NO. 03-15-00596-CV 

 

 

IN THE COURT OF APPEALS 

 THIRD DISTRICT OF TEXAS, AUSTIN 

 

 

GRACY WOODS I NURSING HOME 

 

Appellant, 

 

v. 

 

MARTHA MAHAN, AS THE REPRESENTATIVE 

OF THE ESTATE OF MARY RIVERA 

 

Appellee. 

 

 

ON INTERLOCUTORY APPEAL FROM 

THE 250TH JUDICIAL DISTRICT, TRAVIS COUNTY, TEXAS 

 

 

APPELLANT’S BRIEF 

 

EMILY J. DAVENPORT 

STATE BAR NO. 24012501 

REED, CLAYMON, MEEKER 

& HARGETT, PLLC 

5608 PARKCREST DRIVE, SUITE 200 

AUSTIN, TEXAS 78731 

(512) 660-5960 TELEPHONE 

(512) 660-5979 FACSIMILE 

ATTORNEYS FOR APPELLANT 

ORAL ARGUMENT REQUESTED

ACCEPTED

03-15-00596-CV

7771576

THIRD COURT OF APPEALS

AUSTIN, TEXAS

11/10/2015 3:54:12 PM

JEFFREY D. KYLE

CLERK

 FILED IN 3rd COURT OF APPEALS AUSTIN, TEXAS 11/10/2015 3:54:12 PM JEFFREY D. KYLE Clerk
i 

IDENTITY OF PARTIES AND COUNSEL

 Pursuant to TEX. R. APP. 38.1(a), Appellant certifies that the 

following is a complete list of all parties to this litigation and the names 

and addresses of all counsel. 

Party Appellate Counsel Trial Counsel

Gracy Woods I 

Nursing Home, 

Appellant 

Emily J. Davenport 

Janice Byington 

Reed, Claymon, Meeker & 

Hargett, PLLC 

5608 Parkcrest Drive 

Suite 200 

Austin, Texas 78731 

edavenport@rcmhlaw.com 

jbyington@rcmhlaw.com 

Emily J. Davenport 

Janice Byington 

Reed, Claymon, Meeker & 

Hargett, PLLC 

5608 Parkcrest Drive 

Suite 200 

Austin, Texas 78731 

edavenport@rcmhlaw.com 

jbyington@rcmhlaw.com 

Martha Mahan, as 

the Representative 

of the Estate of Mary 

Rivera, 

Appellee 

Jack Modesett, III 

ModesettWilliams, PLLC 

515 Congress Avenue 

Suite 1650 

Austin, Texas 78701 

jack@modesettlaw.com 

 

 
ii 

TABLE OF CONTENTS

Page

IDENTITY OF PARTIES AND COUNSEL .............................................. i 

TABLE OF CONTENTS ............................................................................ ii 

INDEX OF AUTHORITIES ...................................................................... iv 

ABBREVIATIONS AND RECORD REFERENCES ............................. viii 

APPENDIX ................................................................................................ ix 

STATEMENT OF THE CASE .................................................................. x 

STATEMENT REGARDING ORAL ARGUMENT .................................. 1 

STATEMENT OF JURISDICTION .......................................................... 1 

ISSUE PRESENTED ................................................................................ 1 

 Does Dr. Lipson’s report represent a good faith effort to 

comply with TEX. CIV. PRAC. & REM. CODE §74.351? 

STATEMENT OF FACTS ......................................................................... 2 

SUMMARY OF THE ARGUMENT .......................................................... 4 

ARGUMENT AND AUTHORITIES ......................................................... 6 

 I. Standard of Review ................................................................. 6 

II. The Expert Report Requirement ............................................ 7 

III. The Four Corners Rule .......................................................... 10 

IV. Dr. Lipson is Not Qualified to Offer the Opinions 

Asserted in His Report ........................................................... 11 
iii 

A. Dr. Lipson is Not Qualified to Offer Causation 

Opinions, Particularly That a Sexual Assault 

Occurred ............................................................................. 11 

B. Dr. Lipson is Not Qualified to Offer Opinions 

Concerning Gracy Woods’ Standard of Care or 

Alleged Breach ................................................................... 13 

1. The expert must be qualified on standard of care 

and breach ..................................................................... 13 

2. Dr. Lipson did not establish his qualification ............. 17 

V. Dr. Lipson’s Report is Conclusory, Based on Assumption 

and, Therefore, Deficient ....................................................... 20 

A. Dr. Lipson’s Report is Deficient as to the Element of 

Breach ................................................................................ 20 

B. Dr. Lipson’s Report is Deficient as to the Element of 

Causation ........................................................................... 23 

CONCLUSION ......................................................................................... 27 

PRAYER .................................................................................................... 28 

CERTIFICATE OF COMPLIANCE ........................................................ 30 

CERTIFICATE OF SERVICE .................................................................. 31 
iv 

INDEX OF AUTHORITIES 

Page

CASES 

 

Am. Transitional Care Ctrs. v. Palacios, 46 S.W.3d 873 

(Tex. 2001) ............................. 5, 6, 7, 9, 10, 15, 20, 21, 22, 23, 24,28 

Austin Heart, P.A. v. Webb, 228 S.W.3d 276 

(Tex.App. –Austin 2007, no pet.) .......................................... 9, 10, 20 

Bowie Memorial Hosp. v. Wright, 79 S.W.3d 48 

(Tex. 2002) ......................................................................... 6, 9, 10, 23 

Broders v. Heise, 924 S.W.2d 148 (Tex. 1996) .................. 4, 10, 11, 12, 13 

Certified EMS, Inc. v. Potts, 392 S.W.3d 625 (Tex.2013) ................... 6, 26

Christus Health Southeast Texas v. Broussard, 267 S.W.3d 531 

(Tex.App. –Beaumont 2008, no pet.) .............................................. 16

Cooper v. Arizpe, 2008 WL 940490 

(Tex.App. –San Antonio 2008, pet. denied) ................................ 6, 26

Cortez v. Tomas, 2012 WL 407382 

(Tex.App. –Fort Worth 2012, no pet.) ............................................. 13

Costello v. Christus Santa Rosa Health Care Corp., 141 S.W.3d 245 

(Tex.App. –San Antonio 2004, no pet.) ........................................... 25

Earle v. Ratliff, 998 S.W.2d 882 (Tex. 1999) ............................................. 9 

Foster v. Zavala, 214 S.W.3d 106 

 (Tex.App.—Eastland 2006, pet. denied) ......................................... 19 

Fung v. Fischer, 365 S.W.3d 507 

 (Tex.App.-Austin 2012, no pet.) .................................................. 6, 26 
v 

Hutchinson v. Montemayor, 144 S.W.3d 614 

(Tex.App. –San Antonio 2004, no pet.) ........................................... 26 

In re Samonte, 163 S.W.3d 229 

(Tex.App. –El Paso 2005, orig. proceeding) ........................ 11, 15, 28

In re Windisch, 138 S.W.3d 507 

(Tex.App. –Amarillo 2004, orig. proceeding) .................................. 28

Jelinek v. Casas, 328 S.W.3d 526 

(Tex. 2010) ............................................... 5, 6, 7, 9, 20, 23, 24, 27, 28 

Jones v. King, 255 S.W.3d 156 

(Tex.App. –San Antonio 2008, pet. denied)) ................................... 10

Kerlin v. Arias, 274 S.W.3d 666, 668 (Tex. 2008) ................................... 22

Kettle v. Baylor Med. Ctr., 232 S.W.3d 832 

(Tex.App. –Dallas 2007, pet. denied) .......................................... 7, 10

Lenger v. Physician’s Gen. Hosp., 455 S.W.2d 703 (Tex. 1970) ............. 23

Lewis v. Funderburk, 253 S.W.3d 204 (Tex. 2008) ................................... 8

Ly v. Austin, 2007 WL 2010757 

 (Tex.App. –Austin 2007, no pet.) ................................ 4, 6, 10, 15, 18 

Methodist Hosp. Levelland v. Kimbrell, 2009 WL 3101315 

(Tex.App. –Amarillo 2009, no pet.) ................................................. 15 

Murphy v. Mendoza, 234 S.W.3d 23 

(Tex.App. –El Paso 2007, no pet.) ................................................... 26

Nacogdoches County Hosp. Dist. v. Felment, 2013 WL 6207838 

(Tex.App. –Tyler 2013, no pet.) ........................................... 16, 18, 19

Nexion Health v. Treybig, 2014 WL 7499373 

(Tex.App. –Dallas 2014, no pet.) ................................. 5, 7, 16, 19, 28 
vi 

Pediatrix Med. Servs. Inc. v. De La O, 368 S.W.3d 34 

(Tex.App.–El Paso 2012, no pet.) .................................................... 13 

Reed v. Granbury Hosp. Corp., 117 S.W.3d 404 

(Tex. App. – Ft. Worth 2003, no pet.) ................................... 5, 16, 19 

Samlowski v. Wooten, 332 S.W.3d 404 (Tex. 2011) ................................ 20 

Scoresby v. Santillan, 346 S.W.3d 546 (Tex. 2011) ............................. 9, 10 

Senior Care Centers, LLC v. Shelton, 459 S.W.3d 753 

(Tex.App. –Dallas 2015, no pet.) ..................... 5, 6, 21, 22, 23, 24, 27 

Shelton v. Sargent, 144 S.W.3d 113 

(Tex. App. – Ft. Worth 2004, pet. denied) ................................ 17, 19

Tenet Hosps. Ltd v. Love, 347 S.W.3d 743 

(Tex.App. –El Paso 2011, no pet.) ............. 5, 7, 16, 18, 19, 23, 24, 28 

Tomasi v. Liao, 63 S.W.3d 62 

(Tex.App. –San Antonio 2001, no pet.) ..................................... 15, 18 

Walker v. Packer, 827 S.W.2d 833 (Tex. 1992) ......................................... 6 

STATUTES 

 

TEX. CIV. PRAC. & REM. CODE § 51.014(a)(9) ............................................ 1 

TEX. CIV. PRAC. & REM. CODE § 74.351 ........................................... passim

TEX. CIV. PRAC. & REM. CODE § 74.351(a) ............................................ 3, 7 

TEX. CIV. PRAC. & REM. CODE § 74.351(b) ............................................ 1, 7 

TEX. CIV. PRAC. & REM. CODE § 74.351(c) ................................................. 7 

TEX. CIV. PRAC. & REM. CODE § 74.351(l) ........................................... 8, 28 
vii 

TEX. CIV. PRAC. & REM. CODE § 74.351(r)(5) ...................................... 4, 14 

TEX. CIV. PRAC. & REM. CODE § 74.351(r)(6) .... 5, 9, 10, 20, 23, 24, 27, 28 

TEX. CIV. PRAC. & REM. CODE § 74.402 ..... 4, 10, 13, 14, 15, 16, 18, 19, 28 

TEX. CIV. PRAC. & REM. CODE § 74.403 ............................. 4, 10, 11, 13, 28 

TEX. R. EVID. 702 ...................................................................... 4, 12, 13, 28 
viii 

ABBREVIATIONS AND RECORD REFERENCES

Abbreviations: 

Appellee, Martha Mahan, as the Representative of the Estate of Mary 

Rivera, will be referred to as “Mahan.” 

Mary Rivera will be referred to as “Ms. Rivera.” 

 

Appellant, Gracy Woods I Nursing Home,1 will be referred to as “Gracy 

Woods.” 

The Texas Medical Liability Act will be referred to as “TMLA.” TEX. CIV.

PRAC. & REM. CODE §74.001-§74.507. 

Record References: 

 

References to the Clerk’s Record are in the form of “CR _____.” 

References to the Clerk’s Supplemental Record are in the form of “Supp. 

CR ___.” 

 

References to the Reporter’s Record are in the form of “RR ___.” 

References to Appendix items attached to the Brief are in the form of 

“App. ___.” 

 

                                                            

1 Gracy Woods was sued as “Gracy Woods I Nursing Home.” Appellant is actually known as PM 

Management – Austin NC, LLC d/b/a Gracy Woods Nursing Home (also referred to herein as “Gracy 

Woods”). (CR 8). 
ix 

APPENDIX 

Order Denying Defendant’s Motion to Dismiss ....................... Appendix 1 

Defendant’s Motion to Dismiss ................................................. Appendix 2 

Plaintiff’s Response to Defendant’s Motion to Dismiss ........... Appendix 3 

Defendant’s Objections to Plaintiff’s Expert Report 

and Curriculum Vitae ............................................................... Appendix 4 

Report of Loren Lipson, M.D. .................................................... Appendix 5 

Curriculum Vitae of Loren Lipson, M.D. .................................. Appendix 6 

 
x 

STATEMENT OF THE CASE

Nature of the Case This is a health care liability claim. (CR 

3, 4). Gracy Woods is a nursing home 

where Ms. Rivera resided. Id. Mahan 

has sued on behalf of Ms. Rivera’s 

estate. Id. Mahan claims that Ms. 

Rivera was sexually assaulted at Gracy 

Woods. (CR 4). 

Trial Court 200th District Court, Travis County, 

Texas, Honorable Gisela D. Triana, 

Presiding. 

Filed in 250th District Court, Travis 

County, Texas. 

 

Course of the Proceedings and Disposition 

December 11, 2014: 

 

December 12, 2014: 

 

 

January 30, 2015: 

 

 

February 20, 2015: 

 

 

 

Mahan filed suit. (CR 3). 

Gracy Woods filed its Original Answer. 

(CR 8). 

Mahan served the report and 

curriculum vitae of Loren Lipson, M.D. 

(CR 11). 

Gracy Woods filed its objections to Dr. 

Lipson’s report and curriculum vitae. 

(CR 101). 
xi 

April 11, 2015: 

 

 

August 12, 2015: 

 

August 24, 2015: 

August 25, 2015: 

 

September 1, 2015: 

 

September 17, 2015: 

 

The 120-day expert report deadline 

expired. (CR 8). TEX. CIV. PRAC. & REM.

CODE §74.351(a). 

Gracy Woods filed its Motion to 

Dismiss.2 (CR 301). 

Mahan filed her response. (CR 376). 

The trial court heard oral argument. 

(CR 374, RR 1). 

The trial court denied Gracy Woods’ 

Motion to Dismiss. (CR 446). 

Gracy Woods filed its Notice of 

Accelerated Appeal. (CR 447). 

                                                            

2 Proceedings against Gracy Woods were abated for 60 days on March 4, 2015 pursuant to TEX. CIV.

PRAC. & REM. CODE §74.052 due to Mahan’s failure to identify physicians and health care providers in 

her presuit notice and authorization. (CR 196, 269). TEX. CIV. PRAC. & REM. CODE §74.052. 
1 

STATEMENT REGARDING ORAL ARGUMENT 

 

 Gracy Woods requests oral argument pursuant to TEX. R. APP. P 

39.1 and respectfully submits that oral argument would aid the Court in 

determining the legal and factual issues presented in this appeal. 

STATEMENT OF JURISDICTION 

 

 Gracy Woods seeks interlocutory relief from an order denying a 

motion to dismiss pursued under Section 74.351(b) of the Texas Civil 

Practice and Remedies Code. (CR 446). TEX. CIV. PRAC. & REM. CODE 

§74.351(b). This Court has jurisdiction pursuant to Section 51.014(a)(9) 

of the Texas Civil Practice and Remedies Code. TEX. CIV. PRAC. & REM.

CODE §51.014(a)(9). 

ISSUE PRESENTED 

 Does Dr. Lipson’s report represent a good faith effort to comply with 

TEX. CIV. PRAC. & REM. CODE §74.351? 

 
2 

STATEMENT OF FACTS 

Gracy Woods is a nursing home. (CR 3-4). Ms. Rivera, now 

deceased, was a resident of Gracy Woods. Id. Mahan, Ms. Rivera’s 

daughter, has sued Gracy Woods on behalf of Ms. Rivera’s estate.3 Id. 

 Mahan filed suit on December 11, 2014, alleging that Ms. Rivera 

was sexually assaulted at Gracy Woods on November 10, 2012.4 (CR 3-4). 

Mahan claims that she discovered the alleged assault, based on what 

Mahan describes as “signs of a struggle in her mother’s room” and “bloody 

tissue in the bathroom trash can.” Id. at 4. In her petition, Mahan claims 

that a Sexual Assault Nurse Examination (referred to herein as the 

“SANE nurse report”) “indicated sexual assault on Ms. Rivera.”5 Id. 

                                                            

3 Mahan was appointed guardian of Ms. Rivera in June 2013. Ms. Rivera objected to 

Mahan’s appointment. According to the Order Appointing Permanent Guardian, 

Mahan was prohibited from removing Ms. Rivera from Gracy Woods without further 

order from that court. (CR 69). 

4 The petition asserts that a sexual assault occurred on November 10, 2012. (Supp. 

CR 4). Dr. Lipson’s report implies that an assault allegedly occurred on the night of 

November 8, 2013. (CR 17). The SANE report, reviewed by Dr. Lipson and filed with 

his report, contends that the date and time of the alleged assault were unknown and 

occurred “perhaps early 11/8/13.” (CR 92). 

5 According to the SANE nurse report, Ms. Rivera recalled no sexual contact. (CR 96).
3 

Mahan alleges that Gracy Woods failed to protect Ms. Rivera from sexual 

assault.6 (CR 5). (Supp. CR 4). 

 Gracy Woods denies Mahan’s allegations. (CR 8). Gracy Woods filed 

its Original Answer on December 12, 2014. Id. 

 Mahan served the report and curriculum vitae of Loren Lipson, 

M.D., on January 30, 2015, in an attempt to comply with the 120-day 

expert report deadline. (CR 11). TEX. CIV. PRAC. & REM. CODE §74.351. 

Gracy Woods timely filed objections to the report and curriculum vitae on 

February 20, 2015. (CR 101). TEX. CIV. PRAC. & REM. CODE §74.351(a). 

 The 120-day deadline for Mahan to serve a compliant expert report 

expired on April 11, 2015. (CR 8). TEX. CIV. PRAC. & REM. CODE

§74.351(a). 

 Gracy Woods filed its Motion to Dismiss on August 12, 2015. (CR 

301). Mahan filed her response on August 24, 2015. (CR 376). The 

Honorable Gisela Triana heard oral argument on August 25, 2015. (CR 

374, RR 1). 

                                                            

6 On behalf of Ms. Rivera’s estate, Mahan seeks punitive damages and damages for 

pain, suffering, mental anguish, disability, reasonable and necessary medical 

expenses, lost earning capacity, loss of household services, and past and future 

medical care. (CR 5). (Supp. CR 5). 
4 

 Judge Triana denied Gracy Woods’ Motion to Dismiss on September 

1, 2015. (CR 446). Gracy Woods filed its Notice of Accelerated Appeal on 

September 17, 2015. (CR 447). 

SUMMARY OF THE ARGUMENT

 Dr. Lipson’s report is deficient and does not satisfy the expert report 

requirement set forth in TEX. CIV. PRAC. & REM. CODE §74.351. 

Qualification on Sexual Assault 

 Dr. Lipson is not qualified to offer the opinion that Ms. Rivera was 

sexually assaulted. Dr. Lipson lacks the requisite knowledge, skill, 

experience, training or education regarding the diagnosis or treatment of 

sexual assault to opine that an assault occurred. TEX. CIV. PRAC. & REM.

CODE §74.351(r)(5)(C), §74.403; TEX. R. EVID. 702; Broders v. Heise, 924 

S.W.2d 148, 153 (Tex. 1996); Ly v. Austin, 2007 WL 2010757, at *2 

(Tex.App. –Austin 2007, no pet.). 

Qualification on Nursing Home Standards of Care 

 Dr. Lipson has not shown that he is qualified by training or 

experience to offer the standard of care opinions at issue. TEX. CIV. PRAC.

& REM. CODE §74.351(r)(5)(C), §74.402; Ly, 2007 WL 2010757, at *5 

(generalized, conclusory statements do not establish an expert’s 
5 

qualification); Nexion Health at Garland, Inc. v. Treybig, 2014 WL 

7499373, at *4 (Tex.App. –Dallas 2014, no pet.); Reed v. Granbury Hosp. 

Corp., 117 S.W.3d 404, 411-414 (Tex. App. – Ft. Worth 2003, no pet.). 

Opinions on Breach 

 Dr. Lipson’s report is deficient as to the element of breach. (CR 15-

21). Dr. Lipson’s report offers no explanation based in fact as to when the 

alleged assault occurred, where the alleged assault occurred, who 

committed the alleged assault, or how Gracy Woods departed from its 

applicable standards of care to prevent the alleged assault. (CR 15-21). 

Am. Transitional Care Ctrs. v. Palacios, 46 S.W.3d 873, 880 (Tex. 

2001)(breach cannot be inferred exclusively from an alleged injury);

Senior Care Centers, LLC v. Shelton, 459 S.W.3d 753, 758 and 760 

(Tex.App. –Dallas 2015, no pet.)(plaintiff’s affidavit does not supply a 

basis any greater than the expert’s own conclusions). 

Opinions on Causation 

 Dr. Lipson’s report is deficient as to the element of causation. Dr. 

Lipson offers no explanation to link his conclusions to the facts. TEX. CIV.

PRAC. & REM. CODE §74.351(r)(6); Jelinek v. Casas, 328 S.W.3d 526, 539-

40 (Tex. 2010); Tenet Hosps. Ltd v. Love, 347 S.W.3d 743, 755 (Tex.App. 
6 

–El Paso 2011, no pet.) (“... causation cannot be inferred; it must be 

clearly stated.”). Dr. Lipson’s opinions are based on assumption. Fung v. 

Fischer, 365 S.W.3d 507, 533-34 (Tex.App.-Austin 2012, no pet.), 

overruled on other grounds by Certified EMS, Inc. v. Potts, 392 S.W.3d 

625 (Tex.2013); Cooper v. Arizpe, 2008 WL 940490, at *3-4 (Tex.App. –

San Antonio 2008, pet. denied). He fails to explain how – if at all – he 

eliminated causes other than sexual contact. (CR 15-21). Jelinek, 328 

S.W.3d at 536; Senior Care Centers, LLC, 459 S.W.3d at 759. 

ARGUMENT AND AUTHORITIES 

I. Standard of Review.

 A challenge to a trial court’s decision concerning the sufficiency of 

an expert report is reviewed for abuse of discretion. Am. Transitional 

Care Ctrs. v. Palacios, 46 S.W.3d 873, 875, 877-78 (Tex. 2001). An abuse 

of discretion occurs when a trial court acts in an arbitrary or 

unreasonable manner or without reference to any guiding rules or 

principles. Bowie Memorial Hosp. v. Wright, 79 S.W.3d 48, 52 (Tex. 

2002). A clear failure by the trial court to analyze or apply the law 

correctly constitutes an abuse of discretion. Walker v. Packer, 827 S.W.2d 

833, 840 (Tex. 1992); Ly, 2007 WL 2010757, at *3. 
7 

A court has no discretion to find that a conclusory report is 

sufficient. Palacios, 46 S.W.3d at 880; Jelinek v. Casas, 328 S.W.3d 526, 

540 (Tex. 2010); Kettle v. Baylor Med. Ctr., 232 S.W.3d 832, 837 

(Tex.App. –Dallas 2007, pet. denied). It is an abuse of discretion to 

overrule a defendant’s objection when qualification is not demonstrated 

in the report. Nexion Health v. Treybig, 2014 WL 7499373, at * (Tex.App. 

–Dallas 2014, no pet.); Tenet Hosps. Ltd., 347 S.W.3d at 752. 

II. The Expert Report Requirement. 

 Section 74.351 of the Texas Civil Practice and Remedies Code 

requires a health care liability claimant to serve on each defendant one 

or more expert reports, with corresponding curricula vitae, no later than 

120 days of the date the original answer was filed. TEX. CIV. PRAC. & REM.

CODE §74.351(a). Section 74.351 provides: 

(a) In a health care liability claim, a claimant shall, not later 

than the 120th day after the date each defendant’s 

original answer is filed, serve on that party or the party’s 

attorney one or more expert reports, with a curriculum 

vitae of each expert listed in the report for each physician 

or health care provider against whom a liability claim is 

asserted. ... 

(b) If, as to a defendant physician or health care provider, 

an expert report has not been served within the period 

specified by Subsection (a), the court, on the motion of 
8 

the affected physician or health care provider, shall, 

subject to Subsection (c), enter an order that: 

(1) awards to the affected physician or health care 

provider reasonable attorney’s fees and costs of court 

incurred by the physician or health care provider; and 

(2) dismisses the claim with respect to the physician or 

health care provider, with prejudice to the refiling of 

the claim. 

(c) If an expert report has not been served within the period 

specified by Subsection (a) because elements of the 

report are found deficient, the court may grant one 30-

day extension to the claimant in order to cure the 

deficiency. ... 

TEX. CIV. PRAC. & REM. CODE §74.351(a)-(c). 

Dismissal is mandatory if no report is served within the 120-day 

deadline. Id. at §74.351(b). A deficient report, even if timely served, does 

not satisfy the statute. Lewis v. Funderburk, 253 S.W.3d 204, 207-08 

(Tex. 2008). A report is deficient when it “does not represent an objective 

good faith effort to comply with the definition of an expert report.” TEX.

CIV. PRAC. & REM. CODE §74.351(l). 

The statute defines “expert report” as: 

a written report by an expert that provides a fair summary of 

the expert’s opinions as of the date of the report regarding 

applicable standards of care, the manner in which the care 

rendered by the physician or health care provider failed to 
9 

meet the standards, and the causal relationship between that 

failure and the injury, harm, or damages claimed. 

Id. at §74.351(r)(6). 

To qualify as a “good faith effort” and satisfy the statute, the report 

must provide enough information to fulfill two purposes. First, the report 

must inform the defendant of the specific conduct the plaintiff has called 

into question. Second, and equally important, the report must provide a 

basis for the trial court to conclude that the claims have merit. Scoresby 

v. Santillan, 346 S.W.3d 546, 556 (Tex. 2011), citing Am. Transitional 

Care Ctrs of Tex., Inc. v. Palacios, 46 S.W.3d 873, 879 (Tex. 2001). The 

report or reports must include the expert’s opinion on all three elements 

– standard of care, breach and causation. Scoresby, 346 S.W.3d at 556; 

Palacios, 46 S.W.3d at 878-79. 

 A report cannot merely state the expert’s conclusions about the 

elements, but rather, the expert must explain the basis of his statements 

to link his conclusions to the facts. Jelinek v. Casas, 328 S.W.3d at 539; 

Bowie v. Wright, 79 S.W.3d 48, 52 (Tex. 2002)(quoting Earle v. Ratliff, 

998 S.W.2d 882, 890 (Tex. 1999); Palacios, 46 S.W.3d at 879; Austin 

Heart, P.A. v. Webb, 228 S.W.3d 276, 279 (Tex.App. –Austin 2007, no 

pet.). It is not enough that the report “provide insight” about the 
10 

plaintiff’s claims. Jones v. King, 255 S.W.3d 156, 159 (Tex.App. –San 

Antonio 2008, pet. denied). 

 Also, the author of the report must be qualified. TEX. CIV. PRAC. &

REM. CODE §74.351(r)(6), §74.402 (defining qualifications of an expert 

witness as to departures from the standard of care), and §74.403 (defining 

the qualifications of an expert on causation); Broders, 924 S.W.2d at 153; 

Ly v. Austin, 2007 WL 2010757, at *2 (Tex.App. –Austin 2007, no 

pet.)(“an ‘expert report’ first must be a ‘written report by an 

expert.’”)(emphasis in original). 

III. The Four Corners Rule. 

 When evaluating the report, the court must not fill gaps or draw 

inferences with respect to opinions or qualification.7 Scoresby, 346 

S.W.3d at 556; Wright, 79 S.W.3d at 53; Palacios, 46 S.W.3d at 878 (“... 

the only information relevant to the inquiry is within the four corners of 

the report.”); Austin Heart, P.A., 228 S.W.3d at 279 (the four corners rule 

“precludes a court from filling gaps in a report by drawing inferences or 

guessing as to what the expert likely meant or intended to say.”); Ly v. 

                                                            

7 Reports should not be construed in favor of the claimant. Kettle v. Baylor Med. Ctr., 

232 S.W.3d 832, 837 (Tex.App. –Dallas 2007, pet. denied (emphasis supplied);

Palacios, 46 S.W.3d at 877 (directing courts not to indulge in reasonable inferences 

in favor of the nonmovant). 
11 

Austin, 2007 WL 2010757, at *2; In re Samonte, 163 S.W.3d 229, 234 

(Tex.App. –El Paso 2005, orig. proceeding). 

IV. Dr. Lipson is Not Qualified to Offer the Opinions Asserted in His 

Report. 

 

A. Dr. Lipson is Not Qualified to Offer Causation Opinions, 

Particularly That a Sexual Assault Occurred.

Ms. Rivera did not claim that she was sexually assaulted. (CR 15-

22). According to the records Dr. Lipson reviewed, Ms. Rivera did not 

recall having any sexual contact. (CR 16, 96). Dr. Lipson is not qualified 

to conclude that Ms. Rivera’s alleged injuries and behavior were the 

result of sexual assault. TEX. CIV. PRAC. & REM. CODE §74.403(a); 

Broders, 924 S.W.2d at 152-53. 

The TMLA provides that “... a person may qualify as an expert on 

the issue of the causal relationship between the alleged departure from 

accepted standards of care and the injury, harm or damages claimed only 

if the person is a physician and is otherwise qualified to render opinions 

on that causal relationship under the Texas Rules of Evidence.” TEX. CIV.

PRAC. & REM. CODE §74.403(a). 

The Texas Rules of Evidence state that “[i]f scientific, technical, or 

other specialized knowledge will assist the trier of fact to understand the 
12 

evidence or to determine a fact in issue, a witness qualified as an expert 

by knowledge, skill, experience, training, or education may testify thereto 

in the form of an opinion or otherwise.” TEX. R. EVID. 702. 

 Every licensed doctor is not automatically qualified to testify as an 

expert on every medical question. Broders, 924 S.W.2d at 152. “What is 

required is that the offering party establish that the expert has 

‘knowledge, skill, experience, training, or education’ regarding the 

specific issue before the court which would qualify the expert to give an 

opinion on that particular subject.” Id. (emphasis supplied). 

