Choosing a Gastroenterology Expert Witness for an Advanced Endoscopy Case

Gastroenterology is not one specialty for the purpose of expert testimony. A physician who performs screening colonoscopy and manages reflux holds the same board certification as a physician who performs ERCP in a patient with a gastric bypass. Their daily work has almost nothing in common.

That gap matters when a case involves an advanced procedure. It affects whether an opinion survives a qualification challenge, and it affects whether the opinion holds up under cross examination in front of a jury.

This is a practical guide for attorneys evaluating a candidate expert in a gastroenterology or endoscopy case. It does not address the merits of any particular claim. Every case turns on its own record.

Board certification tells you less than you think

Board certification in gastroenterology confirms training and a passed examination. It does not tell you what the physician performs today.

There is no separate board for interventional or advanced endoscopy. Certification looks the same for a gastroenterologist who has not touched a duodenoscope in a decade and one who performs several hundred ERCPs a year.

The certification is a floor. What matters is the current procedure mix.

Training pathway is one input, not the answer

Physicians reach advanced endoscopy by more than one route.

A dedicated advanced endoscopy fellowship year is the common contemporary pathway. It is not a board, and it is not ACGME accredited. Programs participate in a society-run match rather than a formal accreditation process. Others build the same practice through heavy procedural training during general fellowship, structured mentorship under senior interventional endoscopists, and years of accumulating complex volume.

Both routes produce endoscopists who perform this work well, and both produce endoscopists who do not. Because the field has no board and no accredited pathway to point at, the useful measure is what a physician performs now.

What to ask a candidate expert

Ask direct questions and expect numbers.

Do you perform this procedure now, and roughly how many a year.

What is your full procedure mix. Breadth matters when a case involves a decision to convert, abandon, or choose an alternative technique.

Where do you perform it, and in what setting. Hospital, ambulatory surgery center, or both.

Do you teach or proctor other physicians in this procedure. Teaching is evidence of competence that juries grasp immediately, and course faculty and live demonstration invitations are independently verifiable.

Have you published or presented in this area, and can you point to the work.

Have you testified before, on which side, and how often. Ask for a testimony list.

Do you take work on both sides. Some experts do. Some, by policy, do not. Either answer is workable. An unclear answer is not.

Common problems that surface late

The retired expert. Impressive career, no current practice. Opposing counsel will ask when the witness last performed the procedure, and the answer becomes the cross examination.

The credentialed but low-volume expert. Strong pedigree, thin annual numbers. This can still work. Know the figure before the deposition rather than during it.

The professional witness. A physician whose testimony work has largely replaced clinical work is easy to characterize for a jury. Ask what share of income comes from testimony.

The overreaching expert. A witness who agrees to opine on anything is a liability. An expert who declines part of a case is often the more useful one, because the parts they do take will hold.

Mismatched setting. Community and academic practice differ in equipment, staffing, and support. An opinion built on resources that were not available where the care happened will be attacked on that basis.

Why the specialty match cuts both ways

This is not only a plaintiff problem. A defendant who performed a complex procedure competently deserves a reviewer who recognizes competent performance under difficult conditions.

Difficult anatomy. An unstable patient. A decision to stop rather than push on. A complication managed correctly in the moment. A reviewer who has been in those situations reads the record differently from one who has not. Sometimes that reading supports the defense. Sometimes it does not. Either way it is a better informed reading.

That is the case for matching the expert to the procedure. Not that it produces a friendlier opinion, but that it produces a more accurate one.

About Dr. Devani

Kalpit H. Devani, MD, FACP, FACG, FASGE, is a double board certified interventional gastroenterologist and Director of Endoscopy in Greenville, South Carolina, and a Clinical Assistant Professor at the University of South Carolina School of Medicine. He is board certified by the ABIM in gastroenterology and in internal medicine.

He performs more than 1,000 advanced procedures a year, including complex ERCP in surgically altered anatomy, therapeutic endoscopic ultrasound, advanced resection, and endoscopic bariatric procedures. He has placed more than 1,000 endoscopic sutures. He built his institution's EUS service from roughly 150 to more than 1,100 cases a year and introduced four advanced endoscopy service lines that were not previously offered there.

He has published more than 30 peer reviewed papers, presented more than 75 times nationally and internationally, and serves as invited faculty and live procedure demonstrator at advanced endoscopy courses in the United States and abroad.

Case review and testimony are provided on the defense side only, nationwide. This includes record review, written opinion, affidavit of merit, deposition, and trial testimony.

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Frequently Asked Questions

Frequently Asked Questions