Gracy Woods I Nursing Home v. Martha Mahan, as the Representative of the Estate of Mary Rivera

ACCEPTED
03-15-00596-CV
8332526
THIRD COURT OF APPEALS
AUSTIN, TEXAS
12/21/2015 4:56:48 PM
JEFFREY D. KYLE
CLERK
NO. 03-15-00596-CV
FILED IN
IN THE THIRD COURT OF APPEALS 3rd COURT OF APPEALS
AUSTIN, TEXAS AUSTIN, TEXAS
12/21/2015 4:56:48 PM
JEFFREY D. KYLE
Clerk
GRACY WOODS I NURSING HOME
APPELLANT
v.
MARTHA MAHAN, AS THE REPRESENTATIVE
OF THE ESTATE OF MARY RIVERA
APPELLEE
ON INTERLOCUTORY APPEAL FROM
THE 250TH JUDICIAL DISTRICT,' TRAVIS COUNTY, TEXAS
APPELLEE'S BRIEF
Jack Modesett, III
Texas Bar No. 14244337
Walter V. Williatns
Texas Bar No. 21584800
MODESETTWILLIAMS, PLLC
515 Congress Avenue, Suite 1650
Austin, Texas 78701
512-472-6097- Telephone
512-481-0130- Telecopier
j ack@modesettlaw .cotn
ATTORNEYS FOR APPELLEE
ORAL ARGUMENT REQUESTED
IDENTITIES OF PARTIES AND COUNSEL
Pursuant to Tex. R. App. P. 38.1(a), Appellee cetiifies that the following is a
complete list of all parties to this litigation and the names and addresses of all
counsel.
Party Appellate Counsel Trial Counsel
Grace Woods I E1nily J. Davenpoti Emily J. Davenport
Nursing Home, Janice Byington Janice Byington
Appellant Reed, Claymon, Meeker & Reed, Claymon, Meeker &
Hargett, PLLC Hargett, PLLC
5608 Parkcrest Dr. Suite 5608 Parkcrest Dr. Suite
200 200
Austin, Texas 78731 Austin, Texas 78731
edavenport@rcmhlaw.com edavenport@rcmhlaw.com
jbyington@rcmhlaw.com jbyington@rcmhlaw.com
Martha Mahan, as Jack Modesett, III Jack Modesett, III
the Representative Walter V. Williams Walter V. Williams
of the Estate of ModesettWilliams, PLLC ModesettWilliams, PLLC
Mary Rivera, 515 Congress Ave., 515 Congress Ave.,
Appellee Suite 1650 Suite 1650
Austin, Texas 78701 Austin, Texas 78701
jack@modesettlaw.com j ack@modesettlaw.com
walter@modwill.com walter@modwill.com
1
TABLE OF CONTENTS
IDENTITY OF PARTIES AND COUNSEL .................................................... i
TABLE OF CONTENTS ................................................................................ ii
TABLE OF AUTHORITIES ......................................................... .iv
ABBREVIATIONS OF RECORD REFERENCES ......................................... vi
APPENDIX ..................................................................................................... vii
STATEMENT OF THE CASE ....................................................................... viii
COURSE OF PROCEEDINGS AND DISPOSITION ................................... viii
STATEMENTREGARDINGORALARGUMENT........................................ 1
STATEMENT OF JURISDICTION ................................................................. 1
ISSUES PRESENTED ...................................................................................... 1
STATEMENT OF FACTS ................................................................................ 2
SUMMARY OF ARGUMENT ......................................................................... 4
ARGUMENT AND AUTHORITIES ................................................................ 5
I. STANDARD OF REVIEW ................................................................. 5
II. DR. LIPSON IS QUALIFIED ............................................................. 5
A. Summary ofDr. Lipson's Qualifications ............................... 6
B. Dr. Lipson is Qualified to Offer Causation Opinion ............. 9
C. Dr. Lipson is Qualified to Offer Opinions on
Standard of Care and Breach ................................................ 18
11
III. THE REPORT IS A GOOD FAITH EFFORT
TO COMPLY WITH CHAPTER 74 ................................................. 21
A. Summary of Dr. Lipson's Report ........................................ 21
B. The Report is Sufficient as to Breach and Causation ......... 28
CONCLUSION AND PRAYER ..................................................................... 32
CERTIFICATE OF SERVICE ....................................................................... 33
CERTIFICATE OF COMPLIANCE .............................................................. 34
111
NO. 03-15-00596-CV
IN THE THIRD COURT OF APPEALS
AUSTIN, TEXAS
GRACY WOODS I NURSING HOME
APPELLANT
v.
MARTHA MAHAN, AS THE REPRESENTATIVE
OF THE ESTATE OF MARY RIVERA
APPELLEE
ON INTERLOCUTORY APPEAL FROM
THE 250TH JUDICIAL DISTRICT, TRAVIS COUNTY, TEXAS
APPELLEE'S BRIEF
Jack Modesett, III
Texas Bar No. 14244337
Walter V. Williatns
Texas Bar No. 21584800
MODESETTWILLIAMS, PLLC
515 Congress Avenue, Suite 1650
Austin, Texas 78701
512-4 72-6097- Telephone
512-481-0130- Telecopier
jack@tnodesettlaw.cotn
ATTORNEYS FOR APPELLEE
ORAL ARGUMENT REQUESTED
whether S.B. had been raped. Timberlawn's arguments are best
summarized in the conclusion and prayer set forth in its brief:
[Levine] did not and/ or could not express an opinion, based
on his education, training or experience, that [S.B.] was
sexually assaulted or raped. [S.B.' s] expert did not nor could
not articulate facts to support any opinion that
[Timberlawn' s] alleged breaches in the standard of care
proximately caused [S.B. 's] alleged sexual assault or rape.
[S.B. 's] expert has not shown himself to be qualified to
render an opinion that [S.B.] was sexually assaulted or
raped or that the alleged breaches in the standard of care
proximately caused [S.B. 's] sexual assault or rape.
Thus, the premise of Timberlawn's arguments is that unless
S.B. can present the report of a qualified expert opining that S.B.
was actually raped, her expert report( s) cannot identify the
alleged causal relationship between Timberlawn' s actions or
omissions and S.B.' s alleged injuries, as required by section
74.351(r)(6). We reject this premise.
In some healthcare liability claims, the ((injury, harm, or
damages claimed" flow from the existence of a medical condition
that itself resulted from the breach of the applicable standard of
care. In such cases, identifying the causal relationship between the
alleged breach of the standard of care and the resulting harm
involves not only an explanation as to how the standard of care
was breached, but also how the breach gave rise to the new,
deleterious medical condition. Similarly, other healthcare liability
claims may allege that a breach of the applicable standard of care
exacerbated a pre-existing medical condition, or hindered or
prevented the effective treatment of such a condition. Identifying
the ((breach/injury" causal relationship in these cases may well
require an expert to opine as to the existence, extent, and
prognosis of the pre-existing medical condition, as well as how the
alleged breach of the standard of care aggravated such a
condition, impeded or prohibited its treatment, and otherwise
affected the patient's prognosis.
However, S.B. 's claim is different. S.B. alleges that, as a result
of Timberlawn's failure to meet the applicable standards of care
11
ABBREVIATIONS AND RECORD REFERENCES
Abbreviations:
Appellee will be referred to as "Appellee", "Mahan" or "Ms. Rivera."
Appellant, Gracy Woods I Nursing Home will be referred to as
"Appellant" or "Gracy Woods."
Record References:
References to the Clerk's Record are in the form of "CR "
References to the Clerk's Supplemental Record are in the form of"Supp. CR_."
References to the Reporter's Record are in the form of"RR_."
References to the Appendix items attached to the Brief are in the form of
"App._."
Vl
APPENDIX
Report of Loren Lipson, M.D. with exhibits 1 .......................................... Appendix 1
1
Appellant's Appendix 5, "Report of Loren Lipson, M.D." does not contain all of Dr. Lipson's
referenced exhibits.
Vll
STATEMENT OF THE CASE
Appellee is satisfied with Appellant's statement of the case. Tex. R. App. P.
38.2(a)(l )(B).
COURSE OF THE PROCEEDINGS AND DISPOSITION
Appellee is satisfied with Appellant's Course of Proceedings. Tex. R. App.
P. 38.2(a)(l)(B).
Vlll
NO. 03-15-00596-CV
IN THE THIRD COURT OF APPEALS
AUSTIN, TEXAS
GRACY WOODS I NURSING HOME
APPELLANT
v.
MARTHA MAHAN, AS THE REPRESENTATIVE
OF THE ESTATE OF MARY RIVERA
APPELLEE
ON INTERLOCUTORY APPEAL FROM
THE 250TH JUDICIAL DISTRICT, TRAVIS COUNTY, TEXAS
APPELLEE'S BRIEF
Jack Modesett, III
Texas Bar No. 14244337
Walter V. Williatns
Texas Bar No. 21584800
MODESETTWILLIAMS, PLLC
515 Congress Avenue, Suite 1650
Austin, Texas 78701
512-4 72-6097- Telephone
512-481-0130- Telecopier
jack@tnodesettlaw.cotn
ATTORNEYS FOR APPELLEE
ORAL ARGUMENT REQUESTED
STATEMENT REGARDING ORAL ARGUMENT
Appellee requests oral argument pursuant to TEX. R. APr. P. 39.1 and
respectfully submits that oral argument would aid the Court in determining the
legal and factual issues presented in this appeal.
STATEMENT OF JURISDICTION
Appellee is satisfied with Appellant's Statement of Jurisdiction. Tex. R.
App. P. 38.2(a)(1)(B).
ISSUES PRESENTED
Appellee is satisfied with Appellant's statement of the Issues Presented.
Tex. R. App. P. 38.2(a)(1)(B).
1
STATEMENT OF FACTS
On November 8, 2013, 78 year-old demented Mary Rivera was sexually
assaulted in her room, while a resident at Appellant's nursing home facility. (CR
17.) The rape occurred after regularly scheduled events at the nursing home during
which alcohol was served. (CR 17.) Mrs. Rivera's daughter, Martha Mahan, had
previously complained to the facility that younger male residents had behaved
inappropriately towards Mrs. Rivera. Appellant took no action. (CR 17.)
Early in the morning of November 9, 2013, Mahan went to visit her mother
in the nursing home. Mrs. Rivera was distressed. Mahan noted broken glass on
the floor of her room. When she took her mother to the bathroom, Mrs. Rivera
attempted to urinate standing up, which was unusual. Mahan also found a wad of
bloody rags in Mrs. Rivera's trashcan. (CR 17-18.) Mahan showed this evidence
to nursing home employees, who destroyed it. (CR 17-18.) Ultimately, Mrs.
Rivera was taken to St. David's Medical Center where a Sexual Assault Nurse
Examiner (SANE) performed a post-rape examination. (CR 18, 92, 100.) This
SANE nurse found bruising to posterior fourchette and periurethral areas of Mrs.
Rivera's vulva as well as bruising on her posterior vaginal wall. (CR 18, 94, 100.)
According to the SANE nurse, this definitively indicated penetration of the female
sexual organ. (CR 18, 94, 100.)
2
j. Unive~·sity of Southe111 California S¢l:Cool of Medicine~ Los
Angeles? California; Chie~ Dlvlsion of Gerlatdo Medicine· jn the
DepartJ;ne11t ofMedlcinej January 19&4- 2005.
k. University of Southern Califotnhh Los Angeles~ Califot:nia~
Associate Professot of' Gerontology, L~onard Davis School of
Gerontology~ Ethel Percy An.drus Gerontology Center~ Januaty
1984 ,_ Septetnber 2006.
1. University of Southern CalifomiaJ Los Angeles,· California;
Assooiate Professor cf Clinical Pharmacy, U.S.C7 Sohool of
Pharmacy~ October 1989 .... September 2006~
m. Los Angeles County/University of Southe:n1 California Medical
Center~ Los Angeles, California; Staff Physloia11 in Medioinej
(Oeriatdo Medicine), 1984..2004.
u, Sabbatioal Leave> Harvard Medical School~ Boston,
Massachusetts~ Dlvisio11 of Agingt John A. Hartfol'd Seniol'
Scholar in Gerlatdc Medicine-~ 19 84- 1985.
o. B:dghant & Women~s Hospital, Boston,. Massaohusetts; Clinioal
Fellow in Medioine (Oer!atrio Medicine)~ 1984 ..1985.
p 4 :Beth Israel I-iospital~ Boston~ Massachusetts; Clinical Fel~ow in
Medicine (Ge:dai1'lc Ivfedioine), 1984 .... 1935
q. University of Southern California, Los Angeles~ California; Senior
Research Associate; Getontology Research Institute; Ethel Percy
Andrus Gerontology Cente1~ 1985 .-.. 1989.
r. University of Southern. California., Los Angeles~ California; Fellow
Institute of Advance Study, Ethel Percy Andtus Gerontology
Center, 19B5 . . . 1987.
$. University of Southern California University Hospital, Los
A11geles~ California;
Chief of Geriatric Medicine~ 1991.. 2005
University of Southern California . . . School of DentistJ:y -
Associate Professor of Medical Dentistry and Public HealthJ 1994
i
-September 2006.
I
u. Unlversity of Sottthem California~ School of Independent Health
_Professionals - Associate Professor o:f Oocupa.!ional Science and
Oooupational Therapy~ 1998~ S~ptember 2006.
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APPENDIX 1
SUMMARY OF THE ARGUMENT
A smattering of citations to black letter law belie what Appellant's Brief
really appears to be: a cut-and-paste boilerplate appeal of an adverse ruling on a
Section 74.351 motion to dismiss. Appellant challenges the qualifications of an
expert eminently qualified on nursing home healthcare, and argues that a detailed
and comprehensive export report somehow fails to meet the "good faith" standard.
Appellant largely ignores both the level of detail of Dr. Lipson's report, as
well as his unassailable CV. Dr. Lipson is the expert that the U.S. Department of
Justice, U.S. Department of Health and Human Services, the Office of the
Inspector General, and the states of Alaska, California, and New Mexico have
turned to regarding geriatric medicine, elder abuse, and long term care of the
elderly. He is quite possibly the most qualified expert in the country on these
issues. His report details his background, the facts and documents that form the
basis of his opinion, the applicable standard of care, specifically what Appellant
should have done but failed to do, breach, causation, and the resulting injury. His
report certainly meets the "good faith" standard, as the trial court correctly
determined. The trial court's determination was not an abuse of discretion-- it was
in no way "an arbitrary or unreasonable [act] without reference to any guiding rules
or principles" -- and it should be affirmed.
4
ARGUMENT AND AUTHORITIES
I. STANDARD OF REVIEW
A trial court's order granting or denying a motion to dismiss filed under
Section 74.351 of the Texas Civil Practices and Remedies Code is reviewed under
an abuse of discretion standard. Hendrick Med. Ctr. v. Texas Podiatric Med. Ass'n,
392 S.W.3d 294, 296-97 (Tex. App.-Eastland 2012, no pet.); Bowie Memorial
Hasp. v. Wright, 79 S.W.3d 48, 52 (Tex. 2002); Am. Transitional Care Ctrs. v.
Palacios, 46 S.W.3d 873, 875, 877-78 (Tex. 2001 ). An abuse of discretion occurs
if the court acts in an arbitrary or unreasonable manner without reference to any
guiding rules or principles. Wright, 79 S.W.3d at 52. A court of appeals may not
substitute its own judgment for the trial court's judgment. !d.
II. DR. LIPSON IS QUALIFIED
Appellant complains that Dr. Lipson is not qualified under TEx. CN. PRAC.
& REM. CODE § 74.402 (be a healthcare provider or consultant in "same field" as a
defendant, knowledge of the standard of care and qualified on basis of training or
experience) and § 74.403 (i.e., be a physician and be otherwise qualified).
Dr. Lipson is a nationally prominent physician, professor, lecturer and
consultant in geriatric medicine, abuse of the elderly and related topics. Dr.
Lipson's qualifications are extensive; he may be the most qualified expert in the
country and is the one the U.S. Department of Justice and the U.S. Department of
5
Health and Human Services retain when they need expertise in this area. He is
qualified under both TEX. CIV. PRAC. & REM. CODE §74.402 and §74.403.
A. SUMMARY OF DR. LIPSON'S QUALIFICATIONS
1. Educational Background in Geriatric Medicine
Dr. Lipson is a graduate of UCLA and The John Hopkins University School
of Medicine. (See Dr. Lipson's CV, CR 24-67 1). Dr. Lipson did his internship and
residency at The John Hopkins Hospital. Dr. Lipson has fellowships from Harvard
(Geriatric Medicine), Beth Israel Hospital (Gerontology), Brigham-Women's
Hospital (Gerontology), Hebrew Rehabilitation Center (Geriatric Medicine) and
John Hopkins (Clinical Fellow) among others. Id.
2. Certification in Geriatric Medicine
He is boarded in Internal Medicine and Quality Assurance and Utilization
Review and holds a Certificate of Expertise in Geriatric Medicine from the
American Board of Internal Medicine. Quality assurance is the study and
implementation of improvements to care provided, in Dr. Lipson's case, for the
elder population in both the nursing home and hospital setting. I d.
3. Twenty-Seven Academic Appointments in Geriatric Medicine
Dr. Lipson has received twenty-seven academic appointments to include
John Hopkins, Harvard Medical School (Scholar Geriatric Medicine),
1
Appendix 1 to Appellee's Brief.
6
Massachusetts General Hospital, USC (Associate Professor-Geriatric Medicine),
USC (Chief-Division of Geriatric Medicine), Brigham-Women's Hospital
(Geriatric Medicine), Beth Israel (Geriatric Medicine), USC (Gerontology
Research Institute) and University of Alaska (Geriatrics). His teaching
responsibilities include USC-Fellowship Program-Geriatric Medicine, USC-
Development and Improvement of Geriatric Medical Curriculum, USC-Steering
Committee-Pacific Geriatric Education Center, and USC-Ethel Percy Andrus
Gerontology-Director and lecturer. His teaching responsibilities at the University
of Alaska also include Director-Care of Elderly, Co-Director in Geriatric
Education and Faculty Consultant to Geriatric residents. !d.
4. Geriatric Administrative Positions, Including Directorships
Dr. Lipson has further served in numerous administrative positions to
include Chief of Division Geriatric Medicine, Senior Staff Physician-Geriatric
Programs, Director of the USC Ambulatory Health Center Japanese Retirement
Homes, Director-Geriatric Medicine VA Clinic, Director of USC Teaching
Nursing Home Program, Director of Senior Cancer Center, Director of Senior Care
Program-USC, Co-Director-Adult Protective Team-Geriatric Medicine Program-
LAC/USC, Medical Director-Alaska Geriatric Education Center and Medical
Director National Resource Center for Studies in Native American, Alaskans and
Hawaiian Elders, University of Alaska. !d.
7
5. Geriatric Consultancies: Boards, Program Development
His public service includes Consultant-Geriatric Medicine-State of
Alaska, Board of Directors, California Association of Medical Directors, and Task
Force on Elder Abuse, City of Los Angeles. I d.
Dr. Lipson's consultancies include Geriatric Medicine-Silverado Senior
Living Centers, Geriatric Medicine-Glendale Adventist Medical Center, Geriatric
Program Development-Bay Shores Medical Group, Geriatric Program
Development-San Dimas Community Hospital, Geriatric Program Development
and Long Term Care-The Motion Picture & Television Home, Long Term &
Geriatric Medicine- State of Califo1nia, Elder Abuse & Geriatric Medicine -
State of California, Office of the Attorney General, Long Term Care, Elder
Abuse and Geriatric Medicine-State of California-Office of the Attorney
General - Medicaid Fraud, Geriatric Medicine and Elder Abuse-State of New
Mexico, Geriatric Medicine and Elder Abuse-United States of America-
Department of Justice, and Long Term Care, Geriatric Medicine and Elder
Abuse-United States of America-Department of Health and Human Services-
Office of the Inspector General. I d.
6. Lectures on Elder Abuse: Washington U; Harvard; Stanford;
Yale; Brown; Baylor, etc.
Dr. Lipson has lectured all over the country on issues involving geriatrics,
long term care, and elder abuse. The lectures include Washington University,
8
Harvard, Yale, the University of New Brunswick, the University of Florida,
Stanford, University of Pittsburgh, University of Hawaii, University of California
San Francisco, Brown, University of Nevada, University of Guam, ICansas
University, Baylor, Chicago Medical College, University of Oklahoma, University
of Colorado, University of l(entucky, University of Utah, Southern Illinois
Medical School, Allegheny Medical School, University of Arizona as well as many
others. ld.
Dr. Lipson has published numerous peer-reviewed articles, book chapters
and monograms dealing with the care of the elderly. ld.
B. DR. LIPSON IS QUALIFIED TO OFFER CAUSATION
OPINION
1. Dr. Lipson Does Not Need to "Diagnose" the Sexual Assault
Mrs. Rivera's daughter found her crying and confused, in pain, with a pile of
bloodied tissues in the trashcan and broken Christmas decorations on the floor of
her room. (CR 73-74.) Ms. Mahan noticed her mother appeared to be in pain and
urinated while standing up, which was very unusual, and ultimately took her to St.
David's Hospital. (CR 74.) Mrs. Rivera was examined by a Sexual Assault Nurse
Examiner (SANE nurse), who found specific evidence of vaginal trauma; she had
bruising to both the front of the vagina as well as the posterior of the vaginal wall.
(CR 98, 100.) The SANE nurse concluded that her exam "definitively indicate[s]
9
penetration of the female sexual organ." (CR 100.) She recommended that Mrs.
Rivera have an HIV and other STD tests conducted. (CR 78.)
Appellant strangely treats sexual assault as a disease to be diagnosed and
treated. Appellant argues that Dr. Lipson is not qualified to issue opinions about
whether Mrs. Rivera was sexually assaulted because his report does not show "that
he has ever examined a patient for sexual assault, diagnosed a patient with sexual
assault, or treated a patient for sexual assault." (Appellant's Br. at 12.)
In a health care liability case resulting from a patient's sexual assault by
another patient while under the defendant's care, there is no requirement that
the expert opine that the victim was sexually assaulted. UHS of Timber/awn,
Inc. v. S.B. ex rei. A.B., 281 S.W.3d 207, 211-13 (Tex. App.-Dallas 2009, pet.
denied). In UHS of Timber/awn, Inc., the Dallas Court of Appeals rejected the
identical argument Appellant makes - nearly verbatim - here.
Timberlawn asserts Levine's revised report and curriculum
vitae do not establish he is qualified to render an opinion as to
causation, and the revised report is inadequate and conclusory as
to that issue. These arguments all flow from Timberlawn's
position disputing whether S.B. was, in fact, raped.
Timberlawn contends that, absent a statement in Levine's
revised report (presumably based on all reasonable medical
probability) that S.B. was in fact raped, Levine's revised report
fails to identify the {(causal relationship between [Timberlawn' s
actions] and the injury, harm, or damages claimed." See TEX. CIV.
PRAC. & REM.CODE ANN.§ 74.351(r)(6). Timberlawn argues Levine
did not opine, nor did he show he was qualified to opine, as to
10
1/1. Normal Aging vs. Disease. Symposhtm on Geriatric Medicine. Annenberg
Centerl Rancho Mirage. Californi~ 2/202.
172. Medications in the Eldedy, Memorial Lecture Series, Outpatient
Department, Veterans Administration~ Los Angeles, California, 2/26/0'2.
173. Life Style Redesign in Elder Ca:ro. zua Annual North- Ame.dcan Forum on
Women's Health! Anah~im~ California} 3/1/02.
174. Dementia in the Elderly. Memorial Looture Series, Outpatient Department~
Vetet·ana Adminfstra.tto:n, Los Angeles:. California; ::l/12/02.
175. Diabetes in the Elderly. Endocrine Orand Rounds, Harbor General
Hospital, Torranoe, California, 4/l/0/2.
176. Medications in the Elderly. Mtllll..lecture series~ Co1111'riissloh on Aging~
I" ,,
~f ' • ., .. State of Alaska, Anchorage and Fairbanks,' 4112/02.. 4/26/02.
177. Treatment (!f l)aiti in. the. Elderly. Care o£ the Eldei'ly Cortfereno~\
Univel'sity of Alaska~ Sitka Sitka, Alnska~ 9/19/02.
178. Treatment of Cardiovascular Risk Factors in the Elderly. Care of the
Eldetly Conference~ University of Alaska> SitkaJ. Alaska 9/19/02.
