Proving and Defeating Medical Malpractice Claims: Standard of Care, Causation, Experts, and the “Hidden” Story Inside the EMR

Mary A. Azzarito, Partner | Adler, Cohen, Harvey, Wakeman & Guekguezian, LLP

Mary M. Azzarito is a Partner at Adler, Cohen, Harvey, Wakeman & Guekguezian, LLP, one of New England’s premier medical malpractice defense firms, where she has been litigating since 1994. Her practice centers on the defense of medical professionals across a wide range of specialties, including internal medicine, pediatrics, cardiology, interventional cardiology, obstetrics and gynecology, and maternal fetal medicine. Beyond medical malpractice, Mary brings substantial experience in criminal defense, white collar defense, administrative law, general liability, and Hague Convention matters involving the Civil Aspects of International Child Abduction. She has appeared before the Board of Registration in Medicine, the Division of Administrative Law Appeals, the Massachusetts Appeals Court, the Supreme Judicial Court, and the United States Court of Appeals for the First Circuit. Mary became a Partner at Adler Cohen effective February 2023.

• Education & Credentials

Mary earned a Bachelor of Science in Political Science, summa cum laude, in 1990, and went on to earn her Juris Doctor. She is admitted to practice in Massachusetts state and federal courts, including the U.S. District Court for the District of Massachusetts (1994) and the U.S. Court of Appeals for the First Circuit (1994), and more recently in the federal court in Vermont.

• Recognition & Leadership

In 2021 and 2022, Mary was selected as a Massachusetts “Super Lawyer” by a vote of licensed attorneys and review by an independent blue ribbon panel, a designation awarded to no more than 5% of lawyers in the state and published annually in Boston Magazine and New England Super Lawyers.

• Professional Involvement

Mary is a member of Adler, Cohen, Harvey, Wakeman & Guekguezian, LLP, a firm that has consistently been awarded Tier 1 recognition in Medical Malpractice Law (defense) and Personal Injury Litigation (defense) by Best Lawyers, as published by U.S. News and World Report, and whose attorneys hold Martindale-Hubbell’s highest AV-rating for ability and ethics.

• Experience

Mary has focused her practice for more than a decade on representing physicians and other medical professionals in malpractice defense, administrative proceedings, and employment matters including discrimination claims. She has represented clients in Massachusetts state and federal courts as well as the federal court in Vermont, handling matters ranging from complex professional liability trials to Hague Convention child abduction proceedings.

Katherine Sepcich Drummond, Partner | The Bowling Law Firm, APLC

Katherine “Katie” Sepcich Drummond is an attorney at The Bowling Law Firm in New Orleans, Louisiana, where she handles pharmacy error, personal injury, and medical malpractice cases. She joined the firm in January 2023 following judicial clerkships that grounded her in complex civil litigation practice. Katie devotes 100% of her practice to litigation, with a caseload concentrated in the areas most directly relevant to patient injury and healthcare negligence.

• Education & Credentials

Katie earned her Juris Doctor from Loyola University New Orleans College of Law in 2021, where she specialized in civil law and also received a certificate in common law. She previously earned a Bachelor’s degree in International Relations and Global Studies with a minor in European Studies from the University of Texas at Austin in 2016, where she also held a corporate legal role prior to law school.

• Recognition & Leadership

At Loyola, Katie was a Dean’s Scholarship recipient, a member of Moot Court, and winner of Loyola’s 2019 Best Brief Award. She also participated in Loyola’s Trial Advocacy Program, where she won Best Opening Statement at the 2019 Trial Advocacy Intramural Competition.

• Professional Involvement

Katie is admitted to the Louisiana Bar Association and licensed in all federal courts in Louisiana, including the U.S. District Courts for the Eastern, Middle, and Western Districts of Louisiana, as well as the U.S. Court of Appeals for the Fifth Circuit.

• Experience

Before joining The Bowling Law Firm, Katie served as a law clerk to the Honorable Judge Donald “Chick” L. Foret in the 24th Judicial District Court of Jefferson Parish and as a judicial intern to the Honorable Fredericka H. Wicker at the Louisiana Fifth Circuit Court of Appeal. Prior to law school, she worked in a corporate legal role in Austin, Texas.

Kenny Stein | Kenneth A. Stein, MD

Kenneth A. “Kenny” Stein, MD is a board-certified physician and medical-legal expert serving as an expert witness in emergency medicine, critical care, and internal medicine for both plaintiff and defense in cases involving negligence, causation, and damages. Based in Chesterfield, Missouri, Dr. Stein has practiced Emergency Medicine for 29 years and Critical Care/Intensive Care Medicine for 27 years, and has provided expert witness testimony—at deposition and trial—more than 200 times. He is formerly an Assistant Professor at St. Louis University School of Medicine.

• Education & Credentials

Dr. Stein received his medical degree from Vanderbilt University School of Medicine and completed his residency at the University of Kentucky Medical Center and Washington University Jewish Hospital. He holds board certification in Emergency Medicine from the American Board of Physician Specialties (ABPS), board certification in Internal Medicine from the American Board of Internal Medicine (ABIM), and subspecialty certification in Neurocritical Care from the United Council for Neurologic Subspecialties (UCNS). He is also certified in Advanced Trauma Life Support (ATLS) and Advanced Cardiac Life Support (ACLS).

• Recognition & Leadership

Dr. Stein’s expert witness work spans medical chart review and analysis, EMR/EHR metadata and audit trail review, opinions on standard of care, causation, and damages, preparation of reports and affidavits, and expert witness testimony at deposition and trial. Attorney clients have described his testimony as among the most effective they have encountered in decades of practice.

• Professional Involvement

Dr. Stein’s professional association memberships include the American Association of Physician Specialties, the Society of Critical Care Medicine, and the American College of Chest Physicians.

• Experience

Dr. Stein provides unbiased opinions in medical malpractice and personal injury matters involving emergency medicine, critical care, and internal medicine, including wrongful death cases. His services include medical literature search, preparation for opposing expert deposition and cross-examination, and expert witness testimony. He reviews cases for both plaintiff and defense counsel.

SESSION 1 – Standard of Care: Guidelines, Competent Care, and Breach | 1:00pm – 1:30pm

Builds a proof map covering duty, clinical decision points, and breach timelines using the ALI Restatement (Third). Contrasts plaintiff and defense narratives and teaches attorneys to translate medical standards for juries while avoiding guideline overclaiming and “perfect care” traps.

SESSION 2 – Causation That Survives: Probability, Etiologies, and Damages Linkage | 1:30pm – 2:00pm

Covers but-for, substantial factor, and proximate cause models with elder-care stress-tests involving falls, pressure injuries, and cascade harm. Introduces the alternative etiologies playbook and addresses damages linkage by separating event injuries from downstream complications on both sides.

BREAK | 2:00pm – 2:10pm

SESSION 3 – Expert Witnesses Under Amended Rule 702: Strategy and Motions | 2:10pm – 2:40pm

Covers expert selection by specialty, recency, and bias exposure; report architecture that addresses contrary facts; deposition techniques that lock reasoning steps; and winning themes versus failure modes in post-2023 Rule 702 motions practice.

SESSION 4 – Medical Records as ESI: Audit Trails and Discovery | 2:40pm – 3:10pm

Examines what EMR audit logs capture and identifies high-value ESI targets, order-entry timestamps, late entries, copy-forward indicators, and retention policies, alongside authentication foundations, trial demonstratives, and proportionality strategies for negotiating production formats.