Wednesday, March 17, 2010

Hold Nothing Back

I work with attorneys.  I know that they provide medical experts with selective records targeting their area of expertise.  Some of this is cost containment and some of it is shaping the view of the expert. This practice of selective omission and inclusion does not work for me as a legal nurse consultant. I want everything.  

An expert witness works within a narrow window and focuses upon rendering an informed opinion.  This expert is critically important, but how many will you need in a complex medical action? 

You only need one legal nurse consultant to work your medical case.

If that person is me, send me every scrap of data in your possession.  I am a bloodhound. If you omit information, I will know it.

In asking for the entire file, I have a targeted, cost-efficient yet comprehensive system for discovering critical information, discarding irrelevant data, and knowing what is missing.  My chronology clarifies the diagnostic picture and directs me to the authoritative research that will support my recommendations and conclusions.

The most relevant data is often the most elusive. That chicken scratch that passes for cursive writing may be at odds with the typed dictation. The casual comment to the ER nurse or EMS may not be admissible as testimony, but is no less relevant to the case.

In dealing with this abundance of information, I find the the pleading, affidavits, interrogatory and responses to be critical. These documents reveal the mindset of the claimant and the temerity of the attorney. I need that.

If  I am working a defense case, I know that an over-reaching complaint is an open invitation to investigating past medical care. Discrediting one specious charge will cast doubt on others. It is a rare individual who enjoys perfect health until an unwitnessed slip and fall in the drugstore.

If this is a plaintiff case, I am equally wary of the client who casts a wide net of complaints, or the nondisclosive client who selectively provides data.

In this world of healthcare litigation, we cannot truly function knowing this thing but not that thing.  The practice of picking and choosing data will come back to haunt both plaintiff and defense attorneys…particularly if the opposition has me on their team.


  1. Great Job! and Great Points!

  2. Alice always has great information to share. I am glad that Alice has a blog so that I can enjoy her writings more often. Great differentiation between an expert witness and a legal nurse Alice. I look forward to reading many more of your blogs. Thanks!

    Pam Kline RN, BSN, CLNC

  3. Thank you Paula. I appreciate your comments and hope you will come back soon.

  4. Alice, you've made an excellent differentiation between a nurse who is working as a testifying expert and a nurse who is working as a legal nurse consultant. As a testifying expert, one does NOT want the extraneous information that can cloud the facts of the issue at hand. As a behind the scene legal nurse consultant, however, one DOES want the entire body of information available in order to help the attorney with all information available. Well written blog, valuable information, and proud of your contribution to our wonderful profession!

  5. Alice,

    This is a very impressive piece of information to share with the attorney as he argues about having to get you all the information (cost, time, etc.) Thank you for the insight and helpful tip. I will put into practice right away!

  6. Alice, I think you are one of the best LNC's. But it has little to do with your blog. It has everything to do with discernment. You are able to quickly hone in on the issues that are germane to that attorney client. No wonder so many fine attorneys employ you! It's exciting to see you verbalize some of our day in this area. A little "peak" into the life of an LNC.
    Thanks Alice! Nice job.