Memorable CLNC® Cases

My Legal Nurse Consulting Discovery of a Patient’s Secret Ended This Case

by Lawrence H. Frace, RN, CLNC

Lawrence Frace

One of my most memorable cases is a legal nurse consultant job involving alleged missed diagnosis of a glioblastoma multiformis (GBM) in an elderly patient. My CLNC role was to screen the case for merit and to submit a written report.

My analysis was based on minimal records including radiology reports, medical bills and radiology films. The patient had experienced left-sided weakness for a year but kept that fact to herself.

A legal nurse consultant job involving alleged missed diagnosis of a glioblastoma multiformis in an elderly patient gave me enormous satisfaction knowing that the family was comforted by my findings.

She finally went to the doctor after the weakness increased and she developed pressure behind the eye, projectile vomiting and abdominal pain. CT scans revealed lesions of the liver, an adrenal gland mass and a right occipital brain mass which was biopsied and reported to be a GBM tumor.

Radiation and chemotherapy were initiated but no surgical intervention could be done on the brain tumor due to its size. The patient expired shortly after the completion of the radiation and chemotherapy. The family was convinced that the doctors overlooked something because they didn’t understand how their mother could have “suddenly” developed a brain tumor that was so large it could not be surgically removed.

My research of GBM revealed that this type of brain lesion can appear within a month of a normal CT scan and clearly emphasized the importance of early CT scanning after neurological changes, especially in older patients due to the extreme rapid growth of GBM tumors.

As it turns out, the family did not know that the mother had kept her left-sided weakness a secret for a year until it was revealed in my report. I found this case to be nonmeritorious and my attorney-client agreed. The attorney informed me that once the family knew about their mom’s secret and how fast her particular brain tumor grows, it gave them comfort in knowing nothing was overlooked in the medical treatment. By the way, I discovered the mom’s secret by reading one of the radiology reports. It stated that during one of the patient’s radiation treatments, the patient told the radiologist about her left-sided weakness and that she had experienced it for a year but kept it to herself.

This case gave me enormous satisfaction knowing that the family was comforted by my findings. Whether or not a case turns out to be meritorious, all legal nurse consulting jobs have an impact on someone or something. That’s why I enjoy being a Certified Legal Nurse Consultant and making a difference in the healthcare arena.

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