1 State of Ohio, SS:
2 County of Cuyahoga
3
4 IN THE COURT OF COMMON PLEAS
5 - - -
6 Rudolph Slezak, et al,
7 Plaintiffs, Case No 233611
8 VS Judge Gaul
9 Michael Kalus, MD,
10 Defendant
11
12 THE DEPOSITION OF THOMAS VROBEL, MD
13 TUESDAY, OCTOBER 26, 1993
14 - - -
15 The deposition of THOMAS VROBEL, MD, a witness,
16 called for examination by the Defendant, under the Ohio
17 Rules of Civil Procedure, taken before me, Michelle R
18 Hordinski, Registered Professional Reporter and Notary
19 Public in and for the State of Ohio, pursuant to
20 agreement, at Metrohealth Medical Center, Cleveland,
21 Ohio, commencing at 1:30 pm, the day and date above set
22 forth
23
24 - - -
25
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1 APPEARANCES:

2

3 on behalf of the Plaintiffs:

4 RICHARD BERRIS, ESQ
Weisman, Goldberg & Weisman
5 1600 Midland Buildin
Cleveland, Ohio 44175
6

7
on behalf of the Defendant:
8
JOSEPH FARCHIONE, ESQ
9 Jacobson, Maynard, Tuschman & Kalur
1001 Lakeside Avenue
10 Suite 1600
Cleveland, Ohio 44114
11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

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1 THOMAS VROBEL, MD
2 a witness, called for examination by the Defendant, under
3 the Rules, having been first duly sworn, as hereinafter
4 certified, deposed and said as follows:
5 CROSS-EXAMINATION
6 BY MR  FARCHIONE:
7 Q Doctor, can you state your full name for the
8 record, please?
9 A Thomas Raymond Vrobel
10 Q Dr Vrobel, my name is Joe Farchione, and I'm the
11 attorney representing Dr Kalus in the lawsuit
12 brought by Mr & Mrs Slezak
13 It is my understanding that you have reviewed
14 some documents relating to the care and treatment
15 rendered by Dr Kalus to Mr Slezak and have
16 reached opinions critical to the care of Dr Kalus,
17 is that correct?
18 A That's correct
19 Q I'm going to be asking you some questions about
20 those opinions and a little bit about your
21 background
22 If at any time you don't understand a question
23 that I ask of you or a phrase that I use, please
24 stop me and have me repeat that for you
25 Can we agree to that?
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1 A Yes
2 You understand this is my only opportunity to ask
3 you about your opinions and the basis for those
4 opinions?
5 A Yes
6 Q You have to answer verbally so the court reporter
7 can take it all down
8 A Yes
9 Q Doctor, can you define standard of care for me?
10 A Standard of care is the usual and customary
11 procedures performed by competent physicians in the
12 care of a patient
13 Q Do you use the term medical judgment at all in your
14 practice?
15 A Yes, I do
16 Q How would you define that?
17 A That's the thought process by which physicians come
18 to conclusions they need to provide the necessary
19 care
20 Q What goes into that thought process, what
21 elements?
22 A Well, experience and understanding of the nature of
23 the disease that you're treating are probably the
24 key elements
25 Q Doctor, so we're on the same playing field, when I
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1 use the term probability, I'm talking about a
2 greater than 50 percent chance of occurrence
3 When I'm talking about possibility, I'm talking
4 about a 50 percent or less chance of something
5 occurring Can we agree to that?
6 A That's my understanding of the legal definitions
7 Q Doctor, what area or areas do you feel that Dr
8 Kalus deviated from accepted standards of care?
9 A In the area that he did not appropriately respond
10 to a complication from the cardiac catheterization
11 that he performed on Mr Slezak
12 Q At what point in time did his care of Mr Slezak
13 deviate from accepted standards of care?
14 A At the time that he saw him on the day after the
15 catheterization in the emergency room
16 Q You say he did not respond appropriately
17 How did he not respond appropriately?
18 A Given the circumstances as I understand it from the
19 records, the emergency room records, I believe that
20 Mr Slezak should have been admitted at that
21 particular point to have better management of this
22 complication performed
23 Q Why do you say he should have been admitted at that
24 point in time?
25 A Because, again, from my reading of the records, he
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1 obviously had a fairly major bleed from the
2 arterial puncture, and these are prone to further
3 bleeding
4 Natural history of these is to bleed further
5 Q okay
6 A So therefore Mr Slezak was at further risk for
7 bleeding and subsequent damage from that bleeding
8 Q Was he at further risk for a rebleed or for a
9 continuation of the bleed? In other words --
10 A Well, that's a fine point, whether it's a
11 continuation -- I presume these are intermittent
12 bleeds
13 They bleed and they stop and they bleed again,
14 so I would think the proper term would be rebleed,
15 but I can't tell whether -- you know, nobody would
16 know whether there's a small oozing going on
17 continuously
18 Q So you don't have an opinion to a reasonable degree
19 of medical probability as to whether