1 @virginia: In the Circuit Court of the City of Norfolk 2 3 Kenneth H. Tackett, 4 Plaintiff, 5 VS. At Law No. L91-680 6 Norfolk and Western Railway Company, 7 Defendant. 8 9 Deposition of @L GROAS, JR., M.D., a 10 witness herein, called by the Defendant for 11 direct-examination under the statute, taken before 1 2 me, Robin Elizabeth Allen, a Registered Professional 1 3 Reporter and Notary Public in and for the State of 14 Ohio, pursuant to notice and stipulations and by 15 agreement of counsel at the offices of Bill Gegas, 16 Jr., M.D., on Thursday, May 28, 1992, at 2:00 p.m. 17 18 - - - 19 2 0 21 (C(DF)Y 2 2 23 DILLMAN REPORTING, INC. P.O. Box 297 24 Dublin, Ohio 43017 (614) 798-1800 FAX (614) 798-1131 2 1 @APPEARANCES: 2 Mr. Otis K. Forbes, III . & ., P.C. 3 1294 Diamond Springs Road Virginia Beach, Virginia 23455 4 On behalf of the Plaintiff. 5 Mr. Samuel J. Webster 6 Williams, Kelly & Greer, P.C. 600 Crestar Bank Building 7 500 East Main Street Norfolk, Virginia 23510 8 On behalf of the Defendant. 9 10 11 12 13 14 15 16 17 18 1 9 2 0 21 2 2 2 3 2 4 3 STIPULATIONS 2 3 It is stipulated by and between counsel for 4 the respective parties that the deposition of Bill 5 Gegas, Jr., M.D., a witness herein, called by the 6 Defendant for direct examination under the rules of 7 the Supreme Court of Virgina, may be taken at this 8 time by the Notary pursuant to notice and 9 stipulations of counsel and by agreement of counsel; 10 that said deposition may be reduced to writing in 11 stenotype by the Notary, whose notes may thereafter 12 be transcribed out of the presence of the witness; 13 that proof of the official character and 14 qualification of the Notary is waived; that the 15 signature of the said Bill Gegas, Jr., M.D., is not 16 waived by counsel and the witness. 17 - - - 18 19 2 0 21 2 2 2 3 2 4 I 4 1 INDEX L 2 BILL GEGAS, JR., M.D. DIRECT CROSS REDIRECT 3 By Mr. Webster 5 35 4 By Mr. Forbes 27 5 6 7 8 9 10 11 12 ... 13 14 15 16 17 is 19 2 0 21 2 2 2 3 2 4 5 1 THURSDAY AFTERNOON SESSION 2 May 28, 1992 3 2:00 p.m. 4 - - - 5 MR. FORBES: This is taken pursuant to the 6 rules of the Supreme Court of Virgina. 7 - - - 8 BILL GEGAS, M.D. 9 Being first duly sworn by me, testifies and says as 10 follows: 11 DIRECT EXAMINATION 12 By Mr. Webster: 13 Q. Dr. Gegas, would you state your full name 14 and business address, please? 15 A. Bill Gegas, Jr. My business address is 16 Riverside Family Practice center, 797 Thomas Lane, 17 Columbus, Ohio, 43214. 18 Q. All right. Would you tell the jury, 19 starting with undergraduate education, what degrees 20 you have received and from where? 21 A. My undergraduate education was obtained 22 at Muskingum College where I received a bachelor of 23 science degree. My medical school training was 24 obtained at Ohio State University, and my 1 6 1 postgraduate training at Riverside Methodist 2 Hospital. 3 Q. When did you receive your Bachelor of 4 Science from Muskingum? 5 A. 1984. 6 Q. And did you have a major field of study 7 while you were at Muskingum? 8 A. No. I am sorry. My undergraduate was in 9 1979. I am sorry. Undergraduate was in 1979. 10 Q. Did you have a major field of study at 11 Muskingum? 12 A. Bachelor of Science in biology. 13 Q. And medical degree in 1984 from Ohio 14 State? 15 A. Yes. 16 Q. And that's in Columbus? 17 A. Yes. is Q. Tell the jury, if you could, what your 19 postgraduate training and experience has been. 20 A. Okay. After I was graduated from Ohio 21 State University, I did a three-year postgraduate 22 residency in family practice at Riverside Hospital. 23 I finished my training in 1987, and I spent 24 approximately a little over four years in private 7 lpractice doing family medicine. That included 2 @aspects of internal medicine, obstetrics, 3 neonatology. During that time, I was also teaching 4 @both here at Riverside Hospital, as well as on the 5 1faculty of the University of Cincinnati Medical 6 @School. 7 Q. All right. And during that four-year 8 period, were you practicing medicine in Portsmouth, 9 Ohio? 10 A. Yes. 11 Q- Was there a name of a group or anything 12 like that down there in Portsmouth? 13 A. No, I was in solo practice. 