August 19th, 2013

Judge: No Mulligans for Defendants on Medical-Legal Exams

Who do I see about a mulligan on my choice of experts?

In golf, a mulligan is a do-over. You whack the ball deep into the woods, you yelp “Mulligan!” and tee up a new one. When you’re out with your buddies no one really cares. Unless there’s money on the line. Then it matters.

And so we have the defendants now screaming for mulligans when it comes to so-called “independent” medical exams performed by Dr. Robert Israel. If the name doesn’t ring a bell, I wrote about him on June 3rd after he’d been placed on probation for three years for professional misconduct due to medical-legal exams he conducted for defendants. Yeah, that Dr. Israel.

He agreed, in accordance with his sanction, that his:

…license to practice medicine in New York State shall be limited to preclude me from engaging in any practice as an Independent Medical Examiner as of March 2013. I shall not contract or agree to perform, nor perform Independent Medical Examinations.

Given that he was doing 1,500 orthopedic exams per year for medical-legal purposes, that was a pretty big deal for thousands of cases.

Defendants were, as you might guess, a wee bit concerned that he’d be drawn and quartered by plaintiffs’ attorneys if he took the stand and that whatever credibility he had before the sanction would vanish into the vapors.

So they’ve been making motions, claiming that if Dr. Israel testified on any of his old cases, it would violate the consent order that he’d agreed to.

This was expected when I made my original post — and I said the tactic would fail — writing:

Now here is a big legal issue for all those defense firms and insurance companies that thought they were being so smart in hiring Dr. Israel: The consent order does not preclude him from testifying. He can’t be an examiner for the next three years for sure, but the examination part is done. His records and reports (for what they are worth) are already made. There is no reason he can’t testify, other than the fact he will be (justifiably) torn to bits. But being torn to bits is not the same as being unavailable to testify.

That means there’s a good chance they will all be stuck with him. The insurance companies got the benefit of his exams previously and now they will get the downside. Karma. Sleeping with the devil. Laying down with dogs and picking up fleas. Choose your metaphor or proverb.

The comments on the post lit up with discussion on the consent order and whether it would preclude Dr. Israel from testifying. No way, said I.

And now the first verdicts are in, in three decisions from Justice Kenneth P. Sherman sitting in Brooklyn: Moran v. EMR Mechanical, Diaz-Rivera v. Akindele and Haynes v. Hossain.

The law does sometimes allow for mulligans, of course, in certain situations. Litigants on both sides, for example, often ask for retrials when they are on the losing side claiming some unfairly prejudicial conduct (and usually lose).

But in the first of these three decisions, Moran (decided August 5th), there were problems with the defendants’ application for a second defense medical exam. Justice Sherman wrote that that there was no claim that the plaintiff’s condition had changed (which would obviously warrant a second exam), nor any claim Dr. Israel wasn’t a qualified orthopedist, nor any claim that Dr. Israel was unavailable to testify due to death or disability.

The defendants instead tried to claim that the consent order rendered him unavailable because he would be engaging in “any practice as an Independent Medical Examiner.” Is that good enough for a do-over?

No way, said Justice Sherman. The consent order affects future exams, not the past ones. He wrote: “As those pre-consent order IMEs and reports were not rendered retroactively void by the consent order, there is no reason why Dr. Israel could not testify concerning those reports.”

And, mimicking my comments about Dr. Israel getting shredded on cross-exam, Justice Sherman wrote:

The Court understands that Dr. Israel might be subject to a somewhat intense and difficult cross-examination. However, such an attack on this expert’s credibility, like any other attack on any witness’s credibility, only goes to the weight of that testimony, not it’s admissibility.

Justice Sherman thereafter reviewed appellate cases where other examining doctors had faced license issues, and was unable to find any support for the defense proposition that mere fear of vigorous cross-exam was enough to warrant a mulligan on the medical-legal exam.

The second decision, Diaz-Rivera (dated August 14th), cites to Moran and once again rejects the defendant’s request for a do-over.

The third decision, in Haynes, adds in the additional wrinkle of a letter from the Department of Health that specifically rejects the defense contentions that Dr. Israel would be violating the consent order if he testified about his past cases. (That letter is a July 2nd update to my original post.) The pertinent part reads:

“If [Dr.Israel], in the future, testifies about acts performed, observations or findings made or opinions and/or diagnoses rendered, respectively, at a time that predates the effective date of the Order [June 7, 2013], we would not consider that a reportable violation.”

Now let’s see what happens to Dr. Michael Katz, recently busted on the witness stand for lying about the defense medical exam he did, and perhaps, a few of the other doctors who have for years been doing quickie medical exams and escaped Department of Health oversight.

Do you hear that cheering sound? It comes from gazillions of plaintiff’s attorneys and their clients who have been burned by insurance companies hiring Dr. Israel and his ilk in the past.

