Preview
FILED
6/18/2020 10:32 AM
FELICIA PITRE
DISTRICT CLERK
DALLAS CO.,TEXAS
Jeremy Jones DEPUTY
N0. DC-19-11695
DEEJAY LABRADA IN THE DISTRICT COURT
PLAINTIFF,
AND
INTERVENOR MARIA PINEDA, DALLAS COUNTY, TEXAS
INDIVIDUALLY, AND As NEXT 0F mmmmmmmmmmmmm
FRIEND 0F MINOR N.A.
VS.
MIRIAM TORRES
DEFENDANT. 116TH JUDICIAL DISTRICT
DEFENDANT’S SECOND SUPPLEMENTAL RESPONSE T0 INTERVENOR’S
REQUEST FOR DISCLOSURE AND DESIGNATION 0F EXPERTS
Pursuant t0 TeX R. CiV. P. 194, Defendant serves the following Second Supplemental
Response to Intervenor’s Request for Disclosure and Designation 0f Experts.
f. For any testifying expert:
1. The expert’s name, address, and telephone number;
2. The subj ect matter on Which the expert Will testify;
3. The general substance 0f the expert’s mental impressions and opinions and
a brief summary of the basis for them, or if the expert is not retained by, employed by, 0r
otherwise subject to the control 0f the responding party, documents reflecting such
information;
4. Ifthe expert is retained by, employed by, 0r otherwise subj ect t0 the control
0f the responding party:
A. A11 documents, things, tangible
reports, models, 0r data
compilations that have been provided t0, reviewed by, 0r prepared by or for the
expert in anticipation 0f the expert’s testimony; and
B. The expert’s current resume 0r bibliography.
Response: Defendant hereby designates and reserves the right t0 call any expert Witness(es)
designated by any other party to this case, as well as any experts later designated
by any party t0 this case 0n any subject relevant t0 this litigation 0n Which the
DEFENDANT’S SECOND SUPPLEMENTAL RESPONSE TO
REQUEST FOR DISCLOSURE AND DESIGNATION OF EXPERTS
witness is qualified to testify. In the event that any party to this cause has
designated any experts but has been or is subsequently dismissed for any reason or
fails t0 call any designated expert at the time 0f trial, Defendant specifically
reserves the right to call any such expert previously designated by that party.
Defendant further reserves the right t0 Withdraw 0r de-designate any expert prior
t0 testimony and t0 positively aver that such previously designated expert Will not
be called as a witness at trial and to redesignate same as a consulting expert Who
Will not be called by any party in this cause. Finally, Defendant reserves the right
to supplement this response as additional information concerning experts becomes
available.
Defendant further hereby designates as adverse expert Witnesses all expert
witnesses designated by Intervenor. Defendant reserves the right t0 rely upon 0r
t0 offer, by direct examination or cross—examination, testimony obtained from those
experts and rebuttal experts, if any, designated by Intervenor. By this designation,
Defendant does not necessarily agree with, nor vouch for, the credibility 0f any
such Witnesses 0r their opinions, or the reliability, materiality, or admissibility of
information and/or tangible things produced by these individuals in general; by this
designation Defendant is simply reserving the opportunity t0 rely upon 0r elicit
certain opinions and/or evidence from these witnesses t0 the extent that it deems it
in its interest t0 d0 s0.
Such persons are expected to testify concerning Intervenor’s care and treatment.
See Intervenor’s Responses t0 Defendant’s Request for Disclosure for additional
information concerning such health-care providers including medical bills and
records relating to Intervenor.
Second Supplemental Response:
Defendant hereby designates as an expert witness the following individual:
Dustin R. Leek, MD
5323 Harry Hines Blvd
Dallas, Texas 7539
214.6483 1 11
Dr. Leek is a Texas physician and board certified in physical medicine and rehabilitation
and pain medicine Who has reviewed Naydelin Argueta’s medical records and other case
materials provided t0 him, and is expected to testify regarding the extent of the injuries
sustained by the Plaintiff in the subject motor vehicle accident, the appropriate care and
treatment for those injuries, and the fair and reasonable cost 0f that treatment, both in the
past and in the future, if applicable, as set out in the attached report.
DEFENDANT’S SECOND SUPPLEMENTAL RESPONSE TO
REQUEST FOR DISCLOSURE AND DESIGNATION OF EXPERTS -2-
Respectfully submitted,
CQLQ?
Chad Kimble, StateBar N0. 24007483
Kyle Smith, State Bar No. 24102512
D. Brent Beasley, State Bar No. 24082669
LAW OFFICE 0F CHAD KIMBLE, P.C.
1204 S. White Chapel Blvd.
Southlake, Texas 76092
eservice@chadkimblelaw.com
817.766.7488
817.423.7492 fax
ATTORNEY FOR DEFENDANT
CERTIFICATE 0F SERVICE
The undersigned certifies that 0n the 18th day of June, 2020, a true copy 0f the foregoing
has been served 0n all patties in accordance With Rule 21a, Texas Rules of Civil Procedure.
