ARCHIVES OCT 17 > Past ACMT Conferences > 2013 Forensic Conference


On November 12-13, 2013, ACMT hosted a seminar in Forensic Toxicology in Baltimore, MD entitled Consultation in the Civil and Criminal Arenas. We are pleased to offer a rebroadcast of each module. We have offered these at no charge but registration is required.


So You Think You Are an Expert?
Brian N. Hail, JD, Gruber Hurst Johansen Hail Shank LLP, Dallas, TX
Stacey L. Hail, MD, University of Texas Southwestern Medical Center, Dallas, TX



1. List 3 aspects of being a "medical expert"
2. Identify the role and responsibilities of a medical expert witness
3. Describe the relationship between opinion and facts for an expert


Elements of a Civil Case
Brian N. Hail, JD, Gruber Hurst Johansen Hail Shank LLP, Dallas, TX


1. Identify the roles played by parties in a lawsuit
2. List four requirements of a civil suit
3. Describe the concept of burden of proof
4. Discuss the meaning of such terms as "standard of care", "more likely than not", "'strict' and 'limited' liability", and "medical certainty"

Elements of a Criminal Case
Joel R. Meyers, JD, Assistant United States Attorney New Mexico


1. Identify the roles played by parties in a criminal case
2. Summarize the concept of “beyond a reasonable doubt”

Elements of Workers' Compensation and the Independent Medical Examiner (IME) Evaluation
Brent T. Burton, MD, FACMT, Private Practice Consulting Medical Toxicologist, Portland, OR


1. Describe how IMEs and worker compensation cases are interrelated
2. List the typical referral sources for IME/WC
3. Describe the expectations of an IME
4. Discuss the legal implications of Workman's Comp evaluations and IMEs
5. Summarize why IME/WC evaluations differ from a doctor-patient relationship


Admissibility of Evidence: Frye and Daubert
Brian N. Hail, JD, Gruber Hurst Johansen Hail Shank LLP, Dallas, TX


1. Describe the basis for a Frye or Daubert "challenge"
2. Name 4 key components that an expert needs to demonstrate in order to withstand a Daubert challenge


What Is Causation?
Jeffrey Brent, MD, PhD, FACMT, University of Colorado School of Medicine, Denver, CO


1. Provide the definition of consistency in the Hill criteria
2. Describe why analogy is considered a 'weak' causation criteria
3. Name 3 criteria that are as valid in assessing an individual exposure as they are in epidemiologic studies. 


Initial Case Management and Starting/Building a Forensic Practice
Moderator: Charles A. McKay, MD, FACMT
Panel: A. Nelson Avery, MD, FACMT; Jeffrey Brent, MD, PhD, FACMT; Brent T. Burton, MD,MPH, FACMT; Michael G. Holland, MD, FACMT 


1. Discuss practical experiences that contribute to development as a toxicology expert witness
2. Describe the requirements for listing prior deposition and trial testimony experience in federal cases
3. Discuss the pros and cons of creating notes on a case



Courtroom Pearls from the Medical Examiner
James R. Gill, MD, Connecticut Chief Medical Examiner, Farmington, CT


1. List 3 typical findings for opioid deaths that may help to distinguish respiratory arrest from arrythmic death
2. Identify 2 pathology practices that could improve attribution of death


The Toxicology Expert Written Report
Lewis S. Nelson, MD, FACMT

Discussants: A. Nelson Avery, MD, FACMT; Michael G. Holland, MD, FACMT; Brent T. Burton, MD, FACMT


1. List the important components of a toxicology written report (records reviewed, case summary, expert opinion, basis for opinion)
2. Discuss the importance of qualifying statements regarding causation


Mock Deposition
Brian N. Hail, JD, Gruber Hurst Johansen Hail Shank LLP, Dallas, TX


1. Describe the purpose of the deposition in civil cases
2. Identify the individuals and roles at a deposition
3. List 3 phrases that have meanings in the courtroom different than their common usage


Retrograde Extrapolation and other ETOH Calculations
Robert B. Forney, Jr., PhD, DABFT, Lucas County Coroner's Office, Toledo, OH

Objectives: Forney

1. Describe the Widmark Equation and its assumptions
2. Discuss the experimental basis for conversion of plasma ethanol to whole blood BAC measurements
3. Discuss the value of providing ranges as well as point estimates when back-extrapolating ethanol measurements


Impairment of Driving Related Abilities by Alcohol vs. "Visible Impairment" (the Dram Shop Quandary)
Robert B. Forney, Jr., PhD, DABFT, Lucas County Coroner's Office, Toledo, OH



1. Discuss the impact of ethanol on normal brain pathways for consciousness, response to stimuli, and coordination
2. Discuss the meaning of a quantitative deterioration in complex reaction time on driving safety
3. List the relevant factors in determination of impairment prior to the service of alcoholic beverages
4. Discuss the methodology and limitations of observational studies on "drunkenness"


Breakout Sessions: Ethanol Cases
Brent T. Burton, MD, MPH, FACMT; Charles A. McKay, MD, FACMT


1. Demonstrate the process of back-extrapolation for ethanol concentrations
2. Use specific demographic and drinking scenario information to estimate amount of ethanol consumed
3. Provide a rationale for an expert opinion on visible state of impairment


Issues in Post-Mortem Xenobiotic Measurements
Barry K. Logan, PhD, DABFT, NMS Labs, Willow Grove, PA


1. Discuss the impact of time elapsed since death on the interpretation of cardiac blood xenobiotic measurements
2. Provide examples of drugs with a. insignificant and b. marked changes attributable to post-mortem redistribution
3. Discuss the impact of medication tolerance on the interpretation of opioid concentrations post-mortem


Mass Toxic Tort and Product Liability Cases
Jeffrey Brent, MD, PhD, FACMT


1. Describe the reasons for increased systemic uptake of transdermal drug
2. Discuss appropriate clinical settings for long-term opioid administration
3. Describe the nature of 'expertise' when dealing with large-scale claims of exposure and injury


Environmental Toxic Tort Cases
A. Nelson Avery, MD, FACMT


1. Discuss the interpretation of modeling data for individual human exposure cases
2. Describe the derivation of minimal risk level (MRL)
3. Provide a rationale for the use of animal exposure data in a human exposure claim
4. Describe the regulatory process to derive maximal contaminant levels (MCL) or equivalent


Potpourri of Criminal Cases
Stacey L. Hail, MD; Barry K. Logan, PhD, DABFT; Joel R. Meyers, JD


1. Describe some of the considerations in using hair testing as a basis for decisions regarding drug abstinence compliance
2. Discuss the toxicologic and specific case considerations that impact expert opinion about "ability to form intent"


Potpourri of Civil & Malpractice Cases
Lewis S. Nelson, MD, FACMT; Charles A. McKay, MD, FACMT; Paul M. Wax, MD, FACMT


1. Discuss the strengths and weaknesses of expert opinion in dram shop cases 
2. Discuss the relative value of drug "levels" and testimony regarding behavior in a civil trial
3. Describe the component(s) of a medical malpractice claim that requires testimony from a medical expert


Potpourri of Workers' Compensation and IME Cases
Brent T. Burton, MD, MPH, FACMT and Michael G. Holland, MD, FACMT


1. Define the physician's role in an IME
2. Describe one approach to the identification of a new diagnosis from an IME


Conflict of Interest Policy:  All planning committee members responsible for planning CME activities are required to disclose any actual or apparent conflict of interest related to the content of the presentation via the CME program application. In addition, program planners have an obligation to resolve any actual conflicts by recusing themselves from planning this program so as not to appear to influence the content.