Medical Expert Witness

When the case turns on how the diagnosis was made.

I am Lauren Fine, MD, FAAAAI, a board certified allergist and immunologist, an associate professor of medicine, and an assistant dean responsible for clinical skills education at a United States allopathic medical school. I review cases in allergy, asthma and immunology, and cases across specialties in which the question is whether a diagnosis was reasonably reached. I am retained by plaintiff and defense counsel.

MD, FAAAAI Board Certified, Allergy & Immunology In Practice Since 2006 Associate Professor Assistant Dean, Clinical Skills Education National Certifying Exam Committees Plaintiff & Defense
Request a Conflicts Check Areas of Opinion
Lauren Fine, MD, FAAAAI, medical expert witness
Lauren Fine, MD, FAAAAI
Board certified in Allergy and Immunology

Areas of opinion

Two bodies of work, one method.

Allergy, asthma and immunology

Specialty standard of care

  • Anaphylaxis: recognition, epinephrine administration, observation and discharge
  • Drug allergy and adverse drug reaction, including penicillin and perioperative reactions
  • Food allergy: diagnosis, counseling, avoidance and emergency planning
  • Asthma diagnosis, chronic management and acute exacerbation
  • Allergen immunotherapy and biologic therapy
  • Immunodeficiency: recognition, workup and referral
  • Angioedema, urticaria, and drug eruption
  • Occupational and environmental allergen exposure
  • Adequacy of allergy testing, interpretation and documentation

Diagnostic reasoning and failure to diagnose

Across specialties

  • Whether a reasonable differential diagnosis was generated at each encounter
  • Delayed diagnosis and missed diagnosis
  • Premature closure and anchoring on an initial impression
  • Failure to act on an abnormal finding, vital sign or result
  • Adequacy of history taking and physical examination
  • Failure to reconsider when the clinical course did not fit the working diagnosis
  • Communication, handoff and follow-up failures between clinicians
  • Informed consent and the adequacy of what the patient was told
  • Supervision and competency of residents, students and advanced practice clinicians

Why this matters to your case

The question is rarely what the physician knew.

It is whether the physician's thinking was reasonable given what was actually in front of them at that moment. Diagnostic reasoning is not intuition. It is a structured process that is taught, observed, scored and remediated, and a record can be read for evidence of whether it happened.

That process is my professional field. I direct clinical skills education at a medical school, where I am responsible for how physicians are taught to take a history, build a differential, and revise it. I serve on national committees that develop the examinations used to certify physician competence, which means I work from the same published standards a jury will be asked to apply.

The practical consequence for counsel is this. I can testify not only that a standard was breached, but where in the record the reasoning went wrong and what a reasonable clinician would have done at that point instead. I can do it in plain language, without jargon, in a way a jury can follow. That is a different opinion than most treating specialists are positioned to give, and it applies to cases well outside allergy and immunology.

Qualifications

Credentials relevant to this work.

Board certification

Allergy and Immunology

Fellow of the American Academy of Allergy, Asthma and Immunology (FAAAAI)

Academic appointment

Associate Professor and Assistant Dean of Clinical Skills Education

United States allopathic (MD) medical school

National assessment service

Test development committee service for national medical licensing and specialty certification examinations

Work developing the instruments used to assess physician competence

Medical education

Faculty appointment with a national medical education institute

Curriculum design, assessment, and faculty development in clinical reasoning

Clinical practice

In clinical practice since 2006. Board certified in Allergy and Immunology since 2011.

Active clinical practice, including a federal hospital appointment. Not retired from patient care.

Licensure

Licensed in Florida

Available for remote record review nationally and for travel

A full curriculum vitae, including named institutional appointments and licensure, is provided on request. Institutions are not named on this page because this work is undertaken in a personal capacity and does not represent, and is not endorsed by, any institution. A ten-year publication list, in the form required by Rule 26(a)(2)(B), follows below.

Publications

Ten-year publication list, Rule 26(a)(2)(B) form.

