1 2 SUPREME COURT OF THE STATE OF NEW YORK JOSE …files.ctctcdn.com/1e4e339a001/08bb279d-2757-43a1-8ef9-47503b3… · 1 1 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF QUEENS-----X

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DIAMOND REPORTING (718) 624-7200 [email protected]

1

SUPREME COURT OF THE STATE OF NEW YORKCOUNTY OF QUEENS------------------------------------------XJOSE RIVERA,

PLAINTIFF,

-against- Index No.: 16240/2013

LLOYD LAMPELL,

DEFENDANT.------------------------------------------X

DATE: February 23, 2016

TIME: 6:00 p.m.

VIDEOTAPED TRIAL TESTIMONY of a

Witness for the Plaintiff, PAUL G.

KLEINMAN, M.D., taken by the respective

parties, held at the offices of BRONX PARK

ORTHOPAEDIC GROUP, 2016 Bronxdale Avenue,

Suite 202, Bronx, New York 10462, before

Robert Gonzalez, a Notary Public of the

State of New York.

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A P P E A R A N C E S:

FINE OLIN & ANDERMAN, LLPAttorneys for Plaintiff39 BroadwayNew York, New York 10006BY: BRIAN D. ACARD, ESQ.

-and- CHRISTOPHER CAMASTRO, ESQ.

PICCIANO & SCAHILL, P.C.Attorneys for Defendant900 Merchants ConcourseSuite 310Westbury, New York 11590BY: FRANCIS J. SCAHILL, ESQ.

ALSO PRESENT:MICHAEL BENNETT, VideographerDiamond Reporting, Inc.

* * *

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P.G. KLEINMAN, M.D.

THE VIDEOGRAPHER: We are now

on the record. The time on the video

monitor is six o'clock p.m. on

February 23rd, 2016.

My name is Michael Bennett with

Diamond Reporting and Legal Video.

This is the trial testimony of

Dr. Paul Kleinman taken on behalf of

Plaintiffs.

This testimony is being taken

at the offices of Dr. Kleinman

located at 2016 Bronxdale Avenue in

Bronx, New York. The name of the

case is Jose Rivera, Plaintiff,

against Lloyd Lampell, Defendant.

Index number 16240/13. In the

Supreme Court of the State of New

York, County of Queens.

Would Counsel please identify

themselves.

MR. ACARD: Brian Acard, Fine,

Olin and Anderman, for Plaintiff.

MR. SCAHILL: For the

Defendant, Frank Scahill, Picciano

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4

P.G. KLEINMAN, M.D.

and Scahill, P.C.

THE VIDEOGRAPHER: Thank you

very much.

The Court Reporter is Robert

Gonzalez, also with Diamond

Reporting.

I will ask him to please now

swear in the Witness.

P A U L G . K L E I N M A N ,

M . D . , called as a witness, having been

first duly sworn by a Notary Public of the

State of New York, was examined and

testified as follows:

DIRECT EXAMINATION BY

MR. ACARD:

Q. Please state your name for the

record.

A. Paul G. Kleinman, M.D.

Q. Good evening, Doctor.

Can you tell us what your

business address is?

A. 2016 Bronxdale Avenue, Suite

202, Bronx, New York 10462.

Q. Is that where we are located

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P.G. KLEINMAN, M.D.

tonight?

A. Yes.

Q. Do you duly licensed to

practice medicine in New York State?

A. Yes. Since 1981.

Q. Do you have a specialty in

medicine?

A. Yes, orthopedic surgery.

Q. Can you tell the Jury what

orthopedic medicine involves?

A. It involves the treatment of

problems of the bones, muscles, joints,

nerves, tendons, the extremities and back

and spine.

Q. Can you tell the Court and the

Jury a bit about your educational

background?

A. Yes. I was an undergraduate at

Harvard University, finishing in 1973. I

did my medical degree at Stanford

University School of Medicine, finishing in

1979. I did rotating internship at San

Francisco General. I did a year of general

surgery at St. Luke's Hospital in

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6

P.G. KLEINMAN, M.D.

Manhattan. I did my orthopedic training at

Columbia Presbyterian in Manhattan. Then I

did fellowship training in orthopedic

trauma at Nassau University Medical Center

and in hand surgery at Allegheny General in

Pittsburgh. I have also did pediatric

orthopedic training in the Hospital for

Joint Disease. I have been in practice for

thirty years.

Q. Doctor, have you published any

articles?

A. Yes. I was co-author of an

article on pin track infections. And

another co-author on a letter to the

Journal of Bone and Joint Surgery on hip

fractures.

Q. Have you lectured?

A. To medical students and

residents at St. Barnabas Hospital where I

am on staff.

Q. Do you teach other doctors?

A. Yes. Medical students, well,

residents in their rotations through the

orthopedic service, yes.

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P.G. KLEINMAN, M.D.

Q. Are you board certified?

A. Yes.

Q. Can you explain what it means

to be board certified?

A. You have to complete an

approved orthopedic residency and then you

have to pass written oral examinations

after being in practice for two years.

Q. What are you board certified

in?

A. Orthopedic surgery.

Q. Are you presently a member of

any professional societies or

organizations?

A. Yes, the American Academy of

Orthopedic Surgery.

Q. What is that?

A. It is the professional body for

orthopedic surgeons in the United States.

Q. And do you maintain an office

for the practice of medicine?

A. Yes.

Q. And is that this location we

are at?

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P.G. KLEINMAN, M.D.

A. Yes.

Q. How long have you been at this

location?

A. Sixteen years.

Q. Do you actively treat patients

during the normal week?

A. Yes.

Q. Do you have admitting

privileges at any hospital?

A. Yes, St. Barnabas Hospital.

Q. Do you currently perform

surgery?

A. Yes.

Q. What type of surgeries do you

perform?

A. Orthopedic surgery for

fractures or arthroscopy. Other problem,

congenital problems. Hand problems.

Various orthopedic problems.

Q. How often do you perform

surgery?

A. Usually on Wednesdays. I have

surgery tomorrow.

Q. Now did you and I speak before

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P.G. KLEINMAN, M.D.

you testified here today?

A. Yes.

Q. Do you know when that was?

A. Today.

Q. For about how long did we

speak?

A. Half an hour.

Q. Now before today have you ever

been recognized by any court as an expert

in your field?

A. Yes.

Q. On about how many occasions?

A. Not really sure. Maybe half a

dozen.

Q. Each time that you testified as

an expert in court, have you been

compensated for your time?

A. Yes.

Q. And are you being compensated

today?

A. Yes.

Q. Do you know how much?

A. Yes. Sixty-five hundred

dollars.

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P.G. KLEINMAN, M.D.

Q. Is that your normal fee?

A. Yes.

Q. Now, Dr. Kleinman, do you have

a chart or file with you for Jose Rivera?

A. I have the reports that I

prepared after examining him each time.

Q. Do you have any other file

regarding Mr. Rivera?

A. No.

Q. Are these reports something

that you made in the ordinary course of

your business?

A. Yes.

Q. Are these reports something

that you made contemporaneous or soon after

an office visit?

A. Yes.

Q. Would looking at your records

during your testimony assist you in

recollecting what you did?

A. Yes.

Q. Feel free to look at your

reports as we go along.

A. Yes.

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P.G. KLEINMAN, M.D.

Q. When for the first time did you

examine Jose Rivera?

A. August 31st, 2012.

Q. And were you asked to see Jose

for an entity that's wholly independent of

this case?

A. Yes.

Q. Was that Workers' Compensation?

A. Yes.

Q. Do you know what the purposes

of being asked to do these exams was?

A. Usually they want to know

whether a patient is disabled, what type of

treatment they need and what the causal

relationship to their accident is.

Q. In the case of Jose Rivera,

were you asked to make those

determinations?

A. Correct.

Q. Were you asked to examine Jose

Rivera on more than one occasion?

A. Yes.

Q. On how many occasions did you

examine him?

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P.G. KLEINMAN, M.D.

A. Twelve.

Q. When was the first time?

A. August 31st, 2012.

Q. Do you know when the last time

was?

A. December 1st, 2015.

Q. That was three months ago?

A. Right.

Q. Now when you examined Jose

Rivera, is it fair to say that you were not

examining him as one of his treating

physicians?

A. Right.

Q. Is it fair to say you were not

providing him with any treatment or medical

recommendations?

A. Right.

Q. Is it fair to say that Jose was

not seeing you as a patient, one of your

patients?

A. Correct.

Q. When you were asked to examine

Jose, who was responsible for providing you

with his medical records, if anyone?

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P.G. KLEINMAN, M.D.

A. There was a company called

Unimex that made arrangements from his

Workers Compensation carrier to have him

see me and they provided the records.

Q. Is it fair to say that Jose was

not supposed to give you any medical

records?

A. Correct.

Q. I want to just go back to the

first exam for a second of August of 2012.

Can you tell us what you did in

that exam?

A. I took a history and reviewed

medical records and did physical

examination.

Q. And did your history include

how Jose was injured?

A. Yes.

Q. What was that?

A. He said he was involved in a

head-on collision while he was in a vehicle

at work.

Q. Did Jose make any physical

complaints to you?

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P.G. KLEINMAN, M.D.

A. Yes.

Q. What physical complaints?

A. He -- The accident was on July

5th, 2012, so I was seeing him less than

two months later. He had a burn in the

right, some burns in the right forearm and

developed pain in both shoulders, wrists

and forearms as well as neck and back pain

and was also complaining of tingling down

the left leg.

Q. For that exam, were you

provided with any of Jose Rivera's medical

records?

A. Yes. They are listed on page

two of my report.

Q. What were those records?

A. Chart notes from two treating

doctors, Dr. Solano and Dr. Kubiak, as well

as an MRI report of the lower back, which

described disc desiccation, bulging at the

L5-S1, with severe stenosis and bilateral

foraminal narrowing. And another MRI

report of his neck from 7/23/12 which was

interpreted as showing straightening and

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P.G. KLEINMAN, M.D.

diffuse multilevel bulging and bony ridging

with degenerative disease and central

herniated discs at C5-C6.

Q. In addition to reviewing those

records, did you actually perform a

physical examination of Mr. Rivera?

A. Yes.

Q. What did that exam consist of?

A. Range of motion. Testing motor

exams. Century exam and straight leg

raising.

Q. Can you tell us the results of

-- You mentioned that you did range of

motion exam of his back?

A. Yes.

Q. Can you tell us what the

results of that were?

A. He had 40 degrees flexion,

normal being 90. He had 5 degrees

extension, normal being 30. He had 10

degrees side, side normal being 30. He had

some guarding at the extreme of motion.

Q. Can you just explain for the

Jury what you mean by flexion?

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P.G. KLEINMAN, M.D.

A. Flexion means bending forward

to try to touch your toes.

Q. Bending at the waist?

A. Yes.

Q. He was at 40 degrees?

A. Right.

Q. Normal being 90?

A. Correct.

Q. And what is extension?

A. Leaning back as far as you can.

Q. And he was at 5 degrees for

that?

A. Yes.

Q. And side bends, I guess that's

self-explanatory?

A. Yes.

Q. Side to side?

A. Yes.

Q. And you noted there were

restrictions?

A. Correct.

Q. How was it that you noted the

restrictions?

A. He stopped at that point. He

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P.G. KLEINMAN, M.D.

had some guarding, meaning he had tensed up

a little.

Q. Now you also did range of

motion for his neck; is that correct?

A. Correct.

Q. Can you tell us what the

results of your exam of the neck was?

A. He had 30 degree flexion,

normal being 40. He had 30 degrees

extension, normal being 40. He had 70

degrees rotation each side, which was

normal. And he had 30 degrees head tilting

side, which was normal. He had some mild

guarding at the extremes of motion at the

neck as well.

Q. Now did you also do straight

leg testing?

A. Right.

Q. What is that?

A. It is when you have a person

raise their leg, he was in a sitting

position, I had him raise his leg. And a

normal person should be able to get up to

ninety degrees without having back pain,

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P.G. KLEINMAN, M.D.

but he had back pain raising both legs at

45 degrees.

Q. Now, the results of your exam,

what did they indicate to you?

A. That he had limited range of

motion and pain in his neck and back. And

that the positive straight leg raising exam

indicates pressure on nerve roots in the

lower back. He also had some decreased

sensation in the left buttock, calf and

thigh, which also indicates some nerve root

compression.

Q. How does the straight leg, the

process of straight leg raising testing

indicate nerve compression?

A. You are stretching the sciatic

nerve which connects the nerve roots in the

lower back.

Q. Now, Doctor, when you were

asked to do exams of Jose Rivera were you

asked to state your impression following

the exam?

A. Yes.

Q. And that included your review

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P.G. KLEINMAN, M.D.

of the medical records as well?

A. Yes.

Q. Did you offer an impression

following your August 31st, 2012 exam?

A. Yes.

Q. What was that impression?

A. That he had chronic cervical

low back strain after a motor vehicle

accident and that he had MRI evidence of

stenosis at L5-S1 and a herniated disc at

C5-C6, superimposed on degenerative changes

on the neck and lower back.

Q. You just mentioned degenerative

changes.

A. Yes.

Q. Can you explain what that

means?

A. Those are age-related changes,

such as -- so you can get drying out of the

discs, you can get bone spurs. Those are

all degenerative changes.

Q. Does the presence of the

degenerative changes alone mean that a

person necessarily is experiencing pain?

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P.G. KLEINMAN, M.D.

A. No.

Q. Can you explain why not?

A. Because not everybody

experiences pain with degenerative changes.

Some people, you can do a X-ray and see

they have arthritis in some part of the

body, they feel fine. Other people might

be symptomatic.

Q. Were you provided with

information as to who Jose Rivera's

employer was at the time of the crash on

July 5th, 2012?

A. Yes, it was Verizon.

Q. Were you provided with

information as to the type of work that

Jose Rivera did?

A. Not specifically. Just that he

was a technician. Not specifically his

activities.

Q. As part of your exam that you

were asked to perform, were you asked to

give an opinion with respect to disability

of Mr. Rivera?

A. Yes.

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P.G. KLEINMAN, M.D.

Q. And what was the opinion you

gave in your report?

A. I said he had a moderate,

partial disability and should do only

sedentary work or could do only sedentary

work.

Q. What is sedentary work?

A. Work that's not particularly

active, primarily in a resting position,

that he shouldn't lift more than fifteen

pounds and only occasional. He shouldn't

do any repetitive bending or prolonged

driving.

Q. Doctor, I want you to assume

that Jose Rivera's job involved daily

climbing of telephone poles and ladders as

well as lifting and carrying objects, which

did weight more than fifteen pounds, awed

at the time you did your first exam on

August 31st, 2012.

Assuming those things, was Jose

Rivera physically capable of carrying out

those job responsibilities?

A. No.

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P.G. KLEINMAN, M.D.

Q. Now were you asked to offer an

opinion about causal relationship in that

report in August?

A. Yes. I classified his

condition as what we call preexisting but

exacerbated. He did have preexisting

degenerative changes on MRI scan but they

were not symptomatic, but the accident

exacerbated his condition and made him

symptomatic.

Q. So I want to go back a second.

Causal relationship, what does that mean?

A. There is something caused by

something else.

Q. And in this particular case

what was your opinion about causal

relationship with respect to the July 5th,

2012 motor vehicle crash?

MR. SCAHILL: Objection.

MR. ACARD: You can answer it.

A. Basically I felt that he had

become symptomatic from his, from the

accident, but he did have preexisting

degenerative changes which could contribute

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P.G. KLEINMAN, M.D.

to his symptoms, or could contribute to the

accident making him symptomatic.

Q. At that time, did you have an

opinion as to whether the accident caused

him to become symptomatic?


A. Yes, I thought that the

accident caused him to become symptomatic

although he had preexisting degenerative

changes which are predisposed to that.

Q. Was there any indication to you

in the history or the records that you were

provided he had been experiencing any pain

before July 5th, 2012?

A. Not initially. Later on. I

don't really remember how, it turned out

that he had had a previous motor vehicle

accident involving his neck and back

several years prior. But he, apparently

that resolved, he said. He was not

symptomatic.

Q. When was the next time that you

saw Jose Rivera?

A. December 18th, 2012.

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P.G. KLEINMAN, M.D.

Q. For that exam, were you provide

with additional medical records?

A. Yes.

Q. You have that in front of you

that report?

A. Yes.

Q. What records were you provided

with?

A. His initial emergency room note

from Mercy Hospital, physical therapy

notes, chart notes from Dr. Kubiak and Dr.

Cean and two epidural reports.

Q. And who provided you with those

records?

A. Unimex, which is the company

that contracted to handle this.

Q. You said that there were notes

regarding epidural injections?

A. Correct.

Q. What is that?

A. That's when -- he has had four

epidurals for his back. I saw notes for

two. But that's when a pain specialist or

anesthesiologist will put a spinal needle

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P.G. KLEINMAN, M.D.

into the back and inject steroid medicine

into the area between the covering of the

spinal cord and the cord itself. Or

actually correction. To the area just

outside the covering of the spinal cord.

Q. Now, Doctor, for that December

18th, 2012 exam, did you perform a similar

exam as the one you had done the first

time?

A. Yes.

Q. Can you briefly tell us what

findings you made during the course of that

exam?

