Showing posts with label no really is this a joke. Show all posts
Showing posts with label no really is this a joke. Show all posts

3.18.2012

On evidence

Weeks ago, a doctor wanted to discuss the case of Rossiter v. Evans. She's a well-respected public speaker on health issues who's been on the winning side, and of course, she asked some questions to sate her curiosity.

One thing she asked: Hey, wasn't Alan Evans a pilot?

Yes. It's impressive that she'd notice something like that. Here's why it mattered to her, and to the case: pilots get a physical before they're licensed. It's supposed to involve a detailed description of their medical history, past and present - even medications they've taken.

Then this doctor wanted to know - so, where were the records from Alan Evans' flight physical? Ah, an even better question. Just like several other important things, they were requested and never received.

Which brings us to this discussion about the lack of medical records on Alan's end at trial.

Most people know that Alan Evans was questioned extensively about his past initially: in 2004, he said he got tested every six months or so, never had a bad result, never had been exposed to anyone with anything, hadn't had sex with anyone in the last six months, and colorfully referred to that period as a dry spell. He talked about his past STD testing in detail and made sure to highlight his responsible, conscientious dentist self in relating that he was free and clear. And that all got explained at trial.

Which, in turn, created some problems for Alan. One, he admitted that he was sexually active during the six months immediately preceding the start of this relationship. Now, combine that with this: those STD tests he claimed to have had? He never produced even one. What's worse, at no point during the trial did he attempt to explain their absence. Credibility, meet wood chipper.

But to be fair, Alan did produce a medical record. Just one. And it may have worked to his disadvantage. How? Well, he tested negative for a few STDs in 2007, after he was served with the lawsuit. The ones he tested for were irrelevant to the litigation because they were never in question - it was never said that he transmitted (or ever had) them in the first place. 

So what was purpose of his one medical record, legally speaking? It was submitted to the court alongside his affidavit and a motion for summary judgment - the consequence of this effort, had it been successful, would have been the dismissal of the lawsuit. But wait a minute - the tests he had weren't even comprehensive and definitely didn't include an HPV test. So the reasonable reaction here would be along the lines of, So what?

Alan didn't have an HPV test saying that he was negative - ever - because an FDA-approved test for men doesn't exist. Remember, HPV was the focus of the trial, so it was the main thing that mattered. So what was he trying to say, or get the court to do, with his record and affidavit? Let's let him try to explain that in his trial testimony. Here, it starts off with Alan being asked about the contents of his own affidavit. Now might be a good time for you to go grab some popcorn.
Q: Look at paragraph 7. Could you please read what you said in paragraph 7 to this jury?
EVANS: "I have never tested positive for HPV."
Q: Have you ever been tested for HPV?
EVANS
: My understanding is there is no test for males for HPV.
Q: Did you know that when you wrote this sworn statement saying you had never te
sted positive for HPV?
EVANS
: I didn't know if there was or wasn't.
Q: You just made a sworn statement to the Court implying that you had been tested
and you're negative without even knowing that could be true?
MR. KOURY: Objection, Your Honor. He never said he's been tested and he was negative. His response --
THE COURT: Well, again, Mr. Koury, you have a right to redirect. What's your objection?
MR. KOURY: My objection is that it's a misstatement for Mr. Tronvold to say you were tested and found negative.
THE COURT: I believe he's reading from the affidavit, so that's overruled.

Q: Could you please read paragraph 8 of your affidavit to the jury, and what's it say?
EVANS
: "I had blood drawn and submitted for a physical on May 11, 2007 and was found to have no sexually transmitted diseases."
Q: And that statement would imply that you don't have HPV, correct?
EVANS
: To me it says that whatever diseases that you can test for with a blood test were found to be negative. There is a host of STD's that you cannot make that inference from on a blood test, but any ones that you can draw from -- you know from a blood test were tested, and I was found to not to have those is what that says to me.
Q: Okay. Let me ask you it this way. As we sit here today, you can't be tested for HPV or know one way or the other, correct?

EVANS
: My understanding the only way a male can know if he has HPV for sure is if he has warts.
Q: Okay. This case is only really primarily about HPV, the claim against you, correct?
Evans: There is some other claims, but that's the primary one, yes.
Q: I guess I should have made that more clear. Sexually transmitted disease claim is about HPV, correct?
EVANS
: Correct.
Q: Okay.
EVANS
: Oh, and others also, she -- bacterial vaginosis.
Q: Was your intent to get rid of both of those claims with this affidavit?
EVANS
: Well, again, I said a little bit ago that I don't see that this affidavit is saying anything about getting rid of the claim.
Q: Okay.

