antoine dental - dr. irwin ornish deposition 05.09.13
TRANSCRIPT
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1 A P P E A R A N C E S2 3 FOR PETI TI ONER4 J . A. "TONY" CANALES
Bar Number 037370005 CANALES & SI MONSON, P. C.
2601 Mor gan Avenue6 Cor pus Chr i st i , Texas 78465- 5624
Phone: ( 361) 883- 06017 Fax: ( 361) 884- 7023
t onycanal es@canal essi monson. com8 9 OSCAR X. GARCI A
Bar Number 0764006010 LAW OFFI CES OF OSCAR X. GARCI A
302 Ki ngs Hi ghway11 Sui t e 112
Br ownsvi l l e, Texas 7852112 Phone: ( 956) 554- 3000
Fax: ( 956) 554- 324813 14 FOR RESPONDENT15 DANI EL L. HARGROVE
Bar Number 0079082216 WATERS & KRAUS, L. L. P.
600 Navar r o17 Sui t e 500
San Antoni o, Texas 7820518 Phone: ( 210) 349- 0515
Fax: ( 210) 349- 366619 dhargr ove@waterskr aus. com20 J AMES R. MORI ARTY
Bar Number 1445900021 MORI ARTY LEYENDECKER, P. C.
4203 Mont r ose Boul evard22 Sui t e 150
Houst on, Texas 7700623 Phone: ( 713) 528- 0700
Fax: ( 713) 528- 139024 j i m@mor i ar t y. com25 Cont i nued
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1 A P P E A R A N C E SCont i nued
2
3 FOR RESPONDENT
4 CAI TLYN SI LHANBar Number 24072879
5 WATERS & KRAUS, L. L. P.3219 McKi nney Avenue
6 Dal l as, Texas 75204Phone: ( 214) 357- 6244
7 Fax: ( 214) 357- 7252csi l han@wat er skr aus. com
8
9 KETAN U. KHAROD
Bar Number 2402710510 KHAROD LAW FI RM, P. C.
P. O. Box 15167711 Aust i n, Texas 78715
Phone: ( 512) 293- 155612 ket an@kharodl awf i r m. com
13
14
15
16
17 ALSO PRESENT:
18 BEHZAD NAZARI , D. D. S, Pet i t i oner
19 J OHN R. MEDLOCK, Associ ate Counsel , Sanct i onsHeal t h & Human Ser vi ces Commi ssi on, OI G
20 ENRI QUE M. VARELA, Associ at e Counsel , Sanct i ons
21 Heal t h & Human Ser vi ces Commi ssi on, OI G
22 OI RAM SALI NAS, Par al egal , Canal es & Si monson
23
24
25
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1 I N D E X
2
3 Ti t l e Pages 1
4 Appearances 2
5 I ndex 4
6 Pr oceedi ngs Begun 5
7 I RWI N K. ORNI SH, D. D. S. , M. S
8 EXAMI NATI ON BY MR. HARGROVE 13
9 Deposi t i on Concl uded 87
10 Changes and Si gnat ure 88
11 Cour t Repor t er ' s Cer t i f i cat e 90
12 Fur t her Cer t i f i cat i on 92
13
14 * * * * * *
15
16 17 E X H I B I T S
18
19 NO. DESCRI PTI ON PAGE
20 ( No Exhi bi t s Of f er ed. )
21
22
23 * * * * * *
24
25
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1 P R O C E E D I N G S
2 ( Mr . Gar ci a, Mr . Sal i nas, and Dr . Or ni sh not
3 pr esent . )
4 MR. CANALES: My name i s Tony Canal es. I ' m
5 t he l awyer f or Dr . Nazar i . We have been wai t i ng out si de
6 si nce 8: 50. We sent us a - - a not i ce t o everybody we were
7 gonna be her e at 8: 50. The deposi t i on was schedul ed t o st ar t
8 at 9: 00 o' cl ock. We have been be r eady t o st ar t f r om
9 9: 00 o' cl ock. I t i s now 9: 35. We have been summoned t o
10 at t end t hi s meet i ng. I have avai l abl e and r eady t o be
11 deposed Dr . Or ni sh, pur suant t o our Rul e 11 agr eement .
12 Dr . Or ni sh i s out si de.
13 I have wi t h me my cl i ent , Dr . Behzad Nazar i .
14 I have al so wi t h me my par al egal , Or i Sal i nas. And al so have
15 wi t h me my cocounsel , Oscar Garci a; and my ot her cocounsel ,
16 Tony Goodal l .17 I have been i nf or med by r epr esent at i ve of
18 OI G - - I do not know hi s name - - t hat Mr . Gar ci a and
19 Mr . Goodal l ar e not wel come at t hi s deposi t i on. And I do not
20 know why.
21 I ' d l i ke t o have an expl anat i on, f i r st of
22
al l , as t o why has ther e been a del ay. Ver y unpr of essi onal .23 We wer e not t ol d why.
24 Second reason i s i f you don' t wanna gi ve an
25 expl anat i on, so be i t . But I have Dr . Or ni sh, who' s r eady t o
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1 be deposed, and I need t o have my cocounsel here. Mr . Garci a
2 has been wi t h me i n t hi s case f r om day one. He has not
3 wi t hdr awn f r om t he case. He i s a l awyer i n t he case. And
4 I ' d l i ke t o know what your obj ect i on i s t o Mr . Gar ci a so we
5 can pi ck up t he phone and cal l t he j udge.
6 MR. HARGROVE: My name i s Dan Har gr ove. We
7 r epr esent t he Of f i ce of I nspect or Gener al , Heal t h/ Human
8 Ser vi ces Commi ss i on.
9 And i t ' s our under st andi ng, Tony, t hat
10 J udge Gar ci a i s on t he bench.
11 MR. CANALES: No, he' s not .
12 MR. HARGROVE: Okay.
13 MR. CANALES: He' s not been swor n i n.
14 MR. HARGROVE: What ' s hi s st at us?
15 MR. CANALES: He has not been swor n i n. He
16 wi l l be swor n i n at t he end of t he mont h.17 MR. HARGROVE: Okay.
18 MR. CANALES: He' s i n - - some cases he' s
19 st i l l on. I n some cases he' s not on. I n t hi s par t i cul ar
20 case, he' s st i l l a l awyer i n t he case, deal i ng wi t h t he
21 pl eadi ngs. He has not f i l ed any t ype of mot i on t o wi t hdr aw.
22
He' s not a j udge.23 MR. HARGROVE: And Mr . Sal i nas i s. . . .
24 MR. CANALES: Mr . Sal i nas i s my f ul l - t i me
25 par al egal . Been wor ki ng wi t h me f or 25 year s.
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1 MR. HARGROVE: Okay. And i s t her e an - - a
2 nonpar t y exper t t hat you woul d l i ke t o have si t i n i n t hi s
3 pr oceedi ng?
4 MR. CANALES: No.
5 MR. HARGROVE: Okay. So i t ' s Mr . Sal i nas,
6 Tony Goodal l , and Oscar Garci a.
7 MR. CANALES: Yes.
8 MR. HARGROVE: Okay. Wel l , i t was our
9 under st andi ng t hat J udge Garci a was on t he bench, so
10 t her ef or e he was not per mi t t ed t o - -
11 MR. CANALES: He i s not on t he bench.
12 MR. HARGROVE: Okay. Al l r i ght .
13 Anythi ng el se?
14 MR. MORI ARTY: I f you' r e st at i ng t o us - -
15 MR. CANALES: I s my what ?
16 MR. MORI ARTY: I f you are st at i ng t o us as an17 at t or ney - -
18 MR. CANALES: Who ar e you, s i r ? I i dent i f i ed
19 mysel f - -
20 I t hought I r ecogni zed you. And you wer e
21 ver y r ude a whi l e ago t o me. And I ' d l i ke t o know why you
22
were r ude t o me. Now t hat I ' ve seen you, I say, " I know who23 t hat guy i s. " I don' t know what your posi t i on - - or why you
24 di d t hat .
25 And who ar e you agai n, f or t he record?
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1 MR. MORI ARTY: Here' s my quest i on - -
2 MR. CANALES: I don' t know who you ar e.
3 MR. MORI ARTY: - - ar e you st at i ng - -
4 MR. CANALES: I don' t know who you ar e. He
5 i dent i f i ed hi msel f . I i dent i f i ed mysel f . Who ar e you, si r ?
6 MR. MORI ARTY: I ' m not her e t o answer
7 quest i ons.
8 MR. CANALES: Wel l , I ' m not , ei t her .
9 MR. MORI ARTY: You' r e sayi n' t he j udge i s not
10 a j udge as of t hi s moment ?
11 MR. CANALES: Yes, si r .
12 MR. MORI ARTY: Al l r i ght . I see no r eason
13 why he cannot appear .
14 MR. CANALES: Wel l , I don' t care what you
15 say, si r .
16 MR. MORI ARTY: I s Goodal l counsel i n t hi s17 case?
18 MR. CANALES: He has appeared - - he i s my
19 cocounsel . He has not made an appearance i n t he case.
20 MR. MORI ARTY: And have you gi ven us not i ce
21 t hat he woul d appear ?
22
MR. CANALES: No.23 MR. MORI ARTY: Okay. Have you r ead r ul e - -
24 wel l - -
25 MR. CANALES: I f you don' t want hi m, we' l l
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1 ask hi m t o l eave. Not a pr obl em.
2 MR. MORI ARTY: Al l r i ght . And you' ve got
3 your par al egal her e?
4 MR. CANALES: Yes, si r .
5 MR. MORI ARTY: You may br i ng J udge Gar ci a
6 back and your paral egal .
7 MR. CANALES: I ' l l - - I ' l l do what I need t o
8 do.
9 Can you i dent i f y your sel f , si r ?
10 MR. MORI ARTY: I ' m J i m Mor i ar t y.
11 MR. CANALES: Very, ver y r ude of you guys t o
12 do t hi s. Tot al l y unpr of essi onal . Tot al l y - - i s t hi s t he way
13 we' r e gonna - - we have never had any pr obl em at al l wi t h OI G,
14 wi t h Mr . Var el a, or anybody el se. I cannot bel i eve t hat
15 we' r e st ar t i ng t hi s way.
16 MR. MORI ARTY: Ar e you r eady t o proceed wi t h17 t he deposi t i on?
18 MR. HARGROVE: I ' m not t al ki ng t o you.
19 Who' s gonna be t aki ng t o t he deposi t i on? I
20 t hought he was ( i ndi cat i ng) . Who i s - - who' s gonna be t he
21 guy i n char ge of t he deposi t i on?
22
You ar e, si r ?23 MR. HARGROVE: Yeah.
