Deposition by Gordon T. Margolin MD in Edward A. Patrick MD PhD v. Cleveland Scene et al (4/18/07)

8/13/2019 Deposition by Gordon T. Margolin MD in Edward A. Patrick MD PhD v. Cleveland Scene et al (4/18/07)

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Edward Patrick, M.D.,Plaintiff,

Cleveland ScenePublishing, LLC et al.,Defendants.

Case NO. 05-~~-279

Videotaped deposition of Esar Gordon Margolin, M.D.,a witness herein, called by the Defendants for CrossExamination pursuant to the Federal Rules of Civil Procedure,taken before Jennifer K. Starner, RPR and Notary Public inand for the State of Ohio, at the offices ofRobbins, Kelly, Patterson Tucker, Seven West SeventhStreet, Federated Building, Suite 1400, Cincinnati, Ohio, onWednesday, April 18, 2007, commencing at 1:58 p.m.

IN THE UNITED STATES DISTRICT COURTEASTERN DIVISION


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APPEARANCES2 On b e h a l f o f t h e P l a i n t i f f :

N J e f f r e y B l a n k e n s h i p , E s q u i r eMonohan Blankenship7711 Ewing B ou le va rdS u i t e 1 0 0F l o r e n c e , K e n t u c k y 41002859) 283-1140

8

1 011 On b e h a l f o f t h e D e fe n da n ts :

Randy J B l a n k e n s h i p , E s q u i r eR o bb in s , K e l l y , P a t t e r s o n T u c k e rThe F e d e r a t e d B u i l d i n gS u i t e 1 40 0Seven West S e ve n th S t r e e tC i n c i n n a t i , O h i o 45202

513) 721-3330

Kenne th A . Z i r m E s q u i r eWalter H a v e r f i e l d , LLPThe To wer a t E r i e v i e w13 01 E a s t N i n t h S t r e e tS u i t e 3 5 00Cl ev e la nd , Oh io 44114-1821

216) 781-1212

1 7 A l s o P r e s e n t :E d w a r d P a t r i c k , M D.Evan Newrnan, Vi de o T ec h ni ci an

Page 2


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C ~ C Pn i P\I n7791 1 A n n r ~ r n ~ n t18 F i l ~ d7In717flflR.. Page 31 S T I P U L A T I O N S

It is stipulated by and among counsel for the3 respective parties that the deposition of ESAR GORDON4 MARGOLIN M .D . a witness herein called as uponCross-Examination by the Defendants may be taken at this

6 time place pursuant to the Federal Rules of Civil7 procedure and agreement of counsel as to the time and place8 of taking said deposition; that the deposition was recorded9 in stenotypy by the court reporter Jennifer K. Starner1 RPR and transcribed out of the presence of the witness; and11 that said deposition is to be submitted to the witness for2 his examination and signature and that signature may be13 affixed out of the presence of the Notary Public.1456


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d 07/O7/7OO8 Pane 4 nf 96. Page1 I N D E X2 WITNESS:3 ESAR GORDON MARGOLIN M.D.4 By Mr. Zirm5 By Mr. l a nk e n s h i p

89 Defendants1 6811 69

CROSS RECROSS

E X H I I T SMarked


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VIDEOGRAPHER Going on the record.time is 1:58 on April 18th) 2 0 0 7

ESAR GORDON MARGOLIN, M. D.

Page 5The

4 of lawful age, as having been duly sworn, as hereinafter5 certified, was examined and testified as follows:

CROSS-EXAMINATION7 BY MR. ZIRM:8 Q Dr. Margolin, we just met. My name is9 Ken Zirm. I am an attorney representing Cleveland Scene and

1 0 Tom Francis in a lawsuit filed against them by Dr. Edward11 Patrick. I would first ask whether you ve had your2 deposition taken before?13 A Yes, I have.14 Q You ve been through this process then?15 A I have.

So you re generally familiar with it.17 I m going to ask you a number of questions regarding your18 contact with Mr. Francis and your experience experiences19 with Dr. Patrick. If I ask you a question you don t20 understand, please let me know and 1 11 try to rephrase it2 1 so that we re on the same page.22 Okay. Thank you.23 Q I ll ask you to keep your voice up so24 that the court reporter can hear what you re saying. And


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1 I ll try not to speak over you if you try not to speak overme so it s easier for her to know what we re both saying.

3 Okay?4 Perfect

Okay. Could you just please state your6 full name for the record.

My legal name is Esar Gordon Margolin.8 First name I don t ordinarily use. It s E S A R.

Okay. And your current residence10 address?

7258 Laurel Oak Lane, Cincinnati 45237And, Dr. Margolin, where did you get

13 your undergraduate degree?At the University of Nebraska.And then where did you attend medical

16 school?1718 School, College of Medicine.

At the University of Nebraska Medical

l l9 Q Was there any lapse of time between your20 undergraduate and medical school career?

NO, no.And what year did you graduate from

23 medical school?


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1 And did you then participate in a2 residency program?3 A Yes, I did.4 Q Where was that?5 A I had training and residency both at6 Mount Sinai Hospital in New York City and at the Peter Bent7 Brigham Hospital in Boston, Mass.8 Q How long was your program at Mount9 Sinai?

10 A It was a one-year program followed by11 two years of Peter Bent and then back to Mount Sinai for a12 second year. So a total of four years.

And what kind of residency program was314 that?15 A Internal medicine for the most part, one16 year of pathology mixed in.17 What did you do upon completion of your18 residency?19 A I had two years in the service in the2 Korean War. I was stationed in Japan. Then I came back to21 two more years as a fellow in nephrology, kidney diseases at22 the Peter Bent Brigham Hospital completing that in 19552324 that?

And what did you do upon completion of


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Case 1 05 cv 02791 LW Document 118 Filed 02/07/2008 Page 8 of 96

2 role: I worked at the University part time in the kidney3 department that we established and then private practice the4 other part time.5 Q6 A

And that s about 1955, 1956?55, middle of 55.How long did you hold those dual roles?Well, it s sort of sort of -- in 1959

9 I was sort of drafted and became director of department of1 internal medicine at Jewish ~ o s ~ i t a l . nd so I still held11 some of those roles and part after that. But mainly my role12 was as director of department of medicine. I stayed in that13 job for 7 years until 1986 I guess it was.

I m not quick with math either. Okay.held that position for years?

That is correct.And then what did you do?Then I ve mostly done geriatrics at the

19 University and at the VA and continue to practice in those20 venues to date mostly in education, teaching, some patient2 care.

Okay. No plans to retire?Never.Okay.


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ase1 05 cv 07791 LW nocu ent 118 Filed 02/07/2008 Paae of 961Page 9

I m against retirement in case you want

Just on just on principal. I m going4 to focus most of my questions on your time as director of5 internal medicine at Jewish Hospital. And in particular to6 the extent we can, we ll focus on the years in the mid 70s,7 particularly when Dr. Patrick was there at the same time.8 A Oh, okay.9 Q General question. As director of

1 internal medicine, what was your involvement and11 responsibility for the internal medicine residency program12 there?13 A Well, as director of medicine I had the14 responsibility for the whole department of medicine and all15 of its subparts, cardiology, pulmonary and so forth. And16 then in addition, I was chairman of the committee. I forget17 what we called it. House Staff and Education Committee.18 And so was responsible for appointing and kind of19 overseeing the house staff in all the areas except perhaps2 in surgery.

And what areas were there of house

Well, mainly it was internal medicine.24 We had a number of rotating residencies in different areas


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from time to time. I think there was some orthopedic2 residents and some obstetric residents coming through from3 the University for the most part. Really had two major4 residency programs, medicine and surgery, internal medicine5 and surgery.

And was that true at the time you7 arrived at Jewish Hospital?

Yes.Both programs were in place?Yes, they were.And both were accredited at the time?Yes.Tell me about that process. Did you

14 have to go through a periodic review to keep your15 accreditation?

Oh, yes. regular review every I7 don t remember how many years apart they were, but we had

18 regular accreditation surveys for each of the programs and19 they were always they were always fully accredited as far2 as I can recall.

Okay. Both programs, surgery andYes. Yes.And were they separately accredited?I think so. That s a good question.


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Yes. I didn t have much to do with theI was much more responsible foraccreditation in surgery.

9 the other.1 How long was the typical medicine11 residency program at Jewish Hospital?

