Using expert testimony to help a jury appreciate your client’s injuries Kevin Yoo, MD, FACS

Prep work Meet with your expert Make sure expert is prepared Go over strategy Listen to expert Outline the legal restrictions of the case Allow experts to be themselves and act naturally Get on same page

Think of yourself as a jury member Lay person Very little medical knowledge But all have experienced some injury from some trauma Let the physician expert witness show the jury that your client’s injuries are all reasonable and life-like

Getting hurt is a fact of life!

Getting old is a Bitch!

Can you tell the difference Can you tell the difference?! Blow up the films and let the images speak for themselves.

Egg Shell Client You should want a patient with lots of pre-existing conditions! Degenerative disc disease Cervical/lumbar spinal stenosis Facet hypertrophy Ligamentum flavum hypertrophy Lumbar spondylolisthesis Cervical/lumbar bulging or herniated discs Cervical/lumbar disc annular tear Scoliosis/kyphosis Compression fractures Bone spurs or osteophytes Diffuse idiopathic skeletal hyperostosis Ankylosing hyperostosis Previous back or neck injury

California Civil Jury Instructions (CACI)3927 Aggravation of Preexisting Condition or Disability[Name of plaintiff] is not entitled to damages for any physical or emotional condition that [he/she] had before [name of defendant]'s conduct occurred. However, if [name of plaintiff] had a physical or emotional condition that was made worse by [name of defendant]'s wrongful conduct, you must award damages that will reasonably and fairly compensate [him/her] for the effect on that condition.

California Civil Jury Instructions (CACI)3928. Unusually Susceptible Plaintiff You must decide the full amount of money that will reasonably and fairly compensate [name of plaintiff] for all damages caused by the wrongful conduct of [name of defendant], even if [name of plaintiff] was more susceptible to injury than a normally healthy person would have been, and even if a normally healthy person would not have suffered similar injury.

When is the need for spinal surgery related to traumatic event?

Conditions that are easily attributable to trauma!

Cervical Herniated Discs

Lumbar Herniated Disk

Annular Tear Sign of trauma Can progress to a herniated disc Can be painful

Conditions that are not easily attributable to trauma!

Spondylolisthesis

Spinal Stenosis

Degenerative Disc Disease

MRI with Traumatic Brain Injury Protocol Imaging Healthcare Specialists ADVANCED NEUROIMAGING TECHNIQUES DIFFUSION TENSOR IMAGING (DTI): Looks at fiber tracts SUSCEPTIBILITY WEIGHTED IMAGING (SWI): Looks for microbleeds MR SPECTROSCOPY (MRS): Looks for chemical composition of brain tissue

Post Concussive Syndrome Headaches Dizziness Fatigue Irritability Sleep Problems Concentration Problems Memory Problems Problems tolerating stress/emotion/alcohol Anxiety/Depression Changes in personality Apathy Photophobia/Phonophobia Etc.