the worker's compensation division at the appellate level they are currently holding court today as we are so that's why he is not here today he will watch and listen to the oral arguments and we plan on getting together with him in the near future to review the cases and make our votes accordingly so i just want to let you all know why just as our barracks wasn't here today is everyone ready to proceed yes your honor verged and i think it's it's fair to say that the circuit court read that dr malcolm's remote care gave rise to a cause of action for malpractise in st clair at least the cause of action relevant public and private interest factors certainly in terms of a cause of action bill cause of action for malpractise against dr malcolm roche until her treatment decisions were communicated think the record shows that she does a significant amount of that and then she also treats patients on a personal in person basis believe it said st elizabeth's and sa street carts and so why isn't that significant here in terms of your offense emotion and the holding there was well the record shows that the training was done on an individualized store base and certainly would come some medical care dr malcolm's care to list or hazel was an individualized patient decision had nothing to do with any other decision that she might make another case whether it's in a clear  circuit court did not have the benefit of your decision in brant which in which you held the record business discretion in failing to transfer a case from st clair county believe it was to monroe county even though the she read your and the cause of action against her as occurring in st clair county i mean when you think about it just for two of us where the remote physician might be in this case she was in the sink or in another ca issue and you made some interesting arguments along that line are like hearing pursuit that right so we believe the concept that we're arguing is recognize and other aspects law we cited to the court the interstate medical licensure compact that's the term many what medical board should have jurisdiction over physicians practicing in different states but there that the statute expressed play provides the practice medicine occurs where the patient is located at the time of the patient station encounter and we would say that you know that that's what's doing deciding f n c but that principle applies here and we cited the costo case that's a case on jurisdiction a suit by one plaintiff against a michigan diagnostic laboratory and michigan said hey we just we did our activities in michigan we looked we mis diagnosed your tissue sample but we show you said the same thing you did a little different language saying we focus on the heart of the issue even in her analysis of the right attack and so i mean the elete case was really an we probably don't have time to go in the all the individual facts but when you read the matter well and w right so the the basic point is that if you have allies this remote care which we build in the way we believe it should be and as care that was rendered in to nothing to counter the treatment private and public interest factors it made and you've made it clear other courts have made it clear you know they don't all have to strongly favor a transfer but when you put them all together we would respectfully submit that with the proper focus the proper heart of the issue being the medical care rendered in the county the for all the reasons set forth in the brief that the court did abuse of discretion here then the balance of the totality of those factors but certainly it's the citizens of the county paramount interest in the quality of care that's rendered in their quality in their in their hospitals now there's a new institutional point here about whether the hospital should have  permitted physicians that are as far away as dr malcolm was but that's a decision that was me in again enough again county that's an issue that should be resolved by the citizens of that again county who rely on that neighboring madison county he discussed at the witnesses are scattered including several located in sinclair and you discuss that there are numerous significant connections to sinclair he explained that looking at the totality of circumstances this was not a close call this is not come down to a single staff including the fact that mr griffin discussed dr malcolm who lives in bellville in just to be clear in addition to the fact she has now moved to france for joining in the move and because we know st clair is her home for the most convenient chose not to notify the attending surgeon of the patient's respiratory distress and shortly thereafter that patient who was suffering from progressive airwave struction due to a cervical  remotely from her home every time she does it it's from we're she was at her home that's for work and that's a permanent work location for her for whenever she's providing remote care so there's nothing they explain the same concept that when a doctor is is somewhere taking a phone call giving medical advice from that location that that their action occurs in the location where they are  giving the speech giving the order or forming the differential diagnosis its effect occurs somewhere else where the listener but in this case the acts the actions of doctor and circumstances where a doctor just happens to be in a location like in this case where that are now this permanent stations working from home to provide hospital was here and there was nothing for to this all but in addition to that i don't i don't agree that that that is the controlling issue in this case because there are so many connections just unclear how many i don't think that mr going to you know handle remote hospital remote here but i believe in this case that given that the judge clear was that said he was not giving way to just one of but you know we're talking about the hospital here i mean for all practical purposes the hospital are these five nurses and there are one hundred miles away this is not a contiguous county case this is a case three counties away from st clair and i know judge kroger said well it's really inconvenient for these doctors as a trial to her words to us that's just another reason if that's the case that just another reason why the case should be tried in effingham and they should defend t county but the score and many others that routinely said that's a venue ok the venue that does not us that's not a significant factor to determine where this case should be tried and we also well thank you carol so just this morning on the question you know two again as i stated earlier as when justice barbaric just mourn i get together soon we will discuss the case we take the matter under advisement and issue an order to course