INTRODUCTION - UW Medicine

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https://know1.mcis.washington.edu/manuals/amc_SDT_Guidelines/SDT_GUIDELINES.... 12/31/2014

SUBPOENA, DEPOSITION, AND TESTIMONY GUIDELINES

FOR UW MEDICINE AND THE SCHOOL OF DENTISTRY

Department: Health Sciences Risk Management

Effective Date: December 17, 2014

Revision Dates: September 2008, November 2013, October 2014, December 2014, April 2017

INTRODUCTION

For subpoenas related to patient care, employees should contact Health Sciences Risk Management (HSRM), which serves as a liaison to the Attorney General’s Office (AGO), General Counsel for Children’s University Medical Group (CUMG), Northwest Hospital (NWH), and UW Physicians (UWP), and General Counsel for Valley Medical Center (VMC) (“legal counsel”) for this purpose. Legal questions about responding to non-patient care-related subpoenas (or other legal processes) should be submitted directly to the applicable legal counsel. Questions regarding patient privacy should be directed to UW Medicine Compliance. Providers should also notify their service chief, program director, or other supervisor of receipt of a subpoena.

UW Medicine policy directs employees to comply with their legal obligations to provide fact witness testimony related to subpoenas and similar court processes. Under the law, the individual named in the subpoena has primary responsibility for ensuring that a response to the subpoena takes place; failure to do so can result in contempt citations and other sanctions from the court against that individual. The individual named in the subpoena also has primary responsibility for complying with applicable policies for disclosure and documentation of the disclosure of patient information in accordance with federal law. The guidelines below are intended to assist employees with these duties, while minimizing disruption to patient care.

PROCEDURAL GUIDELINES

How to Use These Guidelines

These guidelines consist of commonly asked questions and answers regarding what to do and expect if you receive a subpoena or request to testify as a witness in a lawsuit, administrative, or criminal proceeding, and/or a subpoena to produce documents of some kind.

Answers include “external” links to policies, forms, and other relevant information sources (the external links will open in a separate browser window). To return to the list of questions, click the “back” button on your Web browser. Please report any broken links to HSRM at (206) 598-6303 or [email protected].

If the FAQs do not provide enough information, contact HSRM or UW Medicine Compliance for further advice regarding patient care-related subpoena issues. HSRM will facilitate any necessary involvement of legal counsel for subpoenas related to patient care.

I. What is the meaning of “subpoena” and “subpoena duces tecum”?

II. What should I do if I receive a subpoena or a subpoena duces tecum?

mailto:[email protected]?subject=CONFIDENTIAL:%20



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A. How can I tell if the University of Washington or my employer is involved in the case?

B. What should I do if the UW or a UW Medicine entity or affiliate is a party to the case?

C. What should I do if the UW or a UW Medicine entity or affiliate is not a party to thecase, but I believe that the case involves a potential quality of care issue for a provideremployed by or a trainee at the UW or a UW Medicine entity or affiliate?

D. What should I do if the UW or a UW Medicine entity or affiliate is not a party to thecase, and I do not believe that the case involves a potential quality of care issue for aprovider employed by or a trainee at the UW or a UW Medicine entity or affiliate?

1. What if the subpoena is requesting medical records?

a) What if I believe that release of my patient’s medical records (to someoneother than my patient) will be harmful to my patient?

2. What if the subpoena also requests my testimony?

3. What if the subpoena requests release of research records or data?

4. What if the subpoena requests something other than patient care information?

III. It looks like I am being asked to testify as a healthcare provider. What should I do?

A. What is the difference between a “fact” witness and an “expert” witness?

1. “Fact” Witness

2. “Expert” Witness

3. Worker’s Compensation (L & I) cases

B. Authorization for disclosure

C. May I access the patient record to review my notes?

D. What if I was a Resident or a Fellow at the time I provided care to the patient?

E. What if I have been asked to attest to the reasonableness of the billings?

IV. Can I agree to be an expert witness?

V. Can I receive compensation for fact or expert witness testimony?

A. Special information regarding compensation as a fact witness

B. If I am a non-billing employee, will I be paid my salary to testify if called, or would Ihave to use benefit time?

VI. What if the subpoena comes from a court outside of King County?

VII. What if the subpoena arrives by mail or on very short notice before the trial or deposition?

VIII. What if I am not available at the time I have been asked to testify?

IX. I have not been subpoenaed, but an attorney has asked to meet with me or speak with me on

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the phone. What should I do?

A. What if my patient or my patient’s attorney is asking me about another provider’s care(either UW or outside provider), and I have concerns about that care?

B. I have been contacted by CPS/APS. Can I speak with them without a patient

authorization?

C. I have been asked to sign a declaration for a case involving my patient. Am I obligated tosign a declaration?

X. I am pretty sure I will need to testify at deposition or at trial. What should I know about the

process?

A. Will an attorney go with me when I testify?

B. Where will I give testimony?

C. What should I expect to occur when I testify?

D. How should I conduct myself as a witness?

XI. How can I get more information about subpoenas, depositions, and testimony or getadditional questions answered?

XII. ATTACHMENTS

A. Attachment 1: UW Administrative Policy Statement 47.3

B. Attachment 2: UWP Policy Regarding Expert Witness Testimony

C. Attachment 3: CUMG Policy Regarding Expert Witness Testimony

D. Attachment 4: Sample Subpoenas

E. Attachment 5: Form #249 - Special Physician Services

XIII. CROSS REFERENCES

• I. What is the meaning of “subpoena” and “subpoena duces tecum”?

• A subpoena is a legal document requiring a specific person to appear and testify as awitness in court or at a deposition.

• A subpoena duces tecum (SDT) orders the person subpoenaed to produce books,documents, or other records under his/her control. It may also require the person toaccompany the records and testify as a witness at a specified time and place. It is servedupon the custodian of the required records, or upon an individual person named in thesubpoena.

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• A subpoena or SDT is issued by an officer of the court or an attorney of record in the case,

and is served on a named individual, department, or organization. A subpoena is not the

equivalent of a “court order” unless it has been signed by a judge.

Click here to see some samples of subpoenas.

• II. What should I do if I receive a subpoena or a subpoena duces tecum?

The answer to this question depends on the following two factors:

• Whether the uw, a UW Medicine component, or any UW practice plan member whilepracticing at an approved site of practice (Hall Health Center, Seattle Children’s Hospital,the VA Puget Sound Health System, etc.) is a party to the case or there is a concernregarding potential liability or an allegation of liability against any of the above entities orpersonnel. This also applies to faculty, trainees, and employees of the School of Dentistry.

• The type of information requested.

• A. How can I tell if the University of Washington or my employer is involved inthe case?

If the UW or a UW Medicine entity or affiliate is a party, this means that the UW or the UW Medicine entity or affiliate will be listed in the caption (box in the upper left hand corner of the document) of the subpoena or subpoena duces tecum (for example, the caption may say University of Washington, Harborview Medical Center, University of Washington Medical Center, or may list a clinic or affiliate name and/or an individual UW Medicine provider name).

Click here to see some samples of subpoenas.

• B. What should I do if the UW or a UW Medicine entity or affiliate is a party tothe case?

Immediately contact HSRM.

If the subpoena is for an ongoing claim or lawsuit, direct any questions about depositions to the UW Office of Risk Management at (206) 543-3657. Ask to speak with the claims manager.

• C. What should I do if the UW or a UW Medicine entity or affiliate is not aparty to the case, but I believe that the case involves a potential quality of careissue for a provider employed by or a trainee at the UW or a UW Medicineentity or affiliate?