179. Special Issues in Long Tenn Cat·~, Assessment and Evaluation of the
Artcho:rage Plorteers' Home; Anchorage~ Alaska, 12!10~12/14/02.
180. Identification and Treatment of Cardiovascular Risk Factors in 'lhe Elderly
- A symposium Montgomery Cardiology · Programs. Montgotnety~
Alabama> 3/2l/03~
I ••• un. Me4ications in the Eldel'ly, Multi..lecture serlesj Connnission,on Aging>
State of Alask~ Anchotage and Fairbanksi 4/23 ..4/26/03.
182. Assess1nent of Mental Competency and Discussion of an Elder Abuse
Case. Symposium on Eldet Abuse) Departtnent of Justice .... Bureau of
Medi~Cal Praud and Bldet Abus`` Squaw Valley; California, 5/27~-5/30/03.
183. Medications in the Elderly. Multi-lecture series, Commission on. Aging,
State of Alt'\ska;,Juneau and K6tchU~JUl, 6127-6129i03.
i84. De1nentla in the Elderly: Medications in the Elderly. Csx~ of the Elderly
Conference~ University ofAlask~ Sitk~ Sitka~ Alask~ 9/18w9/19/03.
18S. Demerttiay Gerlatdc Symposium:.... St. Mmy~s Hospital and Soan, tong
Beach, CaUfonlia; 10/4/03. i
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APPENDIX 1
51
I
relevant to its treatment of her, she was raped. Rape is not a
medical condition. It is an assault. Moreover, rape may-or may
not-be accompanied by medically ascertainable evidence of
physical trauma, or even physical evidence that it occurred.
Medical evidence of an alleged sexual assault is not required
even in criminal prosecutions; the rule in Texas is that
((penetration may be proven by circumstantial evidence." See
Villalon v. State, 791 S.W.2d 130, 133 (Tex.Crim.App.1990) ....
We decline to hold that in order to identify the causal
relationship between Timberlawn 's actions and S.B. 's claimed
injury, see TEX. CIV. PRAC. & REM.CODE ANN.§ 74.351(r)(6), she was
required to proffer an expert report opining that she was in
fact raped. Thus we reject Timberlawn's arguments that the trial
court erred in not dismissing S.B.'s claim because: (1) Levine's
report did not show him to be qualified to render an opinion on
whether S.B. was in fact raped; and (2) because Levine's report
did not render an opinion on that issue.
UHS of Timber/awn, Inc. v. S.B. ex rei. A.B., 281 S.W.3d 207,211-13 (Tex. App.-
Dallas 2009, pet. denied) (emphasis added).
Sexual assault is not a disease, and this is a case about negligence in nursing
home health care, not gynecology; Mrs. Rivera was injured as a result of
Appellant's multiple failures in protecting her from sexual assault. The Court's
inquiry should focus on whether the expert has the "knowledge, skill, experience,
training or education regarding the specific issue before the Court which would
qualify the expert to opine on a particular subject." Tenet Hasp. Ltd. v. Love) 347
S.W.3d 743, 749-50 (Tex. App.- El Paso 2011, no pet.) The specific issue before
the court is the nursing home's breach of its duty to protect its patient from sexual
assault, despite being put on notice of a prior sexual assault and inappropriate
12
behavior towards Mrs. Rivera by males at the facility. See Diversicare Gen.
PartnerJ Inc. v. Rubio, 185 S.W.3d 842, 850 (Tex. 2005) (involving sexual assault
by another resident; nursing home is obligated to protect "the patient population
from harming themselves and each other").
2. Dr. Lipson Properly Relies on the Medical Records and
Exa1nination by Sexual Assault Nurse Examiner
Appellant argues that Dr. Lipson is not qualified to offer causation opinions
under TEX. Crv. PRAc. & REM. CODE § 74.403(a). Under Section 74.403(a), "a
person may qualify as an expert witness on the issue of causal relationship between
the alleged departure from accepted standards of care and the injury, harm, or
damages claimed only if the person is a physician and is otherwise qualified to
render opinions on that causal relationship under the Texas Rules of Evidence."
Dr. Lipson is a physician. CR 15.2 He is also qualified to render opinions on that
causal relationship under the Texas Rules ofEvidence. 3
Appellant suggests that Dr. Lipson may not rely upon the SANE nurse report
or the medical records in detennining that Mrs. Rivera was sexually assaulted. But
Dr. Lipson properly relies on medical records available to him. The assault has
been copiously documented by the SANE nurse and a doctor and reviewed by Dr.
2
Appendix 1 to Appellee's Brief.
3
See generally Tex. R. Evid. 702 (a qualified witness may testify in the form of an opinion if it
will help the trier of fact to understand the evidence or to determine a fact in issue) and 703 (an
expeti may base an opinion on facts or data that the expert has been made aware of, reviewed, or
personally observed).
13
Lipson. (See CR 78-100.) The SANE nurse found bruising to both the front of the
vagina as well as the posterior of the vaginal wall. (CR 98, 100.) The nurse stated
that the findings "definitively indicate penetration of the female sexual organ."
(CR 100.) In arguing that Dr. Lipson is unqualified, Appellant does not even
mention the SANE nurse report or her declaration.
Appellant's argument that Dr. Lipson cannot rely on the SANE examination
or other medical records ignores TEX. R. EVID. 703 and strains credulity. It is like
saying a surgeon could not rely on a radiologist's reading of an MRI to provide the
opinion that a patient had a brain tumor. Experts can undoubtedly rely on medical
records (and even hearsay) in formulating an expert report. See TEX. R. EVID. 703
(expert may base opinion on facts or data that the expert has been made aware of,
reviewed, or personally observed, including facts or data that would not normally
be admissible so long as experts in that field would reasonably rely on those kinds
of facts or data). As the court noted in Palacios,
[A] plaintiff need not present evidence in the report as if it were
actually litigating the merits. The report can be informal in that the
information in the report does not have to meet the same requirements
as the evidence offered in a summary-judgment proceeding or at trial.
See, e.g., Tex. R. Civ. P. 166(f) (setting out the requirements for the
form and content of affidavits offered as summary-judgment proof);
Tex.R. Evid. 802 (stating that most hearsay is inadmissible).
46 S.W.3d at 879.
14
Expert witnesses must be able to rely upon the medical records to render
op1n1on. Expert witnesses may rely on witness statements. If one follows
Appellant's argument to its logical conclusion, experts could not rely on the
nursing home chart (made mostly by nurses), the medical records (made by nurses
and treating doctors whose resumes are not available). This is not the law in
Texas.
A reading of the statute and the relevant case law make it clear that the
limitations of § 74.402 and § 74.403 do not apply to the underlying information
reviewed by experts, such as the medical records or SANE nurse examination.
Indeed, the Texas Supreme Cou1i has expressly stated that expert reports would
likely be inadequate if they did not look at the medical records. See Loaisiga v.
Cerda, 379 S.W.3d 248, 261 (Tex. 2012) (involving the sexual assault of patients).
The Supreme Court also held in the same case that experts could rely upon the
pleadings on file in the case to render expert opinions. Id. Even a case relied on
by Appellant's notes that "section 74.351 does not prohibit experts, as opposed to
courts, from making inferences based on medical history." Cortez v. Tomas, 02-
11-00231-CV, 2012 WL 407382, at *2 (Tex. App.-Fort Worth Feb. 9, 2012, no
pet.) Dr. Lipson may properly rely on the SANE nurse examination and other
medical records in reaching his conclusions.
3. The Cases Appellant Relies On Are Distinguishable
15
Broders v. Heise, 924 S.W.2d 148 (Tex. 1996); Cortez v. Tomas) supra)· and
Pediatrix Med. Servs. Inc. v. De La OJ 368 S.W.3d 34 (Tex.App.-El Paso 2012,
no pet.), on which Appellant relies, are distinguishable. In those cases, simply put,
the expert at issue did not have experience in the area of health care at issue. For
example, in Broders, a hospital and physicians were sued after allegedly failing to
diagnose head trauma, resulting in death. In affirming the trial court's evidentiary
ruling, the Texas Supreme Court noted that there was no evidence that Plaintiffs
expert, while a physician, had experience or knowledge about the effectiveness of
treatlnents for head trauma. Id. at 153.
In contrast to Broders and the other cases Appellant cites, Dr. Lipson is
highly qualified in the precise area of health care at issue. Based on his knowledge
and experience, he is qualified to testify that Appellant should have been able to
prevent Mrs. Rivera's sexual assault. He has taught future nursing home directors
at multiple Tier 1 universities and governmental entities. In his CV there are at
least 9 references to lectures, courses and papers relating to "Elder Abuse." There
are over 30 references .to geriatrics, including fellowships at Harvard. There are
multiple references to his directorships over programs and facilities involving care
for the elderly. His experience includes consulting at nursing homes and
gove1nmental entities on the operation of nursing homes. He is familiar with
treatment of patients like Mrs. Rivera and familiar with the training of employees
16
providing care to residents like Mrs. Rivera. He is board certified in Quality
Assurance. Dr. Lipson has spent many years learning, lecturing, writing, and
testifying on nursing home abuse issues. (See Dr. Lipson's Dec. and CV, CR 15-
67.)
4. The Degree of Appellant's Negligence Does Not Protect It
From Liability
Appellant argues that Dr. Lipson's inability to identify the attacker or the
precise time Mrs. Rivera was attacked means that he is unqualified. (See
Appellant's Br., 21-22.) Appellant's position is that Mrs. Rivera's suit cannot go
forward because the attacker was not apprehended. The reason the attacker was
able to sexually assault Mrs. Rivera in the first place, and the reason he was not
apprehended, was because Appellant did not timely check on Mrs. Rivera in her
room, adequately patrol the halls, or have Mrs. Rivera moved to a more observable
location. Appellant treats its own negligence as a defense; it essentially argues that
it cannot be held liable because its failure to monitor and protect Mrs. Rivera was
so egregious that that attacker cannot be identified and the precise time of the
assault cannot be determined. Sticking one's head in the sand cannot be a defense.
Further, if anyone had superior access to this information, it was Appellant, whose
agents destroyed the bloody rags, evidence of a crime, when given the opportunity.
To meet the requirements of Section 74.351, Dr. Lipson does not have to be
omnipotent. He does not have to succeed where the Austin Police Departtnent
17
failed by identifying the attacker and sleuthing out other details of the assault.
Those details are irrelevant to the cause of action being asserted. No jury is going
to be asked to identify the rapist was or determine precisely when the rape
occun ed. The relevant issues addressed by Dr. Lipson are: what do the records say
4
about Mrs. Rivera's assault; what is the standard of care with respect to the assault;
did Appellant breach the standard of care concerning the assault; and, was Mrs.
Rivera injured as a result of that breach. In short, should this nursing home have
prevented Mrs. Rivera's sexual assault? Dr. Lipson is well qualified to render
those opinions.
C. DR. LIPSON IS QUALIFIED TO OFFER OPINIONS ON
STANDARD OF CARE AND BREACH
In what appears to be a copy-and-paste job of other appeals Appellant has
likely filed in similar cases, Appellant argues that Dr. Lipson is not qualified to
opine on the standard of care for nursing homes, or breach of such standard of care.
Appellant appears to have overlooked the pages and pages of Dr. Lipson's CV
setting out his experience, described in this brief supra. Dr. Lipson is well
qualified to opine on nursing home elder abuse. He is, in fact, perhaps the most
qualified person in the country to opine on this subject. The trial court acted
within its discretion in concluding that Dr. Lipson is qualified to render his
opinions on the standard of care and breach at issue in this case.
18
... ;.:
,;=t
- ··::tt ~- 0·
PART A .. PATIENT INFORMATION ".PLEASE COMPLETE P.ART A AND PART B
(£,, Today's Date: /d___tJvJ3_ Have you received .c~ Facility Before? 0 Yes D No
I came to the Emergency Department today because~ ~ I
T FOR FEMALE PATIENTS ONLY: Are you pregnant? DYes
I Last menstrual period: _ _/_~/_ _ Have you had a baby within the past six weeks? DYes``-
E~F~o~rm~co~m~p~le~te~d~b~y:~O~S~e~lf~·==``````============``R~e~la~tio~n=sh~ip~:``````````````````==
N PART B .. CURRENT SYMPTOMS
~-------------------------------------------------------------------------
1 Please check any of the following symptoms you surre-ntly have:
D Persistent cough greater than 3 weeks ErS__,_Throat
D Fever greater than 100.4oF C}t:rody aches
D Night Sweats D Cough (not related to allergies or COPD)
D Cough with blood production D Rash
D Fatigue D Nasal congestion (not related to allergies or sinus infections)
0 History of TB or Positive TB Skin Test 0 Close contact with person who has lnfluenza-Jil 2 seconds
DEFORMITY/DISABILITY .. Loss of Consciousness: DYes DNo 0 No Neuro Deficits 0 Neuro Changes
I Extremity: Neurovascular Integrity Intact: DYes ON/A
DNa
T CHIEF COMPLAINT:
y
I TRIAGE ACUITY: 1 Resuscitation 2 Emergent 3 Urgent 4 Semi Urgent 5 Non Urgent
DISPOSITION: D Immediate Bed D Stable- To Walling Area after Instructions ~
Comments: ~· {~
-~ctl 5 r I · ttqsrp
Triage Nurse Signature:
·~yfa\ ,-' --=s<-es·- ':):i,
llf\ 11:Y- ,fiJI' \.,,
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11111111111111111111111111111111111
(;:) MARY DELAROSA ·
RlV``1\oo071683103 M/Rii: L001D2Z 5 ~ 3
Acct •
ER
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Loc:L. EH ' 11112/13
\1\\11~\m Ullll\111111111\1\lllllllll\11\11\II\\\ \\1\1 1\1\\ Ill\ 1\11
'"EDPRS*
Sign~ln
Sheet ·for
Ernergency Services
T3107BC (Rev. 7/i2)
~OJ__ APPENDIX 1
Parfb& of
PATIENT INFORMATION FOR OFFICE USE ONLY
f}fL+d._r:t
mt+~u
PATIENT'S NAMErn MRNo.: ACCTNo.:
ADDRESS 1: DOS: LOCATION
ADDReSS 2: I COMMENTS/COMPLETION DATE:
ClTY, STATE, i Cf /)(f) (' '7l;t 7&6/~
FACILITY FROM WHICH PHI WILL
BE RELEASED (Check all that ap_pj'l)
DATES OF
SERVICE
BIRTH DATE: {) St. David's Hospital r/-tl--t_~
SOCIAL SECURitY' NO.: I ' St. David's Rehabilitation Center
(Optional) St. David's Georgetown Hospital
CONTACT NUMBERS:
Other
FACILITY/PERSON TO WHOM PHI WILL BE RElEASED/DISCLOSED: PURPOSE OF DISCLOSURE: (Note:** IJPdicates Foe for Copies}_
Avc;_-fiV\ \Pn l) ( e
NAME: Follow Up Care
Insurance**
ADDRESS 1: Attorney**
Personal Usek* I
ADDRESS2: It
'-f Other** Please Explain L-(___.~
CITY, STATE, ZIP: METHOD OF RELEASE/DISCLOSURE:
1
0 Fax (t::me~ cy Only) Fa}!)umb``~
CONTACT NUMBERS:
0 Mall ther ' ( /JL) rL . (
INFORMATION TO BE USED/DISCLOSED: (Check aJI that apply) 1 t
·-
Is this request for psychotherapy notes? 0 Yes, then this is the only Item you may request on this authorization. You must submit another authorization for other Items below;·-
0 No, then you may check as many Items below as you need,
D Pertinent Package 0 EKG, EEG, EMG 0 Pathology Slides 0 Psychiatric Evaluatlons{Tests
D Front Sheet 0 Laboratory Report 0 Physician Orders 0 Infections Disease (Including HIV Test Results)
0 Discharge summary 0 EA Information 0 Progress Notes 0 Consultations
D History/Physical 0 Imaging Reports (X·rays, CTs, MRis) 0 Nursing Information ~omplete Copy
0 Operative ReporVProcedure
0 Cathl.ab
0 Imaging Films
0 Pathology Report
0 Medication Records
0 Therapy Notes
````lzatlon Record '~P1Slcc· .\
J understand that:
1. I may refuse to sign this authorization and that It Is strictly voluntary.
2. My treatment, payment, enrollment or eligibility for benefits may not be conditioned on signing this authorization.
3. Medldallnformation Is considered Protected Health Information (PHI) under both Federal and State Privacy Laws.
4. Unless otherwise specified, this authorization shall expire 180 days from the date of my signature, OR from the date of discharge, whichever Is later.
(Othervvlse spectfled date )
5. I acknowledge, and hereby consent to such, that the released information may contain alcohol, drug abuse, psychiatric, HIV testing, HIV results or AIDS
information.
6. A facility may not condition the provision of treatment to an individual on signing an authorization except for:
1. · Research-related treatment; and
2. Health care that Is solely for the purpose of creating Information for disclosure to a third party.
7. I may revoke an authorization In writing except to the extent that:
i, The facility has taken action prior to receiving the revocation; or
2. If an authorization was obtained as a condition of obtaining Insurance coverage.
Further details may be found In the Notice of Privacy Practices. --
8. If the requester or receiver Is not a health plan or health care provider, the released Information may no longer be protected by federal privacy
regulations and may be redlsclosed.
9. I understand that I may see and obtain a copy of the Information described on this form, for a reasonable copy fee, If I ask for it. There Is a fee for copy
setvlces rendered.
1o. I will receive a copy of this form after I sign it.
SIGNATURES
J have read the above and authorize tl)p disclosure of the protected health information as~staled.
s~c;::J!Vhori2J~ cU-UL---- Date: !f/;J(~
Witness (If applicable}:
, • v
Wttness (If Applicable): -
Cl\ J(Ll{d '1Clf\\
,) I
Print Name of Patient or Authorized Party: Relationship to Patient:
StDavid's I MEDICAL CENTER
Authorization for Release of Protected Health Information
RIVERA.I1ARY DELAROSA ER
Acct;ff: L00071683103M/R#: L001022503
loc:L.ER IF
Dr: CEA 11/12/13
IUIIlllllllllllllllllll
346 S.W.3d 546, 556 (Tex. 2011). The
Supreme Court's position on expert reports is well described.
The expe1i report must represent only a good faith effort to provide a
fair summary of the expert's opinions. A repo1i need not marshal all
the plaintiffs proof, but it must include the expert's opinion on each
of the elements identified in the statute.
Am. Transitional Care Centers of Texas, Inc. v. Palacios, 46 S.W.3d 873, 878
(Tex. 2001 ). A "fair summary" is "something less than a full statement of the
applicable standard of care and how it was breached," it merely "sets out what care
was expected, but not given." Id. at 880. Dr. Lipson's detailed report exceeds this
standard.
A. SUMMARY DR. LIPSON'S REPORT
1. Dr. Lipson's Review of Pertinent Medical and Other Records
Dr. Lipson's repo1i sets out in detail the information he reviewed in order to
render his opinions. They include:
a. The statement of the daughter Martha Mahan;
21
RIVERA. MARY 11/12/2013 11:15 MR# L001022503 Visit# L00071683103 Clinical Report" Nurses 3 of3
15:1 0. Reassessment after procedure. The patient reports no complaints and the patient is calm and
resting quietly. Patient reports current pain level as 0/10. Overall patient status Is improved~ the patient
states feels better. ED physician notified about patlent1s status. --15:10 Jenny Black, R.N.
15:26. (APD VS here with patient and family. APS referenence number 64190731. APD VS is working
with guardian to move patient to a different ·nursing home. If that is not possible, APD VS will contact
current nursing home to assure patient's safety there.). -~15:26 Jenny Black, R.N ..
Assault I Forensic Flowsheet
15:09. The patient has family for support. Personal safety plan, reporting plans, STD and contraceptive
prophylaxis, need for medical follow-up, counseling, coping/fear reduction and interventions/services
discussed with patient. The patient has been given education and resource materials. --15:09 Jenny
Black, R.N ..
DISPOSITION I DISCHARGE
15:28. BP: 165/70 sitting. HR: 90. RR: 18. Temp: deferred. Condition at departure: improved and
stable. Patient reports pain level on departure as 0/10. The goals identified in the patient's plan of care
were met. The following issues were addressed: psycho-social issues, pain control, comfort issues,
nutritional issues, educational issues and follow up care. Fall risk assessment completed. No fall risk
identified. No learning barriers present. Discharge Instructions provided and reviewed with the patient.
Reviewed referral to family practice, a women's shelter, Planned Parenthood, the public health departmen1
and crisis hotllne for followup and testing. Summary of care provided to famHy. Patient and family
verbalized understanding. Written Instructions provided in English. Guardian verbalized understanding.
The patient was discharged by the physician. The patient was discharged to the nursing home and
accompanied by guardian. The patient left the Emergency Department ambulatory and via private vehicle.
Driving (guardian.). --15:28 Jenny Black, R.N.
15:28.
Departure time; 15:28. --15:28 Jenny Black, R.N.. .
The patient's home medications have been reviewed and validated with patient by the nurse. -.-15:28
Jenny Black, R.N ..
This report is not final
APPENDIX 1
90
3. Dr. Lipson Carefully Reviews Nursing Home Chart and
Ms. Mahan's Statement
Dr. Lipson then conducts a careful review of the nursing home chart to
establish the fact that Mrs. Rivera had very poor short and long term memory
problems and often did not remember people or where her room was. Dr. Lipson
goes on to opine that due to her significant mental limitations, Mrs. Rivera required
careful monitoring by the staff. (CR 17.)
Dr. Lipson then reviews the statement of Martha Mahan, Mrs. Rivera's
daughter and guardian. Ms. Mahan's statement discussed parties on Friday
afternoons where alcohol is served to the residents. Ms. Mahan reports that certain
male residents acted inappropriately towards Mrs. Rivera and that this fact was
reported to the management. (CR 17.)
Dr. Lipson then reviews the facts surrounding the discovery of the broken
glass, bloody rags and distressed Mrs. Rivera. He then notes that an external head
to toe exam was done on Mrs. Rivera which found no exterior wounds. No vaginal
exam was done. (CR 17-18.)
Dr. Lipson then discusses the calling of the police and the examination done
at St. David's Hospital by SANE nurse Jenny Black. Dr. Lipson notes the injuries
to both the posterior and anterior portions of the vagina. He further reviewed the
statement of the SANE nurse indicating definitive "penetration of the female
sexual organ". (CR 18.)
23
4. Dr. Lipson Reviews Literature on Sexual Assaults in Texas
Dr. Lipson then cites literature for the disturbing fact that in the four years
leading up to Mrs. Rivera's assault nearly 400 sexual assaults we!e reported in
Texas nursing homes. Dr. Lipson further relates the fact that those who suffer
from dementia are at particularly high risk for this type of abuse as they are very
poor historians. (CR 18.)
Dr. Lipson then goes on to discuss how these assaults can be prevented. He
notes that these facilities all provide 24-hour skilled nursing care as required by
law. This means the facility must have skilled nurses as well as certified nursing
aides on staff twenty-four hours a day three hundred and sixty-five days a year.
(CR 18-19.)
Dr. Lipson goes on to review the literature and reports that most of these
assaults occur at night and if a facility has a history of reported assaults they are at
a greater risk for additional incidents. He then reviews the history of reported
assault, non-compliance and management awareness of these issues. Dr. Lipson
reviews the generallmowledge within the industry of these assaults and the press
coverage regularly offered this issue. (CR 19.)
5. Dr. Lipson- Rivera's Injury Foreseeable and Defendant Owed
Duty to Rivera
He then opines that with the significant number of assaults in Texas nursing
homes, the recent history of reported assault in Defendant's facility, and the
24
complaints of the daughter Martha Mahan, that it is foreseeable assaults would
occur if precautions are not taken. He then opines a nursing home owes a duty of
protection to patients suffering from mental incapacity. He then writes that such
patients require enhanced supervision and additional staff time to protect them
from others. This is patiicularly true, he states, in a facility with a history of
reported assault and a history of family complaints of inappropriate behavior
towards Mrs. Rivera. (CR 19.)
6. Dr. Lipson Sets Out Standard of Care
After pages of detail concerning the facts, the records and the foreseeability,
Dr. Lipson then sets out the standard of care:
The standard of care requires the nursing home provide twenty-
four hour a day skilled nursing care. The practical result of this
requirement is that the staff must be moving through the halls
and the rooms of the residents all night long. There should
never be a time when a staff member is not in the next room or
moving through the halls next to a resident's room.
