Preview
Filing # 108506729 E-Filed 06/08/2020 10:59:12 AM
IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT
IN AND FOR MARTIN COUNTY, FLORIDA
FREDERIC CHARLES GREER, III, and
MELISSA ANNE GREER, as Husband and CASE NO: 43 2019 CA 000015
Wife, and FREDERIC CHARLES GREER, III
and MELISSA ANNE GREER, individually,
Plaintiffs,
vs.
MARTIN MEMORIAL MEDICAL CENTER,
INC. d/b/a MARTIN MEDICAL CENTER, a
Florida corporation; KUNAL CHAUDHRY, M.D.;
and CARDIOLOGY ASSOCIATES OF STUART,
P.A., a Florida profit corporation,
Defendants.
DEFENDANT MARTIN MEMORIAL MEDICAL CENTER, INC.’s d/b/a
MARTIN MEDICAL CENTER, RESPONSE IN OPPOSITION TO PLAINTIFFS’
MOTION IN LIMINE REGARDING TESTIMONY OF SCOTT SILVESTRY, M.D.
Defendant, Martin Memorial Medical Center, Inc. d/b/a Martin Medical Center
(“MMMC”), by and through its undersigned counsel, submits this response in opposition to
Plaintiffs’ Motion in Limine — Scott Silvestry M.D., and in support states:
Plaintiffs have mischaracterized certain testimony from non-party, treating cardiac
surgeon Scott Silvestry, M.D. (“Dr. Silvestry”) in an attempt to have this Court preclude that
testimony at the time of trial. Quite simply, in response to questions from Plaintiffs’ attorney,
Dr. Silvestry testified that had Mr. Greer been evaluated for triple artery bypass surgery prior to
being in cardiogenic shock on September 1, 2017, “[i]t is doubtful that he would have received a
durable benefit” from that surgery. See Excerpt of Deposition Transcript of Dr. Silvestry, pp.
100-101, a copy of which is attached hereto as Exhibit “A.”
Electronically Filed Martin 06/08/2020 10:59 AM
CASE NO: 43 2019 CA 000015
Plaintiffs’ reliance on Saunders v. Dickens, 151 So. 3d 434 (Fla. 2014) and Cantore v.
West Boca Med. Ctr., Inc., 254 So. 3d 256 (Fla. 2018) is misplaced, as those cases involve
hypothetical questions regarding how a subsequent treating physician would have treated a
patient given different circumstances. Here, however, Dr. Silvestry did not testify as to anything
he would have done differently as Mr. Greer’s subsequent treating physician, but rather whether
Mr. Greer would have benefitted from a triple bypass surgery prior to the alleged negligence in
this case on September 1, 2017. Indeed, dissatisfied with Dr. Silvestry’s response to his own
questions, Plaintiffs’ counsel now seeks to preclude the jury from hearing testimony regarding
Mr. Greer’s cardiac condition from his non-party treating physician.
In Saunders, the Florida Supreme Court precluded testimony of a subsequent treating
neurosurgeon who testified that even if he had possession of the results of the patient’s cervical
MRI, he would not have operated on the patient’s neck. /d. at 438. In doing so, the Court held
that “a physician cannot insulate himself or herself from liability for negligence by presenting a
subsequent treating physician who testifies that adequate care by the defendant physician would
not have altered the subsequent care.” Jd. at 442. The Court further held that “testimony that a
subsequent treating physician would not have treated the patient plaintiff differently had the
defendant physician acted within the applicable standard of care is irrelevant and inadmissible
and will not insulate a defendant physician from liability for his own negligence.” Jd. at 443.
Plaintiffs’ attempt to apply the Court’s holding in Saunders to Dr. Silvestry’s testimony
in this case fails. Dr. Silvestry was not asked what he would have done for Mr. Greer had
defendant physician Dr. Chaudhry met the standard of care, nor did Dr. Silvestry offer testimony
in that regard. Rather, Dr. Silvestry’s testimony establishes that Mr. Greer would not have
benefited from a triple bypass surgery prior to Dr. Chaudhry’s alleged negligence. This
CASE NO: 43 2019 CA 000015
testimony is easily distinguishable from unsolicited testimony regarding what Dr. Silvestry, as
Mr. Greer’s subsequent treating physician, would have hypothetically done had Dr. Chaudhry,
according to Plaintiffs, treated Mr. Greer within the applicable standard of care. Plaintiffs’
questions to Dr. Silvestry did not involve hypothetical care or treatment that would have been
provided to Mr. Greer by Dr. Silvestry and therefore the holding in Saunders is inapplicable. In
fact, Plaintiffs’ questions were with regard to hypothetical care and treatment — a triple bypass
surgery — before Dr. Chaudhry’s alleged negligence, further distinguishing Dr. Silvestry’s
challenged testimony from the challenged testimony in Saunders.