There won’t be any mulligans here. Karma’s a bitch.

July 8th, 2013

Judge Rips Doc for “Huge Lie”; Perjury Prosecution Possible; Victims May Number in Thousands

Supreme Court, Queens County

Reporting by Samson Freundlich and Eric Turkewitz

Last week a state trial judge unsealed a record showing falsified testimony by a New York orthopedist who conducts up to 1,000 medical-legal exams each year. Queens Supreme Court Justice Duane Hart unsealed the April 12, 2013 testimony of Dr. Michael J. Katz as he pondered a referral to the District Attorney for perjury over “a huge lie” concerning so-called “Independent Medical Exams.”

Dr. Katz, an orthopedist frequently hired by insurance companies to defend personal injury cases — who has testified that he may make over a million dollars a year just from his medical-legal practice — had testified in the recent case that he likely spent 10-20 minutes on his examination of the plaintiff. A surreptitiously made video, however, revealed that he spent a mere one minute and 56 seconds on the exam and could not have made all the findings he testified about within that short time.

The underlying labor law case concerns a severe ankle fracture that resulted in a fusion of the joint as well as a shoulder injury that required surgery, suffered when Manuel Bermejo fell from a Bakers Scaffold. The court indicated that there was potential for a verdict of “several million dollars” based on the injuries.

The transcripts in Bermejo v Amsterdam that we obtained over the July 4^th break detail Justice Hart’s concerns not merely with the fact that Dr. Katz was dishonest regarding the estimated length of the actual exam, but that the substance of what he testified to could not be true. Justice Hart said, “He testified as to findings that he obviously could not have had in a minute and 56 seconds.”

These medical exams are often critical to the defense of personal injury cases, and are also used by insurance companies to “evaluate” whether they should continue to pay No-Fault or Workers Compensation benefits. The reason the exams are often problematic is that the insurance carriers have a vested interest in limiting payments and only retaining doctors that give them favorable reports, and there is no stenographer to record what transpires. Quickie exams that serve only to deny benefits to the injured are a constant problem.

But this case had actual evidence in the form of a secretly made video recording. It shows Dr. Katz examining Mr. Bermejo as plaintiff’s trial counsel, who recorded it, and a paralegal-translator looked on. This was the second exam that Dr. Katz had done of Mr. Bermjo, as he had undergone shoulder surgery after the first examination.

Plaintiff’s counsel was moved to record this second exam, according to court transcripts, because he believed that Dr. Katz had been dishonest in his report of what transpired at the first one. The initial exam, Dr. Katz claimed, lated 45 minutes and he also claimed that plaintiff’s counsel impeded it. (The paralegal that was present took the stand and sharply disputed both points.) When the time came for the second exam, plaintiff’s counsel secretly recorded it to protect himself from any possible complaints or accusations from the doctor.

This secret recording was not exchanged during the litigation, as plaintiff’s counsel said there was no requirement to do so since Dr. Katz was a non-party, and the only potential use of the video was if Dr. Katz perjured himself. When Dr. Katz offered testimony at trial that was completely inconsistent with the actual events, the evidence was submitted to the court. As a result of this video substantively contradicting the trial testimony, and concerned about a breach of the discovery rules and orders by the failure to disclose, Justice Hart declared a mistrial after 2-3 weeks of trial.

In a remarkable hearing before Justice Hart after the false testimony had been given, Dr. Katz’s criminal defense attorney stated that the perjury was the fault of the court because the court had demanded the doctor tell the truth in answering the question about how long such exams usually take. Justice Hart characterized this as “the dumbest thing I ever heard” either inside the courtroom or out.

At a hearing July 1st to apportion responsibility for the cause of the mistrial, Justice Hart initially sanctioned the defense firms $10,000.00 each, noting that “It is the carriers and Dr. Katz that I would love to sanction, but I can’t do that” as sanctions are restricted by the court rules to parties and their attorneys. Unhappy with that restriction, Justice Hart said, “You can probably hear my teeth grinding.”

The court had also initially sanctioned plaintiff’s trial counsel $250 for not exchanging the video, which sanction was also withdrawn and plaintiff’s counsel absolved of fault for causing the mistrial. The judge derided Dr. Katz on his assertion that his first exam lasted 45 minutes, and said “it would have been reasonable” to want such a recording. Justice Hart, who has served since 1981 as attorney, law secretary or judge, said regarding the alleged 45-minute claim by Dr. Katz, “What universe does he live in? If I ever see a doctor do a 45-minute IME it will be the first time.”

All the attorney sanctions were vacated later in the hearing.