The standard of care requires that following the report of an
assault at a nursing facility that the facility control unsupervised
access to the rooms of residents at risk. The standard of care
requires the facility take note of the families' concerns of
inappropriate behavior and eliminate access to the patient ·by
unsupervised males. Residents at risk include women with
significant dementia such as Ms. Rivera. In light of the
family's expressed concern of inappropriate advances to Ms.
Rivera, the standard requires heightened scrutiny to include
regular walks through the entire hall at intervals not to exceed
ten minutes to prevent access to her room by males. The
standard of care requires the nursing staff document the fact
that it is performing the regular checks in the patients' charts.
25
In addition, the standard of care requires Ms. Rivera be moved
to a room in close proximity to the nursing station following
complaints of inappropriate contact with Mrs. Rivera.
(CR20.)
7. Dr. Lipson Identifies Breaches of Standard of Care
Dr. Lipson then set out the breaches of the standard of care.
The facility breached the standard of care by not providing
twenty-four hour skilled nursing care. The nursing staff was
not present in the halls or her room to prevent the sexual assault
ofMs. Rivera.
The facility breached the standard of care by not preventing
access to her room by unsupervised males. The records do not
indicate any checks on Ms. Rivera the night she was assaulted.
The facility breached the standard of care by not moving Ms.
Rivera to a room close to the nursing station where no
unsupervised males could enter her room.
(CR20.)
8. Dr. Lipson Identifies the Harm to Mrs. Rivera
Dr. Lipson then sets out the harm caused. The harm caused Mrs. Rivera is
significant. She was sexually assaulted. The injuries to her vagina are well
documented in the SANE nurse report and above. The daughter reports she was
tearful and afraid. This is a common response in sexual assault victims. The
daughter reports this behavior of fear continued even after Mrs. Rivera was
removed from the facility. The fact she suffered from dementia does not lessen the
harmful mental effects of sexual assault. Even an animal can remember when it
26
has been abused. In many ways Mrs. Rivera was like a small child - confused and
afraid as a result of this sexual assault. The history of problems together with the
decision to ignore the families' complaints and eliminate unsupervised males from
Mrs. Rivera's room indicates a conscious disregard for the well-being of Mrs.
Rivera by the facility's management. (CR 20-21.)
9. Dr. Lipson Eliminates Other Causes of Injury
Dr. Lipson then considers other potential causes of this injury. He considers
whether the injuries may be self-inflicted, but discards this idea after a chart review
found no indications of sexual self-stimulation or self-abuse. He further
considered whether the family might have caused these injuries but again discards
this idea after a chart review indicates the family was nothing but supportive. Dr.
Lipson further notes Mrs. Rivera was in the nursing home at all relevant times and
there was no indication she was assaulted on the way to the hospital to check to see
if she had been sexually assaulted. (CR 21.)
In short, Dr. Lipson explains the background facts, his review of the medical
and factual history, explains the problem with sexual assaults in nursing hotnes,
explains the standard of care, the breaches of the standard of care as well as the
harm caused. His report explains the Defendant's conduct called into question and
provides detailed information for the trial court to determine the claims have merit.
27
B. THE REPORT IS SUFFICIENT AS TO BREACH AND
CAUSATION
Appellant argues Dr. Lipson's report is deficient as to breach and causation.
Appellant attempts to put requirements on Dr. Lipson's report that exceed those
required under the Civil Practices and Remedies Code, and ignores what is actually
stated in his report. Appellant's assertions that the report is insufficient in this way
or that way fall apart under examination.
Dr. Lipson expressly details the breach of the standard of care 1n his
declaration. See CR 20, quoted supra. Dr. Lipson states in his report:
The standard of care requires the nursing home provide twenty-
four hour a day skilled nursing care. The practical result of this
requirement is that the staff must be moving through the halls
and the rooms of the residents all night long. There should
never be a time when a staff member is not in the next room or
moving through the halls next to a resident's room.
The standard of care requires that following the report of an
assault at a nursing facility that the facility control unsupervised
access to the rooms of residents at risk. The standard of care
requires the facility take note of the families' concerns of
inappropriate behavior and eliminate access to the patient by
unsupervised males. Residents at risk include women with
significant dementia such as Ms. Rivera. In light of the
family's expressed concern of inappropriate advances to Ms.
Rivera, the standard requires heightened scrutiny to include
regular walks through the entire hall at intervals not to exceed
ten minutes to prevent access to her room by males. The
standard of care requires the nursing staff document the fact
that it is performing the regular checks in the patients' charts.
In addition, the standard of care requires Ms. Rivera be moved
to a room in close proximity to the nursing station following
complaints of inappropriate contact with Ms. Rivera.
28
The facility breached the standard of care by not providing
twenty-four hour skilled nursing care. The nursing staff was
not present in the halls or her room to prevent the sexual assault
ofMs. Rivera.
The facility breached the standard of care by not preventing
access to her room by unsupervised males. The records do not
indicate any checks on Ms. Rivera the night she was assaulted.
The facility breached the standard of care by not moving Ms.
Rivera to a room close to the nursing station where no
unsupervised males could enter her room.
(CR 20.) Dr. Lipson thoroughly and in specific terms describes what tasks the
standard of care requires and how Appellant failed to perform those tasks. Similar
statements were found to be sufficient in another case involving an assault on a
patient (this one committed by the staff):
Moreover, we conclude that [the expert] identified the care that was
expected but not rendered under the applicable standard of care. She
states that Spohn-Shoreline "[f]ailed to provide adequate supervision
to the CNA [DeJesus] and the RN [Njoh]," "[f]ailed to protect Ms.
Sanchez from sexual harassment and sexual abuse," and "[f]ailed to
provide safety to Ms. Sanchez in her immediate post operative [sic]
when the CNA lifted Ms. Sanchez up and began dancing with her."
She explains the specific tasks and responsibilities required of Spohn-
Shoreline and notes that it failed to perform as such.
Christus Spohn Health Sys. Corp. v. Sanchez, 299 S.W.3d 868, 877 (Tex. App.-
Corpus Christi 2009, pet. denied). Dr. Lipson's description of specific failures of
Appellant is tnore than sufficient to meet the good faith standard of Section 74.3 51.
Appellant argues that Dr. Lipson's report is conclusory as to whether sexual
assault occurred. First, Appellant misstates the law when insisting that Appellee
29
offer an expert optnton that Rivera was sexually assaulted. See UHS of
Timber/awn, Inc., 281 S.W.3d at 211-13 (discussed supra; "Rape is not a medical
condition. It is an assault. ... We decline to hold that [plaintiff] was required to
proffer an export report opinion that she was in fact raped.") Second, Appellant
ignores the well-documented medical records including the SANE nurse
examination, Ms. Mahan's statement, and Mrs. Rivera's medical history (which
prevents her from being able to consent to sexual activity). All of these facts are
those upon which Dr. Lipson may rely in forming his opinion. TEX. R. EVID. 703.
Dr. Lipson opined that by not having skilled nursing staff present in the halls
or in Mrs. Rivera's room, no staff was present to prevent the sexual assault. (CR
20.) Appellant failed to prevent access to her room by unsupervised males, failed
to check on Mrs. Rivera the night she was assaulted, and failed to move her close
to the nursing station where no unsupervised males could enter her room. Id. As a
result, "The harm caused [to] Rivera [was] significant. She was sexually
assaulted." Id. These statements, and others in Dr. Lipson's report, are sufficient
as to breach and causation. See, e.g., UHS ofTimberlawn, Inc. v. S.B. ex rei. A.B.,
281 S.W.3d 207, 213 (Tex. App.-Dallas 2009, pet. denied) (in a case involving
sexual assault by another patient, expert report met Section 74.351 requirements
where expert opined that standard of care required facility to house victim where
30
she could not be accessed by unsupervised males and had facility housed her in a
safe and appropriate manner, she would not have been victimized).
Finally, Appellant claims that Dr. Lipson failed to exclude ''other, innocuous
causes" for the vaginal bruising, bleeding, crying and confusion Mrs. Rivera
displayed. Contrary to Appellant's assertion, Dr. Lipson did consider other causes
for the injury and found no evidence to support them. 4 This case is thus
distinguishable from Jelinek v. Casas, 328 S.W.3d 526 (Tex. 2010) and similar
cases cited by Appellants. In Jelinek, there was no causal nexus between the
defendant hospital's lapse in the treatment of antibiotics and the patient's suffering,
where the expert admitted there was no direct evidence that the patient had an
infection treatable by the omitted antibiotics, but the patient did have two other
infections that could account for all of her symptoms and for which the omitted
antibiotics would have been ineffective. Id. at 534-535. Here, in contrast, there are
no realistic alternative causes for Mrs. Rivera's sexual assault. Further, Dr. Lipson
specifically considered other causes and found the evidence did not support any
cause other than Appellant's negligence. (CR 21.)
4
He states: "I have considered other causes of this injury. I considered if the vaginal injuries
were self-inflicted. There is no evidence in Ms. Rivera's chart to indicate she engaged in either
sexual self-stimulation or self-abuse. I considered the injury may have been inflicted by
someone outside the facility or even a family member. There is no evidence to support this
approach. There is no record the family was anything other than suppotiive. The timeline in the
chart indicates she was [in] the facility at all relevant times save during transfer to the hospital.
There is no evidence anyone sexually assaulted her when she was being transferred to the
hospital to have her examined for injuries." (CR 21.)
31
CONCLUSION
As the trial court correctly determined, Appellant's boilerplate arguments
fall apart upon examination of the actual qualifications and report of Dr. Lipson.
The trial court's order denying Appellant's motion to dismiss should be affirmed
because Dr. Lipson is qualified and his expert report adequately sets forth the
standard of care, identifies how Appellant breached the standard, and explains how
the breach caused the injury Mrs. Rivera suffered. The report constitutes a good
faith effort to comply with Section 74.3 51 because it puts Appellant on notice of
the specific conduct complained of and provides the trial cou1i with a basis on
which to conclude Appellee's claim has merit. See TEX. CIV. PRAC. & REM. CODE
ANN. § 74.351(1); Palacios, 46 S.W.3d at 879. The trial court did not abuse its
discretion in denying Appellant's Motion to Dismiss.
PRAYER
For the foregoing reasons, Appellee respectfully requests that the Cou1i
affirm the trial court's denial of Appellant's Motion to Dismiss. In the alternative,
if the Cou1i finds the expert report to be deficient, Appellee prays that the Court
remand the case for consideration of a thirty-day extension to cure the deficiency.
See Scoresby v. Santillan, 346 S.W.3d 546, 557 (Tex. 2011) ("a thirty-day
extension to cure deficiencies in an expert repo1i may be granted if the report is
served by the statutory deadline, if it contains the opinion of an individual with
32
expertise that the claim has merit, and if the defendant's conduct is implicated.");
Leland v. Branda!, 257 S.W.3d 204, 207-208 (Tex. 2008) (court of appeals has
discretion to sua sponte remand the case for consideration of a thirty-day extension
to cure a report's deficiency).
Respectfully Submitted:
Isl Jack Modesett, III
JACI( MODESETT, III
State Bar No. 1424433 7
WALTER V. WILLIAMS
State Bar No. 21584800
MODESETTWILLIAMS, PLLC
515 Congress Ave., Suite 1650
Austin, Texas 78701
Telephone: (512) 472-6097
Facsimile: (512) 481-0130
ATTORNEYS FOR APPELLEE
CERTIFICATE OF SERVICE
I hereby certify that on the 21st day of December 20 15, the foregoing Brief
of Appellee was electronically filed with the Clerk of Court using the Texas Online
E-file system, and a true and correct copy was served via the Court's e-filing
service, electronic mail and U. S. Regular Mail on the following counsel:
Emily J. Davenport
Janice Byington
Reed, Clayman, Meeker & Hargett, PLLC
5608 Parkcrest Drive, Suite 200
Austin, Texas 78731
edavenpo1i@rcmhlaw.com
jbyington@rcmhlaw.com
Isl Jack Modesett, III
Jack Modesett, III
33
CERTIFICATE OF COMPLIANCE
I hereby certify that this brief complies with Tex. R. App. P. 9.4(i)(2)(B) in
that it contains 7333 words, exclusive of the items identified in Tex. R. App. P.
9.4(i)(l ).
Is/ Jack Modesett, III
Jack Modesett, III
34
1/30/2015 3:11:20 PM
Velva L. Price
District Clerk
Travis County
CAUSE NO. D-1-GN-14-005169 D-1-GN-14-005169
MARTHA MAHAN, AS THE REPRE- § IN THE DISTRICT COURT OF
SENTATIVE OF THE ESTATE OF §
MARY RIVERA, §
§
v. § TRAVIS COUNTY, TEXAS
§
PM MANAGEMENT- AUSTIN NC, LLC §
d/b/a GRACY WOODS I NURSING HOME § 250TH JUDICIAL DISTRICT
PLAINTIFF'S CHAPTER 74 PRODUCTION OF EXPERT REPORT
TO THE HONORABLE JUDGE OF SAID COURT:
COMES NOW Martha Mahan, as the Representative of the Estate of Mary Rivera, Plaintiff
in the above-entitled and numbered cause, and files this, Plaintiffs Production of Expert Reports
pursuant to Civil Practice & Remedies Code, Title 4, Liability in Tort, Section 74.351, and in
support thereof, would respectfully show unto the Court as follows:
I.
In cmnpliance with Civil Practice & Remedies Code, Title 4, Liability in Tort, Section
74.3 51, Plaintiffs hereby file the attached report of Loren Lipson, M.D. (attached hereto as Exhibit
A).
APPENDIX 1
11
II.
Plaintiffs hereby also provide opposing counsel with copies of Loren Lipson, M.D.'s
curriculum vitae (attached as Ex. 1 to Report), in co1npliance with Civil Practice & Re1nedies
Code, Title 4, Liability in Tort, Section 74.351.
Respectfully Submitted,
MODESETTWILLIAMS, PLLC
2202 Lake Austin Boulevard
Austin, Texas 78703
512.472.6097 - Telephone
512.481.0130- Telecopier . .
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J atk/Modesett, III
Tpx.{ls Bar No. 14244337
#Iter V. Williruns
Texas Bar No. 21584800
Plaintiff's Chapter 74 Production of Expert Report Page 2
APPENDIX 1
12
CERTIFICATE OF SERVICE
I hereby do certify that in compliance with the provisions of Rule 21a, a true and correct
copy of the above and foregoing has been served via Pro Docs electronic service on this 3oth day
of January, 2015 as follows:
Emily J. Davenport
K.emp Smith, LLP
816 Congress Avenue, Suite 1260
Austin, Texas 78701-2443
Emily.davenport@kempsmith. con1
Plaintiff's Chapter 74 Production of Expert Report Page 3
APPENDIX 1
13
EXHIBIT A
APPENDIX 1
14
DECLARATION OF LOREN G. LIPSON, M.D.
I, Loren G. Lipson, M.D., declare as follows:
I am a licensed physician in the State of California. I am Board-Certified in Internal
Medicine, as well as in Quality Assurance and Utilization Review. I have been board certified in
Geriatric Medicine.
My cuniculun1 vitae, attached hereto as Exhibit 1 accurately reflects my education, training
and experience as a Medical Doctor, Professor Emeritus of Medicine at the ICeclc School of
Medicine at the University of Southern California, Los Angeles, California, Affiliate Professor in
the Biomedical WWAMI Program, College of Arts and Sciences, and Affiliate Professor at the
College of Health and Social Welfare both at the University of Alaska Anchorage. I an1 the
fonner chief of the section of Geriatric Medicine and Associate Professor of Medicine,
Gerontology, Clinical Phan11acy, Medical Dentistry and Public Health, and Occupational Science
and Occupational Therapy, all at the University of Southern California where I have been on the
faculty for over 29 years.
In addition, I am a consultant to the Departtnent of Justice United States and the States of
California and New J\tfexico, and the Office of the Inspector General, U.S. Departlnent of Health
and Human Services in areas of geriatric care and elder abuse. I have served as a Consultant to
the Departments of Administration, Health and Social Services and Law, State of Alaska, in the
areas of geriatric medicine and long term care. I also have been the Physician Advisor to USC
University Hospital in areas of utilization1nanagement and quality assurance.
I have extensive personal experience in primary medical care as well as subspecialty
consultation and long-term care. I personally have provided care for patients in addition to my
acadetnic teaching, research and administrative responsibilities. My background is more fully
DECLARATION OF LOREN G. LIPSON, M.D. PAGE 1
APPENDIX 1
15
described in my curriculum vitae attached hereto as Exhibit A.
I an1 fatniliar with the proble1n of sexual assault in the nursing home setting. I am familiar
with the standard of care for preventing such assaults.
I continue to treat patients in the long tenn care setting and have done so for more than
thirty years. I am fatniliar with the standard of care for the treatlnent of patients like Mary Rivera
and familiar with the required training of employees providing care to residents like Mary Rivera.
I have reviewed the following records. They forn1ulate a basis for my opinions in this
1natter.
1. The statement ofthe daughter, Martha Mahan;
2. The Gracy Woods I records;
3. The SANE Nurse Report;
4. The SANE Nurse Statement
5. The St. David's Hospital Records
6. The guardianship records regarding Ms. Rivera; and
7. Texas Department of Aging and Disability Services' Reports.
The nursing home had a complaint of a sexual assault of a resident several months before
the assault of Ms. Rivera. This report should place the facility on a heightened alert for this
problem. The facility was cited by DADS for:
1. Failing to impletnent written policies that protect against this activity; and
2. Failing to rep011: the incident to law enforcement.
On June 20, 2013, Ms. Mary Rivera was placed under the guardianship of her daughter,
Martha Mahan, by Judge Guy Herman. Judge Herman detennined that Mary Rivera was a
"totally incapacitated person without capacity to care for herself.'' (Ex. 1)
DECLARATION OF LOREN G. LIPSON, M.D. PAGE2
APPENDIX 1
16
The findings of Judge Herman are consistent with the records from Gracy Woods I, (the
nursing home) where Ms. Rivera was a long tenn resident.
When Ms. Rivera adtnitted to the nursing home she carried a diagnosis of dementia. A
review of the nursing home chart indicates that Ms. Rivera's short- and long-te1n1 n1emory
declined over the tin1e of her residency. The chart indicated she frequently did not know the
location of her roon1, the season of the year or recognize staffn1embers. This is confirmed in the
appointment of her guardian when Judge Hern1an finds Ms. Rivera as "totally incapacitated" due
to mental as well as physical limitations.
The nm·sing home chart describes an individual who, while able to ambulate, clearly
required careful monitoring due to significant mentallin1itations. The nursing home chart further
indicates Ms. Rivera suffered frotn depression secondary to the diagnosis of dementia as well as
due to her adtnission to the nursing home, an admission she likely did not fully understand.
The daughter of Ms. Rivera describes in her statetnent alcohol parties that the nursing home
had on Friday aften1oons. (Ex. 2) She states that another male resident would inappropriately
touch or speak to Ms. Rivera. (Ex. 2) The daughter reported this concern to the management of
the nursing home. The nurses caring for Ms. Rivera were aware of this behavior. (Ex. 2)
Early on November 9, 2013, a Saturday 111orning, the daughter visited her mother at the
nursing home. She found her more confused than usual and crying. The daughter also folmd
broken Christmas ornaments on the floor. She took her n101n to the bathroom, and she appeared
to be in pain. Ms. Rivera urinated standing up, which was unusual. After she put her mom back
to bed, the daughter used the restroom herself. When she was discarding a paper towel she noted
there was a pile of bloody rags in the trash.
DECLARATION OF LOREN G. LIPSON, M.D. PAGE3
APPENDIX 1
17
Concerned that her n1other had fallen, she took the rags to the charge nurse, Wendy, who
did ahead-to-toe skin examination. The nursing hmne records confinn that no open wounds were
found. The daughter ultimately took her mother to the hospital where they found bruising to her
back. No vaginal exan1 was done at that thne.
The daughter reports Ms. Rivera continued to act like she was afraid. She noted bleeding
fro1n her mother's vagina. The daughter began to suspect sexual assault. The police were
notified.
Ms. Rivera was taken to St. David's Hospital. An examination was done by a Sexual
Assault Nurse Examiner (SANE Nurse). The SANE nurse told Ms. Rivera that her n1other had
suffered vaginal trauma. The SANE nurse exam specifically found tramna to the posterior
fourchette/fossa navicularis as well as trauma to the periurethral area of the vagina. (Ex. 3) In
other words, she found bruising to both the front of the vagina as well as the posterior of the vaginal
wall. (Ex. 3) The statetnent of the SANE nurse indicates the findings "definitively indicate
penetration of the fetnale sexual organ." (Ex. 4) As referenced above, Ms. Rivera was
incotnpetent. In other words, she was sexually assaulted as she is unable to give consent to sexual
contact.
Sexual assault in the nursing home environn1ent is a very serious problem. In the four
years leading up to this assault, nearly four htmdred sexual assaults were reported in Texas nursing
homes. At high risk are seniors such as Ms. Rivera who suffer from dementia. They are poor
historians due to their illness and many suffer fi·on1 iinpaired cotnmunication sldlls. As such they
are extre1nely vulnerable.
The good nevvs is that, if the ntu·sing home takes a few simple steps, the assaults can be
prevented. Facilities such as this nursing home are 24 hout skilled nursing facilities. This means
DECLARATION OF LOREN G. LIPSON, M.D. PAGE4
APPENDIX 1
18
they are required by law to have sldlled nursing staff as well as certified nurses' aides on duty and
providing care to the residents twenty-four hours a day, seven days a week, three hundred and
sixty five days a year. The nursing hon1e in question has one hundred and eighteen beds in the
entire facility. These types of assaults, according to most reports in the literature, occur at night.
The literature indicates that facilities with a history of abuse arid noncompliance are more
likely to have future incidents of abuse. This nursing facility has a history of reported abuse and
sexual abuse and was cited by the state for several indications of neglect leading up to the assault
of Ms. Rivera. The ntu·sing home management and owners are aware of this history of abuse and
are obligated to take steps to prevent future abuse. Everyone in the nursing home business is
aware of the problen1 of sexual assault. It is well discussed in the literature and the press. Given
the history of problems in the facility and the complaints of the daughter, it is foreseeable assaults
like this would occur without the proper precautions.
This nursing home owes a duty of protection to patients suffering frotn mental incapacity
due to decreased cognitive abilities. This duty includes monitoring the physical and mental
conditions of the patients and meeting the fundamental care needs of the residents. Nursing
homes are required to assess each resident's needs and capabilities. Sotne residents, like Ms.
Rivera, require enhanced supervision and additional staff to protect them from others. The
nursing home must take reasonable precautions to protect Ms. Rivera from the foreseeable
consequences of her impairment including sexual assault. This is particularly true when there is
a previously reported assault and the patient's family has voiced concerns ·of inappropriate
behavior towards their tnother.
DECLARATION OF LOREN G. LIPSON, M.D. PAGES
APPENDIX 1
19
STANDARDS OF CARE
1. The standard of care requires the nursing hmne provide twenty-four hour a day
skilled nursing care. The practical result of this requirement is that the staff must
be n1oving through the halls and the rooms of the residents all night long. There
should never be a time when a staff member is not in the next room or moving
through the halls next to a resident's room.
2. The standard of care requires that following the repoti of an assault at a nursing
facility that the facility control unsupervised access to the rooms of residents at tisk.
The standard of care requires the facility take note of the families' concerns of
inappropriate behavior and eliminate access to the patient by unsupervised n1ales.
Residents at risk include vv-omen with significant dementia such as Ms. Rivera. In
light of the families expressed concern of inappropriate advances to Ms. Rivera, the
standard requires heightened scrutiny to include regular walks through the entire
hall at intervals not to exceed tentninutes to prevent access to her room by males.
The standard of care requires the nursing staff document the fact that it is
perfotming the regular checks in the patients' charts. In addition, the standard of
care requires Ms. Rivera be moved to a room in close proximity to the ntu·sing
station following complaints of inappropriate contact with Ms. Rivera.
BREACII OF STANDARD OF CARE
1. The facility breached the standard of care by not providing twenty-four hour sldlled
nursing care. The nursing staff was not present in the halls or her room to prevent
the sexual assault of Ms. Rivera.