A Well, initially we had an internship13 and, as I recall, three years of medical residency. I I4 can t remember when it changed to about three years total5 which sort of dropped the word internship and sort of made16 everybody a three-year kind of progression.7 Okay.8 A That s what it is to date. I don t9 recall when that happened exactly. There have been changes20 over the years.2 Q22 standard change?

I

1 I yeah, I m pretty sure they were.2 Okay. So there would have been a3 separate review process for the surgery program?4 A Yes

Separate for the internal medicine6 program?

Okay. And was that change a national

Yes. Yes.That wasn t something Jewish Hospital


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Page 121 decided to do?2 A NO, no, no, no. National. Thank you.3 Q How about the surgery program, do you4 recall how long that residency program typically was?5 A It seemed to me it was longer. It may6 have been four years.7 Q Okay.8 A But I I m not a hundred percent sure.9 Okay. Who was director of surgery or

1 was there a director of surgery when you first came to11 Jewish?12 A There always was a director of surgery.13 I don t think we had a full-time director of surgery14 initially. And I can t remember I remember Dr. Ed15 Wallaber (phonetic) was director at one point. There may16 have been several changes during that period of time until17 Dr. Heimlich, Henry Heimlich came on the scene. I think he8 was the first full-time director hired by the hospital to

19 the best of my recollection.2 Were you involved in the process of21 recruiting Dr. Heimlich for that position?22 No, I don t believe that I was.23 Do you recall whether you interviewed24 him before he took the position?


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1 had a passing contact with him when Iwas at Mount Sinai as a resident, so I knew him a little

3 bit. So we had had some kind of relationship, w knew4 people in common. I don t believe I had anything to do with5 his selection.

Okay. Did you have did that past7 relationship provide an impetus for him coming to8 Cincinnati, Ohio?9

1 close.I don t think so. We weren t that

Okay. You didn t contact him and say,12 Dr. Heimlich, there s an opportunity here in Cincinnati?13

1819 the221

program?AQA

2324 all I can.

Not at all.That kind of thing?Not at all.Okay.I had nothing to do with that.

How are the residents chosen forkay.

You re really picking my brains.If you recall.Well, I know how I did it in medicine.I m a blank slate. I m trying to learn


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This i s fin^ We wou.1-d g.ettiom. L e t I s s t a r t ouk wxeh the;-,grBduatesE t h e

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choo l , There waa a period of each year whan t h es tud~n ts~ppiy.

Uh-huh .They applied to all t h e hbspi t ~ nd w e

em alscarding to t h e ones we tKink we want andt they ll come to us. Nowadays it goes through

d I can t remember when we started theof t h e match program but mostly thy weremedical school. But at t h e s me tim we

l d t s of I tters from foreign graduates,udents, people from Ind ia , Philippians nd

applying o r gos,ftiuLns. ~ n df wa did n o t f i Lraduates domestic graduates, we would lookf t h e people who otherwise were applying and

select thos that we thought would he guitable fop

And that s what I r h familiar with isd sf th matching progxam.

The matching program.Q Rap it a matching was it wg 8 there

ki tchiw program even before t was computerized?A Wasn t what we c a l l a matahi.fig p p r q ~ a ,


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Case 1 05 cv 02791 LW Document 118 Filed 02/07/2008 Paae 15 of 96Page 15

1 it was sort of a scramble program. Everybody would apply2 and you hoped you heard from the hospital that prefer3 that you prefer that told you.

OkayIt was really a it was really a

6 difficult era of trying7 going to get them.

to pick people and know that you re

Would you interview candidates?Oh, yes, we interviewed them all. Some

1 of the foreign graduates, I m not sure we interviewed all of11 them unless they were in this country, but mostly they were2 interviewed and looked at by a committee.

14 slots available15 A6 Q

17 A18 governing bodies.

And were there a specific number of

Oh, yes.for each class?

Oh, yes. That was determined by theNot the hospital governing body, the

19 national bodies. We had only so many slots. And don t ask2 me how many. I don t remember.21 Q For each how many slots22 A Yeah.

Did it change over the years?Yeah, there were some slight changes.


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There were modifications.Page 6

You d have to apply for changes.2 Some of the residents would come for only one year and stay3 one year and that was okay. And then some would stay on for4 the full three years and we selected both kinds because we5 needed fewer in the second and third year and many people6 need a one-year training before they go off into some7 subspecialty like physical medicine, rehab or other other8 specialties so that they need a year of medicine before9 of internship before they went on. Just part of the part1 of the system.

And would you know that in advance when2 you selected a particular candidate?

Oh, yes. Oh, yes. Whether they re34 staying a year or more, yes.5 Q So with every class that came in you6 knew this person is going to be here a year, this person at7 least8 A Yeah.9 Q intends to be here longer?2 A Yeah, we didn t we couldn t lock them2 up, but intends to is the right word.22 Q Okay. Another kind of general question.23 What was the role of the chief resident in medicine? How24 did it differ from just a typical resident?


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1 A I m not sure in medicine that I really2 ran the strong chief residency.

Okay.4 A When we did and some of the times I5 would enlist these people to help me with schedules and so6 forth, but I didn t have a strong chief residency program in7 medicine. I think they did in surgery.8 Okay.

But I don t believe we did in medicine.1 I guess I was on the scene so much I was sort of chief11 resident all the time.

Well, that was my next question. What13 was you; relationship with the residents? Was it a close14 working relationship?15 A Oh, very close. I was at all of the16 conferences, I was counseling them, making rounds, teaching,17 a lot of teaching, hearing their complaints, really very18 close. I was there full time.

And that would be true of the first-year20 residents as well as the second and third-year residents?

Absolutely.Okay.Absolutely. As needed without question.Again, I m testing your memory. Do you


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Page 8recall during the years was there someone that held the

2 position of, say, graduate medical education administrator3 at the hospital that was kind of a liaison, handled4 paperwork for the residents, that kind of thing?5 A I had a secretary, of course, who6 assisted me, but a lot of stuff I think much of it had to7 be approved by administration. And so they were always8 behind us with with paperwork and so forth, but9 they weren t I don t think they were responsible for

10 for running the program or selecting the residents.Q Okay .

Not that I recall.But would they have had maybe

213 Okay.4 contact with the residents?15 A Oh, on paper essentially.6 Okay.

A Not otherwise.And there wasWell, there was one director we had when

20 I first came who always made it a point to always meet all21 the residents. Made little notes on their charts that he

had seen them. Didn t do anything but just sort of glad23 handled them, but he wasn t involved with their education24 program at all.


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Q Okay.2 A I don t think that was the case after3 the first few years I was there.4 Q Now, Dr. Heimlich arrived, I believe, in5 the late 60s?6 A I don t remember the exact date. He7 there was during the into the 70s. I know that.8 Q Did your did you have more9 responsibility for the surgical residents prior to his1 arrival?

A I don t believe so.2 Q Didn t really change then after3 your your responsibility and activities with regard to4 the surgical residents didn t really change after he5 arrived?

No, I would say I would say no.Okay.You mean less responsibility or more?Yes. Either way.Well, as chairman of the committee, we

2 always sort of oversaw things.22 Q Okay.23 A But I didn t have any direct24 responsibility for the residents either before or after.


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Do you recall who else sat on that2 committee, the titles of the people?

Well, head of surgery, whoever it was.4 Haven t the slightest recollection of that. We re5 different key people in the hospital obviously.

There was certainly an administrator on8 that committee too, I m positive, because they always had9 administrative on that committee.

But I do not recall who was actually on

Did you at any time participate in the14 selection of the surgical residents?

I really did not.Okay. Let me ask you, if you can, what

17 your first memory of Ed Patrick is?Okay. I shared an office space with

19 Dr. Heimlich. Our offices were right across a small2 vestibule, corridor, waiting area, whatever you call it.21 And there was a period of time where he was having meetings

with several people in the community and I learned23 subsequently that this was what they called the HARP group,24 Heimlich and P was Patrick. I remember that.


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Right.And Dr. Rivershell.Neil Armstrong?

Page 21123

Armstrong. That s right. And they were5 having sort of like I always thought sort of closed door6 meetings. I didn t know what they were doing, but I knew7 they were meeting there. And I knew that ultimately knew8 that Dr Patrick met him at that time, that he was one of9 the participants. And I knew him as a computer expert from

10 Purdue, but I didn t I didn t have any direct initial11 direct relationship with him. That was all through the12 whatever that setup was with Heimlich, that s how I know he13 appeared at the hospital.14 Okay.15 A To the best of my recollection.

Do you recall did there comekay.17 time when you had more of a relationship with Dr. Patrick?18 A Yes. Yes. Uh-huh.

