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Certified Legal Nurse Consultants Know the Devil is in the Details

CLNC® consultants rarely get bored because every case is unique with a set of facts that will never appear the same way in any other. Change any of those facts and the outcome is potentially different.

Two Certified Legal Nurse Consultants share great examples of why they treat every piece of information in a case as important until proven otherwise.

“I find it helpful after reviewing a document to stop and ask: What did I learn? What doesn’t make sense? What’s missing? What do we need to explore further? For example, I was consulting on a case involving a four-year-old girl who claimed she was inappropriately touched in the pre-school bathroom by the custodian. Her mother mentioned to the SANE examiner that the custodian had previously been a principal in another school. Nowhere in any other records was this fact mentioned. Also, the child’s teacher mentioned in her statement that the custodian had been playing his usual game of tag with the children while waiting for parents to pick them up. Both statements raised red flags and merited follow-up. Why was a prior principal working as a custodian in a pre-school setting and why was a custodian playing tag (a game involving physical contact) with pre-school children?”

Carolyn J. Bilodeau, RN, BSN, MS, CLNC

“I have learned from many of my case reviews as a Certified Legal Nurse Consultant that the crux of assessing a case is often found in the smallest of details. I recently reviewed a case involving a patient who, on admission to a skilled nursing facility, was noted to have four small pressure ulcers. The plaintiff alleged that the facility left her unattended for eight days, allowing the pressure ulcers to dramatically increase in size and eventually required an amputation of the foot. My review of the medical records revealed that the wounds were diabetic ulcers and that the patient had recently refused a recommended arteriogram with stenting. More importantly, I found that the plaintiff’s expert had failed to note that the treating consulting physician had described the wounds in millimeters, which consistently corresponded to the nurse’s description of the wounds in centimeters. There was absolutely no increase in the size of the wound. These two details were used to defend what might otherwise be considered a slam-dunk case for the plaintiff.

Margaret Gallagher, RN, MSN, LLNC, CLNC

The next medical-related case you consult on as a Certified Legal Nurse Consultant consciously consider all of the facts. After all, the unique facts are what make that case one-of-a-kind. As Carolyn and Margaret have demonstrated, one detail can make the difference in the outcome of your next medical-related case.

I’m Just Sayin’

P.S. Comment here to share how one fact made a difference in a case.

One thought on “Certified Legal Nurse Consultants Know the Devil is in the Details

  1. I discovered tampering in the medical records of my first case. The devil in the detail was a black blot that was gone on the second set of the same records. The black blot was covering up a fatally slow fetal heart rate and looked like someone had an ink accident, that is what I and the attorneys originally thought.
    I have not found tampering in the next cases, but I will never forget this experience.

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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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