The Patient Safety Committee of the American Society for Metabolic and Bariatric Surgery (ASMBS) encourages its members to testify in court to promote safe and responsible bariatric surgical care. The widespread availability of expert opinion to both defendants and plaintiffs is critical in meeting the Society’s social responsibility. The expert witness in a medical malpractice suit is of criti...

CASE 1 A 37-year-old woman was seen with a chief complaint of new onset headaches for 2 months without any prior history of significant headaches. She described a generalized throbbing and aching pain with an intensity of 10/10 associated with light and noise sensitivity and blurred vision in both eyes but no nausea or aura lasting about 3-4 hours with ibuprofen but then recurring requiring ano...

CASE This 33-year-old woman is seen in headache consultation with a 15-year history of migraine without aura occurring about 8 times monthly with an inconsistent response to triptans. She was tried on amitriptyline 25 mg at bedtime by her primary care physician but stopped on her own after 1 week because she was no better even though she was aware that the medication may take 6 weeks to work an...

Recent Supreme Court decisions emphasize the need to regulate the admissibility of expert testimony by means of standards that require opinions to go beyond ipse dixit--that is, that are based on more than the fact that the expert said it. The authors discuss subtextual themes underlying this issue and suggest approaches to attaining expert clinical opinions that reduce the likelihood of being ...

BACKGROUND Preoperative evaluation of ovarian tumors is challenging. This study was undertaken to evaluate the performance of conventional two-dimensional (2D) ultrasound and CA125 in predicting malignant or benign nature of pelvic masses, and to investigate if three-dimensional power Doppler (3DPD) ultrasound provides any added value. Ninety-six postmenopausal and four perimenopausal women wit...

Sometimes the observations by one astute clinician of one patient lead to new treatments. In 1966, Rabin et al in a study of propranolol to prevent angina, noted that a 59-year-old man reported that his migraines and angina improved on propranolol but the migraines returned after a crossover to placebo medication. Since then, propranolol has become a first-line agent for migraine prevention wit...

Software fault prediction is a process which predicts that the software modules are faulty or not by using the software metrics and some soft computing methods. Software metrics are divided into two main categories such as object-oriented and method-level metrics. While class relationships and dependencies are covered by object-oriented metrics, behaviors of the classes can be also measured by ...

CASE A 45-year-old man has a 10-year history of migraine without aura occurring about once a week relieved by an oral triptan. When he sought treatment for erectile dysfunction from a urologist, the side effect of triggering migraine was brought up. Now the patient and the urologist want my opinion about whether the patient should try an oral phosphodiesterase-5 inhibitor (PDE-5) and, if so, do...

INICAL HISTORY A 28-year-old woman has had migraine without aura since the age of 13 with attacks now occurring about 4 times per month with an inconsistent response to triptans. In addition, she has had recurring endogenous depression for 3 years treated with paroxetine last over one year ago with some help. Her depression is currently mild. There is no history to suggest hypomania or mania. S...