Medical Expert Witness
Medical Speech-Language Pathology
Dysphagia Expert Witness with
SwallowStudy & Associates, LLC
A speech-language pathology (SLP) medical expert witness is someone who is highly qualified and with advanced expertise. SwallowStudy & Associates, LLC provides expert witness services in swallowing & swallowing disorders (dysphagia), including issues of complex airways, airway protection, vocal cords/larynx, choking, aspiration, and more. We have ample experience in both defense and plaintiff cases dealing with adults and older adults. Go to CONTACT tab and reach out.
Experts will assist the family, counsel, judge and jury in understanding the following: the standard of care for diagnosis and treatment, field-specific technical issues, and underlying facts. The expert will help summarize the evidence from the medical records and depositions. An expert witness may testify in the form of expert opinions and conclusions drawn to a reasonable degree of medical speech pathology certainty.
In medical malpractice cases, SLP expert witness asks: What would a reasonable and competent speech-language pathologist and related practitioners do when faced with a similar situation and setting? The expert investigates if prudent decisions, documentations and communications were made to attempt to mitigate (reduce severity or minimize risk for) negative outcomes, as no healthcare practitioner can prevent aspiration and choking 100% of the time. Was the evaluation and treatment process acceptable and sound? This does not ask if the care displayed advanced or exceptional skills. However, if care was below accepted standards of professional conduct, then the expert determines if the care directly lead to the negative outcomes (i.e., the suspected choking and/or aspiration event, the health decline, or death of the person)?
Karen Sheffler, MS, CCC-SLP, BCS-S has extensive experience in medical speech-language pathology (SLP) since 1996, specifically in the field of swallowing and dysphagia for the adult and geriatric population. (She can make referrals to other speech-language pathology experts within the infant to pediatric populations.) She received her board-certification as a specialist in swallowing and swallowing disorders (dysphagia) in 2012, and she can offer a tremendous amount of assistance at any stage in the litigation process.
Karen has clinical experience across the continuum of care, having worked in home health, sub-acute skilled nursing facilities, long-term care, rehabilitation centers and hospitals. She still maintains her clinical practice in a large acute care teaching hospital with inpatients and outpatients. (NOTE: please see ABOUT tab for further details and Karen’s CV link below.)
Karen is now training fellow SLPs who are board-certified specialists in swallowing. George Barnes, MS, CCC-SLP, BCS-S is my highly qualified associate. He started training with me in early 2023. Growing our business (SwallowStudy & Associates, LLC) will help to provide greater national coverage of our dysphagia expert witness services for defense and plaintiff attorneys.
George Barnes, MS, CCC-SLP, BCS-S, has been a certified speech-language pathologist (SLP) with his Certificate of Clinical Competence from the American Speech-Language & Hearing Association (ASHA) since 2013 after completing his Clinical Fellowship Year in 2012-2013. He obtained his Board Certification as a Specialist in Swallowing and Swallowing Disorders (BCS-S) from the American Board of Swallowing and Swallowing Disorders (AB-SSD) in 2022. He has earned 6 ASHA ACE awards for far exceeding the required hours for continuing education through presenting and attending conferences/webinars.
George is the founder/CEO of an SLP company that provides mobile endoscopic swallowing tests in New York, New Jersey, and Pennsylvania. He specializes in dysphagia evaluation and management in various clinical settings, collaborating with a team of medical professionals to provide comprehensive care for people with dysphagia and their caregivers.
George authors research-based articles via ASHA and other online publications. He teaches and mentors regularly throughout the year. He provides dysphagia expert consulting to companies and organizations through publications, live seminars, and live webinars. His special interests include medical complexity, geriatrics, high-risk populations, choking prevention, aspiration pneumonia, oral hygiene/infection control, and end-of-life decision-making.
Since beginning her expert witness practice in 2016, Karen has worked with both defense and plaintiff attorneys on over 55 cases.
Karen is detail oriented in her medical record reviews, writing thorough reports to outline the full timeline of events. Additionally, she can clearly summarize the key points in a case, which has helped to reach favorable resolutions faster.
Key Words and Topics of Cases Addressed:
Normal swallowing.
Diet and liquid modifications made to achieve safer oral intake.
Aspiration and reflux precautions, patient safety, safe swallowing strategies.
Assessment and treatment of swallowing disorders (dysphagia), including all phases: oral, pharyngeal, and esophageal (aka, oropharyngeal dysphagia and pharyngoesophageal dysphagia).
Laryngopharyngeal reflux (LPR) and gastroesophageal reflux disease (GERD).
Differentiating when negative outcomes are potentially related to oral intake of foods, liquids or pills versus other through sources (i.e., not managing secretions or aspiration of regurgitated or refluxed substances).
Instrumental evaluations of swallowing (e.g., Videofluoroscopic SwallowStudy.com/VFSS, also known as the Modified Barium SwallowStudy.com/MBSS, and the Fiberoptic Endoscopic Evaluation of Swallowing/FEES)
Airway issues, vocal cords, larynx
Aspiration, aspiration pneumonia, aspiration pneumonitis
Choking, asphyxiation, hypoxia, anoxia, leading to intubation and death
End-of-life decision-making regarding eating and drinking and accepting risks of aspiration and/or choking (also known as, goals of care discussions).
The person (if they have decision-making capacity) or the person’s appointed health care proxy has a right to make their own informed medical decisions.
Conversations regarding quality of life and palliative care versus curative care as related to maintaining nutrition and hydration through an oral route versus alternative means (e.g., feeding tubes).
Diagnoses & Conditions
Neurological events, disorders & diseases (e.g., stroke, dementia/Alzheimer’s Disease, Parkinson’s Disease, etc.); delirium; post-extubation dysphagia; medication-induced dysphagia; radiation-associated dysphagia; sarcopenia; iatrogenic factors from intensive care; multi-factorial or complex medical issues and more.
Locations of where care was performed in the cases
Home, group home, skilled nursing facility, rehabilitation center, and acute care hospital.