 Dr. Lipson does not claim to have any expertise in the diagnosis of 

sexual assault. (CR 15-67). Dr. Lipson’s report does not show that he has 

ever examined a patient for sexual assault, diagnosed a patient with 

sexual assault, or treated a patient for sexual assault. Id. Dr. Lipson’s 

report does not reveal that he has any experience treating any injury or 

conditions of the female genitalia or even performing pelvic 

examinations. Id. 

 Dr. Lipson’s opinions do not rise above mere speculation. He simply 

lacks the special knowledge, skill, experience, training, or education to 

testify that Ms. Rivera’s alleged injuries were caused by sexual assault. 
13 

(CR 15-67). TEX. CIV. PRAC. & REM. CODE §74.403; TEX. R. EVID. 702;

Broders, 924 S.W.2d at 152-54 (finding that an emergency medicine 

physician was not qualified to offer opinions that earlier diagnosis and 

treatment of a head injury would have prevented the patient’s death due 

to lack of experience treating head injuries); Cortez v. Tomas, 2012 WL 

407382, at *3, 6 (Tex.App. –Fort Worth 2012, no pet.)(finding that a 

Board-certified OB/GYN was not qualified to offer causation opinions 

concerning the outcome of an ovarian surgery due to lack of experience 

performing the surgery); Pediatrix Med. Servs. Inc. v. De La O, 368 

S.W.3d 34, 39-40 (Tex.App.–El Paso 2012, no pet.) (finding that a Boardcertified neonatologist and pediatrician was not qualified to render 

opinions as to the cause of a baby’s blindness). 

B. Dr. Lipson is Not Qualified to Offer Opinions Concerning Gracy 

Woods’ Standard of Care or Alleged Breach. 

 

1. The expert must be qualified on standard of care and breach. 

To offer opinions on the issue of whether a health care provider 

departed from the accepted standards of health care, the expert must 

satisfy the requirements of TEX. CIV. PRAC. & REM. CODE §74.402: 

(b) In a suit involving a health care liability claim against a 

health care provider, a person may qualify as an expert 

witness on the issue of whether the health care provider 
14 

departed from accepted standards of care only if the 

person: 

(1) is practicing health care in a field of practice that 

involves the same type of care and treatment as that 

delivered by the defendant health care provider, if the 

defendant health care provider is an individual, at 

the time the testimony is given or was practicing that 

type of health care at the time the claim arose; 

(2) has knowledge of accepted standards of care for 

health care providers for the diagnosis, care, or 

treatment of the illness, injury, or condition involved 

in the claim; and 

(3) is qualified on the basis of training or experience to 

offer an expert opinion regarding those accepted 

standards of health care. 

(c) In determining whether a witness is qualified on the 

basis of training or experience, the court shall consider 

whether, at the time the claim arose or at the time the 

testimony is given, the witness: 

(1) is certified by a licensing agency of one or more states 

of the United States or a national professional 

certifying agency, or has other substantial training or 

experience, in the area of health care relevant to the 

claim; and 

(2) is actively practicing health care in rendering health 

care services relevant to the claim. 

TEX. CIV. PRAC. & REM. CODE §74.402(b) and (c), §74.351(r)(5)(B). 

 
15 

 “Practicing health care” includes: 

(1) training health care providers in the same field as the 

defendant health care provider at an accredited 

educational institution; or 

(2) serving as a consulting health care provider and 

being licensed, certified, or registered in the same 

field as the defendant health care provider. 

 Id. at §74.402(a). 

 Generalized, conclusory statements do not establish an expert’s 

qualification; the report must provide specific details regarding the 

expert’s training and experience. Ly, 2007 WL 2010757, at *5 (emphasis 

supplied); Tomasi v. Liao, 63 S.W.3d 62, 66 (Tex.App. –San Antonio 2001, 

no pet.); Methodist Hosp. Levelland v. Kimbrell, 2009 WL 3101315, at *2 

(Tex.App. –Amarillo 2009, no pet.)(“... we must know not only what the 

nurse was obligated to do but also how the expert knew that.”); In re 

Samonte, 163 S.W.3d at 234; see Palacios, 46 S.W.3d at 879 (“the only 

information relevant to the inquiry is within the four corners of the 

document.”). 

 Experience as a physician – even experience as a physician who 

treats geriatric patients in nursing homes – does not automatically 

establish expertise on nursing home standards of care. TEX. CIV. PRAC. &
16 

REM. CODE §74.402(b); Nexion Health at Garland, Inc. v. Treybig, 2014 

WL 7499373, at *4 (Tex.App. –Dallas 2014, no pet.)(a physician’s 

statement that he has provided primary care to patients in nursing 

homes did not establish the physician’s familiarity with nursing home 

standards of care); Nacogdoches County Hosp. Dist. v. Felment, 2013 WL 

6207838, at *3-4 (Tex.App. –Tyler 2013, no pet.)(a physician who served 

on hospital ethics and bylaws committees was not qualified to offer 

opinions concerning hospital protocols); Tenet Hosps. Ltd. v. Love, 347 

S.W.3d 743, 750-51 (Tex.App. –El Paso 2011, no pet.) (“merely working 

for a hospital does not automatically qualify an expert with experience in 

running a hospital, nor does serving on a committee without further 

explanation as to whether those committees involved determining 

hospital policies and procedures...”); Christus Health Southeast Texas v. 

Broussard, 267 S.W.3d 531, 536 (Tex.App. –Beaumont 2008, no 

pet.)(“[t]he fact that [Dr.] Peters is on staff at a hospital and serves on 

the hospital’s credentials committee does not establish that he possesses 

specialized knowledge of the protocols, policies, or procedures a hospital 

of ordinary prudence would have in place ... .”); Reed v. Granbury Hosp. 

Corp., 117 S.W.3d 404, 411-414 (Tex. App. – Ft. Worth 2003, no pet.)(a 
17 

board certified emergency medicine physician and neurologist with thirty 

years of experience treating stroke patients was not qualified to offer 

opinions on standards of care for hospital policy relating to 

administration of stroke therapy); Shelton v. Sargent, 144 S.W.3d 113, 

123 (Tex. App. – Ft. Worth 2004, pet. denied) (a physician’s experience 

on tumor boards and staffs of various hospitals did not qualify the 

physician to offer opinions on hospital standards of care relating to the 

diagnosis of cancer). 

2. Dr. Lipson did not establish his qualification. 

 Dr. Lipson describes his experience as follows: 

I am familiar with the problem of sexual assault in the 

nursing home setting. I am familiar with the standard of care 

for preventing such assaults. I continue to treat patients in 

the long term care setting and have done so for more than 

thirty years. I am familiar with the standard of care for the 

treatment of patients like Mary Rivera and familiar with the 

required training of employees providing care to residents like 

Mary Rivera. 

(CR 16). 

 Dr. Lipson does not explain the foundation for his familiarity with 

sexual assault in nursing homes, or how he knows the standard of care 

to prevent sexual assault in nursing homes. (CR 16). Further, Dr. Lipson 

does not explain how or why he knows the standard of care for training 
18 

employees in nursing homes. (CR 16). Dr. Lipson cannot utilize 

generalized, conclusory statements to establish his qualification. Ly, 

2007 WL 2010757, at *5; Tomasi, 63 S.W.3d at 66; see also TEX. CIV.

PRAC. & REM. CODE §74.402. He must provide specific details of his 

training and experience and relate that to the specific issue in this case. 

Ly, 2007 WL 2010757, at *5; Tenet Hosps. Ltd., 347 S.W.3d at 750-51; 

Tomasi, 63 S.W.3d at 66; Nacogdoches County Hosp. Dist., 2013 WL 

6207838, at *3-4. 

 Dr. Lipson asserts that the standard of care requires nursing staff 

to be in each resident’s room, the adjacent room, or moving through the 

hall next to the room at all times. (CR 20). Dr. Lipson also asserts that 

nursing staff should have be walking the halls at intervals not to exceed 

ten minutes and documenting “regular checks” in residents’ charts. Id. 

 Dr. Lipson provides no basis or explanation as to how or why he 

allegedly knows these measures were required by the standard of care 

for nursing home staffing and documentation. (CR 15-67). Dr. Lipson’s 

report does not establish that he has ever participated in determining 

nursing home staffing levels or supervising nursing home staff, or that 

he has any expertise to opine that the standard of care requires nursing 
19 

staff to walk the halls at intervals not to exceed ten minutes. Id. Dr. 

Lipson’s report does not show any basis, nor does he offer any 

explanation, as to how he would know the documentary requirements for 

nursing home staff, generally, or in relation to performing “regular 

checks” on residents. Id. 

 Dr. Lipson’s report does not establish that he has the requisite 

expertise to offer opinions on the alleged nursing home standards of care 

at issue or as set forth in his report, and consequently, his report is 

deficient. (CR 15-67). TEX. CIV. PRAC. & REM. CODE §74.402; Treybig, 2014 

WL 7499373, at *4-6; Nacogdoches County Hosp. Dist., 2013 WL 

6207838, at *3-4; Tenet Hosps. Ltd., 347 S.W.3d at 750-51; Christus 

Health Southeast Texas, 267 S.W.3d at 536; see also Reed, 117 S.W.3d at 

411-414; Shelton v. Sargent, 144 S.W.3d at 123; Foster v. Zavala, 214 

S.W.3d 106, 116 (Tex.App.—Eastland 2006, pet. denied)(concluding that 

an expert report by a person not qualified to testify regarding the 

standard of care does not represent a good faith effort to comply with the 

statute.). 

 
20 

V. Dr. Lipson’s Report is Conclusory, Based on Assumption and, 

Therefore, Deficient. 

 

 To satisfy the “good faith effort” requirement, the report must 

include all the required elements and explain their connection to the 

defendant’s conduct in a non-conclusory fashion. Samlowski v. Wooten, 

332 S.W.3d 404, 410 (Tex. 2011); Jelinek, 328 S.W.3d at 539; Palacios, 46 

S.W.3d at 879. The trial court’s analysis is limited to the four corners of 

the report, and the court may not consider extrinsic evidence or supply 

omissions by inference. Bowie Mem’l Hosp. v. Wright, 79 S.W.3d 48, 53 

(Tex. 2002); Palacios, 46 S.W.3d at 878. 

A. Dr. Lipson’s Report is Deficient as to the Element of Breach.

 Dr. Lipson’s report is deficient as to the element of breach because 

he offers only conclusory opinions without the requisite factual basis and 

explanation. (CR 15-21). TEX. CIV. PRAC. & REM. CODE §74.351(r)(6). 

Consequently, the report does not provide the court with a reasonable 

basis to conclude the claims have merit. (CR 15-21). Palacios, 46 S.W.3d 

at 878-9; Austin Heart, P.A. v. Webb, 228 S.W.3d 276, 279 (Tex.App. –

Austin 2007, no pet.)(the trial court is precluded from drawing inferences 

or filling gaps).
21 

 Dr. Lipson alleges that “[t]he facility breached the standard of care 

by not providing twenty-four hour skilled nursing care. The nursing staff 

was not present in the halls or her room to prevent the sexual assault of 

Ms. Rivera.” (CR 20). Dr. Lipson offers no factual basis for these opinions, 

and therefore, they are deficient. (CR 15-21). Palacios, 46 S.W.3d at 879. 

The opinions are further conclusory because they require the court 

to infer that a breach occurred based solely on the alleged injury. (CR 20). 

A finding of negligence may not be inferred solely on evidence of an 

alleged injury. Palacios, 46 S.W.3d at 880 (breach cannot be inferred from 

the existence of an injury alone because the doctrine of res ipsa loquitur 

generally does not apply in health care liability claims); Senior Care 

Centers, LLC v. Shelton, 459 S.W.3d 753, 758 (Tex.App. –Dallas 2015, no 

pet.); see also TEX. CIV. PRAC. & REM. CODE §74.303(e)(2)(jury instruction 

for health care liability claims) and §74.201 (provision limiting 

application of res ipsa loquitur). 

Dr. Lipson also asserts that “[t]he facility breached the standard of 

care by not preventing access to her room by unsupervised males.” (CR 

20). Dr. Lipson does not explain – with any basis in fact – when the 

assault allegedly occurred, where the assault allegedly occurred, or who 
22 

allegedly assaulted Ms. Rivera. (CR 15-21). His allegations that the 

facility allowed access to Ms. Rivera’s room by unsupervised males is 

merely conclusory and, therefore, deficient. Id.; Palacios, 46 S.W.3d at 

879. 

Dr. Lipson alleges that “[t]he records do not indicate any checks on 

Ms. Rivera the night she was assaulted.” (CR 20). Dr. Lipson does not 

provide any factual basis as to which night he claims the alleged assault 

occurred. (CR 15-21). The court must infer that date based on Dr. 

Lipson’s reliance on Mahan’s affidavit regarding broken Christmas 

ornaments.8 (CR 17). 

Dr. Lipson also asserts that “[t]he facility breached the standard of 

care by not moving Ms. Rivera to a room close to the nursing station 

where no unsupervised males could enter her room.” (CR 20). Dr. Lipson 

does not identify the location of Ms. Rivera’s room or its proximity to the 

nursing station, nor does he describe where Ms. Rivera allegedly should 

have been moved in relation to the nursing station. (CR 15-21). 

                                                            

8 Mahan’s allegations and affidavit do not supply Dr. Lipson with the necessary 

rational basis for his opinion to any greater degree than if they were his own belief 

about the facts. Senior Care Centers, LLC, 459 S.W.3d at 760, citing Kerlin v. Arias, 

274 S.W.3d 666, 668 (Tex. 2008). 
23 

Dr. Lipson’s opinions concerning Gracy Woods’ alleged breach are 

deficient because they do not include the requisite explanation and 

connection to the facts. TEX. CIV. PRAC. & REM. CODE §74.351(r)(6); 

Jelinek, 328 S.W.3d at 539-40; Palacios, 46 S.W.3d at 879-80. Dr. Lipson’s 

bare conclusions do not provide the court with a reasonable basis to 

conclude that the claim has merit. Palacios, 46 S.W.3d at 879-80. 

B. Dr. Lipson’s Report is Deficient as to the Element of 

Causation. 

 

 Causation cannot be inferred; it must be clearly stated. Senior Care 

Centers, LLC v. Shelton, 459 S.W.3d 753, 760 (Tex.App. –Dallas 2015, no 

pet.); Tenet Hosps. Ltd. v. Love, 347 S.W.3d 743, 755 (Tex.App. –El Paso 

2011, no pet.). 

 The causal connection in health care liability claims must be made 

“beyond the point of conjecture” and “must show more than a possibility.” 

Lenger v. Physician’s Gen. Hosp., 455 S.W.2d 703, 706 (Tex. 1970); see 

Wright, 79 S.W.3d at 53; algreen Co. v. Hieger, 243 S.W.3d 183, 186-87 

(Tex.App. –Houston [14th Dist.] 2007, pet. denied)( report stating that the 

patient had symptoms “consistent with” known side effects of medication 

was insufficient to demonstrate causal link). 
24 

 An expert report cannot simply opine that the breach caused the 

injury. Jelinek v. Casas, 328 S.W.3d 526, 539 (Tex. 2010). Otherwise, the 

report does not give the trial court any reasonable basis for concluding 

that the claims have merit. Id.; Palacios, 46 S.W.3d at 879; Jelinek, 328 

S.W.3d at 539-40 (reiterating that the expert must explain, to a 

reasonable degree, how and why the breach caused the injury based on 

the facts presented); Senior Care Centers, LLC, 459 S.W.3d at 760 

(holding that the statement “neglect of [the patient] ... caused her to 

aspirate food into her airway, causing acute respiratory failure and is the 

proximate cause of her death,” was insufficient to satisfy the element of 

causation); Tenet Hosps. Ltd. v. Love, 347 S.W.3d 743, 755 (Tex.App. –El 

Paso 2011, no pet.). 

 Dr. Lipson does not explain, to any reasonable degree, how an 

alleged breach by Gracy Woods caused the injuries, damages or harm 

asserted in this litigation. (CR 15-21). TEX. CIV. PRAC. & REM. CODE

§74.351(r)(6). He simply states “[s]he was sexually assaulted.” (CR 20). 

 Dr. Lipson does not explain how an alleged failure to conduct 

hallway surveillance every ten minutes caused the alleged assault. (CR 

15-21). Dr. Lipson does not explain how or why the alleged assault would 
25 

have been prevented but for such surveillance. Id.; see e.g., Costello v. 

Christus Santa Rosa Health Care Corp., 141 S.W.3d 245, 249 (Tex.App. 

–San Antonio 2004, no pet.)(the report was deficient because it failed to 

explain how the alleged breach was a substantial factor in bringing about 

the injury, without which the injury would not have occurred). 

 Similarly, Dr. Lipson does not explain how the location of Ms. 

Rivera’s room in proximity to the nursing station caused the alleged 

sexual assault. (CR 15-21). Dr. Lipson does not explain how an 

unidentified, unsupervised male allegedly accessed Ms. Rivera’s room, 

nor does he explain how moving Ms. Rivera to a different room would 

have prevented that alleged access. Id. Accordingly, the report does not 

provide the court with a reasonable basis to conclude the claim has merit. 

 Dr. Lipson’s report is equally conclusory as to the question of 

whether sexual contact occurred. (CR 15-21). Dr. Lipson does not explain 

how he concluded that the alleged injuries were sexual in origin. Id. Dr. 

Lipson does not explain how he determined that Ms. Rivera’s alleged 

presentation as “tearful and afraid” was the result of sexual assault 

rather than her depression and dementia, which was documented in his 

report. (CR 17, 20). Dr. Lipson does not explain how he concluded that 
26 

the physical findings were caused by sexual contact rather than medical 

examination or routine perineal care.9 (CR 15-21). (RR 11). 

Connecting the opinion to the facts is key. Reports based on 

assumption, speculation, conjecture or contradictory statements do not 

provide the trial court with a basis to conclude the claim has merit. Fung 

v. Fischer, 365 S.W.3d 507, 533-34 (Tex.App.-Austin 2012, no 

pet.)(opinion was deficient because it turned on assumption unsupported 

by the report), overruled on other grounds by Certified EMS, Inc. v. Potts,

392 S.W.3d 625 (Tex.2013); Cooper v. Arizpe, 2008 WL 940490, at *3-4 

(Tex.App. –San Antonio 2008, pet. denied)(report was deficient because 

it relied on the assumption of what was contained in the emergency 

department chart); Murphy v. Mendoza, 234 S.W.3d 23, 28 (Tex.App. –El 

Paso 2007, no pet.)(report was deficient because it was based on an 

assumption that recuts of pathology slides were identical to the 

originals)(emphasis in original); Hutchinson v. Montemayor, 144 S.W.3d 

614, 617-18 (Tex.App. –San Antonio 2004, no pet.)(report was deficient 

because it did not show more than possibility and speculation that the 

                                                            

9 Ms. Rivera had an extensive list of physicians and health care providers, but Dr. 

Lipson limited his analysis of medical records to Gracy Woods and St. David’s 

Hospital. (CR 16, 282-92). See also CR 105 (Gracy Woods’ objection to Dr. Lipson’s 

limited review of Ms. Rivera’s medical records). 
27 

patient would have had a better outcome had an arteriogram been 

performed). 

 When the facts support equal inferences from which different 

conclusions could be drawn, the expert must explain how he eliminated 

the possibilities not chosen to reach his conclusion. Senior Care Centers, 

LLC, 459 S.W.3d at 753, citing Jelinek, 328 S.W.3d at 536. A conclusion 

should be rejected if it is not accompanied by an explanation 

demonstrating why the other, rational possibilities are inferior to the 

chosen conclusion. Jelinek, 328 S.W.3d at 536; Senior Care Centers, LLC, 

459 S.W.3d at 759-60. 

 Dr. Lipson assumes that Ms. Rivera experienced sexual contact, 

without excluding other, innocuous causes. Consequently, his report is 

deficient. Jelinek, 328 S.W.3d at 536; Senior Care Centers, LLC, 459 

S.W.3d at 759-60. 

CONCLUSION 

 Dr. Lipson’s report does not represent a good faith effort to comply 

with TEX. CIV. PRAC. & REM. CODE §74.351(r)(6). 

 Dr. Lipson is not qualified to render the opinions contained in his 

report, as to the standard of care, alleged breach, or the purported causal 
28 

relationship. (CR 15-67). TEX. CIV. PRAC. & REM. CODE §74.402, §74.403; 

TEX. R. EVID. 702. As such, the trial court abused its by overruling Gracy 

Woods’ objections to Dr. Lipson’s lack of qualification. Nexion Health v. 

Treybig, 2014 WL 7499373, at * (Tex.App. –Dallas 2014, no pet.); Tenet 

Hosps. Ltd., 347 S.W.3d at 752; In re Samonte, 163 S.W.3d 229, 237-38 

(Tex.App. –El Paso 2005, orig. proceeding); In re Windisch, 138 S.W.3d 

507, 514 (Tex.App. –Amarillo 2004, orig. proceeding). 

 Additionally, the trial court abused its discretion in finding Dr. 

Lipson’s report satisfies TEX. CIV. PRAC. & REM. CODE §74.351(r)(6) 

because the report is conclusory and, therefore, deficient as to the 

elements of breach and causation. (CR 15-21). TEX. CIV. PRAC. & REM.

CODE §74.351 (l), (r)(6); Palacios, 46 S.W.3d at 880; Jelinek v. Casas, 328 

S.W.3d at 540. 

PRAYER 

 Gracy Woods prays that the Court reverse the trial court’s Order 

Denying Defendant’s Motion to Dismiss and that the Court render 

dismissal of all claims against Gracy Woods with prejudice to their refiling. Gracy Woods seeks such other relief that the Court deems 

appropriate. 
29 

Respectfully submitted, 

By: /s/ Emily J. Davenport 

EMILY J. DAVENPORT 

State Bar No. 24012501 

JANICE M. BYINGTON 

State Bar No. 24006938 

REED, CLAYMON, MEEKER 

& HARGETT, PLLC 

5608 Parkcrest Drive, Suite 200 

Austin, Texas 78731 

(512) 660-5960 Telephone 

(512) 660-5979 Facsimile 

ATTORNEYS FOR APPELLANT 

 
30 

CERTIFICATE OF COMPLIANCE

I hereby certify that the foregoing brief has been compiled using a 

computer program in Word with 14-point font conventional typeface for 

the body of this brief. Excluding the portions of the brief exempted 

pursuant to rule 9.4 of the Texas Rules of Appellate Procedure, this 

petition for writ of mandamus contains 6,113 words. 

 /s/ Emily J. Davenport 

Emily J. Davenport 
31 

CERTIFICATE OF SERVICE 

 

 Pursuant to rule 9.5 of the Texas Rules of Appellate Procedure, I 

hereby certify that a true and correct copy of the foregoing instrument 

has been served electronically through the electronic filing manager or 

sent by e-mail, if possible, and also by certified mail, return receipt 

requested on the Appellee this 10th day of November, 2015: 

Jack Modesett, III 

ModesettWilliams, PLLC 

515 Congress Ave., Suite 1650 

Austin, Texas 78701 

jack@jmodesettlaw.com 

 /s/ Emily J. Davenport 

Emily J. Davenport 
446

DC BK15246 PG179 

CAUSE NO. D-1-GN-14-005169 

Filed in The District Court 

of Travis County, Texas 

SEP - 1 2015 

MARTHA MAHAN, AS THE REPRESENTATIVE OF THE ESTATE OF 

MARY RIVERA, 

§ 

§ 

§ 

§ 

§ 

§ 

TRAVIS COUNTY, TEXA 

v. 

PM MANAGEMENT- AUSTIN NC, LLC § 

d/b/a GRACY WOODS I NURSING HOME § 250TH JUDICIAL DISTRICT 

ORDER DENYING 

DEFENDANT'S MOTION TO DISMISS 

On~ c~ ~~fi.eard Defendant's Motion to Dismiss in this matter. 

Having heard the evidence and arguments of counsel in this matter the Court hereby denies 

in all things Defendant's motion. 

5~/J --k L rL ~ ~~ .2G1> 

0 ~ J6DGEPRESIDING k1wA.. £) ~ 

1111111111111111111111111111111111111111111111111111111 

004195097 

APPENDIX 1

®!J 
301

8/12/2015 4:05:13 PM 

CAUSE NO. D-1-GN-14-005169 

MARTHA MAHAN, AS THE 

REPRESENTATIVE OF THE 

ESTATE OF MARY RIVERA 

v. 

GRACY WOODS I NURSING HOME 

§ 

§ 

§ 

§ 

§ 

§ 

§ 

IN THE DISTRICT COURT 

TRAVIS COUNTY, TEXAS 

250TH JUDICIAL DISTRICT 

DEFENDANT'S MOTION TO DISMISS 

TO THE HONORABLE COURT: 

Velva L. Price 

District Clerk 

Travis County 

D-1-GN-14-005169 

Tamara Franklin 

NOW COMES Defendant Gracy Woods I Nursing Home, actually known as PM 

Management- Austin NC, LLC d/b/a Gracy Woods Nursing Center ("Defendant"), and files its 

Motion to Dismiss pursuant to TEX. Crv. PRAC. & REM. CODE §74.351(b) and would respectfully 

show: 

I. 

This is a motion to dismiss a health care liability claim pursuant to TEX. Crv. PRAC. & 

REM. CODE. §74.351(b). Plaintiff filed suit on December 11, 2014, alleging that Ms. Rivera was 

sexually assaulted while a resident at Gracy Woods. Defendant filed its answer the next day, 

December 12, 2014, denying Plaintiff's allegations. Plaintiff served the report and curriculum 

vitae of Loren Lipson, M.D., on January 30, 2015 in an effort to comply with the 120-day expert 

report rule. 1 Gracy Woods timely filed its objections? In summary, Defendant objected that Dr. 

Lipson is not qualified to offer the opinions stated in his report, that Dr. Lipson's opinions are 

conclusory and speculative, and that Dr. Lipson relies on and incorporates causation opinions 

1 True and correct copies of Dr. Lipson's report and curriculum vitae are attached hereto as Exhibits A and B, 

respectively, and incorporated herein for all purposes. 2 Defendant previously filed its Objections to Plaintiffs Expert Report and Curriculum Vitae. Defendant 

incorporates its Objections to Plaintiffs Expert Report and Curriculum Vitae herein by reference pursuant to Rule 

58 of the Texas Rules of Civil Procedure. 

1 

APPENDIX 2
302

from witnesses who are barred from offering opinions pursuant to TEX. Crv. PRAC. & REM. CODE 

§74.402 and §74.403. More than 120 days have expired since Defendant filed its original answer 

on December 12, 2014, and Defendant seeks dismissal pursuant to TEX. Crv. PRAC. & REM. 

CODE §74.351(b). 

II. 

Section 74.351 of the Texas Civil Practice and Remedies Code provides: 

(a) In a health care liability claim, a claimant shall, not later than the 120th day 

after the date each defendant's original answer is filed, serve on that party or 

the party's attorney one or more expert reports, with a curriculum vitae of 

each expert listed in the report for each physician or health care provider 

against whom a liability claim is asserted. The date for serving the report may 

be extended by written agreement of the affected parties. Each defendant 

physician or health care provider whose conduct is implicated in a report must 

file and serve any objection to the sufficiency of the report not later than the 

later of the 21st day after the date the report is served or the 21st day after the 

date the defendant's answer is filed, failing which all objections are waived. 

(b) If, as to a defendant physician or health care provider, an expert report has not 

been served within the period specified by Subsection (a), the court, on the 

motion of the affected physician or health care provider, shall, subject to 

Subsection (c), enter an order that: 

(1) awards to the affected physician or health care provider reasonable 

attorney's fees and costs of court incurred by the physician or health care 

provider; and 

(2) dismisses the claim with respect to the physician or health care provider, 

with prejudice to the refiling of the claim. 

(c) If an expert report has not been served within the period specified by 

Subsection (a) because elements of the report are found deficient, the court 

may grant one 30-day extension to the claimant in order to cure the 

deficiency .... 

TEX. Crv. PRAC. & REM. CODE §74.351(a)-(c). 

III. 

A report "has not been served" under the statute when it has been physically and timely 

served but is found deficient by the trial court. Lewis v. Funderburk, 253 S.W.3d 204, 207-08 

2 
303

(Tex. 2008). A report is deficient when it "does not represent an objective good faith effort to 

comply with the [statute's] definition of an expert report." Tex. Civ. Prac. & Rem. Code §74.351 

(!). The statute defines "expert report" as "a written report by an expert that provides a fair 

summary of the expert's opinions as of the date of the report regarding applicable standards of 

care, the manner in which the care rendered by the physician or health care provider failed to 

meet the standards, and the causal relationship between that failure and the injury, harm, or 

damages claimed." !d. §74.351(r)(6). 

IV. 

To qualify as a "good faith effort," the report must provide enough information to fulfill 

two purposes. First, the report must inform the defendant of the specific conduct the plaintiffhas 

called into question. Second, and equally important, the report must provide a basis for the trial 

court to conclude that the claims have merit. Scoresby v. Santillan, 346 S.W.3d 546, 556 (Tex. 

2011), citing Am. Transitional Care Ctrs of Tex., Inc. v. Palacios, 46 S.W.3d 873, 879 (Tex. 

2001). No particular words or formality are required, but bare conclusions will not suffice. 

Palacios, 46 S.W.3d at 879. The report must address all elements, and omissions may not be 

supplied by inference. !d.; Bowie Mem 'l Hasp. v. Wright, 79 S.W.3d 48, 53 (Tex. ("[t]he report 

must include the required information within its four comers."). The trial court is precluded from 

filling gaps by drawing inferences or guessing as to what the expert likely meant or intended to 

say. Austin Heart P.A. v. Webb, 228 S.W.3d 276, 279 (Tex.App. -Austin 2007, no pet.). 

v. 

OBJECTIONS TO QUALIFICATIONS 

An expert report is not adequate unless the author is qualified. Ly v. Austin, 2007 WL 

2010757, at *2 (Tex.App. -Austin 2007, no pet.) ("an 'expert report' must first be a 'written 

report by an expert."') (emphasis in original); In re Windisch, 138 S.W.3d 507, 511 (Tex.App.-

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Amarillo 2004, orig. proceeding). The author must be qualified to offer opinions regarding the 

care which is the specific subject of the claim against the defendant. Broders v. Heise, 924 

S.W.2d 148, 153 (Tex. 1996); Cortez v. Tomas, 2012 WL 407382, at *3. Analysis of the expert's 

qualification is limited to the four comers of the report and the expert's CV. Cortez, 2012 WL 

407382, at *3; Ly v. Austin, 2007 WL 2010757, at *2 (reiterating that the "report itself must 

establish the expert's qualifications on the basis of training and experience"); Foster v. Zavala, 

214 S.W.3d 106 (Tex.App. -Eastland 2006, pet. denied); In re Samonte, 163 S.W.3d 229, 234 

(Tex.App. -El Paso 2005, orig. proceeding); In re Windisch, 138 S.W.3d at 511; Palacios, 46 

S.W.3d at 879. 

