This case takes place in Delaware and involves a middle-aged female who developed blood clots after taking a range of dietary supplements, using both hormonal controls and the popularized tropical Garcinia Cambogia supplement. After purchasing a packet of the hormonal pills, she proceeded to take them as directed by the instructions. After a few weeks of taking the pills, the patient presented to the ER with severe stomach pain. She was diagnosed with blood clots, loss of oxygen, and lack of blood to the spleen. She required an extensive stay at the hospital and was treated with blood thinners, which she now requires on a permanent basis. The plaintiff alleges that the hormones contained in the supplement raised her susceptibility to blood clots and hypercoagulability, causing a host of complications.

I am familiar with this particular supplement. There is little evidence of its efficacy, and also relatively little evidence of it having side effects. Although androgens can enhance clotting, I have never seen nor heard of a case in which the clots are attributed to this drug. As a hematologist, I have used androgens both to treat Aplastic anemia and as replacement therapy in the past. That said, I would be happy to review this matter in more detail, including the patient’s medical records and history, to determine if there's a causal link between the supplement and the clotting described.

1. Do you have experience working with patients who've experienced complications from the DHEA hormone? 2. Are blood clots a common complication from taking the DHEA hormone? What other issues can potentially arise? 3. Have you ever served as an expert witness on a case similar to the one described above? If so, please explain. 4. Please tell us why you’re qualified to serve as an expert reviewer of this case.

Located in: Maryland B.A., Harvard College M.D., Johns Hopkins University Residency, Department of Medicine, Johns Hopkins University Fellowship, Hematology, Johns Hopkins University Board Certified, American Board of Pathology Board Certified, American Board of Pathology - Blood Banking/Transfusion Medicine Board Certified, American Board of Internal Medicine Board Certified, American Board of Internal Medicine - Hematology Member, American Federation of Medical Research Member, American Society of Hematology Member, American Association of Blood Banks Member, American National Red Cross Member, American Society for Apheresis Member, International Society of Blood Transfusion Published, 100+ peer-reviewed articles Current C**** D********* o* T********** M******* m**** h******* Current T****** S******** m**** h******* Current A****** P******** o* M******* a** P******** t** r***** u********* m****** c*****

Northeast

Delaware

This quadruple board certified expert has been practicing for over 40 years. He completed his residency in Internal Medicine at Johns Hopkins University prior to completing a fellowship in Hematology at Johns Hopkins as well. A former President of the American Association of Blood Banks, he holds membership in a multitude of distinguished medical organizations and has published over 100 peer-reviewed articles, while he has held editorial roles with the "Journal of Clinical Apheresis", "Blood", "Transfusion", and "Transfusion Medicine Reviews". He has served as the keynote speaker for various institutions and organizations such as the Portuguese Blood Institute, Canada Blood Services, and the German Blood Transfusion Society, and he is the recipient of awards such as the American Medical Writers Association -“ Medical Textbook Award. Currently, this expert is the Chief of the Department of Transfusion Medicine at a major clinical research hospital, where he is a Tenured Scientist as well. He also serves as an Adjunct Professor of both Medicine and Pathology at a major medical university.

Woman Allegedly Injured By Dietary Supplements

This case involves a nutritional supplement product which the plaintiff in Alaska claimed was contaminated with metallic compounds. The plaintiff also claimed that the manufacturer marketed the product towards special-needs individuals, and that the product claimed to be organic and non-gmo despite indications to the contrary. The plaintiff purchased the supplement over a period of several months, during which time she gave it to her daughter, who suffered from autism, on a daily basis. At the conclusion of this period, the child’s autism had worsened noticeably, allegedly due to the contaminants present in the supplement. The FDA eventually went on to recall the supplement.

I know regulatory limits exist for metallic compounds in products such as drinking and bottled water, and that manufacturers are required to monitor on a periodic basis. The reason the FDA gave for recalling the product was for undeclared ingredients, which implies it was added as an ingredient and its presence was not on the label. Stevia is an FDA approved sweetener, and therefore would not be considered a contaminant. I would be able to provide a risk assessment on these 2 chemicals and their consumption in the product by the child over the course of the year she was using this product.

1. Will you be able to determine if the product was contaminated? 2. Will you be able to determine whether or not there was enough contaminants to affect the child?