A. Limitation of range of motion

of his back although he had a little more

flexion and a little more extension and a

little more side bending. For his neck, he

had more limitation in extension. He had

similar motor, century and straight leg

findings as to the first exam.

Q. Doctor, for that second exam in

December of 2012, were you again asked to

offer an impression?

A. Yes. The impression was the

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P.G. KLEINMAN, M.D.

the same.

Q. The same as your --

A. The previous exam.

Q. For that second exam, were you

asked to offer an opinion as to whether or

not Jose Rivera had a disability?

A. Yes. My opinion was the same

as before.

Q. The same as the first exam?

A. Right.

Q. And again, assuming what I told

you before, that Jose Rivera's job at

Verizon involved daily climbing of poles

and ladders as well as lifting and carrying

objects that weighed more than fifteen

pounds, at the time of your exam on

December 18th, 2012, did you have an

opinion with a reasonable degree of medical

certainty as to whether he could perform

that job?

A. I didn't think he could.

Q. Again, in that particular

report, were you asked to offer an opinion

as to causal relationship?

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P.G. KLEINMAN, M.D.

A. Yes. My opinion was the same,

that he had preexisting degenerative

changes which were not symptomatic and that

his condition was preexisting but

exacerbated.

Q. When was the next time you saw

Jose Rivera?

A. April 9th, 2013.

Q. Now, as part -- Do you have

that report in front of you?

A. Yes.

Q. As part of that exam, did you

record whether or not Jose had attempted to

return to work since your previous exam?

A. Yes. He said that in January

2013 he tried going back to work for about

eight days but had too much back pain and

had to stop.

Q. And as part of that report, did

you record what Jose had done medically

since the last time you had seen him?

A. Yes. He had had facet

injections for the lower back but that

didn't do too much. And he was continuing

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P.G. KLEINMAN, M.D.

therapy. Taking pain medicine.

Q. Had there been any reference

about seeing a surgeon at that point?

A. Yes. He was referred to a

surgeon.

Q. Can you explain what facet

injections are?

A. They are little joints on

either side of the vertebra that helps

stabilize the spine and can cause pain.

Q. At that time, did you do a

physical exam of Jose?

A. Yes.

Q. Was it similar to the previous

exams you had done?

A. More or less, yes.

Q. Can you just briefly describe

for the Jury what your findings were in

that exam?

A. Limitation in range of motion

in his neck and back. He had a normal

motor exam and he had positive straight leg

raising exam. Had decreased sensation to

light touch, but this time he had upper and

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P.G. KLEINMAN, M.D.

lower extremities rather than just the left

lower extremity.

Q. What did that indicate to you?

A. Nerve root irritation or

pressure on the nerve roots.

Q. Now for that exam, did you

offer an opinion as to whether or not Jose

had a disability?

A. Same opinion on disability.

Same opinion on causal relationship.

Q. And did the disability would be

the same regarding the job description that

I mentioned earlier?

A. Yes.

Q. As part of that exam, were you

asked to offer an opinion as to whether

Jose Rivera needed further treatment?

A. Yes, I thought he should

continue physical therapy. He should have

an evaluation by spine surgeon for his

lower back and he should see his treating

physician for pain, refill and monitoring

of pain medication. And if he decided, if

he and the spinal surgeon decided they

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P.G. KLEINMAN, M.D.

would like to go ahead with surgery for the

lower back that he should be authorized to

do so.

Q. And Doctor, at the end of that

report, had your opinion with respect to

causal relationship changed at all?


A. No.

Q. When was the next time you saw

Jose Rivera?

A. August 28th, 2013.

Q. I am sorry.

A. August 28th, 2013.

Q. Now, in that report, in the

report of that exam, did you note what Jose

Rivera had done medically since your last

exam?

A. He had had back surgery, which

was discectomy infusion on July 16th, 2013.

And he was in physical therapy.

Q. And that low back surgery that

you mentioned, is that something that you

had stated in your previous exam that

should be authorized?

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P.G. KLEINMAN, M.D.


A. Right.

Q. At this exam in August, on

August 28th, 2013, did you note whether

Jose had any physical complaints?

A. He still had neck and back

pain. And numbness in his feet and

posterior calf on both sides.

Q. Was there any discussion at

that visit regarding any further surgery?

A. He was planning on talking to

his surgeon about neck surgery.

Q. And did you do another exam at

that visit?

A. Yes.

Q. Was it similar to the other

exams?

A. He wasn't allowed to do back

range of motion. We didn't do that. And

neck range of motion was somewhat worse.

Straight leg raising exam was positive at

only a few degrees rather than 45 degrees.

The century exam showed decreased sensation

in the inner aspect of both feet and the

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posterior calf on both sides and in the

palm of both hands.

Q. And what did that indicate to

you at that time?

A. Nerve root irritation or

compression.

Q. That would be still post

surgery?

A. That would be what?

Q. That was post lumbar surgery?

A. Right.

Q. Now were you again asked to

offer an opinion as to whether or not Jose

had disability?

A. Yes, but at this point I

thought he had total disability and that he

couldn't work at all.

Q. Why is it that you thought he

had a total disability?

A. Because it is examined, it

deteriorated and he had significant pain

that I thought would interfere.

Q. Were you asked in that report

again to offer an opinion as to whether

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Jose had a need for further medical

treatment?

A. Yes. I thought that she (sic)

should continue physical therapy five times

a week and over the next two months and

that if he and his doctor decided they

wanted to do cervical spine surgery, then

he should go ahead and do that, or that he

should be authorized to do that.

Q. Now, Doctor, just so we can

speed things up, is it fair to say that you

next saw Jose again on November 5th, 2013?

A. Correct.

Q. And had any of your previous

findings changed at that exam?

A. Range of motion of his neck was

worse. We weren't doing range of motion of

the back because his doctor had cautioned

him about that. Not much else different.

Q. Were you asked to conduct

another exam of Jose Rivera on February

25th, 2014?

A. Yes.

Q. By the time of that exam, had

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P.G. KLEINMAN, M.D.

Jose Rivera had additional surgery?

A. Yes, he had a discectomy

infusion at C5-C6 in his neck.

Q. Was that surgery that you had

previously mentioned in your earlier

report?

A. Yes.

Q. Did you do a physical exam of

Jose at that exam on February 25, 2014?

A. Yes. We did neck range of

motion, which was still limited. We didn't

do back range of motion. And straight leg

raise exams, once again positive at about

40 degrees bilaterally. He had decreased

sensation to light touch in the interior

neck. He was post surgical. As well as

all the fingers of both hands and his chin.

Q. Did he ever have restriction of

cervical range of motion?

A. Yes, it was decreased.

Q. Now, Doctor, for this exam,

were you again asked to offer an opinion as

to whether Jose Rivera had a disability?

A. Yes, I thought he was totally

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P.G. KLEINMAN, M.D.

disabled.

Q. Did you have any indication at

that time as to when you thought Jose

Rivera might be able to go back to work?

A. That I didn't know.

Q. Now I will try to move things

along a little more.

Doctor, did you next see Jose

Rivera on August 19th, 2014?

A. Correct.

Q. And did you next see him after

that on November 11th, 2014?

A. Yes.

Q. At either of these two exams,

had any of your opinions changed since the

February 25th, 2014 exam?

A. No.

Q. Were you next asked to conduct

an exam on February 10th, 2015?

A. Yes.

Q. Did you conduct a physical exam

of Jose Rivera's neck at that time?

A. Yes.

Q. Did that include range of

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P.G. KLEINMAN, M.D.

motion testing?

A. Yes.

Q. What were the results of the

range of motion testing?

A. It was still decreased. He had

20 degrees flexion instead of 40. He had

30 degrees extension instead of 40. He had

30 degrees rotation to the head instead of

70. He had 30 degrees head tilt to one

side, to the left, which was normal, but

only 15 degrees head tilt to the right.

Q. Did you do an exam of Jose's

lower back at that time?

A. Yes. He had forty degrees

flexion instead of ninety. Ten degrees

extension instead of thirty. And fifteen

degrees side bending instead of thirty to

both sides.

Q. And, Doctor, for the exam of

February 10th, 2015, were you asked to

offer an opinion as to whether Jose Rivera

had a causally related disability?


A. Yeah, I thought he had a total

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P.G. KLEINMAN, M.D.

one hundred percent disability and I didn't

know when he would get back to work.

Q. Now, Doctor, were you asked to

conduct another exam on June 2nd, 2015?

A. Yes.

Q. And were you asked to conduct

another exam on September 8th, 2015?

A. Yes.

Q. And then I believe you told us

your last exam was a few months ago on

December 1st, 2015?

A. Yes.

Q. And during those visits, did

you conduct essentially the same type of

exam that you have been telling us about?

A. Correct.

Q. Did any of your previous

findings change as a result of those exams?

A. There were some minor

fluctuations in range of motion, but

otherwise pretty much the same exam.

Q. At the time of your most recent

exam of December 1st, 2015, were you asked

to offer an opinion as to whether or not

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P.G. KLEINMAN, M.D.

Jose Rivera had a disability?

A. Yes. I thought he had a total

disability.

Q. Is that one hundred percent

disability?

A. Yes.

Q. Did you indicate in your last

report whether you thought Jose could get

back to work?

A. He couldn't work and I didn't

know when he would get back to work.

Q. And you have not been asked to

do any other exams in the last three

months?

A. No.

Q. Now, Doctor, earlier you talked

about degenerative changes being present in

both Jose Rivera's cervical and lumbar

spine; correct?

A. Yes.

Q. Is it fair to say those changes

were present before July 5th, 2012?

A. Yes.

Q. And you had mentioned earlier

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P.G. KLEINMAN, M.D.

that -- Let me ask you this:

From your history of Jose

Rivera, did you have an understanding as to

whether he was symptomatic or asymptomatic

prior to July 5th, 2012?

A. He said he was not symptomatic.

Q. Doctor, based upon all 12 of

your exams over the last three and a half

years of Jose Rivera as well as your review

of the medical records that you were

provided, do you have an opinion within a

reasonable degree of medical certainty as

to whether Jose Rivera's current physical

condition was caused by the crash of July

5th, 2012?


A. I think he became symptomatic

as a result of that accident.

Q. Dr. Kleinman, based upon all 12

of your exams over the last three and a

half years of Jose Rivera as well as your

review of medical records that you were

provided with, do you have an opinion with

a reasonable degree of medical certainty as

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P.G. KLEINMAN, M.D.

to whether the need for Jose Rivera's lower

back surgery was caused by the crash of

July 5th, 2012?


A. Yes, I think it was caused by

that.

Q. Dr. Kleinman, based upon all

twelve of your exams over the last three

and a half years of Jose Rivera as well as

your review of medical records you were

provided with, do you have an opinion with

a reasonable degree of medical certainty as

to whether the need for Jose Rivera's

cervical surgery was caused by the crash of

July 5th, 2012?


A. I think it was caused by, his

need for surgery, yes.

MR. ACARD: Thank you.

No other questions.

CROSS EXAMINATION BY

MR. SCAHILL

Q. Doctor, good evening.

My name is Frank Scahill and I

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P.G. KLEINMAN, M.D.

represent the Defendant in this case, Jose

Rivera (sic).

Doctor, the reason we are

taking this deposition at your office is

due to the fact that you are unavailable or

unwilling to come to court and testify

before a jury in this case; is that

correct?

A. No.

Q. Was this arranged at the

request of Mr. Rivera's attorneys?

A. Yes.

Q. Were you ever asked to come to

court to testify?

A. Yes, I told them I could come

to court, but that I was going to our

national meeting next week.

Q. Are you aware when you say next

week, you are talking about the week of the

29th of February, 2016; correct?

A. Correct.

Q. So you would be able to come to

court the week of March the 3rd or the

following week?

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P.G. KLEINMAN, M.D.

A. I am at the meeting on March

3rd.

Q. The week of March the 7th you

would able to come to court?

A. Depending on the day. Maybe.

Q. And that sixty-five hundred

dollar fee that you are being paid, is that

something you negotiated with Plaintiff's

counsel?

A. I didn't negotiate it. I said

that's what the fee is.

Q. That's the fee to sit in your

office and give an hour's worth of

testimony?

A. Correct.

Q. Mr. Rivera was never your

patient; is that fair to say?

A. That's correct.

Q. And the reason that you have

seen him over the last seven years is

because you were paid by his Workers'

Compensation carrier to examine him to

determine whether or not he should continue

receiving Workers' Compensation benefits?

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P.G. KLEINMAN, M.D.

Is that fair to say?

A. Right.

Q. And the examinations that you

have done, are they done here in your

office in the Bronx?

A. No. I use a friend's office in

Long Island twice a month.

Q. And when you do that twice a

month, how many people do you see at that

time?

A. Could be anywhere from eight to

fifteen.

Q. And the examinations consist of

how much time?

A. It is very variable.

Q. Would it be fair to say that

the examinations are five minutes long?

A. No. Because I talk to them for

a while. I look at their medical records.

The whole process takes a while.

Q. When you say the process takes

a while, could you give the Jury an

estimate of how long you spend with

Mr. Rivera on each of the twelve visits you

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P.G. KLEINMAN, M.D.

saw him?

A. I really don't know.

Q. Was it more than ten minutes?

A. Probably, yeah.

Q. More than fifteen minutes?

A. Probably 20 minutes.

Q. And to prepare for that 20

minute examination, you said you review

medical records; is that fair to say?

A. Correct.

Q. I want to ask you about your

qualifications.

Has your license ever been

suspended or revoked?

A. No.

Q. Have you ever been sued in

malpractice?

A. Yes.

MR. ACARD: Note my objection.

Q. Do you know a patient by the

name of Gretchen Rivera?

A. Yes.


Q. Is Gretchen Rivera a Plaintiff

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P.G. KLEINMAN, M.D.

suing you in malpractice here in Bronx

County currently?

A. No.

What happened was --

Q. Doctor, I didn't ask. This is

cross-examination.

A. Wait, wait, wait. I am sorry,

but I have to finish my sentence. I will

not -- I am sorry, Mr. Scahill.

Q. Doctor, you can make any

statement you want on reexamination.

A. That case was thrown out in

court by a judge. The judge found it

without merit. It was thrown out of court.

Q. Doctor, this is cross

examination.

A. The answer is she is not

currently suing me because the case was

thrown out of court. It was found to be

without any merit.

Q. Do you know a patient by the

name of Debra Baron?

A. Debra Baron is a patient that I

have never seen that came to the emergency

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P.G. KLEINMAN, M.D.

room on the night that I was on call, but I

never saw her.

Q. Are you also being sued

currently in Bronx County by Debra Baron

for malpractice?


A. It is a patient I never saw who

sued everyone who had their name on her

record.

Q. I am asking you a question.

A. I am answering your question.

The answer is Debra Baron is a

patient who is suing everybody who ever saw

her, including me who never saw her,

because she showed up in the emergency room

at St. Barnabas on the night that I was on

call and had a wrist fracture reduce and

never came back. I never saw her. But

since my name is on the chart, sir, she is

suing everybody who ever saw her. She was

then treated at other hospitals where they

did surgery.

Q. You testified before, Doctor,

right?

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P.G. KLEINMAN, M.D.

A. Yes.

Q. How often do you testify per

year?

A. Once, twice. At most.

Q. You also prepare reports;

correct?

A. Correct.

Q. For individuals that you see in

the course of your practice?

A. Yes.

Q. That are not your patients?

A. Correct.

Q. Individuals, such as Mr. Rivera

who you are being paid by the Workers'

Compensation carrier; correct?

A. Yes.

Q. Do you also perform what's

called independent medical examinations?

A. That's what Mr. Rivera had, an

independent medical examination.

Q. So how many independent medical

evaluations do you perform per week?

A. Probably about ten to fifteen,

ten to eighteen.

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P.G. KLEINMAN, M.D.

Q. How much are you paid for those

independent medical examinations?

A. About two hundred fifty

dollars.

Q. You are also paid sixty-five

hundred dollars per testimony; is that

correct?

A. Per testimony for this type of

thing?

Q. Yes.

A. Yeah.

Q. You also testify for the

Workers' Compensation carriers?

A. Right.

Q. And how much are you paid for

testimony from the Workers' Compensation

carriers?

A. Six hundred dollars.

Q. How many times per week do you

do that?

A. Probably once every month or

two.

Q. Were you sued by an individual

by the name of William Polanco?

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P.G. KLEINMAN, M.D.


A. Yes.

Q. So those three individuals that

I mentioned, Gretchen Rivera, Debra Baron

and William Polanco, are or have sued you

for medical malpractice during the course

of your --

A. Thirty year career, yes.

Q. And those cases were filed in

2005, 2014 and 2009; correct?


A. Correct.

Q. Now, when Mr. Rivera first came

to you, he reported to you that he was

involved in a car accident; correct?

A. Right.

Q. And he was receiving Workers'

Compensation at that time?

A. Right.

Q. When you saw Mr. Rivera for the

first time, he gave you a history; is that

fair to say?

A. Yes.

Q. And you asked him whether or

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P.G. KLEINMAN, M.D.

not he ever had any prior injuries to his

neck or his back; correct?

A. Correct.

Q. And Mr. Rivera denied that he

had ever had prior injuries to his neck or

back; correct?

A. Initially.

Q. When you say initially --

A. I found out at a later date one

of the other exams later on.

