Medical Malpractice

Medical malpractice occurs when a health care professional or provider neglects to provide appropriate treatment, omits to take an appropriate action, or gives substandard treatment that causes harm, injury, or death to a patient. The malpractice or negligence normally involves a medical error. This could be in diagnosis, medication dosage, health management, treatment, or aftercare. Medical malpractice law makes it possible for patients to recover compensation from any harms that result from sub-standard treatment.

A health care professional is expected to provide a certain standard of care. The professional is legally responsible if the patient experiences injury because of substandard quality of care.

For medical malpractice to be considered a number of factors must be involved, these are:

• Failure to provide a proper standard of care.
• An injury results from negligence. The patient must prove that negligence caused injury or harm, and that, without the negligence, it would not have happened.
• The injury must have damaging consequences. Considerable damage could be suffering, enduring hardship, constant pain, considerable loss of income, disability.

Case focus for medical record review in medical malpractice cases

• Should show that physician acted negligently in rendering care.
• Negligence resulted in injury.

Types of malpractice

• Misdiagnosis or failure to diagnose.
• Delayed diagnosis.
• Dental malpractice.
• Unnecessary or incorrect surgery.
• Premature discharge.
• Failure to order appropriate tests or to act on results.
• Not following up.
• Prescribing the wrong dosage or the wrong medication.
• Leaving things inside the patient’s body after surgery.
• Potentially fatal infections acquired in the hospital.

Nursing home negligence

Neglect occurs when residents are not properly cared for, resulting in physical harm, illness, or even death. When the standard care is not met by care providers in nursing homes, the resident suffers great physical and mental health problems.

Case focus for medical record review in nursing home negligence

• Failing to administer medications when needed.
• Not regularly moving seniors with mobility issues, putting them at risk of bedsores.
• Not reporting signs of infections or illnesses.
• Improper care for existing health problems like diabetes or dementia.
• Fail to provide canes, wheelchairs, or walkers to residents with mobility limitations.
• Isolating vulnerable residents.
• Not properly bathing a senior.
• Not changing the clothing or bedding of seniors who soil themselves.
• Providing seniors unsafe food or water.

Warning signs of nursing home neglect include:

• Bruises, lacerations, skin tears, broken bones, and other unexplained injuries.
• Bedsores (pressure ulcers/pressure sores).
• Malnutrition.
• Dehydration.
• Burns, often accidentally self-inflicted.
• Personal hygiene issues.
• Insomnia/sleep loss.
• Significant personality changes.
• Excessively using restraints (physical or medical) on a resident.
• Giving incorrect or ineffective doses of medication over long spans of time.
• Consequences of nursing home neglect: Bad odor, dirty skin, recurring sicknesses or injuries, weight loss, dehydration, anemia, fatigue, personality changes (like depression, anxiety and fear), loss of trust in others, insomnia or sleep loss, suicidal thoughts or actions.

Mass tort

Medical Record Review of Mass Tort Claims

A mass tort is a single wrongful action that causes injury to many different people. These injured people can come together in a single mass tort lawsuit, seeking justice for their various injuries against just one defendant (or maybe a few). Mass tort actions can make it much easier for plaintiffs to succeed against giant defendants like product and medication manufacturers.

The lawsuits arise out of the defendants causing numerous injuries through the same or similar act of harm (e.g. prescription drug, medical device, defective product, train accident, plane crash, pollution, or a construction disaster).

What Are Mass Torts?
A Mass Tort is a case where many people are wrongfully harmed in a similar way, by a similar product. Often by a drug, medical device or defective product, a recent example is the Takata airbag recall, which affects millions of cars.

Case focus for medical record review in mass tort cases

• Causation of injury.
• Demographic identification.
• Medical procedure data.
• Product ID.
• Significant procedures and surgeries, per relevant product.
• Plaintiff fact sheet preparation.
• Evaluate questionnaires for medical merit and clinical issues.
• Determine which medical records are pertinent to mass litigation.

Social security disability

When you’re seeking compensation for an injury after any kind of accident, there’s a good chance you’ll be dealing with an insurance company. For example, if you get into a car accident, you (or your attorney) may talk settlement with the at-fault driver’s car insurance company. If you file a personal injury lawsuit after a slip and fall, the property owner’s homeowner’s insurance or liability insurance is probably going to kick in.

Medical record reviews are required for medical as well as legal purposes. Accurate review of medical records is important for insurance companies to help them ensure a fair claim settlement in personal injury, medical malpractice and other medical litigation. Insurance medical record review must be accurate and thorough because it is imperative to prove fairness, medical necessity, fraud, embellishment, and up-coding among other aspects.

Case focus for medical record review in social security disability/insurance claims

• Prior history. Diagnosis, medications, that could prove to be a potential defense.
• Missing information in the records that may prove valuable at some stage or other.
• Whether the diagnosis given by physician is accurate, and whether the treatment/care given is reasonable or necessary.
• Actual expenses (i.e.medical bills) incurred, and those that will be incurred in the future.
• Lost income or lost ability to make a living.
• Pain and suffering.
• Photographs, medical records, and itemized statements of all bills paid and work lost are all essential to maximizing your recovery.
• Demand letter. This is a letter in which you spell out your side of the underlying incident and state what you will accept in order to settle the case.
• Capturing all the details provided by independent medical examiner.
• Medical expenses.

Medical Record Review for workers compensation claims

Employers are legally obligated to take reasonable care to assure that their workplaces are safe. Nevertheless, accidents happen. When they do, workers compensation insurance provides coverage.
Workers receive benefits regardless of who was at fault in the accident. If a worker is killed while working, workers comp (as it is often abbreviated) provides death benefits for the worker’s dependents.

Workers’ compensation

Workers’ compensation is a form of insurance providing wage replacement and medical benefits to employees injured in the course of employment in exchange for mandatory relinquishment of the employee’s right to sue his or her employer for the tort of negligence.

Case focus for medical record review in workers compensation cases

• New diagnoses after the injury.
• Lost income or lost ability to make a living.
• Pain and suffering.
• Photographs, medical records, and itemized statements of all bills paid and work lost are all essential to maximizing your recovery.
• Capturing all the details provided by independent medical examiner.
• Detailed list of all physicians seen for the injury. This will help ensure that a comprehensive and accurate medical history of the injury.
• Determine whether there is any permanent partial disability due to the injury. To review the relevant medical records that document the injury.
• Information like partial disability, reduced capacity, claimant is unable to return to his/her original job, but may be able to work in some other job.
• When the injury does not allow the claimant to work regularly in any capacity.
• When there are pre-existing disabilities.
• When there are planned surgery in office visits.