McGaughey v. District of Columbia et al

REPLY to opposition to motion re MOTION for Modification of Scheduling Order and Increase in Number of Depositions Plaintiff May Take

D.D.C.July 29, 2008

1 IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA ALEXANDRIA McGAUGHEY, ) ) Plaintiff, ) ) Case No. 1:07-cv-01498 (RJL) v. ) ) DISTRICT OF COLUMBIA, et al., ) ) ) Defendants. ) ) PLAINTIFF’S REPLY TO DEFENDANT LANG’S OPPOSITION TO PLAINTIFF’S MOTION TO MODIFY SCHEDULING ORDER AND INCREASE NUMBER OF DEPOSITIONS PLAINTIFF MAY TAKE Plaintiff respectfully submits this Reply to Defendant Lang’s Opposition to Plaintiff’s Motion to Modify Scheduling Order and Increase Number of Depositions Plaintiff May Take. Plaintiff filed her Motion on July 14, 2008, and opposition briefs thus were due yesterday, July 28, 2008. Because Defendant Lang submitted his opposition brief early (on July 17, 2008), Plaintiff’s reply to Lang’s opposition is due today. No other Defendant has submitted an opposition brief to date, although Defendant the District of Columbia has filed a formal notice of its intent to file an opposition brief by July 30, 2008, and Plaintiff expects that other Defendants may do the same because they have informed Plaintiff that they do not consent to the relief sought by Plaintiff.1 Accordingly, Plaintiff today submits this short reply with respect to certain 1 Plaintiff reserves her right to argue that all Defendants’ oppositions other than Dr. Lang’s are untimely, assuming that they are eventually filed. Local Civil Rule 7(b) provides that if an opposition brief “is not filed within the prescribed time, the Court may treat the motion as conceded.” Case 1:07-cv-01498-RJL Document 50 Filed 07/29/2008 Page 1 of 10 2 issues raised by Defendant Lang. Plaintiff will file a consolidated reply with respect to all Defendants once all Defendants have filed responsive briefs.2 I. PLAINTIFF’S DISCOVERY EXTENSION IS REQUIRED, IN PART, BECAUSE OF DR. LANG’S PROFESSED LACK OF KNOWLEDGE ABOUT KEY ISSUES. Dr. Lang’s opposition to Plaintiff’s requested extension of the discovery period and permission to take additional depositions is replete with unsubstantiated and erroneous claims, such as: that this case is “languish[ing]” based on Plaintiff’s alleged lack of diligence, Lang Opp. at 2, that the District of Columbia has already provided a “wealth of documents and information,” id. at 3,3 and that Plaintiff’s counsel “routine[ly] fail[s] to limit their inquiry to relevant topics appropriately tailored to the subject deponent,” id. at 5.4 These and Dr. Lang’s 2 Neither the Federal Rules nor the Local Rules provide guidance as to the timing and consolidation of reply memoranda, where, as here, one defendant in a multi-defendant matter submits an opposition brief prior to submissions of other defendants. On July 25, 2008, undersigned counsel contacted the Court Clerk’s Office to seek guidance, but was transferred to Chambers. Undersigned counsel thereafter spoke with the Court’s Courtroom Deputy, also on July 25, 2008, who conferred with the civil case administrator in the Clerk’s Office and informed undersigned counsel that it was our decision whether to consolidate our reply briefing and that we should refer to the Local Rules for the timing of that briefing. In an abundance of caution, Plaintiff submits this reply memorandum now with respect to Defendant Lang, but reserves her right to make all necessary arguments against Dr. Lang and all other Defendants in the consolidated reply brief that she will file if other Defendants respond to her Motion. 3 Plaintiff is not “disappointed with the lack of existing documents relevant to her case,” Lang Opp. at 4, but is disappointed that some Defendants have failed to provide plainly relevant documents altogether or in a timely fashion. For example, it was not until days before the close of discovery – during the lunch break of a key deposition – that the District of Columbia produced two polices of core relevance to this case. See Mot. at 7-8 & n.7. As Plaintiff’s Motion explains, it is now clear that other Defendants’ productions are also deficient. Plaintiff has attempted to obtain all relevant documents from Defendants in this case, but it now appears that it may be necessary for Plaintiff to subpoena documents from third parties, such as the D.C. Rape Crisis Center. Cf. Lang Opp. at 5. Experience in this case teaches that it will take at least the 90 days proposed by Plaintiff to depose necessary witnesses and resolve issues related to some Defendants’ deficient document productions identified in the Motion. 4 Notably, it was defense counsel’s depositions of each of Plaintiff’s witnesses that took all day, that involved hours of harassing and irrelevant questioning, and that were made longer still by Case 1:07-cv-01498-RJL Document 50 Filed 07/29/2008 Page 2 of 10 3 other unsupported allegations could not be further from the truth. Plaintiff has no desire whatsoever to expend unnecessary time and money on the discovery process, but, out of necessity, has sought the requested expansion of the schedule and the number of depositions in order to obtain highly critical discovery that, to date, has not been provided despite its existence. From the inception of discovery, Plaintiff has diligently pursued written discovery and depositions. Depositions were extremely difficult to schedule, due to the need to coordinate the schedules of all five sets of defense counsel – all of whom attend every deposition.5 For example, Dr. Lang’s deposition alone was rescheduled multiple times due to scheduling issues on his end. All depositions sought by Plaintiff are of witnesses with direct knowledge about Plaintiff’s case or with critical institutional knowledge (such as regarding institutional policies, practices, procedures and training) that individual deponents have not been able to provide – or have not been permitted by their counsel to provide.6 In contrast to Plaintiff’s thorough repetitive questioning from all five sets of counsel. In contrast, undersigned counsel has made every effort to efficiently depose Defendants’ witnesses, but has been hampered by various obstructionist activities, including: lengthy and repetitive speaking objections; delayed start times (due to tardiness of defense counsel, scheduling problems at locations requested by defense counsel, and defense witness availability); and late returns from lunch breaks by defense counsel. 5 One option would be for counsel for Dr. Lang to attend some depositions by phone – as some defense counsel have chosen to do – or to not attend depositions that counsel for Dr. Lang deems unimportant to Dr. Lang’s issues in this matter. Yet, to date, counsel for Dr. Lang has chosen to attend each and every deposition in person. 6 Plaintiff does not seek additional depositions because the witnesses are all newly discovered, as Dr. Lang incorrectly suggests. See Lang Opp. at 6. Plaintiff previously alerted the Court to the likely need for many of these depositions, and the Court’s April 16, 2008 Minute Order expressly contemplated that Plaintiff could seek additional time for discovery and depositions “if necessary, at a later date.” The Court also did not purport to set a permanent “proper balance” in that Minute Order, as Dr. Lang incorrectly claims. Lang Opp. at 7. Notably, Dr. Lang does not point to a single specific witness who has been deposed, or whom Plaintiff proposes to depose, who either has not had or is unlikely to have discoverable information pertinent to this lawsuit. What Dr. Lang really argues for is an arbitrary limit on Plaintiff’s proper discovery, rather than a limit with any conceivable connection to the number of witnesses with relevant information. Case 1:07-cv-01498-RJL Document 50 Filed 07/29/2008 Page 3 of 10 4 explanations of the need for her proposed depositions, see Mot. at 5-13, Dr. Lang’s claim that Plaintiff has deposed “marginally involved witness[es] with no independent recollection of the subject events,” Lang Opp. at 6, is unsupported and incorrect. All witnesses that Plaintiff has deposed to date were directly involved in the handling of Plaintiff’s case in December 2006 and were disclosed as persons with knowledge by Defendants.7 Moreover, as detailed in Plaintiff’s Motion, it is now clear – based on recent deposition testimony, among other things – that several Defendants have not complied with their responsibility to submit complete document productions. Dr. Lang offers nothing but baseless rhetoric in claiming that Plaintiff has an “insatiable desire for discovery.” Lang Opp. at 8. What Plaintiff seeks is the discovery that she needs in this complex, multi-defendant matter in order fairly to litigate her claims. Dr. Lang’s own discovery responses and deposition are illustrative of the difficulties Plaintiff has faced. To date, Dr. Lang has produced only two documents in Response to Plaintiff’s forty-two Requests for Production (other than documents subpoenaed from third parties by Dr. Lang): a five-page curriculum vitae and a one-page declaration page from an insurance policy. He has objected to nearly all of Plaintiff’s Requests, including one that merely Such an arbitrary truncation of legitimate discovery finds no support in the Federal Rules – and indeed runs contrary to their letter and spirit – and would result in the long-abandoned practice of trial by surprise and litigation as gamesmanship. See Fed. R. Civ. P. 30(a)(2) (providing that “the court must grant leave” for a party to take additional depositions “to the extent consistent with Rule 26(b)(2)”). Plaintiff has made a detailed showing of need for additional depositions, and, beyond conclusory assertions, Dr. Lang has made no showing that any of the discovery Plaintiff seeks would run afoul of the guidelines set forth in Rule 26(b)(2) for limiting “discovery otherwise allowed by [the federal] rules.” Moreover, arbitrarily truncating discovery in the manner Dr. Lang advocates likely would lead to inefficiency at the motion stage, in that Rule 56(f) should entitle Plaintiff to depose any witness that she is not permitted to depose now to the extent necessary to defend against any summary judgment motions filed by Defendants. 7 Even with regard to individuals Defendants have disclosed as persons with relevant knowledge, Plaintiff has exercised judgment, and has not sought to depose each individual disclosed by Defendants. Case 1:07-cv-01498-RJL Document 50 Filed 07/29/2008 Page 4 of 10 5 restates Dr. Lang’s initial disclosure obligations under Rule 26.8 In addition, Dr. Lang has “refuse[d] to respond” to many of Plaintiff’s document requests – apparently based on objections or assertions of privilege – but has not produced a privilege log to date.9 Moreover, for over half of Plaintiff’s Requests for Production (twenty-three of forty-two), Dr. Lang responded merely that he “does not maintain or control the documents” regarding policies, practices and procedures of Defendants District Hospital Partners d/b/a George Washington University Hospital (“GWUH”) and The George Washington University (“GWU”), of his own employer Medical Faculty Associates, Inc., or of other entities relevant to this lawsuit. Although – as Plaintiff separately addresses with counsel for Dr. Lang – these responses were incomplete because Plaintiff seeks a broader category of responsive documents, the point here is that Dr. Lang has repeatedly claimed that he has no information regarding the policies and practices of institutions with which he is closely affiliated, but rather can only speak to his own experience. See infra pp. 6-7. Responses like these are part of why Plaintiff requires additional depositions and time for discovery – for example, to take Rule 30(b)(6) depositions of institutions like GWU and GWUH, to determine institutional policies and practices about which Dr. Lang professes ignorance. Dr. Lang’s deposition occurred less than three weeks before the close of discovery and was transcribed as of July 14, 2008, just days before the close of discovery. That deposition was equally telling about the apparent limitations of Dr. Lang’s knowledge and provides further support for Plaintiff’s need for additional discovery from the institutions with which Dr. Lang is 8 Dr. Lang objected and “refuse[d] to respond” to Plaintiff’s request for all non-privileged “[d]ocuments that You may use to support your defenses in this action.” Dr. Lang’s Responses to Plaintiff’s Requests for Production of Documents, ¶ 39. 9 No Defendant has produced a privilege log, despite all Defendants’ claims of privilege in their responses to Plaintiff’s requests for production. Plaintiff produced a privilege log prior to the present close of the discovery period. Case 1:07-cv-01498-RJL Document 50 Filed 07/29/2008 Page 5 of 10 6 affiliated, such as GWUH and GWU. For example, despite having spent his medical residency in the GWUH Department of Emergency Medicine and having practiced in GWUH’s emergency room as an attending physician since 2006, Dr. Lang at his deposition professed no knowledge of any policies or procedures that govern his work in the GWUH emergency department, or any training on any such policies and procedures. E.g., Lang Dep. (cited excerpts attached hereto as Exhibit A), at 85-87. He also stated that he is unaware of any institutional policies from GWUH, GWU or elsewhere that govern his supervision of residents and the amount of participation required by the attending physician, id. at 92-93, 125-27 – policies that are particularly critical now that the depositions have made clear that it was a first-year resident that physically examined Plaintiff during her treatment at GWUH. Dr. Lang also has professed near-complete ignorance about sexual assault medical forensic examinations, hospitals’ role and involvement in such examinations in the District of Columbia, and GWUH’s policies and practices with respect to the handling of alleged sexual assault victims. E.g., id. at 69-71, 75-76, 78-79, 139-40, 143- 44, 149, 159-63, 342-43, 345-47. Indeed, Dr. Lang repeatedly stated that he could not testify to anything beyond his own limited experience with two individual sexual assault victims (including Plaintiff). E.g., id. at 141-42, 148-49, 154-55. Furthermore, and incredibly, Dr. Lang stated that prior to his deposition he had never before seen or reviewed GWUH’s Protocol on Sexual Assault,10 id. at 163-65, which counsel for GWUH has stated was in effect as of December 2006, and which – by its plain terms – applies to “Emergency Department Attending Physicians” such as Dr. Lang, see June 5, 2008 Letter from A. Kelley to K. Hartnett, attaching Protocol (attached hereto as Exhibit B). At his deposition, Dr. Lang was unable to answer questions concerning that key policy and defense counsel 10 That protocol appears to be part of the GWUH Emergency Department Practice Manual, but GWUH has produced no documents from that manual other than the sexual assault protocol. Case 1:07-cv-01498-RJL Document 50 Filed 07/29/2008 Page 6 of 10 7 objected to such questioning based on a lack of foundation. See Lang Dep. at 165-207. Dr. Lang also was unable to explain the representations on GWU’s website that the GWUH emergency department performs sexual assault medical forensic examinations and conforms to the national standard of care with respect to such examinations, based on his apparent unfamiliarity with those representations and issues. Id. at 212-16. Finally, Dr. Lang was unable to provide certain critical information about the workings of the electronic medical record system at GWUH, id. at 98, 256-63, 266-68, 273-75, 342-43. As these detailed examples make clear, Dr. Lang’s limited knowledge claimed in his discovery responses and at his deposition provide a sound basis for Plaintiff’s request for additional discovery from witnesses with the knowledge that Dr. Lang evidently lacks. II. DR. LANG WILL NOT BE PREJUDICED BY THE LIMITED EXTENSION OF ALL DISCOVERY DEADLINES REQUESTED BY PLAINTIFF. Dr. Lang also claims that he will be prejudiced by Plaintiff’s request that all deadlines in the case be moved forward by 90 days – including with respect to his selection of experts – and he thus proposes that if the Court allows Plaintiff’s request for additional discovery, no other deadlines in the case should be moved. See Lang Opp. at 2, 7-8. Lang’s argument lacks merit and should be rejected. As the Court is aware, the Court adopted Defendants’ proposed ordering of expert disclosures and depositions, such that Plaintiff will be required to produce her expert reports and disclosures and have her experts deposed before Defendants are required to produce their expert testimony. This ordering of expert discovery ensures that Defendants will have abundant time to discover the position of Plaintiff’s experts before having to submit their own experts’ conclusions. Thus, there is no prejudice to Dr. Lang from moving all deadlines in the case forward by 90 days to permit Plaintiff (and all other parties, as needed) to complete Case 1:07-cv-01498-RJL Document 50 Filed 07/29/2008 Page 7 of 10 8 discovery. To the contrary, moving all of the deadlines is the only and best way to preserve the schedule that the Court has adopted in this case. Moreover, Dr. Lang’s position that all deadlines should remain intact other than the close of fact discovery would lead to the fundamentally unfair, inefficient, and illogical situation of requiring Plaintiff to present her expert reports and disclosures over a month prior to the close of fact discovery, whereas Defendant would have no obligation to produce any such expert testimony until well after factual discovery has been completed. Obviously, the additional discovery sought by Plaintiff – including critical Rule 30(b)(6) testimony from Defendants regarding institutional policies, practices and training, and additional factual testimony from individuals directly involved in Plaintiff’s case – will be highly relevant to the conclusions reached by all of Plaintiff’s experts. Notably, the additional discovery sought by Plaintiff is relevant not only to her physician expert testimony, but also to her expert testimony regarding SANE/SART procedures and police procedures. Finally, there is no merit to Dr. Lang’s contention that moving the other deadlines in this case creates a barrier to Dr. Lang’s “preparation of his defense and selection of his own experts,” Lang Opp. at 2. Plaintiff’s detailed Complaint, the depositions in this matter (including of Dr. Lang), and Plaintiff’s extensive and detailed responses to all Defendants’ written discovery provides a more than ample basis for Dr. Lang to prepare his defense and consult necessary experts. Plaintiff is eager to continue prosecuting her case against all the Defendants, including disclosure of her experts and their opinions based on a complete factual record, but it would be unfair to require her to make such disclosures without