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Excerpt of my deposition in this case:
PAGE 1 - Cover page - My oral deposition in Morgan v. Nevyas.
PAGE 2 - "he (Dr. Herbert Nevyas) just basically told me to deal with it as far as the problems that I'm having with the sight, people lose (page 3) their sight every day, I'll see you in eight months."
PAGE 3 - "Q. Is this the first time that you had a conversation with Dr. Herbert Nevyas that caused you any concern or that you were upset about? A. No."
PAGE 4 - "Q . I believe you were making complaints about your vision. You had mentioned during the prior testimony two indications where you were upset by conversations that you had with Dr. Herbert Nevyas. A. Yes."
Excerpt of deposition of Anita Nevyas-Wallace in my case:
PAGE 1 - Cover page - Oral deposition of Anita Nevyas-Wallace in Morgan v. Nevyas.
PAGE 2 -
PAGE 3 - "Q. Did you use that protocol when you operated on Mr. Morgan? A. Yes." "Q. Did you adhere to that protocol when you operated on Mr. Morgan? A. Yes."
PAGE 4 - "Q. Are you saying that a history of retinopathy of prematurity is not a contraindication to LASIK surgery? A. That is correct."
PAGE 5 - "Q. Did Mr. Morgan have a complication of LASIK surgery in either eye? A. No." "Q. Did Mr. Morgan have an adverse event of LASIK surgery in either eye? A. No."
PAGE 6 - "Q. Doctor, was the outcome of Mr. Morgan's surgery reported to either the Institutional Review Board or the Food and Drug Administration? A. Yes."
PAGE 7 - "Q. Now, do I understand from what you've told me that you reported the outcome of the LASIK surgery to the Food and Drug Administration, but that such report did not call it either a complication or an adverse event? A. Correct."
PAGE 8 - "DR. FRIEDMAN: The reason we're here is because of a lawsuit which he's claiming that he had either a complication or adverse event MS. NEWMAN: I understand that, and she's told you she doesn't believe that it's related to the surgery. DR. FRIEDMAN: It doesn't say that. It says here, "Complications or adverse events that are observed by the investigator or reported by the subject."
PAGE 9 - "A. To let people know that there is a possibility that they might be candidates to be more independent from their glasses and contact lenses. Q. And in that KYW advertisement what were the patients instructed to do to find out that information? A. I think they were instructed to call a phone number for more information."
PAGE 10 - "Q. When you told him that his vision might drop, did you indicate to him how much it might drop? A. Yes. I told him he could lose one or both eyes or he could die."
PAGE 11 - "Q. Doctor, if there is such a thing as focusing and Mr. Morgan focused and when he focused he did 100 percent of his focusing, you said that both the cornea and the lens were important for focusing. And I'm just asking you was the cornea responsible for 50 percent of his focusing, 75 percent, 99 percent? MS. NEWMAN: As compared only to the lens? DR. FRIEDMAN: As compared to the lens. MS. NEWMAN: If you can answer that question, you can do it. If you can't, tell him. A. I can't."
PAGE 12 - "Q. Is it your understanding that Mr. Morgan has developed cataracts in his eyes since his LASIK surgery has occurred? Your understanding and I'm talking to the period up to the last time you saw Mr. Morgan in the Nevyas Eye Associates group, which was about almost two years after the surgery. A. Yes."
PAGE 13 - "Q. During the time that you were seeing Mr. Morgan did you consider that there would be any other explanation other than cataracts? A. Yes. Q. And what did you consider? A. Considered retinal disease, considered optic nerve disease, considered corneal problems."
Excerpt of deposition Anita Nevyas-Wallace in another case:
PAGE 1 - Cover page - Oral deposition of Anita Nevyas-Wallace in Fiorelli v. Nevyas.
PAGE 2 - "Have you ever been involved in a medical malpractice suit before? A. No." (Comment - Deposition dated in this case was 5 months after I filed suit)
PAGE 3 - "Q. Have you ever discussed this lawsuit with Herbert Nevyas outside the presence of counsel? A. No."
