Ileum, Ilium, and 'Fifty Mikes'
You are reporting a two-hour deposition in a medical-malpractice case. The witness is a nurse administrator testifying from the chart. In one answer she says the patient's 'ileum was resected'; forty minutes later she refers to 'the ilium.' Both 'hydroxyzine' and 'hydralazine' appear in her testimony. She says 'PT' repeatedly without expanding it, uses 's/p' and 'dorsiflexion,' and dictates a dose once as 'fifteen milligrams per kilo' and later as 'fifty mikes.' The transcript will be read aloud at summary judgment, and opposing counsel is known for attacking transcription errors. You cannot interrupt the flow on every term and finish on time.
1. Which items must be clarified on the record at the next break, and which can you resolve without interrupting?
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Sort by consequence of error, not by unfamiliarity.
Must be clarified:
- The dose. 'Fifteen milligrams per kilo' and 'fifty mikes' are not the same order of magnitude, and 'mikes' almost certainly means micrograms. A dose in a malpractice transcript is the single highest-stakes string on the page. Ask for the figure to be read back on the record, with units spelled out.
- The drug names. Hydroxyzine (an antihistamine) and hydralazine (an antihypertensive) are classic sound-alikes with opposite clinical implications. Confirm which drug appears where.
Resolve without interrupting:
- 'PT' - flag for the break but do not stop the flow; a nurse administrator saying 'PT' in a chart context is likely physical therapy, but confirm rather than assume.
- 's/p' and 'dorsiflexion' are standard and unambiguous; transcribe as used.
- Ileum/ilium requires context, not a guess: 'resected' points to the bowel (ileum). But the later 'ilium' is a real statement by the witness and must not be silently harmonized.
2. How do you mark an item you cannot verify, and what belongs in the transcript versus in a separate word list?
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In the transcript: the best available rendering, flagged in the least intrusive way your style permits - a bracketed best guess with a question mark, or a bracketed phonetic spelling, reserved for passages where you genuinely cannot determine the word. Do not use the flag liberally; a transcript peppered with brackets is unreadable and signals carelessness rather than candor.
Outside the transcript, on the record or by letter: a reporter's note listing page and line, the term as transcribed, and the alternatives considered. This is the professional equivalent of an audit trail and it protects everyone. Send it to all counsel, not just the side that hired you.
Never:
- Expand an abbreviation the witness did not expand, silently.
- Substitute a drug name you believe is 'probably right.'
- Use an editorial footnote explaining clinical significance - that is not your role and it will read as advocacy.
A word list (names, drugs, providers, abbreviations, with spellings confirmed) is a legitimate deliverable and a good practice; it just must not become a vehicle for correcting the transcript without a stipulation.
3. The witness later says 'she had her ilium removed.' You now believe your earlier 'ileum' was correct as spoken. Do you change the earlier occurrence?
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No - but you do not ignore the conflict either.
- You cannot retroactively edit a word the witness said. If she said 'ileum' the first time and 'ilium' the second, both appear. Your private belief about which she meant is not a basis for altering one of them; that is the difference between reporting and interpreting.
- Distinguish mishearing from inconsistency. If you transcribed 'ileum' but actually heard something you could not resolve, that is your error and it gets corrected through the errata/read-and-sign procedure. If you plainly heard 'ileum' and she later said 'ilium,' that is the witness's inconsistency, and it belongs in the record exactly as it happened.
- Escalate the right way: at the next break, ask counsel whether the witness will spell or clarify the term on the record, or whether the parties will stipulate to a correction. A stipulated correction on the record is clean; a unilateral one is indefensible at summary judgment.
- Do not annotate. Do not add '[sic]' or a bracketed note comparing the two answers. Noticing the contradiction is counsel's job.