0001 1 IN THE COURT OF COMMON PLEAS OF CUYAHOGA COUNTY, OHIO 2 - - - - - 3 CAESAR C. DAILEY, Individually and as 4 Administrator of the Estate of Lillian Dailey, 5 deceased, 6 Plaintiff, 7 vs Case No. CV-07-629950 8 OHIO PERMANENTE MEDICAL GROUP, Inc., 9 et al., 10 Defendants. 11 12 - - - - - 13 DEPOSITION OF MELANIE GIBBS, M.D. 14 TUESDAY, APRIL 29, 2008 15 - - - - - 16 Deposition of MELANIE GIBBS, M.D., a 17 Witness herein, called by counsel on behalf of 18 the Plaintiff for examination under the statute, 19 taken before me, Vivian L. Gordon, a Registered 20 Diplomate Reporter and Notary Public in and for 21 the State of Ohio, pursuant to agreement of 22 counsel, at the offices of Buckingham, Doolittle 23 & Burroughs, One Cleveland Center, Cleveland, 24 Ohio, commencing at 2:20 o'clock p.m. on the day 25 and date above set forth. 0002 1 APPEARANCES: 2 On behalf of the Plaintiff 3 Becker & Mishkind Co., LPA, by 4 HOWARD D. MISHKIND, ESQ. 5 JESSICA PERSE, ESQ. 6 Skylight Office Tower 7 1660 West Second Street 8 Suite 660 9 Cleveland, Ohio 44113 10 216-241-2600 11 12 13 14 On behalf of the Defendants 15 Buckingham, Doolittle & Burroughs, LLP, by 16 DIRK E. RIEMENSCHNEIDER, ESQ. 17 1375 East Ninth Street 18 One Cleveland Center 19 Suite 1700 20 Cleveland, Ohio 44115 21 216-621-5300 22 23 - - - - - 24 25 0003 1 MELANIE GIBBS, M.D., a witness herein, 2 called for examination, as provided by the Ohio 3 Rules of Civil Procedure, being by me first duly 4 sworn, as hereinafter certified, was deposed and 5 said as follows: 6 EXAMINATION OF MELANIE GIBBS, M.D. 7 BY MR. MISHKIND: 8 Q. Would you state your name for the 9 record, please. 10 A. Melanie C. Gibbs. 11 Q. You are a physician; is that 12 correct? 13 A. Yes. 14 Q. OB/GYN? 15 A. Yes. 16 Q. Dr. Gibbs, my name is Howard 17 Mishkind. I'm going to ask you some questions 18 about Lillian Dailey, okay? 19 A. Okay. 20 Q. My understanding is that you saw 21 Lillian on November 30, 2005; is that correct? 22 A. Uh-huh 23 Q. That's a yes? 24 A. Yes. 25 Q. You are soft spoken, so you need to 0004 1 do two favors for me. One is to keep your voice 2 up and two is avoid the uh-huhs and the opposite 3 of that and answer affirmatively so that Vivian 4 gets your answer, okay? 5 A. Yes. 6 Q. Thank you. I want to talk to you 7 about November 30, 2005. Is this the one and 8 only time that you saw Lillian? 9 A. Yes. 10 - - - - - 11 (Thereupon, GIBBS Deposition 12 Exhibit 1 was marked for 13 purposes of identification.) 14 - - - - - 15 Q. I have handed you Exhibit 1. If you 16 would take a look at Exhibit 1. It's actually a 17 number of pages. Tell me whether that appears to 18 be an accurate copy of your note from that 19 encounter. 20 A. Yes, it is. 21 Q. Can you tell me how it is that you 22 happened to be the one to see Lillian on 23 November 30, 2005? 24 A. I assume that she had called in 25 wanting to be seen and I was the physician that 0005 1 probably had an available spot in my schedule. 2 Q. Was this an emergency appointment or 3 a regularly scheduled appointment? 4 A. An emergency appointment. 5 Q. What was the reason for the 6 appointment? 7 A. Because of her pelvic pain the night 8 before. 9 Q. It looks like a medical assistant or 10 perhaps a nurse took the history? 11 A. On the first page, yes. 12 Q. Who is the nurse, if you can 13 decipher the signature? 14 A. Patti Kallenborn. 15 Q. Kallenborn? 16 A. Uh-huh. 17 Q. Is that a yes? 18 A. Yes. 19 Q. Is Patti still a nurse at the 20 Cleveland Heights facility? 21 A. I don't know. 22 Q. Do you still work at the Cleveland 23 Heights facility? 24 A. No, I don't. 25 Q. Do you still work at Kaiser? 0006 1 A. No, I do not. 2 Q. Where do you work? 3 A. I'm an independent contractor for 4 Physician Staffing. 5 Q. So do you work through the Meridia 6 Hospitals, the former Meridia Hospitals? 