VI. 

For someone offering opinion testimony regarding the standard of care and alleged 

breach, the statute defines an "expert" as follows: 

(a) For the purposes of this section, "practicing health care" includes: 

(1) training health care providers in the same field as the defendant health care 

provider at an accredited educational institution; or 

(2) serving as a consulting health care provider and being licensed, certified, 

or registered in the same field as the defendant health care provider. 

(b) In a suit involving a health care liability claim against a health care provider, a 

person may quality as an expert witness on the issue of whether the health 

care provider departed from accepted standards of care only if the person: 

(1) is practicing health care in a field of practice that involves the same type 

of care and treatment as that delivered by the defendant health care 

provider, if the defendant health care provider is an individual, at the time 

the testimony is given or was practicing that type of health care at the time 

the claim arose; 

(2) has knowledge of accepted standards of care for health care providers for 

the diagnosis, care, or treatment of the illness, injury, or condition 

involved in the claim; and 

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(3) is qualified on the basis of training or experience to offer an expert 

opinion regarding those accepted standards ofhealth care. 

(c) In determining whether a witness is qualified on the basis of training or 

experience, the court shall consider whether, at the time the claim arose or at 

the time the testimony is given, the witness: 

(1) is certified by a licensing agency of one or more states of the United States 

or a national professional certifying agency, or has other substantial 

training or experience, in the area ofhealth care relevant to the claim; and 

(2) is actively practicing health care in rendering health care services relevant 

to the claim. 

TEX. Crv. PRAC. & REM. CODE §74.351(r)(5)(B), §74.402. 

VII. 

For someone offering opinion testimony as to the alleged causal relationship, the statute 

defines "expert" as a physician who is otherwise qualified to render opinions on such causal 

relationship under the Texas Rules of Evidence. !d. at §74.351(r)(5)(C), §74.403 (" ... a person 

may qualify as an expert witness on the issue of the causal relationship between the alleged 

departure from accepted standards of care and the injury, harm, or damages claimed only if the 

person is a physician and is otherwise qualified to render opinions on that causal relationship 

under the Texas Rules of Evidence."); TEX. R. Evm. 702 ("If scientific, technical, or other 

specialized knowledge will assist the trier of fact to understand the evidence or to determine a 

fact in issue, a witness qualified as an expert by knowledge, skill, experience, training or 

education may testify thereto in the form of an opinion or otherwise."). The expert must have 

knowledge, skill, experience, training, or education regarding the specific issue before the court 

that would qualify the expert to give an opinion on that particular subject. Broders v. Heise, 924 

S.W.2d 148, 153 (Tex. 1996). 

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VIII. 

A. LOREN LIPSON, MD, IS NOT QUALIFIED TO OFFER CAUSATION 

OPINIONS. 

Dr. Lipson does not claim to have any special training or experience in the diagnosis or 

treatment of gynecological illnesses or injuries, nor does he claim to have any special 

knowledge, skill, experience, training or education in the diagnosis or treatment of sexual 

assault. Exhibits A and B. Nothing in Dr. Lipson's report or curriculum vitae indicates that he 

has ever diagnosed a sexual assault or rendered any treatment to a patient following an alleged 

sexual assault. !d. Nothing in Dr. Lipson's curriculum vitae or his report indicates that he 

lectures on sexual assault or gynecological illnesses or injuries relevant to this claim or that Dr. 

Lipson has any other special knowledge in the diagnosis or treatment of sexual assault. !d. 

Dr. Lipson has failed to establish that he has any special knowledge, skill, experience, 

training or education on the specific issues in this case: whether Ms. Rivera sustained injuries 

and whether those injuries, if any, were caused by a sexual assault. Exhibits A and B; TEX. Crv. 

PRAC. & REM. CODE §74.403; TEX. R. Evm. 702; Broders, 924 S.W.2d at 152-54. Although Dr. 

Lipson is a physician, his opinions on causation do not rise above mere speculation. !d. at 153. 

Dr. Lipson is not qualified to offer the opinions asserted in his report concerning Ms. Rivera's 

alleged sexual assault, and consequently, his report is deficient. TEX. Crv. PRAC. & REM. CODE 

§74.351, §74.403; TEX. R. Evm. 702; Broders, 924 S.W.2d at 152-54 (finding that an 

emergency medicine physician was not qualified to offer opinions regarding causation in a head 

injury case); Pediatrix Med. Servs. Inc. v. De La 0, 368 S.W.3d 34, 39-40 (Tex.App.-El Paso 

2012, no pet.) (finding that a Board-certified neonatologist and pediatrician was not qualified to 

render an expert opinion as to the cause of a baby's blindness); Cortez, 2012 WL 407382, at *3, 

6 (finding that a Board-certified OB/GYN was not qualified to offer causation opinions 

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concemmg an ovanan surgery because the physician lacked surgical expenence removmg 

ovaries and relating to injury to the patient's bowel). 

B. JENNY BLACK, RN, IS NOT QUALIFIED TO OFFER CAUSATION OPINIONS. 

Plaintiff served a statement by Jenny Black, RN, but failed to serve any corresponding 

curriculum vitae. According to her statement, Ms. Black is a nurse but not a physician. 

Therefore, she is not qualified to make medical diagnoses or offer causation opinions in this 

litigation? TEX. Crv. PRAC. & REM. CODE §74.351(r)(5)(C), §74.403 (limiting causation opinions 

only to physicians who are otherwise qualified pursuant to the Texas Rules of Evidence); TEX. R. 

Evm. 702; Costello v. Christus Santa Rosa Health Care, 141 S.W.3d 245, 248-49 (Tex.App. -

San Antonio 2004, no pet.)( discussing nurses' lack of qualification to render medical opinions in 

expert reports). 

C. LOREN LIPSON, MD, IS NOT QUALIFIED TO OFFER LIABILITY OPINIONS. 

Dr. Lipson has failed to establish that he has the requisite knowledge, training or 

experience in the operation, management or supervision of nursing homes to offer the opinions 

asserted in his report. TEX. Crv. PRAC. & REM. CODE §74.402. 

Dr. Lipson claims that he continues to treat patients in the long term care setting, but 

neither his report nor his CV identifies a medical practice or a long term care facility where such 

treatment occurs. Exhibits A and B. Dr. Lipson does not explain how that alleged experience or 

experience in geriatric medicine qualify him to offer opinions relating to nursing home standards 

of care. !d. Dr. Lipson does not appear to have any current Board Certification in geriatric 

medicine. Exhibit A at 1. 

3 Dr. Lipson's reliance on Ms. Black's opinion does not qualify it for the purposes of TEX. Crv. PRAC. & REM. CODE 

§74.403 and TEX. R. Evm. 702, because Dr. Lipson is not qualified by his own special knowledge, skill, experience, 

training or education in the diagnosis and treatment of sexual assault. See, e.g., Kelly v. Rendon, 255 S.W.3d 665 

(Tex.App. -Houston [141

h Dist.] 2008, no pet.) (finding that "[w]hile a nurse's report, standing alone, is inadequate 

to meet the requirements of the statute as to medical causation, nothing in the health care liability statute prohibits an 

otherwise qualified physician from relying on a nurse's report in the formation of the physician's own opinion.") 

(emphasis added). 

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Dr. Lipson's report and CV do not describe events in the last decade where he has had 

responsibility for the operation or management of a nursing home, nor does he appear to have 

had the responsibility as the medical director of any nursing home. !d. Dr. Lipson offers 

conclusory statements regarding his alleged familiarity with the standard of care by stating "I am 

familiar with the standard of care for the treatment of patients like Mary Rivera and familiar with 

the required training of employees providing care to residents like Mary Rivera," but he provides 

no facts in support of those assertions. Exhibit A at 2. 

Dr. Lipson's conclusory statements do not establish qualification on the specific issues in 

this case. "An expert cannot rely on generalized, conclusory statements to establish [his] 

qualifications; [he] must provide specific details of [his] training and experience." Ly v. Austin, 

2007 WL 2010757, at *5 (Tex.App. -Austin 2007, no pet.) (affirming the trial court's decision 

that a Board Certified Physical Medicine and Rehabilitation physician who treated stroke 

patients was not qualified to offer expert opinions concerning standards of care for the 

emergency care of acute stroke patients). 

Dr. Lipson has failed to establish that he has experience in the specific issue before this 

court- nursing home standards of care to prevent sexual assault. TEX. Crv. PRAC. & REM. CODE 

§74.402. Even if it is recent, Dr. Lipson's experience in geriatric medicine does not quality him 

to offer opinions relating to nursing facility standards of care. Reed v. Granbury Hasp. Corp., 

117 S.W.3d 404, 411-414 (Tex. App. - Ft. Worth 2003, no pet.)(a board certified emergency 

medicine physician and neurologist with thirty years of experience treating stroke patients not 

qualified to offer opinions on standards of care for hospital policy relating to administration of 

stroke therapy); Shelton v. Sargent, 144 S.W.3d 113, 123 (Tex. App. - Ft. Worth 2004, pet. 

denied). Dr. Lipson has failed to demonstrate that he has the relevant, recent experience required 

to offer opinions relating to Gracy Woods' standards of care and alleged breach, meaning that his 

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report is deficient. TEX. Crv. PRAC. & REM. CODE §74.402; Ly v. Austin, 2007 WL 2010757 

(Tex.App. -Austin 2007, no pet.) (concerning Chapter 74's predecessor, TEX. REv. Crv. STAT., 

art. 4590i). 

IX. 

OBJECTIONS TO THE REPORT 

A report is deficient, and dismissal is mandatory, if the report does not represent an 

objective good faith effort to comply with the definition of an expert report as set out in TEX. 

Crv. PRAC. & REM. CODE §74.351 (r)(6). TEX. Crv. PRAC. & REM. CODE §74.351 (b), (1) and 

(r)(6). To constitute a good faith effort to comply with the statute, the report must provide 

enough information to fulfill two purposes: (1) inform each defendant of the specific conduct the 

plaintiff has called into question; and (2) provide a basis for the trial court to conclude that the 

claims have merit. Palacios, 46 S.W.3d at 878. A report cannot merely state the expert's 

conclusions about the elements, but rather, the expert must explain the basis of his statements to 

link his conclusions to the facts. Jelinek v. Casas, 328 S.W.3d 526, 539 (Tex. 2010); Bowie v. 

Wright, 79 S.W.3d 48, 52 (Tex. 2002)(quoting Earle v. Ratliff, 998 S.W.2d 882, 890 (Tex. 

1999); Palacios, 46 S.W.3d at 879. "A report that merely states the expert's conclusions about 

the standard of care, breach and causation does not fulfill the two purposes of the good-faith 

effort." Jelinek, 328 S.W.3d at 539. 

When assessing the sufficiency of an expert report, the trial court's review is limited 

exclusively to the four comers of the report, and the court may draw no inferences as to what the 

expert meant or intended to say. Gray v. CHCA Bayshore, L.P., 189 S.W.3d 855, 859 (Tex.App. 

-Houston [1st Dist.] 2006, no pet.)( citing Palacios, 46 S.W.3d at 879 (Tex. 2001)); Wright, 79 

S.W.3d at 53; Austin Heart, P.A. v. Webb, 228 S.W.3d 276, 279 (Austin 2007, no pet.); see also 

Garcia v. Marichalar, 198 S.W.3d 250, 254 (Tex.App. -San Antonio 2006, no pet.)(holding that 

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the trial court could not consider counsel's argument or any evidence brought forward at the 

hearing). 

A report cannot merely state the expert's conclusions about the elements, but rather, the 

expert must explain the basis of his statements to link his conclusions to the facts. Jelinek, 328 

S.W.3d at 539 (Tex. 2010); Bowie, 79 S.W.3d at 52 (Tex. 2002); Palacios, 46 S.W.3d at 870. "A 

report that merely states the expert's conclusions about the standard of care, breach and 

causation does not fulfill the two purposes of the good faith effort," which is to put the defendant 

on notice of the specific claims against it and to give the trial court a reasonable basis to 

conclude the claim has merit. Jelinek, 328 S.W.3d at 539; Palacios, 46 S.W.3d 873. 

For example, it is conclusory to say that a health care provider's breach in "reasonable 

medical probability, resulted in a prolonged hospital course and increased pain and suffering." 

Jelinek, 328 S.W.3d at 539. An expert cannot simply opine that a breach caused the injury. !d. 

Stated so briefly, the report fails to satisfy the second prong of the good faith effort in that it does 

not give the trial court a reasonable basis to conclude the case has merit. !d.; Palacios, 46 S.W.3d 

at 879. Instead, the expert must go further and explain "to a reasonable degree, how and why the 

breach caused the injury based on the facts presented." Jelinek, 328 S.W.3d at 539-40. 

A. DR. LIPSON'S REPORT IS DEFICIENT AS TO BREACH. 

Dr. Lipson's report is deficient because he offers only broad, conclusory opmwns, 

without the requisite factual basis and explanation. TEX. Crv. PRAC. & REM. CODE §74.351(r)(6). 

For example, Dr. Lipson asserts that "[t]he facility breached the standard of care by not 

providing twenty-four hour skilled nursing care." Exhibit A, at 6. Dr. Lipson offers no 

explanation or factual basis for his opinion. This assertion does not inform Defendant of the 

specific conduct Plaintiff has called into question with respect to twenty-four hour skilled 

nursing care, nor does it give the court a reasonable basis to conclude that the claim has merit. 

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This is merely a bare, conclusory statement, and it does not reflect a good faith effort to comply 

with TEX. Crv. PRAC. & REM. CODE §74.351. TEX. Crv. PRAC. & REM. CODE §74.351; Jelinek, 

328 S.W.3d at 539; Palacios, 46 S.W.3d 873. 

Similarly, Dr. Lipson concludes that "[t]he nursing staff was not present in the halls or 

her room to prevent the sexual assault of Ms. Rivera." Exhibit A, at 6. Dr. Lipson does not 

identify when or how the alleged sexual assault occurred or who the alleged perpetrator was. He 

does not explain the basis for his conclusion that staff were not present in the halls or Ms. 

Rivera's room. Dr. Lipson does not offer an explanation from which Gracy Woods could 

determine how Dr. Lipson believes the events allegedly occurred, so as to put Gracy Woods on 

notice of the claim, nor does Dr. Lipson offer a reasonable basis for a court to conclude this 

claim has merit. TEX. Crv. PRAC. & REM. CODE §74.351. TEX. Crv. PRAC. & REM. CODE §74.351; 

Jelinek, 328 S.W.3d at 539; Palacios, 46 S.W.3d 873. 

Dr. Lipson's report claims that "[t]he facility breached the standard of care by not 

preventing access to her room by unsupervised males." Exhibit A at 6. Dr. Lipson does not 

identify any factual basis for his assertion that Ms. Rivera's room was accessed by any 

unsupervised males. He does not identity the time at which the alleged access occurred, nor does 

he make any effort to identify the person who he claims accessed Ms. Rivera's room. This is 

merely a bare assertion, with no factual basis. It does not provide enough information to inform 

Defendant of the specific conduct Plaintiff has called into question, nor does it give the trial 

court a reasonable basis to conclude this claim has merit. TEX. Crv. PRAC. & REM. CODE 

§74.351. TEX. Crv. PRAC. & REM. CODE §74.351; Jelinek, 328 S.W.3d at 539; Palacios, 46 

S.W.3d 873. 

Similarly, Dr. Lipson asserts that "[t]he facility breached the standard of care by not 

moving Ms. Rivera to a room close to the nursing station where no unsupervised males could 

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enter her room." Exhibit A at 6. Dr. Lipson offers no explanation or factual basis for his opinion. 

He does not describe the location of Ms. Rivera's room as it relates to the nursing station. As 

discussed above, he offers no information concerning the alleged access to Ms. Rivera's room by 

any unsupervised male. This conclusory statement does not provide the trial court a reasonable 

basis to conclude this claim has merit. TEX. Crv. PRAC. & REM. CODE §74.351. TEX. Crv. PRAC. 

& REM. CODE §74.351; Jelinek, 328 S.W.3d at 539; Palacios, 46 S.W.3d 873. 

B. DR. LIPSON'S REPORT IS DEFICIENT AS TO CAUSATION. 

Dr. Lipson does not offer an explanation or factual basis concerning a causal relationship 

between an alleged breach by Gracy Woods and an alleged sexual assault of Ms. Rivera. Exhibit 

A. Dr. Lipson's report does not provide the trial a reasonable basis to conclude that this claim 

has merit. TEX. Crv. PRAC. & REM. CODE §74.351. TEX. Crv. PRAC. & REM. CODE §74.351; 

Jelinek, 328 S.W.3d at 539; Palacios, 46 S.W.3d 873. 

Dr. Lipson does not explain the basis for his conclusion that a sexual assault occurred. 

Exhibit A. His opinion on this is based on assumption and speculation, and therefore, it is 

deficient. 

Dr. Lipson states that he has considered "other causes of this injury," but he does not 

indicate that the "other causes" are by any means exhaustive. Exhibit A at 7. Dr. Lipson 

considers no alternative to sexual assault, except that the alleged injury might have been selfinflicted. !d. 

When facts support equal references from which different conclusions could be drawn, it 

is incumbent on the expert to explain to a reasonable degree of medical probability how the 

expert eliminated the possibilities not chosen and derived his conclusion. Jelinek, 328 S.W.3d at 

536; Senior Care Centers, LLC v. Shelton, 459 S.W.3d 753, 759-60 (Tex.App. -Dallas 2015, no 

pet.). Here, Dr. Lipson failed to consider and eliminate other causes - particularly those 

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incidental to the patient's care or underlying conditions. Exhibit A. An expert's conclusion not 

accompanied by a rational explanation demonstrating why the other possibilities are inferior to 

the expert's chosen conclusion is a conclusory opinion based solely on the ipse dixit of a 

credentialed witness, and the Texas Supreme Court has instructed that such opinions be rejected. 

Jelinek, 328 S.W.3d at 536; Shelton, 459 S.W.3d at 759-60. 

Dr. Lipson's opinions are merely speculative and, therefore, deficient. Dr. Lipson's 

causation opinions do not provide the court with a reasonable basis to conclude this claim has 

merit. Consequently, this report does not constitute a good faith effort to comply with TEX. Crv. 

PRAC. & REM. CODE §74.351. TEX. Crv. PRAC. & REM. CODE §74.351; Jelinek, 328 S.W.3d at 

539; Palacios, 46 S.W.3d at 878 (Tex. 2001). 

X. 

OBJECTIONS TO THE ATTACHMENTS TO THE REPORT 

Defendant reiterates its objections to Dr. Lipson's report to the extent it incorporates 

statements, medical records and other attachments and would require the Court to draw 

inferences and fill gaps in violation of the four comers rule. Exhibit A. Am. Transitional Care v. 

Palacios, 46 S.W.3d 873, 878 (Tex. 2001). 

XI. 

Defendant objects to Ms. Black's statement or other documentation attached to and 

referenced in Dr. Lipson's report to the extent Plaintiff asserts those items, individually, 

constitute expert reports, which they do not.4 Defendant reasserts its objections that Ms. Black 

lacks the qualification to offer expert opinions regarding causation because she is not a licensed 

physician. TEX. Crv. PRAC. & REM. CODE §74.403; TEX. R. Evm. 702. Defendant objects that no 

4 Exhibit 3 to Dr. Lipson's report, documents bearing the names of Austin/Travis County and St. David's Medical 

Center, are attached hereto as Exhibit F and incorporated herein for all purposes. Defendant attaches these 

documents for the purpose of objecting to them pursuant to TEX. Crv. PRAC. & REM. CODE §74.351. Defendant 

objects to the admissibility of these documents pursuant to TEX. R. Evm. 802. 

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curriculum vitae was provided with respect to Ms. Black. TEX. Crv. PRAC. & REM. CODE 

§74.351, §74.402 and §74.403. Defendant objects that Ms. Black is not qualified to offer 

standard of care or breach opinions relating to Defendant. TEX. Crv. PRAC. & REM. CODE 

§74.402. Defendant further objects to Ms. Black's statement and all other documents authored by 

Ms. Black that are attached to Dr. Lipson's report because they are conclusory and do not 

provide the required explanation or factual bases to represent a good faith effort to comply with 

Section 74.351. TEX. Crv. PRAC. & REM. CODE §74.351; Bowie Mem'l Hasp. v. Wright, 79 

S.W.3d 48, 52-53 (Tex. 2002); Palacios, 46 S.W.3d 873, 878 (Tex. 2001). 

XII. 

Defendant reiterates its objections to the Affidavit of Martha Mahan to the extent 

Plaintiff asserts that Ms. Mahan's affidavit constitutes an expert report, which it does not. 

Plaintiff provided no curriculum vitae. Plaintiff lacks the knowledge, skill, training, education or 

experience to offer opinions regarding Defendant's standard of care, alleged breach or the 

alleged causal relationship. TEX. Crv. PRAC. & REM. CODE §74.351, §74.402 and §74.403. 

Defendant further objects to the Affidavit of Martha Mahan because it is conclusory, speculative, 

and does not constitute a good faith effort to comply with TEX. Crv. PRAC. & REM. CODE 

§74.351. Additionally, Ms. Mahan's affidavit does not supply Dr. Lipson with the necessary 

rational basis for his medical opinion to any greater degree than the beliefs stated in Ms. 

Mahan's affidavit were his own beliefs. An affiant's beliefs about what the facts are does not 

make those beliefs facts nor constitute personal knowledge of the believed facts. Shelton, 459 

S.W.3d at 760. 

XIII. 

Defendant reiterates its objections to the records attached as Exhibit 3 to Dr. Lipson's 

report because they do not constitute an expert report. TEX. Crv. PRAC. & REM. CODE §74.351. 

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Defendant objects that no curricula vitae of the records' authors were produced. Defendant 

objects that the authors of the records attached as Exhibit 3 to Dr. Lipson's report are not 

qualified to offer opinions regarding Defendant's standard of care, alleged breach or the alleged 

causal relationship. TEX. Crv. PRAC. & REM. CODE §74.351, §74.402 and §74.403. Defendant 

further objects to the records attached to Dr. Lipson's report as Exhibit 3 because the opinions 

contained therein, if any, are conclusory and do not constitute a good faith effort to comply with 

TEX. Crv. PRAC. & REM. CODE §74.351. 

XIV. 

CONCLUSION 

Defendant object to Dr. Lipson's report because he has not demonstrated that he is 

qualified to offer opinions concerning Defendant's standard of care or alleged breach. TEX. Crv. 

PRAC. & REM. CODE §74.402. Defendant further objects to Dr. Lipson's report because Dr. 

Lipson lacks the requisite experience to offer opinions concerning the diagnosis of sexual assault 

or opinions concerning the alleged causal relationship. TEX. Crv. PRAC. & REM. CODE §74.403; 

TEX. R. Evm. 702. Defendant further objects to Dr. Lipson's report because Dr. Lipson offers no 

explanation or factual basis to support his breach opinions, meaning that they are merely 

conclusory and, therefore, deficient. TEX. Crv. PRAC. & REM. CODE §74.351(!), (r)(6); Jelinek, 

328 S.W.3d at 539; Palacios, 46 S.W.3d 873. Finally, Defendant objects to Dr. Lipson's report 

because it offers no factual basis or explanation of the causal relationship between Defendant's 

alleged breach and the injuries, damages or harm asserted in this litigation, and because Dr. 

Lipson fails to exclude other reasonable causes for Ms. Rivera's presentation. TEX. Crv. PRAC. & 

REM. CODE §74.351(!), (r)(6); Jelinek, 328 S.W.3d at 536, 539; Palacios, 46 S.W.3d 873; 

Shelton, 459 S.W.3d at 759-60. 

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WHEREFORE, Defendant Gracy Woods I Nursing Home, actually known as PM 

Management - Austin NC, LLC d/b/a Gracy Woods Nursing Center, respectfully requests that 

its objections to Plaintiff's expert report be sustained, that all claims against it be dismissed with 

prejudice to their refiling, that it be awarded its reasonable attorneys' fees and costs of court, and 

that it be granted such further relief to which it may show itself justly entitled. 

REED, CLAYMON, MEEKER & HARGETT, PLLC 

5608 Parkcrest Dr., Suite 200 

Austin, Texas 78731 

(512) 660-5960 

(512) 660-5979 (facsimile) 

edavenport@rcmhlaw.com 

jbyington@rcmhlaw.com 

By: /s/ Emily J. Davenport 

Emily J. Davenport 

State Bar No. 24012501 

Janice M. Byington 

State Bar No. 24006938 

ATTORNEYS FOR DEFENDANT 

GRACY WOODS I NURSING HOME 

A/KIA PM MANAGEMENT - AUSTIN NC, LLC 

DIB/A GRACY WOODS NURSING CENTER 

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CERTIFICATE OF SERVICE 

I hereby certify that a true and correct copy of the foregoing document has been served in 

accordance with TRCP 21a on the 12th day of August, 2015 to the following: 

Jack Modesett III 

Walter V. Williams 

ModesettWilliams, PLLC 

2202 Lake Austin Blvd. 

Austin, TX 78703 

j ack@jmodesettlaw.com 

/s/ Emily J. Davenport 

Emily J. Davenport 

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CAUSE NO. D-1-GN-14-005169 

8/24/2015 3:25:36 PM 

Velva L. Price 

District Clerk 

Travis County 

D-1-GN-14-005169 

Jonathan Sanders 

MARTHA MAHAN, AS THE REPRESENTATIVE OF THE ESTATE OF 

MARY RIVERA, 

§ 

§ 

§ 

§ 

§ 

§ 

IN THE DISTRICT COURT OF 

v. TRAVIS COUNTY, TEXAS 

PM MANAGEMENT- AUSTIN NC, LLC § 

d/b/a GRACY WOODS I NURSING HOME § 250TH JUDICIAL DISTRICT 

PLAINTIFF'S RESPONSE TO 

DEFENDANT'S MOTION TO DISMISS 

COMES NOW Plaintiff Martha Mahan, as the Representative of the Estate of Mary Rivera, 

and files this her response to Defendant's Motion to Dismiss and would respectfully show the 

Court the following: 

I. 

INTRODUCTION 

On November 8, 2013, 78 year-old demented Mary Rivera was sexually assaulted in her 

room, while a resident at Defendant's nursing home facility. The rape occurred after regularly 

scheduled events at the nursing home during which alcohol was served. Mrs. Rivera's daughter, 

Martha Mahan, had previously complained to the facility that younger male residents had behaved 

inappropriately towards Mrs. Rivera. Defendant took no action. 

Early in the morning of November 9, 2013, Ms. Mahan went to visit her mother in the 

nursing home. Ms. Rivera was distressed. Ms. Mahan noted broken glass on the floor of her 

room. When she took her mother to the bathroom, Ms. Rivera attempted to urinate standing up, 

which was unusual. Ms. Mahan also found a wad of bloody rags in Mrs. Rivera's trash can. Ms. 

Mahan showed this evidence to nursing home employees, who destroyed it. Ultimately, Mrs. 

Rivera was taken to St. David's Medical Center where a Sexual Assault Nurse Examiner (SANE) 

performed a post-rape examination. This SANE nurse found bruising to posterior fourchette and 

APPENDIX 3
377

periurethral areas of Mrs. Rivera's vulva as well as bruising on her posterior vaginal wall. 

According to the SANE nurse, this definitively indicated penetration of the female sexual organ. 

In general, Defendant's motion complains that Plaintiffs expert is not qualified to opine 

that a nursing home should take reasonable steps to protect its residents from sexual assault and 

failed in that responsibility to Ms. Rivera. This, of course, is just common sense. 

II. 

WHY DEFENDANT'S MOTION SHOULD BE DENIED 

:::} Defendant's criticism ofDr. Lipson's qualifications is misplaced. Dr. Loren Lipson is one 

of the most qualified experts in the nation in geriatric medicine and elder abuse. His 

experience is broad and deep. His 44 page CV makes the point. In addition to his education 

and teaching, he consults with numerous governmental agencies concerning the standard 

of care for nursing homes, including elder abuse. 

:::} Contrary to Defendant's straw man assertion, there is no need for an expert on 

"gynecological illnesses." Ms. Rivera was raped while a resident in Defendant's facility. 

Rape is not an illness. It is a physical, sexual assault. Dr. Lipson's report on the standard 

of care for a nursing home to not let their residents be sexually assaulted, in light of the 

facts contained in the Mrs. Rivera's medical records, witness statements, Defendant's 

records and the unassailable statistical data concerning sexual assault in nursing homes, is 

on point and remains unrefuted. 

:::} Defendant's other criticism of Dr. Lipson's report is equally misplaced. It is axiomatic 

that experts may rely on a patient's medical records for purposes of a Chapter 74 report. 

Experts can even rely on the pleadings to support a Chapter 74 report. Defendant's 

objections are really evidentiary and wholly inappropriate in connection with a Chapter 74 

report. 

:::} Defendant's criticism about the detail in the report- that it is "conclusory," is betrayed by 

a simple reading of the report itself. 

III. 

DR. LOREN LIPSON- NATIONALLY PROMINENT PHYSICIAN, 

PROFESSOR, LECTURER, CONSULTANT IN GERIATRIC MEDICINE, 

ELDER ABUSE AND RELATED TOPICS 

1. Plaintiff retained the services ofDr. Loren Lipson to evaluate and opine on the facts 

of this case. Dr. Lipson's 7 page report and 44 page CV is attached as Exhibit 1. 

Plaintiff's Response to Defendant's Motion to Dismiss Page2 
378

A. Dr. Lipson- Educational Background in Geriatric Medicine 

2. Dr. Lipson is a graduate of UCLA and The John Hopkins University School of 

Medicine (See CV). Dr. Lipson did his internship and residency at The John Hopkins Hospital. 

Dr. Lipson has fellowships from Harvard (Geriatric Medicine), Beth Israel Hospital 

(Gerontology), Brigham-Women's Hospital (Gerontology), Hebrew Rehabilitation Center 

(Geriatric Medicine) and John Hopkins (Clinical Fellow) among others (See CV). 

