Opinion ID: 1864782
Heading Depth: 1
Heading Rank: 8

Heading: Dr. Jonathan D. Wirtschafter, M.D.

Text: Dr. Wirtschafter is a ophthalmologist at the University of Minnesota, engaged in the subspecialty of neuro-ophthalmology. Dr. Opheim referred Foltz to Dr. Wirtschafter, who had a short consultation with Foltz on one occasion in September 1990 almost seven months after the accident. Dr. Wirtschafter's testimony was received via two depositions, one given in March 1992 and another (telephonic) deposition in April 1992. Dr. Wirtschafter stated that he did not observe traumatic damage to the optic nerve head at the time of the consultation, but could not say absolutely that a color change would have been evident in September 1990, approximately six and one-half months after the accident. Two particular tests discussed by Dr. Wirtschafter were the Goldmann test and the Harrington wand tangent screen test. In the Goldmann test, targets of various sizes [5] and brightnesses are brought in from the sides while the patient looks straight ahead, and the patient is supposed to indicate when he sees them. In regard to Foltz' performance on this test, Dr. Wirtschafter stated his assumption that Foltz either was not fully cooperative or did not understand what was required of him. When questioned about one common purpose of the Harrington wand tangent screen test, Dr. Wirtschafter acknowledged that the test is used to find out whether a patient is malingering or is otherwise imagining a problem with a loss of field vision. As described by Dr. Wirtschafter, the patient is shown a target at one meter; then, at two meters, the patient is shown a target double the diameter of the first target. A patient even one with a peripheral vision loss should then be able to see an area twice as wide. As stated by Dr. Wirtschafter, a malingering patient will be stuck on the fact that they ought to see ten degrees and doesn't know that when you move them back double the distance they should be able to see a wide area, so they stick with the 10 degrees even though they're now further away and ought to be able to see a wide field. Unfortunately, Dr. Wirtschafter's staff did not administer the test to Foltz in the correct manner so that a determination of malingering could be made. The test was only administered once, at a one meter distance; they did not move Foltz back to two meters and double the target size. However, as will be seen, ophthalmologist Dr. Thomas White did so administer the test. In summary, Dr. Wirtschafter stated that Foltz' vision problems are not due to some organic disease or trauma, most probably for the reason that he found an absence of any objective findings on the ophthalmological examination of the eye at the point in time in which I examined him. Counsel for Warner asked Dr. Wirtschafter: Q. [D]o you have an opinion with reasonable medical probability whether Mr. Foltz has actually lost his field of vision? A. I do. Q. And what is that opinion? A. I believe he has not lost as much visual field as is shown on our test. Later, when asked again whether Foltz had any loss of peripheral vision, Dr. Wirtschafter similarly stated that, I don't think there is a loss of visual field that is as large as or to the extent that it's being represented.  (Emphasis added.) Thus, when given the opportunity, Dr. Wirtschafter refused to testify that Foltz had no loss of peripheral vision.