Schaab Consulting: April 2009

Sunday, April 26, 2009

How does a solo attorney effectively fight the Insurance Giants? Part 2

Think of all the important steps in this litigation that need to occur quickly:

Filing for jurisdiction in a MVA - accident occurs in Montana, other cars are housed in North Dakota
Determining causation - client has preexisting back surgeries, osteoporosis, or complex medical records from a stay in an intensive care unit
Working on the Bad Faith issues

Solo attorneys need someone to assist with all the medical issues, such as:

o Screen case for merit
o Provide medical research/ literature review
o Develop chronologies/ summaries
o Chart reviews
o Locate experts
o Ongoing assistance with medical questions and case preparation
o Observer at IME’s to uphold client’s rights

Most solo's and small firm use the treating physician to provide this work.

Is there a better way?

Sunday, April 12, 2009

How does a solo attorney effectively fight the Insurance Giants? Part 1

So you took on a great personal injury case; significant damages and insurance bad faith. Do you realize all the resources the Insurance Company will bring against you...and for most solos I really mean just you! Along with a hugh support staff, many Insurance Companies have legal nurse consultants in house.

Here is a job description recently posted for Travelers Insurance:
Our Nurse Consultant will:

Collaborate with Claims Representatives and Defense Council on claims issues
Organize, review, and analyze medical records to assess if treatment meets standards of care and to identify and assess causation issues with correlation of diagnoses
Prepare chronological reports with case analysis and recommendations
Identify files for expert opinion
Provide medical research on related medical issues
Assist with identifying and obtaining expert witnesses and medical reviewers
Prepare questions for depositions, peer review, expert witnesses, and IMEs
Prepare files for mediations, trials, peer review, IMEs, etc as directed
Attend depositions, mediations, and trials as directed by management
Present medical training and education to claims staff
Review and analyze expert witness reports and depositions
Review and audit medical billing

How do you compete?

Susan Schaab RN,BSN,CLNC

Owner Schaab Consulting with over 2 years experience assisting attorneys with medical cases.

RN, BSN with over 20 years experience in both hospital and ambulatory care settings

Clinical expertise in Obstetrics, Newborn ICU, Plastic Surgery, and Ambulatory Surgery

Administrative expertise as Compliance Officer, Laser Safety Officer; creating and reviewing Standards of Care; developing Policies and Procedures

Review, Organize, Analyze, and Summarize the medical record
Case Consultation including: Medical Malpractice, Personal Injury, Literature Research

Sample Report

Mary Smith
Smith & Associates
1701 Main St
Bozeman, MT 59715

Dear Ms. Smith:

Pursuant to our conversation on January 14, 2007; I have completed my review of the medical records for Dave Jones. The medical records reviewed to date are from St. Mary's Health Care, Bridger MT from admissions 5/03/2006, 5/07/2006, and 6/19/2006.
Mr. Jones was admitted to St. James on 10/17 for gastrointestinal bleeding from undetermined source. His history was significant for appendectomy complicated by peritonitis with a small bowel resection. He was evaluated by CT scan of the abdomen (unremarkable), Merkel's scan (evidence of bleeding but location not apparent), colonoscopy (difficulty visualizing entire bowel do to less than ideal prep). Mr. Jones's hematocrit and hemoglobin dropped to a low of 24.4 (normal 42-55) and 8.4 (normal 14-18) respectively. Dr. May deemed it necessary to perform exploratory laparotomy with small bowel enteroscopy [visualizing the bowel directly with a scope]. Considering the low hematocrit and continued bleeding this was a reasonable surgery. Although Dr. May did not find a specific site for the bleeding there was evidence of bleeding at the level of anastomosis [reconnection] of the small bowel.
On October 26, 2007 Mr. Jones was noted to be febrile and his abdominal incision was red with drainage. Dr. May followed the standard of care by opening the incision, culturing the drainage, and ordering wet to dry dressing changes. He also prescribed appropriate antibiotics for methicillin resistant staph aureus [MRSA]. Mr. Jones seemed concerned that this occurred in his room and not under sterile technique. The wound was contaminated so it was impossible to debribe under sterile circumstances. It is within the standard of care to open incisions in non-sterile environments. MRSA is not uncommon in hospitals, and is now found frequently in the community. It is possible Mr. Jones entered St. Mary's Hospital already colonized by MRSA.
Although Mr. Jones has experienced very traumatic and unfortunate complications to his GI bleeding, I find no evidence of malpractice or negligence on the part of Dr. May or St. Mary's Health Care. My opinion is based on the review of the available records and may be supplemented upon further review of records.
Thank you for the opportunity to review this case. Please call if I can be of further assistance or if you have any questions.

Schaab Consulting