B. Dr. Lipson - Certification in Geriatric Medicine 

3. He is boarded in Internal Medicine and Quality Assurance and Utilization Review 

and holds a Certificate of Expertise in Geriatric Medicine from the American Board of Internal 

Medicine (See CV). Quality assurance is the study and implementation of improvements to care 

provided, in Dr. Lipson's case, for the elder population in both the nursing home and hospital 

setting (See CV). 

C. Dr. Lipson- Twenty Seven Academic Appointments in Geriatric Medicine 

4. Dr. Lipson has received twenty-seven academic appointments to include John 

Hopkins, Harvard Medical School (Scholar Geriatric Medicine), Massachusetts General Hospital, 

USC (Associate Professor-Geriatric Medicine), USC (Chief-Division of Geriatric Medicine), 

Brigham-Women's Hospital (Geriatric Medicine), Beth Israel (Geriatric Medicine), USC 

(Gerontology Research Institute) and University of Alaska (Geriatrics). His teaching 

responsibilities include USC-Fellowship Program-Geriatric Medicine, USC-Development and 

Improvement of Geriatric Medical Curriculum, USC-Steering Committee-Pacific Geriatric 

Education Center, and USC-Ethel Percy Andrus Gerontology-Director and lecturer. His 

Plaintiff's Response to Defendant's Motion to Dismiss Page3 
379

teaching responsibilities at the University of Alaska also include Director-Care of Elderly, CoDirector in Geriatric Education and Faculty Consultant to Geriatric residents. 

D. Dr. Lipson - Geriatric Administrative Positions, Including Directorships 

5. Dr. Lipson has further served innumerous administrative positions to include Chief 

ofDivision Geriatric Medicine, Senior Staff Physician-Geriatric Programs, Director of the USC 

Ambulatory Health Center Japanese Retirement Homes, Director-Geriatric Medicine VA Clinic, 

Director of USC Teaching Nursing Home Program, Director of Senior Cancer Center, Director 

of Senior Care Program-USC, Co-Director-Adult Protective Team-Geriatric Medicine 

Program-LAC/USC, Medical Director-Alaska Geriatric Education Center and Medical 

Director National Resource Center for Studies in Native American, Alaskans and Hawaiian 

Elders, University of Alaska. 

E. Dr. Lipson - Geriatric Consultancies: Boards, Program Development 

6. His public service includes Consultant-Geriatric Medicine-State of Alaska, 

Board of Directors, California Association ofMedical Directors, and Task Force on Elder Abuse, 

City of Los Angeles. 

7. Dr. Lipson's consultancies include Geriatric Medicine-Silverado Senior Living 

Centers, Geriatric Medicine-Glendale Adventist Medical Center, Geriatric Program 

Development-Bay Shores Medical Group, Geriatric Program Development-San Dimas 

Community Hospital, Geriatric Program Development and Long Term Care-The Motion Picture 

& Television Home, Long Term & Geriatric Medicine- State of California, Elder Abuse & 

Geriatric Medicine - State of California, Office of the Attorney General, Long Term Care, Elder 

Abuse and Geriatric Medicine-State of California-Office of the Attorney General - Medicaid 

Fraud, Geriatric Medicine and Elder Abuse-State ofNew Mexico, Geriatric Medicine and Elder 

Plaintiff's Response to Defendant's Motion to Dismiss Page4 
380

Abuse-United States of America-Department of Justice, and Long Term Care, Geriatric Medicine 

and Elder Abuse-United States of America-Department of Health and Human Services-Office of 

the Inspector General (See CV). 

F. Dr. Lipson's Lectures on Elder Abuse: Washington U; Harvard; Stanford; Yale; 

Brown; Baylor, etc. 

8. Dr. Lipson has lectured all over the country on issues involving geriatrics, long 

term care, and elder abuse (See CV). The lectures include Washington University, Harvard, Yale, 

the University of New Brunswick, the University of Florida, Stanford, University of Pittsburgh, 

University of Hawaii, University of California San Francisco, Brown, University of Nevada, 

University of Guam, Kansas University, Baylor, Chicago Medical College, University of 

Oklahoma, University of Colorado, University of Kentucky, University of Utah, Southern Illinois 

Medical School, Allegheny Medical School, University of Arizona as well as many others (CV). 

9. Dr. Lipson has published numerous peer reviewed articles, book chapters and 

monograms dealing with the care of the elderly (See CV). 

10. In short, Dr. Lipson is a nationally prominent physician, professor, lecturer and 

consultant in geriatric medicine, abuse of the elderly and related topics. Indeed, he may be the 

most qualified expert in the country and the one the United States Department of Justice and the 

United States Department of Health and Human Services retain when they are in need of this type 

of expertise. 

IV. 

DR. LIPSON'S REPORT EXCEEDS CHAPTER 74's REQUIREMENTS 

A. Dr. Lipson's Review of Pertinent Medical and Other Record 

11. Dr. Lipson's report sets out in detail the information he reviewed in order to render 

his opinions. They include: 

Plaintiff's Response to Defendant's Motion to Dismiss PageS 
381

a. The statement of the daughter Martha Mahan; 

b. The Gracy Woods nursing home records; 

c. The SANE nurse report; 

d. The SANE nurse statement; 

e. The St. David's Hospital records; 

f. The guardianship records regarding Mrs. Rivera; and 

g. The Texas Department of Aging and Disability Services Report. 

B. Dr. Lipson Sets Out Facts Leading to Ms. Rivera's Rape 

12. Dr. Lipson analyzes the facts leading up to the rape of Mrs. Rivera. Dr. Lipson 

notes that several months before Mrs. Rivera's incident another complaint of sexual assault was 

made in the same facility. He opines this should place the facility on heightened alert for this type 

of problem. 

13. Dr. Lipson reviews the citations issued by the State against the nursing home 

including the failure to implement written policies and the failure to report the prior incident to the 

proper law enforcement authorities. 

14. Dr. Lipson then reviews the guardianship records of Mrs. Rivera, which place her 

under the guardianship of her daughter, Martha Mahan. Judge Herman, based on medical exams, 

found Mrs. Rivera was a "totally incapacitated person without capacity to care for herself." Dr. 

Lipson opines this finding is consistent with the records from the nursing home. 

C. Dr. Lipson Carefully Reviews Nursing Home Chart and Ms. Mahan's 

Statement 

15. Dr. Lipson then conducts a careful review of the nursing home chart to establish 

the fact that Ms. Rivera had very poor short and long term memory problems and often did not 

Plaintiff's Response to Defendant's Motion to Dismiss Page6 
382

remember people or where her room was. Dr. Lipson goes on to opine that due to her significant 

mental limitations, Mrs. Rivera required careful monitoring by the staff. 

16. Dr. Lipson then reviews the statement of Martha Mahan, Mrs. Rivera's daughter 

and guardian. Ms. Mahan's statement discussed parties on Friday afternoons where alcohol is 

served to the residents. Ms. Mahan reports that certain male residents acted inappropriately 

towards Mrs. Rivera and that this fact was reported to the management. 

17. Dr. Lipson then reviews the facts surrounding the discovery of the broken glass, 

bloody rags and distressed Mrs. Rivera. He then notes that an external head to toe exam was done 

on Mrs. Rivera which found no exterior wounds. No vaginal exam was done. 

18. Dr. Lipson then discusses the calling of the police and the examination done at St. 

David's Hospital by SANE nurse Jenny Black. Dr. Lipson notes the injuries to both the posterior 

and anterior portions of the vagina. He further reviewed the statement of the SANE nurse 

indicating definitive "penetration of the female sexual organ". 

D. Dr. Lipson Reviews Literature on Sexual Assaults in Texas 

19. Dr. Lipson then cites literature for the disturbing fact that in the four years leading 

up to Mrs. Rivera's assault nearly 400 sexual assaults were reported in Texas nursing homes. Dr. 

Lipson further relates the fact that those who suffer from dementia are at particularly high risk for 

this type of abuse as they are very poor historians. 

20. Dr. Lipson then goes on to discuss how these assaults can be prevented. He notes 

that these facilities all provide 24 hour skilled nursing care as required by law. This means the 

facility must have skilled nurses as well as certified nursing aides on staff twenty-four hours a day 

three hundred and sixty-five days a year. 

Plaintiff's Response to Defendant's Motion to Dismiss Page 7 
383

21. Dr. Lipson goes on to review the literature and reports that most of these assaults 

occur at night and if a facility has a history of reported assaults they are at a greater risk for 

additional incidents. He then reviews the history of reported assault, non-compliance and 

management awareness of these issues. Dr. Lipson reviews the general knowledge within the 

industry of these assaults and the press coverage regularly offered this issue. 

E. Dr. Lipson - Ms. Rivera's Injury Foreseeable and Defendant Owed Duty to Ms. 

Rivera 

22. He then opines that with the significant number of assaults in Texas nursing 

homes, the recent history of reported assault in Defendant's facility and the complaints of the 

daughter Martha Mahan that it is foreseeable assaults would occur if precautions are not taken. 

He then opines a nursing home owes a duty of protection to patients suffering from mental 

incapacity. He then writes that such patients require enhanced supervision and additional staff 

time to protect them from others. This is particularly true, he states, in a facility with a history of 

reported assault and a history of family complaints of inappropriate behavior towards Ms. Rivera. 

F. Dr. Lipson Sets Out Standard of Care 

23. After pages of detail concerning the facts, the records and the foreseeability, Dr. 

Lipson then sets out the standard of care. 

a. The standard of care requires the nursing home provide twenty-four hour a day 

skilled nursing care. The practical result of this requirement is that the staff must 

be moving through the halls and the rooms of the residents all night long. There 

should never be a time when a staff member is not in the next room or moving 

through the halls next to a resident's room. 

b. The standard of care requires that following the report of an assault at a nursing 

facility that the facility control unsupervised access to the rooms of residents at risk. 

The standard of care requires the facility take note of the families' concerns of 

inappropriate behavior and eliminate access to the patient by unsupervised males. 

Residents at risk include women with significant dementia such as Ms. Rivera. In 

light of the family's expressed concern of inappropriate advances to Ms. Rivera, 

Plaintiff's Response to Defendant's Motion to Dismiss Page8 
384

the standard requires heightened scrutiny to include regular walks through the entire 

hall at intervals not to exceed ten minutes to prevent access to her room by males. 

The standard of care requires the nursing staff document the fact that it is 

performing the regular checks in the patients' charts. In addition, the standard of 

care requires Ms. Rivera be moved to a room in close proximity to the nursing 

station following complaints of inappropriate contact with Ms. Rivera. 

G. Dr. Lipson Identifies Breaches of Standard of Care 

24. Dr. Lipson then set out the breaches of the standard of care. 

a. The facility breached the standard of care by not providing twenty-four hour skilled 

nursing care. The nursing staff was not present in the halls or her room to prevent 

the sexual assault of Ms. Rivera. 

b. The facility breached the standard of care by not preventing access to her room by 

unsupervised males. The records do not indicate any checks on Ms. Rivera the 

night she was assaulted. The facility breached the standard of care by not moving 

Ms. Rivera to a room close to the nursing station where no unsupervised males 

could enter her room. 

H. Dr. Lipson Identifies the Harm to Ms. Mahan 

25. Dr. Lipson then sets out the harm caused. The harm caused Ms. Rivera is 

significant. She was sexually assaulted. The injuries to her vagina are well documented in the 

SANE nurse report and above. The daughter reports she was tearful and afraid. This is a 

common response in sexual assault victims. The daughter reports this behavior of fear continued 

even after Ms. Rivera was removed from the facility. The fact she suffered from dementia does 

not lessen the harmful mental effects of sexual assault. Even an animal can remember when it 

has been abused. In many ways Ms. Rivera was like a small child - confused and afraid as a 

result of this sexual assault. The history of problems together with the decision to ignore the 

families' complaints and eliminate unsupervised males from Ms. Rivera's room indicates a 

conscious disregard for the well-being of Ms. Rivera by the facility's management. 

I. Dr. Lipson Eliminates Other Causes of Injury 

Plaintiff's Response to Defendant's Motion to Dismiss Page9 
385

26. Dr. Lipson then considers other potential causes of this injury. He considers 

whether the injuries may be self-inflicted, but discards this idea after a chart review found no 

indications of sexual self-stimulation or self-abuse. He further considered whether the family 

might have caused these injuries but again discards this idea after a chart review indicates the 

family was nothing but supportive. Dr. Lipson further notes Mrs. Rivera was in the nursing home 

at all relevant times and there was no indication she was assaulted on the way to the hospital to 

check to see if she had been sexually assaulted. 

27. In short, Dr. Lipson explains the background facts, his review of the medical and 

factual history, explains the problem with sexual assaults in nursing homes, explains the standard 

of care, the breaches of the standard of care as well as the harm caused. His report explains the 

Defendant's conduct called into question and provides detailed information for this Court to 

determine the claims have merit. 

v. 

ARGUMENT AND AUTHORITIES 

A. The Legal Standard for Qualifications and Reports 

Defendant complains that Dr. Lipson is not qualified under TEX. CIV. PRAc. & REM. CODE 

§74.402 (be a healthcare provider or consultant in "same field" as a defendant, knowledge of the 

standard of care and qualified on basis of training or experience) and §74.403 (i.e., be a physician 

and be otherwise qualified). Dr. Lipson's qualifications are unassailable. 

Defendant also complains that Dr. Lipson's report does not provide it adequate notice 

("good faith effort") under TEX. CIV. PRAc. & REM. CODE §74.351(1). Scoresby v. Santillan, 346 

S.W.3d 546, 556 (Tex. 2011)(To qualify as a good faith effort, it must inform the defendant of the 

Plaintiff's Response to Defendant's Motion to Dismiss Page 10 
386

conduct called into question and provide a basis for the trial court to conclude the claims have 

merit.). The Supreme Court's position on expert reports is well described. 

"The expert report must represent only a good faith effort to provide a fair summary 

of the expert's opinions. A report need not marshall all the plaintiffs proof, but it 

must include the expert's opinion on each of the elements identified in the statute. 

Am. Transitional Care Ctrs. OfTex., Inc. v. Palacios, 46 S.W.3d 873, 878. 

Dr. Lipson's detailed report exceeds this standard. 

A. Dr. Lipson Well-Qualified to Opine on Preventable Sexual Assault in Nursing Home 

Defendant complains Dr. Lipson is not qualified to issue opinions about whether Ms. 

Mahan suffered from a "gynecological illness." Rape is not a gynecological illness. It is an 

assault. The assault has been copiously documented by the SANE nurse and a doctor and 

reviewed by Dr. Lipson. The argument that Dr. Lipson cannot rely on other medical 

professionals' records for his opinions strains credulity. That's like saying a surgeon couldn't 

rely on a radiologist's reading of an MRI to provide the opinion that a patient had a brain tumor. 

The Court's inquiry should focus on whether the expert has the "knowledge, skill, experience, 

training or education regarding the specific issue before the Court which would qualify the expert 

to opine on a particular subject." Tenet Hosp. Ltd. v. Love, 347 S.W.3d 743, 749-50 (Tex. App. 

- El Paso 2011, no pet.) 

The relevant issues addressed by Dr. Lipson are: what do the records say about Ms. 

Mahan's assault; what is the standard of care with respect to the assault; did Defendant breach the 

standard of care concerning the assault; and, was Ms. Mahan injured as a result of that breach. In 

short, should this nursing home have prevented Ms. Rivera's sexual assault? Dr. Lipson is wellqualified to render those opinions. 

Plaintiff's Response to Defendant's Motion to Dismiss Page 11 
387

1. Defendant's Straw Man Argument- Whether Sexual Assault Occurred 

After setting up the straw man-that the required opinions should include whether a sexual 

assault occurred at all - Defendant takes a swing at the medical records that establish the sexual 

assault. Defendant misses. Defendant argues Dr. Lipson may not rely upon the SANE nurse 

report or the medical records in this matter. Defendant cites TEX. CIV. PRAC. & REM. CoDE§ 

74.402 & § 74.403 and Texas Rules of Evidence 702 for this proposition. Defendant's reliance is 

misplaced. §74.402(b)(3) and (c)(2) set out in relevant part: 

(b )(3) (an expert may qualify if he) is qualified on the basis of training or 

experience to offer an expert opinion regarding those accepted standards of health 

care 

( c )(2) is actively practicing health care in rendering health care services relevant to 

the claim. 

§ 74.403 deals with the qualification of a retained expert witness to render 

opmwns. It sets out in part: 

A person may qualify as an expert witness on the issue of causal 

relationship between the alleged departure from the accepted standard of 

care and the injury, harm or damages claimed only if the person is a 

physician ... 

This section does apply to Dr. Lipson. It does not apply to the medical records or 

statements. Only Dr. Lipson addresses the issues of "causal relationships" and "departure from 

the accepted standard of care". Expert witnesses must be able to rely upon the medical records to 

render opinion. Expert witnesses may rely on witness statements. If one follows Defendant's 

argument to its logical conclusion, experts could not rely on the nursing home chart (made mostly 

by nurses), the medical records (made by nurses and treating doctors whose resumes are not 

available). This is not the law in Texas. Defendant knows this because it cites a case for this 

very proposition in a footnote of its motion. See Motion at 7 fn 3. 

Plaintiff's Response to Defendant's Motion to Dismiss Page 12 
388

Indeed, the Texas Supreme Court has expressly stated that expert reports would likely be 

inadequate if they did not look at the medical records. Loaisiga v. Cerda, 379 S.W.3d 248, 261 

(Tex. 2012). This is a case which involved the sexual assault of patients. The Supreme Court 

also held in the same case that experts could rely upon the pleadings on file in the case to render 

expert opinions. Id. A reading of the statute and the relevant case lawmake it clear that§ 74.402 

and§ 74.403 do not apply to the underlying information reviewed by experts, such as the medical 

records or SANE nurse examination. The Defendant's objection to the review ofthe statement of 

Martha Mahan is unfounded for the same reason. 

B. Dr. Lipson- Well-Qualified to Opine on Nursing Home Elder Abuse 

Defendant has closely scrutinized the Plaintiff's report, but appears to have overlooked the 

pages and pages of Dr. Lipson's CV setting out his experience teaching future nursing horne 

directors at multiple Tier 1 universities and governmental entities. In Dr. Lipson's CV, there are 

at least 9 references to lectures, courses and papers relating to "Elder Abuse." There are over 30 

references to geriatrics, including fellowships at Harvard. There are multiple references to his 

directorships over programs and facilities involving care for the elderly. His experience includes 

consulting at nursing homes and governmental entities on the operation of nursing homes. He is 

board certified in Quality Assurance. He has spent a many years learning, lecturing, writing and 

testifying on nursing horne abuse issues. 

v. 

CONCLUSION 

Over the course of its 16 page motion, Defendant strains mightily to copy and paste pages 

of black letter law on Chapter 74 claims. This larding of citations attempts to serve as a 

substitution for actual analysis of Dr. Lipson's report. Defendant ignores the details ofthe report, 

Plaintiff's Response to Defendant's Motion to Dismiss Page 13 
389

cherry-picking quotes to create a false sense that the report is conclusory and has otherwise failed 

to make any meaningful criticism. The report from this nationally recognized physician is 

detailed on the facts, causation and harm. Defendant knows exactly what the claims are against 

it: A helpless old woman got raped in her room after alcohol was served on its premises, and after 

being put on notice of inappropriate conduct towards Mr. Rivera. It should have never happened. 

Plaintiff has met and exceeded the standard for expert qualifications and reports. Defendant's 

motion should be denied in all things. 

By: 

Respectfully Submitted, 

MODESETTWILLIAMS, PLLC 

515 Congress Avenue, Suite 1650 

Austin, Texas 78701 

512.472.6097- Telephone 

512.481.0130- Telecopier 

jack@jmodesettlaw.com 

1 J ck Modesett, III 

/ t'exas Bar No. 14244337 

VWalter V. Williams 

Texas Bar No. 21584800 

Plaintiff's Response to Defendant's Motion to Dismiss Page 14 
390

CERTIFICATE OF SERVICE 

I hereby do certify that in compliance with the provisions of Rule 21a, a true and correct 

copy of the above and foregoing has been served via Pro Docs electronic service on this day 

of July, 2015 as follows: 

Emily J. Davenport 

Kemp Smith, LLP 

816 Congress Avenue, Suite 1260 

Austin, Texas 78701-2443 

Emily.davenport@kempsmith.com 

Plaintiff's Response to Defendant's Motion to Dismiss PagelS 
101

2/20/2015 12:36:17 PM 

CAUSE NO. D-1-GN-14-005169 

Velva L. Price 

District Clerk 

Travis County 

D-1-GN-14-005169 

MARTHA MAHAN, AS THE 

REPRESENTATIVE OF THE 

ESTATE OF MARY RIVERA 

v. 

GRACY WOODS I NURSING HOME 

§ 

§ 

§ 

§ 

§ 

§ 

§ 

IN THE DISTRICT COURT 

TRAVIS COUNTY, TEXAS 

250TH JUDICIAL DISTRICT 

DEFENDANT'S OBJECTIONS TO 

PLAINTIFF'S EXPERT REPORT AND CURRICULUM VITAE 

TO THE HONORABLE COURT: 

NOW COMES Defendant Gracy Woods I Nursing Home, actually known as PM 

Management- Austin NC, LLC d/b/a Gracy Woods Nursing Center, and files its Objections to 

Plaintiff's Expert Report and Curriculum Vitae pursuant to TEX. Crv. PRAC. & REM. CODE 

§74.351(a) and would respectfully show: 

I. 

This is a health care liability claim. On January 30, 2015, Plaintiff served the report and 

curriculum vitae of Loren G. Lipson, M.D., in an attempt to comply with Section 74.351 of the 

Texas Civil Practice and Remedies Code. True and correct copies of Dr. Lipson's report and 

curriculum vitae are attached here to as Exhibits A and B, respectively, and incorporated herein 

for all purposes. 

II. 

OBJECTIONS TO QUALIFICATIONS 

Defendant objects to Dr. Lipson's report and curriculum vitae because Dr. Lipson has 

failed to establish that he has any expertise to offer opinions that an alleged sexual assault 

occurred. TEX. Crv. PRAC. & REM. CODE §74.403; TEX. R. EVID. 702; Broders v. Heise, 924 

1 

APPENDIX 4
102

S.W.2d 148, 152-54 (Tex. 1996). Neither Dr. Lipson's report nor his curriculum vitae indicates 

that he has any education, training, skill or experience in the diagnosis or treatment of sexual 

assault; the diagnosis or treatment of gynecological injury, conditions or disease; or 

gynecological care or treatment of patients like Mary Rivera. Exhibits A and B. Broders, 924 

S.W.2d at 152-54; Thomas v. Alford, 230 S.W.3d 853, 857 (Tex. App.-Houston [14th Dist.] 

2007, no pet.); Pediatrix Med. Servs. Inc. v. De La 0, 368 S.W.3d 34, 39-40 (Tex.App.-El Paso 

2012, no pet.); Cortez v. Tomas, 2012 WL 407382, at *3, 6 (Tex.App. -Fort Worth 2012, no 

pet.). Dr. Lipson lacks the requisite expertise regarding the specific issue before the court that 

would qualify him to offer the opinions asserted in his report. TEX. Crv. PRAC. & REM. CODE 

§74.403; TEX. R. Evm. 702; Broders, 924 S.W.2d at 152-54. 

III. 

Defendant objects to Dr. Lipson's report to the extent it relies on the conclusions of nonphysicians. 1 Dr. Lipson relies on the observations and conclusions of Plaintiff and a registered 

nurse, neither of whom is qualified to offer diagnoses or medical causation opinions. 2 Exhibit A. 

TEX. Crv. PRAC. & REM. CODE §74.403(a) (limiting causation opinions to physicians otherwise 

qualified according to TEX. R. Evm. 702); TEX. R. Evm. 702. Exhibits D, E. Dr. Lipson relies on 

the statement of Jenny Black, R.N. Ms. Black is a registered nurse, not a licensed physician. 

Exhibit E. Registered nurses are expressly prohibited from rendering medical diagnoses, and 

they lack the medical expertise required to offer causation opinions. TEX. Occ. CODE 

§301.002(2)( excluding "acts of medical diagnosis" from the definition of "professional 

1 Defendant also respectfully objects to Exhibit 1 to Dr. Lipson's report to the extent Plaintiff or Dr. Lipson attempts 

to rely upon the opinion of a non-physician for a medical causation opinion in a health care liability claim. TEX. CN. 

PRAC. & REM. CODE §74.403(a); TEX. R. Evm. 702. A true and correct copy of the Order Appointing Permanent 

Guardian is attached hereto as Exhibit C and incorporated herein for all purposes. 2 A true and correct copy of the Affidavit of Martha Mahan is attached hereto as Exhibit D and incorporated herein 

for all purposes. A true and correct copy of the Statement of Jenny Black is attached hereto as Exhibit E and 

incorporated herein for all purposes. 

2 
103

nursing"); TEX. Crv. PRAC. & REM. CODE §74.403(a); TEX. R. Evm. 702; Costello v. Christus 

Santa Rosa Health Care, 141 S.W.3d 245, 248-49 (Tex.App. -San Antonio 2004, no 

pet)(regarding nurses' lack of qualification to render medical opinions in expert reports); Jones v. 

King, 255 S.W.3d 156, (Tex.App. -San Antonio 2008, pet. denied)(regarding application of the 

four comers rule when an expert report attempts to rely on the opinions of a physician whose 

qualifications were not established in the report). 

IV. 

Defendant further objects to Dr. Lipson's report because Dr. Lipson has failed to 

establish that he has the requisite knowledge, training or experience in the operation, 

management or supervision of nursing homes to offer the opinions on standard of care and 

breach asserted in his report. TEX. Crv. PRAC. & REM. CODE §74.402; Reed v. Granbury Hasp. 

Corp., 117 S.W.3d 404, 411-414 (Tex. App. - Ft. Worth 2003, no pet.)(a board certified 

emergency medicine physician and neurologist with thirty years of experience treating stroke 

patients not qualified to offer opinions on standards of care for hospital policy relating to 

administration of stroke therapy); Shelton v. Sargent, 144 S.W.3d 113, 123 (Tex. App. - Ft. 

Worth 2004, pet. denied). Dr. Lipson's conclusory statements about his alleged familiarity with 

the standard of care do not establish that he has the knowledge, training or experience on the 

specific issues in this case. 

v. 

OBJECTIONS TO THE REPORT 

Defendant objects to Dr. Lipson's conclusion that "[t]he facility breached the standard of 

care by not providing twenty-four hour skilled nursing care." Exhibit A, at 6. Dr. Lipson offers 

no explanation or factual basis for his opinion. This conclusory statement does not put Defendant 

3 
104

on notice of the conduct complained of, nor does it constitute a good faith effort to comply with 

TEX. Crv. PRAC. & REM. CODE §74.351. 

VI. 

Defendant objects to Dr. Lipson's conclusion that "[t]he nursing staff was not present in 

the halls or her room to prevent the sexual assault of Ms. Rivera." Exhibit A, at 6. Dr. Lipson 

offers no explanation or factual basis for his opinion. This is a mere conclusion, and it does not 

constitute a good faith effort to comply with TEX. Crv. PRAC. & REM. CODE §74.351. 

VII. 

Defendant objects to Dr. Lipson's conclusion that "[t]he facility breached the standard of 

care by not preventing access to her room by unsupervised males." Dr. Lipson offers no 

explanation or factual basis for his opinion. This conclusory statement does not put Defendant on 

notice of the conduct complained of, nor does it constitute a good faith effort to comply with 

TEX. Crv. PRAC. & REM. CODE §74.351. 

VIII. 

Defendant objects to Dr. Lipson's conclusion that "[t]he facility breached the standard of 

care by not moving Ms. Rivera to a room close to the nursing station where no unsupervised 

males could enter her room." Dr. Lipson offers no explanation or factual basis for his opinion. 

This conclusory statement does not put Defendant on notice of the conduct complained of, nor 

does it constitute a good faith effort to comply with TEX. Crv. PRAC. & REM. CODE §74.351. 

IX. 

Defendant objects to Dr. Lipson's conclusion that Ms. Rivera was sexually assaulted. Dr. 

Lipson offers no explanation or factual basis to support his conclusion that a sexual assault 

occurred. Dr. Lipson offers no explanation or factual basis in support of his conclusion that the 

4 
105

alleged injury was due to sexual contact. Dr. Lipson offers no explanation or factual basis to 

support his conclusion that the alleged assailant was male. Dr. Lipson's opinions are merely 

speculative and, therefore, deficient. 3 Accordingly, Defendant objects to Dr. Lipson's report 

because his statements regarding the alleged sexual assault are merely conclusory, do not put 

Defendant on notice of the claim against it, do not give the trial court a reasonable basis to 

conclude that this claim has merit, and do not constitute a good faith effort to comply with TEX. 

Crv. PRAC. & REM. CODE §74.351. TEX. Crv. PRAC. & REM. CODE §74.351; American 

Transitional Care Ctrs. v. Palacios, 46 S.W.3d 873, 878 (Tex. 2001). 

X. 

OBJECTIONS TO THE ATTACHMENTS TO THE REPORT 

Defendant objects to the report, generally, to the extent it incorporates statements, 

medical records and other attachments and would require the Court to draw inferences and fill 

gaps in violation of the four comers rule. Exhibit A, C, D, E and F. Am. Transitional Care v. 

Palacios, 46 S.W.3d 873, 878 (Tex. 2001). 

XI. 

Defendant objects to Ms. Black's statement or other documentation attached to and 

referenced in Dr. Lipson's report to the extent Plaintiff asserts those items, individually, 

constitute expert reports, which they do not. 4 Defendant reasserts its objections that Ms. Black 

lacks the qualification to offer expert opinions regarding causation because she is not a licensed 

physician. TEX. Crv. PRAC. & REM. CODE §74.403; TEX. R. EVID. 702. Defendant objects that no 

curriculum vitae was provided with respect to Ms. Black. TEX. Crv. PRAC. & REM. CODE 

3 In fact, it appears that Dr. Lipson failed to review all of Ms. Rivera's medical records. 4 Exhibit 3 to Dr. Lipson's report, documents bearing the names of Austin/Travis County and St. David's Medical 

Center, are attached hereto as Exhibit F and incorporated herein for all purposes. Defendant attaches these 

documents for the purpose of objecting to them pursuant to TEX. Crv. PRAC. & REM. CODE §74.351. Defendant 

objects to the admissibility of these documents pursuant to TEX. R. Evm. 802. 