2. The facility breached the standard of care by not preventing access to her room by
unsupervised n1ales. The records do not indicate any checks on Ms. Rivera the
night she was assaulted. The facility breached the standard of care by not moving
Ms. Rivera to a room close to the nursing station where no unsupervised males
could enter her room.
HARM
The harm caused Ms. Rivera is significant. She \Vas sexually assaulted. The injuries to
her vagina are well documented in the SANE nurse report and above. The daughter reports she
was tearful and afraid. · This is a cotntnon response in sexual assault victims. The daughter
reports this behavior of fear continued even after Ms. Rivera was removed fron1 the facility. The
fact she suffered from dementia does not lessen the harmfuln1ental effects of sexual assault. Even
DECLARATION OF LOREN G. LIPSON, M.D. PAGE6
APPENDIX 1
20
an anitnal can remen1ber when it has been abused. In tnany ways Ms. Rivera was like a small
child -confused and afraid as a result of this sexual assault. The history of problems together
with the decision to ignore the fatnilies' cotnplaints and eliminate unsupervised males from Ms.
Rivera's rootn indicates a conscious disregard for the well-being of Ms. Rivera by the facility's
tnanagement.
I have considered other causes of this injury. I considered if the vaginal injuries were self-
inflicted. There is no evidence in Ms. Rivera's chart to indicate she engaged in either sexual self-
stimulation or self-abuse. I considered the injury may have been inflicted by son1eone outside the
facility or even a fatnily n1ember. There is no evidence to support this approach. There is no
record the family was anything other than supportive. The titneline in the chart indicates she was
the facility at all relevant tin1es save during transfer to the hospital. There is no evidence anyone
sexually assaulted her when she was being transferred to the hospital to have her exatnined for
injuries.
DECLARATION OF LOREN G. LIPSON, M.D. PAGE7
APPENDIX 1
21
I declare tmder the penalty of pe1jury under the laws of the State of California that the
foregoing is true and correct
Executed this P,~ay of~ , 2015.
Cf~,
DB:CtARA.TlON OF LO:REN G. LlPSONJ I\1.D. PAGE8
APPENDIX 1
22
EXHIBIT A
APPENDIX 1
23
CDAAIC'OL'VM VITAE
August 1, 2009
A. P~l'HOlUlllnfol'matio:n.
L Nmtie; Loren G. Lipson) M.D.
2. 11tles! Professol' Emeritns ofMedichte at the Keck School
of Medicine of the University of Southern
Califonrlap Los Angeles> Califonrla; and AffiJiat6
Professor~ Biomedical WWAMI Ptogram> College
of A:tts and Sciences~ and Affiliate Professor~
College of Health and Social Welfar1;1 at the
University of Alaska Anchorage.
3. MaiH11g Address! P.O, BoxJ
South Pasadena, California 91 031
4. Business Telephone: 626-403w0169
5. Fax: 626-403.-0165
6. Paget! 800 ..20~-2380 (Numetio Only)
B. Educafio.tt
1. High Sobool- :Sirminghmn Bigh School~ Van Nuys) Califor.hla.
Graduated, June 1961.
2~ University- U.C.L.A.~ B.S. in Chemistrywithami:no1•inMath
and En~lish.
(Sununa Cmn. Laude)1 June 1965,
3. Medical School - The J'olms llopldns University Schqol of
Medicine> Baltimore~ 'Maryland: M.D., June 1969
4, Internship ..... The Johns Hopkins I-Iospital1 Osler Medical Service~
1969-1970.
5. Residency .. The Joh1.1s Hopldns Hospital~ Osle1· Medical Servlce~
1970-1971 I
I
I
-··.-----···-······-··-·------ --- ···----"· .,. --··--·--:--------.-:::-7-:-.------;-:--,-~,-.,·-----~-~----·-;·--·--· ...... ---·-··-·· ·---.. ---·~--·--....- ..,....................... -·------·--'·--··~----------··------- ............
I
! ......... \ . -
ii j
l
iI
'i d • . . "'"' '1l •
I
APPENDIX 1
24
I I
6, Fellowships:
a. Tite Johns Hopkins University School of Medicine,
Balthnote:l Marylnnd: Clinical Fellow in Medicine~ 1969~
1971
· b. The Natiol1al ftlstitutes of Health., Beth~sd~ Marylaud!
Research Associate - l?rote:in Chemistty; Physical
Biochemistry~ Moleculat Biology ..... Labot·atory of
~Chemical Biology. Nationat Institute of Atthtitis~
Metaoolio and Digesti~e Diseases (NIAMDD), 1971-1973,
o. Massaclmsetts Genetal Hospital~ Bostoni Massachusetts:
Clinical and Research Fellow 1n Medicine (Endocrlnology
and Metabolism)~ 1973.-1976
d, Harvard Medical School, Boston, h1assaoltusettsf Clinitml
.and Research Fellow in Medicine (Endoorinology and
Metabolfsin)>l973 .. 197S. ·
e~ Ha:rvru:d Medical School, Boston, Mass~ohusetts: Jolm A.
H'ru:tfht•d Seufol' Scholar in G0ri~rtdc Medicine_, D:lvision of
Aging,1984 ...1985 -
f. Beth Israel .Hospital~ Boston, Massachtlsetts! Clinieal
Fellow in Medicine (Gerontology)~ 1984...1985
g. Brigham - Women~s Hospital, Boston> Massachusetts~
Clinical Fellow in Medlcine (Get:ontology)1 19&4.. 1985 .
h. Hebrew Rehabilitation Center for the Aged> Boston,
Mass'achusetts! Cih1ical Fellow in Gerlatrio Medicine~
1984 ..1985.
i Institute of Advanced Studies on Gerontology; Ethel Pemy
Andrus Gerontology Cente1; ·usc~ Los Angeles, Califot.nla!
Fellow in In.stitute, Area-Drugs .in the Elderly; 1985-19&7
j. Geriatric Research Institute~ Ethel Percy Andrus Gerontology
Center> USC1 Los Angeles; California: Senior ~esearch
Associate; 1985..1989.
7. Honors and. Award
I
-~:-_-----;-.---~·~·#·~-~---~ .. ``----.~-----··;--,-.. ---- .---:-.-=.-·.:.:·:;=·:;-;~·-:::.-:.::::.·.:;·.:.--:;·=..:.:.·.:-..=.:.:.:-•• :· :~:: :_-.;··- ·--2;---~ .. ·-· ........--· ..... ·:-~------------------~-----~··--,..---,..,-
.. c-·``-.~-~ I
----··••----·-i--- ...
I
va , "\ & •
.' II
APPENDIX 1
25__ 1
1965 Phi Beta Kappa; Recipient of' Merck Award
in Chemistry;
Outstanding U~tdergt•aduate in Chemtstty
Award of Phi Llllllbda Upsilo11; Medal for
Soholarship o-£ the Am~dQan Institute of
Chemists; The Ramsey :Ptize irt Physical
Chemistry; Sigma XI-
All atU.C.L.A.
1968-1969 Hemy Strong Denison Scholarship for
Research in Medicine1 The Johns Hopkins
Universlty Sohool of' Medicine~
1975 -1977 National Reseru:oh Sel'Vioe Award in
Diabetes (NIAMDD)} Natioru:tllnstituteu of
Health.
1975-1978 Daland ·Fellowship in Clinical Medicine,
American Phllosophloal Society.
1977 _: '1978 CHnioal Investiga.to1' Awro.'d iu Diabetes,
NIAMDD> National Institutes ofBealth.
1984.-.1985 John. A. Hartfoi'd Senlot Soholat• Award in
Gel'latdo Medicine, Division of Aging,
Hanrard'Medical School.
1989 The Genesis Awru:d, Fo:t.' Innovative Health
Care DeHve1y, Los Artgeles Bushless
Journal.
1989 Ptofessional. Leadership Program Award,
Volunteer Cento:r of Los Artgelos.
1999 One of Top 20 :Physicians in the Ch-eater Los
Angeles Ate a (and only Gerlafliclan
natned)ll Los Atlgeles Business Jm:unal.
2000 One of Top 1?rlmmy--Caxe Physioiaus in th~
U.S.~Tow.n an.d Country Magazine.
2002 One of Top Ten Physicians in Los Angetes1
Amet1car-On-Line.
8. Licensure: California..
·-:::-----· ---~···~---------------··---···---···-···----·-·- ·-·-- -- --.
3
· · · - -·.,.-.:;·.:··-~.-.·--;-;.~-, "0.: .-,.- ...- .., -~,----:·"' ... - . - - - -,·-----·-·--·-............. - .................... ~-- •..• --·-~------;-~,...,...,.
' .
APPENDIX 1
9. Boards! A1nedo(tn Board of I:ntel'nal Medicine> 1974.
Atnedcan Boatd of Quality Assurance rutd Utilization Review
Physicians, 1995
Certificate of Expertise itt Geriatric Medicinel American Board of
Intel'nal Medicine, 1996
C. Pl·ofesstonal Background
1. Academic Appointments
a~ Tlw Jolms Hopkins University School of Medicine~ Baltlmore7
Maryland; Clinical Fellow in Medioine~ 1969"197L
b. Massachusetts General Hospital7 Boston7 Massachusetts; Cltntoa1
and Reaeatoh Fellow in Medicine (Endocrinology and
Metabolism)> 1973 ..1976.
c. Hawatd Medioal School~ J3oston, Massachusetts; Clinioa1 and
Research Fellow in Medicitl.e (Endocrinology and MetaboliStn),
1973.. 1975.
d. Hlu.\Tatd Medical School) Bosto~ Massachusetts; fustructQr ln
M¢dioine (Diabetes)~ 1975~1978-.
e. Mammch\lseii:s General Hospital> Boston1 Massachusetts-; Clitllcal
Assistant in Medicine (Diabetes Unit):~ 1976~1978..
University of Southern California School of Medicine; Los
Angeles~ Califonda; Assistant Pxofessor of Medicine (Diabet(7s
Division); 1978-1981.
gt University of Southern Cruiforoia School of Medicine~ Los
Angelesj Califo:mla; Assistant Professor of Medicine~ with tenure
(Division of Diabetes and Clinical Nutrition)~ 1981 - Jtmtiaty
1984.
h. Los Angeles County/Unive:rsity of So'U-thetn Califomia Medical
Centex) Los Angeloo., California~ Staff Physician in Medicine
(Diabetes Service), 1978 -.January 1984
i. University of Southern California School of lVIediclne;p :Los
Angeles~ Califotuia; Associate Professor of Medicine (Division of
Geriatric Medicine), January 1984-Septelnber 2006.
··"'"'·``~:·-::::~.::o c·c~=::c:."'""'-~O:.-.:-:::;,..,.~·-;_:·:,·:-c. ;.-,-,-··.;·,-:;o·~c-···· ---~·-;--~·-·:~ ·---···c-···-···..··-········ ........,.....!. . -.,........ _--·-- _·- -----~····--· -.· ·------ ·~ .
·."· ..
--~------------ . -.-·. ,. . -.---. l ·-:· --' ~---
`` t1 • ., ' . "\ J •
~ I
APPENDIX 1
27
j. Unive~·sity of Southe111 California S¢l:Cool of Medicine~ Los
Angeles? California; Chie~ Dlvlsion of Gerlatdo Medicine· jn the
DepartJ;ne11t ofMedlcinej January 19&4- 2005.
k. University of Southern Califotnhh Los Angeles~ Califot:nia~
Associate Professot of' Gerontology, L~onard Davis School of
Gerontology~ Ethel Percy An.drus Gerontology Center~ Januaty
1984 ,_ Septetnber 2006.
1. University of Southern CalifomiaJ Los Angeles,· California;
Assooiate Professor cf Clinical Pharmacy, U.S.C7 Sohool of
Pharmacy~ October 1989 .... September 2006~
m. Los Angeles County/University of Southe:n1 California Medical
Center~ Los Angeles, California; Staff Physloia11 in Medioinej
(Oeriatdo Medicine), 1984..2004.
u, Sabbatioal Leave> Harvard Medical School~ Boston,
Massachusetts~ Dlvisio11 of Agingt John A. Hartfol'd Seniol'
Scholar in Gerlatdc Medicine-~ 19 84- 1985.
o. B:dghant & Women~s Hospital, Boston,. Massaohusetts; Clinioal
Fellow in Medioine (Oer!atrio Medicine)~ 1984 ..1985.
p 4 :Beth Israel I-iospital~ Boston~ Massachusetts; Clinical Fel~ow in
Medicine (Ge:dai1'lc Ivfedioine), 1984 .... 1935
q. University of Southern California, Los Angeles~ California; Senior
Research Associate; Getontology Research Institute; Ethel Percy
Andrus Gerontology Cente1~ 1985 .-.. 1989.
r. University of Southern. California., Los Angeles~ California; Fellow
Institute of Advance Study, Ethel Percy Andtus Gerontology
Center, 19B5 . . . 1987.
$. University of Southern California University Hospital, Los
A11geles~ California;
Chief of Geriatric Medicine~ 1991.. 2005
University of Southern California . . . School of DentistJ:y -
Associate Professor of Medical Dentistry and Public HealthJ 1994
i
-September 2006.
I
u. Unlversity of Sottthem California~ School of Independent Health
_Professionals - Associate Professor o:f Oocupa.!ional Science and
Oooupational Therapy~ 1998~ S~ptember 2006.
I
l
I
I
I
I
I
J
·-·--· ----·----,---,--··-·~-------·- --- -····-·····-·----··-·-----:-- ··--· ··--·{:··
i
.. D ' '\,! •
j
'i J .• ``-.
. . J
APPENDIX 1
v. University of Alnska, Anchorage_. Adju11ct Aasooiat~ Professor of
Human Biology) 2001- September 2006.
w. · UniversitJ of Alaska Southeast, Sitka .... Adj\.1not Associate
Professor of Human Studies, 200~ .. 2006.
x, University of Alaska, At~ohorage) Affiliate Professor, College of
Health and Social Welfare, 2006 -:Present.
y. Unive1'sity of Ala~ka. Anchorage~ Afftllate Professm.; Biomedioal
WWAMr Program, College of Axts and Sciences~ 2006- Present.
Univexsity of Alaska; A.ltchol'age~ Faculty Consultant in Geriat.dcs,
• i Alaska Family Medictil Residency! September 2006- Present.
aa, Un1vetsity of Southern California, Keel< School of Medicine~
:Professor Emeli'tt1s ofMediohte~ September 2006 - Present.
2A. Teaching Responsibilities (University ofSouthern Califotnia) ·
a. Attenditl.g· Staff :Physician LAC/USC Medical Cent~t· ott the Geue~al
Medical Service- teaching and supervising patient oru:e~ both inpatient
and ouipatient to house staff and students 1985 - 2004.
b. Attending Staff Physician. at USC UniversitY Hospital in Geriatric
Medicine for lv1edic~L Ho1.1se Staff and students. 1991- i005.
a. Xn charge of the Fellowship Program - Geriatric Medicine. 1985 -
2004.
.
I d. Development at1d improvement of Gerlatdc Medical Cun·loulum in the
Medical School- UniV'et'sity of Southern CaU£omia. 1985 -2004
e. Developn1ent of Oedatrlc Medical Core Cm:d:oulum for
House Staff~ LAC/USC Medical Center, 1985 ~ 2004
fu~ Medical
• I,
f. Member of Stee1·1ng Committee~ Key Faculty and Study Site
Cootditu~tor ~ Pacific Geriatric Education Center at the University of
Southe1n Califottda(DHHS), 1984-1993.
. .
g. Atton.ding Physician Year HI Medicine Rotation) 1992.
1L Dit.'eotot and lecturer in various cou.rses at the Eth£;)1 Percy Andrus
Gerontology Center including Gerontology 599 - Geriatric Health
Issues~
'1 j I
.. 1' . , a•
APPENDIX 1
29
i. Director- C.reriatrics Update- A Board Review Course.
j. Director__. ~istoty of Medicine in the Healtlt Sciences Program~ 1994
~200L
2l3. ·Teaching ResponsibiHttes (University of Alaska)
a. Director.-.. Care oftlte Elderly Cortferenc~,
University of AlaskaJ So\lthefiSt- Sitka>
1994-Ptesent
b. lustruoto:r .- Promoting Best .Practi<3es in Aging, University of
Alaska, Anchorage>
2006- Present
c, Co··Director- University of Washington Med(oal Soltool 596 ~
Human Biology - Course for Alaskan Students . - Muitl..
Disciplinary and Ethnicity in Gerontology and Geriatrics,
(University of Alaska~ Anchotage .. Sprirtg and Fail$ 2009 and then
yeady).
d. Co~Dil'ector in Geriatric Education to Alaskan Medio~U St1Jdents iu.
the University of Washington Medical School WW AMI Progt·arn>
University of Alaska, Anchorage~ 2006 - Prese11t
e. Fa-oulty consulmnt in Oerlatdcs to Residents of the Alaska :Fan:rl.ly
Medicine Residency Program, 2006 . . ., Ptesent.
3. Administrative Responsibilities
a. Chief of the Division of Geriatric Med~oine~ Departme11t of Medicine,
Unive:tsity of Southern Califbrma. School of M~clicine. In charge of
ataff arid fellow recruitment and trahrlng; divisional budg~t; gtatlt
procu;rement; program. development and S\lpervision of researoh a11d
olllrlcal activity. 1984 . . . 2005~
b.. Study Site Coordinato:r and. Key Faculty .of .the Pacific Gedatrlc
Education Center, Dtrl.versity of Southern California Sohool of
Mt;Jdicine1 1984--1993. ·
c. Senlo:t Staff Physician in charge of Ger1atr1o P.rogtmns at Los Ang~les
County/O"niverslty of Southern Califo1nia Medical Center~ 1985 -
20044
d. Chief o:f Geri~ttic Medicine at the USC University Hospital> 1991 -
2004;
- -- --~----· ._ __ ·--· -
.. ··----·-- ,.._,~ __ ...__, __ ,
APPENDIX 1
30
e. Faculty liaison betwee11 Geriatric Medicine and Univel'sity affiliated
hospitals and long term care fuollltles. Director of Oedatrio Medicine
Private Praotice Platt. 1984 ..... 2004
f, Dlrectox of the USC Ambulato1y Health Center sites at the Japanese
Retire:ment Homes and Angelus Plaza., 1985- 1993.
g. Dft•ectot of the Division of Gedatdo Medicine>s Program at the V.A.
OutpatielJ.t Clinic in downtown Los Angeles, 1986- 2001.
h. Director of the DSC Teaching Nm·sing Hon1e Program at Hollenbeck
:Home ~nd. Atherton Ba})tlst Home, 1999 -2005.
i: Director of the Senior· Cancer Center at Nords Comprehensive Cancer
Ce:nte1· and J.iospitalt 1999 - 200 1.
j. Ditector of the Senior Cru:e Program.~ USC Care and. USC )?hysicians.
199& - 2002,. .
k Co.-Director- Adult :Protective Terun - Gerlatdo Medioine Program-
LAC/USC Medical Center, 2000 ..... 2004.
L Director - Cate of the Eldedy Conference~ University of Alaska
Southeast~ Sitka, 1994 - Present.
m. Co~Pxrecto1.· ,__. Gerlatrlo Eduo~t.ion for Alaskan Medical Stndents in the
WWAMr Program;. University of Alaska1 Anchorage. 2006 ~ :r~·esen.t,
n. Medical Directol.' .-Alaska Gel'intdo Eduoatton Center~ Univet·sity of
Alaska1 Anchorage. 2005 - Pxesent,
o. Medical Dh·eotot . . . . National Resource Centet for Studies in l'lative
Amerloan~ Alaskan, and Hawaiia11 Elders, Uni'\lersity of Alask~
Attchorage, 2006 .. Ptesent
4. Senrice
A. University Service
a. Medical Executive Cotunrlttee, Deparhnent ofMedloine~ USC 1985-
2003.
b. Utilizatioll Management Comtnlttee; USC Universit-y Hospital, 1991--
1999~ 2003 ..... Present, .Chairman o:tthis Co;nunlttee, 1994---1999.
"til. 11 4 '
APPENDIX 1
31!
o. Phru:maoy and Therapeutics Committee, LAC/USC Medical Center$
2001-2004.
d. Pharmacy attd Therapeutics C(ntJ.mittee~ USC University Hospital,
1991 - 2005:~ Chairman, 1996- 2000.
e~ Pati~ut Ca1.·e Evaluation Committee~ USC University Hospiial, 1994 -
1999,
f. Le6ture;r in School of Pharmacy:. University of Southern California>
1985 ..2004.
g~ Continuing Medical Post. .Graduate Education Lectures at outlying
hospitals~
1979- 20Ct4.
h. Core Cwt1cultlrn Conunittee forth~ New Medical Sol1ool Cu1·riculu:ml
USC School o:fMedioine~ 1998 ..... 2002 ·
L County Operations Committee~ Department of Medicint)> lAC/USC
Medical Center, 1997 . . . 2000
j. Development CotnrrtitteeJ< Depamnent of Medicine, LAC/USC
Medical Center, 1997-2000,
k. Senior Health Care Progrru.n, USC Cate2 (chair/member);~ USC 199~ .....
2002.
L Executive Committee~ USC Norris Comprehensive Cancer Center and
Hospital._ Senior Cancer Catt;} Center, 1998 ... 200l.
m. Co..Director - Adult l?tot~ctive To British Columbia Health Foundation., 1994 ..... 19,99.
8. Consultant in Gel'latdc Medicine w.d Long Term Care, Silverado Seniot·
L:f:vlng Centers) San Juan Capistt·anoJ CA 2001 ..... 2002.
·9.. Consultant in Geriatric Medicine and Supervisor of the- Gedatdo Medicine
Medical House StaffThaining Pxogram, !Ce:tn Medical Center~ Bakersfield~
CA 1936 .-... 2003.
10. Consultant ill Geriatric Medicine and Supetv1so.t of the Gedab:ic Family ·
Medicine House Staff Training Program, Glendalo Adventist lVIedtcal
Center, Glendale~ CA 1998-2001
········--------·------------ ... -·-: -- ·-.--·:----:·:····----------~-·--.- · : . ····· .- -----·-·. ------. ·---···----1:2---·--.--------- -- ...
... 6 • 1 ~ I
·,
APPENDIX 1
35
11. Cons-ult$lt i.n Geriatric Progran1 Deveiopme11t . _. . Bay Shores Medio~l
Gronp., Torrance~ CA.) 1986-1989.
12. Consultant in Geriat.tlc P1'c;>gram Development .... San Phnas Co):'U1rtun.lty,
Hospital, 1986-1989.
13. Consultant in. Gedatrlc Program Development and Long Tenn Care -
Keiro Services ~ The Jap.!inese ..... American Retirement Homes~ Los
Angeles, CA.> 1986 .... 1993.
14. Consultant in Gedatric Ptogram Development and Loug Term Cal'e--the
Motion Pfoture an State ofCaliforn1a)
Depru.1to.ent of Social.S~rvices> 2000- Ptesent
.I
lI
16.. Consultant in Elder Abuse~ Gedatric Medicine ~nd Long Te11n Care~ State
of California7 Department of Justice~ Office. of the Attorney Gertetalj
Bureau ofMedioal Fraud and Elder Abuse., 2000 _.Present.
17, Consultant in Long Tetm Care~ Eld0r Abuse and Geriatric Medtoi~e -
State ofCalifomia, Department of Justice~ Office of the Attot.ney Ge1~enu~
Bureau of Medical Fraud and Eld{)r Abuse - Operation Gua1'dians (lltttsing
homes .. un.am10unced inspections) 2000 - Ptesent.
18. Consultant in Long Term Care.~ Geriatdo Medicine and Elder Abuse ...,
State of New M~xico 1 Departm.ent of Justice, Offioo of the Attorney
General, Medicaid Fraud and Elde:r Abuse Unit~ 2003 . . . Present.
19. Consulta11t in Long Term Cftte, Geciatrio Medicin6 and Elder Abuse>
United States of Arnerlcal Department of Justice, Civil Rights Dl11Islon,
• •• ·.t. .,......,:."' 1-.. - 2006 ._.Present. · .. ~.IL.".t:=~...·--··
. 20. Consultant mLong Term Cat·~, Gedatric Medioine and Elder AbUSt;\
United States of America} Department of Health and Ruman St:!J:1lloes~
Office <>f the Inspectur General, 2006 ..... Preseht
21. Boatd ofDil'eotors~ Musica Angelica:1 2006- Present.
JF 4 JRcse~:rcb. Activities
1. R~search Tnte1·ests
a. Use o'frnedications in the .senior populations with specific emphasis on
prescribing habits of physicians.
