My Most Memorable CLNC® Case

My Most Memorable CLNC® Case: I Overrode the Physician Expert’s Opinion and Helped Settle a Multimillion Dollar Case

I seriously could write a book about this case. I met the attorney of this memorable case at a legal seminar. I was asked to review the medical records and fetal monitoring strips of a baby who was severely brain injured. An OB/GYN expert reviewed the records and found no deviations to the standards of care by the physician or the labor nurses. It was the OB/GYN’s opinion that the fetal monitoring strips showed no distress.

The attorney, a very accomplished medical malpractice attorney, was then led to believe that the cause of the baby’s injuries was a negligent resuscitation after delivery, with a “0” Apgar score as “proof.”

The attorney hired me to review the records with a focus on resuscitation. After reviewing the records, my opinion was that there were significant hyperstimulation and hypertonus causing a brain compression injury to the baby during labor. I developed a 50-page chronology that detailed every aspect of the labor and delivery, complete with a section that compared and contrasted the documented interpretation of the FMS to mine. I addressed the standard of care for nurses and physicians for staffing guidelines, Pitocin®, intrauterine pressure catheters and amnioinfusion. The hospital had gone against its own protocols in the use of Pitocin® and amnioinfusion. Because the heart beat of the baby showed no “sentinel event” and did not look “ominous,” the original OB/GYN who reviewed the case missed the six hours of hyperstimulus and hypertonus of 50 mmHg. The nurses continued the amnioinfusion and increased the Pitocin® despite the ominous contraction pattern which are both deviations from the SOC and against hospital policy.

The attorney reviewed my interpretation of the case and when we met again, she greeted me with “Okay, I get it! I’m filing this case”, and that was the beginning of one of the best cases of her career. It became as satisfying for her as it was for me.

I was able to secure top medical experts – one of whom she had contacted before on another case but who said he was too busy. When I contacted him he said, “As long as you’ve determined it’s a viable case, I’ll review it”. This wasn’t the first time an expert had agreed to take on a case for me when they had said no to the attorney.

In addition to providing the chronology, educating the attorney and finding several expert witnesses, I flew to Houston to meet the attorney in a labor suite and operating room to teach about all of the equipment used on the mother i.e., IUPC, fetal monitor, IVs, cardiac monitor, pulse oximeter, O2, etc., during labor and delivery and the resuscitation of the newborn.

The defense had their usual arguments explaining why the injuries couldn’t have happened during labor – infection causation, prenatal causation, no sentinel event. The defense also tried a Motion in Limine to prevent the theory of hyperstimulus and hypertonus causing a compression brain injury during labor. All to no avail.

Because of the detailed chronology and up-front, early and thorough education provided to the attorney, the case actually settled prior to any disclosure of expert reports or expert depositions – which is unheard of in brain-injured baby cases.

The impact on my financial status is immeasurable and this attorney-client has referred me to other attorneys. I would not make any changes to the way I prepared this case. My advice to other Certified Legal Nurse Consultants is to follow your instincts about what you think will help your attorney-clients the most.

My mission statement as a CLNC® consultant is to make medicine safer for all. This baby, while injured, will have his life care plan fully funded and will have the most satisfying life possible because of my involvement. My attorney-client continually expresses her gratitude saying: “We never would have gotten here without you. It was because of you that we won this case.”

Becky Mungai, RN, BA, CLNC

P.S. Comment and share your most memorable case or to congratulate Becky.

8 thoughts on “My Most Memorable CLNC® Case: I Overrode the Physician Expert’s Opinion and Helped Settle a Multimillion Dollar Case

  1. Becky, we as patient advocates, are their strongest link!!…Congratulations to your strength to override the doctors who tend to view the big picture as “just a bad outcome”!!!!!….:):):)

  2. Congratulations Becky! Thank you for sharing your story. I am just starting my CLNC® business and it inspires me to hear how much impact a nurse can have on the legal world. That family was very fortunate to have someone like you on their side. I believe you have achieved your mission!

  3. Stacey, Garla, and Mimi (who private emailed me) –

    Thanks so much! I appreciate your kind words.

    I just got a phone call from an attorney I met on a plane last July. He hired me to find an expert witness.

    Remember when Vickie said to talk to everyone within 3 feet of you? That’s been my greatest secret to my success – seriously!

    Have fun with this! Being a Certified Legal Nurse Consultant is amazing!

  4. Becky – thank you for sharing this case. This is a great example of what Certified Legal Nurse Consultants can do through persistence and hard work, with much attention to detail. Congratulations and I am sure the family of this little boy is grateful to you and the attorney you helped.

  5. Congratulations Becky! I have been a full-time Certified Legal Nurse Consultant since taking Vickie’s CLNC® Certification Program in 2005. Your analysis obviously produced a great result for the patient. I often find that the physician experts don’t conduct a detailed review as we were taught – it makes all the difference!

  6. Becky, I was really impressed by your story! I am planning on starting the CLNC® Certification Program this week and your story has further motivated me to apply myself to thorough and attentive to details! I’m wondering…I’m assuming you had experience working in OB prior to being involved in this case. Do you think you could have “solved” it without that experience – simply using research and consulting with RNs in the field?

    Thanks again for sharing!

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*The opinions and statements made by Vickie Milazzo, the founder of Medical-Legal Consulting Institute, Inc. are based on her experiences and expertise, should not be applied beyond the specific context provided, and do not guaranty or project actual results. Vickie Milazzo is no longer involved in the operations or management of the business, but is involved as an independent education consultant.

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