5 
106

§74.351, §74.402 and §74.403. Defendant objects that Ms. Black is not qualified to offer 

standard of care or breach opinions relating to Defendant. TEX. Crv. PRAC. & REM. CODE 

§74.402. Defendant further objects to Ms. Black's statement and all other documents authored by 

Ms. Black that are attached to Dr. Lipson's report because they are conclusory and do not 

provide the required explanation or factual bases to represent a good faith effort to comply with 

Section 74.351. TEX. Crv. PRAC. & REM. CODE §74.351; Bowie Mem'l Hasp. v. Wright, 79 

S.W.3d 48, 52-53 (Tex. 2002); Palacios, 46 S.W.3d 873, 878 (Tex. 2001). 

XII. 

Defendant objects to the Affidavit of Martha Mahan to the extent Plaintiff asserts that 

Ms. Mahan's affidavit constitutes an expert report, which it does not. Plaintiff provided no 

curriculum vitae. Plaintiff lacks the knowledge, skill, training, education or experience to offer 

opinions regarding Defendant's standard of care, alleged breach or the alleged causal 

relationship. TEX. Crv. PRAC. & REM. CODE §74.351, §74.402 and §74.403. Defendant further 

objects to the Affidavit of Martha Mahan because it is conclusory, speculative, and does not 

constitute a good faith effort to comply with TEX. Crv. PRAC. & REM. CODE §74.351. 

XIII. 

Defendant objects to the records attached to Dr. Lipson's report as Exhibit 3 because they 

do not constitute an expert report. TEX. Crv. PRAC. & REM. CODE §74.351. Defendant objects that 

no curricula vitae of the records' authors were produced. Defendant objects that the authors of 

the records attached as Exhibit 3 to Dr. Lipson's report are not qualified to offer opinions 

regarding Defendant's standard of care, alleged breach or the alleged causal relationship. TEX. 

Crv. PRAC. & REM. CODE §74.351, §74.402 and §74.403. Defendant further objects to the records 

attached to Dr. Lipson's report as Exhibit 3 because the opinions contained therein, if any, are 

6 
107

conclusory and do not constitute a good faith effort to comply with TEX. Crv. PRAC. & REM. 

CODE §74.351. 

WHEREFORE, Defendant Gracy Woods I Nursing Home, actually known as PM 

Management - Austin NC, LLC d/b/a Gracy Woods Nursing Center, respectfully requests that 

its Objections be sustained and that it be granted such further relief to which it may show itself 

justly entitled. 

Respectfully submitted, 

KEMP SMITH LLP 

816 Congress Avenue, Suite 1260 

Austin, Texas 78701-2443 

512-320-5466 

512-320-5431 (facsimile) 

emily.davenport@kempsmith.com 

By: /s/ Emily J. Davenport 

Emily J. Davenport 

State Bar No. 24012501 

ATTORNEYSFORDEFENDANT 

GRACY WOODS I NURSING HOME 

A/KIA PM MANAGEMENT - AUSTIN NC, 

LLC D/B/A GRACY WOODS NURSING 

CENTER 

7 
108

CERTIFICATE OF SERVICE 

I hereby certify that a true and correct copy of the foregoing document has been served in 

accordance with TRCP 21a on the 20th day of February, 2015 to the following: 

Jack Modesett III 

Walter V. Williams 

ModesettWilliams, PLLC 

2202 Lake Austin Blvd. 

Austin, TX 78703 

j ack@jmodesettlaw.com 

/s/ Emily J. Davenport 

Emily J. Davenport 

8 
15

DECLARATION OF LOREN G. LIPSON, M.D. 

I, Loren G. Lipson, M.D., declare as follows: 

I am a licensed physician in the State of California. I am Board-Certified in Internal 

Medicine, as well as in Quality Assurance and Utilization Review. I have been board certified in 

Geriatric Medicine. 

My curriculum vitae, attached hereto as Exhibit 1 accurately reflects my education, training 

and experience as a Medical Doctor, Professor Emeritus of Medicine at the Keck School of 

Medicine at the University of Southern California, Los Angeles, California, Affiliate Professor in 

the Biomedical WW AMI Program, College of Arts and Sciences, and Affiliate Professor at the 

College of Health and Social Welfare both at the University of Alaska Anchorage. I am the 

former chief of the section of Geriatric Medicine and Associate Professor of Medicine, 

Gerontology, Clinical Pharmacy, Medical Dentistry and Public Health, and Occupational Science 

and Occupational Therapy, all at the University of Southern California where I have been on the 

faculty for over 29 years. 

In addition, I am a consultant to the Department of Justice United States and the States of 

California and New Mexico, and the Office ofthe Inspector General, U.S. Department of Health 

and Human Services in areas of geriatric care and elder abuse. I have served as a Consultant to 

the Departments of Administration, Health and Social Services and Law, State of Alaska, in the 

areas of geriatric medicine and long term care. I also have been the Physician Advisor to USC 

University Hospital in areas of utilization management and quality assurance. 

I have extensive personal experience in primary medical care as well as subspecialty 

consultation and long-term care. I personally have provided care for patients in addition to my 

academic teaching, research and administrative responsibilities. My background is more fully 

DECLARATION OF LOREN G. LIPSON, M.D. PAGE 1 

APPENDIX 5
16

described in my curriculum vitae attached hereto as Exhibit A. 

I am familiar with the problem of sexual assault in the nursing home setting. I am familiar 

with the standard of care for preventing such assaults. 

I continue to treat patients in the long term care setting and have done so for more than 

thirty years. I am familiar with the standard of care for the treatment of patients like Mary Rivera 

and familiar with the required training of employees providing care to residents like Mary Rivera. 

I have reviewed the following records. They formulate a basis for my opinions in this 

matter. 

1. The statement of the daughter, Martha Mahan; 

2. The Gracy Woods I records; 

3. The SANE Nurse Report; 

4. The SANE Nurse Statement 

5. The St. David's Hospital Records 

6. The guardianship records regarding Ms. Rivera; and 

7. Texas Department of Aging and Disability Services' Reports. 

The nursing home had a complaint of a sexual assault of a resident several months before 

the assault of Ms. Rivera. This report should place the facility on a heightened alert for this 

problem. The facility was cited by DADS for: 

1. Failing to implement written policies that protect against this activity; and 

2. Failing to report the incident to law enforcement. 

On June 20, 2013, Ms. Mary Rivera was placed under the guardianship of her daughter, 

Martha Mahan, by Judge Guy Herman. Judge Herman determined that Mary Rivera was a 

"totally incapacitated person without capacity to care for herself." (Ex. 1) 

DECLARATION OF LOREN G. LIPSON, M.D. PAGE2 
17

The findings of Judge Herman are consistent with the records from Gracy Woods I, (the 

nursing home) where Ms. Rivera was a long term resident. 

When Ms. Rivera admitted to the nursing home she carried a diagnosis of dementia. A 

review of the nursing home chart indicates that Ms. Rivera's short- and long-term memory 

declined over the time of her residency. The chart indicated she frequently did not know the 

location ofher room, the season of the year or recognize staff members. This is confirmed in the 

appointment of her guardian when Judge Herman finds Ms. Rivera as "totally incapacitated" due 

to mental as well as physical limitations. 

The nursing home chart describes an individual who, while able to ambulate, clearly 

required careful monitoring due to significant mental limitations. The nursing home chart further 

indicates Ms. Rivera suffered from depression secondary to the diagnosis of dementia as well as 

due to her admission to the nursing home, an admission she likely did not fully understand. 

The daughter of Ms. Rivera describes in her statement alcohol parties that the nursing home 

had on Friday afternoons. (Ex. 2) She states that another male resident would inappropriately 

touch or speak to Ms. Rivera. (Ex. 2) The daughter reported this concern to the management of 

the nursing home. The nurses caring for Ms. Rivera were aware of this behavior. (Ex. 2) 

Early on November 9, 2013, a Saturday morning, the daughter visited her mother at the 

nursing home. She found her more confused than usual and crying. The daughter also found 

broken Christmas ornaments on the floor. She took her mom to the bathroom, and she appeared 

to be in pain. Ms. Rivera urinated standing up, which was unusual. After she put her mom back 

to bed, the daughter used the restroom herself. When she was discarding a paper towel she noted 

there was a pile of bloody rags in the trash. 

DECLARATION OF LOREN G. LIPSON, M.D. PAGE3 
18

Concerned that her mother had fallen, she took the rags to the charge nurse, Wendy, who 

did a head-to-toe skin examination. The nursing home records confirm that no open wounds were 

found. The daughter ultimately took her mother to the hospital where they found bruising to her 

back. No vaginal exam was done at that time. 

The daughter reports Ms. Rivera continued to act like she was afraid. She noted bleeding 

from her mother's vagina. The daughter began to suspect sexual assault. The police were 

notified. 

Ms. Rivera was taken to St. David's Hospital. An examination was done by a Sexual 

Assault Nurse Examiner (SANE Nurse). The SANE nurse told Ms. Rivera that her mother had 

suffered vaginal trauma. The SANE nurse exam specifically found trauma to the posterior 

fourchette/fossa navicularis as well as trauma to the periurethral area of the vagina. (Ex. 3) In 

other words, she found bruising to both the front of the vagina as well as the posterior of the vaginal 

wall. (Ex. 3) The statement of the SANE nurse indicates the findings "definitively indicate 

penetration of the female sexual organ." (Ex. 4) As referenced above, Ms. Rivera was 

incompetent. In other words, she was sexually assaulted as she is unable to give consent to sexual 

contact. 

Sexual assault in the nursing home environment is a very serious problem. In the four 

years leading up to this assault, nearly four hundred sexual assaults were reported in Texas nursing 

homes. At high risk are seniors such as Ms. Rivera who suffer from dementia. They are poor 

historians due to their illness and many suffer from impaired communication skills. As such they 

are extremely vulnerable. 

The good news is that, if the nursing home takes a few simple steps, the assaults can be 

prevented. Facilities such as this nursing home are 24 hour skilled nursing facilities. This means 

DECLARATION OF LOREN G. LIPSON, M.D. PAGE4 
19

they are required by law to have skilled nursing staff as well as certified nurses' aides on duty and 

providing care to the residents twenty-four hours a day, seven days a week, three hundred and 

sixty five days a year. The nursing home in question has one hundred and eighteen beds in the 

entire facility. These types of assaults, according to most reports in the literature, occur at night. 

The literature indicates that facilities with a history of abuse and noncompliance are more 

likely to have future incidents of abuse. This nursing facility has a history of reported abuse and 

sexual abuse and was cited by the state for several indications of neglect leading up to the assault 

of Ms. Rivera. The nursing home management and owners are aware of this history of abuse and 

are obligated to take steps to prevent future abuse. Everyone in the nursing home business is 

aware of the problem of sexual assault. It is well discussed in the literature and the press. Given 

the history of problems in the facility and the complaints of the daughter, it is foreseeable assaults 

like this would occur without the proper precautions. 

This nursing home owes a duty of protection to patients suffering from mental incapacity 

due to decreased cognitive abilities. This duty includes monitoring the physical and mental 

conditions of the patients and meeting the fundamental care needs of the residents. Nursing 

homes are required to assess each resident's needs and capabilities. Some residents, like Ms. 

Rivera, require enhanced supervision and additional staff to protect them from others. The 

nursing home must take reasonable precautions to protect Ms. Rivera from the foreseeable 

consequences of her impairment including sexual assault. This is particularly true when there is 

a previously reported assault and the patient's family has voiced concerns of inappropriate 

behavior towards their mother. 

DECLARATION OF LOREN G. LIPSON, M.D. PAGES 
20

STANDARDS OF CARE 

1. The standard of care requires the nursing home provide twenty-four hour a day 

skilled nursing care. The practical result of this requirement is that the staff must 

be moving through the halls and the rooms of the residents all night long. There 

should never be a time when a staff member is not in the next room or moving 

through the halls next to a resident's room. 

2. The standard of care requires that following the report of an assault at a nursing 

facility that the facility control unsupervised access to the rooms of residents at risk. 

The standard of care requires the facility take note of the families' concerns of 

inappropriate behavior and eliminate access to the patient by unsupervised males. 

Residents at risk include women with significant dementia such as Ms. Rivera. In 

light of the families expressed concern of inappropriate advances to Ms. Rivera, the 

standard requires heightened scrutiny to include regular walks through the entire 

hall at intervals not to exceed ten minutes to prevent access to her room by males. 

The standard of care requires the nursing staff document the fact that it is 

performing the regular checks in the patients' charts. In addition, the standard of 

care requires Ms. Rivera be moved to a room in close proximity to the nursing 

station following complaints of inappropriate contact with Ms. Rivera. 

BREACH OF STANDARD OF CARE 

1. The facility breached the standard of care by not providing twenty-four hour skilled 

nursing care. The nursing staff was not present in the halls or her room to prevent 

the sexual assault of Ms. Rivera. 

2. The facility breached the standard of care by not preventing access to her room by 

unsupervised males. The records do not indicate any checks on Ms. Rivera the 

night she was assaulted. The facility breached the standard of care by not moving 

Ms. Rivera to a room close to the nursing station where no unsupervised males 

could enter her room. 

HARM 

The harm caused Ms. Rivera is significant. She was sexually assaulted. The injuries to 

her vagina are well documented in the SANE nurse report and above. The daughter reports she 

was tearful and afraid. This is a common response in sexual assault victims. The daughter 

reports this behavior of fear continued even after Ms. Rivera was removed from the facility. The 

fact she suffered from dementia does not lessen the harmful mental effects of sexual assault. Even 

DECLARATION OF LOREN G. LIPSON, M.D. PAGE6 
21

an animal can remember when it has been abused. In many ways Ms. Rivera was like a small 

child - confused and afraid as a result of this sexual assault. The history of problems together 

with the decision to ignore the families' complaints and eliminate unsupervised males from Ms. 

Rivera's room indicates a conscious disregard for the well-being of Ms. Rivera by the facility's 

management. 

I have considered other causes of this injury. I considered if the vaginal injuries were selfinflicted. There is no evidence in Ms. Rivera's chart to indicate she engaged in either sexual selfstimulation or self-abuse. I considered the injury may have been inflicted by someone outside the 

facility or even a family member. There is no evidence to support this approach. There is no 

record the family was anything other than supportive. The timeline in the chart indicates she was 

the facility at all relevant times save during transfer to the hospital. There is no evidence anyone 

sexually assaulted her when she was being transferred to the hospital to have her examined for 

InJuries. 

DECLARATION OF LOREN G. LIPSON, M.D. PAGE7 
22

I declare under the penalty of perjury under the laws of the State of California that the 

foregoing is true and cotteot. 

Executed this R~oy of~ , 2015. 

~ 

DECLARATION OF LOREN G. UPSON, M.D. PAGES 

I 

I 

I 
24

"ld. 

CURRICULUM VITAE 

JLoren G. Lipson~ M.D. 

August 1, 2009 

A. :lle.I·sonallnfol'lllation 

L 

2. 

3. 

4. 

5. 

6. 

Nrurie; 

Titles! 

Loren G. Lipson, M.D. 

Professor Emeritns of Medicine at the Keele School 

of Medicine of the University of Southe.m 

California, Los Angeles, Califonrla; and AffiJiate 

Professor~ Biomedical WW A'M1 Program, College 

of Atts and Sciences, and Affiliate Professor, 

College of Health and Social Welfare at the 

University of Alaska Anchorage. 

Mailing Address: P.O.BoxJ 

South Pasadena, California 91031 

Business Telephone: 626-403-0169 

Fax: 626-403~0165 

Pager! 800-209-2380 (Nume1io Only) 

B. Education. 

1. High School-Birmingham Bigh School, Van Nuys, California. 

Graduated, June 1961. 

2. University-U.C.L.A.: B.S. in Chemistry with a minor in Math 

and English. 

(Summa Cmn. Laude)1 June 1965. 

3. Medical School - The Johns Hopkins University Schqol of 

Medicin(;}, Baltimore. Maryland: M.D., June 1969 

4. Internship-The Johns Hopldns Hospifu11 Osler Medical Service~ 

1969-1970. 

5. Residency H The Joh11s Hopkins Hospital) Osler Medical Service~ 

1970-1971 

~~ ' 

APPENDIX 6
25

T I ' 

6. Fellowships: 

a. TI1e Johns Hopkins University School of Medicine~ 

Baltimore, Maryland: Clinical Fellow in Medi<line, 1969-

1971 

· b. The Natio11al Institutes of Health, Bethesda; Marylaud: 

Research Associate - Protein Chemistty, Physical 

Biochemistry, Molecular Biology - Labo1·atory of 

.Chemical Biology~ National Institute of Arthritis, 

Metabolic and Digestive Diseases (NlAMDD), 1971-1973. 

c. Massachusetts General Hospital, Boston, Massachusetts: 

Clinical and Research Fellow in Medicine (Endocrinology 

and Metabolism), 1973~ 197 6 

d. Harvard Medical School, Boston, Massaolmsettsi Clinbal 

and Research Fellow in Medicine (Endocrinology and 

Metabolisin),l973·1975. · 

e, Harvard Medical School, Boston, Massachusetts: John A. 

Hartford Senio:r Scholar in Gerfatdc Medicine~ Division of 

Aging,l9&4·.1985 -

f. Beth Israel Hospital~ Boston, Massachusetts! Clinieal 

Fellow in Medicine (Gerontology)~ 1984~1985 

g. Brigham - Women~s Hospital, Boston, Massachusetts~ 

Clinical Fellow in Medicine (Getontology), 1984-1985 

h. Hebrew Rehabilitation Center for the Aged, Boston, 

Massachusetts: Clinical Fellow in Geriatric Medicine, 

1984 ~1985. 

i Institute of Advanced Studies on Gerontotogy, Ethel Percy 

Ail.dtus Gerontology Center, USC~ Los Angeles, California: 

Fellow in Insl'itute, Area-Drugs in the Elderly, 1985-19S7 

j. Geriatric Research fnstitute. Ethel Percy Andrus Gerontology 

Center> USC~ Los Angeles, California: Senior Research 

Associate. 1985-1989. 

7. Honors and Award 

... & • .. 
26

I 

i 

!· 

.. , . 

1965 

1968-1969 . 

1975 -1977 

1975-1978 

1977 -·1978 

1984-1985 

1989 

1989 

1999 

2000 

2002 

Phi Beta Kappa; Recipient of Merck Award 

in Chemistry; 

Outstanding Underg1•aduate in Chemistry 

Award of Phi Lambda Upsilon; Medal for 

Soholarshlp of the American Institute of 

Chemists; The Ramsey Prize in Physical 

Chemistry; Sigma XIAll at U.C.L.A. 

Heruy Strong Denison Scholarship for 

Research. in Medicine, The Johns Hopkins 

University School of Medicine. 

National Research Service Award in 

Diabetes (NIAMDD), National Institutes of 

Health. 

Daland ·FelLowship in Clinical Medicine, 

American Philosophical Society. 

Clinical Investigator Award in Diabetes, 

NIAMDD, National Institutes ofHealth. 

John A. Hartfo1·d Seniot Scholat· Award in 

Geriatric Medicine, Division of Aging, 

Harvard. Medical School. 

The Genesis A wru:d, For Innovative Health 

Care Delive1y, Los Angeles Bush1ess 

Journal. 

Professional Leadership Progxam Award, 

Volunteer Center of Los Angeles. 

One of Top 20 Physicians in the G1'eater Los 

Angeles Atea (and only Gerlatl'ician 

named), Los Aflgeles Business Joumal. 

One of Top Primary~Care Physicians in the 

U.S.~ Tow.n an.d Country Magazine. 

One of Top Ten Physicians in Los Angeles, 

Ametica.-On-Line. 

8. Licensure: California. 

; ~ . . . 
27

... 4 ~ 

9. Boards: American Board oflnternal Medicine, 1974. 

Am.edcan Boatd of Quality Assurance ru.td Utilization Revlew 

Physicians, 1995 

Certificate of Expertise in Geriatric Medicine, American Board of 

Internal Medicine, 1996 

C. Professional Baclcground 

l. Academic Appointments 

a. The Jolms Hopkins University School of Medicine~ Baltimore, 

Maryland; Clinical Fellow in Medicine, 1969"1971. 

b. Massachusetts General Hospital7 Boston, Massachusetts; Clinical 

and Research Fellow in Medicine (Endocrinology !ll1d 

Metabolism), 1973" 1976. 

c. Harvard Medical School, Boston, Massachusetts; Clinical and 

Research Fellow in Medioitte (Eltdoctinology and Metabolism), 

1973H1975, 

d. Harvard Medical School, Boston. Massachusetts; fustructor in 

Medioine (Diabetes), 1975"1978. 

e. Massachusetts General Hospital1 Boston1 Massachusetts; Clinical 

Assistant in Medicine (Diabetes Unit), 1976-1978. 

University of Southern California School of Medicine; Los 

Angeles, Califonrla; Assistant Professor of Medicine (Diabetes 

Division)~ 197 8~ 1981. 

g, University of Southern California School of Medicine~ Los 

Angelesj California; Assistant Professor of M~.dicine. with tenure 

(Division of Diabetes and Clinical Nutrition); 1981 - January 

1984. 

h. Los Angeles County/University of Southem Califomia Medical 

Center, Los Angeles. Califomia~ Staff Physician 1:n Medicine 

(Diabetes Service), 1978 ~January 1984 

i. University of Southern California School of Medicine, Los 

Angeles, California; Associate Professor of Medicine (Division of 

Geriatric Medicine), January 1984-September 2006. 

4 

... J • 
28

~ .. 

j. Univel'Sity of Southern California Schbol of Medicine, Los 

Angeles, California; Chief, Division of Geriatric Medicine in the 

Department of Medicine.~ January 19&4- 2005. 

k. University of Southern Califotnhb Los Angeles, California; 

Associate Professor of Gerontology, Leonard Davis School of 

Gerontology, Ethel Percy Andrus Gerontology Center, January 

1984- September 2006. 

1. University of Southern Califomia1 Los Angeles, · California; 

Associate P1'ofessor of Clinical Pharmacy, U.S.C. School of 

Pharmacy, October 1989 ~ September 2006. 

m. Los Angeles County/University of Southe.rn California Medical 

Center~ Los Angeles, California; Staff Physician in Medicine, 

(Geriattic Medicine), 1984~2004. 

u. Sabbatical Leave, Harvard Medical School, Boston, 

Massachusetts; Division of Aging~ John A. Hartford Senior 

ScholarinGeriatdcMedicine~ 1984-1985. 

o. Brigham & Women's Hospital, Boston> Massachusetts; Clinical 

Fellow in Medicine (Geriatric Medicine), 1984 ·1985. 

p. Beth Israel Hospital, Boston, Massachusetts; Clinical Fellow in 

Medicine (Geriatric Medicine), 1984-1985 

q. University of Southern California, Los Angeles~ California; Senior 

Research Associate~ Getontology Research Institute, Ethel Percy 

Andrus Gerontology Center, 1985- 1989. 

r. University of Southern Callfomi~ Los Angeles) California; Fellow 

Institute of Advance Study, Ethel Percy And1us Gerontology 

Center, 1985 -1987. 

s. University of Southern California University Hospital, Los 

Angeles~ California; Chief of Geriatric Medicine, 1991~ 2005 

t. 

u. 

University of Southern California ~ School of Dentisb:y 

Associate Professor of Medical Dentistry and Public Health, l994 - September 2006. 

Uni-versity of Sottthem California- School ofindependent Health 

_Pl'ofessionals - Associate Professor of Occupational Science and 

Occupational 'Therapy, 1998- S~ptember 2006. 

5 

i 

I 

' I 

I 

f 

t 

j ~~~~·--·--~-~ --- -1. 

! 

l 

~A • I 

I ·-·+ 

I 
29

'"{j. 

v. University of Alaska, Anchorage~ Adju11ct Associate Professor of 

Human Biology, 2001- September 2006, 

w. Unive.r:sity of Alaska Southeast, Sitka ~· Adjunct Associate 

Professor of Human Studies, 2001 ~ 2006. 

x, University of Alaska, Attchomge, Affiliate Professor, College of 

Health and Social Welfare, 2006- Present. 

y, University of Alaska Anchorage, Afftliate Professo:t•, Biomedical 

W\VAMI Program, College of Arts and Sciences, 2006-Present. 

z. University of Alaska~ Anchorage~ Faculty Consultant in Geriatdcs, 

Alaska Family Medical Residency, September 2006-Present. 

aa. Univel'sity of Southern California, Keck School of Medicine, 

Professor Emeritus of Medicine, September 2006 -Present. 

2A. Teaching Responsibilities (University of Southern California) · 

a. Attenditl.g Staff :Physician LAC/USC Medical Centel' o1t the General 

Medical Service-teaching and supervising patient care1 both inpatient 

and outpatient to house staff and students 1985 - 2004. 

b. Attending Staff Physician at USC University Hospital in Geriatric 

Medicine for Medical House Staff and students. 1991-2005. 

c. Xn charge of the Fellowship Program - Geriatric Medicine. 1985 -

2004. 

d. Development and improvement of Geriatric Medical Curriculum ill the 

Medical School- Univ~t·sity of Southem California. 1985-2004 

e. Development of Oel'iatdc Medical Core Curriculum for the Medical 

House Staff-LAC/USC Medical Center, 1985-2004 

f. Member of Steering Committee~ Key Faculty and Study Site 

Cootdi11ator - Pacific Geriatric Education Center at the University of 

Southern California (DHHS), 1984-1993. 

g. Attending Physician Year III Medicine Rotation, 1992. 

h. Dit:eotor and lecturer in various courses at the Eth6l Pel'cy Andrus 

Gerontology Center including Gerontology 599 - Geriatric Health 

Issues. 

6 .. --~--~·-~---·--. -- -· ·--- ------· ----'--------:-~--:-----;--:-~-'-;-------, 

·q. 

. ,, 

., l. 
30

i. Director- Geriatrics Update- A Board Review Course. 

j. Director - History of Medicine in the Healtll Sciences Program, 1994 

-200L 

2B. · Teaching Responsibilities (University of Alaska) 

3. 

a. Director-Care of the Elderly Conference, 

University of Alaska, Southeast- Sitka> 

1994-Present 

b. Instructor - Promoting Best Practices in Aging, University of 

Alaska, Anchorage, 

2006-Present 

c. Co~Director - University of Washington Medical School 596-

Human Biology - Course for Alaskan Students.- Multi" 

Disciplinary and Ethnicity in Gerontology and Geriatdcs, 

(Univetsity of Alaska, Anchol'age- Spring and Fall, 2009 and then 

yeat'ly). 

d. Co~Director in Geriatric Education to Alaskan Medical Stgdentll in 

the University of Washington Medical School WW AMI Progt·am, 

Ulliversity of Alaska, Anchorage, 2006- Present 

e. Faculty consultant in Geriatrics to Residents of the Alaska :Family 

Medicine Residency Program. 2006- Present. 

Administrative Responsibilities 

a. Chief of the Division of Geriatric Medicine. Department of Medicine, 

University of Southern Califom1a School of MG:e:Iicine, In charge of 

staff arid feliow recruitment and training; divisional budge;'lt; gtatlt 

procurement; progrw:u development and supervision of research and 

clinical activity. 1984- 2005. 

b. Study Site Coordinator and Key Faculty .of the Pacific Geriatrlc 

Educatio.tl Center, University of Southern California School of 

Medicine, 1984-1993. 

c. Senior Staff Physician in charge of Geriatric Programs at Los Angeles 

County/University of Southern California Medical Center, 1985 -

2004. 

d. Chief of Geriatric Medicine at the USC University Hospital~ 1991 -

2004. 

-·-1 

... ~ - .. ~ . 11 ' -l.l. 

: 

~----~---·-~- ' 

! 

' I 

i 
31

a • 

e. Faculty liaison between Geriatric Medicine and University flffiliated 

hospitals and long term care :fucillties. Director of Geriatric Medicine 

Priv1l.te Practice Plan. 1984 ~ 2004 

f. Director of the USC Ambulatory Health Center sites at the Japanese 

Retil'emen.t Homes and Angelus Plaza, 1985- 1993. 

g. Dit·ectot of the Division of Geriatric Medicine's Program at the V.A. 

Outpatie1lt Clinic in downtown Los Angeles, 1986- 2001. 

h. Director of the USC Teaching Nursing Home Program at Hollenbeck 

:Home and. Atherton Baptist Home, 1999-2005. 

i; Dh·ector of the Senior Cancer Center at Norris Comprehensive Cancer 

Centel' and Hospital, 1999 - 200 1. 

j. Dh-ector of the Senior Cal.'e Program- USC Care and USC Physicians. 

199& -2002, •. 

k. Co~Director- Adult :Protective Team - Oerlatd.c Medicine Program -

LAC/USC Medical Center, 2000 - 2004. 

1. Director - Cate of the Elderly Conference) University of Alaska 

Southeast~ Sitka, 1994- Present. 

m. Co~ Director - Geriatrio Education for Alaskan Medica[ Stndents in the 

WW AMI Program1 University of Alaska1 Anchorage. 2006-Present, 

n. Medical Directo1·- Alaska Geriatdo Education Center, University of 

Alaska, Anchorage. 2005 -Present. 

o. Medical Director- National Resource Centel' for Studies in Native 

American~ Alaskan, and Hawaiian Elders, University of Alaska, 

Anchorage, 2006 ~Present 

4. Service 

A. University Service 

"6 • 

a. Medical Executive Cotll.lllittee, Department of Medicine, USC 1985-

2003. 

b. Utilization Management Committee) USC University Hospital, 1991-

1999, 2003-Present, Chairman of this Co:mmittee, 1994 ~ 1999. 

"'4 • ·u. 
32

c. Phru:maoy and Therapeutics Committee, LAC/USC Medical Center1 

200[- 2004. 

d. Pharmacy and Therapeutics Conunittee1 USC University Hospital, 

1991 - 2005, Chairman, 1996- 2000. 

e. Patient Care Evaluation Committee, USC University Hospiial, 1994-

1999. 

f. Lecturer in School of Pharmacy, University of Southern Californhi., 

1985 ~2004. 

g. Continuing Medical Post~Graduate Edt.tcation Lectures at outlying 

hospitals~ 1919-2004. 

h. Core Ctu'l'icl.llum. Conunittee for the New Medical School Oluiculum, 

USC School of Medicine, 1998 ~ 2002 

L County Operations Committee, Department of Medicine, LAC/USC 

Medical Center, 1997- 2000 

j. Development Cotnmittee, Departm.ent of Medicine, LAC/USC 

Medical Center, 1997- 2000. 

k. Senior Health Care Program, USC Care, (chair/member), USC 199&-

2002. 