And and how did that come about?Well, Dr. Patrick was a computer expert

21 of which there weren t many around at the time. And we hada computerized cardiac monitoring unit and he got interested

23 in using that progkarn in his research and hoping to develop24 some techniques that computer computer recognition,


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1 pattern recognition of disease to see if he could further2 further his computer interest.

Okay. And did you become involved in4 that or did you have to provide approval for that or how did5 you get

Yeah, I m sure that that I did, that7 we that we worked that out, arranged it and talked about8 it. And Dr. Patrick gave us some lectures on what that9 what that meant or how w would do it with a lot of

1 mathematics, which I still to this day don t understand, but11 nonetheless were the appropriate for a man of12 Dr. Patrick s level and training.

When you say he gave us some lectures on14 it, who is the us?

6 Sanghvi who at that time was chief of cardiology serving17 under me and was running that coronary cardiac monitoring18 unit. Vijay Sanghvi. I don t remember whether he gave19 lectures other than that. If he did, I don t recall, but I2 do remember sitting with the three of us talking and looking21 at data.

I m going to show you a number of23 documents and they may or may not refresh your recollection24 and we ll just have to see. First one I want you to look at

Well, the other one I think of is Dr.


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1 is actually in this book.Page 23

These are exhibits we ve already2 used in this case.3 A Okay.

If you could turn to Tab 55. If you canjust take a moment to review the article about Dr. Patrick.

6 A Yes. I was given this by one of the7 attorneys I saw just this weekend. I was looking at it this8 weekend.9

1011

Okay.Okay.This is a do you recall this

12 newsletter?13 A No.14 Okay. This is a appears to be some15 kind of Jewish Hospital publication?16 A That s correct.

From June of 1975?18 A Correct.19 And I guess maybe more generally, do you2 recall that Jewish Hospital did put out a periodic21 newsletter?22 A Yes. Yes, we did.

Okay.Yes, there was.


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Okay. And the article basicallyPage 24

2 announces that Dr. Patrick will be joining Jewish Hospital3 on a part-time basis to develop a research program in the4 area of biomedical engineering. Is this consistent withyour memory of what Dr. Patrick was doing

Yes.when he first came to Jewish?

Yes yes.And Robert A.. Carney executive

That s correct.He was the head of the hospital?

l He was the he was the chief operating

I 4 officer or whatever you call it.He was the boss?Well he was the he was our boss.Okay.Under the board of trustees obviously.Okay. Was it your understanding when

20 Dr. Patrick first arrived to Jewish Hospital that he had21 been brought there by Dr. Heimlich?

Oh that was the only way I knew him was23 his relationship with Dr. Heimlich.

Okay.


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This was a secondary development, as I2 recall. I didn t -- I don t think he came, that I remember,3 with anything like this in mind.

Okay. In your memory then as to theinitial reason he came was what?

6 A7 listed in here.

Was for this so called HARP group that s

Okay. Okay. So you knew about him in9 HARP and then this became -- or you knew -- you came to

1 learn of HARP?11 A Yeah, I came to learn of him and I12 didn t learn of the other people in HARP because we didn t13 have any overlap. But Dr. Patrick -- I don t know how we14 got together, whether Dr. Heimlich asked me to see him or we15 just got together because of his interest in medicine or16 whatever, but we got to know each other during that period17 of time.18 Q Okay. And so then it s your memory is19 consistent that his first position with Jewish Hospital was2 this position discussed in this newsletter?21 A Yes.22 Okay. If you could turn to the next23 exhibit, 56 Take a moment to review that, if you would.24 A Okay..,. .....r W...IW.. .,.,-.. -,.---.-*h---W-- , ----- ..- -a ----


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Okay.

This appears to be a copy of a JewishHospital memo dated July 7th, 1975 from an N.S. Finer to an

3 H R Watts, ccling Dr. Patrick and Dr. Heimlich?Correct.So there s no indication at least on the

6 face of the memo that you were sent this memo at the time it7 was written?

No. I totally have no recollection that9 Dr. Patrick even had an office. And if he had one, I don t

1 know where it was.

13 in the hospital.

This is a surprise to me. I I do not16 recall this at all.

Okay. Who is N.S. Finer?Norman Finer was the administrator to

19 whom I reported at the time. He was or he was under2 Mr. Carney as one of the administrators and he had my21 and a lot of other people reported to him, but my role was

through him. Mr. Watts was the administrator responsible3 for construction and design and building and accommodations

24 of that sort. And so they were both about the same level,

I honestly don t know where he hung out


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see it in here and

absolutely have no recollection of

1 but I reported directly to Finer and so did think2 Dr Heimlich probably did too.

was going to ask that. Okay.I don t don t even know the word

5 surgical teaching unit. I m sorry.6 don t there s no recall for me.

You don t think, oh, I remember exactly8 where that was?

12 Exhibit 35?

Okay. This appears to be Dr. Patrick s18 application for appointment to house staff at Jewish19 Hospital?

22 August 22, 1975?Correct.The on the first line on the first

Okay. f you could turn back to

All right.Take a moment to review that, if you

I ve seen it,

Correct.And the date on the second page is


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Page 281 page at the top it asks in the first blank line, Specify2 type and specialty, flexible, categorical, and then in3 parenthesis, medicine or surgery. Someone has written4 flexible. So was there a flexible that was an option for5 a resident applicant to apply for?

Yes, absolutely. We had different7 designs of the program. And the flexibles went through8 several different specialties during the course of the year.9 And it was a variable rotation, whereas the categoricals in1 medicine and surgery were primarily assigned to medicine or11 to surgery for the year. That was all approved by the12 approving bodies.13 And thatts what I was going to ask.14 A Those were acceptable.15 The flexible residency program was also16 an accredited program?17 A18 Q19 process2 A21

Absolutely.Okay. Were you involved in the review

Yeah.and accreditation process for that?

22 A Yeah, for the flexible I was because23 anything that merged with medicine I had responsibility. As24 a matter of fact, you see I signed the back that I approved


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Case 1 05 cv 02791 LW Document 118 Filed 02/07/2008 Pag e 29 of 96Page 2 9

1 that that this applicant for this flexible program. And2 that s my

And can you read your handwriting?That s my initial.

And can you read what is thatkay.6 your handwriting above it as well?7 A It is.8 Can you read that for us?9 Yes. Okay for flexible program, that is

1 four months of medicine, fourth months of surgery,11 anesthesia, emergency room, that s ER, x-ray, starting12 August 1975 signed by me.13 Q Okay. So you had to approve would14 you have had to approve any flexible resident?15 A Everyone had my everyone had my16 note like this on it if I approved it.17 And were there18 A Not the surgical ones, not the19 categorical surgical.2 I understand. So any flexible and21 medical

Absolutely.was you had to approve?

Absolutely.


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And the flexible program, was there alsoa specific number of slots available?

I don t recall, but I think we had a4 total number of first-year people and we could modify within5 that, but I do not recall if there was a specific number for

Okay. Do you recall the typical date8 that a resident class started?

Yes, usually July 1st. But but we1 had a lot of residents that were off schedule because we11 would fill in with graduates from other schools, foreign12 schools and so forth. Or people would get have babies13 and come later or be sick and have to drop out and change14 dates. So we didn t adhere completely. We couldn t adhere15 fully to the July 1 to July 1 rotation.

This would be not be an unusual

So there but I assume there had to be20 a slot still available?

Oh, absolutely.

Absolutely.Okay. Do you know whether an effort was


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1 made to fill all your slots with the July 1 folks?Always was.Okay.Yeah.

5 And then if you happened to have slots6 still available you might take people starting later?7 A Absolutely.8 Okay.9 A Generally speaking may I make a

1 comment.Sure.Generally speaking, there was a full

13 application that went with this that was a diploma and other14 credentials, background and so forth on each individual.15 Q Okay.16 A I don t see it here and I don t recall17 having seen it at all, but it should have been somewhere18 attached or in the same file. I don t know if you have that19 or not. So assume that all of this was documented.2 Okay. And you so you would expect21 this application to be accompanied by more information about22 the candidate?23 A4 correct.

I would say ordinarily that would be


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Okay.In this case I just don t know.Sure. And I wouldn t expect you to

4 remember a specific case

I don t remember discussions with Dr.

That s what I m here for. I know that23 Dr. Heimlich approached me about this about this program24 for Dr. Patrick.