24 Ar e you f eel i n' okay, Tony? You l ook a
25 l i t t l e - -
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1 MR. CANALES: I ' m pi ssed. Because i t ' s ver y,
2 ver y unpr of essi onal on you guys' par t t o do t hi s. Ver y, ver y
3 unpr of essi onal . Uncal l ed f or - -
4 MR. HARGROVE: You' r e br i ngi ng a j udge and
5 you' r e br i ngi ng a nonpar t y - -
6 MR. CANALES: A j udge. He' s not a j udge.
7 MR. HARGROVE: You' r e br i ng a nonpar t y t o t he
8 deposi t i on.
9 MR. CANALES: Nonpar t i es have at t ended t hese
10 deposi t i ons f or bot h si des.
11 MR. HARGROVE: Wel l . . . .
12 MR. CANALES: Fr om both si des. There has
13 never been an obj ect i on.
14 MR. HARGROVE: Okay.
15 MR. CANALES: I f t her e i s an obj ect i on r i ght
16 now, so be i t .17 MR. HARGROVE: Al l r i ght .
18 MR. CANALES: And I under st and t he r ul es.
19 But al l I ' m sayi ng i s a si mpl e cal l or a si mpl e i nqui r y t o us
20 woul d have sol ved t he pr obl em. I ' m not f i ght i ng over
21 Goodal l . Goodal l - - I di d not gi ve - - I di d not gi ve not i ce
22
r egar di ng Goodal l , so t her ef or e, you know, i f you obj ect t o23 hi m, I wi l l ask hi m not t o appear .
24 MR. HARGROVE: Okay.
25 MR. CANALES: Now, Oscar Garci a i s not a
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1 j udge yet . Al l r i ght .
2 MR. HARGROVE: When i s he gonna t ake t he
3 bench, do you know?
4 MR. CANALES: 24t h, somethi ng l i ke t hat .
5 MR. HARGROVE: Of May?
6 MR. CANALES: Yeah.
7 MR. HARGROVE: ' Kay. So, I mean, i t was
8 al r eady - -
9 MR. CANALES: And I don' t know why you guys
10 are aski ng t hi s quest i on. You guys t hought I was gonna br i ng
11 a j udge i n here? You got t a be ki ddi ng.
12 MR. HARGROVE: The pr ess r epor t s t hat he' s on
13 t he bench.
14 MR. CANALES: No, t here' s no pr ess r epor t .
15 Anyway. Ar e you r eady t o proceed?
16 I cannot bel i eve t hi s. Thi s - - t hi s i s what17 makes l awyer s, by t he way, despi se each ot her . Anyway.
18 MR. MORI ARTY: You know, you' ve been r unni n'
19 your mout h si nce you wal ked i n here. Ar e you about done?
20 MR. CANALES: You shut up.
21 Al l r i ght , s i r . I ' m gonna br i ng my cl i ent s
22
i n. Okay?23 Come on, Doct or .
24 I ' l l be r i ght back.
25 Someone gonna escor t me out si de?
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1 ( Mr . Canal es and Dr . Nazar i l ef t t he r oom at
2 9: 43 a. m. )
3 ( Mr . Canal es, Dr . Nazar i , Mr . Gar ci a,
4 Mr . Sal i nas, and Dr . Or ni sh ent er ed t he r oom
5 at 9: 49 a. m. )
6 MR. HARGROVE: Why don' t you have t he
7 par t i es - - ever ybody i n t he r oom announce t hei r pr esence.
8 I ' m Dan Har gr ove. I ' m wi t h t he l aw f i r m of
9 Wat ers & Kr aus, and I r epr esent OI G.
10 MR. MORI ARTY: I ' m J i m Mor i ar t y, and I al so
11 r epr esent OI G.
12 MS. SI LHAN: I ' m Cai t l yn Si l han wi t h Wat er s
13 and Kr aus, r epr esent i ng OI G.
14 MR. KHAROD: My name i s Ket an Kharod. Al so
15 r epr esent i ng OI G i n t hi s.
16 MR. MEDLOCK: J ohn Medl ock. I am an at t orney17 f or OI G.
18 MR. VARELA: Enr i que Var el a, al so at t or ney
19 f or OI G.
20 MR. SALI NAS: Oi r am Sal i nas wi t h Canal es &
21 Si monson. Par al egal ; vi deogr apher .
22
DR. NAZARI : Behzad Nazar i . Ant oi ne Medi cal23 Cent er .
24 MR. GARCI A: Oscar Garci a on behal f of
25 Ant oi ne Dent al Cent er .
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1 MR. CANALES: Tony Canal es, counsel f or
2 Ant oi ne Dent al Cent er .
3 MR. HARGROVE: J udge Garci a, i t ' s our
4 under st andi ng t hat you' ve been appoi nt ed t o t he
5 di st r i ct - cour t j udgeshi p and I ' ve you' ve been conf i r med by
6 t he senate.
7 I s t hat cor r ect ?
8 MR. GARCI A: Cor r ect .
9 MR. HARGROVE: But you have not been swor n i n
10 t o t he bench yet ?
11 MR. GARCI A: I have not .
12 MR. HARGROVE: And t hat swear - i n dat e i s on
13 or about 24 May, 2013?
14 MR. GARCI A: As i t cur r ent l y st ands.
15 MR. HARGROVE: Okay.
16 MR. GARCI A: Coul d change.17 I RWI N K. ORNI SH, D. D. S. , M. S. ,
18 havi ng been cal l ed as a wi t ness her ei n, havi ng been f i r st
19 dul y swor n, was exami ned and t est i f i ed as f ol l ows:
20 EXAMI NATI ON
21 BY MR. HARGROVE:
22
Q. Woul d you pl ease st ate your f ul l name?23 A. I r wi n Kennet h Or ni sh.
24 Q. And wher e do you l i ve?
25 A. I n Dal l as, Texas.
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1 You need speci f i c addr ess?
2 Q. Sur e.
3 A. 8511 Edgemer e, Number 302, Dal l as, Texas 75225.
4 Q. And what do you do f or a l i vi ng?
5 A. I ' m an or t hodont i st .
6 Q. And how l ong have you been an or t hodont i st ?
7 A. On J une t he 16t h i t ' l l be 48 year s.
8 Q. And where do you pr act i ce or t hodont ur e?
9 A. I n Dal l as, Texas.
10 Do you need an addr ess?
11 Q. Yeah.
12 A. 11661 Pr est on Road, Number 106, Dal l as, Texas
13 75230.
14 Q. What ' s t he name of t he busi ness?
15 A. I r wi n K. Or ni sh, D. D. S. , M. S. , Cl i ni c.
16 Q. And what ki nd of busi ness i s i t ?17 A. I t ' s a or t hodont i c pr acti ce.
18 Q. Okay, Dr . Or ni sh. What i s your r ol e wi t h t hi s
19 case?
20 A. My r ol e was t o eval uat e t he cases f or Dr . Nazar i
21 r el at ed t o t he HLD i ndex.
22
Q. And who i s payi ng you?23 A. Dr . Nazar i .
24 Q. Al l r i ght . How much have you been pai d i n t hi s
25 case?
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1 A. Oh. At t hi s poi nt , I . . . I - - I don' t know
2 of f hand, but I woul d say appr oxi mat el y . . . $7, 000.
3 Appr oxi mat el y.
4 Q. When were you f i r st hi r ed t o wor k on t hi s case?
5 A. Oh, t he exact dat e, I don' t know. I bel i eve I was
6 cont act ed i n March.
7 Q. Who cont act ed you?
8 A. Mr . . . .
9 Q. Canal es?
10 A. Mr . Canal es. I ' m sor r y. Tony Canal es cont act ed
11 me.
12 Q. Mar ch of 2013?
13 A. I bel i eve i t was.
14 Q. Or Mar ch of 2012?
15 A. No, no. Of t hi s year .
16 Q. Al l r i ght .17 A. Yes.
18 Q. And . . . and what was di scussed about r et ai ni ng
19 you?
20 A. He asked me i f I woul d be - - consi der worki ng on a
21 case, and he asked me t o send hi m my f ees f or act i ng as a
22
exper t wi t ness, and, you know, i t was agr eeabl e t o hi m and23 hi s cl i ent , t hey woul d empl oy me t o act as an expert wi t ness.
24 Q. Di d you have a schedul e of f ees f r om pr i or cases?
25 A. I sent hi m a schedul e of f ees.
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1 Q. Have you pr ovi ded exper t consul t i ng or t est i f yi ng
2 ser vi ces i n ot her dent al or or t hodont i c Medi cai d cases?
3 A. Yes.
4 Q. Li st t hose f or me.
5 A. There was one case f or a Wayne Casson t hat I di d
6 ear l y i n 2012, and t hen f or M&M Or t hodont i cs.
7 Q. Wayne . . . l et me - - Wayne Casson?
8 A. Yes.
9 Q. I s t hat t he name of a dent i st ?
10 A. Yes.
11 Q. K or C?
12 A. C- A - - I bel i eve i t ' s C- A- S- S- O- N.
13 And t hat was al l I di d, was eval uat ed some
14 cases f or t hat .
15 Q. What was t he nat ur e of t hat case? Was i t a
16 Medi cai d - -17 A. I t was a Medi cai d case.
18 Q. Hol d- payment case? Fr aud case?
19 A. I have no i dea.
20 Q. So Dr . Wayne Casson. Was t hat t he ver y f i r st t i me
21 t hat you act ed as a exper t consul t ant or t est i f i ed?
22
A. Yes.23 Q. Okay. And when were you f i r st hi r ed by Dr . Casson?
24 A. I wasn' t r eal l y hi r ed by Dr . Casson. I was hi r ed
25 by anot her at t or ney.
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1 Q. Who was t hat ?
2 A. Dr . Rober t Ander t on.
3 Q. When wer e you hi r ed?
4 A. You know, I wanna say i t was i n t he - - I ' m t hi nki ng
5 i t ' s i n t he spr i ng of 2012. I don' t have t hat i nf or mat i on
6 avai l abl e. I can cer t ai nl y get t hat f or you when I r evi ew
7 t he cases.
8 Q. And what happened wi t h Dr . Casson' s case?
9 A. I have no i dea.
10 Q. Di d you i ssue a r epor t i n Dr . Casson' s case?
11 A. Yes.
12 Q. Di d you pr esent t hat repor t t o anybody other than
13 Mr . Ander t on?
14 A. No.
15 Q. Do you have t hat r epor t at your of f i ce?
16 A. Yes. I ' m t r yi ng t o r emember . I - - I - - you know17 what ? I - - I - - I wanna st and . . . put t hat i n quest i on as
18 t o I can' t r emember whet her I i ssued a repor t i n t hat case or
19 not . Because I r evi ewed t he cases, and t hen i t became
20 st agnant . And i t al so happened f r om my st andpoi nt i n t hat .
21 And I can' t r emember i f I di d a r epor t f or t hat .
22
Q. Dr . Casson: Where does he pr act i ce dent i st r y?23 A. I don' t even know.
24 Q. I s i t a dent i st - - i s i t a dent i str y case or an
25 or t hodont i c case?
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1 A. I t ' s an or t hodont i c case.
