Articles Posted in Researching Experts

In Handoff Communication, medical insurance expert witness Ms. Kathy G. Ferrell, BS, RN, LNCC writes:

Handoff communication is simply the relay of information from one healthcare provider to another. Every day nurses are responsible for relaying information regarding patient care to physicians, nurses, radiology, laboratory, dietary and many other health care providers.

A breakdown in this communication has been reported by The Joint Commission (accrediting body for hospitals) as the root cause of 65% of adverse events that occur in hospitals. In 2006 The Joint Commission mandated that hospitals improve the effectiveness of handoff communication including a process whereas the healthcare provider had an opportunity to ask questions and have them answered.

In Medical Malpractice Overview, medical expert witness Eugene DeBlasio writes on substandard care, treatment or surgery:

The standard of care which is owed to people as a patients is that which represents that level of skill, expertise, and care possessed and practiced by physicians found in the same or similar community as the relevant one, and under similar circumstances. However, the advent of “national board” exams for new doctors and “board certifications” for doctor-specialists has resulted in a more uniform and standard practice of medicine not dependent upon geographic locality.

All licensed physicians should possess a basic level of skill and expertise in diagnosing and treating general or recurring types of illnesses and injuries. Thus, a general practitioner who has administered substandard cardio-pulmonary resuscitation (CPR) to a heart attack victim (who subsequently dies as a result of the substandard care) cannot defend that he or she was not a “cardio-pulmonary specialist.” A general practitioner from virtually any other area in the United States could most likely testify as to the level of care and expertise that is to be expected under the circumstances. Conversely, a board-certified cardiopulmonary specialist could not testify that the general practitioner should have done everything that the specialist might have done with his advanced skill and training. Nor, under the locality rule, could an oncology specialist in private practice in Smalltown, U. S. A., be held to the same standard of care as an oncology specialist in a large urban university teaching hospital that has state-of-the-art equipment and facilities.

In Use of a Legal Nurse Nurse Consultant in Client Interviews, medical insurance expert witness Ms. Kathy G. Ferrell, BS, RN, LNCC writes:

Nurses learn communication and interviewing strategies as part of their basic interpersonal and assessment skills in the first semester of training. It is a basic skill that nurses use on each patient admission (or visit to the physician in his office); on each day the patient is in the hospital and even at the beginning of each nursing shift on each hospitalized patient. We are skilled in active listening and the subsequent collection of critical data.

The rapport established between the plaintiff and the attorney and/or staff at the initial interview may have far reaching consequences in terms of the accuracy and completeness of information obtained. Plaintiffs need to believe that the attorney and staff are advocates, working on their behalf, in order to maintain a trusting and amenable relationship. During the initial interview the legal nurse consultant can:

When hiring an annuities expert witness, it may be a good idea to study the appropriate terminology. The Annuities Institute offers an extensive list of annuity terms including:

Annuity An annuity is a contract issued by a life insurance company that provides for tax deferral of investment income until withdrawn from the contract. An annuity can also be referred to as a contract or agreement by which one receives fixed payments on an investment for a lifetime or for a specified number of years.

Deferred Annuities (Tax Deferred)

In Acoustic Signal Analysis For Forensic Applications, acoustics expert witnesses Durand Begault and Christopher Peltier write:

Acoustical analysis of audio signals is important in many legal contexts for determining the authenticity, originality, and continuity of recorded media; determining the circumstances of events in question that may have been recorded; for determining the audibility of signals; and for identification or elimination of talkers as a match to an unknown exemplar.

Recorded media are analyzed in forensic applications using both familiar techniques (waveform and spectral analyses) and more novel methods (e.g., ferro fluid development of media; specialized tape heads with nonstandard reproduction characteristics; crystal microscopy; detection and matching to power grid frequencies). Audibility analyses frequently require careful reconstructive field measurements and criteria in excess of normally accepted standards. Voice identification-elimination protocols must account for examiner bias and exemplar quality and can be described using a receiver operator curve (ROC) model.

In Medical Malpractice Overview, medical expert witness Eugene DeBlasio writes on failure to treat or erroneous treatment:

The most common way in which doctors are negligent by failing to treat a medical condition is when they “dismiss” the presenting symptoms as temporary, minor, or otherwise not worthy of treatment. This situation may result in an exacerbation of the underlying condition or injury, causing further harm or injury. For example only, an undiagnosed splinter or chip in a broken bone may result in the lodging of a piece of bone in soft tissue or internal bleeding caused by the sharp edge of the splintered bone.

