Replies

DR. WALKER'S BONE SCAN DEPOSITION-----11/21/2003

Now, Dr. Walker....

Q The report goes on to say, "The
10 presumption is that the other multiple areas of
11 abnormal activity also relate to previous trauma."

12 A That's what it says.

13 Q And, again, that's based on the fact that
14 Dr. Carnahan is a rehab physician, that you were
15 asked to evaluate for trauma?

16 A And the pattern of activity is fairly
17 typical of multiple traumatic injuries of relatively
18 recent origin.

19 Q I realize you can't assign a cause to
20 these injuries that you picked up in this report.
21 But typically in your experience, what would be the
22 causes of this pattern of abnormality?

23 A In somebody her age, an auto accident is
24 by far the most typical cause.

25 Q Assume that she was not in an auto
P- 29
1 accident but that she had suffered an anoxic or
2 hypoxic encephalopathy type of injury from a cardiac
3 arrest and had been bedridden for a year at this

4 point. What might account for these abnormalities?
5 A In my knowledge, that type of injury.
6 would not account for this pattern of abnormalities.

Thank you, Mr. Mason.

Here is additional testimony to back you up.

16         Q     Then you go on to say, "And the activity
17    in L1 correlates perfectly with the compression
18    fracture which is presumably traumatic."
19         A     That's what it says.
20         Q     In other words, the x-ray confirmed the
21    L1 fracture?
22         A     The x-ray shows an abnormality at L1
23    which happens to correspond with the abnormal bone
24    turnover on the bone scan at that point.
25         Q     What is a compression fracture?
?                                             26
1          A     It's a loss of the mechanical structure
2     of the vertebral body along what we call the end
3     plates of the vertebral body.  And the end plates
4     are those portions that are adjacent to the
5     cartilages that separate each vertebral body, the
6     cartilages being the body's shock absorbers.
7          Q     Is this compression fracture, then, in
8     common parlance, a broken back?
9          A     Yes.
10         Q     Is there any way to tell how old that
11    fracture would be?
12         A     Well, as I've alluded to, the bone scan
13    gives some suggestion of that.
14         Q     More recent rather than less recent?
15         A     Correct.  Typically in trauma the rule of
16    thumb is that a traumatic fracture is not active on
17    the bone scan after 12 to 18 months.  That's the
18    typical rule of thumb.  Now, bodies being very
19    variable, there's a lot of variation there, but
20    that's the typical rule of thumb.  So if a fracture
21    shows up active on the bone scan, then one makes the
22    presumption that it is relatively recent; i.e.,
23    within 18 months.