2 Q. Di d you consul t wi t h Dr . Casson about your repor t ?
3 A. No.
4 Q. And Mr . Ander t on hi r ed you - -
5 A. Mm- hmm.
6 Q. - - t o - - as a consul t ant or t est i f yi ng exper t i n
7 t hat case?
8 A. Wel l . . . he asked me t o r evi ew t he cases. And
9 I ' m not sur e how you def i ne i t .
10 Q. Wel l , what exact l y was your servi ce t hat you
11 pr ovi ded to Mr . Ander t on?
12 A. I eval uat ed t he cases based upon t he HLD i ndex
13 as . . . pr ovi ded i n t he Texas Medi cai d Di r ect or y.
14 Q. You don' t r ecal l i f you di d or di d not pr ovi de a
15 report?
16 A. I - - I can' t r emember - - I - - I know I sent i n17 copi es of my eval uat i on, and I cannot r emember i f t hey
18 r equest ed a r epor t , ot her t han t he eval uat i on sheet s.
19 Q. And i n t hat case, t he Dr . Casson case, di d you
20 pr ovi de any sworn t est i mony i n t hat case?
21 A. No.
22
Q. The Dr . Casson case, t hat was your ver y f i r st t i me23 t o act as - -
24 A. Mm- hmm.
25 Q. Hol d on. So l et me f i ni sh my - -
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1 A. I ' m sor r y.
2 Q. - - quest i on, and t hen I ' l l gi ve you t he cour t esy of
3 answer i ng.
4 The Dr . Casson case was t he ver y f i r st case
5 you have pr ovi ded exper t ser vi ces of any ki nd i n an
6 or t hodont i a case; cor r ect ?
7 A. Yes.
8 Q. Have you pr ovi ded any t ype of exper t servi ces - -
9 t est i f yi ng; consul t i ng - - i n any ot her mat t er ot her t han
10 ort hodont ur e?
11 A. No.
12 Q. Now, t he Dr . Casson case, you don' t know what
13 happened, t he r esol ut i on of t hat case; cor r ect ?
14 A. I have no - - no i dea.
15 Q. And t o sum up, you may or may not have i ssued a
16 repor t . . . .17 A. Ri ght . I - - I can' t be posi t i ve, so I don' t wanna
18 swear under oat h t hat I di d.
19 Q. What woul d you have t o l ook at t o see i f you
20 act ual l y di d i ssue a r epor t ?
21 A. I have some r ecords at home of . . . and I have t o
22
l ook and see i f t hat i ncl uded a r epor t i n t her e or not .23 Q. And you woul d have mai nt ai ned t hose r ecor ds had you
24 i ssued a r epor t i n t hat f i l e?
25 A. Yes.
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1 Q. Okay. Now, so t he f i r st case, Dr . Casson.
2 What was t he second case t hat you pr ovi ded - -
3 A. I n - -
4 Q. Hol d on. We got t a - - can' t t al k over each ot her .
5 A. Sor r y.
6 Q. So what was t he second case you provi ded exper t
7 ser vi ces i n?
8 A. M&M Or t hodont i cs.
9 Q. Where were - - when were you f i r st hi r ed f or M&M?
10 A. Agai n, I don' t have t he exact dat e, but somet i me i n
11 t he spr i ng of 2012. I bel i eve.
12 Q. And who hi r ed you?
13 A. Agai n, i t was t hr ough Dr . Ander t on. And t hen l at er
14 wi t h Mr . Canal es.
15 Q. Al l r i ght . I n t he M&M case . . .
16 A. Mm- hmm.17 Q. . . . t el l me exact l y what you - - what ser vi ces you
18 pr ovi ded.
19 A. I di d t he same ser vi ces. I eval uat ed cases r el at ed
20 t o t he HLD i ndex. I di d pr ovi de a r epor t on t hat . And I was
21 deposed i n t hat case.
22
Q. Di d you pr ovi de more t han one r epor t i n t he M&M23 case?
24 A. Ot her t han deposi t i on, no.
25 Q. And Dr . Ander t on hi r ed you? He was t he at t orney
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1 f or M&M?
2 A. He was one of t he at t orneys f or M&M.
3 Q. And t hen Mr . Canal es got i nvol ved?
4 A. I l ear ned t hat Mr . Canal es was i nvol ved.
5 Q. And what ' s t he st at us, i f you know, of t he M&M
6 case?
7 A. As I under st and r i ght now, i t i s schedul ed
8 t ent at i vel y f or t r i al somet i me i n - - or hear i ng i n - -
9 somet i me i n J ul y of t hi s year .
10 Q. Sounds l i ke t he st ar t of your car eer as a
11 t est i f yi ng exper t was t hr ough Dr . Ander t on.
12 A. Mm- hmm.
13 Q. What ' s your r el at i onshi p wi t h Dr . Ander t on?
14 A. Dr . Ander t on i s a l ongt i me f r i end. We wer e i n
15 col l ege t oget her . We wer e cl assmat es i n dent al school . And
16 over t he past 48 years, we have had pat i ent s i n common.17 Q. Okay.
18 A. As a gener al dent i st , he r ef er r ed pat i ent s t o me as
19 a speci al i st .
20 Q. Okay. Al l r i ght . Ot her t han t he M&M case and t he
21 Dr . Casson case, what other or t hodont i a cases have you
22
pr ovi ded exper t consul t i ng or t est i f yi ng ser vi ces i n?23 A. J ust t hi s par t i cul ar one, t he Nazar i case.
24 Q. Okay. So you' ve been hi r ed t o do - - t o pr ovi de
25 t est i f yi ng ser vi ces i n t hr ee cases; r i ght ?
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1 A. Cor r ect .
2 Q. That ' s i t .
3 A. That ' s i t .
4 Q. Ar e you . . . ar e t her e any on t he hor i zon t hat
5 you' r e gonna pr ovi de exper t servi ces?
6 A. I have no i dea.
7 Q. Okay.
8 A. I ' ve not been - -
9 Q. Have you been asked t o pr ovi de addi t i onal servi ces?
10 A. No.
11 Q. Have you ever been accept ed by a cour t as a
12 t est i f yi ng exper t ?
13 A. Do you consi der deposi t i on a - -
14 Q. Mm- mm.
15 A. No, t hen I guess not .
16 Q. Okay.17 A. I ' ve never been t o cour t .
18 Q. And i n t hi s case, who i s payi ng your f ees?
19 A. Dr . Nazar i .
20 Q. Al l ri ght . And what i s your hour l y r at e?
21 A. The hour l y r at e i s - - f or r evi ewi ng cases i s $300
22
an hour . And t hen f or deposi t i ons and cour t appearances,23 i t ' s $400 an hour .
24 Q. Al l r i ght . I wanna t al k about your credent i al s.
25 Okay?
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1 A. Sur e.
2 Q. What qual i f i es you t o be - - or what do you consi der
3 your exper t i se to be?
4 A. Wel l , I am a uni ver si t y- t r ai ned or t hodont i st . I
5 have been pr act i ci ng or t hodont i cs - - or t hodont i st - -
6 or t hodont i cs excl usi vel y f or 48 year s. I . . . I have . . .
7 r ecei ved some t r ai ni ng by t he f or mer di r ect or J i m Or r on
8 ut i l i zi ng t he HLD eval uat i on syst em as pr ovi ded i n t he Texas
9 Medi cai d . . . Pr ovi der ' s Manual . And. . . .
10 So I f eel t hat t hat gi ves me t he abi l i t y t o
11 qual i f y cases based on t he HLD i ndex.
12 Q. Okay. So your educat i on.
13 A. Educat i on.
14 Q. So j ust t o sum up, what you bel i eve t o be your
15 qual i f i cat i ons t o of f er exper t t est i mony i n t hi s case i s
16 you' ve been t o dent al school , and you have a mast er ' s17 i n. . . .
18 A. I was i n dent al school f or f our year s. Two year s
19 i n a r esi dency pr ogr am i n or t hodont i cs.
20 Q. Okay. Your educat i on.
21 A. Mm- hmm.
22
Q. Your 45 year s of pr act i ce?23 A. 48.
24 Q. 48 year s of pr act i ce.
25 A. Mm- hmm.
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1 Q. I n t hat 48 years had you ever done anyt hi ng el se?
2 Any other t ype of pr of essi on? Deal wi t h any other t ype of
3 l i censes, f or exampl e?
4 A. Wel l , I do have a r eal est at e l i cense, whi ch i s
5 i nact i ve.
6 Q. Were you a r eal est at e sal esman?
7 A. I t ' s a r eal - est at e- sal esman l i cense, but I ' ve never
8 sol d r eal est at e.
9 Q. When di d you get your r eal - est at e- sal esman l i cense?
10 A. Oh, my god. I t ' s been 30 year s ago, pr obabl y.
11 Q. And di d you have a r eal est at e . . . sal es
12 busi ness?
13 A. No.
14 Q. Why' d you get a r eal - est at e- agent / - sal esman
15 l i cense?
16 A. To hel p me eval uat e i nvest ment s.17 Q. Okay. What ki nd of i nvest ment s?
18 A. Wel l , any t i me somebody came t o me wi t h . . . seems
19 l i ke doct or s are al ways good sour ces f or peopl e t o t r y and
20 pawn of f deal s on, and I f el t l i ke i t woul d be ver y hel pf ul ,
21 and gi ve me a pot ent i al t o i nvest some i n r eal est at e wi t h
22
some under st andi ng.23 Q. I n addi t i on t o pr act i ci ng or t hodont i cs, do you al so
24 have a si de busi ness of i nvest ment s or r eal est at e
25 i nvest ment s?
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1 A. Wel l , i t ' s not a si de busi ness. I t ' s j ust what I
2 t r y and do t o pr eser ve my ret i r ement i n t he f ut ur e i s l ooki ng
3 t o di f f er ent t ypes of i nvest ment s.
4 Q. What t ype of i nvest ment s? Fi nanci al pr oduct s?
5 Real est at e? What ?
6 A. Wel l , I do have some r eal est at e i nvest ment s. I do
7 have st ocks. But we r ecei ve hel p i n i nvest i ng wi t h t hose.
8 Q. So goi ng back t o what you bel i eve your cr edent i al s
9 ar e t hat qual i f y you t o be an exper t i n t hi s case, t al ked
10 about your educat i on; 48 year s of pr act i ce.
11 A. Mm- hmm.
12 Q. You ment i oned t hat you went to a semi nar? That J i m
13 Or r pr esent ed?
14 A. Wasn' t a semi nar . I t was a t r ai ni ng sessi on wi t h
15 Dr . Or r .
16 Q. Tel l me about t hat .17 A. Wel l , he sat down. Went over many cases wi t h me.
18 Showed me how t o eval uate these - - how t o ut i l i ze t he
19 syst em. And t o use my own j udgment i n doi ng t hese.
