Opinion ID: 161851
Heading Depth: 3
Heading Rank: 1

Heading: Contradictions in Dr. Bohn's Testimony

Text: 27 Notwithstanding Ralston's protestations to the contrary, our review of Dr. Bohn's March 1999 deposition testimony reveals a number of material contradictions in his subsequent sworn affidavits. First, Dr. Bohn clearly indicated at his deposition that he had reviewed the Surgical Technique Brochure (which contained several warnings concerning the MultiHole Nail), and that he had been satisfied with the information provided therein. The only question he had, according to his deposition testimony, was whether or not to fill all the holes in the nail. 28 Q: And you reviewed that technique brochure? 29 A: Right. 30 Q: Were you satisfied with that information? 31 A: Right. I mean it was basically there was no problem with it, as far as the -- the only question I had is I reviewed that and later in surgery was -- is one required to fill the holes. That was the only thing that I don't remember there being a definite yes or no you're required to fill all of those holes even if you don't, you know, have any purpose for the screw. 32 Deposition Transcript of Dr. Bohn at . 33 By contrast, in his October 3rd Declaration, Dr. Bohn claimed that he had never received any warnings from Smith & Nephew. See October 3rd Declaration at 3-4. Then, in the October 11th Declaration, Dr. Bohn stated that he did, in fact, receive a Smith and Nephew supracondylar Nail surgical technique, that he did review the technical details prior to Mrs. Ralston's April, 1996 operation, but that he simply does not recall reviewing a WARNING page as it appear[ed] in the currently reviewed technical monograph. October 11th Declaration at 3 (emphasis added). He added that he could not say whether or not a WARNING page existed in the material reviewed in 1996, only that [he] did not review it specifically. Id. 34 Second, Dr. Bohn testified at his deposition that he would not have used the Five Hole Nail in lieu of the MultiHole Nail even if he knew that the MultiHole Nail were less durable: 35 Q: At the time you selected the 12 millimeter multi-holed Smith & Nephew nail in April of '96, if you had known there was a five hole design of the same nail that didn't have holes through the length of the nail and was much more durable, would you have selected that nail instead? 36 A: Probably not, because of that additional fracture, the two fractures. 37 Deposition Transcript of Dr. Bohn at -56. 38 Accordingly, Dr. Bohn testified that durability was not a factor in using the MultiHole Nail, suggesting that his choice had to do with the ability of the MultiHole Nail to address the additional fracture in Ralston's leg. However, in his October 3rd Declaration, Dr. Bohn again contradicted his deposition testimony by stating [a]t that time in the surgery, had I had the five-hole nail available to me and had I known of the significant durability advantage of the five-hole nail, I would have used the five-hole nail. October 3rd Declaration at 7. 39 In the October 11th Declaration, Dr. Bohn changed his position again, stating that [t]he multihole nail was selected for its versatility in Karen Ralston's particular complex case in which there were two fractures. . . . I do not recall reviewing information about or having the 5 hole nail made available to me, nor did I have any reason to select that particular nail at the time. October 11th Declaration at 4. 40 Finally, Dr. Bohn emphasized at his deposition that Ralston's condition placed a great deal of stress on the MultiHole Nail, causing it to ultimately break under the strain, and that this failure -- given the nature of Ralston's fractures -- was inevitable. 41 And so basically in that situation where you have a bone that's, you know, not solidly healed, you're just waiting for the pin or the rod to break. . . . I think to be fair, that's basically it. I think the rod broke under circumstances that you wouldn't expect it to in terms of a minor -- basically I'm not sure there was any trauma at all and it broke. So one would guess that she had not had real good stress transfer across the fracture site and that there was still a lot of stress being borne by the rod and it couldn't take it and it just finally gave out. And to elaborate on that, I think it was doomed to happen. In other words, I was disappointed that it happened seven months post implantation, but we now know that it would have happened. It would have been 12 months or 18 months. It would have happened at some point. 42 Deposition Transcript of Dr. Bohn at . 43 In the October 3rd Declaration, however, Dr. Bohn painted quite a different picture by stating that I anticipated the nail would serve its purpose for more than seven months and that the nail would have no trouble serving its purpose from twelve to eighteen months. . . . It is my professional opinion that a nail which is intended to be used to support a non-union bone to facilitate healing should last significantly longer than 7 months, especially when used in a patient, like Ms. Ralston, who weighs only 110 lbs. and is a very compliant patient. October 3rd Declaration at 5. 44 In the October 11th Declaration, Dr. Bohn changed his statement yet again by stating [e]xcess stress occurred at that point in the bone and the nail both. The nail broke. The nail break was associated with a new fracture at the site of the prior fracture (same location, different line). If a nail of significantly higher fatigue strength had been selected, I am of the opinion that eventual failure of the device would have occurred because of the adverse condition of the healing of the patient's bone. October 11th Declaration at 7.