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Refuting Causation in a Nursing Home Medical Malpractice Case

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Refuting Causation in a Nursing Home Medical Malpractice Case

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tampering with medical records, spoliation of evidence, refuting causationThe plaintiff’s nursing home expert is asserting that the nursing home resident died as a result of poor medical or nursing care. A geriatrician is the best expert to evaluate the complicated interplay of chronic and acute illnesses. The long-term care medical record presents details of the resident’s illnesses and conditions. A legal nurse consultant is an effective professional to summarize the details of medical problems documented in acute care, physician office records, and nursing home charts.

Two nursing home defense attorneys (Ami DeMarco, Esq. of Chicago and Eugene Giotto Esq. of Pittsburgh) presented a program in Miami last year. Here is what they did to present medical information to the jury. They created a number of effective exhibits.

1. They created an exhibit with a picture of the nursing home resident, now deceased, with her photo centered on the exhibit. On the left side of her photo, in a column running from the top of the page to the bottom of the page, they listed all of her medical conditions. The problems fit into the categories of heart, lungs, kidneys and other conditions. On the right side of the page, they listed all of her 16 medications.

2. On the second exhibit, they presented her death certificate and highlighted the causes of death in a yellow box. In this case, they were congestive heart failure, ischemic cardiomyopathy, and end-stage renal disease.

3. On the third exhibit, they grayed out all portions of the death certificate except for the causes of death. The causes of death were enlarged. Under the enlarged section, they transcribed the causes of death into typewritten words.

4. The final exhibit showed the medical conditions which were detailed in the left side column of exhibit 1, as described above. The attorneys took the sections of the death certificate and the transcription boxes and placed them on the right side of the exhibit. Using black arrows, they pointed from the causes of death to the left column.

A charge of tampering with medical records was one of the factors in this case. The treatment records showed the resident was discharged from the facility on 10/2/08. Yet the nursing home staff documented care (turning and positioning, application of ointment) as being given until 10/11/08, the day of her death. In an effort to rebut charges of inaccurate charting, the defense attacked the causation of death.

Med League provides nursing expert witnesses with expertise in evaluating nursing malpractice cases. Call us for assistance.

 

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