20 That ' s - - t hat ' s basi cal l y what i t was.
21 Q. When . . . you sai d i t ' s a t r ai ni ng sessi on?
22
A. I t was - - i t was a i nst r ucti on sessi on. Not a23 f or mal t r ai ni ng sessi on. I t was an i nst r uct i on on how t o
24 ut i l i ze and how t o scor e t he syst em.
25 Q. Al l r i ght . An i nst r uct i on sessi on. I s t hat - -
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1 A. Ri ght . I t ' s not - - i t wasn' t a f or mal i zed - -
2 f or mal i nst r uct i on i n t he sense t hat i t was document ed as t he
3 t hi ng t hat you pai d f or , a l i st ed sessi on. I t was on a
4 one- t o- one basi s.
5 Q. So i n t hi s meet i ng wi t h Mr . Or r , i t was a
6 one- on- one sessi on wi t h you?
7 A. Mm- hmm.
8 Q. Al l r i ght . So . . . wher e di d t hi s i nf or mal
9 i nst r uct i on sessi on occur ?
10 A. I t occur r ed i n Aust i n.
11 Q. Where i n Aust i n?
12 A. I t was i n a conf er ence r oom at t he of f i ce - - wel l ,
13 i t wasn' t i n t he of f i ce. I n t he of f i ce bui l di ng t hat
14 Dr . Ander t on had i n Aust i n.
15 Q. I t was i n Dr . Ander t on' s - -
16 A. Wel l , yeah, the conf er ence r oom wasn' t i n hi s17 of f i ce. I t was downst ai r s i n t he bui l di ng.
18 Q. I t was i n t he bui l di ng t hat Dr . Ander t on of f i ced
19 i n; r i ght ?
20 A. Ri ght . One of hi s of f i ces.
21 Q. So not a St at e bui l di ng?
22
A. No.23 Q. Do you r ecal l t he name of t he bui l di ng, or . . . .
24 A. No, I don' t .
25 Q. Where i t was l ocated? Downt own Aust i n?
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1 A. I t ' s - - no. I - - I r eal l y am not f ami l i ar . . .
2 i t ' s . . . I get l ost when I come her e - -
3 Q. Sur e.
4 Thi s mi ght hel p. I s Dr . Ander t on i n t hat
5 same bui l di ng?
6 A. Yes . I n hi s. . . .
7 Q. I ' m sor r y?
8 A. I was j ust gonna say hi s of f i ce i s up on . . .
9 t hi r d or f i r st f l oor . The conf er ence r oom' s down on t he
10 f i r st or basement . Somet hi ng l i ke t hat .
11 Q. Wer e t her e ot her . . . I t was j ust t he t wo of you
12 t oget her i n t hi s conf er ence r oom?
13 A. Mm- hmm.
14 Q. How di d t hat sessi on come t o be?
15 A. I t was - - when I was f i r st empl oyed by
16 Dr . Ander t on, I met wi t h J i m Or r , i n Aust i n, so t hat I woul d17 under st and how t o ut i l i ze t he HLD scor i ng syst em.
18 Q. So t hat woul d have been i n t he spr i ng of 2012;
19 r i ght ?
20 A. Mm- hmm. I bel i eve i t was.
21 Q. Do you have any r ecor ds r ef l ect i ng when t hat
22
meet i ng exact l y occur r ed?23 A. I mi ght be abl e t o - - yeah, I mi ght be abl e t o come
24 up wi t h t hat .
25 Q. And what were t hose r ecords - - what mi ght they be?
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1 A. Onl y t he dat e t hat t hey wer e t her e.
2 Q. I mean, woul d t hi s be l i ke a cal endar ent r y or a
3 memor andum or - -
4 A. I t woul d be a - - no. I t woul d be act ual l y . . .
5 a . . . on my account i ng ent r y of t he t i me t hat I spent i n
6 Aust i n.
7 Q. Okay. You bi l l ed Dr . Ander t on f or at t endi ng t hi s
8 sessi on wi t h Mr . Or r ?
9 A. Yes. Because i t was i n - - r el at ed t o - - i n
10 r el at i on t o one of t he cases.
11 Q. So I ' m st i l l mi ssi ng somet hi ng. How di d t hi s
12 meet i ng come t o be? I n ot her words, di d you pi ck up t he
13 phone and cal l Or r or di d - - di d someone - -
14 A. No, I was i n - - I was . . . f aci l i t at ed - - someone
15 f aci l i t at ed t he meet i ng.
16 Q. Who?17 A. Dr . Ander t on.
18 Q. Okay. So j ust t o - - I wanna be f ai r about t hi s.
19 A. Mm- hmm.
20 Q. Dr . Andert on had you meet wi t h Mr . Or r .
21 A. Mm- hmm.
22
Q. Cor r ect ?23 A. Mm- hmm.
24 Q. And - - got t a answer "yes. "
25 A. Yes . I ' m sor r y.
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1 Q. And t hat meet i ng occur r ed i n spr i ng of 2012 i n
2 Aust i n, Texas; cor r ect ?
3 A. Ri ght .
4 Q. And i t occur r ed i n Dr . Ander t on' s bui l di ng;
5 correct?
6 A. Cor r ect .
7 Q. And you may have some r ecor ds t hat ref - - - t hat
8 basi cal l y memor i al i ze t hat meet i ng; cor r ect ?
9 A. Yes. I t won' t speci f i cal l y say t hat I met wi t h J i m
10 Or r . But I was t her e meet i ng wi t h Dr . Ander t on.
11 Q. And you bi l l ed Dr . Casson f or t hat meet i ng;
12 correct?
13 A. No.
14 Q. Dr . - - you bi l l ed Dr . Ander t on f or t he meet i ng?
15 A. Let me t hi nk about t hat . I bel i eve I di d - - i t
16 woul d have been - - you' r e r i ght . I t was Dr . Casson t hat I17 bi l l ed. That ' s r i ght . Because t hat ' s t he f i r st t i me - - yes,
18 i t was i n t hat case.
19 Q. Pr i or t o t he f ace- t o- f ace meet i ng wi t h J i m Or r , di d
20 t he t wo of you exchange any e- mai l s or cor r espondence?
21 A. Wi t h who?
22
Q. Or r . Di d I say J i m? What ' s hi s name?23 A. Oh, J i m Or r . I t hought you sai d Moor e.
24 No, I had never met nor t al ked t o J i m Or r
25 bef or e.
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1 Q. I don' t wanna keep sayi ng spr i ng of 2012.
2 Do you have - - do you have, l i ke, a pi npoi nt
3 date?
4 A. I don' t .
5 Q. Mar ch? Apr i l ?
6 A. I - - I r eal l y don' t r emember . I - - I don' t mean t o
7 be evasi ve. I t was j ust somet i me . . . I can' t r emember
8 exact l y whi ch dat es t hat I was i n Aust i n f or t hat .
9 Q. You l i ve i n Dal l as; r i ght ?
10 A. Yes.
11 Q. So you - - di d you f l y down/ dr i ve down t o Aust i n f or
12 t hi s?
13 A. I f l ew.
14 Q. And comi ng t o Aust i n, t he sol e pur pose of comi ng t o
15 Aust i n was t o have t hi s meet i ng wi t h Or r ; cor r ect ?
16 A. Not j ust wi t h Or r . But wi t h Dr . Ander t on, Mr . Or r ,17 and a f ew ot her peopl e.
18 Q. At t hi s meet i ng wi t h Or r , di d he gi ve you r ecor ds,
19 i nf or mat i on . . . handout s? Anyt hi ng?
20 A. Yes.
21 Q. What di d he gi ve you?
22
A. He gave me copi es of t he Texas Medi cai d Provi der ' s23 Manual .
24 Q. What el se?
25 A. And . . . t hat ' s t he onl y handout he gave me.
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1 Q. Okay.
2 A. And speci f i cal l y t he sect i ons r el at ed t o t he
3 HL ( si c) i ndexi ng.
4 Q. Do you know i f he was get t i ng compensat ed by
5 somebody - - Mr . Or r was get t i ng compensat ed f or t hi s meet i ng?
6 A. I don' t know f or sur e.
7 Q. Do you have a r eason t o bel i eve he was get t i ng pai d
8 f or t hi s meet i ng?
9 A. I woul d t hi nk so.
10 Q. By whom?
11 A. That I don' t know.
12 Q. Woul d i t most l i kel y be t hat he was get t i ng pai d by
13 Dr . Ander t on?
14 A. I don' t know i f he' s get t i ng pai d di r ect l y by
15 Dr . Ander t on or f r om somewher e el se. I have no i dea.
16 Q. But i t ' s your bel i ef t hat he was get t i ng pai d t o17 have t hi s meet i ng wi t h you; r i ght ?
18 A. I . . . i t ' s my bel i ef .
19 Q. I mean, he wasn' t doi ng i t out of t he goodness of
20 hi s hear t ; r i ght ?
21 A. I woul dn' t t hi nk so.
22
Q. So at t hi s meet i ng he gave you pr i nt out s f r om t he23 Texas Medi cai d Provi der Procedur es Manual ?
24 A. Mm- hmm.
25 Q. Pr i or t o t hi s meet i ng had you ever r evi ewed t he
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1 Texas Medi cai d Provi der Procedur es Manual ?
2 A. Sect i ons of i t , yes.
3 Q. So I ' m gonna - - f or goi ng f or war d, I ' m gonna cal l
4 t hat " t he manual . " So we' r e on t he same page. Okay?
5 A. Okay.
6 Q. So at t hi s meet i ng, do you r ecal l what sect i ons of
7 t he manual he gave you?
8 A. I t hi nk he gave me a whol e copy of - - a copy of t he
9 whol e manual . But speci f i cal l y we wor ked on t he par t t hat he
10 showed me, and t he par t t hat we were revi ewi ng was r el at ed t o
11 t he scor i ng of t he HLD i ndex.
12 Q. Do you r emember whi ch edi t i on - - whi ch
13 ver si on/ year - - of t he manual he gave you?
14 A. No, I don' t .
15 Q. And what sect i on of t he manual ?
16 A. I - - I can' t gi ve you - - quot e t he number s, but17 i t ' s - -
18 Q. Yeah.
19 A. - - t he sect i on r el at ed t o t he HLD scor i ng. And
20 r el at ed t o t he qual i f yi ng f or or t hodont i c t r eat ment under
21 Medi cai d.
22
Q. And sounds l i ke he was gi vi ng you some t r ai ni ng on23 basi cal l y how t o scor e t he HLD scor i ng? Or score sheet?
24 A. Yes.
25 Q. And t el l me. I mean, what - - what was he sayi ng or
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1 i nst r uct i ng you about how t o scor e t he HLD scor e sheet ?
2 A. Basi cal l y j ust read - - he r ead t he manual , t r i ed t o
3 descr i be what each one was sayi ng, and t hat was i t .
4 Q. How l ong di d t hi s meet i ng l ast ?
5 A. I woul d say . . . appr oxi mat el y an hour .
6 Q. Ot her t han how t o score t he HLD score sheet , what
7 el se di d y' al l t al k about i n t hi s meet i ng?
