Dr. Barry Gustin - Medical-Legal Expert Services

Dr. Gustin is residency-trained and board-certified in Emergency Medicine and Forensic Medicine and has been actively practicing in the fields of Emergency Medicine, Toxicology, and Forensic Medicine for more than 25 years.  He has additional training and expertise in Medical, Occupational, and Environmental Toxicology and has Masters Degrees in Biochemistry, Metabolism and Nutrition, as well as Toxicology and Public Health. He is the primary founder of the American College of Forensic Medicine which currently has more than 2,000 members.

Dr. Gustin has reviewed thousands of medical malpractice, personal injury, criminal, and toxicology cases during his career.  Dr. Gustin also has substantial testimony experience as an expert witness.

You can access Dr. Gustin's medical-legal experience by requesting a FREE phone or email consultation now. To review all the Services he offers, please click here.

Dr. Gustin's education, training, and experience qualifies him to evaluate and testify regarding a broad range of cases, in the following medical and toxicology specialty areas:

• Emergency Medicine, medical, surgical, pediatric
• Emergency Medical Ambulance Services (EMS)
• EMTALA
• Trauma and Critical Care
• Forensic Toxicology
• Medical Toxicology and Poisoning (eg: accidental overdose, carbon monoxide poisoning, and all other product and drug exposures)
• Occupational and Environmental Toxicology
• Mechanisms and Forces of Injury in Criminal Cases
• Substance Abuse and Drug Addiction (Drug and Alcohol, including DUI)
• Electrical Injury
• Pharmaceutical Medicine (Drug-Drug interactions, Drug-Disease Interactions, Overdose, Unsafe poorly tested Drugs, Adverse Drug Reactions)
• Flight, Travel, and Wilderness Medicine
• Hospital Malpractice
• Public Health (eg: Legionnaire's Disease, Outbreak Diseases, Food Poisoning, and Waterborne Diseases)
• Legal Medicine (standard of care, evidence-based causation, medical ethics)

His primary areas of specialization are Emergency Medicine and Toxicology.

A partial list of cases Dr. Gustin has consulted on include:  drugs of abuse including Methamphetamine, Cocaine, Opiates, and Alcohol, occupational chemical poisonings including toluene, benzene, isocyanates, other solvents, heavy metals including lead, carbon monoxide, and cyanide, occupational and travel-related infectious illness including Legionnaire's disease, MRSA, skin infections, bacterial enteritis, misdiagnosis and delayed treatments in the ER, civil rights cases, environmental exposure cases including contaminated water and sewage exposure.

Dr. Gustin's expert opinions will comply with ACEP (American College of Emergency Physicians) guidelines for Expert Witness Testimony: See: http://www.acep.org/practres.aspx?id=29446 ; the ACT (American College of Toxicology); and ACFE (American College of Forensic Examiners) Creed of Ethics.  See: http://www.acfei.com/about_acfei/creed/ 

Office: 2928 Derby Street, Berkeley, CA 94705
Tele: 510-549-1041
Fax: 510-549-3268
Email: Click here to email Dr. Gustin

Ambien is the most common sleeping medication at the present time.  Unfortunately, although Ambien is usually quite effective at facilitating sleep, it also has been found to have several disturbing side effects, including tolerance, addiction, and somambulism.  Recently the FDA has revised its dosing guidelines on how the medication should be used.  The news brief follows:

Ambien (zolpidem) is currently the most commonly used sleeping medication on the market. Most physicians believe, unknowingly, that it can be prescribed with impunity.  This is not the case.  Ambien has many side effects that have resulted in a big increase in visits to emergency departments.

The FDA finally approved a new drug which ameliorates the severe constipation that accompanies the use of Opiates.  Constipation is one of the main side effects that causes individuals to stop Opiate medication prematurely without any other option for their pain.  This addition to treatment with opiates is a notable advancement.

At one time or another, most of us have taken the antibiotic, Zithromax.  It is one of the most commonly prescribed medications for conditions including bronchitis, pharyngitis, sinusitis, and others.  The discussion that follows has to do with Zithromax's side-effects, some of which are potentially life-threatening.  Recently, I have seen a case in my emergency room of sudden cardiac arrest secondary to the cardiac effects of Zithromax.  The FDA has recently warned of this phenomenon.

The following article on food poisoning and foodborne outbreak disease was obtained from a recent issue of emedicine #175569.  It is an overview that covers major topics and issues.  It does not address travel medicine.  But it would have direct relevance to community acquired disease, assessments for such diseases, and surveillance.

The following article on food poisoning and foodborne outbreak disease was obtained from a recent issue of emedicine #175569.  It is an overview that covers major topics and issues.  It does not address travel medicine.  But it would have direct relevance to community acquired disease, assessments for such diseases, and surveillance.

A recent article appeared in the Journal of Emergency Medicine that addresses medical malpractice, medical malpractice prevention, improved quality of care and documentation, and medical malpractice defense.  Specific examples are given to illustrate general concepts.  Since the article has particular relevance to the practice of emergency medicine, I include it here on my blog for those who are interested in reading it.

The US Food and Drug Administration (FDA) has issued a warning against use of alcohol and central nervous system depressant drugs (CNS), such as benzodiazepines and opioids, with sodium oxybate ( Xyrem, Jazz Pharmaceuticals) because of the risk for impaired consciousness and respiratory depression.

The drug, used to reduce episodes of cataplexy and treat daytime sleepiness in patients with narcolepsy, is already contraindicated for use with insomnia drugs. The new contraindications are reflected in labeling changes for the drug.

The US Food and Drug Administration (FDA) has added several drugs to its list of products to monitor because of possible signs of serious risks or new safety information. The drugs treat conditions that include cancer, epilepsy, hypertension, and malaria.

The agency spotted yellow flags for these drugs in the FDA Adverse Event Reporting System (FAERS) database during April, May, and June 2012.

Making the FDA's watch list does not mean that the agency has concluded that the drug actually poses the health risk reported through FAERS, formerly known as AERS. Rather, the agency will study the drug to determine whether there is truly a causal link. If it establishes a link, the FDA then would consider a regulatory response such as gathering more data to better characterize the risk, revising the drug's label, or requiring a risk-evaluation and mitigation strategy.

The FDA also is not suggesting that clinicians should stop prescribing watch-list drugs, or that patients should stop taking them, according to an agency press release.

The first consensus guidelines on how to evaluate, treat, and prevent carbon monoxide poisoning has recently been released and published in the American Journal of Repiratory and Critical Care Medicine.  These guidelines standardize management of carbon monoxide poisoning for clinician, toxicologist, and public health worker, and offer a road map to attorneys prosecuting or defending a carbon monoxide exposure legal action.  You can read more about  these guidelines by obtaining the actual article from the journal.  The citation is Hampson et al, Am J Respir Crit Care Med. 2012, October 18. epub, (ahead of print).  The title of the article is: Practice Recommendation in the Diagnosis, Management, and Prevention of Carbon Monoxide Poisoning.