Q. I didn't ask you that.

A. I answered that.

Q. I asked you when you first saw

him in August of 2012, you asked him, did

you ever have any prior injuries to your

neck or back, and he said no.

A. Right.

Q. You specifically inquired of

his prior medical condition because that's

important in obtaining a full medical

history for you as a doctor to come to a

proper diagnosis; is that fair to say?

A. Say it again.

Q. The reason that you asked him

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P.G. KLEINMAN, M.D.

about prior injuries is because it is

important for you as an examining doctor to

obtain a full medical history in order to

elicit a proper diagnosis; is that fair to

say?

A. Right.

Q. So the history that you take

from a patient is a critical part of your

diagnosis; is that fair to say?

A. Correct.

Q. And it is important for that

patient to be open and honest with you when

you asked them questions because depending

on their responses your diagnosis could be

wrong; is that also fair to say?

A. Right.

Q. And when you ask Mr. Rivera

about prior injuries to his neck and back,

he denied those injuries.

Would be it fair to say that

Mr. Rivera was not open and honest with you

when you asked him the questions and he

gave false answers?


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P.G. KLEINMAN, M.D.

A. I wouldn't speculate as to

whether he forgot, whether he is being open

and honest. I don't know what the reason

was. He told me about it later.

Q. You knew that he came to you

with complaints of neck and back injuries?

A. Yes.

Q. Is that a yes or no?

A. Yes.

Q. So it was critical for you to

know whether he had a prior neck or back

injury; is that fair to say?

A. It was important to know.

Q. And when you asked him that

question, that was one of your first

questions, did you ever injure your neck or

back before, he told you no; is that fair

to say?


A. I answered that already.

Q. I am asking you, is that fair

statement?


Q. Is that a fair statement?

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P.G. KLEINMAN, M.D.


I am not going to say the same

thing over and over again. He had said he

had not had prior problem.

Q. Were you aware he was involved

in another accident where he injured his

neck and back in 1998?

A. I was aware of a motor vehicle

accident which I thought was in 2010. That

was my understanding.

Q. I am just asking you, were you

aware that he injured his neck and back in

an accident in 1998?

A. I was aware at a later exam

that he had a motor vehicle accident,

although I thought the date was 2010.

Q. Were you aware that he was

involved in an accident in 1998?

A. I just said, I thought the

accident date was 2010.

Q. So is that fair to say that you

were to this day, you are still unaware

that he was involved in an accident in 1998

when he injured his neck and back?

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P.G. KLEINMAN, M.D.

A. Was he involved in two

accidents?

Q. I am asking you.

A. Well, I am asking you. Let's

be up front about it: Were there two

accidents? Or did I get the date wrong?

Q. Doctor, this is cross

examination.

A. Are you trying to hide

something that you don't want to tell me?

Q. I object and I ask for that to

be stricken.

A. What I would like to say is

that it is possible, what is possible is

that I got the date wrong. All I know is

that at some point at a later exam he told

me he had prior motor vehicle accident.

Although I thought the date was 2010.

Q. I think Plaintiff's counsel

will concede the fact that he was involved

in an accident in 1998. And ordinarily a

judge is present and make rulings when

people make objections and a judge would

instruct you to answer the question that's

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P.G. KLEINMAN, M.D.

asked.

A. I just answered the question.

MR. ACARD: I will object to

this.

Q. I will ask you again:

Were you aware or did you ever

become aware that he was involved in an

accident in 1998 and injured his neck and

back?

A. The answer is I was not aware

of 1998. I thought he had an accident in

2010. That was my understanding.

Q. Were you also aware that he was

involved in an accident in January of 2004

where he injured his neck and back?

A. No.

Q. Would those be items that you

would want a patient or an individual

coming to you for an exam to tell you

about?

A. Yes.

Q. And Mr. Rivera did not tell you

about either of those accidents back in

1998 and 2004; is that fair to say?

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P.G. KLEINMAN, M.D.

A. He told me about one accident

but I may have gotten the date wrong. I

don't know which one he was talking about.

Q. Were you aware he was involved

in an accident on December 11th, 2008 where

he also injured his neck and back?

A. No.

Q. Is it fair to say that

Mr. Rivera failed to reveal to you prior

accidents in 1998, in 2004 and in 2008?

A. He didn't say that.

Q. Do you know, were you ever made

aware that he was previously diagnosed with

herniated discs in his neck and his back?

A. He didn't say that.

Q. Would it be critical to you as

an examining physician to formulate a

proper diagnosis to know that he had prior

MRI evaluations of his neck and back where

he was diagnosed with a herniated disc?

A. It would be important to know.

Q. Would that be a critical

element of your history?

A. What does critical mean? It is

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P.G. KLEINMAN, M.D.

important.

Q. When you talk about important

elements that he tell you about, he didn't

tell you about a prior accidents and prior

injuries.

Do you know he was involved in

prior lawsuits for exactly the same

allegations that he is making in this

claim, problems with his neck and back?


A. No.

Q. Would that also be an important

element of your history?

A. Yes.

Q. And in terms of the records

that you had when you first examined him,

you said you had records from Dr. Solano;

is that fair to say?

A. Yes.

Q. And you had MRI reports; is

that also fair to say?

A. Right.

Q. Now you did not ask him about

this collision itself? You just took a

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P.G. KLEINMAN, M.D.

history that he was in an accident;

correct?

A. No. That's not correct. He

said he was wearing a seat belt and was

involved in a head-on collision. That was

the history I got.

Q. Now did you ask him about the

severity of the impact?

A. No.

Q. Did you ask him whether his

seat belt restrained him?

A. Well, he didn't say it broke,

so I assume it did.

Q. Did you ask him about air bag

deployment, or whether air bags were

deployed in the vehicle?

A. No.

Q. Did you ask him about his

treatment after the accident?

A. Yes.

Q. Were you aware that he went to

Jamaica Hospital and he signed himself out

against medical advise because he had --


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P.G. KLEINMAN, M.D.

A. That's in paragraph three.

Q. That he had to wait for too

long and he decided to leave?

A. He went to Mercy Hospital.

Q. Do you know how he left Jamaica

Hospital?

A. No.

Q. Do you any if his wife picked

him up and they drove back to the --

A. I don't know how.

Q. I will ask you a question:

Were you aware that his wife

picked him up, went back to the Verizon

yard and he got his car and drove it to

Mercy Hospital? Were you aware of that?

A. I told you I don't know how he

went there.

Q. Would you also degree with me

that it was important for you in addition

to the items regarding the history of this

patient that he did not tell you about,

would it also have been important for you

to review his hospital record from Mercy

Hospital?

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P.G. KLEINMAN, M.D.

A. If somebody would have provided

it, it would have been interesting to see.

Q. Would you agree that it would

have been important to see the hospital

record from Mercy Hospital?

A. Okay. It is important.

Q. And are you aware, did you ever

see the hospital record from Mercy Hospital

from the day of the accident?

A. Not that I recall.

Q. You never saw it?

A. No.


Q. I will show you the hospital

record and I would ask Counsel to agree

with me that this is deemed marked as

Defendant's Exhibit A and I would ask you

to review the hospital record from the date

of the accident.

A. You want me to review all this

now? Is there something you want me to,

you want to point me towards? So I don't

have to read all this.

Q. I would like you to read the

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P.G. KLEINMAN, M.D.

diagnosis of the examining physician at

Mercy Hospital on the date of the accident.

A. He had a motor vehicle

accident. Back pain and right forearm

burn. Anything else?

Q. Turn towards the end. There is

a diagnosis.

A. That was under the diagnosis.

Why don't you show me what you want?

Because I looked at the diagnosis right

here. Why don't you pick out what you want

me to look at?

Q. Can you look at that page, tell

me what the diagnosis is, where it

specifically says the doctor thinks you

have?

A. This is a preprinted page that

they hand out at the hospital. It is not

something that the doctor picked as the

diagnosis. It is a preprinted page that

they hand everybody with low back pain.

What is that supposed to mean?

Q. What's the diagnosis there?

A. It is a preprinted page saying

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P.G. KLEINMAN, M.D.

low back strain. Which they hand to

everybody that comes in and complaint about

back pain.

Q. Is there a diagnosis you see in

the records?

A. I told you. It says final

diagnosis. I just said that. Motor

vehicle accident. Back pain. Right

forearm burn.

Q. Would you agree with me that

the diagnosis at Mercy Hospital on the day

of the accident was low back strain?

A. No. It said back pain. What's

written by the doctor is back pain. What

you handed me is a preprinted paper that

they hand to everybody that comes in with a

back problem and they write low back strain

for everybody that complains about back

pain. It was not written by a doctor.

What the doctor wrote was back pain.

Q. Do you know if my radiology

tests, X-rays, MRIs, CAT scans were done at

the hospital on the date of the accident?

A. He had a normal low back

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P.G. KLEINMAN, M.D.

lumbosacral X-ray on 7/5/12.

Q. They took an X-ray of his back

at the hospital and it was normal?

A. Yes.

Q. Do you see anywhere in that

hospital record any reference by either a

report by Mr. Rivera or a notation by a

nurse or doctor or health care professional

of any complaints with respect to his neck?

A. No.

Q. Would it have been important

for you, Doctor, to review the hospital

records from the date of the accident

before making a determination as you said

earlier that he had a causally related

problem to his neck from the accident of

July 2012?

A. I don't think that's

particularly significant. I have seen many

patients that develop neck or back pain

following an accident that's not

immediately apparent on the date of the

accident. I don't think that's unusual at

all.

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P.G. KLEINMAN, M.D.

Q. You are making a statement here

to the Jury that Mr. Rivera injured his

neck in the accident of July 5th, 2012.

However, am I correct that the hospital

record is devoid of even of a complaint of

neck pain by Mr. Rivera on the date of the

accident; is that correct?

A. Right.

Q. You also had MRI reports that

you looked at?

A. Yes.

Q. And by the way, in terms of

neck and back problems, you do not do any

surgery to the neck and back; is that

correct?

A. Yes.

Q. So if an individual came to you

as a patient and had a problem with a neck

and back, you would refer that person to

someone else; correct?

A. Only if they needed surgery.

Ninety-nine percent of the patients I see

with neck and back problems don't need

surgery, so we treat them.

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65

P.G. KLEINMAN, M.D.

Q. But you do not do neck and back

surgeries?

A. Correct.

Q. In your career, other than

being an intern --

A. Resident.

Q. Or resident, you had never did

neck and back surgery; correct?

A. Yes.

Q. So for the last 30 years of

your practice, your specialty is not neck

and back surgery; correct?

A. Right.

Q. You see people with ankle

sprains, ankle fractures?

A. I see people with everything,

including neck and back problems, that

don't need surgery.

Q. And you treat them with

medication, physical therapy, analgesics,

but if an individual needed spinal surgery,

you would send them to a qualified spinal

surgeon; correct?

A. I answered that, yes.

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P.G. KLEINMAN, M.D.

Q. Now you also talked about

reports, MRI reports?

A. Yes.

Q. You never looked at any of

Mr. Rivera's MRIs; is that fair to say?

A. Right. They weren't provide to

me.

Q. You do read MRIs in your

practice; is that fair to say?

A. Right.

Q. On regular basis, you read

MRIs?

A. Right.

Q. So you would know looking at

the MRI itself, not a report, but looking

at the MRI itself, if an individual had

preexisting arthritis to his neck or his

back; correct?

A. Yes.

Q. And you never had the

opportunity to look at any of Mr. Rivera's

MRIs?

A. Right.

Q. During the two or three years

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67

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that you were seeing him periodically for

20-minute examinations every couple of

months for his Workers' Compensation; is

that fair to say?

A. Right.

Q. Did you ever ask for his MRIs?

A. I don't ask for anything. They

send the patient with whatever records they

have available.

Q. Did you ever call any of his

doctors?

A. I am not allowed to talk to

those doctors as an independent medical

examiner. It is not allowed.

Q. You never spoke to any of his

doctors?

A. You are not allowed to.

Q. Did you ever ask Mr. Rivera to

bring in his MRIs because you wanted to

review them yourself?

A. No. I didn't think it was

necessary. It was obvious from his report

that he had preexisting degenerative

changes.

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Q. Let's talk about your report

when you talked about --

A. His report, his MRI report.

Q. So his MRI reports were done by

a radiologist. That's another field,

another specialty of medicine that

concentrates on reviewing and interpreting

radiology films; is that fair to say?

A. Right.

Q. And you yourself are not a

board certified radiologist?

A. Right.

Q. And if you were asking a

patient to undergo MRI testing, you would

not interpret those testings, that test

yourself? You would rely on a board

certified radiologist; is that fair to say?

A. I would look at them as well.

I rely on the radiologist, too.

Q. You talked about the MRI

reports that showed disc desiccation.

That's another form or another term for

arthritis; is that correct?

A. It means the disc has lost

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P.G. KLEINMAN, M.D.

fluid. It is a degenerative finding.

Q. When we say degenerative, we

are talking about age related?

A. Yes.

Q. And that's related to

arthritis?

A. Correct.

Q. And every individual after a

certain age is subject to disc desiccation;

is that correct?

A. What you mean by subject to?

You can't say everybody has.

Q. Individuals with or without

accidents have disc desiccation in their

lumbar and cervical spine; correct?

A. Right.

Q. And that is not caused by

trauma? That's something that's caused by

aging; is that fair to say?

A. Could be caused by many things.

Q. But specifically as to

Mr. Rivera, the preexisting findings that

you talked about, disc desiccation, that

could have been due to his prior accidents;

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P.G. KLEINMAN, M.D.

correct?

A. Could have been due to

age-related changes, prior accidents, lots

of things.

Q. The spinal stenosis you talked

about, that's another form of arthritis;

correct?

A. That means narrowing of the

canal around the spine and the roots. That

has multiple causes.

Q. But that's not trauma related?

That's something that was caused by either

prior accidents or age-related changes; is

that fair to say?

A. Stenosis, yes.

Q. It had nothing to do with the

auto accident of July 2012, the disc

desiccation and the spinal stenosis that he

had was all related to prior conditions; is

that fair to say?

A. Yes.

Q. Also, you talked about, just in

terms of the anatomy, the discs are shock

absorbers between the vertebrae; is that

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P.G. KLEINMAN, M.D.

fair to say?

A. Correct.

Q. It is a gelatinous material

that's primarily made up of water?

A. Yes.

Q. As people age, they lose water

content in those discs and the discs dry

out and flatten; is that fair to say?

A. Yes.

Q. And that's something that you

could easily see on a MRI? In fact, an MRI

picks up the water content in the discs; is

that fair to say?

A. Yes.

Q. The reason that people have

pain is when they age and the discs

flatten, it encroaches on the nerves that

are exiting the spinal canal at a

particular level of the spinal column; is

that also fair to say?

A. Say it again.

Q. The reason that people have

pain from nerve root compression is that

the disc encroaches upon the nerve as it

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exits the particular level of the spinal

column?

A. There are many routes, many

causes of people having pain.

Q. Is that one of the causes?

A. That's one cause. Also trauma

is a cause. Stretch a nerve root. There

are multiple causes.

Q. What contributes to the pain is

if an individual has what's known as neural

foraminal narrowing, that opening that the

nerve passes through in the spinal canal

narrows; is that fair to say?

A. That's one cause.

Q. That's indicative of spinal

stenosis; is that fair to say?

A. That's the definition of spinal

stenosis.

Q. In terms of that finding, that

has nothing to do with trauma? That's a

age-related finding; is that fair to say?

A. What's your question? Is

spinal stenosis an age-related problem?

Q. Yes.

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73

P.G. KLEINMAN, M.D.

A. Is that your question?

Q. Yes.

A. Yes.

Q. So the three findings on the

MRI report that you highlighted with

respect to Mr. Rivera when he first came to

see you were disc desiccation, spinal

stenosis and neural foraminal narrowing; is

that fair?

A. Yes.

Q. All of those findings predate

the accident of July 5th, 2012; is that

also fair to say?

A. Right.

Q. Now you talked about Mr. Rivera

beings symptomatic.

He told you that he was having

pain?

A. Correct.

Q. But you as a board certified

physician for 30 years you can't measure

pain?

A. Right.

Q. Pain is something that's

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subjective; is that right?

A. Right.

Q. Now I would like to explain to

the Jury the difference between subjective

and objective findings and I will use an

analogy: If someone tells you they have a

stomach ache or an upset stomach, that's a

subjective complaint; correct?

A. Right.

Q. If someone vomits and you see

it, that's an objective finding; is that

fair to say?

A. Yes.

Q. If someone tells you they can

only bend their neck a certain degree or

bend their back a certain degree, you take

them at their word as the examining

physician but that's all subjective; is

that fair to say?

A. Subjective, but I don't force

them to go then what they do.

Q. The symptoms that you are

talking about, the symptomatic findings

that you had, that's that Mr. Rivera

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P.G. KLEINMAN, M.D.

related to you, that he was asymptomatic,

he had no problems before the accident, and

after the accident he was symptomatic; is

that fair to say?

A. Yes.

Q. But you had no way of measuring

that, you didn't look at any of his prior

medical records; is that fair to say,

Doctor?

A. Right.

Q. Even though you are now aware

that he had MRIs before this accident and

he was diagnosed with herniated discs in

the neck and back and he had treatment for

many years for his neck and back pain.

