spine imaging alfonso morales deposition.pdf

8/13/2019 Spine Imaging Alfonso Morales Deposition.pdf

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CASE 0:10-cv-04636-JRT-AJB Document 151-10 Filed 07/10/12 Page 1 of 17

Exhibit 10


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Alnso Moales, M.D., 4/24/2012

NTD STATS DSTRCT CORT

DSTRCT OF MNNSOTA

Spine maging MR, L L C , a Minnesota

imited iabiit compan,

Paintiff,

s

Libert Mutua Fire nsurance Compan, a

Wisconsin corporation, and Astate

2 nsurance Compan, an inois corporation,

3 Defendants,

4

5 and

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7 Libert Mutua Fire nsurance Compan,

8 Third-Part Paintiff,

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2 s

2

22 duardo Buon, indiidua; Rafae

23 Mendez, indiidua, Centra Medica

24 Cinic, LLC; Dr Afonso Moraes, M D ,

25 indiidua; Northstar Radioog

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age:

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Alnso Morales, M.D., 4/24/2012 age 2

Corporation P A Dr Wiiam Ford

M D indiidua and Dr Hans Michae

Castro D C indiidua

Third-Part Defendants

------------------------

DPOSTON OF ALFONSO MORALS M D

Taken Apri 24, 2 12

Commencing at 9:5 a m

RPORTD BY KLLY ZILLS RPR

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Alnso Morales, M.D., 4/24/2012 age 88

Q Oka And what knowedge or understanding do

2 ou hae as MR machines compare to one another, in

3 other words, a Fonar ersus a Picker ersus a Toshiba?

4 A think thats minutia, rea mean, think

its minutia to ook at eer singe tpe of scanner,

6 whether its Toshiba or Siemens or G think a

7 scanner, as ong as ou hae a good resoution and ou

8 can see the scans correct, think thats what was

9 ooking at

Q Oka And ou made reference to getting a

report of findings or an interpretation report done

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A Yes

Q - of the scan?

A Yes

Q Oka s that one of the things ou accept when

6 ou refer a patient of ours to Spine maging?

7 A To hae an adequate interpretation and

8 professiona done, es

9 Q Oka Who do ou expect that to come from?

2 A At the time it was Dr Ford, Dr ohnson, there

2 was another doctor that cant remember his name

22 Q Oka Woud ou eer refer a patient of ours

23 to an MR faciit that did not proide a report of

24 findings?

2 A. No.

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Anso Moraes, M.D., 4/24/2012 age89

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Q Thats a gien, in other words?

A Yes

Q s that fair?

A Yeah, ou hae to hae that

5 Q Oka And does that report of findings hae to

6 come from a medica doctor whos a radioogist?

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A t has to be from a radioogist, es

Q Oka And so woud it be fair to understand

9 then when ou determined ou were going to refer

1 patients of Centra Medica to Spine maging that ou

11 knew Dr Ford and/or Dr ohnson woud be interpreting

12 those scans and ou were satisfied the were competent

13 radioogists?

A14 That is correct, es

15 And ou were in fact counting on that?Q

A

Q17 Did ou hae an concern about the ownership of

the MR18 faciities ou were referring patients of ours

19 to?

A2 No, that was not m business

21 What use are ou making of the MR scans and theQ

22 report of findings issued to ou b Spine maging?

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A What use?

Q. Yes

A ts important to know what is the anatom and

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nso Moraes, M.D., 4/24/2012 age204

2 no

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A dont know what kind of reationship he has,

Q Did ou eer see an kind of contract or4 agreement between Spine maging and Dr Ford?

5 A No

6 Q think ou indicated earier that to the extent

7 that there were reports generated foowing some

8 diagnostic testing done at Spine maging, that woud

9 come to ou on Spine maging etterhead, is that

correct?

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A Yes

Q Woud that report be signed b a phsician or

3 some quaified person interpreting the, the resuts?

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A Yes

Q Do ou reca on an of those reports that ou

6 woud receie was there an indication that the person

7 signing it was not an empoee of Spine maging?

8 A No

9 Q Was there an indication that the person signing

2 those reports was somehow an independent contractor to

2 Spine maging?

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A No

Q So ooking at the report ou woud assume that

24 that person worked for Spine maging, whoeer was

25 signing it?

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Alfnso Morals, M.D., 4/24/2012 Pag: 213

A. Tat te MRI tec wod ca and say ts s not

2 nderstandabe or can we do a better resoton If

3 tey can't I wod jst send tem somewere ese

4 Q So te, so te mage wod be provded to yo,

5 yod ave an opportnty to at east try to get t

6 corrected, and f t codnt get corrected yo wod

7 send tem somewere ese?

8 A Yes.

9 Q. And do yo reca dong tat wt Spne Imagng

at all?

A No, tey ad exceent resoton

2 Q Have yo ever provded any medcaton to any of

3 te patents tat were ndergong scans?

4 A. Yes, some of tem are castropobc or severey

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anxos so I ave to gve tem sometng

Q Okay How are yo made aware of ts

7 castropobc or ts anxety tat tey are gong

8 trog?