a complete factual record from which her experts can formulate their opinions, particularly in light of the critical nature of that discovery and Plaintiff’s concrete plan for obtaining that discovery as efficiently as possible. Case 1:07-cv-01498-RJL Document 50 Filed 07/29/2008 Page 8 of 10 9 CONCLUSION For the above reasons, as well as those in Plaintiff’s Motion and forthcoming consolidated reply brief, Plaintiff respectfully requests that the Court grant Plaintiff’s Motion to Modify Scheduling Order and Increase Number of Depositions Plaintiff May Take. Dated: July 29, 2008 Respectfully submitted, /s/ Bruce V. Spiva Bruce V. Spiva, D.C. Bar. No. 443754 bspiva@spivahartnett.com Kathleen R. Hartnett, D.C. Bar. No. 483250 khartnett@spivahartnett.com SPIVA & HARTNETT LLP 1776 Massachusetts Avenue, N.W., Suite 600 Washington, D.C. 20036 Telephone: (202) 785-0601 Facsimile: (202) 785-0697 Counsel for Plaintiff Case 1:07-cv-01498-RJL Document 50 Filed 07/29/2008 Page 9 of 10 CERTIFICATE OF SERVICE I hereby certify that a true and accurate copy of the foregoing Plaintiff’s Reply to Defendant Lang’s Opposition to Plaintiff’s Motion to Modify Scheduling Order and Increase Number of Depositions Plaintiff May Take, was served on July 29, 2008, by electronic filing with the Court’s ECF system, upon: Thomas V. Monahan, Jr. tvm@gdldlaw.com Adam Kelley axk@gdldlaw. com GOODELL, DEVRIES, LEECH & DANN, LLP One South Street, Suite 2000 Baltimore, MD 21202 Dwayne Jefferson dwayne.jefferson@dc.gov OFFICE OF THE ATTORNEY GENERAL FOR THE DISTRICT OF COLUMBIA 441 4th Street, N.W., 6th Floor South Washington, D.C. 20001 Larry D. McAfee lmcafee@gleason-law.com GLEASON, FLYNN, EMIG & FOGLEMAN, CHARTERED 11 North Washington Street, Suite 400 Rockville, MD 20850 Robert W. Goodson robert.goodson@wilsonelser.com Deidre L. Robokos deidre.robokos@wilsonelser.com Christine M. Costantino chrissy.costantino@wilsonelser.com WILSON ELSER MOSKOWITZ EDELMAN & DICKER, LLP 1341 G Street, NW, Suite 500 Washington, D.C. 20005-3105 Karen R. Turner karen.turner@hacdlaw.com HAMILTON ALTMAN CANALE & DILLON LLC 4600 East-West Highway, Suite 201 Bethesda, MD 20814 /s/ Bruce V. Spiva Bruce V. Spiva Case 1:07-cv-01498-RJL Document 50 Filed 07/29/2008 Page 10 of 10 Exhibit A To Plaintiff’s Reply to Defendant Lang’s Opposition to Plaintiff’s Motion to Modify Scheduling Order and Increase Number of Depositions Plaintiff May Take McGaughey v. District of Columbia, et al., No. 1:07-cv-01498 (RJL) Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 1 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company Page 1 IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA - - - - - - - - - - - - - - - x ALEXANDRIA McGAUGHEY, : : Plaintiff, : : v. : Case No. : 1:07-cv-01498(RJL) DISTRICT OF COLUMBIA, et al., : : Defendants. : - - - - - - - - - - - - - - - x Washington, D.C. Friday, June 27, 2008 Video Deposition of CHRISTOPHER R. LANG, M.D., called for examination by counsel for Plaintiff, pursuant to notice, at the Law Offices of Wilson Elser Moskowitz Edelman & Dicker, LLP, 1341 G Street, Northwest, Fifth Floor, Washington, D.C., commensing at 9:15 a.m., before Barbara A. Huber, Notary Public in and for the District of Columbia, when were present on behalf of the respective parties: Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 2 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 18 (Pages 66 to 69) Page 66 1 A No. 2 Q Have you received any -- have you 3 attended any trainings or any other courses from 4 ACEP? 5 A They had a national conference that I -- 6 that I think I attended one lecture on emergency 7 medical records. 8 Q Do you recall anything at the conference 9 addressing the sexual assault patients? 10 A No. 11 Q It also mentions member of EMRA. 12 Can you explain what that is? 13 A That's the Emergency Medicine Residents 14 Association. 15 Q What does that group do? 16 A It's more of social networking with 17 emergency medicine physicians. I wasn't that 18 involved with it. 19 Q And I take it that now that you're not a 20 resident, you're no longer a member? 21 A That's correct. 22 Q Just so we don't have to walk through Page 67 1 each and every -- 2 A Sure. 3 Q -- employment, but I -- my main question 4 is whether, in the course of your duties in the 5 other entries on this second page, physician, navy 6 reservist, and etc., whether any of those duties 7 involved treating or caring for sexual assault 8 patients? 9 If you want to take a minute and look. 10 I don't want to rush you. 11 But -- 12 A Sure. 13 Q -- if you could tell me if any of 14 those -- 15 A No, they don't. 16 Q And I notice that you've listed on this 17 page and the next page, the page 3, three 18 publications and research entries? 19 A Uh-huh. 20 Q Did any of those have to do with sexual 21 assault patients? 22 A No. Page 68 1 Q And just for the second one, that you 2 have listed on the top of page 3, Comparison of 3 psychometric and clinimetric methods for measuring 4 patient satisfaction? 5 A Uh-huh. 6 Q What -- what was that about? 7 A Basically, measuring the patient 8 satisfaction in the internal medicine clinic. 9 Q And just again I -- I think the 10 remainder of this page is your honors and 11 recognitions. 12 A Uh-huh. 13 Q And I just -- if you could look at those 14 and let me know if any of those had to do with -- 15 were related to the treatment of sexual assault 16 victims? 17 A No. 18 Q And turning to the next page, where it 19 lists your undergraduate honors and scholarships. 20 A Uh-huh. 21 Q Did any of these involve treatment or 22 care of sexual assault patient -- or victims? Page 69 1 I know you weren't a physician at that 2 point. 3 A No, it didn't. 4 Q Do you know what a sexual assault 5 medical forensic examination is? 6 MR. GOODSON: Objection to form. 7 THE WITNESS: No. 8 BY MS. HARTNETT: 9 Q Is there another name that you would use 10 professionally for the examination that's done of 11 a sexual assault victim? 12 A I've never performed one personally, so 13 I -- I don't -- I couldn't tell you the -- the 14 names associated with it. 15 Q Do you know if performing a sexual 16 assault examination is part of the core competency 17 for a resident in internal -- for emergency 18 medicine? 19 MR. McAFEE: For a resident? 20 MR. GOODSON: Objection to the form. 21 MR. McAFEE: Objection. Form, and 22 foundation as well. Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 3 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 19 (Pages 70 to 73) Page 70 1 MR. GOODSON: You haven't established 2 what you're asking about, what type of exam. I 3 think you need to establish what you're first 4 referring to before you ask him what -- 5 MS. HARTNETT: I understand. Thank you. 6 BY MS. HARTNETT: 7 Q Do you have an understanding of what 8 treatment a -- I understand you haven't performed 9 a sexual assault examination personally. 10 A Uh-huh. 11 Q Is there some specific treatment that a 12 sexual assault patient receives -- a specific 13 examination a sexual assault patient receives, for 14 example at the Howard University Hospital that you 15 described earlier? 16 MS. TURNER: Objection. Foundation. 17 MR. McAFEE: Objection. 18 THE WITNESS: I'm not sure I can 19 comment, because I'm not -- I'm not -- I don't 20 know. 21 BY MS. HARTNETT: 22 Q So you -- you -- you do not have an Page 71 1 understanding of what, if any, examination occurs 2 to a patient who's complaining of sexual assault? 3 A My understanding is it's a forensic 4 exam -- I'm not sure what it -- it includes -- to 5 assist the police department, whoever is the 6 governing body over that, to ensure chain of 7 custody of specific types of specimens and 8 other -- whatever else is required in that kit. 9 MR. JEFFERSON: I'm going to object and 10 move to strike on the basis of speculation. 11 BY MS. HARTNETT: 12 Q And where did you get that understanding 13 that you just described? 14 A Well -- 15 MR. GOODSON: Let me just object, 16 because he said he wasn't sure what it was. So I 17 don't know what he -- what you're referring to as 18 what he described. 19 MS. HARTNETT: He just described a kit, 20 something about chain of custody, the police, and 21 so had -- he had some understanding of something. 22 And I'm asking where he got that understanding Page 72 1 from. 2 MR. GOODSON: I'll object to the form. 3 You can answer. 4 THE WITNESS: I assume it was the same 5 as if -- if someone was assaulted. It's the 6 same -- you know, we -- it's protocol as far as 7 the Metropolitan Police Department is alerted. 8 They make a decision. And then they go ahead and 9 do whatever. We assist the police department in 10 whatever they need, if the decision is made that 11 they're going to go ahead and pursue something. 12 MR. JEFFERSON: I'm going to object and 13 move to strike on the basis that the witness 14 testified that he's assuming; so, again, 15 speculation. 16 BY MS. HARTNETT: 17 Q Have you been involved in not 18 necessarily sexual assault, but have you been 19 involved in the care or treatment of a patient 20 that's been assaulted? 21 A Yes. 22 Q Have you given medical center or Page 73 1 treatment to such a patient, not -- not a sexual 2 assault, but another type of assaulted patient? 3 A How do you define medical care? 4 Q What I'm trying to understand is have 5 you performed any of this sort of examination on a 6 patient, not a sexual assault patient but another 7 type of patient that's been assaulted? 8 MR. GOODSON: Okay. I'm going to 9 object. Because you referred to some sort of 10 examination and haven't defined what you're 11 referring to. So I'll object to the form. 12 BY MS. HARTNETT: 13 Q And I'm referring to whatever you're -- 14 you -- you described some sort of forensic 15 examination that you -- you believe happens with 16 assaulted patients. And I'm asking if you've ever 17 participated in that type of examination not with 18 sexually assaulted patients but with other -- 19 otherwise assaulted patients? 20 MR. GOODSON: I'll object. He -- he's 21 never made any mentioned at all about some 22 forensic examination. You haven't established Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 4 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 20 (Pages 74 to 77) Page 74 1 that. You simply ask him a question: Has he 2 treated an assault victim? So you haven't 3 established any forensic examination foundation 4 testimony for that question. 5 MS. HARTNETT: Okay. 6 MR. GOODSON: You can answer, though. 7 THE WITNESS: I performed medical 8 examinations on assaulted patients. 9 BY MS. HARTNETT: 10 Q In any of those cases, is it -- have -- 11 have you learned from the police or otherwise that 12 some type of forensic examination is also being 13 performed on that patient? 14 MR. JEFFERSON: Object to form and 15 foundation. 16 THE WITNESS: The -- typically, if the 17 police are involved, they'll ask the -- who the 18 name is of the attending physician that's in the 19 emergency room. And we'll, from that point on, 20 you know, ask if the stab -- if the patient is 21 stable, if we -- if we feel that the patient is 22 going to be admitted to the hospital. Page 75 1 BY MS. HARTNETT: 2 Q But in your experiences with these 3 assaulted patients in which the police are 4 involved, is any of your -- I don't want to use 5 the word treatment, but does any of your 6 interaction with that patient involve the 7 collection of forensic evidence? 8 A We've -- you know, you -- we have a 9 gunshot wound patient. Whatever clothes is on 10 that body, you -- you attempt to preserve for 11 forensic evidence. So that's an example I can 12 give as to what we do. 13 Q Do you know what the sexual nurse -- 14 assault nurse examiner is? 15 A I've never worked with them, so -- I 16 know that they perform some sort of examination. 17 Q Have you ever interacted with anyone in 18 the -- in Washington, D.C. who is a SANE examiner? 19 A No. 20 Q I guess I don't want to limit it to 21 Washington, D.C., but have you ever interacted 22 with a SANE examiner anywhere? Page 76 1 A No. 2 Q With respect to your practice when a 3 sexual assault victim presents and you direct them 4 to the police and then they are -- I -- from my -- 5 what I understand you -- they are then directed to 6 the Howard University Hospital; is that correct? 7 A With my interactions, that's what I've 8 seen happen. 9 Q And do you have any understanding of 10 what happens to that patient when they arrive at 11 the Howard University Hospital? 12 A I don't know that -- 13 MR. JEFFERSON: Object to form and 14 foundation. 15 THE WITNESS: I'm not sure of the 16 intricacies. I know they're a funded program that 17 deals with that issue. 18 BY MS. HARTNETT: 19 Q And when you say -- 20 A They're the -- they're the center, you 21 know, for sexual assault for the city. And my 22 understanding is they get fed -- they get -- I Page 77 1 don't know if it's federally funded, or it's by 2 the District to be that center. 3 Q Do you have an understanding of who pays 4 for the treatment of patients that -- the sexual 5 assault patients that go to Howard University 6 Hospital? 7 A No, I have no understanding. 8 Q And where did you get your 9 understanding, what limited understanding you may 10 have of what happens at Howard University 11 Hospital, whatever understanding you've described? 12 A I'm not sure if it was, you know, during 13 my training as a resident that I heard something. 14 I'm -- I'm not -- 15 Q Was that your under -- prior to December 16 2006 when the patient in this case presented at 17 The George Washington University Hospital, was 18 that your understanding of how the system worked? 19 A As far as? 20 Q Sexual assault patients and how they 21 should be directed and where they should seek 22 treatment in the District of Columbia? Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 5 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 21 (Pages 78 to 81) Page 78 1 A My understanding is you con -- you 2 initially contact the Metropolitan Police 3 Department, who then will provide assistance with 4 what needs to be done in that situation. 5 Q Do you have an understanding of the 6 medical treatment that would be provided to a 7 sexual assault victim separate and apart from any 8 forensic evidence function that occurs with that 9 patient? 10 A Yeah, I mean I -- I -- they would be 11 treated like any other patient that came in with a 12 complaint. And you would address the complaint, 13 correlate with what their complaint is, what -- 14 what their physical findings are, and come up with 15 a diagnosis and treatment plan. 16 Q Would there -- at The George Washington 17 University Hospital, is there a treatment plan 18 specific to sexual assault patients? 19 A Not to my knowledge. 20 Q Is there a diagnosis specific to sexual 21 assault patients at The George Washington 22 University Hospital? Page 79 1 A Not to my knowledge. 2 Q Do you know what the model of the 3 clinical practice of emergency medicine is? 4 A The model for the -- 5 Q Clinical practice of emergency medicine? 6 A Never heard of it. 7 Q Do you know what date rape drugs are? 8 A There's drugs -- there's medications 9 that -- I shouldn't say medications. There's 10 drugs that can be given to potentially distort 11 someone's perception of things. 12 Q Do you know the names of any drugs that 13 could be used for this purpose? 14 A There are a lot of different types of 15 medications. There's a -- there's a -- there's a 16 plethora, so -- 17 Q And do you -- can you explain any 18 typical affects or symptoms that -- for -- for 19 someone who's been given a date rape drug, who's 20 ingested a date rape drug? 21 A You know, there's -- there's -- there's 22 a wide array. So it just -- it just depends on -- Page 80 1 and, again, I don't have personal experience in -- 2 in someone that's taken in a, quote/unquote, date 3 rape drug and presented to me in an altered mental 4 status state complaining that they were raped. 5 Never had that situation. 6 Q Are you aware of any health risks to the 7 patient, separate from the perhaps increased 8 suseptibility of a rape of ingesting a date rape 9 drug? 10 A It all depends on which drug it is. You 11 know, all drugs have different types side-effects. 12 So, you know, there's -- there's. Again, it 13 depends on what it is. And -- and we make the 14 determination at that point. 15 Q Just as an example, can you identify 16 one -- a drug that could be used for this purpose? 17 A GHB would be one that come to mind. 18 Q And what are -- what are some of the 19 symptoms of having ingested GHB? 20 A I would say that the -- some of the 21 symptoms -- again, I've had very limited 22 experience on these type of ingestions, as far as Page 81 1 the presentations to the emergency department. 2 But there is some sort of intoxicated maybe look 3 to them. And then, you know, they could -- 4 depending on the dosage of the medication, they 5 can become more tired or somnolent, etc. 6 Q And are there any potential long-term 7 health affects or -- that could be to a patient 8 that's had the -- ingested the GHB? 9 MR. JEFFERSON: Object to form and 10 foundation. 11 THE WITNESS: Not to my knowledge, 12 outside of any secondary effects of when they 13 actually ingest it at that time. 14 BY MS. HARTNETT: 15 Q And where did you come to the 16 understanding that you've described of GHB? 17 A My reading in the literature about the 18 effects of the drug. 19 Q And was this something that -- the 20 understanding that you described, is this an 21 understanding that you had as of December of 2006? 22 MR. JEFFERSON: What understanding are Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 6 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 22 (Pages 82 to 85) Page 82 1 you talking about? 2 MS. HARTNETT: Well, he's -- whatever 3 he's testified so far as to the GHB. 4 BY MS. HARTNETT: 5 Q Is that something that you understood as 6 of December of 2006? 7 A I would -- I would say that the general 8 principles of the medication. But, again, there's 9 many other medications, so -- 10 Q And -- and understanding that this is an 11 example, have you done any research or reading 12 about GHB since December 2006? 13 A No. 14 Q Other than GHB, is there any other date 15 rape drug that you can identify specific -- 16 A Well, there's a lot of different types 17 of medications. You know, you can give them, you 18 know, any sort of sedatives, hypnotics. You know, 19 there's a -- there's a whole plethora of 20 medications, you know, ecstasy, you know. There's 21 just -- just a -- like I said, there's a wide 22 range. And that's why we like to kind of step Page 83 1 back from when people term it as date rape, 2 because it can mean a -- a lot of different types 3 of medications. 4 Q And have you received any training or 5 instruction during your time at The George 6 Washington University Hospital regarding date rape 7 drugs? 8 A Not that I rec -- can recollect. 9 Q Sorry. Just turning back to your CV for 10 one more moment. 