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ANATOMY FOR LITIGATORS - By Samuel D. Hodge, Jr., Esq.
A Book Review by Holly B. Haines
The title of this book is misleading. The book should be called “Anatomy for Defense Attorneys”, because almost every chapter ends with litigation tips for defense attorneys to defeat causation in personal injury, worker’s compensation and disability claims. Overall, however, this book is a very useful, solid primer on limited areas of human anatomy, and I would highly recommend it to any younger lawyer beginning a career in personal injury, worker’s compensation, social security, or insurance defense work, or any more experienced litigator seeking a quick refresher on limited aspects of human anatomy, a litigation checklist, or a jury verdict analysis of specific personal injury claims.
The author, Samuel D. Hodge, Jr., is Professor of Law at Temple University and an experienced trial attorney in Philadelphia, Pennsylvania. Professor Hodge says that he wrote this book for attorneys who want to understand the basics of human anatomy and to help attorneys understand the medico-legal issues involved in personal injury claims. Professor Hodge achieves these purposes in his book, but the scope of the book is limited to the most commonly injured areas of the body and the most common personal injury claims. Anyone involved in more complex personal injury litigation or medical malpractice cases would be better served by referring to more authoritative anatomy texts or educational medical texts in the specialty area in which an injury claim resides.
The beginning and ending chapters of the book are the most useful to all practitioners, as they provide the most litigation tips for pursuing and defending injury claims. The book begins with a solid overview of human anatomy, summarizing all of the systems of the human body and providing interesting historical anecdotes. There are hundreds of illustrations in this book, most which are very simple and drawn in pen and ink, that are useful to learn the parts of the body, but that would not be particularly impressive standing alone in front of a jury.
Professor Hodge provides a very simple, plain written lesson on how to request, organize and interpret medical records. He aptly recognizes the irony between the difficulties inherent in obtaining and interpreting medical records and the regulations that mandate that medical records be created and maintained whenever a patient receives treatment. He discusses the non-uniformity of medical provider record keeping, abbreviations, handwritten comments and diagnostic codes, and provides tips for how to organize and interpret the records. Professor Hodge also provides tips on how to decipher ICD codes and health insurance billing statements to determine what treatments a patient actually received. He further analyzes the different motivations and reasons that plaintiff and defense counsel need medical records and what each counsel should seek within the shadows of the records they receive. Finally, Professor Hodge discusses the different preexisting conditions that can be discovered with a careful analysis of pharmacy and medical records - - or, an analysis of how defense attorneys can defeat or discount a plaintiff’s claim.
In addition to the helpful hints he provides for reading medical records, Professor Hodge discusses the different types of investigation that counsel should conduct into the background of each treating physician. He briefly touches on licensing and credentialing issues, and provides web sites to aid counsel in their investigation. He further provides basic, but non-authoritative, internet references and tips for how to conduct medical research for personal injury claims and how to find illustrations and trial exhibits for use in prosecuting or defending such claims. Unfortunately, he does not incorporate these highly recommended illustrations for use in his book.
Professor Hodge provides a very useful primer on the different types of diagnostic imaging and their limitations, and his defense bias radiates throughout this discussion. Professor Hodge actually seems to advocate for less diagnostic testing of patients who present for medical treatment after a traumatic injury because Athe taking of an x-ray only encourages the patient’s belief that he or she is not well. He opines that abnormal findings on films are not usually clinically significant and provides several limited population studies to support this assertion. He further discusses what x-rays can tell the defense and provides a survey of different legal challenges to the tests and their result validity. Despite the glaring defense bias, this primer on diagnostic imaging does provide an overview of almost every different type of diagnostic test, their purposes and uses, and when they are indicated. This primer is a useful reference to any attorney who seeks a concise explanation of the different nuclear scans and tests available and their limitations.
The remainder of the book is a solid anatomy primer, but its primary focus is on fractures, sprains and strains more than it is on serious medical conditions. The author acknowledges that the focus of the book is on the most common workplace injuries and personal injuries from falls and motor vehicle accidents. The anatomy lessons provided are on the bones, the back, the chest, the shoulder, the hand, the hip, the knee, the ankle, the foot, and the tooth -- a chapter that seemed very out-of-place and written solely because it is an academic legal interest of the author or a focus of his practice for claims he defends. Each chapter explains how to use a claimant=s risk factors or preexisting medical conditions to defeat causation or discount the severity of the injury claimed. In addition to the defense tips provided, there are numerous non-authoritative references and websites for further information, case examples, and a brief analysis of jury verdicts and settlements for each type of injury to the body part being discussed.
The most interesting chapters in the book are those at the end that discuss the independent medical examination or (IME), which the author acknowledges is colloquially called Athe defense physical. Professor Hodge provides a detailed explanation for how attorneys should determine when an IME is really necessary and he analyzes the legal considerations that are involved whenever an IME occurs. He notes that while an IME is a good snapshot of the plaintiff’s condition at a moment in time and is very useful to objectively discount a plaintiff’s subjective complaints, it can also be a snapshot that ends up substantiating all of the plaintiff’s claims or enhancing injuries that are benignly described in the medical records. The book ends with a detailed verbal and pictorial orthopedic IME exam, including all of the questions that must be asked and all of the tests that must be performed for the test to be completed. This chapter is particularly useful to a plaintiff’s counsel who videotapes or attends an IME to ensure that all tests are administered correctly and that all appropriate information is gathered to ensure an independent examination result.
All in all, this is a solid, but non-authoritative, anatomy book with useful tips for young litigators or for more experienced litigators with a general practice who do not exclusively practice in the injury and disability arena. While the book is definitely biased and focused on how to defend injury and disability claims, this focus is actually useful for a plaintiff’s lawyer to review so they can prepare their cases with the defense perspective at the forefront of their minds. Experienced practitioners or practitioners who deal with more complex injury claims will likely be very disappointed with this book, as it is non-authoritative and limited in both scope and application, but it would be a great book to give to a young associate beginning their practice to allow them to hit the ground running with their personal injury career.