Contact HSRM as soon as possible.

• D. What should I do if the UW or a UW Medicine entity or affiliate is not aparty to the case, and I do not believe that the case involves a potential qualityof care issue for a provider employed by or a trainee at the UW or a UWMedicine entity or affiliate?



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This depends on the type of information being requested.

1. What if the subpoena is requesting medical records?

• All subpoenas requesting release of patient-related records for HHC, HMC, UWMC, and the UW Neighborhood Clinics should be promptly sent to UW Medicine’s Health Information Management (HIM) for processing (HIM Dept., Box 359738, Fax: (206)

744-9997). Subpoenas for release of medical records from ALNW, NWH, SCH, VMC, or any other entity whose records are not maintained by HIM, should be promptly sent to the individual or department responsible for release of medical records in the facility where the patient was treated. For more information, please see: http://depts.washington.edu/comply/compliance-programs/hipaa-program/release-of-patient-information/

• Medical record preparation and release must be done by HIM or the designated medical record custodian to ensure that the release is legally appropriate, that the medical record is complete, and that the request and any records released as a result of the request are tracked as required by law. When you follow this procedure, HIM or the medical record custodian is responsible for providing the relevant records and for properly documenting the disclosure in accordance with UW Medicine patient privacy policies and all relevant laws. Do NOT attempt to gather or provide the medical records yourself.1

a) What if I believe that release of my patient’s medical records (to someone other than my patient) will be harmful to my patient?

• Contact HSRM for further advice.

2. What if the subpoena also requests my testimony?

• If this is the case, the subpoena will usually ask you to appear to provide testimony, and the medical records request will take the form of a subpoena duces tecum asking to you bring records with you. A subpoena asking you to appear only as a “custodian” of the records usually will be handled entirely by the applicable HIM department (a representative from HIM would provide the “custodian” testimony if necessary; HIM will notify you if your presence is required). Contact the applicable HIM department to coordinate transferring the subpoena to them and to answer any questions they may have about providing your patient’s records.

• If the subpoena appears to be requesting your testimony as a healthcare provider for the patient, coordinate with the applicable HIM department to make sure that the appropriate steps have been taken to permit release of the patient’s healthcare information (this applies to any records that have been requested, as well as to your actual

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testimony about your care of the patient). You would then follow the

steps listed below under “fact” witness testimony.

• If you provide testimony through a declaration/affidavit, at a deposition, or at trial without a patient authorization, but pursuant to a court order or other legal procedure allowed by state law, these disclosures should be documented in the healthcare entity’s Accounting of Disclosure Log when the testimony is given. These disclosures can be documented in UW Medicine’s Accounting of Disclosures database for ALNW, HHC, HMC, UWMC. For providers at NWH, VMC, or any other site of practice, please contact the applicable medical records department. See UW Medicine Compliance Policy PP-25 for further details, or contact UW Medicine or School of Dentistry Compliance for support.

• An informal conference with the patient’s attorney (or joint conference with two or more parties of the case) may occur only pursuant to a valid patient authorization or court order. A copy of any signed authorization or court order should also be forwarded to UW Medicine HIM and/or, as applicable, to any other individual or department responsible for release of medical records in the facility where the patient was treated. However, no Accounting of Disclosures is necessary if the disclosure is made pursuant to a valid patient authorization.

3. What if the subpoena requests release of research records or data?

• Identification information and research information collected pursuant to an approved IRB protocol may be protected. Contact the UW Human Subjects Division at (206) 543-0098 for initial review and advice. If the Human Subjects Division determines that the information sought in the subpoena is not protected research information, but the subpoena is requesting patient-related information, you should contact HSRM for further advice.

4. What if the subpoena requests something other than patient care information?

• Contact your component’s legal counsel if the subpoena does not appear to be related to clinical patient care. Patient care-related subpoenas generally involve a patient as a plaintiff, defendant, or victim (criminal case). Examples of subpoenas that should be initially referred to legal counsel include, but are not limited to:

O A subpoena from the Department of Justice or the Office of Inspector General.

O A case that appears to involve a contract dispute, financial issues, patent issues, or copyright issues.

• III. It looks like I am being asked to testify as a healthcare provider. What should I do?

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This depends upon whether you will be testifying as a “fact” witness or as an “expert” witness.

A. What is the difference between a “fact” witness and an “expert” witness?

In a typical litigation setting, a “fact” witness was involved in the events at issue in the case, and testifies solely about his/her personal knowledge of those events (e.g., eyewitness testimony). Most fact testimony does not involve opinions of any kind. “Expert” witnesses, on the other hand, typically have not been personally involved in the events at issue in the case, but have reviewed them from a third-party perspective. These witnesses offer opinions about the issues in the case that are relevant to their areas of expertise.

Healthcare providers sometimes testify in the expert role described above; that is, they will review cases in which they were not personally involved and offer opinions in their areas of expertise. Sometimes healthcare providers who have been involved in a patient’s treatment are asked to testify as “expert” witnesses; in this situation, they function in a type of “hybrid” role because expert opinions may be elicited if formulated as part of the basis of care. However, there are limits to the scope of the opinions that are properly asked of a healthcare “fact” witness, as described below.

Slightly different concepts apply in worker’s compensation (L& I) cases; see

below.

1. “Fact” Witness

• Treating providers can be compelled to appear to testify about the“facts” of their care of the patient. (See above for information aboutappropriate release of medical records.)

O Example: Dr. X., when you examined the patient in January 2002, what was his range of motion?

• In connection with their testimony, providers may be required toanswer questions about their qualifications, including education,training, publications, etc. Providers may also be required to answerquestions about medical opinions they formed in connection with theircare of the patient. As a “fact” witness, the provider may appropriatelydecline to formulate a current opinion in the case. You do not need toformulate an opinion about matters that go beyond your involvement inproviding care to the patient; it is best to testify only as to the care youprovided and what you charted. Testify only on matters within thescope of knowledge of your practice or medical specialty.

O “Fact” opinion example (witness may be required to answer): Dr. X, based upon your examination of the patient in January 2002, what did you think was causing the patient’s pain?

2. “Expert” Witness

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• A treating provider also may act as a “hybrid” witness and testifyregarding opinions that he or she formulated as part of the basis of careof the patient, as described in III (A) above. If you have beensubpoenaed to give testimony about your own patient, you need notagree to provide “expert” testimony (see example below). Yougenerally cannot be required to testify in an “expert” witness capacity,but if you express an opinion that could be considered an “expert”opinion (e.g., an opinion on the standard of care or causation ofdamages), attorneys in the case may then be able to treat you as anexpert witness.

O “Expert” opinion example (witness may decline to offer if not formulated at the time of treatment): Dr. X, on a more likely than not basis, do you believe that my client’s current disability was caused by the November 2001 accident?

3. Worker’s Compensation (L & I) cases

• If you are the provider for an injured worker (or someone with an occupational illness) in the state of Washington, you may be asked by the Department of Labor & Industries or the self-insured employer to provide information about your care of the patient related to the injury or illness. State law mandates cooperation with this process, within the scope of your role as treating provider. You also may be asked to provide certain specific types of expert opinion. Typically, these involve questions about “rating” the patient’s level and degree of disability under a state regulatory scheme. Most of this activity takes place at the “claims management” level (i.e., through correspondence with the claims manager for the patient’s L & I claim) and does not involve attorneys or legal process. You may decline to offer a rating opinion, but you will need to provide requested information about your care of the patient (see below). If actual medical records are requested, follow the procedures described above.