8 A. Af t er we di d t hat , we went over some cases.
9 Q. Okay.
10 A. That he want ed me t o eval uat e.
11 Q. That was Or r ?
12 A. Mm- hmm.
13 Q. Okay. So Or r want ed you t o eval uat e cases?
14 A. They were not hi s cases. They were cases t hat he
15 was wor ki ng on.
16 Q. Ar e t hose cases di f f er ent than t he t hr ee cases you17 ment i oned ear l i er ?
18 A. No.
19 Q. So t hey' r e new cases; r i ght ?
20 A. They' r e - -
21 Q. Cases t hat we have not di scussed yet ; r i ght ?
22
A. No. They' r e - - I t hi nk t hey wer e Wayne Casson' s23 cases.
24 Q. When you say "cases, " ar e you r ef er r i ng t o pat i ent
25 cases, or ar e you r ef er r i ng t o - -
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1 A. Pat i ent cases. Cases t hat Wayne Casson had
2 t r eat ed.
3 Q. Got i t . Al l r i ght . As i t r el at es t o some of t he
4 speci f i c def i ni t i ons i n t he - - t hat ar e appl i cabl e t o t he HLD
5 scor e sheet t hat you and Or r di scussed, I mean . . . what
6 t erms was he - - were . . . I - - I j ust don' t get i t . I ' m - -
7 I ' m j ust - - I can' t pi ct ur e what was goi n' on i n t hat r oom.
8 And you wer e t her e, and I wasn' t t her e. So I need you t o
9 t el l me. What he was t el l i n' you as i t r el at es t o t he HLD
10 scor e sheet . I t ' s been pr et t y vague so f ar .
11 But speci f i cal l y what was he t el l i n' you
12 about t he HLD score sheet ?
13 A. He was r e- - - showi ng me, " Thi s i s - - t hi s i s a
14 f or m you use. These ar e t he i nst r uct i ons t hat you f ol l ow.
15 Thi s i s how you f i l l out t he f or ms. " And t hat ' s basi cal l y
16 what i t was.17 Q. And di d you - - di d he go over t he speci f i c t er ms?
18 For exampl e, "ect opi c er upt i on, " "mal occl usi on, "
19 "handi cappi ng, " t er ms l i ke - -
20 A. He went over hi s - - as t hey wer e l i st ed i n t he
21 manual i t sel f .
22
Q. Di d he have any of t he mater i al s wi t h hi m when he23 was goi n' over t he manual ? For exampl e, an or t hodont i a
24 t ext book?
25 A. No.
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1 Q. Okay. I t was j ust t he manual .
2 A. Ri ght .
3 Q. Al l r i ght .
4 A. I mean, he coul d have had ' em, but he di dn' t show
5 ' em t o me.
6 Q. I mean, i f you' r e a pr act i ci ng or t hodont i st , why do
7 you need t o go get t hi s t r ai ni ng i n 2012?
8 A. The Texas Medi cai d - - or t he manual doesn' t
9 necessar i l y f ol l ow t r ai ni ngs or qual i f i cat i ons t hat we
10 det er mi ne - - or r at her t hat we use i n det ermi ni ng t he need
11 f or t r eat ment .
12 Q. I wanna - - we got ki nd of si det r acked her e. I
13 wanna go back t o - - we st ar t ed of f her e wi t h your - - your
14 cr edent i al s, t o - -
15 A. Sur e.
16 Q. - - t o pr ovi de exper t t est i mony i n t hi s case.17 A. Sur e.
18 Q. Tal ked about your educat i on. Tal ked about your 48
19 year s of pr act i ce. We t al ked about t hi s t r ai ni ng sessi on
20 wi t h Or r t hat he gave you i n t he spr i ng of 2012. What ot her ,
21 you know - - what - - what el se i n your backgr ound makes you an
22
exper t i n t hi s case?23 A. Wel l , I ' m not sur e what ot her qual i f i cat i ons I
24 need, ot her t han t he f act t hat I am a pr act i ci ng
25 or t hodont i st . I ' ve done i t f or 48 year s. I shoul d have t he
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1 or t hodont i st s i n Dal l as r espect my opi ni on and wi l l come to
2 me f or a second opi ni on when t hey' r e havi ng pr obl ems.
3 Q. Have you ever used an occl usi oni st i n your
4 pr act i ce?
5 A. I ' m not sur e what an occl usi oni st i s.
6 Q. Have you ever pi cked up t he phone and cal l ed an
7 occl usi oni st ?
8 A. I ' m not sur e what an occl usi oni st i s. I t ' s not a
9 r ecogni zed speci al t y i n dent i st r y.
10 Q. What about . . . you haven' t served i n any
11 educat i onal capaci t y si nce 1969; cor r ect ?
12 A. Tr ue. Not a f or mal educat i onal pr act i ce.
13 Q. Now, you' r e not boar d cer t i f i ed i n or t hodont i cs;
14 correct?
15 A. That ' s cor r ect .
16 Q. But ar e you boar d el i gi bl e?17 A. Yes.
18 ( Mr . Khar od r et ur ned. )
19 Q. ( BY MR. HARGROVE) What does t hat mean?
20 A. I n or der t o become boar d cer t i f i ed, you have t o
21 pr esent a cer t ai n number of cases and do a exami nat i on,
22
wr i t t en exami nat i on, and pr esent a number of cases t o t he23 Amer i can Boar d of Or t hodont i cs. I n 1965, t her e were ver y f ew
24 or t hodont i st s - - a smal l - - onl y a smal l er per cent age of
25 or t hodont i st s became boar d cer t i f i ed, because i t was a ver y
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1 t i me- consumi ng t hi ng t o do, and t her e was a l ot of f i nanci al
2 i nvol vement i n i t . So i t wasn' t as i mpor t ant i n t he ear l y
3 st ages of my pr act i ce as i t has become t oday.
4 Today t he qua- - - i n or der t o qual i f y f or i t ,
5 you' r e al l owed t o - - t o do some of t he t est i ng whi l e you' r e
6 st i l l i n your r esi dency. Year s ago, you had t o be i n
7 pr act i ce f or a number of year s bef or e you coul d even appl y t o
8 be test ed f or your boar ds.
9 Wel l , back i n t he ' 60s, t hey' r e - - get t i ng a
10 pr act i ce goi ng, r ai si ng a f ami l y, t he t i me and t he r ewar d was
11 not t hat cri t i cal t o me j ust t o have anot her cer t i f i cat e.
12 That ' s t he onl y di f f er ence.
13 Q. Ar e you boar d el i gi bl e?
14 A. Boar d el i gi bl e, yes.
15 Q. What does t hat mean?
16 A. I t means t hat you meet al l t he qual i f i cat i ons,17 ot her t han t aki ng t he t est i ng, t o be boar d cer t i f i ed. I have
18 t he educat i on/ I have t he t r ai ni ng t hat al l ows me t o t ake t he
19 t est i ng.
20 Q. Woul d i t be f ai r t o say t hat somebody who' s boar d
21 cer t i f i ed i n or t hodont i cs mi ght have, you know, credi bi l i t y
22
t o be a t est i f yi ng exper t i n a case l i ke t hi s?23 A. They' d have credi bi l i t y. I don' t know i t woul d be
24 any mor e t han nonboar d cer t i f i ed. Most of t he
25 or t hodont i st s - - mat t er of f act , t her e' s a l ar ge gr oup of
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1 or t hodont i st s t hat wer e t r ai ned year s ago t hat ar e not boar d
2 cer t i f i ed, but t hey' r e cer t ai nl y qual i f i ed.
3 Q. I f you coul d pi ck out an exper t f or a case l i ke
4 t hi s, I mean, what cr i t er i a woul d you - - woul d you want i n
5 t hat exper t ?
6 A. I woul d want someone who i s boar d qual i f i ed,
7 someone who I r espect as a . . . r esponsi bl e or t hodont i st ,
8 who I r espect t hei r abi l i t y i n t r eat i ng cases. Those ar e t he
9 mai n t hi ngs t hat I woul d l ook at .
10 Q. What about i f t hey wer e boar d cert i f i ed? Woul d
11 t hat i ncr ease t he - -
12 A. That - -
13 Q. Hol d on.
14 - - t hat i ncrease t hei r st at ur e i n your eyes?
15 A. Not i n my eyes, but i t mi ght i n someone el se' s
16 eyes. And agai n, as I sai d, year s ago boar d cer t i f i cat i on17 was not a cri t - - - wel l , I shoul dn' t say cri t i cal . Was not
18 st r essed as i t i s t oday.
19 Q. Al l ri ght . Let ' s go back t o t hi s meet i ng.
20 Wel l , f i r st of al l , have you . . . have
21 you . . . done Medi cai d . . . have you bi l l ed Medi cai d?
22
Texas Medi cai d?23 A. Not di r ectl y.
24 Q. What do you mean?
25 A. I ' ve wor ked wi t h a f r i end of mi ne at a cl i ni c f or
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1 about ei ght or ni ne mont hs i n whi ch t hey di d Medi cai d
2 t r eat ment . Now, I . . . was not r esponsi bl e f or bi l l i ng
3 Medi cai d i n t he cl i ni c t hat I wor ked i n.
4 Q. Your f r i end - - who' s your f r i end?
5 A. Dr . Pat Br ady.
6 Q. Pat Br ady?
7 A. Mm- hmm.
8 Q. Mal e or f emal e?
9 A. Mal e.
10 Q. So ni ne t o t en mont hs?
11 A. I t was ar ound ni ne t o t en mont hs, appr oxi mat el y.
12 Q. When?
13 A. Thi s was i n . . . par t of 2011 and 2012.
14 Q. Okay. And Pat Br ady, a f r i end of your s who' s an
15 or t hodont i st - -
16 A. Mm- hmm.17 Q. - - i nvi t ed you t o j oi n hi m wi t h t he pr act i ce?
18 A. Ri ght . He act ual l y was wi t h a cl i ni c t hat he was
19 r esponsi bl e f or t he or t hodont i c ser vi ces of t he cl i ni c.
20 Q. What was t he cl i ni c' s name?
21 A. Bear Cr eek Dent al - -
22
Q. Bear Cr eek?23 A. I bel i eve i t ' s Bear Cr eek Fami l y Dent i st r y. I
24 bel i eve t hat ' s what i t i s.
25 Q. Where are t hey l ocat ed?
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1 A. They have sever al of f i ces i n Dal l as.
2 Q. Do you know how many of f i ces?
3 A. Of f hand, no.
4 Q. Mor e t han f i ve?
5 A. I don' t t hi nk mor e t han f i ve.
6 Q. So . . . t hr ee?
7 A. I ' d say t hey may - - t hr ee t o f our . I don' t - - I
8 woul dn' t - - i t coul d be f i ve, but I don' t bel i eve i t ' s any
9 mor e t han f i ve. I haven' t been i n . . . i nvol ved wi t h ' em
10 f or some t i me, so I don' t know i f t hey' ve expanded or not .