CQW
Chad Kimble
DEFENDANT’S SECOND SUPPLEMENTAL RESPONSE TO
REQUEST FOR DISCLOSURE AND DESIGNATION OF EXPERTS -3-
DUSTIN R. LEEK, M.D. 12001 N. CENTRAL EXPRESSWAY
PHYSICAL MEDICINE AND REHABILITATION SUITE 800
PAIN MEDICINE DALLAS, TX 75243
(214) 750—61 10
FAX -
(214) 750-5825
June 4, 2020
Mr.Chad Kimble
Law Office of Chad Kimble, PC
1204 S. White Chapel Blvd.
Southlake, TX 76092
RE: Naydelin Argueta
CLAIM #: 0500530647.1
DATE OF INJURY: 04/28/18
CASE #2 21 132198
Dear Mr. Kimble:
| have had the opportunity to review medical records on Ms. Naydelin Argueta.
| have been fully licensed to practice medicine in Texas since 2017. In that time, completed a 4-year residency
|
in Physical Medicine & Rehabilitation (PM&R), a year of which included serving as Chief Resident. After this, |
began accredited sub-specialty training in the field of Pain Management. In addition, have gained
|
experience through maintaining extracurricular part-time employment at two separate community inpatient
rehabilitation facilities and another outpatient clinic focused on the treatment of patients with opioid
dependence. The practice of PM&R (and Pain Management) routinely involves caring for patients with disease
or injury to musculoskeletal and/or neurological systems and can require the use of radiological imaging,
electrodiagnosis, physical therapy, medications, injections, and other modalities. have personally ordered,|
performed, and reviewed these diagnostic and treatment interventions on thousands of patients. Therefore, |
am an expert in the evaluation and treatment aspects of this case.
My training across multiple practice settings, including private, county, and federal hospitals has provided me
with an acute awareness 0f medical costs, both to the patient and to the system. Even now as transition |
from academics and part-time extra-curricular employment to a 100% private practice model for PM&R/Pain
Management, have spent considerable effort dedicated to the understanding of local market trends and
|
(medical) business modeling with the goal of running a fair and competitive practice. As a result, feel |
confident in deciphering what is a reasonable charge and what is not.
“Reasonable amounts” are determined based on this experience and my current fee schedule, and have been
additionally cross-referenced to the usual, customary, and reasonable fees outlined in Medical Fees Directory,
edited and published by James Davis, 2020.
SUMMARY OF MEDICAL RECORDS
The patient was and previously healthywhen on April 28, 2018, she was involved in a motor vehicle
15 years old
She was a restrained passenger in the passenger-side rear seat. Her vehicle was impacted on
collision (IVNC).
the passenger side and tipped over. Airbags did not deploy. She was ambulatow at the scene and
transported by ambulance to Baylor Medical Center at Irving with complaints of scalp laceration and back
pain. A computed tomography (CT) scan of her brain without contrast read, “1. No acute intracranial
abnormality. 2. 3.7 x 0.3 cm subgaleal hematoma overlying the left frontal calvarium. 3. Mild paranasal sinus
disease. Once medically stabilized, she was discharged with a prescription for ibuprofen.
Naydelin Argueta
June 4, 2020
CASE #: 21132198
Page 2 of 5
On May 7, 2020, the patient established care with Momentum Spine & Joint, Dr. David Sheng, MD, with
complaints of severe head pain and cervical, thoracic, and lumbar pain. She reported the pain started
following the April 28, 2018 MVC. She described it as throbbing, pounding, and aching, with radiation from the
low back into the buttocks. It was made worse with house cleaning, lying down, and when sleeping. It was
not made better with anti-inflammatory medication. She denied pain complaints prior the April 28, 2018 MVC.
Her exam was notable for bilateral C5/6, C6/7, T6-T8, L4/5, and L5/S1 facet pain with deep palpation, a positive
facet loading test in the cervical, thoracic, and lumbar spine, a positive Spurling’s test bilaterally, and a
positive straight leg raise on the left. Cervical and lumbar range of motion was limited due to pain. Peripheral
sensation and strength was intact. She was diagnosed with sprain of the cervical, thoracic, and lumbar spine.
She was ordered to undergo MRI of the head, cervical, and lumbar spine and referred to a neurologist for
evaluation of headaches, blurred vision, and dizziness. She was prescribed naproxen and Flexeril for pain relief
and muscle spasms and referred for chiropractic/physiotherapy to evaluate and treat.
MRI brain (May 9, 2020): “Limited study. No evidence of acute intracranial abnormalities.”
MRI cervical spine (May 9, 2020): “1. C3-C4 unchanged posterior central 1.5 mm disc protrusion
(herniation) indents the thecal sac. Central canal and neural foramina are patent. 2. C5-C6 worsening
posterior central 2.0 mm disc protrusion (herniation) indents the thecal sac. Central canal and neural
foramina are patent.”
MRI lumbar spine (May 9, 2020): “L5-S1 worsening posterior central 1.8 mm disc protrusion (herniation)
extends into the epidural fat and indents the thecal sac. Neural foramina are patent.”
Rather than follow-up with Momentum Spine & Joint, the patient established care with Principle Pain and
Health, Dr. Simon Tan, MD and Ronald Kimmel, FNP-C on July 24, 2018. On July 31, 2018, as ordered by Dr. Ryan
Bass, D.C., the patient underwent repeat MRI of the cervical and lumbar spines.
OPINION
I have reviewed all the medical records pertaining to this case including the affidavits provided from
Momentum Spine and Joint and MRI Centers of Texas. My opinions will be based on the treatment and charges
provided by Momentum Spine and Joint and MRI Centers of Texas.
In this case, a previously healthy 15 year-old female was involved in an MVC on April 28, 2018, which resulted in
chronic radiating spine pain. Given the mechanism of her injury and persistent symptoms, I am of the opinion
that it was necessary to have her evaluated by a pain-certified physician. Her symptoms and exam were
consistent with a traumatic cervical spine syndrome – including neck pain, headache, blurred vision, and
dizziness. Additionally, she had low back pain with radiation into her lower extremities and positive nerve
tension signs on exam (straight leg raise), raising concern for neurogenic compromise. Whereas X-ray and CT
images display bony tissue well, MRI can clearly delineate the soft tissues, including nerves, discs, and ligaments.
Identifying pathology in these structures would serve to further diagnose, prognosticate, and direct further
treatment. Therefore, in the context of trauma and pain refractory to conservative management, I am of the
opinion that it was medically indicated and necessary for this patient to be referred for MRI of the brain,
cervical spine, and lumbar spine.