• You also may become involved in a claimant’s or employer’s “appeal” and you may be subpoenaed for testimony in an administrative hearing before the Board of Industrial Insurance Appeals. In most cases, you do not need to appear “live” at the hearing; it is very common for the testimony of healthcare providers in these cases to be taken by“perpetuation” deposition (see description of the perpetuation process below). These disclosures should be documented in the UW Medicine’s Accounting of Disclosures database, in the absence of a patient authorization.

B. Authorization for disclosure

• Prior to testifying about the patient’s health information, one of the followingconditions must have been met:


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O You have been provided with a valid, HIPAA-compliant, signed patient authorization allowing you to testify;

O You have received a court order (either written, or verbal at the time of trial) directing you to testify;

O The judicial proceeding involves allegations of child abuse (injury, neglect, sexual abuse) which falls under an allowable exception for disclosure; or

O The attorney seeking such information has followed a legal procedure whereby he/she has provided a “Notice of Intent” to obtain the PHI and allowed the legally required time period for the patient to object, and no objection has been made or protective order obtained. Contact HSRM for additional information before providing testimony. Note: This process is not applicable for heightened confidentiality PHI.

• If indicated, the patient’s legally authorized surrogate may sign the authorization; this usually is acceptable only if the patient is incapacitated. For a deceased patient, the personal representative of the estate must sign the authorization. If someone other than the patient is signing an authorization, additional documentation must be provided showing that the individual has the appropriate authority to sign on behalf of the patient. As noted above, send all signed authorizations to HIM and/or, as applicable, other relevant medical records custodian(s) for inclusion in the patient’s medical record. For further guidance, see Privacy Policy PP-08

• In a situation where you receive a valid subpoena but have not been provided with the appropriate patient authorization in response to your request, you must still comply with the subpoena by appearing on the date you coordinate. You can then explain that you have not been provided with an authorization to disclose the patient’s health information and have a concern regarding patient privacy, and the judge may order your testimony at that time.

• After you testify, you must document the disclosure in the UW Medicine Accounting of Disclosures database if the disclosure was made pursuant to court order or other valid legal process without a patient authorization. No Accounting of Disclosures is necessary if the disclosure is made pursuant to a valid patient authorization.

C. May I access the patient record to review my notes?

• Yes. If you receive a request related to a legal matter or a subpoena for testimonyinvolving a patient you cared for, you may access the records, but do not disclosethem or their contents without one of the conditions in III (B) being met.

D. What if I was a Resident or a Fellow at the time I provided care to the patient?

• If you were a Resident or Fellow at the time you provided care to the patient, youwill want to explain to the requesting attorney that an Attending physician wouldhave signed off on your care. It is possible that it is really the Attending physicianwhom the attorney wishes to have testify, if he or she is available. HSRM routinelyencourages attorneys to seek testimony from Attending physicians in lieu ofResidents or Fellows, if possible. If you are currently a Resident or a Fellow, youwill want to notify your program director for additional support. However, thedecision to call a witness at trial is for the issuing attorney to make and only the

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issuing attorney can release you from a subpoena.

E. What if I have been asked to attest to the reasonableness of the billings?

• As healthcare providers do not generate or process billings and are not experts in thatarea, any request to authenticate billing records or attest to the reasonableness ofbillings should be referred to the Patient Financial Services (PFS) Department at(206) 598-0306 for HMC/UWMC, or other similar department for another facility.As the appropriate billing records custodian for HMC and UWMC, PFS can providecounsel with a certification of the billing records. It is not UW’s practice for PFS toprovide “expert” testimony as to reasonableness of the charges.

• IV. Can I agree to be an expert witness?

• You are not obligated to serve as an expert witness. However, you may agree to serve as anexpert witness, as an outside consulting activity, in a case involving a patient who has notbeen treated by any UW component or provider. Please note that when serving as a retainedexpert witness outside of your CUMG or UWP services, you are prohibited from using UWresources or staff for any activities related to that service and must follow the appropriateapproval procedures. (See below for witness compensation information.) In situationswhere you are being asked to serve as an expert witness or provide expert opinions about apatient you have treated, you should consider whether participating in the patient’s case asan expert witness will affect your therapeutic relationship with your patient. You will alsowant to consider whether the activity could be in conflict with, or could appear to be inconflict with, the proper discharge of your official duties, state ethics laws, and/or relatedUniversity policies (see UW Administrative Policy Statement 47.3 for more information).You should also consider that an expert witness will be subject to cross examinationregarding any opinions provided.

• V. Can I receive compensation for fact or expert witness testimony?

• If you will be receiving any direct compensation for your testimony (beyond “statutory”fees; see below), you must follow the UW policies for outside consulting (see UWAdministrative Policy Statement 47.3 for more information). It is up to you and/or yourdepartment to determine in what situations and how much you will charge. Members ofCUMG or UWP must also review and follow the subpoena and testimony policiesdeveloped by these organizations, including the applicable CUMG or UWP PolicyRegarding Expert Witness Testimony. Billing staff will assist in determining the appropriatecharges for staff testimony as an expert witness.

• Briefly, compensation for testimony involving CUMG/UWP patients must be handledthrough CUMG/UWP billing procedures. Compensation for testimony involving “outside”patients can be handled through outside consulting procedures. See the applicable CUMGand UWP policy.

A. Special information regarding compensation as a fact witness

• Payment for fact witness testimony is set by court rules and involves a minimalfee. However, many attorneys are willing to pay healthcare providers

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more than the nominal fees set by the courts. If you wish to receive compensation for fact witness testimony beyond the “statutory” fees, your request for compensation must be discussed with the attorney requesting the testimony before the deposition or testimony. Questions about appropriate billing procedures should be referred to your CUMG, UWP, or department billing coordinator:

O CUMG Finance: (206) 987-8472

O UWP Manager of Coordinated Services: (206) 520-5378

• The correct billing form for UWP physicians to use to bill for time is the“Special Physician Services” form (#249).

B. If I am a non-billing employee, will I be paid my salary to testify if called, or

would I have to use benefit time?

• In most cases, your testimony would be considered part of the scope of yourduties. You should discuss time and compensation issues with your manager.

• VI. What if the subpoena comes from a court outside of King County?

• Subpoenas for testimony outside of King County may be covered by special rules, including any witness fees to be paid in advance or how far a witness may be compelled to travel. Attorneys must follow special procedures for matters outside the state of Washington. For an out-of-jurisdiction subpoena, contact HSRM, which will assist you or refer you to legal counsel, if needed.

• VII. What if the subpoena arrives by mail or on very short notice before the trial or deposition?

• Depending on the court where the case is filed, service by mail may be technically improper. You also may receive a subpoena that technically does not provide the required “reasonable notice.” However, that does not mean that these subpoenas may be ignored. The UW encourages compliance with subpoenas, if possible, even when they are sent by mail or when short notice is provided. Additionally, the date on a subpoena is often the first day of trial, and the attorney may coordinate a later testimony date with you. These issues usually can be resolved through contact with the issuing attorney. For additional support, contact HSRM.

• VIII. What if I am not available at the time I have been asked to testify?

• Sometimes witnesses are subpoenaed to give deposition or trial testimony at a time that is inconvenient or when the witness is unavailable. If this occurs, contact the attorney right away to explain the situation and request an alternate date and/or time to provide testimony. An attorney is not obligated to change the subpoena to accommodate an individual’s convenience, but, at least for depositions, most are usually willing to reschedule for a mutually agreeable time.