Peer-Reviewed Journal Articles

1.Chawla K, Nazarian T, Fine L, Kreuger S, Laloo A, Al-Eyd G. Enhancing Ophthalmology Education in Medical Schools: Learned Lessons from a Medical-Optometry Interprofessional Education Curriculum. Medical Science Educator. Accepted February 26, 2026.
2.Takla T, Muoio JM, Fine L. Strategies to Reinvigorate the Bedside Clinical Encounter. New England Journal of Medicine (Letter to the Editor). Accepted February 2026.
3.Chachad N, Levy A, Fine L, Uzdavines M, Rajput V. Interprofessional Collaboration Between Law and Medicine: Opportunities for Health Equity Through Pathway Programs. Academic Medicine. 2025.
4.Hayer R, Fine L, Kirley K, Rakotz M. Closing the Gap: Standardizing Blood Pressure Measurement Training for All Healthcare Students. Journal of Clinical Hypertension. 2025.
5.Al-Eyd G, Payne-Jameau Y, Fine L. Integrating Basic Sciences and Clinical Skills: A Thread of Clinicopathological Correlations in a Clinical Skills Course. Diagnosis. May 23, 2025.
6.Al-Eyd G, Bonfil D, Torres A, Al-Khayat T, Levy A, Bauckman K, Fine L. Integration of Social Determinants of Health in Undergraduate Medical Education: From Evidence to Implementation. Medical Science Educator. Accepted April 29, 2025.
7.Wrench A, Fine L, Griffin D. Communicating Effectively With Limited English Proficiency Patients: Incorporating Training on Working With Medical Interpreters in the Undergraduate Medical Curriculum. Cureus. 16(12), 2024.
8.Fine L, Takla T, Rajput V. Role Modeling Kindness at the Bedside. Cureus. 16(3), 2024.
9.Toonkel R, Castiglioni A, Danforth D, Fine L, Foster J, Jacomino M, Johnson M, Keller B, Mendez P, Saunders J, Scalese R, Schocken D, Stalvey C, Stevens M, Suchak N, Syms S, Uchiyama E, Velazquez M. The Florida Clinical Skills Collaborative: A New Regional Consortium for the Assessment of Clinical Skills. Cureus. 14(11):e31263, 2022.
10.Santiesteban L, Young E, Tiarks G, Boemi M, Patel R, Bauckman K, Fine L, Padilla M, Rajput V. Defining Advising, Coaching, and Mentoring for Student Development in Medical Education. Cureus. 2022.
11.Labiste C, Huntley K, Bauckman K, Fine L, Rajput V. Advanced Placement Courses for Medical School: A Novel AMed Track to Reduce Financial Burden and Attract Nontraditional Students. Cureus. 2021.
12.Huntley K, Raber J, Fine L, Bernstein JA. Influence of the Microbiome on Chronic Rhinosinusitis With and Without Polyps: An Evolving Discussion. Frontiers in Allergy. 2021.
13.Huntley K, Labiste C, Bauckman K, Fine L, Rajput V. Adapting Small-Group Medical Education by Fostering Early Clinical Integration: A Student Perspective. American Journal of Medicine. 2021.
14.Bhattad P, Durkin M, Fine L, Rajput V. Art in Clinical Practice. The Health Professional, a Story Listener and a Storyteller: The Role of Narrative-Based Medicine in Clinical Practice and Education. Alternative and Complementary Therapies. 27(3):1-10, 2021.
15.Bapatla N, Pearson S, Stillman S, Fine L, Bauckman K, Rajput V. Looking Into the Future of Clinical Skills Assessment in Undergraduate Medical Education During the COVID-19 Pandemic. MedEdPublish. 2021.
16.Cocuzzo B, Fine L, Rajput V. Virtual Sensitive Communication During COVID-19 and Beyond (CME-granting review). Duval County Medical Society. 2021.
17.Bapatla N, Fine L, Rajput V. The Future Role of Augmented Reality and Virtual Reality Simulation in Clinical Skills Assessment. Indian Journal of Medical Specialties. 12(3):113, 2021.
18.Fine L, Rajput V. The Smile Is Stronger Than the Handshake. MedEdPublish. 9(1):68, 2020.
19.Fine L. Curriculum Evolution: Innovations From a New Medical School. STFM Education Columns. June 2018.

