0001 1 IN THE COURT OF COMMON PLEAS SUMMIT COUNTY, OHIO 2 - - - - - 3 4 Charles DeLorean, ) Judge Brenda Individually and as Executor ) Burnham-Unruh 5 of the Estate of Shirley ) DeLorean, Deceased, ) 6 ) Plaintiff, ) Case No. 7 ) CV-2009-05-3844 vs. ) 8 ) Copley Health Center, et al., ) 9 ) Defendants. ) 10 - - - - - 11 12 Deposition of: 13 LEO D. CLAVECILLA, M.D. 14 15 January 20, 2010 16 2:12 p.m. 17 18 Location: Reminger Co., LPA 80 South Summit Street, Suite 200 19 Akron, Ohio 20 21 Reporter: Christine Leisure, Notary Public 22 23 24 25 0002 1 APPEARANCES: 2 3 On behalf of the Plaintiff: DAVID A. KULWICKI, ESQ. 4 Becker & Mishkind Co., LPA 1660 West Second Street 5 Skylight Office Tower, Suite 660 Cleveland, OH 44113 6 866.477.4097 dkulwicki@beckermishkind.com 7 8 On behalf of the Defendants Copley Medical 9 Center, Heritage Management Co., LLC, and Communicare Health Services, Inc.: 10 JEFFREY W. VAN WAGNER, ESQ. Bonezzi, Switzer, Murphy 11 Polito & Hupp Co., LPA 1300 East 9th Street, Suite 1950 12 Cleveland, OH 44114 216.875.2767 13 jvanwagner@bsmph.com 14 15 On behalf of the Defendants Leo Clavecilla, M.D., Ellet Primary Care, Meredith Girard, 16 M.D. and Summa Physicians, Inc.: STEPHAN C. KREMER, ESQ. 17 Reminger Co., LPA 80 South Summit Street, Suite 200 18 Akron, OH 44308 330.375.1311 19 skremer@reminger.com 20 21 On behalf of the Defendants Kennard C. Ford, M.D. and Summit Rehabilitation Medicine, Inc.: 22 GREGG A. PEUGEOT, ESQ. Hanna, Campbell & Powell, LLP 23 3737 Embassy Parkway Akron, OH 44334 24 330.670.7300 gpeugeot@hcplaw.net 25 0003 1 APPEARANCES (Continued): 2 3 On behalf of the Defendant Akron General Medical Center: 4 KATHERINE S. KNOUFF, ESQ. Roetzel & Andress, LPA 5 222 South Main Street Akron, OH 44308 6 330.376.2700 kknouff@ralaw.com 7 8 On behalf of the Defendants Rohit S. 9 Chandurkar, D.O. and General Emergency Medical Specialists, Inc.: 10 NATHAN F. STUDENY, ESQ. Roetzel & Andress, LPA 11 222 South Main Street Akron, OH 44308 12 330.376.2700 nstudeny@ralaw.com 13 14 On behalf of the Defendants David A. Miller, 15 M.D. and Northeast Ohio Pulmonary, Critical Care and Sleep Specialists: 16 MICHAEL OCKERMAN, ESQ. Hanna, Campbell & Powell, LLP 17 3737 Embassy Parkway Akron, OH 44334 18 330.670.7300 mockerman@hcplaw.net 19 20 21 - - - - - 22 23 24 25 0004 1 I N D E X 2 3 EXAMINATION OF LEO D. CLAVECILLA, M.D. 4 Page Line 5 BY MR. KULWICKI...................5 6 BY MR. OCKERMAN...................53 6 6 BY MR. KULWICKI...................53 18 7 8 EXHIBITS MARKED 9 Deposition Exhibit 1 .............7 5 10 Deposition Exhibit 2 .............7 12 Deposition Exhibit 3 .............7 23 11 12 - - - - - 13 14 15 16 17 18 19 20 21 22 23 24 25 0005 1 LEO D. CLAVECILLA, M.D., of lawful age, 2 called for examination, being by me first duly 3 sworn, as hereinafter certified, deposed and said 4 as follows: 5 EXAMINATION OF LEO D. CLAVECILLA, M.D. 6 BY MR. KULWICKI: 7 Q. Good afternoon, Doctor. My name is 8 Dave Kulwicki. I represent the Estate of Shirley 9 DeLorean in a lawsuit that's been filed against 10 you and a number of other defendants. I'm here 11 today to take your deposition. 12 Why don't we start by having you state 13 your full name and spell your last name. 14 A. Leo, middle initial D, Clavecilla, 15 C-l-a-v-e-c-i-l-l-a. 16 Q. Would you kindly give us your current 17 home address. 18 A. 3742 Cascade Boulevard, Apartment 311, 19 Kent, Ohio, 44240. 20 Q. Thank you. 21 Doctor, during the course of today's 22 deposition I'm going to ask you questions and ask 23 you to answer those. If I ask you a question 24 that you don't understand, please tell me that 25 and I'll restate it to your satisfaction. Okay? 0006 1 A. Uh-huh. 2 Q. And the next rule is when you answer -- 3 A. Yes. 4 Q. -- please answer verbally as opposed to 5 an uh-huh or uh-uh. 6 And finally, Doctor, if you need to take 7 a break for any reason, if you want to talk to 8 Mr. Kremer, please let me know that and we'll 9 accommodate that. 10 A. Thank you. 11 MR. KREMER: Dave, as a matter of 12 housekeeping, I just passed out a copy of 13 Dr. Clavecilla's CV, one page, and then a page 14 which is his two notes typewritten from the 15 nursing home. 16 Then the last set is two pages stapled 17 together and they are the phone notes from my 18 client to Dr. Girard that she maintains when she 19 gets a phone call covering for one of 20 Dr. Clavecilla's patients. 21 MR. KULWICKI: Thank you. 22 MR. KREMER: And everybody has been 23 provided copies as well. 24 Q. Why don't we, along those lines, mark 25 these. The first thing I'm going to mark is a 0007 1 one-page document that purports to be your 2 Curriculum Vitae. Is that what that is? And 3 I'll mark that as Exhibit 1. 4 A. Yes, it is. 5 (Deposition Exhibit 1 was marked for 6 purposes of identification.) 7 Q. And the next item is a one-page document 8 that appears to be a typewritten transcription of 9 your two handwritten notes. Is that what Exhibit 10 2 is? 11 A. Yes, that's correct. 12 (Deposition Exhibit 2 was marked for 13 purposes of identification.) 14 Q. And finally, Exhibit 3 is a two-page 15 document. Would you tell me what that is? 16 MR. KREMER: If you know. 17 A. These are Dr. Girard's on-call notes. 18 MR. KREMER: There are other patients' 19 notes on there. The names and identifying 20 information has been redacted, but I produced 21 them in the same form that she has them. 22 MR. KULWICKI: Thank you. 23 (Deposition Exhibit 3 was marked for 24 purposes of identification.) 25 Q. And, Doctor, with respect to Exhibit 3, 0008 1 Dr. Girard's on-call notes, where would these 2 come from? In other words, where would the 3 original of these documents be? 4 A. Usually she sends them to me several 5 days after and I usually look at them and then 6 discard them unless there's something valuable 7 that needs to be saved. 8 But usually the notes are saved with 9 her, the copies are saved with her and then the 10 nursing home has their own record. 11 Q. So you would have the original or you 12 would have a copy of the original? 13 A. I don't have the originals. 14 Q. All right. Would the original be made 15 part of the nursing home chart typically? 16 A. No. 17 MR. KREMER: Objection. He already told 18 you he discards the original. 19 Q. Where was this particular document that 20 we have a copy of here marked as Exhibit 3, where 21 was this at? Where did you locate this at? 22 MR. KREMER: He didn't. He doesn't have 23 a copy of that. I'm providing it to you today 24 because Dr. Girard's deposition is on Friday. 25 Dr. Clavecilla has already indicated he 0009 1 does not have a copy of it. 2 MR. KULWICKI: Okay. 3 MR. KREMER: This is not his document. 4 MR. KULWICKI: Can you just tell me 5 where this came from? 6 MR. KREMER: From Dr. Girard. 7 MR. KULWICKI: From her personal 8 records? 