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Legal Nurse Consultant (LNC) Medical Malpractice Case Review

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Author:    Julia Tortorice (RN, MBA, MSN, NEA-BC, CPHQ)

Purpose/Goals

The purpose of this program is to assist the LNC successfully develop and manage a LNC consulting practice. This program was designed to provide LNC's with the scope of experience and a mentoring relationship needed for advancement as an LNC. It involves an actual case evaluation, a multitude of tools, and activities to put into practice and grow a business. There is an additional cost for the coaching sessions from LNC Resource.

Objectives

After completion of this program, the learner will be able to:

  1. complete a case review,
  2. organize and index a medical record,
  3. develop a medical chronological timeline,
  4. complete a case summary analysis,
  5. conduct a medical literature review,
  6. develop exhibits and demonstrate evidence for trial,
  7. discuss the IME and LNC’s role, and
  8. write deposition questions and objections.

Introduction

The Medical Malpractice Case Review involves a missed MI in the Emergency Room.  The case is worked up from the plaintiff perspective, but coordinating defense reports are integrated to illustrate a contrast between what alternate clients desire and expect.  There are activities designed to be completed in between each session and are submitted via email for review prior to the next scheduled session.  By the end of the program, the LNC will then have a complete set of reports/documents to share with prospective clients as an example of the type of work product they are able to produce.


By the end of the program, the LNC will have 5 sample reports they have developed themselves and may use as potential marketing pieces for promoting their own LNC practice.  These same reports may be used to secure an in-house position with a law firm, insurance company or risk management department.  In addition, the coach will send out reports developed by an experienced LNC to illustrate an alternative perspective of report preparation and development.

Applicable skills and experience are achieved through the following tasks:

  • General Information surrounding case reviews, research, and reporting to potential clients will be presented, as well as a worksheet utilized to assist the LNC in the review process for the sample case.
  • A Stack of Medical Records are sent out to allow for basic record organization and indexing.  A table of contents of all documents, duplicates and requesting procedures are discussed. 
  • A Fact Based Chronology of all abstracted data and findings will be prepared using the sample set of medical records, with critique and feedback of the LNC’s report.
  • Medical Summary Report preparation is accomplished following discussion of the variety of report styles and types to implement.  This report will also be critiqued.
  • Multiple Aspects of a Medical Literature Search and research techniques are discussed with case examples and how to best locate and implement standards of care to illustrate what was done versus what should have been done.
  • Discussion of the medical literature search results and case application is explored as it relates to the allegations in the file.  A report according to one issue per each potential defendant will be required as the class assignment for this session.  Potential testifying experts are discussed on how they can be found and utilized from the medical literature on particular issues.  A sample report for this task will also be shared with the LNC.
  • Qualifying, selecting the appropriate candidate and utilizing testifying experts are discussed as it relates to the facts of the sample case, as well as interacting with the attorney client is discussed.  The LNC will also be required to locate and provide the coach with curriculum vitas of 2 potential testifying experts as a class assignment.
  • Preparation, development and integration of deposition questions will be explored as they relate to the conduct and activities of the potential defendants in the sample case.  A completed example of deposition questions will be provided.
  • Independent Medical Exams and the role of the LNC will be discussed as it relates to the activity before, during and after the IME event. 

Outline of Sessions

  1. Case Overview with Review Worksheet (may take 2 sessions)
  2. Organization & Indexing of Records sent
  3. Medical Chronology/Timeline Development
  4. Case Summary Analysis Report Writing (may take 2 sessions)
  5. Medical Literature Research Principles
  6. Finding and Working with Expert Witnesses (may take 2 sessions)
  7. Developing exhibits and Demonstrative Evidence for Trial
  8. The IME and LNC’s role, Report Writing
  9. Writing Deposition Questions & Objections