Memorable CLNC® Cases

I Saved My Attorney-Client’s Life and His Manslaughter Case Too!

by Lisa Alsip, RN, MHCM, CLNC

Lisa Alsip

My first legal nurse consultant job came from an attorney whose child attends school with my children. I introduced myself to him and told him I was a Certified Legal Nurse Consultant and briefly explained the CLNC® services I offer. He told me about a bar fight case and he wanted me to work on it. He was defending the bar’s bouncer who was being tried for manslaughter. A 50+ year-old patron got into a fight inside the bar and the bouncer had allegedly picked the man up, shoved him out, using his head like a battering ram to open the door and then dropped him in the parking lot on his face. The bar patron died a month after the incident.

I have received many more cases from this attorney-client because of our shared experience and because he won the case. He no longer uses his MD brother!

I picked up the records on a Friday and promised to return them the next Friday. I was excited, but two things tempered my excitement. First, the attorney’s brother was an MD and the attorney had already consulted with him. Second, all the attorney wanted me to do was organize, tabulate and paginate the medical records.

I dutifully sorted the records, grouped computerized and handwritten records separately, and put them into binders for each of the two hospitals where the deceased was a patient after the incident. On my own I decided to read every page of the medical records from both hospitals, the ambulance service and the air medic transport service. I studied the autopsy report, including the stomach-wrenching photos of the victim’s brain. I found it interesting that the hospital report of the CT scan results did not at all match the autopsy findings.

I Discovered How the State’s Allegation Contradicted the Medical Records

Only two witnesses at the scene said they saw the bouncer ram the victim’s head into the door to open it. When the victim was being escorted out of the bar at midnight, these witnesses were arriving. They claimed this was the first bar they had visited that night, and that they had not been drinking prior to witnessing the incident.

More than 40 other witnesses saw the bouncer bear-hug the victim, back him out the bar door, release him while he was standing on his own two feet and ask him nicely not to return that evening. Then the bouncer went back inside, leaving the victim outside. Some patrons outside saw the man back up a step or two and trip over a parking block, falling backwards stiff as a tree trunk and hitting the back of his head.

The state alleged that the bouncer caused the victim’s death because the front of his brain (forehead area) was mush after he was used as a battering ram to open the bar door. If that were the case, the top of the head would have been damaged, not the forehead. The state didn’t even address the damage to the back of the victim’s head.

I closely inspected the autopsy photos and matched them to the hospital records. One sentence in the records mentioned the insertion of a shunt into the victim’s head just days after the incident to relieve pressure and bleeding into the brain. My attorney-client received only the CT films, not the records of this insertion.

However, the autopsy pictures showed the victim’s head with an area near the hairline where the hair was shorter than the hair on the rest of his head. It looked as if the hair in that area had been shaved and had grown back for about a month. The photos of the brain and skull taken during the autopsy showed a corresponding cut in the skull and indentation in the brain. These features all lined up. In the picture I could make out the J-flap and sutures. I said to myself, “This is where the shunt was put in, and the films prove it. This ‘injury’ that the state is basing their case on (and that the coroner says killed him) is not the cause of death.”

The autopsy photos of both the back of the brain and the forehead area of the brain showed old, black blood, mushiness and atrophy. This probably happened when the victim tripped and fell, hitting the back of his head. The blow could have been hard enough to cause a contrecoup injury to the front of his brain as well.

My Report to the Attorney Turned the Case Around – After a Startling Interruption

I took the medical records back to the attorney’s office and asked to see him. We met in a first-floor conference room with tall windows looking out onto the main street in the small rural community. We sat down and began discussing the photos. I started describing where I believed the shunt was inserted and what probably happened inside the victim’s head when he fell.

Suddenly, I heard wheels spinning and people outside screaming. When I turned to look out the window, I saw a car speeding right toward the conference room. I had time to grab the attorney by his suit jacket and pull him with me away from the outside wall. Our chairs were on casters so in effect I wheeled him out of the way.

The careening car, a big old station wagon, crashed into the building, demolishing the conference table and coming to rest right where we had been sitting. Glass went flying, and the attorney and I were cut – his cuts were mostly to his face and neck, and mine were to my back, arms and neck. We looked a mess, but we were saved from being pinned under the car.

I think my days as an Army nurse made me react as quickly as I did to save those around me instead of worrying about myself. I’m also an American Heart Association certified CPR/First Aid/AED instructor, so I did what any good instructor (or nurse) would do. I ran to the smoking car, climbing over the rubble to see if I could help the driver.

Sure enough, the elderly man inside the vehicle had sustained a heart attack and had slumped over the wheel while still pressing the accelerator. His speed as he came through the window and into the conference room was estimated at about 60 mph. He had his seat belt on, but the car was too old for air bags, so he was bloody too. All the car windows were up and the doors were locked. The attorney thought fast and grabbed a signed baseball bat he had in his office. We broke a window, unlocked the driver’s door and pulled the driver to safety. Other attorneys used fire extinguishers to put out the engine fire. I performed CPR on the man and found a pulse upon recheck.

The fire station was located diagonally across the intersection and firefighters came running when they saw the accident. They gave the driver a shock from their AED (automated external defibrillator) and with drugs got him back for good. I have been told all this happened in less than five minutes. The driver is fine, the attorney is fine and I’m fine.

As for the case I was working on, my attorney-client was very impressed with my work and he was completely upset that his MD brother had not noticed the discrepancies. In court, my initial findings turned the case on its ear. The jury believed the 40+ witnesses who backed the bouncer’s story, and they found him not guilty. This verdict saved the bouncer from serving prison time and also from facing a civil lawsuit.

My Findings Resulted in a Shake-Up in the Offices of the Coroner and the District Attorney (DA)

The attorney also learned that the green-behind-the-ears county coroner had never passed his boards and was not the licensed physician he had claimed to be during the election. He was a “yes” man for the police and the DA, giving them the findings they wanted to hear. Now all of his cases have been reopened and he has been fired, fined, sued – you name it. The DA’s office has been turned upside down. This one case showed everyone the political wheeling and dealing going on in this small rural county.

Some of the reopened cases involve my attorney-client and require my legal nurse consulting services. I have already started working on some of them.

This case was memorable because: it was my first win on a case I had not been assigned to work up, analyze or to write any kind of report; it literally involved the most blood, sweat and tears for both the attorney and me; and, I have received many more cases from this attorney-client because of our shared experience and because he won the case. He no longer uses his MD brother!


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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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