7 A. Yes and no. Physicians Staffing 8 staffs maybe five or six OB hospitals. I work 9 out of Marymount, Hillcrest, Southwest, and 10 Parma. 11 Q. As an OB/GYN? 12 A. As a house officer. So I am in the 13 hospital either 12 or 24 hours and I triage 14 patients that come in the hospital. They all 15 have their own private doctor. Most of it is 16 OB, very little GYN. 17 Q. Let's go back to November 30, 2005. 18 Nurse Kallenborn would have taken the initial 19 history which indicated abdominal pain and then 20 it looks like right pelvic pain? 21 A. Yes. 22 Q. That would have been her 23 handwriting, not yours; is that correct? 24 A. Yes. 25 Q. It looks like it says bleeds almost 0007 1 every day. Was that also her handwriting or was 2 that yours? 3 A. That is her handwriting. 4 Q. Did you determine when you saw the 5 patient how long bleeding almost every day had 6 been going on? 7 A. I don't remember if I determined 8 that or not. 9 Q. Do your notes reflect any such? 10 A. The notes do not reflect that. 11 Q. Did you put a no, N-O, through 12 history of dysplasia? Is that your note or 13 would that have been the nurse's note? 14 THE WITNESS: What page are we on? 15 MR. RIEMENSCHNEIDER: Right there. 16 A. That is the nurse's note. 17 Q. And just so I can get to the point 18 where these are your notes as opposed to 19 nurse's, there is a reference to a mammogram 20 that was performed in July of '05 and some 21 reference to a biopsy and fibrocystic disease. 22 Is that your handwriting or is that, again, the 23 nurse's? 24 A. That's the nurse's handwriting. 25 Q. In terms of the medications where it 0008 1 says new med, there are three different items 2 that are marked down. Would that have been your 3 handwriting or the nurse's? 4 A. That's the nurse's. 5 Q. Would you tell me where it says new 6 med what that represents or what that is 7 referring to? Is that current medications that 8 the patient is taking? 9 A. That usually means current 10 medications, yes. 11 Q. Is it reasonable for me to conclude 12 that when you saw her that the patient gave a 13 history of being on progesterone, Motrin and 14 calcium? 15 A. No, because when I saw her the 16 patient gave me a history of being on 17 Depot-Lupron. 18 Q. I'm sorry being on what? 19 A. Depot-Lupron. 20 Q. Did the patient give you an 21 indication as to whether she was or wasn't also 22 on progesterone? 23 A. No. 24 Q. Do you know? 25 A. I don't know if she was at that 0009 1 time. 2 Q. So the Lupron that she talked to you 3 about may have been in addition to the 4 Progesterone, the Motrin and the calcium; 5 correct? 6 A. It may have been, but I don't know. 7 Q. You performed an exam? 8 A. I did. 9 Q. And where it says 14 week, I think 10 it says 14 week tender, especially -- what does 11 that say there? 12 A. Right. 13 Q. Is that your exam or would that be 14 the nurse's? 15 A. That's my exam. 16 Q. And 14 week would be the size of the 17 uterus on clinical -- 18 A. On clinical exam, yes. 19 Q. Did you compare that to any previous 20 clinical notes to determine on examination 21 whether or not the uterine size was consistent 22 with prior exams? 23 A. I'm assuming that on my initial note 24 it says uterine fibroids 14 week size, that that 25 was from a previous note of Dr. Green's. 0010 1 Q. Do you remember this visit? 2 A. No, I do not. 3 Q. Do you remember Lillian at all? 4 A. No, I do not. 5 Q. Fair enough. Up in the upper 6 right-hand corner where it says chaperone 7 offered, what does that mean in this particular 8 case? She declined a chaperone? Is there a 9 normal process that you go through at the end of 10 an appointment? 11 A. No. When the patient comes in to be 12 seen, they are all asked do they want a 13 chaperone in the office during the exam. It's 14 more so with the men, but they started asking 15 everybody, even if the physician was a female. 