West Coast Veterinary Forensics – Forensic report

I contracted Amy Raines DVM, of West Coast Veterinary Forensics, to examine case files and write a veterinary forensic report. There were many issues with Amy Raines report as itemized below.

1. Amy Raines assessed a diagnosis of hypovolemia that was not supported by any evidence given and was not assessed by the attending veterinarian at the time, as evidenced by the lack of any mention of hypovolemia in the medical file. Follow up testimony from the attending veterinarian states that the patient was not cyanotic, not dyspneic, and his temperature was recorded as 39.4C in the medical file. Given the slightly elevated body temperature and the fact that the patient was neither cyanotic nor dyspneic and there was no obvious source of blood loss, despite two very visible deep puncture wounds at the site of injury for drainage, makes a diagnosis of hypovolemia very unlikely.

2. Amy Raines assessed that a bolus delivery of fluids to a patient that was assessed as having suffered brain trauma was appropriate (the medical file notes "suspect brain trauma"). In fact, the intravenous delivery of fluids as a bolus is contraindicated in the case of a brain injured patient. For a TBI patient the type of fluid used is also critical.

3. Amy Raines stated that the hydromorphone delivered was a low dose. In fact, it was a maximum recommended dose of 0.1 mg/kg delivered intravenously as a bolus (https://www.merckvetmanual.com/multimedia/table/opioids-used-in-emergency-practice). Such a delivery of hydromorphone contradicts hydromorphone dosing guidelines (https://www.drugs.com/dosage/hydromorphone.html). Delivering a large dose of opioid intravenously as a bolus is especially contraindicated in the case of a brain injured patient (https://www.vin.com/apputil/content/defaultadv1.aspx?id=7054626&pid=12886&print=1)

4. Amy Raines also made unsubstantiated and unjustified assumptions about the location of the incident and the travel time to the clinic.

5. Amy Raines disregarded witness testimony of the patient being probably shaken and insisted that such a thing was unlikely. It was in fact very likely as evidenced by the finely dispersed blood splatter on the chest of the attacking dog.

6. Amy Raines assumed electronic monitoring of the patient to support the medical record assessment of fibrillation. In fact, no electronic monitoring was performed.

When these issues were presented to Amy Raines, including the additional testimony from the attending veterinarians, Amy Raines was non-responsive on two occasions.

Amy Raines appears to not be in the business of conducting serious objective forensic analysis grounded in medical science but instead appears to be in the business of concocting sham reports to defend fellow veterinarians that are alleged to have committed malpractice.