PAGE 4 -
PAGE 5 - "Q. That you were doing, well, just give me an idea of what you were doing in '97? A. Corneal surgery, conjunctival surgery, refractive surgery, cataract surgery. Q. Refractive surgery, how much of your time was doing refractive procedures? A. About half."
PAGE 6 - "Q. Yes. Well, who were you involved in training with there? Q. Who are her, not your peers, who are your superiors, professors? A. Let's see. Theordore Krupin, William Frayer, Stephen Orlin, Alexander J. Brucker, James Ketowitv, David Schaffer."
PAGE 7 - "Q. I just want to know everybody you can think of right now. And at MCP, the fellowship, Who were you involved with in training at MCP in your fellowship? A. At MCP that was supervised by the department chairman of ophthalmology, at that time, Herbert Nevyas M.D. Q. Herbert Nevyas is that your father? A. Yes."
PAGE 8 - "Q. Now, the presentations that you've given, I did have one quick question on that. You have Nevyas Eye Associates Clinical Lecture Series, what's that? A. Nevyas Eye Associates offers lectures for doctors in the community for educational purposes. Q. Was that in Existence in 1997? A. Yes. Q. Have you lectured regarding the lasik procedure? A. Yes."
PAGE 9 - "Q. What I'd like to talk about is your experience and your training in lasik. When did you receive -- describe for me your training in lasik? A. My training in lasik began with my training in ALK, Automated Lamellar Keratopiasty, a procedure in which the microkeratome is used to raise a thin flap of cornea and then the underlying keratoma is then reshaped using the microkeratome. I began to perform that operation in 1992. That operation was supplanted in our practice by lasik in 1995 and then after the flap was created we instead used, come 1995, a computer guided excimer laser to reshape the stromal bed instead of using the microkeratome to reshape the stromal bed. My training in automated lamellar keratoplasty consisted both of courses taken and time spent with surgeons who were experienced in this technique."
PAGE 10 - "Q. 1995 you started to do lasik, the lasik procedure, did you have any additional training in using the lasik procedure? A. Yes. Q. And tell me about your training that you had in using lasik procedure? A. I had taken at least one course in using the laser, I think I took two."
PAGE 11 - "Q. Did you have any training that involved actually performing the procedure using the laser? A. Perform lasik? Q. Performing lasik, A . I would have to -- there's not a simple answer to that. Q. Why not? A. Because we were performing lasik under IDE with the FDA before there were courses from that."
PAGE 12 - "MS. NEWMAN: Let me object because if you're talking about lasik, unless I'm mistaken, the only lasik procedure was in March of 1997 on Ms. Fiorelli. MR. KAFRISSEN: There are three lasik. MS. NEWMAN: Three lasik? THE WITNESS-: There was one lasik and two enhancements. MR. KAFRISSEN: Right. And my understanding is that those were lasik enhancements, right? THE WITNESS: Lasik enhancements."
PAGE 13 - "Q. So tell me '95 to 97 tell me what do you consider to be postoperative symptoms, you told me postoperative is things patient experience, what is that, explain it? A. Postoperative symptoms include loss of best corrective visual acuity. Need I explain what that is? Q. Sure? A. Best corrective visual acuity means the best vision the patient is able to get with glasses or contact lenses. Q. Okay. A. And loss of best corrective visual acuity means that even with glasses or contact lenses the patient can't see as well before -- after surgery, as he did before surgery so that's the loss of best corrective visual acuity. Q.Anything else? A. Sure. Glare, halo symptoms, star burst. Q.Okay. A. Undercorrection, overcorrection. Q. Okay. A. Foreign body sensation. I can't think of any others. Q. The post operative symptoms, would you agree with me, that they can be caused by surgical complications? A. They can."
PAGE 14 - "Q. When you perform a lasik procedure and it's on a patient that is referred to you by an optometrist, does the optometrist receive any portion of the fee charged to the patient for the lasik procedure? A. Sometimes."
