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Case Studies in Forensic Psychiatry / Medical-Legal

Stephen M. Raffle, M.D.

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Curriculum Vitae

By Stephen M. Raffle, M.D.

As a forensic psychiatrist I have worked on many fascinating cases. Following are studies of a few cases in which I have testified and forensic issues requiring a Psychiatrist. In most instances, details are changed to preserve confidentiality.

Testamentary Capacity:

An elderly woman decided to discontinue kidney dialysis.  Several weeks later she changes the beneficiaries in her Will and shortly thereafter passes away.  How much, if any, brain damage has occurred in the several weeks without dialysis, and was she competent to change her Will?

Borderline Personality Disorder (BPD) and PTSD:

An individual has made allegations of kidnapping and rape.  I conduct a psychiatric IME including psychological tests.  In the IME she reports the specifics about her history of trauma and victimization.  Ultimately I diagnose her with a Post-Traumatic Stress Disorder and BPD.  Individuals with BPD may be impaired in accurately perceiving the intentions of others and unintentionally magnify their experiences.  How has BPD impacted the later encounter?  Were the circumstances consensual?  I opined her judgment was impaired but BPD did not preclude the alleged liability and exploitation of her condition.

Direct and Cross-Examination of Mental Health Expert Witnesses:

Opposing counsel retained a forensic psychologist, who conducted an IME of plaintiff, including psychological testing, and rendered an opinion.  Because discovery was closed, I was prevented from conducting my own IME.  After reviewing medical records and deposition testimony, I came to different conclusions.  I was able to assist the attorney to form questions of the expert at deposition and at trial which revealed the expert’s opinion was partly formed without adequate training to interpret medical records or to make an expert medical diagnosis, which impeached the expert’s opinions.  I testified as a rebuttal witness.

Undue influence:

The longtime companion of an elderly man who was diagnosed with Alzheimer’s Disease (dementia) was named as the beneficiary of his estate.  Some family members alleged undue influence.  On review of extensive medical records, personal communications, and deposition testimony, I was able to render my opinion, by report, about the nature, extent, and effect of Alzheimer’s Disease on testamentary capacity and the man’s vulnerability to undue influence at the time the bequest was made.

Fitness for Duty and Ensuing Wrongful Termination Litigation:

I am retained to conduct a Fitness for Duty on an employee who has made numerous complaints about co-workers harassing him at work.  On clinical examination, review of records and psychological testing, I report the employee is experiencing delusions, psychosis and a Paranoid Personality Disorder.  The employee is terminated but alleges he was terminated because he believes his complaints about co-workers constituted “whistle blowing.”  Litigation follows.  I testify to my findings about how his psychopathology resulted in Plaintiff/Employee’s delusional perception of harassment and victimization by the employer.

Fitness for Duty: An Employee’s Psychosis Does Not Preclude the Ability to Perform the Essential Functions of His Job:

As a psychiatric FFD, with psychological testing, l examine an employee who reports auditory hallucinations.  The employee is a janitor and the hallucinations do not interfere with his performance of his duties.  I conclude his hallucinations do not prevent him from performing the essential functions of his job and he is returned to work.

PTSD in an Employee Covered by the Defense Base Act:

An employee covered under The Defense Base Act has committed suicide and his widow has filed a claim for benefits.  Her claim rests on her belief his suicide was the result of pathology from untreated PTSD.  My experience with untreated PTSD and its manifestation contribute to my expert opinion presented to the Court.  The widow is granted benefits.

PTSD and Emotional Distress After a Motor Vehicle Accident:

Emotional Distress is a significant element in this lawsuit.  The survivor of a motor vehicle accident exhibits symptoms of a severe PTSD.  He can no longer ride in a vehicle, is visited by constant thoughts replaying the accident many months after the event, and in other ways meets the clinical criteria for a PTSD diagnosis.  Prognosis is guarded.  Damages for emotional distress, need for treatment to mitigate damages, an estimate for need for future treatment and estimated costs are presented to the jury.

DISCLAIMER: The information provided on this website does not constitute legal or medical advice. Readers should consult with their own legal counsel or physician for the most current information and to obtain professional legal advice or medical advice before acting on any of the information presented.

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