first wrote about this in 2009 (2009!) when I asked Is the “Independent” Medical Exam Dead?

I wrote it because of a dissenting opinion from this same court, the First Department, where Justice McKeon asked a question that former Chief Judge Lippman had already asked (also in dissent):

…the “independent” prong of the term, has long been winked at by the bench and bar. Few consider the physical examination conducted for purposes of litigation as independent; indeed, one court has described it as part of the “adversarial process” (Bazakos v Lewis, rev’d on other grounds) with Chief Judge Lippman forthrightly observing that “[t]hese exams, far from being independent in any ordinary sense of the word, are paid for and frequently controlled in their scope and conduct by legal adversaries of the examinee (id. at 6 [Lippman, Ch. J., dissenting).

At that time I prognosticated:

So let me be the first to proclaim that the “independent” medical exam is dead. Sure, it may still take a few years to see it buried altogether, but make no mistake about it, it is on an irreversible course to the trash heap of litigation history.

And now it is dead. For reals. There is no longer a question mark on the issue, at least in the First Department (New York and Bronx counties). It seems unlikely that any other appellate department would continue to claim such exams are “independent.” The dissents of Lippman and McKeon have won the day. The First Department now says:

It should also be noted that defendant has mischaracterized the nature and role of “independent” MEs in personal injury litigation, presumably to cast plaintiff’s surgery as an egregious and sanctionable act. Such examinations “far from being independent in any ordinary sense of the word, are paid for and frequently controlled in their scope and conduct by legal adversaries of the examinee. They are emphatically not occasions for treatment, but are most often utilized to contest the examinee’s claimed injury and to dispute the need for any treatment at all” (Bazakos v Lewis, 12 NY3d 631, 638 [2009] [Lipman, Ch. J., dissenting]). Viewed in this context, an ME is simply one piece of evidence in a personal injury action.

So the Gilliam case addresses two significant issues. The first is somewhat limited and a little bit quirky — the issue of spoliation of the human body.

But the second is significant to all personal injury actions where the plaintiffs are examined. No more should a court refer to these exams — either in decisions or in front of jurors — as independent.

They aren’t. And they never were. And we should no longer be asking if the “independent” medical exam is dead. It is. Good riddance.

October 10th, 2019

Personal Injury and …Copyright? Seriously?

Well, it isn’t often (read: never) that personal injury law runs headlong into copyright. But here we are.

As many people know, when you sue somebody over a broken body part the defendant gets to have that body part examined by one of their own doctors. This is known as a defense medical exam, or medical-legal exam, but sadly often referred to as an independent medical exam despite being an inherently adversarial situation.

But regardless of terminology, the defense still gets their exam. And every so often that may entail a neuropsychologist exam.

And these exams are often contentious because what actually happened (a fly-on-the-wall view) and what doctors write in reports may be starkly different. Some exams last just 2-3 minutes. A few years back there was a big hullaballoo when a lawyer had someone secretly record that exam to prove the point. The appellate courts ultimately said no dice, not without a court order. Notes only.

In a neuropsych exam nobody asks you to touch your toes. The point is to ask questions and get answers.

And so, because recording the exam needs a court order, lawyers (or their representatives) sit there and take those notes.

Full stop! The reason I’m writing this is that a doctor actually tried to claim, I shit you not, that the plaintiff’s representative couldn’t take notes about the questions. Only the answers.

Client showed up with lawyer for exam. Doc tells lawyer no note taking regarding the questions allowed because “it might violate copyright law.” Lawyer refuses to budge on the issue and doctor refuses to do exam.

Next stop, motion practice.

If the defendant were to win such an argument then it would be even more difficult than it is now to cross-examine the doctor at trial. After all, no notes. And the trial lawyer wasn’t in the room (or would likely be disqualified as also being a witness).

Justice Arlene Bluth, a trial court judge in New York County, made short work of that outrageous copyright argument.

“Because an IME is used solely for litigation purposes, the Court cannot limit the ability of plaintiff’s counsel (or a representative) to take notes in order to zealously represent his or her client.”

