CardiologyElectrophysiologyPlaintiff-side

Built for the $5M cardiac case.
AI deposition trainer with EP-grade depth.

Cardiac medmal cases — missed MI, atrial fib stroke, ablation complications, sudden cardiac death — regularly settle or verdict at $5M to $25M. The defense expert pool is small. The same names cycle case to case. Their cross patterns are predictable if you know the HRS/ACC/AHA canon. Generic AI doesn't engage that canon. This one does.

Try the 2-min cardiology demo → All specialties
18
Cardiology + EP failure modes
9
HRS/ACC/AHA guidelines cited
2
Signature impeachment traps

Why a cardiology-specific trainer matters

Cardiology is the highest-verdict medmal specialty AND has the smallest expert-witness pool. Roughly 2,500 board-certified electrophysiologists practice nationally. The same defense expert names appear in case after case, deposition after deposition. Their answering patterns are predictable — if you and your witness know the HRS/ACC/AHA published canon they're either citing or trying to dodge.

The trainer runs your defendant doctor or expert witness through a hostile cross built on that canon. Every question is grounded in either the chart you uploaded or the published guideline that governs the standard of care.

The 18 failure modes — what gets your witness in trouble

General cardiology (10)

Sev 10

STEMI door-to-balloon >90 min

Door-to-balloon exceeded the 90-min ACC/AHA benchmark without documented systems-level explanation.

"The cath lab wasn't ready right away — there were some delays."
Sev 10

Aortic dissection — no CTA

Chest+back pain or pulse-deficit patient. No CT angiogram, no dissection in the documented differential.

"I didn't think dissection — her pain wasn't classic tearing."
Sev 10

Cardiac tamponade missed

Beck's triad or pulsus paradoxus. No emergent bedside echo documented.

"I thought it was just sepsis — I was working her up that way."
Sev 9

Serial troponins not drawn

Single negative troponin and out the door. Serial q3h is the published standard.

"The first troponin came back negative so I sent her home."
Sev 9

"Low-risk gestalt" without HEART/TIMI

Witness characterized the patient as low-risk on gestalt with no HEART, TIMI, or GRACE score documented.

"She just didn't look like an MI to me."
Sev 9

ECG interpretation conflict

Initial read differs from later cardiology over-read; difference didn't prompt re-evaluation.

"I read the ECG as normal — the cardiologist later said there were subtle changes."
Sev 9

DAPT discontinued pre-op without bridging

DAPT stopped in a stented patient with no documented multidisciplinary discussion.

"I just stopped the Plavix five days before surgery — that's what they usually want."
Sev 9

Anticoag reversal not initiated

Bleeding patient on warfarin/DOAC. Reversal agent delayed without documented rationale.

"I was waiting on the INR before deciding on PCC."
Sev 8

Failed cardioversion → discharge

Newly cardioverted A-fib patient discharged with no CHA2DS2-VASc + anticoag plan documented.

"She converted to sinus so I sent her home with metoprolol."
Sev 7

CHF readmission blamed on outpatient

30-day CHF bounceback. Witness blames patient or outpatient team without owning discharge planning.

"She was supposed to follow up with her PCP — that's where the breakdown happened."

Electrophysiology depth (8)

Sev 10

QT-prolonging drug stack → torsades

Started azithromycin + ondansetron + amiodarone-class drug stack with no baseline QTc, no follow-up monitoring, patient developed torsades.

"I didn't think about the QT — I was just trying to control her nausea."
Sev 10

Post-PVI chest/GI symptom dismissed

Atrioesophageal fistula presents 2–6 weeks post-PVI with fever or chest pain. Workup as "post-procedural" or sepsis → mortality.

"She came in 3 weeks after the ablation with fever and chest pain — I admitted her to medicine for sepsis workup."
Sev 9

Periprocedural DOAC interruption

DOAC held for elective procedure with no bridging plan referenced to HRS/ACC consensus → embolic stroke during interruption window.

"I just told her to hold the Eliquis the day before the colonoscopy."
Sev 9

Primary-prevention ICD missed

Post-MI or NICM patient with persistent EF ≤ 35% past the waiting window. No documented ICD evaluation or EP referral.

"Her EF was 30% but she was doing fine on the meds."
Sev 9

Syncope — no SCD workup

Exertional syncope or syncope with FHx SCD diagnosed as vasovagal without ECG/echo screen, no EP referral, no event monitor.

"She fainted at soccer practice — I told mom it was probably dehydration."
Sev 9

CIED infection — extraction delayed

Pacemaker/ICD pocket infection or S. aureus bacteremia treated with antibiotics alone — HRS 2017 calls for complete extraction.

"We were treating the bacteremia with IV vancomycin — the device was working fine."
Sev 8

Ablation informed-consent gap

PVI complications (AE fistula, perforation, PV stenosis, phrenic nerve, vascular access) not specifically named in consent.

"I always tell them there's a small risk of complications."
Sev 7

General cardiologist played EP

Refractory arrhythmia or device problem managed without EP referral — defines own scope-of-practice limit and admits they exceeded it.

"I felt comfortable managing her A-fib — I see a lot of arrhythmia in my practice."