Page 32

I do not remember.from the mid 1970s. But for

7 instance, a medical school transcript, would that be8 something?9 A Yes. Usually a dean s letter from1 medical school or a copy I know the foreign graduates you

get copies of their diplomas and university letters and12 their grades. And we have to have documentation that they3 were bona fide people.4 Do you have any recollection of having15 discussions with Dr. Heimlich about whether some of those6 requirements should be waived for Dr. Patrick?17

18 yeah, I remember Dr. you re really picking my brains19 and that s okay. That s what I m here2 Well, I appreciate your efforts to2 answer.22


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Case 1 05 cv 02791 LW Document 1 18 Filed 02/07/2008 Page 34 of 96Page 34

1 description of the flexible program, but each one might have2 been a little bit different.

Would there have been something in4 writing at the time that indicated the general description5 of the flexible program?

There probably was in the in the7 somewhere in the documents, but I don t know where you re8 going to dig those up. f you can dig them up, I ll look at9 them.

Okay.Sorry.That s all right.Just don t have it all.

I guess what I m getting at were there15 some core requirements for every flexible program?

Oh, yeah. They had to have so much17 some medicine and I think maybe at least two months of18 surgery, as I recall.

Okay.And I don t remember about the rest.And, again, that would have been a

22 national accrediting board requirement?Yeah, yeah, yeah, absolutely.If you could go ahead one exhibit to 36


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Page 35Okay. I have seen this one too.

2 Okay. This is the at least the first3 page is a letter to Dr. Patrick from Robert Carney4 congratulating him and offering him a house staff position?5 A That's right.

Okay.7 A It was standard.8 Okay.9 A Standard letter.

1 Q And standard to say as recommended by11 Dr. E. Gordan Margolin, Chairman of the Committee on House12 Staff and Education?13 A Yes.14 After consultation with the executive15 board of the medical staff. What was who was on the6 executive board?

At that time I don't remember, but there8 were always practicing physicians or heads of department.9 Usually, oh, ten or 12 physicians met regularly.

20 Q Okay.21 A Helped do the medical planning for the

And I was I was on that as an ex-officio and2 hospital.23 Dr. Heimlich was on the executive board ex-officio.24 5 Okay.


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And I think all our applicants were at2 least way past the

I understand.sheets of paper. They really had the

5 overriding medical decision making poss- potentials.The procedure at least allowed for them

7 or required their approval?

The staff's approval?Yes, I think that was standard.

I don't think they ever turned anybody

Okay. Are the if you could turn to5 the second page of this exhibit. Does this appear to be a6 standard residency agreement form that was in place at the

I don't know why they crossed out the2 dollar amount, but because I don't remember that

Yeah. It says, Stipend per agreement.23 So apparently

That's exactly right.

Oh, per agreement, yeah.


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there was a separate document that2 would have indicated a stipend in this case. Generally was3 it filled in in this agreement itself?

And the hours of duty, is that standard?Yes. Everything in here was the same

7 that everybody signed.

This was our standard. It wasn t10 I look at it, it wasn t very fancy or pretty, but it was11 nonetheless, that s what we used. We used we used2 typewriters in those days. Remember the typewriters?

With carbon copies.That s right.No. 10 Type of residency still on

16 the first page.

2 to be a one-year program?

Do you have a recollection that that s24 what Dr. Patrick intended was just one year?

Oh, I m sorry.Item 10 there, you see Flexible l?Yes.Did that indicate to you that was going


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Oh, yes, just one year, absolutely.

And did you have an understanding of why

Well, my understanding was that he my4 that was?

6 recollection is that Dr. Patrick had been out of medical7 school, hadn't had any further training, wanted to fulfill8 that, I guess, for state licensure or whatever requirements.9 But my recollection was his particular interest was to do1 computing and to stay in the engineering field or somehow to

meld it, but he wanted to be recognized as a as a full2 fledged physician who needed this extra training.

Do you have any recollection that at the4 time you approved Dr. Patrick's flexible residency program5 that he was interested particularly in emergency medicine.

No, except that I we put emergency in17 this thing.

2 recall that.Okay. If you could turn to the next

22 page, it says Supplement to Residency Agreement.

You've had a chance to review this?

Uh-huh.I don't recall any any I don' t


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Oh, no, not necessarily.Okay.

Yes, I have.And it lists the rotation the

3 department rotations he was going to undertake. So do you4 know whether those rotations were to be taken in the orderlisted here?

No. This was an agreed upon program.9 I I think he just fit into the rotation the way the

1 program would best suit it. I don t recall the order.

But I think I if I can comment.

This is a very unusual supplement. I5 don t remember ever writing one like this for anybody.

Okay. And do you know why it was done7 in this instance?

9 thoughts

for what they re worth. In reading22 this, it looked to me like I had some doubt. There was23 another document that went with it.

There was two versions and then there

Well, in reading may I just offer my


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Page 41 appears to be a supplement, a rough draft?

This rough draft.Uh-huh.This rough draft these little

5 notations are my understand handwriting.6 Okay.7 And apparently I I m guessing that I8 probably wrote this rought draft trying to elaborate what we9 were offering to Dr. Patrick and ended up with some of the

1 changes that went into my handwriting in here.11 Okay.12 A So I recognize that as my my3 documentation. And then that turned into the supplement to

14 the residency agreement.15 Okay.16 A It s obvious and I think you can see7 it in the writing that I had some doubts about his being8 able to fulfill the requirements fully at the time because9 he had other responsibilities in the hospital that were

2 going to take a significant amount of time.2 Q Uh-huh .22 A And to be a resident, my feeling was it23 should be a full-time position. And you I say24 we ve never I ve never written this that I can recall on


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Case 1 05 cv 02791 LW Document 1 18 Filed 02/07/2008 Page 41 of 96Page 41

anybody else and it is -- it is well delineated in here that2 there was some concern in my mind and it reads that way. As3 it says, It is the desire of all that this program be a4 proper one so that at no time in the future could questions5 be raised about the validity of this accredited year.

You can see I had some doubt -- some8 issues because Dr. Patrick was otherwise given other jobs at9 the same time and none of my other house staff were given

I understand.I want to make that clear because

3 that's -- that's strictly unusual.

And and the last paragraph mentions5 two of these commitments that he had?

Right.An eight-hour-per-week job as physician

18 in charge of clinical computing and eight hours was the HARP9 program?

That s right.And was that the basis of your concern?

And that was -- it said hebsolutely.23 would fulfill those outside the required hospital duties in24 his internship.


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So that would I was trying to 13 was trying to clarify that lest those two things went to

So in your view Dr. Patrick was expected6 during that year to do everything that his peers his7 first-year residents would do?

Oh, absolutely. It says that here.

In order to be properly accredited.Did you have an understanding of whether

2 he had continuing duties at Purdue during this year?I don t remember.Okay. Would that have caused you

15 concern?

Okay. Do you remember having18 discussions with Dr. Heimlich about these concerns?

I don t recall having discussions, but2 obviously this was written so that Dr. Heimlich also was21 aware of it.

And signed by him allegedly. There s no24 signature on this piece of paper.

Oh, absolutely.


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Right. Right. And we ve not been able2 to obtained a signed copy.

It looks like it was set up to be

It would be asking too much, wouldn t6 it, if I asked you if you recall signing this?

I do not recall signing. In fact, I8 was I did not exactly recall this until reading it that I9 remembered the concern that this was expressing,1 difficulties we had in putting it together.

Do you see the paragraph after the12 rotations are set out, in the last sentence of that13 paragraph Dr. Patrick requests that his assignment be14 primarily in surgery and surgical subspecialties and it15 is and, therefore, it is understood that in the above6 rotations only the four months of medicine will be the17 direct responsibility of Dr.

I see that.Was that something you wanted to have in

2 this supplement?Oh, absolutely.And why is that?Well, because because Dr. Patrick

24 came to us under the auspices of Dr. Heimlich, he wanted


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Case 1 05 cv 02791 LW Document 1 18 Filed 02/07/2008 Page 44 of 96

1 surgical training and I didn t want to take full2 responsibility for a full year and, hence, formulated that3 Dr. Heimlich would be the responsible person for the rest of4 the training.

Given that you had these concerns, did

7 residency to satisfy yourself that he wa,s eeting the8 requirements?

We knew that he was fulfilling his1 assignments. I will say in front of Dr. Patrick that I m

sure that all of his peers did not feel that he was carrying2 his full load.

5 remember.6 evanescence in his appearance. Not that he didn t do not17 that well, we never found that the job wasn t fulfilled,8 but we weren t so sure it was done in the full manner that9 we that a full-time intern should have done it.

