presentation

Whether you are screening medical malpractice cases for plaintiff or defense, as a Certified Legal Nurse Consultant, you should be on the lookout for those obvious meritorious cases. When you see them, the red flags go up as long as there is significant injury or death. For example, maternal death gets everyone’s attention. The plaintiff CLNC^® consultant’s response is – this is one the plaintiff attorney should absolutely represent. The defense CLNC^® consultant’s initial response is – the defense should settle and settle fast.

Plaintiff attorneys usually want to see significant injuries, even in obvious cases of medical malpractice. They have to weigh the cost of litigation against the return. They must consider if it makes sense. They don’t want to spend $150,000 to win back $250,000.

The Centers for Medicare and Medicaid Services (CMS) recently made it so easy for plaintiff attorneys to successfully litigate 13 types of medical malpractice cases that plaintiff attorneys may be more willing to take on these 13, even if the damages do not meet their usual expected criteria.

To start at the beginning, the National Quality Forum (NQF) endorses a list of 27 serious, preventable and reportable “Never Events.” CMS, issued a ruling last year, effective October 1, 2008: CMS would no longer reimburse for 10 selected “Never Events” – events that should never happen and which are clearly caused by the hospital and/or its staff. Then, effective January 15, 2009, CMS issued another ruling adding three additional, surgery-related “Never Events.” In other words, CMS is trying to save lives by saving money.

Cases involving “Never Events” account, according to AON, for a large percentage (12.2% or more) of medical malpractice claims and will be difficult to defend and easy for the plaintiff attorney to settle fast, thus reducing their litigation costs. Insurance companies will fear taking these cases to trial and losing at great expense. They can settle out of court cheaper.

“Never Eventland” provides the perfect playground for a law firm’s new, young and inexperienced associate attorneys to practice on.

Add these 13 CMS “Never Events” to your “Plaintiff Alert Signal” list.

1. Unintentional retention of a foreign object after surgery.
2. Air embolism.
3. Blood incompatibility.
4. Pressure ulcers (Stages III and IV).
5. Hospital-acquired injuries from falls and certain traumas (fracture, dislocation, intracranial injury, crushing injury, burns and/or electric shocks).
6. Manifestations of poor glycemic control.
7. Catheter-associated urinary tract infections (UTI).
8. Vascular catheter-associated infection.
9. Deep vein thrombosis (DVT) or pulmonary embolism following total knee replacement and hip replacement procedures.
10. Surgical-site infections following certain orthopedic procedures, mediastinitis following coronary artery bypass graft (CABG) and/or following bariatric surgery for obesity.
11. Surgery on the wrong body part.
12. Surgery on the wrong patient.
13. Wrong surgery performed on a patient.

Educate your attorney-clients about “Never Events.” Offer to do a 20-minute presentation for all of the attorneys in the law firm. Even with attorneys, small wins are good.

Success Is Inside!

I just hung up from mentoring a new Certified Legal Nurse Consultant regarding a med-surg case. After listening to her ramble aimlessly about the case for three minutes, I politely stopped her and said, “I would really like to help you solve your issue, but would you please describe the issue?” After a few more attempts at rambling and a lot more nudging by me to keep her focused, she finally got to the heart of the matter, and we dealt with it easily and swiftly.

As we were about to wrap up, she confessed that she still found it uncomfortable and often unsuccessful to talk to attorneys about her legal nurse consulting role. I immediately realized the source of her problem. I had just lived it! It was her rambling method of communication.

Those of you who know me, know that I tell it like it is. I firmly but nicely shared that I had a direct insight into her communication challenge just from our brief conversation. Attorneys are crazy busy. They’re working for a living. They’re not like patients who lay around in bed with lots of time to spare waiting for the next visit from their favorite nurse, happy for any company other than a bad reality show.

When you are talking to an attorney, you have to focus, focus and focus some more. You cannot go into an interview or meeting with an attorney being unprepared or misdirected. Once you lose the attorney, you lose the opportunity. There’s no place like an attorney’s office to prove the truth of the old saying, “You never get a second chance to make a first impression.”

The fastest way to lose the attorney is to appear unprepared. Practice your presentation before you give it. Try it on a spouse – if you can keep their attention, you’ll probably be able to keep an attorney’s.

Preparation and focus are the keys to successfully communicating and to feeling comfortable about any communication you are about to engage in.

And remember, if you can say it in five words/minutes, try doing it in three words/minutes instead.

Success Is Inside!