When it comes to chart review for medical malpractice or other cases that involve medical records, attorneys rely on legal nurse consultants or medical review companies providing the service. Legal nurse consultants play a significant role in developing expert testimony to support defense theories as regards causation and standard of care. So, what are the different ways in which they assist attorneys engaged in medical litigation?
- Place a request for the relevant medical records: In this first step, the medical records that are relevant for each case are identified. This is achieved by categorizing known providers and healthcare facilities. As the review progresses, additional relevant providers may be identified and medical documentation requested from them if required. If the defense side is making the medical record request, a subpoena may be required to release certain certified documents. It is vital to stay HIPAA-compliant when completing and signing the request.
- Medical record organization: Once the medical records are all received, the next step is to organize them and conduct an initial analysis to check whether the record is complete. The next step is electronic bookmarking of the record and preparing for Bates stamping/numbering. This involves annotating the documents by page numbers and are preceded by a letter signifying the healthcare provider/facility from where the records were sent. Programs such as Adobe Acrobat can be used to Bates stamp records electronically. Medical record organization is very important in the overall review process because it enables you to identify missing records and facilitates more methodical analysis.
- Medical record review: The medical records are then reviewed with regard to the particular case. A meticulous review would focus on known case issues, if any, and also on other areas of concern. In the process of review, a medical case chronology or timeline is also completed. While thoroughness of the medical chart is vital, there may be many aspects in it that are not relevant to the case. Those aspects would be avoided, and only the information applicable to the claim is included. The trained eye of a legal nurse consultant can easily locate the information that is relevant to the case and that which isn’t. When the medical records are initially reviewed, missing records, ambiguous records, and potentially fraudulent records are all noted and listed. These will be included in a second round of record request. Their expertise in the field enables legal nurse consultants to quickly screen for missing records that may be needed in the case.
- Identifying medical experts: To strengthen the case, the right medical expert opinion is vital. Legal nurse consultants help attorneys in determining the specialty of expert needed and also in finding a qualified and experienced medical expert to provide an opinion. Identifying the right experts is challenging because the requirements vary from one state to another. So, the legal nurse consultant must be familiar with these state-specific requirements. Some states even allow the legal nurse consultant to testify as a “fact witness” on the basis of their knowledge of the medical chart.
- Assist with trial preparation: In cases that go to trial, legal nurse consultants help with preparing medical fact reports, exhibits with graphs and applicable data, medical case chronologies and other aspects that could be admitted as evidence. Moreover, they can also help attorneys draft effective questions to use during depositions, interviews, and testimonies.
Legal nurse consultants and medical review companies that assist them are a great support to attorneys and their legal teams. They provide effective solutions in medical litigation in diverse practice areas such as personal injury, medical malpractice, product liability, workers’ compensation, toxic tort and mass tort class actions, criminal law, life care planning and elder law. They simplify complex medical facts and present them to the legal team as straightforward and practical information that can be used effectively.