FILED
`8/30/2018 12:28 PM
`JOHN F. WARREN
`COUNTY CLERK
`DALLAS COUNTY
`
`PATRICIA PERKINS,
`
`
`Plaintiff,
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`Defendants.
`
`
`VS.
`
`THOMAS C. DILIBERTI, M.D.
`AND NORTH CENTRAL
`SURGICAL CENTER
`
`
`CAUSE NO. CC-17-06775-A
`
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`IN THE COUNTY COURT
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`
`AT LAW NO. 1
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`DALLAS COUNTY, TEXAS
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`PLAINTIFF’S EXPERT DESIGNATIONS
`
`COMES NOW Patricia Perkins, Plaintiff in the above-styled and numbered action, and
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`pursuant to TRCP 194.2(f), and the Court's current Scheduling Order, and designates the
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`following expert witnesses who may testify at the time of trial:
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`RETAINED EXPERTS FOR PLAINTIFF
`
`Deowall Chattar-Cora, M.D.
`Elite Plastic & Reconstructive Surgery
`11212 State Highway 151
`Medical Plaza 2, Suite 230
`San Antonio, TX 78251
`(210) 265-1924
`
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`1.
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`Dr. Chattar-Cora, a board-certified hand surgeon, has knowledge regarding the
`medical treatment, causation, extent/duration of disability, and the necessity of the medical
`services rendered to patients suffering from hand/finger/thumb injures and the reasonableness
`of the charges made for such services. Dr. Chattar-Cora will testify to the subject areas set out
`in his report and supplemental report, which are attached hereto as Exhibit 1 and Exhibit
`2, respectively, and incorporated herein by reference. More specifically, he is of the
`opinion that Dr. Diliberti operated on the right thumb without Plaintiff’s consent, which
`was below the standard of care and which cause harm to Plaintiff.
`
`See Dr. Chattar-Cora’s Report and Supplemental Report for a statement of the opinions
`he will express and the basis and reasons for them. His report also contains a listing of all
`information, records, and documents reviewed and relied upon to form his opinions.
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`In addition, he may provide testimony on any other subjects to which he is qualified
`to testify, such as the reasonable and necessary treatment for Plaintiff’s injury and the reasonable
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`__________________________________________________________________________________
`Plaintiff’s Expert Designations
`
` pg. 1
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`

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`and necessary cost of dame, both in the past and furture; and to the extent that testimony on
`such subject(s) becomes necessary in rebuttal of testimony given by one or more of
`Defendants' own expert witnesses. For his qualifications, see Dr. Chattar-Cora’s curriculum
`vitae which is attached as Exhibit 3 and incorporated herein by reference.
`
`NON-RETAINED EXPERTS
`
`The following persons may be used at trial to present evidence under Texas Rules of
`Evidence 702, 703, and/ or 705. Plaintiff Perkins hereby designates the following persons as
`experts who are not retained or specially employed by Plaintiff to provide expert testimony:
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`Bane Smith, M.D.
`Wheatland Medical Associates
`And all treating physicians, nurses, employees, representatives and staff, and custodians of records
`3920 Wheatland Rd., Ste. 152
`Dallas, TX 75237
`(214) 999-1956
`
`
`Treating physicians and health care professionals of Plaintiff Perkins. Have knowledge
`regarding Plaintiff’s physical condition, medical treatment past and future, as well as the
`reasonable and necessary costs of such treatment, and causation. In addition, have knowledge
`of the cause of the pain and the suffering experienced and likely to be experienced in the future
`by Plaintiff due to the incident made the basis of this lawsuit.
`
`The above doctors and medical providers have knowledge regarding the health and
`physical condition, medical treatment, causation, extent and duration of disability and the
`necessity of the medical services rendered to Plaintiff and the reasonableness of the charges
`made for such services past and future. Please see medical and billing records obtained in this
`case. Furthermore, the treating physicians have knowledge of the cause of the pain and the
`suffering experienced by Plaintiff due to the occurrence made the basis of this lawsuit, and
`that likely to be suffered in the future. See medical and billing records previously produced
`or subpoenaed by Defendant.