I could not find a reason for repeating an MRI of the cervical and lumbar spine. Sometimes this may be
necessary, especially if there is a neurologic change or new and concerning symptom. However, in the
absence of any supporting documentation, I am of the opinion that it was not medically indicated, nor was it
necessary for this patient to be referred for repeat MRI of the cervical and lumbar spine that was completed
July 31, 2018.
Naydelin Argueta
June 4, 2020
CASE #: 21132198
Page 3 of 5
In regards to charges by Momentum Spine and Joint:
On May 7, 2020, $975.00 was charged for a level 3 new patient visit. A reasonable charge may be
$330.00 – a difference of $645.00.
In regards to the charges by MRI Centers of Texas:
On May 9, 2020 $2,634.00 was charged for a brain MRI. A reasonable charge for this area would be
closer to $2300.00 – a difference of $334.00.
On May 9, 2020 $2,554.00 was charged for a cervical MRI. A reasonable charge for this area would be
closer to $2,400.00 – a difference of $154.00.
On May 9, 2020 $2,634.00 was charged for a lumbar MRI. A reasonable charge for this area would be
closer to $2,400.00 – a difference of $234.00.
I declare that the information contained within this document was prepared and is the work product of the
undersigned, and is true to the best of my knowledge and information.
w
Thank you for the opportunity to review the medical records on Ms. Naydelin Argueta.
Dictated, reviewed, opinion verified, and attested to by my original signature.
Sincerely,
Dustin R. Leek, M.D.
Physical Medicine and Rehabilitation
Pain Medicine
R3129
DRL/kf
The opinions rendered in this case are the opinions of the evaluator. This review has been conducted on the
basis of the medical records provided, with the assumption that the material is true and correct. If more
information becomes available at a later date, an additional service/report/reconsideration may be
requested.
Naydelin Argueta
June 4, 2020
CASE #: 21132198
Page 4 of 5
SUMMARY OF RECORDS
• Crash report – Texas Department of Transportation, Date of accident: April 28, 2018
• Emergency report – Irving Fire Department, Date of service: April 28, 2018
• Hospital records – Baylor Scott and White Medical Center of Irving, Date of service: April 28, 2018
• Examination and treatment notes: Metro Spine Chiropractic, Date of service: June 18, 2018 - September
4, 2018
• Medical notes and consultation – Principle Pain and Health, Date of service: July 24, 2018
• Imaging report – DFW MRI, Date of service: July 24, 2018, X-rays – cervical spine, lumbar spine, and
thoracic spine
• Imaging report – MRI Centers of Texas, Date of service: July 31, 2018, MRI – cervical spine and MRI –
lumbar spine
• Final evaluation – Metro Spine Chiropractic, Date of service: September 4, 2018
• Affidavit of Medical Records – MRI Centers of Texas, September 12, 2018
• Billing Charges Affidavit – MRI Centers of Texas, September 17, 2018
• Affidavit of Medical Records – Metro Spine Accident & Injury Rehab, September 21, 2018
• Billing Charges Affidavit – Metro Spine Accident & Injury Rehab, September 21, 2018
• Affidavit of Medical Records – Irving Fire Department, December 2, 2019
• Billing Charges Affidavit – Change Healthcare TES as Billing Custodian for Irving Department, October
19, 2018
• Affidavit of Medical Records – Dura Medic, LLC, October 2, 2018
• Billing Charges Affidavit – Dura Medic, LLC, October 2, 2018
• Affidavit of Medical Records – DFW Open MRI, September 25, 2018
• Billing Charges Affidavit – DFW Open MRI, September 25, 2018
• Affidavit of Medical Records - Baylor Scott and White Medical Center, January 28, 2020
• Billing Charges Affidavit – Baylor Scott and White Medical Center, October 15, 2018
• Affidavit of Medical Records – Century Integrated Partners, Inc., April 13, 2020
• Billing Charges Affidavit – ASP Cares Pharmacy, October 29, 2018
• Notice of Service of Affidavits and Records, April 15, 2020
• Intervenor’s Responses to Defendant’s Request for Disclosure, April 15, 2020
• Itemized statement – MRI centers of Texas, Date of service: July 31, 2018
• Health Insurance Claim Form – MRI Centers of Texas, Date of service: July 31, 2018
• Itemized statement – Metro Spine Chiropractic, Date of service: June 18, 2018 - September 4, 2018
• Health Insurance Claim Form – City of Irving, Date of service: April 28, 2018
• Itemized statement – City of Irving, Date of service: April 28, 2018
• Itemized statement – Dura Medic, Date of service: April 28, 2018
• Health Insurance Claim Form – DFW Open MRI, Date of service: July 24, 2018
• Itemized statement – Baylor Scott and White Medical Center of Irving, Date of service: April 28, 2018
• Itemized statement – ASP Cares, Date of service: July 24, 2018
• Itemized statement – American Radiology Consultants, Date of service: April 28, 2018
• Momentum Spine & Joint, David Sheng, M.D., 05/07/20
• MRI Centers of Texas, Chad Porter, M.D., 05/09/20, 07/31/18
• Dr. Alex Soberanis, 06/20/18, 06/25/18, 06/27/18, 06/29/18, 07/02/18, 07/09/18, 07/13/18,
• DFW MRI-Referral, 07/17/18
• MetroSpine Chiropractic, Dr. Ryan Bass, 07/18/18, 07/23/18, 07/24/18, 07/25/18, 07/31/18, 08/01/18,
08/02/18, 08/07/18, 08/14/18, 08/15/18, 08/21/18, 08/23/18, 08/29/18, 09/04/18,
• Principle Pain and Health, Ronald Kimmel, D.C., 07/24/18, 08/07/18,
• DFW MRI, Solomon Bierman, M.D., 07/24/18
• Ramin Ansari, M.D., 05/15/20
• Affidavit, Principle Pain & Health, 04/14/20
• Affidavit, MRI Centers of Texas, 05/15/20
Naydelin Argueta
June 4, 2020
CASE #: 21132198
Page 5 of 5
• Affidavit, Momentum Spine & Joint, 05/13/20
• Affidavit, Metrospine Accident & Injury Rehab, 04/07/20
• Affidavit, Lone Star Neurology, 05/21/20
• Affidavit, DFW Open MRI, 04/16/20
• Intervenor’s First Supplemental Responses to Defendant’s Request for Disclosure, 05/22/20
• Plaintiff’s Responses to Defendant’s Requests for Disclosure, undated
• Affidavit, ASP Cares Pharmacy, 05/12/20
• Copy of Identification
• Itemized Statement, Principle Pain and Health, Statement Date, 10/04/18; Dates of Service, 07/24/18-
08/21/18
• Itemized Statement, MRI Centers of Texas, Statement Date, 04/28/18; Dates of Service, 07/31/18-05/09/20
• Itemized Statement, Momentum Spine and Joint, Statement Date, 05/13/20; Dates of Service, 05/07/20
• Health Insurance Claim Form, Lone Star Neurology, 05/15/20
• Itemized Statement, DFW Open MRI, LP, Statement Date, 04/15/20; Dates of Service, 07/24/18
DUSTIN R. LEEK, M.D.
