Underdeveloped Claims: How Early Investigation Can Help

Developing a body of facts is a crucial aspect of litigation. Medical malpractice cases rise — and fall — on the fact record legal professionals obtain over the course of a lawsuit.

It’s common for attorneys and paralegals to fill the role of investigator, reviewing medical records and interviewing key individuals to sort out the facts of the matter.

Not having a complete, balanced picture of a case can lead to something no lawyer wants for their client: a weakened position in settlement negotiations and at trial. While legal professionals can, and often do, develop a deep understanding of their practice areas, there’s still a role that specialists can play in ensuring that no plaintiff’s claims are left underdeveloped.

Consider a now-closed case in which plaintiffs engaged Med Law Advisory Partners’ consulting nurse experts to perform a medical-legal investigation. The plaintiffs hired Med Law to do a deep dive into the care provided at the defendant facility after their settlement negotiations, more than a year after filing the case.

The plaintiffs alleged the facility allowed a patient’s Stage 3 pressure injury to develop while the patient was under their care. The defense argued that the breakdown of the patient’s skin existed before their admission to the facility, and the care rendered was proper. The defense further countered that the patient’s non-compliance contributed to their worsening condition.

As part of the investigation, Med Law reviewed the patient’s medical records to determine whether the facility’s nursing staff met the standard of care, the generally accepted measure of quality of care, related to the prevention and treatment of wounds.

What they found were several deviations from acceptable practice, including the following:

  • Failure to properly document a complete skin assessment on admission
  • Inaccurate and inconsistent Braden Skin assessments
  • Failure to initiate a baseline and comprehensive plan of care for prevention and treatment of skin breakdown in a timely manner
  • Failure to timely appreciate and communicate a change in skin condition to the treating provider
  • Failure to timely and appropriately administer medications and nutritional supplementation in the presence of malnutrition and a Stage 3 pressure injury
  • Failure to consistently administer wound care treatments in the presence of a Stage 3 pressure injury

Because these issues were not thoroughly investigated early in the claim, the plaintiffs did not fully understand the depth and breadth of the case before them, including the level of the defendant’s contribution to the patient’s injuries.

Our consulting nurse experts’ assessment helped the plaintiffs show that the patient’s skin breakdown was more likely not present at the time of their admission. Further, the analysis demonstrated a delay in developing a plan of care to prevent skin breakdown likely contributed to the development and worsening of a Stage 3 wound.

The case shows the importance of early-stage assessment and the value of engaging medical-legal experts to build out a case fully.

Attorneys have an ethical responsibility to provide diligent representation on behalf of their clients. This includes fully investigating claims and making sure that their case is well-developed. Med Law can help plaintiffs’ counsel gain a deeper understanding of their cases, setting them up for greater success.

Our medical-legal team is comprised of highly experienced legal nurse consultants and dedicated support staff. Our registered nurses have extensive clinical experience in the areas of acute/critical care, long-term care, health systems management and many specialty areas within the nursing profession. Additionally, 75 percent of our legal nurse consultants carry the Legal Nurse Consultant Certified (LNCC) certification, demonstrating their industry expertise.

This expertise allows us to conduct efficient, in-depth analyses of medical malpractice matters and develop strategic, data-driven reports that help inform the direction of litigation for our clients.

Contact us today to learn more about how we help plaintiffs in their litigation.


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