`
`Additionally, these physicians and medical providers may provide testimony on any other
`subjects to which they are qualified to testify, to the extent that testimony on such subject(s)
`becomes necessary in rebuttal of testimony given by one or more of Defendant's expert
`witnesses.
`
`
`Olayinka Ogunro, M.D.
`Hands & Upper Extremity Center
`And all treating physicians, nurses, employees, representatives and staff, and custodians of records
`3450 W. Wheatland Rd., Ste. 430
`Dallas, TX 75237
`(972) 566-5051
`
`
`__________________________________________________________________________________
`Plaintiff’s Expert Designations
`
` pg. 2
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`

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`Treating physicians and health care professionals of Plaintiff Perkins. Have knowledge
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`regarding Plaintiff’s physical condition, medical treatment past and future, as well as the
`reasonable and necessary costs of such treatment, and causation. In addition, have knowledge
`of the cause of the pain and the suffering experienced and likely to be experienced in the future
`by Plaintiff due to the incident made the basis of this lawsuit.
`
`The above doctors and medical providers have knowledge regarding the health and
`physical condition, medical treatment, causation, extent and duration of disability and the
`necessity of the medical services rendered to Plaintiff and the reasonableness of the charges
`made for such services past and future. Please see medical and billing records obtained in this
`case. Furthermore, the treating physicians have knowledge of the cause of the pain and the
`suffering experienced by Plaintiff due to the occurrence made the basis of this lawsuit, and
`that likely to be suffered in the future. See medical and billing records previously produced
`or subpoenaed by Defendant.
`
`Additionally, these physicians and medical providers may provide testimony on any other
`subjects to which they are qualified to testify, to the extent that testimony on such subject(s)
`becomes necessary in rebuttal of testimony given by one or more of Defendant's expert
`witnesses.
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`__________________________________________________________________________________
`Plaintiff’s Expert Designations
`
` pg. 3
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`

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`By:s/ D. Bradley Kizzia
`
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`D. BRADLEY KIZZIA
`Lead Attorney
`State Bar No. 11547550
`bkizzia@kjpllc.com
`NICHOLAS D. CUSTRED
`State Bar No. 24101664
`ncustred@kjpllc.com
`KIZZIA JOHNSON PLLC
`1910 Pacific Ave., Ste. 13000
`Dallas, Texas 75201
`(214) 451-0164
`Fax: (214) 451-0165
`
`ATTORNEYS FOR PLAINTIFF
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`CERTIFICATE OF SERVICE
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`The undersigned certifies that a true and correct copy of the above and foregoing
`instrument has been forwarded to all counsel of record on the 30 day of August, 2018 in
`accordance with the Texas Rules of Civil Procedure.
`
`s/ D. Bradley Kizzia
`
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`D. BRADLEY KIZZIA
`
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`__________________________________________________________________________________
`Plaintiff’s Expert Designations
`
` pg. 4
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`

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`CHAPTER 74 EXPERT REPORT— PRIVILEGED
`CHAPTER 74 EXPERT REPORT- PRIVILEGED
`March 27 2018
`March 27 2018
`
`Re: Patricia Perkins
`Re: Patricia Perkins
`
`Dear CouncilorJohnson:
`Dear Councilor Johnson:
`
`I am writing to convey my opinions regarding the medical and surgical care that was provided to Patricia
`I am writing to convey my opinions regarding the medical and surgical care that was provided to Patricia
`Perkins during his surgery on April 25, 2016. At your request, | have reviewed the following medical
`Perkins during his surgery on April 25, 2016. At your request, I have reviewed the following medical
`records in the formulation of my opinions: Notes from Olayinkq Ogunro, MD dates treatment Juen 28,
`records in the formulation of my opinions: Notes from Olayinkq Ogunro, MD dates treatment Juen 28,
`2016— November 17, 2016, and Thomas Diliberti, MD dates of service September 9, 2014 to June 21,
`2016- November 17, 2016, and Thomas Diliberti, MD dates of service September 9, 2014 to June 21,
`2016 and North Central Surgical Center notes April 28, 2016 that were submitted to me.