Justice Hart, in finding that it was the doctor’s false testimony that caused the mistrial, stated that while he had seen abuse of the system before, “This is clearly the most blatant example of a doctor getting up there and just not telling the truth.” He also suggested that plaintiff’s counsel who had spent $40,000 on trying the case so far, should sue Dr. Katz for the expenses and legal fees caused by the mistrial.

Feeling handcuffed by the relatively few options available to him for a non-party witness that lies and causes a mistrial, and recognizing that there are others doing the same, Justice Hart asked the attorneys:

How do I stop carriers from putting people like Dr. Katz on the stand and causing the state to spend thousands and thousands of dollars trying a case and putting a lying witness on the stand? How do people like me, people in this building, people that wear black robes send a message to them that they cannot condone perjury?

Despite all the admonitions thus far from Justice Hart the matter remains open as Dr. Michael Katz is still conducting medical-legal examinations and has refused to retire from these activities. Justice Hart had offered him the option of bowing out of the business and he declined. Thereafter the court ordered a full transcript, intending to send the matter to the Administrative Judge for a civil contempt hearing and send the matter to the District Attorney with a recommendation that they explore a perjury prosecution.

Regarding the fact that Dr. Katz was still doing these medical-legal exams on July 1^st when this hearing took place, and recognizing that he had been caught lying back on April 12th, Justice Hart said:

It is like a wound that is festering. Every time he does another IME. When is it going to stop? He is making 7 figures a year doing IME’s. Then he comes to my part and lies.

Judge Hart did not mince words when he said that, aside from the effect of any potential criminal issues, that Dr. Katz’s career was essentially finished when it comes to his substantial medical-legal practice: “Dr. Katz’ future doing IME’s because he lied in this one will probably be finished.”

“It is that the tape shows that he didn’t do the tests that he spent a considerable period of time talking about that he did. That is the perjury. Yes, didn’t do the tests. It is not just me saying it. It is not just the plaintiff saying it. The defendants are saying it too. Does your client really think if the insurance industry or some of the insurance companies that hired him before when they find out that he lied, do you really think they are going near him?”

The impending denouement of Dr. Michael Katz is all the more stunning since it comes fresh on the heels of his fellow New York orthopedist Dr. Robert Israel being sanctioned for his conduct in medical-legal exams. Dr. Israel had been doing up to 1,500 per year, but has now been barred from doing them for three years.

Together, Drs. Katz and Israel have no doubt sent New York’s insurance carriers frantically scrambling, as the two of them were responsible for thousands of insurance exams each year, the results of which are now all thrown into question. The scope and scale of insurance fraud being perpetrated — by the insurance companies themselves — could have resulted in hundreds of millions of dollars in payments being withheld. It remains unclear just how many New Yorkers have been fraudulently denied benefits based on quickie exams that were set up to deny benefits and minimize jury verdicts.

The scope of such an investigation of the insurance industry, it seems, could only be done by Attorney General Eric Schneiderman.

Last week’s hearing regarding Dr. Katz was adjourned until this afternoon (July 8th) at 2:00 pm. It is unclear whether Dr. Katz will voluntarily agree to halt his lucrative medical-examination business — though this now seems like a moot point now since the record regarding his false testimony has now been unsealed.

It’s worth adding that this is not the first time Dr. Katz was caught by a court with less than candid conduct that caused a mistrial. A year earlier while testifying in Brooklyn, Dr. Katz went outside the confines of his report to suddenly testify about a relationship between tinnitus and aspirin. Justice Francois Rivera, after making an inquiry, said that he was “satisfied that this witness is less than forthcoming” about his decision to suddenly stray from his report to a new subject, and was concerned with Dr. Katz “materially misleading the court.”

The legal fallout may result in any or all of the following:

Civil contempt of court;
Criminal perjury prosecution by the District Attorney;
Civil suits for causing this mistrial by any/all of the attorneys involved;
Civil suits based on fraud by past litigants saying they were also victimized by Dr. Katz;
Action against his license from the Department of Health-Bureau of Professional Medical Conduct;
Racketeering suits for conspiring with insurance companies to commit insurance fraud; and
Investigation by the Attorney General into the issue of insurance fraud perpetuated by the insurance industry.

These predictions regarding a wide-ranging insurance fraud scandal are backed up by Justice Hart, who repeatedly referenced the insurance carriers as being part of the problem:

I can blame the attorneys and the carrier who hired him to do an IME on this case because they should have known what this guy was doing. They should have known. And again the man is making literally millions of dollars doing IME’s. Now, he gets caught lying. There is no other way to put it. He lied. There is no other way to make it nice. He said the IME took between 10 to 20 minutes. It took a minute and 56 seconds.

