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Internal Medicine Nephrology Clinical Nutrition Expert Witness

Provides Opinion & Testimony In:

internal medicine, nephrology, clinical nutrition, parenteral nutritional, internal medicine, nephrology, clinical nutrition, medical legal,

Expert Witness No. 3773

Medical-Legal Biographical Sketch

I would like to discuss my background and experience as it pertains to my work as an expert in the medical legal field. I am a native New Yorker, I graduated from Columbia College in 1964 and from Albert Einstein College of Medicine in 1968. I did my internship and 2 years of residency in the field of Internal Medicine at the Hospital of the University of Pennsylvania. I then spent a year traveling and studying in Europe. I came to Wadsworth VA and UCLA in 1972 for training in nephrology. During the next decade, and to a limited degree until the mid-1980s, I did extensive clinical research primarily in the fields of dialysis and clinical nutrition. I presented and defended innumerable papers at both national and international meetings, published extensively and was invited as Visiting Professor to a number of institutions in the United States and abroad.

During the last 20 years, I have been primarily in private practice. In the 1980s, my practice was centered in the total care of dialysis patients and consultative work in the hospital. Since 1990, my practice has involved more time in the office, about 20 hours a week; approximately 70% of the patients that I follow in the office have internal medicine needs. About 30% have varying degrees of renal insufficiency. I spend 20-25 hours per week teaching, seeing patients in the hospital and dialysis units. I devote approximately 10-15 hours per week to medical-legal work; I consult on approximately 30 or 40 medical legal cases per year; approximately 60% plaintiff and 40% defense. 30 ¬40% of these cases involves renal issues, 60-70% in the field of internal medicine. I have been deposed approximately 90 times and have testified in approximately 25 trials and arbitrations. I will be very pleased to discuss any perspective cases with you. Thank you.

Experience: Nutrition and Nutritional Support

I had my first experience with total parenteral nutritional (TPN; then termed hyperalirnentation) while working with a Doctor and his disciples at the Hospital of the University of Pennsylvania from 1968-1971. When I came to Los Angeles and Wadsworth VA Hospital, I set up one of the first nutritional support teams in the country in the early 70s. At that time I termed it “catastrophe avoidance service” because of problems people were having with TPN. In about 1975, with a Doctor-we obtained a feasibility grant from the VA Central Office to set up an early nutritional support team.

In 1975-76, I was the lead author (a Doctor was the senior author) on a very extensive review of parenteral nutrition that was published in Kleeman and Maxwell’s textbook, 2nd edition, 1977. As the junior author, I did most of the research and extensive review of several hundred articles on the subject. In the 1970s, I taught nutrition to UCLA medical students, lectured at the UCLA graduate nutrition program and taught medical students and house staff at the VA Wadsworth and other physicians in private practice. I was one of the early members of the American Society of Parenteral and Enteral Nutrition (ASPEN). With Dr. Kopple, I set up and lectured at several local ASPEN meetings.

Throughout my academic career, I did extensive research and published in the areas of nutrition and nutrition support and TPN. (See my Bibliography.) I qualified for and passed ‘my boards in Clinical Nutrition in 1981 and was elected as a Fellow of the American College of Nutrition (FACN) a few years later.

I have been an active member of the Nutritional Support Team at Cedar Sinai Medical Center since 1991 and in the mid-90s I became certified as Clinical Support Physician (CCNP) tinder the auspices of ASPEN. Throughout my career, I have lectured on enteral nutrition and total parenteral nutrition and nutritional support at numerous meetings locally, nationally and internationally. I have been a consultant for various pharmaceutical companies in so far as their nutritional products. I have continued to teach dieticians, medical students, house staff and physicians.

Expert 3771 is a Board Certified specialist in Nephrology, general Internal Medicine and Clinical Nutrition. After graduating from Columbia University and the Albert Einstein College of Medicine in New York, Expert 3771 did his internship and residence at the Hospital of the University of Pennsylvania. Following that, he studied for a year at London’s Royal Postgraduate Medical School and National Heart Institute.

In 1972, he came to Los Angles to work at the VA Hospital in Westwood and at UCLA where he achieved the rank of Associate Professor of Medicine-in-Residence at UCLA’s School of Medicine, hi Is clinical research and expertise in kidney disease, CAPD, hemodialysis, and nutrition have earned him international recognition. Expert 3771 has published more than 80 scientific articles and book chapters which has led to visiting professorship and lectureships around the world including Germany, Japan, Turkey, Australia, Czechoslovakia, South Africa, Argentina, Columbia and Peru. Expert 3771 is a Fellow in the American College of Nutrition (FACN) and the American College of Physicians (ACP).

In 1982, Expert 3771 moved to the challenge of private practice, where he combines his scientific knowledge and clinical expertise with a warm and outgoing personality. Dr. “B” is considered by many an “old-fashioned” doctor — a doctor who cares for the “total” patient, taking the time to listen and to develop individualized treatment, He treats patients with a broad range of medical problems. In addition to his expertise in the care of patients on dialysis and those with kidney disease and hypertension, he emphasizes preventive medicine and nutrition in his practice. He has spent time consulting at the Pritikin Center in Santa Monica.

Expert 3771 was born and raised in New York City. He has been married for 30 years. He and his wife, Bonnie, a licensed marriage and family psychotherapist with a practice in West L.A., enjoy reading, gardening, tennis, bicycle riding and travel.

