The mission of Piedmont Liability Trust is to serve the professional liability legal needs of the University of Virginia Physicians Group clinicians and to be a trusted resource for all of their health law and medical/legal issues.


The Trust serves as legal counsel to University of Virginia Physicians Group clinicians for medical professional liability matters related to patient care and provides liability and indemnity coverage for claims against Trust Covered Persons.


Patient Care Support

  • Physician/Patient Responsibilities
  • Termination of Patient Care
  • Informed Consent
  • Issues with Minors
  • Patient Competency
  • Patient Complaints
  • Subpoenas for Patient Records
  • Subpoenas for Treating Physician Testimony


Claims and Litigation

  • Patient or Lawyer Threatening Suit
  • Service of Lawsuit Papers
  • Inquiry from Media re: Claim or Lawsuit

Financial Services

  • The Trust funds professional liability losses for UVA Physicians Group clinicians for services provided on behalf of UVA.


Administrative Documents Provided upon Request

  • Terms of Coverage
  • Proof of Coverage
  • Claims History

The Trust Team

Rebecca W. West, J.D.

Trustee and Chief Executive Officer

Rebecca was responsible for the startup of the Trust in 1989. Since that time, she has served as the Chief Executive Officer, as well as one of two Trustees for the Trust. She is responsible for all aspects of the Trust mission. Rebecca has specialized in health care and corporate law since graduating from law school. She continues to provide advice and counsel to insureds. Her priorities are appropriate Trust funding, sound investment of the Trust portfolio, and wise stewardship of Trust claims.

Bruce D. Gehle, J.D.

Chief Operating Officer

Bruce came to the Trust in 2007 after eleven years of private practice defending physicians in Kentucky and Virginia. His expertise in defending medical malpractice claims was well recognized in private practice and is the backbone of the Trust’s management. As Chief Operating Officer, Bruce is responsible for overseeing the day-to-day operations of the Trust, including claims and risk management, as well as financial and underwriting management. Bruce continues to provide advice and counsel to Trust insureds and directs Trust educational programming for insureds.

Skip White, J.D.

General Counsel

Skip joined the Trust in 2020. Prior to assuming his role as Associate General Counsel and then General Counsel of the Trust, Skip served as Assistant and Associate General Counsel to the physician practice plan for UVA Health where he was recognized as being a central support to the clinical departments and their clinicians. As a member of the Trust’s management team, Skip supports the operational, financial, claims, educational and legal operations of the Trust. He is integrally involved in providing advice and counsel to insureds to manage risks. Skip also represents Trust insureds in Department of Health Professions investigations and regularly serves as legal counsel on behalf of providers in litigation matters.



Lance Frasier

Chief of Financial Operations

Lance came to the Trust in 2005 as an IT specialist, initially working part-time as he attended college, receiving his Bachelor of Science in Business in 2011. Over the years, Lance has expanded his responsibilities with the Trust; in 2022, he became the Chief of Financial Operations. His financial responsibilities include accounting, financial reporting, budgeting and overseeing the Trust’s outside financial audit and tax filings. Lance is also in charge of the Trust’s Information Technology services. He is currently working on completing his CPA.

Rachel D.G. Horvath, J.D.

Claims and Litigation Counsel

Rachel joined the Trust in 2023. Prior to joining the Trust, Rachel was a partner at the firms of Smith Bain Manuel & Horvath and Morin & Barkley, where she defended health care providers in medical malpractice cases and complaints to the Department of Health Professionals, as well as other types of civil litigation defense. As Claims and Litigation Counsel at the Trust, Rachel represents insureds in medical malpractice lawsuits and federal and state licensing and regulatory actions. Rachel is also responsible for the Trust’s overall claims management and oversees the Trust’s retained outside counsel.

Judy L. Fortineux, A.R.M.

Chief of Staff & Risk Manager

Judy has been the Risk Manager for the Trust since 1989, assisting insureds in managing risks, providing day-to-day advice and counsel. She also is responsible for maintaining risk management data, providing insight and recommendations for change in medical practice. Judy also serves as Chief of Staff, overseeing Trust administrative staff and overseeing human resources and benefits. In addition, she oversees the underwriting process for Trust insureds and risk exposures.



Amy Rossello

Associate Chief of Staff

Amy joined the Trust in 2022.  She assists with Trust administrative operations, including management of clinician data and facilitation of premium assessments.  Amy also oversees aspects of human resources and benefits in coordination with the Chief of Staff.  In addition to her administrative role, Amy assists with risk management functions at the Trust by investigating reported incidents to assess risk exposures.

Kirin L. Johnstone

Legal and Operations Coordinator

Kirin came to the Trust in 2020 as a part-time Litigation Assistant while she was finishing her Bachelor’s degree at the University of Virginia. When Kirin graduated, she began full-time expanded responsibilities with the Trust and has continued to grow in her responsibilities. She came with prior paralegal experience, which provided a good base for her to expand upon. Kirin is presently responsible for the initial investigation of all claims and presents these findings to the Claims Committee. In preparation, she works with insureds and outside medical experts to assess the Trust’s exposure. In addition to her claims responsibilities, Kirin also assists with subpoenas issued to insureds and provides risk management support.

Tammy Tuthill
Educational Coordinator & Administrative Assistant

Tammy is responsible for matters related to Covered Person applications, rate classifications, and other Trust educational events and credits.  Tammy also provides administrative and technical support to the Trust.