EVANS
: My intent was just to give an honest statement about what I've been through so far in regards to this case.
Q: So it was the intent to convince somebody you don't have and have never had HPV. I'll ask that question.

EVANS
: At the time that I answered that, I wasn't aware if there was or wasn't a test for men for HPV, and so I wanted to make it clear to the Court that I had never taken an HPV test and got a positive result from it and saying, yes, you have tested positive for HPV. That's why I made that statement.
Q: Okay. I'll try -- do you remember most of your testimony from yesterday?

EVANS
: This is a hard place to be in for a good recollection, to be honest.
Oh my.

Put yourself in his shoes and answer some hypothetical questions. If you went to the doctor to get tested for STDs, wouldn't you specifically ask to be tested for the one that you've been sued for transmitting - HPV? And wouldn't you think that any knowledgeable doctor would tell you that there is no test for men? So isn't the fact that a man generally can't be tested for HPV something you should have known pretty easily, and certainly should have known before you signed a sworn statement? Couldn't Google tell you the same thing in about 2 seconds?

In another brief submitted at the same time as his affidavit, one part says, "As of May 11, 2007, the Defendant was clear of sexually transmitted diseases, specifically, HPV." That's interesting, since he wasn't even tested for HPV. And no one - not even a doctor - can tell that someone is negative for HPV just by looking, because most people who are positive don't show symptoms - and if a person ever has symptoms, they're not always readily apparent. Warts and cancer can both develop internally.

If Alan Evans really wanted his affidavit to be clear and honest, shouldn't he have said something like, 'I have never taken an HPV test' instead of saying he'd never tested positive for a test he couldn't even get? You'd think that would be kind of important, since this dude is claiming to to be trying to be "clear" and "honest."

The other big thing about medical records? One girl came to testify in Alan's defense at trial - Shalan Schramm - the same one he knocked up. And get this: at trial, Shalan Schramm she said she'd never been tested for HPV. Here's her testimony on cross exam.
Q: You've never been tested for HPV to your knowledge, have you?
SHALAN SCHRAMM: I don't think so. I have a medical record that has HPV, and it says negativ
e, but I don't remember requesting, unless -- I don't know.
Q: Are you familiar with the fact that HPV tests are normally only requested when you have an abnormal pap smear?
SHALAN SCHRAMM: No.
Q: So if you have an HPV test in your records, that might indicate that you did have an abnormal pap smear?
SHALAN SCHRAMM: No, I don't, because the records I have say that all my paps have always been clean, but on the bottom there is little corner of, like, other -- chlamydia and just other things, and they are all checked just negative, but I've never asked for an HPV.
Q: So you really aren't telling this jury you've had an HPV test then?
SHALAN SCHRAMM: I don't think so. I don't believe so.
So on the stand at trial, she doesn't think she's ever had an HPV test. That really doesn't seem like an appropriate topic on which to be wishy-washy. Obviously, the jurors didn't buy what she was selling.
 

Because it doesn't make sense. Regardless of her choice to defend Alan, it seems like most women who cared about their own health would have wanted - no, demanded - to be tested for their own safety and/or knowledge. And in light of Shalan Schramm's choice to defend him, the best way she could have done so would have been to show that in spite of the fact that she was having sex during the relevant period, she had an actual negative HPV test at some point after that. In order to do that, all she had to do was go and get tested. That's it. And if that was too much to ask, she could done something even easier, like bolster her credibility by backing up everything she said with records, instead of asking the jury to take her word on something that would have been so simple to show with documentation. Instead, she brought no medical documents whatsoever with her to trial. Zero. It was a glaring absence. In the words of Carolyn Wells, "Actions lie louder than words."

But here's the kicker: you have to have personal knowledge to testify about an issue. If she'd (allegedly) never been tested, there was no way she could possibly know for sure that she was definitely free of HPV, and she couldn't tell the jury with certainty that she's HPV-negative at trial.

Take a minute to let all that sink in.

So back to the folly. Over a year later,
after the Court of Appeals and the Supreme Court put their stamp of approval on the jury's decision, someone was desperately flailing to defend Alan in online comments, and even went so far as to volunteer this lil' fib: That "Court docs" showed that Alan Evans and the woman he impregnated "both had medical records there that were both 100% free from STD's." [sic]

Right. I wonder, if the intellectual who posted that were to sit down and take a simple lie detector test, do you think they could beat it? Most people get that polygraphs are nothing but hocus pocus, but still, I can imagine it having serious potential for hilarity - maybe something like this.



