Timothy R. Primrose, Digital Forensic Analyst

Case Summary: Plaintiff underwent a procedure involving the removal of a cyst from their armpit to alleviate irritation and prevent potential complications.  The plaintiff experienced initial discomfort during the recovery process and later developed an infection, which they attributed to improper post-operative care by the defendant, the performing surgeon.  As part of the medical malpractice case, Plaintiff presented photos documenting their recovery process, claiming the surgical wound was improperly managed.  When discrepancies in the photographic evidence were discovered, the elevated complexity of this case prompted the defense to retain a digital forensics expert.

Plaintiff’s recovery process included a two-week period during which they took daily photos to document healing.  At a two-week follow-up visit, Plaintiff’s general physician observed no irregularities and noted that healing appeared on track.  However, the wound reopened the following day, leading to pain, bleeding, and eventually, infection.

Photos provided by the plaintiff had been taken after this follow-up appointment, omitting photos from the first two weeks of post-procedure recovery.  When questioned, Plaintiff stated the earlier photos had been deleted.  Photos produced by Plaintiff’s counsel were notably blurry and showed visual artifacts that suggested possible tampering.

Expert Analysis: A digital forensic analyst with DJS Associates, Inc. conducted a data extraction of the plaintiff’s cell phone.  In addition to obtaining deleted photos taken during the initial recovery period, the photos that Plaintiff’s counsel had previously produced were also collected.  These photos were clear and of significantly higher quality than those initially provided.

Key findings from the photos included:

1. Shaving in the Operated Area: Photos revealed stubble and ingrown hairs around the surgical site, indicating that Plaintiff had recently shaved the area.  This was against the surgeon’s explicit post-operative care instructions, which warned that shaving could irritate the wound and increase the risk of infection.
2. Evidence of a New Cut, Post-Physician Appointment: Photos recovered from Plaintiff’s device that were taken prior to the follow-up appointment showed no signs of additional cuts near the surgical site.  However, photos taken on the days following this visit clearly display a fresh cut close to the surgical wound.  This discovery was pivotal in linking Plaintiff’s actions, in disregard of the surgeon’s post-operative care instructions, to the wound reopening and subsequent infection.
3. Evidence of Tampering: The blurry photos provided by the plaintiff were determined to have been altered.  A comparison revealed that the images were printed, physically manipulated (possibly by printing at a lower resolution and rescanning), and re-uploaded to a computer.  This process introduced differences in saturation, quality, and detail, obscuring visual evidence of the plaintiff’s actions during recovery.

Result: The court acknowledged that the photos produced by Plaintiff’s counsel were intentionally manipulated to hide critical details.  This led to penalties against Plaintiff’s counsel, for attempting to mislead the court.  Furthermore, the deletion of the original photos taken during the initial recovery period resulted in a spoliation charge.  The court ruled that these photos would have likely demonstrated proper post-operative care as instructed by the defendant and undermined Plaintiff’s claims of negligence.  The defense used the recovered photos to establish that the infection was likely caused by the plaintiff’s failure to follow post-operative instructions, rather than by any fault in the surgeon’s care.

Through meticulous forensic work, the defense successfully demonstrated that the plaintiff’s actions, not the surgeon’s care, were the primary contributors to the complications, leading to a favorable outcome for the defendant.

Timothy R. Primrose, Digital Forensic Analyst with DJS Associates, Inc., can be reached via email at experts@forensicDJS.com or via phone at 215-659-2010.

Categories: Case Studies | Digital Forensics | Medical Malpractice

Tags: Cell Phone Downloads | Data Acquisition | Digital Media Evidence | Spoliation