Did any of the records that you

did not see cause you to question your

diagnosis at this time?


A. I didn't see them. How would I

know? How would I know something that I

didn't see would cause me to question? It

doesn't make any sense.

Q. Would it be fair to say that

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your diagnosis would be more accurate if

you had those records to look at?

A. Right.


Q. Would it also be fair to say

that you would be able to give a more

accurate picture to the Jury as to whether

or not the accident of July 5th, 2012 was

the competent producing cause of

Mr. Rivera's pain if you had those prior

records to look at?


A. Possibly.

Q. Would you have been in a better

position to give an opinion on whether or

not the accident of July 5th, 2012 was the

causal producing element or incident for

Mr. Rivera's condition if you had the

opportunity to look at his prior or his

hospital records from the date of the

accident?


A. Your sentence was too long.

Can you say it again?

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P.G. KLEINMAN, M.D.

Q. Would your diagnosis have been

more accurate if you looked at the hospital

records from the date of the accident?


A. I don't think it would have

been more accurate.

Q. Would it have been more

accurate if you looked at his prior MRI?

A. It might have been helpful,

yes.

Q. In terms of the purpose of your

visit with Mr. Rivera, he came to you

because the Workers' Compensation carrier

wanted to know whether or not he would

qualify for continued use, receipt of

Workers' Compensation benefits; is that

fair to say?


A. No. What they asked was three

things. They wanted to know, did he need

more treatment, if so, what treatment.

They wanted to know what his work capacity

was and they wanted to know causal

relationship. They didn't ask me about

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P.G. KLEINMAN, M.D.

receipt of benefits.

Q. We already talked about causal

relationship and all the records and tests

and MRIs that you didn't have the

opportunity to look at.

A. Right.

Q. Let me talk to you for a minute

about the complaints that Mr. Rivera was

making to you.

You were aware of a medical

term known as secondary gain?


A. Yes.

Q. That's taught in medical school

to you as an intern, as a resident and

throughout your practice, there is

continuing education requirement that you

have as board certified physician; correct?

A. Related to secondary gain?

Q. Related to your practice, you

have to --

A. We do continuing medical

education, yes.

Q. In medical school you were

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79

P.G. KLEINMAN, M.D.

taught about secondary gain.

Can you explain to the Jury

what secondary gain is, what your

understanding of that is?


A. When people do something or

claim something in order to gain something.

Q. Is it fair to say that you as

an examining physician for Workers'

Compensation take into account secondary

gain during your examinations?

A. Right.

Q. Many individuals that come to

you to be examined for the Workers'

Compensation carrier exaggerate the extent

of their injuries because they want to

continue receiving Workers' Compensation

benefits; correct?


A. I have never in my life seen a

patient undergo neck and back surgery for

secondary gain. That is ridiculous. It

just doesn't happen. No one would undergo

neck and back surgery for secondary gain.

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P.G. KLEINMAN, M.D.

That's ludicrous.

Q. I ask that that be stricken and

I object to that response. That wasn't my

question, Doctor.

A. Well, that's my answer.

Q. My question was, in the course

of your practice, do you take into account

secondary gain when examining people for

the Workers' Compensation carrier?

A. Yes.

Q. Now, as far as Mr. Rivera is

concerned, you never recommended a course

of treatment for him; correct?

A. I said that if he wanted to --

no, I did recommend, I recommended he do

therapy for a while, that he try epidurals,

that if he and his physician wish to

perform surgery, then that should be

authorized. I didn't specifically

recommend, but I agreed with the plans that

his treating doctors --

Q. He was never your patient;

correct?

A. Correct.

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Q. And when was the last time you

saw him?

A. December 1st, 2015.

Q. And as far as your visits, the

twelve visits you had, you never prescribed

medication for Mr. Rivera; correct?

A. Correct.

Q. And you never prescribed any

diagnostic tests for him?

A. That I don't remember, but I

don't think so. I am not one hundred

percent sure.

Q. And as far as your evaluation

of him in August of 2012, on your first

evaluation, you noted that he had a

disability to a certain degree; correct?

A. Uh-hum.

Q. Is that a yes?

A. Yes.

Q. What was your finding as far as

the disability is concerned?

A. Moderate partial.

Q. One more question about the

hospital record:

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You are familiar with triage

forms in the hospital; correct?

A. Right.

Q. And they do ask you on a scale

of one to ten what is your level of pain?

A. Okay.

Q. Is that --

A. Some hospitals, yes, okay.

Q. I would ask you to look at the

Mercy Hospital records from the date of the

accident.

Was Mr. Rivera asked that same

question, what's your degree of pain on a

scale of one to ten? It is in the upper

left hand corner.

A. Yes. He said it was moderate.

Q. And specifically as to the

numbers of pain, one, two, three would be

mild; right?

A. On this scale, yes.

Q. And three, four, five would be

moderate?

A. On this scale, one, two, three

is mild. Four, five, six, seven is

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moderate.

Q. And Mr. Rivera's level of pain

on the date of accident was a moderate; is

that fair to say?

A. That's what they circled.

MR. SCAHILL: Thank you,

Doctor.

I have nothing further.

REDIRECT EXAMINATION BY

MR. ACARD:

Q. Just a few more questions,

Doctor.

First of all, Mr. Scahill just

spent a lot of time with you going over

degenerative changes and what they mean,

and I had asked you about them before.

So we are clear, all of those

degenerative changes that he talked about

and arthritic changes, those type of

things, if they exist, do they necessarily

mean that pain exists?


A. No.

Q. And can those conditions exist

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without pain?

A. Correct.

Q. In fact, do they exist without

pain in patients?

A. Yes.

Q. And can trauma cause those

conditions to begin to cause pain?

A. Yes.


Q. Can you explain that?

A. When people have degenerative

changes, they sometimes cannot be

symptomatic, but trauma can, for example,

can cause swelling around nerve roots or

around discs and cause pressure to be

placed on nerve roots in areas where they

didn't have much space to begin with.

There are tiny nerve in, even in the discs

and the bone that could be irritated and

inflamed from trauma. All of these things

can cause pain.

Q. Doctor, would you expect

somebody who had lower back pain and

sciatica to be climbing telephone poles and

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P.G. KLEINMAN, M.D.

ladders?


A. No.

Q. Why is that?

A. I would expect that he would

have too much pain or it might be dangerous

for him to do so if he were having pain.

Q. Now, Doctor, we have gone over

some records before.

I am going to jump for a

second.

In your second report regarding

Jose Rivera of December 18th, 2012, you

have that?

A. Yes.

Q. In that report, you did

indicate that you reviewed medical records;

correct?

A. Yes.

Q. In fact, in that report, you

did indicate that you had reviewed the

Mercy Hospital records; correct?

A. Yes. I don't remember now.

Q. Just so we are clear, you don't

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keep -- is it correct you don't keep a file

of all of your notes from your exams with

Mr. Rivera?

A. No.

Q. You don't keep a file of his

medical records that you were given?

A. Right. I don't.

Q. Why is that?

A. I don't really have the space

for it and they are stored in the Workers'

Compensation files as well as in the files

of Unimex that sends them to me as well as

Sedgwick, the insurance carrier.

Q. As we said before, Mr. Rivera

doesn't bring you the medical records;

correct?

A. Correct.

Q. And he is not responsible to

bring you the medical records; correct?

A. Correct.

Q. And it's the responsible (sic)

of -- Who is it?

A. Unimex, which is the company

that contracts with the compensation

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P.G. KLEINMAN, M.D.

carrier called Sedgwick.

Q. And Sedgwick or Unimex, are

they the ones that are supposed to provide

you with the medical records that they feel

are important for your exam?

A. Right.

Q. That's not Mr. Rivera's

responsibility to decide what records you

should have?

A. Correct.

Q. Is he instructed to bring any

type of MRI films or medical records with

him?

A. I don't know what instructions

he has.

Q. Have you ever had a patient for

Workers' Comp exam be instructed to bring

those things with them?

A. I don't know if they are

instructed, but once in a while somebody is

brought something.

Q. Just to be clear, you don't

have any notes, any physical notes from

your exam?

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P.G. KLEINMAN, M.D.

A. Correct.

Q. All we are relying on are your

reports?

A. Correct.

Q. Again, on December 18th, 2012

report, does that refresh your recollection

as to whether you actually did review the

Mercy Hospital records before your exam?

A. Apparently I did, but I didn't

remember it when I was being questioned

about it.

Q. Questioned by Mr. Scahill?

A. Yes.

Q. But does that indicate that you

had reviewed the record?

A. Yes.

Q. First of all, Doctor, I will

ask you to take the records that

Mr. Scahill gave you before and go back

to -- you were trying to explain before on

page four, the fourth page of the records,

there is a box I believe in the lower left

hand corner regarding final diagnosis.

A. Yes.

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P.G. KLEINMAN, M.D.

Q. And you had reviewed that

record; correct?

A. Yes.

Q. And what was the doctor at the

emergency room's final diagnosis?

A. Motor vehicle accident. Back

pain. Right forearm burn.

Q. Now does that -- And that's

handwritten by the doctor?

A. Correct.

Q. That's not a preprinted --

A. Also high blood pressure.

That's handwritten by the doctor.

Q. That's not a preprinted form;

correct?

A. Correct.

Q. The pages that you had

mentioned before that Mr. Scahill asked you

about, can you explain again, are those

forms that are premade before a patient

ever arrives?

A. Yes, they are preprinted and

they are given to anybody with a back

problem.

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90

P.G. KLEINMAN, M.D.

Q. Regardless of what the back

problem is?

A. Correct.

Q. And does that doctor in his

handwritten notes say anything about a back

strain?

A. No.

Q. Again, you would have reviewed

all of these records, correct, before your

exam? Would you have reviewed this Mercy

record?

A. Yes.

Q. On page four of that record, I

believe at the top it says motor vehicle

accident in a box.

A. Which one?

Q. The fourth page of the record.

A. Yes, right.

Q. You see that?

A. Right.

Q. About halfway down, do you see

where it has the initials P.M.H. on the

left side?

A. Show me.

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91

P.G. KLEINMAN, M.D.

Q. Perhaps we are looking at a

different page.

The next page.

A. Okay.

Q. You see on that page it says

P.M.H.?

A. Yes.

Q. What does that stand for?

A. Past medical history.

Q. That would have been asking the

patient his past medical history?

A. Yes.

Q. And on that line, is there

handwriting?

A. Yes. It says '98, back injury,

1998. Sleep apnea and asthma.

Q. Does that indicate to you that

Mr. Rivera must have told somebody at the

hospital about his 1998 back injury?

A. Right.

Q. And would you have reviewed

this record at the time of your exam;

correct?

A. Right. I guess I didn't notice

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P.G. KLEINMAN, M.D.

that.

Q. Now, Doctor, you also indicated

in your -- I am sorry to jump around -- in

your initial report of August 31st, 2012.

A. Right.

Q. Can you go back to that?

A. Yeah.

Q. In that report, you indicated

that among the records you reviewed was a

chart note from Dr. Solano?

A. Correct.

Q. Dated 7/9/2012?

A. Right.

Q. I will hand you what was

marked, what we will mark -- I guess

Plaintiff's 1 for identification. Is that

a note from Dr. Solano's July 9th office

note?

A. Yes.

Q. And that would have been four

days after the accident?

A. Right.

Q. And in that note, does

Dr. Solano note that Mr. Rivera complained

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93

P.G. KLEINMAN, M.D.

of neck pain?

A. Yes.

Q. Thank you.

Now, Doctor, in your first

exam, you used, regarding disability, you

said moderate disability; correct?

A. Right.

Q. Was that in reference to Jose

Rivera's actual job?

A. No. Under Workers'

Compensation rules, you are supposed to

give a disability rating for any job. For

example, if a person isn't able to do their

regular job, you call them totally disabled

if they can do some other type of job.

Q. So he could have done a

sedentary job as we stated?

A. Right.

Q. But with respect to the job

that he was required to do, was he more

than moderately disabled?

A. I think he wasn't able to do

his regular job at all if it involved

climbing poles.

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P.G. KLEINMAN, M.D.

MR. ACARD: Thank you. I have

no other questions.

RECROSS EXAMINATION BY

MR. SCAHILL:

Q. Just a few follow up, Doctor.

Did you have an opportunity to

review the report of the Plaintiff's

radiologist, Dr. Tantlef?


A. I don't know. You would have

to look through all twelve reports and see

if I listed it.

MR. ACARD: Just note my

objection.

Off the record.

(Whereupon, an off-the-record

discussion was held.)

Q. I was asking you whether or not

you had the opportunity to review the

reports of Dr. Tantlef.

A. I don't know.

MR. ACARD: Just note my

objection.


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95

P.G. KLEINMAN, M.D.

the Plaintiff had multilevel disc

desiccation of both the cervical and lumbar

spine and multilevel disc bulging of the

cervical and lumbar spine?

A. In the cervical spine,

according to the report I have, in the

lumbar spine they just spoke about one

level, not multilevel. Just L5-S1.


there was diffuse, meaning throughout the

entire cervical lumbar spine, disc

desiccation?

A. Well, the report I had

described diffuse bulging and bony ridging

and degenerative disease. I would have to

see the original report again to see if

they mentioned desiccation.

Q. When we talk about bony

ridging, that's the bone growing out to

compensate for the loss of disc height; is

that fair to say?

A. No. It is a little ridge of

bone that can form at the edges of the

vertebra, but it is not as compensation for

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96

P.G. KLEINMAN, M.D.

disc.

Q. That's also known as an

osteophyte; is that fair to say?

A. An osteophyte is sort of a

bigger thing than a ridge. Projection.

Q. That's something that has

nothing to do with trauma; that's strictly

age related?

A. Well, it could be posttraumatic

as well. Not posttraumatic a few days

later, but it could be posttraumatic.

Q. But the MRI findings as to Mr.

Rivera, those bony ridges you talked about,

that had nothing to do --

A. That was preexisting.

Q. Nothing to do with trauma?

A. Not this trauma.

Q. When you say not this trauma --

A. You could have posttraumatic

changes with ridging.

Q. It had nothing to do with the

accident that brings us here?

A. Right.

Q. Would it also be fair to say

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97

P.G. KLEINMAN, M.D.

that multilevel disc pathology is the

hallmark of preexisting degenerative

findings and have nothing to do with

trauma?


A. I said that he had preexisting

degenerative findings. There is nothing

new.

Q. I am just talking about --

A. The answer is yes. And the

answer, we discussed that already. I said

he does have preexisting degenerative

changes.

(Continued on next page.)

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98

P.G. KLEINMAN, M.D.

Q. In both the neck and the back?

A. Yes.

MR. SCAHILL: Nothing further.

Thank you, Doctor.

MR. ACARD: Thank you, Doctor.

(Whereupon, at 7:20 p.m., the

above matter concluded.)

I, ROBERT GONZALEZ, a Notary

Public for and within the State of

New York, do hereby certify that the

above is a correct transcription of

my stenographic notes.

___________________________ ROBERT GONZALEZ

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P.G. KLEINMAN, M.D.

E X H I B I T S

EXHIBIT EXHIBIT PAGE

DESCRIPTION

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I N D E X

EXAMINATION BY PAGE

MR. ACARD 3, 83

MR. SCAHILL 40, 94

INFORMATION AND/OR DOCUMENTS REQUESTED

INFORMATION AND/OR DOCUMENTS PAGE

(None)

QUESTIONS MARKED FOR RULINGS

PAGE LINE QUESTION

(NONE)

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883 [1] - 99:118th [1] - 37:8

990 [2] - 15:20, 16:8

900 [1] - 2:1094 [1] - 99:129th [2] - 27:9, 92:18

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absorbers [1] - 70:25Academy [1] - 7:16ACARD [33] - 2:6, 3:22,

4:16, 22:21, 40:20, 44:20, 44:24, 46:7, 49:2, 49:12, 51:25, 52:20, 55:4, 57:11, 58:25, 60:14, 75:20, 76:5, 76:13, 76:23, 77:5, 77:19, 78:13, 79:6, 79:20, 83:11, 94:2, 94:10, 94:14, 94:23, 97:6, 98:6, 99:11

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accidents [9] - 54:3, 54:7, 55:24, 56:11, 57:5, 69:15, 69:25, 70:4, 70:14

according [1] - 95:7account [2] - 79:11,

80:8accurate [5] - 76:2,

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59:20additional [2] - 24:3,

34:2address [1] - 4:22admitting [1] - 8:9advise [1] - 58:24

P.G. KLEINMAN, M.D.