11 Have you written any other publications 12 in whole or in part other than the three that are 13 listed here regarding medicine? 14 A No. 15 Q And other than the memberships in ACEP 16 and EMRA that we described, are there any other 17 professional memberships that you've had or -- or 18 currently have, as far as an association? 19 A American College of Internal Medicine, I 20 think it was, when I was a -- back when I was an 21 intern at Bethesda. 22 Q And anything else at present? Page 84 1 A No. 2 Q Are there any publications that you view 3 as authoritative with regard to the treatment and 4 care of sexual assault patient? 5 MR. GOODSON: Objection to form. 6 You may answer. 7 THE WITNESS: Can you re -- repeat that? 8 Sorry. 9 BY MS. HARTNETT: 10 Q Are there any publications that you 11 consider authoritative with respect to the 12 treatment or care of a sexual assault patient? 13 MR. GOODSON: Objection to form. 14 MR. JEFFERSON: I'll join. 15 THE WITNESS: No, not to my knowledge. 16 BY MS. HARTNETT: 17 Q I'm assuming the answer is no, but have 18 you had your hospital privileges revoked or 19 suspended anywhere? 20 A No. 21 Q And have you ever had your license 22 revoked or suspended? Page 85 1 A No. 2 Q Have you been disciplined by any state 3 medical board? 4 A No. 5 Q Have you ever been sued before regarding 6 your professional duties? 7 A No. 8 Q I apologize for asking this, but have 9 you been convicted of any crimes? 10 A No. 11 VIDEOGRAPHER: This concludes tape one 12 in the deposition of Dr. Christopher Lang. Off 13 the record at 10:45:35. 14 (Recess) 15 VIDEOGRAPHER: This begins tape two in 16 the deposition of Dr. Christopher Lang. On the 17 record at 10:49:10. 18 BY MS. HARTNETT: 19 Q Dr. Lang, are there policies and 20 procedures that govern your work in The George 21 Washington University emergency department? 22 A Not to my knowledge. Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 7 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 23 (Pages 86 to 89) Page 86 1 Q Are there -- I -- how do you as an 2 attending physician in that emergency department 3 learn of the -- the policies or practices of how 4 you're supposed to perform your duties in the 5 emergency -- emergency department there? 6 A My duty as the attending physician is 7 perform the duties that I was trained to do, which 8 is act as an emergency physician. 9 Q So in the course of your work at the 10 emergency department at George Washington 11 University Hospital, do you have any occasion to 12 refer to the policies or practices that the -- the 13 hospital may have? 14 A No. 15 Q Have you received any training on any 16 hospital policies or procedures? 17 A No. 18 Q Has that been your experience at the 19 Naval Hospital as well, that -- sorry, just to be 20 clear, that -- are there any policies or 21 procedures from the Naval Hospital that you follow 22 when you're doing your work there? Page 87 1 A It's is same as -- as at George 2 Washington University. 3 Q And that your -- your work as an 4 attending physician doesn't require you to consult 5 any hospital policies or procedures at the Naval 6 Hospital? 7 A Not to my knowledge. 8 Q Do you know if there are hospital policy 9 and procedures for the emergency department at The 10 George Washington University Hospital? 11 MR. KELLEY: Object to the form. 12 THE WITNESS: No -- 13 MR. GOODSON: Same objection. 14 You -- you can answer. 15 THE WITNESS: Not to my knowledge. 16 BY MS. HARTNETT: 17 Q If you have a question regarding -- in 18 the -- in your care of a patient at George 19 Washington University Hospital regarding the 20 appropriate procedure or treatment to -- for a 21 patient, is there someone you ask -- is there 22 somewhere you can ask that question, someone you Page 88 1 can ask it to? 2 A Yes. 3 Q Where would you go? 4 A Initially the charge nurse. 5 Q And why would you go to the charge 6 nurse? 7 A They're the -- the main person that's 8 in -- during that shift that's really in charge 9 of, you know, the nurses and techs and movement of 10 patients. They're kind of the quarterback on that 11 side of the house. 12 Q When you say side of the house, what -- 13 what are you referring to? 14 A Nurses, techs, flow of the emergency 15 room. 16 Q On a given shift in The George 17 Washington University emergency department -- and 18 this is during your time as an attending 19 physician -- 20 A Sure. 21 Q -- what other personnel are -- medical 22 personnel are in the emergency department other Page 89 1 than the attending physician? 2 A There'll be residents. And typically 3 there's three teams that -- on the main -- I'll 4 speak first on the main side. There is the 5 attending physician, potentially a second one -- 6 usually just one -- with three residents and 7 sometimes a senior resident on top of it. There 8 could -- there's usually medical students -- and 9 that could range from zero to ten -- physician's 10 assistants, and physician assistant students. 11 And then on the nursing side, there's -- 12 you know, there's a charge nurse. There's triage 13 nurses that take intake from the front. There's 14 what's called float nurses that if there's issues 15 that are going on in the ER that the nurses are 16 maybe consumed with another patient, that they'll 17 go ahead and help them out with their other 18 patients. And then there's the nurses that are 19 assigned to each one of the patients. 20 And then from there there's techs that, 21 you know, will assist the nurse in things such as 22 EKG's, blood work, bringing patients down to Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 8 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 24 (Pages 90 to 93) Page 90 1 x-ray, those types of -- and then there's a front 2 desk like clerk. And their roles and 3 responsibilities are to get the admissions into 4 the computer system, answer the phone, page people 5 for us maybe. 6 Q And when you're on a shift as the 7 attending, which, if any, of these -- the people 8 that you described are you supervising? 9 A My supervision is -- how do you define 10 supervision? 11 Q I guess which of those individuals are 12 you responsible for what -- what their doing, the 13 tasks they're performing in the emergency 14 department? 15 A You mean our responsibilities with the 16 physicians or physician train -- trainees? 17 Q As far as the nursing staff goes you -- 18 I mean I take it that you can direct them to do 19 something for the care of the patient, and they -- 20 they have to do what you say? 21 A Oh, I wouldn't like to refer to it as 22 that. I think it's a very collegial relationship Page 91 1 that they will honor what we have to say, unless 2 they think it's such an extreme, you know, 3 aversion to what the -- you know, what -- what 4 appropriate care may be for that patient. 5 Q I take it you -- I just want to be clear 6 that you -- do you have -- since you -- I didn't 7 want to use the words supervision if that's 8 confusing, but do you have oversight over what the 9 nurses are doing with respect to the patients that 10 you're caring for? 11 MR. GOODSON: Object to form. 12 You can answer. 13 THE WITNESS: I mean we make sure that 14 they're getting, you know, things performed 15 which -- whatever their job description is to get 16 those done. And there's a mechanism, if I have an 17 issue, to go to people. But, again, they're not 18 under my direct supervision. I don't have the 19 authority to -- to counsel, you know, write them 20 up, etc. That's -- 21 BY MS. HARTNETT: 22 Q And are the physician assistants and the Page 92 1 physician assistant students under your 2 supervision? 3 A Yes. 4 Q And is there any -- be it from George 5 Washington University Hospital or elsewhere, are 6 there any policies or -- or guidelines that you 7 follow in how you supervise the -- the personnel 8 that are under your supervision in the emergency 9 department? 10 A Not to my knowledge. 11 Q Are there any medical faculty associates 12 policies or procedures regarding supervision of 13 residents or other medical personnel? 14 A Not that I've seen. 15 Q How did you develop your understanding 16 of what is entailed in supervision of the medical 17 personnel that are under your supervision at 18 the -- in the emergency department? 19 A It's -- it's well known just in the 20 medical field of how the -- you know, you graduate 21 medical school. As a medical student, you're 22 first thrown into the -- the throws of rotating Page 93 1 around the special -- with each specialty. And 2 there's a hierarchy system of a medical student, 3 you know, resident, and attending physician. And 4 so during that process is -- is how you, you know, 5 how you learn how, for a lack of a better term, 6 chain of command exists. 7 Q And just for example in your own 8 experience at The George Washington University 9 Hospital versus the Naval Hospital, do you employ 10 the same basic -- your own same practices with 11 regard to supervision of the -- any medical 12 personnel that are under your supervision? 13 A Yes. 14 Q And I -- I just want to make sure I was 15 clear, because I -- I had mentioned George 16 Washington University Hospital policies that -- 17 there any George Washington University policies 18 that you're aware of that govern your work as an 19 attending physician in the emergency department? 20 A Not to my knowledge. 21 Q The -- the work address that you gave 22 earlier in the deposition, is that an office? Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 9 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 26 (Pages 98 to 101) Page 98 1 your training you learn of seeing patients and -- 2 and how to treat that way. Then there's on-line 3 searches that you could potentially do. But I 4 don't have a specific on-line search that I use in 5 my medical practice. 6 Q In your work at the emergency department 7 at George Washington University Hospital, what is 8 your -- what is the system for keeping any -- 9 keeping records about the patients that you see? 10 A We have an electronic medical record. 11 Q Is that something that you were trained 12 on when you first began your work in the emergency 13 department at GW? 14 A Yes. 15 Q Is this during your residency that you 16 received that training, or is this when you became 17 an attending? 18 A It was during my residency. 19 Q And are there any guidebooks or manuals 20 with respect to, you know, how to keep the records 21 in that electronic system? 22 A Not to my knowledge. Page 99 1 Q Do you recall what the training entailed 2 regarding the -- making the -- using the 3 electronic medical record system? 4 A When they brought it on-line, it was -- 5 I believe it was two or three, you know, four- or 6 five-hour sessions on -- on how the electronic 7 medical record is utilized. 8 Q And you -- can you describe what your 9 practice is for making entries into the electronic 10 medical record? 11 MR. GOODSON: What year? 12 BY MS. HARTNETT: 13 Q Well, let's start with current. 14 A My current? 15 Q Yes, please. 16 A I mean depends. There's several 17 different types of entries you put into the 18 medical record. 19 Q Is an attending order some of the 20 different types that you can put in? 21 A Order of laboratory testing, diagnostic 22 testing, medications. Page 100 1 Q Do you use the medical record to diag -- 2 to document your interactions with the patient? 3 A Yes. 4 Q And how do you -- how do you denote that 5 in the medical record? 6 A There's a section. There's an attending 7 section that you can denote. 8 Q And what's your practice for what you -- 9 you put into the attending section of the medical 10 record? 11 A My practice is a -- whatever my 12 encounter is what that patient, and would describe 13 that encounter. 14 Q And in the course of treating a patient, 15 I'm just trying to understand is it that you 16 put -- do you input the entries into the 17 electronic record while you're seeing them, or do 18 you do it sometime after you've seen them, or does 19 it just vary depending on the situation? 20 A Yeah, it's so variable, especially a 21 large metropolitan emergency room. It's just -- 22 it's vari -- it's variable. Page 101 1 Q Are there any guidelines or practices 2 that you're aware of as to like how soon you're 3 supposed to put the -- the information into the 4 record or anything of that sort? 5 A There's no guidelines. I -- I think 6 it's common practice to before your shift is done 7 to make sure that your notes are completed. 8 Q And separate from the medical record, 9 regarding your supervision of the residents 10 specifically, is there some way you keep track of 11 each resident's work during the shift that you're 12 working with them? 13 Is there any way that you make notations 14 or -- or any records of that? 15 A Outside of what they input into the 16 electronic medical record that's -- that I'm privy 17 to, you know, their entries, there's -- there's no 18 other documents. 19 Q Is part of your role as attending to 20 evaluate the work of the residents? 21 A Yes. 22 Q And how do you -- how do you -- how do Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 10 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 32 (Pages 122 to 125) Page 122 1 A Yes. 2 Q Do you do residents ever ask for you to 3 be present while they're doing some sort of 4 examination or treatment of a patient? 5 A Yes. 6 Q In what circumstances? 7 A When they don't feel comfortable about 8 the specific type -- it's usually procedure that 9 they're doing, or if they found a -- if they have 10 a physical finding. 11 Q Before you actually talk to the patient, 12 are there -- do you look at any electronic records 13 that have been generated to that point by the 14 nurse -- other nurses or other personnel? 15 A Can you clarify the question? 16 Q Sure. I get -- what I'm trying to 17 understand is before you actually go physically 18 see the patient and talk -- 19 A Uh-huh. 20 Q -- to them, do you look at a chart or 21 any other electronic record to get some background 22 on what -- what the patient's status is? Page 123 1 A Some -- if I can, sometimes. You know, 2 it -- it -- again, it depends on how -- how busy 3 it is. And it's not only busy in volume, but it's 4 also just if I'm walking and there -- and I'm in 5 room two and there so happens to be someone that 6 rolled into -- right into room three, I'll go in 7 there because we always have to go back to a 8 central location to do our data input. We 9 don't -- you know, it's not done -- [inaudible] -- 10 so -- 11 THE REPORTER: It's not done what? 12 THE WITNESS: At bedside. So we go 13 ahead and -- I would go ahead and do it that way. 14 BY MS. HARTNETT: 15 Q At that point, you would just talk to 16 the patient to get the basic information that you 17 need to proceed further? 18 A That's correct, I -- yeah. 19 Q Okay. Are there times when the nurse or 20 some other personnel will orally explain -- say 21 something about the patient to kind of brief you 22 on that patient as opposed to you looking at the Page 124 1 computer or reading their chart before you see 2 them? 3 A Yes. 4 Q Any particular situations where a nurse 5 would do that, or just depends on the situation? 6 A Yeah, it's -- it's -- it's variable. 7 Q What's the minimum that you have to do 8 as an attending to actually be able to have that 9 patient kind of properly received and -- and 10 discharged from the -- from the -- from the 11 emergency department? 12 MR. GOODSON: Objection. Form. 13 THE WITNESS: Me, personally, or -- 14 BY MS. HARTNETT: 15 Q An attending. I guess what's the 16 minimum task that an attending must do for any 17 patient that presents in the emergency department 18 before they're discharged? 19 MR. GOODSON: Objection to form. 20 THE WITNESS: The minimum task would be 21 to -- to have a discussion with whoever saw the 22 patient, come up with a treatment plan, and go Page 125 1 from there. 2 BY MS. HARTNETT: 3 Q Are there situations where the patients 4 actually come in and is discharged without you 5 personally ever -- as the attending ever 6 interacting with the patient directly? 7 A Me, personally, yes. Very limited. 8 Q Are there any particular kinds of cases 9 where that would occur, or is it -- or does it 10 vary? 11 A Yeah, I mean it's mainly you cut your 12 finger. You had sutures placed in five days ago. 13 The physician's assistant remove the sutures. 14 Q Right. 15 A Everything seemed to be fine. I don't 16 necessarily go and take a look at those patients. 17 Q In your understanding of the basic 18 minimum that you have -- I understand that you 19 probably do more than the minimum, but -- but your 20 understanding of the minimum that you as the 21 attending need to do for supervision for each 22 patient, where does that come from? What informs Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 11 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 33 (Pages 126 to 129) Page 126 1 your understanding? 2 A From my training. 3 Q Are there any specific written 4 guidelines or policies that you or -- or training 5 materials that you -- that come to mind when 6 you -- for this topic? 7 A No. 8 Q Can a patient be accompanied by a friend 9 or relative when they're being treated in the 10 emergency department at GW? 11 MR. JEFFERSON: Object to form and 12 foundation. 13 THE WITNESS: It depends on the 14 situation. 15 BY MS. HARTNETT: 16 Q What is your practice in that regard? 17 A It's, one, if the patient doesn't want 18 the family member to come back, we honor that. If 19 they feel that they're -- that person is of danger 20 to them for any sort, we don't allow them to come 21 back. Or in a critical patient, where we're doing 22 lots of procedures with lots of people in the room Page 127 1 and we don't have space to put -- to bring them 2 back yet, or we don't want them to see the patient 3 in that fashion quite yet, we would wait, but 4 allow them to come back at some point. 5 Q And again, regarding your practice, 6 would that topic of when a patient could be 7 accompanied, where does that come from, as far as 8 you're -- what -- 9 A I get it from my training. 10 Q And are there any particular written 11 policies or -- or training materials that -- that 12 you're referring to? 13 A No, not that I'm aware of. 14 Q The patient that presents for treatment 15 reports having lost consciousness -- 16 A Uh-huh. 17 Q -- can you describe what would be part 18 of that -- your assessment of that patient or -- 19 and your treatment of that patient? 20 MR. GOODSON: Objection. At what point 21 in time and what circumstance? I mean it's such a 22 broad question. Page 128 1 BY MS. HARTNETT: 2 Q Within the last 24 hours had lost 3 consciousness? 4 MR. GOODSON: And they're still 5 unconscious? 6 BY MS. HARTNETT: 7 Q No. They're there and they regain 8 consciousness there. And they reported that to 9 you. 10 Can you describe what your -- 11 MR. GOODSON: Let me just object to -- 12 THE WITNESS: Well, first, they've got 13 to complain to me that they've lost consciousness. 