The two signature impeachment traps

1. "Low-risk gestalt" vs HEART/TIMI score

Lock the witness into "low-risk clinical feel" framing, then juxtapose against the HEART, TIMI, or GRACE score they admit is the published standard.

"You used your clinical experience to determine she was low risk?" → "Yes."
"You're familiar with the HEART score?" → "Yes."
"HEART is in the ACC/AHA 2021 chest-pain guideline?" → "Yes."
"You did not calculate a HEART score on this patient."

Why this lands: the witness has framed their judgment as an unstudied alternative to a guideline-endorsed tool. Jury hears: "I used my feeling instead of the published standard."

2. "Treating cardiologist" vs EP referral standard

Lock the general cardiologist into "I felt comfortable managing this myself," then juxtapose against the HRS/ACC/AHA referral criteria. The witness defines their own scope-of-practice limit and admits they exceeded it.

"You're a general cardiologist — comfortable managing AF in your practice?" → "Yes."
"You did a cardiology fellowship — not an electrophysiology fellowship?" → "Correct."
"EP is its own ACGME-accredited subspecialty with separate board certification?" → "Yes."
"When the AHA/ACC/HRS guidelines talk about complex arrhythmia management — refractory AF, recurrent VT, primary-prevention ICD — they reference EP consultation?" → "Generally yes."
"You did not refer this patient to an electrophysiologist."

Why this lands: the witness has now self-defined the line they crossed. Hard to walk back at trial.

The 9 cited guidelines

2021 ACC/AHA Chest Pain GuidelineHEART-score and chest-pain pathway adoption — the "you didn't risk-stratify" canon
ACC/AHA STEMI Guideline (2013 + 2017 focused update)Door-to-balloon 90-min benchmark and systems-of-care standards
2023 ACC/AHA/ACCP/HRS Atrial Fibrillation GuidelineCHA2DS2-VASc + HAS-BLED, rhythm vs rate control, anticoag decision standards
2017 AHA/ACC/HRS Ventricular Arrhythmia / Sudden Cardiac Death GuidelineClass I/IIa ICD indications, primary vs secondary prevention, 40-day post-MI + 3-month NICM-on-GDMT waiting periods
2018 ACC/AHA/HRS Bradycardia and Cardiac Conduction Disorders GuidelinePacemaker indications, AV block criteria, post-TAVR conduction management
2017 HRS Expert Consensus on CIED Lead Management + ExtractionClass I extraction indications for infected CIEDs, pocket infections, S. aureus bacteremia, vegetations
2017 HRS/EHRA/APHRS/SOLAECE AF Ablation ConsensusAblation complications (AE fistula, PV stenosis, phrenic nerve, cardiac perforation), informed-consent standards, post-procedure follow-up
2017 ACC Periprocedural Anticoagulation Management ConsensusDOAC / warfarin periprocedural management framework, bridging decisions, restart timing
2017 AHA/ACC/HRS Syncope Guideline + 2020 AHA/ACC HCM GuidelineSyncope workup standard, channelopathy + HCM screening in young / exertional / family-history-positive patients

FAQ

How is this different from generic AI deposition tools?

Generic depo-prep AI runs the same script regardless of specialty. This trainer loads the cardiology + EP specialty pack as soon as you tag the case — the AI examiner cites HRS Lead Extraction Consensus when relevant, runs the HEART-score trap on chest-pain cases, runs the EP-referral trap on general-cardiology defendants, and recognizes 155 specialty-specific medical terms in your witness's voice so transcription stays clean.

Does it work for defense expert prep too?

Yes. Flip to expert-prep mode and the AI runs as the hostile plaintiff attorney cross-examining your defense expert. Same 18 failure modes are exactly what you need to patch in pre-depo prep.

What case types should I bring to it?

Anything cardiac. Missed MI, atrial fib stroke from failure to anticoagulate, periprocedural DOAC management, sudden cardiac death in young patient (channelopathy / HCM screening), post-MI primary-prevention ICD, EP ablation complications (atrioesophageal fistula, PV stenosis, phrenic nerve), pacemaker/ICD infections, DAPT mismanagement, aortic dissection missed.

How accurate is the medical transcription?

The trainer boosts the speech-to-text with 155 cardiology + EP keywords on top of the base medical vocabulary. Terms like "torsades de pointes," "CHA2DS2-VASc," "atrioesophageal fistula," "MADIT-II," "pulmonary vein isolation," "phrenic nerve palsy," "andexanet alfa" are recognized correctly the first time.

Pricing?

Bundled in MedLegal AI Pro ($49/mo) for 1 user, Professional ($249/mo) for 5 users, or Firm ($499/mo) for 20 users. Free 14-day trial, no credit card. Pay-per-analysis $19/run if you only handle a few cardiac cases per year.

Start with the 2-minute cardiology demo

No signup, no mic. Walk through a sample missed-MI deposition in your browser. See the cross-exam questions, the impeachment trap firing, the Bates-cited contradiction detection.

Run the 2-min demo → Start free 14-day trial

Deposing a cardiology expert on the other side? See questions to ask a cardiology expert witness at deposition.