Opinion ID: 2582741
Heading Depth: 3
Heading Rank: 1

Heading: Dr. Rudd's Testimony Was Consistent.

Text: The first flaw alleged in Dr. Rudd's testimony concerns what Curtis describes as a switch in Dr. Rudd's position midway through his deposition. In Curtis' view, Dr. Rudd in his July 2002 letter to the SIF first advanced a view that because Curtis did not complain to him of pain in her hip until near the end of the period that he was treating her  from approximately six weeks after the June 2001 accident until May 2002  she was not afflicted with advancing avascular necrosis during that time. That position, according to Curtis, was untenable because if Curtis' avascular necrosis was retriggered by the 2001 accident, the time during which Dr. Rudd was providing care would correspond to the quiescent period of the condition. As a result, rather than being evidence that Curtis' condition was idiopathic, the lack of hip pain during that period would be entirely consistent with Curtis' theory that the 2001 accident retriggered her avascular necrosis. Curtis asserts her counsel confronted Dr. Rudd with this alleged problem in his testimony, and Dr. Rudd reacted by backtracking and changing his analysis. According to Curtis, Dr. Rudd spontaneously invented a new theory as to why the absence of reported hip pain was important. This allegedly new theory held that although the absence of hip pain during the time Dr. Rudd was treating Curtis was consistent with a developing case of avascular necrosis, if the condition had been retriggered by the 2001 accident there would have been hip pain associated with that accident  and if Curtis had suffered from such past pain she would have reported it to Dr. Rudd even if the pain had abated by the time he first examined her. In his deposition testimony, Dr. Rudd explained that the human hip is robust, and only severe trauma is normally sufficient to induce avascular necrosis. Although Curtis' fall was hard enough to damage a disk in her back, Dr. Rudd offered that in his opinion Curtis' spine was already badly degenerated prior to her 2001 accident and prone to damage from even a low energy fall. According to Dr. Rudd, the degree of trauma necessary to retrigger the avascular necrosis in Curtis' hip would have also produced hip pain. Dr. Rudd acknowledged that any pain produced as a direct result of the trauma (as distinguished from much later pain associated with avascular necrosis when the condition became advanced) would likely have come and gone in the six weeks between the 2001 accident and Curtis' first appointment with Dr. Rudd. However, he testified that Curtis was thorough in describing the history of her injury and the timing and locations of the pain she suffered. Dr. Rudd maintained that if Curtis had suffered the kind of hip pain that would be associated with trauma sufficient to retrigger avascular necrosis in the hip, he was confident that she would have reported that pain  even weeks after the accident, and even if the hip pain had since ceased. On appeal, Curtis argues that Dr. Rudd's expert opinion regarding her condition is valueless in part because of the sudden change in his analysis under cross-examination. Contrary to Curtis' argument, however, the position taken by Dr. Rudd in his July 2002 letter to the SIF is consistent with his later testimony. Dr. Rudd's July 2002 letter placed much emphasis on the absence of reported pain in Curtis' hip. Curtis asserts that Dr. Rudd erroneously believed that such hip pain would be perceived early in the development of avascular necrosis, and that by expecting such pain at that stage Dr. Rudd demonstrated ignorance of the nature of the condition. In his July 2002 letter, however, Dr. Rudd never expressed the view Curtis attributes to him. Instead, the letter stresses the significance of the absence of reported hip pain, but does not state why the absence of pain was significant. Curtis does not direct our attention to any point in the record, in the July 2002 letter or elsewhere, where Dr. Rudd describes the significance of the lack of hip pain in a way that is inconsistent with his testimony in the deposition. Instead, the record suggests that Dr. Rudd placed much weight on the absence of reported hip pain, but only in his deposition did he elaborate his reasoning as to why.