PAGE 15 - "Q. How did they know that? A. They had her cover one eye and read the eye chart and she could read down to the 20/70 line -- Q. Okay. A. -- with her glasses on. And then we cover the other eye and she was able to get two letters on the next line so it's going to be 70+2."
PAGE 16 - "Q. Did you make any decision as to whether Cheryl could wear contact lenses again at no time, at any point in the future? A. At that visit? Q. At that visit. A. No."
PAGE 17 -
PAGE 18 - "Q. Prior to any of the surgery that you performed, am I correct that the astigmatism Cheryl had in both eyes was correctable with spectacles? A. I'm not sure I can answer that."
PAGE 19 - "Q. How does an irregular astigmatism occur during the lasik procedure, how can it occur? A. Certain flap-complications can result in an irregular astigmatism."
PAGE 20 - "Q. And if you can just explain to me why this vision with correction differs from the vision that you came up with, with the refraction? A. First, I should mention that, that is Dr. Sterling's refraction, not my own."
PAGE 21 -
PAGE 22 - "Q. And what did you tell her? A. I told her that best she could expect is vision as good as she gets with her glasses only without her glasses and that it might not be as good as that, but that was the best she could hope for. And that she might require a thin glass or a contact lens to give her better vision."
PAGE 23 - "Q. Okay. What did you talk about? A... Q. Okay, A. I told her that of the serious and rare complications, the first one to consider is infection. That with any operation anywhere in the body there is a risk of infection and that there's a possibility of getting an infection with an organism for which we have no antibiotic and that the eye could be lost. And she said to me, you mean I could go blind? And I said, yes, but I can't say that's the worst thing that could happen because you could die, nobody's died yet, but you could be the first."
"Q. Okay. So tell me what could she see with her glasses prior to the lasik 3/20 surgery in the right Eye? A. 20/70, Q. And in her left eye what could she see with her glasses? A. 20/70+2."
PAGE 24 - "Q. And there's nothing in here about discussion of the risks, the complications, any of that type of thing, am I correct that there is nothing in your note about that? A. There is a very important phrase in that note. Q. Okay. A. Discussed in detail. Normally, I would only write discussed and that means, I went through risk complications, my entire speech. And then after I got done with that and I had written discussed in detail, if you look in the actual chart the slant of the letters is different after discussed in detail."
PAGE 25 - "A. The only clue in the chart is that I said, reevaluate 10 weeks and then I said return 2/18 that - she had persuaded me to at least -- not insist that she simply spend a month without lenses and that we'd take a look sooner and see whether she could possibly put them in sooner."
PAGE 26 - "Q. Okay. Did you, my question was, document it when she said it? A. No. Q. What we have is your independent recollection of that conversation? A. Yes. Q. And your interpretation of a questionnaire filled out in May 1991; is that accurate? A. My recollection, yes." (Comment - Deposition dated in this case was 2000, 9 years later)
PAGE 27 - "Q. Are there any records that you see written by someone at Nevyas Eye Associates that documents a glare problem before you saw her in 1997? A. No. Q. Are there any documents that you see from Nevyas Eye Associates that documents a halo problem prior to your seeing her in 1997? A. No."
PAGE 28 - "Q. Did you document anywhere that the patient said she had problems with glare or halos prior to the surgery? A. No. Q. Okay. Now, did you document anywhere that she had problems with star burst prior to the surgery? A. No. Q. Did she tell you she had problem with star burst before surgery? A. I don't recall."
PAGE 29 - "Q. Let me ask you this then, the bill, were all of the services you rendered throughout the entire course of treatment to Cheryl Fiorelli necessary services? MS. NEWMAN: Did she need them? Were they necessary? THE WITNESS: Is elective surgery -- I don't know what elective surgery falls under."