9 MR. KREMER: Correct, this is a copy of 10 the records as she keeps them. 11 Q. Doctor, what was your affiliation with 12 Copley Health Center, if any, in 2007, the 13 timeframe relevant to this case which I think was 14 roughly May of 2007? 15 A. I'm an attending physician that sees 16 patients there. I'm not the medical director. 17 Q. Do you have any ownership interest in 18 that company? 19 A. No. 20 Q. I'm not familiar with Copley Health 21 Center. Does it have staff bylaws that would 22 apply to you? 23 A. I don't know that. 24 Q. Do you have to apply for staff 25 privileges in order to attend to patients there? 0010 1 A. Yes. 2 Q. Do you still have staff privileges at 3 Copley Health Center? 4 A. Yes. 5 Q. Who is the chief of staff there or who 6 was in 2007? 7 A. I don't know the answer to that. 8 Q. Who was the medical director in 2007? 9 A. I don't know the answer to that. 10 Q. Do you know how many attendings had 11 privileges to admit patients to Copley Health 12 Center in 2007? 13 A. I do not. 14 Q. In 2007 it appears that you were a 15 member of Summit County Internists; is that 16 correct? 17 A. Yes, it is. 18 Q. And what other physicians were members 19 of that group? 20 A. It was about 20 doctors at that time all 21 through Summit County. 22 Q. Did Summit County Internists have any 23 relationship with Copley Health Center that 24 you're aware of? 25 A. No, not that I'm aware of. 0011 1 Q. Besides internal medicine doctors, did 2 Summit County Internists employ any other 3 specialties of medicine? 4 A. There were several geriatricians at that 5 time. 6 Q. Is Summit County Internists 7 incorporated? 8 A. Correct, yes. 9 Q. And what is the status of that company 10 today? 11 MR. KREMER: If you know. 12 A. As far as I know, it's no longer in 13 existence. 14 Q. What was the reason for your leaving it 15 in 2008 pursuant to your CV? 16 A. The whole group joined and became 17 members of Summa Physicians, Incorporated, except 18 for two doctors out of the 20, I believe. 19 Q. At the time that you provided care and 20 services for Mrs. DeLorean, were you employed by 21 and acting within the course and scope of your 22 employment with Summit County Internists? 23 A. Yes, as far as I know. 24 Q. Besides seeing patients at Copley Health 25 Center, where else did you see patients in an 0012 1 inpatient setting in 2007? 2 A. In 2007 I saw patients at St. Thomas and 3 City Hospital as far as hospital settings. I'm 4 not sure what you mean by inpatient setting. 5 Q. Well, what hospitals did you have 6 privileges at? 7 A. I had privileges at Akron City Hospital, 8 St. Thomas, and I had courtesy privileges at 9 General but I wasn't seeing any patients at that 10 facility at that time. 11 Q. Tell me what you mean by courtesy 12 privileges at Akron General. 13 A. Well, in order to take patients that 14 have that insurance you have to have those 15 courtesy privileges, but those doctors don't 16 necessarily admit patients to that hospital. 17 And at that point I was not admitting patients to 18 Akron General. 19 Q. Do you know if any other physicians in 20 Summit County Internists had staff privileges at 21 Akron General back in 2007? 22 A. I do not know that. 23 Q. Do you know if either Dr. Girard or 24 Dr. Ford had privileges at Akron General in 2007? 25 A. I do not know about Dr. Ford, and 0013 1 Dr. Girard did not have privileges there as far 2 as admitting patients there. 3 Q. Were you Mrs. DeLorean's admitting 4 physician at Copley Health Center in 2007? 5 A. Yes, I believe so. 6 Q. And what does that mean when you are a 7 patient's admitting physician? 8 A. I supervise their care, make sure that 9 they're on the proper medicines, and I'm the one 10 or someone that's on call for me is the one that 11 gets the phone calls if there's problems in 12 general. 13 Q. If you and Dr. Girard did not have 14 privileges, full privileges at Akron General 15 Medical Center, why was it that Mrs. DeLorean was 16 transferred there from Copley Health Center? 17 A. I don't know the answer to that. 18 Q. If she had been admitted to Akron City 19 or St. Thomas, would you have been her admitting 20 physician under those circumstances or would your 21 group have been her admitting physicians? 22 A. It depends. 23 Q. Normally when a patient under your care 24 at Copley Health Center is transferred from that 25 facility to Akron City or St. Thomas, normally 0014 1 would your group admit that patient to their 2 service? 3 A. It really depends on the specific 4 instance. 5 Q. What factors come into consideration? 6 A. Whether the patient's private physician 7 is admitting patients and willing to take the 8 patient. That's the main -- 9 Q. Did you consider yourself to be 10 Mrs. DeLorean's private physician? 11 A. No. 12 Q. Do you know who that was? 13 A. Not at the time, no. 14 Q. Prior to 2007 how long had you had 15 admitting privileges at Copley Health Center? 16 A. If I recall, it was approximately one 17 year. 18 Q. And can you tell me as of May of 2007 19 what percentage of your patients -- or your 20 patient care took place at Copley Health Center 21 as opposed to your outpatient facility or any 22 other hospital? 23 A. It's difficult to give a percentage, but 24 it would probably be less than ten percent. 25 Q. Did you have -- or did Summit County 0015 1 Internists have a facility where they saw 2 patients on an outpatient basis? 3 A. Yes. 4 Q. And where was that? 5 A. My office is in Ellet, the address 6 that's on my CV. 7 Q. How many other offices did Summit County 8 Internists maintain back in 2007 besides the 9 Ellet facility? 10 A. Somewhere around five to six. 11 Q. Did you have set hours where you would 12 cover patients at or round on patients at Copley 13 Health Center as part of your duties with Summit 14 County Internists? 15 A. I didn't have set hours. I generally 16 would go on Tuesday afternoons, but sometimes I 17 would go at other times depending on other 18 factors. 19 Q. And let me try to understand how Summit 20 County Internists managed its patients that were 21 inpatients at Copley Health Center. 22 Would it be the case that when you went 23 there you would look at all patients of Summit 24 County Internists, you rounded on all those 25 patients that needed to be seen by a physician, 0016 1 or would you only go see the patients that were 2 specifically your patients? 3 A. I would just see specifically my 4 patients. 5 Q. So on Tuesday afternoon it might be the 6 case that you would be there seeing a group of 7 your patients or one of your patients and some 8 other physician from Summit County Internists 9 might be there seeing one of their patients as 10 well, true? 11 A. No. 12 Q. Okay. Why would that not be the case? 13 A. At the time of this incident there was 14 no other physician from Summit County Internists 15 going to Copley. 16 Q. Why was it that you were the only one 17 that had patients there from your group? 