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Rosner defense witnesses strongly defend his work

Neurosurgeon Peter J. Jannetta testifies in the Justus v. Rosner trial.

Witnesses called by the defense team for Dr. Michael Rosner strongly defended the neurosurgeon's work at Park Ridge Hospital, the hospital's vetting of his background and the overall supervision of his work.

 

As the Justus v. Rosner medical malpractice trial entered its fifth week on Monday, attorneys for the neurosurgeon, Park Ridge and its corporate parent, Adventist Health System, called a parade of witnesses to rebut the plaintiff's case.
The lawsuit brought by Billy Bruce Justus on behalf of his wife, Pamela Justus, is the first of 33 pending lawsuits against Rosner to reach a jury trial. The trial started on Aug. 11 in Henderson County Superior Court. Justus's team of five lawyers put on testimony to support their argument that in June 2000 Rosner performed unnecessary surgery on Pam Justus that left her immobile and contributed to her death 12 years later at age 58.
Defense attorneys argue that Pam Justus suffered from multiple serious medical problems all her adult life and that her death in September 2012 arose from those, not the neurosurgeon's operations 12 years earlier. The testimony of renowned neurosurgeons, hospital administrators and other medical experts has undergirded the defense case that Rosner's surgery on Pam Justus was a medically warranted operation commonly performed to reduce pressure on her spinal column and relieve pain and other symptoms.

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Last week, defense witness Dr. Peter J. Jannetta, a pioneer of microvascular decompression surgery and past Nobel Prize nominee, testified for several hours about Rosner's surgeries. A strong ally of the Fletcher neurosurgeon, Jannetta supported Rosner professionally and went to him for help for his own daughter. Rosner operated on Jannetta's daughter, Carol, in 2000.
During the North Carolina Medical Board's investigation of Rosner, in January 2003, Jannetta confirmed that he had reviewed patient charts and Rosner's interpretation of MRIs. Later, when he did review the films, his interpretation matched Dr. Rosner's, Jennetta said under questioning from Phillip Jackson, an attorney for Park Ridge.
"I was willing (to say so) and was not allowed to testify," he said.
A year later, in 2004, he did testify during a Medical Board hearing, saying that Rosner's surgeries on Pam Justus were "indicated" — justified by the medical evidence — and appropriate. Rosner had good reason to recommend a cervical spine decompression when he treated Pam Justus in June 2000, Jannetta said.
"She had evidence of myelopathy and corroborative evidence on her MRI scan — they were compatible," he said.
In his cross examination of Dr. Jannetta, plaintiff's attorney Wade Byrd asked the surgeon if knew that the state Medical Board had revoked Rosner's license.
"Shame on North Carolina," he answered. "They're lucky to have him."
Although he had not seen the MRIs from the eight patients the Medical Board said had received unnecessary surgeries, Jannetta testified that Rosner's surgeries were justified and medically indicated.
"I've seen their records," he said. "I thought it was appropriate and I think so now."

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Under questioning by Jackson, Jannetta said he saw no evidence that Rosner was treating fibromyalgia or chronic fatigue syndrome. "Never mentioned it," he said.
The plaintiffs argue that Rosner, Park Ridge and Adventist Health system engaged in a "civil conspiracy" to promote Rosner's surgeries by suggesting that the procedures had successfully treated fibromyalgia. The surgeries, the plaintiffs argue, should have been treated as experimental and subjected to an independent review board. The defense has rebutted that assertion repeatedly through a variety of experts.
The surgery Dr. Rosner performed in 2000 on Pam Justus, Jannetta testified, "was not research" but was in fact warranted by her symptoms and suggested by her MRI. It was a well-performed operation, he said, and Rosner had used his best judgment in the treatment and care of the patient.
Rosner's attorney, Scott Stevenson, held up the neurosurgeon's operating room notes that he said confirmed the MRI image. In the notes, Rosner wrote that he repaired a tonsil that pressed on Justus's medulla.
"This tonsil adhered to the medulla, compressing the medulla — does that then, from your mind, substantiate that Dr. Rosner was absolutely correct in his diagnosis and treatment of Pam Justus?"
"Yes," Jannetta said.

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The defense team also bolstered its argument that Park Ridge and its parent, Adventist, had acted strictly by the book in the hiring and monitoring of Rosner.
James W. Albright, who had been CEO of Bayfront Medical Center in St. Petersburg, Fla., and Rex Hospital in Raleigh, testified on Monday that Park Ridge had done everything right when it initially credentialed Dr. Rosner in 1999.
"I was very impressed by the process at Park Ridge Hospital," Albright said. "The bylaws and rules and regulations were very complete, very inclusive."
Instead of neglecting to fully investigate Rosner's past service and the circumstances of four malpractice lawsuits patients brought when he practiced at the University of Alabama at Birmingham, as the plaintiffs argue, Albright said Park Ridge had carefully vetted the surgeon.
"In general terms," he said, "there was an exhaustive amount of reaching out to find out what was in the background of Dr. Rosner."

 

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The defense caught a discrepancy in a plaintiff's exhibit, a blowup of a Park Ridge website promotion of Dr. Rosner's surgeries. One sentence of the text said Rosner's surgeries successfully treated a pain syndrome. The website actually said "symptoms" and not "syndrome," Jackson noted as he questioned Albright.
"I think it's significantly significant," Albright said. "If you have symptoms it could come from any syndrome or any disease. ...
"That meant so much to me when I saw that because the case is being argued over syndrome" — the plaintiff's argument that Rosner and Park Ridge promoted his surgeries as a groundbreaking treatment for chronic fatigue syndrome — "but it's really symptoms that Dr. Rosner has been treating, that are similar to people that have the syndrome," Albright said.
Jackson also got Albright to respond to a part of the plaintiff's case intended to show that the Adventist Health System took an active role in promoting Rosner and his innovative surgeries. The plaintiffs had called to the stand a public relations specialist in crisis management who helped Rosner prepare for an interview on "20-20," a television news magazine.
That was not only unusual, Albright said, but also appropriate and "good management."
"Whoever you put in front of a newspaper reporter, a television reporter, a magazine writer, especially if it might have some kind of controversy, it's fair to your organization but it's also fair to the individual involved to have some type of training," he said. "So I think it was a very good decision to have that training done, not to influence what was going to be said but to influence how it was said."
The defense team has also chipped away at the plaintiff's suggestion that accounted for an unusually high percentage of Park Ridge income from 2000 to 2003.
Rosner had a high "contribution margin" because neurosurgeries pay more than other general surgery, Albright said.
"I could have predicted that once he came on board," he added. "There are certain subspecialties that do generate more income."