Books, Chapters, and Other Scholarly Work

20.Patel D, Fine L, Bernstein J. A Focused Report on Progestogen Hypersensitivity. Expert Review of Clinical Immunology. 2023.
21.Rajput V, Fine L, Mookerjee A. Pimping in Medicine: A Closer Look Into the Benefits of Pimping and Its Comparison With Stand-Up Comedy. In Teach Medical Science With a Sense of Humor. 2021.
22.Huntley K, Fine L, Bernstein J. Atopic Endotypes as a Modulating Factor for SARS-CoV-2 Infection: Mechanisms and Implications. Current Opinion in Allergy and Clinical Immunology. 21(3):252-260, 2021.
23.Fine L, Kimchi N. Vaccinations in Primary and Secondary Immunodeficiencies Including Asplenia. In Bernstein JA (Ed), Primary and Secondary Immunodeficiency: A Casebook for Clinicians. 2021.
24.Fine L. Definition of an Allergen (Immunobiology). In Lockey R, Ledford D (Eds), Allergens and Allergen Immunotherapy: Subcutaneous, Sublingual and Oral, 6th Edition. CRC Press, Taylor and Francis. February 2020.
25.Fine L, Casiano R, Al-Bader A. Rhinosinusitis Without Polyposis. In Bernstein JA (Ed), Rhinitis and Related Upper Respiratory Conditions: A Clinical Guide. Springer. 2018.
26.Fine LM, Bernstein JA. Guideline of Chronic Urticaria Beyond. Allergy, Asthma and Immunology Research. 8(5):396-403, 2016.

This list covers peer-reviewed articles, books, and chapters from the preceding ten years, in the form required by Rule 26(a)(2)(B). It does not include published abstracts, blog posts, podcasts, or presentations predating this window; a complete record of all scholarly work, including items outside the ten-year period, is provided with the full curriculum vitae on request.

How an engagement works

What to expect, in order.

Conflicts check and case summary

Send the parties, the jurisdiction, the general allegation and your deadlines. A conflicts check is returned quickly, along with whether the case falls inside my areas of opinion. There is no charge for this step.

Record review and preliminary opinion

Records are reviewed and a preliminary opinion is given verbally before anything is committed to writing. If the record does not support your theory of the case, you will hear that at this stage rather than after a report exists.

Written report

If the case proceeds, a written report is prepared to the standard your jurisdiction requires, with opinions stated to a reasonable degree of medical probability and the basis for each identified in the record.

Deposition and trial testimony

Available for deposition and for trial. Teaching physicians and testifying before a jury draw on the same skill, which is explaining a complex reasoning process to an audience that does not have a medical background.

How I work

Four commitments, stated up front.

The opinion does not depend on who retained me. I accept engagements from both plaintiff and defense counsel, and the analysis is the same either way. An expert who only ever reaches one conclusion is not an expert.

I will decline cases outside my expertise. A referral to a better qualified colleague is more useful to you than an opinion that will not survive cross examination.

Nothing is written before you have heard it. The preliminary opinion is verbal so that an unfavorable review does not become a discoverable document.

I will tell you what is weak in your case. Including when the record supports the other side. Counsel who learn that early can act on it.

Inquiries

Start with a conflicts check.

Include the case caption or party names, the jurisdiction, the specialty and general allegation, and your report and discovery deadlines. Please do not send records with the first message.

Inquiries are answered within two business days.

Direct email

drlaurenfine@gmail.com

Send an Inquiry

Fee schedule and an engagement letter are provided once the conflicts check clears. Based in Fort Lauderdale, Florida. Available nationally.