14 Okay. And then after their complaint of losing 15 consciousness, we would then dive into how they 16 lost consciousness. 17 BY MS. HARTNETT: 18 Q So it would just depend on how they lost 19 consciousness kind of where you went from there? 20 A Exactly. 21 Q As of December 2006, had you worked with 22 Dr. Khozeimeh previously? Page 129 1 A I believe so. 2 Q Do you have any recollection of your 3 work with her prior to December of 2006? 4 A Not -- not -- nothing that sticks out to 5 me, no. 6 Q Have you worked with her since December 7 2006? 8 A Not to my knowledge. 9 Q Do you know what your -- where she was 10 in her residency program in December 2006? 11 A Yes. I believe she was a -- a surgical 12 resident. 13 Q And what does that mean? 14 A She is persuing a residency in general 15 surgery. 16 Q So why -- why was she in the emergency 17 department at that point? 18 A They rotate through. 19 Q And, sorry, just -- do you know what 20 year of the program she was in at that point, 21 12/06? 22 A I believe she was first year. Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 12 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 36 (Pages 138 to 141) Page 138 1 calling the police and then the -- the patient 2 would be transferred to Howard if necessary, where 3 did that understanding come to you from, a person 4 or a document? 5 MR. JEFFERSON: Object to form and 6 foundation, particularly to the 7 mischaracterization of the witness's testimony. 8 The question presupposes that the patient was in 9 fact sexually assaulted or had a complaint of 10 sexual assault. 11 MS. TURNER: Same objection. 12 THE WITNESS: The -- again, the patient 13 is -- they have the intake. And then the 14 Metropolitan Police Department is -- is -- is 15 contacted. And that's what has been my training 16 for any assault case that comes in, that we call 17 the Metropolitan Police Department. 18 BY MS. HARTNETT: 19 Q Okay. So understanding -- I don't want 20 to separate out sexual assaults if that's 21 incorrect with respect to your experience. 22 And where did that train -- you said Page 139 1 that's what we'd been trained on. 2 Where did that come from? 3 A Seeing assaulted patients during my 4 residency training. 5 Q And any anywhere else? 6 Anywhere that this understanding of the 7 practice of the -- the procedure that you would 8 follow in a case of an assaulted patient, anywhere 9 else that understanding came from? 10 A No. 11 Q Okay. Do you know if The George 12 Washington University Hospital is involved in the 13 SANE program? 14 MR. GOODSON: I'll object to the form of 15 the questions as to involved. 16 You can answer. 17 THE WITNESS: Not to my knowledge. 18 BY MS. HARTNETT: 19 Q And do you know what the -- sorry. I 20 should ask this first. 21 But do you know what the SANE program 22 is? Page 140 1 A I think I -- I -- I think we discussed 2 this before. I have a very limited knowledge on 3 the program. But it is a -- there is a designated 4 center where people are processed once the 5 decision is made that this a sexual assault case. 6 MR. JEFFERSON: Object to the 7 responsiveness of the answer. Move to strike. 8 Speculation. 9 MS. TURNER: Same objection. 10 BY MS. HARTNETT: 11 Q Are you aware of any situation, either 12 from your own treatment or from some other 13 knowledge you have of any patient being treated 14 for, once it's determined it is a sexual assault 15 case, as you put it, being treated at The George 16 Washington University Hospital with regard to that 17 sexual assault? 18 A I'm not aware -- 19 MR. JEFFERSON: Object to form and 20 foundation. 21 THE WITNESS: I'm not aware of any case. 22 BY MS. HARTNETT: Page 141 1 Q Is your -- is your understanding that 2 there are any cases or any situations in which 3 that sexual assault patient who has been some -- 4 someone has made the decision this is a sexual 5 assault case, are you aware of any of -- any 6 situations in which those patients would be 7 treated at The George Washington University 8 Hospital? 9 MR. JEFFERSON: Same objection. 10 MS. TURNER: I'll object to also the 11 term "someone." 12 You can answer. 13 THE WITNESS: I've never been in a 14 specific situation to be able to answer that 15 question. 16 BY MS. HARTNETT: 17 Q So is it fair to say you don't know 18 whether there are situations in which a patient 19 who has been -- well, that -- whether this has 20 been made as a sexual assault case that could be 21 treated at The George Wash -- George Washington 22 University Hospital? Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 13 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 37 (Pages 142 to 145) Page 142 1 MR. JEFFERSON: Object to form. 2 THE WITNESS: We have a conversation 3 with the Metropolitan Police Department, and 4 whatever their decision is to do. And I've only 5 had those two -- the two instances. So I only can 6 comment on that. 7 BY MS. HARTNETT: 8 Q And I take it your -- from your 9 experience, your understanding is that it's the 10 Metropolitan Police Department's decision as to 11 whether the patient is going to be treated as a 12 sexual assault case or not? 13 MR. JEFFERSON: Object to form and 14 foundation. 15 THE WITNESS: My job as a physician is 16 to make sure that the patient's medically safe. 17 BY MS. HARTNETT: 18 Q And I -- I -- I understand that. I -- I 19 just -- from your two experiences with -- 20 A Uh-huh. 21 Q -- these personal experiences in these 22 two patients' -- Page 143 1 A Uh-huh. 2 Q -- treatment -- 3 A Uh-huh? 4 Q -- was your understanding from that that 5 the police were the ones making a decision as to 6 whether that was going to be a sexual assault 7 patient treated pursuant to the other procedures 8 you described, or assaults, or it's just going to 9 be a regular patient in your medical care? 10 MR. JEFFERSON: Same objection. Form 11 and foundation. 12 THE WITNESS: We don't have the means, 13 you know, to perform forensic exams without the 14 aid of Metropolitan Police Department. Our duties 15 as the physician in treating is to make sure that 16 the patient is adequately treated, and any -- any 17 injuries due to the -- you know, any sort of 18 assault or whatever it may be is taken care of; 19 and any forensic issues, that we will be under the 20 guidance of whoever that governing body is to 21 respond to. 22 BY MS. HARTNETT: Page 144 1 Q What do you mean when you say forensic 2 issues under the guidance? 3 What role, if any, would you have in 4 those forensic issues? 5 A I've never been involved, so I'm not 6 sure. 7 Q Okay. And I understand your 8 responsibility -- we'll get to the -- the means 9 point that you brought up. 10 But my understanding, from the second 11 patient at least, was that some -- that patient 12 was moved to the, in your understanding, the 13 Howard University Hospital for treatment; is that 14 correct? 15 A That's correct. 16 MR. JEFFERSON: Object to the form of 17 the question. 18 BY MS. HARTNETT: 19 Q And I -- my -- my question is who made 20 the decision that that was going to be a case in 21 which the patient was going to be transferred to 22 the Howard University Hospital? Was that decision Page 145 1 made by the police, or by somebody else? 2 MR. JEFFERSON: Same objection. 3 THE WITNESS: We called the Metropolitan 4 Police Department. 5 BY MS. HARTNETT: 6 Q Yep. 7 A They came and did intake. They came 8 back to me and said, Dr. Lang, I'm taking this 9 patient over to Howard University Hospital. 10 Q Is it fair to say, from that experience 11 at least, that second experience, that it was the 12 police that made the decision about the -- that 13 the patient would be receiving care at the Howard 14 University Hospital rather than at The George 15 Washington University Hospital? 16 MR. JEFFERSON: Object to the form and 17 foundation, asked and answered as well. 18 THE WITNESS: My understanding is that 19 the Metropolitan Police Department is the -- as 20 far as any criminal prosecution for any forensic 21 exam, is the -- the appropriate personnel to be 22 involved. And I -- I -- I think the only Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 14 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 38 (Pages 146 to 149) Page 146 1 personnel to be involved, to my knowledge. 2 BY MS. HARTNETT: 3 Q Did you provide any medical center to 4 that -- the second patient, the second patient 5 that presented with the sexual assault claim? 6 A No. 7 Q And my question is why did you not 8 provide medical care to that patient? 9 A Well, I guess we have to clarify what 10 medical care is. 11 Q Please do. 12 A She was triaged. She had stable vital 13 signs. And she had no obvious concerns about 14 being transported to another facility. 15 Q Was it your decision as the attending to 16 send her to the Howard University Hospital for 17 medical -- for additional care? 18 A No. 19 Q Whose decision was it? 20 A The Metropolitan Police Department came. 21 And they told me they're taking the patient to 22 Howard University Hospital for further evaluation. Page 147 1 Q To your knowledge, does a SANE nurse 2 ever come to the emergency department at Howard 3 University Hospital during the time that you've 4 been there to perform any sort of medical care or 5 treatment? 6 MR. GOODSON: Can we, just for the 7 record, you're referring to a capital S, capital 8 A, capital N, capital E nurse, correct? 9 MS. HARTNETT: Absolutely. 10 MR. GOODSON: Okay. 11 You can answer. Make sure it's 12 confirmed for the record. 13 THE WITNESS: I don't work at that 14 institution, so I can't comment on that. 15 BY MS. HARTNETT: 16 Q Did I say Howard University Hospital? 17 A Uh-huh. 18 MS. TURNER: You did. 19 MS. HARTNETT: Sorry. I was looking at 20 you. 21 BY MS. HARTNETT: 22 Q Okay. Sorry. I mean The George Page 148 1 Washington University Hospital. I'm sorry for 2 that. 3 A Can -- can you just repeat -- 4 Q Sure. 5 A -- the question, please? 6 Q To your knowledge, during your time at 7 The George Washington University Hospital 8 emergency department, are you aware of a SANE 9 nurse ever coming to the emergency department to 10 participate in the care and treatment of a 11 patient? 12 A I've only been involved in those two 13 cases, so no. I mean the -- as I stated prior, 14 I've only had two experiences at George Washington 15 University. And that's all I can comment on. 16 Q And I understood those to be ones in 17 which you were personally involved in the care of 18 the patient. 19 I was -- 20 A I'm referring to that. 21 Q -- trying to -- trying to actually just 22 go a little bit broader and ask you if you're -- Page 149 1 A Oh. 2 Q -- aware of any other situation where 3 the SANE nurse had come to give care or treatment? 4 A Gotcha, yeah. No, I'm not. 5 Q Okay. Was any part of your medical 6 training, did you receive any training on how to 7 actually, for lack of a better term, perform the 8 SANE examination or a SANE kit on a patient? 9 A No. 10 Q Have you ever observed a SANE kit or a 11 SANE exam being performed on a patient? 12 A No. 13 Q And have you ever assisted anyone in any 14 part of a SANE exam or SANE kit? 15 A No. 16 Q Is it your understanding, as an 17 emergency room physician, that that's something 18 that you -- that is -- that could be required of 19 you to do in some sort of -- in -- in some 20 circumstance, to actually perform a SANE exam or a 21 SANE kit? 22 MR. GOODSON: Objection to form, the Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 15 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 40 (Pages 154 to 157) Page 154 1 what extent that presence is -- could be, I have 2 no clue. 3 MR. JEFFERSON: Move to strike the 4 response as speculation as what he stated his 5 position is. 6 BY MS. HARTNETT: 7 Q Going back to your practice at The 8 George Washington University Hospital, you've 9 testified -- we -- we've covered what happens when 10 the police or somebody else, whoever determines 11 it's a sexual assault case, that it's going to 12 proceed that way. 13 What happens in the case of it's a 14 patient who complains of sexual assault, but for 15 whatever reason it is not going to be handled as a 16 sexual assault case after speaking to the 17 Metropolitan Police Department, what happens at 18 the -- 19 MR. JEFFERSON: Object to form -- 20 BY MS. HARTNETT: 21 Q -- to that -- 22 MR. JEFFERSON: -- and foundation. Page 155 1 BY MS. HARTNETT: 2 Q -- to that patient at the hospital? 3 MR. GOODSON: Same objection. 4 THE WITNESS: I only can comment on my 5 experience that I had with this. And this is this 6 case. 7 BY MS. HARTNETT: 8 Q Okay. And what was your -- what -- what 9 was your practice in that situation? 10 MR. GOODSON: Are you asking him what 11 his practice was on this case, or -- 12 MS. HARTNETT: I'm asking -- 13 MR. GOODSON: -- in general? 14 MS. HARTNETT: -- what his practice is 15 in general -- 16 THE WITNESS: Can you rephrase -- 17 MS. HARTNETT: -- what the -- sorry. 18 THE WITNESS: I mean can you -- can you 19 ask the question again? 20 BY MS. HARTNETT: 21 Q Sure. 22 What I'm -- what I'm asking you is what Page 156 1 your -- 2 A Uh-huh. 3 Q -- present practice is regard -- this 4 case or not, but what is your practice with 5 respect to a patient that the Metropolitan Police 6 Department determined is not -- or somebody else 7 determines is not a sexual assault case, and thus 8 the patient remains at The George Washington 9 University Hospital? What's your practice with 10 respect to that patient? 11 MR. JEFFERSON: Object to form and 12 foundation. 13 THE WITNESS: We would make sure that 14 they're med -- they're -- they're medical 15 treatment, and they're medically safe, that we -- 16 we've -- we've treated all their issues 17 accordingly, have a treatment plan. 18 BY MS. HARTNETT: 19 Q And I know depends on if the patient has 20 particular injuries, but in general as a -- is 21 there any general treatment plan for a patient 22 that's complained of sexual assault? Page 157 1 MR. GOODSON: Objection to form. 2 BY MS. HARTNETT: 3 Q That you're going to -- that you're to 4 see but that's not going to be going elsewhere? 5 A There's certain prophylactic medication 6 that we offer the patient. 7 Q And what medication is that? 8 A The morning-after pill, we offer that. 9 We offer -- offer GC/chlamydia coverage. 10 Q Uh-huh. 11 A GC meaning gonococcal/chlamydia, and HIV 12 prophylactic medication. 13 Q And where did you learn that this -- or 14 come to an understanding that this is the 15 treatment -- potential treatment regimen for a 16 patient complaining of sexual assault? 17 A I wouldn't put them as just a patient 18 complaining of sexual assault. I think anyone 19 that had sexual contact with an unknown individual 20 or individual they -- they -- they don't know what 21 their sexual histories were, these are the types 22 of things that are offered to them. Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 16 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 41 (Pages 158 to 161) Page 158 1 Q Okay. As far as you -- you know, are 2 there differences in how the procedure for 3 treating a patient -- this is not just sexual 4 assault patients -- if they're a GW student or 5 personnel versus just a -- other person that comes 6 up to the emergency department? 7 And this is with respect to the 8 emergency department. 9 A No. 10 Q And just -- so specifically with respect 11 to sexual assault, it -- there wouldn't be a 12 distinction made between the GW students or 13 employees or other people that come with a 14 complaint of sexual assault? 15 A Only if you -- for university police, 16 for example, they may want to know, for example, 17 if Metropolitan -- you know, we would call 18 university police in -- instead of Metropolitan 19 Police, per se. That would be the only 20 distinction. 21 Q And is that something that's true for 22 all categories of assault, as well? Page 159 1 A I don't know if there's any guidelines 2 or procedures. But anything that happens on 3 campus, the Met -- the -- the campus police want 4 to be aware of that situation. 5 Q Okay. 6 A But, you know, to -- to further -- my 7 standard question to a patient isn't: Are you a 8 GW student? Okay. That is not part of my medical 9 screening process. It's not part of my treatment 10 plan. It's not -- it's part of any sort of 11 authorities to be getting involved outside of the 12 university police that this is something to -- or 13 to be pursued. 14 Q Understood. 15 Have you ever -- sorry. 16 Do you know any physician that's 17 performed a sexual assault exam or a SANE exam on 18 a patient? 19 A No, not personally. 20 Q Do you have any knowledge as to whether 21 the length of time that passes between the alleged 22 assault and the time when the patient is -- Page 160 1 receives this sexual assault forensic exam whether 2 that affects the effectiveness of the exam? 3 A No, I don't -- I don't know of any time 4 constraints. 5 Q And do you know of any things such as 6 eating, drinking, etc., that a patient should not 7 do between the time that an alleged assault and 8 the time they get the sexual assault exam in order 9 to maximize the effectiveness of the exam? 10 A Again, not being part of a -- that type 11 of examination, I -- it's really hard for me to 12 answer. Because I don't know what they take, 13 draw, etc. I don't -- I don't know all the 14 intricacies of that. 15 Q So, for example, in the situation of the 16 second patient, not -- not the one in this case -- 17 A Uh-huh. 18 Q -- was there any guidance you provided 19 to that patient as to what to do or not to do 20 between the time she saw you and the time she was 21 going to be at Howard University Hospital? 22 A She was escorted by the police. Page 161 1 Q So I take it you didn't have any 2 interactions about what she should or shouldn't do 3 between the time she saw you and going to Howard 4 University Hospital? 5 A No. 6 Q Do you know if a patient urinating 7 between the time of the assault and the time of a 8 sexual assault exam would have some affect on the 9 effectiveness of that exam? 10 MR. JEFFERSON: Objection. Asked and 11 answered. 12 THE WITNESS: Again, to my knowledge, I 13 don't know what they're testing for to know if 14 that would be useful information or not. 15 BY MS. HARTNETT: 16 Q How about defecating? 17 MR. JEFFERSON: Same objection. 18 THE WITNESS: Same answer. 19 BY MS. HARTNETT: 20 Q I'm just -- I'm going to ask you a 21 couple of them -- 22 A Okay. Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 17 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 42 (Pages 162 to 165) Page 162 1 Q -- and you can answer same or not -- 2 A Okay. 3 Q -- but -- 4 A Okay. 5 Q How about eating? 6 A Again, I -- I'm not sure what they're 7 testing for, so I can't comment on that. 8 Q And drinking? 9 A Again, I'm not sure what they're testing 10 for, so I can't comment on it. 11 Q Okay. Showering? 12 A I'm not sure what they're testing for, 13 so I can't comment on it. 14 Q Last one. Brushing teeth? 