In my best recollection.I understand. Is there any specific

23 recollection of any peers that you had these discussions

Okay.And I do remember that. I don t

I think we discussed it, but a little bit of


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No, I don t. I don t. I just rememberthis as a general concept.

Do you ever recall approaching4 Dr. Heimlich about these concerns during the course of that5 year?6 A I do not recall.7 I m trying to figure out the best way to8 ask you this, but was having flexible residents or interns9 common or uncommon in a given year?

Oh, it was variable. It wasOkay.

not uncommon. Let s put it that way.13 Okay. And would you say that was true14 your entire tenure at Jewish Hospital?

Yeah. I m not sure we continued the16 flexibles all the way up to the end. I just don t remember.17 Okay.18 A It was true through much of the time.19 Can I make another comment which

Sure?21 A may not be to your what you want

to hear, I can t help it At the end of the time we we23 provided internship a certificate of having completed the24 program.


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Case 1 05 cv 02791 LW Document 118 Filed 02/07/2008 Pag e 47 of 96Page 47

1 Dr. Heimlich was vouching for thatWell he signed

as opposed to you?He signed for it.Yes.Yeah.Would multiple year residents residents

8 that were going to be with the program for more than a year9 sign a new resident agreement every year?

Each year right.Okay. Would multi-year residents get a

12 certificate at the end of their first year?A No.

14 the training program.They get one at the conclusion of

Did you have much direct contact with16 Dr Patrick during his rotation through internal medicine?

I cannot recall. I had a lot of contact8 with the residents on the service at the time. So I assume19 I had the same or similar with him. I would not have2 treated him any differently during the time.

22 recollect?Nothing extraordinary that you

I do not recall.24 Either positive or negative?


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3 evaluations

Neither way.Would you expect to find written

of him in his file?Yes.Okay. And of every resident?Every resident.Okay.We required it.Okay.I I have no I have not seen them

or I don t know what they say.2 Sure.3 A Are they in the book?

14 No. No. And in response to our15 subpoena to Jewish Hospital, none have been turned over.

I have no knowledge of that.So we have not seen it.I will tell you that the rules at the

19 time were much less intense than they are now. Nowadays,2 when you have a resident, you do so much paperwork regarding2 each resident. Gradually, gradually they ve enhanced it so22 that what we did in retrospect was fairly slim, but we did23 have records that showed the progress and involvement and so4 forth all the way through. We have to keep those records.


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I Page 49And would there be would you expect2 there to be even in the mid 7 0 ~ record of his3 assignments, rotational assignments in his file, in a4 resident s file?

In a file? Probably there should have6 been a an assignment page.7 Okay.8 A Should have been.

I understand.I have no 30 years is a long time.

2 documents here.3 A4

5 Exhibit 65.

No, I understand. We ll hand you

Okay.And I ll show you what s been marked as

Yeah.7 And ask you whether that s the8 certificate you just testified about?

That is exactly the one.And that has Dr. Heimlich s signature?That is right.

19

20222 And and that is you asked Dr.23 Heimlich to sign that?24 A That s correct, I did. Ordinarily I


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And is a resident 1 the correct term,

1 would have been the one to sign it.Okay. And ordinarily for any flexible

3 resident would that have been true?

6 the term that the hospital used?I don t remember I don t remember

8 using that term, but obviously it appears on there so we9 must have used it that way.

And does that look like the typical11 certificate that Jewish Hospital issued?

Resident 1 Yeah, this is a typical13 certificate.

Uh-huh. I m sorry. Were you about to15 say something about resident l?

17 recall using that term, but that s obviously what we18 accepted at the time.

And how did these certificates gets

They would be created through our22 secretarial and we would all sign them and hand them out at3 the appropriate times to the finishing residents, sometimes4 at a party, sometimes if they re finished in between in the

No. I see it says resident 1 I don t


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Page 511 middle of the year would be just given to them.2 Okay.3 A But all residents should have copies of4 their experience and documentation which this is.5 Okay.6 A But ordinarily this would have been7 signed by me. This was an exception.8 Q I see. Were there any other9 documentation to demonstrate that a resident had completed a1 program at Jewish Hospital?11 A At some point in the course of all this12 we had t summarize the resident s activities on in his13 file.14 Okay.15 A And I I would write those on all my16 residents at the end of the year because obviously they were17 available for future references and stuff.18 Uh-huh19 A And I do not recall whether in 76, or20 whatever that date was, if we were required to do it, but my21 guess is that we did.22 Okay.

A But it would be in his file.Q And when you say that that was a


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requirement, again, a national accreditedPage 52

Yeah. Yeah, they they wanted they3 wanted documentation. Makes sense to them.

Do you have any personal recollection of5 observing Dr. Patrick treating patients?

No, : do not.Do you have any personal recollection of

ever observing Dr. Patrick in the emergency room?9 A No.

Would you observe residents as theyrotated through the emergency room, for instance?

2

3 have.Emergency room I wouldn t ordinarily not

Okay. What what departments would

Just oncontacted?medicine essentially.

Okay.And making rounds and teachingAnd you

and reading their reading their

And you indicated there s subspecialties


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1 within medicine or subdepartments. What were those?2 A At the time there was cardiac,3 pulmonary, there was gastro gastroenterology I m sure.4 We had a for a while we had immunology,5 rheumatology/immunology I don t remember what we had at6 that time. They all sort of developed over time.

Okay.And they sort of grew. That s the way

9 medicine has grown all these years and has become so10 overwhelmingly huge now with subspecialties.11 I think you testified earlier that12 sometimes residents from the University would rotate through13 Jewish Hospital?14 A Yes.15 Would the opposite occur, residents at16 Jewish rotate through University?17 At that time I would say no. There were18 some attempts to do that from time to time, but I don t9 recall exactly when that was.20 both ways.

Okay.

It never it never worked

(Whereupon, Defendants Exhibit 68 wasmarked for identification purposes.)Let me hand you a document that s been


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Case 1 05-cv-02791 LW Document 118 Filed 02/07/2008 Page 54 of 96

1 identified or marked as Exhibit 682 A Okay.3 Is that a clean copy?4 markings on that?5 A

789 recently?

1011

Yeah, this is okay.Okay.

Are there any

Yeah, I ve seen this one too.Okay. And had you seen this until

Just recently with all this.Okay. And do you recognize what this

Page 54

12 is?13 A Yes.14 What is this?15 A Well, it s an affidavit of signatures16 indicating that Dr Patrick is has completed his17 residency and w s eligible for state licensure.18 Do you recall signing this for19 Dr. Patrick?2 0 A No, I don t, but it s obvious I did. It21 was in November of 7 6 I see that I signed it

Do you recall any of the circumstances23 around this?24 A

Okay.

No, except when any of our residents


55/96


1 applied for state licensure they had to have documentation2 that they had completed their program and that s what3 that s what this was, a standard form standard form.

Okay . It indicates you re signing5 that he s been in the practice of medicine for the last one6 and a half years?7 A Yeah.8 Q I guess my first question is is a9 resident considered in the practice of medicine?1 A I would I think so for terms in11 the terms of this, sure.12 Q In your view?13 A Oh, yeah.14 Q Okay. And the one and a half years,15 September 1, 1975, and this is November of 1976, do you16 recall whether someone prepared this form for you or where17 that figure one and a half years came from?18 A No. That s probably a guess of my own19 or an estimate of my own. He was involved a little bit with2 the cardiac unit before he became before in that21 computing thing he did before he became an intern or a22 flexible intern. And so I don t know where I got the one23 and a half, but that s he was certainly around the24 hospital at that time.


56/96


Okay.At least a year and a half more than

1 Q2 A3 that I m sure.4 Q Do you know whether while he was working5 in that cardiac unit he was giving patient care?6 A No, I don t think so. That was I7 don t believe I don t recall. He he shouldn t have8 been. I don t recall that he was.9 Okay. Did residents at Jewish Hospital

1 at this time as best can you recall have to have any kind of11 certificate from the Ohio State Medical Board, training or1 2 temporary certificate?13 A To be

To serve in the residency program?A There was a temporary certificate at one

I don t think I don t think it was required1 7 because I don t remember making any effort to get it ready,18 making sure the residents had that in any of my files.19 Okay.2 A They were allowed to practice within our21 purview with patients as long as they were being overseen by2 2 supervision, appropriate supervision. But I don t recall3 temporary licensure. There was talk about it, though, now

24 that you say it. I have no recollection of being involved


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Page 571 with that at any time.2 Okay. And, again, you left Jewishbefore in the late 80s, correct?