14 Q- FroTn the time you finished up your 15 residency at Riverside Hospitals until approximately 16 1991, you were in private practice in Portsmouth, 17 Ohio; is that correct? 18 A. Yes. 19 Q. And at that time you had academic 20 appointments both at The Ohio State University 21 Medical School and the University of Cincinnati 22 Medical School. 23 A. Yes, I was part of a rotation where 24 medical students were rotated through a private 8 1 lphysician's office in order to get firsthand L 2 experience what real practice was like. 3 Q. All right. Are you licensed to practice 4 medicine? 5 A. Yes. 6 Q. Where? 7 A. The State of Ohio. 8 Q. Are you board certified? 9 A. Yes. 10 Q. In what area? 11 A. Family medicine. 12 Q. Would you tell the jury what that means, 13 to be board certified, and how that occurs? 14 A. Board certification is a designation that 15 is given to a physician who has done a specific 16 postgraduate training period. The physician is 17 required to train in specific areas including 18 internal medicine, pediatrics and obstetrics. it 19 requires a minimum of three years. And then at the 20 end of that three years a formal test is given, which 21 has to be passed. 22 Q. And you have done all of that? 23 A. Correct. 24 Q. All right. Now, can you describe for the 1 jjury what a family practice is? 2 A. A family practice is a type of medicine 3 that entails the whole broad spectrum of medicine 4 ranging from obstetrics and delivering babies and 5 taking care of the infants through adults and into 6 geriatric medicine. 7 Q. Would a family care physician be a 8 primary care physician? 9 A. Yes. 10 Q. Can you tell the jury what orthopedic 11 surgery is? 12 A. Orthopedic surgery is basically surgery 13 that deals primarily with the treatment of bones or 14 bony injuries. 15 Q- How about the practice of a neurologist 16 or neurology? 17 A. A neurologist is a specialist that -- 18 whols training is primarily geared towards nerve 19 damage, nerve disorders, any neurologic process, 20 including that which may occur in the brain. 21 Q. And what about neurosurgery? 22 A. Neurosurgery would be surgery that 23 essentially would deal with nerve damage, brain 24 damage, brain surgery and depending on how the 1 0 1 !training of the neurosurgeon was, as well as back 2 isurgery, if there were particular pressure on nerves 3 coming out of the back. 4 Q. Now, Doctor -- well, let me back up. 5 Your academic appointments -- what academic 6 appointments do you hold now? 7 A. My current position is I am the associate 8 director of the family practice residency at 9 Riverside Hospital. 10 Q. Is that in connection with the Ohio State 11 University Medical School? 12 A. We are affiliated with the Ohio State 13 College of Medicine in that we teach their students 14 and periodically give lectures at Ohio State, but we 15 are not a formal part of Ohio State. 16 Q. Here in Columbus do you have any hospital 17 privileges? 18 A. Yes. 19 Q. What are they? 20 A. Riverside Methodist Hospital. 21 Q. While you were practicing in Portsmouth, 22 did you have any hospital privileges? 2 3 A. Yes. 24 Q. Where were those? 1 A. Riverside Methodist Hospital, as well as 2 IMercy Hospital and Scioto Memorial Hospital in 3 Portsmouth. 4 Q. Are you a member of any professional 5 organizations? 6 A. Yes. 7 Q. Would you tell the jury what those 8 associations are? 9 A. The usual medical societies, including 10 the Franklin County Medical Society, the Central Ohio 11 Academy of Family Physicians, the American Academy of 12 Family Physicians would be the major ones. 13 Q. What is the name of the board that 14 certified you as a family practitioner? 15 A. American Board of Family Practice. 16 MR. WEBSTER: At this time, Mr. Forbes, I 17 would tender -- well, let me back up. 18 Q. (By Mr. Webster) Do you know a Dr. James 19 Mullins? 20 A. Yes. 21 Q. And who is he? 22 A. He also is a family physician practicing 23 in Portsmouth, Ohio. 24 Q- Did you know him in connection with your 1 2 1 practice down in Portsmouth, Ohio? 2 A. Yes. 3 Q. Did you have occasion to treat Kenneth 4 Tackett while you were practicing medicine in 5 Portsmouth, Ohio? 6 A. Yes. 7 MR. WEBSTER: At this time, Mr. Forbes, I 8 would tender Dr. Gegas as an expert witness and 9 treating physician. 