Erroneous treatment is most likely to occur as a result of a misdiagnosis. However, a doctor who has correctly diagnosed a disease or condition may nonetheless fail to properly treat it. Other times, negligence is the result of a doctor attempting a “novel” treatment that fails, when in fact a more conventional treatment would have been successful.

In Using A LNC As A Expert Fact Witness, medical insurance expert witness Ms. Kathy G. Ferrell, BS, RN, LNCC writes:

Although treating physicians have an understanding of the care given to a patient, they seldom have the time to read a medical record from start to finish. Even if requested to do so by the attorney, the demands on a physician’s time prevent him from having the needed hours to read a medical record and provide the attorney with a detailed report of the care given to a patient. Even if the physician was able to perform this service, the cost would be prohibitive for many plaintiff or defense attorneys.

Family members are often acutely aware of the care received by the patient, but have no knowledge of its significance and are unable to explain the reasons for such care to a judge or jury. On the other hand, the legal nurse consultant (LNC) has the special knowledge, training and skill to educate the triers of fact about the care given to a patient as documented in the medical record. This can be extremely important in very complex and lengthy medical cases. The LNC serving as a fact witness does not express opinions about the quality of care or the treatment given, but educates the judge and jury on the care given and the patient’s response to this care.

In Medical Malpractice Overview, medical expert witness Eugene DeBlasio writes on failure to diagnose or erroneous diagnosis:

Generally, a delay or failure to diagnose a disease is actionable, if it has resulted in injury or disease progression above and beyond that which would have resulted from a timely diagnosis. This situation may be difficult to prove. For example, a patient may ALLEGE that a doctor failed to timely diagnose a certain cancer, resulting in “metastasis” (spread of the cancer to other organs or tissues). But experts may TESTIFY that “micrometastasis” (spreading of the disease at the cellular level) may occur as much as ten years before a first tumor has been diagnosed, and cancerous cells may have already traveled in the bloodstream and lodged elsewhere, eventually to grow into new tumors. Therefore, it may be difficult in some cases to establish that a patient has suffered a worse prognosis because of the failure or delay in diagnosis.

If a patient is treated for a disease or condition that he or she does not have, the treatment or medication itself may cause harm to the patient. This is in addition to the harm caused by the true condition continuing untreated.

In Medical Malpractice Overview, medical expert witness Eugene DeBlasio writes on actionable malpractice:

State laws govern the viability of causes of action for medical malpractice. The laws vary in terms of time limits to bring suit, qualifications of “expert” witnesses, cognizable theories of liability, and proper party defendants/proper party plaintiffs. Notwithstanding these differences, there are common requisites for all cases.

First and foremost, a physician must owe a duty to patients before his or her competency in performing that duty can be judged. In U. S. JURISPRUDENCE, a person has no affirmative duty to assist injured individuals, -in the absence of a special relationship with them (such as doctor-patient, attorney-client, guardian-ward, etc.) A doctor dining in a restaurant has no duty to come forward and assist injured others if they suffer a heart attacks while dining in the same restaurant. If the doctor merely continues with his meal and does nothing to help, the ailing others would not have an action for malpractice against him, notwithstanding their harm. However, once a doctor voluntarily decides to assist others or come to their aid, he or she becomes liable for any injury that results from any negligence during that assistance.

In Medical Malpractice Overview, medical expert witness Eugene DeBlasio explains:

Medical malpractice is negligence committed by medical professionals. For negligence to be “actionable” (having all the components necessary to constitute a viable cause of action), there must be a duty owed to someone, a breach of that duty, and resulting harm or damage that is proximately caused by that breach. The simplest way to apply the concept of proximate cause to medical malpractice is to ask whether, “but for” the alleged negligence, the harm or injury would have occurred.

When determining whether the conduct of a member of the general public is negligent, the conduct is judged against a standard of how a “reasonably prudent person” might act in the same or similar circumstance. Conversely, when determining whether a medical professional has been negligent, his or her practice or conduct is judged at a level of competency and professionalism consistent with the specialized training, experience, and care of a “reasonably prudent” physician in the same or similar circumstances. This constitutes the “standard of care” or professional “duty” that a physician owes to his or her patient. If the physician breaches the standard of care and his patient suffers accordingly, there is actionable medical malpractice.