COMMONWEALTH OF SUPERIOR COURT
MASSACHUSETTS CIVIL ACTION
PLYMOUTH, ss.
LYNNE MILLICAN, in )
her individual capacity, )
Plaintiff )
)
vs. )
) NO. 92-2140A
HARVARD COMMUNITY HEALTH PLAN, )
NATALIE SCHULTZ, MAHMOOD NIARAKI, )
BRIAN WALSH, BOSTON IVF, SELWYN )
OSKOWITZ, MICHAEL ALPER, )
Defendants )
ANSWERS OF THE DEFENDANT, BRIAN WALSH, TO THE PLAINTIFF, LYNNE MILLICAN75 INTERROGATORIES (FIPST SET)
Ql. Please identify yourself fully.
Al. My name is Brian W. Walsh. I am a physician and my specialty is obstetrics and gynecology. My business address is Brigham and Women's Hospital, Boston, Massachusetts.
Q5. What was the title, the name of the author, the name of the publisher, and the date of publication, of each medical book, medical journal, magazine, newsletter, circular or other publication to which you owned, subscribed to, had possession of or which you read in enlarging your medical knowledge prior to and at the time of this action?
A5. OBJECTION OF COUNSEL: This request is beyond the scope of discovery under Rules 26 and 34 of the Mass. R. Civ. P., as it is overly broad in scope, has no reasonable time limitation on the request, seeks information not relevant to the case at bar, and is not reasonably calculated to lead to the discovery of admissible evidence.
Otherwise answering, I regularly read the New England Journal of Medicine, JAMA, Obstetrics and Gynecology, Fertility and Sterility, and American Journal of Obstetrics and Gynecology.
Q6. Did you refer to, or rely on, any of the above publications in treating the plaintiff or in forming an opinion concerning the diagnosis and treatment of the plaintiff's condition, and if so state with particularity which information you relied upon, including the title, author, name of publisher, and the date the information was published, and state the date which the information was read.
A6. No, I did not.
Q7. Please describe fully and in complete detail any and all sources of information which you used in managing, prescribing, or otherwise facilitating the Plaintiff's medication regime with Lupron, and state with particularity the number of patients to that date which you had similarly prescribed and managed relative to this medication regime, and identify the means in which you are relying upon to enable you to provide numbers.
A7. I received information on Lupron from my training in Reproductive Endocrinology. I have treated numerous patients with Lupron.
Q8. Kindly state the number of patients on Lupron which you had treated with supplemental hormones, including those treated prior to, during, and since this cause of action, and state with particularity the reasoning for such a proscription for supplemental hormones, and the means you are relying upon to provide any and all such numbers.
A8 . OBJECTION OF COUNSEL: This request is beyond the scope of discovery under Rules 26 and 34 of the Mass. R. Civ. P., as it is overly broad in scope, has no reasonable time limitation on the request, seeks information not relevant to the case at bar, and is not reasonably calculated to lead to the discovery of admissible evidence.
Otherwise answering, prior to and during my treatment of the Plaintiff from February 2, 1989 to June 1, 1989, I was not prescribing supplemental hormones to patients on Lupron. Since that time, in instances which might call for it, I have prescribed recently developed new medications.
Q9. Please describe fully and in complete detail the reasoning behind the Plaintiff undergoing the Lupron medication regime, and set forth the response the Plaintiff had while receiving Lupron, and whether or not the Plaintiff's response was typical or atypical, and state with particularity the source you are relying upon to determine whether the Plaintiff's response was typical or atypical.
A9. [Plaintiff’s previous physician] prescribed this medication initially, and I had no disagreement with this regimen. I continued the same as it had a pain-relieving effect. Plaintiff's response to this medication was as reported in the Harvard Community Health Plan medical record. I did not have a protocol by which I operated. Plaintiff's response was typical, based upon my experience.
Q10. Kindly state whether you knew the drug Lupron to be experimental at the tine of this cause of action, and set forth any and all knowledge you had at that time concerning administration protocol, including but not limited to the dosage and administration, indications and usage, clinical pharmacology, contraindications, warnings, precautions, overdosage, and management of side effects.
A10. No, Lupron was not experimental at the time of the events alleged in this action. There were no protocols operative for the administration of this drug, to my knowledge.
Qll. Please describe fully and in complete detail any and all
adverse reactions, adverse events or side effects, common or uncommon, known to you at the time of this action, and state with particularity the source of your knowledge, and set for any and all options available to manage, decrease or otherwise ameliorate any and all side effects, and state with particularity any and all options you prescribed or otherwise advised to the Plaintiff to decrease her side effects, and set forth the date and time such advice was provided and state any and all documentation of such advice.