Likewise, the Florida Supreme Court in Cantore examined the testimony of a subsequent
treating physician who testified that he would not have treated the minor patient had she arrived
at the hospital an hour or two earlier. /d. at 259. The Court held that “the substance of [a
subsequent treating physician’s] testimony about how he would have treated [the patient] under
circumstances other than those that actually occurred is no different from the testimony of the
subsequent treating physician in Saunders. Cantore, 254 So. 3d at 262. Again, Dr. Silvestry was
asked questions regarding whether Mr. Greer would have benefitted from a particular surgery
prior to Dr. Chaudhry’s alleged negligence. Like in Saunders, the holding in Cantore is similarly
inapplicable to the testimony of Dr. Silvestry which Plaintiffs now seek to preclude. Both of
these cases relied upon by Plaintiffs explicitly involve the testimony of a treating physician
regarding what that treating physician would have done under hypothetical circumstances and
following the alleged negligence of a defendant physician. Here, however, Dr. Silvestry did not
testify — nor was he ever asked — if he would have treated Mr. Greer any differently had Dr.
Chaudhry met what Plaintiffs claim is the appropriate standard of care.
CASE NO: 43 2019 CA 000015
Finally, Dr. Silvestry’s testimony which Plaintiffs now seek to preclude is precisely the
type of testimony permitted from treating physicians. As the Florida Supreme Court explained
in Gutierrez v. Vargas, 239 So. 3d 615 (Fla. 2018):
While an expert witness assists the jury to understand the facts, a treating
physician testifies as a fact witness ‘concerning his or her own medical
performance on a particular occasion, and is not opining about the medical
performance of another.’ . . This necessarily involves testifying with regard to
the exercise of the treating physician’s specialized medical knowledge as applied
to other facts of the case, namely the plaintiff's symptoms. A treating physician is
a fact witness, and testifies to past facts based on personal knowledge. Those facts
involve a technical matter about which the jury lacks basic knowledge, [] but they
e facts nonetheless. The treating physician’s perception of the plaintiff's
symptoms, their diagnostic opinion, and their recommendation of a particular
treatment are all facts in issue .. . Although a treating physician may possess the
same qualifications as an expert witness, treating physicians form medical
opinions in the course of treatment and may therefore testify to the fact that
they formed those opinions, and explain why they did so, provided such
testimony is otherwise admissible.
Id. at 622-23 (citations omitted; emphasis added).
WHEREFORE, Martin Memorial Medical Center, Inc. d/b/a Martin Medical Center
respectfully requests that the Court deny Plaintiffs’ Motion in Limine regarding the testimony of
Scott Silvestry, M.D., and awarding MMMC such other and further relief as the Court deems just
and proper.
CASE NO: 43 2019 CA 000015
CERTIFICATE OF SERVICE
WE HEREBY CERTIFY that on this 8 day of June, 2020, a copy of the foregoing was
served via the Florida E-Filing Portal to the parties on the attached service list.
STEARNS WEAVER MILLER
WEISSLER ALHADEFF & SITTERSON, P.A:
Attorneys for Martin Memorial Medical Center, Inc.
200 East Las Olas Blvd., Suite 2100
Fort Lauderdale, FL 33301
Telephone: (954) 462- 9500
Facsimile:
Se 54, 2.9564
Ui
By, Ce JE
SG. AU! 'N, ESQU:
—_—
ae
008060
taubin@stearn: eaver.com
MATTHEWS. PODOLNICK, ESQUIRE
FBN: 112126
mpodolnick@stearnsweayer.com
CASE NO: 43 2019 CA 000015
SERVICE LIST
Peter J. Somera Jr., Esq. Keith J. Puya, Esq.
Paul M. Silva, M.D., Esq. Hector R. Buigas, Esq.
Somera & Silva, LLP Law Offices of Keith J. Puya, P.A.