18 A. The majority at that time did not go to 19 nursing homes. Only a few did. 20 Q. Was it the case that Copley Health 21 Center would refer patients who were admitted to 22 their facility to you or would you refer patients 23 to be admitted to Copley Health Center or was it 24 a mix of both? 25 A. It was a mix of both. 0017 1 Q. Can you break it down by percentage in 2 terms of what percent of your inpatient 3 population at Copley Health Center where you were 4 the admitting physician would come from them or 5 come from you? 6 A. I would say the majority came from them. 7 Q. Was there a particular person at Copley 8 Health Center that you had a relationship with or 9 you knew such that you were on their referral 10 list? 11 A. I can't remember anyone at that time, 12 no. 13 Q. Do you have any special training in 14 gerontology? 15 A. No. 16 Q. Are you board certified in internal 17 medicine? 18 A. Yes, I am. 19 Q. And besides that board certification, do 20 you have any other specialty certifications? 21 A. No. 22 Q. Prior to today's deposition, did you 23 have an opportunity to review the Copley Health 24 Center medical chart in preparation for today's 25 deposition? 0018 1 A. Yes, I did. 2 Q. And is it your understanding from review 3 of that chart that you made two entries in that 4 chart, one on May 1st and one on May 8th? 5 A. Two notations. 6 Q. Why don't we look at those and then I'm 7 going to have you interpret what you did on those 8 occasions and maybe ask you some questions about 9 those notes. 10 Okay. So the first one is dated May 1, 11 2007 at noon, correct, Doctor? 12 A. Correct. 13 Q. And I think as we talked earlier, you 14 had typewritten out for us what your note says 15 and that's set forth in Exhibit 2, true? 16 A. Yes. 17 MR. KREMER: Just so we're clear, I 18 typed it up, he didn't type it up. I don't want 19 to attribute any typos to him. It's my fault if 20 there's typos. 21 MR. KULWICKI: Thanks. 22 MR. KREMER: I figured it might make 23 things go faster. 24 MR. KULWICKI: Thank you. 25 Q. Doctor, with respect to the third line 0019 1 where it says "Also with DOE," can you tell me 2 what that means? 3 A. That's an abbreviation for dyspnea on 4 exertion. 5 Q. And then going down to the fifth line 6 from the bottom where it says "Knee OA," what 7 does that mean? 8 A. That's an abbreviation for knee 9 osteoarthritis. 10 Q. Based on this note -- the patient had 11 actually been admitted on April 24th, correct? 12 A. No. 13 Q. Do you have the date of her admission? 14 A. April 27th. 15 Q. Now, between April 27 and May 1, did any 16 attending physician see her? 17 A. No. 18 Q. And the purpose for the admission to 19 Copley Health Center was to rehabilitate from her 20 knee replacement, true? 21 A. True. 22 Q. Was her prognosis excellent as of her 23 admission to that facility? 24 A. I would say you could call it good. 25 Q. Okay. Was she at any particular risk 0020 1 for infection based on the history and physical 2 that you performed on May 1st? 3 A. Generally these patients are at some 4 risk of infection because they're postoperative, 5 but she wasn't at any more risk than the average 6 person. 7 Q. And the risk of infection or the 8 infection that she was at risk for was primarily 9 a wound infection; is that true? 10 A. That and, you know, there's always risk 11 of bladder infection. But primarily wound 12 infection. 13 Q. Was she on antibiotics as a prophylactic 14 measure following this surgery? 15 A. Not at the nursing home. 16 Q. And with respect to her admit orders, 17 who authored those, if you know? And feel free 18 to look at the chart. And if you don't know, 19 tell me that as well. 20 A. I don't know. 21 Q. Okay. Based on your -- and take your 22 time, look through the admit orders from April 27 23 through your visit on May 1st, do you have any 24 concerns or criticisms of those admit orders in 25 any regard prior to your seeing the patient? 0021 1 A. No. 2 Q. One of the things that you added to the 3 orders was Senokot, true? 4 A. Yes. 5 Q. And that is a laxative, true? 6 A. It's actually Senokot S. It's a stool 7 softener/laxative combination. 8 Q. Besides ordering the Senokot, did you 9 make any other changes or additions to her 10 orders? 11 A. No, I did not, not at that time. 12 Q. Do you know if any other -- and I 13 apologize if I asked you this. I very well may 14 have. Do you know if any other doctor saw her at 15 Copley Health Center between the date of her 16 admission and your evaluation on May 1st? 17 A. No. 18 Q. No, none did, or you don't know? 19 A. None to my recollection. 20 Q. Was it standard practice in 2007 for a 21 new admit to Copley Health Center to be seen on 22 admission by a physician for purposes of 23 establishing admit orders and a plan of care? 24 A. Yes. 25 Q. And can you tell me why she wasn't seen 0022 1 by anybody for those couple of days between her 2 admission and May 1 when you saw her? 3 A. Well, she came after 5:00 on Friday. 4 I don't recall being informed that she was there 5 until Monday. You know, they clarified the 6 orders with the doctor, but I don't recall who 7 that doctor was. I don't recall if I got those 8 orders. 9 Q. Let me see if I understand that. Are 10 you talking about the orders dated April 27th, 11 2007? 12 A. Correct. 13 Q. So let me just understand how this 14 happens. 15 This wasn't your private patient prior 16 to this admission, true? 17 A. Correct. 18 Q. So it appears that someone from Copley 19 Health Center would have contacted you or your 20 service and asked for permission to admit this 21 patient under your care, true? 22 A. Correct. 23 Q. And either you or someone in your 24 service would have given that permission, true? 25 A. Correct. 0023 1 Q. And they would have given that 2 permission on April 27th, 2007, right? 3 MR. KREMER: Objection. If you know. 4 A. I don't know about that. 5 Q. Okay. Is there some way to find out who 6 authored -- or who gave these admit orders on 7 April 27, 2007? 8 A. Not that I can tell. 9 Q. Had you had any instances with Copley 10 Health Center in the past where they had admitted 11 patients to your service but not told you about 12 it for a couple of days and you didn't know about 13 it for a couple of days? 14 A. I don't remember. 15 Q. Do you know if in this case this was a 16 situation where a patient was admitted to your 17 service and you just didn't -- nobody told you 18 about it for a couple of days? 19 A. I don't know the answer to that. 20 Q. That wouldn't be appropriate care, 21 correct? 22 A. I mean it depends if they told someone 23 else. 24 Q. Another physician? 25 A. Correct. 0024 1 Q. But in terms of the documentation that 2 we have here for the orders from April 27th, 3 2007, April 30th -- or, I'm sorry, through May 1, 4 2007, there's no indication of identifying a 5 physician who gave those orders, true? 6 A. Correct. 