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age [10] - 19:19, 69:4, 69:10, 70:4, 70:14, 71:7, 71:17, 72:22, 72:24, 96:9

age-related [5] - 19:19, 70:4, 70:14, 72:22, 72:24

aging [1] - 69:20agree [5] - 60:4, 60:16,

62:11, 94:25, 95:10agreed [1] - 80:21air [2] - 58:15, 58:16allegations [1] - 57:9Allegheny [1] - 6:6allowed [4] - 31:19,

67:13, 67:15, 67:18alone [1] - 19:24ALSO [1] - 2:13American [1] - 7:16analgesics [1] - 65:21analogy [1] - 74:7anatomy [1] - 70:24AND/OR [2] - 99:15,

99:16Anderman [1] - 3:23ANDERMAN [1] - 2:4anesthesiologist [1] -

24:25ankle [2] - 65:15, 65:16answer [8] - 22:21,

45:18, 46:13, 54:25, 55:11, 80:6, 97:11, 97:12

answered [6] - 50:13, 52:21, 52:24, 53:2, 55:3, 65:25

answering [1] - 46:12answers [1] - 51:24anybody [1] - 89:24anywhere [2] - 43:12,

63:6apnea [1] - 91:17apparent [1] - 63:23apparently [2] - 23:20,

88:10approved [1] - 7:7april [1] - 27:9area [2] - 25:3, 25:5areas [1] - 84:17arranged [1] - 41:11arrangements [1] - 13:3arrives [1] - 89:22arthritic [1] - 83:20arthritis [5] - 20:7,

66:18, 68:24, 69:7, 70:7arthroscopy [1] - 8:18article [1] - 6:14articles [1] - 6:12asking [8] - 46:11,

52:22, 53:12, 54:4, 54:5, 68:14, 91:11, 94:19

aspect [1] - 31:25

assist [1] - 10:20assume [2] - 21:15,

58:14assuming [2] - 21:22,

26:12asthma [1] - 91:17asymptomatic [2] -

39:5, 75:2attempted [1] - 27:14attorneys [1] - 41:12Attorneys [2] - 2:4, 2:9August [14] - 11:4, 12:4,

13:11, 19:5, 21:21, 22:4, 30:12, 30:14, 31:4, 31:5, 35:10, 50:15, 81:15, 92:5

author [2] - 6:13, 6:15authorized [4] - 30:3,

30:25, 33:10, 80:20auto [1] - 70:18available [1] - 67:10Avenue [3] - 1:19, 3:13,

4:23aware [18] - 41:19, 53:6,

53:9, 53:13, 53:15, 53:18, 55:7, 55:8, 55:11, 55:14, 56:5, 56:14, 58:22, 59:13, 59:16, 60:8, 75:12, 78:11

awed [1] - 21:19

Bbackground [1] - 5:18bag [1] - 58:15bags [1] - 58:16Barnabas [3] - 6:20,

8:11, 46:17Baron [5] - 45:23,

45:24, 46:5, 46:13, 49:5based [3] - 39:8, 39:20,

40:8basically [1] - 22:22basis [1] - 66:12behalf [1] - 3:9beings [1] - 73:17believe [3] - 37:10,

88:23, 90:15belt [2] - 58:5, 58:12bend [2] - 74:16, 74:17bending [5] - 16:2, 16:4,

21:13, 25:18, 36:18bends [1] - 16:15benefits [4] - 42:25,

77:17, 78:2, 79:19BENNETT [1] - 2:14Bennett [1] - 3:6bigger [1] - 96:6bilateral [1] - 14:22bilaterally [1] - 34:15bit [1] - 5:17

blood [1] - 89:13board [7] - 7:2, 7:5,

7:10, 68:12, 68:17, 73:21, 78:19

body [2] - 7:19, 20:8bone [4] - 19:21, 84:20,

95:20, 95:24Bone [1] - 6:16bones [1] - 5:13bony [4] - 15:2, 95:15,

95:19, 96:14box [2] - 88:23, 90:16Brian [1] - 3:22BRIAN [1] - 2:6briefly [2] - 25:12, 28:18brings [1] - 96:23Broadway [1] - 2:5broke [1] - 58:13BRONX [1] - 1:18Bronx [6] - 1:20, 3:14,

4:24, 43:6, 45:2, 46:5Bronxdale [3] - 1:19,

3:13, 4:23bulging [4] - 14:21,

15:2, 95:4, 95:15burn [4] - 14:6, 61:6,

62:10, 89:8burns [1] - 14:7business [2] - 4:22,

10:13buttock [1] - 18:11BY [7] - 2:6, 2:11, 4:15,

40:22, 83:10, 94:4, 99:10

CC5-C6 [3] - 15:4, 19:12,

34:4calf [3] - 18:11, 31:9,

32:2call [5] - 22:6, 46:2,

46:18, 67:11, 93:15CAMASTRO [1] - 2:7can you [20] - 4:21,

5:10, 5:16, 7:4, 13:12, 15:13, 15:17, 15:24, 17:7, 19:17, 20:3, 25:12, 28:7, 28:18, 61:14, 76:25, 79:3, 84:11, 89:20, 92:7

canal [3] - 70:10, 71:19, 72:13

capable [1] - 21:23capacity [1] - 77:23car [2] - 49:16, 59:15care [1] - 63:9career [2] - 49:9, 65:5carrier [8] - 13:4, 42:23,

47:16, 77:14, 79:16, 80:10, 86:14, 87:2

carriers [2] - 48:14, 48:18

carrying [3] - 21:18, 21:23, 26:15

case [8] - 3:15, 11:7, 11:17, 22:16, 41:2, 41:8, 45:13, 45:19

cases [1] - 49:10CAT [1] - 62:23causal [10] - 11:15,

22:3, 22:13, 22:17, 26:25, 29:11, 30:7, 76:18, 77:24, 78:3

causally [2] - 36:23, 63:16

caused [12] - 22:14, 23:5, 23:9, 39:15, 40:3, 40:6, 40:15, 40:18, 69:18, 69:19, 69:21, 70:13

cautioned [1] - 33:19Cean [1] - 24:13Center [1] - 6:5central [1] - 15:3century [3] - 15:11,

25:20, 31:24certainty [4] - 26:20,

39:13, 39:25, 40:13certified [7] - 7:2, 7:5,

7:10, 68:12, 68:18, 73:21, 78:19

certify [1] - 98:12cervical [10] - 19:8,

33:8, 34:20, 38:19, 40:15, 69:16, 95:3, 95:5, 95:6, 95:12

change [1] - 37:19changed [3] - 30:7,

33:16, 35:16changes [21] - 19:12,

19:15, 19:19, 19:22, 19:24, 20:5, 22:8, 22:25, 23:11, 27:4, 38:18, 38:22, 67:25, 70:4, 70:14, 83:16, 83:19, 83:20, 84:13, 96:21, 97:14

chart [5] - 10:5, 14:18, 24:12, 46:20, 92:11

chin [1] - 34:18CHRISTOPHER [1] -

2:7chronic [1] - 19:8circled [1] - 83:6claim [2] - 57:10, 79:8classified [1] - 22:5clear [3] - 83:18, 85:25,

87:23climbing [4] - 21:17,

P.G. KLEINMAN, M.D.


101

26:14, 84:25, 93:25co [2] - 6:13, 6:15co-author [2] - 6:13,

6:15collision [3] - 13:22,

57:25, 58:6Columbia [1] - 6:3column [2] - 71:20, 72:3coming [1] - 55:20Comp [1] - 87:18company [3] - 13:2,

24:16, 86:24compensate [1] - 95:21compensated [2] -

9:18, 9:20compensation [2] -

86:25, 95:25Compensation [17] -

11:9, 13:4, 42:23, 42:25, 47:16, 48:14, 48:17, 49:19, 67:4, 77:14, 77:17, 79:11, 79:16, 79:18, 80:10, 86:12, 93:12

competent [1] - 76:10complained [1] - 92:25complaining [1] - 14:10complains [1] - 62:19complaint [3] - 62:3,

64:6, 74:9complaints [6] - 13:25,

14:3, 31:6, 52:7, 63:10, 78:9

complete [1] - 7:6compression [4] -

18:13, 18:16, 32:7, 71:24concede [1] - 54:21concentrates [1] - 68:8concerned [2] - 80:13,

81:22concluded [1] - 98:8Concourse [1] - 2:10condition [6] - 22:6,

22:10, 27:5, 39:15, 50:20, 76:19

conditions [3] - 70:20, 83:25, 84:8

conduct [6] - 33:21, 35:19, 35:22, 37:5, 37:7, 37:15

congenital [1] - 8:19connects [1] - 18:18consist [2] - 15:9, 43:14contemporaneous [1] -

10:16content [2] - 71:8, 71:13continue [4] - 29:20,

33:5, 42:24, 79:18continued [2] - 77:16,

97:15continuing [3] - 27:25,

78:18, 78:23contracted [1] - 24:17contracts [1] - 86:25contribute [2] - 22:25,

23:2contributes [1] - 72:10cord [3] - 25:4, 25:6corner [2] - 82:16, 88:24correction [1] - 25:5counsel [2] - 42:10,

54:20Counsel [2] - 3:20,

60:16COUNTY [1] - 1:2County [3] - 3:19, 45:3,

46:5couple [1] - 67:3course [6] - 10:12,

25:13, 47:10, 49:7, 80:7, 80:13

Court [3] - 3:18, 4:5, 5:16

court [10] - 9:10, 9:17, 41:7, 41:15, 41:17, 41:24, 42:5, 45:14, 45:15, 45:20

COURT [1] - 1:2covering [2] - 25:3, 25:6crash [5] - 20:12, 22:19,

39:15, 40:3, 40:15critical [5] - 51:9, 52:11,

56:17, 56:23, 56:25CROSS [1] - 40:22cross [3] - 45:7, 45:16,

54:8cross-examination [1] -

45:7current [1] - 39:14currently [4] - 8:12,

45:3, 45:19, 46:5

Ddaily [2] - 21:16, 26:14dangerous [1] - 85:7DATE [1] - 1:11date [17] - 50:10, 53:17,

53:21, 54:7, 54:16, 54:19, 56:3, 60:19, 61:3, 62:24, 63:14, 63:23, 64:7, 76:21, 77:4, 82:11, 83:4

dated [1] - 92:13day [4] - 42:6, 53:23,

60:10, 62:12days [3] - 27:18, 92:22,

96:11Debra [5] - 45:23,

45:24, 46:5, 46:13, 49:5December [11] - 12:7,

23:25, 25:7, 25:23, 26:18, 37:12, 37:24, 56:6, 81:4, 85:14, 88:6

decide [1] - 87:9decided [4] - 29:24,

29:25, 33:7, 59:4decreased [6] - 18:10,

28:24, 31:24, 34:15, 34:21, 36:6

deemed [1] - 60:17Defendant [4] - 2:9,

3:16, 3:25, 41:2DEFENDANT [1] - 1:8Defendant's [1] - 60:18definition [1] - 72:18degenerative [21] -

15:3, 19:12, 19:14, 19:22, 19:24, 20:5, 22:8, 22:25, 23:10, 27:3, 38:18, 67:24, 69:2, 69:3, 83:16, 83:19, 84:12, 95:16, 97:3, 97:8, 97:13

degree [11] - 5:21, 17:9, 26:19, 39:13, 39:25, 40:13, 59:19, 74:16, 74:17, 81:17, 82:14

degrees [21] - 15:19, 15:20, 15:22, 16:6, 16:12, 17:10, 17:12, 17:13, 17:25, 18:3, 31:23, 34:15, 36:7, 36:8, 36:9, 36:10, 36:12, 36:15, 36:16, 36:18

denied [2] - 50:5, 51:20depending [2] - 42:6,

51:14deployed [1] - 58:17deployment [1] - 58:16deposition [1] - 41:5describe [1] - 28:18described [2] - 14:21,

95:15description [1] - 29:13DESCRIPTION [1] -

99:5desiccation [10] -

14:21, 68:22, 69:10, 69:15, 69:24, 70:19, 73:8, 95:3, 95:13, 95:18

deteriorated [1] - 32:22determination [1] -

63:15determinations [1] -

11:19determine [1] - 42:24develop [1] - 63:21developed [1] - 14:8

devoid [1] - 64:6diagnosed [3] - 56:14,

56:21, 75:14diagnosis [20] - 50:23,

51:5, 51:10, 51:15, 56:19, 61:2, 61:8, 61:9, 61:11, 61:15, 61:21, 61:24, 62:5, 62:8, 62:12, 75:19, 76:2, 77:2, 88:24, 89:6

diagnostic [1] - 81:10Diamond [3] - 2:14, 3:7,

4:6did he [2] - 34:19, 77:21did you [37] - 8:25,

11:2, 11:24, 15:6, 17:17, 19:4, 23:4, 25:8, 26:18, 27:13, 27:20, 28:12, 29:7, 30:16, 31:5, 31:14, 34:9, 35:3, 35:9, 35:12, 35:22, 36:13, 37:14, 38:8, 39:4, 50:15, 52:17, 55:7, 58:8, 58:11, 58:15, 58:19, 60:8, 67:7, 67:11, 67:19, 94:7

difference [1] - 74:5diffuse [3] - 15:2, 95:11,

95:15DIRECT [1] - 4:15disability [20] - 20:23,

21:5, 26:7, 29:9, 29:10, 29:12, 32:15, 32:17, 32:20, 34:24, 36:23, 37:2, 38:2, 38:4, 38:6, 81:17, 81:22, 93:6, 93:7, 93:13

disabled [4] - 11:14, 35:2, 93:15, 93:22

disc [17] - 14:21, 19:11, 56:21, 68:22, 68:25, 69:10, 69:15, 69:24, 70:18, 71:25, 73:8, 95:2, 95:4, 95:12, 95:21, 96:2, 97:2

discectomy [2] - 30:20, 34:3

discs [11] - 15:4, 19:21, 56:15, 70:24, 71:8, 71:13, 71:17, 75:14, 84:16, 84:19

discussed [1] - 97:12discussion [2] - 31:10,

94:18Disease [1] - 6:9disease [2] - 15:3,

95:16do they [2] - 83:21, 84:4do you [34] - 5:4, 5:7,

6:22, 7:21, 8:6, 8:9, 8:12, 8:15, 8:21, 9:4, 9:23,

P.G. KLEINMAN, M.D.


102

10:4, 10:8, 11:11, 12:5, 27:10, 39:12, 39:24, 40:12, 43:10, 44:21, 45:22, 47:3, 47:18, 47:23, 48:20, 56:13, 57:7, 59:6, 59:9, 62:22, 63:6, 80:8, 90:22

doctor [21] - 6:11, 25:22, 33:7, 33:19, 39:8, 41:4, 45:6, 45:11, 50:22, 51:3, 61:16, 61:20, 62:15, 62:20, 62:21, 63:9, 84:23, 89:5, 89:10, 89:14, 90:5

Doctor [27] - 4:20, 18:20, 21:15, 25:7, 30:5, 33:11, 34:22, 35:9, 36:20, 37:4, 38:17, 40:24, 45:16, 46:24, 54:8, 63:13, 75:10, 80:5, 83:8, 83:13, 85:9, 88:18, 92:3, 93:5, 94:6, 98:5, 98:6

doctors [6] - 6:22, 14:19, 67:12, 67:14, 67:17, 80:22

DOCUMENTS [2] - 99:15, 99:16

does that [7] - 22:13, 88:7, 88:15, 89:9, 90:5, 91:9, 91:18

doesn't [3] - 75:24, 79:24, 86:16

dollar [1] - 42:8dollars [4] - 9:25, 48:5,

48:7, 48:19dozen [1] - 9:15Dr [15] - 3:9, 3:12, 10:4,

14:19, 24:12, 39:20, 40:8, 57:18, 92:11, 92:18, 92:25, 94:9, 94:21

driving [1] - 21:14drove [2] - 59:10, 59:15dry [1] - 71:8drying [1] - 19:20due [3] - 41:6, 69:25,

70:3duly [2] - 4:12, 5:4

Eeasily [1] - 71:12edges [1] - 95:24education [2] - 78:18,

78:24educational [1] - 5:17eight [2] - 27:18, 43:12eighteen [1] - 47:25element [3] - 56:24,

57:14, 76:18

elements [1] - 57:4elicit [1] - 51:5emergency [4] - 24:10,

45:25, 46:16, 89:6employer [1] - 20:12encroaches [2] - 71:18,

71:25end [2] - 30:5, 61:7entity [1] - 11:6epidural [2] - 24:13,

24:19epidurals [2] - 24:23,

80:17ESQ [3] - 2:6, 2:7, 2:11essentially [1] - 37:15estimate [1] - 43:24evaluation [3] - 29:21,

81:14, 81:16evaluations [2] - 47:23,

56:20evening [2] - 4:20,

40:24everybody [8] - 20:4,

46:14, 46:21, 61:22, 62:3, 62:17, 62:19, 69:13

evidence [1] - 19:10exacerbated [3] - 22:7,

22:10, 27:6exactly [1] - 57:8exaggerate [1] - 79:16exam [65] - 13:11,

13:13, 14:12, 15:9, 15:11, 15:15, 17:8, 18:4, 18:8, 18:23, 19:5, 20:21, 21:20, 24:2, 25:8, 25:9, 25:14, 25:21, 25:22, 26:4, 26:5, 26:10, 26:17, 27:13, 27:15, 28:13, 28:20, 28:23, 28:24, 29:7, 29:16, 30:16, 30:18, 30:24, 31:4, 31:14, 31:22, 31:24, 33:16, 33:22, 33:25, 34:9, 34:10, 34:22, 35:17, 35:20, 35:22, 36:13, 36:20, 37:5, 37:8, 37:11, 37:16, 37:22, 37:24, 53:15, 54:17, 55:20, 87:6, 87:18, 87:25, 88:9, 90:11, 91:23, 93:6