9 A e were faxed sometng tat te patent s

2 castropobc or overszed, reqres maybe some

2 sedatve

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Q So tat wod come from Spne Imagng?

A Tey wod fax sometng, yea, to s, yes

Q And dd yo ever prescrbe some medcaton for

25 any patents tat weren't yor patents tat yo

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Anso Moraes, M.D., 4/24/2012 age: 214

referred to Spine Imaging?

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A Nmeros times, yes

Q So yo od prescribe medication for patients4 tat ere not yor patients?

A Tat ere not my patients, yea

6 Q And tat od ave been at te reqest of Spine

7 Imaging?

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A Yes

Q. And od yo examine tese patients?

A No, I od jst try to get a istory from tem

of at's going on, are tey aready taking oter

2 medications, do tey ave any probems, and jst go

3 aead and give tem a very o dose sedative Im

4 say very conservative, so most of te time it orked

very e, even if tey ere oversized I od give tem

6 a o dose

7 Q So yo od tak it tese patients?

8 A No, no taking, no I st get a istory from

9 te person o is faxing it, ike from Jason or from one

2 of te tecs tats doing te MRI Typicay it od

2 be one of te tecs tat od do tat

22 Q Okay So a tecnician od be tere taking a

23 medica istory?

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A Yes

Q. From te patient and ten reaying tat to yo

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An Mrae M.D. 4/24/2012 Page:215

and requestng tat you gve some knd of medcaton for

2 te purpose of

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A Yes

Q reevng te anxety for tat partcuar

patent gong troug te MRI scan?

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A Yes

Q And you woud not ave seen tat patent?

A No

9 Q. You woud not ave revewed any medca records

reatng to tat patnt?

A No

2 Q You woud ave reed upon a story tat woud

3 ave been taken by an MRI tecncan?

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A Yes

Q Okay I ave no furter questons

6 FRTHER EXAMINATION

7 BY MR LOWDEN:

8 Q Mr Moraes agan, Mcae Lowden I just ave

9 a few foowup questons I want to jump on tat

2 ssung medcatons for some of te Spne Imagng

2 patents Dd you get pad for tat?

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A No

Q Dd you ave some knd of an agreement wt

24 Spne Imagng tat you woud provde tat medca

2 servce?

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Alfn Mrae MD 4/24/2012 Page:226

1 A Dd tat on my own And I ave oter practces

2 tat, tat I knew were LLC's tat I never, I togt

3 PLLC was sometng attorneys sed

4 Q Okay Bt my qeston was, yo ddnt ave te

advce of conse at tat tme?

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A No

Q Yo were asked qestons abot contrast, MRI's

8 wt contrast Yo don't send patents down to Spne

9 Imagng, bt are yo aware weter Spne Imagng

1 performs MRIs wt contrast or not?

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A Im not aware of tat, no

Q Te, n terms of te anxos or obese patent

13 ne of qestonng Yo wod get a fax and ten yo

14 wod ave a teepone ca wt a tec at Spne

1 Imagng, tat's ow tat wod work, rgt?

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A Yes

Q Okay And someone asked yo weter yo wod

18 actay examne te patent and yo sad no, t was te

19 teepone ca Bt wo wod actay dever te

2 medcaton?

21 A. O, I wod prescrbe te medcaton trog a

22 parmacy, we sed to ave a parmacy down, or pstars

23 n te frst foor, and I wod wrte te prescrpton

24 to gve tem a tabet or af a tabet of sometng

2 Q Mmmm

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Alfonso Morales, M.D. 4/24/2012 Page:227

1 A And to sedate the patient. Usually it was a

2 safe medication and they would give me the weight of the

3 patient to make sure I was giving an adequate dose. And

4 then the receptionist would come up and pick it up or

5 Jason would come up and pick it up or they would send

6 somebody to come up and pick it up.

7 Q. So how many times during the 12 years has that

8 happened?

9 A. I can't tel you how many times, but it happened

0 several times.

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Q. More than a hundred?

A. dont think a hundred.

Q All right. So less than a hundred?

A. Much less, yes.

Q. Okay. More than ten?

A. More than ten.

Q. All right. And more than 50?

A. Not more than 50

Q. All right. So somewhere between 50 and ten?

A. Yes.

Q. And on none of those occasions did you ever

22 actually witness physically the patient, right?

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MR. MYERS: Object to the form.

A. A few times they had to come in because was

concerned. mean, can think of maybe a handful of

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An Mrae, M.D., 4/24/2012 Page:228

1 tmes where I sad send them over because I need to see

2 f they had too many medcal problems that I was

3 concerned wth, I woud go through that and do an exam,4 but usually most of the tme they dd we.

5 Q Okay. So n what, bear wth me, what percentage

6 of these peope who needed some sedatves dd you

7 actually meet wth n person?

8 A. Id say a quarter of them, 25 percent.

9 Q. Okay, 25 percent. And the queston, you had the

10 queston earler, you never receved payment for ths

11 servce even, even n those crcumstances where you

12 actuay had to evauate the patent?

13 A. No. I, I thnk we couldn't realy code on that

14 and sometmes I, I dont know f we woud ever get pad

15 on t, so we woud wrte t off.