15 A I'm -- I'm not sure what they're testing 16 on, so I can't comment on it. 17 Q Is there any form that you're aware of 18 or any written document that would outline 19 procedures or practices for treating a sexual 20 assault patient at George Washington University 21 Hospital, a patient that presents with a complaint 22 of sexual assault? Page 163 1 A No, I'm not aware. 2 Q Just give me a moment, please. 3 VIDEOGRAPHER: This concludes tape two 4 in the deposition of Dr. Christopher Lane. Off 5 the record at 12:08:15. 6 (Recess) 7 VIDEOGRAPHER: This begins tape three in 8 the deposition of Dr. Christopher Lane. On the 9 record at 12:19:15. 10 MS. HARTNETT: Let's mark this as Lang 11 2, please. 12 (Lang Deposition Exhibit 13 No. 2 was marked for 14 identification.) 15 BY MS. HARTNETT: 16 Q Dr. Lang, I've handed you what's marked 17 as Lang 2. It's a document that was produced to 18 us by The George Washington University Hospital. 19 Do you know what this document is? 20 A (Witness examined document). No. 21 Q Have you ever seen it before? 22 A No. Page 164 1 Q Have you ever seen any document with the 2 heading, George Washington University Hospital 3 emergency department practice manual? 4 A No. 5 Q And if I asked you where is the practice 6 manual located, would you have any idea? 7 A No. 8 Q Looking at the face of the policy under 9 scope, I notice it says, Emergency department 10 attending physicians, emergency department 11 registered nurses. 12 Is this some pol -- does this policy 13 apply to you? 14 MR. GOODSON: Objection. 15 MR. KELLEY: Same objection. 16 MR. GOODSON: But I'll also object to 17 the form and foundation, because you've already 18 established that he's never seen this document 19 before. So how would he know whether it applied 20 to him or not? 21 MS. HARTNETT: I'm -- I'm asking him if 22 reference to the scope section helps him determine Page 165 1 whether it applies to him or not. 2 THE WITNESS: No. 3 BY MS. HARTNETT: 4 Q I understand you haven't seen this 5 document. I'm going to ask you some questions as 6 to whether it's consistent with your practice. 7 I'm just going to direct you to number -- if you 8 at -- at any time would like to read more of the 9 document, please let me know. And we can stop. 10 And you can read as much as you like. 11 The second paragraph under -- just to 12 get the context, it says, If a patient comes to 13 the emergency department with a history of alleged 14 sexual assault -- this is on the first page, the 15 second sentence -- the following should be 16 accomplished by the nurse. 17 Directing down to three it says, 18 Notification of the Metropolitan Police Department 19 after permission is granted by the patient. 20 Is this consistent with your 21 understanding of the experience of the practice in 22 The George Washington University emergency Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 18 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 43 (Pages 166 to 169) Page 166 1 department? 2 MR. GOODSON: Can -- can we have a time 3 frame you're talking about? 4 BY MS. HARTNETT: 5 Q I would say -- I mean my time frame is 6 both December '06 through the present, but let me 7 know if there's any difference in that. 8 MR. McAFEE: Let me object. I think 9 this witness's testimony earlier was to his 10 experience. And you've asked a question about the 11 entire institutional experience, but -- 12 BY MS. HARTNETT: 13 Q I -- I think I asked -- well, is it 14 consistent with your practice in the emergency 15 department? 16 MR. GOODSON: Let me just object again. 17 I asked you to please clarify. We -- you've given 18 a document that appears to have a date of 1984, 19 and 2003. And I'd like you to clarify for him 20 what you're referring to is the year that it would 21 be his practice. 22 MS. HARTNETT: I'll be happy to make it Page 167 1 clear again. 2 BY MS. HARTNETT: 3 Q But I'm -- I'm -- what I'm -- these 4 questions pertain to your practice from December 5 2006 to the present. 6 MR. GOODSON: So you're referring to 7 anything after the date of the alleged incident in 8 this case? Is that what your question is? 9 MS. HARTNETT: No. I'm actually 10 referring to December 2006, including December 11 2006 and forward to the present. 12 MR. GOODSON: Do you know what the -- 13 recall what the question is? 14 THE WITNESS: I guess she's asking me to 15 look at number three? 16 BY MS. HARTNETT: 17 Q Informed by the fact that there's a 18 sentence leading into that. 19 But is that consistent with your 20 practice at the emergency department? 21 A Again, this -- this is -- it all -- it 22 depends on if the patient was seen before by the Page 168 1 Metropolitan Police Department, if this is the 2 initial complaint of the patient. There's -- 3 there's a lot of variables within that -- within 4 that. So I would say that is a typical practice, 5 but that doesn't encompass every single situation 6 that -- coming to the emergency department. 7 Q Okay. Just moving down to the sentence 8 that says after the one through seven, there's a 9 sentence that starts, The following should be 10 accomplished by a doctor -- by the doctor, with 11 the assistance of the nurse? 12 A Uh-huh. 13 Q And number one says, A general 14 explanation of what will transpire in the 15 department? 16 A Uh-huh. 17 Q Is that consistent with your practice 18 regarding patients that present with a complaint 19 of sexual assault to the emergency department? 20 MR. GOODSON: Objection to form and 21 foundation. 22 BY MS. HARTNETT: Page 169 1 Q And, again, this is -- these questions 2 are from Dec -- including December 2006 to the 3 present. 4 A Again, the -- I've only had two cases -- 5 Q Uh-huh. 6 A -- that I've discussed before. One was 7 already seen at the District of Columbia's SANE 8 center prior to arrival to my department. And the 9 second one was brought to the SANE center 10 immediately from my department over there. 11 Q Is your -- to your understanding, is 12 there any sexual assault case -- situation of a 13 sexual assault patient presenting in which number 14 one would be the -- would be your practice? 15 MR. GOODSON: All right. You're -- 16 listen, you've got a document from Exhibit 2. 17 Okay. And in -- in Exhibit 2, there are two 18 different number one's listed. So please don't 19 confuse the witness with asking a question as to 20 whether number one applies. 21 MS. HARTNETT: I think our questions 22 were -- I apologized if I confused the witness. I Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 19 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 44 (Pages 170 to 173) Page 170 1 think we were focused on the doctor portion of it, 2 and number one, which you were just discussing. 3 BY MS. HARTNETT: 4 Q But I'm happy to clarify that I'm -- my 5 question is, under the doc -- we're now under the 6 doctor numbers. 7 The following should be accomplished by 8 the doctor with the assistance of the nurse: A 9 general explanation of what will transpire in the 10 department. 11 Is that your understanding of the 12 practice that applies to sexual assault patients 13 in The George Washington emergency department? 14 MR. GOODSON: Objection to form and 15 foundation. And there's also -- there's no 16 establishment in the document as to what time 17 they're referring to. 18 So I -- don't answer the question if you 19 have to guess or speculate. 20 THE WITNESS: I'll be guessing or 21 speculating. 22 MS. HARTNETT: I'm not asking about -- Page 171 1 I'm asking him if the words in the document that 2 describe a procedure are consistent with his 3 understanding of the practice in The George 4 Washington emergency department from 12/06 to the 5 present, including 12/06. 6 MR. GOODSON: And I'll object, because 7 you haven't -- you've already established he has 8 never seen this document. Second, the document 9 speaks for itself. And the third, he said he 10 can't answer the question because he cannot 11 understand what is written there. So he -- 12 MS. HARTNETT: I don't think he said 13 that. 14 MR. McAFEE: I object. You -- you just 15 now changed it back to consistent with the 16 practice at George Washington, as opposed to this 17 witness's -- 18 MS. HARTNETT: I said his understanding 19 of the practice, which is -- I think I said it 20 twice now, but I'm happy to make it clear again 21 that's what I'm asking. 22 BY MS. HARTNETT: Page 172 1 Q I'm asking you what your understanding 2 is of the current practice in The George 3 Washington emergency department with reference to 4 a document that states, at least on its face, 5 Emergency department practice manual; Title: 6 Sexual assault; Scope: Emergency department 7 attending physicians. 8 I understand you haven't read the 9 document. 10 But all I -- what I'm asking you -- and 11 I -- I'd like to be clear, so please let me know 12 if I'm not being clear -- whether the following 13 should be accomplished by a doctor: A general 14 explanation of what will transpire in the 15 department, is consistent with your understanding 16 of the practice in the emergency department at The 17 George Washington University Hospital? 18 MR. McAFEE: Objection to form and 19 foundation. 20 MR. GOODSON: Same objection. 21 MR. KELLEY: Same objection. 22 THE WITNESS: Again, as stated, Page 173 1 there's -- there's variables as to is this the 2 initial presentation of a sexual assault victim? 3 Is it the fifth presentation of a sexual assault 4 victim for the same case? Are they going right 5 to -- there's -- there's variabilities. And I 6 think the -- a general explanation, I can't -- I 7 don't know what -- what's involved in the general 8 explanation. I think that has a lot of 9 interpretations. 10 Q Okay. I -- I accept that. 11 Under number two under the -- The 12 following should be accomplished by the doctor 13 with the assistance of the nurse, it states, 14 Assessment of the patient's support systems. The 15 patient may be allowed to have a relative or 16 companion with them during the examination as long 17 as he/she does not interfere with medical 18 procedures. 19 Is the description in number two 20 consistent with your understanding of the practice 21 of -- 22 A Again, of the -- Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 20 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 45 (Pages 174 to 177) Page 174 1 MR. GOODSON: Objection to form and 2 foundation. 3 MR. McAFEE: Objection. Form and 4 foundation. 5 MR. KELLEY: Same objection. 6 THE WITNESS: The first sentence, again, 7 seems ambiguous and very general. The second -- 8 so I have no comment on that. The second 9 sentence, as I believe I've answered before, 10 the -- there are certain situations where family 11 members are not allowed to come back into the 12 room. 13 BY MS. HARTNETT: 14 Q And I understood your earlier answer on 15 that point. Thank you. 16 Just to be completely clear, moving 17 back -- 18 A Uh-huh. 19 Q -- up to the nurse -- 20 A Uh-huh. 21 Q -- directive, if the patient comes to 22 the emergency department with a history of sex -- Page 175 1 alleged sexual assault -- 2 A Uh-huh. 3 Q -- the following should be accomplished 4 by the nurse. 5 And moving down to number six -- 6 A Uh-huh. 7 Q -- it says, Notify the attending 8 physician in the emergency department or an 9 emergency medicine resident licensed in the 10 District of Columbia to perform the necessary 11 gynecologic exam and laboratory procedures. 12 For completion, it goes on to state, At 13 the request of the patient, a private licensed 14 gynecologist on staff at The George Washington 15 University Hospital may be perform the 16 examination. 17 Is what's described in number six 18 consistent with your understanding of the practice 19 at The George Washington University Hospital in 20 the 12/06 to present time period? 21 MR. GOODSON: Objection. Form and 22 foundation. Page 176 1 MR. McAFEE: Join. 2 MR. KELLEY: Objection. 3 MR. GOODSON: And there's also no time 4 frame listed on that. 5 But you can answer. 6 THE WITNESS: (Witness examined 7 document). Again, I -- I believe they're making 8 the assumption on this statement that the -- that 9 there has been communication with the Metropolitan 10 Police Department and a decision to -- to move 11 ahead with some sort of a sexual assault kit. 12 MR. JEFFERSON: Object to the 13 responsiveness -- 14 THE REPORTER: Object to the -- I'm 15 sorry. I didn't hear. 16 MR. JEFFERSON: Responsiveness of the 17 answer. The witness stated that he is assuming. 18 Speculation. 19 BY MS. HARTNETT: 20 Q Understanding that your prior 21 response -- assuming that the -- they had decided 22 to go ahead with the sex kit or what -- what you Page 177 1 just said, is it consistent with your 2 understanding of the practice at The George 3 Washington University Hospital that the -- the 4 attending physician in the emergency department 5 would be notified or an emergency medicine 6 resident licensed in the District of Columbia 7 would be notified to perform the necessary 8 gynecologic exam and laboratory procedures? 9 MR. GOODSON: Objection. Form and 10 foundation, and also no timeframe. 11 MR. McAFEE: I join. 12 THE WITNESS: I can't comment because I 13 have -- I haven't been part of a sexual assault or 14 rape kit. So I can't comment on what the 15 requirements are. 16 BY MS. HARTNETT: 17 Q I'm -- I'm -- just to be clear, I'm not 18 asking about the requirements for a sex kit, 19 but -- or a rape kit, but I'm -- what I'm asking 20 is, is it consistent with your understanding and 21 practice that the physician or the -- the 22 attending physician or the resident at GWH would Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 21 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 46 (Pages 178 to 181) Page 178 1 be notified to perform the necessary gynecologic 2 exam and laboratories procedures in the case of 3 where the police have decided to proceed with the 4 case? 5 MR. GOODSON: Objection. Form and 6 foundation. 7 MR. McAFEE: I join. 8 MR. JEFFERSON: I join. 9 MR. GOODSON: I think this is the third 10 time you've asked the same question. 11 You can answer. 12 THE WITNESS: If this is a forensic 13 exam, I'm not sure what the requirements are for 14 the District of Columbia or the Metropolitan 15 Police Department to perform that exam. 16 BY MS. HARTNETT: 17 Q But in your -- at least your experience, 18 assuming the exam -- or the police were going to 19 go forward with the kit or case, are the necessary 20 gynecologic exam and laboratory procedures 21 performed by personnel in the GW emergency 22 department, or are they performed elsewhere? Page 179 1 MR. GOODSON: Objection. Form and 2 foundation. 3 MR. JEFFERSON: Objection. Form and 4 foundation. 5 MR. McAFEE: I join. 6 MR. KELLEY: I join. 7 THE WITNESS: I've never been part of a 8 rape kit that was processed through the -- The 9 George Washington University Hospital. So it's 10 difficult for me to comment on that. 11 BY MS. HARTNETT: 12 Q Well, for example, in the second case 13 that you had described -- 14 A Uh-huh. 15 Q -- earlier in the deposition, where the 16 patient presented with a complaint of sexual 17 assault -- 18 A Uh-huh. 19 Q -- were you notified to perform the 20 necessary gynecologic exam and laboratory 21 procedures with respect to that patient? 22 A No. The Metropolitan Police Department Page 180 1 took the intake and said they were going to be 2 taking them to Howard University Hospital to 3 process the patient. 4 Q Okay. Moving back to the doctor 5 sentence and follow-on numbers, The following 6 should be accomplished by the doctor with the 7 assistance of the nurse. 8 Turning to page 2. 9 A Uh-huh. 10 Q Notification of -- number three. 11 Notification of the arrival of the 12 sexual assault victim to a representative of the 13 case management department for their assistance, 14 evaluation, and recommendations. 15 My question is whether number -- what's 16 described in number three there under the doctor 17 section is consistent with your understanding of 18 the practice at the emergency department at the GW 19 Hospital for patients presenting with a complaint 20 of sexual assault? 21 MR. GOODSON: Objection. Form and 22 foundation. Page 181 1 MR. McAFEE: I join. 2 MR. KELLEY: Join. 3 THE WITNESS: I've only had two 4 experiences. And with both of those experiences, 5 this does not apply to me. And I -- 6 BY MS. HARTNETT: 7 Q Do you know -- 8 A Sorry. 9 Q Are you done? 10 A Uh-huh. 11 Q Do you know what the case management 12 department is? 13 A I've never had to utilize their 14 services, so I'd have to say no. 15 Q Is there a case management department at 16 the GW Hospital? 17 A I don't know. 18 Q Okay. 19 A I don't know. 20 Q I just -- I just don't want to -- I want 21 to be clear that we're still in -- 22 A Sure. Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 22 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 47 (Pages 182 to 185) Page 182 1 Q -- the doctor section, number four, on 2 page 2. 3 An explanation of the PD-124 form and 4 the implications of signing this form. 5 Do you know what a PD-124 form is? 6 A No. 7 Q And is this number four -- what's 8 described in number four consistent with your 9 understanding of the practice at The George 10 Washington University Hospital emergency 11 department? 12 MR. JEFFERSON: Objection. Form -- 13 MR. GOODSON: Objection. Form and 14 foundation. 15 MR. JEFFERSON: -- and foundation. The 16 witness has already testified he doesn't even know 17 what a PD-124 is. 18 MR. McAFEE: I join Mr. Goodson's 19 objection. 20 BY MS. HARTNETT: 21 Q You can answer. 22 A I don't know what the PD-124 form is, so Page 183 1 I can't answer to if that's a standard practice to 2 have a person sign that. 3 Q Number five says, Inform the patient not 4 to bathe/shower, or change clothes, douche, smoke 5 or drink in the emergency department before the 6 examination is performed, otherwise vital evidence 7 may be destroyed. 8 Is that sentence consistent with your 9 understanding of the practice in The George 10 Washington University Hospital emergency 11 department? 12 MR. GOODSON: Objection. Form and 13 foundation. 14 MR. McAFEE: I join. 15 MR. KELLEY: Join. 16 THE WITNESS: I haven't had an instance 17 where I've had to apply this, so my answer would 18 be no. 19 BY MS. HARTNETT: 20 Q Is there any instance where you would 21 have to apply this? 22 MR. GOODSON: Objection. Form and Page 184 1 foundation, and speculation as to any instance. 2 THE WITNESS: I'm not sure. I mean if a 3 patient were to present, I would take in the 4 information and see what I needed to do with the 5 patient. 6 BY MS. HARTNETT: 7 Q Just previously you'd said that there -- 8 you haven't had an instance in which you had 9 provided this information. 10 Is there any specific instance that 11 comes to mind as when -- when you would, as a 12 matter of your practice, provide this information 13 to a patient? 