L Executive Co:nunittee, USC Norris Comprehensive Cancer Center and 

Hospital- Senior Cancer Care Center, 1998 - 200L 

m. Co~ Director - Adult Protective Team ~ Geriatric Medicine ProgramLACJ{]SC Medical Center~ 2000- 2004. 

B. Public Service 

a. Consultant in Geriatric Medicine and Long Term Care; State of 

Alaska. Depru.'tm.ents of Administration Law, Health and Social Services, 

1991 -·2004 

b. Consultant in Gerontology and Geriatric Medicine, UniveJ:sity of 

Alaska, both at the Anchorage and Sitka campuses~ 1994- present. 

c. Board of Directors, California Association of Medical Directors, 1992-

~~ 1999. 
33

.., 6 ' 

d, Citizen's Oversight Committee-- California Stem Cell Research & 

Cures Act, 2007- Present. 

e. Board of Directors, USC Friends ofMusic} 1989-1997. 

f. Task Fotce on Elder Abuse, City of Los Angeles, 2001 -2004-. 

g. Califomia Rare Fruit Growers, 198 8 - Present. 

h. Pennsylvania Horticulture Society, 1992-2007. 

i. Affenpinscher Club of Amedca, 2002 ~Present. 

j. Kennel Club ofPasadena, 2004-2007. 

5, Military Service 

1971 ~-1973 Active duty as Surgeon - U.S.F.B.S. serving as Research 

Associate (Protein Chemisuy) in the Laboratory of Chemical Biology with 

Dr. Robert Goldberger and Dr. Christian Anfmse~ NIAMDD, NIH: 

Inactive Resorvc U.S.P.lLS. 1969-1971, 1973- 1979. 

6. Other Activities 

a. Editor for ENDOCRlNOLOGY for Diabetes and Intermediary 

Metabolism~ 1985- 1986. 

b. Member of the Committee of Interdisciplinary Geriatdc Education, 

Association for Ge1·ontology In Highet Education, 2002 -2006. 

c. Reviewer for: · AMERJCAN JOURNAL OF l?HYStOLOGY 

ANNALS OF INTERNAL MEDICINE 

ARCHIVES OF INTERNAL MEDICINE 

BIOCHEMICAL MEDICINE 

DIABETES 

ENDOCRINILOGY 

EXPERIMENTAL GERONTOLOGY 

JOURNAL OF CLINICAL ENDOCRINOLOGY 

AND METABOLISM 

JOURNAL OF GERONTOLOGY 

HORMONE AND METABOLISM RESEARCH 

JOURNAL OF THE AMERICAN GERIATRICS 

SOCffiTY 

DRUGS AND AGING 

NEW ENGLAND JOURNAL OF MEDICINE 

clO · ·-· ·.-- ---·------·· ·· 

~ 

I 

I 

I I 

I 

I l 

I 

I 

I 

j 

; 

i 

l 

I I 

~ 

~ -- -.---~---~ - --t~~ 

I 

I 

! 

l 

I l 
34

D. S()ciety Membe.i•ships 

1. Local 

Cross Town Endocrine Club 

Professional Staff Association of LAC/USC Medical Center 

Center Fellow of the UCLMJSC Long Tenn Care Gerontology 

Center 

Far Eastern Study Centel' USC/UCLA 

California ~ssocia.tion of Medical Directors 

2. Regional 

3. 

We.'ltern Society for Clinical Investigation 

Western Section of the Amedcan Federation for Clinical Research 

Nai"ional 

Sigma Xi, Phi Beta Kappa, Phi Lam.bda Upsilo11 

The Johns Hopldns Medical an.d Surgical Society 

The Johns Hopkins flistoty ofMedic1ne Club 

The Associates of the Countway Library 

The American Association for the History of Medicine 

American Federation fot Clinical Research 

Amerioan.Diabetes Assocration 

The Endocrine Society 

American Physiological Society 

The Gerontological Society of A1tl.edca 

The American Geriatric Society 

The American Federation for Aging Research 

Atnerican Gerontological Association 

American Association of Medical Directors ,;:::.,.,,. 

E, Consulta.llltships and Directorships 

... , . 

1. Consultant in Geriatric Medicine and Supewisot of the Oerlatl.'ic Progre.m 

at the Veterans Administration Outpatient Clinic in downtown Los 

Angeles, 1986-2001. 

2. Executive Director of the USC Ambulatoty Health Center at Angelus 

Plaza, 1989- 1993. . 

3. Board of Diteotors, California Association of Medical Directors, 1992 -

1999. 

4. Board of Director, USC friends ofMusic, 1989-1997 . 
35

... 6 • 

5. Consultant in Geriatric Medicine and Long Term Care- State of Alaska 

1991-2004; 

a, Department of Administration 

b, Department of Health and Social Services 

c, Department of Law 

d. Mental Health Board 

6. Appointments in Gedatdos- University of Alaska: 

a. Sitka 

I. Adjunct Associate Professor of Human Studies, 2003~ 

2006. 

IL Course Director - Care of the Bldel'ly Conference> 1994 

Present 

b. Anchorage · 

I. Affiliate Ptofessm~ College of Arts and Sciences, 

Biomedical WW AMI FrogramJ 2006 ~Present 

II. Consultant1 Co~Founder and Medical Director - Alaska 

Gei'iatdc Institute thtough the Alaska Geriatric Education 

Center, 2003 -Present. 

IIL Consultant ~ rnstitute of Circumpolar Health 

IV. Consultant and Medical Director -National Resource 

Center for Ar.nedcan Indians, Alaska Natives and Native 

Hawaiian Eldets. 2005 -Present. 

V. ·Faculty Consultant in Geriatrics, Alaska Family 

Reside11cy Program, 2005 ·· Present 

VL Affiliate P.F.ofess.or. College of Health a11d Social Welfare. 

7. Consultant, BritishColumbiaHealthFoundation, 1994-1999. 

8. Consultant in Gel'latdc Medicine and Long Tenn Care, Silverado Senior 

Living Centers, San Juan Capistrano, CA 2()01 -2002. 

9. Consultant in Geriatric Medicine and Supervisor of the Geriatric Medicine 

Medical House Staff Training Program, Ketn Medical Center~ Bakersfield, 

CA 1986-2003. 

10. Consultant ill Geriatric Medicine and Supervisor of the Geriatl.'ic Family 

Medicine House Staff Training Program, Glendal~ Adventist Medical 

Center, Glendale, CA 1998-2001 

·---. ··-····· --12-···--------·-· ------ --

; ~ . 
36

./ 

11. Consultmt in Geriatric Program Development - Bay Shores Medical 

Gronp, Torrance, CA., 1986-1989. 

12. Consultant in Geriatric Progratt1 Development- San Dimas Coxnmunlty, 

Hospital, 1986-1989. 

13. Consultant in Gel'iatrlc Program Development and Long Tenn Care ~ 

Keiro Services - The Jap$.nese - American Retirement Homes~ Los 

Angeles, CA., 1986 ~ 1993, 

14. Consultant in Geriatric J?.r:ogram Development and Long Term Care-1'he 

Motion Pioture and Television Home, Woodland Hills, CA 1986- 1990. 

15. Consultant in Long Term Care and Geriatric Medicine, State of California, 

Depru.1thent of Social. Services, 2000- Pt·esent. 

16. Consultant in Elder Abuse, Geriatric Medicine and Long Tenn Care, State 

of California, Department of Justice, Office of the Attorney General, 

Bureau of Medical Fraud and Elder Abuse, 2000 ~Present. 

17. Consultant in Long Term Care, Elder Abuse and Geriatric Medicine -

State ofCalifomia, Department of Justice~ Office of the Attorney General, 

Bureau of Medical Fraud and Elder Abuse- Operation Gual'dians (nttrsing 

homes ~ unaru10unced inspections) 2000- Present. 

18. Consultant in Long Term Care, Geriatric Medicine and Elder Abuse ~ 

State of New Mexico, Department of Justice, Office of the Attorney 

General, Medicaid Fraud and Elder Abuse Unit, 2003 ~ Present. 

19. Consultant in Long Term Care, Geriatric Medicine and Elder Abuse, 

United States of America, Depru:t.tue.nt of Justice, Civil Rights Division, 

· .. ·t.~-~""'-··- 2006- Present. · .. '·""""'-.... ··-·· 

. 20. Consultant in Long Term Care, Geriatric Medicine and Elder Abuse, 

United States of America, Department of Health and Human Sclrvices, 

0 ffioe of the Inspectur General, 2006 -Present. 

21. Board of Directors. Musica Angelica, 2006-Present. 

JF. Research Activities 

.. , ' 

1. Research Interests 

a. Use of medications in the senior populations with specific emphasis on 

prescribing habits of physicians . 

... . JJ .. 

" J • '11. 
37

... 

b. Health care systems and delivery modes for the demented eldedy in 

Alaska. 

c. D1'Ug interactions it1 the elderly, looking at drug-drug interactions. 

changed actions; polypharmacy} misuse' and abuse. 

d. Studies In the elderly diabetic patient. 

e, Studies in the elderly hypertensive patient. 

f. Studies in sexual dysfunction in the eldedy. 

g. Studies in elde1' abuse. 

h. Maintenance of jndependence of living in frail and demented seniors. 

2. Research in Progress: Investigations in man 

a. Studies in prescribing habits {If physicians in retirement housing. 

b. Studies of adverse drug effects in the aging population with special 

emphasis on the most commonly prescribe medication and 

psychotropio agents. 

c. Studies on care of frail and demented senio~·s in Alaska. 

d. Studies on the prevention and early detection of elder abuse. 

e. Studies on decreased longevity in th~ Pueblo lndians. 

G. Long Tel'm Ca:re Experience 

1. Director of the two USC Teaching-Nursing Home Progl·ams, 1999 - 2005 

a. Hollenbeck Home- Los Angeles 

b. Atherton Baptist Home - Alhlllilbra 

2. Member and Member Board of Director, California Association of 

Medical DirectOl'S, 1992 ~ 1999. 

3. Consultant~ State of Alask~ Department of Administration, Division of 

Longevity Services (Aging Progtruns. and State of Alaska Long :r'l;lmtCare 

Facilities-the Pioneers' Homes). 1991-2004. ·· 

4. Affiliate Professor, College of Health atld Social Welfare and College of 

Arts and Sciences~ University of Alaska, Anchorage, · Areas of 

involvement - Alaska Geriatric Education Center, Geriatric Assessment, 

Prewmed and Medical Education~ Long nmn Care, 2006 to Present. . 

5. Consultant'- Universtty of Alaska"' Sitka. Areas of involvement- Care of 

Elderly Conference-Director, 1994 "Present 

~. Consultant in Long Term Care. Elder Abuse and Oerlatdc Medicine -

State of Alaska. Department ofLaw; 2000 - 2003 

JA .. 

• , 8 - 'H • 
38

. ' . 

7. Consultant in Long Tenn Care and Geriatric Medicine - State of 

California, Department of Social Services. 

8. Consultant in Long Tettn Care, Geriatric Medicine and Elder Abuse -

State ofCalifomia, Department of Justice) Office of the Attomey General, 

Bureau of Medical Fraud and Elder Abuse~ 2000-2003. 

9. Consultant in Long Tenn Care - State of California1 Department of 

Justice) Office of the Attomey General, Bureau of Medical Fraud 1:1nd 

Elder Abuse - Operation Guardians (nursing home- unannouniY'.Al 

inspections), 2000 -·Present. 

l 0. Consultant in Long Term Care, Geriatric Medicine and Elder Abuse -

State of New Mexico, Department of Justice~ Office of the Attorney 

General, Medicaid Fmud and Elder Abuse Unit} 2003 -Present. 

11. Consultant in Long Term Care, Geriatric Medtcine and Elder Abuse, 

United States of America~ Department of Justice, Civil Rights Division, 

2006- Present. 

12. P:dmary cat•e provider for Geriatric Medicine for Long Term Cal'e Patients 

-Hollenbeck Home, Los Angeles; California, 1998 - 2004. 

13. LACfUSC M(ldioal Center Clinic -Adult Protective Team - Geriatric 

Medicine-Clinic Co~director, 2000-2004. 

14. Member of the Arn.ericatl Association of Medical Directors. 

15. USC - Angeles Plaza - Senior Clinic ~ Founding Director and oare 

provider (1989- 1992). (The largest low-income senior l1ousing pl'Oject in 

the Western United States). 

16. Consultant in Geriatric Medicine and Long Term Care- Silvemdo Senior 

Living Centers1 San Juan Capistrano, 2001 -2002. 

17. Consultant in Geriatric Program Development and Long Term Care -

K.eiro Services - The Japanese AlUerican Retirement Homes, Los 

Angeles, 1986-1994. · 

18. Consultan.t in Geriau:ic Program Development and Long Term Ca.l.'e- The 

Motion Picture and Television Home, Woodland Hills~· CA~ 1986 -1990 

m. Sigllificant lnvited Lectures (Since JU!ly 1984 - selected flt'Oilll over 3,500 

lectures given) 

t Harbor General Hospital- U.C.L.A. Medical Center. 7/84 . 

. li -

->!' ·, ' '\" . ->!' 
39

... . 

Medical Grand Rounds - uew concepts in the treatment of Type II 

Diabetes. 

2. Harbor General Hospital- U. C.L.A. Medical-center, 7/84. 

Endocrine Orand Rounds -The hewer oral agents. 

3. Mm:tinLuthel' King Gene~al Hospital, Los Angeles, CA, 7/84 

Medical Grand Rounds~ The approach to the pathmt with NIDDM. 

4. Nisei Awat:eness Day; Little Tokyo, Los Angeles, CA, 7/84 

Health issues for the elderly. Keynote speech. 

5. The Cleveland Clinic, 9/84. Symposium on Diabetes Mellitus- -

The T~·eatment of the Patient with NIDDM. 

6. American Academy of ;Family Practice, Kllnsas City, MO, 10/84 

·National Meeting, Invited Speaker: 

a. Nutrition in the elderly 

b. New concepts in the thet•apy of the Type II diabetic patient. 

7. Associates of the Countwa.y Library, Harvard Medical School, 11184. 

Biannual History of Medicine lecture - "The Black Death Comes to 

AJ.:nedca.~~ 

8. Washington University of St. Louis and St. Louis V.A. Hospital, 11/84. 

Symposium on Diabetes Mellitus - The treatment of hYPertension in the 

patient with Diabetes Mellitus. 

9. The Jackson Laboratory, Bar Harbor, Maine~ 12/84. 

Visitjng Scientist-Insulin seo1·etion in aging. 

10. .Gordon Research Conference,.01mat.d, CA, 2/85. The biol<Jgy Of aghg ~ 

Invited Speaker-Cyclic AMP and insulin secretion in aging. 

11. Tnorodike Rounds, Beth Israel Hospital, Boston, MA 3/85. 

The approach to the treatment of diabetes mellitus in the elderly 

individual. 

12. Division on Aging, Harvard Medioal School, 3/85. 

Grand Rounds - Hyperosmolar coma.,_... a complication of diabetes mellitus 

in the Elderly. 

13. The University ofNewBrunswick~ SaintJo~ N.B •• 3/85. 

Visiting professor of Biology. Lecture topics: 

a. The role of calmodulin in insulin secretion. 

_J6 .. 

.. 4 • 
40

... 

b. The exciting new approaches to the treatment of diabetes 

mellitus. 

14. Beth lsi:ael Hospltal1 Boston) MA> 3/85 

Endocrine G1·and Rounds -Sex and the diabetic. 

15. The Johns Hopkins University Scholl of Medicine, Baltimore, MD) 3185. 

Visiting Professor of the History of Medicine. Lectw:e topic- «Black 

Death Conte to America.,, 

16. Btigham-Women1s Hospital, Boston, MA, 3/85 

Endocrine Grand Rounds ~·Insulin secretion in aging. 

17. Yale University School ofMedioine, New Have~ CT, 4/85 

Endocrine Research ConfetefiCe -Insulin seGretion in aging • .... t... Hypertension Grand Rounds- Special problems of hypetteusioll fn ~ 

the diabetic patient. · 

18. University ofFlorida} Gainesville~ FL 4/85 

Gedatric Medicine Grand Rounds -The older diabetic patient. . . 

19. University of California at Los Ang~l~s School of Medicine, 4/85. Fanl.ily 

Medicine Grand Rounds- Treatment of diabetes mellitus in tbe elderly. 

20. Stanfoi:d University of Medicine~ V.A. Hospital. Menlo Pari; CA, 5/85, 

Clinical Conference - Sexual dysfunction in the elderly. 

22. University of Pittsburgh School of Medicine, Pittsburgh, PA, 6/85. 

Symposium on Diabetes Mellitus -The older diabetic patient. 

23~: ,·.:.!W.Jliv.etsity of Hawaii School of Medicine, Honolulu, HI. 8/85 

Medical Orand Rounds-Diabetes in the elderly. 

. 24. 

25. 

26. 

27. 

Department of Public Health and Sooial Welfare1 Guat_n, 8/SS 

Special Leotru:e-Wellness and pathology in the elderly. 

American Academy ofFamily Practice, Anaheim, CA. 10/fiS. 

National Meeting -:tn.vited Speaker-Oiabetes in the elderly. 

University of C111ifornia at San Francisco - Valley Medical Center, 

Fresno, CA, 11/85. Endo01ine symposium~ Sexual Dysfunction .in fue 

elderly, 

Mayor's Conference on Aging, Los Angeles, CA. 3/86. treatment of 

chronic diseases in the elderly. 

'"lj. 

I .. l 
41

.. •. 

. . . 

28. 

29. 

30. 

31. 

32. 

,:33·. 

34. 

V.A. Hospital, Mmtinez, CA and U.C. Davis School afMedidne, 4/86. 

Medical Grand RoUll,ds -Treatment of hypertension in diabetic patients. 

Pasadena Council on Alcoholism, Pasadena, CA, 4/86. Symposium on the 

Older Alcoholic Patient. Pathology and normalcy in aging. 

Brown University Medical School, Providence, RI 4/86. Medical Grauel · 

Rounds-Hypertension in the elderly. 

Medical Board Drug Review, Sacramento1 CA, 5/86. Invited Speaker -

The new oral agents. · 

Conference - Scientific Basis of Sexual Dysfunction - Sponso:red by NIH 

and the National Kidney Foundation, Baltimore, MD, 6/86, 

F.D.A. Symposium of Bioequivalence of Solid Preparations, Washington, 

D.C., 10!86. Itwited Speaker- Oral sulfonyhu:ea agents. 

University of Nevada, Reno, NV, 2/87. Visiting Professot of Medicine, 

Lecture topic ~Sex after 60. 

35. University of Guam, .Guam., USA, 4/87. Symposium on Care of the 

Elderly - Symposium Leader. 

36. National Council on Hypertehsion1 Biannual Meeting, Las Vegas, NV. 

4/87. Invited Speaker - Antihypertensive medications and sexual 

dysfunction. 

37. American Hospital Pha.nnacists Association, Washington, D.C. 5/87. I~vited Speaker-Aging in America- Wellness vs. Disease. 

3S. University of California, Davis- School of Medicine, 6/87. Course on 

Medicine, Invited Speaker-f:I;vpertension in the elderly. 

39. University of Nevada, Las Vegas, Nevada, 10/87. Visiting Professor of 

Medicine, Lecture Topics; Gel'iatric Medicine Today l' Geriatric Cmu:se 

Planning. 

40. California Pharmacy Association, San Francisco, CA, 11/87. Invited 

Speakeu-Endocrinology of aging. 

41. Evanston Hospital~ Northwestern University School of Medicine, 

~v:mston> IL, 11/87. Visiting Professor of Medicine, Topic ~ Sex after 60. 

······--18--·· 

., 4 • "'i4 • 'I' . 
42

. . . 

42. Conference on Pathogenesis and Treatment of Pressure Sores. Kansas 

City, MO, I/88. Invited Speaker. 

43. Conference on ~?What Phannaceuti~als are Needed for the Elderly?" 

Phoenix) AZ, 2/88. Invited Speaker. 

44: Confert;lnce on "Post Retirement IJealth Care Funding" sponsored by 

I.R.L, New York, NY, 3/88. Invited Speaker-The gedatricirnperative. 

45. Board Review Com:se: Geriatrics Update, 1988, U.S.C. School of 

Medicine, Pasadena, CA, 3/88. Two and one-half day symposium on 

geriatrics. Director, Moderator and Presenter for the course. 

46. Symposium on Geriatric. Medicine - Motion Picture and Television 

Retirement Home And Hospital, Woodland Hills, CA, 4/88. Moderator 

and Presenter. 

47. American Geriatdc Society National Meeting, Symposium and Physician 

- Patient Communication, Aneheim, CA, 5/l.l8. Co-moderator and 

presenter. 

48. Symposium on Geriatric Medicine, San Dimas Community Hospital~ Sa11 

Dimas, CA, 9/88, Moderator attd Presenter. 

49. American Society for Enteral and Pa:rental Nutrition Confere:t.lCes: Ethics 

and Nutrltion, New York, NY, 10/88 

50. Symposium on Nutrition in the Elderly, California Medical Center, Los 

Angeles, CAj 12/88. Moderator and Pre~enter~ Topic- Nutrition in the 

Elderly. 

51. Calif@n.tia Academy of Family Medicine, Annual Meeting, San Fraucigco~ ~ .. ~.!1~;<t{·' ,_, 

CA 2/89. fuvited Keynote Speaker, Topic-Dementia. 

52. Kansas University Medical Center, Family Medicine Grand Rounds, 

Kansas City, KS, 5/89,; Visiting Profess<lr, Topic- Drngs in the elderly. 

53. California Association for Homes for the Aged, Anmtal Mcefulg. 

Symposium on Drugs In the Elderly, San Diego, CA. 5/89. In-vited 

Speaker, Topic~ Medical Aspocts of Drugs in the Bldedy. 

54. Symposium on. Geriatric Ca1'e~ Motion Picture and Television Home, 

·woodland Hills, CA., 6(89. Modera.tot and Presenter, Topic- Tests and 

exams pedodically needed fqr Senior health 

.... -····19 , ..... . 

'\j' ~!. '\ & • .., . 
43

, I·• '~ 

55. Symposium of Diseases Affecting Extended Care Management of 1he 

Eldel'ly, California Federation on· Aging, Newport Beach, CA, 6/89. 

Moderatol'. 

56. Symposium of Diabetes in the Elderly, USC School of Medicine~ Los 

Angeles~ CA} 8/89. Moderator. 

57. V.A. Medical Center, Phoenix, AZ, 9/89. Medical Grand Rounds, dmgs in 

the Elderly. 

58. Gel'iatric Medicine Symposium, Hawaii Medical Association, 9/&9, 

Invited Speaker. Topic- Hypertension in th.e Elderly. 

59. 

I 60, 

61. 

62. 

63. 

64 .. 

65 •.. 

66. 

67. 

68. 

69. 

University Medical Center of Kansas City~ Kansas City, MO, 9/89. 

Medical Grand Rouuds- Sex after 60. 

National Confexence of Consulting Actuaries, Hot Springs, VA, 9/89. 

Invited Speaker. 

California Phartuacists Association, Los Angeles; CA, 10/89. 

Endocrinology in the Eldel'ly. Program Director. 

Family Medicine Program, Santa Rosa, CA, 11/89. Visiting Professot of 

Geriatric Medicine. 

Symposium on Geriatric Medicine. Tacoma General Hospital, Tacon1a, 

W A~ 1/90. Course Directo1· and Speaker. 

Symposium. on Gedatric Medicine, Antelope Valley Medical Center, 

Lancaster, CA, 2190. Course Director and Speaker. 

Unive.t:sity of Nevada School of MediGin~,,~Re:no, NV, 3/90. Visiting 

Professor of Geriatric Medicine. 

USC Gedat:dc Review Course, USC School of Medicine, Los Angeles, 

CA, 3/90. Two and one~half day intensive course in gerlatdc medicine. 

Course Director and Speaker. 

Eisenhower Hospital, Rancho Mirage, CA, 3/90. Medical Gl:and RoundsDrugs in the Elderly. 

American Geriatric Society Arumal Meeting, Atlanta, GA, 5190. 

Symposium on Syndrome X; The correlation of diabetes and hypertension. 

American Diabetes Association Symposium, Santa Ba1-·bara, CA, 6/90. 

Diabetes in Th~;: Mexicat'l. American Population. Invited Speaker. 

20 
44

~ .. ' . 

·70. Lorna .Linda University School of Medicine~ Loma Linda, CA, 7/90. 

Grand Rotmds, Drugs in the Elderly. 

71. American Heart Association/ American Diabetes Association Symposium, 

Santa Barbara, CA, 9/90. Treatment of the hypertellSive diabetic patjent. 

Keynote Speaker. 

72. Baylol' College of Medicine, Houston, TX, 10/90. Symposimn on the 

Complicated Diabetic. Invited Speaker. 

73. City of Hope, Duarte1 CA, 1/9 L Medical Grand Rounds, Diabetes i11 the 

Elderly. 

74. Providence Hospital, Anchorage, AK, 2/91. Medical Grand Rounds} Sex 

after60. . .. 

75. Symposium on Geriatdc Medicine, Antelope Valley Medical Cente1', 

Lanoaste1; CA, 3/91. Course Director and Speaker. 

76. U.C.S.F. - Valley Medical Center, Fresno, CA, 3/91. Medical Grand 

Rounds, Sex after 60. 

77. U.C.D • ...:.. Sacramento, ¢A, 4/91. Medical Grand Rounds, Sex after 60. 

78. Chicago Medical College, Chicago~ IL, .5/91, Medical Grand Rounds, 

Drugs in the Elderly. 

79. Symposium of G~;~riatric Medicine, Antelope Valley M('ldical Center, 

Lancaster, CA~ 2192. Course Director and Speaker. 

80. Depa.tr.Wlrw.t .of Administration, State of Alaska, 4/92. Invited Speaket', -·"'"<l'l.>l'-"F<t·f• · .. ~. 

Assisted living in long tenn care. 

81. International Institute for Reseal'oh Symposium.: Utilities and FAS 106, 

Washington, D.C., 7/92. Keynote Speaker, Drugs in tho retired population. 

82. Alaska Gexiatric Institute, Anchorage~ AK, 2/93 ~ Keynote Speake:r. 

83. University of Oklahoma, Tulsa, OK, 3/93. Family Medicine Grand 

Rounds, Drugs in the elderly. 

84. Symposium on Geriatric Medicine, Antelope Valley Medical Center, 

Lancaster, CA1 3/93. Course Director and Speaker. 

" .. .., . "1! • 

t 

! 

,. 

I 

I 

t 
45

.l_ •. 

85. Depru:tment of Administration, State of Alaska, 4/93. Invited Speaker, 

MedicatiollS in the nursing home population. 

· 86. Dallas Business Group on Health, 5/93. Invited Speaker, Medications in 

the Elderly. 

87. Symposium on Rl;ltirement Health~are Benefits, Chicago, JL, 9193. lnvited 

Speaker~ Medications fn the elderly. 

88. University of Hawaii, Division of Geriatric Medicine1 Honolulu, ·m, 

10/9/93. Visiting Professor ofGerlatria Medicine, Diabetes i11 tlie elderly, 

Use of drugs in th.e elderly. 

89. Providence Hospital, Anchorage, Alaska. Medical Grand Rounds, 2/94. 

:Dementia. 

90. Nevada Academy of Family Medicine, A)IDUal Meeting. Lake Tahoe> 

Nevada, 2194. Keynote Speake!'~ Sex after 60. 

91. University of Cclorado Mfiliated Hospital. Medical Grand RQunds, 3194. 

Dnlgs in the Elderly. 

92. University of Kentucky Affiliated Hospital. Gerlatdc Medical Orand 

RolUlds, Lexington, Kentucky, 4/94. Dementia. 

93. Alaska Psychiatric Institute - API 2000 Meeting, Anchorage, Alaska, 

6/94. Plans for the Future-C<Jnsultant and Facilitator. 

94. USC School of Medicinet Los Angeies1 California - Medical Gnmd 

Rounds, 9/94. Drugs in the elderly. 

95. Alaska State Mental Health Board - Q~JJly ... Meeting, bilingham,~. 

Alaska; 9194. Invited Speaker, The Alaska Geriatric Institute. 

96. Alzheimer's Society of Northem Califot.nif4 Sacramento, CA, 10/94. 

Speakett Research In dementia. 

97. Alaska Geriatric Institute, Anchorage, Alaska, 2/95. Organizer and 

Keynote Speaker. The largest health care symposium in the history of the 

state of Alaska. 

98. V.A. Medical Center Westwood and UCLA- Medical Grand Rounds~ 

2/95. 

99. Symposium on 'Geriatric Medicine) Antelope Valley Medical Center} 

IJancasterJ CA, 3/95. Course Director and Speaker . 

·---·--·---- -:·-:--::--:·--:--- -·- -~---·---- - . -----;---·.· ---

., .. "'4 • ~ j • 
46

100. Nevada. Academy of Family Medicine~ Annual Meeting, Lake Taltoe, 

Nevada, 3/95. Key11ote Speaker~Den:tentia 

101. Idaho Academy of Family Medicine, Annual Meeting, Sun Valley, Idaho, 

5195. Keynote Speaker- Dementia: Sex after 60. 

102, Martin Luther ICing, Jr. Medical Center, Los Angeles, CA, 6/95, Medical 

Orand Rounds- Dementia. 

103. Martin Luther King, Jr. Medical ~nter, Los Angeles, CA, 8/95. Medical 

Grand Rounds- Sex after 60. 

104, University of Alaska, Southeast - Sitka Geriatric Symposium, Sitka, 

Alaska, 9/95. Organizer, Keynote Speaker. 

105. V.A. Outpatient Clinic, Las Vegas, NV, 10/95, Medical Gmnd Rounds, 

Dementia. 

106. V.A. Outpatient Clinic~ Los Angeles, CA, 11/95, Grand Rounds - Dementia. · 1 

107. V.A .. Outpatient Clinic Los Angeles, CA, 12/95. Grand Rounds- Sleep 

disorder in the elderly. 