So what if the test is copyrighted? Use a different test, says the judge.

The doctor, the court also notes, had one other itty, bitty problem: The doc was merely speculating that it might be a copyright violation, having provided zero proof that it was. Not that it would have mattered, of course, as the court made clear.

And the idea that only the answers could be recorded and not the questions was equally dispensed with by the court. How, Justice Bluth wrote, would you actually enforce such a rule? The lawyers’ notes from such exams, after all, are privileged. Are our seriously understaffed courts now going to do tens of thousands of in camera reviews after these exams?

And that’s how copyright law managed to wangle its way into a personal injury case.

The case is here: Nieto-v.-CLDN Download

March 19th, 2019

Appellate Court: Notes of “IME” “Watchdog” are Privileged

The fact that I used quotes on two different words/acronyms is, to be fair, a lousy way to start. But this New York appellate decision yesterday is important in any personal injury litigation because it goes to this essential question for plaintiffs’ lawyers: Would you allow your client to have an unrecorded deposition and physical exam with an agent of the defendant?

Regular readers know I’ve written often about medical-legal exams — those exams that defendants are entitled to when claimants place their medical condition at issue in a lawsuit. The courts errantly refer to these as Independent Medical Exams (IME), though they are far from independent. (See: Is the “Independent” Medical Exam Dead?, and Dear Judge Smith — You gotta be kidding me.)

There are a number of frequent flyer doctors that will do 1,000 or more of these per year for insurance companies, with predictable results. They were the source of a series I did in 2013, with many exams lasting little more than a few minutes at best. (See: Premature Evaluations – The Evidence on Quickie Medical-Legal Exams)

And because these exams are anything but independent, and the doctors so heavily dependent on insurance company money, it’s the custom of plaintiffs’ lawyers to send along an observer, a chaperone, a watchdog, of some kind.

The problem of skewed exams became so great that a cottage industry was born with a company, IME Watchdog, being born for the express purpose of sending along an observer to take notes.

As a puppy lawyer I used to attend these with some frequency since I was not going to try the case. If the doctor lied about something obvious — claiming the exam lasted longer than it did, for example, or falsely claiming that the client made some comment about his condition or how a collision occurred — the observer would be able to take the stand in rebuttal and dispute what the doctor claimed happened in that exam room. The person being examined is, after all, quite preoccupied by being probed and tested and can’t sit there and take notes.

With that way-too-long introduction, we turn to the decision of the First Department yesterday in a matter of first impression: Can defense counsel use discovery to gain access to the notes take by the observers’ and take their depositions. Lower courts had mixed answers to that discoverability issue.

But that issue was laid to rest yesterday in a unanimous appellate decision in Markel v. Pure Power Boot Camp. And that answer is emphatically no.

The court first observed that “No special or unusual circumstances need be shown in order for the IME observer to be present during the examination.”

While the “information contained in the IME observer’s notes and other materials are not protected by either the attorney-client or work product privileges” there is still the qualified or conditional privilege of material prepared for litigation under CPLR 3101(d)(2).

The observer is there as an agent of plaintiff’s counsel in order to assist in the preparation of the case for trial, and that includes cross-examination of the hired guns that insurance companies routinely use.

The only way of circumventing this is by showing a “substantial need” for the discovery and that without “undue hardship” the requesting party is unable to obtain the substantial equivalent by other means.

Except that defendants can’t show that because they have doctors in the rooms taking their own notes.

A final note: The court stressed that, “An important consideration in the Court’s analysis is plaintiff’s representation that the IME observer will not be testifying at trial on plaintiff’s affirmative case.”

The representative, of course, is not hired to be there for the affirmative case, but to be available for rebuttal in case the doctor makes up some cock-and-bull story about what happened or what the doctor claimed that the plaintiff.

This is all the more important since the courts barred people from actually recording the exam, which would have done a helluva lot more for keeping the doctors honest that allowing observers.