7 Q. Now, on May 1, 2007, the orders from 8 that date, the very first item at the top there 9 says "Full code." What does that refer to? 10 A. It refers to the DNR or do not 11 resuscitate status of the patient. 12 Q. Is that sort of a routine order that is 13 made for all patients at Copley Health Center? 14 A. As far as I'm aware, yes. 15 Q. Do they have both long-term residents as 16 well as rehabilitation patients there? 17 A. Yes. 18 Q. How does their population break down 19 between rehab patients and long-term residents -- 20 A. I don't know the answer to that. 21 Q. -- by percentage? Okay, thank you. 22 And I think I asked this. I apologize, 23 I just forgot what you told me. Dr. Girard, was 24 she a member of Summit County Physicians back in 25 2007, Summit County Internists? 0025 1 A. No, she wasn't. 2 Q. And how about Dr. Ford? 3 A. No. 4 Q. How do they come to cover for you when 5 you're not at -- let me strike that and I'll 6 re-ask it. 7 After your May 1 visit with the patient, 8 there are a couple of visits from I believe 9 Dr. Girard or Dr. Ford or both. How did they 10 come to round on this patient if they're not 11 members of Summit County Internists? 12 A. I'll just answer them individually. 13 Dr. Girard was just covering on the 14 weekend for me, plus several doctors at the 15 hospital and their patients. She never rounded 16 on a patient. 17 Q. Okay. So she would be like a house 18 physician? 19 A. She's basically what you would consider 20 a hospitalist. 21 Q. Okay. And was she a full-time employee 22 of -- if you know, of Copley Health Center? 23 A. No, she was not. 24 Q. Do you know if she acted as a 25 hospitalist at any other facilities? 0026 1 A. At this time? 2 Q. Yes, in 2007, yes. 3 MR. KREMER: I don't think he knows, but 4 she acts at City right now. 5 A. Oh, she's a hospitalist at City and St. 6 Thomas right now. 7 Q. Currently? 8 A. Currently. 9 Q. What about in 2007, do you know if she 10 was a hospitalist anywhere besides Copley Health 11 Center? 12 MR. KREMER: She was not a hospitalist 13 at Copley Health Center. 14 MR. KULWICKI: That's what I got screwed 15 up on. Okay, let me clarify that then. 16 Q. With respect to her involvement with 17 patients at Copley Health Center, was she just 18 moonlighting as an internist? 19 A. She was the covering physician for 20 myself and several other doctors. 21 Q. Okay. And why would it be that you 22 would have her cover for you when she wasn't an 23 employee of Summit County Internists as opposed 24 to one of your partners in that group? 25 A. That's how her contractual relationship 0027 1 with her employer was, that she would cover 2 several doctors that are mostly hospital based, 3 and I was in that group, that call group. 4 Q. And who was her employer back in 2007, 5 if you know? 6 A. I believe it was Summa Physicians, 7 Incorporated. 8 Q. As part of your staff privileges at 9 Copley Health Center, did you have the right to 10 have one of your partners in Summit County 11 Internists cover for you on days when you weren't 12 working for patients at Copley Health Center? 13 A. Yeah, there would be someone covering 14 for me and I would notify them as to who was 15 covering for me or whoever was on call for me if 16 it was a weekend. 17 Q. Was it the case that Summit County 18 Internists back in 2007 went to outside 19 providers, in other words, providers not employed 20 by Summit County Internists, to do on-call work 21 for them on weekends and holidays and that sort 22 of thing on a routine basis? 23 A. As far as I know, it was just 24 Dr. Girard -- 25 Q. Okay. 0028 1 A. -- and possibly one other physician at 2 that time. 3 Q. You know, maybe I'm just confused or 4 maybe I'm confusing you. But what I'm really 5 just trying to understand here is it seems odd 6 that you would -- that you would not have another 7 of your partners with Summit County Internists on 8 call, you know, on an on-call list to cover your 9 patients at Copley Health Center, but instead you 10 went to this Dr. Girard who wasn't part of your 11 group. I'm just trying to understand why that 12 would be. 13 A. What happened was Summa hires -- 14 MR. KREMER: Don't guess. If you know 15 the answer, go ahead and answer him, but don't 16 guess as to what Summa does. 17 A. Okay. She was just the one that was 18 assigned to cover several doctors and I was one 19 of them that weekend. 20 Q. At Copley Health Center? 21 A. Just whoever my patients were. 22 Q. Okay. 23 A. Including my office patients and my 24 hospital patients. 25 Q. And do you know why she would be -- who 0029 1 was she assigned by to cover your patients? 2 A. Dr. Sweet at the time would make the 3 call schedule and it was agreed upon that she 4 would be covering certain people and I was the 5 one that she was covering that weekend. 6 Q. And Dr. Sweet, was she a member of 7 Summit County Internists? 8 A. He was a member of Summit County 9 Internists. 10 Q. All right, I think I've got it. 11 And how about Dr. Ford, how would 12 Dr. Ford -- was it the same situation with 13 Dr. Ford as with Dr. Girard, that Dr. Sweet would 14 just assign them to cover -- 15 A. No, his was a different situation. 16 Q. What was Dr. Ford's situation? How 17 would Dr. Ford come to cover your patients, say, 18 at Copley Health Center in 2007? 19 A. He's the rehab doctor. 20 MR. KREMER: First off, clarify that -- 21 A. He never really was -- he didn't really 22 cover for me per se. He was just the rehab 23 doctor there. 24 Q. Is he a physiatrist? 25 A. As far as I know, he's a physiatrist. 0030 1 Q. All right. So he would see patients of 2 yours that were admitted to Copley Health Center 3 almost as a specialty consultation as opposed to 4 covering for you when you weren't available, 5 true? 6 A. As far as I know, yes. 7 MR. PEUGEOT: Objection. 8 Q. When Dr. Ford saw a patient of yours who 9 was admitted to your service at Copley Health 10 Center, would he see a patient only when 11 requested by a consult order or would he see 12 patients at other times even when not 13 specifically ordered for a consult? 14 MR. KREMER: Objection. If you know. 15 A. I don't know the answer. 16 Q. And, again, looking at your orders from 17 May 1, 2007, they say through May 31, 2007. 18 Let me try to understand that. 19 Was it your expectation that these 20 orders would remain the same throughout the 21 duration of that month, that patient's month at 22 Copley Health Center? 23 A. No, not necessarily. 24 Q. Okay. Why does it say through May 31, 25 2007? 0031 1 A. As far as I know, each patient has 2 monthly orders so they generate a new set of 3 order lists if they're there the next month and 4 that's how they do it. 5 Q. And with respect to your relationship 6 with the nursing staff at Copley Health Center, 7 it's true that the nurses are not employees of 8 yours or of Summit County Internists in 2007, 9 true? 10 A. True. 11 Q. And they would function just like nurses 12 at a hospital in that they would be the eyes and 13 ears of attending physicians like yourself when 14 you were not at the facility, true? 15 A. Correct. 