10 MR. FORBES: An expert in what, Mr. 11 Webster? 12 MR. WEBSTER: Expert in the area of 13 family practice medicine. 14 MR. FORBES: Okay. 15 Q. (By Mr. Webster) Now, Dr. Gegas, do you 16 know the plaintiff in this case, Kenneth H. Tackett? 17 A. Yes. 18 Q. Can you tell the jury when he first came 19 under your care? 20 A. Mr. Tackett initially presented to my 21 office on the 4th of November, 1987. 22 Q. At that time what did he come to your 23 office for? 24 A. Ten-day history of sore throat, as well 1 3 1 las a cough over the previous two to three days. 2 Q. All right. Any back problems at that 3 time? 4 A. None. 5 Q. Okay. Now, in 1987 did you give Mr. 6 Tackett any medicine that would be used for treating 7 high blood pressure? 8 A. Yes. 9 Q. What was that medicine? 10 A. Aldomet. 11 Q. So in 1987 Mr. Tackett had a history of 12 high blood pressure? 13 A. Yes. 14 Q. Did you continue to prescribe medicine to 15 him through the years for high blood pressure? 16 A. Yes. 17 Q. All right. Focusing, if you will, on 18 that time period, did you see Mr. Tackett -- well, 19 let me ask you this: Did you ever see him for a 20 problem with his ankle? 21 A. Yes. 22 Q. And when was that? 23 A. July 31st, 1989. 24 Q- Did he present -- did he give you a 1 4 1 history at that time? 2 A. Yes. 3 Q. What was it? Would you tell the jury 4 lwhat that history was? 5 A. According to my records, Mr. Tackett 6 stated that five weeks prior to his visit with me, he 7 had fallen on some railroad ties, striking the right 8 side of his chest and twisting his left ankle. 9 Q. All right. Were you aware at that point 10 that he had worked regularly since that accident that 11 he told you about? 12 A. I believe I was. 13 Q. Okay. When you examined him -- did you 14 conduct an examination of Mr. Tackett at that time? 15 A. Yes, I did. 16 Q. What did that exam disclose? 17 A. Essentially the chest wall showed no 18 obvious signs of trauma or injury. The standard 19 things that we would look for would be bruising, 20 disruption of the skin, bony abnormalities. 21 Essentially all of that was normal. 22 He was tender along the right side of his 23 chest when I did press with some force. 24 His ankle also was unremarkable in terms I 1 5 1 @of bruising, swelling, et cetera; but he also had 2 some tenderness on exam also. 3 Q. Is there a layman's way of describing the 4 injury that he had to his chest and his ankle? 5 A. He bruised his chest and he sprained his 6 @ankle. 7 Q. Okay. Did you make any recommendations 8 for his further treatment at that point in time? 9 A. Yes, I did. 10 Q. What were those? A. What I wanted to do was reduce the 12 inflammation so I gave him a medication called 11 13 !Disalcid that he was to take for a week. Mr. Tackett 14 jappeared that he was still in some discomfort with 15 his ankle so I also gave him one week off from work 16 and told him I wanted to reevaluate him in one week, 17 or sooner, if he had problems. is Q. All right. Did you see him a week later? 19 A. Yes. 20 Q. What history -- or what did your 21 examination disclose at that time? 22 A. Mr. Tackett, after one week, said that 23 there had been definite improvement in both his ankle 24 and chest pain. He felt that his ankle was more i 1 6 1 stable, there was less pain along his chest wall. He 2 @was still a little bit tender in those areas. Since 3 he had improved so much I felt that probably an 4 @additional week would essentially resolve his 5 symptoms. 6 Q. Did you see him one week later? 7 A. Yes, I did. 8 Q. What was his history at that time? 9 A. Mr. Tackett said at that point that he 10 had minimal improvement from his previous visit, he 11 Isaid he still had feelings of instability in the 12 lankle, although when questioned he said he had been 13 lwalking without problems. And still complains of 14 @pain with deep breath but had no shortness of breath. 15 Q. At that point did you have any 16 recommendations? 17 A. Yes, I did. is Q. What were they -- or what was that? 19 A. Essentially since he had been off work 20 for two weeks with just slight improvement, despite 21 the medicine and the therapy, I requested that Dr. 22 Ron Turner, who is an orthopedist, evaluate him. 23 Q. Did Dr. Turner see him? 24 A. Yes. 1 7 Q. Did you receive a report from Dr. Turner? 