And to those judges that may be reading this, please stop using the phrase Independent Medical Exam. You’ve got a legitimate choice between Defense Medical Exam or simply medical-legal exam. And former Chief justice Jonathan Lippmann agrees with me. In Bazakos v. Lewis he wrote in a dissent:

“[t]hese exams, far from being independent in any ordinary sense of the word, are paid for and frequently controlled in their scope and conduct by legal adversaries of the examinee.

January 28th, 2016

Doctor Tries To Take Down Lawyer’s Blog Post By Filing Grievance – updated x2

Michigan attorney Steven Gursten

Wow. Defense-medical exams and a defamation claim against a law blogger! Two of my favorite topics wrapped up in one ugly Michigan incident now ongoing.

Now you folks know I have a thing or two to say about doctors that do a lot of defense medical-legal exams. And you know I have a thing or two to say about BS claims of defamation, having been on the receiving end of a couple of moronic lawsuits.

Now comes before us today one Dr. Rosalind Griffin, a Michigan psychiatrist, with a different tactic: Filing a grievance against lawyer Steven Gursten for blogging about a medical-legal exam that she did on one of his clients.

Gursten was so ticked off at Dr. Griffin, that he wrote about her. Like me, he thinks that many of the doctors that make these exams a staple of their practices are doing hatchet jobs on the injured plaintiffs in order to benefit the insurance companies.

(For a comic view of how one lawyer sees it, you can view this cartoon.)

The short version of today’s story is that Gursten’s client was hit by two trucks, and he asserts that the client suffered a traumatic brain injury, broken back, and other significant injuries. Dr. Griffen then did the defense medical exam (DME) — sometimes improperly called an independent medical exam (IME) — and issued a report.

Gursten then presented evidence and asked readers to draw their own conclusions as to whether Dr. Griffen committed perjury. In fact, by the title of his posting, you can see that this invitation to readers was his explicit intention:

Heading: IME abuse? Read the transcript of Dr. Rosalind Griffin in a terrible truck accident case and decide for yourself

Subheading: How many thousands of innocent and seriously hurt people lose everything because of so-called “independent medical exams,” such as this example by Michigan psychiatrist Dr. Rosalind Griffin?

Dr. Rosalind Griffen

He presented evidence that Dr. Griffen — who he said is “a rather notorious IME doctor here in Michigan” — was less than candid in her assessment.

Gursten asserts that this evidence disproves the doctor’s claim that the client said during the exam that his condition was improving, that the client had minor medical conditions, and despite “a closed-head injury, traumatic brain injury, abnormal memory and concentration, PTSD and a badly fractured and collapsed T12 vertebral body, as well as fractures to his mouth, shoulder and knee” that the client’s chronic pain actually came from a 30-year-old whiplash that had been asymptomatic.

This presentation of evidence, and request that readers make their own determination as to whether Dr. Griffen committed perjury, occurred Nov. 13, 2014.

Thirteen months later, Dr. Griffen filed a grievance, claiming defamation, and asking that the Committee require the lawyer to:

“delete his outrageous posting”; and
“[R]emove the link to Google results for my name.” [I didn’t make that up, I swear. — ET]
Punish and sanction him for putting her testimony and her conduct under oath on the internet for people to read.

Gursten wasn’t cowed by the complaint and proceeded to put it up online this week in a new posting with this heading and subheading:

Heading: Sticks and stones and…attorney disbarment? Will the First Amendment lose out when IME doctor files grievance to conceal her testimony in injury case from the public?

Subheading: IME doctor files grievance to suppress blog post and punish attorney for disclosing her conduct

Over the course of a very extensive follow-up posting this week, he provided many examples of differences between what the doctor claimed, and what he said actually happened. This is a sample, with much more at the original posting:

What Dr. Griffin claims James Fairley said.	What James Fairley actually said.
“[A]ccording to his own statement he feels less depressed and is making progress.” (IME Report, Page 8)	“Q. What’s a good day for you? A. I don’t know. I haven’t had one lately. … I just have a profound sadness … Q. Do you think you’re depressed, sir? A. I do. … Q. Have you been tearful? A. Oh, yeah. I cry at the drop of a hat sometimes.” (Fairley Dep., Page 58 (lines 1-2, 7), Page 61 (lines 13-14), Page 62 (lines 4-5))

In the text of the grievance, Dr. Griffen complains thusly about the original blog post:

Notably, it is the first item returned when someone uses the Google search engine on my name, thereby ensuring that it will be noted and read by individuals researching me or selecting a psychiatrist who will best meet the needs of the patient.