2255 Glades Road, Suite 232W 4880 Donald Ross Road, Suite 225
Boca Raton, FL 33431 Palm Beach Gardens, FL 33418
Tel: 561-981-8881 Tel: 561-408-3772
Fax: 561-981-8887 Fax: 561-408-3759
pleadings@somerasilva.com service@puyalaw.com
litigation@somerasilva.com Attorneys for Defendants Kunal Chaudhry,
Attorneys for Plaintiffs M.D. and Cardiology Associates of Stuart,
PA,
Dinah Stein, Esq. Adam Richardson, Esq.
Hicks, Poerter, Ebenfeld & Stein Burlington & Rockenbach, P.A
799 Brickell Plaza, 9"" Floor 444 West Railroad Avenue
Miami, FL 33131 West Palm Beach, FL 33401
Tel: 505-375-8171 Tel: 561-721-0400
Attorneys for Defendants Kunal Chaudhry, ir@FLAppellateLaw.com
M.D. and Cardiology Associates of Stuart, fa@FLA: ellateLaw.com
PA, Appellate attorneys for Plaintiffs
#8503897 v1
Scott Silvestry, M.D.
= = Soe a a
IN THE CIRCUIT COURT OF THE
19TH JUDICIAL CIRCUIT IN AND
FOR MARTIN COUNTY, FLORIDA
CASE NO.: 2019CA000015
FREDERIC CHARLES GREER, II
and MELISSA ANNE GREER, as
Husband and Wife, and FREDERIC
CHARLES GREER, III and MELISSA
ANNE GREER, individually,
Plaintiffs,
Vv
MARTIN MEMORIAL MEDICAL CENTER,
10 INC., D/B/A MARTIN MEDICAL
CENTER, a Florida Corporation,
11 KUNAL CHAUDHRY, MD, and CARDIOLOGY
ASSOCIATES OF STUART, P.A., a
12 Florida Profit Corporation,
13 Defendants.
14 * * * * * * * * * * * * * * * * * * *
15
16 DEPOSITION OF: SCOTT SILVESTRY, M.D.
ae DATE TAKEN: November 18, 2019
18 TIME: 1:25 p.m. - 3:45 p.m.
19 PLACE: 2415 North Orange Avenue
Suite 600
20 Oriando, Florida 32801
21 REPORTED BY: STACY PACE, RPR, CRR
Court Reporter and Notary Public
22
23
24
25
er
1A
7 — —
www.uslegalsupport.com
Scott Silvestry, M.D.
pee een ee cee a a oo
Page 98° Page 100
the cardiovascular intensive care unit and treated by 1 treating window I saw no evidence of a
medical optimization for revascularization? hypoxic-anoxic or other injury.
A I've -- BY MR, SILVA:
MR. MITTELMARK: Mittelmark. Object to the Q And have you seen any medical records for
form. Mr. Greer suffering various strokes to his middle
‘THE WITNESS: I've had patients who have been cerebral artery?
transferred and were operated on after an interval j A I nay have seen a CAT scan. T can't speak to
of getting to know them and treating them, yes. that as I sit here. And I have not had an opportunity
;
BY MR. SILVA: to review them.
|
10 Q Did you know, prior to Mr, Greer caning to the | 10 Q Okay. Do you have any opinion on what
Ww emergency room on September 1st, 2017, he was a | i Mr. Greer’s ability to be bypassed prior to September
12 full-time sheriff's police deputy chasing and 12 the Ist, 2017 would have been?
13 apprehending criminals and doing the other stuff that 3 A Please restate that.
4 cops do on a regular basis? 44 Q Yeah. If Mr. Greer had.been evaluated. for
15 MR. BUIGAS: Object to the form. 15 triple artery bypass surgery prior to being in shock and
16 MR, MITTELMARK: Mittelmark joins. being in cardiogenic shock, what is your opinion on
iT ‘THE WITNESS: ‘Twas aware that Mr. Greer was Ww. bypassing his triple vessel disease?
ba involved in law enforcement. Iwas not aware of 18 MR. MITTELMARK: Object to the form.