11 Q. Whi ch of f i ce di d you wor k at ?
12 A. The one on Spr i ng Val l ey and Coi t .
13 Q. Spr i ng Val l ey and . . . spel l t hat ?
14 A. C- O- I - T.
15 Q. Does i t have an addr ess?
16 A. I ' m sur e i t does, but I coul dn' t t el l ' ya.17 Q. When you go . . . so Dr . Br ady i nvi t ed you t o Bear
18 Cr eek Fami l y Dent i st r y t o wor k i n hi s or t hodont i cs cl i ni c
19 t her e.
20 A. Mm- hmm.
21 Q. And . . . di d you st i l l have your pr act i ce?
22
A. Oh, yes.23 Q. So di d you mai nt ai n t wo pr act i ces dur i ng t hi s
24 per i od?
25 A. Wel l , I was - - mai nt ai ned my pr act i ce, but I wor ked
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1 i n t he cl i ni c f or hi m.
2 Q. Do you st i l l have a or t hodont i cs pr act i ce?
3 A. Oh, yes.
4 Q. Do you r ecal l t he mont h t hat you st ar t ed at Bear
5 Cr eek?
6 A. No, I don' t .
7 Q. Al l r i ght . I wanna go back - - so you sai d t hat you
8 di d Medi cai d pat i ent s. You per f or med or t hodont i c ser vi ce f or
9 Medi cai d benef i ci ar i es at Bear Cr eek; r i ght ?
10 A. Ri ght .
11 Q. But I ' m a l i t t l e bi t conf used. You sai d you di dn' t
12 bi l l di r ect l y.
13 A. That ' s r i ght . I di dn' t - -
14 Q. So t el l me about t hat .
15 A. I di dn' t do t he bi l l i ng. I was pai d by Dr . Br ady,
16 and t he pat i ent s . . . t he bi l l i ng was done by Bear Cr eek.17 Q. Who . . . i s Br ady t he owner of Bear Cr eek?
18 A. No.
19 Q. Who i s t he owner ?
20 A. Gi ve me a mi nut e, I ' l l t hi nk about i t .
21 Q. Okay.
22
A. I ' m sor r y. But . . . .23 Q. Mal e? Femal e?
24 A. I t ' s a mal e.
25 Q. Ol der gent l eman? Younger?
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1 A. I t depends. Rel at i ve.
2 Q. Yeah, I - - t r ust me.
3 A. I t hi nk he' s ar ound hi s 50' s.
4 Q. Okay.
5 A. I - - I ' l l t hi nk about i t i n a mi nut e.
6 Q. Okay. We' l l ci r cl e back.
7 A. Okay.
8 Q. Get on t he I nt er net i f we have t o.
9 Okay. The - - t he . . . Tel l me what you di d
10 at Bear Cr eek.
11 A. I per f or med or t hodont i c ser vi ces i n t he f or m of
12 t r eat i ng pat i ent s. I al so di d some eval uat i on usi ng t he HLD
13 i ndex.
14 Q. Sounds l i ke t hat st ar t ed maybe i n t he summer of
15 2011? Or 20- - -
16 A. Pr ox- - - appr oxi mat el y. Coul d have been spr i ng or17 summer .
18 Q. Of 2011.
19 A. Yes.
20 Q. And i t car r i ed over i nt o 2012; r i ght ?
21 A. Ri ght .
22
Q. Was your - - what was t he nat ur e of your - - how were23 you get t i n' pai d?
24 A. From Dr . Br ady.
25 Q. From Dr . Br ady?
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1 A. On a dai l y basi s.
2 Q. Was he your empl oyer ?
3 A. He was . . . Yes, he was my empl oyer .
4 Q. Di d he cut you a - - were you a W- 2 empl oyee or di d
5 he gi ve you 1099?
6 A. Yes, I di d get a 10- . . . uh . . . t r yi ng t o
7 r emember di d he gi ve me a W- 2 or 1099. Whatever i t was, I
8 got i t .
9 Q. Wel l , were you an i ndependent cont r act or or were
10 you an empl oyee?
11 A. No, I was an i ndependent cont r act or . So I guess i t
12 woul d have been a 1099.
13 Q. Was t hi s your f i r st exper i ence wi t h ser vi ng a
14 Medi cai d benef i ci ar y?
15 A. Yes.
16 Q. So pr i or t o j oi ni ng Bear Cr eek i n t he summer of17 2011, you had never t r eat ed a Medi cai d benef i ci ar y; cor r ect ?
18 A. Cor r ect .
19 Q. And si nce you' ve l ef t Bear Cr eek, you have not
20 t r eat ed a Medi cai d benef i ci ar y; cor r ect ?
21 A. Cor r ect .
22
Q. So t he ent i r e uni ver se of your Medi cai d exper i ence23 i s t he ni ne or t en mont hs at - - whi ch you wer e at Bear Cr eek;
24 correct?
25 A. Cor r ect .
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1 Q. And at Bear Cr eek, you were an i ndependent
2 cont r act or of Dr . Br ady; cor r ect ?
3 A. Mm- hmm.
4 Q. Or were you an i ndependent cont r act or of Bear
5 Cr eek?
6 A. The checks came f r om Br ady. So I assume I was
7 i ndependent cont r act or of Br ady' s.
8 Q. Whose TPI / NPI number wer e you usi ng? Whose
9 pr ovi der i dent i f i er wer e you bi l l i ng under ?
10 A. Act ual l y . . . you know what ? They had t o be
11 bi l l ed under Bear Cr eek.
12 Q. Al l r i ght . So t he ser vi ces you per f or med - -
13 A. But act ual l y, my . . . I had a pr ovi der number , but
14 t hey wer e bi l l ed under Bear cr eek, so I ' m not sur e.
15 Q. Sounds l i ke t he - - t he bi l l i ng submi t t ed t o
16 Medi cai d f or ser vi ces t hat you pr ovi ded t o Medi cai d17 benef i ci ar i es at Bear Cr eek wer e bi l l ed under Bear Cr eek' s
18 pr ovi der number ? I s t hat f ai r ? Does t hat sound cor r ect ?
19 A. I woul d t hi nk so, because I never saw any of t he
20 bi l l i ng.
21 Q. Al l r i ght . And . . . was t hi s a f ul l - t i me posi t i on
22
at Bear Cr eek?23 A. No.
24 Q. How many days a week wer e you wor ki ng t her e?
25 A. One.
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1 Q. One day a week? What day was t hat ?
2 A. Tuesdays.
3 Q. And t hen t he ot her days of t he week you were at
4 your pr i vat e pr act i ce?
5 A. Mm- hmm.
6 Q. And on average, how many ki ds. . . .
7 What was t he - - t he popul at i on at Bear Cr eek?
8 A. I ' m not sure what you mean by t hat .
9 Q. The - - t he per cent age of Medi cai d benef i ci ar i es at
10 Bear Cr eek rel at i ve - - compar ed or - -
11 Was i t excl usi vel y Medi cai d?
12 A. I don' t know. I t was a hi gh per cent age, but I have
13 no i dea.
14 Q. So we know i t was a - - t hat pat i ent popul at i on at
15 Bear Cr eek was a hi gh per cent age of Medi cai d benef i ci ar i es;
16 correct?17 A. I n t he or t hodont i c sect i on.
18 Q. I n t he or t hodont i c sect i on?
19 Di d you wor k i n t he dent al sect i on?
20 A. No.
21 Q. You - - you do not do dent i st r y or pedi at r i c
22
dent i st r y; cor r ect?23 A. No.
24 Q. You do or t hodont i cs; r i ght ?
25 A. Ri ght .
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1 Q. And you don' t know t he exact - - was i t - - I mean,
2 i s i t cl oser t o 100 per cent of t he pat i ent popul at i on at Bear
3 Cr eek i n your exper i ence f or Medi cai d benef i ci ar i es?
4 A. Cl oser t han what ? I have r eal l y no i dea. I woul d
5 t hi nk t hat t he maj or i t y wer e Medi cai d pat i ent s, but I have no
6 way of knowi ng what - -
7 There wer e some pr i vat e- pay pat i ent s t here,
8 but I have no i dea whi ch ones were whi ch.
9 Q. So, I mean, we have maj or i t y. So we' r e above 50.
10 And . . . you don' t t hi nk i t ' s qui t e 100 per cent . So - -
11 A. I know i t wasn' t 100 per cent .
12 Q. Okay. So i n t hat r ange, we' r e above - - a l i t t l e
13 bi t above 50, a l i t t l e bi t above ( si c) 100. Hol d on.
14 Was t he percent age cl oser t o 100 percent or
15 was t he per cent age cl oser t o 50 percent ? Of Medi cai d
16 benef i ci ar i es?17 A. I can' t t est i f y . . . t r ul y t o t hat , because I
18 don' t r eal l y know.
19 Q. What ' s your bel i ef ?
20 A. My bel i ef , i t woul d be - -
21 ( Mr . Medl ock l ef t t he r oom. )
22
THE WI TNESS: - - cl oser t o 100 t han cl oser t o23 50.
24 Q. ( BY MR. HARGROVE) Di d you t r ansf er any of your
25 pat i ent s f r om your pr i vat e pr act i ce t o Bear Cr eek?
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1 A. No.
2 Q. And how di d you get your pat i ent s at Bear Cr eek?
3 A. They weren' t my pat i ent s. They were Bear Cr eek
4 pat i ent s.
5 Q. Wel l , you had a . . .
6 A. I n ot her wor ds - -
7 Q. . . . a pr of essi onal rel at i onshi p wi t h t he chi l d
8 t hat you' r e t r eat i ng; r i ght ?
9 A. Yes, but t her e wer e ot her or t hodont i st s t hat saw
10 t he pat i ent s.
11 Q. You wer e one of sever al or t hodont i st s?
12 A. That ' s t r ue.
13 Q. How many?
14 A. I don' t know t he number .
15 Q. Mor e t han f i ve?
16 A. No. I know - - I know of . . . Dr . Br ady.17 Q. Have you f i gur ed out who t he owner i s?
18 A. I t ' s comi ng t o me. I ' m sor r y. I ' l l get back t o
19 you.
20 Q. Okay.
21 A. Yes. Taf el . Rober t Taf el i s t he owner .
22
Q. He' s t he owner?23 A. Yes. I ' m sor r y. Seni or moment s.
24 Q. Di d you have t o. . . .
25 Wel l , i t ' s st ar t i ng t o happen t o me.
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1 Di d you . . . when you . . . I mean, di d
2 Taf el i nt er vi ew you or . . . .
3 A. No.
4 Q. Okay. Di d he have anyt hi ng t o do wi t h you comi ng
5 i nt o hi s cl i ni c?