16 Q You woudn't bll Spne Imagng though for that

17 servce?

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A. No.

Q And you weren't pad or

A. I thnk the person woud have to drecty b

21 the nsurance company, but I don't thnk the nsurance

22 company would pay.

23 Q What about, ast queston on ths topc, when

24 some of the patents that needed ths sedatve treatment

25 were actually patents of yours, you sad some were from

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An Mrae M.D. 4/24/2012 Page:229

other referra sorces bt some were yors?

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A. Yeah, a ot of them were ors

Q And on those occasons where yo had yor own4 Centra Medca patent who ends p at the MR and s

5 nervos or what have yo and yo get ths fax and yo go

6 throgh ths machnaton of sedatng them, yo wod

7 agree we wod expect to fnd that fax and any other

8 docmentaton of that epsode n the patent's chart

9 rght?

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A. Yes

Q That wod end p n the chart?

A t's n the chart, yes.

3 Q Thats t have nothng frther Thank yo,

4 Doctor

5 FRTHER EXAMNATON

6 Y MR MORAN

7 Q. st have a cope more here ong back to

8 ths sse of, of prescrpton of medcaton, Doctor, to

19 patents that were not beng treated by yo. Yo wod

20 rey on the nformaton that was provded to yo by a

2 tech over the phone or prsant to a fax, correct?

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A Yes

Q Yo wod rey on that tech then to propery

24 reay to the patent what knd of medcaton was gong

25 to be admnstered to the patent?

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Aonso Moras, MD, 4401 Pag: 30

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A. Yes.

Q Yo wod rey on te tec to propery advse

3 te patent as to potenta compcatons tat te4 medcaton mgt ave

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MR MYERS: Obect to te form

A Was , can yo repeat tat

Q Wod yo rey on te tec to provde

8 nformaton to te patent as to potenta

9 compcatons10

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MR MYERS: Obect to form

A Certan story, yes

Q Bt

A et a certan story ot of t

Q Bt n terms of commncatng to te patent,

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yo're reyg on te tec to be te condt of

16 nformaton to tat patent as we

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A Yes

MR MYERS: Obect to form

Q t's not jst te patent's nformaton comng

20 to yo, bt yo provdng nformaton to te tec wc

21 n trn s reayed to te patent, correct

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A Yes

MR MYERS: Obect to te form

Q And tat mgt ncde compcatons from te

25 medcaton

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Afn Mrae, M.D., /2/2012 Page: 231

1 MR MYERS Obect to te form

2 A f we tnk tere were any compcatons or

3 tngs tat were senstve wod ave tem be

4 cecked

5 Q Bt generay speakng, most medcaton as

6 stated ndcatons and compcatons, correct?

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A Rgt

Q And wod yo rey on te tec to reay te

9 typca, ts cod case yo nasea, ts cod case

10 yo dzzness, tat type of tng?

11 MR MYERS Obect to te form

12 A ncdng te scan, yes And te MR scan yo

13 can be castropobc, yo can pass ot yo can ave

14 nose, yo can ave probems wt te scan. Yes

15 teres, ts ter responsbty to tak to tem abot

16 ts

17 Q And so at east n terms of wen, wen yo were

18 prescrbng medcaton to patents tat werent yor

19 patents tat yo adnt seen yo were reyng on te

20 tec to provde ts medca nformaton to te

21 patents?

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A Yes

MR MYERS Same obectons

Q And ten yo wod aso rey on te tec to

25 provde nformaton as to te prpose bend te

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1 medcaton?

2 A Yes.

Alfnso Moraes, M.D., 4/24/2012

3 Q ave no furter questons.4 MR. OWDEN Mr. Myers dont beeve

5 teres any furter questons.

Page:232

6 MR. MYERS Okay. Te wtness w read

7 and sgn.

(Proceedngs concuded at 2:5 1 p. m

910

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Alnso Moals MD 4/24/2012 Pa233

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REPORTER'S CERTIFICATE

STATE OF MINNESOTA )4 ) SS.

COUNTY OF WASHINGTON )5

6 I hereby certify that I reported the deposition ofAlfonso Morales on the 24th day of April 202, in

7 Minneapolis, Minnesota, and that the witness was by mefirst duly sworn to tell the whole truth;

8That the testimony was transcribed by me and is a

9 true record of the testimony of the witness;

0 That the cost of the original has been charged tothe party who noticed the deposition, and that all

parties who ordered copies have been charged at the samerate for such copies;

2That I am not a relative or employee or attorney or

3 counsel of any of the parties, or a relative or employeeof such attorney or counsel;

4That I am not financially interested in the action

5 and have no contract with the parties, attorneys, orpersons with an interest in the action that affects or6 has a substantial tendency to affect my impartiality;

7 That the right to read and sign the deposition bythe witness was reserved.

8WITNESS M HND AND SEAL THIS 24th day of April

9 202

20

2 lu f.222324 Kelley E Zilles, RPR

25Notary Public, Washington County, MinnesotaMy commission expires -3205

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spine imaging alfonso morales deposition.pdf

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