{19 his daily activities and his exercise capacity or 19 Mittelmark,
| 20 incapacity. 20 BY MR. SILVA:
21 BY MR, SILVA: a1 Q You can answer’.
22 Q Okay. And you don't have any opinions on 22 A So if Mr. Greer had presented for a stress
23 whether Mr, Greer can work as a police officer in the 23 test because of shortness of breath or other symptoms
24 future, or do you? 24 prior to September Ist and received a catheterization,
25 aA I would say that our heart transplant patients 25 it is possible that he would have gotten coronary artery
Page 99° Page 101
work in a variety of capacities, and I've had other bypass grafting.
patients that I've transplanted that have gone back to It is doubtful that he would have received a
law enforcement. I will say parentheticaily, looking at durable benefit on the basis of my assessment of his
the cath report and the pathology report, that I find it covonary arteries at the time of his previous surgery.
somewhat hard to believe that Mr. Greer was able to ‘a And when you ++ when you say possible, is that
C
exercise and perform his job at a level greater than six nore Likely than not?
to eight metabolic energy transfers, or MaTs, which is a A Tw iid say the spectrum of cardiovascular
quick walk and at a slight uphill based on those surgery in eiF ‘lorida would allow that someone would have
coronary arteries, operated on him.
10 Q Un-uh, And is Mr, Greer going to be on 10 Q Okay. And if -- knowing
what we know about
n lifelong antirejection medication as a result of his lu his cardiovascular coronary arteries on September ist,
12 heart transplant? 2 2017, could -- could his right coronary artery and his
13 A Yes. 13 left anterior descending artery have been bypassed?
4 Q Have you seen any of the medica. records for M4 A I can't speak to the left anterior descending,
45 his treating neuropsychologists or neurologists? iS because I chose not to bypass it for a variety of
16 A I have not. 26 reasons, but I think the right coronary artery obviously
7 MR. MITIELMARK: Mittelmark. Object to the nv could have been bypassed because that's what I did.
18 form. 18 Q Yeah, But at the tine after his coronary
19 BY MR. SILVA: 19 perforation and all the complications from it, why did
20 Q Do you know if any of those doctors have 20 you choose at that time not to bypass the LAD?
a diagnosed him with a hypoxic ischemic insult or injury? a1 MR, MITTELMARK: Object to the form.
22 MR. MITTELMARK: Mittelmark. Chject to the 22 Mittelmark. Asked and answered.
23 form. 23 WITNESS: Because we had adopted a
24 ‘THE WITNESS: I am unaware if they diagnosed 24 different strategy for this.
25 him with a hypoxic or ischemic injury, but in ay 5 BY MR. SIL
_
U.S. LEGAL SUPPORT
www.uslegalsupport.com
Preview
Filing # 108506729 E-Filed 06/08/2020 10:59:12 AM IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT IN AND FOR MARTIN COUNTY, FLORIDA FREDERIC CHARLES GREER, III, and MELISSA ANNE GREER, as Husband and CASE NO: 43 2019 CA 000015 Wife, and FREDERIC CHARLES GREER, III and MELISSA ANNE GREER, individually, Plaintiffs, vs. MARTIN MEMORIAL MEDICAL CENTER, INC. d/b/a MARTIN MEDICAL CENTER, a Florida corporation; KUNAL CHAUDHRY, M.D.; and CARDIOLOGY ASSOCIATES OF STUART, P.A., a Florida profit corporation, Defendants. DEFENDANT MARTIN MEMORIAL MEDICAL CENTER, INC.’s d/b/a MARTIN MEDICAL CENTER, RESPONSE IN OPPOSITION TO PLAINTIFFS’ MOTION IN LIMINE REGARDING TESTIMONY OF SCOTT SILVESTRY, M.D. Defendant, Martin Memorial Medical Center, Inc. d/b/a Martin Medical Center (“MMMC”), by and through its undersigned counsel, submits this response in opposition to Plaintiffs’ Motion in Limine — Scott Silvestry M.D., and in support states: Plaintiffs have mischaracterized certain testimony from non-party, treating cardiac surgeon Scott Silvestry, M.D. (“Dr. Silvestry”) in an attempt to have this Court preclude that testimony at the time of trial. Quite simply, in response to questions from Plaintiffs’ attorney, Dr. Silvestry testified that had Mr. Greer been evaluated for triple artery bypass surgery prior to being in cardiogenic shock on September 1, 2017, “[i]t is doubtful that he would have received a durable benefit” from that surgery. See Excerpt of Deposition Transcript