ED UCA TION
201 1-2015 Loma Linda University School of Medicine, Loma Linda, CA
Doctor 0f Medicine ,
earned May 20 1 5.
2007-2011 Southwestern Adventist University (SWAU), Keene ,
TX
BS in Biolog y, magna cum La ude.
POSTDOCTORAL TRAINING
2019 - current Fellow in Pain Medicine
Anticipated Graduation June 2020
University of Texas Southwestern (UTSW) Medical Center
5323 Harry Hines BlVd., Dallas ,
TX 75390
2015 - 20 1 9 Resident in Physical Medicine & Rehabilitation (PM&R)
Graduated June 20 1 9; passed written boards 08/201 9
*due t0 COVID—19 oral boards postponed t0 09/21/2020
,
UTSW Medical Center
5323 Harry Hines BlVd., Dallas ,
TX 75390
LICENSURE & CERTIFICATION
2017 - current Physician Waiver under the Drug Addiction Treatment Act of 2000 (DATA 2000)
2017 - current Federal Drug Enforcement Agency certified, exp . 03/31/2023
2017 - current Full Texas Medical Lice nse, Texas Medical Board, exp. 05/3 1/2021
2016 - current Basic Life Support/Advanced Cardiovascular Life Support certified, exp. 02/2021
PROFESSIONAL MEMBERSHIPS
2018 - current Texas Medical Association
2018 - current American Society ofRegional Anesthesia and Pain Management
2017 - current American Society of Addiction Medicine
2014 — current American Academy 0f Physical Medicine and Rehabi 1i tatio 11
HONORS & A WARDS
2011 SWAU Honors Program Graduate with thesis title, "A Study of Applied Extra—sensory Perceptio n
among Homo sapiens ."
2019 UTSW Senior Resident of the Year
2019 UTSW Special Thanks and Recognition (S.T.A.R.) Award Recipient
RESEARCH
2016 — current Resident Investigator . PI Thiru Annaswamy, MD, Veterans Affairs North Texas Health Care
System :
'
Narrative review evaluating relation between OSA and chronic neck pain
' Retrospective chart review evaluating efficacy ofmisoprostol for management of back
pain due t0 central lum bar stenosis
° "Intraarticular Hyaluronate versus Triamcinolone Inj ections for Lumbar Zygapophyseal
Joint Arthropathy: A Prospective, Randomized, Sham-Injection-Con trolled, Double-
Blind Trial."
Summer 2012 Research Assistant. Edward Tagge, MD, Loma Linda University Medical Center. Through chart
review, compared pain medication use in pediatric patients Who underwent emergent versus
scheduled appendectomies .
QUALITY IMPROVEMENT
2018 - 2019 Cui, C., Leek, D.., and Muffler, A. Improving rate of standing versus bed weights in the inpatient
rehabilitation setting.
20 1 9 - current Formulating peri-operative protocol for management ofbuprenorphine. Invested parties to include
anesthesia, surgery, and pain management with goal of improved pain, discharge outcomes.
PUBLICA TIONS
2018 Yang, J. and Leek, D. "Performing Arts Medicine." Published 02/15/2018 on PM&R Knowledge
Now: https://now.aapm norg/performing—a rts-med icine /
2013 Tagge, E., Natali, E. L., Lima, E., Leek, D., Neece, C., and Randa ll, K. "Psychoneuroimmunology
and the pediatric surgeon." Seminars in Pediatri c Surgery. 20 1 3 22(3): 144-8. ;
EXPERIENCE
2019 - current Physician at Acee) Rehabilitation Hospital 0f Plano, providing PRN weekend coverage for a
forty-two-bed unit; general, neu r010 gic ,
and orthopedic rehabilitation.
230 I Marsh Lane, Plano, TX 75093.
2018 - current Physician at Mesquite Rehabilitation Institute ,
providing PRN weekend coverage for a thirty-
bed unit; general, neu rologic, and orthopedic rehabilitation.
1023 N Belt Line Rd, Mesquit e, TX 75149.
2018 - 2019 Chief Resident, PM&R UTSW. ,
20 1 7 - 20 1 9 Physician at Foundation Medical Group , treating patients With opioid dependence.
8390 LBJ Freeway, Ste 500, Dallas, TX 75243.
2017/03/ 19 Medical Volunteer at the Humana Rock ‘n'
R011 Dallas Half Marathon, Main MedicalTent.