`2016 and North Central Surgical Center notes April 28, 2016 that were submitted to me.
`
`Qualifications to Render Opinions
`Qualifications to Render Opinions
`I am qualified on the basis of my education, training, and experience to offer the opinions expressed in
`I am qualified on the basis of my education, training, and experience to offer the opinions expressed in
`this report. I am a plastic and reconstructive surgeon current|y in private practice in San Antonio, Texas.
`this report. I am a plastic and reconstructive surgeon currently in private practice in San Antonio, Texas.
`l attended the New York
`A significant amount of my practice is devoted to treating hand disorders.
`A significant amount of my practice is devoted to treating hand disorders. I attended the New York
`University School of Medicine for my medical degree. After that | completed one year of clinical
`University School of Medicine for my medical degree. After that I completed one year of clinical
`research. I went on to complete a five-year residency in general surgery at Morristown Memorial
`research. I went on to complete a five-year residency in general surgery at Morristown Memorial
`Hospital in Morristown, New Jersey. To further advance my clinical training l completed a one-year
`Hospital in Morristown, New Jersey. To further advance my clinical training I completed a one-year
`fellowship in burn surgery at the Jacobi Hospital Medical Center/Albert Einstein College of Medicine.
`fellowship in burn surgery at the Jacobi Hospital Medical Center/Albert Einstein College of Medicine.
`Three years were then devoted to a plastic and reconstructive surgery residency at the University of
`Three years were then devoted to a plastic and reconstructive surgery residency at the University of
`Texas Health Science Center at San Antonio, Texas. I finally completed a one-year fellowship in hand
`Texas Health Science Center at San Antonio, Texas. I finally completed a one-year fellowship in hand
`surgery at the San Antonio Hand Center. l am certified by the American Board of Plastic Surgery.
`surgery at the San Antonio Hand Center. I am certified by the American Board of Plastic Surgery.
`I then joined the faculty at the medical school in San Antonio. For 5 1/2 years I was an assistant
`I then joined the faculty at the medical school in San Antonio. For 5 1/2 years I was an assistant
`professor in both the Department of Orthopedic Surgery and the Division of Plastic and Reconstructive
`professor in both the Department of Orthopedic Surgery and the Division of Plastic and Reconstructive
`Surgery at the University of Texas Health Science Center at San Antonio. While on the faculty of the
`Surgery at the University of Texas Health Science Center at San Antonio. While on the faculty of the
`medical school, I was responsible for training medical students and doctors in both the Division of Plastic
`medical school, I was responsible for training medical students and doctors in both the Division of Plastic
`Surgery, and Department of Orthopedic Surgery the intricacies of hand surgery and the various
`Surgery, and Department of Orthopedic Surgery the intricacies of hand surgery and the various
`disciplines of plastic surgery.
`disciplines of plastic surgery.
`In addition to teaching others, a significant amount of my time was spent practicing medicine. While at
`In addition to teaching others, a significant amount of my time was spent practicing medicine. While at
`the University of Texas Health Science Center at San Antonio, the majority of my time was devoted to
`the University of Texas Health Science Center at San Antonio, the majority of my time was devoted to
`hand surgery. Since | operated at one of the major level I trauma centers in south central Texas, I
`hand surgery. Since I operated at one of the major level I trauma centers in south central Texas, I
`treated many complicated hand injuries and various problems involving the hand and upper extremities.
`treated many complicated hand injuries and various problems involving the hand and upper extremities.
`Furthermore, as one of the few hand surgeons in the city of San Antonio, l have frequently been
`Furthermore, as one of the few hand surgeons in the city of San Antonio, I have frequently been
`consulted in our community to treat rhany patients with hand problems.
`consulted in our community to treat many patients with hand problems.
`
`Exhibit 1
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`

`

`My opinions regarding the care and treatment of Patricia Perkins are based on my formal medical and
`My opinions regarding the care and treatment of Patricia Perkins are based on my formal medical and
`i am
`surgical training and 11 years of experience as a doctor practicing in hand and plastic surgery.