• Witnesses who are subpoenaed to give testimony at trial are frequently summoned to appear



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at the court on the first day of trial. Always contact the attorney who has issued the subpoena for trial testimony to arrange for the actual appearance date and time. It is recommended that you request to be the first witness of the day or the first witness after the lunch break to minimize your wait time at the courthouse.

• Because trials are unpredictable, scheduling testimony during trial is more difficult. If it is not possible to adjust your schedule, discuss with the requesting attorney whether any alternatives are possible, such as a “perpetuation” deposition (generally videotaped). A perpetuation deposition is one in which your trial testimony is given in a deposition setting, outside of the courtroom. At the time of trial, the attorney can then have your testimony read into the record or have the videotape played for the jury.

• Contact HSRM if you are absolutely unavailable (e.g., scheduled to be out of the country) for the time you have been subpoenaed and the party who subpoenaed you is refusing to reschedule or consider alternatives. This is unlikely with attorneys but may also occur with lay litigants who are representing themselves.

• IX. I have not been subpoenaed, but an attorney has asked to meet with me or speak with me

on the phone. What should I do?

• This depends on the nature of the case. Follow the guidelines in the questions above. Ifyour employer or entity where you are a member of the medical staff is not a party,and you do not think that the case involves a potential quality of care issue for aprovider employed by or trainee at UW, NWH, or VMC, you may agree to meet orspeak with attorneys if they have the appropriate authorization form signed by the patient.

• In criminal cases, you may request a joint meeting with the prosecutor and defense attorneyto minimize the amount of time necessary to answer their questions. However, the attorneysare not obligated to agree to a joint meeting.

• In civil (non-criminal) personal injury cases that do not involve the UW or one of itscomponents, you should not meet or speak “ex parte” (alone) with the defense attorney (i.e.,the attorney who is not representing the patient) without a specific authorization from thepatient to do so. The exception to this is workers’ compensation, where you may meet orspeak with the employer’s attorney/representative or an attorney/representative for theDepartment of Labor & Industries without a written authorization from or on behalf of thepatient.

• You are not obligated to meet informally with attorneys absent a court order or workers’compensation exception, and may request to be deposed instead if the case is in litigation.Even if you do prefer to be deposed over an informal meeting, working cooperatively withthe attorney to schedule the deposition can help you avoid last-minute subpoenas that mayoffer you little flexibility. If you are concerned about these scheduling conversationsdeveloping into substantive conversations, you can address this by having your support staffwork directly with the attorney’s support staff.

• You may request compensation in accordance with CUMG/UWP policies when you meetwith an attorney informally. The fee should be agreed upon with the attorney requesting the

meeting in advance. Payment must be billed in accordance with CUMG/UWP policies.2

A. What if my patient or my patient’s attorney is asking me about another provider’scare (either UW or outside provider), and I have concerns about that care?


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• You must ultimately decide what you are comfortable discussing with your patient oryour patient’s attorney. Here is some information that may be helpful to you whenconsidering these issues:

O Taking a “legal position” with your patient may affect the therapeutic nature of the provider-patient relationship. It is perfectly appropriate to tell your patient you do not wish to become involved in legal proceedings (other than as a fact witness) in order to preserve a purely therapeutic relationship.

O If you express an opinion that could be considered an “expert” opinion as described above (e.g., an opinion on the standard of care or causation of damages), this allows an attorney to properly subpoena you to testify as an expert witness.

O Patients who express dissatisfaction to you about other providers may simply have unanswered questions. It may be more beneficial for you to try to facilitate communication between your patient and the other provider. For example, you may be able to resolve the issue by contacting the other provider and encouraging them to speak with the patient, if you have sufficient authorization to do so. Staff should always include their manager or department director in these issues.

O If the other provider is a UW provider, it would be more helpful to the patient, to you, and to UW if you contact HSRM about your concerns. You will be able to tell the patient that you will bring their concerns to the appropriate UW, NWH, or VMC personnel. We will be able to coordinate an appropriate QI investigation, involve the other provider, facilitate communication with the patient, and share the results with them.

O Different providers can have differing views on clinical care. It is generally not helpful for a treating provider to directly criticize another provider’s care, especially without complete information. This is why retained expert witnesses generally do not offer opinions without reviewing all the relevant records and other information. In addition, if you do express an opinion without having all the relevant information, you eventually may be in an awkward position when you are examined by another party to the case.

O If you do express an opinion on standard of care or causation without a thorough review of all relevant information, you will make it difficult for the provider you are criticizing to defend what in fact may have been appropriate care.

O If you would like to discuss any of these issues, you may contact HSRM.

B. I have been contacted by CPS/APS. Can I speak with them without a patient

authorization?

• Yes. There is an exception within HIPAA and Washington State law allowing you todiscuss a patient’s information with a CPS or APS investigator conducting a currentinvestigation without authorization from the patient (PP-16j). You should be sure toverify the investigator’s identification.

C. I have been asked to sign a declaration for a case involving my patient. Am I

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obligated to sign a declaration?

• No. Just as you are not obligated to participate in an informal interview, you aresimilarly not obligated to author and/or sign a declaration and may respectfullydecline. However, if you feel comfortable providing information via declaration andhave been provided with an appropriate patient authorization, you may choose todiscuss the proposed contents of, and sign, a declaration in lieu of providingtestimony. If you choose to sign a declaration for a pending legal matter, be sure toreview it very carefully and strike out or revise any proposed sections or sentencesyou do not agree with or cannot attest to (e.g., statements about care you did notprovide, authentication of records, reasonableness of billings, expert opinions). Arevised version should be rechecked to verify that all of your requested changes havebeen made by the attorney. Remember that you are signing the declaration underpenalty of perjury and may be cross examined on its contents.

• X. I am pretty sure I will need to testify at deposition or at trial. What should I know about the process?

• Answers to frequently asked questions about the process of testifying are below. If you have additional questions, you may contact the HSRM Legal Proceedings Consultant or Risk Manager on call.

A. Will an attorney go with me when I testify?

• If the UW, NWH, or VMC is not a party to the case, there generally will not be an attorney attending your testimony with you. However, there may be rare exceptions to this general approach if the circumstances are unique. If there are concerns about whether the UW, NWH, or VMC may be implicated in a case, contact HSRM right away.

B. Where will I give testimony?

• Testimony may occur in several different settings:

O At a deposition (usually held at a private office),

O At a hearing, or

O In a courtroom.

• In any of these testimony situations, the testimony is a formal statement givenunder oath or promise of telling the truth.

• A deposition allows each party to question any other party or other witness inthe case. Depositions are generally conducted prior to trial. A “perpetuation”deposition is like testifying at trial and may become part of the court record. Ifthe deposition is taken solely for “discovery” purposes, the depositiontestimony generally may be used at trial only if the witness’ trial testimonycontradicts his/her deposition testimony, or if the witness is unavailable, asdefined by applicable rules, during the trial to testify in person. However, any



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discovery deposition may become part of the court record (a public record),

and you should assume that might happen with your deposition testimony.

C. What should I expect to occur when I testify?

• After being sworn in as a witness, you will be asked questions, usually by allof the attorneys representing parties to the case.

• Testimony as a witness is not a “grand rounds” forum. There may be strategicreasons why some issues are not explored during the testimony. It is not yourresponsibility to tell everything you know or believe to be important. Wait forthe question and answer it or ask the attorney if he/she will repeat or rephraseit if you do not understand it. The “scope” of questioning is much broader in adiscovery deposition than at trial or in a perpetuation deposition.

• Both the questions and answers you provide will be recorded, usually by acourt reporter. If testimony is provided at a deposition, a written transcript ofthe testimony will be prepared. As the witness, you will be asked whether youwant to later review it or not. You may choose to read it and either sign that itis accurate or identify corrections.