PAGE 30 - "Q. Tell me what part of it is documented here? A. I have discussed matters in detail with Ms. Fiorelli. Discussed in detail means that in itself, in detail. MS. NEWMAN: Just tell him what you said. THE WITNESS: She is interested in having refractive surgery, and we discussed the lasik procedure. She understands that her best spectacle corrected acuity is in the 20/60 to 20/70 range and that is the expected postoperative best corrected acuity as well." (Comment - The Nevyases' Study protocol stipulates 20/40 or better.)
PAGE 31 - "Q. When you say negative 12, I think we had discussed earlier her refraction was around negative 15? A. Minus 14 when she was refracted on March 3rd when I refracted her."
PAGE 32 - "Q. All of your visits up to his point, where were you seeing Cheryl at, physically? A. I'm not sure they were all at the same office. Q. Were you employed at the time? Are you an employee of Nevyas Eye Associates at the time that you were seeing Cheryl? A. Yes. Q. Tell me where are Nevyas Eye Associates offices, where sere they then? A. Actually, I can answer your first question. I was seeing her at our Bala Cynwyd office, that is where all the visits are."
PAGE 33 - "Q. The information on this sheet was the programming for the laser, the instructions for the laser's programming, are they made by you, were they made by you for Cheryl Fiorelli? A. The instructions for the laser's programing were made by me. Q. Did you get this sheet at some point before the surgery? A. Yes. Q. And did you review it? A. Yes."
PAGE 34 - "Q. Did you consider Cheryl a good candidate for lasik? A. I considered her a good candidate with some -- as long as she was aware of the things that I mentioned."
"MS. NEWMAN: Well, it's clear that she's got a best corrected visual acuity of 20/70. She said that she considered herself -- Dr. Nevyas-Wallace said that the plaintiff considered herself a high handicap with glasses other than what's already been discussed."
PAGE 35 - "Q. Okay. My question was, was there any standard within the medical community that you were aware of in 1997? Is it your testimony that the standard was to negative 24 or is it your testimony that some doctors were out there doing it? A. Standard worldwide at that time was in the 20 to 22 diopter range." (Comment - See the Nevyases' Study protocol.)
"Q. No, what? A. No. I didn't measure cornea thickness. Q. Okay. A. Prior to that surgery. Q. Prior to the lasik on 3/20? A. Correct. Q . Why not? A. That was not standard of care in 1997. Q. You just said that it wasn't standard of care to measure cornea thickness in 1997, is it your testimony that regardless of what the vision of the patient you were dealing with was, you would have to measure corneal thickness?"
PAGE 36 - "Q. Ultrasonic pachymetry. Did you have the capacity to perform ultrasonic pachymetry in your office? A. Yes. Q. Did you have that capacity prior to February of 1997? A. Yes. Q. For how long prior to 1997 did you have that capacity in your office? A. We had optical pachymetry since the 1960's and ultrasonic pachymetry since 1990."
Excerpt of deposition of Herbert Nevyas in my case:
PAGE 1 - Cover page - Oral deposition of Herbert Nevyas in Morgan v. Nevyas
PAGE 2 - "Q: As far as the KYW information that was broadcast on the air, what time frame did that run from? A: I don't remember-There was very little. We had a few — I think we had some advertising on KYW to let people know what we were doing as far back as '93 or '94 and I'm not sure what was done in the next couple of years. I really don't recall. I'm not even sure there was much around that time, if any, I think — if I think back to '94 or '95, we had some advertising at that time. I don't think there was later."
PAGE 3 - "Q: How did you get approved for laser surgery if they didn't have a laser? A: By taking courses that they gave. They may have been using a laser at a laser center. I'm not sure. This was some years ago. to be certain, I'm referring to formal hospital privileges and not — A: I'm not sure. I don't recall whether it was formal hospital privileges or whether it was their approval for using the Summit laser at that time. I do not recall. I had no intention of using it, so I don't remember."
PAGE 4 - "Q: Do you know if Dr. Nevyas-Wallace has performed LASIK at any hospital?" "A: I don't know. Not as far as I know, let's put it that way. Not as far as I know."