All. The side effects of Lupron are similar to those experienced during menopause, from my experience and the literature. The only viable option was to discontinue treatment, which Plaintiff refused on June 1, 1989, documented by Plaintiff's Harvard Community Health Plan medical records.
Q12. Have you or any of your patient’s ever been involved in or otherwise participated in a Lupron study, and if so state the date and location of any and all studies, the sponsors and number of patients involved, and set forth the purpose, specifics, and conclusion of any and all studies, and state whether the results have published, and if so the title of the study, and the name, date, author, and title of publication.
A12. Not that I recall.
Q13. Please describe fully and in complete detail all Lupron
studies known to you before and at the time of this action, and state with particularity, and if so state the date and location of any and all studies, the sponsors and number of patients involved, and set forth the purpose, specifics, and conclusion of any and all studies, and state whether the results have published, and if so the title of the study, and the name, date, author, and title of publication.
A13. OBJECTION OF COUNSEL; This request is beyond the scope of discovery under Rules 26 and 34 of the Mass. R. Civ. P., as it is overly broad in scope, has no reasonable time limitation on the request, seeks information not relevant to the case at bar, and is not reasonably calculated to lead to the discovery of admissible evidence.
Otherwise answering, I do not recall.
Q14. Please provide the date of, rationale for, and location of the first time you had ever had a patient with whom you treated and/or prescribed Lupron therapy for.
A14. The first time I treated a patient with Lupron was during my Fellowship in Reproductive Endocrinology from 1986 to 1988 at the Brigham and Women's Hospital in Boston, Ma. The rationale for treating the patient with Lupron was to ameliorate pain of severe endometriosis.
Q16. Please describe fully and in complete detail the symptoms, complaints, and physical response of the Plaintiff to the drug Lupron, and state with particularity any and all of your assessments and conclusions relevant to your documentations that the Plaintiff was considered disabled as a result of Lupron.
A16. Please see my notes of 2/2/89, 2/16/89, 5/1/89 and 6/1/89 in the Plaintiff’s Harvard Community Health Plan medical records, in which this is set forth in detail.
Q21. Set forth any and all facts, circumstances, or conditions
which caused you to maintain the Plaintiff on Lupron without the addition of any and all supplemental hormones, and state with particularity upon what information or experience you relied upon to come to the decision to withhold or exclude add-back therapy 01 hormonal supplementation during the Plaintiff's medication regime.
A21. The addition of hormones could have detracted from the
intended efficacy of the Lupron, and have caused her pain to recur, based upon my training and the literature.
Q24. Kindly state with particularity the name of any and all
persons you had informed, advised, or otherwise consulted regarding the need to reevaluate the Plaintiff after your departure as treating physician, and set forth in complete detail the type of information conveyed, the times and dates of any and all such communication, and the conclusions you drew from any and exchanges regarding this reevaluation, and state with particularity your understanding of who would manage the plaintiff's treatment after your termination with Harvard Community Health Plan.
A24. I do not recall.
Q26. Kindly describe fully and in complete detail any and all rationale, advantage, indication, or effect for the utilization of supplemental hormones or add back therapy during a Lupron medication regime, and set forth the expected outcome of such supplemental hormonal therapy, and state with particularity any and all effects such hormonal therapy has with relation to amelioration of Lupron side effects.
A26. OBJECTION OF COUNSEL: This is beyond the scope of
permissible discovery under Rules 26 and 33 of the Mass. R. Civ. P. in that it seeks information about matters not related to this case, natters which are irrelevant and
immaterial.
Q28. With reference to your documentation in the Plaintiff's medical record on May 1, 1989, in which you state "she undergoes IVF in June"; kindly describe fully and in complete detail any and all efforts, communications, or other endeavors you undertook to ensure or accomplish that fact, and set forth the facts which allowed you to make such a statement, including any and all arrangements, conversations, and referrals, and state the dates which these arrangements were made and the name of the person(s) involved in establishing this June date for IVF on behalf of the Plaintiff.
A28. I do not recall.
Q29. With reference to your documentation in the Plaintiff's medical record on June 1, 1989, in which you state "Leuprolide will be continued through that time to be used as an ovulatory adjunct for ovulation induction", please describe fully and in complete detail the rationale behind such recommendations, and state with particularity the exact date you knew "that time" to be.
A29. I do not recall beyond what is set forth in my Harvard Community Health Plan notes.
Subscribed under the penalties of perjury at Boston, Massachusetts this 15th day of June 1993.
BRIAN WALSH, M.D.
AS TO OBJECTIQNS OF COUNSEL:
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LAURENCE J. BLOOM, BBO #046520
BLOOM AND BUELL
Attorney for Defendant,
Brian Walsh, M.D.
1340 Soldiers Field Road, Suite Two Boston, Massachusetts 02135
(617) 254-4400