Expert Witness Emergency Medicine, Critical Care and Internal Medicine

Case Descriptions

Obese 55 year old female presented to the ED complaining of upper back pain & neck pain. She had multiple risk factors for cardiovascular disease. In the ED, no EKG, labs or x-rays were obtained. She was discharged with the diagnosis of back pain and died 3 days later. I addressed the most likely causes of her death and what testing would have shown and what treatments could have been offered.

A female patient who was six months pregnant presented to the ED with complaint of left sided sharp, stabbing back and shoulder pain and difficulty taking deep breaths. Several days later she died from a pulmonary embolism. I was asked to explain the evaluation, diagnosis and treatment of pulmonary embolism during pregnancy.

35 year old male with history of IV drug abuse presented to the ED with signs and symptoms of spinal epidural abscess. There was a delay in obtaining MRI and surgical consultation. This patient developed permanent paraparesis and bladder dysfunction. I was asked to address timing of imaging, the process of requesting surgical consultation and how these relate to outcome in patients with spinal epidural abscess.

32 year old male brought to the ED after a polysubstance overdose. Patient was intubated; however, the endotracheal tube descended into the right mainstem bronchus and this was not recognized. The patient became bradycardic, cyanotic, and then suffered cardiac arrest and died. I was asked to explain pulmonary anatomy, the process of intubation, including evaluation for proper endotracheal tube position, and appropriate monitoring of vital signs, cardiac rhythm and oxygenation.

89 year old female presented to the ED with abdominal pain. She was found to have mesenteric ischemia and died secondary to this. I was asked to discuss the evaluation of elderly patients with abdominal pain including the differential diagnoses, diagnostic testing, and treatment.

"[Dr. Stein's testimony was] extremely persuasive and credible."

Judge in written opinion

"Dr. Stein, several months ago I attended your deposition in a case where I was an opposing attorney. I made sure to remember your name because I was very impressed with you during that deposition. That case has since settled. I am hoping that you would be willing to review a new case for my firm."

Attorney Comment