16 Q. So Dr. Shuffer, you may or may not 17 know -- I met just a couple hours ago -- his 18 note indicated that he accepted the chaperone. 19 That's more common -- 20 A. Well, it's not the doctor who 21 accepts it or not, it's the patient. 22 Q. Is it more common where the patient 23 being seen by a male doctor, that they accept 24 the chaperone or is it individualized? 25 A. I'm sure, I'm assuming it's more 0011 1 common. And then I know that some men will not 2 see a female patient unless they are chaperoned. 3 Q. Thanks. How long has it been since 4 you worked at Kaiser? 5 A. I last worked there November of 2006 6 in the office, but I used to do call for them 7 until September of 2007. 8 Q. Tell me why you stopped working the 9 office as of November of 2006. 10 A. Well, the reason is because I'm a 11 single parent, I'm a widow, and I just had to 12 figure out a way to spend more time with my 13 child. 14 Q. So between November of '06 and 15 September of '07, you took call but didn't have 16 regularly scheduled hours? 17 A. Correct. 18 Q. And then as of September of '07, did 19 you then stop working through Ohio Permanente 20 Medical Group? 21 A. Well, I officially stopped actually 22 as of last month when they asked me if I wanted 23 to be recredentialed again and I said no. 24 Q. What is involved in being 25 recredentialed? 0012 1 A. Well, I'm assuming every so many 2 years they determine that -- you sort of have to 3 do a short application on your CME's and they 4 update everything that you are doing. So I was 5 a supplemental provider at that point. 6 Q. When did you start working with 7 Physicians Staffing? 8 A. March of 2005. So when I was at 9 Kaiser I was part time. 10 Q. That was going to be my next 11 question. How long had you worked at Kaiser; 12 starting when? 13 A. Well, I initially worked at Kaiser 14 from 1983 through '85 and then I worked again 15 from July of 2005 until officially November of 16 2006 as a part-time person and then I did 17 supplemental from November of 2006 until, I 18 would assume, May of 2008. 19 Q. Do you have any subspecialty within 20 the area of obstetrics and gynecology? 21 A. No. 22 Q. You are not a GYN oncologist, are 23 you? 24 A. No. 25 Q. I find it hard to believe that you 0013 1 have worked at Kaiser since '83. You don't look 2 old enough. 3 A. I'm old. 4 Q. On this visit of November 30, 2005, 5 there is a reference to the patient is due for a 6 second Depot-Lupron shot for enlarging fibroid 7 by Dr. Green. Apparently the first injection by 8 Dr. Green had been back on November 2, 2005. 9 Do you know what the working 10 diagnosis was other than enlarging fibroids? Do 11 you know why she was getting Lupron shots? 12 A. I don't think I investigated that. 13 The patient wanted to get it that day because 14 she was due for it in a couple days, so she got 15 the injection. 16 Q. So you, rather than her waiting for 17 Dr. Green, you gave her the injection on that 18 date? 19 A. Well, she wasn't going to come back 20 in to see Dr. Green. She was just going to come 21 back in to get the injection and she was there 22 on the 30th, which was a couple days before her 23 next injection was due. 24 Q. What type of conditions are treated 25 with Lupron? 0014 1 A. Fibroids, endometriosis. Prostate 2 cancer in the male population. 3 Q. That one we can eliminate. 4 A. You don't need to worry about that 5 one. 6 Q. Any other conditions within the 7 female population? 8 A. I have seen some people put patients 9 on it for dysmenorrhea thinking they have 10 endometriosis, but they hadn't really documented 11 it yet. 12 Q. The Lupron, as best as you 13 understood, was being provided to her because of 14 her uterine fibroids? 