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AAOS Now

Published 11/1/2008
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Peter J. Mandell, MD

Board takes professional compliance action

At its meeting on Sept. 13, 2008, the AAOS Board of Directors considered a grievance filed under the AAOS Professional Compliance Program. After considering the information presented and the recommendations of the Hearing Panel of the Committee on Profession­alism (COP) and the Judiciary Committee, the Board suspended Jonathan A. Lewis, MD, for 1 year for violations of Mandatory Standards 2, 3, 4, and 7 of the Standards of Professionalism (SOPs) on Orthopaedic Expert Witness Testimony.

Jonathan A. Lewis, MD
Edinburg, Texas
1-year suspension

On July 10, 2007, a grievance was filed against Dr. Lewis alleging violations of the Mandatory Standards 2, 3, 4, 6, and 7 of the SOPs on Orthopaedic Expert Witness Testimony. The grievance arose from statements made by Dr. Lewis during his testimony as the patient/plaintiff’s medical expert in a lawsuit. In the court case, the patient/plaintiff alleged that the defendant/orthopaedic surgeon failed to adequately perform the technical aspects of a scapholunate capitate fusion, leading to the need for further surgical management and disability. In September 2006, the jury found in favor of the defendant/orthopaedic surgeon.

In March 2008, the COP Hearing Panel conducted a grievance hearing at which Dr. Lewis did not appear. The panel found that Dr. Lewis had violated Mandatory Standards 2, 3, 4, and 7 of the AAOS SOPs on Orthopaedic Expert Witness Testimony, but not Mandatory Standard 6. The COP Hearing Panel recommended that Dr. Lewis be suspended from the AAOS for 1 year.

In making its recommendation, the panel considered Dr. Lewis’s deposition and written report. The COP Grievance Hearing Report found that, during his deposition, Dr. Lewis adopted a role of strong advocacy for the plaintiff, frequently using the terms “definitely” and “absolutely.” Dr. Lewis also criticized the defendant/orthopaedic surgeon for presenting multiple options to the patient. The COP Hearing Panel, on the contrary, found that orthopaedic surgeons should present sufficient information to the patient to permit him or her to select the best treatment option.

In addition, the COP Hearing Panel found that the written report authored by Dr. Lewis for this case stated that the defendant/orthopaedic surgeon’s “failure” to take down the lunocapitate joint was below the standard of care; Dr. Lewis repeated this opinion in his deposition. He also advocated the use of a bone scan for intercarpal ligament injury, suggesting that the defendant/orthopaedic surgeon’s failure to order the study represented poor medical practice. The hand surgery literature does not support this position.

During his deposition, Dr. Lewis refused to address plain radiograph and computed tomography (CT) findings. This evidence was a critical component of the case and multiple questions focused on Dr. Lewis’ interpretation of CT scans and radiographs. Dr. Lewis’ responses to these questions were evasive; in essence, he abdicated responsibility as an expert witness in failing to address this material. Consequently, in his function as an expert witness, Dr. Lewis did not fulfill his obligation to assess the critical information in the case.

Dr. Lewis appealed the recommendations of the COP Hearing Panel and in July 2008, the Judiciary Committee conducted an appeals hearing. Dr. Lewis was not present. A document was submitted by his attorney. The Judiciary Committee unanimously determined that due process had been afforded to Dr. Lewis and that the clear weight of evidence supported the COP Hearing Panel’s recommendations.

On Sept. 13, 2008, the AAOS Board of Directors considered this matter. Dr. Lewis was not in attendance, but an audiovisual presentation was sent by his attorney and viewed by board members. After careful deliberation and discussion, the Board upheld the findings and recommendations of the COP Hearing Panel and Judiciary Committee and voted to suspend Jonathan A. Lewis, MD, for 1 year because of unprofessional conduct in the performance of expert witness testimony.

The Board found that Dr. Lewis had violated Mandatory Standards 2, 3, 4, and 7 of the AAOS SOPs on Orthopaedic Expert Witness Testimony:

2. An orthopaedic expert witness shall provide opinions and/or factual testimony in a fair and impartial manner.

3. An orthopaedic expert witness shall evaluate the medical condition and care provided in light of generally accepted standards at the time, place, and in the context of care delivered.

4. An orthopaedic expert witness shall neither condemn performance that falls within generally accepted practice standards nor endorse or condone performance that falls outside these standards.

5. An orthopaedic expert witness shall have knowledge and experience about the standard of care and the available scientific evidence for the condition in question during the relevant time, place, and in the context of medical care provided and shall respond accurately to questions about the standard of care and the available scientific evidence.

Peter J. Mandell, MD, is chair of the Committee on Professionalism.