PAGE 5 - "Q: In all of the meetings and courses that you've attended, has there been any mention of any patient who had LASIK who had a similar condition to Mr, Morgan?" "MS. KRAMER: I'm going to object to the form and ask if you can define "similar condition." "Q. A similar condition would be a history of retinopathy of prematurity with a large positive angled kappa." "A: Not to my recollection."
PAGE 6 - "Q: Doctor, do you have any income earned as an ophthalmologist that comes to you other than via Nevyas Eye Associates or Nevyas Eye Associates of New Jersey? MR. LAPAT: Objection. MS. NEWMAN: Objection. MS. KRAMER: You can answer it. A: Income earned as an ophthalmologist that comes to me? That is assuming that I have income earned as an ophthalmologist that comes to me from the corporation. The answer is no. Q: Doctor, do you have income from the Nevyas Eye Associates or Nevyas Eye Associates of New Jersey? MR. LAPAT: Objection. Again, that has no bearing on this litigation. A: Probably not, no. Q: They don't pay you? A: No."
PAGE 7 - "Q: What was the purpose of working with MDTV?" "A: They were going to make a video which we could use to show our patients, give them some idea of the refractive surgery we do, and they were going to put it on some public access channels to show people what we were doing."
PAGE 8 - "Q: Are you familiar with the requirements for driving a car, the requirements I am talking as far as vision for driving a car in Pennsylvania, what they are? A: Pretty much."
"Did you ever tell Mr. Morgan that he should not drive? A: I don't think so. I don't recall that." (Comment - 7 years after this deposition Herbert wrote a letter to NJ DMV (I believe as an act of vindication) to make sure my license was revoked.)
PAGE 9 - "Q: Did you consider the possible diagnoses of malingering, hysteria, nuclear sclerosis or a physical problem that is retinal as being a complication of LASIK surgery? A: No. Q: Did you consider malingering, a physical problem that is retinal, hysteria or nuclear sclerosis as being an adverse event following LASIK surgery? MR. LAPAT: Objection. MS. KRAMER: Go ahead.You can answer. A: Absolutely not."
PAGE 10 - "Q: If the patient, when examined preoperatively, doesn't show any evidence of nuclear sclerosis — I' m not sure I understood your answer. Does that mean you could anticipate nuclear sclerosis? A: No, we would anticipate it by examining him, and if we saw it developing, not operate him. Q: I take it since he was operated that it wasn't seen? A: It was not. It seemed to be developing now afterwards. It has been several years."
PAGE 11 - "Q: Doctor, do you see that, "No change in ghost image with hard contact lenses"? A: Yes. Q: Are you able to identify who wrote that note? A: That is Dr. Anita Wallace.That is the first mention I see of a ghost image.There is no complaint of a ghost image. She just said that there is no change in any. I don't even know that there were any."
Excerpt of deposition of Herbert Nevyas in another case:
PAGE 1 - Cover page - Oral deposition of Herbert Nevyas in Fiorelli v. Nevyas
PAGE 2 -
PAGE 3 - "Q. And my understanding, from Anita's deposition, is that Anita is your daughter?" "A. Anita's my daughter. Other than to say it's a pity that this woman has resorted to lawsuits, that's all. We haven't discussed the facts of the case at all."
PAGE 4 -
PAGE 5 - "Q. Was corneal thickness a factor in planning the Lasik surgery prior to March of 1997?" "A. I really don't know if it was a factor or not. Obviously, the gross appearance of the cornea was. I do not have in the record here -- perhaps you have it; I'm not sure, since I didn't see the patient initially --"
PAGE 6 -
PAGE 7 - MS. POST: Objection to the form. If you know." "A THE WITNESS: The purpose of the procedure was the same as any of myopic Lasik procedure: to relieve the patient of the myopia, which made her dependent upon glasses or contact lenses, and in her case made her absolutely blind and helpless without an optical prosthesis."
PAGE 8 - "Q. Okay. There is a note on the operative form about the laser keratome stopping on its forward and its backward pass." "A. Yes."