14 A I haven't been confronted with this 15 specific issue, so I would have to comment I don't 16 know. 17 Q And when you say specific issue, what do 18 you mean? 19 A A patient that is coming into my 20 emergency department that has been confirmed to be 21 sexual assault, first presentation, and a rape 22 kit's being brought over, or brought over to our Page 185 1 emergency department to process. 2 Q Do you have any -- do you have an 3 understanding that that's something that could -- 4 that could happen, that a rape kit could be 5 brought to your hospital to process? 6 MR. GOODSON: Objection. 7 MR. KELLEY: Object to form. 8 MR. GOODSON: Foundation, also 9 speculation. 10 You can answer, though. 11 THE WITNESS: I'm not sure. Again, 12 looking over this, I'm assuming that a PD-124 form 13 is some sort of police department. But, again, 14 that's speculation -- 15 MR. JEFFERSON: Object. 16 THE WITNESS: -- so -- sorry. 17 MR. JEFFERSON: Foundation. 18 THE WITNESS: It looks like a lot of 19 these questions are -- are formulated after the 20 decision of some sort of a kit has been presented 21 to the -- to a department or their -- wherever 22 this kit is going to be performed. Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 23 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 48 (Pages 186 to 189) Page 186 1 MR. JEFFERSON: Object to the 2 responsiveness of the -- of the answer. Move to 3 strike. Speculation. The witness confirmed that 4 he's making assumptions. 5 MR. McAFEE: Kathleen, when you have a 6 minute, I'd like to flip-flop with Jim Gleason, 7 who's holding, backing me up. 8 MS. HARTNETT: Sure. 9 VIDEOGRAPHER: Off the record at 10 12:38:34. 11 (Discussion off the record) 12 (Whereupon Mr. Gleason 13 replaced, via telephone, 14 Mr. McAfee in representing 15 Defendant George Washington 16 University.) 17 VIDEOGRAPHER: On the record at 18 12:41:25. 19 BY MS. HARTNETT: 20 Q Dr. Lang, we're still on the -- what's 21 been marked as Lang 2, and the second page. 22 I think we had left off with number five Page 187 1 under the numbered paragraphs on this page, with 2 respect to number six, which states, Inform the 3 patient that the clothing the patient is wearing 4 may be collected as evidence, place in a paper bag 5 and labeled as evidence. 6 My question is whether that statement is 7 consistent with your understanding of the practice 8 as a doctor in the emergency department at The 9 George Washington University Hospital? 10 MR. GOODSON: Objection. Form and 11 foundation. 12 THE WITNESS: Again, I believe this is 13 under -- under the assumption that there's going 14 to be some sort of forensic collection to be done. 15 I can't comment any further than that. 16 BY MS. HARTNETT: 17 Q For example, in the second case, where 18 from your earlier testimony I take it that the 19 forensic examination was going to be done, is 20 there a reason why this, Inform the patient that 21 the clothing the patient's wearing may not -- may 22 be collected as evidence, place in a paper bag and Page 188 1 labeled as evidence, is that something that didn't 2 apply to you? 3 Is that not your practice in that 4 situation? 5 MR. GOODSON: Objection to form and 6 foundation. You just asked the same question. 7 MR. JEFFERSON: I'll join in the 8 objection. 9 THE WITNESS: As stated prior, the 10 patient was processed in the Metropolitan Police 11 Department. And I don't think I'd put a patient 12 through walking through public in a -- in a 13 hospital gown to go to expeditious processing over 14 at Howard University Hospital. And I've never 15 seen this statement or this document before. 16 BY MS. HARTNETT: 17 Q I understand. 18 With respect to number seven, A history 19 of present illness should be collected to 20 include -- and then there's questions A through 21 I -- 22 A Uh-huh. Page 189 1 Q -- in your practice, are these -- and 2 please take the time you need to read them so I 3 don't have to belabor the point. But I'm reading 4 for the record, although I'll have you do if you 5 want. 6 Are any of these questions, questions 7 that you in your practice ask patients that 8 present with complaint of sexual assault at the 9 general -- at The George Washington University 10 Hospital? 11 MR. GOODSON: Objection. Form and 12 foundation. 13 THE WITNESS: Again, my job as a 14 physician is to treat the patient with a medical 15 screening exam. Any other types of information 16 that needs to be done by the proper or appropriate 17 authorities, I will do under guidance. I've never 18 seen this document before. 19 BY MS. HARTNETT: 20 Q Do you have an understanding one way or 21 the other of whether it's the practice of the 22 physicians in the emergency department at The Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 24 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 49 (Pages 190 to 193) Page 190 1 George Washington University Hospital to ask these 2 questions of sexual assault patients that present? 3 MR. GOODSON: Objection. Form and 4 foundation. 5 MR. KELLEY: Adam Kelley. I'll join. 6 THE WITNESS: I've never been party to 7 any other situation with any other physician in 8 the department. 9 BY MS. HARTNETT: 10 Q Reading number eight, A careful medical 11 history and assessment of physical injuries not 12 related to the sexual assault should be collected 13 and documented by the doctor. 14 Is the information in that sentence 15 consistent with your understanding of the practice 16 of the doctors in the emergency department at The 17 George Washington University Hospital? 18 A The practice -- 19 Q Sorry. 20 A I'm sorry. The practice of physicians 21 at The George Washington University Hospital 22 emergency department is to medically assess the Page 191 1 patient and make sure they're medically safe. So 2 whatever is required to do that, we will perform. 3 Q Okay. And number nine states, A 4 complete and full -- states, A complete physical 5 examination, including pelvic, should be 6 performed. Specimens will be taken according to 7 the policies in the relevant jurisdiction for 8 collection of evidence. Note: All specimens are 9 to be collected following evidence collection 10 guidelines. 11 Are you aware of any evidence collection 12 guidelines, what that refers -- is that a term 13 that has meaning to you? 14 MR. GOODSON: Objection. Form and 15 foundation. 16 THE WITNESS: I've never collected 17 evidence in any specific situation, so I'd have to 18 answer no. 19 BY MS. HARTNETT: 20 Q Okay. 9-B states, A cotton -- I'm not 21 trying to -- feel free to read any part that you 22 need to answer the question, but B states, A Page 192 1 cotton applicator to be used to swab the vaginal 2 vault and placed on one slide with one drop of 3 saline solution and a cover slip for the examining 4 physician's use for determination of the presence 5 of motile sperm. 6 Do -- do you understand -- have an 7 understanding of the term "motile sperm"? 8 MR. GOODSON: Objection. Form and 9 foundation. 10 THE WITNESS: Again making an 11 assumption, but motile sperm would be sperm that 12 are actively moving. 13 BY MS. HARTNETT: 14 Q And what assumption are you making to 15 answer that? 16 A Motile sperm would be sperm that are 17 actually -- I would assume; I've never done this 18 before -- but that are actually moving under the 19 slide. So you're looking under a microscope, 20 you'd see movement. 21 Q And are you -- you're saying you assume 22 that because you haven't actually seen it before, Page 193 1 but that's what you understand those words to 2 mean? 3 A Right. I'm assuming. 4 Q Well, what does the word -- does the 5 word "motile" have a meaning in medical practice? 6 A Not necessarily. 7 Q Okay. And I understand from what you 8 said that you haven't done what's described in B, 9 9-B here before. 10 Is this consist -- is it consistent with 11 your understanding of the practice of the 12 physicians in The George Washington University 13 Hospital emergency department that this procedure 14 is performed for patients that complain of sexual 15 assault? 16 MR. KELLEY: Object to form and 17 foundation. Adam Kelley. 18 MR. GOODSON: Same objection. 19 THE WITNESS: I've never been part of a 20 sexual assault outside of the two cases that I 21 mentioned before. 22 BY MS. HARTNETT: Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 25 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 50 (Pages 194 to 197) Page 194 1 Q And outside of those cases, do you have 2 any understanding of whether this description in 3 9-B is the practice of the emergency department 4 physicians at The George Washington University 5 Hospital? 6 A I've never seen it practiced. 7 Q I'm just going to move to D, but please 8 feel free to read what you need to, to answer the 9 question. 10 D states, A wet culturette swab to be 11 used to swab the cervix for the determination of 12 GC and Chlamydia, in place of the TM plate. The 13 oral pharynx and rectum may also be cultured 14 separately if indicated. 15 Do you have an understanding of what 16 determination of GC means? 17 A Determination if -- if they have 18 gonococcal gonorrhea, what's -- what's the common 19 term. 20 Q And do you know what a TM plate is? 21 A Never seen that. 22 Q What is the oral pharynx? Page 195 1 A It's your mouth. 2 Q And do you have an understanding of the 3 -- well, what does -- what does indicated mean? 4 MR. GOODSON: Objection. Form and 5 foundation. 6 THE WITNESS: If there was a 7 presentation on physical exam of -- of violations 8 of those areas, then that would be a 9 consideration. 10 BY MS. HARTNETT: 11 Q And what's described in D, is that 12 consistent with your understanding of the practice 13 of emergency department physicians at The George 14 Washington University Hospital for patients 15 presenting with sexual assault complaint? 16 MR. GOODSON: Objection foundation. 17 MR. KELLEY: Join. 18 THE WITNESS: I've never been in a 19 situation to be able to answer that question. 20 BY MS. HARTNETT: 21 Q And I understand that you're not -- you 22 haven't personally had the situation. Page 196 1 Do you have an understanding one way or 2 other of whether this is the practice in the 3 emergency department of emergency department 4 physicians at The George Washington University 5 Hospital? 6 MR. GOODSON: Objection. Form and 7 foundation. 8 THE WITNESS: I don't know, because I've 9 never -- I -- I -- I don't know. I don't know if 10 it is or not. 11 BY MS. HARTNETT: 12 Q Okay. 10, I'm going to move to 10, 13 which goes onto the next page. 14 After completion of the pelvic 15 examination the following specimens can be 16 collected. 17 And then 10-A states, Urine for the 18 determination of pregnancy. 19 With respect to 10-A, is that consistent 20 with your understanding of the practice at The 21 George Washington University emergency department 22 with respect to sexual assault -- patients that Page 197 1 present with the complaint of sexual assault? 2 MR. GOODSON: Objection. Form and 3 foundation. 4 THE WITNESS: Again, I haven't had a 5 situation to be able to address this specific 6 question. 7 MR. GOODSON: May I make a suggestion? 8 He's given the same answer to every question 9 you've asked for the last 20 minutes. Why don't 10 you just ask him all inclusive, everything from 13 11 through the remaining of the document? It might 12 move this along a little quicker. 13 MR. JEFFERSON: I endorse that. 14 MS. HARTNETT: Well, I endorse it, too. 15 But I certainly -- I just -- I want him to be -- 16 have a full understanding of each -- I don't want 17 to rush through the document and be accused of 18 asking him to agree to a document without having 19 read each part of it. Let me see if I can find 20 some specific ones that I -- 21 BY MS. HARTNETT: 22 Q Actually, the first one I'd ask for -- Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 26 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 51 (Pages 198 to 201) Page 198 1 sorry. Going back to A -- 2 A Uh-huh. 3 Q -- which I understand you've said that 4 you haven't had that experience. 5 Do you have any understanding about the 6 practice in the emergency department, aside from 7 yourself, as to whether that's a practice in the 8 emergency department with respect to patients 9 presenting with sexual assault complaint? 10 MR. GOODSON: Objection. Form and 11 foundation. 12 MR. KELLEY: Join. 13 THE WITNESS: I can't comment on that. 14 BY MS. HARTNETT: 15 Q And would your answer be the same both 16 respect to your own practice and your 17 understanding or lack thereof of the general 18 practice with respect to B, Serum test for 19 syphilis? 20 A Yes. 21 Q Do you know what VDRL is? 22 A It's a testing mechanism for syphilis. Page 199 1 Q Okay. Just give me one moment, please. 2 MR. GOODSON: Off the record. 3 (Discussion off the record) 4 BY MS. HARTNETT: 5 Q If you could review what's in 11-A 6 through D and -- 7 A Okay. 8 Q -- tell me if -- whether that 9 explanation about, At the conclusion of the 10 examination, the doctor will -- and those four 11 subparts, are they consistent with your 12 understanding of the practice at the GW University 13 Hospital emergency department for patients 14 complaining of sexual assault? 15 MR. JEFFERSON: Object to form and 16 foundation, for reasons stated before with respect 17 to the PD-124 form. 18 MR. GOODSON: Same objection. 19 THE WITNESS: I haven't had experience 20 outside of what I've discussed, so I can't comment 21 on it. 22 BY MS. HARTNETT: Page 200 1 Q Okay. With respect to 12, it states -- 2 and we're still under -- again, we're still under, 3 The following should be accomplished by the doctor 4 with the assistance of the nurse, earlier. 5 Number 12 says, In addition, the 6 following procedures may be completed. A, 7 Administration of prophylactic antibiotics for 8 sexually transmitted diseases. This may include 9 one of the following regimens -- and lists Cipro 10 and azithromycin. 11 Is this consistent with your 12 understanding of the practice with respect to the 13 patients at the emergency department at GW 14 Hospital that present with complaint of sexual 15 assault? 16 MR. GOODSON: Objection. Form and 17 foundation. 18 THE WITNESS: Again, since I haven't -- 19 outside of those two cases, I don't have specific 20 knowledge or experience with any other individuals 21 to know or to comment on that. 22 BY MS. HARTNETT: Page 201 1 Q Is the same the case for B? 2 A Yes. 3 Q And 12-C, as well? 4 A That's correct. 5 Q Okay. If you could review 13 and also 6 let me know if that is -- your same answers with 7 respect to 12 would apply to 13-A through G? 8 A (Witness examined document). That's 9 correct. 10 Q If you could review 14 to 19, and let me 11 know if your answer is the same. 12 A (Witness examined document). 13 MR. JEFFERSON: And I will note an 14 objection similar to the earlier one with respect 15 to 15, 16, and 19 make reference to PD-124 -- 16 [inaudible] -- 17 THE REPORTER: PD-124, what was the end 18 of that? 19 MR. JEFFERSON: Or the Metropolitan 20 Police Department's involvement, given this 21 witness's lack of knowledge and experience as he 22 so testified to these type examinations. Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 27 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 52 (Pages 202 to 205) Page 202 1 MR. GOODSON: Same objection. 2 THE WITNESS: And I've reviewed. And my 3 answer will be the same. 4 BY MS. HARTNETT: 5 Q Okay. With respect to number 20, The 6 patient will be offered a handbook that discusses 7 many of the possible reactions to sexual assault 8 that she may be expected to have, are you aware of 9 any handbook that the emergency department -- 10 covering that topic? 11 A No. 12 Q Under note -- there's a note; and then 13 it says non-consenting patient? 14 A Uh-huh. 15 Q The patient who does not give permission 16 for notification of the police department should 17 have the following protocols completed -- and then 18 it references 9 b and d, 10 a and b, 10 a and b. 19 Please take a moment to review which 20 ones those are. 21 But my question is whether the 22 completion of those protocols at the emergency Page 203 1 department at The George Washington University 2 Hospital for a patient complaining of sexual 3 assault, whether it's consistent with your 4 experience that this in fact occurs or not. 5 MR. KELLEY: Object to form and 6 foundation. 7 MR. GOODSON: Same objection. 8 MR. JEFFERSON: I'm going to renew my 9 objection earlier stated, and generally make it 10 with reference to any discussion of the 11 Metropolitan Police Department or PD-124 or any 12 other language that could be attributed to law 13 enforcement. 14 THE WITNESS: My answer will be the 15 same. 16 BY MS. HARTNETT: 17 Q And your -- sorry. To be clear, based 18 on your personal experience, you can't answer that 19 question; is that -- is that -- sorry. 20 Can you establish, just because I think 21 we're getting a little -- 22 A I -- I was under the assumption that you Page 204 1 had the same question for these types of questions 2 also. Is it the same one, or is it a different 3 question? 4 Q Yeah, it's the same, the same -- well, 5 let me just ask it -- 6 A Okay. 7 Q -- if you don't mind. I'm -- 8 A Sure. 9 Q -- sorry to belabor the point, but -- 10 A No. 11 Q -- is it consistent with your experience 12 in the emergency department that for patients that 13 do not give permission to notification of police 14 department, that these -- that these denoted 15 protocols are performed at the emergency 16 department at The George Washington University 17 Hospital? 18 MR. JEFFERSON: Same objection. 19 MR. KELLEY: Object to form and 20 foundation. This is Adam. 21 MR. GOODSON: Same objection. 22 THE WITNESS: I have no knowledge of Page 205 1 these. 2 BY MS. HARTNETT: 3 Q I understand it's no knowledge with 4 respect to your experiences. 5 Do you have knowledge with respect to 6 any other -- the practice of any other physicians 7 at the hospital? 8 A No. 9 Q Okay. Under sexual assault there's a 10 few bullets. And, again, please read what you 11 need to, to answer the question. 12 The third one says, The sexual assault 13 kit will be opened in the room of the patient 14 only. The sexual assault kit will be sealed per 15 chain of custody rules. 16 Are you aware of any chain of custody 17 rules in this context at The George Washington 18 University Hospital? 19 A No. 20 MR. GOODSON: Objection. 21 BY MS. HARTNETT: 22 Q And then on the final page, the next to Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 28 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 53 (Pages 206 to 209) Page 206 1 last bullet, it states, Never utilized Q-Tip swabs 2 or wooden sticks from pelvic tray setup. 3 Do you -- it goes on to state, Always 4 use sterile Q-Tip swab stick provided in physical 5 evidence recovery kit. 6 Do you have an understanding of what is 7 meant by Q-Tip swabs or wooden sticks from pelvic 8 tray setup? 