EXAMINATION [5] - 4:15, 40:22, 83:10, 94:4, 99:10

examination [7] - 13:16, 15:7, 44:9, 45:7, 45:17, 47:21, 54:9

examinations [8] - 7:8, 43:4, 43:14, 43:18, 47:19, 48:3, 67:3, 79:12

examine [5] - 11:3, 11:21, 11:25, 12:23, 42:23

examined [5] - 4:13, 12:10, 32:21, 57:17, 79:15

examiner [1] - 67:15examining [8] - 10:7,

12:12, 51:3, 56:18, 61:2, 74:18, 79:10, 80:9

example [2] - 84:14, 93:14

exams [14] - 11:12, 15:11, 18:21, 28:16, 31:18, 34:14, 35:15, 37:19, 38:14, 39:9, 39:21, 40:9, 50:11, 86:3

EXHIBIT [2] - 99:4Exhibit A [1] - 60:18exist [3] - 83:21, 83:25,

84:4exists [1] - 83:22exiting [1] - 71:19exits [1] - 72:2expect [2] - 84:23, 85:6experiences [1] - 20:5experiencing [2] -

19:25, 23:14expert [2] - 9:10, 9:17explain [10] - 7:4, 15:24,

19:17, 20:3, 28:7, 74:4, 79:3, 84:11, 88:21, 89:20

explanatory [1] - 16:16extension [7] - 15:21,

16:10, 17:11, 25:17, 25:19, 36:8, 36:17

extent [1] - 79:16extreme [1] - 15:23extremes [1] - 17:15extremities [2] - 5:14,

29:2extremity [1] - 29:3

Ffacet [2] - 27:23, 28:7fact [5] - 41:6, 54:21,

71:12, 84:4, 85:21failed [1] - 56:10fair [54] - 12:11, 12:15,

12:19, 13:6, 33:12, 38:22, 42:18, 43:2, 43:17, 44:10, 49:23, 50:23, 51:5, 51:10, 51:16, 51:21, 52:13, 52:18, 52:22, 52:25, 53:22, 55:25, 56:9, 57:19, 57:22, 66:6, 66:10, 67:5, 68:9, 68:18, 69:20, 70:15, 70:21,

71:2, 71:9, 71:14, 71:21, 72:14, 72:17, 72:22, 73:10, 73:14, 74:13, 74:20, 75:5, 75:9, 75:25, 76:6, 77:18, 79:9, 83:5, 95:22, 96:4, 96:25

false [1] - 51:24familiar [1] - 82:2February [8] - 1:11, 3:5,

33:22, 34:10, 35:17, 35:20, 36:21, 41:21

fee [4] - 10:2, 42:8, 42:12, 42:13

feel [3] - 10:23, 20:8, 87:5

feet [2] - 31:8, 31:25fellowship [1] - 6:4felt [1] - 22:22field [2] - 9:11, 68:6fifteen [7] - 21:11,

21:19, 26:16, 36:17, 43:13, 44:6, 47:24

fifty [1] - 48:4file [4] - 10:5, 10:8,

86:2, 86:6filed [1] - 49:10files [2] - 86:12films [2] - 68:9, 87:13final [3] - 62:7, 88:24,

89:6finding [5] - 69:2, 72:20,

72:22, 74:12, 81:21findings [13] - 25:13,

25:21, 28:19, 33:16, 37:19, 69:23, 73:5, 73:12, 74:6, 74:24, 96:13, 97:4, 97:8

fine [1] - 20:8FINE [1] - 2:4Fine [1] - 3:22fingers [1] - 34:18finish [1] - 45:9finishing [2] - 5:20, 5:22First [1] - 88:18first [17] - 4:12, 11:2,

12:3, 13:11, 21:20, 25:9, 25:21, 26:10, 49:14, 49:22, 50:14, 52:16, 57:17, 73:7, 81:15, 83:14, 93:5

five [7] - 9:24, 33:5, 42:7, 43:18, 48:6, 82:22, 82:25

flatten [2] - 71:9, 71:18flexion [7] - 15:19,

15:25, 16:2, 17:9, 25:17, 36:7, 36:16

fluctuations [1] - 37:21fluid [1] - 69:2

P.G. KLEINMAN, M.D.


103

follow [1] - 94:6following [4] - 18:22,

19:5, 41:25, 63:22follows [1] - 4:14FOR [1] - 99:20foraminal [3] - 14:23,

72:12, 73:9force [1] - 74:21forearm [4] - 14:7, 61:5,

62:10, 89:8forearms [1] - 14:9forgot [1] - 52:3form [4] - 68:23, 70:7,

89:15, 95:24forms [2] - 82:3, 89:21formulate [1] - 56:18forty [1] - 36:15forward [1] - 16:2found [3] - 45:14, 45:20,

50:10four [6] - 24:22, 82:22,

82:25, 88:22, 90:14, 92:21

fourth [2] - 88:22, 90:18fracture [1] - 46:18fractures [3] - 6:17,

8:18, 65:16FRANCIS [1] - 2:11Francisco [1] - 5:24Frank [2] - 3:25, 40:25free [1] - 10:23friend's [1] - 43:7front [3] - 24:5, 27:11,

54:6full [2] - 50:21, 51:4

Ggain [9] - 78:12, 78:20,

79:2, 79:4, 79:8, 79:12, 79:23, 79:25, 80:9

gave [4] - 21:3, 49:22, 51:24, 88:20

gelatinous [1] - 71:4give [7] - 13:7, 20:23,

42:14, 43:23, 76:7, 76:16, 93:13

given [2] - 86:7, 89:24GONZALEZ [2] - 98:10,

98:16Gonzalez [2] - 1:21, 4:6gotten [1] - 56:3Gretchen [3] - 44:22,

44:25, 49:5GROUP [1] - 1:19growing [1] - 95:20guarding [3] - 15:23,

17:2, 17:15guess [3] - 16:15,

91:25, 92:16

Hhalf [5] - 9:8, 9:14, 39:9,

39:22, 40:10halfway [1] - 90:22hallmark [1] - 97:3hand [9] - 6:6, 8:19,

61:19, 61:22, 62:2, 62:17, 82:16, 88:24, 92:15

handed [1] - 62:16handle [1] - 24:17hands [2] - 32:3, 34:18handwriting [1] - 91:15handwritten [3] - 89:10,

89:14, 90:6Harvard [1] - 5:20have you [7] - 6:11,

6:18, 8:3, 9:9, 9:17, 44:17, 87:17

head [6] - 13:22, 17:13, 36:9, 36:10, 36:12, 58:6

head-on [2] - 13:22, 58:6

health [1] - 63:9height [1] - 95:21held [2] - 1:18, 94:18helpful [1] - 77:10helps [1] - 28:10hereby [1] - 98:12herniated [5] - 15:4,

19:11, 56:15, 56:21, 75:14

hide [1] - 54:10high [1] - 89:13highlighted [1] - 73:6hip [1] - 6:16history [15] - 13:14,

13:17, 23:13, 39:3, 49:22, 50:22, 51:4, 51:8, 56:24, 57:14, 58:2, 58:7, 59:21, 91:10, 91:12

honest [3] - 51:13, 51:22, 52:4

Hospital [17] - 5:25, 6:8, 6:20, 8:11, 24:11, 58:23, 59:5, 59:7, 59:16, 59:25, 60:6, 60:9, 61:3, 62:12, 82:11, 85:23, 88:9

hospital [17] - 8:10, 59:24, 60:5, 60:9, 60:15, 60:19, 61:19, 62:24, 63:4, 63:7, 63:13, 64:5, 76:21, 77:3, 81:25, 82:3, 91:20

hospitals [2] - 46:22, 82:9

hour [1] - 9:8hour's [1] - 42:14how many [5] - 9:13,

11:24, 43:10, 47:22, 48:20

how often [2] - 8:21, 47:3

hum [1] - 81:18hundred [8] - 9:24,

37:2, 38:5, 42:7, 48:4, 48:7, 48:19, 81:12

Iidentification [1] -

92:17identify [1] - 3:20immediately [1] - 63:23impact [1] - 58:9important [14] - 50:21,

51:3, 51:12, 52:14, 56:22, 57:2, 57:3, 57:13, 59:20, 59:23, 60:5, 60:7, 63:12, 87:6

impression [5] - 18:22, 19:4, 19:7, 25:24, 25:25

Inc [1] - 2:14incident [1] - 76:18include [2] - 13:17,

35:25included [1] - 18:25independent [6] - 11:6,

47:19, 47:21, 47:22, 48:3, 67:14

index [1] - 3:17Index [1] - 1:5indicate [9] - 18:5,

18:16, 29:4, 32:4, 38:8, 85:18, 85:22, 88:15, 91:18

indicated [2] - 92:3, 92:9

indicates [2] - 18:9, 18:12

indication [2] - 23:12, 35:3

indicative [1] - 72:16individual [7] - 48:24,

55:19, 64:18, 65:22, 66:17, 69:9, 72:11

individuals [5] - 47:9, 47:14, 49:4, 69:14, 79:14

infections [1] - 6:14inflamed [1] - 84:21information [2] - 20:11,

20:16INFORMATION [2] -

99:15, 99:16infusion [2] - 30:20,

34:4initial [2] - 24:10, 92:5initially [3] - 23:16,

50:8, 50:9

initials [1] - 90:23inject [1] - 25:2injections [3] - 24:19,

27:24, 28:8injure [1] - 52:17injured [8] - 13:18, 53:7,

53:13, 53:25, 55:9, 55:16, 56:7, 64:3

injuries [9] - 50:2, 50:6, 50:16, 51:2, 51:19, 51:20, 52:7, 57:6, 79:17

injury [3] - 52:13, 91:16, 91:20

inner [1] - 31:25inquired [1] - 50:19instruct [1] - 54:25instructed [3] - 87:12,

87:18, 87:21instructions [1] - 87:15insurance [1] - 86:14interesting [1] - 60:3interfere [1] - 32:23interior [1] - 34:16intern [2] - 65:6, 78:16internship [1] - 5:23interpret [1] - 68:16interpreted [1] - 14:25interpreting [1] - 68:8involved [15] - 13:21,

21:16, 26:14, 49:16, 53:6, 53:19, 53:24, 54:2, 54:21, 55:8, 55:15, 56:5, 57:7, 58:6, 93:24

involves [2] - 5:11, 5:12involving [1] - 23:19irritated [1] - 84:20irritation [2] - 29:5, 32:6is that [67] - 4:25, 7:24,

10:2, 17:5, 30:23, 38:5, 41:8, 42:8, 42:18, 43:2, 44:10, 48:7, 49:22, 50:23, 51:5, 51:10, 51:16, 52:9, 52:13, 52:18, 52:22, 52:25, 53:22, 54:14, 54:15, 54:16, 55:25, 57:19, 57:21, 64:8, 64:15, 66:6, 66:10, 67:4, 68:9, 68:18, 68:24, 69:11, 69:20, 70:14, 70:20, 70:25, 71:9, 71:13, 71:20, 71:24, 72:6, 72:14, 72:17, 72:22, 73:2, 73:9, 73:13, 74:2, 74:12, 74:19, 75:4, 75:9, 77:17, 81:19, 82:8, 83:4, 85:5, 86:9, 92:17, 95:21, 96:4

is there [3] - 60:22, 62:5, 91:14

P.G. KLEINMAN, M.D.


104

Island [1] - 43:8items [2] - 55:18, 59:21

JJamaica [2] - 58:23,

59:6January [2] - 27:16,

55:15job [12] - 21:16, 21:24,

26:13, 26:21, 29:13, 93:10, 93:13, 93:15, 93:16, 93:18, 93:20, 93:24

Joint [2] - 6:9, 6:16joints [2] - 5:13, 28:9Jose [54] - 3:15, 10:5,

11:3, 11:5, 11:17, 11:21, 12:10, 12:19, 12:24, 13:6, 13:18, 13:24, 14:13, 18:21, 20:11, 20:17, 21:16, 21:22, 23:24, 26:7, 26:13, 27:8, 27:14, 27:21, 28:13, 29:8, 29:18, 30:11, 30:16, 31:6, 32:14, 33:2, 33:13, 33:22, 34:2, 34:10, 34:24, 35:4, 35:9, 35:23, 36:22, 38:2, 38:9, 38:19, 39:3, 39:10, 39:14, 39:22, 40:2, 40:10, 40:14, 41:2, 85:14, 93:9

JOSE [1] - 1:3Jose's [1] - 36:13Journal [1] - 6:16judge [4] - 45:14, 54:23,

54:24July [17] - 14:4, 20:13,

22:18, 23:15, 30:20, 38:23, 39:6, 39:15, 40:4, 40:16, 63:18, 64:4, 70:18, 73:13, 76:9, 76:17, 92:18

jump [2] - 85:11, 92:4June [1] - 37:5Jury [9] - 5:10, 5:17,

15:25, 28:19, 43:23, 64:3, 74:5, 76:8, 79:3

jury [1] - 41:8

Kkeep [3] - 86:2, 86:6KLEINMAN [1] - 1:17Kleinman [6] - 3:9,

3:12, 4:19, 10:4, 39:20, 40:8

Kubiak [2] - 14:19, 24:12

LL5-S1 [3] - 14:22, 19:11,

95:9ladders [3] - 21:17,

26:15, 85:2LAMPELL [1] - 1:7Lampell [1] - 3:16last [12] - 12:5, 27:22,

30:17, 37:11, 38:8, 38:14, 39:9, 39:21, 40:9, 42:21, 65:11, 81:2

lawsuits [1] - 57:8leaning [1] - 16:11leave [1] - 59:4lectured [1] - 6:18leg [12] - 14:11, 15:11,

17:18, 17:22, 17:23, 18:8, 18:14, 18:15, 25:20, 28:23, 31:22, 34:13

Legal [1] - 3:7legs [1] - 18:2let's [2] - 54:5, 68:2letter [1] - 6:15level [5] - 71:20, 72:2,

82:6, 83:3, 95:9license [1] - 44:14licensed [1] - 5:4life [1] - 79:21lift [1] - 21:11lifting [2] - 21:18, 26:15light [2] - 28:25, 34:16limitation [3] - 25:15,

25:19, 28:21limited [2] - 18:6, 34:12line [1] - 91:14LINE [1] - 99:21listed [2] - 14:15, 94:13Lloyd [1] - 3:16LLOYD [1] - 1:7LLP [1] - 2:4located [2] - 3:13, 4:25location [2] - 7:24, 8:4lose [1] - 71:7loss [1] - 95:21lost [1] - 68:25lot [1] - 83:15lots [1] - 70:4low [7] - 19:9, 30:22,

61:22, 62:2, 62:13, 62:18, 62:25

lower [13] - 14:20, 18:10, 18:19, 19:13, 27:24, 29:2, 29:3, 29:22, 30:3, 36:14, 40:2, 84:24, 88:23

ludicrous [1] - 80:2Luke's [1] - 5:25

lumbar [7] - 32:11, 38:19, 69:16, 95:3, 95:5, 95:8, 95:12

lumbosacral [1] - 63:2

MM.D [2] - 1:17, 4:19maintain [1] - 7:21malpractice [4] - 44:18,

45:2, 46:6, 49:7Manhattan [2] - 6:2, 6:3March [3] - 41:24, 42:2,

42:4mark [1] - 92:16marked [2] - 60:17,

92:16MARKED [1] - 99:20material [1] - 71:4matter [1] - 98:8mean [8] - 15:25, 19:24,

22:13, 56:25, 61:23, 69:12, 83:16, 83:22

meaning [2] - 17:2, 95:11

means [5] - 7:4, 16:2, 19:18, 68:25, 70:9

measure [1] - 73:22measuring [1] - 75:7medical [43] - 5:21,

6:19, 6:23, 12:16, 12:25, 13:7, 13:15, 14:13, 19:2, 24:3, 26:19, 33:2, 39:11, 39:13, 39:23, 39:25, 40:11, 40:13, 43:20, 44:10, 47:19, 47:21, 47:22, 48:3, 49:7, 50:20, 50:21, 51:4, 58:24, 67:14, 75:9, 78:11, 78:15, 78:23, 78:25, 85:18, 86:7, 86:16, 86:20, 87:5, 87:13, 91:10, 91:12

Medical [1] - 6:5medically [2] - 27:21,

30:17medication [3] - 29:24,

65:21, 81:7medicine [7] - 5:5, 5:8,

5:11, 7:22, 25:2, 28:2, 68:7

Medicine [1] - 5:22meeting [2] - 41:18,

42:2member [1] - 7:13mentioned [9] - 15:14,

19:14, 29:14, 30:23, 34:6, 38:25, 49:5, 89:19, 95:18

Merchants [1] - 2:10

Mercy [12] - 24:11, 59:5, 59:16, 59:24, 60:6, 60:9, 61:3, 62:12, 82:11, 85:23, 88:9, 90:11

merit [2] - 45:15, 45:21MICHAEL [1] - 2:14Michael [1] - 3:6mild [3] - 17:14, 82:20,

82:25minor [1] - 37:20minute [2] - 44:9, 78:8minutes [4] - 43:18,

44:4, 44:6, 44:7moderate [7] - 21:4,

81:23, 82:17, 82:23, 83:2, 83:4, 93:7

moderately [1] - 93:22monitor [1] - 3:4monitoring [1] - 29:23month [3] - 43:8, 43:10,

48:22months [6] - 12:8, 14:6,

33:6, 37:11, 38:15, 67:4motion [18] - 15:10,

15:15, 15:23, 17:5, 17:15, 18:7, 25:15, 28:21, 31:20, 31:21, 33:17, 33:18, 34:12, 34:13, 34:20, 36:2, 36:5, 37:21

motor [13] - 15:10, 19:9, 22:19, 23:18, 25:20, 28:23, 53:9, 53:16, 54:18, 61:4, 62:8, 89:7, 90:15

move [1] - 35:7Mr [44] - 10:9, 15:7,

20:24, 41:12, 42:17, 43:25, 45:10, 47:14, 47:20, 49:14, 49:21, 50:5, 51:18, 51:22, 55:23, 56:10, 63:8, 64:3, 64:7, 66:6, 66:22, 67:19, 69:23, 73:7, 73:16, 74:25, 76:11, 76:19, 77:13, 78:9, 80:12, 81:7, 82:13, 83:3, 83:14, 86:4, 86:15, 87:8, 88:13, 88:20, 89:19, 91:19, 92:25, 96:13

mR [1] - 49:2MR [48] - 3:22, 3:24,

4:16, 22:20, 22:21, 23:7, 30:8, 31:2, 36:24, 39:17, 40:5, 40:17, 40:20, 40:23, 44:20, 44:24, 46:7, 49:12, 51:25, 52:20, 55:4, 57:11, 58:25, 60:14, 75:20, 76:5, 76:13, 76:23, 77:5,

P.G. KLEINMAN, M.D.


