Certified Legal Nurse Consultant, Marcia Bell Discusses the Differences Between Plaintiff and Defense Attorneys

I consult on legal nurse consultant jobs with both plaintiff and defense attorneys, which helps me look at a case from both sides. I sponsor two plaintiff attorney associations, so I get the bulk of my work from my sponsorship. I also consult on criminal cases for public defenders. I review all cases (plaintiff or defense) with the same degree of detail.

For plaintiff attorneys I am involved in locating experts because I’m often called in early to consult on the case. I often assist with discovery by suggesting interrogatories and items to request through the requests for production. I also prepare questions prior to the deposition of some of the medical experts and treating physicians.

In general plaintiff attorneys are more willing to pay for a comprehensive report to build their case. For plaintiff attorney reports, I give opinions based on the facts of the case including duty, breach of duty, causation and damages. Sometimes it’s difficult to address causation because the facts of the case are medically complicated and related to a physician’s treatment. I then recommend the type of physician expert needed and the medical records necessary for the physician expert to do a thorough summary of the matter. A thorough summary of the medical records often provide more symptoms and diagnostic support of an injury or medical error. If I need to locate a nurse expert witness, I use the NACLNC® Directory to reach out to Certified Legal Nurse Consultants.

Frequently when I receive a case from a defense attorney, discovery has been completed and several depositions have already been taken. If the case has issues from a nursing perspective, I believe the defense attorney would have saved money to have me review the medical records up front. A potential fact witness could have been missed, a request for production of policies and procedures or other tangible items may not be inclusive. If there are issues of defense, some matters could be resolved at an earlier date.

For criminal defense reports I focus on intent and whether the medical records support the facts of the case. Often, the victim has given statements or reported facts to medical personnel. These facts can be helpful or damaging to the defendant. Whatever is found, it is extremely helpful for the defense attorney to know about it in advance.

I do not feel that I am helping criminals. The truth of the medical records makes it fair for everyone involved. My role is to educate the attorney about “the good, the bad, and the ugly” of what is in the medical records regardless of who my attorney’s client is.

Personalities differ from attorney to attorney and I don’t notice much difference between plaintiff and defense. Some attorneys are assertive, some are organized and some are quick to respond to emails and phone calls. Others are more laid back and slower to respond. Some attorneys are aware of the fine points and details of the case. Others make me wonder if they even looked at the medical records. I’ve learned to work with all personalities and know I can make a difference in how they represent their clients.

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Marcia L. Bell, RN, BSN, CAPA, CLNC owns Bell Legal Nurse Consulting in Maryland. Marcia works as a consulting expert on medical malpractice, personal injury and criminal cases. She also works as a testifying expert in PACU cases. Marcia is clinically active part time at a magnet hospital.