·-·--·----·-·---·----·- ·--·-·-·-·--·---·-····-···.···-·-·---:--···;-·-··-- _________ _13_·-·-··-····-··-··---------·--- ·- ``- -·-··----~·-- ~-; ·--~--'"-:-··-:·!;..:·.::o.:-•... ~···.::::.::=-;;;---.-;-·~;--·--- ·--·---····-···~-- •.. -· .
..... I
APPENDIX 1
36
b, Health cat·e systems and delivery modes fat' the demented eldedy in
Alaska.
c. D1'Ug interactions in. the eldel'lyt looking at dtug-dtug interacttomt~
changed actions~ polypharmacy} n1isuse' and abuse.
d. Studies in the elderly diabetic patient.
e. Studies in the elderly hypertenst-ve patient.
f. Studies in sexual dysfunction in the eldedyr
g. Studies iti -elde1 abuse.
1
h~ Ma.h.).tenance of independen?e of living in frail attd demented ~etlio:rs.
2. Research it1 Progress: In'lestigations bt man
a. Studies in prescribing habits .ofphysicilitns in retirement housing.
b. Studies of adverse drug effects in the aging population with special
[ emphasis on the most commonty prescribe medication and
psychotropic agents~
c. Studies on. care- offi:ail and demented senfo~·s in Alaska.
d, Studies on the prevention and early detection of elder abuse.
e. Stud.tes on d~reased longevity in the Pueblo lndians~
G~ Long Tel·.m Cu:re Expedeuce.
1. Dltector of the two. USC Teaching"Nursing Hom~ Prog~·ams) 1999 ~ 2005
a. Hollen~beck Home- LOS Angeles
b. Atherton Baptist Home- Alhambra
2. Member and M~mber Boru:d of Plreotor~ California Association o£
Medical DirectOJ.'S, 1992 .... 1999.
3. Consultant,_, State of Alask~ Department of AdministratlonJ Division of
Longevity Se1·vioes (Aging Prow,wna and State of Alaska Long t~nn.Cnre
Facilities- the Pionoo:ta' Hontes). 1991-2004.
4.. · Affiliate Professot, College of Ifealth at:td Social Welfare and College of
Arts and Sciences~ Uruvet.sity of Alaska;- Anchorage. · Areas of
involvement - Alaska Oerlatric Educatl011 Center, Gerlatrio. Assessment.~
Pre~med aud Medioal Education,. Long Tel'm Care, 2006 to Present. .
5. Consultant'- UniV'erslty of Alaska, Sitka. ArtYa.3 of involvement- Care of
Elderly Cotuerettce-- Dit·ect()r=- 1994 . . Present
!5. Consultant in Long Tetro Care) Elder Abuse and Gerlatdc Medidne -
State of Alask`` Peparlment ofLaw> 2000 - 2003
·~.--- . -~ ---- -··-- ~-.- ---. - -- ---
..
~ ., b -
"\a •
APPENDIX 1
37
7. Consultat1.t in Lo11g Tenn Cru·c rutd Ged£~ttio Medicine ~ State of
Californi~ DepartmentofSocxal Services.
Consultant in Long Tetm Care~ Geriatric Medicine and Elder Abuse -
• j
State ofCalifomi~ Depru.1:ment of Justice~ Office of the Attmney General,
Bureau of Medical Fraud and Elder Abuse; 2000 ..... 2003.
9. Consultant in Long Te:nn Cro:e . . . State of California> Department of
Justice> Office of the Attomey GeneraL~ Bureau. of Medical Fraud 1:1nd
Eldet Abuse - Operation Guardians (nuraiug home~ unannounwA
inspections)? 2000 -·Present
10. Consultau.t in Long Term Caxej Gerlatrio M~dicine and Elder Abuse -
State of New Mexico, Departroent of Jusdc{}~ Office of the Attorn~y
General~ Medicaid Fraud and Eldet Abuse Unit> 2003 - Present.
11. C 2001 -2002. .
1'1, Consultant in Geriatric Program Development mtd Long Term cm~e -
K.eiro Services ~ The Japanese Atu~rioan Retirement Homes, Los
Angeles~ 1986-1994. ·
18. Consultafit ih Gcdau:ic P.rogram. Developtnent and Long Term Cm·e- The
Motion Plcture and Television Home; Woodland Hills~· CA1 1986 -1990
:m. Significant ln'Vi:ted :Luc¢ures (Since J utly 1984 ..... selected fll•onn ()ver 3,500
leetutres given) · ·
t Harbor General Hospital- U.C,L.A, Medical Center~ 7/a4.
··----. -~- --· ------ - ··-- ~-~-- -oo- ~--~-· ----- 0 --·-· _ _ _ _ _ _ _ _ _ _ . . _____ o --.`` •• - ... --0 ~- o
15
--00---~.-.;·-~-·~···--•' ·- -•- ''~'"'"' -···-·--• - o -··.- 0-- • 0 -0 0 - .. o ~-·-- 0 -- * • 0 0 -----M 0 .... - -
"o 0 0'".
!
APPENDIX 1
lI
381
Ivfedicnl Grand Rounds - new concepts in the tl'eatment of Type II
Diabetes,
2. Harbor General Hospital- U.C.L.A. Medicatcenter~ 7/84,
Endocrl11e Grand Rounds -The ;t>.ewer oral agents.
3. MattinLnthe~· King Getteml Hospita~ Los Angeles, CA) .7/84
Medioal Grand Rounds .... The approach. to the patient with NIDDJ\4.
4. Nisei Awat:en~as Day1 Little Tokyo:. :Los A.tlge.les, CA, 7/84
Health issues for the elderly. Key11ote speech.
5, The Cleveland Clini¢, 9/84. Sym.posiUtn on Diabetes Mellitus- ·
The 'f~'eatment ofthe Patient with NIDDM.
6. American Academy ofVamily Practice> Kansas City> MO, 10/84
·National Meeting, Jnvl£ed Speake:~::
a. Nutdtton in the elderly
b~ New concepts in the thetapy of the Type II diabetic patient.
7. Associates of the Countway Library:t BatVatd Medical School~ 11184.
Biannual History of Medicine lecture ~ "The Black Death Cornes to
A:l.nedoa:H
3. Washington University of St. Louis and St. Louis V.A. Hospital, 11/84.
Symposium on Diabetes Mellitus - The u:ootment of hYPertension in the
patient with Oiabctes Mellitus,
9. The Jackson Laborato1'y, Bar Harbot·, Maine~ 12/84.
Visithlg Scientist..- Insulin secretion in aging.
10. ,Gordon Research C<;mferenoo,.O:gmat,(}, CA~ 2/85. The biol()gy of' agbg; .-
Invited Speake.r . . . Cyclic AMP and insulin secretion ~n aging.
.
11. Thorndike Rounds,. Beth Israel Hospital, Boston~ MA 3/85.
The appl'oach to the treatment of diabetes mellitus in the elde:dy
individual.
12. Division on Aging, HarvardMedioa1Schoo1, 3/SS.
Gtw.d Rounds - Hyperosmolru.· co11:1a""' a complication of diabetes mell~tus
in the Elderly.
13~ The University ofNewBrunswiok~ SaintJohr4 N.B. 1 3/85.
Visiting professor of Biology; Lecture topics:
a. The role of calmodulin in insulin secretion .
..... . ·u.
APPENDIX 1
b~ Th~ exciting new approaches to the treatment of diabetes
·mellitus.
14. Beth lsraeL :Hospital:- Boston~ MA> 3/85
Endocrine Gl·and Rounds -Sex and the diabetic.
15. The Johns I-Iop1dns University Scholl of Medicin~, Baltimoret MD~ 3185.
Visiting Professor of the History of Medioine. Lectw:e topic - ' 3/85
Endoorine G.ra.nd Rounds ...-·Insulin secre.tim1 in aging.
17. Yale Uni-versity School ofMedioine~ New Have14 CT, 4/85
Endocrine Reseruch Confel'en.ce -Insulin seQretion in aging~
··• t... Hypertension Grand Rounds- Special problems ofhypei'tetlsioll in ·
the diabetio patient. ·
18. University ofifl01'ida~ Gainesville~ FL 4/85
Gel'iatdc Medicine Grand Rounds
. -The older diabetic
. patient.
19i University of California at Lo::: Ang~les School of Medicine, 4/85, FaroHy
Medicine Grand 'Rounds ~ Treatment of diabetes 1nellitus in the elderly.
20. Stanfol;'d University of Medicine .- V.A. Ho.apital, Menlo Patl; CAt 5/85~
Clinical Conference- Sexual dysfunction in the elderly.
22. University of Pittsburgh School o£ Medicine_, Pittsbut·gh) PA, 6/85.
Symposium on Diabetes Mellitus - ~rhe older diabetiG patient.
23.. : ...t~!W..niv.ersity ofHawaH School o£Medio1ne) Honolulu, :HI~ 8/85
Medical Grand Rounds- Diabetes in the elderly.
· 24. Depattme.nt of' Public Health and Social Welfare1 Guatp., 8/85
Special L~otute- Wellness and pathology in the eldedy,
25. American Aoade,my ofFamily Practice) Anaheim, CA. 10/85..
National Meetlttg -ln.vited Speaker- Oiabetes ill. the elderly.
26. University of Ct1lifornia at San Pranoisoo ~Valley Medical Center,
Ftesno, CA:. 1liS$. Endootine symposium ..... Sexual Dysfunction 1u. the
elderly,
21. Mayol'->s Conference on Aging, Los .Augeles> CA.:, 3/86. treatment of
chronic diseases in the elderly.
'( p • ~ 4 • -\ l
I
APPENDIX 1
40
28. V.A. Hospital~ Miutinez1 CA. and t.J.C. Davis Sohool afMedic1ne7 4/86.
Medical Grand Rouu.ds ._ Treatmep,t of hypertension in diabetic patients.
29. Pasadena Council on Alcoholism, PasadenC4 CA> 4/86. Symposium on tlie
Older Alcoholic Patient. Pathology and normalcy in aging.
30. Brown University Medical School) Providence, R1 4/86. Medical Gra.nct ·
Rounds- Hypertension in the eldf;}rly.
31. Medical Board Dl'ug Review, Sacramento1 CA, 5/86. Invited Sp~aker-
The new otal agents. ·
32~ Confere1lce - Scll;lntific Basis of Se~ual Dysfunction- Sponso:red by NlH
a11d the National Kidney Foundation, Baltitnote> MD) 6/86,
" •. ··SS·. F.D.A. SyJnposlum of Bioequivalenoe of SoHd Pt¢paratlons~ Washington>
D.C., 10!86. htvited Speaker- Oral sulfonyhu:ea agents.
34.. Univetsity of Nevada, Reno, NV~ 2/87. Visiti11g Professor of Medicine,
Lecture topic . . . Sex after 60.
35. University of Guam~ .Guatu~ USA> 4/87. Sym.poslum on Cru:e of the
EI~etly - Symposium Leader.
36. National Council on Hypertehston, Biannual Meeting; Las Vegas~ NV,
4/87. Invited Speaker ~ Antihypertensive medications and se``H1l
dysfunction.
37. Ame:doan Hospital Phrumaciats Assoolatlon, Washington~ D.C. 5/87,
!~vited Speaker ..... Aging in .Alnerioa ~ Wellness vs. Disease.
! t,.,._;__.
I
f 38. University of California;. Davis- School o.f Medioine~ 6/87. Cours~ (In
~
Medicine~ Invited Speaker- f~ypertension i11 the elderly.
i
39. University of Nevada, Las Vegas> Nevad~ 10/87. Visiting Professo1: ()f
Medicine~ L~cture Topics: Ge1'iat.ric Medicine Today~ Geriatric Course
Planning.
40. California Phrumacy Association~ San Francisco~ CA> 11/87. Invited
Speake!!- Bndocrinology·of aging.
i '
41. Evanston Hospital> No1'thwestern Ui1iversity School of Medicine}
1 ~vanstou> lL~ 11/&7. V1sitingProfessm.·ofMedicine~ TQpic . . . Sr;;x after60.
I
I
.. n ' '"'A • i /J •
APPENDIX 1
41
42. Confe1'enct o:n Pathogenesis and Treatment of 'Pressure "Sores. Kansas
City, MO, I/88. Invited Speaker.
43. Conference on HWhat Phannaceuti~als are Needed for the Elderly?,
Phoenlx~ AZ>2/&8. Invited Speaker.
44: Confet~nce on l'Post Retirement I;Iealth Care Funding'~ sp'onsored by
l.R,t, New Yotl; NY~ 3/88. I11vited Speat{er-The gedatdo I.mperative. ·
45. Board Review Course: Geriatrics Updatej 1988, U.S.C~ School of
Medicine, Pasadena, CA> 3(88 .. Two and one~half day s-ymposium on
gel'iatrios. Dk~ctor, Modet·ator and Presenter for the course,
46. Symposhun on Geriatric Medicine - Motion Picture and Television
Retirement Home And Hospital~ Woodland Hills, CA~ 4/88. Moderator.
and Presenter, ·
47. America11 Getiatdo Society National Meetingt Symposium and Phys~oian
- :Patient Conununicatlou, Anaheim~ CA> 5/88. Co. .moderator and
presenter.
48. Symposium on G$datdo Medicine, San Dima~ Co1111t).unity Hospital~ San.
Pimas., CA, 9/88, Moderatot· attd Presentet.
49, .Amedcan Society for Entem1 Md Pal'ental Nutritlon Conferences= Ethios
and Nutrltion~ New York~ NY, 10/88
SO. Symposium on Nutrition in the Elderly, California lv.tedical Centet1~ Los
Angeles) CAJ 12/8&. Mod~rator and Pl'e.~enter~ Topic- Nutrition in the
Eldel'ly.
51. Cali:f``rJ:iia Academy ofFatuily Medicine~ AnuWll Meetlug, San Ftaucigoo> .. \.t-r.~<.l;lt{·s~---.
CA 2/89. fuvited Keynote Speakel'7 Topic- Dementia.
52. Kansas University Medical Center, Fa.rully Medicint;1 Grand Rounda;
Kansa$ City; KS; S/89~ Visiting FrofesS()f, Topic-- Drngs in the eldet•ly.
53. California Association f'ol' Homes for the Aged:~ Ann1.1al Meeting.
Symposium on Drugs In the ElderlY:~ San Diego~ CA) 5/89, Invited
SpefJ.ker, Topio ..... Mooioal Asp~ots ofDtugs in the Eldet'Ly.
54. Symposium on. Gel1atdc Ca1·e,. Motion Picture and Television I{Qme;
·\Voodland Hills, CA.; 6189. Modemtot and Pt:esenter1 Topic- Tests and
exams pedodically needed fqr Seniot health
i ············--·· ·······--·----·-·-.·---:---··--·········-····- ·-............ -. --- ···-····- ....._.- --;. --··-··-----19 ,--·-- ·-· - ·····-·- ---- .----··..·-·- -:-::~-~·. : : :.-. . o-.- -···· --· - - • -·----· • ·-
·-·-``--:# ~#·-----· ---.. .
"7.- ·~
'i 4 I
'\ J • ~I,
APPENDIX 1
42
55. Syrn.poshu:n of Diseases Affecting Ex.t~nd¢d C-are Managentent of 1he
Elde1'ly~California Federation on· Aging, Newport Beach, CA, 6/89y
Moderato1·.
56. Symposium of Diabetes in the Elderly, USC School of Medicine~ Los
Angeles~ CA> 8/S9. Moderator.
57. V.A. Medical Centet; Phoenix, AZ) 9/89. Medical Grend Rounds~ d111gs in
the Elderly.
58r Gel'iatl.ic Medicine Symposium, Hawaii Medioa.l Association_, 9/&9~
lnvi.ted Speaket'7 Topic- Hypertension in the Elderly.
59~ Univ~rslty Medical Center of Kansas City~ Kansas City~ MO, 9/B9~
Medical OJ:and Routtds- Sex after 60.
• 1~-l ...
I 60, National Confe-.veuoc of Consulting Actuaries, Hot Springs~ VA> 9/89.
fuvited Speaker.
61. California Pharmac.ista A~sooiatlCH\, Los Angeles1 CA~ 10/89.
Enc'toorlnology in ihe Elde1'1y. Progran1 Dll'cotor..
62. Family Medicine Program, Santa Rosa, CA~ 11/89~ Visiting Professor of
Geda.trlc Medicine.
63. Symposium on Geriatric Moclioine. Tacoma Ge!leral Hospital> Tacoma,
WAj 1/90, Course Director and Speaker.
64.. Symposium on Gedatric Medicine~ Antelope Valley Medical Center,
Lancastet1 CA, 2190. Cour~e Diteotor and Speaker.
65 •.. Unive.t:sity of Nevada School of Medi~1ne>.. ~-R~no,. NV, 3/90. Visiting
Ptofessot {)f Gel'iatrlc Medicine.
66. USC Gedat;dc Review CQurse; USC School of Medicine~ Los Angeles~
CA~ 3/90. Two and one ..half day :intensive course in geriatric medicine.
Co1.u:s~ Director and Spe~er.
67. Eisenhowet· Hospital~ Rancho Mttag`` CA, 3/90. Medical Grand Rounds-
Dl'ugs in the Elderly.
68~ Atnedcau Geriatric Society Arulual Meeting, AtlantaJ GA, 5190.
Symposium on Syndrome X: The con:elation of diabetes and hypertension.
69. American Diabetes Assooiaiiolt Symposit'tltl> Santa B~bartt;, CA; 6/90.
Diabetes in The Mexicati. American Population. Invited Speaker.
-- --- ·--.. . . ~-- -~--..- ---- -~ .... -·---:·----~· ----· --- . . -:- --~ --.. . ~:. -- -: . ----- ·--.. . -·· -~ - . 20
• - - - - - - - - - ----- -'; .7' ::;: :-~-.;:;::·:-. - .::·-••. • :· .-:;---.--·---.---·-·
. ..___. ____ ···- - ---------- .. -~ ----·-.---.-·--
.... ... d •
APPENDIX 1 I
I
43 1
·70. Loma .Linda Univer$ity School of Medicine~ Lorna Linda~ CA, 7/90.
. ! Grand Rollilds, Drugs in the Eld~rly.
71. A.me;ricl;lll Heart Association/ American Diabetes Association Symposium,
Santa Bal'bata, CA, 9/90. Treatm.en:t of the hypertel1Sive diabetic pat.ient.
Keynote Speaker.
?2. Baylol' College of lVledioine, HotlSton l'Xl 10/90. Symposium on the
3
Complicated Diabetic. Invited Speaker.
73. City of Hope, Duarte~ CA1 1/9 L M~dical Gra11d Rounds, Diabetes ht the
Elderly.
74. Providence Hospital, Anohol'age, AK) 2/91. Medical Grand Rounds-~' Sex
after60.
.•,
75. Sym.posium on Geriatdo Medicine, Antelope Valley Medical Cente1'11
Lanoaste1~ CA~
3/91. Course Director and Speaker.
76. U.C.S.F. - Valley MedicaL Center1 FresnD~ CA, 3/91. Medical Gtand
Rounds, Sex after 60.
77. U.C.D. ~ Sacram~ll:t<>., ¢A) 4/91. Medical Grand Rounds) Sex after 60.
78, Chicago Mec11cal College~ Cl'ticago~ IL~ .5/91. Medical Gtatul Rounds,
Drugs in the Eldedy.
79. Symposium of Gt}riatric Medicine~ Antelope Vall~y M('3dical Center,
Lancastet; CA~ 2/92. Couts<.1 Directo1' and Speaker.
80. Dep~oot ~-of Administration~ State of Alaska> 4192. In:vited Speaket, ~ .. '-llr..'l!I.>HN~·f~ ·~.-.·
Assisted living in long tenn c~te.
8L Intetnational Institute for Reseru:oh Symposium.: Utilities and FAS 106,
Washington~ D.-C.~ 7/92. Keynote Speaker, J?rugs in the~ retited population.
82, Alaska Oe.datric Institute$ Anoho1'age~ AK, 2/9'3~ Keynote. Spe~ke;r.
33. University of Oldahoma, Tulsa, OI~ 3/93., Farnily Medici11e Grand
Rounds, Dt•ugs in the elderly.
84. Symposium on Gerlau:lc Medicine, Antelope Valley Medical' Center,
Lancaster> CA1 3/93, Cours~ Ph:eotor and Speaker.
.. .
~
I r '1 a • 1 A •
APPENDIX 1
44
:
85, Depru:tme:nt of Administra.tion, State of Alaska~ 4/93. Invited Speaker~
Medfcatkms in the nursing home population.
·86. Dallas Business Group on Health, 5/93. In-vited Speaker, Medications in
the Elderly.
87. Symposium on Rc;Jtirem~nt He~Ithoare Benefits, Chicago, lL) 9/93. lnvited
Speaicer) Medications in the elderly.
88. University of Hawaii~ Divigio~1. of Geriatric Medicine~ Honolu.lu.) ·lU,
10/9/93. Visiting Professol' of Gerlatric Medicine Diabetes h1 tn~ eldetly,
7
Use of drugs in the eldetly.
89~ Providence l-Iospital~ Anchomge~ Alaska. Medical Oxand Rounds~ 2194.
))ementia.
90. Ne-vada AoadeJny of Fatn..Lly Medicine~ A).1l1Ual !vfeeting. Like Tahoe>
Nevada> 2194·.. Keynote Speak~i'- Sex. niter 60r
91. University ofCnlorado Mfiliated Hospital. Medioa.l Grand Rounds~ 3194.
Dl1lgs in the Elderly.
92,. University of Keu.tuclcy Affiliated Hospital. Geriatdc Medl.oal Orand
Rounds~ Lexhlgfon, l{entuoky, 4/94. Dementia.
93. Alaska Psyclrlatrlc Institute- API 2000 Me~ting> Anchorage;. Alaska,
6/94. Plans for the Future_.. C()nsultant and Facilitator.
94. USC School of Medici·ne7 los Angeles> California - Medical Gnmd
Rounds, 9/94. Drugs in the elderly.
95. Alaska State Mental Health Boatd - Q"tUru~dy:..,Meetlng, :OiHnghun~"·
Alask~ 9/94~Invited Speaker~ The Alaska Geriatric Institute.
96. Alzheimer's Society of Northe~n Califomi~ Sacramento~ CA) 10/94-.
Speaketf Researoh in dementia.
91. Alaska Gedatrlc Institut`` Anchomg<;J~ Alask~ 2/95. Organizer an.d
. Keynote Spealcer, The largest health ¢ate symposium in ihe history of the
state of Alaska.
98. V.A, Medical Center W<;~stwood and UCLA-- Medical Grand Rounds)
2/95.
99. Symposium on ·Geriatri<} Medicinell A.ntelop~ V.alley MediQal Centet~
I.Jancast~r~
CA, 3/95~ Course Direotot' and Speaker.
'\A • ~II'
APPENDIX 1
45
100. Nevada Academy of Family Medicine} Ann.ual Meeting, Lake Taltoe~
Nevada, 3/95. Keyltote Speaker-.Dementia
10L Idaho Academy of Family Medicine, Annual Meeting~ Sun Valley~ Idaho,
5!95. Keynote Speaker-- Dementia! Sex aftet 60.
102. Martin L'Uthet King, Jr. Medical C~ntel\ Los Angeles~ CA, 6/95, Medical
Orand Rounds- Dementia.
103, Martin Luther Ring, J'r.. Medical C~nter, Los Angeles> CAJJ 8/95. Mecioal
C3nU1d Rounds~ Sex after 60.
l 04. University of Alaska~ Southeast - Sitka Geriatric SymiJosium, Sitka1
Aluskaj 9/95. Orgauizer, Keynot~ Speaker.
105. V.A. Outpatient Clinic~ tas Vegas~ NV~ 10/95, Medioa1 Gmnd Rounds,
Dementia.
106. V.A. Outpatient CHnic~ Los Angeles, CA~ 11/95. Gx~n.d Routlds -
Dementia. '
107. V.A..Outpatient Clinic Los Angeles> CA} 12/95. Grand Rounds- Sleep
disorder in the elderly.
108. State of Alaska.) Di'Vision of Senior Serviof.'ls, 2{96. Leotutes and site visits
to six State of Alaska nw:aing homes.