Education

  • A.B., Columbia College, New York City, New York, 1960-1964
  • M.D., Albert Resident and Resident in Medicine, New York, 1964-1968
  • Intern, Assistant Resident and Resident in Medicine, Hospital of University of Pennsylvania, Philadelphia, Pennsylvania, 1968-1971
  • Visiting Physician, National Heart, Hospital, London, England, Oct. 1971-Dec. 1971
  • Student, Postgraduate Medicine, Royal Postgraduate Medical School (Hammersmith Hospital), London, England – Jan. 111172-Mar. 1972
  • Student, National Neurology Hospital (Queen’s Square), London, England, April 1972 Fellow in Nephrology, VA Wadsworth Medical Center/UCLA, Los Angeles, CA, 1972-1974

Medical Licenture

  • California 1970
  • Pennsylvania1968

Specialty Certification

  • Diplornate American Board of Internal Medicine – 1972
  • Diplomate in Subspecialty of Nephrology, American Board of Internal Medicine -1976
  • Specialist in Clinical Nutrition, American Board of Nutrition – 1981

Honors

  • Fellow, American College of Physicians (F.A.C.P.) – 1977
  • Fellow, American College of Nutrition (F.A.C.N.) – 1989

Positions

  • Instructor in Medicine, Medical School of University of Pennsylvania, 1970-1971
  • Director, Home Peritoneal Dialysis Program, VA Wadsworth Medical Center, 1972-1982
  • Research Fellow, National Kidney Foundation of Southern California, July 1974-Dec. 1974
  • Research and Education Associate (Career Development Award), VA Wadsworth
  • Medical Center, Jan. 1975-Oct. 1975
  • Coordinator, VA Cooperative Dialysis Study, 1975-1982
  • Assistant Professor of Medicine, UCLA School of Medicine, 1975-1981
  • Coordinator, Nutrition Support Service, VA Wadsworth Medical Center, 1976-1982 Consultant in Peritoneal Dialysis 1,7A Wadsworth Medical Center and UCLA Center for Health Sciences, 1979-1982
  • Associate Professor of Medicine (in Residence), UCLA School of Medicine, 1981-1982
  • Adjunct Associate Professor of Medicine, UCLA School of Medicine, 1983-85
  • Private & Consultative Practice – Internal Medicine, Nephrology and Nutrition, 1982-Present Consultant, Nephrology and Dialysis, Children’s Hospital of Los Angeles, 1988-1989 Consultant, Pritikin Center, Santa Monica, 1991

Editorial Activities

Editorial Board:

  • Artificial Organs
  • Dialysis & Transplantation
  • Nutrition Support Services
  • Peritoneal Dialysis Bulletin
  • Contemporary Dialysis and Transplantation
  • Nephrology News and Issues

Reviewer

  • American Journal of Nephrology
  • American Journal of Kidney Diseases
  • Annals of Internal Medicine
  • Archives of Internal Medicine
  • Asaio
  • Nephron
  • Kidney International
  • Obstetrics & Gynecology
  • American Journal of Clinical Nutrition
  • Journal of American Medical Assoc. (JAMA)

Other Activities

  • Scientific Organizing Committee – First International Symposium on Peritoneal Dialysis; Chapala, Mexico, June
  • “Expert” Advisory Panel – Continuous Ambulatory Peritoneal Dialysis; HEW, Medicare,
  • Nov, 1978.
  • Co-Chairman, American Society Parenteral and Enteral Nutrition, L.A. Regional Seminar,
  • Nov. I979.
  • Planning Committee, Proposed VA. Cooperative Study Comparing CAPD to Hemodialysis, 1980.
  • Scientific Organizing Committee – Second International Symposium on Peritoneal Dialysis; Berlin, 1981.
  • Advisory Committee on Clinical Nutrition, VA Central Office, Washington, D.C., 1981-1982
  • Program Committee – American Society of Artificial Internal Organs, 1982-1985.

Research Contracts

  • Controlled Evaluation of Maintenance Peritoneal Dialysis
  • Sorbent Peritoneal Dialysis, Subcontract Cedars-Sinai
  • Sorbents of Application in the Treatment of ESRD Patients

Invited Speaker at International Meetings

  • First International Congress on Nutrition in Renal Disease, Wurzburg, Germany; June, 1977.
  • First International Symposium on Peritoneal Dialysis, Chapala, Mexico; June, 1978. Symposium: Hemoperfusion, Dialysate and Diafiltrate Purification, Tutzing, Germany;
  • September, 1978.
  • Czechoslovakian Society of Nephrology, Prague; June, 1979.
  • Second International Congress on Nutrition in Renal Disease, Bologna; June, 1979.
  • Symposium: Continuous Ambulatory Peritoneal Dialysis, Buenos Aires; July, 1980.
  • Pan Pacific Symposium on Peritoneal Dialysis, Melbourne; October, 1980.
  • Second International Symposium on Peritoneal Dialysis, Berlin; June, 1981.
  • Fourth National Congress of Nephrology, Mexico City; September 1981.
  • Fourth International Course – Columbian Society of Nephrology, Bogota; September, 1981.
  • 54th Hahneman International Symposium: Self-Care Dialysis, Venice, Italy; April, 1982.
  • First International Course on Peritoneal Dialysis, Vicenza, Italy; May 1982.
  • South African Society of Nephrology: Biannual Congress, Pretoria, So. Africa; March, 1984

Societies

  • Council of the Kidney – American Heart Association – 1973
  • American Society of Nephrology – 1974
  • International Society of Nephrology – 1974
  • Los Angeles County Medical Association – 1974
  • American Medical Association – 1.974
  • American Society of Artificial In fernal Organs – 1974
  • American Federation for Clinical Research – 1976
  • European Dialysis and Transplant Association, Assoc. Member – 1977
  • American Society of Parenteral and Enteral Nutrition – 1978
  • International Society for Artificial Organs – 1979
  • American Society for Clinical Nutrition – 1979
  • American Institute of Nutrition – 1979
Groups

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