KATHLEEN DIFIORE VS. TOMO PEZIC, ET AL. DORA DELEON VS. THE ACHILLES FOOT AND ANKLE GROUP, ET AL. JORGE REMACHE-ROBALINO VS. NADER BOULOS, M.D., ET AL. (L-0123-19, L-2412-20, and L-1929-19, ESSEX AND HUDSON COUNTIES AND STATEWIDE) (CONSOLIDATED) (A-2826-20/A-0367-21/A-1331-21)

 KATHLEEN DIFIORE VS. TOMO PEZIC, ET AL. DORA DELEON VS. THE ACHILLES FOOT AND ANKLE GROUP, ET AL. JORGE REMACHE-ROBALINO VS. NADER BOULOS, M.D., ET AL. (L-0123-19, L-2412-20, and L-1929-19, ESSEX AND HUDSON COUNTIES AND STATEWIDE) (CONSOLIDATED) (A-2826-20/A-0367-21/A-1331-21)

These three consolidated appeals in personal injury cases pose related but distinct questions involving the application of Rule 4:19. The appeals concern when, if ever, a plaintiff with alleged cognitive limitations, psychological impairments or language barriers can be accompanied by a third party to a defense medical examination ("DME"), or require that the examination be video or audio recorded in order to preserve objective evidence of what occurred during the examination.

With the input of the parties' counsel and amici, the court revisits and updates the opinion from twenty-four years ago in B.D. v. Carley, 307 N.J. Super. 259 (App. Div. 1998) (authorizing the "unobtrusive" audio recording of a neuropsychological DME of a plaintiff who claimed in her civil action that she was suffering emotional distress). The court also considers 2016 Policy Statement of the American Board of Professional Neuropsychology disfavoring the third-party observation and recording of DMEs and urging practitioners to refuse such conditions except where required by law.

In the absence of more specific guidance within the present text of Rule 4:19, the court adopts adopt the following holdings.

First, a disagreement over whether to permit third-party observation or recording of a DME shall be evaluated by trial judges on a case-by-case basis,with no absolute prohibitions or entitlements.

Second, despite contrary language in Carley, it shall be the plaintiff's burden to justify to the court that third-party presence or recording, or both, is appropriate in a particular case.

Third, given advances in technology since 1998, the range of options should include video recording, using a fixed camera that captures the actions and words of both the examiner and the plaintiff.

Fourth, to the extent that examiners hired by the defense are concerned that a third-party observer or a recording might reveal alleged proprietary information about the content of the exam, the parties shall cooperate to enter into a protective order, so that such information is solely used for the purposes of the case and not otherwise divulged.

Fifth, if the court permits a third party to attend the DME, it shall impose reasonable conditions to prevent the observer from interacting with the plaintiff or otherwise interfering with the exam.

Sixth, if a foreign or sign language interpreter is needed for the exam (as is the case in two of the appeals before us) the examiner shall utilize a neutral interpreter agreed upon by the parties or, if such agreement is not attained, an interpreter selected by the court.

The three cases are accordingly remanded to the respective trial courts to reconsider the conditions of each DME, consistent with the guidance expressed in this opinion.