105

77:19, 78:13, 79:6, 79:20, 83:7, 83:11, 83:23, 84:10, 85:3, 94:2, 94:5, 94:10, 94:14, 94:23, 97:6, 98:4, 98:6, 99:11, 99:12

MRI [20] - 14:20, 14:23, 19:10, 22:8, 56:20, 57:21, 64:10, 66:3, 66:16, 66:17, 68:4, 68:5, 68:15, 68:21, 71:12, 73:6, 77:9, 87:13, 96:13

MRIs [9] - 62:23, 66:6, 66:9, 66:13, 66:23, 67:7, 67:20, 75:13, 78:5

multilevel [5] - 15:2, 95:2, 95:4, 95:9, 97:2

multiple [2] - 70:11, 72:9

muscles [1] - 5:13

Nname [9] - 3:6, 3:14,

4:17, 40:25, 44:22, 45:23, 46:9, 46:20, 48:25

narrowing [4] - 14:23, 70:9, 72:12, 73:9

narrows [1] - 72:14Nassau [1] - 6:5national [1] - 41:18neck [55] - 14:9, 14:24,

17:5, 17:8, 17:16, 18:7, 19:13, 23:19, 25:18, 28:22, 31:7, 31:13, 31:21, 33:17, 34:4, 34:11, 34:17, 35:23, 50:3, 50:6, 50:17, 51:19, 52:7, 52:12, 52:17, 53:8, 53:13, 53:25, 55:9, 55:16, 56:7, 56:15, 56:20, 57:10, 63:10, 63:17, 63:21, 64:4, 64:7, 64:14, 64:15, 64:19, 64:24, 65:2, 65:9, 65:12, 65:18, 66:18, 74:16, 75:15, 75:16, 79:22, 79:25, 93:2, 98:2

needle [1] - 24:25negotiate [1] - 42:11negotiated [1] - 42:9nerve [15] - 18:9, 18:12,

18:16, 18:18, 29:5, 29:6, 32:6, 71:24, 71:25, 72:8, 72:13, 84:15, 84:17, 84:19

nerves [2] - 5:14, 71:18neural [2] - 72:11, 73:9NEW [1] - 1:2night [2] - 46:2, 46:17

nine [1] - 64:23ninety [3] - 17:25,

36:16, 64:23ninety-nine [1] - 64:23NONE [1] - 99:22normal [15] - 8:7, 10:2,

15:20, 15:21, 15:22, 16:8, 17:10, 17:11, 17:13, 17:14, 17:24, 28:22, 36:11, 62:25, 63:4

Notary [3] - 1:21, 4:12, 98:10

notation [1] - 63:8Note [1] - 79:6note [30] - 24:10, 30:16,

31:5, 44:20, 44:24, 46:7, 49:2, 49:12, 51:25, 52:20, 57:11, 58:25, 60:14, 75:20, 76:5, 76:13, 76:23, 77:5, 77:19, 78:13, 79:20, 92:11, 92:18, 92:19, 92:24, 92:25, 94:10, 94:14, 94:23, 97:6

noted [3] - 16:20, 16:23, 81:16

notes [10] - 14:18, 24:12, 24:18, 24:23, 86:3, 87:24, 90:6, 98:14

notice [1] - 91:25November [2] - 33:13,

35:13number [1] - 3:17numbers [1] - 82:19numbness [1] - 31:8nurse [1] - 63:9

Oo'clock [1] - 3:4object [3] - 54:12, 55:4,

80:4objection [34] - 22:20,

23:7, 30:8, 31:2, 36:24, 39:17, 40:5, 40:17, 44:20, 44:24, 46:7, 49:2, 49:12, 51:25, 52:20, 57:11, 58:25, 60:14, 75:20, 76:5, 76:13, 76:23, 77:5, 77:19, 78:13, 79:6, 79:20, 83:23, 84:10, 85:3, 94:10, 94:15, 94:24, 97:6

objections [1] - 54:24objective [2] - 74:6,

74:12objects [2] - 21:18,

26:16obtain [1] - 51:4obtaining [1] - 50:21

obvious [1] - 67:23occasion [1] - 11:22occasional [1] - 21:12occasions [2] - 9:13,

11:24OF [3] - 1:2, 1:2off-the-record [1] -

94:17offer [12] - 19:4, 22:2,

25:24, 26:6, 26:24, 29:8, 29:17, 32:14, 32:25, 34:23, 36:22, 37:25

office [7] - 7:21, 10:17, 41:5, 42:14, 43:6, 43:7, 92:18

offices [2] - 1:18, 3:12okay [4] - 60:7, 82:7,

82:9, 91:5Olin [1] - 3:23OLIN [1] - 2:4ones [1] - 87:4open [3] - 51:13, 51:22,

52:3opening [1] - 72:12opinion [24] - 20:23,

21:2, 22:3, 22:17, 23:5, 26:6, 26:8, 26:19, 26:24, 27:2, 29:8, 29:10, 29:11, 29:17, 30:6, 32:14, 32:25, 34:23, 36:22, 37:25, 39:12, 39:24, 40:12, 76:16

opinions [1] - 35:16opportunity [5] - 66:22,

76:20, 78:6, 94:7, 94:20oral [1] - 7:8order [2] - 51:4, 79:8ordinarily [1] - 54:22ordinary [1] - 10:12organizations [1] - 7:15original [1] - 95:17ORTHOPAEDIC [1] -

1:19orthopedic [11] - 5:9,

5:11, 6:2, 6:4, 6:8, 6:25, 7:7, 7:12, 7:20, 8:17, 8:20

Orthopedic [1] - 7:17osteophyte [2] - 96:4,

96:5outside [1] - 25:6

PP.C [2] - 2:9, 4:2p.m [3] - 1:12, 3:4, 98:7P.M.H [2] - 90:23, 91:7PAGE [4] - 99:4, 99:10,

99:16, 99:21page [13] - 14:15, 61:14,

61:18, 61:21, 61:25, 88:22, 90:14, 90:18, 91:3, 91:4, 91:6, 97:15

pages [1] - 89:18paid [6] - 42:8, 42:22,

47:15, 48:2, 48:6, 48:16pain [49] - 14:8, 14:9,

17:25, 18:2, 18:7, 19:25, 20:5, 23:14, 24:24, 27:18, 28:2, 28:11, 29:23, 29:24, 31:8, 32:22, 61:5, 61:22, 62:4, 62:9, 62:14, 62:15, 62:20, 62:21, 63:21, 64:7, 71:17, 71:24, 72:5, 72:10, 73:19, 73:23, 73:25, 75:16, 76:11, 82:6, 82:14, 82:19, 83:3, 83:22, 84:2, 84:5, 84:8, 84:22, 84:24, 85:7, 85:8, 89:8, 93:2

palm [1] - 32:3paper [1] - 62:16paragraph [1] - 59:2PARK [1] - 1:18part [7] - 20:7, 20:21,

27:10, 27:13, 27:20, 29:16, 51:9

partial [2] - 21:5, 81:23parties [1] - 1:18pass [1] - 7:8passes [1] - 72:13pathology [1] - 97:2patient [20] - 11:14,

12:20, 42:18, 44:21, 45:22, 45:24, 46:8, 46:14, 51:9, 51:13, 55:19, 59:22, 64:19, 67:9, 68:15, 79:22, 80:23, 87:17, 89:21, 91:12

patients [6] - 8:6, 12:21, 47:12, 63:21, 64:23, 84:5

Paul [2] - 3:9, 4:19PAUL [1] - 1:16pediatric [1] - 6:7people [13] - 20:6, 20:8,

43:10, 54:24, 65:15, 65:17, 71:7, 71:16, 71:23, 72:5, 79:7, 80:9, 84:12

percent [4] - 37:2, 38:5, 64:23, 81:13

perform [10] - 8:12, 8:16, 8:21, 15:6, 20:22, 25:8, 26:20, 47:18, 47:23, 80:19

periodically [1] - 67:2person [5] - 17:21,

17:24, 19:25, 64:20,

P.G. KLEINMAN, M.D.


106

93:14physical [15] - 13:15,

13:24, 14:3, 15:7, 24:11, 28:13, 29:20, 30:21, 31:6, 33:5, 34:9, 35:22, 39:14, 65:21, 87:24

physically [1] - 21:23physician [8] - 29:23,

56:18, 61:2, 73:22, 74:19, 78:19, 79:10, 80:18

physicians [1] - 12:13Picciano [1] - 3:25PICCIANO [1] - 2:9pick [1] - 61:12picked [3] - 59:9, 59:14,

61:20picks [1] - 71:13picture [1] - 76:8pin [1] - 6:14Pittsburgh [1] - 6:7placed [1] - 84:17PLAINTIFF [1] - 1:4Plaintiff [6] - 1:16, 2:4,

3:15, 3:23, 44:25, 95:2Plaintiff's [4] - 42:9,

54:20, 92:17, 94:8Plaintiffs [1] - 3:10planning [1] - 31:12plans [1] - 80:21Please [1] - 4:17please [2] - 3:20, 4:8point [5] - 16:25, 28:4,

32:16, 54:17, 60:23Polanco [2] - 48:25,

49:6poles [4] - 21:17, 26:14,

84:25, 93:25position [3] - 17:23,

21:10, 76:16positive [4] - 18:8,

28:23, 31:22, 34:14post [3] - 32:8, 32:11,

34:17posterior [2] - 31:9,

32:2posttraumatic [4] -

96:10, 96:11, 96:12, 96:20

pounds [3] - 21:12, 21:19, 26:17

practice [10] - 5:5, 6:9, 7:9, 7:22, 47:10, 65:12, 66:10, 78:17, 78:21, 80:8

predate [1] - 73:12predisposed [1] - 23:11preexisting [13] - 22:6,

22:7, 22:24, 23:10, 27:3, 27:5, 66:18, 67:24,

69:23, 96:16, 97:3, 97:7, 97:13

premade [1] - 89:21prepare [2] - 44:8, 47:6prepared [1] - 10:7preprinted [7] - 61:18,

61:21, 61:25, 62:16, 89:12, 89:15, 89:23

Presbyterian [1] - 6:3prescribed [2] - 81:6,

81:9presence [1] - 19:23present [3] - 38:18,

38:23, 54:23PRESENT [1] - 2:13presently [1] - 7:13pressure [4] - 18:9,

29:6, 84:16, 89:13pretty [1] - 37:22previous [7] - 23:18,

26:4, 27:15, 28:15, 30:24, 33:15, 37:18

previously [2] - 34:6, 56:14

primarily [2] - 21:10, 71:5

prior [24] - 23:20, 39:6, 50:2, 50:6, 50:16, 50:20, 51:2, 51:19, 52:12, 53:5, 54:18, 56:10, 56:19, 57:5, 57:8, 69:25, 70:4, 70:14, 70:20, 75:8, 76:11, 76:20, 77:9

privileges [1] - 8:10problem [8] - 8:18,

53:5, 62:18, 63:17, 64:19, 72:24, 89:25, 90:3

problems [9] - 5:13, 8:19, 8:20, 57:10, 64:14, 64:24, 65:18, 75:3

process [3] - 18:15, 43:21, 43:22

producing [2] - 76:10, 76:18

professional [3] - 7:14, 7:19, 63:9

projection [1] - 96:6prolonged [1] - 21:13proper [3] - 50:23, 51:5,

56:19provide [3] - 24:2, 66:7,

87:4provided [11] - 13:5,

14:13, 20:10, 20:15, 23:14, 24:8, 24:14, 39:12, 39:24, 40:12, 60:2

providing [2] - 12:16, 12:24

Public [3] - 1:21, 4:12,

98:11published [1] - 6:11purpose [1] - 77:12purposes [1] - 11:11

Qqualifications [1] -

44:13qualified [1] - 65:23qualify [1] - 77:16QUEENS [1] - 1:2Queens [1] - 3:19QUESTION [1] - 99:21question [14] - 46:11,

46:12, 52:16, 54:25, 55:3, 59:12, 72:23, 73:2, 75:18, 75:23, 80:5, 80:7, 81:24, 82:14

questioned [2] - 88:11, 88:13

questions [6] - 40:21, 51:14, 51:23, 52:17, 83:12, 94:3

QUESTIONS [1] - 99:20

Rradiologist [5] - 68:6,

68:12, 68:18, 68:20, 94:9radiology [2] - 62:22,

68:9raise [3] - 17:22, 17:23,

34:14raising [6] - 15:12, 18:2,

18:8, 18:15, 28:24, 31:22range [16] - 15:10,

15:14, 17:4, 18:6, 25:15, 28:21, 31:20, 31:21, 33:17, 33:18, 34:11, 34:13, 34:20, 35:25, 36:5, 37:21

rating [1] - 93:13ray [3] - 20:6, 63:2, 63:3rays [1] - 62:23read [4] - 60:24, 60:25,

66:9, 66:12reason [6] - 41:4, 42:20,

50:25, 52:4, 71:16, 71:23reasonable [4] - 26:19,

39:13, 39:25, 40:13recall [1] - 60:11receipt [2] - 77:16, 78:2receiving [3] - 42:25,

49:18, 79:18recent [1] - 37:23recognized [1] - 9:10recollecting [1] - 10:21recollection [1] - 88:7recommend [2] - 80:16,

80:21recommendations [1] -

12:17recommended [2] -

80:13, 80:16record [21] - 3:3, 4:18,

27:14, 27:21, 46:10, 59:24, 60:6, 60:9, 60:16, 60:19, 63:7, 64:6, 81:25, 88:16, 89:3, 90:12, 90:14, 90:18, 91:23, 94:16, 94:17

records [45] - 10:19, 12:25, 13:5, 13:8, 13:15, 14:14, 14:17, 15:6, 19:2, 23:13, 24:3, 24:8, 24:15, 39:11, 39:23, 40:11, 43:20, 44:10, 57:16, 57:18, 62:6, 63:14, 67:9, 75:9, 75:17, 76:3, 76:12, 76:21, 77:4, 78:4, 82:11, 85:10, 85:18, 85:23, 86:7, 86:16, 86:20, 87:5, 87:9, 87:13, 88:9, 88:19, 88:22, 90:10, 92:10

RECROSS [1] - 94:4REDIRECT [1] - 83:10reduce [1] - 46:18reexamination [1] -

45:12refer [1] - 64:20reference [3] - 28:3,

63:7, 93:9referred [1] - 28:5refill [1] - 29:23refresh [1] - 88:7regarding [8] - 10:9,

24:19, 29:13, 31:11, 59:21, 85:13, 88:24, 93:6

regardless [1] - 90:2regular [3] - 66:12,

93:15, 93:24related [15] - 19:19,

36:23, 63:16, 69:4, 69:6, 70:4, 70:12, 70:14, 70:20, 72:22, 72:24, 75:2, 78:20, 78:21, 96:9

relationship [9] - 11:16, 22:3, 22:13, 22:18, 26:25, 29:11, 30:7, 77:25, 78:4

rely [2] - 68:17, 68:20relying [1] - 88:3remember [4] - 23:17,

81:11, 85:24, 88:11repetitive [1] - 21:13report [32] - 14:16,

14:20, 14:24, 21:3, 22:4, 24:6, 26:24, 27:11, 27:20, 30:6, 30:15,

P.G. KLEINMAN, M.D.