2015-2016 Medical Resident (Intern) at Parkland Health & Hospital System, Dallas TX. Rotations included
Internal Medicine (4 months) Emergency Medicine (4 months), and Trauma Surgery, Neurology
, ,
Neurocritical Care, and Musculoskeletal Radiology (I month each).
INTERESTS & HOBBIES
°
Piano
' Guitar
°
Golf
o
Aquaponics
Preview
FILED 6/18/2020 10:32 AM FELICIA PITRE DISTRICT CLERK DALLAS CO.,TEXAS Jeremy Jones DEPUTY N0. DC-19-11695 DEEJAY LABRADA IN THE DISTRICT COURT PLAINTIFF, AND INTERVENOR MARIA PINEDA, DALLAS COUNTY, TEXAS INDIVIDUALLY, AND As NEXT 0F mmmmmmmmmmmmm FRIEND 0F MINOR N.A. VS. MIRIAM TORRES DEFENDANT. 116TH JUDICIAL DISTRICT DEFENDANT’S SECOND SUPPLEMENTAL RESPONSE T0 INTERVENOR’S REQUEST FOR DISCLOSURE AND DESIGNATION 0F EXPERTS Pursuant t0 TeX R. CiV. P. 194, Defendant serves the following Second Supplemental Response to Intervenor’s Request for Disclosure and Designation 0f Experts. f. For any testifying expert: 1. The expert’s name, address, and telephone number; 2. The subj ect matter on Which the expert Will testify; 3. The general substance 0f the expert’s mental impressions and opinions and a brief summary of the basis for them, or if the expert is not retained by, employed by, 0r otherwise subject to the control 0f the responding party, documents reflecting such information; 4. Ifthe expert is retained by, employed by, 0r otherwise subj ect t0 the control 0f the responding party: A. A11 documents, things, tangible reports, models, 0r data compilations that have been provided t0, reviewed by, 0r prepared by or for the expert in anticipation 0f the expert’s testimony; and B. The expert’s current resume 0r bibliography. Response: Defendant hereby designates and reserves the right t0 call any expert Witness(es) designated by any other party to this case, as well as any experts later designated by any party t0 this case 0n any subject relevant t0 this litigation 0n Which the DEFENDANT’S SECOND SUPPLEMENTAL RESPONSE TO REQUEST FOR DISCLOSURE AND DESIGNATION OF EXPERTS witness is qualified to testify. In the event that any party to this cause has designated any experts but has been or is subsequently dismissed for any reason or fails t0 call any designated expert at the time 0f trial, Defendant specifically reserves the right to call any such expert previously designated by that party. Defendant further reserves the right t0 Withdraw 0r de-designate any expert prior t0 testimony and t0 positively aver that such previously designated expert Will not be called as a witness at trial and to redesignate same as a consulting expert Who Will not be called by any party in this cause. Finally, Defendant reserves the right to supplement this response as additional information concerning experts becomes available. Defendant further hereby designates as adverse expert Witnesses all expert witnesses designated by Intervenor. Defendant reserves the right t0 rely upon 0r t0 offer, by direct examination or cross—examination, testimony obtained from those experts and rebuttal experts, if any, designated by Intervenor. By this designation, Defendant does not necessarily agree with, nor vouch for, the credibility 0f any such Witnesses 0r their opinions, or the reliability, materiality, or admissibility of information and/or tangible things produced by these individuals in general; by this designation Defendant is simply reserving the opportunity t0 rely upon 0r elicit certain opinions and/or evidence from these witnesses t0 the extent that it deems it in its interest t0 d0 s0. Such persons are expected to testify concerning Intervenor’s care and treatment. See Intervenor’s Responses t0 Defendant’s Request for Disclosure for additional information concerning such health-care providers including medical bills and records relating to Intervenor. Second Supplemental Response: Defendant hereby designates as an expert witness the following individual: Dustin R. Leek, MD 5323 Harry Hines Blvd Dallas, Texas 7539 214.6483 1 11 Dr. Leek is a Texas physician and board certified in physical medicine and rehabilitation and pain medicine Who has reviewed Naydelin Argueta’s medical records and other case materials provided t0 him, and is expected to testify regarding the extent of the injuries sustained by the Plaintiff in the subject motor vehicle accident, the appropriate care and treatment for those injuries, and the fair and reasonable cost 0f that treatment, both in the past and in the future, if applicable, as set out in the attached report. DEFENDANT’S SECOND SUPPLEMENTAL RESPONSE TO REQUEST FOR DISCLOSURE AND DESIGNATION OF EXPERTS -2- Respectfully submitted, CQLQ? Chad Kimble, StateBar N0. 24007483 Kyle Smith, State Bar No. 24102512 D. Brent Beasley, State Bar No. 24082669 LAW OFFICE 0F CHAD KIMBLE, P.C. 1204 S. White Chapel Blvd. Southlake, Texas 76092 eservice@chadkimblelaw.com 817.766.7488 817.423.7492 fax ATTORNEY FOR DEFENDANT CERTIFICATE 0F SERVICE The undersigned certifies that 0n the 18th day of June, 2020, a true copy 0f the foregoing has been served 0n all patties in accordance With Rule 21a, Texas Rules of Civil Procedure. CQW Chad Kimble DEFENDANT’S SECOND SUPPLEMENTAL RESPONSE TO REQUEST FOR DISCLOSURE AND DESIGNATION OF EXPERTS -3- DUSTIN R. LEEK, M.D. 12001 N. CENTRAL EXPRESSWAY PHYSICAL MEDICINE AND REHABILITATION SUITE 800 PAIN MEDICINE DALLAS, TX 75243 (214) 750—61 10 FAX - (214) 750-5825 June 4, 2020 Mr.Chad Kimble Law Office of Chad Kimble, PC 1204 S. White Chapel Blvd. Southlake, TX 76092 RE: Naydelin Argueta CLAIM #: 0500530647.1 DATE OF INJURY: 04/28/18 CASE #2 21 132198 Dear