Opinion ID: 3035397
Heading Depth: 1
Heading Rank: 3

Heading: D., PTO 2457 (May 31, 2002). The District Court

Text: acknowledged and applied the correct standard under the Settlement Agreement. According to the District Court, “[t]he issue presented for resolution of this claim is whether [Patterson] has met her burden in proving that there is a reasonable medical basis for the attesting physician’s finding that she had moderate mitral regurgitation.” In re Diet Drugs, 2007 WL 674720, at . The court concluded that “the attesting physician’s answer lacks a reasonable medical basis . . . because the attesting physician’s finding failed to reflect the actual level of [Patterson’s] mitral regurgitation.” Id. at . It faulted Patterson for failing to “address the improper measurements underlying the finding of her attesting physician.” Id. As noted, in an attempt to support her claim, Patterson submitted a certification prepared by Dr. Silvestry. But because Dr. Silvestry’s report identified the maximum regurgitant jet without any discussion of its representativeness, the court concluded that the report did not support Patterson’s contention that Dr. Harris’ opinion had a reasonable medical basis. Id. at  (“Claimant has not established that the ‘maximum regurgitant jet’ offered in support of her claim is representative of her level of mitral regurgitation . . . .”). Dr. Churchwell found trivial to mild mitral regurgitation 27 in Patterson’s echocardiogram. Under the Audit Policies and Procedures, Patterson had the burden to prove that Dr. Harris’ opinion had a reasonable medical basis. Patterson had the opportunity to show that Dr. Harris’ finding represented the actual level of Patterson’s mitral regurgitation. But Dr. Silvestry’s report failed to satisfy Patterson’s burden because it only identified a single maximum regurgitant jet without any indication of the jet’s representativeness. Accordingly, the District Court properly rejected Dr. Silvestry’s report because it failed to rebut Dr. Churchwell’s conclusion that Dr. Harris’ report lacked a reasonable medical basis.