D. How should I conduct myself as a witness?

• Guidelines for Testimony

O Tell the truth. You will be under oath. Giving an intentionally false answer is perjury, which is a crime. In addition, any false or inconsistent answers may be used to attack your credibility on all matters. Be honest. Be accurate. If only approximate dates, times, or distances are known, then give only your best approximation and say it is an approximation. If you answer mistakenly during testimony, simply say that you were mistaken and correct your statement as soon as you realize the mistake.

O Discuss matters of concern in advance with the appropriate Risk Management office. If you are concerned about something that might prove embarrassing or something that you have done, discuss it candidly with Risk Management before giving testimony. The matter will be referred to legal counsel as necessary.

O Listen carefully to every question. Be aware that the question might include assumptions on which further questions might be based. Be sure that you understand each aspect of the question before answering, or clearly state any qualifications you believe are needed for complete accuracy.

O Be alert for leading or hypothetical questions. Some leading or hypothetical questions may result in a conclusion that you did not intend to articulate.

O Be careful when asked about “authoritative texts.” If you are asked whether a particular text is authoritative and you respond “yes,” that answer may be interpreted to mean agreement with every statement

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contained in that text.

O Answer in your own words and answer only the questions asked. Do not volunteer any additional information. Answer the questions with words that you normally use and feel comfortable using. Answer only one question at a time. If a question is compound or has multiple parts, be sure to indicate that you are answering each part of the question separately.

O Pause before beginning each answer. This gives you time to reflect on the question, and it also gives the attorneys an opportunity to make any necessary objections.

O Listen carefully to objections; something can be learned about the question from the objection. For example, an objection that a question is speculative may mean that you would need more information to be able to answer the question. If an objection is made to any question or answer, stop talking until you are directed to continue your testimony by the judge (at trial) or by the examining attorney (at depositions). If you have serious concerns about answering a question, state that you need to consult with counsel and cannot answer until you have done so. Contact the appropriate legal counsel for further advice: UW Attorney General’s Office at (206) 543-4150; General Counsel for CUMG, NWH, and UWP at (206) 543-6420; or General Counsel for VMC at (425) 656-4034.

O If you do not understand a question, say so. Ask for clarification or for the question to be repeated. If requested, the court reporter will repeat a question as it was recorded.

O Do not guess or offer an opinion unless specifically requested to do so, and then answer only after waiting to hear if there is any objection. A witness will generally be allowed to testify only to what he/she personally saw, heard, or did. If you do not have personal knowledge, say so. Be willing to acknowledge the limits of your knowledge or expertise.

O Where appropriate, qualify your answers. Testify accurately based on your memory. It may be necessary to be vague about a date or fact if you are uncertain. If you are not sure, say so (e.g., “to the best of my recollection” or “as best as I can recall,” or “I believe”). There is no need to apologize if you do not recall or know requested information.

O Avoid using absolutes unless you are certain they are accurate. For example, saying “I never” or “I always” may be problematic later.

O Indicate whether you are paraphrasing or quoting, especially in testifying regarding conversations.

O Do not offer or bring with you documents that have not been appropriately requested in advance. If an attorney wants to obtain documents, other legal procedures may apply. This is especially true of medical records. Attorneys who seek medical records should be referred to HIM or the appropriate medical records department. If requested via a subpoena duces tecum, you may bring with you any records that were provided to you by the attorney. However, you

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should indicate that the records were provided by counsel and reiterate that you cannot authenticate the records as you are not the Records Custodian.

O If you are presented with and asked about a document, read it carefully before you begin to answer. If you do not recall the document, or do not know what the document says or what its author meant, then say so. Do not guess at what it might have meant.

O Speak slowly, clearly, and audibly. The court reporter must hear every word you say in order to transcribe your testimony. Let the examiner complete the question before you begin to answer. Try to answer “yes” or “no” when appropriate; do not nod your head or say “uh-huh.”

O If warranted, make an oral statement about inappropriate actions by counsel. The transcript will reflect only what is said. It will not reflect, for example, that an attorney yells or hovers over you. If you are confronted with inappropriate actions such as these, you may say what is happening at the time, and the transcript will include the statement. However, do not let yourself be provoked into an argument with the lawyers.

O Be serious and polite at all times. Do not give cute or clever answers, as they may be misinterpreted. Avoid all obscenities, slurs, and references that could be considered derogatory or offensive to others. Remember that your statement may be read to a judge or jury, and thus become part of a public record.

O If you need a break, ask for one. Paying attention to your level of fatigue will help ensure effective listening and help avoid mental lapses that can result in problems with your testimony.

O Avoid casual conversation with counsel. This applies before, during, and after the deposition or trial.

• XI. How can I get more information about subpoenas, depositions, and testimony or get

additional questions answered?

• Call HSRM at (206) 598-6303 and ask to speak with the Legal Proceedings Consultant orthe Risk Manager on call.

• XII. ATTACHMENTS

A. Attachment 1: UW Administrative Policy Statement 47.3

B. Attachment 2: UWP Policy Regarding Expert Witness Testimony

C. Attachment 3: CUMG Policy Regarding Expert Witness Testimony

D. Attachment 4: Sample Subpoenas

E. Attachment 5: Form #249 - Special Physician Services

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1For example, most medical records or PHI may be released pursuant to a subpoena as longas a “notice of intent” to subpoena the records or PHI has been sent (and copied to the patient) 14 days in advance of the service of the subpoena. However, certain types of records (e.g., mental health records) may be released ONLY upon express agreement of the patient or under a court order.

2This refers to cases involving CUMG/UWP patients. For cases involving “outside”patients (i.e., if you are a reviewing expert), you would not request to be deposed by the party retaining you, and you would not agree to meet informally with the other party.

• XIII. CROSS REFERENCES

• APS 47.3 UW Policy Administrative Statement – Outside Consulting Activities and Part-Time Employment by Professional or Classified Staff Employee

• PP-08 Use & Disclosure of Protected Health Information Requiring Authorization

• PP-16g Use & Disclosure of Protected Health Information (PHI) Permitted for Judicial and Administrative Proceedings

• PP-16j Use & Disclosure of Protected Health Information (PHI) Permitted for Victims of Abuse, Neglect or Domestic Violence

• PP-25 Accounting of Disclosures of Protected Health Information

• UW Medicine Compliance Release of Information contact page

[1] Limited to the following UW Medicine entities and UW Medicine affiliates: Airlift Northwest(ALNW); Children’s University Medical Group (CUMG); Hall Health Center (HHC); HarborviewMedical Center and Clinics (HMC); Northwest Hospital & Medical Center and Clinics, includingemployees of its wholly-owned subsidiaries (NWH); UW School of Medicine; Stadium Clinic atUWMC; University of Washington Medical Center and Clinics (UWMC); UW Neighborhood Clinics(UWNC/UWPN); and The Association of University Physicians d/b/a UW Physicians (UWP).