A 86.5 Okay.

A That s an interesting question, though.7 it kind of bothers me that I don t really remember because8 it has some familiar ring to it, but I have no recollection9 of of assuring that we had documentation for the state10 board at the time any of our residents were there. I don t11 recall ever communicating names or even sending lists or12 anything to them.13 Okay.

(Whereupon, Defendants Exhibit 69 wasmarked for identification purposes.)

16 I m going to show you what we ve marked17 as Defendant s Exhibit 69. This is one of the resumes18 that s been provided to us from Dr. Patrick, one of his19 resumes. And I just have a question for you about his20 description of his residency at the top. Do you see that?21 A Well, it says 7 4 to 76.

Correct. That s that s notThat doesn t.

consistent with the certificate?


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59/96


Page 5 9Research in Emergency Medicine, Purdue University and

2 University of Cincinnati with Dr. Henry J. Heimlich,3 1 9 7 4 1 9 7 5 .4 A5 Q

Uh-huh.Is that your understanding of what he

was doing in the year before his residency?7 A I I don t remember anything related8 to emergency medicine, no, sir.9 Okay. And then do you agree with his

1 0 description of his rotating internship?Yeah, we called it flexible. But the

1 2 rotating was an alternative term for it.13 Okay.1 4 A That that would not that is not1 5 misdirected at all.

Okay. And then again, it says Jewish1 7 Hospital, University of Cincinnati?18 A Where does it say that? No.1 9 You see that?2 A Oh, no, this is not part that was21 not our program was completely separate from that of the2 2 University of Cincinnati.2 3 Okay. And then below that do you see24 Special Residency in Emergency Medicine under directorship


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1 of Henry J. Heimlich from 1976 to 78?A We had Jewish Hospital had no

3 residency in emergency medicine. So I have no knowledge of4 what that where that came from or what that refers to. I5 had no involvement in it.

Okay.This is talking about the emergency

8 medicine as a sub as a specialty in medicine. It doesn t9 fit our Jewish Hospital thing at all.

1 0 Do you have any recollection of11.Dr. Patrick still being present in Jewish Hospital after he12 completed this flexible rotating internship?1 3 A I was trying to think about that. I14 I don t have a clear idea of what happened after the15 residency, after the internship. I think I am not16 sure that he was still around a while doing the computing17 thing.18 Okay.1 9 A I don t recall any particular period of2 time when he when he was no longer there or how long he21 was there. I was trying to think of that the other day.22 have no I just don t recall what happened like, you know,23 faded away somewhere thereafter and I don t how soon or how24 late.


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1234

Okay.I have no idea.Okay.No idea. And we ve not had any contact

5 ever since that time at all until today.6 Okay.7 A That I can recall.8 If you could turn back a few exhibits in9 that book to Exhibit 45, another resume of Dr. Patrick. I d

10 like you to take a look at that.All righty. Have it.Yeah, there you go.Okay.Resume of March 2002 at the top.

16171819 training.20

Yes, I got it.Uh-huh.Uh-huh.And, again, the description is post M.D.

I d ask you to take a look at it.I I I have no idea the

21 relationship on this whole business of the Heimlich Maneuver22 or how long that went on. I had no involvement in that.23 Okay. So the 1974/ 75 description4 there, you have no knowledge of that?


62/96


1 A My guess is that Dr. Patrick was around2 the hospital at that time. All I knew was the HARP thinginitially.

4 Q Okay.But whether that s incorporated in that,

6 I m unable to say.7 Q Okay. And then how about 75/ 76,8 resident 1 designed for emergency medicine at Jewish9 Hospital?10 No, it was not designed for emergency

It s clearly emphasis on surgery, general

Okay.And then the 76 to 79, he was there in

I don t remember I don t know anything

11 medicine.12 surgery.1314 A15 the hospital.16 about that.17 Okay. Do you remember having any18 discussions with Dr. Heimlich about arranging a special19 residency after that20 A No.

for Dr. Patrick?A No. We were not we were not

3 accredited in emergency medicine.4 Q Okay.


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Case 1 05-cv-02791 LW Document 118 Filed 02/07/2008 Page 63 of 96

This appears to be an article

In fact, I think emergency medicine may2 have been just becoming a new specialty about that time and3 there were few sites where training was approved, as I4 recall: But again, that s 30 years ago.

I understand.(Whereupon, Defendants Exhibit 7 0 wasmarked for identification purposes.I m going to hand you another document

9 which I ve marked as Exhibit 7 0 .Okay. I ve seen this too.

12 that you coauthored with Dr. Patrick and Dr. Sanghvi13 and Russ I m not going to attempt to pronounce the last

Uthurusamy.Uthurusamy. Do you have a recollection

7 of coauthoring this article with Dr. Patrick?I this came across my desk recently.

19 I saw it. I don t remember I don t remember it. My20 name s on it, I m embarrassed, but I do I just absolutely2 do not remember this, that my name was on any articles. As22 a matter of fact, I went back and opened my own CV to look23 it up and I had never recorded this on my own CV So24 somewhere either I knew about it and ignored it or


64/96


Page 641 deliberately decided not to include it. I don t know. This2 to me was sort of like a surprise to me that my name was on3 here. Though, obviously I m sure that I was I had seen4 it. I must have seen it.

Okay.There s no way this could have gotten by

me without me seeing it, but I have no recollection of being8 involved. We were involved to the point of discussion of9 all this. I was not involved with the actual development

1 0 of the accomplishment of this program. Dr. Sanghvi I11 know was. He was head of cardiology and he was doing1 2 patient assessment with with or for Dr. Patrick and for3 his fellow here, this Ramassamy man, but I personally don t

14 remember any hands-on involvement in this in any of these1 5 programs.

Okay.I I must have approved them, though,

18 because I did know about them, that the were going on.Q So as best you can you have no

2 0 present recollection. As best as you recall it, you may2 1 have reviewed this a draft of this article before it was2 2 published?

No recollection.Okay.


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This is like a little blue.

No* Did I?I don t have any answers.

And I m sorry about that.But you did not participate in the

5 pattern recognition research that Dr. PatrickNot in the research.

I participated in the discussion about9 what pattern research was pattern recognition was, but I1 don t remember ever having any hands-on involvement11 with this with this program, with actually developing the12 program or producing the program.

Do you recall do you recall ever14 attending a conference where this article or paper was ever15 presented?

8 to surprise you.Maybe I did something I don t know. I

2 have total amnesia for. No, I don t recall any such any21 such program.

2 3 Tom Francis gave you a call?

I m not going

There came a time when a reporter named


66/96


67/96


Yes.

1 because I don t believe that s how you give information.Okay. Well, let me hand you

I know I know he quoted me.

Out of totally out of context.(Whereupon, Defendants Exhibit 7 wasmarked for identification purposes.)Let me hand you what s been marked as

9 Exhibit 71 And let me give you some context for this10 exhibit.

Mr. Francis has produced these and3 testified that they are a transcription of his notes of his4 conversation with you.

And if you go through the pages, there7 appear to be two separate conversations.

Well, that may be.The first four pages a long conversation

20 and the last page a short conversation.

He was I do not recall. He did24 testify that some of his interviews were tape recorded, not

He was record all this as he was talking


68/96


69/96


70/96


That is correct.Do you know if and then there s a fax

Do you recall there was some3 discussion about this article on Page 3 of this document?

Yes. Yes.And I think you indicate there as you

6 did here that you have your own CV and that there was no7 article on there?

1 number. Is that your fax number?That s my fax number.Do you know whether Mr. Francis faxed

13 you this article for you to look at?Oh, he sent me some stuff in between

That s probably what that meant. I18 that is correct. That s my fax number and he did send me9 some information and then I think after that I didn t talk

2 much to him.Okay. He there was some discussion

22 on the first page about an affidavit bearing your signature23 and it sounds like from his notes that you at the time24 weren t sure what he was referring to?


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ase1.05-cv-02791 LW Document I 8 Filed 0210712008 Page 71 of 96Page 71

Tbatvs corrmt Apparently --Maw Y O . ~ hink it s the affkdavit we've

@Is-cuasedto the medical baa ?Thatus hat J t h i n k he w s te l l i f ig W

i5 that s igned f o r because I knew indicating here 1 had nstI;6 signed t h e i n t e r n s h i p cer t i f i , ea t e .Okay,1 sai-d that in bere too.