6 A. No.
7 Q. Di d you ever t al k t o Taf el ?
8 A. Oh, yes.
9 Q. About - -
10 A. Af t er - - af t er I - - af t er I went to wor k wi t h
11 Dr . Br ady, I met and vi si t ed wi t h Taf el sever al t i mes.
12 Q. And what - - what - -
13 A. Soci al basi s.
14 Q. Soci al basi s? Woul d you ever di scuss pr of essi onal
15 mat t er s or . . . .
16 A. Onl y i n t he f act that he woul d come i n per i odi cal l y17 and say, "You' r e doi ng a good j ob. I l i ke t he way t he
18 or t hodont i c depar t ment i s wor ki ng. I appr eci at e you bei ng
19 her e. " That t ype t hi ng.
20 Q. I s he a dent i st or or t hodont i st ?
21 A. He' s a dent i st .
22
Q. Di d he ever di scuss your compensat i on wi t h you?23 A. No.
24 Q. Di d he ever di scuss pr oduct i on wi t h you?
25 A. No.
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1 Q. And what was t he - - how were you pai d? I mean, I
2 know you were pai d on a - -
3 A. I was pai d on a dai l y basi s.
4 Q. Ever y - - dai l y - - ever y Tuesday t hey pai d you?
5 A. Mm- hmm.
6 Q. For t he wor k t hat you per f or med t hat day or f or - -
7 A. For t he dai l y ser vi ce.
8 Q. Was i t a per cent age of - -
9 A. No.
10 Q. - - pr oduct i on?
11 A. No.
12 Q. How' d t hey - -
13 So sal ar y?
14 A. I t was a st r ai ght sal ar y per day.
15 Q. And how much was i t ?
16 A. I t was $1500.17 Q. $1500?
18 A. St ar t ed out at 1400, and t hen af t er a f ew mont hs,
19 Dr . Br ady f el t l i ke i t shoul d be - - i t - - he f el t l i ke t he
20 goi ng r at e was 1500.
21 Q. Okay.
22
A. So he r ai sed i t .23 Q. I ' m sor r y. I mi ssed t he l ast par t . I mean, t he
24 f i r s t par t . You star t ed of f at - -
25 A. 1400 a day.
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1 Q. Why' d you l eave?
2 A. Because Medi cai d qui t accept i ng or t hodont i c
3 pat i ent s, t hey di d not have t he pat i ent f l ow t o j ust i f y me
4 bei ng ther e.
5 Q. Al l r i ght . So you woul d have l ef t , i t sounds l i ke,
6 maybe Apr i l or - - at t he l at est of 2012?
7 A. I t hi nk i t was bef or e t hat . I don' t r emember when
8 Medi cai d st opped accept i ng or t hodont i c cases.
9 Q. What r ecor d woul d show your l ast day of empl oyment
10 wi t h Bear Cr eek?
11 A. I woul d have t o go back and t r y and check i n my
12 checkbook . . . t o see when t he l ast t i me I saw - -
13 Q. Maybe t hat l ast 1099 woul d r ef l ect your . . .
14 A. Probabl y woul d.
15 Q. . . . your l ast day of empl oyment ?
16 A. Not necessar i l y. I t j ust shows t he - - t he 109917 j ust shows t he annual t hi ng. So i t doesn' t show a dat e.
18 Q. Mm. Okay.
19 And di d you ever - - whi l e you were at Bear
20 Cr eek ever l ook at or see or t al k about pr oduct i on r epor t s?
21 A. No.
22
Q. Di d . . . di d you - - so t el l me t he ci r cumst ances23 of your - - of your - - of , you know, l eavi ng Bear Cr eek. I
24 mean . . . di d you j ust get up and l eave? Di d you qui t ?
25 A. No. Dr . Br ady sai d, "Hey, t hi ngs have sl owed
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1 down. I can' t af f or d t o pay you anymor e. Sor r y. "
2 Q. Okay. And you sai d t hat Medi cai d st opped
3 t aki ng. . . .
4 A. St opped appr ovi ng or t hodont i c cases.
5 Q. When di d t hat occur?
6 A. You' d pr obabl y know bet t er t han I woul d. I can' t
7 r emember t he dat e. But i t happened shor t l y af t er Channel 8
8 st ar t ed i nvest i gat i ng t he or t hodont i c Medi cai d pr ogr ams.
9 Q. But - - I mean, i t . . . f r om what you' r e t el l i n'
10 me, t he - - t he change i n any Medi cai d pol i cy had t o occur
11 bef or e you l ef t Bear Cr eek; r i ght ?
12 A. Yes.
13 Q. And t hat ' s what I ' m t r yi ng t o get at , i s, you know,
14 when exact l y you l ef t Bear Cr eek.
15 A. I - - as I sai d, when Medi cai d put t he hol d on al l
16 t he new cases, bef ore t hey swi t ched t o i nsur ance- company17 admi ni st r at i on of ' em, at t hat poi nt was when I was no l onger
18 empl oyed t her e.
19 Q. The whol e - - was i t - - t hat hol d uni que t o Br ady or
20 Bear Cr eek or was i t - -
21 A. No, i t was uni que t o ever ybody t hat di d Medi cai d
22
or t hodont i cs.23 Q. Al l r i ght . Al l r i ght . So . . . and Br ady j ust
24 sai d, " I can' t af f or d t o keep you anymor e, " and you went
25 back?
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1 A. Ri ght .
2 ( Mr . Medl ock l ef t t he r oom. )
3 Q. ( BY MR. HARGROVE) What happened t o t hose pat i ent s
4 t hat you had st ar t ed br aces?
5 A. Wel l , t hey wer en' t my pat i ent s, as I sai d. I was
6 one of t he or t hodont i st s t r eat i ng t hose pat i ent s. So t hey
7 wer e st i l l r ecei vi ng t r eat ment by Dr . Br ady, and t her e was
8 anot her f ul l - t i me or t hodont i st t her e, at t he t i me.
9 Q. We wer e gonna l i st t he names of t he or t hodont i st s.
10 Do you r emember who t hey wer e?
11 A. One of ' em was Dr . J ack Bel l .
12 Q. Who el se?
13 A. Dr . Randy Ray. And . . . J ason . . . I ' m sor r y.
14 Agai n, anot her seni or moment . I can' t r emember . I ' m
15 t er r i bl e wi t h names. J ason . . . was a young or t hodont i st
16 who was t her e f ul l - t i me. He' s no l onger t her e f ul l - t i me. I n17 f act, none of ' em ar e.
18 Q. None of ' em ar e?
19 A. Except Dr . Br ady.
20 Q. Dr . Br ady' s st i l l t her e?
21 A. Yes.
22
Q. Okay. But t he pat i ent s t hat you st ar t ed . . . I23 woul d t hi nk t hat t her e' s some, you know, bi l l i ng i dent i f i er
24 or pr ovi der i dent i f i er on t hose - -
25 A. I t pr obabl y - -
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1 Q. - - associ at ed wi t h t hose pat i ent s; r i ght ?
2 A. There has t o be wi t h Bear Cr eek, yeah.
3 Q. Okay. So I - - goi ng back t o a coupl e quest i ons
4 bef ore - - ear l i er . . .
5 A. Mm- hmm.
6 Q. . . . you l ef t . You di dn' t t ake t hose pat i ent s
7 wi t h you; r i ght ? To your pr act i ce.
8 A. They wer en' t my pat i ent s.
9 Q. Okay. They di dn' t f ol l ow you t o your pr act i ce;
10 r i ght ?
11 A. No.
12 Q. They j ust cont i nued wi t h t hei r t r eat ment , you
13 t hi nk, at Bear Cr eek; r i ght ?
14 A. Yes.
15 Q. Okay. How di d t he - - t hat pat i ent popul at i on at
16 Bear Cr eek - - how i s i t t he same or di f f er ent t han t he17 pat i ent popul at i on i n your pr i vat e pr act i ce?
18 A. Pat i ent i n my pr - - - pr i vat e pr act i ce ar e ei t her
19 pr i vat e- pay or pai d - - r ei mbur sed somewhat by i nsurance
20 compani es. And . . . doesn' t r equi r e St at e aut hor i zat i on
21 pr i or t o begi nni ng t r eat ment .
22
Q. You have t o excuse me. I ' m not f ami l i ar wi t h23 Dal l as. ' Kay?
24 A. Mm- hmm.
25 Q. I gr ew up on t he bor der . Dal l as - - so your . . .
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1 your nei ghbor hood, i n your pr act i ce, I mean, what ar e t he - -
2 what ' s i t l i ke? I mean, t er ms of af f l uence or demogr aphi cs.
3 What ' s i t l i ke?
4 A. I t ' s . . . an af f l uent ar ea of pr act i ce.
5 Q. And t hat ' s how t hose par ent s can af f or d t o pay an
6 or t hodont i st and put br aces on t hei r ki ds?
7 A. I t ' s not necessar i l y al l af f l uent pe- - - pat i ent s.
8 Q. Al l r i ght .
9 A. We have pat i ent s t hat al so ar e l abor er s. They
10 don' t have t o be af f l uent .
11 Q. But t hey have money t o pay f or braces.
12 A. They pay f or i t , yes.
13 Q. Okay.
14 A. We wor k out f i nanci al ar r angement s wi t h ' em. To
15 t r y and make i t af f or dabl e f or ' em al l .
16 Q. Goi n' back t o Bear Cr eek. What t r ai ni ng, i f any,17 di d you get on how t o bi l l Medi cai d?
18 A. I - - as f ar as bi l l i ng, I have no i dea. I have no
19 i dea what t he Medi cai d f ees were. I have no i dea how
20 Medi cai d was bi l l ed.
21 Q. And as i t rel at es t o whet her a Medi cai d benef i ci ar y
22
was ent i t l ed t o br aces, what t r ai ni ng di d you get at Bear23 Cr eek?
24 A. I was shown t he HLD char t s, as wel l . And af t er I
25 was t her e f or sever al mont hs, and some of t he t r ai ni ng - -
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1 af t er some of t he t r ai ni ng I had wi t h Dr . Or r , t hey asked me
2 t o eval uate ' em on t he HLD i ndex.
3 Q. Wel l , I t hought your meet i ng wi t h Or r was af t er you
4 l ef t Bear Cr eek.
5 A. Let me t hi nk about t hat . Wel l , i t ' s . . . l et ' s
6 see. Wi t h t he - - you' r e absol ut el y r i ght . I ' m sor r y.
7 I - - my t r ai ni ng, t hen, was j ust basi cal l y
8 shown by Dr . Br ady at t hat poi nt , how he f i l l ed ' em out . He
9 woul d t hen - - af t er he f i l l ed ' em out he asked me t o t r y and
10 do i t i n a si mi l ar manner ; gi ve my opi ni on based upon t hose.
11 Q. At Bear Cr eek di d you act ual l y r ead t he manual ?
12 A. I r ead t hose par t s of the manual .
13 Q. But your t r ai ni ng on how t o i nt erpr et t hat manual
14 came f r om Dr . Br ady?