16 Q. And you would rely on the nurses at 17 Copley Health Center to tell you about changes in 18 condition that patients experienced when you 19 weren't there, true? 20 A. True. 21 Q. And those nurses, based on your 22 relationship with them, had a duty to call you 23 and advise you promptly of changes in condition 24 as they arose for individual patients of yours 25 that were at Copley Health Center; fair enough? 0032 1 A. Yes, that seems correct. 2 Q. In terms of the types of changes in 3 conditions that you as an admitting physician 4 would want to be and would expect to be apprised 5 of by the nursing staff at Copley Health Center, 6 one of them would be intractable diarrhea, true? 7 A. Yes. 8 Q. And another condition that you would 9 want and expect to be apprised of by the nursing 10 staff would be diarrhea that leads to 11 dehydration; fair enough? 12 A. Yes. 13 Q. Are there any contraindications to 14 administering Senokot to a patient who has either 15 intractable diarrhea or diarrhea that has caused 16 dehydration? 17 A. Can you repeat that again? 18 Q. Sure. Let me ask it a different way. 19 Can we agree that it would be 20 inappropriate to give a patient who has either 21 intractable diarrhea or diarrhea that has led to 22 dehydration Senokot? 23 MR. KREMER: Objection. Go ahead and 24 answer. 25 A. It depends on the situation. 0033 1 Q. Okay. And I'm talking about Senokot S. 2 Do you understand that? 3 A. I understand you're speaking about 4 Senokot S. 5 Q. Tell me under what situation Senokot S 6 would be appropriate to administer to a patient 7 who has intractable diarrhea or diarrhea that has 8 led to dehydration. 9 A. If it's -- if you're expecting the 10 diarrhea to be improving you may want to continue 11 the Senokot S since the patient is already on a 12 medicine that can cause constipation and benefit 13 from it initially. 14 As far as the diarrhea causing 15 dehydration, I don't know if you continue giving 16 that at that particular juncture. 17 Q. Doctor, would it be appropriate to 18 administer Senokot S to a patient who is 19 suspected of having C. Diff infection? 20 A. It depends on the degree of suspicion. 21 Q. If there's a high degree of suspicion 22 that a patient has a C. Diff infection, is it 23 appropriate to get a culture of their stool to 24 make a definitive diagnosis? 25 A. If there's a high degree, correct, yes. 0034 1 Q. And if there's a high degree of 2 suspicion that a patient has a C. Diff infection 3 such that a culture is ordered, can we agree that 4 it's inappropriate to administer Senokot S while 5 that culture result is pending? 6 MR. KREMER: Objection. Go ahead and 7 answer. 8 A. I think you're kind of breaking it down 9 into two parts. If there's a high degree of 10 suspicion, the Senokot S should be held or 11 discontinued. But if there's a high degree of 12 suspicion, that's not the only reason that you 13 would order the C. Diff. I mean even if you have 14 a low degree of suspicion in a select population 15 you would order the C. Diff. 16 Q. With respect to this patient's 17 subsequent course, did you review records from 18 her admission to Akron General Medical Center 19 following transfer from Copley Health Center up 20 until the time of her death? 21 A. No, I didn't review those. 22 Q. Is it fair for me to conclude, sitting 23 here today, that you don't have any opinions with 24 respect to whether the care provided at Akron 25 General Medical Center fell within accepted 0035 1 standards of care; is that true? 2 A. Yes, I have no opinion. 3 Q. And, likewise, do you have any opinions 4 sitting here today as to the cause of 5 Mrs. DeLorean's death? 6 A. I have no opinion on that. 7 Q. The death certificate in this case was 8 authored by a Dr. Miller. Was Dr. Miller by any 9 chance a partner in Summit County Internists in 10 2007? 11 A. No, he was not. 12 Q. Do you know Dr. Miller? 13 A. Yes, I do. 14 Q. And how do you know him or her? 15 A. He was a former member of Summit County 16 Internists. The years I can't give you, but 17 that's how I knew him. 18 Q. Would you consider yourself a social 19 friend of his currently? 20 A. No. 21 Q. Just a professional colleague who used 22 to work together? 23 A. Correct. 24 Q. When you were going through your 25 training at NEOUCOM did you ever train under 0036 1 Dr. Miller? 2 A. No, I did not. 3 Q. Did he ever train under you? 4 A. No. 5 MR. KULWICKI: Want to take a break? 6 We've been at it for an hour. 7 MR. KREMER: Yes, I can. 8 (A recess was taken.) 9 Q. Doctor, going through the orders, it 10 appears that your next order for this patient was 11 on May 4; is that correct? 12 A. Yes, that's correct. 13 Q. And those appear to be nutritional 14 supplements; is that true? 15 A. Yes. 16 Q. And, Doctor, just stepping back for a 17 second, you've got a patient whose got a good 18 prognosis, she's just had a knee replacement, 19 she's in a rehab facility like Copley Health 20 Center for rehabilitation following knee 21 replacement surgery. 22 This is not a patient that you really 23 have to see every day or even necessarily weekly 24 as long as her rehabilitation progresses 25 according to plan, true? 0037 1 A. That's correct. 2 Q. All right. And to that extent, you are 3 very dependent on the nurses to alert you to any 4 problems because, as a matter of course, you're 5 just not going to be dropping in on this patient 6 on a daily or even a frequent basis, true? 7 A. I generally see them once a week, but I 8 agree that I'm dependent on them to notify me of 9 any changes otherwise. 10 Q. The next order that I see is May 7, 11 true, from you? 12 A. Correct. 13 Q. And can you just tell me, generally 14 speaking, what that's about? 15 A. That's just to signify that the patient 16 has a follow-up appointment with her orthopaedic 17 doctor, Dr. Musgrave. 18 Q. Thank you. 19 And then you see the patient on May 8th, 20 correct? 21 A. Correct. 22 Q. And to clarify what you just told me, it 23 is the case on a patient like this of low acuity 24 or who is a rehab patient with an otherwise good 25 prognosis, that your routine would be to see them 0038 1 on a weekly basis, correct? 2 A. Correct. 3 Q. And, again, you've given us a 4 typewritten summary typed by your counsel of your 5 note from May 8 and that's set forth in Exhibit 6 2, correct? 7 A. Correct. 8 Q. Let's just go through that. This visit 9 on May 8, would that be a bedside visit -- 10 A. Yes. 11 Q. -- as opposed to over the phone? 12 A. Yes, this would be a bedside visit. 13 Q. And same with the May 1? 14 A. Yes. 15 Q. All right. And do you recall this 16 patient in your mind's eye in the sense that you 17 can visualize what she looks like and you can see 18 your interactions with her? 19 A. No. 20 Q. Based on your note from May 8, she 21 didn't appear to have any abdominal symptoms, 22 true? 23 A. Correct. 