107

30:16, 32:24, 34:7, 38:9, 63:8, 66:16, 67:23, 68:2, 68:4, 73:6, 85:13, 85:17, 85:21, 88:7, 92:5, 92:9, 94:8, 95:7, 95:14, 95:17

reported [1] - 49:15Reporter [1] - 4:5Reporting [3] - 2:14,

3:7, 4:7reports [15] - 10:6,

10:11, 10:15, 10:24, 24:13, 47:6, 57:21, 64:10, 66:3, 68:5, 68:22, 88:4, 94:12, 94:21

represent [1] - 41:2request [1] - 41:12REQUESTED [1] -

99:15required [1] - 93:21requirement [1] - 78:18residency [1] - 7:7resident [3] - 65:7, 65:8,

78:16residents [2] - 6:20,

6:24resolved [1] - 23:21respect [6] - 20:23,

22:18, 30:6, 63:10, 73:7, 93:20

respective [1] - 1:17response [1] - 80:4responses [1] - 51:15responsibilities [1] -

21:24responsibility [1] - 87:9responsible [3] - 12:24,

86:19, 86:22resting [1] - 21:10restrained [1] - 58:12restriction [1] - 34:19restrictions [2] - 16:21,

16:24result [2] - 37:19, 39:19results [5] - 15:13,

15:18, 17:8, 18:4, 36:4return [1] - 27:15reveal [1] - 56:10review [13] - 18:25,

39:10, 39:23, 40:11, 44:9, 59:24, 60:19, 60:21, 63:13, 67:21, 88:8, 94:8, 94:20

reviewed [9] - 13:14, 85:18, 85:22, 88:16, 89:2, 90:9, 90:11, 91:22, 92:10

reviewing [2] - 15:5, 68:8

revoked [1] - 44:15

ridge [2] - 95:23, 96:6ridges [1] - 96:14ridging [4] - 15:2,

95:15, 95:20, 96:21ridiculous [1] - 79:23right [57] - 12:9, 12:14,

12:18, 14:7, 16:7, 17:19, 26:11, 31:3, 32:12, 36:12, 43:3, 46:25, 48:15, 49:17, 49:20, 50:18, 51:7, 51:17, 57:23, 61:5, 61:11, 62:9, 64:9, 65:14, 66:7, 66:11, 66:14, 66:24, 67:6, 68:10, 68:13, 69:17, 73:15, 73:24, 74:2, 74:3, 74:10, 75:11, 76:4, 78:7, 79:13, 82:4, 82:20, 86:8, 87:7, 89:8, 90:19, 90:21, 91:21, 91:25, 92:6, 92:14, 92:23, 93:8, 93:19, 96:24

Rivera [63] - 3:15, 10:5, 10:9, 11:3, 11:17, 11:22, 12:11, 15:7, 18:21, 20:17, 20:24, 21:23, 23:24, 26:7, 27:8, 29:18, 30:11, 30:17, 33:22, 34:2, 34:24, 35:5, 35:10, 36:22, 38:2, 39:4, 39:10, 39:22, 40:10, 41:3, 42:17, 43:25, 44:22, 44:25, 47:14, 47:20, 49:5, 49:14, 49:21, 50:5, 51:18, 51:22, 55:23, 56:10, 63:8, 64:3, 64:7, 67:19, 69:23, 73:7, 73:16, 74:25, 77:13, 78:9, 80:12, 81:7, 82:13, 85:14, 86:4, 86:15, 91:19, 92:25, 96:14

RIVERA [1] - 1:3Rivera's [17] - 14:13,

20:11, 21:16, 26:13, 35:23, 38:19, 39:14, 40:2, 40:14, 41:12, 66:6, 66:22, 76:11, 76:19, 83:3, 87:8, 93:10

ROBERT [2] - 98:10, 98:16

Robert [2] - 1:21, 4:5room [3] - 24:10, 46:2,

46:16room's [1] - 89:6root [5] - 18:12, 29:5,

32:6, 71:24, 72:8roots [6] - 18:9, 18:18,

29:6, 70:10, 84:15, 84:17rotating [1] - 5:23rotation [2] - 17:12,

36:9rotations [1] - 6:24routes [1] - 72:4rules [1] - 93:12rulings [1] - 54:23RULINGS [1] - 99:20

SSan [1] - 5:23saying [1] - 61:25SCAHILL [19] - 2:9,

2:11, 3:24, 22:20, 23:7, 30:8, 31:2, 36:24, 39:17, 40:5, 40:17, 40:23, 83:7, 83:23, 84:10, 85:3, 94:5, 98:4, 99:12

Scahill [8] - 3:25, 4:2, 40:25, 45:10, 83:14, 88:13, 88:20, 89:19

scale [4] - 82:5, 82:15, 82:21, 82:24

scan [1] - 22:8scans [1] - 62:23School [1] - 5:22school [2] - 78:15,

78:25sciatic [1] - 18:17sciatica [1] - 84:25seat [2] - 58:5, 58:12second [6] - 13:11,

22:12, 25:22, 26:5, 85:12, 85:13

secondary [8] - 78:12, 78:20, 79:2, 79:4, 79:11, 79:23, 79:25, 80:9

sedentary [4] - 21:6, 21:8, 93:18

Sedgwick [3] - 86:14, 87:2, 87:3

self [1] - 16:16self-explanatory [1] -

16:16send [2] - 65:23, 67:9sends [1] - 86:13sensation [4] - 18:11,

28:24, 31:24, 34:16sense [1] - 75:24sentence [2] - 45:9,

76:24September [1] - 37:8service [1] - 6:25seven [2] - 42:21, 82:25severe [1] - 14:22severity [1] - 58:9shock [1] - 70:24shoulders [1] - 14:8show [3] - 60:15, 61:10,

90:25showing [1] - 14:25

sic [2] - 33:4, 86:22sic) [1] - 41:3sides [3] - 31:9, 32:2,

36:19signed [1] - 58:23significant [2] - 32:22,

63:20sir [1] - 46:20sit [1] - 42:13sitting [1] - 17:22six [3] - 3:4, 48:19,

82:25sixteen [1] - 8:5sixty [3] - 9:24, 42:7,

48:6sixty-five [3] - 9:24,

42:7, 48:6sleep [1] - 91:17societies [1] - 7:14Solano [4] - 14:19,

57:18, 92:11, 92:25Solano's [1] - 92:18somebody [4] - 60:2,

84:24, 87:21, 91:19someone [4] - 64:21,

74:7, 74:11, 74:15somewhat [1] - 31:21sorry [4] - 30:13, 45:8,

45:10, 92:4sort [1] - 96:5space [2] - 84:18, 86:10speak [2] - 8:25, 9:7specialist [1] - 24:24specialty [3] - 5:7,

65:12, 68:7specifically [7] - 20:18,

20:19, 50:19, 61:16, 69:22, 80:20, 82:18

speculate [1] - 52:2speed [1] - 33:12spend [1] - 43:24spent [1] - 83:15spinal [16] - 24:25, 25:4,

25:6, 29:25, 65:22, 65:23, 70:6, 70:19, 71:19, 71:20, 72:2, 72:13, 72:16, 72:18, 72:24, 73:8

spine [12] - 5:15, 28:11, 29:21, 33:8, 38:20, 69:16, 70:10, 95:4, 95:5, 95:6, 95:8, 95:12

spoke [2] - 67:16, 95:8sprains [1] - 65:16spurs [1] - 19:21St [4] - 5:25, 6:20, 8:11,

46:17stabilize [1] - 28:11staff [1] - 6:21

P.G. KLEINMAN, M.D.


108

stand [1] - 91:9Stanford [1] - 5:21STATE [1] - 1:2state [2] - 4:17, 18:22State [5] - 1:22, 3:18,

4:13, 5:5, 98:11stated [2] - 30:24, 93:18statement [4] - 45:12,

52:23, 52:25, 64:2States [1] - 7:20stenographic [1] -

98:14stenosis [9] - 14:22,

19:11, 70:6, 70:16, 70:19, 72:17, 72:19, 72:24, 73:9

steroid [1] - 25:2stomach [2] - 74:8stop [1] - 27:19stopped [1] - 16:25stored [1] - 86:11straight [9] - 15:11,

17:17, 18:8, 18:14, 18:15, 25:20, 28:23, 31:22, 34:13

straightening [1] - 14:25

strain [5] - 19:9, 62:2, 62:13, 62:18, 90:7

stretch [1] - 72:8stretching [1] - 18:17stricken [2] - 54:13,

80:3strictly [1] - 96:8students [2] - 6:19, 6:23subject [2] - 69:10,

69:12subjective [5] - 74:2,

74:5, 74:9, 74:19, 74:21sued [5] - 44:17, 46:4,

46:9, 48:24, 49:6suing [4] - 45:2, 45:19,

46:14, 46:21Suite [3] - 1:20, 2:10,

4:23superimposed [1] -

19:12supposed [4] - 13:7,

61:23, 87:4, 93:12Supreme [1] - 3:18SUPREME [1] - 1:2surgeon [6] - 28:4,

28:6, 29:21, 29:25, 31:13, 65:24

surgeons [1] - 7:20surgeries [2] - 8:15,

65:3Surgery [2] - 6:16, 7:17surgery [32] - 5:9, 5:25,

6:6, 7:12, 8:13, 8:17, 8:22, 8:24, 30:2, 30:19, 30:22, 31:11, 31:13, 32:9, 32:11, 33:8, 34:2, 34:5, 40:3, 40:15, 40:19, 46:23, 64:15, 64:22, 64:25, 65:9, 65:13, 65:19, 65:22, 79:22, 79:25, 80:19

surgical [1] - 34:17suspended [1] - 44:15swear [1] - 4:9swelling [1] - 84:15sworn [1] - 4:12symptomatic [16] -

20:9, 22:9, 22:11, 22:23, 23:3, 23:6, 23:9, 23:22, 27:4, 39:5, 39:7, 39:18, 73:17, 74:24, 75:4, 84:14

symptoms [2] - 23:2, 74:23

Ttakes [2] - 43:21, 43:22talk [6] - 43:19, 57:3,

67:13, 68:2, 78:8, 95:19talked [11] - 38:17, 66:2,

68:3, 68:21, 69:24, 70:6, 70:23, 73:16, 78:3, 83:19, 96:14

talking [6] - 31:12, 41:20, 56:4, 69:4, 74:24, 97:10

Tantlef [2] - 94:9, 94:21taught [2] - 78:15, 79:2teach [1] - 6:22technician [1] - 20:19telephone [2] - 21:17,

84:25telling [1] - 37:16tells [2] - 74:7, 74:15ten [6] - 36:16, 44:4,

47:24, 47:25, 82:6, 82:15tendons [1] - 5:14tensed [1] - 17:2term [2] - 68:23, 78:12terms [5] - 57:16, 64:13,

70:24, 72:20, 77:12test [1] - 68:16testified [4] - 4:14, 9:2,

9:16, 46:24testify [4] - 41:7, 41:15,

47:3, 48:13testimony [7] - 3:8,

3:11, 10:20, 42:15, 48:7, 48:9, 48:17

TESTIMONY [1] - 1:15testing [6] - 15:10,

17:18, 18:15, 36:2, 36:5,

68:15testings [1] - 68:16tests [3] - 62:23, 78:4,

81:10thank [7] - 4:3, 40:20,

83:7, 93:4, 94:2, 98:5, 98:6

THE [3] - 1:2, 3:2, 4:3therapy [7] - 24:11,

28:2, 29:20, 30:21, 33:5, 65:21, 80:17

thigh [1] - 18:12thirty [4] - 6:10, 36:17,

36:18, 49:9three [13] - 12:8, 38:14,

39:9, 39:21, 40:9, 49:4, 59:2, 66:25, 73:5, 77:20, 82:19, 82:22, 82:24

thrown [3] - 45:13, 45:15, 45:20

tilt [2] - 36:10, 36:12tilting [1] - 17:13TIME [1] - 1:12times [2] - 33:5, 48:20tingling [1] - 14:10tiny [1] - 84:19toes [1] - 16:3tomorrow [1] - 8:24tonight [1] - 5:2total [4] - 32:17, 32:20,

36:25, 38:3totally [2] - 34:25, 93:15touch [3] - 16:3, 28:25,

34:16towards [2] - 60:23,

61:7track [1] - 6:14training [3] - 6:2, 6:4,

6:8transcription [1] - 98:13trauma [13] - 6:5, 69:19,

70:12, 72:7, 72:21, 84:7, 84:14, 84:21, 96:8, 96:17, 96:18, 96:19, 97:5

treat [3] - 8:6, 64:25, 65:20

treated [1] - 46:22treating [4] - 12:12,

14:18, 29:22, 80:22treatment [10] - 5:12,

11:15, 12:16, 29:18, 33:3, 58:20, 75:15, 77:22, 80:14

triage [1] - 82:2TRIAL [1] - 1:15trial [1] - 3:8twelve [5] - 12:2, 40:9,

43:25, 81:6, 94:12twice [3] - 43:8, 43:9,

47:5type [8] - 8:15, 11:14,

20:16, 37:15, 48:9, 83:20, 87:13, 93:16

Uuh [1] - 81:18uh-hum [1] - 81:18unavailable [1] - 41:6unaware [1] - 53:23undergo [3] - 68:15,

79:22, 79:24undergraduate [1] -

5:19understanding [4] -

39:4, 53:11, 55:13, 79:5Unimex [5] - 13:3,

24:16, 86:13, 86:24, 87:3United [1] - 7:20University [3] - 5:20,

5:22, 6:5unusual [1] - 63:24unwilling [1] - 41:7upper [2] - 28:25, 82:15upset [1] - 74:8

Vvariable [1] - 43:16vehicle [12] - 13:22,

19:9, 22:19, 23:18, 53:9, 53:16, 54:18, 58:17, 61:4, 62:9, 89:7, 90:15

Verizon [3] - 20:14, 26:14, 59:14

vertebra [2] - 28:10, 95:25

vertebrae [1] - 70:25video [1] - 3:3Video [1] - 3:7Videographer [1] - 2:14VIDEOGRAPHER [2] -

3:2, 4:3VIDEOTAPED [1] - 1:15visit [4] - 10:17, 31:11,

31:15, 77:13visits [4] - 37:14, 43:25,

81:5, 81:6vomits [1] - 74:11

Wwaist [1] - 16:4wait [4] - 45:8, 59:3wanted [7] - 33:8,

67:20, 77:15, 77:21, 77:23, 77:24, 80:15

was he [3] - 17:8, 54:2, 93:21

P.G. KLEINMAN, M.D.


109

was it [4] - 16:23, 28:15, 31:17, 44:4

was that [3] - 11:9, 34:5, 93:9

was there [2] - 23:12, 31:10

water [3] - 71:5, 71:7, 71:13

wearing [1] - 58:5Wednesdays [1] - 8:23week [10] - 8:7, 33:6,

41:18, 41:20, 41:24, 41:25, 42:4, 47:23, 48:20

weighed [1] - 26:16weight [1] - 21:19were you [36] - 11:5,

11:18, 11:21, 14:12, 18:21, 20:10, 20:15, 20:22, 22:2, 24:2, 24:8, 25:23, 26:5, 26:24, 29:16, 32:13, 32:24, 33:21, 34:23, 35:19, 36:21, 37:4, 37:7, 37:24, 41:14, 48:24, 53:6, 53:12, 53:18, 55:7, 55:14, 56:5, 56:13, 58:22, 59:13, 59:16

weren't [2] - 33:18, 66:7Westbury [1] - 2:11what are [1] - 7:10what did [4] - 15:9,

18:5, 29:4, 32:4what is [8] - 7:18,

16:10, 17:20, 21:8, 24:21, 54:15, 61:23, 82:6

what was [7] - 13:20, 19:7, 21:2, 22:17, 81:21, 89:5, 92:15

what were [2] - 14:17, 36:4

what's [6] - 47:18, 61:24, 62:14, 72:11, 72:23, 82:14

when you [19] - 12:10, 12:23, 17:21, 18:20, 35:4, 41:19, 43:9, 43:22, 49:21, 50:9, 50:14, 51:13, 51:18, 51:23, 52:15, 57:3, 57:17, 68:3, 96:19

Whereupon [2] - 94:17, 98:7

who is [2] - 46:14, 86:23

who was [1] - 12:24wholly [1] - 11:6wife [2] - 59:9, 59:13William [2] - 48:25, 49:6wish [1] - 80:18witness [1] - 4:11

P.G. KLEINMAN, M.D.


110

Witness [2] - 1:16, 4:9word [1] - 74:18work [15] - 13:23, 20:16,

21:6, 21:7, 21:8, 21:9, 27:15, 27:17, 32:18, 35:5, 37:3, 38:10, 38:11, 38:12, 77:23

Workers [1] - 13:4Workers' [17] - 11:9,

42:22, 42:25, 47:15, 48:14, 48:17, 49:18, 67:4, 77:14, 77:17, 79:10, 79:15, 79:18, 80:10, 86:11, 87:18, 93:11

worse [2] - 31:21, 33:18worth [1] - 42:14wouldn't [1] - 52:2wrist [1] - 46:18wrists [1] - 14:8write [1] - 62:18written [3] - 7:8, 62:15,

62:20wrong [4] - 51:16, 54:7,

54:16, 56:3wrote [1] - 62:21

XX-ray [3] - 20:6, 63:2,

63:3X-rays [1] - 62:23

Yyard [1] - 59:15yeah [4] - 36:25, 44:5,

48:12, 92:8year [3] - 5:24, 47:4,

49:9years [12] - 6:10, 7:9,

8:5, 23:20, 39:10, 39:22, 40:10, 42:21, 65:11, 66:25, 73:22, 75:16

YORK [1] - 1:2York [11] - 1:20, 1:22,

2:5, 2:11, 3:14, 3:19, 4:13, 4:24, 5:5, 98:12

yourself [3] - 67:21, 68:11, 68:17

Documents

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