3.04.2012

Accepting facts can be hard

LOL:
Baby Ruth?
"I have no idea why the jury seem[s] to have overlooked the testimony and medical records showing the lady had a bad pap [smear] two years before meeting the man ... Did anyone hear the male's testimony that he did not have sex with her until months AFTER her Jan. 11, 2005 positive HPV finding?” -- Ruth

Oh, 'Ruth'! Stamping your little cartoon feet, while entertaining, isn't going to help you because the facts are not on your side.  Rossiter didn't have a pap indicating HPV positivity prior to meeting Alan Evans. And Rossiter never had a trace of dysplasia. And Rossiter never had a problem. She always got regular paps, so she would have known if she did. Then Alan Evans comes along and suddenly Rossiter has not one problem (high risk HPV), not two problems (low risk HPV), but three problems (BV), all after he said he got tested regularly as a dentist and hadn't been with anyone in months (both shown to be false at the trial).

We kinda like the game 'Ruth' is playing though, so let us have a go at it! We have no idea why 'Ruth' seems to have overlooked the testimony and medical records showing that Rossiter had just had a perfectly normal annual pap TWO MONTHS prior to meeting Alan Evans - not to mention all the others that came before it. 'Ruth' also overlooked the gynecologist saying that she thought Rossiter was wasting her time and money getting tested in January since everything was fine just two months prior at the  annual exam. Why did Rossiter want this again, the doctor wanted to know? Two words: Alan Evans. And 'Ruth' somehow ignored another big nagging issue, which, apparently, the jury did not: Alan Evans suffered from a severe lack of medical records at trial (since he brought ZERO medical records dated prior to the filing of the lawsuit), and his attempt to get the case dismissed with the one irrelevant medical record he did bring did not help his cause.

And 'the male's' testimony' that 'Ruth' mentioned? It doesn't exist, since no one said that at trial. Alan Evans didn't say a word about not having sex for months after January 11. He didn't claim to remember too much related to the timeline, and only said that he thought there was more on top of what already had occurred on January 1 "in late January." Yes, indeed, you read that right: Alan Evans agreed with Rossiter that there was sexy time on January 1, he just disagreed as to the nature of that contact.  Another glaring omission courtesy of 'Ruth' is that intercourse isn't required to transmit HPV. But why should someone like her let scientific facts get in the way? We would suggest that 'Ruth' feel shame, but given that she couldn't be bothered to get the simplest fact about HPV transmission right before acting like her sense of justice had been offended (or worse, maybe she knows how HPV works and deliberately ignored it), we don't know if that's possible.

We're not sure who the poster is, but it would be quite a coincidence if it was a random commenter with no connection to Alan Evans. And by the way, Alan's mother's name is Ruth. But here's the thing: she wasn't present for most of the trial. The only people who were present on an in-and-out basis were various members of the families. The only people who were there the entire time were the attorneys, the judge, the jury, Rossiter and Alan Evans. Occasionally members of the general public would pop in, but no one stuck around for long. So it's probably safe to say that Joe Blow didn't pass these fake gems on to our indignant pal 'Ruth.'

But if Alan Evans' mother was the one who posted this comment, there's a problem somewhere - because if she was there to "hear" the part of the testimony she's claiming to refer to, well, you can see that she's wrong across the board, and maybe should get her ears checked. And if she wasn't there in person for the stuff she's referring to, she had to have heard it secondhand, in which case, she would be wise to consider her source. Or read the appellate decision?

And if it was indeed Alan Evans' mom who posted this, and she did hear her information secondhand from someone who was there, I'm sure that "source" was only doing their best to stick up for Alan Evans in saying whatever they had to say to make him seem halfway presentable to the world. There'd be no surprise there. Of course they're desperate and they probably have to be quite the revisionist to get anyone with a conscience on their side. But just remember, everything was on the record. So if they're going to play fast and loose about facts and what happened at trial, they'd better tell the person they're talking to not to repeat the line of bullshit they told them on the internet. They don't want to look stupid... right?


12.16.2010

Misconception #2: All about strains of HPV

Strains are a major source of confusion, even for some medical doctors and others in the health industry. Some basic questions for this blog: Are there different strains of HPV? (Yes! Many!) What do the strains do? (Depends on which strain.) Can you have more than one strain of HPV at once? (Absolutely.) Which strains are the most common? (High risk types 16 and 18.) Does Gardasil help if it only covers four strains? (Yup, and read on for explanation.)