`surgical training and 11 years of experience as a doctor practicing in hand and plastic surgery.
`I am
`qualified to render an opinion within a reasonable degree of medical probability. l am knowledgeable of
`qualified to render an opinion within a reasonable degree of medical probability. I am knowledgeable of
`the accepted standards of care applicable to physicians, nurses a-nd other health care providers for the
`the accepted standards of care applicable to physicians, nurses and other health care providers for the
`diagnosis, care, and treatment of the injury and condition affecting Patricia Perkins. For a full iisting of
`diagnosis, care, and treatment of the injury and condition affecting Patricia Perkins. For a full listing of
`my qualifications, see the attached current curriculum vitae.
`my qualifications, see the attached current curriculum vitae.
`
`Clinical History
`Clinical History
`
`Ms. Perkins initially presented to Dr. Dilberti September 9, 2014 with diagnosis of left thumb trigger,
`Ms. Perkins initially presented to Dr. Dilberti September 9, 2014 with diagnosis of left thumb trigger,
`right thumb pain.
`‘She subsequently presented to him on March 16, 2015 with right middle trigger
`right thumb pain.
`·she subsequently presented to him on March 16, 2015 with right middle trigger
`finger, and left trigger thumb and early right trigger thumb. On March 16, 2015 she underwent steroid
`finger, and left trigger thumb and early right trigger thumb. On March 16, 2015 she underwent steroid
`injection of the left trigger thumb and right middle trigger finger. The right middle finger was reinjected
`injection of the left trigger thumb and right middle trigger finger. The right middle finger was reinjected
`On April S, 2016 the
`on February 1, 2016, however there was little improvement in her symptoms.
`on February 1, 2016, however there was little improvement in her symptoms. On April 5, 2016 the
`patient is reexamined for possible surgery and the physical examination demonstrates that there is
`patient is reexamined for possible surgery and the physical examination demonstrates that there is
`triggering of the right middle finger, and non-locking right trigger thumb. A decision is made to proceed
`triggering of the right middle finger, and non-locking right trigger thumb. A decision is made to proceed
`with release of the right middle finger with injection of the left trigger thumb. As with most surgery
`with release of the right middle finger with injection of the left trigger thumb. As with most surgery
`centers surgical a sche'duling document is sent to North Central Surgical center requesting surgical time
`centers surgical a sche.duling document is sent to North Central Surgical center requesting surgical time
`for right middle finger release and left thumb injection. On this document CPT codes (two current
`for right middle finger release and left thumb injection. On this document CPT codes (two current
`procedural codes (26145x2) are requested for tenolysis of the middle finger and injection of the left
`procedural codes {26145x2) are requested for tenolysis of the middle finger and injection of the left
`thumb (20550) there is no mention of the right trigger thumb release or coding for this procedure).
`At
`thumb (20550) there is no mention of the right trigger thumb release or coding for this procedure). At
`some point, Dr. Diliberti modifies the consent to include release of the right trigger thumb, however the
`some point, Dr. Diliberti modifies the consent to include release of the right trigger thumb, however the
`patient does not initial the change; additionally, I do not see a dictated or hand-written note that there
`patient does not initial the change; additionally, I do not see a dictated or hand-written note that there
`At the hospitals, surgical centers in which I operate
`was going to be a change in the surgical plan.
`was going to be a change in the surgical plan. At the hospitals, surgical centers in which I operate
`modifications to consents require a patient to acknowledge these changes by putting their initials next
`modifications to consents require a patient to acknowledge these changes by putting their initials next
`to any changes in the procedure and diagnosis.
`In this case there is no patient initial indicating
`to any changes in the procedure and diagnosis.
`In this case there is no patient initial indicating
`acknowledgement of the additional procedure.
`acknowledgement of the additional procedure.