108. State of Alaska, Division of Senior Services~ 2/96. Leotutes and site visits 

to six State of Alaska nursing homes. 

109. Symposium on Geriatric Medicine, Antelope Valley Medical Center, 

Lancaster, CA) 3/96. Course Director and Speaker . 

.110. Family ~e._Tfaining Program, Spokane} Washington, 3/96. Lecture ~Dementia. 

111. Family Medicine Training Program, Central Montana, 4/96. Lecture ~ 

Drugs in the Elderly. 

112. University of Utah Affiliated Programs, Salt Lake City, 4/96. LectlU'e -

Depression in the Eldedy. 

113. State of Alaska, Department of Administration, Divlsi<m of SEmior 

Services, Course Coordinator for visits of 16 Alaskan State officials to 

USC School of Medicine, Andrus Gerontology Center and affiliated local 

Southern California Geriatric Programs. Duration ~ one month, earty May 

to em:ly June, 1996, Los Angeles, CA. 

•, M~i.<t<ilf 

- ·- ·- ~- -- . - -- --------;--~- ·--- -----· .---_::~-.- --. -----

... 4 • ·q, 
47

.. I~ ~ '1 " 

114. State of Alaska) Division of Senior Services, Department of 

Administration. Site visit to Administrative offices for review of Geriatric 

Programs. Junea~ Alaska, 6/96. Outside ConsuLtant and Lecturer. 

115. University of Alaska; Southeast Sitka. Care of the Elderly Symposiu:n~ 

Sitka, Alaska> 9/96. Course Director and Lecturer. 

116. Boise Health Consortium - Medical Grand Rounds, Boise~ Idaho, 11/96. 

Sex. after 60. 

117. Symposium on Long Term Cm:e for Providers, Milwaukee; Wisconsin, 

2/97. KeynDte Speaker-Drugs in the elderly. 

118. Symposium on Geriatric Medicine, Antelope Valley Medical Ce:nter1 

Lancaster, CA, 3/97. Course Director and Speaket'. 

119. Osteopathic Medical College, Des Moines, Iowa,· 4/97.· Symposium on 

diabetes Mellitus> Keynote Speclcer- Diabetes in the Elderly. 

120. University of Southern Illinois Medical School, ChampaigiJ, Urbana, 

Illinois, 4/97, Medi:cal House Staff Lectures. Topics - Diabetes in the 

Eldedy~ Drugs in the Elderly. 

121. Aliegheny Medi(la-1 School, Philadelphia, P.A, 5/97. Keynote Speaker~ 

Sytnposium on Diabetes and Lipids in the Elderly. 

122. State Senior Care Program, Oldahoma City, Oklahoma, 7/97, Keynote 

Speaker- State of Oklahoma Senior Care Ptogtam. 

123. Eastem Carolina Univel'Sity Medical School, Greensboro, North Carolina, 

8/97. Medical Grand Rounds. 

124. University of Alaska, Southeast Sitka. Cw;e of the Eldedy Symposium, 

Sitka, Alaska) 9/97, Course Director and Lecturer. 

125. 

126. 

127. 

128. 

Unive"J:sity of Colorado, Denver, CO, 10/97. University of Colorado 

Affiliated. Programs, Several States, Medical Grimd Rounds. 

Arizona Chapter of the American Gerontologic Society, Phoenix, AZ, 

11/97. Sex After 60. 

Symposium of Geriatric Medicine, Antelope Valley Medical Centet·, 

Lancaster, CA, 3/93. Course Din:ctor and Speaker. 

Medical University of South Carolina, Charleston, South Caroliua, 4!98. 

Family Medicine Grand Rounds~ Sex After 60. 

----24-- - ---------~--------~------; --------;--:--- --:.--:-"----- ___ .........., _________ ------

~' ' 

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l

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I 
48

,. . 

129, University of Colorado, Denver~ CO~ 4/98, University of Colorado 

Affiliated Progrants1 Several Sites, Medical Grand Rounds. 

1:30. Eisenhower Medical Center, Rancho Mirage, CA, 4/98. Medical Grand 

RoUtlds, Drugs in the Elderly. 

131. University of Alaska mid U.S.C., Sitka, Alaska, 9/98. Care ofthe Elderly 

Symposium, Course Director and Speaker. 

132. University of South Carolina School of Medicine, Charleston, South 

Carolina, 10/98. Family Medicine Grand Rounds. Sex After 60. 

133. V.A. Outpatient Clinic, Los Angeles, CA1 10/98. Memorial Lecture Set[es, 

Medi.cations in the Elderly. 

134. V.A. Outpatient Clinic, Los Angeles, CA, 10/98, Memorial Lecture Series 

Alzheimer's disease. 

135. Visiting Professor of Geriatric Medicine, Alaska Gedatric Institute, 

Anchorage, AlMka, April, 1/99. Multiple Lectnres •. 

136. Visiting Professor of Geriatric Medicine, University of New Mexico 

School of Medicine. Albuquerque, New Mexico, 6/99, Alzheim~r's 

disease. 

137. UniveJ;Sity of Alaska, Sitka, Alaska, 9/17/99~9119/99. Care of the Elderly 

Conferenc~;J, Course Director and Lecturer. 

138. Visiting Professor of Geriatric Medicine, University of Arizona Affiliated 

Hospitals of Tucson and Phoenix, AZ, 10/20/99-10/23/99. 

139. Symposium of the Gerontological Society of America, San Francisco, CA1 

11/21/99. Interdisciplinary Approaches to Teaching Geriatrtcs, Invited 

Speaker. 

140. State of Alaska, Anchorage, Alaska, 2/20/00-2/23/00. Task Force for the 

Assessment of Assisted Living in the Pioneers' Homes, Leader and 

Spokesperson. 

141. Visiting Professor of Geriatric Medicine, University of Colorado School 

of Medicine Affiliated Hospitals, Denver, Colorado, 3/7/00-3/8/00. 

142. Visiting Professor of Geriatric Medicine, Affiliated Internal Medicine 

Programs, El Paso, Texa-,, 4/26/00~4/47/00. 

'\j. H o 

. . -

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49

.n::; ~\.t· ·~ t • ....,. 

143. 

144. 

145. 

146. 

147. 

148. 

149. 

150. 

151. 

152. 

153. 

154. 

155. 

Newport Beaoh1 California) 5/5/00, Alumal Meeting of the California 

Association of Medical Directors~ Invited Speaker. 

Antelope Valley Hospital, Lancaster, California. Medical Gnmd Rounds, 

11!17 /99, Treatment of Artlu·itic Pain in the Elderly. 

Kern County Medical Center, Bakersfield, California. Medical Grand 

Rotu1ds, 117100. Hazards ofDrugTherapies in the Elderly. 

Hoag Hospital, Newport Beach, California. Medical Grand Rounds, 

3/10/00. Sex After 60. 

Visiting Professor of Geriatric Medicine, Affiliated Internal Medicine 

Programs~ E1 Paso, Texas. 4/26/00A/27/00 

Arrowhead Medical Center, San Bem~rdino County Hospital, Colt()n, 

Ca.Iiforniaj 5/17/00. Medications in the Eiderty. 

11 Annual Meeting of the California Association of Medical Directors/j 

Invited Speaker, Newpo1t Beach, California. 5/5!00. 

Riverside General Hospital, Merino Valley, California) 6/16/06. Medical 

Gral'l.d Rounds, Medications in the Eldedy. 

The Elderly Diabetic, Care of the Elderly Conference, University of 

Alaska. Sitka) Alaska; 9/21/00. 

Treatme11t of Artbxitic Pain. Care of the Elderly Conference, University of 

Alaska, Sitb, Alaska, 9/21!00. 

Depression in the Elderly. Care of the Elderly Conference, University of 

Alaska, Sitka, Alaska, 9/21/00. . . '·· 

Treatment of Hypertension in the Elderly. Cro:e of the Elderly 

Conference, University of Alaska, Sitka, Alaska. 9/21/00, 

Medications ln the Elderly. Continuous Quality Improvement (CQI) in 'the 

State~Assisted Living Facilities, Depa.rtment of Administration, Stat~ of 

Alaska, Anchotag~, Alaska, 11/13/00. 

156. Fails in the Elde:dy. Continuous Quality Improvement (CQl) in the State~ 

Assisted Living Faoilities, Department of Administration, State of Alaska, 

Anchorage! Alaska, 11/13/00. 

157. Dementia. Memorial Lecture Series, Outpatient Department, Vet~rans 

Administration, Los Angeles, California, 112/0 1. 

"4. "'d. .,1' 
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158. Geropsychiatric Assessment of the Elderly. Bureau of Medi-Cal Fraud and 

Elder Abuse) Department of Justice, State of Ca.tifomta, Ontario 

California~ 2/22/01. 

159. Treating Chronic Pain in the Elderly. Memorial Lecture Sedes, Outpatient 

Depruimet1t, Veterans Administration Los Angeles, California. 1/2/01. · 

160. Medications in the Elderly. Continuous Quality Irt>.provemem (CQI) and 

the Risk~Plus Program ill the State~Assisted Living Facilities~ Department 

of Administration> State of Alaska, Sitka, Alaska, SflfO 1. 

161. Falls in the Elderly. Continuous Quality Improvement (CQI) and the 

:Risk-Plus Pwgram in the State~Assisted Living Facilities, Depa:t1ment of 

Administration) State of Alaska, Sitk~ Alaska, 5/1101. 

162. Sexuality. Nol'th American Forum on Women's Health, Los Angeles, 

Calif01nia, 6/19/01. 

163. Alzheitner~s Disease. North American Forum on Women's Health, Los 

Angeles, California~ 6/19/0l 

164. Ge:ropsy(:hological Evaluation of Seniors. Symposiu111 on Elder Abuse. 

165. 

166. 

167. 

168. 

169. 

170. 

Department of Justice-Bureau of Medical Fraud and Elder Abuse~ Rancho 

Mirage, California, 9/7/01 

Depression in the Elderly. Hoag Hospi1al. Newport Beach, Callfomia, 

9/7/01. 

Sleep Disorders iu th" Eldel'ly. Care of the Elderly Conference. Univetsity 

of Alaska~ Sitka, Sitka, Alaska, 9/23/01. 

"' 

Medications in the Elderly. Memorial Hospital, S;mta Rosq., califo:mia, 

10/19/0L 

Dementia. Medical Orrutd RoundsJ Riverside General Hospital, Marino 

Valley, California, 11115/01. · 

Dementia in the Elderly. Medical Grand Rounds, Arrowhead Medical 

Center, San Bernardino Gene.t:aJ Hospital, Colton, California, 11129/0l. 

Patient and Family Satisfaction in Long Term. Care. Alaska Pion~tlrs~ 

Home, Anchorage, Alaska. A site 'ilisit and symposi~ 12/11101~ 

12/15/01. . 

.,, ' "J . 

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51

I- ·• .···. .. 

' .. 

171. 

172. 

173. 

174. 

175. 

176. 

177. 

178. 

179. 

180. 

Normal Aging vs. Disease. Symposium on Geriatric Medicine. Annenberg 

Center, Rancho Mirage, Califmnl~ 2/202. 

Medications in the Elderly, Memorial Lecture Series, Outpatient 

Department) Veterans Administration, Los Angeles, California, 2/26/02. 

Life Style Redesign in Elder Care. 2nd Annual North American Forum on 

Women's Health, Anaheim, California, 3/1/02. 

Dementia in the Elderly. Memorial Lecture Series, Outpatient Department, 

Vetet·ans Administration, Los Angeles) California, 3/12/02. 

Diabetes in the Elderly. Endocrine Grand Rounds. Harbor General 

Hospital, Torrance, California, 4/l/0/2. 

Medications in the Elderly. MultiHlecture series~ Commission on Aging, 

State of Alaska, Anchorage and Fairbanks,' 4112/02~4/26/02 . 

Treatment (!f Pain in the. Elderly. Care of the Eldei'ly Confel'ence; 

University of Alaska~ Sitka. Sitka, Alaska, 9/19/02. 

Treatment of Cardiovascular Risk Factors in the Elderly. Care of the 

Eldel'ly Conference, University of Alaska, Sitka, Alaska9/19/02. 

Special Issues in Long Term Care. Assessment and Evaluation of the 

Artchorage Pioneers' Home, Anchorage, Alaska, 12/10-12114/02. 

Identification and Treatment of Cardiovascular Risk Factors in ihe Elderly 

- A symposium Montgomery Cardiology· Programs. Montgomery~ 

Alabama, 3/21/03. 

'··· 181. Medications in the Elderly. Multi~lecture series, Conunissio:n.on Aging, 

State of Alaska, Anchorage and Fairbanks1 4/23~4/26/03. 

182. Assessment of Mental Competency and Discussion of an Elder Abuse 

Case. Symposium on Elder Abuse, Department of Justice ·~ Bureau of 

Medi~Cal Fraud and Elder Abuse~ Squaw Valley~ California, 5/21 kS/30/03. 

183. Medications in the Elderly. Multi-lecture series, Commission on Aging, 

State of Alaska, Juneau. and Ketchikan, 6J27-6129i03. 

i84. Dementia in the Elderly: Medications in the Elderly. Care of the Eldedy 

Conference, University of Alaska, Sitk~ Sitka, Alask~ 9/18-9/19103. 

185. Dementia. GeriatJ:ic Symposium :.... St. Mary~s Hospital and Scan~ Lang 

Beach. California, 10/4/03. ; 

! 

' 

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186. Senior Assessment for the Care Provider. Public Health Fonun- State of 

Alaska. Anchorage, Alaska, 12/1/03. 

187. Senior Assessment Workshop. Alaska Geriatric Education Center, 

University of Alaska, Ancho1·age, Alaska, 1/23/04. 

188. Sleep Disorders in the Elderly. Coping with Chronic Disease. Care ofthe 

Elderly Conference, University of Alaska1 Anchorage; Alaska, 9/17/04. 

189. Elder Abuse. Coping with Chronic Disease. Cardiovasculru: Risk Factors 

in the Elderly. Senior Lives Conference~ University of Alaska> Anchorage, 

Alaska 6/10/05. 

190. Assessment of the Chart in Skilled Not'sing Facilities. Symposium on 

Eld.er Abuse, Department o~ Justice, Bureau of Medical Fraud and Elder .. . 

Abuse, Long Beach~ California, 6/6-6/9/05. 

191. Coping with Chronic Disease. The Chart in the Skilled Nursing Home. 

Care·ofthe Elderly Conference, University of Alaska, Sitka, 9/16/0S. 

192. Sex After 60. The Chart in the Skilled Nursing Home. Promoting :Best 

Practices in Aging Conference, University of Alaska1 Anchorage- 6/8/06 

-6/10/06. 

193. Medic-al Realities and Diminished Tribal Longevity, New Aspects of Long 

Tenn Care. Cate of the Elderly Confetenc~, University of Alaska , Sitka, 

9/14/06-9/16/06. . 

194. Standw:d of Care, Symposium on Elder Abuse, Depal.iment of Justice, 

State of Califomia, Buteau of M~di~CAL Fraud and Elder Abuse~ San. 

. . Mateo, California May~M0FJ,..:.. 

195. futegrated Therapies for Aging. The Thet'apies, Care of the Elderly 

Conference, University of Alaska, Southeast; Sitka 9/~5'/0S- 9/27/08. 

196. Human Biology 596 Course University of Washington Medical School -

WW AMI Program- Multi-Disciplinary and Bthnicity in Gerontology and 

Geriatrics. Lectu.r:es to Alaskan Medical Students, University of Alaska~ 

Anchorage, Aprll2009. 

197. Mental Health and Dementia. Inter-disciplinary l?taciioo in Geriatrics Sex 

After 60. Prompting Best Ptactices in Aging Conference, University of 

Alaskf4 Anchorag·e, 6/3/09-6/5109. 

][, PUBLICAT][ONS 

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53

Papers- Pee1· Review 

L McCleverty, J.A, an.d Wilklrtso~ Q, (Submitters), Lipson, L.G., Maddox, 

M.D. and Kaesz, H.D. (Checkers): Dichlorotetracarbonyldirhodbm. 

Inorganic Synthesis Vol. VHf, oltzclaw, H.F., Jr. (Ed) McGraw-Hill, New 

York, 1966, pp.211-214. 

2. McCleverty, J.A. and Wilkinson. G. (Submitters), Lipson1 L.G., Maddox~ 

M.D. and Kaesz1 H.D. (Checkers): Chlorocarbonylbis (uiphenylphospine) 

rhodh.un and cblorocarbonylbis (tdpheuylarslne) rhodium. Inorganic 

Synthesis Vol. VIII~ Holtzclaw, B.G. Jr. (Ed), McGraw-Hill> New York, 

NY 1966, pp214~2l7. 

3. Lip~pn, L.G., Capuzzi, C.M. and Margolis, S.M: Effect on method of cell 

isol'll.tion on the metabolic activity of. isolated rat liver cells. J. CellSC. · · · 

10:167A179, 1972. 

4. Lipson, L.G.: Plague il.t San Francisco in 1900, Atm. Int. Med. 77~303~ 

310, 1972. 

5. Kohler, T.R., Lipson, L.G., Flores~ J.> Witkum, P.A., Fischer, J.B.~ and 

Sharp, G. W.O.! Sequence of events in the activation of adenylate cyclase 

by cholera toxin. Bull Schweitz, Akad. Med. Wiss. 32·223w23Z, 1976. 

6. Beiteins, l.Z., Lipson~ L.G. and McCarthur, J.W.:Luteiniz\ng hormone, 

follicle stimulating hormone and their subunits released in cultnre by 

hmnanpituitary tumors. J. Clin. Endo. Metab. 45:1271-1280, 1977. 

7. Fischer, J.J;3.~ Kohler, T.R., Lipson, L.G.:I Flores,~ J., Witkam. P.A., and 

Shru:p_, G.W.G.; Studies on the time course and rat~ limiting steps in the 

activation of adenylate cyclase by cholera toxin. Biocltem. J. '173: 59-64. 

1978. 

8. Lipson, L.G., Beitins, I.Z., Komblith, l?.D.~ McArtluu·. J.W .• Frie~en, 

H.G., Kliman, B. and Kjelbexg, R.N.; Tissue cultw:e studies on human 

pitultal'y ·tumors: Radioimtnunoa.ssay of ante11or pituitary hotntones in 

culture medium. Acta. Endocrln. 88:239-249, 1978. 

9. Lipson, L.G. and Shmp~ G.W.G.; 1nsulin sec1'etion in pregnancy: Studies 

on adenylate Cyclase, phosphodiestarase, protein kinase and 

phosphoprotein phosphotase in Isolated islets of Langerhans of the rat. 

Endocrinology 103:1272~1280j 1978. 

10. Lipson, L.G., Beitins, I.Z., Kornblith, P.D., McArthur, J.W., Friesen, 

H.G.j Klimat~, B. and Kjelberg, R.N.~ Tissue culture studies on hu.tnan 

. ·-30--· .... -.. -------~---:: ---"::---.-----:-;·--;------

' .. 
54

piMtru.y tumors: Loug~term .r:elease of anterior pituitary hormones. Acta. 

Endocrin. 90~421~433, 1979. 

lL Lipson~ L.G.~ Siegal, E., Wohlheim, C.B. and Shatp, G.W.G.: Insulin 

release in fasting: Studies on adenylate cyclase, phosphodiesU~rase, pr<~tein 

kinase and phosphoprotein phosphatase in isolated islets of Langerhans of 

the rat Endocrinology 105:702-717, 1979. 

12. Lipson, L.G., Bush, M.J., Tietjen, O.E. and Yooll, A.; Role ofthe 

adenylate cyclase sy.stem in altered insulin release from. islets of 

1angerhans of aging rats. Acta. Endocrin. 96:222·226, 1981. 

13. Lipson, L.G., Bobt·ycki~ V.A., Bush, M.J., Tietjen, G.B. and Yoon, A.: 

Insulin release in aging: Studies on adenylate cyclase, phosphodiestarase 

and protein kiuase iu islolated islet'l on Lange1'hans of the rat. 

Endoodnology 108: 602-624> 1981: •. t, ·' · 

14. Lipson, L.G., Moore1 D., Pope, A.M.J Todd, G.J., and Avila. S.: S~xual 

dysfull.Ction in Hypertensive diabetic patients. J. Cardiovascular Med. 6: 

Supp.l, 30-37,1981. 

15. Cotton, D.B., Strassner1 H. G., Lipson, L.G., and Goldstein, D.A.: the 

effects ofterbutaline on acid-base, electrolytes and glucose homeostasis 

during the managementofpretenn labor. Am. J. Obstet. And Gy:n. 141: 

617-624, 1982. 

16. Oldhrun, S.B., Upson, L.G. and Tieijen, G.B.: Evidence for the presence 

of calmodulin in human parathyroid tissue .. Mineral and Electrolyte 

Metabolism 7: 273-280, 1982. 

17. Lipson, L.G., Oldham, S.B.: The presence of calmodulin-stimulatflb1e 

phospho.diestatase in pancl'eatic islets of Langerhans of pregnant and 

11011nal female rates. Life Sciences 32! 775-780, 1983. 

18. Mircheff, A.C.~ Conteas, C.N., Lu, C.C,, Santiago, N.A., Gray, G.M. ood 

Lipson, L.G.: Basal»lateral a.nd intracellular membrane populations of the 

rate exorbitallacd.mal gland. Am. J. Pltysiol. 24-5: G 133*142, 19&3. 

19. Premdas, F.H., Molina, J.M. and tipso.11; L.G.: Insulint·elease in aging: 

Role ofglyce:raldehydes.Acta. Endoorin. 103:539-543, 1983. 

20. Lipson, L.G. and Lipso~ M.: Treatment of the obese maturity onset 

diabetic patient, Arch. Int. Med. 144: 135-138, 1984 . 

' . ' ... d • 
55

21. Oldham, S.B., Molloy, C. and Lipson, L.G.: Calc~um inhibition of 

adenylate cyclase in the parathyroid gland. Endoorlnology 114: 207-214, 

1984. 

22. Lipson,.L.G.: Sexual dysfunction in the diabetic patient with hypertension. 

Am. J, Cardiol. 53: 46A~50~ 1934. 

23. Lipson, L.G.: Special problems in the treatment of hypertension in the 

patient with diabetes mellitus. Arch. Int Med. 144: 1829ul831, 1984. 

24. Olclliam, S.B., Rude, R.K., Molloy, C. and Lipson, L.G.~ The effect of 

·magnesium on calcium inhibition of parathyroid adenylate cyclase. 

Endocrinology. 115: 1883-1890, 1984. 

25~ ... Molina, J.M., Prem.das, F.H .• Klenck, R.R. Eddlestone, G., Oldham, S.B: 

' ·and Lipson, L.G.: The dynamic insulin-secretory response or isolated .· · · 

pancreatic islets of the diabetic mouse: Evidenoe for a gene dosage effect 

on insulin secretion. Diabetes 33: 1120-1123. 

26. Bddlestone, G.T.~ Oldham, S.B., Lipson, L.G.~ Premdasl F,B. and 

Beigehnan, P.M.: Electrical activity, cAMP concentration and insulin 

release in mouse islets ofLangerhans, Am. J. Physiol. 248: C 145-1531 

1985. . 

27. Molina, J.M., Premdas, F.H. and Lipson, L.G.: Insulin release in aging! 

Dynamic response ofisolated islets ofLangerhans of the rat to D~ 

glyceraldehyde. Endocrinology 116: 821~826, 1985. 

28. Oldham, S.B. and Lipson, L.G.: The high affinity c~lcium inhibition of 

parathyroid adenylate cyclase is not calmodulin-dependent. Catcif, Tissue 

Int. 38: 275-281, 1986 . 

• ····"t-"i- • • ~.. • • ...,. ' ... 

29. Bailey, C.J., Day, D., Bray, G.A., Lipson, L.G. and Flatt, P.R.: Role of 

adrenal glands in the development of the abnormal glucose and insulin 

homeostasis in genetically obese (ob/ob) mice. Hormone and Metabolism 

Research. 18~ 357-360, 19&6. 

30. Prochazka, M .• Premdas, F.H.y Leiter, E.H. and Lipson, L.G.: Estrone 

treatment dissociates primary ve1·sus secondary consequences of 

"diab~tes" (DB) gene expression in mice. Diabetes, 35: 725w728, 1986. 

31. Lipson, L.G.: Diabetes .in the elderly: Diagnosis~ pathogenesis, and 

therapy. Am. J. Med. 80: Supp. SA: 10-21l 1986 . 

y ~ • ... , ' 
56

. ' 

32. Fadda, G.Z., Alanal, M., Premdas, F.H., Lipso11l L.G. andMassry, S.G.; 

Insulin release from pancreatic islets! Effects o{CRF and excess PTH. 

Kidney 1nt. 33: 1066wl072,1988. 

33. Leiter, E. H., Premdas, F.H., Hanison, D.H. and Llpson, L.G.: Aging at:d 

glucose homeostasis in C57BL/6Jmale mice. FASEB Joumal. 2: 2807· 

2811~ 1988. 

34. Fadda, G.Z., Alttnal, M., Lipson, L.G., Soliman, A. andMassry, S.G.: 

Correction of glucose into~erance and the impaired insulin release of 

chronic nmal failure by verapamil. Kidney lnt 36: 173-770, 1989. 

35. Fadda, G,Z., Akmal, M., Lipson, L.d. and Massry, S.G.: Direct effect of 

parathyroid homtone secl'etio.n from pancreatic islets. Am. J. Physiol., 258 

(Endocrinol. Metab. 21): E975~B984, 19.90. 

• I I ~ 

36': Mulligan, R.J Lipson, L.G. and Heaton, S. G.: Detecting diabetes in an .... · 

eldel'ly dental patient population. Special care in Dentistry: Feature 

Article: September-October, 142-147, 1990. 

37. Xin·Gin, Z., Fad.d~ G.Z,, Lipson, L.G. and Massry. S.G.: Phosphate 

depletion impairs insulin secretion by panc~·eatic islets. Kid. Int. 39: 120-

128, 1991. 

38. Fadda, G.Z., Hajjar, S.M.~ Perna, A.F., Chau, X.J., Lipson, L.O. and . 

Massry, S.G.: On the mechanisms of impaired insulin secretion in chronic 

renal failure. Jour. Clin. Invest. 87: 225~261 ~ 1991. 

39. Clark, F. Carlson, M., Zhnlce, R., Frank~ 0,, Patterson, K., Lru·son, B., 

Rankin~ Martinez, A.) Hobson, L., Crandall, J •• Mandel, D. and Lipson, 

L.G.: A qualitative study of the life domains and adaptive stmtegies of the 

lowincome,.wellelderly. Am. J. Occup. Therapy, 1994 

40. Clark F. Carlson, M., Zimke, R., Frank, G., Patterson, K.., Ennevor, B., 

Rankin-Millilnez, A, Hobson, L., Crandall, J., Mandel, D.and Lipson, 

L.G.~ Life domains and adaptive strategies of a gl'oup oflow~income, well 

older adults. Am. Jt. of Occupational Therapy, 99-108, 1995. 

41. Rho, Jay P. and Lipson, L.G.: Focus on acetylcholinestreraseiuhi.bitor for 

the treatment of Alzheimer's disease. Fonnulazy, Vol. 32, 677~684, 1997. 

42. Clark, F., Azen, S.P., Zemke, R.~ Jackson, J., Carlson1 M., Mandel, D., 

Hay, J., Josephson, K., Cherry, B., Hessle, C.~ Palmer, J. and Lipson, L.G.: 

Occupational Therapy for IndependenMjving Older Adults. JAMA, 278: 

1321-1326, 1997. 

33·· 

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43. Clm'k1 F., Azen~ S.P., Cttrlson, M.~ Mandel, D., LaBree, 1., Hay, J.. 

Zemke, R., Jackson, J. and Lipson, L.G.: Ernbedding health~promoting 

changes into the daily lives of independent~ living older adults: Long-tenn 

followwup of occ11pational therapy inte1vention. Journal of Gerontology: 

Psychological Sciences, 56B, PP- 60"63, 2001. · 

Requested Chapters, Papers, and Monograms 

1. Sharp~ G. W.O., Fisher, J.G., Lipson, L.G., Kohler, T.R., Flores, J. and 

Witkum, P .A.! Time course studies on the mechanisms of action cholem. 

toxin. Hormonal Receptors in Digestive Tract Physiology. In Bonftls, S.~ 

Fromageot, P ., Rosselin. G. (~ds.). Eldevier~North Holland Biomedical 

Press, Amdsterdam, pp.447-454, 1976. 

2. Sharp, G. W.O., Wiedenkeller1 D.E., Lipson~ L,G., Oldhnm, S.B., I{J;ausz, 

"''1"'' • ': Y., Janjis) D., PianwSrn.ith, M.C.M. and Wollheim, C.B.: Multiple roled of 

calmodulin, the endocrine p~ucrea.s and the control of1nsu1in secretion. 

P1·oceedings of the 11th Congress of the Intentattonat Dlabetes Federation. 

Int. Congress Series #600: Excerpta Medica, Princeton, N.J., Mngola, 

En.N. (Ed.) pp 329-336, 1983. 

3. Lipson, L.G.: Hypertension and diab~tes rrielUtus. Diabetes forecast 

38:53, 1985. 

4. Lipson, L.G.: Diabetes mellitus in the elderly: Special problems, special 

approaches. Co. Medical, New York, N.Y.j pp. 1-20) l98S. 

5. Lipson, L.G.: Diabetes after sb;.ty~five. Diabetes Forecast. VoL 39, No. 

7, 54-58, 1986. 

6. Lipso~ L.G.: Diabetes in the elderly! A multifaceted problem. A.nl. J. 

Med, 80: supp. 5A:1-2, 1986. 

7. Lipson, L.G. an.d Bray~ G.A." Energy intake and utilization in aging 

man: Chen (ed.), Nutritional Aspects of Aging, Voi. 1, CRCpress .. In.o., 

BocaRaton,J:<"'L. Pp.184-185, 1986. 

8. · Lipson, t.G.: Diabetes and aging.lu Beigelman1 P.M.an.d Kuman, D., 

(Eds ), Diabetes Mellitus for the house <Jfficer. Williams and Wilkins., 

Baltimore, MD., pp. 184~185, 1986. 

9. Lipson, L.G. and Kumar, D.: O.:al hypoglycemic agents. In Beigehnan, 

P.M. and Kumar, D. (Eds.) Diabetes Mellitus for the House Officer. 