Let's kick things off with the statements of a commenter going by the screen name
Dr Williams, whose full name is probably Dr. Mark Williams, which we know thanks to another genius who replied to him by first name repeatedly. Do you think this is the guy? Anyway, it all began with Dr Williams proudly proclaiming his medical background:

First of all, let me start by saying I am not afraid to hide behind some screen name. My name is Dr. Williams, M.D.
Oh yes, and this is important:

Alan and I have been best friends since we met our freshman year in college.
While Dr Williams was discussing whether Dr. Alan Evans had warts, he went off on a bizarre tangent about "the cancer causing kind" of warts. Say what? This statement he made regarding the visual diagnosis of "cancer causing" warts versus "the bumpy strand" is something to behold:
He does not have warts. And even if he did, there is no way by looking at them to tell if they are the cancer causing kind. I guess a future conversation may be.. [sic] "so, do you have warts?", [sic] um [sic] yes." what [sic] genotyps [sic] are they, the cancer causing kind or just the bumpy strand?" ummmm... [sic] I don't know.
No, really. Is this a joke, in more ways than one? 
It's common knowledge that the strains of HPV that cause genital warts do not cause cancer. This isn't information you have to dig for or have a medical degree to know; it's plastered everywhere. Cancer-causing strains and warts-causing strains are two different things. And you can definitely have more than one strain at a time.

Keep in mind that Dr Williams made these statements after directing everyone else to get as edumacated as he is on the subject of low risk strains by visiting CDC.gov.

I hope people took his advice on that one point and read the CDC website, because on a page labeled "basic information," the CDC comes right out and obliterates his nonsense about "cancer causing" warts in one sentence:

The types of HPV that can cause genital warts are not the same as the types that can cause cancer.
Shortly after this leg of the tantrum-tirade and as part of a list of attempted scapegoats to blame for the consequences of his friend's actions, Dr Williams sniffled about his perceived "ignorance of the jury." Dr Williams went on to seethe that the Muscatine jury wasn't "informed" about cancer-causing warts. Um, the reason the jury wasn't informed of "cancer causing" genital warts is because they don't exist. Both medical experts explained HPV to the jury for hours, and that piece of information the CDC provided above was one of the things covered. Fortunately for those who value the truth, the legal system is a place where medical facts are taken into consideration, not bullshit some blowhard pulled out of his ass to defend his bestest buddy, who showed no regard for innocent people who might have relied on his posts. 

It's a good story, but I digress. It'd take a chapter of a book to fully explore the bitter, factually incorrect, facially inconsistent and puerile ravings contained within the comments and e-mail correspondence (oh yes, he sent me e-mails too - another time, perhaps?) from
Dr Williams.

Here's a second commenter whose ignorance is worth learning from:
rosiejr1. Notice that rosiejr1 also claims to know a thing or two about STIs thanks to her line of work with the CDC, so you had better listen up! Or not.

I am a CDC Rep at a local health department in TN, which is top ten for ALL STD's. [sic] Obvoiusly [sic] the courts had some medical experts in it, but [. . .] only one strain can cause cervical cancer.
Rosie is scary uninformed. HPV is a family of viruses. There are many strains — almost 200 that we know of so far — and like I said, different strains do different things. We're mainly talking about the ones transmitted via intimate contact. There are roughly 40 of those. This group can be divided into two types: high risk and low risk. As discussed before, high risk strains can cause cancer. Low risk strains can cause warts.

So let's get down to pointing out the incorrect information that this supposed 'CDC Rep' is carelessly broadcasting to the masses: Does just one strain cause cancer like
rosiejr1 said? Um, no. To simplify things to the point of seroius inaccuracy is unacceptable — especially after bragging about how she's in the medical field, so that people will buy what she's saying.

HPV isn't simple, so don't try to make it simple. To give you an idea of how many strains of HPV can cause cancer, the Hybrid Capture II High Risk HPV test looks for 13 different high risk (e.g. cancer-causing) types — 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68. It tests for the most common types, but that's not all of them. For example, there are at least two more well-known high risk types not included in that test: 73 and 82. There's also a test for low risk types, which looks for 5 different strains : 6, 11, 42, 43, and 44. And once again, that's not all. Examples of other low risk types not included in the test are 54, 61, 70, 72, and 81.

The HPV vaccine known as Gardasil protects against four distinct strains: two high risk strains (strains 16 and 18, which together cause 70% of all cervical cancers), and two low risk strains (strains 6 and 11, which together cause 90% of all genital warts). Those four strains cause the vast majority of the most common health problems caused by HPV, which is why it makes sense to get the vaccine. You'd think someone who works as a "CDC Rep" would know that much simply from experience, maybe while talking to people about Gardasil or something in her day-to-day work. But you'd be wrong. Maybe you should be worried, too.

UPDATE: The FDA approved Gardasil to help prevent anal cancer caused by HPV, the vast majority of which is, in fact, caused by HPV.

This is Post #2 in the series, Debunking HPV Myths. For other parts of the series, click here.