The transcript of the proceedings is here: July 1 Transcript

From what we’re watching unfold, this may be the tip of the iceberg. Stay tuned…

Part 2: Dr. Michael Katz’s License and Liberty Placed in Jeopardy Due to Lying Over Medical-Legal Exam — 7/9/13

Part 3: So, Just How Short Were Dr. Katz’s Medical-Legal Exams? (Dozens of his other exams are investigated) — 7/10/13

Part 4: Premature Evaluations — the Evidence on Quickie Medical-Legal Exams — 7/16/13

Part 5: Quickie Medical Exams: What Next? (7/23/13)

Part 6: To Tell the Truth: Which Doctor’s Signature is the Real One? (7/30/13)

Part 7: Doctor Testifies That Six Different Signatures Are All His (8/5/13)

June 4th, 2013

Dr. Robert Israel Slapped with 3-Year Probation Sanction (Updated)

It is unlikely that the name Robert Israel means much to many of my readers. But if you are a practicing personal injury lawyer in New York, it means a whole lot. And the fact that he was just placed on probation for professional misconduct means a whole lot more.

Dr. Israel has been, for many years, one of the most frequent orthopedists that defense firms and insurance companies turn to for medical-legal exams. These are done so that the defendants get an “independent” view of a plaintiff’s injuries, apart from the opinions of the treating doctors. Then he comes in to testify. It’s fair to say that he has far more experience in the courtroom then the vast majority of attorneys in the country.

How many litigation exams has he done? When I cross-examined him five years ago, he said he was doing 30 of these exams per week; 1,500 per year. Robert Israel Cross (page 20). He’s testified hundreds of times, and never for a plaintiff unless it was his own patient (page 33). That is a stunning business that also has a remarkable impact on those who’ve brought suit for personal injuries.

And what was he placed on probation for? Well, I wouldn’t be writing this post if it was for getting drunk and tossing his skivvies at a cop. That would be wholly unrelated to his practice and, I think, a cheap shot.

No, he was sanctioned because of his conduct doing these types of “independent” medical exams, which are more properly referred to as Defense Medical Exams. (Because the docs that do these things aren’t being selected by the court.)

As per the charges against him, it all deals with his conduct performing these medical-legal exams by failing to take adequate, accurate and complete medical histories and by failing to note accurate, complete and appropriate physical exams. This is, as it happens, directly in accord with the testimony I took from him where he botched (deliberately or not, I don’t know) the history of my client, making statements of things that were never claimed in the lawsuit.

(By coincidence, I blogged that trial in day-in-the-life format in 2008. This was part one.)

How many victims were turned out of court due to Dr. Robert Israel’s misconduct? Only he knows. Maybe. Will anyone turned out of court due to questionable testimony he gave sue him? Intriguing question, glad you asked.

As per the three-year probation agreement that he consented to, online here, he agrees that his:

…license to practice medicine in New York State shall be limited to preclude me from engaging in any practice as an Independent Medical Examiner as of March 2013. I shall not contract or agree to perform, nor perform Independent Medical Examinations.

Now here is a big legal issue for all those defense firms and insurance companies that thought they were being so smart in hiring Dr. Israel: The consent order does not preclude him from testifying. He can’t be an examiner for the next three years for sure, but the examination part is done. His records and reports (for what they are worth) are already made. There is no reason he can’t testify, other than the fact he will be (justifiably) torn to bits. But being torn to bits is not the same as being unavailable to testify.

That means there’s a good chance they will all be stuck with him. The insurance companies got the benefit of his exams previously and now they will get the downside. Karma. Sleeping with the devil. Laying down with dogs and picking up fleas. Choose your metaphor or proverb.

Will a judge allow the insurance companies to take a mulligan on the medical-legal exams? Will a plaintiff respond by saying, hey, if you don’t like the guy, let’s re-open all those cases where Dr. Israel previously testified?

Now if a doctor that performed an exam dies or becomes incapacitated during litigation, they would be entitled to another exam since s/he would be unavailable. But Dr. Israel is still available and is not precluded from his regular practice as an orthopedist.

The order goes into effect this Friday, June 7th.

Update: July 2, 2013: In the comments is a discussion as to whether this sanction can serve as a basis for defendants obtaining a second defense medical exam, and pretending that Dr. Israel is unavailable to testify based on the order. That issue has now been resolved, courtesy of attorney Jonathan Fier who obtained an opinion on the subject from the Department of Health. That letter is here Robert-Israel-OpinionLetter and states, in relevant part:

“…the order neither bars all testimony nor permits all testimony”

“If licensee, in the future, testifies about acts performed, observations or findings made or opinions and/or diagnoses rendered, respectively, at a time that predates the effective date of the Order, we would not consider that a reportable violation.”

“If, in relation to any Independent Medical Examination occurring at any point in time, the licensee engages in or testifies regarding any further act of observation. finding, opinion, and/or diagnosis (including but not limited to providing his opinion on any subsequent and/or supplemental medical we would consider that to be reportable as a possible violation.”