[2] Airlift Northwest (ALNW); Children’s University Medical Group (CUMG); Hall Health Center(HHC); Harborview Medical Center and Clinics (HMC); Northwest Hospital & Medical Center andClinics, including employees of its wholly-owned subsidiaries (NWH); UW School of Medicine; StadiumClinic at UWMC; University of Washington Medical Center and Clinics (UWMC); UW NeighborhoodClinics (UWNC/UWPN); The Association of University Physicians d/b/a UW Physicians (UWP); andValley Medical Center and Clinics (VMC).


https://depts.washington.edu/comply/docs/PP_16g.pdf

https://depts.washington.edu/comply/docs/PP_16g.pdf

https://depts.washington.edu/comply/docs/PP_16j.pdf

https://depts.washington.edu/comply/docs/PP_16j.pdf



ATTACHMENTS

Attachment 1: UW Administrative

Policy Statement 47.3

APS 47.3, Outside Consulting Activities and Part-Time Employment by Professional or Classified Staff Employees

http://www.washington.edu/admin/rules/policies/APS/47.03.html[3/28/2017 3:36:54 PM]

ADMINISTRATIVE POLICY STATEMENTS (APS)

BOARD OF REGENTS GOVERNANCE (BRG)*

EMPLOYMENT AND ADMINISTRATIVE POLICIES (EAP)*

FACULTY CODE AND GOVERNANCE (FCG)*

PRESIDENTIAL ORDERS (PO)*

STUDENT GOVERNANCE AND POLICIES (SGP)*

WASHINGTON ADMINISTRATIVE CODE: TITLE 478 WAC - UW RULES (WAC)

*Formerly part of the University

Handbook

UW HOME DIRECTORIES CALENDAR LIBRARIES MAPS MY UW

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Outside Consulting Activities and Part-Time Employment by Professional or Classified Staff Employees(Approved by the Executive Vice President by authority of Administrative Order No. 9)

1. Policy Regarding University Employee Obligations andOfficial Duties

University of Washington employees are responsible for meeting the job expectations and work effort requirements of their positions. At the same time, the University recognizes that individuals, the University, and the state benefit from staff involvements in and support of outside organizations and industry. Staff may engage in outside consulting work or part-time employment provided that such outside employment is not to the detriment of their University obligations and job performance or in conflict with the proper discharge of the employee's official duties.

2. Ethics in Public Service Act

RCW 42.52.120, part of the Washington State Ethics in Public Service Act("Ethics Act"), permits a University employee to engage in outsideconsulting or part-time employment only if the consulting work or part-time employment is:

Bona fide and actually performed;

Neither within the normal course of the employee's official University duties nor under the employee's supervision;

Policy Directory > APS Home > Section 40

Administrative Policy Statement 47.3

Table of Contents

http://www.washington.edu/admin/rules/policies/APS/APSTOC.html

http://www.washington.edu/admin/rules/policies/BRG/BRGTOC.html

http://www.washington.edu/admin/rules/policies/EAP/EAPTOC.html

http://www.washington.edu/admin/rules/policies/FCG/FCGTOC.html

http://www.washington.edu/admin/rules/policies/PO/POTOC.html

http://www.washington.edu/admin/rules/policies/SGP/SGPTOC.html

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http://apps.leg.wa.gov/RCW/default.aspx?cite=42.52.120



http://www.washington.edu/admin/rules/policies/APS/TOC40.html



Does not involve assisting others in transactions with the University in which the employee has participated or which has been under his or her official responsibility;

Not for an organization or person from whom the law prohibits receipt of gifts;

Not under a grant or contract created by the University employee; and

Does not result in the unauthorized disclosure of confidential information or unapproved transfer of University intellectual property.

Consistent with the purposes of the 2005 Ethics Act Amendment, the University may approve requests by University Research Employees to engage in outside professional work even if one or more of the foregoing conditions are not met, provided that the procedures and other requirements of this policy are followed and the University is satisfied that the outside professional work will be consistent with relevant University and public interests. "University Research Employee" has the meaning stated in RCW 42.52.010(21). For purposes of this policy, University Research Employee shall include:

Research scientists and other University employees, including professional and classified staff, who have been specifically assigned to sponsored research projects and whose work contributes to the design or conduct of research or to the analysis or reporting of results; and

Other professional staff members who have been granted the right to apply for sponsored research projects by the Provost or by their respective schools, colleges, or campuses.

Furthermore, if the employee is consulting for another state agency, the employee must in most cases obtain prior approval from the state's Executive Ethics Board. The employee should consult the rules of the Executive Ethics Board in WAC 292-110-060.

3. Advance Review and Approval

A. Requirements

While the state of Washington Ethics in Public Service Act permitsoutside work, University professional and classified staff must secureadvance review and approval of outside work whether or not forcompensation whenever such activities stem from, could conflict with,or relate to the individual's official duties or status as a Universityemployee. The requirement for advance review and approval isdesigned to protect both the University's and the individual's interests

http://apps.leg.wa.gov/RCW/default.aspx?cite=42.52.010

http://apps.leg.wa.gov/WAC/default.aspx?cite=292-110-060



in minimizing employee involvement in activities that conflict with or appear to conflict with the state ethics laws and related University policies.

Any consulting or part-time employment should ordinarily be outside the employee's regular work schedule. When this is not possible, the employee's request for vacation or unpaid leave time for such activities must also be approved in advance by the employee's supervisor.

B. Requesting Advance Review and Approval

Outside consulting or part-time employment covered by the review requirements identified in Section 3.a must be approved in advance. The employee must secure advance approval for each consulting engagement that meets the criteria for review. The immediate supervisor will recommend approval/disapproval of the request and forward it to the head of the concerned academic or administrative unit for final review and determination. The review by the supervisor and department head should be as timely as possible and should focus on the request's conformance to the criteria listed in Sections 2 and this section. Use the Request for Approval of Outside Professional Work for Compensation—Professional and Classified Staff form for requesting such approval.

4. Intellectual Property

Intellectual property must be disclosed to the University pursuant to the "Patent, Invention, and Copyright Policy" (Executive Order No. 36) and "Patents and Inventions" (Administrative Policy Statement 59.4). Intellectual property in which the University may have an ownership interest may not be transferred by University employees while engaged in outside consulting or part-time employment. Clauses in consulting agreements (including but not limited to, clauses on confidentiality and ownership/transfer of intellectual property) must be consistent with the policy of the University and with University commitments under sponsored research agreements. Accordingly, consulting agreements should contain the company's acknowledgement that to the extent the consulting agreement is inconsistent with any of the University employee's obligations to the University, the employee's obligations to the University shall prevail.

5. Independent Legal Status of Outside Consulting or Part-Time Employment

Employees who engage in outside consulting or part-time employment must clearly identify that they are doing so as independent professionals and not as representatives of the University of Washington and that such undertakings are outside of their University responsibilities. The Washington State Ethics in Public Service Act and the University's policy on "Employee Responsibilities and Employee Conflict of Interest"

http://hr.uw.edu/wp-content/uploads/2016/07/1555_V8_Outside-Work-Request-for-Approval-Professional-And-Classified-Staff_82016.pdf




http://www.washington.edu/admin/rules/policies/PO/EO36.html

http://www.washington.edu/admin/rules/policies/APS/59.04TOC.html

http://www.washington.edu/admin/rules/policies/APS/59.04TOC.html



Rules Coordination Office

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(Executive Order No. 32) preclude state employees from using their University position for private gain. The Attorney General of the state of Washington will not represent University employees in claims stemming from outside part-time employment or consulting work, and the state of Washington cannot indemnify University employees from liability related to their outside employment or consulting work.

6. Use of University Facilities and Equipment

In the context of outside consulting engagements, University facilities, employees, materials, or equipment may not be used unless permitted by the University's policy on Personal Use of University Facilities, Computers, and Equipment by University Employees, Administrative Policy Statement 47.2.

7. Additional Information

Contact the appropriate Human Resources Service Team Member listed on the Human Resources Service Team Assignments web page.