of Dr. Silvestry, pp. 100-101, a copy of which is attached hereto as Exhibit “A.” Electronically Filed Martin 06/08/2020 10:59 AM CASE NO: 43 2019 CA 000015 Plaintiffs’ reliance on Saunders v. Dickens, 151 So. 3d 434 (Fla. 2014) and Cantore v. West Boca Med. Ctr., Inc., 254 So. 3d 256 (Fla. 2018) is misplaced, as those cases involve hypothetical questions regarding how a subsequent treating physician would have treated a patient given different circumstances. Here, however, Dr. Silvestry did not testify as to anything he would have done differently as Mr. Greer’s subsequent treating physician, but rather whether Mr. Greer would have benefitted from a triple bypass surgery prior to the alleged negligence in this case on September 1, 2017. Indeed, dissatisfied with Dr. Silvestry’s response to his own questions, Plaintiffs’ counsel now seeks to preclude the jury from hearing testimony regarding Mr. Greer’s cardiac condition from his non-party treating physician. In Saunders, the Florida Supreme Court precluded testimony of a subsequent treating neurosurgeon who testified that even if he had possession of the results of the patient’s cervical MRI, he would not have operated on the patient’s neck. /d. at 438. In doing so, the Court held that “a physician cannot insulate himself or herself from liability for negligence by presenting a subsequent treating physician who testifies that adequate care by the defendant physician would not have altered the subsequent care.” Jd. at 442. The Court further held that “testimony that a subsequent treating physician would not have treated the patient plaintiff differently had the defendant physician acted within the applicable standard of care is irrelevant and inadmissible and will not insulate a defendant physician from liability for his own negligence.” Jd. at 443. Plaintiffs’ attempt to apply the Court’s holding in Saunders to Dr. Silvestry’s testimony in this case fails. Dr. Silvestry was not asked what he would have done for Mr. Greer had defendant physician Dr. Chaudhry met the standard of care, nor did Dr. Silvestry offer testimony in that regard. Rather, Dr. Silvestry’s testimony establishes that Mr. Greer would not have benefited from a triple bypass surgery prior to Dr. Chaudhry’s alleged negligence. This CASE NO: 43 2019 CA 000015 testimony is easily distinguishable from unsolicited testimony regarding what Dr. Silvestry, as Mr. Greer’s subsequent treating physician, would have hypothetically done had Dr. Chaudhry, according to Plaintiffs, treated Mr. Greer within the applicable standard of care. Plaintiffs’ questions to Dr. Silvestry did not involve hypothetical care or treatment that would have been provided to Mr. Greer by Dr. Silvestry and therefore the holding in Saunders is inapplicable. In fact, Plaintiffs’ questions were with regard to hypothetical care and treatment — a triple bypass surgery — before Dr. Chaudhry’s alleged negligence, further distinguishing Dr. Silvestry’s challenged testimony from the challenged testimony in Saunders. Likewise, the Florida Supreme Court in Cantore examined the testimony of a subsequent treating physician who testified that he would not have treated the minor patient had she arrived at the hospital an hour or two earlier. /d. at 259. The Court held that “the substance of [a subsequent treating physician’s] testimony about how he would have treated [the patient] under circumstances other than those that actually occurred is no different from the testimony of the subsequent treating physician in Saunders. Cantore, 254 So. 3d at 262. Again, Dr. Silvestry was asked questions regarding whether Mr. Greer would have benefitted from a particular surgery prior to Dr. Chaudhry’s alleged negligence. Like in Saunders, the holding in Cantore is similarly inapplicable to the testimony of Dr. Silvestry which Plaintiffs now seek to preclude. Both of these cases relied upon by Plaintiffs explicitly involve the testimony of a treating physician regarding what that treating physician would have done under hypothetical circumstances and following the alleged negligence of a defendant physician. Here, however, Dr. Silvestry did not testify — nor was he ever asked — if he would have treated Mr. Greer any differently had Dr. Chaudhry met what Plaintiffs claim is the appropriate standard of care. CASE NO: 43 2019 CA 000015 Finally, Dr. Silvestry’s testimony which Plaintiffs now seek to preclude is precisely the type of testimony permitted from treating physicians. As the Florida Supreme Court explained in Gutierrez v. Vargas, 239 So. 3d 615 (Fla. 2018): While an expert witness assists the jury to understand the facts, a treating physician testifies as a fact witness ‘concerning his or her own medical performance on a particular occasion, and is not opining about the medical performance of another.’ . . This necessarily involves testifying with regard to the exercise of the treating physician’s specialized medical knowledge as applied to other facts of the case, namely the plaintiff's symptoms. A treating physician is a fact witness, and testifies to past facts based on personal knowledge. Those facts involve a technical matter about which the jury lacks basic knowledge, [] but they e facts nonetheless. The treating physician’s perception of the plaintiff's symptoms, their diagnostic opinion, and their recommendation of a particular treatment are all facts in issue .. . Although a treating physician may possess the same qualifications as an expert witness, treating physicians form medical opinions in the course of treatment and may therefore testify to the fact that they formed those opinions, and explain why they did so, provided such testimony is otherwise admissible. Id. at 622-23 (citations omitted; emphasis added). WHEREFORE, Martin Memorial Medical Center, Inc. d/b/a Martin Medical Center respectfully requests that the Court deny Plaintiffs’ Motion in Limine regarding the testimony of Scott Silvestry, M.D., and awarding MMMC such other and further relief as the Court deems just and proper. CASE NO: 43 2019 CA 000015 CERTIFICATE OF SERVICE WE HEREBY CERTIFY that on this 8 day of June, 2020, a copy of the foregoing was served via the Florida E-Filing Portal to the parties on the attached service list. STEARNS WEAVER MILLER WEISSLER ALHADEFF & SITTERSON, P.A: Attorneys for Martin Memorial Medical Center, Inc. 200 East Las Olas Blvd., Suite 2100 Fort Lauderdale, FL 33301 Telephone: (954) 462- 9500 Facsimile: Se 54, 2.9564 Ui By, Ce JE SG. AU! 'N, ESQU: —_— ae 008060 taubin@stearn: eaver.com MATTHEWS. PODOLNICK, ESQUIRE FBN: 112126 mpodolnick@stearnsweayer.com CASE NO: 43 2019 CA 000015 SERVICE LIST Peter J. Somera Jr., Esq. Keith J. Puya, Esq. Paul M. Silva, M.D., Esq. Hector R. Buigas, Esq. Somera & Silva, LLP Law Offices of Keith J. Puya, P.A. 2255 Glades Road, Suite 232W 4880 Donald Ross Road, Suite 225 Boca Raton, FL 33431 Palm Beach Gardens, FL 33418 Tel: 561-981-8881 Tel: 561-408-3772 Fax: 561-981-8887 Fax: 561-408-3759 pleadings@somerasilva.com service@puyalaw.com litigation@somerasilva.com Attorneys for Defendants Kunal Chaudhry, Attorneys for Plaintiffs M.D. and Cardiology Associates of Stuart, PA, Dinah Stein, Esq. Adam Richardson, Esq. Hicks, Poerter, Ebenfeld & Stein Burlington & Rockenbach, P.A 799 Brickell Plaza, 9"" Floor 444 West Railroad Avenue Miami, FL 33131 West Palm Beach, FL 33401 Tel: 505-375-8171 Tel: 561-721-0400 Attorneys for Defendants Kunal Chaudhry, ir@FLAppellateLaw.com M.D. and Cardiology Associates of Stuart, fa@FLA: ellateLaw.com PA, Appellate attorneys for Plaintiffs #8503897 v1 Scott Silvestry, M.D. = = Soe a a IN THE CIRCUIT COURT OF THE 19TH JUDICIAL CIRCUIT IN AND FOR MARTIN COUNTY, FLORIDA CASE NO.: 2019CA000015 FREDERIC CHARLES GREER, II and MELISSA ANNE GREER, as Husband and Wife, and FREDERIC CHARLES GREER, III and MELISSA ANNE GREER, individually, Plaintiffs, Vv MARTIN MEMORIAL MEDICAL CENTER, 10 INC., D/B/A MARTIN MEDICAL CENTER, a Florida Corporation, 11 KUNAL CHAUDHRY, MD, and CARDIOLOGY ASSOCIATES OF STUART, P.A., a 12 Florida Profit Corporation, 13 Defendants. 