Mr. Kimble: | have had the opportunity to review medical records on Ms. Naydelin Argueta. | have been fully licensed to practice medicine in Texas since 2017. In that time, completed a 4-year residency | in Physical Medicine & Rehabilitation (PM&R), a year of which included serving as Chief Resident. After this, | began accredited sub-specialty training in the field of Pain Management. In addition, have gained | experience through maintaining extracurricular part-time employment at two separate community inpatient rehabilitation facilities and another outpatient clinic focused on the treatment of patients with opioid dependence. The practice of PM&R (and Pain Management) routinely involves caring for patients with disease or injury to musculoskeletal and/or neurological systems and can require the use of radiological imaging, electrodiagnosis, physical therapy, medications, injections, and other modalities. have personally ordered,| performed, and reviewed these diagnostic and treatment interventions on thousands of patients. Therefore, | am an expert in the evaluation and treatment aspects of this case. My training across multiple practice settings, including private, county, and federal hospitals has provided me with an acute awareness 0f medical costs, both to the patient and to the system. Even now as transition | from academics and part-time extra-curricular employment to a 100% private practice model for PM&R/Pain Management, have spent considerable effort dedicated to the understanding of local market trends and | (medical) business modeling with the goal of running a fair and competitive practice. As a result, feel | confident in deciphering what is a reasonable charge and what is not. “Reasonable amounts” are determined based on this experience and my current fee schedule, and have been additionally cross-referenced to the usual, customary, and reasonable fees outlined in Medical Fees Directory, edited and published by James Davis, 2020. SUMMARY OF MEDICAL RECORDS The patient was and previously healthywhen on April 28, 2018, she was involved in a motor vehicle 15 years old She was a restrained passenger in the passenger-side rear seat. Her vehicle was impacted on collision (IVNC). the passenger side and tipped over. Airbags did not deploy. She was ambulatow at the scene and transported by ambulance to Baylor Medical Center at Irving with complaints of scalp laceration and back pain. A computed tomography (CT) scan of her brain without contrast read, “1. No acute intracranial abnormality. 2. 3.7 x 0.3 cm subgaleal hematoma overlying the left frontal calvarium. 3. Mild paranasal sinus disease. Once medically stabilized, she was discharged with a prescription for ibuprofen. Naydelin Argueta June 4, 2020 CASE #: 21132198 Page 2 of 5 On May 7, 2020, the patient established care with Momentum Spine & Joint, Dr. David Sheng, MD, with complaints of severe head pain and cervical, thoracic, and lumbar pain. She reported the pain started following the April 28, 2018 MVC. She described it as throbbing, pounding, and aching, with radiation from the low back into the buttocks. It was made worse with house cleaning, lying down, and when sleeping. It was not made better with anti-inflammatory medication. She denied pain complaints prior the April 28, 2018 MVC. Her exam was notable for bilateral C5/6, C6/7, T6-T8, L4/5, and L5/S1 facet pain with deep palpation, a positive facet loading test in the cervical, thoracic, and lumbar spine, a positive Spurling’s test bilaterally, and a positive straight leg raise on the left. Cervical and lumbar range of motion was limited due to pain. Peripheral sensation and strength was intact. She was diagnosed with sprain of the cervical, thoracic, and lumbar spine. She was ordered to undergo MRI of the head, cervical, and lumbar spine and referred to a neurologist for evaluation of headaches, blurred vision, and dizziness. She was prescribed naproxen and Flexeril for pain relief and muscle spasms and referred for chiropractic/physiotherapy to evaluate and treat. MRI brain (May 9, 2020): “Limited study. No evidence of acute intracranial abnormalities.” MRI cervical spine (May 9, 2020): “1. C3-C4 unchanged posterior central 1.5 mm disc protrusion (herniation) indents the thecal sac. Central canal and neural foramina are patent. 2. C5-C6 worsening posterior central 2.0 mm disc protrusion (herniation) indents the thecal sac. Central canal and neural foramina are patent.” MRI lumbar spine (May 9, 2020): “L5-S1 worsening posterior central 1.8 mm disc protrusion (herniation) extends into the epidural fat and indents the thecal sac. Neural foramina are patent.” Rather than follow-up with Momentum Spine & Joint, the patient established care with Principle Pain and Health, Dr. Simon Tan, MD and Ronald Kimmel, FNP-C on July 24, 2018. On July 31, 2018, as ordered by Dr. Ryan Bass, D.C., the patient underwent repeat MRI of the cervical and lumbar spines. OPINION I have reviewed all the medical records pertaining to this case including the affidavits provided from Momentum Spine and Joint and MRI Centers of Texas. My opinions will be based on the treatment and charges provided by Momentum Spine and Joint and MRI Centers of Texas. In this case, a previously healthy 15 year-old female was involved in an MVC on April 28, 2018, which resulted in chronic radiating spine pain. Given the mechanism of her injury and persistent symptoms, I am of the opinion that it was necessary to have her evaluated by a pain-certified physician. Her symptoms and exam were consistent with a traumatic cervical spine