15 A. Yes. 16 Q. Do you know whether Lupron is used 17 to treat uterine sarcoma? 18 A. I have never heard of that before. 19 Q. The abdominal pain that she had, in 20 seeing this patient -- and certainly look at 21 your notes to answer this question -- was the 22 abdominal pain that she had, was it in response 23 to her Lupron shot or was it in response to her 24 fibroid tumor? 25 MR. RIEMENSCHNEIDER: Note my 0015 1 objection. Go ahead. 2 A. I don't know. 3 Q. Does Lupron cause abdominal pain in 4 patients that are being treated for uterine 5 fibroids or can it cause abdominal pain? 6 A. It can. I don't hear of that often 7 that patients complain of abdominal pain from 8 it. 9 Q. I want to walk through your notes in 10 terms of your exam. Do your notes, other than 11 the 14 week tender, especially on the right, is 12 the rest of the notes on that page from the 13 nurse or are any of the notes made by you on the 14 first page? 15 A. My notes starts with the exam. 16 Q. So you did an exam and found no 17 lesions, no discharge. You examined the vagina 18 and you saw no discharge from the cervix. You 19 didn't mention anything about the uterus other 20 than the 14 week size. 21 Was there anything else in terms of 22 your clinical exam that is of significance that 23 you didn't note on that first page? 24 A. On the second page I put that the 25 uterus was irregular. 0016 1 Q. How were you able to determine that? 2 A. Well, usually a uterus is smooth, so 3 when it's irregular you feel lumps and bumps on 4 it. 5 Q. This would have been from palpation? 6 A. Yes. 7 Q. So on the second page, if you just 8 sort of walk me through it, it says 56-year-old 9 female -- 56-year-old with uterine fibroids 10 approximately 14 weeks size. 11 A. Seen by Dr. Green on 11-2. Started 12 on Depot-Lupron. Due for second injection 13 12-2-05. Complained of severe pelvic pain right 14 last night. Better now, without fever. 15 Her abdominal exam was soft, 16 nondistented, tender in the right lower quadrant 17 without rebound. On pelvic exam she had normal 18 external genitalia. Vagina was clear. Cervix 19 normal. Uterus was 14 to 15 weeks irregular, 20 tender especially on the right. 21 And then I put probable degenerating 22 fibroids. Repeat ultrasound, CBC, sed rate. 23 She was going to get her 24 Depot-Lupron today and she already had an 25 appointment with Dr. Shuffer for the 15th of 0017 1 December. 2 Q. Now, on that date, you ordered 3 another ultrasound; correct? 4 A. Correct. 5 Q. And why did you do that? 6 A. Well, because your clinical exam is 7 not as sensitive as ultrasound and they can 8 measure the fibroids. They actually measure the 9 uterine size with calibers. They can compare it 10 with their previous ultrasound. And I had never 11 seen the patient before, so, I mean, I had 12 nothing to compare it with as far as my own exam 13 and I wanted to see what was going on with her 14 uterus. 15 Q. Did you get the results of the 16 ultrasound before the patient left? 17 A. No. The ultrasound wasn't done 18 until the next week. 19 Q. If you had reason to be concerned 20 about the patient on that date that there is 21 something else going on, could you have done a 22 stat ultrasound? 23 A. I possibly could have. I have no 24 idea what time of the day the patient was seen. 25 Usually I do a stat ultrasound if there was an 0018 1 acute problem, meaning something that I needed 2 to act on that very same day. 3 Q. Did you get a history directly as 4 opposed to what was noted by the nurse 5 concerning her bleeding? 6 A. I don't remember if I did or not. 7 Q. Is it fair to say that regardless of 8 whether you did or didn't, you didn't note 9 anything about her, whether she had the regular 10 uterine bleeding, or, if so, how long it had 11 been going on; is that a fair statement? 