2 A. Yes, I did. 3 Q. Is that a report that you relied upon in 4 @connection with your treatment of Mr. Tackett? 5 A. Yes. 6 Q. What did that report disclose? 7 A. On the report itself, his physical exam 8 basically reiterated that he had some tenderness both 9 at the ankle and at the ribs, X rays were 10 unremarkable, and the opinion at that time was an 11 ankle strain that was resolving and a contusion, or 12 bruise, of the right chest wall. 13 Q. All right. After -- and this last 14 examination of Mr. Tackett was August 14, 1989, about 15 his chest wall and ankle, when you referred him to 16 Dr. Turner? 17 A. Yes. 18 Q. All right. Did you see him again about 19 the complaints about his chest wall and sprained 20 ankle? 21 A. No. 22 Q. All right. Now, according to some 23 records that I have examined, at some point in 1990 24 he was prescribed a medicine called Tenex. Do your I 1 8 1 records disclose that? 2 A. Yes. 3 Q. Do you know when in 1990 that was? 4 A. Well, my records that I have currently 5 @are copies and the date is clipped off, but my 6 originals would have that date. 7 Q. All right. Is Tenex a high blood 8 pressure medicine? 9 A. Yes. 10 Q. At that time do your records reflect any 11 complaints by Mr. Tackett about any problems with his 12 back? 13 A. No. 14 Q. And if he had complained about problems 15 in his back, would those have been noted in the 16 records? 17 A. Yes. 18 Q. All right. Did you then see Mr. Tackett 19 on February 13, 1990? 20 A. Yes. 21 Q. And at that time did he give you a 22 history? 2 3 A. Yes. 24 Q. What was that history? Would you tell 1 9 1 the jury what he told you? 2 A. Mr. Tackett presented to my office and 3 said that on approximately September 26, 1989, he had 4 been struck in the back by a railroad car. During 5 the previous several months before he presented to my 6 office, he said he had been evaluated by Dr. Soto, 7 who is another orthopedist in Portsmouth, Ohio. He 8 had had several tests, including several X rays done 9 @of his back, and no cause of his pain was felt or 10 found, other than muscle and ligamentous strain. He was also sent to a neurologist in 11 @Columbus, Dr. Michael Meagher. And his evaluation 12 i 13 was also normal. Mr. Tackett, when he was in my 14 office, said that he had persistent pain and wanted 15 another evaluation. 16 Q. All right. So he told you he had seen 17 Dr. Meagher and Dr. Soto? 18 A. Yes. 19 Q. All right. Did he tell you he had worked 20 since September 26, 1989, up through November 14, 21 1989? 22 A. I don't recall that specifically. 23 Q. What did your examination of Mr. Tackett 24 disclose beyond February 13, 1990? 2 0 A. Well, in overall appearance, facial 2 jappearance, movements, he did appear to have some 3 pain when he moved and sat on the exain table. And 4 lagain the back was unremarkable for any obvious 5 deformities or trauma, et cetera. And there was no 6 @bruising or swelling, et cetera. 7 He did have some diffuse muscle pain from 8 his upper back ranging down to the lower back. The 9 @spine itself was normal on exam. 10 When I moved his back from side to side, 11 @he complained of this discomfort also. On neurologic 12 lexam there was no evidence of nerve impingement 13 related to the back at all and his reflexes were 14 normal. 15 Q. You said there was diffused muscular 16 pain. What does that mean, diffused? 17 A. Wide spread. 18 Q. Not located at a specific point? 19 A. Correct. 20 Q. Now, the tests that you did, were these 21 subjective or objective tests? 22 A. They are objective tests for any 23 presenting back problem. 24 Q. All right. Do they rely upon the patient 2 1 1 @telling you when he feels pain? 2 A. To some degree, yes. 3 Q. But you can also sense that yourself? 4 A. Yes. 5 Q. All right. It says straight leg raises 6 are negative. Tell the jury what straight leg 7 @raising tests are. 8 A. There are nerves that exit the spinal 9 cord and go down the backs of the legs. These nerves 10 provide the nerve sensations to both legs. If there 11 @is pressing or impingement on those nerves, very 12 @often when you straighten the leg, it stretches the 13 nerve and that causes pain. Depending on how high 14 you can stretch the leg depends on how much pressure 15 or pain is elicited on the nerves. By saying his 16 straight leg raises were negative, it ineant that he 17 had no pain with raising the legs. is Q. All right. At the time you saw him on 19 February 13, 1990, did you have the benefit of any 20 test results by Dr. Soto or Dr. Meagher? 