Byron J. Mitchell, J.D.

Outside General Counsel

Byron is the founding partner of the Mitchell Law Group in Alexandria, Virginia. Since 1994, he has devoted his practice of law to defending physicians in medical malpractice claims, including physicians at the University of Virginia covered by Piedmont Liability Trust. In 2022, Byron was designated Outside General Counsel to the Trust, serving as lead defense counsel for insureds in Trust claims. H also provides legal guidance to Trust management, the Claims Committee as well as the Trust Board of Directors, in addition to acting as defense counsel on Trust claims, along with attorneys from his law firm, as well as four other law firms.


Ron Hodges


The Ronald D. Hodges Award is presented annually to an individual who has made a significant and lasting contribution to the cooperative relationship between the sister professions of law and medicine.

Ron Hodges was an attorney who specialized in defending physicians, nurses and hospitals in medical malpractice litigation. He was a counselor, in every sense of the word, guiding the physicians and nurses who relied upon him through the personal and painful ordeal of litigation. Though Ron represented health professionals throughout the state, he had a special devotion to the University of Virginia Health System. He spent hours providing curbside consults, speaking to professional groups, and advising administrators, nurses and physicians without ever thinking about billing for his time. The legal and the medical professions lost a great friend and advocate when Ron unexpectedly passed away in 1998 at the age of fifty-three.

Karen Johnston, M.D.

The Trust is proud to announce Karen Johnston, M.D., as the 2022 recipient of the Ronald D. Hodges Award.  Dr. Johnston graduated from Colgate University with a degree in Neuroscience in 1986. A year later she attended the University of Rochester School of Medicine where she also completed her residency in Neurology. Thereafter, she completed a vascular neurology fellowship at the University of Virginia (UVA). She joined the UVA faculty in 1997 and obtained a master’s degree in outcomes research and clinical investigation in 1999.

Dr. Johnston is board certified in general neurology and vascular neurology. Dr. Johnston is the Harrison Distinguished Professor of Neurology and Associate Vice President for Clinical and Translational Research at the University of Virginia. Her research has focused on treatment and outcomes in acute ischemic stroke and she is the principle investigator on numerous NIH funded grants. She participates in numerous NIH-NINDS study sections and data safety monitoring committees and is chair of the NIH-NINDS clinical research collaboration (CRC) advisory team. She was an associate editor of the journal Neurology and the founding editor of the neurology resident and fellow section. She maintains a strong commitment to education and mentoring. She was the founding chair of the University of Virginia’s Academy of Distinguished Educators and also was the director of the UVA internal K12 scholars program for career development in clinical and translational research. Dr. Johnston also directed the ANA Junior Faculty Career Development Symposium, the AAN Research Career Development Symposium, and the NINDS Clinical Trials Methods Course Career Development Program. She is currently the director of the integrated Translational Health Research Institute of Virginia.

Dr. Johnston was the vice chair of research for the Department of Neurology at UVA prior to becoming Chair of the Department from 2007 to 2018.  She is also a graduate of the UVA Executive Leadership in Academic Medicine (ELAM).

In 2022 Dr. Johnston was the first American woman to win the William M. Feinberg Award for Excellence in Clinical Stroke. This international award recognizes ongoing contributions to the investigation and management of stroke clinical science.

Dr. Johnston has been an invaluable contributor to the Trust. She has served as a member of the Board of Directors since January 1, 2017, and a member of the Executive Committee since January 1, 2018; she served as Vice Chair of the Board in 2022. In her work both as a clinician-researcher and trusted advisor to the Trust she has exemplified the spirit of Ron Hodges. Ron was an attorney whose practice was primarily the defense of health care providers in medical malpractice claims. Similar to Ron’s significant contributions to the Trust, Dr. Johnston has greatly contributed to the Trust’s successes.



Rebecca W. West, J.D.
Scott A. Syverud, M.D.

The Trustees are overseen by the Trust Board of Directors. Monthly oversight of Trust activities comes from the Trust Executive Committee. Oversight of claims handling comes from the Claims Committee.

Trust Board of Directors

Megan Bray, M.D., Ex-Officio, Dean’s Office Representative
Christopher P. Holstege, M.D.
Anita H.L. Clayton, M.D.
Peter T. Hallowell, M.D.
James Howell, J.D. Vice Chair
Andrew M. Southerland, M.D.,
Christopher A. Moskaluk, M.D.
Stephen S. Park, M.D.
Mitchell H. Rosner, M.D.
Donald R. Morin, J.D.
Mark E. Shaffrey, M.D
Scott A. Syverud, M.D., Chair
James M. Larner, M.D., Ex-Officio, UPG President
J. Scott Just, M.D., Ex-Officio, UPG CEO
Jonathan D. Truwit, M.D., Non-UPG Clinician Director
Rebecca W. West, J.D., Ex-Officio, PLT CEO

Executive Committee

Megan Bray, M.D.
James Howell, J.D. Vice Chair
Andrew M. Southerland, M.D.
Christopher A. Moskaluk, M.D.
Donald R. Morin, J.D.
Mark E. Shaffrey, M.D.
Scott A. Syverud, M.D. Chair
James M. Larner, M.D., Ex-Officio, UPG President
Rebecca W. West, J.D., CEO

Board Member


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