109. Symposium. on Geriatric Medicine~ Antelope Valley Medioal Center,
Lancaster, CA~ 3/96. Course. Director and Speak~t.
.11 0. Family ~e..T1'aitling Program, Spokane, Was4tngton, 3/96. Lecture
..... De:rnenti:a.
111. Family Medicine Tratu.ing Ptograrn, Central Montana7 4/96. Lecture .....
Drugs in the Elderly.
112. University of Utah Affiliated Programs, Salt Lake City, 4/96. Lectm:e -
Depression in the Eldedy.
113, State of Alask~ Department of Administration~ DlvlslQn ()f S6nior
Services, Course Cootdinato:c for visits of l6 Alaskan State officials to
USC School of Medicine, Andtu$ Oetontology Center and affiliated local
Southern California Geriamo Programs. Duration. ._ one month, early May
to eaxly J~me, 1996:> Los .Angeles~ CA.
APPENDIX 1
46!
114. State of Alaska; Division of Senior Services; Department of
Administ.t:ation. Site visit to Ad111inistrative offices for review of Geriatric
Programs. Jtmeau,. Alaska, 6/96. Outside Consultant and Lecturet
115. University of Alaska; Southeast Sitka. Care of the Elderly Sym.pOSA\l.!il~
Sitka, Alaska~ 9196. Cours~ Direotor and Leotut·e:c.
116. Boige Health Consortium- Medical Grand Rou11ds1 Boise~ Idaho, 11/96.
Sex. after 60.
117. Symposium on Long 1'~nn Cm.•e for Prov1dc.ts~ Milwaulcee~ Wisconsin)
2197, Keynnte Speaker~ Drugs in the elderly,.
118. Symposium. on Gel'iatdc Medicine:~ Antelope Valley Medical Center~
Lancaster, CA:. 3/97. Course Director and Speaket'.
Osteopathic Medical College, Des Moines1 Iowa~· 4/97: Symposium on
• ,, ... "' u
119.
diabetes Mellitus> Keynote St'ooker ~ Diabetes in the Elderly.
120. Utiiversity of Southern Illinois Medical School, ChampaigiJ, Urbana)
IiHnois, 4/97, Medi:oal House Stuff Lectures. Topics - Diabete$ in -the
Bldedy~ Drugs in the Elderly.
121. Allegheny Medioal School, :Philadelphia, PA, 5/97. Keyn<)te Speak(}7: ....
Sy.trtposiunl. on Diabetes ruul Lipids in the Elderly.
122. State Seni-or Care Progratrl> Oldaho:ma City~ Oklahoma, 7/97, Keynote
Speaker- Stat~ of Okl~homa Senlor Care Ftogram.
123.. Eastent Cal'olina Unive1'8ity Medical SchoolJ Greensboro, North Carolima>
S/97. Medioal Grand Rounds.
124. University of Alaska, Southeast Sitka. Cm·e of the Eldel'ly Symposium,
Sitka> Alaska~ 9/97~ Coutse Director and Lecturer.
125. Univel'sity of Colo1'ado11 Denver> CO~ 10/97. University of Colorado
AffiHated. Programs~ Several States~ Medicat G1.m1d llounds.
i
126. Arizona Chapter of the Amedcan Gerontologio Society) Pho~uix, A'l,
11197.. Sex Aftet 60. t
. . l
i
127. Symposium of Gerlattlc Medicine, Antelope Valley Medical Cenfut',
Lancaster~ CA, 3/98. Course Director and Speaker.
128. Medical University of South Carolina, Charleston, Soutl1 Carolina_, 4!9&.
Family Medicine Grand Rounds:> Sex After 60. I I
I
I I
1
I
I
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I
l lI
'16. .... 6 • t !
, I
APPENDIX 1
47
129. University of ColDrado2" Denvet~ CO~ 4/98 1 University of Colorado
Affiliated Programsi Several Sites, Medical Grand Rounds.
130~ Eisenhowst M~dical Center; Rancho Mirage~ CA, 4/98. Medioal Chand
Rounds/~
Dntgs itt the Elderly,
l3L University of Alaslca 1:'\nd U.S.C.:> Sitka, Alaska; 9/98. Cro:e of the Elderly
Symposium, Course Dh'eotor and Speal~:t:n'.
132. University of South Carolirta School of Medicine~ Charleston~ South
Carol:ina11 10/98, Family Medicine G:ta.nd Rounds~ Sex A.ftel' 60.
133. V.A. Outpatient Clinic, Los Angeles; CA, 10/98, Memorial Leoture Set[es~
Medi.cations in the Elderly,
134. V.A. Outpatient Clirtio, tos Angeles_, CA~ 10/98, Me1notial Lecture Series . ~ -
Alzheimer's disease.
135~ Visiting Professor of Geriatdo Medicine; Alaska. Gedatric Institute,
Anchorage: Alaska> Aprilj 1199. Multiple Lectures~·
136. Visiting Profess('~\' of Gelia.trio Medicine, University of New Mexico
School of Medicine;. Albuquerque, New Mexico, 6/99) Alzheim~t's
disease.
137. Univetsity of Alaska~ Sitka, Alaska) 9/17/99..9/19/99. Care of the Elderly
Conferenc1;J~ Course Director and Leoturel'.
138. Visiting Ptof~ssor of Ger1au1c Medioine~ University of .Arizona Affiliated
Hospitals of Tucson and Phoenbc, A2} 10/20/99-10/23/99.
139. Symposium of the G!7rontological Society of .Alnerfc~ San Francisoo, CA.,
11/.21/99. Inte1·disoiplinary Approaches to Teaching Gerlatrlcs, Invited
Speaker.
140. State of AI~sk~ Anchorage, Alaslm~ '2/20/00-2/23/00. Task Force for the
Assessment of Assisted Living in the Pioneersi Homes, Leader and
Spokesperson.
141. Visiting Professor of Geriatric Medicine; University of Colorado School
ofMedicine Afftliated Hospitals~ Denvo`` Colorado, 3/7/00~3/8/00.
142. Visiting Ptofessor of -Geriatric Medicine, Affiliated lntel'nal Medicine
Programs, Bl Paso, Texa~, 4/26/00--4/'2.7/00.
I
. . I
~---~--- ~_;-o-··-·· -·-: --:-----· ·----· -·-.--- ···;--;-;·· ... :····-··--,.--~- .... ·-- :.-;;-:::."·~·-·:;:·:=::.· ·.. :c;,.,.,~;-:-;··,·:·-···-.- ---------.1'~-----·-- . -- --·------" --- ---·· -- ------- --·
i -1-------·
'!
.. u • .. 'Ll '
APPENDIX 1
143. Newp01t Beach> California> 5/5/00. Al111ual Meeting of the California
Associ~tion ofMedioal Directors~ In~ited Speaker.
144. Antelope Valley Hospital,. tancaste;c, California, Medical Grand Roun,.1s,
11!17/99~ Treatment of Artlll'itic Fain in the Eldedy.
145. Kern Cotmty Medical CenterJ Bakersfield, California. Medfoal Grand
Ro\U1c1s~
1/7/00. Hazards ofDrugThecapies in the Elderly.
I 1
146. Hoag Hospit~ Newport Beach.t Californ.ia, Medical Gr~nd Roun.ds)l
3/10/00. Sex After 60~
1474 Visiting Professor of Oeriatric Medioin(i}; Affiliated Internal Mediolne
Programs~ Bl Paso., Texas. 4/26/00.. 4/27/00
;
148. Arrowhead Medical Ccnte:t.·~ San Bern~tdino County Hospital, Colt<>n,
California~ 5/17/00. Medications in the ElderLy.
149. Annual Meeting of the Callfor.rrla Association of Medical Directors),j
11
Invited Speaker~ Newport Beach, Califoxnia, 5/5!00.
150.. Riverside General HospitaL, Merino Valley~ California~ 6/16/06. Medical
Grm1d Rounds~ Medications in the Eldedy.
151. The Elderly Diabetic. Care of the Elderly Conference, University. of
Al~ska:- Sitka~ Alaska~
9/21100.
152. Treatmel1t of Arthxitic Pain. Care of the Elderly Conference;, University of
Alaska, Sitk~, Alaska, 912.1100~
153. Depression in th~ Elderly. Care of the Elderly Conference~ University of
:_n:..; ,,11~ ·~ t.w~ Al~sl<:~ Sitl\~ .Alaska:, 9/21/00. ·. .. t.,
154+ Treatment of Hype;rtension in the Elderly. Cw:e of the Elderly
Confere11ce1 University ofAlask~ Sitka, Alaska., 9/21/00,
155. Medioations in the Elderly. Continuous Quality lw.ptovement (CQI) in ihe
Smte..Assisted Living Faoilitles:- Depw:tment of Administration) Stat~ of
Alaska, Ancho:tagej Alru1k~ 11/13/00.
156. Falls in the Eldedy~ Continuous Quality Improvement (CQl) in the State..
Assisted Living Faoilitles, Depru.tment o£ Adrrt:b:rlstratioll,· State of Alaska,
Anchorage" Alaska, 11/13/00.
l57. Dementia. Memorial Lecture Series) Outpatient Department~ Vet~rsns
Admittistratlon~
Los Angeles:t California, 112101.
-·- --~-· --·-~---:·--:------- :·-:-·- - ·--- ·:--:--------------------:-··--- -------· ----·-.. ·-··---------·----·-------16:
~t I
APPENDIX 1
49
158. &ropsychiatdc Assessment of the Eld-e:rly. .Bu1'eau of Medi-Cal Fraud and
Elder Abuse, Department of Justice~ State of Cali£ontta~ Ontario
California> 2/22/01.
159. Treating Chronic Pain in the Elderly. Memol'lal Lecture Sed~s, Outpatient
Depatime11t, Veterans Administration Los Angeles1 Californi~ 1/2/0L ·
160, Medications in the Elderly. Continuot\s Quality In>.protrement (CQI) and
the Risk..Plus Ptogrrun irt the State. .Asslsted Living Facilities~ Department
of Administt'a.tion) State of Alaska, Sitka, Alaslta, SflfOl.
161. Falls in the Elderly. Con:tmuous Quality Improvement (CQI) and the
IUsk-Plus PL'Ogran1 in the StateMAssisted Li'ving Faoilitieg; Depru.iment of
Administration, State of Alaska, Sitk~ Alaskat 511101'.
' ·.
162, Sexuality. N01'th Amerioan Fotun1 on Women's Health, Los Angeles,
1
Cnllfotnia, 6119/01.
' I
i 163. Alzheimet~s Disease, North American Fo1·urn on Women.~s Health1 Los
Angele~> Califot·nia~ 6/19/0 1·
164. Ge:ropsycht>logical Evaluatron of Seniors. Syroposiuh1 on Eldet AbtlSt).
Depattment of Justice-Bureau. of' Medical Fraud and Elder Abuse,. R~mcho
Mirage1 California~ 9/7/01
165. Depression in the Elderly. Hoag Hospi1al. Newpott Beach> Califomla>
9/7101.
I
166. Sleep Disorders in th~ Eldel'ly. Care of the Elderly Coufeten.oe. Uuivetsity
I' of Alaska ..... SitkaJ Sitka.., Alaska, 9/2'3/01.
t ....
! 167.. Medications in the El San Bernardino Gene.t:aJ Hospital, Colto~1)1 Californl~ 1l/29/01.
170F Patient and Family Satisfaction in Long Ter1n Cat~. Alasku. Pio.n``ra~
Home, Anchorage~ Alaska. A :site visit and symposi~ 12111101...
1~/15/0L .
····-····-·-···· .... ···- . --·.---.·-::;-"-;':"';:-.!~--.-:::·-··--:~.: •.-.":.::-: ·-;- :·.·;-~ ..
.. ~ . ., ~ ' . ... J •
APPENDIX 1
sol
1/1. Normal Aging vs. Disease. Symposhtm on Geriatric Medicine. Annenberg
Centerl Rancho Mirage. Californi~ 2/202.
172. Medications in the Eldedy, Memorial Lecture Series, Outpatient
Department, Veterans Administration~ Los Angeles, California, 2/26/0'2.
173. Life Style Redesign in Elder Ca:ro. zua Annual North- Ame.dcan Forum on
Women's Health! Anah~im~ California} 3/1/02.
174. Dementia in the Elderly. Memorial Looture Series, Outpatient Department~
Vetet·ana Adminfstra.tto:n, Los Angeles:. California; ::l/12/02.
175. Diabetes in the Elderly. Endocrine Orand Rounds, Harbor General
Hospital, Torranoe, California, 4/l/0/2.
176. Medications in the Elderly. Mtllll..lecture series~ Co1111'riissloh on Aging~
I" ,,
~f ' • ., .. State of Alaska, Anchorage and Fairbanks,' 4112/02.. 4/26/02.
177. Treatment (!f l)aiti in. the. Elderly. Care o£ the Eldei'ly Cortfereno~\
Univel'sity of Alaska~ Sitka Sitka, Alnska~ 9/19/02.
178. Treatment of Cardiovascular Risk Factors in the Elderly. Care of the
Eldetly Conference~ University of Alaska> SitkaJ. Alaska 9/19/02.
179. Special Issues in Long Tenn Cat·~, Assessment and Evaluation of the
Artcho:rage Plorteers' Home; Anchorage~ Alaska, 12!10~12/14/02.
180. Identification and Treatment of Cardiovascular Risk Factors in 'lhe Elderly
- A symposium Montgomery Cardiology · Programs. Montgotnety~
Alabama> 3/2l/03~
I ••• un. Me4ications in the Eldel'ly, Multi..lecture serlesj Connnission,on Aging>
State of Alask~ Anchotage and Fairbanksi 4/23 ..4/26/03.
182. Assess1nent of Mental Competency and Discussion of an Elder Abuse
Case. Symposium on Eldet Abuse) Departtnent of Justice .... Bureau of
Medi~Cal Praud and Bldet Abus`` Squaw Valley; California, 5/27~-5/30/03.
183. Medications in the Elderly. Multi-lecture series, Commission on. Aging,
State of Alt'\ska;,Juneau and K6tchU~JUl, 6127-6129i03.
i84. De1nentla in the Elderly: Medications in the Elderly. Csx~ of the Elderly
Conference~ University ofAlask~ Sitk~ Sitka~ Alask~ 9/18w9/19/03.
18S. Demerttiay Gerlatdc Symposium:.... St. Mmy~s Hospital and Soan, tong
Beach, CaUfonlia; 10/4/03. i
I
i
~:
!
- ......·-----:- ·~--;-~*'--.~., .•- ------ ~..t.....
``·-···-·----18-. ·-"--·-·· -··-···-.. ·-.......... · · "· ,- - ·- - . --.----·------·--·-----.._. ___,____,_~--~. - -1---
. !
"'". ..,. A •
l
APPENDIX 1
51
I
1&6. Senior Assessment for the Care Provider. Public Health Foront-- State of
Alaska. Anchorage~ Alaska~ 12/1(03.
187. Seniot Assessment Workshop, Alaska G~tiatrlc Education Center,
Unlversity· ofAlaskar Anohom.ge.,. Alaska) 1/23/04.
'i
188. Sleep Disorders in. the Eldedy. Coping wlth Chronic Disease. Care ofthe
Elderly Conference~ Unive1'sity of Alaska~ Anchorage, Alaska.t 9/11/04.
189. Eldet Abuse. Coping wlth Chronic Oisease. Cardiovasoulru: lUsk Factors
in the Elderly. Senio:r Lives Conference~ Untve1·.sity of Alm~ka-> Anohoragej
Alaska 6/10/05.
190. Assessment of the Chart ln Sldl1ed Nul'Sing Facilities. Symposium on
l • .:t.... ,.,. ..
Eld.er Abuse; DeparttnJ}nt o~ Justice~ Bureau of l\1edical Fraud attd Eldet ...
i
. ! Abuse~ Long Beach~ CaUfo1nia~ 6/6~6/9/05. · ·'
191. Coping with Chronic Disease. The Chru:t in. the Skilled Nursing Home.
Care· of the Elderly Conference~ University of Alaska~ Sitka~ 9/16/0S.
192. Sex After 60. The Chati: ifi the Skilled Nursing Home. Ptolnoting :Best
Practices in Aging Gonfetence~ Unive~'Sity of Alaska> Anchorage- 6/S/06
-6/10/06.
l93. Medic.al Realities and Dimin{sh~d Tribal Longevity. New Aspects of Long
Tenn Care. Cate of th(1 Elderly Confetenc~, University of Alaska , Sitka~
9114106- 9/16/06. .
194. Standw:d of Care> Symposium on Elder Abuse~ ))epattment of .Justice~
. State Qf Califomin, Buteau of Medi...CAL Fxaud a11d Elder AbuBe~ San
·. Mateo1 Callfotni.a IY.Iay~oo.ou-~..:..
195. Integrated Therapies fot· Aging. The Thet·apies~ Care of the Elderly
Conference~ University \>f AlMka~ Southeas~ Sitka 9/~S/08 ..... 9/27/08.
196. Human Biology 596 Course University of Washirtgton Medical School -
WWAlYJl Program- Mnlti~Disciplinaty and E1hnicity in Gerontology and
Geriatrics. L~ctur:es to Alaskan Medical Students~ Unive1's1ty of Alaska~
Anchorage, Apdl2009. · ·
197. Mental Health and Dementia. . Inter-disciplinm'Y Ptao1ioo in Geriatrics Se)r
After 60. Pt:omptlng Best Practices in Aging Confet-Gnce., Univexs~ty of
Alaskf4 Anchorage, 6/3/09-6/5109.
)[. PllJBLJ(CAT)[ONS
- ---~--;-.- •• ·--~-:-·---~ -·- -- ------ -~.· - - - - - - · · - - - - - - •• · - - - : - · · · ,:, ·~: :!--.: - ·'--29 -.--::.·:-. ··-- ;-- ---,-·- ____ : . - ~----- ... -------- ~ . --·- ---·-- ..
---------- ----· ----
'Yl1 •
APPENDIX 1
52
Papers- Peet• Re'View
L McCleverty> J.A. and Willdnsol\ Gl (Submi«~rs)~ Lipson> L. O., Maddox,
M.D. and Kaesz, H.D. (Checkers): Dichlorotetracarbonyldbhodbm.
Inorganio Synthesis Vol. VIIr. oltzclaw, H.F., Jr. (Ed) MoOrawwBill, New
York, 1966 pp.211-214.
1
2. McCleV'erty1 J.A. and Wilkinson) G. (Submitters), Lipson~ L.G., Maddox~
M.D. and Kaesz~ H.D. (Checkers): Chlorocarbonylbl$ (tdpl1enylphosph1e)
rl1odium and chloroom·bonylbis (triphenylarsh1e) thQdium. Inorganic
Synthesis VoL VIII; Holtzclaw) H.G. Jr. (Ed), McGraw~Hill~ New Yotlc)
NY 1966, pp214..217~
lipa~m} L.G. 1 Capuzzi1 c.M. and Margolis> S.M! Effect on method of cell
isol~tion on the metabolic activity of. isolated rat liver cells. J. CellSC. · ··
10~167 ..179, 1972.
Lipson~ L.G.: Plague itt San. :F):anoisoo in 1900, Atm, Int. Med~ 77~303 ..
310, 1972.
Kohler, T.R., Lipson> L.G., Flores,) J.> Witkum, P.A.~ Fischer~ J.B,~ and
Sharp, G.W.O.! Sequence of events in the activation. of adenylate cyclase
by cholera toxin. Bull Schwe;itz, Akad. Med. Wiss. 32--223..23:2~ 1976.
6. Beiteins~ r.z.) Lipson~ L.G. and McCarthur~ J.W.~Lu.teinizing hormone,
follicle stimulating honuone and their subunits released in cultnre by
human pituitary tumors. J. Clin. Endo. M~tab. 45!1271-1280~ 1977.
7. Fisoher, J.J.3~> Kohle1 1- T.R.., Lipson.t L.G.:~ Flores.t J.; Wttkam., P.A.; and
1
I
I
Shru:p.t G.W~G.~ Studies on the time oours~ and tat~ limiting steps irt the
i activation of adenylate cyclase by cholera toxin. Biocltetu. J. '173 ~ 59-64..
J '197ft
J
f
l 8. Lipso~ L. G., Beitins, LZ., Kornblith, F.D.lo MoArthm·!! J.W., Frie~en.,
fl llG.~ Klirnan~ B. and Kjelbe1·g, R.N.: Tissue cu1tme studies on lm.t.nan
!
pituitruy ·tumors: Radioitumunoassa.y of ant~nior pituitary hormones in
culture medium. Acta. Endo(~.cln. 88:239--249~ 1978.
9. Lipson, L.G~ and Shw.p~· G.W.G+; 1nsulin sec1·etion in vregnan.cy! Studies
on adenylate Cyolase, phosphodiestarase, protein kinase and
phosphoprotein phosphotase in Xsolated islets of Langerhans of the xat.
Endocrinology 103!l272.-1280j 1978.
10~ Lipson, L.G.~ Beitins) l.Z.~ Kornblith, P.D., McArthur,· J~W., Friesen~
HLG.; Klim~ B. and Kjelberg, R.N.~ Tissue culture studies on hu.tnan
.... , A ' .. 14 •
APPENDIX 1
53
pitnitru:y tumoxa~ Loug"term .t:elease of antetior pituitary l1ormones. Acta.
Endocrln. 90~421~433, 1979~
1L Lipson~ L,G.~ Siegal~ E., Wohlheim~ C.B. and Shatp, G.W.G.: Insulin
release in fast[ng! Studies on ade.nylate cyolaset phosphodies~rase7 p);.otein
kinase and phosphoprotein phosphatase in isolated islets ofLa.ngerha.ng of
the rat. E:ndoc1·inology 105:702..717~ 1979.
12. Lipson> L.G.) Bush~ M.J., Tieljen3 G.E. and Yoon, A.; Role of the
aden.ylate cyclase sy.ste111 in altered insulin ~eiease from. islets of
Langerhans of aging rats. Acta. Endoodn.. 96:222H226, 19tH.
13. Lipson~ L.O.: Bobl'ycld~ V.A.$ Bush, M.J.> Ttetjert, G.E. and Yoon~ A.:
Insulin release in aging: Studies on adenylate oyclase, phosphodiestatase
at1d protein kirt.ase in islolated islets on Lange1'hans of the rat.
Endoodnology 108: 602-624> 1~81: 1;~ •• -: · ' •
14. Lipson> L.G.> Moore,~ D., Pope" A.M.J ToddJ G.J., an.dAvil~ S.; S~xual
dysfunction in Hypertensive diabetic pf.ltients. J. Cardiovascular Med. 6:
Supp. 1) 30-37~ 1981.
15. Cottou? D.B.~ Straa.anet1 B.G~, Lipson} L~G., and Goldstein~ D.A,: 'Ih~
effeets of terbutaline on add-base) eleob:olytes and glucose homeostasts
dur1n.gthe managementof'preterm labor. Am. J. Obstet. And Gy.n, 14l~
617.. 624~ 1982.
16. Oldhru~ S.B .1 LipsQ~ L. Lu~ C.C~, Santiago, N.A. 1 Gray~ G.M, and .
Lipson, L.G.: Basal.-Jate.eal and intJ:acellular membrane vopulations of th(l
tate exorbitallacd:tnttl gland. Am+ J. Physiol. 2.45: G 133 ..142, 19S3.
19. Premdaa, F.H., Molin~ I.M. and tipso.t4 L.G.: fusulini'elease in aging:
Role L.G. and Lipso~ M.: Treatment of the obes~ maturity onset
diabetic pmient$ A:roh. Int. Med. 144! 135-138, 1934.
'n ,
APPENDIX 1
54
21. OJdha.m, S.B.}Molloy, C. and Lipson~ L.G.: Calo~um inhibition of
adenylatecyclase in the parathyroid gland. Endooi'lnology 114~ 207~214,
1984.
22. Lipson>.L.G,: Sexual dysftmction in the diabetic patient with hypert<;}nsion.
Am.. J, Cardloi. 53: 46A..50[\ 1984.
23. Lipson> X.,. G.: Speci.ai problems in the treatment of hypertension in tht>
patient with diabetes mellitus. Arch, Int Med. 144! 1829.. 1831> 1984.
24. Oldllam~ S.B,; Rude, R.K.; Molloy~ C. and Lipson:r L.G.~ The effect of
)nagnesiun.t on calcium inhibition of parathyroid ade:nylate cyclase.