`Upon review of the intra operative documents there are several inconsistencies; Dr. Diliberti's operative
`Upon review of the intra operative documents there are several inconsistencies; Dr. Diliberti's operative
`report indicates that a lysis of adhesions was done. It is not clear why this procedure was chosen since a
`report indicates that a lysis of adhesions was done. It is not clear why this procedure was chosen since a
`trigger finger release is the standard treatment (that cpt code is 26055 and only one codes is required
`trigger finger release is the standard treatment (that cpt code is 26055 and only one codes is required
`per digit that is operated on for that diagnosis, not two cpt codes per digit as was requested in this case.
`per digit that is operated on for that diagnosis, not two cpt codes per digit as was requested in this case.
`The anesthesiologist's record shows preop diagnosis of ”right middle and left thumb flexor tenso"....no
`The anesthesiologist's record shows preop diagnosis of "right middle and left thumb flexor tenso" .... no
`mention of right thumb tenosynovaginitis. Perioperative nursing record (by Daniel Perez) has preop
`mention of right thumb tenosynovaginitis. Perioperative nursing record (by Daniel Perez) has preop
`diagnosis of right middle finger and left thumb tenosynovitis. Surgical procedures listed radical flexor
`diagnosis of right middle finger and left thumb tenosynovitis. Surgical procedures listed radical flexor
`tendon synovial removal (cpt 26145x2) on two tendons only (not three that we would see with thumb
`tendon synovial removal (cpt 26145x2) on two tendons only (not three that we would see with thumb
`treatment) Intra operative norms require the circulating nurse to do a time out before surgical incision,
`treatment.) Intra operative norms require the circulating nurse to do a time out before surgical incision,
`and that time out requires the entire operating room staff to agree on what the correct surgical
`and that time out requires the entire operating room staff to agree on what the correct surgical
`procedure and site(s) to be operated on are and confirm that the correct sites have been marked before
`procedure and site(s) to be operated on are and confirm that the correct sites have been marked before
`making any incisions. Mr. Perez documents that the procedure that was done was radical flexor tendon
`making any incisions. Mr. Perez documents that the procedure that was done was radical flexor tendon
`synovectomy twice for the middle finger.
`synovectomy twice for the middle finger.
`Following surgery on May 17, 2016 patient returned to the clinic of Dr. Dilberti, and by June 21, 2016
`Following surgery on May 17, 2016 patient returned to the clinic of Dr. Dilberti, and by June 21, 2016
`she is presenting with swelling, stiffness and shooting pain in arm pulling in her hand.
`she is presenting with swelling, stiffness and shooting pain in arm pulling in her hand.
`
`I
`I
`I
`I
`I
`
`I
`I , I
`
`Exhibit 1
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`

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`After reviewing all the documents that were provided to me I do not see any indication that Ms. Perkins
`After reviewing all the documents that were provided to me I do not see any indication that Ms. Perkins
`had any idea that her right thumb was going to be operated on, and while on occasion modifications to
`had any idea that her right thumb was going to be operated on, and while on occasion modifications to
`the surgical plan will legitimately be made on the date of surgery I do not see that the patient agreed to
`the surgical plan will legitimately be made on the date of surgery I do not see that the patient agreed to
`have surgery done on her right thumb and the documentation (from the scheduling request, anesthesia
`have surgery done on her right thumb and the documentation (from the scheduling request, anesthesia
`record, perioperative notes ) in the chart appears to support the patient's allegation that she did not
`record, perioperative notes ) in the chart appears to support the patient's allegation that she did not
`agree to have her right thumb operated on . Unfortunately, because her right thumb was operated on
`agree to have her right thumb operated on . Unfortunately, because her right thumb was operated on
`in error, Ms. Perkins suffered post—operative swelling and pain problems with her hand which area
`in error, Ms. Perkins suffered post-operative swelling and pain problems with her hand which area
`correlated to her surgery.
`correlated to her surgery.
`
`All of my opinions and the conclusions stated in this report regarding the negligent conduct of Dr.
`All of my opinions and the conclusions stated in this report regarding the negligent conduct of Dr.
`Thomas Diliberti and the causation of right thumb injury are based upon reasonable medical probability.
`Thomas Diliberti and the causation of right thumb injury are based upon reasonable medical probability.