Q Okay. And da yau recalk ~h6th- he10 faxed t h a t to you that a-ffidaufk?I

reme s q a ~fi wa4;5 is t h e a r t i c l e on Heimlich? Is t h a t what @ Wt m? Or16 was it on couldn't have been an ar t i c l e . I don't know.17 I Okay. He does mentian in here that he18 had ust wr i t t en an article about Df. Heimlich and I think19 you a n f i r m e d that you had read t h a t or that you had seen20 t h a t Do you remember that?21 I had s n something on that. I don't

remerrber what he f xed me, T have t h e papers here . Maybe3 ran identify it from the fax notes to h e l p you. I don t sea4 any t a x designation on any of t h e pieoes of paper that I've


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ase1.05 cv 02791 LW Document 8 Filed 0210712008 Page 72 of 96

i1

~ e e ngiven.2 P Okay.3. So I an t rea Ly rernem gr f a r sure, Idid 6 an article on Heimlich I t i q k that s aw man had

5 w r i t t e n What s his name?

Page 72

Yes. Tom Franc i sTam Francis Had he written that befdre

He had written an ar t i c l e a b a ~ t1 Dr. Heimlich.11 Well, Maybe thntV,s-- did s that arid

faxed to me. donTt h i n k had any athc.~3 access to it.

Okay =Unless swwbady gav@& Q don t

Okay,Okay,Do you remember these no tes thissome discussion abaut an WSF grant?

21. Yeah. And I don t know where that came


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Case 1.05 cv 02791 LW Document I 8 Filed 0210712008 Page 73 of 96

Page 733 d ,not.'dliay.I see it's n here.Okay So you were n o t aware -- at le st

5 n't Irecall b e i n g aware that Dr. Patr i ck may have beenwprkirsg un r an NSF grant?

17- I have no r e m l l e c t i o n of that at all,Q Okay

9 1 A And I do remember that Mr. F r a n c i s asked1 me aho t t h a t until I m reading this if t h a t was, t h e correctP notes r i g h t .HR. ZIRM: Okay. I don't have any more

questions for you at t h i s time, D r . Masgalin.Mr. Blankenship I'm sure will.

CROSS-EXAMINAT N16 BY MR. BLANKENSHIP:17 I Dr. Margalin, my name is Je f f8 I ken h @, My bi.pt-r 'Randy q d 9 reptesmt DS +Patrick.

lg in I ~ & ' T s a l t f i l ed against C&ve;lqfi Scerig. Hsvd you 'had2 i a n ~ \ a p p p o ~ u n i t yreview the ar t i c l e w i h i t h e su1,5e~k Z

:

Yes, I have.XC t s , en t i t l ed Playing ~ o c t o x ?Ye@.


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ase1.05-cv-02791 LW Document 8 Filed 0210712008 Page 74 of 96

Page 74C L@ q;=qa @ ?@a$#A*@ qe &pg @4m a *


75/96

Case 1.05-cv-02791 LW Document 8 Filed 0210712008 Page 75 of 96Page 75

Sge, I had: hbQ i f i m ~ .dhen I xeadt the docmmt,, 1 t h i n k therefs my

H e pas arbund a e b s s t a l fm &fee pears,4 but he was only in the p~ogr@i i.. E q i p a r :56 A

Okay.h d don't -- I t h ink if you read t h a t

that s; what I sa id .8 Q9 A

Okay.I think this is incorrect. I didn t

I 10 contradict myself.So do you believe that h a s 4 upon your

12 reading t h i s a r t i c l e nd based upon what you eme ember13 tellinq Mr. Francis --

-- t h a t h ha^ taken what you b Pe a tY e , Z absolutely do

I $ Okay Hext page E says, ' Yeu d i d it19 again, 'But after being tala t h t i xefercing to you, his2.A s igna tu re is QQ an a f f i d a v i t kqyin P.atrfd;.k pmacti~ed t21 Jewish ospital f a ne and a haif y n a ~ s Margalin rrve.r~edt22 coqrse. suddenly ke is certain ~ d t r i c k as indeed a23 fes;ide'rrg. Dfci u evdr s y that he wasn t a resident?

I24 ' A No, No. 1 -- 1 aekn6wledged the fac t


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Case 1.05 cv 02791 LW Document 8 Filed 02/07/2008 Page77 of 96

Q/ t h a t qow Qr . Sanghvi w a s there.Page 77

kay9 wasng8 t hhat didzrTtcoma tb nz-d as

~afph m and when m O a s n iik,And Dr. X T @ k & ~ ~ d i= 2 that h yea?

use t qs y khgm =p~ sp. I Sj phim yea+ several hundred .

Tkfi ;new. mes a y e a ?


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Case 1.05 ev 02791 LW Document 8 Filed 0210712008 Page 78 of 96

Twen'ty-slev~tgp a r ten & yeak, 270

At 1-east.A t Lgg&& @

-. . - W P I g n t h e n a t e s ,- -bv.t don't see in the a r t i c l e something t h a t y@ told

8 Q And you're asked if y u d id Did Ds,P ka ic have a right to c l a i m t h a t he did a re~fdency?~' ndI 4 cVs l i k from t h e notes you've seen the notes there

I

11 they a r e on Page 2 abo t three paragxaphs down, it12 ap@@ats that you said, and quote, I think it was13 legitimate year.

That s correctNow you said didn'k sign t h e

? h a t r i g h t .cns made sure Dr. Heimlich signed it?

T Qat s csrrectWas t h a t b @. Heimlich was mare

gj '&&lved with Dr. PZ Z than you?I Yeah. He he arranged aske8 forand the thing was t o be the empbasi. was

24 on BurgeTy and be and wer& of eqpal standing in t h e


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Case 1.05-cv-02791 LW Document 8 Filed 0210712008 Page 79 of 96

Page 79

role +a, sign for: itOkay. Have ydu ever heard of what was

4 c a l l e d t h e p rac t i c e eoute far eniergency niedicfne?5 A No.6 B Hot f d T a r w%bh &ae k m7 I A SQ8 Q Do you know when t h e Bmezican B~ard f9 Emergegcy Medicine began certifying physicians as emergency1 doctors?

No, I do not. I t h i n k my notes in hare12 say thought ~ y b ehere was an emergency medicine program13 a t t h e :bnlversity at this time, but I don t know when it14 s ta r t ed . It was a fairly dew program. I don t knaw when15 when erriergency medicine began certification.

I think you s a id in your testimony from17 M . ~ i r f hat the whole area of emergency medicine18 epecialktation was n ~ack in t h i s day?

A Yeah. Well people were doing emergency2 medicine I'd bape so to speak j u s t hecause -- they're

There's a 1 ~ tf places where people still1 s t l l doing :,%k,I

22 do it without certification, but th actual residency andI

23 the -- qnd t h e c e r t i f i c a t i o n it was a later development in24 my experience in my lifetime.


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If you look at the article where he2 says, One moment he says there's no way Patrick did an3 emergency medicine residency and claims he would have4 never''5 A6 Q7 article, Page 28 A Page 2

Claims he would have never signed a10 residency certificate, but after being told that his11 signature is on an affidavit saying Patrick practiced at12 Jewish Hospital for 1 5 years, Margolin reverses course.13 Suddenly he is certain Patrick was indeed a resident. You14 say you never did change your mind in this conversation?15 I didn't change my mind. I can't read16 it that way at all. I said he was a he was a he had a17 qualifying residency and flexible residency or whatever we18 called it at the time, flexible internship. But I never19 said he had an emergency medicine qualification.

Right. So he's taking two concepts and

What page is that on?I'm looking at the bottom of the

21 putting them together?22 A Yeah, they got overlapped somehow.23 Q So again, what you said was taken out24 of context?


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Case 1.05-cv-02791 LW Document I 8 Filed 0210712008 Page 81 of 96- .

Exactly.'IIn fact you said In your i n t e rv i ew w i t h

3 h i m accsrdfng to his nates if you look at th bottom sf Page4: 2 ;oS ME. Franc i s notes, last l i n e you s a i d , and quote,5 NB he was there. T &t can promise you, didn't you6 A Ye ah.7 I Please loak at agairr Mr. Ftancis* notes

O k a y .Page 3 sf those notes about jugt

34 @@ ,halfway dolrn r i g h t af tex the l i n e that says apeII Wxth C,aroli.na.

