3 CLNC® Consultants Describe Their Preferences for Plaintiff or Defense Legal Nurse Consultant Jobs

I asked three CLNC consultants to describe their preferences for plaintiff or defense legal nurse consultant jobs. You’ll find a variety of reasons from objectivity to keeping nonmeritorious cases out of the system motivate the choices of these Certified Legal Nurse Consultants. They also share a few favorite cases involving respiratory distress, septic shock, compartment syndrome and birth injury.

1. Interview with Connie S. Chappelle, RN, MN, CLNC:

Do you consult with both plaintiff and defense?

Yes, it keeps me honest and objective.

Briefly discuss a favorite plaintiff case and why it’s a favorite.

I was consulting with a plaintiff attorney on a case in which the plaintiff extubated herself in the middle of the night. The RN made the decision to wait to see if the patient could breathe on her own. When the patient developed respiratory distress almost immediately, she called the patient’s physician (out of hospital) who instructed her to call a code.

A code was called and the emergency department (ED) physician attempted to intubate but was unsuccessful due to the patient’s existing neck injury. Then the ED physician attempted a crichotomy and failed. The staff continued to bag the patient. A pulmonologist was called (out of hospital) who came and intubated using bronchoscopy. The patient suffered anoxic brain injury requiring lifelong, supportive care.

In this case, the plaintiff attorney used my work product to win a $6.7 million dollar settlement and enthusiastically shared that I “was worth every penny.”

Briefly discuss a favorite defense case and why it’s a favorite.

I consulted for the hospital defense on a case involving septic shock. In reviewing the records it was my opinion that the ED physician made an error when assessing the patient which caused a delay in treatment and resulted in death. I told the hospital defense attorney my finding, and he asked if the ED physician’s attorney could talk to me about the finding. Of course, I said yes (thinking of the opportunity to market). When I advised the ED physician’s attorney of my finding, he was silent for a moment and then said to me, “Well, it’s a good thing you’re not consulting with the plaintiff’s attorney.” The plaintiff’s attorney was struggling to build his case and was unaware of this finding.

2. Interview with Jane Hurst, RN, CLNC:

Do you consult with both plaintiff and defense?

I have consulted with both plaintiff and defense attorneys, but my current clients are only plaintiff attorneys. I prefer plaintiff work because I’m able to make a difference in two ways. First, I can identify nonmeritorious cases where members of the medical profession upheld the standards of care. Second, I identify meritorious cases that deserve legal recourse. In my experience with defense cases, I was tasked with finding defenses for actions that were not defensible. I recognize that my experience is based upon the defense attorneys I’ve worked with and not all are alike.

Briefly discuss a favorite plaintiff case and why it’s a favorite.

A 26-year-old woman fell off a two-story home when cleaning leaves off the roof. She landed feet first on the ground. She was taken to the ED and x-rays showed bilateral tibial fractures. In answering the admission assessment questions, she admitted she had a drug problem ten years prior (her drug screen was negative). She was held in the ED until her bed on the ortho floor was ready. The patient began complaining of severe left leg pain.

The ED nurse documented that the patient was a drug addict and displayed drug-seeking behavior in the ED. She also documented in her report to the floor nurse that the patient’s leg pain was not as severe as she said. The patient’s left leg pain worsened when she was transferred to the orthopedics floor, and she frequently requested pain medication. Nursing noted the patient’s left leg was becoming cool to touch, and they did a great job documenting assessments of the left leg. The staff nurse asked the charge nurse to check the patient’s leg. The charge nurse’s assessment was consistent with the staff nurse’s.

The charge nurse called the orthopedic surgeon and asked permission to do a Stryker test to check pressures for possible compartment syndrome. The surgeon refused and said she did not have compartment syndrome. Fortunately, the charge nurse also did an excellent job documenting, and included details of the phone conversation with the surgeon.

The neurological status of the patient’s left leg declined further, and the charge nurse called the nursing supervisor. The supervisor assessed the patient’s left leg and documented in detail. She also called the orthopedic surgeon and was told the patient did not have compartment syndrome and not to call back. The nursing supervisor documented a detailed account of her conversation with the surgeon. After that, nursing dropped the ball. The supervisor did not continue up the chain of command to advocate for the patient by contacting the director of nursing, chief nursing officer, medical director or the hospital administrator.

Up to that point, I was thoroughly impressed with the nursing staff and supervisor. However, the nursing assessments abruptly ended. The last documentation in the record was the patient’s signed and dated AMA form.

The patient called her mother and asked her to take her to a different hospital, which she did. The second hospital’s ED records immediately noted compartment syndrome. The patient was taken for emergency surgery where they did an initial four-compartment fasciotomy. The operative note stated that when the first incision was made, gelatinous material under pressure was released from the patient’s leg. The gelatinous material was once her leg muscle. After a lengthy surgery to salvage her leg, it was evident there was not enough viable tissue, and it was necessary to amputate her leg above the knee.

Three years later and after low settlement offers, the case went to trial. The jury verdict was in favor of the plaintiff, and she was awarded millions of dollars.

3. Interview with Rebecca Jones, RN, MSN, CNM, CLNC:

Do you consult with both plaintiff and defense?

I consult with both plaintiff and defense which always reminds me that there are two sides to a story. My goal is to understand that the truth usually runs down the middle. It’s an excellent way to stay grounded in the facts of the case and not allow myself to be swayed one way or another before I review the medical records. I always ask, “If I were on the other side, what would my argument be?”

Briefly discuss a favorite plaintiff case and why it’s a favorite.

My favorite plaintiff case involves a home birth that resulted in neonatal death. It sounds a bit dark to call this my favorite, but it was a reminder to me how precious life is and how important it is for me, as a midwife, to always practice within my scope. There isn’t a dollar amount that can be placed on the loss of a newborn.

Briefly discuss a favorite defense case and why it’s a favorite.

My favorite defense case involves a midwife who was named as a defendant in a birth injury case resulting in encephalopathy and permanent disability for a newborn. The midwife practiced within her scope, followed the standards of care and followed hospital policies and procedures. She was supported by staff nurses and other providers but was not supported by her physician colleague who did not respond to her call for help. This is a favorite case because it allowed me the opportunity to support a midwife colleague and redirect the case in the appropriate direction.

Plaintiff or defense legal nurse consultant jobs? You decide.

Success Is Yours!

P.S. Comment and share your preference for plaintiff or defense legal nurse consultant jobs.