syndrome – including neck pain, headache, blurred vision, and dizziness. Additionally, she had low back pain with radiation into her lower extremities and positive nerve tension signs on exam (straight leg raise), raising concern for neurogenic compromise. Whereas X-ray and CT images display bony tissue well, MRI can clearly delineate the soft tissues, including nerves, discs, and ligaments. Identifying pathology in these structures would serve to further diagnose, prognosticate, and direct further treatment. Therefore, in the context of trauma and pain refractory to conservative management, I am of the opinion that it was medically indicated and necessary for this patient to be referred for MRI of the brain, cervical spine, and lumbar spine. I could not find a reason for repeating an MRI of the cervical and lumbar spine. Sometimes this may be necessary, especially if there is a neurologic change or new and concerning symptom. However, in the absence of any supporting documentation, I am of the opinion that it was not medically indicated, nor was it necessary for this patient to be referred for repeat MRI of the cervical and lumbar spine that was completed July 31, 2018. Naydelin Argueta June 4, 2020 CASE #: 21132198 Page 3 of 5 In regards to charges by Momentum Spine and Joint: On May 7, 2020, $975.00 was charged for a level 3 new patient visit. A reasonable charge may be $330.00 – a difference of $645.00. In regards to the charges by MRI Centers of Texas: On May 9, 2020 $2,634.00 was charged for a brain MRI. A reasonable charge for this area would be closer to $2300.00 – a difference of $334.00. On May 9, 2020 $2,554.00 was charged for a cervical MRI. A reasonable charge for this area would be closer to $2,400.00 – a difference of $154.00. On May 9, 2020 $2,634.00 was charged for a lumbar MRI. A reasonable charge for this area would be closer to $2,400.00 – a difference of $234.00. I declare that the information contained within this document was prepared and is the work product of the undersigned, and is true to the best of my knowledge and information. w Thank you for the opportunity to review the medical records on Ms. Naydelin Argueta. Dictated, reviewed, opinion verified, and attested to by my original signature. Sincerely, Dustin R. Leek, M.D. Physical Medicine and Rehabilitation Pain Medicine R3129 DRL/kf The opinions rendered in this case are the opinions of the evaluator. This review has been conducted on the basis of the medical records provided, with the assumption that the material is true and correct. If more information becomes available at a later date, an additional service/report/reconsideration may be requested. Naydelin Argueta June 4, 2020 CASE #: 21132198 Page 4 of 5 SUMMARY OF RECORDS • Crash report – Texas Department of Transportation, Date of accident: April 28, 2018 • Emergency report – Irving Fire Department, Date of service: April 28, 2018 • Hospital records – Baylor Scott and White Medical Center of Irving, Date of service: April 28, 2018 • Examination and treatment notes: Metro Spine Chiropractic, Date of service: June 18, 2018 - September 4, 2018 • Medical notes and consultation – Principle Pain and Health, Date of service: July 24, 2018 • Imaging report – DFW MRI, Date of service: July 24, 2018, X-rays – cervical spine, lumbar spine, and thoracic spine • Imaging report – MRI Centers of Texas, Date of service: July 31, 2018, MRI – cervical spine and MRI – lumbar spine • Final evaluation – Metro Spine Chiropractic, Date of service: September 4, 2018 • Affidavit of Medical Records – MRI Centers of Texas, September 12, 2018 • Billing Charges Affidavit – MRI Centers of Texas, September 17, 2018 • Affidavit of Medical Records – Metro Spine Accident & Injury Rehab, September 21, 2018 • Billing Charges Affidavit – Metro Spine Accident & Injury Rehab, September 21, 2018 • Affidavit of Medical Records – Irving Fire Department, December 2, 2019 • Billing Charges Affidavit – Change Healthcare TES as Billing Custodian for Irving Department, October 19, 2018 • Affidavit of Medical Records – Dura Medic, LLC, October 2, 2018 • Billing Charges Affidavit – Dura Medic, LLC, October 2, 2018 • Affidavit of Medical Records – DFW Open MRI, September 25, 2018 • Billing Charges Affidavit – DFW Open MRI, September 25, 2018 • Affidavit of Medical Records - Baylor Scott and White Medical Center, January 28, 2020 • Billing Charges Affidavit – Baylor Scott and White Medical Center, October 15, 2018 • Affidavit of Medical Records – Century Integrated Partners, Inc., April 13, 2020 • Billing Charges Affidavit – ASP Cares Pharmacy, October 29, 2018 • Notice of Service of Affidavits and Records, April 15, 2020 • Intervenor’s Responses to Defendant’s Request for Disclosure, April 15, 2020 • Itemized statement – MRI centers of Texas, Date of service: July 31, 2018 • Health Insurance Claim Form – MRI Centers of Texas, Date of service: July 31, 2018 • Itemized statement – Metro Spine Chiropractic, Date of service: June 18, 2018 - September 4, 2018 • Health Insurance Claim Form – City of Irving, Date of service: April 28, 2018 • Itemized statement – City of Irving, Date of service: April 28, 2018 • Itemized statement – Dura Medic, Date of service: April 28, 2018 • Health Insurance Claim Form – DFW Open MRI, Date of service: July 24, 2018 • Itemized statement – Baylor Scott and White Medical Center of Irving, Date of service: April 28, 2018 • Itemized statement – ASP Cares, Date of service: July 24, 2018 • Itemized statement – American Radiology Consultants, Date of service: April 28, 2018 • Momentum Spine & Joint, David Sheng, M.D., 05/07/20 • MRI Centers of Texas, Chad Porter, M.D., 05/09/20, 07/31/18 • Dr. Alex Soberanis, 06/20/18, 06/25/18, 06/27/18, 06/29/18, 07/02/18, 07/09/18, 07/13/18, • DFW MRI-Referral, 07/17/18 • MetroSpine Chiropractic, Dr. Ryan Bass, 07/18/18, 07/23/18, 07/24/18, 07/25/18, 07/31/18, 08/01/18, 08/02/18, 08/07/18, 08/14/18, 08/15/18, 08/21/18, 08/23/18, 08/29/18, 09/04/18, • Principle Pain and Health, Ronald Kimmel, D.C., 07/24/18, 08/07/18, • DFW MRI, Solomon Bierman, M.D., 07/24/18 • Ramin Ansari, M.D., 05/15/20 • Affidavit, Principle Pain & Health, 04/14/20 • Affidavit, MRI Centers of Texas, 05/15/20 Naydelin Argueta June 4, 2020 CASE #: 21132198 Page 5 of 5 • Affidavit, Momentum Spine & Joint, 05/13/20 • Affidavit, Metrospine Accident & Injury Rehab, 04/07/20 • Affidavit, Lone Star Neurology, 05/21/20 • Affidavit, DFW Open MRI, 04/16/20 • Intervenor’s First Supplemental Responses to Defendant’s Request for Disclosure, 05/22/20 • Plaintiff’s Responses to Defendant’s Requests for Disclosure, undated • Affidavit, ASP Cares Pharmacy, 05/12/20 • Copy of Identification • Itemized Statement, Principle Pain and Health, Statement Date, 10/04/18; Dates of Service, 07/24/18- 08/21/18 • Itemized Statement, MRI Centers of Texas, Statement Date, 04/28/18; Dates of Service, 07/31/18-05/09/20 • Itemized Statement, Momentum Spine and Joint, Statement Date, 05/13/20; Dates of Service, 05/07/20 • Health Insurance Claim Form, Lone Star Neurology, 05/15/20 • Itemized Statement, DFW Open MRI, LP, Statement Date, 04/15/20; Dates of Service, 07/24/18 DUSTIN R. LEEK, M.D. ED UCA TION 201 1-2015 Loma Linda University School of Medicine, Loma Linda, CA Doctor 0f Medicine , earned May 20 1 5. 2007-2011 Southwestern Adventist University (SWAU), Keene , TX BS in Biolog y, magna cum La ude. POSTDOCTORAL TRAINING 2019 - current Fellow in Pain Medicine Anticipated Graduation June 2020 University of Texas Southwestern (UTSW) Medical Center 5323 Harry Hines BlVd., Dallas , TX 75390 2015 - 20 1 9 Resident in Physical Medicine & Rehabilitation (PM&R) Graduated June 20 1 9; passed written boards 08/201 9 *due t0 COVID—19 oral boards postponed t0 09/21/2020 , UTSW Medical Center 5323 Harry Hines BlVd., Dallas , TX 75390 LICENSURE & CERTIFICATION 2017 - current Physician Waiver under the Drug Addiction Treatment Act of 2000 (DATA 2000) 2017 - current Federal Drug Enforcement Agency certified, exp . 03/31/2023 2017 - current Full Texas Medical Lice nse, Texas Medical Board, exp. 05/3 1/2021 2016 - current Basic Life Support/Advanced Cardiovascular Life Support certified, exp. 02/2021 PROFESSIONAL MEMBERSHIPS 2018 - current Texas Medical Association 2018 - current American Society ofRegional Anesthesia and Pain Management 2017 - current American Society of Addiction Medicine 2014 — current American Academy 0f Physical Medicine and Rehabi 1i tatio 11 HONORS & A WARDS 2011 SWAU Honors Program Graduate with thesis title, "A Study of Applied Extra—sensory Perceptio n among Homo sapiens ." 2019 UTSW Senior Resident of the Year 2019 UTSW Special Thanks and Recognition (S.T.A.R.) Award Recipient RESEARCH 2016 — current Resident Investigator . PI Thiru Annaswamy, MD, Veterans Affairs North Texas Health Care System : ' Narrative review evaluating relation between OSA and chronic neck pain ' Retrospective chart review evaluating efficacy ofmisoprostol for management of back pain due t0 central lum bar stenosis ° "Intraarticular Hyaluronate versus Triamcinolone Inj ections for Lumbar Zygapophyseal Joint Arthropathy: A Prospective, Randomized, Sham-Injection-Con trolled, Double- Blind Trial." Summer 2012 Research Assistant. Edward Tagge, MD, Loma Linda University Medical Center. Through chart review, compared pain medication use in pediatric patients Who underwent emergent versus scheduled appendectomies . QUALITY IMPROVEMENT 2018 - 2019 Cui, C., Leek, D.., and Muffler, A. Improving rate of standing versus bed weights in the inpatient rehabilitation setting. 20 1 9 - current Formulating peri-operative protocol for management ofbuprenorphine. Invested parties to include anesthesia, surgery, and pain management with goal of improved pain, discharge outcomes. PUBLICA TIONS 2018 Yang, J. and Leek, D. "Performing Arts Medicine." Published 02/15/2018 on PM&R Knowledge Now: https://now.aapm norg/performing—a rts-med icine / 2013 Tagge, E., Natali, E. L., Lima, E., Leek, D., Neece, C., and Randa ll, K. "Psychoneuroimmunology and the pediatric surgeon." Seminars in Pediatri c Surgery. 20 1 3 22(3): 144-8. ; EXPERIENCE 2019 - current Physician at Acee) Rehabilitation Hospital 0f Plano, providing PRN weekend coverage for a forty-two-bed unit; general, neu r010 gic , and orthopedic rehabilitation. 230 I Marsh Lane, Plano, TX 75093. 2018 - current Physician at Mesquite Rehabilitation Institute , providing PRN weekend coverage for a thirty- bed unit; general, neu rologic, and orthopedic rehabilitation. 1023 N Belt Line Rd, Mesquit e, TX 75149. 2018 - 2019 Chief Resident, PM&R UTSW. , 20 1 7 - 20 1 9 Physician at Foundation Medical Group , treating patients With opioid dependence. 8390 LBJ Freeway, Ste 500, Dallas, TX 75243. 2017/03/ 19 Medical Volunteer at the Humana Rock ‘n' R011 Dallas Half Marathon, Main MedicalTent. 2015-2016 Medical Resident (Intern) at Parkland Health & Hospital System, Dallas TX. Rotations included Internal Medicine (4 months) Emergency Medicine (4 months), and Trauma Surgery, Neurology , , Neurocritical Care, and Musculoskeletal Radiology (I month each). INTERESTS & HOBBIES ° Piano ' Guitar ° Golf o Aquaponics