Pain and suffering reports/Federal Rule 1006 Summaries

Pain and suffering reports (also known as Federal Rule 1006 summaries) developed by an expert witness can help the judge and jury understand the details of treating an injury. Instead of bringing on a parade of witnesses, an option is to retain an expert who can review the medical records and summarize the pain and suffering. The Federal Rule of Evidence Rule 1006 states that contents of voluminous material may be presented by the summary. The comments on that rule state that the use of summaries is often the only practical means of presenting the contents of voluminous evidence to the judge and jury. The person who prepared the summary should be available to testify at the time of trial as to the method of preparation of the document and/or to give an explanation of the summary.

A nurse is an ideal person to prepare such a report. While doctors specialize in diagnosing and treating disease, nurses care for the whole person. The identification of complications, the administration of pain medications and the analysis of medical records falls within the scope of practice of a nurse. Physicians tend to minimize pain and suffering. A great deal of attention has been focused on this issue recently. Efforts are being made to teach physicians how to appropriately manage pain by prescribing sufficiently strong narcotics incorrect dosages. One of the reasons for the development of clinical practice guidelines on the management of pain was due to the prescription of inappropriate medications and dosages. Nurses are frequently involved in assessing and relieving pain. A nurse is able to explain to the jury the medical procedures involved in the patient’s care, using the language they can understand so that they can appreciate what the plaintiff went through.

The Federal Rule 1006 Summary which summarizes medical records is a strategic tool that should not be overlooked when the circumstances of the case warrant the preparation of this type of report. The types of cases in which this type of report is helpful to include the following:

1. The patient has suffered serious physical injuries as a result of personal injury or malpractice.
2. The medical records detail the pain and suffering experienced by the patient.
3. The patient is dead, cognitively impaired or otherwise unable to provide a coherent description of the suffering that accompanied the injury.

The typical components of a pain and suffering report include a narrative summary of the patient’s medical history, a vivid description of the complications and problems experienced by the patient, quotes from the medical record, and charts of complications and pain medications. Medical records, patient diaries and interviews with the patient can be used to prepare this type of report. The length of the report can vary from 5-12 or more pages, depending on the size of the medical records and the injuries.

Federal Rule 1006 summaries are used to reach a settlement in the case. The following case histories demonstrate that this tool brings results. Med League provided experts in these cases:

1. A woman was admitted to a hospital for treatment of cervical cancer. The oncologist made an arithmetic error and ordered a total dose of chemotherapy that was 4 times larger than it should have been. The pain and suffering report provided vivid descriptions of how the plaintiff’s body became swollen, her skin peeled off in strips and blood oozed from her eyes. The case was settled out of court for $1.4 million with a structured settlement payout of $4 million. The family received $500,000 for the woman’s 15 days of pain and suffering.

2. An 18 month-old toddler developed severe esophageal burns after he drank acrylic nail primer at a beauty shop. He went through a year of painful dilations of his esophagus before he finally healed. Using the pain and suffering report, the attorney was successful in settling the case for $100,000 and acknowledged that the size of the verdict was quite good considering that there were $10,000 in medical expenses and the child sustained no permanent damage.

3. An elderly man developed complications after a gall bladder surgery and slowly died over a three month period of time. The testimony at the time of the trial focused on the pain and suffering endured by this man during his agonizing death. The jury awarded $560,000.

4. A physician received a head injury when she was rear ended. A pain and suffering report was prepared using her diary which she kept on her computer. The 250 pages of daily entries were summarized in an 8-page report accompanied by a lengthy chart which detailed her symptoms. The attorney was able to settle the case for $700,000 which was the policy limit.

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