Williams and Wilkins, BaltimoJ:e, MC. Pp. 112~118. 1986 . 

. . . "1 A • "~ . ... 6 • 
58

. . 

10. Lipson> L.G.: Dental problems ill. the diabetic patients. In Beigelmru.t, 

P.M. and Kumar, D. (Eds.) Diabetes Mellitus for the House Officer. 

Williams and Wilkins~ Baltimore> MD., pp. 181~183, 1986. 

11. Lipson, L.G.,: Hypertension in the diabetic patient. In Beigelman, P.M. 

and Kumar, D., (Eds.) Diabetes Mellitus for the House Officer. Williams 

and Wilkins, Baltimore, MD., pp 160 .. 163, 1986. 

12. Lipson, L.G.: Hypertension in the diabetic patient. In Beigehnan, P.M. 

and Kumar, D., (Eds.), Diabetes Mellitus for the House Officer. 

Williams and Wilkins, Balthnore, MD., pp. 173~175, 1986. 

13. Dinwiddie, R. and Lipso~ L.G.: Improved control of serum glucose in 

obese, new~onset u1sulinopenic non-insulin dependent diabetes mellitus: 

Partial respiration of Norman dynamic insulin secretion. Roerlg 

Division, pp. l-6, 1986, · :,... ' · •••• ,.. ~ • } ·" ., ••. ~ t,r14. Lipson1 L.G. and Katow:Patrner1 S.: Diabetes in Asians. Diabetes 

Forecast, Vol. 41, No.9, 4Sw51, 1938. 

15. Lipson, L.O., Kato-Palmer, S., Boggs, W.L., Moore,D., and ope1 A.: 

. Diabetes in the :Slack population. Diabetes Forecast Vol. 41, No.9, pp. 

34w38, 1988, 

16. Williams; B.R., Nichol, M.B., Lowe, B.F., McCombs, J.S. 1 Yoon, P.S. 

and Lipson) L.G.: phru:ruacist intervention residential care faciliti6s. In 

Rowet J.W, and Alu·onheim, ,T.C. (Eds.) Annual Review of Geronto:ogy 

at1d Geriatrics; Foc·us on Medications and the Elderly. Springer 

Publishing Co. New York, N.Y., pp. 150wl62, Vol. 12, 1992. 

17. The Use of Medications: A Tmining and Reference Manual Developed 

for Staffin.Residential Care Facilities for the Elderly, 1195. Lipson. . ,_,.., 

L.G.- Project Co-Director. 

18. Weiner, J. and Lipson, L.G.: Human diseases as models of accelerated 

aging. In Rose~ C., Glowacld, J. and Bilezikian> J. (Eds.) The Aging 

Skeleton1 Academic Press, Chapter ~:.pp. 51~58, 1999. 

19. Raghaven1 D.~ Weiner, J. and Lipson, L.G.: Cancer in the elderly: 

principles of treatment in Soulbami, R.L. et al (Bds.), Oxford Textbook 

Oncology~ znd Edition, Oxford University Press, Oxford1 London) i 999. 

Films atld Videos 

. . . .. & • "d . 
59

1. Discharge Plmming for the Elderly Hospitalized Patient: r. \Vhat to do 

wllen you go Home. Hospital Sateiiite Network, 1986. 15 min. L.G. 

Lipson- Moderator and Context Exper. 

2. Discharged Planning for the Elderly Hospitalized Patient: H. The patient 

with acute medical problems after discharge. Hospital Satellite Network 

1986, 15 min. L.G. Lipson- Moderator and content expert. 

3. Discharge Planning for the Elderly Hospitalized Patient: UI. The 

chronically disabled patient. Hospital Satellite Netwotk) 1986, 15 min. 

L.O. Lipson- Moderator and content expert. 

4. Discharge PlEU11ling for the Elderly Hospitalized Patient: IV. Community 

programs for the elderly. Hospital Satellite Network, 19861 15 min. L.G. 

Lipson-Moderator m~d content expert. 

5. Normal Aging Versus Disease:"l'hysicianJoumai Update. Lifetime 

Network, 1987, 15 min. L.G. Lipson- Content expert. 

6. Drugs and the Elderly. Physician's Journal Update. Lifetime Network, 

1987, 15 min. L.G. Lipson- Content expert. 

7~26. Caring for and Aging Soo(ety. 20 videos on various aspects of Geriatrics 

gnd Gerontology. Each 30 minutes in length. Producer- Neil Steinbe):g 

Produotions1 Executive Producers- Hospital Satellite Network and Age 

Wave~ Sponsor-Marion Laborato:des. 1987"1988. L.G. LipsonTechnical advisor and content exp~rt. 

~SP#. HSN# 

001 8649X 

()02 0462X 

003 57.33X 

Q04 8648X 

005 77l6X 

006 5734X 

012 8650X 

013 5735X 

014 5736X 

.OIS 5737X 

016 8652X 

017 7717X 

018 612SX 

\l19 6726X 

CARING FOR AN AGING SOClETY 

SHOW TITLES AND NUMBER .. , ....... ~~ .. -..... 

!lTLE 

NEW IMAGES OF AGIN"G (F) DYCHTWALD 

flOW TO TALK TO YOlJR.'DOCTOR (F) LIPSON 

GERIATRIC ASESSMENT (F) BUtLER 

DRUGS AND THB ELDElll,Y (F) :LAMY 

ACUTE CARE GERIATRIC NURSING (F) FOLMER 

HEART DISEASE AND THE ELDERLY (F) SWAN 

PRINCEPLES OF AGING (F) HAZZARD 

PRESENTATION OF DISEASE (F) ABRASS 

GEROl;JSYCHfATRIC FOUNDATIONS (W) OLSEN 

PltYS!CtA:N'S ROLE IN DRUG THBMPY (F) VESTAL 

ETHICAL ISSUES lN ELDERCARB (F) CASSEL 

GEROJ?SYC:HIATRlC NURSlliG (W) WYKLE 

TBE HUB CONCEPT (W) DYCHTWALD 

ELDBRCARE FlNANClNG (W) DYCH!WALD 

.. 4 • 
60

020 

021 

022 

023 

()24 

02S 

27. 

28. 

3(). 

31. 

32. 

6727){ ELPERCARE: MODELS OF SUCCESS (F) DYCHTWALD 

5738X DJABBTES IN THE ELDERLY {W) Lrl?SON 

8651X GERIATRIC DISCHARGE PLANNING (F) WERTHEIMER 

0473X PROMOTING WELLNESS {W) F ARQUJ!Al!. 

0475X SELF~MEDXCATWN IN THE ELDERLY (W) StMONSOl\' 

0414X FAMILY ROLES lN BEALTHCARE FOR BRATI'ER 

THE ELDERLY 

Medical Checkup; Health Aware11ess '88. Aging in the Black Conunuqtty. A 30 min. 

Video. Producer, Mark Alyn Communications) Sponsor- Marion LabOratories) 1988. 

L.G. Lipson- Moderator and content expert. 

Medical Checkup: Health Awareness , 88 Aging in the Hispanic Community. A 30 min. 

Video, Producer, Mark Alyn Communications, Sponsor- Marion Lab<>ratories, 1988. 

L.G. Lipson-Moderator and content expert. 

Medical Checkup: Health Awareness '88. Aging in the Asian Commuuity. A 30 min. 

Video. Producer, MarkAlyn Communications~ Sponsor- Mad on' Laboratories, 1988. 

L.O. Lipson- Mode1·ator and content expert. 

Medical Checkup: Health Awareness '88. Diabetes Mellitus in the Black Community. A 

30 min. Video. Producer> Mark Alyn Commonlcations, Sponsor- Madan Labotatories, 

1988. L.G. Lipson- Modemtor and content exp~rt. 

Medical Checkup: Health Awl'll:eness '8 8. Diabetes Mellitus in the Asian Community. A 

30 min. Video. Producer7 Mark Alyn Communications~ Sponsor-Marion LaboratotieS1 

1988. L.G. Lipson~ Mode1·ator and content expert. · 

Medical Checkup: Health Awareness '88. Diabetes Mellitus in the Hispanic Community. 

A 30 min. Video. Producer, Mark Alyn Communications1 Sponsor- Marion 

Laboratories, 1988. L.G. Lipson- Moderatot and content expe1t. 

33~38. Diet and Exexciw-~Lifustyles for Aglng. Hospital Satellite Network. Six lO~minute ''"' 

Segments, 1989. L.G. Lipson- conteil.t expett. 

39. How to Talk to the Older Patient. Baylor Hospital and Age Wave, 1989. L.G. LipsonMedical Moderator and content expert. 

40-41. The Aging Skin. Age Wave, 1991. L.G.Lipson- Medical Editor. 

42. Diabetes and the Eldel'ly. Living with Diabetes: Diabetes on the Air, 1991. 

43. Sex and Sexuality in Seniors- A Documentary, 1999 L.G. Lipson- Guest E:xpert. I, 

Abstracts 

'\ ~ . 
61

*1. Upson} L.G.~ Margolis, S.M. and Capuzzi, D.M.: Comparison of acetate and amino acid 

incorporation in. rat liver cells isolated by three techniques. Fed. Ptoc. 28:336 (absl 607). 

1969. 

2. Lipson, L.G., Ackerman, I.P. and Klima:n, B.: simultaneous acromegaly and partlally 

suppressible adrenocot'tioal function in a patient with a pituitary tumor. Clin. Res. 24: 

274A, 1976. 

3. Lipson. L.G.) Beitins, I.Z., Kornblith, P.O., McArthur, J, W., Friesen> H.G .• K.liman. B. 

and Kjelberg~ R.N. Hormone secretory patterns of human pituitary tumors in tissue 

culture. Clin. Res. 328A, 1976. 

4. Lipson, L.G.> Fon:istall, C.A. and Shatp, G.W.G. Phosphorylation and dephosphorylation 

in the control of the insuliu release: Islet phosphoprotein phosphatase. Diabetes 25: Supp. 

1,374 (abst. 213). 1976. 

*5. Lipson, L.G., Vachon, C., F6histall, C.A" and Sharp~ G.W.G.: Stimulation of specific 

protein phosphorylation in intact rats islets ofLangerhans by both 3-isob\ltyl-1-

methlxanthine and D-glucose. Clin. Res. 26:530A) 1978. 

6. Lipson, L.G. and Sharp, G.W.G.: Insulin release in pregnancy; Relatior.ship to ptotein 

and phosphorylation. Endocrinology 102: (abst. 711), 1978. 

7. Lipson, L.G. Wollhei:m, C.B. and Sharp, O.W.G.: Insulin release in fas1ing. Diabetes 27: 

Supp. 2, 489 (abst. 236), 1918. 

S. Lipsonl L.G.J Bobrycki, V.A., Bush, M.J •• Gross~ E. and lnouyte1 D.: Role of adenylate 

cyclase system in altered insulin release from islets of aged rats, Clin.Res. 28:51A~ 1980, 

~'9. Cotton, D.B., Strassner, H.G., Lipson. L.G. and Goldstein, D.A.: Effect ofterbutaHne on 

serum concentrations of glucose, insulin, J_Jo'tassium, ionized and total calcium lactate, 

and colloid osmotic pressure. Gyecol. Invest. 1980... .·t-:· .•.. 

*10. 

11. 

12. 

*13. 

Lipson, L.G., Bush, M.:r.~ Tie~ en, .G.E. and Yoon, A.; Insulin release itt aging: the role of 

adenylate cyclase system. Endoorinology 106: (abs~. 34)) 1980. 

Mircheff, a. C., Lipson, L.G .• Bush, MJ., Yoon, A. and Barish, J.J.: Analytical fraction of 

B·cells. Diabetes 29: Supp. 2, 109A (abst. 425), 1980 

Moore, D., Pope, A.M.1 Todd, G.J.:I Rosenquist, R.J.1 and Lipson, L.G.: Treatment of 

hypertensive diabetic patients with pl'azosin. Diabetes 29: Supp. 2, 67 A (abst. 267) 1980. 

Oldham, S.B., Lopson, L.G. and Tiegen. G.B.: Ev-idence for the presence of calmodulin 

in human parathyroid tissue. VIII International Conference in Calcium Regulating 

Honnones, 1980. 

-····· -- ·-ss 

' ' "'! . ... 4 • 
62

I 

*14. Lipso'n, L.G .• Bush, M.J. and Bobrycki, V.A.: The role of the adenylatecyclase system in 

the decreased glucose~stirnulated insulin. release from isolated islets ofLangerhans of . 

aging rats. Gordon Research Conference-The Biology of Aging. 1980. 

15. Lipson, L.G. Oldham, S.B. and Bush, M.J.; Calmodulin--stimulatable phosphodiestarase 

in isolated islets ofLangerhans oftherat. Clin. Res. 29:56A, 1981. 

16. Lips~n. L.G., Moore. 0.1 Pope A.M., Todd, F.J. and Avila, S.: lncidenceofhypertension 

in male diabetic populations. Clin. Res. 29:413A. 19tH. 

17. Lipson, L.G. and Oldham, S.B ,! Colmodulin~stimulatable phosphodiestarase in pancreatic 

islets of the pregnant rat. Clin. Res. 29-413A, 1981. 

*18. Conteas, C.N., Lipson. L.G. and Mircheff; A, C.: Basal lateral membranes fl•om rat 

parotid acinar cells. Gastroenterology 80: 1128A, 1981. 

• • • ..... t .. 19 . Lipson, L.G. and Oldham, S.B.: The presence of a calmod"ulin!:stimulatable 

phospl10diestarase in pancreatic islets from pregnant and notmal female rats. 

Endocrinology 108:343, (abst. 1942), 1981. 

' .. 

20. Lipson, L.G. Bush, M.J. and Najdziuk, J.: lnsulitll'elease in aging: Role of 

glyceraldehydes. Diabetes 30: Supp. 1 (abst. 296), 198.1. · 

*21, Lipson, L.G,: Insulin release in aging. Gordon Rese!U'ch Conference-The Biology of 

Aging. 1982. · 

22. Lipson. L.G., Moore1 D., Pope, A.M. and Todd, Ci.J,: Sexual dysfunction in hypertensive 

diabetic patients: The role ofprazosin in its prevention. Diabetes 31: Sup. 2 (abst. 365)t 

1982. ) 

*23. Oldham, S.D. and Lipson, L.G.: Biphasio inhibition of parathyroid adenylate cyclase 

activity by calcium1, ~~llf., Tissue int. 34:843, 1982. 

*24. Lipsou, L.G., Premdas, F.H., Molina, J.M.:Studies on dynamic insuli.nr.elease in aging. 

The physiologist 25: 288 (abst. 47.8), 1982. · 

*25. Molina, J.M., Premdas, F, H. and Lipson, L.G.! Dynamics ofinsulinsecretion inagirtg 

Clin.Res. 31~58A, 1983. 

*26. Sharp, G.W.G., Wolheim, C.B., Siegel, E., Lipson,.L.G. and Kraus, Y.: The role of 

calmodulin in insulin secretion. International Diabetes Fed. Meeting in Kenya1 November 

1982. 

*27. Eddlestone, G. T., Oldham, S.B., Lipson, t •. G. and Beigehnan, l? .M.~ Fotskolin inc~:eases 

cyclic AMP and potel\tiates electrical activity in the mouse pancreatic B·ce1L Fed. Proc. 

42: 897, (abst. 3544), 1983. 

'tl. ..j. -\ d • 
63

*28, Eddlestone, o:r., Oldha~ S.B., Lipson, L.G. and Beigelman, P.M.: Forskolin 

potentiati<m of the B-cell response to glucose. Diabetes 32; Supp. l(abst 552), 1983. 

*29. Oldham, S.B. and Lipson, L.G.: The effects of ionic calcium on magnesium activation of 

parathyroid adenylate cyclase. Calcif. Tissue Int. 35:686~ 1983. 

*30 Premdas, F.H., Molina, J.M. and Lipson, L.G.: Restol'ation of normal dynamic insulin in 

secretion in aging rats. The Physiologist 26:ASO, (abst. 32.1), 1983. 

*31. Oldham, S.B. and Lipson, L.G.! Calcium inhibition of parathyroid a.denylate cyclase: Is 

calmodulin medicated? VIII International Conference on Calcium Regulation l!ol.'ll1.ones, 

Kobe, Japan, October, 1983. 

32. Johnson, M.D. and Lipson, L.G.: Prevalence ofHypertenslon and sex\tal dysfunction in 

diabetic women. Clin. Res. 32:48A, 1984. 

*33. Molina, J.M., Pt~inaJs, F.H., Lipson~ L.G., Klenckj R., Eddleston.e; G. and Oldham, S.B.: · 

Comparison of dynamic insulin release to P-glucose and D~glyceraldehyde in isolated 

pancreatic islets .from the db/db mouse. Clin. Res. 32:51A, 1984. 

*34. Oldhatn, S.B. and Lipson, L.G.: Ionic control ofparathytoid adenylate cyclase activity. 

UCLA symposium 1984 on Membrane Receptors and Cellular Recognition. 

35. Lipson, L.G., Liebig, P.S. and Sloane~ R.B.: Training of facuLty mentors and advocates i~ 

geriatrics. Annual Meeting of Gerontological Society of America. November, 1984, San 

Antonio, Texas. 

*36. Lipson, L.G., Premdas, F.H., Molinas, J.M. and Lewis, D.: Cyclic Al\1P and insulin 

secretion. Gordon Reseaxch Conference~ The Biology of Aging, 19&5. 

*37. Flldda G., Akmal, M.~ Premdas, F.H .• Lipson, L.G. and Mass1y. S. G.: Direct evidence o:l 

..... .,. •• :·•!<.. an inhlbitoty effect if parathyroid hormone (PTfD on insuHn.xe,ea:::e in chronic renal 

failure (CRF). Kidney International. 31:348; 1987, American SooietyofNeplu·ology, 

Washington, D.C.i 1986. 

*38. Fadda G., Akma~ M .• P,;emdas, F.H .• Lipson, L.G. an4 Massry. S. G.! Correction of 

glucose intolerance (OINT) mtd the impaired insulin release o chronic renal faibn•e (CRF 

by verapamil. American Society ofNephrology, San Antonio. Texas 1988. 

39. Palmer. S.I(.i Madison, R.E. and Lipson. L.G.~ Self-reported prevalel'!lce and associated 

factors in type II diabetes in Japanese Am.edcans in Los Angeles. Diabetes: 37:1 SOA 

(abst. 587), 1988. 

*40. Garcia, D.L., Palmer, S.K., Boggs, W.L. and Lipson, L.G.: Challenges inwpatient 

compliance of elderly Mex:.ican Am.ericatt Diabetics. Diabetes: 37;68A (abst. 269)1 

American Diabetes Association, New Orleans, L.A., 1988 . 

.. , . .. .. 
64

. ~ . 

41. Schwa111, W.J ,, Lefevre .. T.M. and Lipson, L. G.: Falls in the elderly~ Tl:e use of IU.ultiple 

balance tests. Nov. 1988 meeting of Gerontological Society of America. 

*42. Oldham, S.B., Eddlestone, G.T., Premdas, F.H. and Lipson; L.G.: the influence of age on 

glucose and forakolin- stimulated :insulin release from islets of the diabeti~ mouse. No. 

198 8 meeting of Gerontological Society of Amedca. 

*43. ·Lipson, L.G.: Cal'ing for an aging society-twenty 30 minute -videos on gerontology and 

geriatrics. Nov. 1988~ meeting of Gerontological Socjety of America. 

*44. Palmer, S.K., Madison~ R.E. and Lipson, L.G.: Diabetes in older Japanese~Amerioans. 

November 198 S meeting of Gerontological Society of America. 

*45. Boggs, W.L., Garcia, D.L.~ Palmer, S.K., and Lipson, L.G.; Patient compliance in an 

ethnic population: Diabetes care in elderly Mexican" Americans, Nov. 1988, meeting of 

Gerontological Society of America. 

*46. Fadda, G.Z., Akm.al~ M., Lipson, L.G. and Massry, S.G.~ Correction of Glucose 

lntolerance (GINT) and the impaired ·insulin release of chronic renal failure (CRF) by 

Verapoamil.Kidneylnt. 35:427,1989,1989 Meetingofthe21~ Natio:na1Kidney 

Foundation scientific Symposium. 

*47 Fadda., G.Z., Akmal, M., Lipson, L.G. and Massry. S.G.: Evidence for a direct effect of 

parathyroid hormone (PTH) on pancreatic islets. Kidney Int. 37:466, 1990, 1990 meeting 

of the 22nd National Kidney Foundation Scientific Symposium, 

*48 Fadda, G.Z., Akmal, M., Lipson, L.G. and Massry, S.G.: Mechanism of impaired insulin 

secretion in chtonic renal failure. Kidney Int. 37!505, 1990. 1990 meeung of the 22nd 

National Kidney Foundation Scientific Symposium.' 

*49. Comunale, R., Fadda, G.Z., Premad, F.H., Tha.naldtcharu, P, Lipson, L.G, andMassryt 

S.G.: Reduced K-inducedJt'!S.Ulh.t secretion in chronic renal fail me (CRF) contribute to 

impaired extrarenal disposal ofK: Role of excess PTH. Am. Soc. Nephrol. 1:624, 1990. 

*50 Williams, B., Lowe, B., Nichol, M., McCombs, J.~ Yoon, P. and Lipson, L.G.: Improving 

drUg therapies in residential care facilities. 1994 Annual Meeting of the American 

Geriatric Society, Los Angeles, CA. 

*51. Lipson, L.G., McCombs~ J., Jelliffe, R., Williams, B., and Wilson, P.: Medications I the 

elderly: problems, policies and new solution, a symposium. 1995 Annual Meeting of the 

Ge.t:ontological Society of America, Los Angeles~ CA. 

*52. Lipson, L.G. and Kohn, J.: Govetlltnental responsiveness to changes in demographics of 

aging disease: A unique state approach to geriatric ADRD care and treatment. 1996 

Annual Meeting of Southern Medioal Association, Baltimore, Maryland • 

.. 4 • '\A • 1 A • 
65

53. Symposium Annual Meeting of Gerontological Society of America, San F:rancisco1 

California, 1998. 

*Presented 

I. Gl'Mits and Research Funding (1975~2001) 

L National Research Sentice Awards in Diabetes~ 1975-1977. 

NIAMDD. NIH. 1F32 AM 05219 MET. 

2. Clinicalfnvestigator Award in Diabetes. 1977 ~ 1978. NIAMDD, NlH. 1 KOB AM 0320 

MET. Two additional ye~us of suppoxt,yrere given up in ol'der to change institutions. 

3. Daland Fellowship in Clinical Medicine (Diabetes Research) ofth.e American Philosophical 

Society, 1975-1978. 

4. NIH research Grant- "Pregnancy: Its role in altered insulin release." NICHlD, NIIi 1/79 

through 12/81, $134,000. 1R01 HD 12517. L.G. Lipson, P.I. 

5. American Diabetes Association Grant- "Mechanism of Insulin Release.~) 3/79 through. 8/80. 

L.G. Lipson, PJ. 

6. American Cancer Society Pilot Project Grant- "Tissue Cultul'e Studies on Human. Pituitary 

'fumors.'t 10178-9/79.1.0. Lipson, PJ. 

7. Los Angeles County Medical Association Auxiliary Grant -~~Research in Clinical Diabetes." 

7/78~1/82. L.G. Lipson, P.I. 

8. NIH Research Grant- "Calcium modulated proteins in the parii;thyroid." lWAMDD, NIH 

lROl am 27816. 12/80 through 6/85, *205~000 L.G. Lipson, Co-P .X • 

. ~,.,., .. ~iL, NIH Ttai:u.ing Grant- "Training in Endocrine Hypertension and EnclGc:ciru)logyMetabolism.''NIAMDD~ NIH. T 32 AM 07119. 7/8(J THROUGH6i85 $414,500. L.G. 

Lipso~ Iusttuctor. 

10. NIH Training Grant- "Training in the Endool'inology and Neurobiology of Aging." NIA, 

NIH, 9/82 through 8/87~ $803,882. L.G. Lipson, Co~director. AG 00093. 

11. NIH Research G:rant- "Microencapsulation: A novel transplantation technique." NfAj NIH. 

3/83~2/85. L.G. Lipson, P.r. 

12. Amel'ican Diabetes Association Grant- "The 1'ole of cyclic AMP in insulin secretion in the 

diabetiomouse.j' 8/83 through 1/85. L.G. Lipsoni Co-P.I. 

----------------· ·42- ·-···-·· ---·- ----- ----~- ---- --------- ------- - ----

~' . 'i A • 
66

• •••••••• .. • ol 

13, E>HHS Center Gmnt -· ~·oerlatlic Education Center Gl'ant.'' DFlliS 1031 AH 69000. 

$9521000. 10/83 through 9/88. L,G, Lipson, Faculty Coordinator and Membetofthe 

Steering Committee. 

14. NIH Center Grant~ "Southern California Consortium for the Study of Alzheimer's Disease." 

NIA, NIH. 1/85 through 12/89. $750,000/year. L.G. Lipson, Clinical Investigator. 

15. John A. Hartford Senior Scholar Award in Geriatric Medicine- at Harvard Medical School. 

9/84 tlu·ough 8/85. L.G. Lipson, Award~e. 

16. Research Grant from Roerig, Pfizer Pharmaceuticals, ~'Diabetes in Elderly Mexican 

Amerlcans ... l/86 through 7/87. $80,000 L.G. Lipson, M.D . .,P.L 

17. Research Grantfi.·omRoss Laboratories~ '!Diet and Dementia." 1/88 through 12/89.$37,500. 

L.G. Lipson, M.D., P.I. 

18. Research Gxant from HoechstPhaw.aoeuticats- "Neuropathy in the Elderly!' 1/83 through 

12/89, $27, 500. L.G. Lipson, M.D., P.l. 

19. Research Grant fi:om Boehr1n.ge1' Ingelhehn Phannaaccutioals- <'Control of Mild 

Hypertension in the Elderly lnnc:r- City Population." 6/88 through 12/8&. $45, 000. 

L.G. Lipson, M.D.,P.l. 

20. Research Grant from Marion Laboratories- "A New Tl'eatment foJ: Pressure Sores.'' 6/88 

through 3/89.$15,000 L.G. Lipson, M.D., P.I. · 

21. Research Gtantfrom Roerig Pharmaceuticals·~ ''Diabetes in the Elderly." 7/1/89-12/31/90. 

$15~000, L.G. Lipson, M.D., P.I. 

22. Reseru:ch Grant from the John A. HaTtford Foundatiou- '"Prescribing Habits of Physicians in 

Retirement Housing." 2/89 through 1/93. $487,000. L.G. Lipson} M.D., P.l. 

......... t.~ ... 

23. DHHS center Grant- "Geriatric Education Center. u 10/89 through 9/92. $450,000 L.G. 

Lipson, M.D. Clinical Site Coordinator, Key Faculty Member, and Member of the 

Steering Committee. 

24. Gel'iatdc Medicine Fellowship Grant from the Japanese Retirement and Skilled Nursing 

Facilities (Keiro Services), 7/88 tiu·ough 7/90, $170,000. L.G. Lipson, M.D., P.I. 

2-5. Geriatric Medicine Fellowship Grant from the Motion Picture and Television Retirement 

Home and Hospital 7/87 through 6/90. $50,000/year. L.G. Lipson, M:D., P.I. 

26. Nffi Research Grant-NIDDK- "Subtle Disturbc:l.nces of Cobalamin Status." 2R01-

DK32640-07. 2/1191 through 1/31/95. $235)827. L,G, Lipson) M.D., Co~Investigator. 

, .. ~ l • .., . 
67

. . . 

27. Development Grant- USC Irvine Foundation. Diversity Project. Couxse Development. 

!(Diversity in Aging: Roles in Bthnicity, Gender, Biology and Environment.~> 1992· 

onward, $5;000, L.G. Lipson, M.D., Course Director and P.r. 

28. NIH Research Grant- "Multicenter Ti'ail of Prednisone in Alzheimer's Disease." 1995, 

$80,000. L.O. Lipson, M.D., Co-P.I. 

29. State of Alaska- Educational Grant ('Training of Administrators in Long Tenn. Care 

Institutions and Health Care Providers and Planners in Special Topics 'of Gerontology 

and Gedatrics." 3/l/96- 5120196, $16,000. L.G. Lipson, M.D., Director. 

30. Glendale Adventist Medical Center- "Family Practice Residency Training in Geriatric 

Medicine!' 7/l/96- 6/30/00, $6,000/year. L.G. Lipson, M.D., DireQtol'. 

31. Research Grant from G.D. Searle and Co. ' ·~controll¢d Onset Verapamil Investigation of 

Cardiovascular Endpoints." 5/97 through 5/02. $75.000. L.G. Lipson, M.D.~ P.I. ~ ,, ' ... 

32. State of Alaska, "Training in Gemphatmacy, Fall P!.'evention, and Quality Assurance in the 

frail and demented elderly.'' 4/98~ 111102~ $200~000. L.G. Lipson, M.D .• P.I. 

33. Research Grant from Pfizel' Phrumaceuti<lals,- ~~studies in Fine Motor Coordination in 

Alzheimer's Disease.'' 6/98-10/99,$97,000. L.G. Lipson, M.D., PJ. 

34. Research Grant from the Keck Foundation "Studies on the Use of Medications in the 

Eldedy.>'9/30/02, $4,000. L.G. Lipson, M.D., P.I.~ 12/31/02. 

35, State of Alaska, "Training in Geropharmacy: Quality Assurance in the FtaJ and Demented 

Elderly; CQI ofPjoneers' Homes,"l/1/02-12/31/02. $100,000. L.G. Lipson, M.D., P.I. 

36. State of Alaska, "Training in Quality Assuranc~;~ of the Frail and Demented Elderly: CQI of 

Pioneers' Homes/' 1/1/03-12/21/03. $100,000 L.G. Lipson, M.D., P.(. 

t ..... ,.,.J;." .. ~IJ...r.l!"'-~,o-. • 

. 37. State of Alaska- University of Alaska. Alaska Getiatric Education Center~ Consultant 

7/1/03 ~ 12/31/04. $18>000. 

38. State of Alaska- University of Alaska,. Alaska Geriatric Education Center-Consultant 

. 10/1/07- 6/30!08. $10~000. 

39. State of Alaska- University of Alaska, Alaska Geriatric Education Center- Consultant 

7/1/08-6/30/09. $1 o.ooo . 

... 4 • "''.