9 A I understand what they are. I believe, 10 since I've been in the emergency department 11 starting with my residency, that everything is 12 sealed now. So this -- this must have been when 13 they didn't package things, and just had bulk, and 14 would leave them out. So I'm -- I'm assuming that 15 that's why they were commenting on that. 16 Q So your experience from December -- 17 including December of 2006 to the present is the 18 pelvic tray setup, the swabs or wooden sticks 19 would be sealed and sterile on that setup? 20 A They're -- they're single use, single 21 package. 22 Q Okay. Great. I think we're done with Page 207 1 that one. 2 MS. HARTNETT: Can we go off the record 3 for one second. 4 VIDEOGRAPHER: Off the record at 1:00 5 o'clock and 8 seconds. 6 (Whereupon, at 1:00 p.m., a 7 luncheon recess was taken.) 8 A F T E R N O O N S E S S I O N 9 (1:25 p.m.) 10 (Lang Deposition Exhibit 11 No. 3 was marked for 12 identification.) 13 VIDEOGRAPHER: On the record at 1:25:39. 14 Whereupon, 15 CHRISTOPHER R. LANG, M.D., 16 was recalled as the witness and, having been 17 previously sworn, was examined and testified 18 further as follows: 19 EXAMINATION BY COUNSEL FOR PLAINTIFF 20 CONTINUED 21 BY MS. HARTNETT: 22 Q Dr. Lang, we hand you what's marked -- Page 208 1 I've handed you what's marked as Lang 3, a page 2 from The George Washington University police 3 department website. 4 Can you review this document and let me 5 know if you've seen it before? 6 MR. GLEASON: Excuse me. What was the 7 number, Kathleen? 8 MS. HARTNETT: It's Lang 3. 9 MR. GLEASON: Lang 3. Thanks. 10 THE WITNESS: (Witness examined 11 document). I've never seen this document before. 12 BY MS. HARTNETT: 13 Q And in your experience at the emergency 14 department at George Washington University 15 Hospital, are you aware of The George Washington 16 University Hospital police involvement in any case 17 of a patient presenting for treatment -- 18 presenting with a complaint of sexual assault; and 19 I know not -- not just in your practice, but just 20 in general? 21 A No. 22 Q Okay. And other -- other than the Page 209 1 Metropolitan Police Department, are you aware of 2 any other law enforcement entity that would be 3 involved in the -- or contacted regarding a sexual 4 assault patient presenting at The George 5 Washington University Hospital? 6 A Yeah. I mean D.C., you know, has a lot 7 of different jurisdictions with police 8 departments. Give you an example Capital Hill 9 Police has their own department. And that would 10 be another police department. And I'm not sure -- 11 the Secret Service has their own police 12 department. And then there's the different 13 organizations. The Department of Agriculture may 14 even have their own. So I -- I can't comment on 15 how many different types of departments can 16 actually report into ours, but -- 17 Q Okay. And -- 18 A It's more than the Metropolitan Police 19 Department in the -- 20 MR. GLEASON: Excuse me. This is Jim 21 Gleason. Dr. Lang, could you be -- before the 22 break your voice was very clear and audible. I Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 29 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 54 (Pages 210 to 213) Page 210 1 don't know if you're sitting a little further away 2 from the mike. But if you could just move closer, 3 that'd be great. 4 MR. GOODSON: We intentionally moved it 5 away so you could hear less about this testimony, 6 but we'll move it back. 7 MR. GLEASON: Thank you, Mr. Goodson. 8 THE WITNESS: All right. Is that 9 better? 10 MR. GLEASON: That's better. 11 THE WITNESS: I'll speak louder, too. 12 BY MS. HARTNETT: 13 Q Just turning to page 3 of this document. 14 MS. HARTNETT: Which is for the folks on 15 the phone it's the immediate emergency services 16 portion. 17 MR. GOODSON: My comment was off the 18 record. 19 BY MS. HARTNETT: 20 Q And under immediate emergency services, 21 there's the -- in the first paragraph you see 22 several sentences. If you could read this. I Page 211 1 want to go to the third sentence. But please feel 2 free to read the entire paragraph so that -- when 3 you answer. 4 But after the evidence is collected, it 5 is -- sorry. I'll just start from the top. 6 A special exam should be conducted as 7 soon as possible following an assault to ensure of 8 your physical well-being and to collect evidence 9 that may be useful in criminal proceedings. 10 And it goes on to say, after a -- after 11 another sentence, After the evidence is collected, 12 it can be stored in case you wish to present -- 13 press criminal changes. 14 Do you have any understanding of whether 15 any such evidence can be store at The George 16 Washington University Hospital? 17 A No. 18 Q If you wanted to find an answer to that 19 question, who -- who would you ask at The George 20 Washington University Hospital, whether such 21 evidence could be stored there? 22 A I would probably ask the clinical Page 212 1 supervisor of the emergency department. 2 Q And who is that? 3 A Nina Salizar. 4 Q And the next sentence states, The exam 5 is performed by an emergency department physician 6 or gynecologist. 7 I just want to kind of somewhat similar 8 to the question I was asking you prior to our 9 break. 10 The sentence, The exam is performed by 11 an emergency department physician or gynecologist, 12 is that consistent with your understanding of what 13 the practice is at The George Washington 14 University Hospital with respect to patients 15 presenting with a complaint of sexual assault? 16 MR. GOODSON: Objection. Form and 17 foundation. 18 MR. JEFFERSON: I join. 19 MR. KELLEY: This Adam. Same objection. 20 MR. JEFFERSON: I join the objection, 21 particularly to the extent that this document 22 appears to be addressing GW students with Page 213 1 reference to "your" throughout it. And clearly 2 this Plaintiff in this case is not a GW student. 3 So I question the relevance of this entire line of 4 questioning. 5 MR. GLEASON: This is Mr. Gleason. I 6 would join in the objection. 7 BY MS. HARTNETT: 8 Q The sentence with, The exam is performed 9 by the emergency department physician or 10 gynecologist, is that consistent with your 11 understanding of practice at The George Washington 12 University Hospital with respect to patients 13 presenting with a complaint of sexual assault? 14 MR. GOODSON: Objection. Form and 15 foundation. 16 You can answer. 17 MS. HARTNETT: And so understanding for 18 the record that those previous objections all 19 pertain to my question. I was just repeating it 20 for the witness. 21 THE WITNESS: No, I don't know of any -- 22 any practice or policy that is consistent with Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 30 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 55 (Pages 214 to 217) Page 214 1 that statement. 2 BY MS. HARTNETT: 3 Q Okay. And is the same true for the next 4 sentence, A nurse is present throughout the 5 procedure, and a support person of your choice can 6 also be present? 7 A That's correct. 8 Q Moving on to the next paragraph, which 9 states, GW students can receive the exam for a fee 10 at The George Washington University Hospital 11 emergency unit. 12 Is that statement consistent -- do you 13 have any understanding of whether that statement 14 is true or not? 15 A No. 16 Q Do you know whether -- do you know 17 whether George Washington students can receive the 18 exam or a fee at The George Washington University 19 Hospital emergency unit? 20 A I don't know. 21 Q It goes on to state, Students can 22 receive the exam for free by going to the Howard Page 215 1 University emergency unit. 2 Do you know if that sentence is 3 accurate? 4 A I don't know. 5 Q And then it goes on to state, The 6 hospital's emergency unit follows the national 7 standard for victim care, rape exams, and evidence 8 collection procedures. 9 Do you know if that's a true statement 10 with respect to The George Washington University 11 Hospital? 12 MR. GOODSON: Objection. Form and 13 foundation. 14 MR. KELLEY: Same objection. 15 MR. GLEASON: This is Gleason. I join 16 it. 17 THE WITNESS: I don't know what the 18 national standard for rape -- for victim rape is, 19 for rape exam and evidence collection procedures. 20 I don't know what they're referring to or what the 21 national standard is. 22 BY MS. HARTNETT: Page 216 1 Q That's with respect to three items 2 listed in that last sentence: Victim care, rape 3 exams, and evidence collection procedures? 4 A Anything to do with national standard 5 for victim care, rape exams, and evidence 6 collection procedures. 7 Q Okay. And it states at the -- the next 8 paragraph has a note. And please feel free to 9 read the entire note. 10 My question's about the final sentence, 11 where it states, In addition, it is recommended 12 that a survivor use a hospital in the county/state 13 where the incident occurred. 14 Do you have any understanding if that is 15 a accurate statement? 16 MR. GOODSON: Is an accurate opinion, as 17 far as recommendation, or a statement? 18 BY MS. HARTNETT: 19 Q Are you aware of whether it's 20 recommended or not by anyone at George Washington 21 University that a survivor use a hospital in the 22 county/state where the incident occurred? Page 217 1 A I don't know what the jurisdictional 2 restrictions are per state or county. 3 Q Okay. I'm going to turn to page 9 of 4 this document. And please feel free to look at 5 the other categories that we're passing by. 6 A (Witness examined document). 7 MS. HARTNETT: For the people on the 8 phone, this is the substance related sexual 9 assault portion of the -- this web page. 10 BY MS. HARTNETT: 11 Q Sorry. One moment. I'm on page 10. 12 A Oh, page 10. 13 (Witness examined document). 14 Q So at the bottom of page 10 -- 15 A What -- 16 Q -- under how do -- How can I reduce my 17 risk of substance-related rape? And there's 18 several bullet points. And then there's a 19 statement. 20 Anyone who believes that they have 21 consumed a sedative-like substance should be 22 driven to a hospital emergency room or should call Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 31 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 65 (Pages 254 to 257) Page 254 1 [inaudible] -- meaning when -- 2 THE REPORTER: We have a what? 3 THE WITNESS: A capped balloon time. 4 When a person comes in with an acute MI, or 5 myocardial infarction, that patient has a time 6 frame of 90 minutes to get to the cath lab. So 7 that -- those times are -- are time indicators 8 that we're held to standards and actually rated 9 for. Outside of those two, it doesn't weigh that 10 much significance to me. 11 BY MS. HARTNETT: 12 Q Under the vital signs, if you could 13 just -- and this is still in the triage data. 14 In the pain -- focusing on the pain of 15 five -- 16 A Uh-huh. 17 Q -- do you have an understanding of what 18 that means? 19 A That is a subjective numbering scale 20 that the triage nurse, nurse, or tech places in 21 the chart if they complain about pain somewhere. 22 And they ask how -- on the scale of zero to ten, Page 255 1 and what -- what pain level are you at. 2 Q And -- 3 A And there's no real descriptors of this 4 is what one means, this is what two means, this is 5 what three means, so on, so on. They just say 6 zero to ten. And they -- you know, people say 7 five, or two, or ten. But there's no 8 clarification of this is what a five means, this 9 is what a three means, this is what a one means. 10 Q And in your practice is it -- is -- do 11 you review the pain information in the course of 12 treating a -- a patient under your care? 13 A I guess part of the whole process, the 14 most important thing is what the patient tells me. 15 MS. HARTNETT: Off the record. 16 VIDEOGRAPHER: This concludes tape three 17 in the deposition of Dr. Christopher Lane. Off 18 the record at 2:09:45. 19 (Recess) 20 (Lang Deposition Exhibit 21 No. 5 was marked for 22 identification.) Page 256 1 VIDEOGRAPHER: This begins tape four in 2 the deposition of Dr. Christopher Lane. On the 3 record at 2:15:39. 4 BY MS. HARTNETT: 5 Q Dr. Lang, we're still on page 11 of 18 6 of that document, Lang 4. Under diagnosis -- 7 A Uh-huh. 8 Q -- so moving to the bolded categories, 9 it says, Final: Primary: Vaginitis, any cause. 10 Can you explain what that diagnosis 11 section of the medical record is for, generally? 12 A To try to match up what the patient 13 presented with, with a diagnosis code. 14 Q And can there be more than one diagnosis 15 code per patient? 16 A Yes. 17 Q Is there a list of the possible 18 diagnoses, and you pick one; or do you actually -- 19 does one type in the diagnosis? 20 A Yeah, the problem we have in our 21 department is we actually have preset ICD-9 code 22 diagnoses. So if we can't find something, we have Page 257 1 to try to match something that's maybe close to 2 but not exactly what the patient came for. So we, 3 unfortunately, can't have exact matches for all 4 clinical presentations. 5 Q And what does ICD-9 mean? 6 A It's a coding system that we use for 7 diagnoses. 8 Q Is there a list of all the possible 9 codes? 10 A Yeah, you can get that on-line, like -- 11 it's accessible. 12 Q Okay. And -- 13 A But, again, we have a preformatted one 14 that we only can use in our emergency room. We 15 can't use ones outside of what the -- what -- what 16 is in our computer system. 17 Q And do you have an understanding of 18 whether the ones in your system are some subset of 19 the ICD-9 codes, or whether they're all -- the 20 ICD-9 codes and ones in your system are the same 21 thing? 22 A They're universal. So I don't -- Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 32 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 66 (Pages 258 to 261) Page 258 1 Q Sorry. I guess I'm -- what I'm trying 2 to -- from your last answer -- 3 A Sure. 4 Q -- I'm just trying to understand whether 5 they're -- the ICD-9 codes are -- are equivalent 6 to the ones in your system, or whether the ICD -- 7 ICD-9 codes are -- are universal and there's some 8 subset in the system at the emergency department. 9 A Yeah, the emergency department only has 10 a -- a small subsection of the ICD-9 codes. 11 Q Okay. 12 A I mean I -- there's thousands of them. 13 Q I see. 14 And is there somewhere where there's a 15 list of the -- the ones that are available in the 16 emergency department? 17 A Yeah, when we -- when we go to diagnose 18 the -- put in a diagnosis, there's a pick list. 19 And that's what you pick from. 20 Q Can you estimate the number of choices 21 on the pick list? 22 A It -- you know, it -- it builds. So Page 259 1 it's -- it's really hard to say in one period of 2 time how much they -- how much are in there. 3 Q I'm just trying to get a sense of like 4 at -- just at present, I understand that -- 5 A Yeah, which -- I apologize. I -- I -- I 6 would be speculating -- 7 Q Then don't -- 8 A -- so -- 9 Q -- do it. Okay. 10 What is vaginitis? 11 A Vaginitis is just a general description 12 of -- of any sort of inflammation potentially 13 in -- in or around the vaginal area. 14 Q Is that term used to refer to 15 inflammation in and around the anal or rectal 16 area, as well? 17 A No. 18 Q What would the term be for that, if 19 anything? 20 A I have never used that diagnosis, so I 21 don't know. 22 Q Is there an "itis" I guess associated Page 260 1 with the anal or rectal area? 2 A I mean there's specific things like 3 hemorrhoids that are on the anal or rectal area. 4 But a generic term for anal/rectal irritation, not 5 to my knowledge. 6 Q When it says, Final: Primary, can you 7 explain what those words -- in the context of the 8 diagnosis, what those words mean? 9 A Final means final diagnosis. And 10 primary means the reason why the -- the diagnosis 11 code that was associated with her. So that was 12 it. 13 Q And with -- who made the determination 14 of the diagnosis in -- in this case? 15 A That -- the diagnosis of vaginitis? 16 Q That's correct. 17 A They would be the person who entered. 18 Q And that's, I take it, Dr. Khozeimeh? 19 A Uh-huh. 20 Q And did you consult with Dr. Khozeimeh 21 before she rendered -- regarding the diagnosis to 22 be rendered in this matter before she rendered the Page 261 1 diagnosis of vaginitis? 2 A I'm sure we discussed. You know, 3 there -- there's unfortunately no code for want -- 4 desiring a medical screening exam. There's none 5 that exists. We don't have it. So I'm sure we 6 had a discussion -- I can't recollect -- about is 7 there anything that we can put. It's like that 8 these matches may be with a screening exam and its 9 focus. But, unfortunately, there's the -- the 10 specific descriptor of what we wanted is not part 11 of at least an ICD-9 code that we can pick from in 12 our emergency department. And I don't even know 13 if it exists. 14 Q And just to be clear on what the -- what 15 you were searching for was some sort of a medical 16 screening exam just generally, or in a specific 17 sense? 18 A I don't know if there's any other 19 options besides the medical screening exam. 20 Q Okay. And when you and the resident are 21 both caring for a patient, do you have a practice 22 as to which of you inputs the diagnosis -- or Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 33 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 67 (Pages 262 to 265) Page 262 1 makes the diagnosis and inputs that into the 2 electronic medical record? 3 A I mean a majority of the time it's the 4 resident that puts it in. 5 Q Are there any particular situations 6 where you would put it in, or does it just depend 7 on how things are going; there's not a -- there's 8 not a particular set of cases where you do it 9 versus the resident doing it? 10 A That's correct. 11 Q And is there any diagnosis available 12 in -- to your knowledge, in the -- in the 13 emergency department system related to a alleged 14 sexual assault? 15 A Not to my knowledge. 16 Q How about for like pain in the leg? 17 A I'm not sure. 18 Q How about for exposure to -- well, this 19 is a general matter, actually, not -- not saying 20 about this case in particular, but exposure to 21 date rape drugs? Is there any diagnosis that 22 would correspond to that? Page 263 1 A Not that I'm aware of. 2 Q Okay. And can you tell from this, not 3 just this first page, but from, you know, any of 4 the pages in this medical record, when was the 5 first time that you saw the patient? 6 And please feel free to take your time. 7 A The exact time of when I saw that 8 patient? I -- I -- I can't tell you the exact 9 time when I saw that patient. 10 Q Just turning to the -- the page 14 of 11 18 -- 12 A Uh-huh. 13 Q -- the -- the last page. 14 A Okay. 15 (Witness examined document). 16 Q It's one of the entries. This is in the 17 admin area. And on -- one of the entries I notice 18 was Sunday, December 10th, 2006, 1:16 LAC, 19 attending changed from none to Christopher Lane. 20 What, if anything, does that entry tell 21 you? 22 A All that tells me is when there's an Page 264 1 initial patient in the queue, no one's clicked -- 2 clicks on them. And at some point during their 3 evolution in the emergency room, you click on the 4 patient. And that just happened to be the time I 5 did that. 6 Q So from this entry, you can't tell 7 whether you saw the patient before that or after 8 that? 9 A Yeah. There's no correlation. 