21 A. No. 22 Q. Did you acquire those sometime after that 23 date? 24 A. Yes. 2 2 1 Q. All right. What did you recommend for 2 Mr. Tackett on February 13th, 1990? 3 A. At that time I felt since he had chronic 4 muscle pain, that physical therapy would be indicated 5 @in his case. I recommended that we do that three 6 times a week at the local physical therapy 7 department. That would include range of motion, 8 massage, localized heat. I started him on some 9 Prednisone, which is a type of anti-inflammatory, to 10 reduce swelling and stiffness in his back, and asked 11 Ihim to obtain his previous records for me. 12 Did he obtain those previous records? 13 A. Yes. 14 Q. All right. Can you tell the jury what 15 records those were that you acquired? 16 A. According to the copies that I have, I 17 received a copy of a letter to Dr. Soto from Dr. 18 Michael Meagher, who is a neurologist, as well as a 19 letter from Dr. Soto regarding his treatment. 20 Q. All right. Dr. Soto, I believe you told 21 he jury, is an orthopedist in Portsmouth? 22 A. Correct. 23 Q. And Dr. Meagher is a neurologist here in 24 Columbus? 2 3 A Yes. 2 Q. All right. Were these records that you 3 @would normally rely upon in the normal course of your 4 practice as a family practitioner? 5 A. Yes. 6 Q. Is it customary for physicians to report 7 to one another or forward records to one another? A. Absolutely. 9 Q. Did you see Mr. Tackett again after 10 IFebruary 13, 1990? ii A. No. 12 Q. Did you have a conversation with him over 13 @the telephone after February 13, 1990? 14 A. Yes. 15 Q. When was that? 16 A. That was March lst, 1990. 17 Q. What did Mr. Tackett tell you at that 18 time? 19 A. Mr. Tackett was extremely upset with me 20 that I would not sign forms stating that he was 21 disabled. 22 Q. And when you say disabled, disabled from 23 what? 24 A. Disabled from his work. 2 4 1 Q. All right. Did he want you to sign those 2 forms? 3 A. Yes. 4 Q. Is there a reason why you would not sign 5 those forms? 6 A. Yes. 7 Q- What was that reason? 8 A. Well, I explained to Mr. Tackett that 9 from the time of his apparent injury in September of 10 1989 until he had seen me, several months had passed. 11 I could not make any objective statement that his 12 back pain was due to his injury; and I explained this 13 to him. 14 Q- All right. At that point when you talked 15 with him on the telephone on March 1, 1990, had you 16 reviewed the reports of Dr. Soto and Dr. Meagher? 17 A. Yes. 18 Q. Can you tell the jury what those reports 19 disclosed? 20 A. The report from Dr. Meagher to Dr. Soto 21 indicated that his neurologic exam was entirely 22 normal. Dr. Meagher did some objective tests 23 checking the function of the nerves. These were also 24 normal. He did not see any evidence of pressure on 2 5 1 ithe nerves going to his legs, and he felt that he was 2 not the candidate for any particular type of surgery. 3 Q- How about Dr. Soto? 4 A. Dr. Soto's note indicates that Mr. 5 Tackett had been seen initially for his pain. When 6 he had been seen in follow-up, the pain in his back 7 lwas better and the patient stated that he had been 8 feeling better. 9 Again in follow-up the patient said he 10 still had pain in his back, hips and legs. 11 The patient underwent some tests, 12 including an MRI of the back. The MRI showed no 13 @acute ruptured disc, except for some mild bulging. 14 At that point Dr. Soto apparently felt 15 that he should be evaluated by a neurologist or a 16 neurosurgeon. Mr. Tackett apparently wanted to see a 17 doctor in Columbus of his own choice. And according 18 to the letter, Dr. Meagher saw him in follow-up. 19 Q. All right. Dr. Gegas, do you have an 20 opinion within a reasonable degree of medical 21 certainty as to whether Mr. Tackett was totally 22 disabled from any employment at the time you saw him 23 on February 13, 1990, or spoke with him on March 1, 2 4 1990? 