May 1, 2002; December 20, 2006.

http://www.washington.edu/rules/

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http://www.washington.edu/admin/rules/policies/PO/EO32.html

http://www.washington.edu/admin/rules/policies/APS/47.02.html

http://www.washington.edu/admin/rules/policies/APS/47.02.html

http://hr.uw.edu/contact-us/

http://hr.uw.edu/contact-us/

Attachment 2: UWP Policy Regarding

Expert Witness Testimony

1-8-98

University of Washington Physicians

POLICY REGARDING EXPERT WITNESS TESTIMONY

Members and associates of University of Washington Physicians (“UWP”)

provide expert witness testimony from time to time in lawsuits. Such testimony may

involve, for examples, claims of medical malpractice, assessments of injuries in tort

actions of all types, or industrial insurance claims.¹

I. Expert Witness Testimony as a UWP Activity

When a UWP member or associate testifies as to any UW, UWP, or Children’s

University Medical Group (“CUMG”) patient, regardless of whether a present or former

patient, such testimony is considered to be in the line of duty, and the fee or revenue with

respect to the testimony must be billed through UWP. When a UWP member or associate

acts as an expert witness under these circumstances, the activity is covered by the risk

management program of the UW. A patient is considered a “UW, UWP, or CUMG

patient” if the patient’s medical record presented for review to the member or associate

indicates treatment by a UWP or CUMG physician or if the member or associate

otherwise knows that such treatment has occurred.

A UWP member or associate also may act voluntarily as an expert witness in a

lawsuit not involving his/her patient or another patient of UW, UWP, or CUMG and treat

that service as a UWP service. In such case, the service will be billed in the ordinary

course through UWP, conducted at UWP sites of practice, and covered by the UW risk

management program.

If testimony of any kind is given, it must be honest. Testimony, including expert

witness testimony, is subject to perjury penalties in all events. A UWP member or

associate cannot be required to give expert witness testimony except in limited

circumstances where he/she has actually treated the patient in question and has formed

such an opinion in the course of treatment. Even if he/she is subpoenaed to testify as a

fact witness with respect to a patient he/she treated, his/her obligation to give an expert

opinion should be limited to those opinions within his/her expertise and actually formed

in the course of his/her services to the patient. Before accepting voluntary service as an

expert witness, a UWP member or associate should consider the implications of

testimony involving the UW, UWP, or CUMG and avoid conflicting loyalties and

¹ Members and associates should also refer to the memorandum entitled “Guidelines for Deponents” and/or any

successor guidance from the Attorney General’s Office for University of Washington (“UW”) faculty members

regarding legal testimony, copies of which may be secured through the UW Dean of the School of Medicine (the

“Dean”).

2

interests when possible, especially when expert witness testimony is available from other

sources.

Exceptions to this Section I, “Expert Witness Testimony as a UWP Activity,” may

be made under unusual circumstances after review and advice of the Management

Committee and with the approval of the Dean. An appeal for exception must be made in

writing with supporting rationale and addressed to the Dean, with copies to the UWP

President and the Trustee of the requesting individual’s department. It is expected that

few exceptions will be granted.

II. Expert Witness Testimony as a Consulting Activity

A UWP member or associate acting as an expert witness in a lawsuit not

involving his/her patient, or another patient of UW, UWP, or CUMG and not billed

through UWP, is acting in a consulting capacity for purposes of UWP guidelines. Acting

as an expert witness is always voluntary (see discussion above). The activity must be

reviewed and approved prospectively by the involved Department Chair and the Dean of

the UW School of Medicine in the manner that consulting activity is normally approved

under the UW faculty rules (e.g., using Form 1460). UW rules with respect to outside

consulting require that the activity not be incompatible with and not interfere with UW

faculty duties and that UW resources not be inappropriately utilized in this activity. No

engagement is to be accepted which is likely to embarrass or involve the UW in

unwarranted controversy.²

Under UWP’s Bylaws and policies, UWP members and associates are also

precluded from engaging in the outside private practice of medicine. Expert witness

activities which involve examination, diagnosis and/or treatment of patients could violate

this limitation. Fees for outside consulting belong to the individual member or associate.

Outside consulting, including expert witness testimony, is not covered by the UW risk

management program.

Recommended: _____________________ Approved: ___________________________

Carlos A. Pellegrini, M.D. Paul G. Ramsey, M.D.

President Vice President for Medical

University of Washington Affairs and

Physicians Dean, School of Medicine

Date: _____________________ Date: ___________________________

(g:admin_secs\chron97\oct\exprtwit.doc)

² See Vol. IV, page 47, of the UW Handbook, and UW Form 1460 or any successor or related forms from the Dean.

Attachment 3: CUMG Policy Regarding Expert Witness Testimony

Attachment 4: Sample Subpoenas

[SUBPOENA SAMPLE]

SUPERIOR COURT OF WASHINGTON FOR KING COUNTY THE STATE OF WASHINGTON,

Plaintiff, vs. JOHN DOE,

Defendant

) ) ) ) ) ) ) )

SUBPOENA No: 17-1-00000-0 SEA Charge: Assault in the First Degree

TO: Dr. John Smith

Harborview Medical Center 325 9th Avenue, Box 359735 Seattle, WA 98104

Patient Name: _________ Record Number: _________ Treatment Date: _________

You are hereby commanded to be and appear at the Superior Court of the State of Washington in and for King County on , 2017, or as directed by the Prosecutor’s Office, at W554 King County Courthouse, 516 Third Avenue, Seattle, Washington, where you will be directed to a courtroom of the Superior Court to give evidence on behalf of the Plaintiff in the above entitled cause and to remain in attendance at said Court until discharged. Your failure to appear may be considered contempt of court and may result in your arrest.

NOTICE: Upon receipt of this subpoena, immediately call paralegal _________at (206) _________or email him/her at _________.

Dated: , 2017

_________, WSBA No. _____ Attorney(s) for the Plaintiff, State of Washington Homicide and Violent Crimes Unit W554 King County Courthouse 516 Third Avenue Seattle, WA 98104-2385

SHERIFF’S RETURN I HEREBY CERTIFY that I personally served the above subpoena on each person whose name is encircled hereon by (giving him/her a true copy hereof) leaving a true copy hereof at the place of his/her abode with via e-mail) in King County, Washington on the __th day of ______, 2017. SHERIFF’S FEE: John Urquhart, Sheriff Service $ King County Sheriff’s Office Travel $ Total $ By

[SUBPOENA SAMPLE]

IN THE MUNICIPAL COURT OF THE CITY OF SEATTLE

KING COUNTY, WASHINGTON

SUBPOENA

THE CITY OF SEATTLE PLAINTIFF

VS.

JOHN DOE, DEFENDANT

) ) ) ) ) ) ) )

CASE NO.: ___________

INCIDENT NO: ___________

INCIDENT DATE: ___________

HEARING TYPE: Jury Trial

CHARGE: DUI

TO WITNESS: ____________________, RN C/O HMC BOX # 359735 325 9TH AVE SEATTLE, WA 98104

You are commanded to appear in court to testify as a witness for the plaintiff at the following time and place, or as directed by the Seattle City Attorney’s Office. Seattle Municipal Court Trials run Tuesday, Wednesday and/or Thursday. You are to remain in attendance at said Court until discharged:

Seattle Municipal Court Seattle Justice Center - 10th Floor 600 5th Avenue - Courtroom #1003 Seattle, WA 98104

Your trial is set for: _______________, 2017, Tim e: 09:00 A.M. Please contact the assigned prosecutor at (206) 684 -7757 upon receipt of this subpoena. This case may be delayed or canceled. Please check the status of your case @ www.seattle.gov/law after 5pm the Friday before the court date to lea rn if your case is still scheduled. If you do not have access to the internet call our office Monday–Friday 8am-5pm at (206) 684 7757.