12 A. Yes. 13 Q. An on that particular day, your 14 focus was dealing with the right lower quadrant 15 pain that she presented with on an urgent basis? 16 A. Correct. 17 Q. Did you make any notations on this 18 office visit as to whether or not she was 19 perimenopausal or postmenopausal? 20 A. I did not. 21 Q. And did you have an opinion on that 22 date as to whether or not she was perimenopausal 23 or postmenopausal? 24 A. I don't think so. 25 Q. What is climacteric? 0019 1 A. That is a term I really have not 2 used very much, so I'm not exactly sure how they 3 are using that. I would use that probably to 4 say climacteric state is that period of time 5 that the person is going through menopause. 6 Q. But the issues as to whether or not 7 she was in menopause or perimenopausal, that 8 really wasn't a concern of yours when you saw 9 her during this one limited urgent visit; is 10 that a fair statement? 11 A. Yes. 12 Q. While you were still working at 13 Kaiser, did you come to learn that this 14 particular patient had been diagnosed with 15 uterine sarcoma? 16 A. No. 17 Q. Do you know -- you may or may not -- 18 whether or not a patient that has a uterine 19 sarcoma, that is diagnosed with a uterine 20 sarcoma, whether or not the pain that she 21 exhibited on November 30, 2005 is consistent 22 with pain associated with a fibroid tumor that 23 is in actuality a uterine sarcoma? 24 In other words, can this pain that 25 she exhibited be consistent with a patient who 0020 1 has uterine sarcoma? 2 A. It can be. 3 Q. I will represent to you that in 4 December of 2005, the patient was diagnosed with 5 uterine sarcoma. And I'm just going to ask you 6 whether you have an opinion, knowing that a 7 month later she was diagnosed with uterine 8 sarcoma, whether looking at what she presented 9 with on that date, whether it's more likely than 10 not that this pain was, in fact, associated with 11 a uterine sarcoma? 12 MR. RIEMENSCHNEIDER: Note an 13 objection. 14 A. I don't know. 15 Q. No opinion one way or another? 16 A. Yes. 17 Q. Thank you. The ultrasound that was 18 ordered on November 30th, did you actually see 19 that at any time in the clinical setting? 20 A. What do you mean in a clinical 21 setting? 22 Q. Well, excellent question. Poorly 23 worded. Excellent question by you, poorly 24 worded by me. 25 When the ultrasound was interpreted, 0021 1 would the report have come back to you as the 2 requesting ordering physician? 3 A. Yes. 4 Q. Okay. And did you, in fact, see the 5 ultrasound from that visit? 6 A. I would assume that I saw the 7 ultrasound from that visit. I also knew that 8 that patient had an appointment with 9 Dr. Shuffer, which probably would have occurred 10 around the same time that I got the ultrasound 11 result back. 12 Q. In the actual report where it says 13 the possibility of an adenomyosis should be 14 considered, what is that? 15 A. That's where you have a thickening 16 of the myometrium due to glands growing into the 17 wall of the uterus. It's a benign condition. 18 Q. Is that always a benign condition or 19 can that be associated with a malignancy? 20 A. Adenomyosis is always a benign 21 condition. 22 Q. The pertinent clinical data on the 23 ultrasound says a leiomyoma of the uterus. That 24 doesn't tell us one way or another whether or 25 not that leiomyoma is a fibroid; correct? 0022 1 A. Correct. 2 Q. That doesn't tell us one way or the 3 other whether the fibroid is malignant or 4 benign, does it? 5 A. No. 6 Q. In looking at -- and I think 7 Mr. Riemenschneider has a copy in his hands that 8 he is very willing to hand to you. 9 In looking at the ultrasound, does 10 that give you any indication as to whether or 11 not the patient on November 30th when you saw 12 her, whether or not the patient had any 13 diagnostic evidence that would be consistent 14 with uterine sarcoma? 