2 6 1 A Yes. 2 O. And what is that opinion? 3 A. I do not feel that he was considered 4 disabled from performing any employment. 5 Q. All right. Do you have an opinion within 6 @a reasonable degree of medical certainty as to 7 whether Mr. Tackett was totally disabled from working 8 as a brakeman on the Norfolk and Western Railway 9 Company as of February 13, 1990, or when you spoke 10 with him on March 1, 1990? 11 A. No. 12 Q. No, you don't have an opinion or no, he 13 was not? 14 A. No, I don't have an opinion. 15 Q. Okay. Did you disqualify him from 16 working as a brakeman? 17 A. No, I did not. 18 Q. Did you see Mr. Tackett after March 1, 19 1990? 20 A. No. 21 Q. Did you talk with Mr. Tackett after March 2 2 1, 1990? 23 A. No. 24 MR. WEBSTER: That's all the questions I 2 7 1 ihave at this time. 3 CROSS-EXAMINATION 4 By Mr. Forbes: 5 Q. Doctor, you noted earlier that it was 6 your understanding that Mr. Tackett worked regularly 7 @since his injury of June of 1989; is that correct? 8 A. Yes. 9 Q. But your notes also indicate, do they 10 Inot, that he stated that work had increased his 11 @discomfort; is that correct? I am referring to your 12 notes of June -- or of July 31st, 1989. 13 A. Can you repeat the question? 14 Q. Yes. You testified earlier that Mr. 15 Tackett -- you believe Mr. Tackett told you that he 16 @had worked regularly since his injury where he had 17 fallen and struck his chest and twisted his ankle. 18 A. Yes. 19 Q. Your records, however, indicate that he 20 told you that he -- that working increased his 21 discomfort; is that correct? 2 2 A. Yes. 23 Q. All right. He did have complaints of 24 ain on July 31st, 1989, when he saw you; is that 2 8 1 Icorrect? 2 1 A. Yes. 3 Q. And you noted that he did exhibit pain 4 @through palpation about his chest and about his 5 ankle? 6 A. Yes. 7 Q. When you did a palpation and found 8 tenderness, what does that mean? 9 A. That there is discomfort or irritation of 10 the muscles or bones that are pressed on. 11 Q. And you found irritation about the 12 muscles or bones about his chest and his ankle at 13 that time? 14 A. Tenderness, yes. 15 Q- All right, sir. You mentioned that you 16 prescribed a medication for him. What is that 17 medication called? 18 A. Disalcid. 19 Q. What is that for, Doctor? 20 A. Disalcid is an anti-inflammatory that has 21 several uses. Primarily it is used for swelling and 22 the pain that is associated with it usually dealing 23 with joints and/or bones. 24 Q. Doctor, your note of July 31st, 1989, 2 9 1 states that you were going 'to keep him off work for 2 approximately a week and th.!Lt you were concerned 3 about his working around railroad cars. Why were you 4 concerned about him working around railroad cars? 5 A. In my practice in Portsmouth I had 6 numerous employees of both the railroad, as well as 7 the local prison, so I was very cognizant of them 8 working in a situation where they might be impaired 9 in some way. So I felt it would probably be in his 10 best interest, from a safety standpoint, that if his 11 mobility wasn't what he thought it should be, that he 12 should be out of that environment until he was 13 better. 14 Q. In fact, you kept him off of work from 15 the date of his first visit July 31st, 1989, until 16 August 15th of 1989; is that correct? 17 A. Yes. 18 Q. When you saw him on the following two 19 occasions, on August 7, 1989, and August 14th, 1989, 20 he still had complaints of pain; is that correct -- 21 A. Yes. 22 Q. -- about his chest and his ankle? 2 3 A. Yes. 24 Q. Did you find tenderness about those areas 1 3 0 1 on palpation again? 2 A. Yes. 3 Q. And you referred him to Dr. Turner, who 4 is an orthopedist, is that right? 5 A. Yes. 6 Q. And I understand that Dr. Turner's 7 Idiagnosis confirmed yours, which was contusion to the 8 chest wall and an ankle sprain. 9 A. Correct. 10 Q. Did Dr. Turner's report to you indicate 11 @that this -- these two injuries would take some time 12 to heal? A. Yes. 14 Q. And did it indicate that any further 15 therapy or treatment was needed? 16 A. None other than continued wrapping of the 17 ankle. is Q. And what would that have been for? 19 Stability of the ankle? 