10 Q Sorry to jump around, but if we go back 11 to page 11 of 18. I have a couple more questions. 12 A (Witness examined document). 13 Q And under the instruction section, can 14 you explain what the purpose of that section is in 15 the record? 16 A To give some sort of information to the 17 patient on what they were seen -- or what was 18 performed for them, to give them guidance. 19 Q And what role, if any, do you have of 20 generally -- generally with the discharge of a 21 patient? 22 A That's -- that's more of a resident Page 265 1 responsibility. 2 Q And how does that -- how does that 3 process typically work -- 4 A We complete -- 5 Q -- in your experience? 6 A -- the care, where we agree on what 7 we're supposed to do. And from there, we say, 8 okay, when can you discharge the patient? So look 9 it up the -- put in the diagnosis, put in the 10 discharge instructions, and then close the loop 11 with the patient. And then the nurse usually will 12 come in with the instructions. Sometimes the 13 resident does it themselves. But sometimes the 14 nurse will come in after, and then put -- make 15 sure the patient's discharged, take them out of 16 the system. 17 Q And is there -- in your practice, is 18 there a situation where you, Dr. Lang, would be 19 the one presenting the discharge instructions to 20 the patient? 21 A On the Fast Track side sometimes, unless 22 they don't need provider. Most -- most of the Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 34 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 68 (Pages 266 to 269) Page 266 1 times the nurse does all that for us. 2 Q And are you -- do you have an 3 understanding of what the -- under -- like with 4 the dispo -- I'm sorry -- with the diagnosis, 5 there is a click-down menu. 6 Is there some similar system in place 7 with regard to what discharge instructions are 8 provided? 9 A There is -- you free -- you type. And 10 it will populate what you can put in. And if it's 11 there, it's there. If it's not -- so if you -- 12 you know, like our example with your urinary tract 13 infection -- 14 Q Thank you. 15 A -- if I put it in, I put in "UTI." And 16 it may come up as UTI, or I might have to put in 17 "urinary," or -- and then it either populates it, 18 or it doesn't. If it doesn't, it means there's no 19 instructions for it. 20 Q And so have you actually done that 21 yourself before, attempted to pull up a -- a 22 discharge instruction on the system? Page 267 1 A Yes. 2 Q And so if the one you're going to put in 3 is not -- for some reason not populating, do you 4 just try for a different one, to try to come up 5 with the -- some discharge instruction to provide 6 the patient that's most relevant? 7 A Yeah, I mean you try to match up what 8 you can. 9 Q Are there ever instances where you 10 actually prepare discharge instructions that are 11 separate from the preformatted ones that pop up 12 and you populate the field in one way or the 13 other? 14 A There's additional comments you can put 15 on. 16 Q In your practice, is it always the case 17 that at least one discharge instruction is 18 provided to the patient, or are there some cases 19 where there's nothing that populates the field and 20 thus no instruction that's relevant? 21 A I mean you try to match up the 22 instructions. And then -- and if you come -- if Page 268 1 you strike out with everything it's -- it's almost 2 the same as this, these diagnosis. Except 3 diagnosis you're stuck. You have to pick 4 something for the discharge. You hopefully will 5 find something that's close to it. If you can't, 6 then you would try to type in something. 7 But, you know, it's not as -- like 8 they're not standard instructions with help. You 9 know, it's -- it's a lot of fat-fingering. And 10 you're not sure if you're going to incorporate 11 everything that you need to. 12 Q And with regard to the "special" part of 13 the -- this -- this entry in the medical record, 14 the special, what does that mean, if you know? 15 A I think that might -- I think that might 16 have been the free text. 17 Q And do you recall who selected these 18 discharge instructions for the -- for 19 Ms. McGaughey? 20 A It would be who is annotated under 21 instruction. 22 Q Is it Dr. Khozeimeh? Page 269 1 A Uh-huh. 2 Q And do you recall conferring with 3 Dr. Khozeimeh regarding either the HIV testing or 4 the alleged sexual discharge instructions? 5 A I don't remember specifically. I know 6 that, you know, our residents make every attempt 7 to again match what we feel is similar to that, 8 so -- I know that she was doing her best to match 9 what she could as close as she could to what the 10 presentation was. 11 Q And do you recall whether you saw 12 Ms. McGaughey after you and Dr. Khozeimeh -- or 13 after Dr. Khozeimeh said a lot of disposition with 14 any input from you that may have occurred. 15 But do you recall whether you saw her 16 again from that point forward, once you -- once 17 the deposition was established? 18 A Yeah, I'm -- I'm not sure of the -- the 19 time frame of all of that. So, no, I can't 20 comment. 21 Q Okay. And with regard to the "special" 22 part of the instruction area -- Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 35 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 69 (Pages 270 to 273) Page 270 1 A Uh-huh. 2 Q -- follow-up with your primary care 3 doctor for HIV testing and further medication and 4 treatment, take HIV prophylactic meds as 5 instructed. Follow-up with your private physician 6 if needed. Return to ED if worse. 7 I take it that was entered by 8 Dr. Khozeimeh, those -- what I read? 9 A That's speculation. 10 Q And I was just asking that because her 11 initials are on the instruction part. 12 But is there some -- who else could it 13 be? 14 A Probably no one else, but I just can't 15 say for sure that it was her. 16 Q Okay. Did you enter that? 17 A No, I didn't enter it. 18 Q And do you recall discussing any of 19 those matters that were covered in that "special" 20 area with Dr. Khozeimeh? 21 A I remember discussing the -- trying to 22 get the most of appropriate discharge information. Page 271 1 And so she tried to get through that, and then 2 discharged the patient. 3 Q And you recall that with respect to this 4 case in particular? 5 A No. That's my standard practice. 6 Q Okay. Under the orders section, where 7 it says GC/Chlamydia PCR by KN for LAC -- 8 A Uh-huh. 9 Q -- on Sunday at 2:04. 10 Can you explain what -- does this tell 11 you what role, if any, you had in regarding these 12 orders? 13 A No. It just -- it just says that the 14 resident KN had ordered that specific test. And 15 any time the -- the -- a resident does it, it 16 automatically populates the attending physician 17 that covers that. So it's always for the 18 attending. So it's the resident for the 19 attending, or the PA for attending. 20 Q And do you recall conferring with 21 Dr. Khozeimeh regarding this order for the 22 GC/Chlamydia PCR? Page 272 1 A I don't remember specifically. But, 2 again, my standard practice is we confer. And it 3 seems to be appropriate. 4 Q Is this a test that she could have 5 ordered without your express approval? 6 A Sure. Anyone can order the test. 7 Q I understand your general practice, 8 however, is how -- how you described it. 9 What is O2 SAT interpretation? 10 A That is oxygen saturation in your blood. 11 Q And what did -- 12 A It's part of the vit -- it's a -- it's a 13 vital sign. 14 Q And is there a reason why Dr. Khozeimeh 15 performed this as opposed to a -- a nurse or 16 somebody else? 17 A She interpreted what the nurse put in 18 the vital signs. So it just checks off the I 19 looked at the O2 saturation that the nurse or 20 whoever triaged that patient at -- she didn't 21 actually -- it doesn't necessarily mean she per -- 22 performed the procedure herself. Page 273 1 BY MS. HARTNETT: 2 Q HPI sexual assault? 3 A Uh-huh. 4 Q What does that heading mean? 5 A History of present illness. And so, 6 again, we only -- we only have set amount of pick 7 lists that you can pick from when you do a 8 complaint. I'm trying to think of another example 9 I can give you. But there's -- but people don't 10 necessarily fit. You know, we have chest pain, or 11 knee. It just says knee. Or we have extremity, 12 but we don't have an ankle. So then we go under 13 the knee one for that. 14 And so there's -- there's topic headings 15 that start the process off. But, again, it 16 doesn't necessarily mean that's what the category 17 is. 18 Q Do you know if there's -- I guess with 19 HPI extremity or HPI whatever, is that -- is that 20 how it would appear on the -- depending on which 21 drop-down -- 22 A Right. HPI chest pain, HPI trauma. Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 36 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 70 (Pages 274 to 277) Page 274 1 Q Is there any HPI for unprotected sex? 2 A Not to my knowledge. 3 Q And is there -- can you estimate how 4 many HPI's there are at the present time? 5 A Maybe forty. 6 Q What is the purpose of the chief 7 complaint portion of the HPI section of this 8 record? 9 A It's what the -- the -- again, I didn't 10 enter this. But the chief complaint is what -- 11 what is the complaint of the individual presenting 12 to the emergency room. 13 Q And in your practice, is it ever your 14 role as attending to enter this information in 15 regarding a patient, the HPI? 16 A No. Again, it's part of the resident 17 duties. 18 Q And just reviewing this, this particular 19 HPI in this case, which appears to be input by 20 Dr. Khozeimeh at 2:22 and 2:27 a.m. on Sunday the 21 10th. 22 Do you know -- do you recall whether you Page 275 1 reviewed this -- these entries during the time 2 that you were treating Ms. McGaughey? 3 A I don't recall specially looking at 4 every single entry she made. I -- I can't tell 5 you which ones I did and which ones I didn't. 6 Q And then under assault there's a 7 category for that. 8 Again, my -- I guess my question is the 9 chief complaint, history, and assault, those 10 categories, are they a standard category that come 11 up depending on which HPI you pick? 12 A Yeah, again, I haven't -- I don't know 13 this one, because I haven't entered in this one -- 14 Q Uh-huh. 15 A -- to actually know. But usually that 16 sets off questions you have to answer. And it 17 forces you to put something in those categories. 18 So you're -- you're kind of -- once you pick that, 19 you're actually now setting yourself in a path of 20 answering questions that may or may not pertain to 21 the complaint. 22 Q And under assault, the -- there's an Page 276 1 entry here. 2 It says, Assault occurred 0200 12/9, 3 LOC: Unknown, police notified. 4 During your -- the time that you were 5 treating Ms. McGaughey, were you aware of the -- 6 any information that the assault occurred at 0200, 7 12/9? 8 A I was unaware of the exact timing of the 9 incident. 10 Q And were you -- was it your 11 understanding -- or did you have an understanding 12 of where the incident had occurred? 13 A Like specific location? 14 Q If you had one. 15 A No. 16 Q Did you have a general understanding of 17 where it occurred? 18 A No. 19 Q Okay. Just under the notes section, I'm 20 just going to ask. I understand that 21 Dr. Khozeimeh input this. But I -- I just would 22 like to know if you have independent knowledge of Page 277 1 this at the time that you were treating 2 Ms. McGaughey. 3 19-year-old female allegedly assaulted 4 Saturday at 2:00 a.m., just describe that. 5 It says, Plus ETOH use. 6 What does that mean? 7 A That means she admitted to using 8 alcohol. 9 Q And is that a question that would be 10 asked of her, or is this a -- I guess when you say 11 admitted, how -- 12 A Again, I didn't -- I didn't write this 13 note. 14 Q Right. 15 A So then I'm -- I am then speculating as 16 to why this was put in. 17 Q But when you read the plus ETOH use, 18 that, to you, means that she's said that she's 19 used the al -- she's admitted using alcohol? 20 A That's correct. 21 Q Okay. It says goes on to say, Patient 22 passed out, raped by acquaintance. Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 37 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 87 (Pages 342 to 345) Page 342 1 A No. 2 Q Are you -- do you ever -- in your 3 experience is this -- is this consistent with 4 what -- the appearance of discharge instructions 5 from The George Washington University Hospital? 6 A The general layout, yes. 7 Q Okay. And where it says at the bottom 8 prepared and it has Dr. Khozeimeh's name, do you 9 know what that means, what that indicates? 10 A That indicates that she's the one that 11 composed the discharge instructions. 12 Q Okay. And just turning to the second 13 page, which marked MCG 32, the -- there's a -- 14 what appears to be a discharge instruction: 15 Alleged sexual assault, adult. 16 Have you ever -- other than in this 17 case, are -- have you been involved in any case 18 with a discharge instruction of alleged sexual 19 assault, adult? 20 A Not to my knowledge. 21 Q And do you have any understanding of 22 when this discharge instruction is to -- is to be Page 343 1 used at The George Washington University emergency 2 department? 3 A Not to my knowledge. 4 Q And did you -- have you reviewed this 5 discharge instruction? 6 A No. 7 Q Is this the first time that you've seen 8 this discharge instruction, sort of in the -- 9 spelled out with all the -- all the information in 10 it? 11 A Yes. 12 Q Okay. Turning to the final three pages 13 of this document 33 through 35, which are -- 14 appear to be prescriptions given to the Plaintiff. 15 Is that your signature on these 16 documents, or is the physician signature, or do 17 you -- 18 MR. GOODSON: Can you just refer as to 19 which page? 20 BY MS. HARTNETT: 21 Q Sorry. 33, is that your signature on 22 that document? Page 344 1 A No. 2 Q Do you know whose signature it is? 3 A No. 4 Q Can Dr. Khozeimeh, as a resident at that 5 time, in December '06, would she be authorized to 6 sign this prescription? 7 A Yes. 8 Q Okay. Flipping back to -- sorry. Can I 9 just take it back? 10 Remember question on number four, line 11 four of the medical -- which includes the medical 12 record. If you would just turn to page 17 of 18. 13 I'm sorry, page 16 of 18. 14 A (Witness examined document). 15 Q I believe you said -- stated this is not 16 part of the medical record. 17 Do you know what this form is? 18 A No. 19 Q And this is a form that you do not see 20 in the course of your treatment of a patient? 21 A No. 22 Q Have you seen this form for this Page 345 1 Plaintiff before right now? 2 A No. 3 Q Do you have an understanding of whether 4 sexual assault examination kits are kept at The 5 George Washington University Hospital? 6 A Not to my knowledge. 7 Q If I wanted to find out whether that 8 they are in fact kept at The George Washington 9 University Hospital or not, who would -- who would 10 you ask? 11 A The Metropolitan Police Department. 12 Q Is there anyone in the emergency 13 department that you would ask that would -- 14 A I could, but that's not who I'd -- who 15 I'd ask. 16 Q You -- you -- you would first contact 17 the Metropolitan Police Department and ask them? 18 A My standard protocol is to contact the 19 Metropolitan Police Department for any sort of 20 complaint of sexual assault. 21 Q I guess just the more -- the -- not -- 22 separate from any patient, just the question of Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 38 of 39 fa7ee533-aa41-48e9-a3d7-49cd1cd95fcf Christopher R. Lang, M.D. June 27, 2008 Washington, DC 1-800-FOR-DEPO Alderson Reporting Company 88 (Pages 346 to 349) Page 346 1 whether there's actually a sexual assault kit that 2 is kept at the hospital for use if necessary, is 3 that a question that you similarly you would ask 4 the Metropolitan Police Department before you 5 would ask someone at the hospital? 6 A I'd have to think about, but probably. 7 Q And if there -- instead I asked you 8 that -- what -- what person would you ask at the 9 hospital if you had asked someone at the hospital 10 as opposed to outside, who would you ask? 11 A Probably the highest ranking emergency 12 room like the -- the director or assistant 13 director, whoever is the -- you know, depends on 14 the time of day. 15 Q Can you -- would -- can you name any -- 16 a name of someone that you would ask to -- if I 17 asked you to -- 18 A Depends what time of day you -- you 19 asked, talk about. 20 Q It just depends on who is in the -- in 21 the facility? 22 A Well, again, there's eight to five jobs Page 347 1 which are the main people. And then there's after 2 the -- after the five and before the eight. 3 Q Just normal business hours? 4 A Normal business hours, it would be the 5 director of the -- [inaudible] -- 6 Q Okay. 7 THE REPORTER: I didn't hear that 8 clearly. 9 THE WITNESS: Director of the emergency 10 department. 11 MS. HARTNETT: Thank you. I'm done. 12 Anyone else? 13 MS. TURNER: No questions. 14 MR. GOODSON: Mr. Gleason? 15 MR. GLEASON: No, sir, I have no 16 questions. 17 MR. GOODSON: Adam, do you have any? 18 MR. KELLEY: No, I don't have any 19 questions. 20 Kathleen, I do -- I am confused about 21 whether the depos of the detectives are going 22 forward on Tuesday -- Page 348 1 MS. HARTNETT: Can we go -- let's go off 2 the record. 3 MR. KELLEY: Yeah, are we off? We're 4 not? 5 MS. HARTNETT: One second. 6 VIDEOGRAPHER: This concludes the 7 videotaped deposition of Dr. Christopher Lane. It 8 consists of five videotapes. We're off the record 9 at 3:49:01. 10 11 12 13 (Whereupon at 3:49 p.m., the 14 deposition of CHRISTOPHER R. 15 LANG, M.D., was adjourned.) 16 17 18 19 20 21 22 Page 349 1 A C K N O W L E D G E M E N T O F D E P O N E N T 2 3 4 I, CHRISTOPHER R. LANG, M.D., do hereby 5 acknowledge I have read and examined the foregoing 6 pages of testimony, and the same is a true, correct 7 and complete transcription of the testimony given 8 by me, and any changes or corrections, if any, 9 appear in the attached errata sheet signed by me. 10 11 12 13 14 15 __________________ __________________________ 16 Date CHRISTOPHER R. LANG, M.D. 17 18 19 __________________________ 20 NOTARY PUBLIC 21 22 Case 1:07-cv-01498-RJL Document 50-2 Filed 07/29/2008 Page 39 of 39 Exhibit B To Plaintiff’s Reply to Defendant Lang’s Opposition to Plaintiff’s Motion to Modify Scheduling Order and Increase Number of Depositions Plaintiff May Take McGaughey v. District of Columbia, et al., No. 1:07-cv-01498 (RJL) Case 1:07-cv-01498-RJL Document 50-3 Filed 07/29/2008 Page 1 of 7 Case 1:07-cv-01498-RJL Document 50-3 Filed 07/29/2008 Page 2 of 7 Case 1:07-cv-01498-RJL Document 50-3 Filed 07/29/2008 Page 3 of 7 Case 1:07-cv-01498-RJL Document 50-3 Filed 07/29/2008 Page 4 of 7 Case 1:07-cv-01498-RJL Document 50-3 Filed 07/29/2008 Page 5 of 7 Case 1:07-cv-01498-RJL Document 50-3 Filed 07/29/2008 Page 6 of 7 Case 1:07-cv-01498-RJL Document 50-3 Filed 07/29/2008 Page 7 of 7