`l have relied on the following definitions as part of my review:
`I have relied on the following definitions as part of my review:
`”Negligence” when used with respect to the conduct of Dr, Diliberti means failure to use ordinary care,
`"Negligence" when used with respect to the conduct of Dr. Diliberti means failure to use ordinary care,
`that is, failing to do that which a person of ordinary prudence would have done under the same or
`that is, failing to do that which a person of ordinary prudence would have done under the same or
`similar circumstances or doing that which a person of ordinary prudence would not have done under the
`similar circumstances or doing that which a person of ordinary prudence would not have done under the
`same or similar circumstances.
`same or similar circumstances.
`”Ordinary Care” when used in respect to the conduct of Dr. Diliberti means that degree of care that
`"Ordinary Care" when used in respect to the conduct of Dr. Diliberti means that degree of care that
`would be used by a person of ordinary prudence under the same or similar circumstances.
`would be used by a person of ordinary prudence under the same or similar circumstances.
`”Proximate Cause" when used in respect to the conduct of Dr. Diliberti means a cause that was a
`"Proximate Cause" when used in respect to the conduct of Dr. Diliberti means a cause that was a
`substantial factor in bringing about an occurrence or injury, and without which cause such occurrence or
`substantial factor in bringing about an occurrence or injury, and without which cause such occurrence or
`injury would not have occurred. In order to be a proximate cause, the act or omission complained of
`injury would not have occurred. In order to be a proximate cause, the act or omission complained of
`must be such that a person using ordinary care would have foreseen that the occurrence or injury, or
`must be such that a person using ordinary care would have foreseen that the occurrence or injury, or
`some similar occurrence or injury, might reasonably result there from. There may be more than one
`some similar occurrence or injury, might reasonably result there from. There may be more than one
`proximate cause of an occurrence or injury.
`proximate cause of an occurrence or injury.
`
`Because the wrong site surgery can have detrimental and potentially life threatening consequences,
`Because the wrong site surgery can have detrimental and potentially life threatening consequences,
`concerted efforts have been made to eliminate these avoidable complications.
`The World Health
`concerted efforts have been made to eliminate these avoidable complications. The World Health
`Organization, Joint Commission for Accreditation of Health Organizations, and various American surgical
`Organization, Joint Commission for Accreditation of Health Organizations, and various American surgical
`societies have made a concerted effort to eliminate wrong site surgery. The proper standard of care in
`societies have made a concerted effort to eliminate wrong site surgery. The proper standard of care in
`any surgery includes operating on the correct, and consented to, body part.
`any surgery includes operating on the correct, and consented to, body part.
`In order to eliminate wrong site surgery there is a three step protocol that has been recommended by
`In order to eliminate wrong site surgery there is a three step protocol that has been recommended by
`The first step is Verification: This consists of verifying the correct
`the World Health Organization.
`the World Health Organization. The first step is Verification: This consists of verifying the correct
`patient, site and procedure at every stage from the time a decision is made to operate to the time the
`patient, site and procedure at every stage from the time a decision is made to operate to the time the
`patient undergoes the operation. Marking: The site or sites to be operated on must be marked. This is
`patient undergoes the operation. Marking: The site or sites to be operated on must be marked. This is
`especially important in case of laterality, and multiple structures. The marking must be: at or next to the
`especially important in case of laterality, and multiple structures. The marking must be: at or next to the
`operative site; non-operative sites shpuld not be marked; clearly visible and‘made with a permanent
`operative site; non-operative sites sh~uld not be marked; clearly visible and· made with a permanent
`marker so that the mark is not removed during site preparation). The American Academy of Orthopaedic
`marker so that the mark is not removed during site preparation). The American Academy of Orthopaedic
`Surgeons endorses a ’sign your site‘ protocol in which surgeons write their initials or name on the
`Surgeons endorses a 'sign your site' protocol in which surgeons write their initials or name on the
`operative site; and completed, to the extent possible, while the patient is alert and awake, as the
`operative site; and completed, to the extent possible, while the patient is alert and awake, as the