PAGE 9 - "Q. Can you tell me what significance, if any, the fact that the keratome is recorded as having stopped three-quarters of the way on forward and one-quarter of the way on the backward pass?" "THE WITNESS: The significance is that the microkeratome that was in use at that time, and is still in use pretty widely, had a gear system which could sometimes hang up momentarily, and if the laser hesitates, it could create some unevenness in the cut making the corneal flap. The significance here is that it stopped toward -- I don't know -- the three-quarters was recorded either by the nurse or the optometrist who was assisting, who obviously couldn't be looking in the microscrope, -but it looked to them as if it hesitated when it was pretty well through the pass and, therefore it would have no significance really except to, you know, we note everything that happens in the procedure. No clinical significance."
PAGE 10 - "Q. Is there any indication in the record or in the notes that Cheryl was not looking at the light?" "A. There's no way we could know. We have to tell her what to do and then we can only tell by the topography whether her optical axis was indeed lined up with the laser beam center."
PAGE 11 - "Q Okay. Do you know why the lensectomy on the left eye was done seven days after the Lasik on the right eye?" "A. Well, from the record, I gather the patient was unhappy with the imbalance now and wanted to get something done on the other eye, and why it was done as a lensectorny rather than as a Lasik, I could give you my assumptions but I don't recall discussing it."
PAGE 12 - "MR. KAFRISSEN: What he testified to is that he couldn't recall exactly what he did during this surgery but here are the things that the doctor normally does as an assistant." "THE WITNESS: I must take exception. These are things I might have done as an assistant. Other people might have done them too."
PAGE 13 - "Had you ever discussed her between the previous surgery and May I5 surgery with Doctor Nevyas Wallace?" "A. Probably there was some discussion but I don't recall. Most likely, Doctor Nevyas-Wallace told me what the situation was and what she had planned, but I don't recall that specifically. She may have mentioned it to me, but she is quite expert on her own and I do not monitor each thing she does. In fact, she's got a national and international reputation particularly in the interpretation of elevation topographies."
PAGE 14 - "Q. Okay. With regard to the left eye, as of May 21 27, 1997, what was your assessment?" "A. I have nothing there except that it looked normal. I didn't note any abnormalities. I would have noted abnormalities."
PAGE 15 - "Q. Okay. Did the second enhancement have the desired effect as of 7/11/1997?" "A. I haven't testified what the desired effect was. I think you should ask Doctor Wallace exactly what she was hoping to accomplish. It looks like, from her record, that the vision was much better and refractive error was reduced. She had very little astigmatism and essentially no refractive error. If that's what she was aiming to accomplish, then she was successful."
PAGE 16 - "Q. Let me get -- I'll get to that in one minute. Did you note that the lens was decentered prior to the July 14 surgery?" "A. No." "MS. POST: Did he make any notation that it was?" "MR. KAFRISSEN: Yes."
PAGE 17 - "Q. And what was her overall assessment?" "A. She had very strange complaints. I have vague complaints, Estonopia(ph) is a term that we use for somatic complaints being expressed visually." "Q. Meaning?" "A. That is, complaints that may not be based in physical problems but perhaps in mental problems. It was my impression that she had a lot of complaints beyond what I could see a base for, and some people express their anxieties in terms of physical complaints, and I felt that hers was perhaps somewhat that."
PAGE 18 - "Q. Do you have any recollection of any discussions between you and Cheryl Fiorelli at any time, either the specific discussion or just generally?" "A. I'm sure I talked to -her when I saw her. I don't recall much except that she appeared to be an anxious person who seemed to have complaints in excess of what I could find physically. She was always complaining. I do remember that, but we tried our best to try to remedy her complaints."
PAGE 19 - "MR. KAFRISSEN: I'm asking from his review of the record that was from his office that he produced, did he have any reason to suspect or believe or any information that there were erroneous entries or misstatements of fact in the records." "THE WITNESS: Absolutely not."