24 Q. And she didn't appear to have any GI 25 symptoms, true? 0039 1 A. Correct. 2 Q. And her prognosis at that point in time 3 remained good, true? 4 A. I would say it was good, yes. 5 Q. Now, on May 10, Dr. Ford enters an order 6 to send stool for C. Diff. Let me just ask you 7 about that. 8 In terms of when you would round on a 9 patient like Mrs. DeLorean -- and let me step 10 back further and make sure I'm using terms right. 11 Do you call it rounding when you see a rehab 12 patient like Mrs. DeLorean every week? Do you 13 call it rounding on that patient? 14 A. Yeah, I would use that term. 15 Q. Okay. And when you round on a rehab 16 patient like Mrs. DeLorean on a weekly basis, do 17 you have a routine in terms of what you do when 18 you go in to visit her? In other words, do you 19 check the previous orders? 20 A. I wouldn't say that I have a routine. 21 It depends on the patient and the acuity and my 22 level of comfort with their care. 23 Q. Would it be your routine for such a 24 patient to go in and see them first before you 25 look at any documentation or records and just ask 0040 1 them how things are going and kind of get a sense 2 of how this rehabilitation is going along? 3 A. Yeah, that's something I would do. 4 MR. KULWICKI: We can go off the record. 5 (Discussion had off record.) 6 Q. So, Doctor, between your May 8 visit 7 with Mrs. DeLorean and her transfer to Akron 8 General Medical Center, it appears that Dr. Ford 9 saw her on May 10, and I take it that you did not 10 order Dr. Ford to see the patient by way of a 11 consult or otherwise; is that correct? 12 A. That's correct, not on this date. 13 Q. Okay. And do you know under what 14 circumstances it was that Dr. Ford got involved 15 in her care or came to evaluate her for 16 gastroenteritis and make orders for a C. Diff 17 culture? 18 A. I don't know that. 19 Q. Do you know back in 2007 or subsequent 20 to that based on your interactions with Dr. Ford 21 and/or your dealings at Copley Health Center, 22 whether Dr. Ford acted like a quasi hospitalist 23 and would sometimes evaluate patients for things 24 beyond physiatry? 25 MR. PEUGEOT: Objection. 0041 1 A. I don't know the answer to that. 2 Q. Is it true that on May 10 when Dr. Ford 3 is making notations about possible 4 gastroenteritis and sending stools for C. Diff 5 culture that the nursing staff at Copley Health 6 Center did not contact you to advise you of a 7 change in this patient's condition that might 8 warrant a C. Diff culture? 9 A. I don't recall any conversation between 10 Copley and myself regarding the patient at this 11 time. 12 Q. If they had contacted you on May 10, 13 would that be charted somewhere? 14 A. I don't know their protocol. 15 Q. How about your protocol? If they had 16 contacted you and conveyed to you that this 17 patient appears to have gastroenteritis and we're 18 concerned about C. Diff, would you typically 19 chart that or would there be some record of that 20 interaction somewhere? 21 A. Not necessarily. 22 Q. In looking back at these records, were 23 you surprised to see that it was Dr. Ford as 24 opposed to you that was involved initially in 25 requesting a culture for C. Diff on this patient 0042 1 on May 10? 2 A. I don't know that I was surprised. 3 Q. Okay. And why would it be within 4 accepted norms for Dr. Ford, a physiatrist who is 5 not the admitting physician, not a member of the 6 admitting physician's service nor on call for the 7 admitting physician, to be making orders for a 8 stool culture for C. Diff? 9 A. I wasn't there, so I don't know. 10 Q. Well, the way things worked, do you 11 think you should have been called and would you 12 expect to be called under these circumstances? 13 MR. PEUGEOT: Objection. 14 MR. KREMER: Go ahead and answer. 15 A. I mean I would -- obviously as a 16 physician you would want to be called about your 17 patient, but I don't know that -- I don't know 18 the whole situation to be able to formulate an 19 opinion as to why I wasn't called. 20 Q. Would it be fair for me to conclude that 21 on May 10 at any point in time on that day, if 22 Dr. Ford or Copley Health Center had contacted 23 you or attempted to contact you, that either you 24 or someone on call for you would be available to 25 evaluate this patient for potential 0043 1 gastroenteritis and C. Diff? 2 A. It depends on the situation. 3 Q. Well, let me clarify. You have 24-hour 4 coverage, true? 5 A. Yes. 6 Q. So if somebody calls your service and 7 tells your service that one of your patients 8 needs to be evaluated for possible C. Diff, 9 either you or somebody on call for you would be 10 available to check them out for that, right? 11 A. Yes, and if not available, then they 12 would be seen in the emergency room. 13 Q. Okay, thank you. 14 Did you ever talk to Dr. Ford about why 15 he was evaluating the patient for C. Diff and not 16 advising you or your service about that? 17 A. No, I never -- 18 MR. PEUGEOT: Objection. 19 MR. KREMER: Go ahead. 20 A. No, I never talked to him about this. 21 Q. Now, his order on May 10 doesn't appear 22 to be timed, but it says, "Send a stool for C. 23 Diff," and I want to ask you some questions about 24 that. 25 First of all, do you have an 0044 1 understanding in May of 2007 how long it takes to 2 get a C. Diff culture read and reported back in 3 sort of normal turnaround? 4 A. It really depends on the situation. 5 Q. Well, let's talk about a non stat order, 6 just a routine order for a C. Diff culture. 7 How long do you expect for a lab to grow 8 that out and report back on whether it's positive 9 or negative? 10 MR. KREMER: Objection. If you know 11 what a lab will do. 12 A. I don't know how quick the turnaround 13 time for that lab would be. 14 Q. Have you ever ordered C. Diff on a 15 nonemergent basis in your practice in 2007? 16 A. Yes. 17 Q. And how long does it take for you to get 18 a report back in your experience generally 19 speaking? 20 A. In general terms I would say between one 21 to two days. 22 Q. And do you know if there's any way to 23 expedite a culture for C. Diff? 24 A. No, I don't. 25 Q. When a doctor like Dr. Ford puts an 0045 1 order on to send a stool for C. Diff, that's an 2 order for the Copley Health Center nurses to get 3 a culture to ship off for a pathology 4 interpretation, true? 5 A. Correct. 6 Q. And if the patient isn't actively 7 creating a stool, can the nursing staff get a 8 stool sample simply by a swab or some other 9 technique in the colon or rectum for a C. Diff 10 culture? 11 A. Not that I'm aware of. 12 Q. Okay. Is it your understanding that 13 there actually has to be stool in order to get a 14 C. Diff culture? 15 A. Yes. 16 Q. In a patient who has diarrhea or loose 17 stools can we agree that usually it's not a 18 problem getting a stool sample for a C. Diff 19 culture? 20 MR. OCKERMAN: Objection. 