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`EXHIBIT 5
`
`
`TO THE DECLARATION OF BRIAN J. NISBET
`IN SUPPORT OF DEFENDANTS’ MOTION
`TO EXCLUDE THE EXPERT TESTIMONY
`OF STEPHEN K. KUNIN, BLAKE INGLISH
`AND JIM YOUSSEF
`
`ALPHATEC HOLDINGS, INC., ALPHATEC SPINE INC. v. NUVASIVE INC.
`IPR2019-00362, Ex. 1059, p. 1 of 4
`
`
`
`Case 3:18-cv-00347-CAB-MDD Document 251-7 Filed 01/17/20 PageID.22217 Page 2 of 4
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`· · · · ·Highly confidential - Attorneys' Eyes Only
`·1· · · · · · ·UNITED STATES DISTRICT COURT
`
`·2· · · · · · SOUTHERN DISTRICT OF CALIFORNIA
`
`·3· · · · · · · · · ·SAN DIEGO DIVISION
`
`·4· · · · · · · · · · · * * * * * *
`
`·5
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`·6· ·NUVASIVE, INC., a Delaware
`· · ·corporation,
`·7
`· · · · · · · ·Plaintiff,
`·8· · · · · · · · · · · · · · · · · Case No.
`· · · · · vs.· · · · · · · · ·3:18-cv-00347-CAB-MDD
`·9
`· · ·ALPHATEC HOLDINGS, INC., a
`10· ·Delaware corporation and
`· · ·ALPHATEC SPINE, INC., a
`11· ·California corporation,
`
`12· · · · · · ·Defendants.
`· · ·________________________________
`13
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`14
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`15· · · · · · · · VIDEOTAPED DEPOSITION OF
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`16· · · · · · · · · JIM A. YOUSSEF, M.D.
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`17· · · · · · · · · ·Durango, Colorado
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`18· · · · · · · · · · January 10, 2020
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`19· · · · · · · · · · · ·9:15 a.m.
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`20
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`21
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`22
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`23· · · · Reported by: Heidi K. Konsten, RPR, CCR
`· · · · · Nevada CCR No. 845 - NCRA RPR No. 816435
`24· · · · · · · · · ·JOB NO. 596170
`
`25
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`ALPHATEC HOLDINGS, INC., ALPHATEC SPINE INC. v. NUVASIVE INC.
`IPR2019-00362, Ex. 1059, p. 2 of 4
`
`
`
`Case 3:18-cv-00347-CAB-MDD Document 251-7 Filed 01/17/20 PageID.22218 Page 3 of 4
`
`·1· ·have any tissue creep or if you have any issue
`
`Page 46
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`·2· ·where a nerve slips underneath one of the
`
`·3· ·retractor blades, you don't want to inadvertently
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`·4· ·injure that nerve.
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`·5· · · · Q· · The stimulated dilator doesn't provide
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`·6· ·you that information?
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`·7· · · · A· · It provides a neurography mapping of
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`·8· ·the -- of the lumbar plexus.
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`·9· · · · Q· · Do you always use an EMG wand?
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`10· · · · A· · Always.
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`11· · · · Q· · Do you always -- you also testified
`
`12· ·about inserting a shim.
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`13· · · · · · ·Do you always use a shim in XLIF?
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`14· · · · A· · A majority of cases I use a shim.
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`15· · · · Q· · And in what circumstances do you not?
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`16· · · · A· · It's variable.· It's based on the
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`17· ·patient's pathology.· Doing a large deformity case
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`18· ·and the disk space is severely collapsed and has a
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`19· ·concavity to it, I -- I sometimes can't get a shim
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`20· ·in.
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`21· · · · · · ·There's a variety of different
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`22· ·pathologies where I would probably avoid using a
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`23· ·shim for fear that it might cause bleeding in the
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`24· ·bone or injure the bone.
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`25· · · · Q· · What type of -- what type of data do you
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`ALPHATEC HOLDINGS, INC., ALPHATEC SPINE INC. v. NUVASIVE INC.
`IPR2019-00362, Ex. 1059, p. 3 of 4
`
`
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`Case 3:18-cv-00347-CAB-MDD Document 251-7 Filed 01/17/20 PageID.22219 Page 4 of 4
`
`Page 285
`·1· · · · · · ·Dr. Youssef, neuromonitoring for use in
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`·2· ·spine surgery was known before 2003; correct?
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`·3· · · · A· · Correct.
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`·4· · · · Q· · And I think earlier in the testimony,
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`·5· ·you were -- you had a question for me about why I
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`·6· ·was using 2004.· So I'm just going to ask you the
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`·7· ·same questions regarding 2003, since you pointed
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`·8· ·that out.
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`·9· · · · · · ·Lateral trans-psoas surgery to approach
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`10· ·the lumbar spine was known before 2003; correct?
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`11· · · · A· · Correct.
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`12· · · · Q· · And stimulated dilators for use in spine
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`13· ·surgery were known before 2003; correct?
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`14· · · · · · ·MS. DEVINE:· Objection.· Asked and
`
`15· ·answered.
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`16· · · · · · ·THE WITNESS:· Correct.· In fact,
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`17· ·NuVasive had them.
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`18· ·BY MS. WICKRAMASEKERA:
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`19· · · · Q· · Publicly available?
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`20· · · · A· · I don't know.
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`21· · · · Q· · Was that for the INS-1?
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`22· · · · A· · I don't recall.
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`23· · · · · · ·MS. WICKRAMASEKERA:· Does everyone mind
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`24· ·if I take a quick break?· Because I've got to use
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`25· ·the restroom.
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`ALPHATEC HOLDINGS, INC., ALPHATEC SPINE INC. v. NUVASIVE INC.
`IPR2019-00362, Ex. 1059, p. 4 of 4
`
`
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