CLNC - for
Medical-Legal Case Success: Volume 2003.1
LNC UpDate™ A Guide to
Successful Medical-Legal Case Resolution!
Introduction
This
newsletter's purpose is to keep all attorneys and other interested
parties abreast of changing medical and nursing standards, and how
they can impact a medical-legal case. Going one-step further, this
newsletter will also attempt to provide high-level examples of how
medical and/or nursing information can be best presented in order to
achieve a successful outcome in a medical and/or nursing
malpractice, general personal injury, product liability, worker's
compensation, criminal, or any other type of case involving health,
bodily injury, illness, or environmental issues.
How can a Certified Legal Nurse Consultant
(CLNC), High Technology, or ParaLegal Help?
New
high-technology software announcements and fast-changing medical
standards are causing a great deal of confusion about what is needed
to prevail in many medical-legal cases. Some people talk about the
ability of litigation-support software to rapidly retrieve documents
relevant to new case issues, other people point to dynamic
presentation software illustrating things more clearly. But take
away all the marketing hype and one thing stands clear: the
medical FACTS of a case are the holy grail.
Litigation-support and presentation software are simply ways to
present the FACTS.
The
medical facts make or break any case,
no matter how much technology is behind them. Notice the importance
of the word "medical" in the preceding sentence. Medical-legal cases
are NOT won or lost because the correct signature was (or was not)
obtained, or if the correct form was filed on-time, but rather on
how medical professionals reacted to a patient's previous medical
history, diagnostic tests, radiological & lab findings, and many
other information sources.
This REQURES a certified legal nurse
consultant (CLNC) with expert knowledge of the medical/nursing
practices involved to review ALL the records of the case to identify
the medical problems involved, and the best way to present them.
This means all medical examination and consult notes, diagnostic
tests, and operative reports must be reviewed so the significant
medical issues and related Standards of Care (SOC) can be
determined. Then the diagnosis and actions of all involved must be
analyzed to:
determine if the proper medical records have been kept
identify if the Standards of Care (SOC) were adhered to, or
assess the future cost of care of a specific medical
condition.
A paralegal is invaluable for ensuring the
proper legal procedures are followed, and a CLNC is absolutely
mandatory to obtain the information needed to prevail in a
medical-legal case!
Major CLNC
Functions
There are many ways a
CLNC can help your case! Since each case is different, with a wide
range of possible scenarios, there is no way they can all be listed
here. But we list below the major categories these activities and
benefits fall into. (click for details!)
CHRONOLOGICAL TIMELINE - In many
complex cases involving many factors, having all pertinent events
listed in chronological order is extremely helpful. This may sound
almost trivial, but is actually a very difficult task when the many
sources of this information is considered (such as multiple
hospitals & physicians). This includes, but is not limited to,
sources such as:
Initial examination
Physician Consultation notes
Hospital admission notes
History & Physical (H&P) and Discharge notes
Diagnosis reports: radiology, lab tests, etc.
Operative reports
This helps uncover unusual activity
which can be used to uncover deviations from accepted Standards of
Care (SOC) or worse.
CATALOG SIGNIFICANT INFORMATION -
Identify and document all significant information - diagnosis,
radiological / lab findings, physicians and their specialties,
operative reports, etc..
STANDARDS OF CARE - Identify all
applicable Standards of Care (SOC) for each procedure occuring in
the incident in question. For each procedure, list the source of the
applicable SOC.
SOC DEPARTURES (DEVIATIONS) - Detail
all instances where generally accepted Standards of Care were not
followed, and the implications of each instance.
CAUSATION/PROBLEM IDENTIFICATION -
Detail the negligence that caused each of the injuries complained.
Also, list any problem that may arise when presenting this causation
to the court.
EXPERT WITNESS PROFILE - A profile of
the best type of expert witness to call, if needed. Also, a
cross-reference back to relevant case issues the expert must
address. Very useful when consulting with the expert in preparation
of the best expert testimony.
CASE SUMMARY - A detailed explanation
of who was at fault, for what, and what the specific injuries are.
Also, a list of damages cross-refernced back to the specific
action(s) that caused it.
ADDITIONAL/MISSING INFORMATION -
Identify what additional documents need to be retrieved in order to
obtain information that will bolster the case. Also, identify what
records or documents seem to be missing or tampered with, and
cross-reference back to the pertinent case issues.
ADDITIONAL EVIDENCE -
Identify/retrieve additional sources of evidence that could bolster
the case, i.e., all records, documents, policies, procedures, and
other tangible items essential to a comprehensive review of the
case. Examples would include operative videos, applicable SOC
documents from the appropriate governing organizations, and
suggerstions for additional 3rd party reviews.
