Excerpted from Medical Malpractice, Third Edition, Ê 25
by David M. Harney
Copyright 1993, The Michie Company, 1-800-446-3410
http://www.michie.com
All rights reserved. Personal use only. No distribution or
republication without prior permission from the publisher.
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Review by medical expert.
After procurement of as many medical reports as possible, and
photostatic copies of physicians' office records and the patient's
hospital charts, you should have a competent physician review the
material to ascertain whether there has actually been negligence or a
violation of applicable standards of medical or hospital practice, and
whether there is a causal relationship between such negligence and the
client's injury.
Because of the discovery rules that appertain in most states, it is
advisable to meet personally with your reviewing expert rather than have
him prepare a report at this stage of the case. You should dictate his
opinion into memorandum form, which in most instances will then be
considered your work product and thus immune from direct discovery by
your opponent.
Obviously, the question arises as to how one finds a good medical
reviewer. This, of course, is not always an easy task. It may be
possible to procure a physician from friends and associates;
occasionally you will find one who at least is willing to review your
file and briefly advise you. Probably such a reviewer will want to
remain anonymous, and it is doubtful if he will be willing to give
testimony for you in any form. Another possible source is the faculty of
a medical school. Although preferable, your reviewer need not be a
specialist in the field involved; if he has a good basic medical
education, he should be able to review your pertinent material, conduct
necessary research, check with specialist friends, and give you an
adequate, objective opinion.
Another method an attorney might employ to find a medical expert is to
call or write the author or editor of a leading treatise on the subject
matter involved. Our office is presently representing a 43-year-old lady
who underwent a posterior lumbar interbody fusion (PLIF). The surgeon
used an oversized bone plug and the lady became paralyzed (see Section
8.6, this volume). When we were taking the deposition of one of the
defense's experts, he referred to a brand new book on the PLIF
procedure. Our office got in touch with the editor of the book, who
agreed to look over our client's medical records. The editor believes
that our client's case involves gross negligence and he said he will so
testify. Inasmuch as the defense expert has stated in his deposition
that this new book is the "Bible" on this type of surgery, we anticipate
that our editor will be a devastating expert at trial.
If an attorney is presented with a potential major medical malpractice
case, and he is unable to procure a medical reviewer, it may be best to
seek out an attorney who specializes in malpractice litigation and refer
the matter. It is very risky for any attorney to proceed to trial with
significant malpractice litigation without available competent medical
consultation on a continual basis. This does not mean that it cannot be
done, however. Some plaintiff's lawyers have been able to prosecute
successfully a malpractice case, even through trial and appeal,
primarily on the strength of their own medical research. And, of course,
many have achieved very attractive settlements without the help of
medical consultation. But these are the exceptions rather than the rule.
Even where help is promised by a medical adviser, the malpractice
plaintiff's attorney, in many cases, will find that he must conduct much
medical research on his own. Thus, where full professional assistance is
not available, or where circumstances are such that he or his client
cannot undertake the necessary cost of a thorough evaluation by an
expert, the plaintiff's attorney must be prepared to rely on what he can
find in the medical and medicolegal literature. However, if the case
goes to trial, success almost always depends upon the testimony of an
expert witness.
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