14 * * * * * * * * * * * * * * * * * * * 15 16 DEPOSITION OF: SCOTT SILVESTRY, M.D. ae DATE TAKEN: November 18, 2019 18 TIME: 1:25 p.m. - 3:45 p.m. 19 PLACE: 2415 North Orange Avenue Suite 600 20 Oriando, Florida 32801 21 REPORTED BY: STACY PACE, RPR, CRR Court Reporter and Notary Public 22 23 24 25 er 1A 7 — — www.uslegalsupport.com Scott Silvestry, M.D. pee een ee cee a a oo Page 98° Page 100 the cardiovascular intensive care unit and treated by 1 treating window I saw no evidence of a medical optimization for revascularization? hypoxic-anoxic or other injury. A I've -- BY MR, SILVA: MR. MITTELMARK: Mittelmark. Object to the Q And have you seen any medical records for form. Mr. Greer suffering various strokes to his middle ‘THE WITNESS: I've had patients who have been cerebral artery? transferred and were operated on after an interval j A I nay have seen a CAT scan. T can't speak to of getting to know them and treating them, yes. that as I sit here. And I have not had an opportunity ; BY MR. SILVA: to review them. | 10 Q Did you know, prior to Mr, Greer caning to the | 10 Q Okay. Do you have any opinion on what Ww emergency room on September 1st, 2017, he was a | i Mr. Greer’s ability to be bypassed prior to September 12 full-time sheriff's police deputy chasing and 12 the Ist, 2017 would have been? 13 apprehending criminals and doing the other stuff that 3 A Please restate that. 4 cops do on a regular basis? 44 Q Yeah. If Mr. Greer had.been evaluated. for 15 MR. BUIGAS: Object to the form. 15 triple artery bypass surgery prior to being in shock and 16 MR, MITTELMARK: Mittelmark joins. being in cardiogenic shock, what is your opinion on iT ‘THE WITNESS: ‘Twas aware that Mr. Greer was Ww. bypassing his triple vessel disease? ba involved in law enforcement. Iwas not aware of 18 MR. MITTELMARK: Object to the form. {19 his daily activities and his exercise capacity or 19 Mittelmark, | 20 incapacity. 20 BY MR. SILVA: 21 BY MR, SILVA: a1 Q You can answer’. 22 Q Okay. And you don't have any opinions on 22 A So if Mr. Greer had presented for a stress 23 whether Mr, Greer can work as a police officer in the 23 test because of shortness of breath or other symptoms 24 future, or do you? 24 prior to September Ist and received a catheterization, 25 aA I would say that our heart transplant patients 25 it is possible that he would have gotten coronary artery Page 99° Page 101 work in a variety of capacities, and I've had other bypass grafting. patients that I've transplanted that have gone back to It is doubtful that he would have received a law enforcement. I will say parentheticaily, looking at durable benefit on the basis of my assessment of his the cath report and the pathology report, that I find it covonary arteries at the time of his previous surgery. somewhat hard to believe that Mr. Greer was able to ‘a And when you ++ when you say possible, is that C exercise and perform his job at a level greater than six nore Likely than not? to eight metabolic energy transfers, or MaTs, which is a A Tw iid say the spectrum of cardiovascular quick walk and at a slight uphill based on those surgery in eiF ‘lorida would allow that someone would have coronary arteries, operated on him. 10 Q Un-uh, And is Mr, Greer going to be on 10 Q Okay. And if -- knowing what we know about n lifelong antirejection medication as a result of his lu his cardiovascular coronary arteries on September ist, 12 heart transplant? 2 2017, could -- could his right coronary artery and his 13 A Yes. 13 left anterior descending artery have been bypassed? 4 Q Have you seen any of the medica. records for M4 A I can't speak to the left anterior descending, 45 his treating neuropsychologists or neurologists? iS because I chose not to bypass it for a variety of 16 A I have not. 26 reasons, but I think the right coronary artery obviously 7 MR. MITIELMARK: Mittelmark. Object to the nv could have been bypassed because that's what I did. 18 form. 18 Q Yeah, But at the tine after his coronary 19 BY MR. SILVA: 19 perforation and all the complications from it, why did 20 Q Do you know if any of those doctors have 20 you choose at that time not to bypass the LAD? a diagnosed him with a hypoxic ischemic insult or injury? a1 MR, MITTELMARK: Object to the form. 22 MR. MITTELMARK: Mittelmark. Chject to the 22 Mittelmark. Asked and answered. 23 form. 23 WITNESS: Because we had adopted a 24 ‘THE WITNESS: I am unaware if they diagnosed 24 different strategy for this. 25 him with a hypoxic or ischemic injury, but in ay 5 BY MR. SIL _ U.S. LEGAL SUPPORT www.uslegalsupport.com