Endocrinology.115: 1883u1890, 1984.
25~. ... Molina, J.M.J P.rem.das, F.H.~ Klenck, R.E.~ Eddlestonej G.~ Oldhmn~_S.~.:-
' · and Lipson; 1.G.: The dynamic insulin. secretmy respon~e or isolateci · · ·
pancreatic islets of the diabetic .mouse~ Evidenoe fot a gene dosage effect.
on il'lsulin secretion. Diabetes 33: 1120.. 1123.
26. Bddlestone, G.T.~ Oldham> S.B.~ Lipson) L.G.~ Premdnsj F.H~ and
Beigebna~ P.M.! Electrloal aotivtty~ cAMP concentration and insulin
release in mouse islets ofLangerh~s, Am. J. Physiol. 248: C 145-153~
1985.
27. Molina, J.M., Prerndas~ F.E. and Lipson1 L.G.: Insulin release in aging!
Dynnntio response of isolated islets ofLangerhans of the rat ton . .
glyce~aldehyde. Endoctinclogy 116: 821 ..826> 1985.
28. Oldham> S.B. and Lipson) L.G.: The high affinity cJtlcium inhibition \If
parathyroid adenylate oyolase is not calmodulin-dependent. Calcif1 Tissue
Int. 38~ 275-281~ 1986.
29. Bailey., C.J.; Day, D.; Bray~ G.A.; Lipson) L.G. and Flatt> P~R.: Role of
adrenal glands in the development of the abnonnal glucose and insulin
homeostasis ingenetioa,lly obese (ob/ob) mice. Hormone and Metabolism
Research, 18~ 357-360; 19&6,
30. Prochazka_, M._, Pxemdaa, F.H.t Leiter1 EJI. and Lipson1 L.G.: Estrone
treatment di$sociat~s. primru.y vel·sus secondary consequences of
''diabetes'' (DB) gene ~xp:ressionh1nrloe. Diabetes, 35~ 7?/5.. 728~ 1986.
31. :Gipson, L.G.: Diabetes in the elderly: Diagnosis.'# pathogenesis~ and
therapyA Am. J. Med. 80! Supp. SA: 10~21~ 1986.
--·~------------- ------~----·---
y ~ •
APPENDIX 1
55
32.. Fadda> G.Z., Ak.tnal, M.~ Premdas, F.H., Lipso11~ L.G. andMassry) S.G.;
Insulin release from pancreatic isLets! Effects of.CRF at1d excess l?TH.
Kidney 1nt. 33% 1066.. 10721 1988.
3j, L~lter, E. H.) Prerodas> F.H.~ Hmrlson, D.H. and Lipson, L.G.~ Aging ar:d
glucose homeostasis in C57BL/6J male mice. FASEB Journal. 2: 2807. .
2811,.1988.
34. Fadd~ G.Z.~ Aktnal~ M., Lipson~ L.G.~ SolimM, A. andMassry1 S.G.~
Correction of glucose into~erance and the impaired insulin release ()f
chronic renal failure by verapamll. Kidney lnt. :36: 773~7?0, 1989.
35.. Fadda, G,Z., Akma.4 M.~ Lipson, L.G. and Massry, S.G.: Directeffeot of
p~athyroid homtcne seo1•etion from pancreatic islets. Am. J. Physiol.~ 258
(EndoorlnDl. Metab. 21)~ E975.-.B984, 19.90. ·
.... ,.
36': Mulligan, R., Lipson~ L.G. and Heaton;! S. G.: Detecting diabetes iu ari"'' ·
eldel'ly dental patient population. Special cate in Dentistry: Feature
Article: SeptemberwOctobex, 142.. 147, 1990.
37. Xin ..Gin) z.~ Fad.d~ G.Z,, Lipson, L.G. and Massry1 S.G.! Phosphate
depletion impaits insulin seotetion by pa11CJ.'eatic islets. Kid. Int. 39~ 120..
128~ l99L
38. Fadda.1 G.Z.) H$Jjat·, S~M.~ Pe.tna A. F.~ Chaut X.J., !Jipson, L.G. ar1d
1
Massry, S.G.: On the mechtmisms of impaired insulin secretion in chtonic
l'enal.:failure. Jout~ Clin. Invest. 87: 225. .261~ 1991. ·
39. Clark~ F. Carlson~ M., Zim.Ice, R.~ Frank~ 0,~ Patterson, K.~ Lat·son, B.)
Rankin--Martinez> A.) Hobson, L., Crandall> J,~ Mcu1del, D. and Lipson,
L.G.: A qualitative study (lfthe life dCJ.tnilins w:td adaptive stmt~gies of the
lowincome).wellelderly~ Am. J. Occup. Therapy~ 1994
. 40. Clark F~ Carlson, M., Zhnke, R., Franlc1 G. 1 Patterson~ lC; Et1I1evor, B.~
Rankin-Martinez> A., Hobson~ L., Crandal~ J.~ Mandel) P.and Lipson,
L.G,; Life domains and adaptive strategies of a gl'oup oflow..inconle, well
older adults, Am. J1'. ofOocupati.onal Therapy~ 99.. 108~ 1995.
41. Rho 1 Jay P. and Lipson, L.G.! Focus on acetylcholinestnmmeinhibitot~ for
the treatment ofAlzheitrt(lt's disease. Fot.tnulacy)) Vol. 32~ 677. .684_, 1997.
42. Clark, F., Azet)) S.P., Zemke, ll.~ Jacl :Hessle; C`` Palmer) J. and Li.pson> L.G,:
1
Occupational Therapy for Independent...J..Av.i.ng Older Adults. J'AMA) 273:
1321..1326;J 1997.
--·-·. --· --- _,......, __ *~--.. ··-- -:-:--:-: .. :-·:.--··---- ~- ..- - -··-··-·····~··· .. -·--·- ... --·· ·-·----·····-
. \. .., a • 1! • 4111 I
APPENDIX 1
56
43. Clad<~ F., Azen> S.P., C\ltlson> M.,. :M~andel~ D.~ LaBl·ee, L.~ Hay~ J.~
z~'nnke1 R.~ Jackson) J. and Livson!l L.G.: EPibeddhlg health..promoting
chang~s into the daily lives of independent... living older adults~ Long.. tenn
foUow..up of oco11pational therapy intel'Vention. Journal of Gerontology:
Psychological Sciencest 56B, pp. 60"6~, 20<)1. ·
Reqt1ested Chapters, Papers> and Monograms
1. Sharp~ G.W.G.) Fisltet·, J.Cf., Lipsot~ L.G.~ Kohl~w, T. R., Flores, J. and
Witkum, P.A.! Titne course studies on the mechanisms of action cholet'l:\
toxin. .Hormonal Receptors in Digestive Tract Physiology. In Bonftls, S,~
Fromageot~ P., Rosselin~ G. (-eds.)lt·Bldevier..North Holland Biomedical
Press~ Amdste.rdm~ pp.447-454~ 1976.
. 2. Sharp, G.W.O.) Wledenkellert DjE. 1 Lipson~ L,G., Oldham, S.B.~ l{J;a.ue!z,
"'' 1M\,,: Y., .Tanjis> D.> Pian-.Strdth, M.C.l\1!. and Wollheim, C.B.! ·Multiple :r:oledof
calmodulin> the endocrine p~ncreas and the conttol of insulin secretion.
Pa·oceedinga ofthe 11th Congress of the lnteruatlonat Dlabetes Fede1'ation.
Int. Congress Serlea #600! E::tcerpta Medica.) Princeton, N.J.~ Mngofa}
En.N. (Ed.)pp 329..336, 1983.
3. Lipson, L.G.! Hyperte11sion and diab~t~s niellttus. Diabetes forecast
38:53) 1985.
4. Lipson, L.(b Diabetes 1neiHtus in the elderly: Special problems, special
a.ppt{)aches. Co. Medical, New York, N.Y.~ pp. 1-20) L985.
5.. Lipson,. L.G.: Diabetes after si-x.ty. .five. Dfabet~ Foxecast. Vol. 39~ No.
7, 54.. 58, 1986.
6. Lipso~ L.G.t Diabetes in the elderly! A multifaceted problem. Am. J.
Med, 80! supp. 5A:1~2, 1986.
7. Lipson~ L.G. mtd Bray, G.A."j Energy intak:e and utilization in aging
man: Chen (ed,), Nutdtional Aspects of Aging~ Vol. 1~;~ CRCpl'~SS.t tfio.~
Boca Raton_, lt"'L. Pp. 184..18S, 1986.
8~ · Lipson, t.G.: Diabetes and aging. fu Beigelrnan1 P .M~ and Kuman> D.J
(Eds)? Diabetes Mellitus fo,: the house ()fficer. Williams and Willdn~
l3altimore, MD. 1 pp. 184.. 185, 1986.
9.. Lipson, L.G. and Kumar, D.~ Otal hypoglycemio agents. In Beigelman1
P.M, and Kumm.·, D. (Eda.) Diabetes Mellitus for the House Officer1
WHliams and Wilkins, Baltimore~ MC. Pp. 112.. tl8) 1986.
•II • '1 A•
APPENDIX 1
57
10. Lipson> L.G.~ Dental problems i11 the diabetic patie~1.ts. In Beigelmrut~
P.M. tmd Kumar~ D. (Eds,) Diab~tes Mellitus for the House Offic~r.
Williams and Wilkins~ Baltimore~ MD., pp. 181 .. 183, 1986.
'!
11. Lipson, L.G.,: Hypertension ln the diabetio patient. In Beigelman, P.M~
and Kumarp D.) (Eds.) Diabetes Mellitus for the Hol..lse Officer. Williams
and Wilkins, Baltimol.'e~ MD,~ pp 16().. 163, 1986.
12, Lipson~ L.G.: Ryp~rtensio1tin the diabetic patient. In Beigehnan~ P.M.
and Kumru.·~ D., (Eds.), Diabetes Mellitus fox the House Offl(ler.
Williams and Wflldns~ Baltintore~ MD., :pp. 173.. 175p 1986 .
13. Dinwiddie, R. tmdL~pso~ L.G~: Improved control ofsenlm glucose in
obese~ 11ew~onset h1sulinopenio non-immHn dependent diabetes mellitus:
Partial respiration o£Nonnm1 dy11amic insulin secretion. Roedg
Division, pp. J..6, 1986, .:..... ' ·
.,.., ·-- ",,_ ,"\ •a,., ... tt/"'
14. Lipson~ L.O. and Kato . .:Pahner> S.: Diabetes in Asians. Diabetes
Forecast, V<>t 41, No.9, 48 ..51, 19B8.
15. Lipson~ L.OI) Kato~Palmer~ S., Boggs, W.L.) Moore,D., and. ope-1 A.:
. Diabetes in the :Slack population. Dlabetes Forecast Vol. 41, No.9; pp.
34--38> 1988.
16. Williams~ B.R., Nichol, M.B.~ Lowe:~ B.F., McCombs~ J.S.~ Yoon, P.S.
and Lipson) L.G.: phatmacist intetverttion residenti~l care f<\cnities.ln
Rowet 1-W. and Alu·onheim1 J. C. (Eds.) Annual Re'\l'iew Qf Geronto~ogy
a11d Geriatrics; Foous on Medioatlons and the Elderly. Spdnger
PublishingCo.NewVod~N.Y.~pp.150.-162, Vo1.12, 1992,
17. The Use of Medications: A Ttaiuing and Referenoe Manual Developed
fot Staff in.Residentlal Care Facilities for the Elderly~ 1195. Lipsort; • •``-<"
L.O.- Project Co-Director.
1&. Weiner, J. and Lipson,. L.G.: Htunrut diseases as n1odels of accelerated
agblg. In Rose~ C., Glowacld, J. and :Silezikian> J. (Bds.) The Aging
Skeleton> Academic Press, Chapter ~;.pp. 51..-58, 1999.
19. Raghaven~ D.~ Weiner1- J. and Lipson~ L.G.: Cancer in tlte elderly~
principles oftr~atrn~nt mSoulbartli~ R.L. et al (Bds.)~ Oxford Textbook
Oncology; 1.nd Edition> Oxford University Press~ Oxford1 London~ 1999.
Films and Videos
-``-~ ~-·~-~·~-·
--·-·---· ·----- -=----=.::: __ ==-··:-_-,c·-;;·. ~ -------.-· --·· ·-·- ·---- .... ···:35-·--- ---·-----.--·------ --· ·-- ·-· -. ······----·-- . -·····---·---·-----··---·
. ' • p • ··.& •
APPENDIX 1
58
:
1. Discharge Planning for the Elderly H 1986~ 15 min.
L.O. Lipson~ Moderator and oontent expert.
4. Discha:cge Plru.ll1irLg for the Elderly Hospitalized Patient IV. Community
programs fotthe eldel.'ly. Hospital Satellite-Network, 1986~ 15 min. L.G.
Lipson..,. Moderato1• trt~d content expert. .. .
5. Normal Aging Versus Disease:·:Physician1ourna! Update. Lifetime
Netwotkj 1987 ~ 15 min. L. G. Lipson- Conten.t expert.
6. Dl'ugs and the Elde.rly. Physlcian1s Journal Updato. Lifethne N~twork)
1987~ 15 min. L.G~ Lipson- Collteni:expert,
7. .26. Caring fot a.11d Agirtg Soolety. 20 videos on various aspects of Geriatrics
gnd Gerontology. Each 30 minutes in length. Producer- Neil Steinbetg
Productions1 Executive Producers- HospitatSat~llite Netwot'lc and Age
Wave~ 8ponsor-¥ariort Laborato:d¢s. 1987. .1988. L~G. Lipson.-
Technical advisor and content exp~rt.
CAlUNG FOR AN AGING SOCIETY
SHOW TITLES AND NUMBER
"tiSP#_ HSN# !lTLE
001 8649X NEW!MAGESOFAGING(F) DYCHTWALD
()02 0462X ff.OW tO TALK TO YOOR:DOCTOR (F) LIPSON
003 5733X GERIATRIC ASESSMENT (F) B'Ul'LER
004 8648X DRUGS AND THE ELDEl.U.,Y (F) :LAMY
o. Producer> MarkAlyn Conunm1ications) Sponsor- Mal'ion LaboratOJ:ies) 1988.
L.G. Lipson- Moderator and content expert.
28. Medical Checkup: Health .Awa:eenesa 1 88 Aging in the Hispanic Community. A 30 min.
Video, Ptoduoer, Mru:kAlY.n Co.oornunioations~ Sponsor- Marlon LabQ(atodes. 1988.
L.G. Lipson- Moderato:r attd content expert.
Medical Cheokup: Hea.IthAwru·eness 188. Aging in the Asian Community. A30 min.
Video. Produoer11 Mad<:Alyn Communications> Sponsor- Mation'Labor.atodes, 1988.
L.G. Lipson ..... Model~atol' and content expert,
3Ct. MedicaL Checkup: Health Awareness ~ 88. Diabetes Mellitus in fue Black Community. A
30 min. Video. Pl'oduce.r)' Mark Alyn Comm\1~1lcations, Sponsot- Mation. Labotatodes 1
19$8. L.G.. .Lipson- Mode1•ator and content expert.
31. Medical Checkup; ftertlth Aw~u:eness '88. bia.betes MellitU$ in the Asian Community. A
30 min. Video. Ptoducer, Mark Alyn Conununicatio:ns~ Sponsor.-Marion Labofatoties~
1988. t.G. Lipson.-- Mode1•ator and content expert. ·
32. Medical Checkup~ Health Awareness ~ss. Diabetes Mellitus in the Hispanic Comriiuutty.
A 30 min. ·video. Producer~ Mark Alyn Cmonmnications~ Sponsor- Marlon
Laboratories, 1938. L.G. tipson ~ Moderato.t and content ex.pett.
I 33--38. Diet and Exexci``-~rArestyles for Aghtg. Hospital Sat~llite Network. Six lO~miutttE>
Segments, 1989. L.G. Lipson- contei\t expe.r:t.
,.,p
39~ flow to Tall<; to the Older Patient. Baylor Hospital and Age Wave, 1989. L.G. t.ipson-
Medical Moderator and content expert.
40-41. The Agifig Skin. Age Wa'Ve, 1991. t.G.Lipson-- Medical Bdito1:
42. Diabetes and the Elderly. Li-ving with Diabetes! Diabetes on the Air~ 1991.
43. Se:>r and Sexuality it1 Seniors-· A Pocumentary~ 1999 L.G. Lipson ..... Guest E.:s.pert.
I •
Abstracts
~ ll •
I I '\,S..
APPENDIX 1
60
*1. Lipson} L.G.~ Mal'golis, S.M. and Cap-uzz4 D~M·.~ Compru.ison of acetate and mnino acid
incorporation in rat li-ver cells isolated by thtee techniques. Fed.l?toc. 28:336 (abst. 607):.
1969.
2. Lipson} L,G,> Ackerman,) l.P, and K.liman, B.: simultaneous acl'omegaly and partlally
suppressible ~dtenocol'tioal fun<~Hon in a patient with a pituitary tumor. Clin. Res. 24:
274A)1976. .
3. Lipson. L.G.) Beitins, I.Z.s Ko1·nblith, P.P~) McArthur, J. W., Ftlesen> H.G,j Klima.nt B.
and Kjelberg, R.N. Horn:tone secretory patterns ofhmnan pituitary tumors in tissne
culture. Clin. Res. 328A~ 1976,
4. Lipson~ L,G.> Fol'dsta11, C.A, and Sharp, G.W.G. Phosphorylation and dephosphotylation
in the oontrol of the insulin release: Islet phosphoprotein phosphatase, Diabetes 25: Supp.
1``74 (abst. 213)~ 1976.
*5. Lipson) t.G.~ Vachon~ ·c., Fdiristall, C.A,.:I and Sharp~ G.W.G.: Stimula1ion of specific
protein phosphotylation in intact rat~ islets of Langerhans by both 3wfsob\lty1..1-
methlxanthine and :0-glucose. Olin. Re$, 26:530A~ 1978.
6~ Lipson, L.G. and Sharp~ G. W.O.: Insulin release in pregnancy~ Relatior.ship to protein
and phosphorylation. Endocrinology 102: (abst. 711)~ 1978.
7. Lipson, L.G. WolJheim, C.l3. and Sharp, Q.W.G.i lnsulin release in fasling. Diabetes 27:
Supp. 2, 489 (abst. 236), 1978.
8. Lipson~ L.G,J Bobtycki1 V.A.~ Bush~ MJ., Gt·oss~ E. and Inouyte) D.: Role ofadenylate ·
cyclase system in altered insulin rel~ase from islets of aged tats~ Clin.R$S, zg~s tA} 1980,
*9. Cotto~ D.B.~ Strassner~ H.G,~ Lipson~ L.G. and Goldstein, D.A.! Effect ofterbutaline on
se.J:l'Jl)1 concentrations of glucose~ insulin) votassiurn, ionized and total calcium lactate>
and colloid osmotic pressure. Gyecol, Invest. 1980.,, .·t-:· .•..
*10. Lipson, L.G\~ Bush1 M.J.~ Ti~'ijen; .G.E. and Yoo:n) A.~ Insulin release ittagh~g! the t•ole of
adenylate cyclase system. Endocrinology 106! (abs~. 34).} 1980.
11. Mirche~ a. C.~ Lipson~ L.G.;I Bush~ M.J?~ Yoon~ A. andBaxlsh~ J.J.: Analytical fraction of
B.. c~lls. Diabetes 2.9: Supp. 2, 109A (abst. 425), 1980
12. Moore, D.) Pope~ A.M.~ Todd~ G.J.:t Rosenquist~ R.J.1 and Lipson> L.G. : Treatment of
hypertensive dia.b~tia patients with pmzosln, Diabetes 29; Supp~ 2t 67A (abst. 267) 1980.
~
*13~ Oidhamj S.B., Lopson} L.G. and Ti~qen) G. E.; Evidence fo:r the presence of calmodulin 1
in human parathyroid tl.ssue~ VIII International Conference in Calcium Regulating f
Honnones, 1980. I
I
.. ··--· ·-·-·~-·----·--·-·-- --- ·-----· ··-·- -· ·-·. . ........... _...._______,. . . . . . - .................... "'-'" . . -................................._3 8· ..... ·- ·- . . . . .:-···----............ --..·-·-----·-· . . . . . . . . . . . . . . . . _, _____. . ._....................................
'II •
I '
APPENDIX 1
61
. ~
*14. Lipsd'n, L.G.,. Bush} M.J. and Bobrycld, V.A.: The role of the aden.ylate cyalase system In
the deoreased gluoose.-stirnulated insulin release fl'om isolated islets of' Langerhans of .
aging rats. Gordon Research Conference . . . The Biology of Aging. 1980.
15. Lipson~ L.G. Oldham) S.B. and Bush, M.J,; Calmodulin·- stimula.tabl.e phosphodiestatase
in isolated islets ofLangerhans oftherat. Clin. Res. 29:S6A, l981.
16. Lips~n. L.G., Moo:re, D.~ Pope. A.M., Todd, F.J. andAvlla> S.: lncldenceofhypertension
in male diabetic populations. Clln. Res. 29:413A.l981.
17. Lipson1 L. G. and 0 Idham,. S.B ,! Colmodulfn...gf:irnulatable phosphodiestaxase ht pancreatic
islets of the, pregnant rat. CHn. ~es. 29w413A_, 1981.
fk18. Conteas, C.N.~ Lipson~ L.G, and Mircheff, A, C. .: Basal lateral membranes fi•om rat
pm:otid acinar cells. Gastroenterology 80: 1128A> 198L
.'. 19.
LipsoJJ, L.G. and Oldham, S.B..: The presen Tissue int. 34!843, 1982.
*24. Lipson, L.G., P.remdast F.H., l\1oli:na~ J.M.:Studies on dynamic insulin release in aging.
The physiologist 25: 288 (abst. 47.8)> 1982. ·
*25. Molina, J.M., Pr.emdasJ F\ H. and Lipson) L.G,! Dyrtamics of insulin secretion in. aging
Clin.Res. 31:58A1 1983.
*26.- Shatpj G~W.G.~ Wolheim, C.B,j Siegel, E.; Lipson~.L~G. and Kraus, Y.: The tole of
calmodulin in insulin soo:r:etion. International Diabetes Fed~ Meeting in Kenyaj November
1982.
)It27. Eddlestone, G.T., Oldham~ S.B.> Lipson, l.t.G.. and Beigehnan~ P.M.; ~otskolin inc~;eases
cyclic AMP and potentiates electrical acti-vity in the n1ouse pancreatic B.. oe11~ Fed. P1·oc.
42: 89711 (abst. 3544)~ 1983.
-~·--:---:-···-----·---;-c-:``-:-- --···-----~----·--·· -··------- ······-····:·---:-·--·- ··-·· --·_-·····-··---..-... ···---·--·-·--- ----39-- ·------- -···-··-·····--· ... - ··-··· ·- ··-· - . -:·--------···- · · · ·---·---- - - - • - ·-~---;---;··~--- ~· .. :-~:.-==·.:.::·~·-:·::--:::-.._:...--:-7o.~-:-:···.·-.· -~- •.• ~---
' ' "'\ d •
APPENDIX 1
62
*28, Bddlestont7t G~'l\~ Oldha~ S.:B.) Lipson, t.G. and Beigelman, PJvf.~ Forskolin
·potentiatiol1 of the B~cell resports~ to glucose. Diabetes 32; Supp. l(abst 552), 1983.
*29. Oldham, S.B. and Lipson: L.G.: The effects of ionic ca1oium on magnesium activation of
parathyroid adenylate cyclase. Calcif. Tissue IntA 35:686~ 1983.
*30 Premdas~ F.H., Molina} J.M. and Lipson, L.G.: RestOL'a.tion ofnormal dynamic insulin in
secretion in aging l'ats. The Phy~jologist26:A50~ (abst. 32.1)) l9S3.
*31. Oldham, S.B. and Lipson~ L.G.! Calcium inhibition ofparathyroid adeuylate cyolase: Is
calmoduli-n medicated? VIlllnternatiortal Conference on Calcium Regulation l!o~mones,
Kob`` Japan, October, 1983.