21 MR. KREMER: Objection. 22 A. It depends on the patient. The patient 23 has to cooperate with the whole procedure. 24 Sometimes they don't. 25 Q. Do you have any evidence that this 0046 1 patient did not cooperate with getting a culture 2 for C. Diff? 3 A. I don't see any evidence of that. 4 Q. The next order that I have of yours is 5 May 11, Phenergan for nausea and Imodium for 6 apparently diarrhea; is that true? 7 A. That's an order that was made and I 8 signed off on the order after the fact, but I 9 didn't actually make the order. 10 Q. Okay. Tell me, if you can, who made the 11 order and when you would have signed off on it. 12 A. I believe it was Dr. Girard who made the 13 order. 14 Q. She would have made the order on May 11? 15 A. Yes. 16 Q. And you would have signed off on it on 17 May 12th? 18 A. Well, the nursing home records just 19 state that you have to sign it within seven days 20 so I usually just pick a date within that 21 timeframe, but I don't know exactly the date that 22 I signed it. 23 Q. In the left-hand corner of that order 24 there's a date 5/12/09 and then above it there's 25 a word there. Can you interpret that? Does that 0047 1 make any sense to you? 2 MR. KREMER: Let's make sure we're 3 looking at the same note. There's no 5/12 in the 4 left-hand corner. 5 MR. KULWICKI: Right there (Indicating). 6 A. I don't know what that means. 7 Q. Okay. That's not your handwriting 8 though? 9 A. No. 10 Q. Where on here did you countersign the 11 order? 12 A. It's right there (Indicating). 13 Q. Just the check mark? 14 A. Yes. 15 Q. Okay. And why would it be that you 16 would be countersigning or -- yeah, I guess 17 countersigning an order of Dr. Girard? 18 A. Because I'm the physician of record, the 19 patient's attending physician at the nursing 20 home. 21 Q. When Dr. Girard saw your patients at 22 Copley Health Center -- well, let me try to ask 23 this the right way. 24 Would she ever do phone orders or were 25 all of her orders for Copley Health Center 0048 1 patients based on her being present at the 2 facility? 3 MR. KREMER: Okay. First off, she's 4 never present at the facility and he's testified 5 to that already. So I want to make sure that's 6 clear. 7 MR. KULWICKI: Okay. That wasn't clear. 8 Q. Go ahead. 9 MR. KREMER: Go ahead and answer. 10 A. She doesn't go to Copley Health, she 11 just does verbal orders. So that would be her 12 only orders, were orders based on what the nurses 13 tell her. 14 MR. KREMER: She's the hospitalist at 15 City, if you recall. 16 Q. What would happen in a circumstance 17 where one of your patients at Copley Health 18 Center needed to be seen by a physician and 19 Dr. Girard was on call for you, how would it take 20 place that they would be seen by a physician? 21 A. They're usually going to the emergency 22 room to get evaluated. 23 Q. What is the nearest emergency room to 24 Copley Health Center? 25 A. I don't with a hundred percent certainty 0049 1 know the answer. I would think Akron General is 2 the closest at that time. 3 Q. In the Copley chart there's an H&P and 4 at least my copy of it isn't very detailed. It 5 appears to be signed -- well, let me ask you, is 6 that your handwriting where your name appears? 7 A. My handwriting is just the notations in 8 the middle of the page and then the signature and 9 the date. 10 Q. Okay. And what did you chart there? 11 A. I wrote see hospital H&P, my progress 12 note -- or my PN, my progress note. 13 Q. And so the hospital H&P would be from 14 the surgery that she had? 15 A. Correct. 16 Q. Okay. And your progress note would be 17 the May 1 progress note that we went through? 18 A. Yes. 19 Q. Thank you. 20 We talked about Dr. Ford's May 10 note. 21 Let me try to sort of finish up here and maybe we 22 can do it quickly, I'm not sure. 23 Between May 10 and the patient's 24 discharge on May 12 -- actually between May 8 and 25 the patient's discharge on May 12, you did not 0050 1 see the patient, correct? 2 A. Correct. 3 Q. And did you have any contact with 4 anybody, whether Dr. Girard or Dr. Ford or the 5 nursing staff at Copley Health Center, regarding 6 the patient prior to her transfer to Akron 7 General? 8 A. No. 9 Q. These notes here in Exhibit 3, 10 Dr. Girard's notes, do you know what these mean? 11 I mean do you know what these are? 12 A. They're her documentation of the phone 13 calls that she got from Copley. 14 Q. So when Dr. Girard was on call and 15 covering for you for your patients at Copley 16 Health Center, she would have been dealing with 17 the patient or the nursing staff directly, not 18 involving you in any respect during that time 19 period, correct? 20 A. Correct. 21 Q. And then after the patient was 22 discharged from Copley Health Center, at some 23 point in time you would have gotten copies of 24 what we have marked as Exhibit 3, correct? 25 A. Correct. 0051 1 Q. All right. You weren't involved in any 2 respect in the decision to transfer the patient 3 to Akron General, true? 4 A. No, I was not. 5 Q. Okay. And, likewise, between May 10 and 6 her discharge on May 12 from Copley Health 7 Center, you weren't involved directly in any 8 treatment decisions during that time period, 9 true? 10 A. Correct. 11 Q. And I think I asked this, but let me 12 make sure I'm clear. Between May 10 and May 12, 13 the discharge date, you didn't have any 14 discussions with Dr. Girard or Dr. Ford regarding 15 Mrs. DeLorean, correct? 16 A. Correct. 17 Q. Were you aware of any problems with C. 18 Diff infection rates at Copley Health Center back 19 in May of 2007? 20 A. No. 21 Q. Did you have patients - and again 22 without disclosing their identity - at Copley 23 Health Center who developed C. Diff during their 24 admission to that facility? 25 A. I don't recall any. 0052 1 Q. I asked you at the time of 2 Mrs. DeLorean's admission on May 1 whether she 3 was at any increased risk for a C. Diff infection 4 over any other resident at Copley Health Center. 5 Let me ask you over the ensuing roughly 6 12 days through May 12th, did she develop any new 7 conditions that would have put her at a 8 heightened risk for that condition during that 9 admission to your knowledge? 10 A. None to my knowledge. 11 Q. Were you aware back in May of 2007 that 12 Copley Health Center had been cited by any 13 government regulatory body for its handling of or 14 preparation for prevention of C. Diff infections 15 at its facility? 16 MR. VAN WAGNER: Objection. 17 MR. KREMER: Go ahead and answer. 18 A. I don't know of any such thing that 19 you're talking about. 20 Q. Besides your role as a staff physician 21 at Copley Health Center, did you have any other 22 positions or involvement with that facility in 23 terms of being on any committees or infection 24 control committees or staff privileges -- or 25 staff committees or anything like that? 0053 1 A. No. 2 MR. KULWICKI: Okay, thank you. That's 3 all the questions I have. 4 MR. KREMER: Anybody else? 5 EXAMINATION OF LEO D. CLAVECILLA, M.D. 6 BY MR. OCKERMAN: 7 Q. Hi, Doctor. My name is Michael 8 Ockerman. I'm here on behalf of Dr. Miller. 