Location: New Mexico B.S., Biological Sciences, University of California Davis Ph.D., Comparative Pharmacology and Toxicology, University of California San Francisco Board Certification, American Board of Toxicology Member, Society of Toxicology Member, Roundtable of Toxicology Consultants Former B******** S******* R******* I******** Former A******** R******* P************* D********* o* P*********** U********* o* C********* D**** S***** o* M******* Former A******** P****** C********** D*** T******** T******* P****** W*** C***** C**** C******** H***** C*** C**** Former A****** P******** D********* o* P*********** a** T********* Former D******* P****** S***** a** R********* A****** D*** C********** Former I********* S** J*** C****** Current P******** a* p******** o**** c********* f*** i* t********* a** r********* a******

Non-Continental

Alaska

This expert is highly experienced in the field of toxicology and pharmacology. She is board certified by the American Board of Toxicology and has been a consultant in the field for approximately 20 years. Her specialty includes safety evaluation and risk assessment of ingredients/drugs.

Toxicology Expert Discusses Alleged Link Between Supplement Contamination and Autism

: United States District Court for the District of Utah, Northern Division 

In this case, the plaintiffs alleged that the defendant’s mink supplementary feed led to the loss of almost half of the plaintiff’s herd. The plaintiff’s veterinary expert explained that the supplement affected the mink’s immune system but incorrectly calculated the vitamin E levels. Due to the miscalculations, the defendant filed a motion to exclude the veterinary expert witness’s testimony.

Despite the veterinary expert’s error, the court ruled the testimony is admissible. It determined the expert’s robust experience and education still allowed for opinion testimony.

The plaintiffs, a family of mink ranchers, filed a suit against the defendant, an animal food manufacturer. The complaint alleged that the defendant’s mink supplementary feed caused a fatal vitamin E deficiency and had led to a loss of almost half of the plaintiff’s herd. The plaintiffs retained a veterinary expert witness to support their case. The defendant filed this current motion to exclude the veterinary expert’s testimony.

The Plaintiff’s Veterinary Expert Witness

The plaintiff’s veterinary expert was one of the foremost researchers in mink and animal fur. The expert had over 30 years of experience at a veterinary clinic, focusing on food animal clients. He graduated with a degree in veterinary medicine from the University of Wisconsin School of Veterinary Medicine and was board certified.

The plaintiff’s veterinary expert opined that the supplemental mink feed, Reproduction Crumlet, caused a drop in the total fat level present in the mink’s diet. This, in turn, caused a vitamin E deficiency when anything attacked their immune system. The veterinary expert further testified that monensin present in the supplemental feed accelerated the depletion rate for the already low levels of vitamin E. This, in the veterinary expert’s opinion, caused suppression in the mink’s immune systems. As a result, the mink died from infections and kidney failure.

The court noted that the veterinary expert had incorrectly calculated the vitamin E levels. However, the expert corrected this mistake in his supplemental report without explaining the initial miscalculation. But the court explains this did not automatically mean the expert was unqualified to opine about nutrition. The court thus rejected the defendant’s argument that the calculation required specialized knowledge of diet formulation. Additionally, the court was unaware of any expert obligation to explain their mistake. The court further noted that the veterinary expert had extensive experience treating animals’ dietary and nutritional needs. It found no basis on which to exclude the expert’s testimony pertaining to dietary issues.

The court explained that the veterinary expert, over the course of his practice, helped clients determine toxicology issues. Further, the expert participated in clinical studies that studied the effects of toxins on various animals. This extensive clinical experience, along with his skill and education in the subject, qualified him as an expert who was entitled to provide opinion testimony. The court further noted that the defendant’s challenge on the basis of methodology and the presence of contrary evidence affected the testimony’s weight and not its admissibility.

The court denied the defendant’s motion to exclude the plaintiff’s veterinary expert witness’s testimony.

This case demonstrates that although incorrect calculations may hurt your argument, that is not always the case. This error type may affect the weight of the testimony but not always the admissibility. Here, the expert’s background in research and education was more important in the court’s eyes. But remember, the opposition will go after anything they can to exclude an expert witness’s testimony so it’s critical to make sure there are no flaws.

Veterinary Expert’s Testimony Admitted Despite Miscalculations

Location: Texas A.S., Biology, Idaho State University B.S., Health Science, Idaho State University M.S., Nutrition, University of Saint Joseph Former, Store Manager, General Nutrition Centers, Inc Former, Research Scientist, Nature's Sunshine Products, Inc. Former, Manager, Technical and Regulatory Affairs, Vitamin Research Products, LLC Current, Vice President of Regulatory Affairs and Quality, vitamin and health company Current, Owner / Consultant, dietary supplement company

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Woman Allegedly Injured By Dietary Supplements

Toxicology Expert Discusses Alleged Link Between Supplement Contamination and Autism

Veterinary Expert’s Testimony Admitted Despite Miscalculations

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