Using Medical Textbooks for Impeachment
Our firm has well over 1000 of the leading medical textbooks in its office covering almost all medical specialties. There is a good reason for that. Textbooks are not only a great source of information to “learn the medicine” in order to pursue a complex medical malpractice case, better understand the injuries your client has sustained and assist you in proving the extent of your client’s injuries and damages to a jury. However, there is another great use for medical textbooks. They can be a persuasive source of impeachment of the opposing party’s physician expert witness in a personal injury case – especially in medical malpractice cases.
A statement in a medical textbook that directly contradicts your opposi- tions’ expert witness testimony is a powerful tool. You can almost always get the expert to agree that the chapter in the textbook that contains
The statement on the issue was written to teach physicians in training and in practice how to best treat patients. Furthermore, you can show the chapter and statement were written by leading experts in the field and point out that at the end of the textbook chapter there are many references and medical articles that were reviewed by the authors of the chapter to support their statements. Since the textbook chapter was written by a physician who was not hired by any of the parties at the time of its publication, it is undeniable that the author was free from any potential influence from a party to the litigation. Certainly, to a jury, the unbiased author who is an expert in his field packs tremendous credibility when he has published a book chapter on the subject at hand.
An example from a recent case illustrates the effectiveness of impeachment using a leading medical textbook. A child presented to the ER with transverse myelitis. The disastrous effects of the disease can be prevented by administering steroids. All of defendants’ experts testified that the administration of steroids to a pediatric patient with suspected transverse myelitis would not have been effective therapy in preventing brain injury – thus had it been given (the claim of error) it would not have made any difference in the outcome. They all stated in their expert reports that they relied on Nelsons Textbook of Pediatrics (2004 edition) to support their opin- ions. In fact, the defense experts were happy to supply a copy the relevant textbook chapter with their expert disclosures. Later, we disclosed to the defense that the same chapter in Nelsons Textbook of Pediatrics (2007 edition) stated that steroids indeed have been shown to be effective therapy in the treatment of transverse myelitis. Notably, the more recent textbook edition cited two medical studies in the bibliography (which studies were not cited in the 2004 edition) as the basis for the change in treatment protocol. This totally destroyed the defense experts’ opinions on the key issues of standard of care and causation.