9 Did you have any conversations that you 10 recall with Dr. Miller about this patient? 11 A. No. 12 MR. OCKERMAN: Thank you. No further 13 questions. 14 MR. KREMER: Anybody else? 15 MR. PEUGEOT: I don't have any questions 16 for you, Dr. Clavecilla. Thanks. 17 EXAMINATION OF LEO D. CLAVECILLA, M.D. 18 BY MR. KULWICKI: 19 Q. Let me just follow up on that. I should 20 have asked this. 21 In terms of after the patient was 22 transferred to Akron General, you didn't have any 23 further involvement with her in any respect and 24 no physician called you, no nursing staff called 25 you to apprise you of her status after her 0054 1 transfer, correct? 2 A. Correct. 3 MR. KULWICKI: All right. 4 MR. KREMER: Just so the record is clear 5 though, when he came in to see her the following 6 Tuesday, she wasn't there. So you might want to 7 ask him -- 8 MR. KULWICKI: Okay. 9 Q. So you came in on May 15 -- 10 A. 15, yes. 11 Q. Part of your usual rounds? 12 A. Yes. 13 Q. And who did you talk to when you came 14 in? 15 A. Well, the nurses told me that she was 16 sent to the hospital but I didn't know -- I 17 really didn't even know what hospital she was 18 sent to. I just knew she went to the hospital. 19 I didn't even know what reason she was sent to 20 the hospital. 21 Q. Okay. Did you learn about her death? 22 A. I think it was -- 23 MR. KREMER: On May 15th or later? 24 MR. KULWICKI: Ever. 25 A. Down the road I knew that she had died. 0055 1 Q. When did you first find out about that? 2 A. I don't remember the exact day but it 3 was sometime later in May. 4 Q. And who told you about it? 5 A. If I recall, it was Copley Health 6 Center. 7 Q. Do you know who it was that you talked 8 to? 9 A. No, I don't know specifically. 10 Q. Do they have a peer review committee at 11 Copley Health Center that you're aware of? 12 A. I wouldn't know. I don't know that. 13 Q. Do you know if there was any 14 investigation into the circumstances of 15 Mrs. DeLorean's death? 16 A. I don't know the answer to that. 17 Q. Well, were you questioned about any of 18 your involvement in her care by someone that was 19 investigating the circumstances of her death? 20 A. No. 21 Q. Why do you think someone from Copley 22 Health Center told you about her death? 23 A. I think they were just updating me on 24 her. 25 Q. Okay. I know physicians can be 0056 1 protective of their relationships with their 2 patients in a setting like this. You weren't 3 upset at all that no one told you that your 4 patient was being transferred to an outside 5 hospital? 6 A. It frequently happens. I don't know 7 that "upset" would be the word. I mean I wasn't 8 on call so they -- I mean they just told me when 9 they saw me the next day or a couple of days 10 after that. 11 Q. Okay. 12 MR. KULWICKI: That's all I have. Thank 13 you. 14 MR. KREMER: We'll read. 15 16 (Deposition concluded at 3:36 p.m.) 17 - - - - - 18 19 20 21 22 23 24 25 0057 1 CERTIFICATE 2 3 The State of Ohio, ) 4 ) SS: 5 County of Cuyahoga. ) 6 7 I, Christine Leisure, a Notary Public within and for the State of Ohio, duly 8 commissioned and qualified, do hereby certify that the within named witness, LEO D. CLAVECILLA, 9 M.D., was by me first duly sworn to testify the truth, the whole truth and nothing but the truth 10 in the cause aforesaid; that the testimony then given by the above-referenced witness was by me 11 reduced to stenotypy in the presence of said witness; afterwards transcribed, and that the 12 foregoing is a true and correct transcription of the testimony so given by the above-referenced 13 witness. 14 I do further certify that this deposition was taken at the time and place in the 15 foregoing caption specified and was completed without adjournment. I do further certify that I 16 am not a relative, counsel or attorney for either party, or otherwise interested in the event of 17 this action. 18 IN WITNESS WHEREOF, I have hereunto set my hand and affixed my seal of office at 19 Cleveland, Ohio, on this _______ day of ___________________________ , 2010. 20 21 22 23 _______________________________________ Christine Leisure, Notary Public 24 within and for the State of Ohio 25 My commission expires April 21, 2012 0058 1 AFFIDAVIT OF NOTARY PUBLIC 2 3 The State of Ohio, ) 4 ) SS: 5 County of Cuyahoga. ) 6 7 Before me, a Notary Public in and for said 8 County and State, personally appeared LEO D. 9 CLAVECILLA, M.D., who acknowledged that he did 10 read his transcript in the above-captioned 11 matter, listed any necessary corrections on the 12 accompanying errata sheet, and did sign the 13 foregoing sworn statement and that the same is 14 his free act and deed. 15 In TESTIMONY WHEREOF, I have hereunto 16 affixed my name and official seal at this______ 17 day of _____________________ A.D. 2010. 18 19 20 ________________________ 21 Notary Public 22 23 _________________________ 24 My Commission Expires: 25 0059 1 SIGNATURE PAGE 2 3 Re: Charles DeLorean, Individually and as 4 Executor of the Estate of Shirley 5 DeLorean, Deceased vs. Copley Health 6 Center, et al. 7 Case Number: CV-2009-05-3844 8 Deponent: LEO D. CLAVECILLA, M.D. 9 Deposition Date: January 20, 2010 10 11 To the Reporter: 12 13 I have read the entire transcript of my 14 Deposition taken in the captioned matter or the 15 same has been read to me. I request that the 16 following changes be entered upon the record for 17 the reasons indicated. I have signed my name to 18 the Errata Sheet and the appropriate Certificate 19 and authorize you to attach both to the original 20 transcript. 21 22 23 24 _________________________________ 25 LEO D. CLAVECILLA, M.D. 0060 1 ERRATA SHEET 2 Page Line Change 3 _____ _____ _________________________________ 4 _____ _____ _________________________________ 5 _____ _____ _________________________________ 6 _____ _____ _________________________________ 7 _____ _____ _________________________________ 8 _____ _____ _________________________________ 9 _____ _____ _________________________________ 10 _____ _____ _________________________________ 11 _____ _____ _________________________________ 12 _____ _____ _________________________________ 13 _____ _____ _________________________________ 14 _____ _____ _________________________________ 15 _____ _____ _________________________________ 16 _____ _____ _________________________________ 17 _____ _____ _________________________________ 18 _____ _____ _________________________________ 19 _____ _____ _________________________________ 20 _____ _____ _________________________________ 21 _____ _____ _________________________________ 22 _____ _____ _________________________________ 23 _____ _____ _________________________________ 24 _____ NO CHANGES 25 Signature:_________________________ Date:________