An often-encountered scenario in a workers’ compensation or personal injury setting involves a diabetic claimant or plaintiff who sustains a blunt-force trauma or laceration injury to his or her foot or a toe. The blunt-force trauma or laceration injury many times begins as a minor trauma and then progresses to pressure necrosis (and ultimately gangrenous changes), osteomyelitis, acute infection and then amputation of the toe or foot.

While this might seem like an obviously causally related condition, the defendant in a personal injury action will almost always dispute causal relationship. In so doing, the defendant will hire a medical expert who will testify that the diabetes is the sole cause of the amputation and that the so-called traumatic event was incidental to any amputation undergone by the claimant or plaintiff. In order to effectively cross-examine the defense medical witness presenting this testimony, there are several important points critical to the plaintiff’s arguments.