20 A. More to reduce any swelling which may 21 occur. 22 I see. Doctor, you next saw -- well, I 23 am sorry. Strike that. 24 Earlier you mentioned that in 1990 you I 1 3 1 1 prescribed Tenex, which is a high blood pressure 2 medication, for Mr. Tackett; is that correct? 3 A. Correct. 4 Q. Do you know the date when you did that, 5 the specific month in 1990? 6 A. I am not sure you are asking what I think 7 you are asking. I initially prescribed the Tenex in 8 February of 1989. 9 Q. But later on in your records it indicates 10 sometime in 1990 you prescribed Tenex to him again. 11 Do you know the month when you prescribed that to him 12 again in 1990, that Mr. Webster was discussing with 13 you earlier? 14 A. Yes. That month would be noted in my 15 original notes. 16 Q. But you don't know it today? 17 A. No. 18 Q. You next saw Mr. Tackett in February of 19 1990, when he gave you a history of having been 20 struck in the back by a railroad car on September 21 26th of 1989; is that correct? 22 A. Correct. 23 Q. And you noted that he was in distress at 24 that time? 3 2 A. He appeared to be. 2 Q. What does that mean, distress? 3 A. Discomfort. 4 Q. And did he have complaints of pain? 5 A. Yes. 6 Q. Where were his complaints of pain, 7 Doctor? 8 A. He stated that he had pain in the back of 9 his legs, as well as in his lower back. 10 Q- And he also mentioned that he had a 11 pulling sensation down the back of his legs, is that 12 correct? 13 A. Correct. 14 Q- You mentioned earlier that you found 15 diffuse muscular pain that ranged from the upper 16 Trapezious muscles, which are in the shoulder; is 17 that right, Doctor? 18 A. Upper back and shoulder area. 19 Q. And then came down to the lumbosacral 20 area, is that correct? 21 A. Yes. 22 Q. Did you determine whether there was any 23 tenderness at that time through palpation? 24 A. Yes. 3 3 1 Did you find any? 2 A. Yes. 3 Q. Where was that tenderness, Doctor? 4 A. Again, in those areas previously 5 mentioned: the upper back, shoulder area, and down 6 into the lumbosacral area, back. 7 Q- He also had complaints of muscular pain, 8 lateral -- with lateral rotation and forward flexion; 9 is that correct? 10 A. Yes. 3.1 Q- What is lateral rotation? 12 A. Lateral rotation is when you turn to 13 either side. 14 Q. And forward flexion is when you bend 15 over. 16 A. When you bend forward, correct. 17 Q. And when he did the straight leg raises 18 that you have described earlier, you did find they 19 were positive for some muscular pain at the back of 20 the thighs in the lumbosacral area; is that correct? 21 A. That is correct. 22 Q. Is that an objective test, Doctor? 23 A. Yes. 24 Q. Are the palpations that you do, are they 3 4 1 objective also? 2 A. Yes. 3 Q. Your diagnosis for him on that day was a 4@musculo -- or ligamentous strain? 5 A. Chronic musculoskeletal pain. 6 Q. Is that the same as a strain? 7 A. Well, the pain was there. Whether the 8 pain was due to strain/sprain, trauma, et cetera was 9 the key question. 10 Q. And on the basis of that diagnosis, you 11 prescribed a course of Prednisone; is that correct? 12 A. Yes. 13 Q. What is that medication for, Doctor? 14 A. That is essentially a steroid that has 15 powerful anti-inflammatory effects. We were using it 16 in his instance with his chronic discomfort to see if 17 we could reduce swelling and inflammation in those 18 areas to relieve his pain. 19 Q. And you also prescribed a course of 20 physical therapy, specifically heat therapy; is that 21 right? 22 A. Heat therapy, as well as physical 23 therapy, which would include massage and range of 24 motion. 3 5 Q. Through that physical therapy did you 2 @hope to reduce the tenderness throughout his body 3 ithat he complained of? 4 A. Yes. 5 Q. When you spoke to him over the phone in, 6 I believe it was March of 1990, was he also upset 7 about the fact that he was still in pain? 8 A. I don't recall that. 9 Q. okay. And you did not see him or speak 10 to him after that period of time, correct? 11 A. No. 12 And you are not aware of his current 13 physical condition? 14 A. Correct. 