The problem, of course, is that Gursten merely provided the documents and video testimony, and pointed to various sections of them, while offering his opinions. He did what lawyers do: He presented evidence and asked the jury (his readers) to decide.

The doctor’s complaints that calling her “notorious,” or her exam a “hatchet job,” would be merely opinion. And opinion is not actionable under the First Amendment. It isn’t even a close call.

She also tries to make the complaint, unconvincingly I might add, that writing about her exam and testimony violates Rule 8.4 of Michigan’s rules of professional conduct which state that it is attorney misconduct to:

(c) engage in conduct involving dishonesty, fraud, deceit or misrepresentation;

(d) engage in conduct that is prejudicial to the administration of justice;

Since there is nothing dishonest or fraudulent about providing evidence and asking a series of questions about where that evidence leads, I don’t see how she can possibly prevail. Nor is a public discussion of a very serious issue prejudicial to the administration of justice. In fact, a public discussion is beneficial to the administration of justice. I do it here all the time.

Why would Dr. Griffen — who happens to be a member of the very grievance committee to which she is complaining — file this?

Leaving aside the obvious possibility that she may have friends on the committee, the other possibility is that she tried mightily to find an attorney to bring a lawsuit, and that everyone told her “Are you shittin’ me?” though they may have been a tad more blunt. Then a year went by, the statute of limitations expired in Michigan, and she made this complaint feeling she had to do something.

And so she did. And now people out of state, who had never heard of her, are writing about her. Well played, doctor, well played.

(Pro tip: If you need to file a dopey defamation case, you might try Jonathan Sullivan at Ruskin Moscou Faltischek in New York. He’s the guy that brought Dr. Michael Katz’s pointless and doltish suit against me regarding an “IME” and testimony that Katz did. Who knows, maybe he wants to do it again?)

Addendum: More at Public Citizen, a small excerpt below. At the link are also case citations, and a thorough exposition on the chilling effect that permitting such grievances has on free speech.

Griffin’s complaint amounts to a lightweight defamation claim (lightweight because most of the quoted words are either not actually about Griffin or are opinion rather than facts, because Griffin does not spell out any other allegedly defamatory words as Michigan law would require, and because she says nothing about knowledge of falsity or reckless disregard of probable falsity). It is therefore not surprising that Griffin did not file a defamation claim within the one-year statute of limitations. Instead, six days after the statute expired, she chose to file this bare-bones grievance complaint, hoping that paid grievance staff will conduct an investigation for her, and force Gursten to spend his time and money responding to questions from public officials about his opinions about whether and how justice is afforded to accident victims and specifically how Griffin has or has not testified unfairly or unjustly.

In discussing the Michigan’s Grievance Commission, in highly critical terms for allowing this to go forward and requiring a response from Gursten, Public Citizen’s Paul Alan Levy writes:

The Commission staff might well be hoping to exact an apology as Gursten’s price for peace, but at least so far, Gursten is not only not caving in to Griffin’s pressure, but he has called Griffin’s bluff and raised the ante.

Addendum #2: Scott Greenfield weighs in on Rosalind Griffin using a disciplinary complaint because an actual defamation case would fail, and the completely expected reaction (from anyone in the least bit savvy about the internets):

But if the lawyer disciplinary process seems like easy pickin’s to silence blawgers, the flip side is that we’re not particularly inclined to run scared, and we have this tendency not to take kindly to being extorted through the use of the grievance procedure to shut us up.

Has Dr. Rosalind Griffin ever heard of Barbra Streisand? If she thought she had something to twist her face into a frown before, she’s really gonna hate what happens when her effort to use the disciplinary procedure to silence Gursten not only fails, but backfires big time.