Seattle City Attorney

_________________________ ASSISTANT CITY ATTORNEY

� Original Subpoena delivered for Personal Service.

X Copy of Original Subpoena sent via Electronic Mail.

� I certify or declare under penalty of perjury under the laws of the State of Washington that on the below noted date in Seattle, Washington, I sent the original subpoena by first class mail, postage prepaid, to the address on the subpoena above, which is the witness’s last known address.

Approved For Payment

(Signature/ Date) Court Clerk /Date

YOU HAVE RECEIVED A SUBPOENA FROM THE SEATTLE CITY ATTORNEY’S OFFICE

TO APPEAR BEFORE SEATTLE MUNICIPAL COURT

JURY TRIALS: This case may be delayed or canceled. Please check the status of your case @ www.seattle.gov/law after 5pm the Friday before the court date to learn if your case is still scheduled. If you do not have access to the web, call our office at (206) 684 7757. This information will be available until the trial day. Cases will be listed by the case number. If you still have questions call (206) 684-7757. BENCH TRIALS, CONTESTED HEARINGS, MOTION HEARINGS, REVOCATION HEARINGS: These will proceed as scheduled unless you are contacted by the assigned prosecutor. For further information or if you cannot make it please contact our office directly at (206) 684-7757. WHAT IS A SUBPOENA? A subpoena is a court order which requires you to appear at the specified time and place to testify as a witness. You are paid $10.00 plus mileage (based on your zip code) for appearing – but must bring your subpoena with you to court. WHAT HAPPENS IF YOU DON’T APPEAR? Failure to appear as specified may result in the issuance of a material witness warrant for your arrest or a contempt of court citation. You may only be excused from appearing by the judge or assigned prosecutor. WHAT SHOULD I DO IF I CANNOT APPEAR? Please leave a detailed message for the assigned prosecutor at (206) 684-7757. WHAT HAPPENS IN COURT? When you initially appear in court there may be a lot of activity. There are generally several cases set at the same time. The attorneys for both sides check in all of their witnesses and advise the judge as to their ready status for the trial. If both sides are ready your case may proceed to trial. The defendant may enter a guilty plea at any time, in this instance your trial will be canceled and you will be excused. Please be prepared to spend at least most of the morning in court and all day if your trial is going forward, sometimes the case will need to be set over for the next day, or two. Your testimony may be needed any day of the trial week. If you need proof of your attendance in court for your employer please ask – you can be provided with a copy of your subpoena for your records.

Attachment 5: Form #249 - Special Physician Services

Testimony & Depositions 99075 Medical Testimony and

Depositions (billed per hour)

Date of Testimony/Deposition:

/ /

Total Hours:

Testimony/Deposition Fee:

$

Special DSHS Requested Evaluations

99199 DSHS Physical Eval form requested by CSO

Fee: $

Special Services 99080 Special Reports such as

insurance forms Fee: $

99199 Unlisted special service, or report

Fee: $

Bill services to the following: Name:

Address:

City: State/Zip: Phone:

Notes:

Washington State L&I Workers Comp Forms

1027M LEP - Loss of earning power 1038M req 1st Rev JA Job Analysis 1028M “ each add Rev JA 1040M ROA - Rpt of Accident/Injury 1041M Reopening L&I application 1046M Mileage >14 miles round trip 1055M Detailed Occ Dis History 1057M Opioid Progress Rpt Supp 1063M req Attg MD rev of IME 1064M req 1st rpt opioid - chronic 1068M Ret to Wrk Assess (COHE) 1070M Ref pt to Occ/Med (COHE) 1073M APF Activity Presc Form 1074M req by VRC employers APF 1190M Att MD IMR - Limited 1191M “ Standard 1192M “ Complex 1193M Approved Consult IME-Ltd 1194M “ Standard 1195M “ Complex 99080 Rtp req by L&I or 60 day rpt

** Do not report 99080 in conjunction with 99455, 99456 for the completion of

Workers’ Comp. forms

Medical Team Conference 30 min or more w/interdisciplinary team of health care professionals 99366 Face-to-Face w/ patient

and/or family w/non phys qualified health care prof

99367 Patient and/or family not present w/physician

99368 Patient and/or family not present w/ non phys qualified health care prof

Mail white copy and supporting documentation to: Attn: UWP Outpatient Charge Capture Box 359110 Keep the pink copy of the fee sheet for your records.

Check Enclosed: No Yes

Check Amount: $

Check Number:

Telephone & Online Services 99441 Phone E&M service by a

phys to an est. patient, parent or guardian, 5-10 minutes of med. discussion.

99442 “ 11-20 minutes of med. discussion.


99444 Online E&M by phys to est patient not originating from related E&M visit

98966 Phone assessment & management service by a qualified non-phys health care prof, 5-10 min of med discussion.

98967 “ 11- 20 minutes of medical discussion.


Nursing Facility Services Nursing Facility, Intermediate Care or Long Term

Facilities

NF Discharge Services 99315 Disc. Day Mgmt 30 min < 99316 Disc. > 30 min Name of Skilled Nursing Facility:

*(Required for billing SNF services)

Home Services Physician Services provided in a

private residence New Patient face-face

99341 Level 1 20 min 99342 Level 2 30 min 99343 Level 3 45 min 99344 Level 4 60 min 99345 Level 5 75 min Established Patients face-face

99347 Level 1 15 min 99348 Level 2 25 min 99349 Level 3 40 min 99350 Level 4 60 min

Basic Life/Disability Eval. 99450 Basic Life/Disability Eval

Fee: $

99455 ** Work Related or Med. Disability Exam by treating physician.

Fee: $

99456 ** Work Related or Med. Disability Exam by non-treating physician.

Fee: $

** Do not report 99080 in conjunction with 99455, 99456 for the completion of Workers

Comp. forms Home Health Certifications for

Medicare patients G0180 Physician certification for

Medicare-covered home health services (patient not present) per certification period.

G0179 Physician re-certification for Medicare-covered home health services (patient not present) per certification period.

G0181 Physician supervision of a patient receiving Medicare-covered services provided by a HHA (patient not present) > 30 minutes per month.

G0182 Physician supervision of a patient under a Medicare-approved hospice.

Medicare-approved Home Health Agency Provider #

(*Required for billing cert. services)

Care Plan Oversight From Date: To Date:

Home, Domicili. Or Equiv. environment 99374 15-29 mins. per month 99375 > 30 mins. per month

Nursing Facility (Not paid by Medicare)

99379 15-29 mins. per month 99380 > 30 mins. per month

Critical Care Services Physician attended interfacility transport of a critically ill or critically injured patient over 24

months of age. 99291 First 30-74 minutes

99292 Each addl. 30 minutes

X CPT Code Mod Write in Description of Procedure or Supply UWP Fee

Diagnosis ICD-9 CODE Write in description of diagnoses ICD-9 CODE Write in description of diagnoses

1st

2nd

Date

Pt. No.

Name

DOB

Special Sponsor

Budget #

Referring or Ordering Physician/Practitioner Med. Staff ID or MPI

Performing Physician/Practitioner Med. Staff ID or MPI

I certify that the services shown were furnished by me personally or under my personal supervision.

COHE Provider UWP Billing Physician/Practitioner UWP /Med. Staff ID

UWP Service Area

Form #249 Special Physician Services Revised: 04/09/2010 Epic Department

INTRODUCTION - UW Medicine

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