15 MR. FORBES: I don't have any further 16 questions at this time. 17 - - - is REDIRECT EXAMINATION 19 By Mr. Webster: 20 Q. Doctor, just one follow-up question. You 21 state from your examination on February 13, 1990, 22 that the plaintiff appeared to be in some distress. 23 And I believe you told Mr. Forbes that the distress 24 meant discomfort. 3 6 1 A Uh-hum. 2 Q. Is that a subjective or objective 3 finding? 4 A. It was objective in that that's what his 5 appearance was to me. It can be subjective in that 6 he can make any grimaces or movements to indicate 7 that if he wanted to. 8 MR. WEBSTER: Thank you, Doctor. That's 9 all I have. 10 MR. FORBES: I have nothing further. 11 MR. WEBSTER: Doctor, you have the right 12 to read and sign the deposition under our rules of 13 court in Virginia, or you may waive that right. 14 THE WITNESS: I do wish to review it. 15 MR. WEBSTER: You want to review it 16 before it gets sent down to us? 17 THE WITNESS: Yes. 18 - - - 19 Thereupon, the deposition was concluded 20 at 2:55 p.m. 21 - - - 2 2 2 3 2 4 3 7 1 CERTIFICATE 2 STATE OF OHIO S S 3 COUNTY OF FRANKLIN: 4 I, Bill Gegas, Jr., M.D., do hereby certify 5 that I have read the foregoing transcript of my 6 deposition given on May 28, 1991; that together with 7 the correction page attached hereto noting changes in 8 form or substance, if any, it is true and correct. 9 ---------------------- 10 Bi Gegas, Jr., M.D. 11 I do hereby certify that the foregoing 12 transcript of the deposition of Bill Gegas, Jr., 13 M.D., was submitted to the witness for reading and 14 signing; that after he had stated to the undersigned 15 Notary Public that he had read and examined his 16 deposition, he signed the same in my presence on the 17 day of 1992. is 19 Notary Public-State of Ohio 2 0 My Commission expires: 21 ----------------------- 22 2 3 2 4 3 8 1 DEPOSITION ERRATA SHEET 2 I have read the entire transcript of my deposition taken in this pending matter, or the same 3 has been read to me. I request that the following changes be entered upon the record for the reasons 4 indicated. I have signed my name to the signature page and authorize you to attach the same to the 5 original transcript. 6 PAGE LINE Correction or change and reason therefor: 7 .... .... ......................................... 8 ---- ---- ----------------------------------------- 9 ---- ---- ----------------------------------------- 10 11 ---- ---- ----------------------------------------- 12 13 14 15 16 17 18 19 20 21 22 23 24 DATE SIGNATURE ---------------- 3 9 CERTIFICATE 2 STATE OF OHIO SS: COUNTY OF FRANKLIN 3 4 I, Robin E. Allen, a Registered Professional 5 Reporter and Notary Public in and for the State of 6 Ohio, duly commissioned and qualified, do hereby 7 certify that Bill Gegas, Jr., M.D., was by me first 8 duly sworn to testify to the truth, the whole truth, 9 and nothing but the truth in the cause aforesaid; 10 that the testimony then given by him was by Tne 11 reduced to stenotype in the presence of said witness, 12 afterwards transcribed by means of a computer; that 13 the foregoing is a true and correct transcript of the 14 proceedings; that the testimony was given at the time 15 and at the place in the caption so specified; and 16 that I am in no way related to or employed by any 17 attorney or party hereto, or financially interested 18 in the action. 19 IN WITNESS WHEREOF, I have hereunto set my 20 hand and affixed my seal of office at Columbus, Ohio, 21 on this 15th day of June, 1992. 2 2 my commission expires 2 3 OL June 13, 1994. ROBIN ELIZAB LEN, RPR 24 Notary Publi e of Ohio 3 7 1 CERTIFICATE 2 STATE OF OHIO S S 3 COUNTY OF FRANKLIN: 4 I, Bill Gegas, Jr., M.D., do hereby certify 5 that I have read the foregoing transcript of my 6 deposition given on May 28, 1991; that together with 7 the correction page attached hereto noting changes in 8 form or substance, if any, it is true and correct. 9 10 11 G D. 11 I do hereby certify t oing 12 transcript of the deposition of gas, Jr., 13 M.D., was submitted to the witness for reading and 14 signing; that after he had stated to the undersigned 15 Notary Public that he had read and examined his 16 deposition, he signed the same in my presence on the 1 7 @4-4- day of 1 9 9 2 . 18 19 @@,ic-State of 0 10 2 0 My commission expires: 21 22 23 24