`
`Exhibit 1
`
`

`

`patient’s involvement is important. Time out: This is a brief pause before the incision to confirm the
`patient's involvement is important. Time out: This is a brief pause before the incision to confirm the
`patient, the procedure and the site of operation are correctly identified. The Joint Commission states
`patient, the procedure and the site of operation are correctly identified. The Joint Commission states
`that all team members are actively involved in this process. Any concerns or inconsistencies must be
`that all team members are actively involved in this process. Any concerns or inconsistencies must be
`clarified at this stage. The checks during the time out should be documented as best suited for each
`clarified at this stage. The checks during the time out should be documented as best suited for each
`individual organization. The 'time out' also serves to foster communication among team members. A
`individual organization. The 'time out' also serves to foster communication among team members. A
`commonly followed five step protocol in the United States is: Step 1: Check that the consent form is
`commonly followed five step protocol in the United States is: Step 1: Check that the consent form is
`correct. Step 2: Mark the surgical site. Step 3: Confirm identification with the patient. Step 4: Take a
`correct. Step 2: Mark the surgical site. Step 3: Confirm identification with the patient. Step 4: Take a
`'team time out’ in the operating room. Step 5: Ensure appropriate and available diagnostic images. It is
`'team time out' in the operating room. Step 5: Ensure appropriate and available diagnostic images. It is
`the responsibility of the entire medical team, including the surgeon, nurse and anesthesiologist, to make
`the responsibility of the entire medical team, including the surgeon, nurse and anesthesiologist, to make
`sure the correct body part is identified and operated on by the doctor.
`sure the correct body part is identified and operated on by the doctor.
`
`Breaches of the Standards
`Breaches of the Standards
`In my opinion, Dr. Diliberti violated or departed from the standard of care with regard to Patricia Perkins
`In my opinion, Dr. Diliberti violated or departed from the standard of care with regard to Patricia Perkins
`when he wrongfully and without consent operated on right thumb. It is unclear how the right thumb
`when he wrongfully and without consent operated on right thumb. It is unclear how the right thumb
`was operated on since the documentation that was submitted indicates that the correct protocols were
`was operated on since the documentation that was submitted indicates that the correct protocols were
`For example, when reviewing the documentation from his office, the surgery center, the
`followed.
`followed. For example, when reviewing the documentation from his office, the surgery center, the
`anesthesiologist and peri operative nurses, with the exception of his operative note, surgical treatment
`anesthesiologist and peri operative nurses, with the exception of his operative note, surgical treatment
`of the right thumb does not appear to have been part of the operative plan.
`Nevertheless, Dr. Diliberti
`of the right thumb does not appear to have been part of the operative plan. Nevertheless, Dr. Diliberti
`operated on the right thumb, and this conduct falls below the applicable standard of care.
`operated on the right thumb, and this conduct fa lls below the applicable standard of care.
`All opinions expressed herein are based on my education, clinical background, and records review. My
`All opinions expressed herein are based on my education, clinical background, and records review. My
`opinions in this report are stated to a reasonable degree of medical probability. The opinions herein are
`opinions in this report are stated to a reasonable degree of medical probability. The opinions herein are
`based upon my education, training, and experience and my review of the records provided to me. I
`based upon my education, training, and experience and my review of the records provided to me. I
`reserve the right to amend any of these opinions in the event l receive new information, including any
`reserve the right to amend any of these opinions in the event I receive new information, including any
`documents, medical records or other data that | may receive in the future.
`documents, medical records or other data that I may receive in the future.
`
`’
`
`E
`
`V W..
`
`/
`SincereZ/Q
`J
`D wa Chattar-Cora,MD
`
`,
`
`|
`
`Exhibit 1
`
`

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`May 14, 2018
`M ay 14, 2018
`Addendum to expert report March 27, 2018
`Addendum to expert report March 27, 2018
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`To whom it may concern I have read Dr. Diliberti's objection to my report in the Patricia Perkins case.
`To whom it may concern I have read Dr. Diliberti's objection to my report in the Patricia Perkins case.
`The following is my response.
`The following is my response.
`1am a fully trained bo