15 A. There is nothing on this report that 16 is consistent with that. 17 Q. Is there anything in looking at the 18 report -- and recognizing that you didn't see it 19 on that day and never saw the patient again -- 20 but is there anything of clinical significance 21 to you when you correlate what you saw on 22 November 30th from your exam with the ultrasound 23 result that you had ordered? 24 A. That the uterus is larger than -- in 25 one respect, you know, it's 17.7 by 14.4 by 15.5 0023 1 centimeters in size. So I was calling it 14 to 2 15, but I can't get a three dimensional 3 measurement like they can. So it was 17 4 centimeters in length, so it's a little bit 5 bigger than what I felt on exam. 6 Q. Did you on the date of your visit 7 look at any of the previous ultrasounds? 8 A. I don't recall. 9 Q. Do you know the significance of an 10 increasing, a rapid increasing uterine size in a 11 patient that is complaining of abdominal pain? 12 What does that from a differential diagnosis 13 suggest to you? 14 MR. RIEMENSCHNEIDER: Objection. Go 15 ahead. 16 A. Well, you have to define rapid. 17 Rapid over what period of time? When we read in 18 the literature rapid growth of a uterine 19 fibroid, it could mean sarcoma, so that would be 20 a thought in your mind. 21 Q. What is your understanding of the 22 literature in your knowledge, training and 23 experience in terms of what period of time are 24 you normally looking at to define rapidity? 25 A. Unfortunately they don't give any 0024 1 period of time. 2 Q. What have you used in your 3 experience as an OB/GYN in a clinical setting 4 where you see an increase in size of the uterus? 5 What length of time between serial ultrasounds 6 is of clinical significance to you that you 7 would be concerned about growth? 8 MR. RIEMENSCHNEIDER: Objection. Go 9 ahead. 10 A. Probably within a year, six months 11 to a year. 12 Q. Did you ever talk with Dr. Shuffer 13 about his exam that occurred just a week or so 14 later? 15 A. Not that I recall. 16 Q. When Lillian was seen on the one 17 visit, was anyone else with her? 18 A. No. 19 Q. If she had been with someone else, 20 would it have been noted in the record? 21 A. Sometimes it could be. 22 Q. How is it that you are able to say 23 that she wasn't if no one was with her? 24 A. Usually I will put -- often I will 25 put patient present with spouse or friend in the 0025 1 room during an exam. 2 Q. The fact that you didn't do that, 3 can you say without any question in your mind 4 that she was alone? 5 A. No. 6 Q. You are working at Physicians 7 Staffing. Are you essentially a hospitalist at 8 this point? 9 A. They call it a house officer. 10 Q. You provide some obstetrics and 11 gynecology as a house officer? 12 A. When the patients come in for OB, I 13 see all the patients, triage them, and then 14 contact their obstetrician. 15 Sometimes I go to the emergency room 16 for questions that the ER doctor may have, but 17 they have already called the attending and the 18 attending asks me to go down and evaluate the 19 patient. 20 Q. Do you currently have privileges to 21 perform GYN surgeries? 22 A. Yes. 23 Q. What about obstetrical? 24 A. Yes. 25 Q. You have privileges at Marymount, 0026 1 Southwest -- did you say St. Vincent? 2 A. Hillcrest and Parma. 3 Q. Back in November of 2005, where did 4 you have privileges? 5 A. The same places. 6 Q. Are you board certified? 7 A. Yes. 8 Q. In obstetrics and gynecology? 9 A. Yes. 10 Q. Have you ever given a deposition 11 before? 12 A. No. 13 Q. First time? 14 A. First time. 15 Q. It's not that bad, is it? 16 A. Do I have to answer that? 17 Q. You don't. 18 Have you ever been a party to any 19 litigation? 20 MR. RIEMENSCHNEIDER: Objection. Go 21 ahead. 22 A. I have had -- I have had suits that 23 were brought up but they were all -- 24 Q. Dismissed? 