3 A Righ t .The question is, Why has he moved

30 much? Was that your .quastionor Mr, Francisr

That appa~ant lywas my guesuon.And Mr. Francis told you what?It says here, Nevak g o t a reoldcney

had tqoga to states wi th he loosestI That was not mine.

Q Y@u didn t say khat?A No, I didnrt say that.

@$ M,r. F~anc&ik that a@ f it


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Case 1.05-cv-02791 LW Document 8 Filed 0210712008 Page 82 of 96Page 82

MR. ZXRM: Objection.MR, B LANKE NSRIF: Tha t tB okay, I

That's in his -- okay.6 :@- Okay. Nowf as an i n t e r n in that f i r s tg : I - .,ie d s~sidency r first year of internship, w o u d8 i Phtrfck have handled p a t i e n t s

A ureawould w~rk,wi batgents like a strake

I ;EInk you weze asked about a stzoke v i c t W ?Yeahr t 5 -- yes, I W ~ S k & , Sum

Not hgpe idea .d yo= believe you w d e you r eX f .clear+

rancis that Dr Patrick d i d indeed do a 0ne-p ar-W&'W*@ :@ g ~W&* B

That's the way this.MR. XIRM: @bT'ee@ ~m,.You caDTmayaerI an answex ie-x& ai@ gm9wgg


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MR. Z IRM: Yes.T h a t ' s t h e way I read t h i s . I s a i d t h i s

w a s an a c c r e d i t e d r e s i d e n c y a nd h e d i d do t h a t and I knew4 t h a t w a s t r u e .

Okay. And do you b e l i e v e you a l s o made6 y o u r s e l f c l e a r t o M r . F r a n c i s t h a t D r . P a t r i c k was a t Jew ish7 a n a d d i t i o n a l p e r io d o f t i m e p r i o r t o h i s r e s id e n c y working8 i n t h e c omputer d i a g n o s t i c s t u d i e s ?

A Y e s I d o .If you l o o k a g ai n a t t h e t h i r d pag e o f

t h e a r t i c l e , t h i r d f u l l pa ra gra ph down an d I read, Whi le i tI 1 2 w a s n o s e c r e t among h o s p i t a l s t a f f t h a t M a rg o l in had a low

13 o p i n i o n o f H e im l ic h and ev en l e s s r e ga r d f o r P a t r i c k . Did1 4 you e ve r t e l l M r . F r a n c i s t h a t ?15 A NO I n ev er s a i d t h a t e v e r i n my l i f e1 6 t h a t I know about and t d o e s n ' t r e f l e c t i n t h i s -- i n t h i s17 d o c u m e n t a t i o n t h a t w e h a v e h e r e f r o m M r . F r a n c i s . S o I1 8 d o n ' t know where h e g o t t h a t .19 Then i t s a y s , H i s s i g n a t u r e --20 r e f e r r i n g t o your s i g n a t u r e -- was a n en o rmo us f a v o r t o21 b o th , meaning D r . H e i ml i c h a n d D r . P a t r i c k . Did you s i g n22 t h e a f f i d a v i t t h a t w e ' ve lo ok ed a t as a f vor t o23 D r . H e iml ic h o r D r . P a t r i c k ?24 A No, not a t a l l . T h at w a s -- t h a t was a


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Case 1.05 cv 02791 LW Document 8 Filed 02/07/2008 Page 84 of 96I Page 8 4gna -ma that was a routine signature fo r -- indicat3ngP the mbn w s eligible at that point f o r state licenaure,baaedan hid having ~omp'leteda res ldqcy or a year of taL dng at

Would p u have signed i k had you Ew t h~

Qh, ,ii ,So you didnl t do it as a favar f o r

No, PIOr no, no, no That was t h a t

Okay.Arid t h a t was -- i t was -- it as tt

&-dl @,.;&@gi g a tu r e . It was properly ighed-15 Q okay. When yay w e ~ e sked a ut t h e16 &l ica t i on process f o r getting inta t h e residency program17 at ew ~ hospital, you had mentiGn9d that there u sua l l yIf w r aktompanying document in addition to the application?19 A Righe. &I h d I bel ieve that s Exhibit 35.

a age 2 ef t h a t24 graduat, I & ~ B . DD you see that?


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Uh-huh.And what is Dr. Patrick's answer?It says, Full professor. See CV.

Must have been an attached CV. Is that what you're saying?5 Q Yes. So it appears that there was an6 attached CV.7 A8 don' t have here.

Must have been an attached CV which we

9 Okay. And that's also on the next1 answer as well, isn't it, See CV ?11 A Yeah, but that would be Dr. Patrick's12 report of his background, unconfirmed report. I mean, I3 don't have any reason to believe it's not right, but that

Sure.would be what I have.

I guess what.I1m rying to get at is17 that there appear to have been additional documents8 attached?

Yeah, it does appear.Do you know how long Jewish Hospital

21 would normally maintain medical transcripts, schedules and22 that sort of thing on a resident?23 A As long as I was there and had any24 control over it, we kept all the residents' packet files as


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Case 1.05-cv-02791 LW Document I 8 Filed 02/07/2008 Page86 of 96Page 86

Th s ~ , e e r e same that we @,u& Lder than my >appea.xingherei h e y were k e p t vexy

3 41+51y by a Secretary tll;ft adn6t even w o r k in e d w i o nf4 a & & Z h e w . We Bould @e veP'I%aity loo gp t h e o l d

I

5 ones, but a s long as 1 was there, t h e r e was a f i l e that wasI6 fSfStfhtdinedstraight th rough.

N ow , how l o n g they keep them? As far as8 hod I donf know that any were ever thrown o u t in my

I

w , what's happened since then -- because we stillery so o f t e n I s t i l l get an occasional letter frompita1 +$ing that. and so serve under you s a

$h@ f a c t . that Xfrn s i l ; k aY %& &d c@nansGers t , can answeE ik, but gene~a l l yt goas to the'

1J fgf confirmation of traifikng..15 . I @ Q kay.l A T t h i n k they keep them all. -- Iquid &h%n'k h e y should e deskxoyed.

I Q Buk as far as the cantents a P t ha t f i l e ,1 o w f, say, fgr axarnpJa, the schedule - he

3, schedule or whatever was kept in t h e f i l e ?Pos s i b l y n a t . When you g through a

:e i%&.I b iianuary it was signeiiby Las X* that.q Z %f@-EBg:... w ~ @_ @& - ~~~- I a-t rh@,ntv ~ d3% : *--C@@he cq.I ,, - - = A A @ &&WSgq .wF@thW @G

I


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1 actual schedule was put in each file, I I have my doubts.

Whether they were kept in another file4 that one could look back and see when people how people5 were scheduled the schedules are of no count once the6 resident is gone. It s the file and the documentation that7 they ve done what they ve done that s in the file. So I8 doubt very much that a lot of the schedules are in those9 files to the best of my recollection.

Back in I m sorry.The yearly schedules, yeah.Okay. Back in the late 70s was there

13 some type of an affiliation between Jewish Hospital and the14 UC Medical Center?

Or even informal?As I said, some there were some

8 residents who were rotating through Jewish based on each19 departmental arrangement. Like if an OB resident rotated2 through, it was between the OB doctors and the two21 hospitals. I don t it must have been okayed by22 administration, but I didn t have anything to do with it.23 Or orthopedics, we had some orthopedic residents rotating24 through for a month or so, they d get some experience at

A formal in writing affiliation?


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Jewish. So I guess there were some informal, but I don t2 recall any fully formal arrangements that went between the3 two hospitals.4 Okay. Did any of the professors, for5 example, at the UC medical school also teach some of the6 residents at Jewish Hospital?7 A Well, I was a professor at the medical8 school at the time and I was I was teaching, of course,9 and some of our staff men had positions and did some10 teaching at the University teaching and teaching with us,

but of the full-time professorial staff at the University, I12 don t believe there was anyone teaching at our place.3 Okay. Full time?

A Well, that s another thing that changed5 over the years. When I first started, a lot of6 practitioners in the community would go to the University7 and help do the teaching and make rounds, they d run clinics8 and so forth. Later on the University began hiring more and19 more physician setting up their own departments and20 gradually pushing aside the people who were in practice who2 were coming in and doing some teaching. But many of them22 had appointments because they had been working at the23 University and were interested in a

Deposition by Gordon T. Margolin MD in Edward A. Patrick MD PhD v. Cleveland Scene et al (4/18/07)

Documents

Transcript of Deposition by Gordon T. Margolin MD in Edward A. Patrick MD PhD v. Cleveland Scene et al (4/18/07)