How to get the job as an expert witness:
- Sometimes (rarely) a job falls into your lap. This is how my first one came to me.
- Talk with potential patients – if they tell you a story about a friend or family that recently had an eye problem that is in litigation, ask if you can offer your help as an expert witness.
- Talk with potential lawyers – the lawyers that advertise for an auto accident or worker’s comp claims are likely to have a few cases a year with eye complications, opening the market for you to step in. Call and let them know what you can do for them. Straight up medical malpractice lawyers usually already have an ophthalmologist on retainer.
What the job offer as an expert witness looks like:
- On the phone, the lawyer will give you a 30-second summary of the case, tell you what they want your opinion on, and ask:
- What is your rate?
- How long do you think it will take you?
What to charge as an expert witness:
- The lawyer just forwards your fees on to the client, so they usually don’t blink an eye at high rates. They expect rates to be high because they expect you to not only be credentialed but to be an expert in your field.
- If it’s your first case, you want to keep it to get it on your resume. I recommend listing:
- $50/hr for review and report
- $150/hr for deposition, with 2hr minimum
- $150/hr for trial testimony, with 4hr minimum
- Once you’re established with one or two cases as experience, up your rate to at least:
- $100/hr for review and report
- $200/hr for deposition, with 2hr minimum
- $200/hr for trial testimony, with 4hr minimum
The more complicated the summary sounds, estimate more hours.
What to do for the “Review and Report”
- The lawyer will send you all the records they have – medical, police, etc.
- I had a complicated case with about 400 pages of records
- Don’t be overwhelmed – most of the records are fluff. The hospital record alone was 200 pages, and about 150 of that was the nurses saying nothing had changed in his major medical history in the past 20 minutes, over and over.
- Keep track of the time you are working on the case. It’s easy to work on and off without keeping track, but then how will you know what to charge?
- Make personal notes of what you’re reading. You will forget details and need to refer to them later. Get the timeline down on an excel sheet, so you know what happened in order.
Four documents to submit to the lawyer
1) Cover Letter
2) Statement
- (List, with numbers, the records you have, and the studies you reviewed.)
- Medical records from (doctor) (dates of service)
- Medical records from (doctor) (dates of service)
- Police report of (type of accident) (date)
- Martínez-Castillo V., et al. Epiretinal membrane after pars plana vitrectomy for primary pseudophakic or aphakic rhegmatogenous retinal detachment: incidence and outcomes. Retina. 2012 Jul;32(7):1350-5.
- You’ll want to reference a lot of studies. If they question you in court about the plaintiff, the more studies you can refer to, the less you have to defend yourself. If the fact that ERM’s show up after vitrectomies is simply part of your expert “opinion,” the lawyer can tear you apart with questions about how many you’ve dealt with, and what else causes ERM’s, to look for some shadow of a doubt. But if you submit a journal article as evidence, then that is not your opinion. It becomes evidence that you refer to and don’t need to defend.
- (List, with numbers, key facts from records that are the most important in determining cause and effect. Also, summarize the study findings.)
- Medical records from (doctor) show that on (date), (plaintiff)’s best correctable vision was 20/20 in each eye.
- Police reports show (plaintiff)’s accident occurred on (date), and that (describe trauma).
- Medical records from (doctor) show that on (date), (plaintiff) had an (eye problem), and was referred for same-day surgery to (describe surgery).
- Martínez-Castillo V., et al. show that of patients who undergo vitrectomy for retinal detachment, about 9% develop an epiretinal membrane afterward. Visual acuity improves after surgical removal of the epiretinal membrane, although eyes with the macula detached had lower final best-corrected vision.
- (Plaintiff)’s (eye problem) was caused by physical trauma from the associated (type of accident) that occurred on (date).
- (Plaintiff)’s epiretinal membrane which was removed on (date) was caused by his retinal tear and detachment, which were caused by the associated (accident). (5)
- Conditions that continue to affect (plaintiff)’s vision include: (problem 1, problem 2, etc.)
- (Plaintiff)’s macula-off retinal detachment caused permanent functional damage that will permanently affect his vision
- The prognosis for complete restoration of vision in his right eye is very poor.
- With 20/400 vision in his right eye, binocular depth perception is functionally lost.
3) CV
4) Invoice
Date | Activity Type | Hours | Rate | Total |
---|---|---|---|---|
[date] | Review of Medical records and preparation of report | 4 | $100 | $400 |
Total: | $400 |
Here is an example of a case I was involved in as an expert witness:
- X started out with perfect vision and wore monovision contacts.
- He was rear-ended at a stop sign. Later that day, his near eye was blurry. He assumed it was a problem with the contact lens, and scheduled a “contact lens follow-up” for one week out.
- The car crash had caused two problems:
- Macula-off retinal detachment and tear
- Epiretinal membrane (ERM).
- He had surgery to repair the detachment and remove the ERM.
- The retina surgery caused three complications:
- Cataract formation
- Epiretinal membrane (ERM) – a second one formed again on the same eye
- Neurotrophic keratitis (they clipped the long posterior ciliary nerve during surgery)
- He then had cataract surgery, and it caused two complications:
- Posterior capsule opacity (PCO)
- Cystoid macular edema (CME, Irvine-Gass Syndrome)
- The CME became chronic, unresolved even after a year of treatment.
- The neurotrophic keratitis caused a central scar to form.
- In the end, his vision was 20/400, with potential acuity of 20/50 with a corneal transplant and RGP.
- The question: With a reasonable degree of medical certainty, was the retinal detachment caused by the car crash, and if so, were all of the post-op complications foreseeable expected risks caused by the surgeries associated prior to their onset?
- If so, the defendant’s car insurance company is going to pay a lot of money for all the surgeries, and for the loss of vision in one eye.