32. Johnson~ 1vf.D. and Lipsont L.G.: Prevaleltce ofHypertenslon and sex\lal d.ysfunction in
diabetic women. Clin. Res. 32:48A1 1984,
*33. Molina, J.M.~ Pt~fna~s, F,H,, Lipson~ L.G., Klenckj R,; Eddleston.e; G. and Oldham~ S.B.: ·
Comparison. of dynamic insulin release to P~glucose md D"glycera.ldehyde in isolated
pancre~tic 1slets .from the db/db mouse. Clin. Res, 32:51~ 1984~
*34. Oldhatn~ S.B. and Lipson, L.G.: IoniQ oontrol ofpal'athy,..oid adenyla'te cyclase af)tivity.
UCLA aymposium 1984 on.Mernbr~me Receptors and CeUular Recognition.
35. tipson> L.G.; Liebig, P.S, and Sloane~ R.B.! Training o-f faculty mentors and advocates in
geriatrics. Annual Meeting of Gerontological Society-oflun.edca. November~ 1984> San
Antonio~ Texas.
*36. Lipson) L.G..1 Premdas, F.H.~ Molinas~ 1.M, and Lewis~ D.: Cyclic AMP end insulin
secretion. Gordon Research Conference--. The Biology of Agi~g, 19~5.
*3 7. F~dda G.~ Akmal.lvf.~ Pxemdas~ F.H.~ Lipson~ L.G. and Massl'Y~ S. G.: Direct evidence o1
..... ~v~·:·t!:l·· an inhibitoty effect .if patathYJ.·oid hormone (PTil} on insulin,;;e'e``e in chronic renal
failure (CRF). KidneyJnternation.a1. 31~348~ 1987, Ar.o.e:ricanSooietyofNeplttology,
Washington, D.C.j 1986.
*38, Fadda G., Akma~ M., P,;erndas, F.H.~ Lipson, L.G. an41Vfassry, S. G.~ Cot.t:eotionof
glucose intoletan.oe (GINT) ~d the impaired insulin release<> olu:onic renal failm'e. (CRF
by verapamit Arnerioan SocietyofNeplu:ology, San. Antonio~ Texas 1988.
39. Palmer, S.K.~ Madlso.n, R.E~ and Lipson, L.G.~ Self-reported pre-val~ntce and. associated
factors in type II diabetes in Japanese Amedcans in Los Angeles. Diabetes: 37: 150A
(abst 537)~ 1988.
*40. Garcia, D~L., Palmer} S.K., Boggs~ W.L. aud Lipson~ L.G.: Challenges in..patient
oom.plianoe. of elderly Mex.lcan Amel'ioatt Diabetics. Diabetes: 37~68A (abst.. 269),
Amerlcan Diabetes Association, New Odeans; t.A.~ 1988,
~--............_._ _,_ ...__....._ ~ ....... __ _
------ -----~.-------:----·c-·---·-·-------- ---·--40----·- - -.... . - ~ . --~ . ~· ~ ---~-- --·· -- •-• ................... _. -~ ~ - o .... - - - - - - - -- - -~··--H~ ....
'1J. •\ A • '\ ..
APPENDIX 1
63
41. Schwamj W.J., Lefevre.} T.M. andLipsol\ L.G.! Falls in fh.e eldedy! Tleu~e ofmultipte
balance tests. N?v· 1988 1neeting of Gerontological Society of Alnerica. ·
*42. Oldham, S.B., Eddlestone, G.T.> Premdas, FJI. and Lipson; L,G.: the influence of age on
glucos~ and forskolin- stirrmlated insulih release from islets of the diabeti(} mOllSe. No.
198 8 meeting of Gerontological Society of Ametion~
*43. ·Lipson) L.G.: Caring for an aging society- twenty 30 minute 'Videos on gerontology and
getiatrics. Nov, 1988~ meeting ofGerontologioal Society of America.
•!144. Palmel', S.K.~ Madisonj R.E. and Lipson, L.G.~ Diabetes in older Japanese. .Am~:d.oans.
November 198 Smeeting of Gerontological Society of Amedc~
*45. Boggs, W~L., Garcia, D.L,~ Palmer~ S,J(. ~ and Lipson, L.G.; Patient compliance in an
ethnic population~ Diabetes oar~ in elderly Mexican"Amedoans> Nov. 19&8J meeting of
Get:ontolo girreotion ofGlucosl:l
rntole.rance (OINT) and the impah'ed ·insulin release of chronic renal failure (CRF) by
Vel'apoamil.Kidneylnt. 35:427~ 1989,1989 Meetingoft11e21~ Nationa1Kidney 1
Foundation scientific Symposium.
*47 Faddf4 G.Z.~ A1ctnal1 M.~ Lipson:, L.G. and Massry~ S.G.: Evidence for a dh:ect eff~ct of
parathyroid honnone (PTH) on pancreatic isl~ts. Kidney Int. 37:466} 1990, 1990 meeting
o:fthe 22nd National Kidney Foundation Scientific Symposium~
*48 Fadd~ G.Z., Akmal 1 M, 1 Lipson> L.G. and Massry 1 S.O.: Meohanism of impaired insulin
.secretion in chtonlc renal failure. Kidney Int. 37!50`` 1990. 1990 meeting ofthe 22nd
National Kidney Foundation Scientific Symposium.
*49, Com.unale, R., Fadda, G.Z.~ Ptem.ad, F.H.~ Thanaldtoharu~ P, Lipso~ L.(h andMe.ssl'Yt
S.G.! ~educed K...fnduce.G!Jmulin secretion. in ·chronic renal failme (C:RF) oontribute to
hnpah:ed extrarenal disposal ofK: Role of excess PTff. Am. Soc. Nep:hrol. 1~624~ 1990.
*50 Williams~ B.:l Lowe) B., Nichol1 M., McCombs~ J,~ Yoon~ P. rutd Lipson, L.G.: hnptovlng
drUg tberapi"s inresldetl.tial care faoilitiea. 1994 Annrutl Meeting of the Alnerloon
Geriatric Society, Los Augeles, CA.
lf 51.
1
Lipson, L.G.:~ McCombs,. J.~ Jelliffe~ R., Williams~ B., and Wilson~ P. : Medications I the
elderly: pi'oblems, polici~s and new solutio~ asymposlun1. 1995 Annual Meeting of the
Ge.t:on.tologloal Society of Amerlca, Los Angeles#- CA.
*52. Lipson, L.Gv and Kohn> J.: Govetil.tne.ntal responsivenesg to ohangos in dentographios of
aging disease: A unique state apptO$.Oh to geriatLic ADRD ctU'e and tteatment. 1996
Annual Meeting of Southern Medioal Association, Baltimore~ Maryland.
i
-·--·- ·- .. __ --. -· .......... _.. ... --· ---· --·-· ..,_ ·-·. ---··- -#-- --- ·--
-~---
---~
-~---.
-- -·--~·-··-----·····- -···- ·· . ..........41· ··-.··:•·, ;·· ·:·"~.-;:-~·."-,·.~o=.--:=,;;,.;:•:;·;;··"'---···"•·-··· .. -
!
· ......... - •• ,. .. --··•- ..... _ ... , -·-~-,r CCC
"A , 1.!. •
APPENDIX 1
64
53. Syrnpositn:n Anm.lal Meeting of Gerontological Society of America~ San Francisco,
California~ 1998.
*Presented
I. G~·a>J.ts and Research Funding (1975..2001)
I
1. National Rese~rch Service Awards irtDiabetesb 1975..1977.
NIAlYIDD) NlH. 1F32 AM 05219 MET.
2. Clinical fnvestigatorAwardinDiabetes.19T7--197$. NIAMDD, NrH.l KOB ArV£0320
MET. Two adHHS Center Grant-· '~Gerlatl'io Education Center Ch:ant. ~' DHHS 1031 AH 69000.
$952>000. 10/83 through ~/88. L. G. Lipson, Faculty Coordinator and Member of the
Steering Co:rn:mittee.
14. NIH Center Grant .... t $5~000. L.G~ Lipson, M.D.> Course Director and P,L
28. NlH Research Gt~nt- <~Multicenter Tl'ail ofPl'ednisone h,_ Alzheimer's Disease. n 1995~
$80,000. L.G. Lipson, M.D., Co--P.I.
29~ State ofAlaska- Educational Grant (~Training of Administrators in Long Tenn. Care
lnstitutions and Health Care Providers and Planners in Special Topics 'of Gerontology
and Gedatdcs~n 31V96- 5/20/96, $16,000. L.G~ Lipson~ M.D., Director.
30. Glendale Adventist Medical Center- '~Family Praotioe Residency Training in Geriatric
Medicine.~' 7/1/96- 6/30/001 $6,000/year. L.G. Lipson, M.D., DlreQtol!.
31. Research Grant from GJ). Searle and Co. ' '~Conttoll~d Onset Verapamll Investigation of
Cardiovascular Ettdpoin.ts/' 5/97 through 5/02. $75.000. L.G. LipSOI\ M.D.~ P.t
., ......
32. State of Alaska> "Training in Ge1•ophatntaoy, Fall Prevention> and Quality Assurance in the
fraU and demented eldedy.H 4/98.. 1/1/02} $200}000. L.G. Lipson) M.D._, P.I.
33. Research Grant from Pfizer Phmmaceu.ticals, ~ HStudtes in Fine Motor Coordination in
Alzheimer)s Disease.`` 6/98.. 10/99, $97)000. L.G. Lipaon~ M.D.) PJ.
34.. Research Grantft·om the Keck Foundatio:n '1Studies on the Use ofM~dicattous in the
Eldedy.~) 9/30/02~ $4,000. L.G. Lipson) M.P., P.J... 12/31/02.
35, State of Alaska~ '" "Training ~uality Assutancf;'l of the Frail and Demented Bldedy: CQI of
Pioneers; ltomes/) 1/1/03~12/21/03. $100,000 L.GA Lipson> M.D.j P.r.
r ••t\\'lJ'.e',.tt:J..H'J'J.c.."' 4 \'11i~&Jhrtl'1'~".t \.a.
. 37. ~tate of ALaska_. Uuiversity of Alaska. Alaska Geriatric Education. Centet~- Conaultant
7/1103 ~ 12/3l/04. $18~000,
38, State of Ataska ..... University of Ala.Bk~ Alaska Geriatric Education Center ..... Consultant
. _10/1/07 ..... 6/30!08. $10~000.
39. State ofAlaska.- University of Alaska, Alaska Oe11atrio Education Center- Consultant
7/1/08 ,_ 6/30/09, $10~000.
. I
-···· ··-·-;:----. ···----·-·----··,........_-.--·····-· .. .. ::- - ----`` :---:--``-··-- .... ···-·······- --·--··- ~ ·: .... -;-"";-;::·:--::--·-·--·~----· .. -----~-----·- ·--·~---·-··--··- ·····------· ~·-. - -----``-;;· ··-·-- --
~a ' ... 4 •
APPENDIX 1
67
APPENDIX 1
68
NO. C-1 ..1)B .. 12~00162S
INTHEGUARDIANSHIPOF § INTHEPROBATECOURTN~l ·~
§ ~ ~\
MARYRIVERA, § OF ;.. ~.;. ~>
~ (:)
..,'\
§ 1!/1:.· ._g~ 0 ~ 2 seconds
DEFORMITY/DISABILITY .. Loss of Consciousness: DYes DNo 0 No Neuro Deficits 0 Neuro Changes
I Extremity: Neurovascular Integrity Intact: DYes ON/A
DNa
T CHIEF COMPLAINT:
y
I TRIAGE ACUITY: 1 Resuscitation 2 Emergent 3 Urgent 4 Semi Urgent 5 Non Urgent
DISPOSITION: D Immediate Bed D Stable- To Walling Area after Instructions ~
Comments: ~· {~
-~ctl 5 r I · ttqsrp
Triage Nurse Signature:
·~yfa\ ,-' --=s<-es·- ':):i,
llf\ 11:Y- ,fiJI' \.,,
Ae!) ~f'~
'"'*=
11111111111111111111111111111111111
(;:) MARY DELAROSA ·
RlV``1\oo071683103 M/Rii: L001D2Z 5 ~ 3
Acct •
ER
8 I
15``~
Loc:L. EH ' 11112/13
\1\\11~\m Ullll\111111111\1\lllllllll\11\11\II\\\ \\1\1 1\1\\ Ill\ 1\11
'"EDPRS*
Sign~ln
Sheet ·for
Ernergency Services
T3107BC (Rev. 7/i2)
~OJ__ APPENDIX 1
Parfb& of
PATIENT INFORMATION FOR OFFICE USE ONLY
f}fL+d._r:t
mt+~u
PATIENT'S NAMErn MRNo.: ACCTNo.:
ADDRESS 1: DOS: LOCATION
ADDReSS 2: I COMMENTS/COMPLETION DATE:
ClTY, STATE, i Cf /)(f) (' '7l;t 7&6/~
FACILITY FROM WHICH PHI WILL
BE RELEASED (Check all that ap_pj'l)
DATES OF
SERVICE
BIRTH DATE: {) St. David's Hospital r/-tl--t_~
SOCIAL SECURitY' NO.: I ' St. David's Rehabilitation Center
(Optional) St. David's Georgetown Hospital
CONTACT NUMBERS:
Other
FACILITY/PERSON TO WHOM PHI WILL BE RElEASED/DISCLOSED: PURPOSE OF DISCLOSURE: (Note:** IJPdicates Foe for Copies}_
Avc;_-fiV\ \Pn l) ( e
NAME: Follow Up Care
Insurance**
ADDRESS 1: Attorney**
Personal Usek* I
ADDRESS2: It
'-f Other** Please Explain L-(___.~
CITY, STATE, ZIP: METHOD OF RELEASE/DISCLOSURE:
1
0 Fax (t::me~ cy Only) Fa}!)umb``~
CONTACT NUMBERS:
0 Mall ther ' ( /JL) rL . (
INFORMATION TO BE USED/DISCLOSED: (Check aJI that apply) 1 t
·-
Is this request for psychotherapy notes? 0 Yes, then this is the only Item you may request on this authorization. You must submit another authorization for other Items below;·-
0 No, then you may check as many Items below as you need,
D Pertinent Package 0 EKG, EEG, EMG 0 Pathology Slides 0 Psychiatric Evaluatlons{Tests
D Front Sheet 0 Laboratory Report 0 Physician Orders 0 Infections Disease (Including HIV Test Results)
0 Discharge summary 0 EA Information 0 Progress Notes 0 Consultations
D History/Physical 0 Imaging Reports (X·rays, CTs, MRis) 0 Nursing Information ~omplete Copy
0 Operative ReporVProcedure
0 Cathl.ab
0 Imaging Films
0 Pathology Report
0 Medication Records
0 Therapy Notes
````lzatlon Record '~P1Slcc· .\
J understand that:
1. I may refuse to sign this authorization and that It Is strictly voluntary.
2. My treatment, payment, enrollment or eligibility for benefits may not be conditioned on signing this authorization.
3. Medldallnformation Is considered Protected Health Information (PHI) under both Federal and State Privacy Laws.
4. Unless otherwise specified, this authorization shall expire 180 days from the date of my signature, OR from the date of discharge, whichever Is later.
(Othervvlse spectfled date )
5. I acknowledge, and hereby consent to such, that the released information may contain alcohol, drug abuse, psychiatric, HIV testing, HIV results or AIDS
information.
6. A facility may not condition the provision of treatment to an individual on signing an authorization except for:
1. · Research-related treatment; and
2. Health care that Is solely for the purpose of creating Information for disclosure to a third party.
7. I may revoke an authorization In writing except to the extent that:
i, The facility has taken action prior to receiving the revocation; or
2. If an authorization was obtained as a condition of obtaining Insurance coverage.
Further details may be found In the Notice of Privacy Practices. --
8. If the requester or receiver Is not a health plan or health care provider, the released Information may no longer be protected by federal privacy
regulations and may be redlsclosed.
9. I understand that I may see and obtain a copy of the Information described on this form, for a reasonable copy fee, If I ask for it. There Is a fee for copy
setvlces rendered.
1o. I will receive a copy of this form after I sign it.
SIGNATURES
J have read the above and authorize tl)p disclosure of the protected health information as~staled.
s~c;::J!Vhori2J~ cU-UL---- Date: !f/;J(~
Witness (If applicable}:
, • v
Wttness (If Applicable): -
Cl\ J(Ll{d '1Clf\\
,) I
Print Name of Patient or Authorized Party: Relationship to Patient:
StDavid's I MEDICAL CENTER
Authorization for Release of Protected Health Information
RIVERA.I1ARY DELAROSA ER
Acct;ff: L00071683103M/R#: L001022503
loc:L.ER IF
Dr: CEA 11/12/13
IUIIlllllllllllllllllll
90 minutes. ·-15:09 Jenn·
Black, R.N.
APPENDIX 1
89
RIVERA. MARY 11/12/2013 11:15 MR# L001022503 Visit# L00071683103 Clinical Report" Nurses 3 of3
15:1 0. Reassessment after procedure. The patient reports no complaints and the patient is calm and
resting quietly. Patient reports current pain level as 0/10. Overall patient status Is improved~ the patient
states feels better. ED physician notified about patlent1s status. --15:10 Jenny Black, R.N.
15:26. (APD VS here with patient and family. APS referenence number 64190731. APD VS is working
with guardian to move patient to a different ·nursing home. If that is not possible, APD VS will contact
current nursing home to assure patient's safety there.). -~15:26 Jenny Black, R.N ..
Assault I Forensic Flowsheet
15:09. The patient has family for support. Personal safety plan, reporting plans, STD and contraceptive
prophylaxis, need for medical follow-up, counseling, coping/fear reduction and interventions/services
discussed with patient. The patient has been given education and resource materials. --15:09 Jenny
Black, R.N ..
DISPOSITION I DISCHARGE
15:28. BP: 165/70 sitting. HR: 90. RR: 18. Temp: deferred. Condition at departure: improved and
stable. Patient reports pain level on departure as 0/10. The goals identified in the patient's plan of care
were met. The following issues were addressed: psycho-social issues, pain control, comfort issues,
nutritional issues, educational issues and follow up care. Fall risk assessment completed. No fall risk
identified. No learning barriers present. Discharge Instructions provided and reviewed with the patient.
Reviewed referral to family practice, a women's shelter, Planned Parenthood, the public health departmen1
and crisis hotllne for followup and testing. Summary of care provided to famHy. Patient and family
verbalized understanding. Written Instructions provided in English. Guardian verbalized understanding.
The patient was discharged by the physician. The patient was discharged to the nursing home and
accompanied by guardian. The patient left the Emergency Department ambulatory and via private vehicle.
Driving (guardian.). --15:28 Jenny Black, R.N.
15:28.
Departure time; 15:28. --15:28 Jenny Black, R.N.. .
The patient's home medications have been reviewed and validated with patient by the nurse. -.-15:28
Jenny Black, R.N ..
This report is not final
APPENDIX 1
90
AUSTIN/TRAVIS COUNTY
SEXUAL ASSAULT NURSE: EXAMINERS
CONSENT FOR MEDICAL FORENSIC EXAMINATION, TREATMENT.,__AND COLLECTION OF EVIDENCE
1. I hereby authorize J (\'?( tterlL_ ·(2_;j C£Q MJf\--CJr·``¥ual assault nurse
examiner who is credentialed at St. David's Medical Center to perform a
medical forensic examination, treatment and the collection of evidence. (.!Wj))(lnitial)
2. I understand that a forensic medical examination for evidence of sexual
assault can, with my .consent, be conducted by a health care professional
to discover and preserve evidence of the assault. I understand that the
examination may include the collection of reference specimens at the11 If JJJ
time of the examination or at a later date. {llLt!!!.!1 (initial)
3. I understand that the collection of evidence may include photographing~/////
injuries, and that t~ese photographs may include the genital area. ~(initial)
4. I understand that I may refuse to consent or withdraw my consent at any
time for any portion of the examination. I understand that if r refuse consen~ .
to any exam procedure, it may result in loss of evidence. (initial)
5. I understand that I will not be billed for the evidence collection portion of
this examination. I understand that I will be responsible for the payment of
any medical treatment and medications to the extent I am not eligible for
discounted medical care based on my financial classification and ability to~
pay. (initial)
6. I understand that the collection of evidence may include the collection o, ;/;t
111
blood and urine specimens for toxicology (drug screening). y~\initial)
7. I understand data without patient identity may be collected from this
report for health and forensic purposes and provided to health authorities
and other qualified persons with a valid educational or scientific interest for.. 1 , 1 JA
demographic and/or epidemiological studies. ~ (rnittal)
8. If conducted, the report of the examinatron and any evidence obtained, ~ !1/J A
will be released to law enforcement authorities. · 1
~rnitial)
I certify this form has been fully explained to me, that I have read It or have had it read to me, and
that I understand Its contents. I hereby consent to a forensic medical examination for evidence of
sexual assault. I similarly consent to the examination of mfnor child{ren) for whom I am the legal
guardian.**
I understand that under § 261.101 of the Texas Family Code, St. David's Medical Center, its
employees, and/or representatives are required to report suspected or identified child abuse or
neglect to the proper authorities. /
o Patient o Parent ~uardian o Surrogate
m~m``
signature
````IL3~--
2
Dfftf/ F
.
*"'If the parent or guardian Is not available, the child may be·examlned for sexual abuse under the
T~xa.s Family Code § 32.005.
RIVERA,HARY DELAROSA ER
Acct#-: L00071683103 14/R#: L001022503
Loc:L.ER 78 /F
li li l il~ lllllllllllllllllllllllllllllllllil~1111~111111111111111
APPENDIX 1
91
Austin/Travis ColUlty Sexual Assault Nurse Examiners
Sexual Assault Forensic Examination Report
Patient name: Rivera, Mary
Case: 13..3140743
Date of exrun: 11/12/2013
MR #: 1022503
DOB:
Name of examiner.................. Jenny Black, RN, SANE A, CA~SANE
Name offacility..................... St. David's Medical Center
Law enforcetnent agency ....... Austin Police Department
CPS~ APS notified.................. Yes (~ ~ \101 ~ \
Beginning time of exam 13:30 Ending time of exam 15: 15
Patient information
Gender ................. Female
. ........... ,. . H'lSpantc
EthniClty .
Accompanied by ·
Agency or relationship ........ Safe Place Advocate, Family
Present during exam per patient's request. ...... daughter/~ \)(i\;vd ~e.t-vx.
Advocate present during exam ......... ,.. No
Patient action after assault and before exam
Douched....... No
j . . . . . . . . . . . . . . . . . . 111 • • •
Wiped vulva................. ``···· ... No
Wiped anal area.................... No
Washed................................. Yes
Bathed................. ,.................. No
Showered.. Yes
I •• I . . . . . . . . . . . . . . . . . . . . . . . .
Urinated................................ Yes
Defecated..................... Yes I. I ......
Vonll.ted............. ,................. , No
Had food .................. ,.. ,......... Yes
Had drinlc........................... Yes I ..
Brushed teeth ........................ No
Used mouthwash ...................No
Changed clothes .................... Yes
Smoked........................... ,..... No
Medications taken................. unknown (not received from hospital)
Other..................................... Yes; cleaned dentures
Information on assault
Date and time of assault. ...... unknown, perhaps early 11/8/13
Number of assailants ........... unknown
Gender of assailants ............. Unknown.
?jj~ ..P-JJ SAiJ6-A-
Signature of examiner Page# 1 of4
APPENDIX 1
92
Patient name: Rivera, Mary Austin/Tmvis County Sexual Assault Nurse Examiners
Case: XX-XXXXXXX Sexual Assault Forensic Examination Report
Date of exam: 11/12/2013
MR #: 1022503
DOB:
At time of assault
Condotn..................... ,........... Unknown
Lubrica11t............................... Unknown
Contraceptive foam/
spertnicide .. ~ ...................... Unknown
Assailant injured.................... unknown
Assailant scratched................ unknown
Penetration. Anal penetration.......
I •••••• I ••••••••••••••••••• Unknown I ••••• I •••••
Vaginal penetration............... Unknown
....................... 1 ........... 1 ..........
Oral penetration.................... Unlmown
. . . . . . 1.1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ejaculation, ............................ Unknown
Weapon.................. Unkno'Wll I •••••••••••••••
Physical force ........................ Unknown
Restraint .. ,...... Unknown
I •••• I , , • • • • • • • • • I • • • • •
Tllreat................................... ,.. Unlmown
Coercion................................ Unlmown
Feru--..................... ,............... 4 .......... Uil.lal.o'Wll.
At time of exam
Most recent sexual contact 0 ...... , More than a week ago
Significant medical history
Last normal menstrual period began..... ,.