Detail in Defendant Doctor's Direct Exam Key to Clearing Her in Med Mal Trial

Medical malpractice cases are often considered to be won on a “battle of the experts,” with each side offering their own expert testimony to support their theory of the case. However, the most crucial “expert” in med mal trials is often the defendant healthcare professional. Though they aren't classed as experts for procedural purposes, the testimony of a confident, knowledgeable, well-prepared defendant healthcare professional often carries great weight in a jury's eyes.  In Cox v. Fatemi, Scott Bailey’s direct exam of a defendant doctor was pivotal in clearing her in a wrongful death malpractice trial.

Tom Cox, 61, died of a heart attack in 2010, days after he had seen Dr. Arezou Fatimi, complaining of nausea and neck pain, among other symptoms. Cox’s wife claims Fatimi misdiagnosed Cox with a virus rather than acute coronary syndrome, a heart condition she says led to his fatal heart attack.

Fatimi, represented by Huff Powell Bailey’s Scott Bailey, contended Cox did not have ACS when she saw him, and her examination was thorough and appropriate under the circumstances.

Fatemi was the last witness called, ensuring her voice would remain fresh in the jury’s minds when they deliberated. Through more than an hour of testimony, Fatemi detailed her treatment of Cox, from her review of his medical history and symptoms before she walked through the examining room door through her half-hour physical exam and subsequent follow up review of his blood work.  Despite the fact that seven years had passed since the exam, Fatemi remembered key details of the visit and thoroughly explained her notes in the record, likely reinforcing her credibility when it came time for the jury to resolve conflicts between Fatemi and Cox’s wife over what occurred in the exam room.

Importantly, Fatemi explained in detail that she considered a variety of possible reasons for Cox’s illness, including meningitis and heart problems, before ruling each of them out and concluding he had a virus.

During direct exam, Bailey played devil’s advocate, asking, for example, why, given Cox’s symptoms, she would not have sent him to the emergency room to be cautious in ruling out ACS. The question allowed Fatemi to detail her conclusion that Cox’s symptoms did not fit the profile of someone with ACS. The two days Cox had complained of his symptoms before seeing Fatemi, combined with his general body aches, she explained, definitively ruled out ACS. “That body ache being in those seven non-specific symptoms [Cox complained of] makes a huge difference,” Fatemi said. “You don’t get body aches with acute coronary syndrome. You just don’t.”

Fatemi noted that Cox showed none of the telltale ACS signs of chest pain or shortness of breath. And, she countered the plaintiff’s theory that Cox’s neck pain was an atypical, but not unheard-of symptom of ACS, by explaining such pain radiated to the jaw and down the arm when associated with acute coronary syndrome. Cox, Fatemi said, did not complain of jaw and arm pain. “You have to look at the pathophysiology of these atypical symptoms. They’re all nerve related,” Fatemi explained, adding she remained as confident in her original diagnosis, seven years later, as the day she made it.

After trial, both sides agreed Fatemi was a key to the jury’s verdict, clearing her of negligence. “I really think that was probably the major factor in swaying the jurors to believe that this was good medical care," Bailey said.

Fatemi, through her confident, detailed testimony driven by Bailey, served to be the most critical “expert” at the seven-figure trial.