25 A. -- dismissed, yes, prior to 0027 1 depositions ever being given. 2 Q. On how many occasions have you been 3 named? 4 MR. RIEMENSCHNEIDER: Objection. Go 5 ahead. 6 A. Three or four times. 7 Q. Are any of them still open, to your 8 knowledge? 9 A. No. 10 Q. How long ago? Are we talking more 11 than five years ago? 12 A. Yes. 13 Q. All in Cuyahoga County? 14 A. Not in Cuyahoga County. 15 Q. What county? 16 A. Oklahoma County. 17 Q. Oklahoma County. Is that in Ohio? 18 A. No, it's in Oklahoma. 19 Q. There are some counties in Ohio that 20 have strange names. 21 How long did you practice out there? 22 A. From 1989 to 2004. 23 Q. Have you ever had your privileges 24 suspended or revoked? 25 MR. RIEMENSCHNEIDER: Objection. Go 0028 1 ahead. 2 A. No. 3 Q. Have you ever been the subject of 4 any disciplinary action? 5 MR. RIEMENSCHNEIDER: Objection. 6 A. No. 7 Q. Have you applied for privileges to a 8 hospital and been denied? 9 A. No. 10 Q. When you read over Lillian Dailey's 11 note, I presume that's the only document, the 12 November 30, 2005 document, the encounter that 13 you reviewed; is that a fair statement? Or did 14 you review any other records? 15 A. No. 16 Q. This is the only one? 17 A. Yes. 18 Q. Okay. And perhaps the ultrasound, 19 did you look at that also? 20 A. Yes. Just that he had given it to 21 me one other time. 22 Q. Mr. Riemenschneider? 23 A. Yes. 24 Q. You have not reviewed anything else, 25 have you? 0029 1 A. No. 2 Q. No literature? 3 A. No. 4 Q. In looking at the November 30 note, 5 the ultrasound report, is there anything that 6 you are able to recall at all, even if it's just 7 a fleeting recollection, anything about this 8 appointment or the patient or anything that 9 occurred on that date? 10 I know I asked you before whether 11 you remembered this patient and you said no. 12 But as you read over the note, is there anything 13 about this visit that you are able to recall 14 independently from the note? 15 A. No. 16 MR. MISHKIND: I am done. 17 MR. RIEMENSCHNEIDER: We will 18 reserve signature. 19 20 - - - - - 21 (Deposition concluded at 3:00 p.m.) 22 (Signature not waived.) 23 - - - - - 24 25 0030 1 AFFIDAVIT 2 I have read the foregoing transcript from 3 page 1 through 29 and note the following 4 corrections: 5 PAGE LINE REQUESTED CHANGE 6 7 8 9 10 11 12 13 14 15 16 17 MELANIE GIBBS, M.D. 18 19 20 Subscribed and sworn to before me this 21 day of , 2008. 22 23 Notary Public 24 25 My commission expires . 0031 1 CERTIFICATE 2 3 State of Ohio, 4 SS: 5 County of Cuyahoga. 6 7 8 I, Vivian L. Gordon, a Notary Public within and for the State of Ohio, duly 9 commissioned and qualified, do hereby certify that the within named MELANIE GIBBS, M.D. was by 10 me first duly sworn to testify to the truth, the whole truth and nothing but the truth in the 11 cause aforesaid; that the testimony as above set forth was by me reduced to stenotypy, afterwards 12 transcribed, and that the foregoing is a true and correct transcription of the testimony. 13 I do further certify that this deposition 14 was taken at the time and place specified and was completed without adjournment; that I am not 15 a relative or attorney for either party or otherwise interested in the event of this 16 action. I am not, nor is the court reporting firm with which I am affiliated, under a 17 contract as defined in Civil Rule 28 (D). 18 IN WITNESS WHEREOF, I have hereunto set my hand and affixed my seal of office at Cleveland, 19 Ohio, on this 21st day of July, 2008. 20 21 22 Vivian L. Gordon, Notary Public 23 Within and for the State of Ohio 24 My commission expires June 8, 2009. 25 0032 1 INDEX 2 DEPOSITION OF MELANIE GIBBS, M.D. 3 4 BY MR. MISHKIND: 3 7 5 6 EXHIBITS 7 8 Exhibit 1 was marked 4 12 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25