15 A. Agai n, not how t o i nt er pr et i t . J ust t o r ead what
16 i t says and t he r ul es t o f ol l ow.17 ( Mr . Medl ock r et ur ned. )
18 THE WI TNESS: The i nter pret at i on was on my
19 own.
20 Q. ( BY MR. HARGROVE) At Bear Cr eek, di d you
21 r equest - - t hey' r e Bear Cr eek pat i ent s. But di d you submi t
22
any pr eaut hor i zat i on to TMHP t o - -23 A. I di d not .
24 Q. Okay.
25 A. Per sonal l y.
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1 Q. Al l r i ght . Let me f i ni sh t he quest i on, ' cause
2 we' r e gonna be tal ki n' over each ot her .
3 A. Oh, sur e. Go ahead.
4 Q. You know how depo. ' s wor k.
5 So at Bear Cr eek - -
6 A. Mm- hmm.
7 Q. - - di d you per sonal l y submi t any pr eaut hor i zat i on
8 t o TMHP t o - - t o do or t hodont i a work on a Medi cai d
9 benef i ci ar y?
10 A. No.
11 Q. Di d you ever si gn any HLD score sheet s at Bear
12 Cr eek?
13 A. Yes.
14 Q. Okay. How many?
15 A. I coul dn' t t el l you.
16 Q. Mor e t han 100?17 A. I don' t t hi nk so.
18 Q. Less t han 100?
19 A. Yeah.
20 Q. Bet ween 50 and 100?
21 A. I woul d say . . . yeah, between 50 and 75.
22
Q. And . . . di d you have a dent al assi st ant who woul d23 hel p you scor e t he HLD scor e sheet s?
24 A. No.
25 Q. You di d i t your sel f ?
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1 A. Yes. I scor ed ' em. She - - I had dent al assi st ant s
2 t her e, because . . . t hey . . . a number of t he pat i ent s
3 di dn' t speak Engl i sh; t hey spoke Spani sh. And I speak no
4 Spani sh. So I had an i nt er pr et er . Or a dent al assi st ant
5 woul d be t here t o hand me i nst r ument s when I was eval uat i ng
6 ' em. But not do any of t he scor i ng.
7 I ' m sor r y.
8 Q. And so you' ve t r eat ed - - i t sounds l i ke you' ve
9 compl et ed i n your - - i n your pr of essi onal capaci t y - - not as
10 an exper t . But you' ve compl et ed bet ween 50 and l ess t han 100
11 HLD score sheet s; cor r ect ?
12 A. Yes. I n - - i n t he - - at Bear Cr eek.
13 Q. Whi l e at Bear Cr eek.
14 A. Yeah.
15 Q. And your t r ai ni ng on how t o compl ete t hose score
16 sheet s came f r om - - f r om Dr . Br ady.17 I s t hat f ai r t o say?
18 A. Basi cal l y j ust showi ng me t he - - yes. The scor e
19 sheet s and t he i nst r uct i ons. And r eadi ng t he i nst r uct i ons.
20 Q. Ot her t han Dr . Br ady at Bear Cr eek, di d you r ecei ve
21 i nst r ucti on f r om any ot her - -
22
A. No.23 Q. Hol d on.
24 A. I ' m sor r y agai n.
25 Q. So ot her t han Dr . Br ady' s t r ai ni ng at Bear Cr eek,
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1 di d you r ecei ve any ot her i nst r uct i on - -
2 A. I woul dn' t r eal l y cal l that t r ai ni ng - -
3 Q. Wel l , what woul d you cal l i t , t hen?
4 A. J ust basi cal l y, "Thi s i s how you do i t . Thi s i s
5 t he f or m. Thi s i s t he f or m t o f i l l out . " Ther e was no
6 i nst r uct i on of , "Now, you l ook at t hi s f or m and you measur e
7 her e and you measur e her e. " I t was a mat t er of , "Thi s i s t he
8 f or m. "
9 ( A woman ent ered t he r oom, t o adj ust
10 t her most at , and l ef t . )
11 THE WI TNESS: "You f i l l i t out . You have t o
12 put i n t hese squar es. " Not t he i nt er pr et at i on of i t .
13 Q. ( BY MR. HARGROVE) Okay.
14 A. The i nt er pr et at i on was ent i r el y mi ne.
15 Q. Al l r i ght . Di d you . . . di d you - - what ot her
16 st eps di d you per f or m t o submi t t he pr eaut hor i zat i on f or a17 Bear Cr eek pat i ent ?
18 A. None.
19 Q. None?
20 Di d Bear Cr eek st af f t ake car e of t hat f or
21 you?
22
A. Yes. Not f or me. For Bear Cr eek.23 Q. For Bear Cr eek.
24 And j ust t o sump sum up. Your . . . You
25 know, as i t r el at es t o t he pr eaut hor i zat i on, your - - your
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1 r ol e at Bear Cr eek was l i mi t ed t o f i l l i ng out t he HLD scor e
2 sheet s; cor r ect ?
3 A. Cor r ect .
4 Q. Do you know how many of your 50 t o 100 pat i ent s
5 were appr oved f or or t hodont i a work by Medi cai d?
6 A. No.
7 Q. Do you know i f any of ' em were r ej ect ed?
8 A. Possi bl e. I have no way of knowi ng.
9 Q. I s i t your bel i ef t hat any had been r ej ect ed?
10 A. I have no i dea. Woul dn' t even specul at e on i t .
11 Q. Di d you ever have a parent t el l you t hat , you know,
12 or di d you ever have t o t el l a pat i ent t hat t hei r
13 preauthor i zat i on had been deni ed by TMHP?
14 A. No. That was not my j ob.
15 Q. Al l r i ght . What di d Dr . Br ady say about t he - -
16 t he - - t he - - t he - - t he pr obabi l i t y of t hese17 pr eaut hor i zat i ons bei ng appr oved by TMHP?
18 A. Never di scussed.
19 Q. Okay. Do you know i f any of hi s pat i ent s had ever
20 been deni ed based upon a pr eaut hor i zat i on?
21 A. I don' t know f or a f act , but I woul d i magi ne t hat
22
had he been doi ng i t f or sever al year s, t her e had t o be some23 r ej ecti ons.
24 Q. But you don' t know.
25 A. I don' t know f or sur e. I can' t t el l you t hat .
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1 Q. And at Bear Cr eek you di dn' t have t o cover your
2 cost . You wer e j ust pai d a dai l y wage. Ri ght ?
3 A. Bear Cr eek I was j ust pai d a dai l y wage.
4 Q. So goi n' back t o your - - your pr i vat e pr act i ce.
5 A. Mm- hmm.
6 Q. Sound l i ke . . . al most - - t her e' s no Medi cai d
7 popul at i on at al l .
8 A. None.
9 Q. Okay. And i n - - t hese are ki ds whose parent s or
10 guar di ans can af f or d t o pay f or br aces, or t hey have
11 i nsur ance; r i ght ?
12 A. I t ' s not j ust chi l dr en. I t ' s adul t s .
13 Q. Okay. So . . . t hat ' s i nt er est i ng. So t he - - what
14 i s t he . . . t he per cent age of pedi at r i c or t hodont i a you do
15 compared wi t h adul t or t hodont i a?
16 A. Oh, I ' d say i t ' s about 50/ 50 now. May even be - -17 yeah, about 50/ 50.
18 Q. And how does an adul t or t hodont i a pat i ent - - I
19 mean, what ' s - - j ust gener al l y speaki ng, what ar e the
20 di f f erences bet ween an adul t or t hodont i a pat i ent compared
21 wi t h, you know, a chi l d?
22
MR. CANALES: Obj ect i on t o t he f orm.23 Q. ( BY MR. HARGROVE) You can answer .
24 A. Okay. Wel l . . . adul t . . . t he - - one of t he
25 maj or di f f er ence ( si c) bet ween adul t and chi l dr en i s you
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1 don' t have gr owt h wor ki ng f or you. You al so - - adul t s can be
2 much more compl i cat ed cases because of mi ssi ng teet h, worn
3 t eet h, and t her e ar e a l ot of ot her f act or s i nvol ved i n
4 t hat . Adul t s have por cel ai n cr owns; met al cr owns that ar e
5 di f f i cul t t o get at t achment s t o st ay on.
6 So adul t cases i n many areas can be much mor e
7 di f f i cul t .
8 Q. And t hr oughout your pr act i ce, has about hal f your
9 pat i ent popul at i on been adul t s?
10 A. No.
11 Q. Maj or i t y chi l dr en?
12 A. Ear l i er year s i t was chi l dr en. But as t he - - as
13 t he pr of essi on changed and t he . . . soci al aspect of . . .
14 i n the popul at i on, peopl e became - - adul t s became more and
15 mor e awar e of t he avai l abi l i t y of or t hodont i cs and what can
16 be done wi t h or t hodont i cs f or adul t s has expanded, I bel i eve17 t he st at i st i cs show t hat mor e and mor e pr act i ces have a
18 hi gher percent age of adul t s t han t hey di d year s ago.
19 Q. So f r om about 2005 t o t he pr esent , your pr act i ce,
20 i s i t about 50/ 50 now adul t - -
21 A. Even bef or e t hat .
22
Q. Bef ore t hat ? Okay.23 So when di d i t st ar t ?
24 A. Oh, I ' d - - i t ' s har d t o say. J ust gr adual l y over
25 t i me. I ' ve seen - - seems l i ke I ' ve seen mor e adul t
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1 pat i ent s. I - - I wor k wi t h a l ot of r est or at i ve dent i st s who
2 need teet h moved around bef ore t hey can do t he rest orat i ons.
3 So my pr act i ce - - and I can' t t el l you exact l y what t hat i s.
4 As you mat ur e i n a pr act i ce, t her e ar e a l ot of dent i st s who
5 go mor e and mor e t o r est or at i ve, so i t ' s dent i st s t hat I ' ve
6 known f or a l ong t i me. And t hey need t eet h moved bef ore t hey
7 coul d do t he r est or at i ve wor k.
8 So j ust gr adual l y i t ' s gone t o wher e I have a
9 l ar ger per cent age of adul t s t han chi l dr en.
10 Q. Woul d i t be f ai r t o say t hat over the past t en
11 year s maj or i t y of your pat i ent s ar e adul t pat i ent s?
12 A. I f you mean by maj or i t y more t han 50 percent - -
13 Q. Yeah.
14 A. Pr obabl y. Yeah, i t ' s gonna be cl ose.
15 Q. Okay. Goi n' back t o your pr act i ce and how i t
16 compares wi t h Bear Cr eek, what are the demogr aphi cs, t he17 r aci al demogr aphi cs, of your pr act i ce? Ar e t hey most l y
18 Angl i cans?
19 A. I t ' s a combi nat i on. The . . . Hi spani cs,
20 Af r o- Amer i cans, and Angl os. But we al so have some Asi ans.
21 We have mi d- East er ner s. So I can' t say i t ' s j ust i n - - you
22
know, pr i mar i l y Angl o.23 Q. At Spr